Objective Through studying the extracorporeal membrane oxygenation (ECMO)alleviating kidney damage caused by unstable circulation function following brain deaths to improve the utilization rate of donation after brain death (DBD) for renal transplantation.Methods Randomly selected 60 DBD patients with unstable circulatory function were randomly divided into 3 groups according to the time of perfusion by ECMO.The first group used ECMO perfusion for 2 h,group 24 h and group 36 h.At the same time,20 cases of stable DBD were randomly selected as the control group.The incidence of primary graft failure,delayed graft function and acute rejection,renal function recovery time,urine volume on the first day after surgery,creatinine and urea nitrogen one year after surgery were compared between two groups.Results The incidence of delayed recovery of renal function in experimental groups 1,2,3 and control group was 10％ (2/20),15％ (3/20),5％(1/20) and 10％ (2/20) respectively.The incidence of acute rejection in experimental groups 1,2,3 and control group was 30％ (6/20),25％ (5/20),35％ (7/20) and 25％ (5/20) respectively.There were no statistically significant differences between the experimental groups and the control group (P ＞0.05).The mean renal function recovery time in the experimental groups 1,2,3 and control group was (9.6 ± 2.0),(9.7 ± 2.7),(9.5 ± 1.9) and (7.3 ± 3.1) days respectively.The average urine volume in experimental groups 1,2,3 and control group was (3 405 ± 755),(3 300 ±600),(3 810±825),and (3 600 ± 80) mL respectively.In experimental groups 1,2,3 and control group,the average creatinine level was (92 ± 28),(92 ± 28),(101 ± 31),and (98 ± 30) μmol/L respectively.The average urea nitrogen in experimental groups 1,2,3 and control group was (4.2 ± 2.2),(5.6 ± 2.6),(5.2 ± 2.6) and (5.5 ± 2.5) mmol/L respectively.The recovery time of renal function in the experimental groups was longer than that in the control group (P＜0.05),but there was no significant difference among the experimental groups (P＞0.05).There was no statistically significant difference between the experimental groups and the control group in urine volume one day after surgery and kidney function one year after transplantation (P＞0.05).Only recovery time after operation of the DBD with the unstable circulation function assisted by EMCO was slightly longer than that with stable circulation function,while the rest indexes showed no statistically significant difference.Conclusion DBD with unstable circulation function with ECMO auxiliary circulatory function can protect the renal function and increase the utilization rate of donor organs.

Objective To explore the protective effect of extracorporeal membrane oxygenation (ECMO) on donor kidneys from non-controllable donation after cardiac death (DCD). Methods A total of 60 non-controllable DCD donors were selected and divided into 3 groups randomly based on the in vivo perfusion time of ECMO: test group 1 received EMCO perfusion for 2 h, test group 2 for 4 h and test group 3 for 6 h, with 20 cases in each group. Corresponding recipients were also divided into 3 groups, with 20 cases in each group. Meanwhile, 20 recipients from donation after brain death (DBD) with stable circulatory function were randomly selected as control group. Incidence of delayed graft function (DGF), primary graft nonfunction (PNF) and acute rejection of the recipients in different groups was compared. The indexes including graft function recovery time, urine volume on day 1 and graft function within 1 year after renal transplantation were compared for the recipients in different groups. And 1-year survival rate of the recipients and grafts after renal transplantation was compared. Results Compared with the control group, various test groups presented no significant differences in the incidence of PNF, DGF and acute rejection (all P>0.05). Compared with the control group, graft function recovery time prolonged significantly in each test group, which presented statistically significant differences (all P<0.05), while the urine volume on day 1 and graft function within 1 year after renal transplantation presented no statistically significant difference in each test group (all P>0.05). The 1-year survival rate of the recipients and grafts after renal transplantation was 100％ in various test groups and control group, which presented no statistically significant difference (all P>0.05). Conclusions ECMO can protect donor kidneys effectively through assisting the circulatory or respiratory function of non-controllable DCD, and improve their utilization rate.

Objective:To investigate the killing effects in vitro of a new photosensitizer black titanium dioxide b-TP-700-mediated photodynamics on prostate cancer cell line PC-3 cells.Methods:The b-TP-700 was successfully prepared by using solid phase in situ thermal reduction method. PC-3 cells were treated with 31.25, 62.5, 125, 250, 500, 1 000 μg/ml b-TP-700 for 12, 24, 48 h. The cell activity was detected by using CCK-8 method, and the morphology of PC-3 cells was observed by using confocal fluorescence microscope, the toxicity of b-TP-700 to PC-3 cells was also judged. PC-3 cells were treated with different concentrations of b-TP-700 (31.25, 62.5, 125, 250, 500 μg/ml) and irradiated with laser (1 W/cm, 808 nm) for 1, 3, 5, 7 min. The cell activity was detected by using CCK-8 method. The production of reactive oxygen species in PC-3 cells cultured in 250 μg/ml b-TP-700 after laser irradiation for 5 min was detected by using confocal fluorescence microscopy. The non-laser irradiation cells were selected as the control group.Results:There were no statistically significant differences in cell activity of PC-3 cells treated with different concentrations of b-TP-700 for the same time ( F value was 1.26, 0.39 and 0.37, respectively; all P > 0.05). PC-3 cells were treated with 1 000 μg/ml b-TP-700 for 24 h, no obvious morphological changes and no obvious dead cells were observed under fluorescence microscope. When PC-3 cells were treated with the same concentration of b-TP-700, the activity of PC-3 cells was decreased with the extension of laser excitation time. Under the same laser excitation time, the activity of PC-3 cells was decreased with the increase of b-TP-700 concentration (all P < 0.05). Under laser irradiation, obvious green fluorescence could be detected in the PC-3 cells treated with 250 μg/ml b-TP-700, while almost no green fluorescence could be observed in the control group. Conclusions:A new photosensitizer b-TP-700 has the good reactive oxygen generation ability. b-TP-700-mediated photodynamics show obvious killing effects on prostate cancer PC-3 cells in vitro, which is expected to be a new method for the treatment of prostate cancer.

Humans ; Urinary Bladder Neoplasms/pathology* ; Carcinoma, Transitional Cell/pathology* ; Genetic Markers ; Biomarkers, Tumor/genetics* ; Urothelium/pathology*