Animals ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Humans ; Mouth Mucosa ; pathology ; Mouth Neoplasms ; drug therapy ; pathology ; prevention & control ; Precancerous Conditions ; drug therapy ; pathology ; prevention & control

Hepacivirus ; Hepatitis C ; complications ; epidemiology ; Humans ; Lichen Planus, Oral ; complications ; epidemiology ; virology

Objectives To investigate the surgical technique and some other related problems of simultaneous heptorenal transplantation. Methods Combined liver-kidney transplantation was performed in one patient with huge polycystic liver, bilateral kidney, and another with liver cirrhosis after hepatitis B complicated with hepatic carcinoma and uremia due to chronic nephritis. Donors' organs were infused in situ with UW solution and rapidly harvested. Orthctopic or piggyback liver tranlsplantation was carried out and the kidney was transplanted with conventional method respectively. The patients received an immunosuppression therapy including simulect (CD25 antibody), FK506 or CsA, Mycophenolate mofitil (MMF), and Predinision. Results Both transplanted organs rapidly functioned well after the operation. One patient recovered well but suffered from ALI (acute lung injury) on the 2nd postoperative day and ARDS on the 11th postoporative day. There were no acute rejection or recurrence of the primary diseases in both cases. Conclusions Simultaneous hepatorenal transplantation is one of the treatment methods for end stage liver and kidney diseases. Skillful operative technique, comprehensive perioperative monitoring and appropriate management are all important factors for obtaining a successful result. It requires more shillful techniques than single organ transplantation.

Objective To evaluate the effect of biochemotherapy (?-interferon or recombinant interleukin 2 plus 5-fluorouracil) in the treatment of renal cell carcinoma (RCC) after nephrectomy. Methods Thirty-six patients with RCC admitted during 1993 and 1996 were randomly divided into two groups; the treatment group (combined nephrectomy and biochemotherapy) and control group with nephrectomy alone. Results Biochemotherapy did not show significant effect on five-year survival rate in those patients with the lower grading (Ⅰ, Ⅱ stages) RCC or with negative expression of matrix metalloproteinases 2 and 9 (MMP 2,MMP 9). On the other hand, this treatment regimen showed good clinical results in the higher grading (Ⅲ, Ⅳ stages) cancer patients, and the five-year survival rate was higher in the patients with positive expression of MMP 2 and MMP 9 of RCC than those without biochemotherapy. Conclusion Biochemotherapy is a safe and effective adjunctive treatment for patients with RCC after nephrectomy. Some side-effects should be taken care of. Its doses and administration route should be further studied to enhance the treatment efficacy and reduce side-effects.

Objective To investigate the causes of death of renal transplantation recipients during perioperative period. Methods One thousand one hundred and twenty-three cases of renal transplantation patients admitted to 309 Hospital of PLA from Nov. 1988 to Apr. 2003 were analyzed retrospectively. Results Twenty-four patients died (2.1%), among them, 10 died from infection, 8 from cadio-cerebral vascular disease, 3 from stress ulcer, 2 from fulminant hepatic failure, and 1 from hyperosmolar nonketosis diabetic coma. Conclusions It is essential to confirm the diagnosis early and give effective treatment immediately in renal transplantation patients during perioperative period. Preventive measures aiming at decreasing the risk factors should be emphasized.

Objective To evaluate the technique of modified simultaneous renal-pancreatico-duodenal transplantation (SKPT) with enteric drinage (ED). Methods Simultaneous pancreaticoduodenal and kidney transplantation of cadaver donors has been performed for one uremic patient with insulin-dependent diabetes mellitus (IDDM). The allograft exocrine secretions were drained into the proximal jejunum via a side-to-side duodenojejunostomy (non Roux-en-Y). The patient received an immunosuppression therapy including zenapax (CD25 antibody), FK506, mycophenolate mofitil (MMF), and predinisone. Results Exogenous insulin was withdrawn on the 7 th day after operation and the renal function became normal on the 3 rd day. No serious surgical complication occurred. 35 days after operation, the patient was discharged with normal pancreatic and renal function. Conclusions (1) The modified ED-SKPT without Roux-en-Y anastomosis is a safe and effective procedure for the treatment uremia accompanied by of IDDM. (2) The modified ED-SKPT (non Roux-en-Y) is simpler than traditional method (with Roux-en-Y) in surgical technique, and it has no operation related complications as seen after BD-SKPT (simultaneous kidney-pancreatico-duodenal transplantation with bladder drainage). (3) Current immunosuppressive agents and good HLA-typing may decrease complications.

Objective To study the inhibition effect of anti-CD 25 monoclonal antibody (Simulect) to the activated T cells in the recipients of kidney transplantation. Methods Forty-six recipients of renal transplantation were randomly divided into therapeutic group with simulect (23 cases) and control group (23 cases).All recipients in both groups received immunosuppressive therapy with neoral,azatheoprine and predonine conventionally.The recipients in simulect group received additionally 20 mg simulect at 2h preoprative and 4d postoperative,respectively.Several phenotypes of lymphocyte in the peripheral blood of all recipients were observed sequentially with flow cystometer. Results Compared with the control group,the number of activated T cells(CD + 25 ) decreased significantly within 24h after the first dose in the patients who received simulect,and the level of the cells that expressed CD 25 was significantly lower than that of control during the whole observation( P

Objective To explore the clinical characteristics and management of kidney transplantation in the older adults.Method Forty older kidney recipients (≥60 years old) and 777 younger (18～59 years old) recipients from June 2009 to December 2012 were retrospectively reviewed to evaluate the clinical characteristics and managements.Result Of 40 older recipients,the comorbidities of diabetes and coronary artery disease in older group were higher than in the younger (25％ vs.4.9％,and 32.50％ vs.11.38％).During the first 6 months,7 older patients died,among which 4 died from severe pneumonia,2 from heart failure and 1 from pulmonary embolism.There were 31 deaths in younger group,among which 21 died from severe pneumonia,4 from heart failure,5 from cerebrovascular accident and 2 from pulmonary embolism.The mortality in the older group was higher than in the younger group (17.5％ vs.4.6％).Six-month and 3-year survival rate in the older recipients was lower than the younger recipients (81.56％ vs.95.35％,and 81.56％ vs.94.5％,respectively).Six-month graft survival rate and 3-year survival rate in the older group were also lower than in the younger group (78.75％ vs.92.02％,and 68.82％ vs.85.40％).At the 1st and 2nd year during follow-up,the serum creatinines in the older group were close to those in the younger group,while lower level was observed 3 years after transplantation in the older patients (89.38 ± 11.34 (mol/ L vs.116.57±48.68 (mol/L).Conclusion The patients with ESRD older than 60 years have more preoperative concomitant diseases and worse health status,which contribute to the complex clinical characteristics.More aggressive indication selection,sufficient pre-operative preparation,wellmatched histocompatibility and high quality of donor kidney are the key factors of successful transplantation.Optimized immunosuppressant therapy,delicate perioperative management,preventve and effective treatment of related complications are necessary to promote the survival of recipients and graft in long term.

Cochlea ; metabolism ; Deafness ; genetics ; Humans ; Mutation

Humans ; Mouth Diseases ; drug therapy ; Mouth Mucosa ; pathology ; Thalidomide ; therapeutic use