Objective:To explore the role of peripheral blood lymphocyte (PBL) of the renal transplant recipients during the acute rejection phase by gene chips.Methods:The 8 patients with acute rejection (AR) after renal transplantation were collected peripheral blood before operation (as control samples) and renal biopsy (as experimental samples).By Ficoll method,PBL was collected.Total RNA were extracted by one-step technique and purified.The total RNA were labeled with Cy5-dUTP (experimental samples) or Cy3-dUTP (control samples),then to label the cDNA probe by reverse transcript way.The gene chip (419 genes) was hybridized and scanned.Then fluorescent signal value of gene expressing was obtained,and differential expression genes were sifted.Results:There were differential expression 49 immunological genes in peripheral blood lymphocyte (PBL) of the renal transplant recipients during the acute rejection phase,including up-regulated 25 and down-regulated 24.Conclusion:Peripheral blood lymphocyte was involved in various stages during the acute rejection,and immunosuppressants influenced on these stages in various degrees. [

Diabetes incidence rate is increasing in recent years, along with below knee artery disease, which develops into severe ischemia in many patients.This paper introduced the horizon about endovascular techniques in this field.

Objective To report our experience of nephron sparing surgery (NSS) with mini-incision approach.Methods Sixty-one mini-incision NSS were analyzed retrospectively from 2005 to 2011 in our department.Demographic and clinical data,complications,histologic and oncologic data were analyzed.There were 35 males and 26 females with average age of 41 years.B ultrasound and CT scan were performed in all cases and MR was performed in 23 cases.CT angiography was performed in 10 cases.Renal cell cancer was diagnosed in 38 cases,angiomyolipoma in 14 cases,complicated renal cyst or duplicated kidney in 6 cases and no definite diagnosis in 3 cases.All the lesions were single with 21 in the right side and 40 in the left side.The average diameter of the lesions was 3.2 (2.3-8.8) cm.The mini-flank supra-12th rib incision was performed in all cases.The renal artery was clamped with bulldog clamp,all transected blood vessels on the renal incisal surface were sutured with 3-0 Vicryl sutures,and collecting system was closed with continuous' 3-0 Vicryl suture.Results The average length of incision was 8.1 (6.5-11.0) cm.The average operative time was 93 (70-140) min.The average warm ischemia time was 19 (12-32) min.The average blood loss was 72 (20-300) ml and the average hospital stay was 6 (5-15) d.The delayed hemorrhage was occurred in 1 patient who was treated with conservative treatment.Clear cell carcinoma was found in 28 cases,chromophobe carcinoma was found in 6 cases,papillary carcinoma was found in 5 cases,angiomyolipoma was found in 16 cases,complicated cyst was found in 3 cases and renal duplication was found in 3 cases.Fortyfive patients were followed up from 28 to 82 months with no delayed complication and no recurrence or metastasis in 35 malignant cases.Conclusions The approach of mini-incision NSS can duplicate the procedure of traditional open NSS.This approach can also couple the benefits of both laparoscopic and open NSS techniques with a smaller incision which can be used to remove the specimen.

Objective To assess the clinical efficacy of patient controlled intravenous analgesia (PCIA) with mixture of fentanyl and droperidol for post-prostatectomy pain. Methods 104 patients undergone prostatectomy were randomly divided into two groups. In group A, the patients received PCIA.In group B, they received routine analgesia.The pain scores of visual analogue pain scale (VAS) and control of bladder spasm were recorded at various time postoperatively, and the time of continuous infusion of bladder, the time of indwelling catheter and the mean hospitalization time were also recorded. Results Compared with those of group B,the VAS,continuous time and ratio of bladder spasm decreased markedly in group A ( P

Objective To explore the influence of renal allograft donor's and recipient’s SNP of recipient cytokine and cytokine receptor on the infection after renal transplantation and to provide some useful information for preventing and managing infection.Methods 129 cases of cadaveric renal allograft recipients were divided into infection group and no infection group. The distribution of 21 polymorphisms in cytokines and cytokine receptors gene were compared between two groups by oligonucleotide array. Previous positive gene polymorphisms were compared between infection group and no infection group. With the help of SPSS 11.5 software, association was assessed using Krusakal Wallis test where appropriate.Results The frequency of gene distribution was significantly different between the infection group and the no infection group as follows: the genotype IL-6R (-183G/A, GG), IL-10 (-824C/T, -597C/A), TNF-? (-308GG, G/A), and the allele IL-10R1 (1112G/A), IL-6R (-183G/A), IL-4R(1902A/G), TNF-? (-308G/A), TGF-?_1 (+869T/C) respectively.Conclusion The susceptibility of infection after renal transplantation may be predicted by the SNP of recipient cytokine and cytokine receptors such as these genotypes IL-6R(-183GG), IL-10(-824CT, -597CA), TNF-?(-308GG), and the allele IL-4R(1902A).

