Objective To evaluate the clinical value of two-hour post-dose cyclosporine (CsA) level (C 2) monitoring in renal transplantation (RTx) recipients with functional renal allograft more than one year.Methods 126 RTx recipients with functional renal allograft more than one year treated with CsA-microemulsion-based triple therapy immunosuppression were enrolled. Whole blood samples were collected 2?h after CsA administration and the CsA level was measured by fluorescence polarization immunoassay (TDx).Results C 2 levels at 3 month and 1 year following RTx were 0.830 ? 0.307 ??mol/L and 0.678 ? 0.306 ??mol/L respectively, average C 2 level between 1 to 5 years was 0.609 ? 0.195 ??mol/L,and after 5 and 10 years, C 2 levels decreased to 0.546 ? 0.163 ??mol/L and 0.547 ? 0.227 ??mol/L respectively. Adequate C 2 level in the first 5 years after RTx was correlated with improved allograft renal function and there was a significant relationship between C 2 level and CsA dose. Variation of C 2 level became greater in long-term survival RTx recipients.Conclusion In long term maintenance phase of RTx recipients, C 2 concentration was also useful in the CsA therapeutic monitoring, but the variation became greater in such patients.

0.05).But it showed significant higher level in moderate and severe PIH patients than the normal ones. (prepartum. 1195?72、1206?96 vs 1102?89, intrapartum, 1256?81、1308?84 vs 1174?86). The concentration of IECa 2+ has positive relationship with MAP in PIH patients. Conclusions The best method to decrease the harmfulness of overload IECa 2+ is to normalize its level by effective measure of decrease the blood pressure.

Objective To analyze the impact of allograft category on the result of living related donor kidney transplantation (LRKT)and to evaluate the predominant donors. Methods A retrospective analysis of 104 recipients receiving LRKT from Apr. 2004 to Mar. 2008 was performed. Based on donor resource, all the recipient-donor pairs were divided into four groups: spousal donation group,parental donation group, sibling donation group and cousinly donation group. The observational parameters were selected for analysis, such as average post-transplant hospitalization dates, time for serum creatinine (Scr) back to normal level, Scr levels of every observational time point, incidence of major complications (infection, rejection, DGF) and recipient/graft survival rate. Results Recipient/graft survival rate of sibling donation group seemed higher. Recipients of sibling donation group seemed to have fewer post-transplant hospitalization dates, but higher rates of infection, while those of parental donation group seemed to have higher rates of rejection. Rates of rejection and infection of spousal donation group were lower than supposed. There was no statistically significant difference in time for Scr back to normal level and Set levels of every observational time point among these four groups. Conclusions The result of sibling donor renal transplantation is better, while short-term outcome of spouse donor renal transplantation is ideal, which is similar with parent or cousin donor renal transplantation. Except for human leukocyte antigen, aspects such as quality of donor kidney, predominance during operation and self-administration post-transplant are also the guarantee for the success.

Objective To explore effect of diosmin on serum and prostatic fluid immune mediated factors and clinical effect in patients with chronic prostatitis.Methods 89 cases of old male patients with chronic non bacterial prostatitis were selected, and divided into two groups.The control group were treated with universal tablets, the experiment group were treated on the base of the control group with diosmin.12 weeks as a course.Clinic effect, adverse reaction rate, prostatic fluid MIP-2 and MIP-1αwere compared after treatment.Results Compared with control group, MIP-1αand MIP-2 in serum and prostatic fluid were lower(P<0.05),NIH-CPSI score and QOL scores were lower(P<0.05), total effective rate was higher than control group(P<0.05),the incidence of adverse reactions was lower(P<0.05).Conclusion Diosmin can reduce MIP-1α, MIP-2 in serum and prostate fluid of patients with chronic none bacterial prostatitis, and improve the pelvic pain, dysuria, sexual dysfunction and other symptoms, and has less adverse reaction.

