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 investigate the clinical effects of tube flushing in donor duodenum to prevent the hematuria post combined pancreas-kidney transplantation(SPK)with pancreatic fluid drainage through bladder.Methods 18 cases of diabetic patients associated with end-stage renal disease were subjected to combined pancreas-kidney transplantation with pancreatic fluid drainage through bladder,within which 12 cases were pre-placed douche tube in donor duodenum,while the other six were not.As for the cases in group with the tube,T tube of No.10 was put in the donor duodenum through the abdominal wall and then bladder.After that the tube was fixed using 5-0 absorbable suture,then the bladder sutured if the tube was smooth confirmed by flushing with saline.After the operation,flushing was maintained using saline consecutively with the speed of 500 ml/h through the douche tubes of these 12 patients.Then the speed was changed to 250 ml/h 3 days later if the flushing fluid was limpid.One week later,changed to rinse intermittently and prolonged the flushing interval gradually.Till 14 days post the operation,flushing was ceased.After 2 days' survey,the urethral catheter was removed.As for the other 6 cases without douche tube,the urethral catheter was removed during 7-10 days after the operation if hematuria didn't occur.Results In the 12 cases with douche tube,there was only one patient(8.3 %,1/12)having slight hematuria on the 7th day after the cessation of the bladder washout.Through strengthening the flushing,the hematuria disappeared.The urethral catheter was removed on the 14th day after the operation and the hematuria never happened again.In the group without the douche tube,4 cases(66.7 %,4/6)had serious hematuria complicated with bladder obturation.The incidence of that was obviously higher than in the group with the douche tube(P＜0.05).Only one patient(1/12,8.3%)in the group of regular insertion of douche tube had urinary system infection,but in the group without the tube,the incidence of urinary system infection was 66.7 %(4/6)(P＜0.05).Conclusion The tube flushing in donor duodenum can significantly reduce the occurrence of hematuria after combined pancreas-kidney transplantation with pancreatic fluid drainage through bladder.

Objective To investigate the impact of detrusor hyperactivity with impaired contractile function(DHIC)on voiding function in benign prostatic hyperplasia(BPH).Methods68 patients with BPH accepted the test of urodynamics.The urodynamic parameters between DHIC group and no DHIC group were compared statistically.ResultsThe residual urine in DHIC group was larger and the detrusor pressure at Qmax,the bladder volume were smaller than that in no DHIC group(P<0.01).ConclusionDHIC worsens the voiding function of the patients with BPH,and the test of urodynamic is helpful to diagnose and to treat it.

Tet (ten-eleven translocation) proteins belong to α-ketoglutaric acid (α-KG or 2-OG) and Fe2+ dependent dioxygenases. Tets are found to be involved in the unique mammalian DNA active demethylation process by specifically oxidizing the methyl group of 5-methylcytosine (5mC) in mammalian genome, and play critical roles in gene regulation in early embryonic development and stem cell differentiation via regulating the dynamic balance distribution of 5mC. Abnormal expression and function of Tets are closely associated with various hematological malignances, including myelodysplastic syndrome, chronic myelomonocytic leukemia, and acute lymphoblastic leukemia, as well as solid tumors. Hence, Tets and Tets-mediated DNA demethylation are novel anti-tumor drug targets. Investigation of biological function and catalytic mechanism of Tets is helpful for further understanding mechanisms of tumor incidence and development relevant to DNA demethylation pathway and can provide reference for developing new anti-tumor targeted drugs.

AIM:To explore the supportive and expansive effects of aorta-gonad-mesonephros(AGM) region derived stromal cells on hematopoietic stem cells(HSC) in vitro.METHODS:The murine stromal cells were separated and cultured from AGM region of a 11 day postcoitum(dpc) mouse embryo and 6 week mouse.After identification by Wright's staining and flow cytometry,the stromal cells were co-cultured with the embryonic stem cell(ESC)-derived,cytokine-induced HSCs,and the maintenance and expansion of HSCs were evaluated by detecting CD34+,CD34+Sca-1+cells with flow cytometry.Blast colony-forming cell(BL-CFC) and high proliferative potential colony-forming cells(HPP-CFC) were determined by semi-solid medium clonal culture.RESULTS:AGM-derived and bone marrow(BM)-derived stromal cells were similar in morphology and phenotype,and had common character of stromal cells.Supported by AGM stromal cells or by BM stromal cells,more primitive progenitor cells HPP-CFC were expanded,but BL-CFC expansion was only detected in AGM-derived stromal cells.In the supporting of BM stromal cells CD34+ hematopoietic stem/progenitor cells were expanded 3-4 times,but no significant expansion in CD34+Sca-1+ cells was observed.While in the supporting of AGM stromal cells,both CD34+ hematopoietic stem/progenitor cells and CD34+Sca-1+ cells were expanded significantly from 4 to 5 times,respectively(P

