ObjectiveTo explore the efficacy and safety of percutaneous antegrade stenting in the treatment of ureteral obstruction after renal transplantation.MethodsWe retrospectively reviewed 11patients with renal graft ureteral obstruction (2 cases of acute obstruction and 9 cases of chronic obstruction) from March 2009 to March 2011.The etiology of the obstruction was renal graft-ureter-bladder anastomotic stricture in 5 cases,stone obstruction in 2 cases,and undetermined in 4 cases.Renal graft and collecting system were examined by ultrasonography preoperatively to select suitable puncture position,and then ureteropyelography was performed under X-ray guidance.When the obstruction location was clear,the urology guidewire was implanted to the bladder by needle,and then guidewire was released by cystoscopy.Ureteral stent was implanted along the guidewire,and upper ureteral stents was observed under X-ray. After removal of guidewire,the stent location was confirmed once again.The renal pelvis fistula drainage lasted for 1-2 weeks,and ureteral stent to 6 months to one year.Ultrasound and renal function were tested after 1week,1month,3 months and 6 months,and then every six months.ResultsOperation was done successfully in 10 patients,and failed in one case due to a long segment of ureteral stenosis.The operating time of ureteral stent implantation was 54±27 min.Serum creatinine of patients was reduced from preoperative 326±147 to postoperative 89±49 μmol/L.During a follow-up period of 6 to 27 months,no complications occurred.ConclusionPercutaneous antegrade stenting in the treatment of ureteral obstruction after renal transplantation is safe and effective.

Objective To explore clinical value of intraoperative extra strong electrical stimulation in the treatment of birth brachial plexus palsy. MethodsFrom July 2008 to September 2011,intraoperative extra strong electrical stimulation was applied in 9 cases of incomplete birth brachial plexus palsy after neurolysis.The latency and amplitude of compound muscle action potentials before and after electrical stimulation were recorded and the extent of improvement was compare.ResultsThe latency was improved in 7 cases with 8.02％ in average,amplitude in 8 cases with 185.97％ in average.The related nerve recover partial motor function in 8 cases in 2 weeks after operation.ConclusionIntraoperative extra strong electrical stimulation is a effective assistant technique to promote motor functional recovery of birth brachial plexus palsy.

Objective To study the relationship between rs290487,rs7903146 of transcription factor 7-Like 2 (TCF7L2) gene and post-transplantation diabetes mellitus in Han Zhejiang population.Method We genotyped two single nucleotide polymorphisms (SNPs) across the TCF7L2 gene in 90 unrelated post-transplantation type 2 diabetes mellitus (PTDM) patients,112 unrelated non-PTDM patients,and a set of post-transplantation diabetes mellitus patients (n =68).Genotyping was performed using direct sequencing SNP Genotyping Assays.The association of SNPs with post-transplantation diabetes mellitus was analyzed.Result In this study,there was statistically significant difference in the T-allele of TCF7L2.rs7903146 between PTDM group (5.1％) and non-PTDM group (1.3％) (P＜0.05).For rs7903146,the frequencies of genotype C/C,C/T (70.0％) and T/T (35.8％) was statistically significant in PTDM group (P＜0.05).For rs290487,the frequencies of genotype C/C,C/T and T/T was 14.7％,38.2％ and 47.1％ respectively in PTDM group,P＞ 0.05.The incidence of PTDM was significantly higher in patients with the CT genotype (odds ratio 18.54 [95％ CI 1.21-282.26],P =0.03).Conclusion With the current sample size,we found that the CT genotype of rs7903146 was significantly associated with post-transplantation diabetes mellitus.

Objective To investigate the method to isolate and culture hepatic stellate cells ( HSCs) for studying the cellular mechanisms of hepatic frbrosis.Methods HSCs were isolated by nycodenz density gradient centrifugation after the hepatocytes obtained from adult male gebils were digested with pronase, collagenase and DNase, infused via portal vein.The cell viability was determined by trypan blue exclusion test.The purity of HSCs was identified by detectingα-SMA, desmin immunohistochemical staining.Results The yield rate of HSCs was 0.5~1 ×107 per gerbil liver, and the cell viability was more than 90%.The percentage ofα-SMA-positive cells was more than 75%after 3 days primary culture and almost 100% cells were α-SMA and desmin positive in passage culture.Conclusion The successful protocol of primary culture of Mongolian gerbil HSC provide a technical support for research of relevant liver diseases and drug development in the future.

Objective To observe the application effect of the risk of ovarian malignancy algorithm(ROMA)in screening ovarian cancer among high risk population.Methods The human epididymis protein 4(HE4)and carbohydrate antigen 125 (CA125 )were detected in 1 753 cases of high risk for overian cancer,56 cases of ovarian cancer(positive control)and 60 healthy people,patients. Then the ROMA value was calculated in combination with the subject′s menstruation status.The detection results were analyzed and compared among groups.The high risk group for ovarian cancer devided according to the ROMA value was further performed the confirmatory test and the low risk group was monitored by follow up.The detection rates of ovarian cancer were compared be-tween the two subgroups.Results In the high risk population,the diagnostic performance of the ROMA value for ovarian cancer was superior to that of the single HE4 or CA125;the ROMA value had statistically significant difference between the high risk sub-group in the high-risk population with ovarian cancer or the healthy control group(P <0.05);in 1 753 cases of high risk popula-tion,37 cases were included in the high risk subgroup,in which 3 cases of ovarian cancer were screened out and in clinical early stage.The detection rate of ovarian cancer in the high risk subgroup was 8.1%.No case of ovarian cancer was detected out in the low risk subgroup.Conclusion The ROMA value is conducive to early screening for ovarian cancer in the high risk population, which can save the medical cost and increase the detection rate.