Objective To evaluate the clinical efficacy of percutaneous nephrolithotomy (PNL) in combination with pneumatic and ultrasonic lithotripsy in the treatment of complex renal calculi. Methods Under general anesthesia,an ureteral stent was placed into the patient by cystoscopy. With the prone position,percutaneous access was established by inserting an access needle into the intended calix under the guidance of ultrasonography or fluoroscopy. Afterwards,combined pneumatic and ultrasonic probes were used by nephroscopy for lithotripsy. Results A single tract was used in 137 patients,while two or three tracts were created in the other patients (11 and 2 respectively). One-step procedure to remove the stones was achieved in 119 patients,while a second intervention was performed in 27,and three procedures was carried out in 4. The mean time of the operations were (88?34) min. After the operation,one patient developed infectious shock,and then was cured by anti-shock therapy;two patients showed secondary hemorrhage in two weeks postoperation,and was cured by conservative therapy. In this series,the rate of stone clearance was 84.7% (127/150);23 cases had residual stones,10 of them received ESWL (the stone was removed completely in 7 of the 10 cases),and the other 13 were treated by oral medicines. Six months after the operation,follow-up examination showed a stone-free rate of 89.3% (134/150). Conclusion Combination of ultrasonic and pneumatic intracorporeal lithotripsy is effective and safe for complex renal calculi,which is intractable by open surgery.

Objective To study the surgical treatment of the primary retroperitioneal sarcoma(RPS). Methods The treatment and prognosis of 63 patients with primary retroperitoneal sarcomas (liposarcomas and leiomyosarcomas) from Jan 1992 to Dec 2000 were analyzed retrospectively. Results The rate of complete tumor resection was 88.2%, and concomitant resection of involved adjacent organs was 21.6%. There was no operation death. The median survival time(MST) in liposarcomas that for was 36.5months, and leiomyosarcomas was 27.6 months. The MST in highly differentiated tumor was 34.7 months,and that of intermiade and low differtiated tumors was 18.1months(P

Objective To evaluate the clinic value of multiple tumor markers plus PSA in diagnosing prostate cancer.Methods We collected serum samples of 140 prostate cancer patients with average age of 68 (48-82) years,104 benign prostate hyperplasia patients with average age of 70 (52-87) years,and 162 healthy people with average age of 38 (23-49) years.We had detected PSA levels and also the protein expressions of XAGE-1b,SSX-2,AM ACR and AKAP4.In healthy people,the ranges of the normal values with 95％ data range were determined.Multiple tumor markers and PSA were calculated their positive rate,specificity and sensitivity in diagnosing prostate cancer.We had randomly chosen one positive serum,and analyzed the 4 protein expressions by Western bolt.We detected the serum with the four markers plus PSA by Luminex medthod,then drew ROC curve and calculated AUC area according to the results.Results Among all those samples,PSA levels of 266 samples were under 4tμg/L,86 samples were between 4-10 μg/L,and 54 samples were above 10 μg/L.The positive rates of XAGE-1b,SSX-2,AMACR and AKAP4 in prostate cancer patients were 53.6％ (75/140),34.3％ (48/140),27.9％ (39/140),44.3％ (62/140) respectively.The AUC of XAGE-1b,SSX-2,AMACR,AKAP4 and PSA were 0.666,0.615,0.551,0.768,0.675 respectively.The AUC of their combination was 0.887; The specificity and sensitivity of single PSA detection and combination detection were 60.0％,46.2％ and 80.0％,82.2％.Among those whose PSA value was between 4-10 μg/L,the AUC of single PSA detection was 0.505,the specificity and sensitivity of single PSA detection were 43.2％ and 31.8％; the AUC of the combination detection was 0.803; their specificity and sensitivity were 83.7％ and 73.2％.Conclusions Compared with the single PSA detection,the combination of XAGE-1b,SSX-2,AMACR,AKAP4 and PSA has been greatly improved the specificity and sensitivity in prostate cancer detection.This tool still has significant value even in patients with PSA value between 4-10 μg/L.

Objective To investigate the relationship between metabolic syndrome (MS) and recurrence of urolithiasis.Methods A retrospective analysis was performed in urinary stone patients from March 2008 to February 2012.Patients were divided into MS group and non-MS group according to the diagnose criteria of metabolic syndrome (2007 version) by the joint committee for developing Chinese guidelines on prevention and treatment of dyslipidemia in adults.The patients were followed up for 24-72months (median 47 months) since operation.The difference of stone recurrence was compared between the 2 groups.Results Two hundred and eighteen patients with urinary stone disease were enrolled.Of them,52 patients were diagnosed with MS.Stone recurrence occurred in 29 patients (55.8％) of MS group,whereas 66 patients (39.8％) of non-MS group suffered stone recurrence.It demonstrated the median recurrence free survival of group MS and non-MS was 36 months and 59 months by Kaplan-Meier analysis,respectively (Log-rank test,P =0.019).Multivariate Cox regression analysis results revealed that MS was significantly associated with stone recurrence (HR 1.817,95％ CI 1.105-2.988,P =0.011),however,the gender (P =0.336),age (P =0.246) and recurrence urolithiasis at first visit (P =0.051) were not associated with stone recurrence.Conclusions MS is an independent risk factor for urinary stone recurrence.It is suggested that the treatment of MS may have a important role in prevention of stone recurrence in MS patients with urolithiasis.