Objective To sum up the experience of renal transplantation in order to improve transplant effect and enhance the long-term survival and recovery rate.Methods The data of renal transplantation of 1 124 cases who received renal transplantation from Jul. 1978 to Oct. 2001 were summarized. All the possible factors that could influence the transplant effect such as pre-operative preparation, HLA match, donors' quality, surgical procedure, immunosuppressive therapy and so on were analyzed. Results The 1-, 3-, 5-year survival rate (%) of patient/kidney was 83.1/ 70.3, 74.6/ 68.6 and 62.6/ 56.1 respectively. The rate of AR was decreased significantly from 3.09?% only with LXM to 0.89?% with LXM test in combination with HLA serological test. The rate of HAR and AR in 130 cases with additional PRA test were lower than those only with LXM test.Conclusions The well pre-operative preparation, the ideal HLA match, the high quality of donor's kidney and transplant operation were keys for successful renal transplantation. Reduction of the complications, individual and combined medication in reason and long-term follow-up were very important in the long-term survival time.

Cerebral Hemorrhage ; etiology ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage

Acupuncture Therapy ; Adult ; Aged ; Bloodletting ; Combined Modality Therapy ; Crying ; Female ; Humans ; Laughter ; Male ; Middle Aged ; Stroke ; psychology ; therapy ; Treatment Outcome

Objective To study the impact of pregnancy on differentiated thyroid cancer. Methods Retrospective comparative analysis were made between pregnancy-related thyroid cancer patients ( including nine months before delivery and one year after delivery) and the age-matched non-pregnancy-related thyroid cancer patients treated in the Department of head and neck, Fudan University Shanghai Cancer Center. Results There were 125 cases of pregnancy-related thyroid cancer patients from 1998 to 2008, including 28 cases (22.4%) of neck recurrence and metastasis after the surgery of thyroid cancer, meanwhile there were 691 cases of the agematched non-pregnancy thyroid cancer patients, including 90 cases ( 13% ) of neck recurrence and metastasis after the surgery of thyroid cancer. The rate of neck recurrence and metastasis after the surgery of thyroid cancer in the pregnancy-related group was higher than that in the non-pregnancy related group ( P ＜ 0.05). The maximum diameter of tumor in the pregnancy-related group and the non-pregnancy group is 2. 1 cm and 2.6cm respectively.There were 19 cases of multi-focal cancer ( 19.6% ) in the pregnancy-related group and 58 cases (9. 6% ) in the non-pregnant group, P ＜0.05. There were 23 patients (23.7%) of extrathyroid invasion in the pregnancy-related group and 65 patients ( 10.8% ) in the non-pregnant group, P ＜0.05. There were 67 cases (53.6%) and 35 cases (28%) of the central and lateral cervical lymph node metastasis in the pregnancy-related group respectively and 296 cases (42.8%) and 117 cases (16. 9% )in the non-pregnant group, P ＜0.05. There were 19 cases (15.2%) of extralymph invasion in the pregnancy-related group and 32 cases (4.6%) in the non-pregnant group, P ＜ 0.05. Conclusions The incidence of Extrathyroid invasion, multi-focal cancer, cervieal lymph node metastasis and extralymph invasion of the differentiated thyroid cancer is higher in pregnancy-related patients.Pregnancy may deteriorate the prognosis of thyroid cancer. For patients after the surgery of thyroid cancer, pregnancy may increase the risk of neck recurrence and metastasis. However, pregnancy does not affect the stage of thyroid cancer and the prognosis is still good.

Objective To investigate the effects of cardiopulmonary bypass (CPB) with mild hypothermia on the pharmacodynamics of rocuronium in infants undergoing cardiac surgery.Methods Fifty ASA Ⅰ or Ⅱ and NYHA class Ⅰ or Ⅱ infants,aged 6 months-3 yr,weighing6-15 kg,undergoing repair ofventricular septal defect or atrial septal defect under CPB,were randomly divided into 2 groups ( n =25 each):profound hypothermia group and mild hypothermia group.The target temperature was controlled at 28-30 ℃ during CPB in profound hypothermia group,and at 32-34 ℃ during CPB in mild hypothermia group.Neuromuscular block was assessed by TOF-stimulation of ulnar nerve using with TOF-Watch accelerometer.Anesthesia was induced with midazolam O.1 mg/kg,propofol 2 mg/kg,fentanyl 6-8 μg/kg and rocuronium 600 μg/kg,and maintained with intermittent iv boluses of fentanyl and midazolam.The patients was tracheal intubated and mechanically venti1ated when the maximal depression of T1 was achieved.PETCO2 was maintained at 30-40 mm Hg.When T1 returned to 75％ of the control twitch,rocuronium 200 μg/kg was injected intravenously.The onset time,maximal N-M block time,clinical muscle relaxation time,and recovery index were recorded before CPB,during CPB and after CPB.Results Compared with profound hypothermia group,the onset time,maximal N-M block time and clinical muscle relaxation time were significantly shortened during CBP in mild hypothermia group ( P ＜ 0.05).Conclusion Compared with profound hypothermic CBP,mild hypothermic CBP can shorten the onset time and muscle relaxation time of rocuronium in infants undergoing cardiac surgery.