BACKGROUND:Studies have shown that polyethylene polymer-synthesized ureteral stents have good biocompatibility in vivo, but the side effects are found to induce the body to produce inflammatory, pyrogenic, and al ergic reactions. Therefore, studies have mainly aimed to explore the biocompatibility, toxic and side effects, inflammation of newly developed ureteral stents synthesized by L-lactic acid, glycolide, and barium sulfate. OBJECTIVE:Based on the biocompatibility comparisons on cel toxicity test, inflammatory reaction, al ergic reaction, pyrogen reaction and mortality after implantation between the usage of polyethylene material and L-lactic acid, glycolide, barium sulphate syntheses, to provide a better reference to introduce a new clinical ureteral stent material. METHODS:There were three groups in the experiment:blank control group, new material group, polyethylene group. Cel s were cultured in normal medium, leach liquid of L-lactic acid, glycolide, barium sulphate syntheses and leach liquid of polyethylene, respectively. RESULTS AND CONCLUSION:The toxic effects were significantly enhanced in the urethral epithelial cel s that grew in the leach liquids of two materials compared with the blank control group (P<0.05), but the two kinds of materials had no significant statistical difference in the toxicity test (P>0.05). Hematoxylin-eosin staining results showed that there were obvious inflammatory infiltrations in muscle tissue and the number of neutrophils and eosinophils were increased when the two kinds of materials were implanted in the rats for 2 and 6 weeks (P<0.05), but the inflammatory infiltration and tissue damage in the new material group was less than that in the polyethylene group (P<0.05). ELISA results showed that the serum concentrations of interleukin-10 and interleukin-23 were significantly increased when the two kinds of materials were implanted in the rats for 6 weeks (P<0.05), but the content of inflammatory cytokines in the new material group was less than that in the polyethylene group (P<0.05). In the new material group, there was only one rat that developed al ergic reaction and there was no pyrogen reaction or death;however, in the polyethylene group, there were three rats with presence of al ergic reaction and one rat with pyrogen reaction but no death. These findings indicate that the new ureteral stent material synthesized with L-lactic acid, glycolide and barium sulphate can reduce inflammation reactions, al ergic reactions and pyrogen reactions to the body, and has better biocompatibility than polyethylene composite material.

Objective To investigate the change and implication of plasma osteopontin (OPN) levels in renal allograft rejection.Methods The clinical data and biological samples of 46 renal transplant recipients were analyzed rerrospecnvely,including 16 patiens with stable allograft function and no evidence of biopsy-proved rejection (Non-R),22 patients with biopsy-proved acute cellular rejection (ACR),and 8 paients with biopsy-proved chronic allograft nephropathy (CAN).Six living related donors served as healthy controls (HC).Plasma OPN level was determined by using the human OPN ELISA kit.Type and grade of ACR were diagnosed based on Banff 03 classification criteria of renal allograft pathology.The plasma OPN levels were compared among different groups.The assistant diagnostic value of plasma OPN levels in differentiating rejection patients were also evaloated.Results The plasma OPN level in HC,Non-R,CAN and ACR groups was ( 12.23 ±5.95),(19.38±8.23),(27.77± 12.27) and (41.84± 18.51) μg/L,respectively.There was no significant difference in plasma OPN levels among HC,Non-R and CAN groups (P＞0.05),but the OPN levels in ACR group were decreased significantly as compared with Non-R and CAN groups (P＜0.05 ).OPN levels were positively correlated with Banff grading of ACR (P＜0.05).OPN levels were significantly different between grade Ia and grade IIb (P＜0.05).Conclusion The change in plasma OPN level has a relationship with acute rejection.Besides,the plasma OPN levels were also positively correlated with the severity of ACR.Monitoring plasma OPN levels should be useful in predicting and evaluating the severity of ACR in renal transplant recipients.

