Objective To analyze the complications,treatments and prognosis of simultaneous pancreas-kidney transplantation,especially on surgical complications and treatments.Method The causes and outcomes of surgical treatment in 70 cases of simultaneous pancreas-kidney transplantation performed between Dec.1999 and June 2012 were retrospectively analyzed in our center.Result Sixteen patients (22.9％) underwent one or more reoperations.The causes for reoperation were as follows:2 cases of hematuria,4 cases of abdominal hemorrhage,4 cases of abdominal infection,4cases of pancreatic thrombosis,2 cases of renal graft's artery rupture,1 case of renal allograft rupture,1 case of intestinal fistula,and 1 case of pancreatic fistula.Eight pancreas grafts were lost in the first year.Pancreatectomy was performed on the other 5 cases:4 cases of pancreatic thrombosis,1 case of intestinal fistula,accounting for 43.8％ of the patients subject to reoperation.The recipients,kidney,pancreas survival rate in reoperation group at 1 year was 87.5％,75％,and 56.3％ respectively; and that in control group at 1 year was 98.1％,98.1 ％,and 98.1 ％ respectively.There was significant difference in kidney survival rate (P＜0.01,chi-square =6.79),and pancreas survival rate (P＜0.01,chi-square =17.47) between two groups.Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with end-stage renal disease,surgical treatment due to complications is still an important factor in short-term survival on the grafts.

Objective To explore the indications of simultaneous pancreas-kidney (SPK) transplantation for type 2 diabetes mellitus (DM) combined with end-stage renal disease by comparing the outcome of patients with type 1 and type 2 DM combined with end-stage renal disease after renal transplantation.Methods 109 patients accepting SPK from January 2008 to July 2016 in our center were divided into two groups according to the types of DM:T1DM (n =36),and T2DM (n =73).The basic characteristics of recipients,outcome,and pancreas and kidney functions after operation were compared between two groups.Results There was no significant difference in 5-year survival rate and surgical complications between two groups although recipients of T2DM group were older and had higher BMI than T1DM group.But rejection rate was higher in T1DM group.Conclusion SPK for T2DM recipients will not increase the surgical risk and can get good long-term outcome.

Objective To assess the distribution of recombinant fusion protein dTMP-GH in mice and to determine whether it is of tar-geted distribution characteristics. Methods A laboratory scale preparation of dTMP-GH recombinant fusion protein was obtained. Protein dT-MP-GH was labeled with radioactive 125 I,then mice were sacrificed at 5 min,15 min,30 min,1 h,2 h,4 h,8 h,12 h,24 h after tail vein injec-tion of 125 I-dTMP-GH at a dose of 100 μg/kg,and the organs and tissues ( heart,liver,spleen,kidney,bone and thyroid) were collected for radioactive counting. Results Preparation of purified ( >98%) dTMP-G was obtained. 125 I labeling rate was 71. 53%,radiochemical purity was 96. 53%,and specific activity was 0. 22 MBq/μl. 30 min after tail vein injection of 125 I labeled dTMP-GH,radioactivity accounted for 10% of the total injected in femoral,and metabolism was carried via liver and kidney over time. Conclusion Fusion protein mainly distribu-ted in bone marrow via tail vein injection in mice,which expressed that dTMP-GH has the characteristics of selective distribution in bone mar-row tissue.

Objective To investigate the effects of rTMP-GH, a recombinant fusion protein of thrombopoietin mimetic peptide (TMP) and human growth hormone (GH), on the proliferation and thrombocytopoiesis of cultured megakaryocytes. Methods After being treated with 100 ng/ml of rTMP-GH for 7 d, Dami cells, a kind of megakaryocyte cell line, were analyzed by observing the numbers of colony forming unit. Meanwhile, Western blotting and RT-PCR were applied to detect the expression changes of globin transcription factor-1 (GATA-1), which is a main regulator of thrombocytopoiesis in megakaryocytes. Results The numbers of colony forming unit were markedly increased in cultured Dami cells incubated with rTMP-GH. Compared with normal control and GH treatment groups, both the mRNA and protein levels of GATA-1 were up-regulated significantly in Dami cells treated with rTMP-GH. Conclusion rTMP-GH has a strong ability to promote the proliferation and thrombocytopoiesis of megakaryocytes.

Objective To study the awareness of perimenopausal hormone replacement therapy (HRT) among a part of the medical care personnel in Guiyang . Methods A survey was conducted among 500 medical staff members in 4 hospitals of Guiyang by cluster random sampling using questionnaire about HRT. Results The survey showed that 74.6% (373/500) medical staff thought that the hormone replacement therapy was necessary to perimenopausal women; 96.7% (87/90) of obstetrics and gynecology doctors believed that it was necessary for perimenopausal women to use HRT,which was significantly higher than the doctors of other specialties 68.6% (166/242) and the nurses group 71.4% (120/168) (χ2=28.509, 23.537, P<0.01). Only 5.8%(29/500) of the medical personnel were willing to recommend HRT. In light of the attitude for recommending HRT, the obstetricians and gynecologists group was more significantly higher than the other specialties doctors group (χ2=86.781, P<0.01). Conclusion The knowledge of hormone replacement therapy in part of Guiyang medical personnel is not sufficient;the recommending rate of HRT was low;the side effects of HRT was still a concern. There are differences between obstetrics and gynecology doctors and doctors other specialties and nurses in HRT knowledge.