Objective To investigate the relationship between HLA antibodies strength and complement-binding ability in sensitized renal patients waiting for renal transplantation.Method Serum samples of 31 sensitized renal patients waiting for renal transplantation were retrospectively analyzed by single-antigen bead array (SAB) to identify HLA antibodies and in parallel by C1q-SAB to determine the complement binding of HLA antibodies.Result C1q-positive HLA antibodies had significantly higher MFI than C1q-negative HLA antibody (for Class Ⅰ,11052 ± 3291 vs.4506 ± 2960,P＜0.05;for Class Ⅱ,13347 ± 4076 vs.4448 ± 3602,P＜0.05).The mean fluorescence intensities (MFI) of IgG-SAB were correlated with the MFI of C1q-SAB for the same antibodies (Spearman correlation; Class Ⅰ,r =0.665,P ＜ 0.01 ; Class Ⅱ,r =0.761,P ＜ 0.01).Receiver operating characteristics (ROC) curve analysis showed that the MFIs of HLA antibodies by IgG-SAB could predict their C1q-binding abilities [area under the curve (AUC)Class Ⅰ =0.917; AUCclass Ⅱ =0.927).Using MFI cut-off value of 8238 and 6754 for HLA Class Ⅰ and Class Ⅱ antibodies,respectively,the sensitivity and specificity for C1q binding were 82.4％ and 87.4％ for Class Ⅰ antibodies,and 90.9％ and 82％ for Class Ⅱ antibodies,respectively.Conclusion The MFI of HLA antibodies by IgG-SAB can predict the C1q binding capability at a certain extent before transplantation.

ObjectiveTo explore the relationship between the impairment cognitive function and the location and number of infarcts.MethodsThe composites the scores for memory,processing speed and executive function were detected using the neuropsychological measuring scales and determined the cortical,subcortical and cerebral infarcts by magnetic resonance imaging( MRI),then analyzed the relationship between the impairment cognitive function and the location and number of infarcts.ResultsCompared to the control group,the patients with infarcts in multiple locations had poorer memory(the score of AVLT-5 was 6.14 ± 1.89 and 7.26 ± 1.82,respectively,P ＜ 0.01 ).Compared to the patients without infarcts,a combination of cortical and subcortical infarcts was associated with slow processing speed.The patients with multiple infarcts in multiple locations had significantly lower composites scores for memory(the score of LMT-delay was 10.86 ± 3.48 and 12.69 ± 2.60,respectively,P＜ 0.01 ),processing speed ( the score of SDMT was 27.08 ± 11.13 and 34.23 ± 7.44,respectively,P ＜ 0.01 ) and executive function( the score of TMT-B was 1.34 ± 0.65 and 0.40 ± 0.35,respectively,P ＜ 0.01 ) compared to control group.ConclusionThe multiple infarcts in multiple locations is associated with the impairment cognitive function in patients with cerebral infarcts.Suggesting that both the location and the number of infarcts jointly contribute to cognition impairment.

A descriptive study to investigate the situation of cross-cultural adaptation and health status among medical international students was carried out using cluster sampling method and self-designed questionnaire in Dalian Medical University.148 international students come from 24 countries.There are 5 religions belief among these students.Islam,Catholic,Hindu,Buddhism and Sikhism.The main obstacles of cross-cultural adaptation are language,accommodation and diet.Economic status and stress of interpersonal relationship are also the main causes affecting the physical and mental health of medical international students.

OBJECTIVE To survey the distribution of class Ⅰ integron in extended-spectrum beta-lactamases(ESBLs)-producing Escherichia coli and Klebsiella pneumoniae and its contribution in horizontal transfer of ESBLs genes.METHODS The presence of class Ⅰ integron among 230 ESBLs-producers and 197 non-ESBLs-producers of E.coli and K.pneumoniae were detected by PCR.The correlation and co-transfer between integron and genes coding for SHV,CTX and TEM were studied. RESULTS One hundred and thirty-seven(59.6%) isolates were positive for intⅠ gene among ESBLs-producers,contrasted to 48(24.4%) in non-ESBLs-producers(P

OBJECTIVE To determine the drug resistance phenotype and genotype of plasmid-mediated AmpC ?-lactamase in Klebsiella pneumoniae isolated from Harbin.METHODS Isolates of K.pneumoniae with an inhibition ring to cefoxitin of ≤18 mm diameter were used.Antimicrobial susceptibilities were determined by disc diffusion method.AmpC genes were detected by PCR with six pairs of primers.RESULTS Sixty-three isolates had an inhibition ring to cefoxitin of ≤18 mm diameter and 26(11.3%)were detected to be AmpC-producing in a total of 231 clinical isolates of K.pneumoniae.Seventy-six percent,70.2%,53.8%,50.5%,57.7%,38.5% and 7.7% of AmpC-producers were resistant to cefoxitin,cefotaxime,ceftazidime,amoxicillin/clavulanic cid,ciprofloxacin,amikacin and imipenem,respectively.ACT,DHA and CIT types of AmpC beta-lactamase were detected in 13,8 and 5 isolates,respectively.No ACC,MOX and FOX were detected.CONCLUSIONS The AmpC ?-lactamase in Harbin is mainly in the types of ACT,DHA and CIT.AmpC-producing K.pneumoniae shows decreased susceptibilities to cefoxitin and third generation cephalosporins.