Objective To observe the incidence of residual gallbladder in patients undergone cholecystectomy through laparotomy (OC),mini-incision laparotomy cholecystectomy (MC) or laparoscopic cholecystectomy (LC),and to explore the causes,diagnosis,prevention and treatment of residual gallbladder.Methods The clinical data of 241 patients undergone laparotomy cholecystectomy (OC group),231 patients undergone mini-incision laparotomy cholecystectomy (MC group) and 290 patients undergone laparoscopic cholecystectomy (LC group) were retrospectively analyzed,and the incidence of residual gallbladder was compared among the three groups.Results Residual gallbladder was found in 32 patients after the surgical procedures,with 4 in OC group (1.7%),13 in MC group (5.6%) and 15 in LC group (5.2%),respectively.Statistical analysis showed that the incidence of residual gallbladder was lower in OC group than in MC and LC group (P0.05).Multivariate analysis showed that severity of inflammation before the operation,operative methods and operator's experience were correlated with the incidence of residual gallbladder.All the 32 cases were diagnosed by ultrasonography,computed tomography (CT),magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP).24 patients were cured with surgical procedure,and the symptoms disappeared during a follow-up period of 6 months to 9 years;other 8 cases were treated with conservative management and the results were unsatisfactory.The pathological examination showed no tumor or malignant change in the excised specimen.Conclusions Residual gallbladder is not a negligible complication of cholecystectomy.Effective control of inflammation of the gallbladder,selection of a proper time and procedure of operation,and the operation done by an experienced surgeon can reduce the incidence of residual gallbladder,and reoperation is the effective treatment for it.

The complete mitochondrial genome sequence of Phlaeoba albonema Zheng Was determined by using L-PCR and conserved primers walking sequencing.The obtained genome sequence is 15657 bp in size.containing 13 protein-coding genes,2 ribosomal RNA and 22 transfer RNA genes.All the 37 genes are conserved in the same orientations as observed in Locusta migratoria.11202 bp of the mtDNA are coding for proteins,1486 bp for tRNAs,1312 bp for rRNA large subunit(1rRNA),and 844 bp for rRNA small subunit(srRNA).The A+T-rich region is 728 bp in size.The genes overlapping sequences are 41 bp in total and are spreading over 9 locations(1-8 bp at each site).A total of 126 bp intergenic spacer sequences are scattered in 21 regions at the size of 1 to 20 bp,where the largest 20 bp region iS located between the tRNALys and ATP8 genes.The predicted secondary structures of both srRNA and lrRNA were compared with that of Ruspolia dubia,and the patterns of base pairs in tRNA anticodon stem and A/T,C/G bias of protein-coding genes in different strands were discussed.

Objective To study the relationship between the methylation of p16 promotor and the pathogenesis and progress of psoriasis. Method Methylation-specific PCR and DNA sequencing were used to detect the methylation of p16 promotor. Results The methylation of p16 promotor was found in 23.08% (6/26) of psoriatic lesions and 19.23% (5/26) of non-lesional areas in psoriatic patients, but none in normal controls. The frequency of methylation of p16 promotor was higher in psoriatic lesions than that in normal skin (P

Objectives To detect the loss of heterozygosity(LOH)frequencies of microsatellite loci D9S171and D9S1604in p16gene of psoriatic keratinocytes,and to study the correlation between mi-crosatellite LOH of p16gene and the development of psoriasis.Methods By the use of polymerase chain reaction(PCR)-denaturing polyacrylamide gel electrophoresis-silver staining,LOH was detected with23sam-ples of keratinocytes from psoriatic lesions and non-lesion skin.Results LOH was identified at loci D9S171and D9S1604in5and10out of23keratinocyte samples from LOH-exhibited psoriatic lesions,and in2and3of keratinocyte samples from psoriatic non-lesion skin,respectively.The frequency of LOH at D9S1604was significantly higher in psoriatic lesion samples than that in psoriatic non-lesion skin(P

BACKGROUND: Organ for transplantation is insufficient, and primary transplant of nonfunction caused by perfusion cryopreservation occasionally occurs. It is clinically significant to reduce organ damage caused by perfusion preservation. OBJECTIVE: To explore the protective effect of hyperoxic perfusion fluid on liver transplantation in rats. METHODS: A total of 40 Wistar rats were randomly divided two groups (n = 20) and respectively poured with Ringer lactate solution or hyperoxic ringer lactate solution. Each group comprised equal number of donors and recipients to prepare liver, kidney, and pancreas transplantation models. Hyaluronic acid (HA), alanine aminotransferase (ALT) and CD8+CD28- T cells were compared between two groups at the end of perfusion, and 1st and 3rd days after liver transplantation. The acute rejection score of liver tissues were also compared after operation. RESULTS AND CONCLUSION: The HA, ALT and CD8+CD28-T cells were no significantly different between two groups before operation (P> 0.05). The HA and ALT of hyperoxic ringer lactate solution group was significantly Ringer lactate solution group after liver transplant (P < 0.05), but the CD8+CD28-T cells were greater (P < 0.05). The acute rejection scores for liver in hyperoxia liquid group were significantly less than the common liquid group (P< 0.05). Results show that hyperoxic solution can attenuate ischemia/reperfusion injury and protect rats undergoing liver transplantation.

