Objective To explore the effect of MICA-Ab expression on the prognosis of sensitized renal transplantation recipients.Methods A total of 51 sensitized recipients (PRA more than 20%) in our hospital from August 2007 to April 2010 were enrolled in the study.In these patients,29 cases received protein A immunoadsorption and detection of MICA-Ab was performed before and after protein A immunoadsorption.Other 22 patients received MICA-Ab detection when they were hospitalized.Associations of PRA,HLA-matches,acute rejection,and serum creatinine of postoperative week 1 and week 4 with MICA-Ab were analyzed retrospectively.Results Sixteen recipients (31.4%) had positive MICA-Ab expression but their acute rejection rate was not higher as compared to the patients with negative MICA-Ab expression.Recipients with PRA＞40% showed higher expression level of MICA-Ab than recipients with PRA≤40% (P≤0.05).HLA-match did not show influence on MICA-Ab expression.MICA-Ab positive group had no higher serum creatinine level than negative group in postoperative week 4.MICA-Ab level decreased significantly after protein A immunoadsorption.Conclusions MICA-Ab expression increases in the sensitive recipients but does not influence the prognosis.Protein Aimmunoadsorption can eliminate MICA-Ab effectively in sensitized recipients.

Objective To investigate the preventive effect of the artificial nerve canal on irritating neuralgia after neurilemmoma resection.Methods Thirty patients diagnosed as neurilemmoma were divided into artificial nerve group and control group at randomly.There were 15 patients in each group.The nerves in artificial nerve group were enclosed using the artificial nerve besides neurilemmoma resection.The nerves in control group only had neurilemmoma resection.All patients were assessed with VAS for the degree of irritating neuralgia at 3 time points after operation.Calculate the incidence of irritating neuralgia and analyze the data using statistical methods.Results In control group,the VAS scores were 7.5,5.1,2.8,and the incidences of irritating neuralgia were 80％,67％,40％,respectively.In artificial nerve group,the VAS scores were 3.2,1.5,0,and the incidences of irritating neuralgia were 33％,13％,0.The VAS scores and the incidences of irritating neuralgia of two groups had significant difference by statistical analysis (P ＜ 0.05).Conclusion The artificial nerve canal can relieve the degree and decrease the incidence of irritating neuralgia after neurilemmoma resection,which is a useful method to prevent irritating neuralgia in clinic.

Objective To explore the expression of anti-MICA antibodies and evaluate its influence on acute rejection and renal function in early period after renal transplantation. Methods A total of 29 sensitized subjects (PRA＞20 %) were enrolled in this study. All the patients underwent protein A immunoabsorption treatment and the expression of anti-MICA antibodies was detected before and after treatment. Triple immunosuppressive regimen consisting of tacrolimus, mycophenolate mofetil (MMF) and steroid was given to prevent graft rejection. The correlation between the expression of anti-MICA antibodies and acute rejection or serum creatinine (SCr) level was analyzed.Results The expression of anti-MICA antibodies was detected in 8 candidates (27. 6 % ,8/29) ,and 6 kinds of anti-MICA antibodies simultaneously expressed were found in one individual, 3 kinds in one case,and sole kind in 6 patients. There was no significant difference in acute rejection rate between positive anti-MICA antibodies group and negative group [37.5 % (3/8) vs 38. 1% (8/21), P＞0.05). The positive expression rate of anti-MICA antibodies in the recipients with PRA ≥40% was higher than that in those with PRA ＜40% [43. 8 % (7/16) vs 7. 7 % (1/13),P＜0.05]. The SCr level in patients positive for anti-MICA antibodies was markedly higher than that in those negative anti-MICA antibodies at the 1st week postoperatively ( 135.4 ± 21.4 vs 108. 6 -+ 31.6 μmol/L, P＜0.05). The SCr level in the patients with positive anti-MICA antibodies, however, was reduced to the normal range at the 2nd week after surgery (P＞0.05). The levels of anti-MICA antibodies were continuously decreased in the candidates undergoing protein A irnmunoadsorption treatment. Conclusion Higher expression of anti-MICA antibodies exists in sensitized recipients and possesses an influence on the recovery of renal function in early postoperative period. Protein A immunoadsorption can eliminate anti-MICA antibodies effectively in sensitized recipients.