Objective To investigate the activity changes of gelatinase in the formation of ascending aortic aneurysm.Methods Thirty five young Wistar rats were divided into two groups:the control group and the experiment group.The rat models induced by ascending aorta banding were made.The ascending aortas were taken after 3-5 months operation,changes of gelatinase activity was observed by gelatin zymography and film in situ zymography.Results Gelatinase activity of ascending aortic aneurysm was significantly increased compared with that of normal ascending aortic aorta.Conclusion Elevation of gelatinase activity may play a significant role in the formation of ascending aortic aneurysm.

The expressions of hepatocyte growth factor (HGF) and its receptor (c-Met) protein were examined by immunohistochemistry in benign and malignant thyroid neoplasms.The results showed that the positive rates of HGF and c-Met protein expressions in thyroid carcinomas were significantly higher than those of thyroid adenomas,and especially the expressions of HGF and c-Met proteins in follicular thyroid carcinomas were significantly higher than those in follicular thyroid adenomas.There existed significantly positive correlation between the expression degrees of HGF and c-Met in follicular thyroid carcinoma.Thus,the expressions of HGF and c-Met may be valuable in predicting prognosis of thyroid carcinomas and differentiating benign from malignant thyroid neoplasms.

Muscle recently has been identified as a good source of adult stem cells that can differentiate into cells of different lineages.Researchers have identified two types of stem cells in skeletal muscle.Further research is necessary to delineate the relationship between different populations of musclederived stem cells(MDSCs)and between MDSCs and other adult stem cells.The methods used to isolate these cells appear to influence the stem cell characteristics.As these efforts continue,the potential for MDSCsbased therapy for other musculoskeletal injuries,as well as for cardiac and smooth muscle injuries,is currently being explored.The behavior,biocharacteristic,isolation,differentiation and the probability of application to regenerate lost or diseased tissue of MDSCs were summarized.

Objective　To explore the effect of hypoxia on the apoptosis of cultured human umbilical vein endothelial cells（HUVECs） and the role of vascular endothelial growth factor（VEGF） in inhibition of apoptosis． Methods　①Culture and identification of HUVECs．②Establishment of hypoxic model（0，12，24，48 h）in HUVECs．③Incubation of HUVECs with VEGF(0 ng, 100 ng) under hypoxic condition for 24 h. ④Detection of apoptosis of HUVECs with TUNEL method． Results　The percentages of apoptosis were different under different hypoxic conditions． The longer hypoxic time was，the higher apoptosis percentage was．VEGF reduced the apoptosis of HUVECs induced by hepoxia． Conclusion　Over-apoptosis EVCs in one of the important factors for the impairment of endothelial function. HEGF inhibits the apoptosis of HVCs and having a pretive function on them.

Objective To retrospectively analyze the diagnostic value of a noninvasive score system based on transient elastography (TE),serological test and imaging examination on esophageal variceal bleeding (EVB) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between April 2011 and December 2012,172 patients with HBV-related cirrhosis including 120 males and 52 females who visited clinic or hospitalized at the Department of Hepatology,Tianjin Third Central Hospital,were retrospectively enrolled.The mean age was (52.9 ± 10.6) years.Patients underwent upper gastrointestinal endoscopy to evaluate esophageal varices (EV) and were further categorized into three stages of mild,moderate and severe according to the morphology of EV and the risk of bleeding.Liver stiffness and spleen stiffness measurement were performed using Fibroscan.Portal vein width,splenic width and spleen thickness were measured using color Doppler ultrasound.All the patients were tested for white blood cell counts and platelet counts.With endoscopy as the gold standard,receiver operating characteristic (ROC) curves and the areas under curves (AUC) were used to assess the performance of the noninvasive score system in predicting EV by liver stiffness,spleen stiffness,portal vein width,spleen thickness and platelet counts.Student's t-test was performed to determine differences between continuous variables.Pearson's correlation was used to evaluate the association between EVB and these parameters.Results All these 172 patients underwent endoscopy.Among them,41 were EVB patients and 131 with no bleeding of EV.Among 172 EV patients,39 without EV,30 were mild EV,47 were moderate EV and 56 were severe EV.EVB was all positively correlated with liver and spleen stiffness,portal vein width,spleen thickness,splenic vein width (r=0.224,0.771,0.214,0.425 and 0.364,respectively; all P＜0.05).EVB was negatively correlated with platelet counts (r=-0.408,P=0.000).Liver stiffness,spleen stiffness,portal vein width,spleen thickness and splenic vein width in EVB patients were significantly higher than those in EV patients (P＜0.05).In contrast,platelet counts level was lower in EVB patients with difference of statistical significance (P＜0.05).AUC of non-invasive score system for EV and EVB were 0.953 and 0.882,respectively (P＜0.05).The optimal cut-off level of noninvasive score system for prediction of EV and EBV were 7 (sensitivity:96 ％,specificity:85 ％) in EV patients and 10 (sensitivity:78％,specificity:89 ％) in EVB patients.Conclusion Non-invasive score system based on liver stiffness,spleen stiffness,spleen thickness,width of splenic and portal vein and platelet counts is of clinical importance in assessing the presence of EV in patients with HBV-related cirrhosis,which is higher clinically valuable in the diagnosis for EV.