SUMMARY Alport syndrome (AS) is a progressive renal disease characterized by hematuria and progressive renal failure. AS is a clinical and genetic heterogenous disease, X-linked dominant Alport syndrome(XLAS) is the major inheritance form. XLAS females have variable phenotypes, from microscopic hematuria to chronic renal failure. The effects of pregnancy course on pregnant woman and fetus were observed by follow-up study of an XLAS female. Results showed that pregnancy of the XLAS female was complicated by renal function deterioration, and fetal growth restriction. It suggests that the AS female with damaged renal function should be cautious in the choice of pregnancy.

Objective To investigate the diagnosis and surgical management of ureteral obstruction after renal transplantation.Method A respective study was performed on 15 cases of ureteral obstruction who received renal allografts.All of the cases were confirmed,including 5 cases of stenosis of ureterovesical junction,4 cases of stenosis of distal ureter,2 cases of blood clot blockage,2 cases of edema due to perforation of distal ureter,1 case of ureteral calculi,and 1 case of extrinsic compression of hematoma.All 14 patients underwent open surgical management to reestablish ureter with D-J catheter as stent for 12-16 weeks.One patient was subjected to percutaneous nephrostomy followed by percutaneous ureteroscopy,the obstructed site was identified at ureterovesical junction and antegrade balloon dilation and D-J stent in ureter were performed subsequently.Result Fifteen patients were diagnosed as ureteral obstruction by colour Doppler ultrasound and MRU.All of the patients were resolved the obstructions after surgical managements and the renal function got improved.No reobstruction occured during one year follow-up period.Conclusion Colour Doppler ultrasound and MRU can definitely be used to diagnose ureteral obstruction after renal transplantation.Early diagnosis and surgical management are very important.Open surgical management of the obstructed ureter is an effective method.Antigrade balloon dilation is a therapeutic approach to treat ureteral obstruction.

Humans ; Nephritis, Hereditary ; therapy

Objective To explore the clinical features, treatment and follow-up of Cockayne syndrome with renal involvement. Method The clinical data of one child with Cockayne syndrome confirmed by gene detection with renal injury were reviewed, and the clinical features of renal involvement in Cockayne syndrome were summarized. Results A male child aged 3 years and 8 months had clinical manifestations of mental retardation, growth retardation, special face and photosensitive dermatitis, and renal involvement was manifested by nephrotic syndrome. Cranial CT showed symmetrically calcification in bilateral basal ganglia. The targeted next generation sequencing results showed homozygous mutations of c.394_398del and p.Leu132Asnfs in ERCC8 gene (NM_000082) of the child, and the same heterozygous mutation was found in both his parents (non-consanguineous marriage). After the diagnosis of nephrotic syndrome, full dose prednisone was given for experimental treatment. The urine protein decreased but did not disappear, which was considered hormone resistance. After 4 months of combined treatment with cyclosporin, the urine protein turned negative. During 20 months of follow-up, urine protein remained negative and renal function remained stable. The renal involvement in Cockayne syndrome was seldomly reported, and its clinical manifestations are heterogeneous. Condusion Renal involvement in Cockayne syndrome may be manifested with nephrotic syndrome which should be noticed.

OBJECTIVETo analyze the clinical and genetic features of X-linked Alport syndrome (XLAS) in men positive for the collagen α5(Ⅳ) chain in epidermal basement membrane.

METHODThis was a retrospective study. Totally 725 families were diagnosed as Alport syndrome in Department of Pediatrics of Peking University First Hospital during January 1998 to December 2014, among them 450 patients were males with XLAS. Patients who met both of the following two criteria were included in this study. (1)Patients underwent α5(Ⅳ) chain staining in the epidermal basement membrane. (2)Mutations in COL4A5 gene were detected.Mann-Whitney test and χ(2) test were used.

RESULTTotally 140 males with XLAS were included in this study, 18 cases were α5 (Ⅳ)-positive and 122 cases were α5 (Ⅳ)-negative. The two groups of patients were compared, the median age at analysis was 11.0 vs. 7.2 years (Z = -1.839, P = 0.066), the 24-hour urine protein was 1.50 vs. 0.57 g/d (Z = -1.212, P = 0.226), the rate of hearing loss was 28% vs. 53% (χ(2) = 3.619, P = 0.067), the number of patients progressed to end stage renal disease (ESRD) was 4 vs. 12 (χ(2) =2.377, P = 0.128), the median age of ESRD was 31.0 vs. 16.6 years (Z = -2.554, P = 0.011), the rate of missense mutations in COL4A5 gene was 67% vs. 52% (χ(2) = 1.424, P = 0.313).

CONCLUSIONCompared the two groups of patients with positive and negative staining for the collagen Ⅳ α5 chain in epidermal basement membrane, there was no significant difference in the proteinuria level, the rate of hearing loss and genotype of COL4A5 gene. But the patients with positive staining progressed to ESRD significantly later than the patients with negative staining.

Basement Membrane ; pathology ; Child ; Collagen Type IV ; genetics ; DNA Mutational Analysis ; Deafness ; Humans ; Kidney Failure, Chronic ; Male ; Mutation, Missense ; Nephritis, Hereditary ; genetics ; pathology ; Proteinuria ; Retrospective Studies