Objective To compare the early renal function recovery after kidney transplant from donation after cardiac death (DCD) and brain death (DBD).Methods The Medline (1950-2011),Embase and Cochrane library database were searched and supplemented by review of conference proceedings and publication bibliographies.All original single institution studies reporting outcomes for DCD and DBD kidney transplant recipients were considered.Odds ratios (OR) and 95％ confidence intervals (CI) based on random effects models were calculated.Results Nine publications,all cohort studies,involving 2049 DCD and 5498 DBD recipients,were included.DCD recipients had 7.24 times increased odds of DGF (OR=7.24,95％ CI =3.86-13.58),and 4.97 times increased odds of PNF (95％ CI =3.77-6.55).Conclusion DCD renal transplantation is associated with higher risks of DGF and PNF.

Graphene oxide (GO) modified stationary phase for open tubular capillary (3 m × 25 μm i. d. ) of liquid chromatography ( OT-CLC) was fabricated by coating GO sheets onto poly ( vinylbenzyl chloride-divinylbenzene) porous composite layer via covalent coupling, which was prepared by in-situ polymerization. Scanning electron microscopy ( SEM), Raman spectroscopy and transmission electron microscopy ( TEM) were used to characterize the structure of the stationary phase. The results demonstrated that poly(vinylbenzyl chloride-divinylbenzene) porous composite layer had decentralized globular structure, and the GO sheets covered on the porous layer homogenously. The phase ratio and sample capacity were greatly improved due to the spherical polymer layer and the coverage of GO. Thus, alkyl benzenes, neutral polycyclic aromatic hydrocarbons, acidic and basic compounds could be well separated by using acetonitrile-water as eluent, while four nucleobases were completely separated by using acetonitrile-0. 02 mol/ L ammonium acetate as mobile phase. The run-to-run, day-to-day, and column-to-column reproducibilities were evaluated by calculating the relative standard deviations (RSDs, n =6) of the retention time of o-phenylenediamine, aniline and 2, 4, 6-trifluoroaniline, respectively. These RSD values were all in the range of 0. 3% -2. 0% .

Objective Pancreas perfusion is an essential step in human islet isolation.To develop the new methods for introductal canulation,collagenase infusion and to observe their effects on islets isolation.Methods A total of 17 pancreases were digested from March 2005 to April 2010.The pancreases were distended by three methods:the standard method (n =3),the one-cannula method (n =11) and three-cannula method (n =3).In the standard group,the pancreases were completely cut into half at the mid-body.Two catheters were inserted into the main duct:one directed toward the tail and the other to the head.In the one-cannula method group,a long tube was inserted into the duct at the head,advancing to the tail In the three-cannula method group,pancreatic parenchyma was then minimally cut at the mid-body and three catheters were inserted into the main pancreatic duct:one at the head (the first catheter) and two at the mid-body,one toward the tail (the second catheter) and the other toward the head (the third catheter).The pancreases were digested by improved Ricordi technique.Ficoll continuous density/grads centrifuge method was performed to purify the islets.DTZ staining was adopted to identify islets and count islet equivalent (IEQ). AO/EB fluorescence examination was used to count active islet percentage.Static glucose stimulating test (SGS) in vitro was designed to estimate islet function and calculate SI.Results The distension volume of the threecannula method group was 1.24 rnl/g pancreas,and higher than the other groups (for the standard group:0.71 ml/g pancreas; for one-cannula method group:0.96 ml/g pancreas,P＜0.05).The yield of islet in the three-cannula method group and the one-cannula method group was 2514 and 2270 IEQ/g,which was significantly more than that in the standard group (1914 IEQ/g pancreas,P＜0.05).The purity and viability of the islets were 74 ％/79.3 ％,75.6 ％/79.4 ％ and 78.3 ％/84.0 ％ respectively in the three groups with the difference being not significant among the groups.SI in the one cannula method group (4.74) and the three-cannula method group (5.27) was significantly higher than that in the standard group (3.46).ConclusionThe three-cannula method improved collagenase infusion and the islet yields.