OBJECTIVE: To discuss the efficacy and safety of simultaneous bilateral endoscopic surgery (SBES) for bilateral upper urinary tract calculi, and to summarize the initial experience. METHODS: Patients diagnosed with bilateral upper urinary tract calculi who underwent SBES in the Department of Urology, Beijing Chao-Yang Hospital from January 2019 to January 2020 were enrolled retrospectively. The demographic and clinical data of the patients were recorded, and the operation status, stone free rate (SFR) and peri-operative complications were analyzed. The primary end point was SFR, and second end point was peri-operative complications. RESULTS: A total of 23 patients underwent SBES, of which SBES was completed in 19 patients (12 males, and 7 females). The mean age was (41.3±12.0) years. Fourteen patients underwent modified supine position surgery and 4 patients in prone split-leg position. There was no statistical difference in the demographic and baseline clinical data of the patients in different positions. One patient underwent right percutaneous nephrolithotomy (PCNL) and left endoscopic combined intra-renal surgery (ECIRS) in the prone split-leg position, while 18 patients received simul-taneous surgery with PCNL and contralateral retrograde intra-renal surgery (RIRS). The mean anesthesia and operation time was (128.7±26.5) min and (70.7±20.3) min, respectively, which was significantly longer in the patients with prone split-leg position than in the patients with modified supine position, anesthesia time in the patients with prone split-leg position and modified supine position: (148.4±20.4) min vs. (121.6±25.3) min, respectively, t=－2.121, P=0.049, while the operation time in the patients with prone split-leg position and modified supine position: (86.4±21.1) min vs. (65.1±17.4) min, respectively, t=－2.222, P=0.040. There was no significant difference between the two groups in indwelling of nephrostomy [prone split-leg position and modified supine position: (2.6±0.9) d vs. (2.1±1.0) d, respectively; t=－0.880, P=0.391] and the length of hospital stay [prone split-leg position and modified supine position: (6.0±2.7) d vs. (5.2±1.8) d, respectively; t=－0.731, P=0.475]. One month after the operation, the SFR was 78.9%, and 3 patients had minor peri-operative complications (Clavien-Dindo grades Ⅰ/Ⅱ) without any serious complications (Clavien-Dindo grades Ⅲ/Ⅳ/Ⅴ). CONCLUSION The simultaneous bilateral endoscopic surgery would decrease the operation time and anesthesia exposure under the premise of ensuring the SFR, which is helpful to reduce the risk of peri-operative complications, especially to the patients who can not tolerate the second-stage or long-time operation.
Adult ; Calcinosis/surgery* ; Endoscopy ; Female ; Humans ; Kidney Calculi ; Male ; Middle Aged ; Nephrolithotomy, Percutaneous ; Nephrostomy, Percutaneous ; Retrospective Studies ; Treatment Outcome ; Urologic Diseases/surgery*

OBJECTIVE: To compare the outcomes of endoscopic combined ultrasound-guided access (EUGA) with the conventional ultrasound-guided access (UGA) to achieve percutaneous renal access in endoscopic combined intrarenal surgery (ECIRS). METHODS: A retrospective review of 53 patients undergoing ECIRS to treat upper urinary tract calculi between January 2017 and October 2019 was con-ducted. All of the cases were of complex upper urinary tract stones larger than 2 cm in diameter. The com-plex stone situations, such as multiple renal calyces calculi or staghorn calculi necessitated ECIRS. Under general anesthesia, the patients were placed in the galdakao-modified supine valdivia (GMSV) position, thus allowing both antegrade and retrograde accesss. The patients were divided to UGA and EUGA groups according to the protocol of achieving percutaneous renal access. In 28 cases, endoscopic combined ultrasound-guided accesss were obtained. Puncture and dilation were performed under direct flexible ureteroscopic visualization, while percutaneous renal access of 25 cases were performed with the conventional technique employing ultrasound guidance. Demographic and perioperative information, such as stone burden, presence of hydronephrosis and number of calyces involved was compared. Primary outcomes included total operative time, renal access time, repeat puncture, hemoglobin level, perioperative complications, and stone-free rate. RESULTS: No major intra-operative complication was recorded in all the 53 ECRIS. No significant difference was observed between the groups in age and gender. There was no significant difference in body mass index[BMI (29.21±3.14) kg/m² vs.(28.53±2.56) kg/m²], stone burden (37.68±6.89) mm vs. (35.53±6.52) mm, number of calyces involved 2.72±0.68 vs. 2.86±0.71, presence of hydronephrosis (56.0% vs. 46.4%), total operative time (93.0±12.2) min vs. (96.8±14.2) min, hemoglobin level reduction (6.56±2.16) g/L vs. 97.54±2.64) g/L, stone-free rate (92.0% vs. 92.8%), hospital stay (5.52±0.59) d vs. (5.64±0.62) d, perioperative complication rate (8.0% vs. 7.2%). Two patients in EUGA group experienced perioperative complications (one urinary tract infection and one hematuria) while two patients in UGA group experienced perioperative urinary tract infection. None in both groups received blood transfusion. The patients undergoing EUGA had shorter renal access time [(4.0±0.7) min vs. (6.8±2.6) min, P < 0.01] and less repeat puncture (0 vs. 4 cases, P < 0.05). CONCLUSION EUGA is an optimal technique to establish percutaneous renal access in ECIRS, which minimizes access time and repeated procedures.
Humans ; Kidney Calculi ; Nephrostomy, Percutaneous ; Retrospective Studies ; Treatment Outcome ; Ultrasonography, Interventional ; Ureteroscopy