Objective To reassess the treatment of Bosniak category Ⅱ-Ⅲ renal cyst.Methods Sixty-eight cases of Bosniak category Ⅱ-Ⅲ renal cyst were operated from 2005 to 2008 in our institute.The average patient age was 40 years with the average renal cyst diameter of 5.1 cm.There were 37 left lesions and 31 right lesions with 31 cases of category Ⅱ (including 13 cases of category Ⅱ F) and 37 cases of category Ⅲ.Renal unroofing were performed in 49 cases with 9 cases found malignant and followed by radical nephrectomy,19 cases were diagnosed as malignancy preoperatively and nephron sparing surgery or radical nephrectomy were performed in these cases.Results Malignant lesions were found in 21 cases and benign lesions were found in 47 cases.The malignant rate was 9.7％ in category Ⅱ (15.4％ in category Ⅱ F),48.6％ in category Ⅲ.Nine cases were diagnosed benign preoperatively but confirmed malignancy after operation; 7 cases were diagnosed malignancy preoperatively but confirmed benign after operation.Forty-two cases were followed up for 8-65 months with 15 cases of malignancy and 27 cases of benign lesions.The recurrence of renal cyst occurred in 6 cases of benign lesions and recurrence and metastasis occurred in 3 cases of malignancy in 1-5 years.Conclusions It is difficult to draw a therapeutic principle for Bosniak category Ⅱ-Ⅲ renal cyst because of the uncertainty of the lesion.Partial nephrectomy or renal cystectomy is a good choice in the treatment of Bosniak category Ⅱ-Ⅲ renal cysts.

Objective To investigate the effects of postoperative adjuvant chemotherapy (CT) and chemoradiotherapy (CRT) or radiotherapy(RT) for Ⅰ b-Ⅱ a cervical cancer with risk factors.Methods From March 1995 to June 2010,there were 137 patients underwent radical hysterectomy and systematic pelvic lymphadenectomy for stage Ⅰ b-Ⅱ a cervical cancer admitted at Peking University First Hospital.These patients had risk factors,intermediate risk factors including bulky tumor (＞4 cm),lymph vascular space invasion,deep stromal invasion; high risk factors including positive surgical margin,parametrial invasion,lymph node involvement.Of the all patients,79 cases of them were treated with CT,58 of them were treated with RT or CRT.The 5-year survival and prognosis factors were analyzed retrospectively,the prognosis was compared between two adjuvant therapy groups.Results The univariate analysis shown that types of pathology,different grade of risk factors,stroma invasion and lymph node involvement were prognostic factors of 5-year overall survival Patients with squamous cell carcinoma,intermediate risk factors,no parametrial invasion,and no lymph node involvement had better prognosis (P ＜ 0.05).Whether patients with high-risk factors or intermediate-risk factors,the 5-year overall survival and 3-year disease-free survival had no difference between CT and RCT or RT groups respectively.Cox regression multivariate analysis of survival indicated that clinical stages,types of histology,different grade of risk factors were independent prognostic indicator.Patients with early stage,squamous cell carcinoma,intermediate risk factors had better prognosis.Univariate and multivariate analysis indicated that different postoperative adjuvant therapies had no effects on the prognosis.The 5-year overall survival was 88.6％ in patients treated with CT,and 89.7％ in patients treated with RT or CRT (P =0.455).Conclusion There are equivalent therapeutic results between CT and RT or CRT for patients with risk factors after radical surgery,CT may be as one choice of postoperative adjuvant therapy for stage Ⅰ b-Ⅱ a cervical carcinoma with risk factors.

