Post-transplant diabetes mellitus (PTDM) remains a major clinical challenge following transplantation.This article reviews the long-term negative impact of PTDM on transplant recipients, including impaired allograft function, poor patient survival, accelerated onset of diabetic complications, a significantly higher rate of infection, as well as chronic rejection, etc.

ObjectiveTo explore the long-term fluctuation of fasting plasma glucose (FPG) and its effect on prognosis in patients surviving for more than 1 year after renal transplantation.MethodsFour hundred and forty-six patients underwent kidney transplantation from January,1993 to December,2008.According to preoperative FPG levels,patients were divided into diabetic,impaired fasting glucose (IFG),and normal fasting glucose (NFG)groups. The changing trend of FPG level was observed and analyzed. For 428 non-diabetic patients before transplantation,the prevalence and different outcomes of post-transplantation diabetes( PTDM ) according to FPG after transplantation were analyzed.The characteristics of the patients with persistent PTDM ( P-PTDM ) and transient PTDM (T-PTDM) were compared.The incidence of complications and patient survival between the PTDM group and non-PTDM groups were also compared.ResultsFPG level was increased early and then decreased in patients after renal transplantation.Of the 428 patients,87 developed into PTDM ( 20.3％ ) including 15 T-PTDM patients ( 17.2％ of total PTDM ),who eventually recovered to NFG or IFG.Compared with P-PTDM group,the incidence of acute rejection episodes was higher for T-PTDM ( P =0.043 ).The incidence of infections,hypertension,and dyslipidemia within the first year,was higher in PTDM group compared with non-PTDM group but patient survival was not different within a mean follow-up of ( 5.65 ± 3.68 ) years.ConclusionPTDM will not be permanent and may recover to NFG or IFG in the course of the disease.Acute rejections are associated with the onset of T-PTDM.The overall patient survival is not affected by PTDM,although complications,such as infections,hypertention,and hyperlipidemia are more frequently encountered in PTDM patients.

Objective To evaluate the status of abnormal glucose metabolism in patients being alive over 3years after liver transplantation and discuss the possible mechanism of post-transplant diabetes mellitus ( PTDM ).Methods In this study, the clinical data of patients with liver transplantation were collected from April 2001 to December 2008. Patients with diabetes mellitus before operation and those who had died and failed to appear during follow-up were exluded. 199 patients living over 3 years after liver transplantation were follow-up. The prevalence of PTDM was evaluated according to fasting plasma glucose(FPG). Among those without diabetes according to FPG,32patients underwent 75 g oral glucose tolerance test (OGTT) , and fasting and 2 h plasma glucose and insulin were determined. 32 patients were divided into three groups [normal, impaired glucose regulation ( IGR ) , and PTDM groups], proportion of PTDM and homeostasis model assessment ( HOMA ) index were calculated. Results In patients alive over 3 years after liver transplantation, the prevalence of PTDM was 34.67% according to FPG. The OGTT result showed that the proportion of PTDM was 9.38%, IGR, including impaired fasting glucose(IFG) and impaired glucose tolerance ( IGT ) , was 56. 25% , while 34. 37% remained normal. The homeostasis model assessment β cell function index( HOMA-β ) decreased progressively from normal group, IGR group to PTDM group,and that in PTDM group was significantly lower than those in normal and IGR group( P＜0.01 ). IGR group had the highest homeostasis model assessment for insulin resistance (HOMA-IR) and PTDM group the next, and HOMA-IR in IGR group was significantly higher than normal group. Conclusion In patients alive over 3 years after liver transplantation, the prevalence of PTDM reached 44.05%. Insulin resistance existed during early period of impaired glucose regulation, while the degeneration of β cell progressed with the worsening of impaired glucose regulation.

[Summary] Interleukin-2 receptor antagonist (IL-2Ra,ie,basiliximab and daclizumab),a new antibody agent,is widely employed in lowering the risk of acute rejection after organ transplantation,but it meanwhile causes increasing concerns on the effect it exerts on glucose metabolism in transplant recipients,and so far the exact effect still remains controversial.New onset diabetes after transplantation (NODAT) is one of the most influential metabolic complications affecting graft survival and patients' long-term outcomes.Some of the current researches indicate that IL2Ra may improve glucose metabolism in the transplant recipients,some show just the opposite,yet others show no effects.Hence further investigations focusing this aspect are needed.

[Summary] Dyslipidemia after organ transplantation is one of the important risk factors of postoperative cardiovascular disease and graft dysfunction. There are many factors that result in postoperative dyslipidemia. However, the factors influencing serum lipid levels are changing with the development of organ transplantation. In this article the effects of different anti-rejection drugs such as cyclosporine, azathioprine, mycophenolate mofetil, tacrolimus, rapamycin ( sirolimus ) , corticosteroids, and monoclonal antibody on dyslipidemia after organ transplantation were summarized in different eras.