Objective To analyze the risk factors of BKV infection and compare the real-time PCR procedure and urinary sediment smears of patients checked for decoy cells. Methods The peripheral blood samples of 129 renal recipients were collected. According to the result of PCR, 129 patients were divided into 2 groups:①BKV-DNA(+);②BKV-DNA(-). The sex, age, cold ischemia time, hemotodialysis duration, immunosuppressive agent and other clinical parameters were compared between the 2 groups and a Logistic regression was performed to analyze the risk factors of BKV infection. Results There were 20(15. 5%) patients in BKV-DNA(+), 109(84. 5%)patients in BKV-DNA(-)group. Logistic regression found that the cold ischemia time, hematodialysis duration, living donor were significantly related to the BKV-DNA. The results of the real-time PCR procedure and urinary sediment smears of patients checked for decoy cells were related. Conclusion Real-time fluorescent quantitative PCR and urine decoy cell are good way for detection of BKV infection after renal transplantation. The cold ischemia time and hematodialysis duration and brain death donor were the risk factors of BKV infection post renal transplantation.

Objective To fulfill high-efficient expression of rTMP-GH,a recombinant fusion protein of thrombopoietin mimetic peptide and human growth hormone,in Pichia pastoris.Methods cDNA fragment coding for rTMP-GH was amplified by PCR,and subsequently cloned into the expression vector pPIC9K.The linearlized plasmid pPIC9K-rTMP-GH was transformed into Pichia pastoris GS115 cells and screened in MD/MM plates under pressure of G418.The recombinant fusion protein rTMP-GH was identified by Western blotting,and its biological activity was analyzed by its ability on colony formation of megakaryoblasts.Results The pPIC9K-rTMP-GH expression plasmid was successfully constructed.GS115 cells with high expression of rTMP-GH was screened out,and the rough purified rTMP-GH showed promotive effect on megakaryoblast colony formation.Conclusion High-efficient expression of rTMP-GH in Pichia pastoris is achieved.

BACKGROUNDSimultaneous pancreas-kidney transplantation (SPKT) is the best treatment option for diabetic patients with advanced chronic renal failure. The current study aimed to analyze the surgical indications, treatments and prognosis of SPKT.

METHODSWe retrospectively analyzed 40 cases of SPKT performed between December 1999 and January 2010 in our center, including the survival rate, complications and the reasons of reoperation.

RESULTSOf all the 40 SPKT cases, the one-year survival rates of the recipients, kidney and pancreas transplant graft were 97.6%, 97.6% and 92.7%, while 97.6%, 91.1%, 92.7% at 3 years and 83.6%, 78.0%, 79.4% at 5 years, respectively. After SPKT, 10 patients need reoperation because of surgical complications (14 operations). The reoperation rate was 25%, including 2 patients (4 operations) with hematuria, 4 patients with abdominal hemorrhage, 2 patients (3 operations) with abdominal infection, 1 patient with pancreatic venous thrombosis, 1 patient with anastomotic leakage, and 1 patient with fistula.

CONCLUSIONAlthough SPKT provides a successful and effective treatment for diabetics with end-stage renal disease, how to reduce the complications of this treatment still need further effort.

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Cephalosporins ; therapeutic use ; Child ; Female ; Humans ; Kidney Transplantation ; Male ; Metronidazole ; therapeutic use ; Middle Aged ; Pancreas Transplantation ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo study the risk factors regarding heredity and environment in familial incident type 2 diabetes mellitus (DM).

METHODSTo compare the difference of environmental risk factors between type 2 DM, impaired glucose tolerance (IGT) and normal persons through study on familial information and environmental risk factors in 125 familial incident type 2 DM in-patients and out-patients from 1999 to 2001. Falconer was used to estimate heritability. Penrose was used to study the heredity damagers by polygene analysis.

RESULTSThere was a significant constituent ratio diversity (P < 0.01) in triglyceride, body mass index, waist to hip ratio, hypertension history and physical activities history among 3 groups, while no significant diversity in blood lipids and history of coronary heart disease. 83.42% +/- 5.84% heritability of type 2 DM in 125 familial predigree indicated that dominant major gene might exist in these familiar pedigrees. Analysis of polygene in these groups showed type 2 DM might conform to the model of polygene heredity.

CONCLUSIONThis study suggested that type 2 DM had significant heritability and genetic heterogeneity, which generally appeared to be a disease of multi-factorial inheritance. Environmental risk factors, genetic factors and their interactions were due to type 2 DM.

Adult ; Blood Pressure ; Body Mass Index ; Cholesterol ; blood ; Cholesterol, LDL ; blood ; Diabetes Mellitus, Type 2 ; blood ; genetics ; physiopathology ; Family Health ; Female ; Glucose Tolerance Test ; Humans ; Male ; Middle Aged ; Risk Factors ; Triglycerides ; blood

Objective To study the epidemiological characteristics of abnormal glucose and lipid metabolism in in-patients with ischemic stroke. Methods A total number of 771 in-patients with ischemic stroke, hospitalized in the Department of Neurology/Endocrinology from Changzhou No.2 Hospital from April 2007 to April 2008 were enrolled in this study. After identifying the condition of glucose metabolism, all diagnosis-undetermined patients received oral glucose tolerance test. Results Among in-patients with ischemic stroke, 41.8% of the patients were finally diagnosed as diabetes, with 23.4% classified as 'impaired glucose tolerance'. The prevalence of 'abnormal glucose metabolism' was 65.2% in total. If diabetes in the in-patients with ischemic stroke was diagnosed only by fast plasma glucose instead of oral glucose tolerance test, 58.5% diabetic patients would have been misdiagnosed. Abnormal lipid metabolism existed in inpatients with cerebral ischemic stroke were noticed. These abnormalities of lipid metabolism were mainly consisting of increased triglyceride and decreased HDL-C cholesterol. Conclusion The majority of in-patients with ischemic stroke appeared to have had abnormal glucose and lipid metabolism. It seemed necessary to promptly and correctly diagnose these patients with abnormal glucose metabolism by oral glucose tolerance test to reduce the chances of developing the recurrence of stroke.