ObjectiveGeneration of human induced pluripotent stem cells from human skin fibroblasts.MethodsSox2, Klf4, Oct4, c-Myc were transfected into HSF cells with retrovirus, and then HSF cells was reprogrammed to iPS cells.Detecting cells endogenous and exogenous gene, analyzing karyotype,cells alkaline phosphatase staining and immunofluorescence staining, differentiating into teratomas in vivo and embryoid bodies in vitro were performed.ResultsiPS cell morphology was similar to embryonic stem cells (ES).The expression of Nanog, Oct4, Rex1, Sox2 in iPS cells were higher than HSF cells, and Sox2, Klf4, Oct4, c-Myc were silenced for the iPS cells.Exogenous genes were inserted into the nucleus of iPS cells, which was confirmed by 1％ agarose gel electrophoresis.iPS cell karyotype was normal, alkaline phosphatase activity increased, ES cell-specific protein expressed.iPS cells were differentiated into a teratoma in vivo and embryoid bodies in vitro.ConclusionsiPS cells were similar to ES cells, which have pluripotency.

Heterogeneous nuclear ribonulcleoprotein(hnRNP)plays a variety of roles in pre-mRNA splicing, nuclear export of mRNA and turnover. It is reported that hnRNP not only takes part in regulating the development of neuron and glial cells, but is closely related to various central nervous system diseases. This paper reviewed the structure, function and the role of hnRNP in the central nervous system in order to provide new insight into the molecule mechanism of nervous system diseases.

Objective To determine whether intermittence irradiation of single blue or white light have an adverse effect on the DNA of newborn infants with hyperbilirubinemia by examining the sister chromatid exchange(SCE)frequency of peripheral blood lymphocytes.Methods The frequency of SCE in lymphocytes of 40 icteric infants treated by different phototherapy(PT) methods was a nalyzed by sister chromatid differetance staining technique (SCD).The patients receiving PT were divided into three groups according to two methods of PT,group A:single blue light,20 cases; group B:single white light,20 cases.Results 1.In group A, there was no difference between the levels of SCE before and after therapy within 3 days;but after 4 days, the levels of SCE increased.2.Obvious changes were observed in group B,and the frequency of SCE increased after 1 day and increased significantly in a dose-dependant manner.3.After treatment, the SCE frequency of group B was higher than that of group A.Conclusions PT has mutagenic effect on newborns with hyperbilirubinemia. The effect of single white light on peripheral blood lymphocytes of neonates is more significant.

Adult ; Aged ; Carcinoma, Basal Cell ; pathology ; Carcinoma, Papillary ; pathology ; Carcinoma, Squamous Cell ; pathology ; Female ; Humans ; Lacrimal Apparatus Diseases ; pathology ; Male ; Middle Aged ; Nasolacrimal Duct ; pathology ; Young Adult

Objective To compare clinical effect of gonadotropin releasing hormone agonist(GnRH-a) alone and GnRH-a combined with low-dose dydrogesteronea and estradiol valerate on sex hormone, hypoestrogenic symptoms, quality of life and bone mineral density (BMD)in treatment of endometriosis.Methods Seventy patients with moderate or severe endometriosis, who were diagnosed by laparotomy or laparoscopic surgery within two months, were randomly assigned into two groups.35 patients in GnRH-a group were treated by goserelin (3.6 mg)for three months, and 35 patients in add-back group were treated by goserelin (3.6 mg)combined with estradiol valerate 0.5 mg and dydrogesteronea 5 mg daily.Before and after the treatment, clinical parameters were recorded and analyzed, including visual analog scale (VAS), medical outcomes survey short form 36 (SF-36), Kupperman menopausal index(KMI), BMD, the serum level of follicle stimulating hormone (FSH), estradiol (E_2) and bone gla-protein (BGP) .The first menstruation and VAS were also followed up after treatment.Results Every 3 cases in two groups lost follow-up.(1)Reproductive hormone: the level of E_2 in add-back group [(94 ± 71) pmol/L]was significantly higher than (54±52) pmol/L in GnRH-a group(P <0.01).The level of FSH in add-back group [(3.0 ± 1.9) U/L]was significantly lower than (5.7 ± 2.9) U/L in GnRH-a group (P < 0.05).(2) VAS: after treatment, VAS in both group decreased significantly when compared with that before treatment(P < 0.05), and remained until menstruated.(3) KMI: KMI in add back-group (10 ± 8) was significantly lower than (14 ± 6) in GnRH-a group (P < 0.05).(4) BMD: compared with that before treatment, BMD decreased significantly after treatment in GnRH-a group (P < 0.05), no remarkable difference of BMD was observed before and after treatment in add-back group.Before treatment, serum BGP in both groups did not show statistical difference.After treatment, the level of BGP in GnRH-a group [(7932±5206) ng/L]was significantly higher than (5419±2917) ng/L in add-back group (P <0.05).Conclusions GnRH-a combined with estrogen-progesterone regimen could relieve pain from endometriosis as effectively as GnRH-a alone and reduce hypoestrogenic symptoms and bone loss.Therefore,it is a safe and effective treatment.