Objective To explore the CT and MR imaging findings of acinic cell carcinoma (ACC)in salivary gland and enhance the diagnosis of this rare disease.Methods The CT and MR imaging characteristics of 20 patients (7 males and 13 females,median age 44 years old) with pathologically proved ACC were retrospectively reviewed.CT and MR images were evaluated in relation to the following: location,size,morphology,margin,CT density/MR signal intensity and enhancement pattern.Results Twelve lesions were located in parotid gland,two lesions in maxillary Sinus,and one lesion in submandibular,parapharyngeal,infratemporal fossa,buccal,nasal cavity,and hard palate respectively.The size of lesions were 0.7～5.8 cm.Sixteen lesions less than 3 cm in size demonstrated round or oval round masses with well defined margin.Four lesions more than 3 cm in size demonstrated irregular masses with unclear margin.Among them,bony destruction of the wall of the maxillary sinus was noted in 3 cases,and the preauricular skin was invaded in 1 case.The densities (signal intensity) were homogeneous in 6 cases and heterogeneous in 14 cases.Lesions were slightly low density in 11 case and isodensity in 3 cases on CT plain scan.Lesions were homogeneous isointense in 2 cases and heterogeneous isointense in 4 cases on T1WI,heterogeneous hyperintense in all cases on T2WI.On post contrast images,lesions demonstrated remarkable enhancement in 14 cases,moderate enhancement in 2 cases and mild enhancement in 3 cases.Conclusions The imaging characteristic of ACC were nonspecific.CT and MR could accurately detect the extent of tumor involvement and was helpful to provide more comprehensive information for the strategy of clinic therapy.

s:Objective To explore the anatomical distribution characteristics of pelvic endometriosis lesion, size of the cyst, tissue ad-hesion degree and the correlation with the pain symptoms in patients with ovarian endometriosis cyst. Methods 342 cases of patients with o-varian endometriosis cyst who has underwent gynecologic laparoscopic surgical treatment in our hospital were selected as the research objects. According to the pain symptoms, they were divided into the pain group (195 cases) and the painless group (147 cases). The influence of cyst growth area and size on the pain symptoms were compared, and whether there were cyst adhesion and the relationship between adhesion area and pain were analyzed. Results The operation time of pain group was longer. The average operation time was 81. 2 min in pain group while it was 62. 1 min in painless group. The bleeding volum was 74. 3 mL in pain group which was higher than 56. 2 mL in the painless group. The average diameter of cyst was 11. 26 cm in the Pain group, and it was 6. 10 cm painless group. Rate of adhesions in patients of pain group was significantly higher than that of the painless group. Adhesion occured most frequently in ovary, followed by the fallopian tubes. Conclusion Pain symptoms have a close relation with cyst diameter and degree of surrounding tissue adhesion. As the cyst diameter get larger and the surrounding tissue adhesions grow broader, the pain symptoms would be more significant in patients .

Human osteoblasts from donors of different age (≤5, 30-40, 50-60, ≥70) groups were isolated and cultured. Osteoprotegerin (OPG) and osteoclast differentiation factor (ODF) mRNA expressions were assayed by RT-PCR when the osteoblasts in the second passage were cultured for 14 days. Results showed that human osteoblasts from different age groups expressed OPG and ODF mRNA. Quantity of OPG mRNA and ODF mRNA expressions was correlated to donor′s age.

Objective To investigate the differences in function and collagen type I(COL-1) expression of cultured human ostoblastic cells between different age donors in vitro. Methods Human osteoblasts from different age donors(

OBJECTIVE:To establish a method for simultaneous determination of spironolactone and erythromycin in Com-pound spironolactone gel. METHODS:HPLC was performed on the column of Thermo-Hypersil ODS2-C18 with mobile phase of 0.1 mol/L ammonium dihydrogen phosphate solution (pH was adjusted to 7.0 by triethylamine)-acetonitrile (60∶40,V/V) at flow rate of 1.0 ml/min,detection wavelength was 215 nm and 238 nm,column temperature was 30℃,and injection volume was 5 μl. RESULTS:The linear range was 0.251 6-5.032 μg/ml for spironolactone and 0.577 2-11.544 μg/ml(r=0.999 9) for erythromycin (r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 0.83%;average recoveries were 97.8%(RSD=0.74%,n=9)and 96.7%(RSD=2.60%,n=9),respectively. CONCLUSIONS:The method is simple,reproducible,ac-curate and reliable,and can be used for the quality control of Compound spironolactone gel.