Objective To analyze the role of the introperative vessel Doppler sonographic evaluation of the hepatic artery and portal vein. Methods Intraoperative vessel Doppler sonograms of 116 patients were analyzed for peak systolic velocity of hepatic artery and blood flow of the portal vein.In patients having abnormal findings on sonography (peak systolic velocity of hepatic artery less than 30 cm/s, blood flow of the portal vein less than 800 ml/s), the vascular anastomoses were checked.Results Fourteen of 116 cases revealed less hepatic arterial peak systolic velocity than 30 cm/s. In 9 of the 14 cases, the hepatic arterial peak systolic velocity was normal after injection of 0. 5 % lidocaine into celic trunk root, and papaverine and 654-2 into artery, 3 of the 9 cases endured artery thrombosis. In the other 5 of the 14 cases, by-pass anastomoses were done, and the hepatic arterial peak systolic velocity was normal, and no hepatic arterial complication occurred. Five of 116 cases revealed less hepatic portal vein blood flow than 800 ml/rnin. 4 of the 5 cases revealed shunt between portal vein and vena cava. The blood flow was normal after ligation of the shunt, and thrombosis occurred in 1 case of the 4. The another 1 of the 5 cases was presented with portal vein thrombosis of grade m, and the blood flow remained lower than normal when side-to-side anastomosis was done after resection of thrombosis. Then vein by-pass of the superior mesenteric vein to portal vein with donor iliac vein was done, the blood flow became normal, and no complication occurred. Conclusions The vessel Doppler sonography during liver transplantation was of pivotal values in preventing and diagnosing vessel complications. For the patients with abnormal findings though intraoperative vessel Doppler sonography, the close monitoring should be done in order to find out vessel complication as

Objective To evaluate the clinical application of percutaneous biopsy CT-guided in spine lesions.Methods CT-guided percutaneous biopsy in spine lesions was performed in 53 cases,the final diagnosis was confirmed by operation or following-up. Results The accurate rate was 85 percent for CT -guided percutaneous biopsy in spine lesions without complication.The reason of misdiagnosis was mainly that the biopsied lesions was incorrect. Conclusion The perfect percutaneous needle is the successful key for biopsy in spine lesions, we should coordinate the relationship between imaging diagnosis and percutaneous bone biopsy.

Objective To establish a molecular typing system of Staphylococcus aureus by using resolution melting for food-poi-soning fast tracing.Methods Primers were designed and synthesized according to the literature of VNTR in Staphylococcus au-reus ,and were used to perform molecular typing on the strains which had detected by PFGE,then 4 types of VNTRs were with higher discriminatory power were selected.On this basis,we established a molecular typing system for the detection of 59 Staphy-lococcus aureus isolated from food poisoning.Results The molecular typing system has good precision for detection.The standard deviation(s)of within-batch repetitive experiments were 0.03 -0.05 ℃,between-batch repetitive experiments were 0.04 -0.06℃,between-day repetitive experiments were 0.04-0.06 ℃.At the same time,the 59 strains of Staphylococcus aureus were divided into 19 types which were 11 epidemic clones and 8 sporadic clones.The correlation coefficient of Simpson was 0.916 4.Conclusion The molecular typing system for Staphylococcus aureus based on resolution melting was simple,fast and repeatable.It can be ap-plied to fast tracing and screen of Staphylococcus aureus in food poisoning.

Objective To summarize our experience in the liver transplantation from the donation after cardiac death (DCD).Methods The livers from three DCD donors (2 cases of brain trauma and 1 case of cerebral hemorrhage) were harvested according to the Guidelines for Donation after Cardiac Death in China.These grafts were orthotopically transplanted into three recipients including 2 cases of decompensative hepatic cirrhosis and 1 case of primary liver cancer.The warm ischemic time ranged from 7.5 to 10 min and the cold ischemic time was 4.5,8.2 and 6.5 h respectively.Postoperative immunosuppressive regimens included prednisone,FK506 and mycophenolate mofetil (MMF).Antibiotics and anticoagulatants were used accordingly.Results All of the 3 recipients obtained normal liver function within 3 weeks since the grafts were implanted without PNF,thrombosis and rejection.No postoperative complications occurred in 3 recipients during the follow-up period of 2 to 9 months with normal liver function.Conclusion The liver transplant from DCD donor showed good results in our center.Chinese group Ⅲ of DCD donor,UW score above the middle level and the short warm ischemic time are three keys ensuring the success of the liver transplant from DCD donors.

