Renal transplantation was performed successfully in five cases with high risk. All are alive with functioning grafts at the time of report.The first patient was suffering from cardiac failure, and he was operated on immediately after an implantation of a pace-maker. The second patient was having malignant hypertention before and after transplantation, and bilateral nephrectomy through a mid-line abdominal incision was done, resulting in gradual decline of blood pressure to within normal range. The third patient suffered from chronic pye-litis, and renal transplantation was done immediately after bilateral nephrectomy. The fourth patient suffered from chronic renal failure and leukopenia (total white count 2900-4000/mm3), and the total white count became normal (5000-7500/mm3) despite the use of immunosuppressive drugs after renal transplantation. The fifth case, ages 50, developed stress ulcers with repeated massive hematemesis and bloody stools 12 days after transplantation, and a subtotal gastrectomy was performed to save the patient.It is the opinion of the author that the renal transplantation may be considered to be a life-saving operation, and the key of success is that the quality of the graft should be good.

Kidney is the most important organ to maintain the balance of hyperkalemia.Due to reduced glomerular filtration rate or renal tubule potassium excretion dysfunction, all kinds of acute and chronic kidney diseases can result in increased hyperkalemia.Therefore, hyperkalemia becomes a common electrolyte disorder in children with kidney disease.Hence, the diagnosis and differential diagnosis of renal hyperkalemia are particularly important for clinicians.

Objective To probe the effect of perioperative therapeutic regime on breast reconstruction after surgery in breast cancer patients.Methods We retrospectively reviewed the clinical data of 145 consecutive breast cancer patients with 162 reconstructions.Results 127 of 145 patients got an excellent or good appearance (87.6％),and 42 cases had complications occurring in 162 operations (25.9％).After a median follow-up of 38.4 months,recurrences were found in 9 patients,3 cases died,and the disease free survival rate was 93.1％.Multivariate analysis showed that radiation therapy,without nipple-sparing and one-stage prosthesis implant were independent risk factors for negative postoperative aesthetic outcome;Delayed reconstruction and implant reconstruction were found to be protective factors for the postoperative complications.Conclusions Although the survival rate appears to be scarcely affected,different treatment modalities in reconstruction strategy bring different clinical results and outcomes.The perioperative decision-making of reconstruction strategy should be based on oncological safety,postoperative complications,aesthetic outcomes and subsequent therapies.

BACKGROUND:How to keep the intact shape of the breast while treating tumor has been widely concerned by more doctors and patients, breast reconstruction is introduced, developed and considered an important part in the treatment of breast tumors. OBJECTIVE:To explore the feasibility and therapeutic effects of immediate breast reconstruction after modified radical mastectomy and latissimus dorsi myocutaneous flap transplantation. METHODS:We retrospectively analyzed the clinical and pathological features of 42 breast cancer patients under immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap or extended latissimus dorsi musculocuraneous flap. The procedure duration, postoperative complications and cosmetic outcome were assessed. RESULTS AND CONCLUSION:Among the involved 42 patients, 33 cases underwent modified radical mastectomy, retaining the nipple and areola of breast, 9 cases underwent modified radical mastectomy, retaining the skin of breast, 24 cases underwent breast reconstruction with latissimus dorsi musculocuraneous flap, 18 cases underwent breast reconstruction with extended latissimus dorsi musculocuraneous flap. The skin flap and reconstructed breast al survived, without severe complications. According to objective evaluation results, the cosmetic outcome was good in 39 cases and fair in 3 cases. The subjective evaluation results were good in 40 cases and fair in 2 cases. Al the patients were fol owed up for 9-41 months. One patient had bone metastasis 19 months after operation and there was no case with local recurrence. Immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap is a simple and feasible operation process, with optimal effects, high security, and high survival.

Radiotherapy (RT) is the primary treatment for nasopharyngeal carcinoma (NPC). In order to achieve tumor control, nearby normal brain tissues, especially the temporal lobes, often receive unnecessary radiation. Patients with NPC treated by RT may occur cognitive impairments, which significantly compromises the quality of life. The symptoms of cognitive dysfunction induced by RT in NPC patients can exhibit at the early or later stage after RT, which may be related to temporal lobe injury or brain damage induced by radiation. However, the relationship between the cognitive declines induced by RT and the radiation dose or volume of the temporal lobe (or the dosimetry to treat NPC) has not yet been definitively established, and few reports have focused on cognitive impairment following intensity modulated RT. Therefore, this paper will review the progress in radiation-induced cognitive decline of NPC patients in order to provide the basis for preventing side effects of RT and improving the quality of life after RT.

