BACKGROUND: Infection following kidney transplantation has become one of the main reasons for graft failure and death of allograft recipients. However, there is not a standard therapeutic scheme for infection following kidney transplantation. OBJECTIVE: To investigate the clinical features and treatment measures of infection, additionally, to increase the cure rate of infection following kidney transplantation.DESIGN, TIME AND SETTING: A retrospectively analysis was performed at the Organ Transplantation Center, the First Affiliated Hospital of Kunming Medical College from February 2006 to February 2008.PARTClPANTS: Eighteen cases of infections in 84 kidney allograft recipients.METHODS: All cases were checked by chest X-ray. Patients who had no significant lung infection symptoms or obvious signs received lung CT scan. Pathogen detection was performed, including hemoculture, urine culture, sputum culture, nose swabs culture, throat swab culture, checking clinically important cytomegalovirus (CMV), EB-DNA and mycoplasma in blood, acid-fast bacilli and eumycete culture in sputum. All cases of pulmonary infection underwent a comprehensive treatment-antiviral drugs, antibiotics and antifungal. Depending on the individual condition and absolute values of lymphocytes and CD4+T cells, the immunosuppressant was adjusted individually. The occurrence time, clinical symptom, auxiliary examination and treatment strategies were analyzed.MAIN OUTCOME MEASURES: The occurrence time of infection and clinical symptoms; imaging manifestation and results of pathogenic detection; selection of antibiotics and immunosuppressant adjustment.RESULTS: Among 18 cases, 11 cases (61.2%) were deceased-donor kidney transplant recipients. Inflection following kidney transplantation occurred in 12 cases (66.7%) within 3 months, and increased to 15 cases (83.3%) within 3-6 months. Of the 18 infection cases, 14 cases (77.8%) had a main symptom of fever. There were 15 cases (83.3%) of respiratory tract infection, including 13 cases (72.2%) of pulmonary infection. Fungal cultivation, especially Monilia, was positive in 6 cases. Three out of the 18 cases (16.7%) died, two of whom had CMV infection. Mixed infection occurred in all cases.CONCLUSION: Infected patients following kidney transplantation present with diversity pathogens, which are dominated by bacteria, fungus and virus. Severe pneumonia combined with CMV infection demonstrates that poor prognosis, fungal and virus infection following kidney transplantation should be given more attention. Combined de-escalation therapy is the main method, and timely adjustment and even discontinuance of immunosupprassive agents is one of the key points in the treatment of infection following kidney transplantation

Objective To explore factors influencing the prognosis of hepatocellular carcinoma (HCC) patients after hepatectomy. Methods From May 1994 to January 1998, 189 patients who underwent hepatectomy for HCC were enrolled for reviewing their clinical characteristics, treatment and prognosis. Twenty-two parameters contributing to long-term survival rate (SR) and disease-free SR were analysed. Results The 3,5-year cumulative SR of the whole group was 63%,45%, respectively. The 3,5-year SR and disease-free SR in the curative resection (CR) group ( n =162) were 67%,47% and 45%,26% respectively. Results showed that the way by which a tumor was found, tumor size, portal tumor thrombi, satellite nodule, TNM stage, cirrhosis type, recurrent and treatment, blood transfusion, differentiation grade,and CR were risk factors by individual variable analysis( P =0.0000～0.0034); A multivariable analysis showed that CR, tumor size, tumor finding mode and reoperation were significant factors associating with prognosis( P =0.0000～0.0024). Blood transfusion and type of cirrhosis were closely correlated with tumor-free survival ( P =0.0001). Conclusions Curative resection, tumor size, reoperation for recurrence were important factors for recurrence by multivariate analysis. The severity of concomittant liver cirrhosis and perioperative blood transfusion were closely correlated with postoperative tumor free survival.

Tetrandrine(TET),a natural bisbenzyl isoquinoline alkaloid extracted from Stephania tetrandra S.Moore,has diverse pharmacological effects.However,its effects on melanoma remain unclear.Cellular prolif-eration assays,multi-omics analyses,and xenograft models were used to determine the effect of TET on melanoma.The direct target of TET was identified using biotin-TET pull-down liquid chromatograph-mass spectrometry(LC-MS),cellular thermal shift assays,and isothermal titration calorimetry(ITC)analysis.Our findings revealed that TET treatment induced robust cellular autophagy depending on activating transcription factor 6(ATF6)-mediated endoplasmic reticulum(ER)stress.Simultaneously,it hindered autophagic flux by inducing cytoskeletal protein depolymerization in melanoma cells.TET treatment resulted in excessive accumulation of reactive oxygen species(ROS)and simultaneously triggered mitophagy.Sirtuin 5(SIRT5)was ultimately found to be a direct target of TET.Mechanistically,TET led to the degradation of SIRT5 via the ubiquitin(Ub)-26S proteasome system.SIRT5 knockdown induced ROS accumulation,whereas SIRT5 overexpression attenuated the TET-induced ROS accumula-tion and autophagy.Importantly,TET exhibited anti-cancer effects in xenograft models depending on SIRT5 expression.This study highlights the potential of TET as an antimelanoma agent that targets SIRT5.These findings provide a promising avenue for the use of TET in melanoma treatment and underscore its potential as a therapeutic candidate.

Emerging SARS-CoV-2 variants have made COVID-19 convalescents susceptible to re-infection and have raised concern about the efficacy of inactivated vaccination in neutralization against emerging variants and antigen-specific B cell response. To this end, a study on a long-term cohort of 208 participants who have recovered from COVID-19 was conducted, and the participants were followed up at 3.3 (Visit 1), 9.2 (Visit 2), and 18.5 (Visit 3) months after SARS-CoV-2 infection. They were classified into three groups (no-vaccination (n = 54), one-dose (n = 62), and two-dose (n = 92) groups) on the basis of the administration of inactivated vaccination. The neutralizing antibody (NAb) titers against the wild-type virus continued to decrease in the no-vaccination group, but they rose significantly in the one-dose and two-dose groups, with the highest NAb titers being observed in the two-dose group at Visit 3. The NAb titers against the Delta variant for the no-vaccination, one-dose, and two-dose groups decreased by 3.3, 1.9, and 2.3 folds relative to the wild-type virus, respectively, and those against the Omicron variant decreased by 7.0, 4.0, and 3.8 folds, respectively. Similarly, the responses of SARS-CoV-2 RBD-specific B cells and memory B cells were boosted by the second vaccine dose. Results showed that the convalescents benefited from the administration of the inactivated vaccine (one or two doses), which enhanced neutralization against highly mutated SARS-CoV-2 variants and memory B cell responses. Two doses of inactivated vaccine among COVID-19 convalescents are therefore recommended for the prevention of the COVID-19 pandemic, and vaccination guidelines and policies need to be updated.