AIM: To explore the neuroprotective action of progesterone(PROG), which has been proved to be a "neuroactive steroid". METHODS: The model of focal cerebral ischemia was established in rats by reverserble inserting a nylon thread with a diameter of 0.2 mm into the anterior cerebral artery through the internal carotid artery. The effect of PROG was assessed by determining water,sodium, potassium, and calcium contents in striatum of rats subjected to 2 h ischemia followed by 22 h reperfusion. RESULTS: The water,sodium,and calcium contents of middle cerebral artery occlusion(MCAO) striatum were obviously higher,the potassium content was obviously lower than those of non-MCAO striatum in I/R and DMSO groups,but there was no significant difference between these two groups.Compared with the result in I/R and DMSO groups , water, sodium and calcium contents significantly decreased, but potassium(P0.05). CONCLUSION: Treatment with PROG can significantly reduce the striatal injury of rats with cerebral ischmia-reperfusion.

Report a case sustained Gustilo type III C open fracture of the left humerus with brachial artery injury who has limb ischemia and wound infection after operation in June, 2014. To salvage the limb, performed cross limb vessel transfer to restore blood supply at one-stage. After multiple debridement, Flow-through flap transfer was performed for definitive reconstruction of the arterial injury and repair the wound in secondary stage. In the 3rd stage, cutting the pedicle of transposition vessels. Follow-up at 1 year after surgery, the patient's left upper limb had survived with limited movement and confirmed Flow-through the vessel reconstruction using CTA.

Biopsy ; Endopeptidase K ; Fluorescent Antibody Technique ; Glomerulonephritis, IGA ; pathology ; Glomerulonephritis, Membranous ; pathology ; Humans ; Kidney ; pathology ; Lupus Nephritis ; pathology ; Paraffin Embedding ; Staining and Labeling

Objective To explore the correlation between post-transplant glomerular filtration rate (GFR) in 1 year and long-term graft survival in renal transplant patients.Methods The clinical data of 334 patients who received their cadaveric kidney transplantations between November 1994 and October 2004 were analyzed retrospectively.According to the GFR at one year after transplant operation, normal GFR group was defined as GFR more than or equal to 1.083 ml/s, while patients whose GFR less than 1.083 ml/s were fallen into abnormal GFR group.Cockeroft-Gault (C-G) formula was used to compare the difference in the renal function between the two groups.Kaplan-Meier assay was used to compare the difference in the allograft survival between the two groups in the functional renal allograft or the non-functional renal allograft.The correlativity of GFR level at the first year and the GFR level at the 5th year was analyzed.Results The GFR level at the first year after transplantation was proportional to the graft survival time of the kidney.Five and ten years after transplantation, the renal transplantation long-term survival rate in the normal renal function groups was significantly higher than in the abnormal renal function groups (P＜0.05).As compared with the GFR level at the first year after transplantation, the changes in amplitude of GFR level at the 5th year after transplantation was (0.080 ±0.248) ml/s, and the descent had a positive correlation with GFR level at the 5th year after transplantatioa Conclusion GFR level at the first year after transplantation predicts long-term renal functioa The higher of GFR level at the first year, the higher of GFR level at the 5th year.

OBJECTIVETo identify the type of iron deposition and describe its amount, distribution and associated lesions, in order to support an etiologic diagnosis for hemochromatosis.

METHODSHematoxylineosin (HE) stain, reticular fiber stain, Masson's stain and Perl's iron stain were used to assess liver biopsies from 31 patients with hemochromatosis. The Ishak scoring system and Deugnier scoring system were used to assess the histological change in liver and to semi-quantify the excess of hepatic iron. Genetic testing results were received from a portion of the patients and used in analysis.

RESULTSOne patient had hereditary (-HFE) hemochromatosis complicated with Gilbert's syndrome, for which the pattern of iron deposition was similar to that of the four patients with Gilbert's syndrome. Iron accumulation appeared as fine granules predominating at the biliary pole of cells and was distributed throughout the lobule with a decreasing gradient spanning from the periportal to centrolobular areas. Mild chronic inflammation was found to be commonly associated with low stage fibrosis.One patient had HFE hemochromatosis complicated with hepatitis B virus infection, and the pattern of iron deposition resembled that in the eight patients with viral hepatitis, wherein the deposition was mainly in the sinusoidal cells and/or portal macrophages. Histological grading and fibrosis staging differed among patients. The five patients with blood disordered showed iron accumulation mainly in the periportal hepatocytes, but mesenchymal iron deposits were also present. The grade of inflammation, as well as of fibrosis,was mild. The five patients with alcoholic disease and the five patients with drug-induced hepatitis showed hepatic iron deposition in swollen or ballooned hepatocytes. The two patients with excessive iron supply showed iron deposition localized within the parenchymal and mesenchymal cells.

CONCLUSIONEtiologic diagnosis of hemochromatosis relies on both the type of iron deposition and the nature of associated lesions. Liver biopsy is necessary for both diagnosis and prognosis.