Objective To compare the perioperative outcomes of robot-assisted partial nephrectomy (RAPN) with transperitoneal laparoscopic partial nephrectomy (LPN).Methods From July 2009 to March 2013,114 patients were treated in our hospital due to renal carcinoma,including RAPN in 45 patients and LPN in 69 patients.Their data were retrospectively reviewed.Clinical and pathological variables,R.E.N.A.L nephrometry score,operation time (OT),warm ischemia time (WIT),estimated blood loss (EBL),drainage volume,the length of hospitalization,estimated glomerular filtration rate (eGFR) outcomes,and complications were analyzed.Results There were no significant differences between the RAPN and LPN group with respect to patient age,sex,tumor laterality,size,R.E.N.A.L nephrometry score,the rate of hilar tumor and preoperative eGFR (P＞0.05).The median OT was shorter in the RAPN group than that in LPN group (165 min vs.196 min,P＜0.05).The median WIT was shorter in the RAPN than that in LPN group (21 min vs.25 min,P＜0.05).However,there were no significant differences in the postoperative eGFR and changing of eGFR within the 2 groups (P＞0.05).The rate of transfusion was similar between the RAPN (2/45) and LPN (4/69) group (P=0.72).There was also no significant difference in EBL (P=0.16).The drainage volume was also similar within two groups (167 ml vs.163 ml,P=0.81).The length of hospitalization was more favorable in the RAPN group (6.5 d vs.8.0 d,P=0.01).In RAPN group,27 cases were clear-cell carcinoma,5 cases were papillary cell carcinoma,2 cases were chromophobe cell carcinoma and 1 1 cases were angioleiomyolipoma.In LPN group,45 cases were clear-cell carcinoma,9 cases were papillary cell carcinoma,3 cases were chromophobe cell carcinoma and 12 cases were angioleiomyolipoma.There was no difference of pathological types between LPN and RAPN groups (P＞0.05).The rate of positive surgical margins was 0％ (0/45) in RAPN group and 1.4％ (1/69) in LPN group (P=0.69).The rates of complication requiring intervention (Clavien grade Ⅲ) were 2.2％ (1/45) and 2.9％ (2/69) in the RAPN and LPN group,respectively (P＞0.05).Median follow up was 12 (4-36) months in the RAPN and 13 (5-34) months in the LPN group.No local recurrence or metastasis occurred in two groups.Conclusions Early comparative outcomes suggest that RAPN has a significant benefit over the LPN in terms of OT,WIT and hospital stay.Meanwhile,it offers equivalent prognosis and postoperative renal function preservation compared with LPN.

Objective The purpose of this study is to assess the value of multi-slice spiral CT(MSCT)in the preoperative evaluation of living renal donor as a all in one modality.Methods Thirty-six potential living renal donors underwent the examination using a GE light VCT scanner.Informed consent was obtained from all participants.The plain scan,early arterial phase,late arterial phase and excretory phase scans are performed in the former 25 donors(injection rate 5 ml/s,total volume 100 ml,tube tension 120 kV).While in the later 11 donors(2 ml/s 40 ml+4 ml/s 60 ml),the scanning protocol included the plain scan(100 kV),vascular phase and excretory phase scans(100 kV).The excretory phase data were used in the reconstruction of CT urography in both groups.All images were reviewed by one radiologist and one urologist,and the findings of MSCT were compared with intraoperative findings for 33 donors,to investigate the utilities of MSCT in assessing renal vascularity,urinary tract and lesions of renal parenchyma.When discrepancies are found between the two reviewers,consensus was obtained via discussion.Au data was statiscally processed with SPSS for Windows.Results MSCT angiography is in accordance with intraoperative findings in demonstrating the anatomy of renal arteries and renal vein trunk,accesary arteries,early branching of renal artery.The findings from CTA are highly in accordance with the intraoperative findings,which facilitate intraoperative ligation and reduce relevant complications.CTU demonstrates the anatomy of urinary tract in good agreement with the intraoperative findings.The image quality of 3D vascularity and CTU between the two groups.scored 4.4±1.2 vs 4.2±1.3 and 4.6±0.8 vs 4.4±0.9 respectively,no statistical between-groups difference was found(Z=-0.89,-0.47,P＞0.05).Conclusion MSCT multiphase scanning combined with CTA and CTU play a important role in the evaluation of living renal donor,which preoperatively provide detailed information of renal vascularity,urinary tract and renal parenchyma as a all-in-one modality.