ObjectiveTo investigate the association between endothelial NO synthase (eNOS) gene G10T polymorphism and the susceptibility of sporadic congenital heart disease (CHD).MethodsThe genotype oneNOS G10T locus was detected and compared in 1323 children with sporadic CHD and 1323 non-CHD children.ResultsCompared with the CC genotype, the AA genotype signiifcantly increased the risk of CHD (adjustedOR=1.42, 95%CI=1.01-2.04). Compared with the CC/AC geno-type, the AA genotype signiifcantly increased the risk of CHD (adjustedOR=1.39, 95%CI=1.08-1.92). Based on stratiifed analy-sis, the AA genotype was associated with the susceptibility of perimembranous ventricular septal defects (adjustedOR=1.56, 95%CI=1.17-2.47).ConclusionsIn Chinese population, theeNOS G10T polymorphism may increase the susceptibility of sporadic CHD.

Humans ; Hyperamylasemia ; physiopathology ; Infant, Newborn ; Neonatology

Objective:To compare the therapeutic effect of immediate breast reconstruction using latissimus dorsi musculocutane-ous flap after modified radical mastectomy with the conventional modified radical surgery of breast cancer. Methods:A retrospec-tive analysis of 224 female patients with Stage 0 to IIIA breast cancer was conducted. The patients were admitted to the Department of Breast Surgery of Liuzhou People's Hospital between November 2009 and July 2012. The cases were divided into two groups accord-ing to different surgical options:immediate breast reconstruction (IBR) and modified radical surgery of the breast (MRSB). After con-trastive analyses of the postoperative complications, cosmetic results, quality of life, local failure rate, distant metastases and mortality rates between the two groups, the therapeutic efficiency of the two surgeries was evaluated. Results:No statistical differences were ob-served in the postoperative complications between the two groups, such as hydrops, skin flap necrosis, limb exercise and shoulder joint motion, drainage time, and starting time of adjuvant therapy (P>0.05). The patients in the IBR group had a better quality of life than those in the MRSB group (P<0.01). The aesthetic evaluation of the breast reconstruction was favorable in 39 cases and secondary in 3 cases, which surpass the evaluation of the patients in the simple MRSB group. No obvious statistical differences were observed in the distant metastasis rate, local recurrence rate, and mortality rate between the two groups (P>0.05). Conclusion:Compared with the tradi-tional MRSB group, the option of IBR after modified radical mastectomy not only achieves similar therapeutic outcomes but also pres-ents advantages such as better aesthetic effect of the reconstructed breast, easy surgical procedures, high safety, improvement of the breast contour outline, and improved quality of life after operation. Therefore, IBR is a safe and available therapeutic method for pa-tients with early breast cancer.

Objective: To develop the Padua Inventory(PI) for the use of Chinese college students;explore the structure and examine the sex difference in non-clinical sample in China.Methods: The PI was filled by 1300 college subjects,including 680 males and 542 females(78 gender missing),aged 19.6?2.2,for exploratory factor analysis(EFA).The second sample has 30 college students from Peking University for test-retest study.Results: The results of EFA has four factors: impaired control over mental activities/doubting,worries of losing control over motor activities,contamination,and checking.Reliabilities of four factors are 0.94,0.85,0.86,0.83 for each and 0.96 for the total scores.The test-retest correlations of the four factors are 0.77,0.87,0.85,0.84 for each.Females scored significantly higher in factor 3(P=.000) while males scoring significantly higher in factor 4(P=.017).Conclusion: The results suggest that PI has eligible psychometric reliability,but needs further study for the validity in China.

Objective To explore the clinical effect of mobilization and harvesting by autologous peripheral blood stem cell transplantation (APBSCT) on treating myasthenia gravis (MG).Methods One patient with MG was enrolled in the study. Autologous peripheral blood stem cells(APBSCs) were mobilized with cyclophosphamide(CTX) and granulocyte colony-stimulating factor(G-CSF). PBSCs harvesting was performed by continuous flow leukapheresis using a CS-3000 plus blood separator.CD +_ 34 cells were analyzed by flow cytometer and granulocyte-macrophage progenitors (GM-CFU) was detected by semisolid methlcelluose after mobilization. The clinical effect was evaluated by a relative score system.Results The numbers of mononuclear cells (MNC),GM-CFU and CD +_ 34 cells were 8.08?10 8/kg,7?10 5/kg or 81/10 5/MNC and 1.09?10 6/kg after mobilization in graft respectively. The clinic relative score of the patient was 7/8.Conclusion CTX and G-CSF can mobilize effectively and provide enough peripheral blood stem cells for transplantation in treating MG.