Objective To summarize the clinical experience of harvesting and using the kidneys from donation after cardiac death (DCD) donors.Methods Fourteen kidney transplantations were successfully performed on 14 patients with end-stage renal diseases.The kidneys were harvested from 7 volunteer donors (age 30～53 years) diagnosed with cardiac death,who were scored 19～23according to the University of Wisconsin donation after cardiac death evaluation.Primary diseases of the donors were cerebral hemorrhage,brain injury,ischemic cerebral vascular disease and brain tumor.Warm ischemia time ranged from 5 to 45 min,and cold ischemia time was 4.5 ～ 12.5 h.Results After transplantation,three patients had delayed graft function (DGF),one had primary non-function (PNF),and two patients developed acute rejection.In the patient with PNF,the transplanted kidney was removed one day after operation and the patient went back to hemodialysis.One patient with DGF was still in recovery with serum creatine 149 μmnol/L (within 3 months after operation).The above two cases both utilized the kidneys with 45 min of warm ischemia time.The rest 12 patients were discharged with normal renal function.Conclusion Under the condition of our country,kidneys strictly harvested from DCD donors can be used as one of the main sources of kidney grafts for kidney transplantation.

Objective To evaluate the effect of islet transplantation for patients with type 2diabetes mellitus (DM). Methods Since December 2007, 4 cases of islet transplantations were performed on 3 patients with type 2 DM and end-stage renal disease (ESRD). Two patients received simultaneous islet-kidney transplant from single-donor (SIK), and one received 2 consecutive islet transplants 5 months following kidney transplantion (IAK). All recipients given insulin with a dose of percutaneous transhepatic portal catheterization. Anti-CD25 monoclonal antibody was used as induction. For SIK, low-doses of Tacrolimus and sirolimus were used as maintenance immunosuppression protocol. For IAK, the maintenance protocol included cyclosporine and MMF.Insulin dose, the level of blood glucose, C-peptide and the value of HbA1 were observed. Results The first patient of SIKhad normal glucose level 3 days after surgery and became insulin independent within the first month, but insulin was administered gradually and the dose reduced to 1/3. The second patient of SIK died of bleeding and secondary infection of liver puncture site 5 days following operation, the blood glucose level recovered to normal 24 h after operation. The insulin dose of the patient of IAK was reduced to 1/2 after the first transplant. The patient became insulin free after the second operation. The level of fasting and postprandial C-peptide of the surviving recipients increased by 600 pmol/L. The value of HbA1 of the SIK was 6.7 %～7.3 %, while that of the IAK was 5. 5 %～ 5. 9 %. Conclusion Islet transplantation is an effective treatment for patients with type 2 DM.

Objective:To explore the application effect of dyadic intervention scheme based on dyadic disease management theory and Information, Knowledge, Attitude, and Practice model in the discharge preparation of elderly stroke patients and family caregivers.Methods:The 92 pairs of elderly stroke patients and their caregivers hospitalized in the Department of Neurology in People′s Hospital of Zhengzhou University were conveniently selected. The non synchronous control method quasi experimental research was adopted. Totally 46 pairs of subjects who met the criteria for admission and discharge from May to July 2022 were set as the control group, and routine nursing was carried out; from August to October 2022, 46 pairs of subjects who met the criteria for admission and emission were set as the observation group to implement the dyadic intervention program. The scores of discharge readiness, self-efficacy and unplanned readmission rate of patients between the two groups were compared, and the scores of caregiver readiness, self-efficacy and caregiver stress between the two groups were compared.Results:Finally, 85 pairs of subjects completed the study, with 42 pairs in the control group and 43 pairs in the observation group. On discharge day, the total scores of discharge readiness and caregiver readiness in the observation group were (95.19 ± 4.47), (23.02 ± 2.20) points, respectively, which were higher than those in the control group (85.71 ± 5.31), (19.57 ± 1.65) points, with statistically significant differences ( t=8.91,8.16, both P<0.01); the self-efficacy levels of patients in the observation group at discharge and one month after discharge, as well as those of caregivers at discharge and one month after discharge were (73.86 ± 4.87), (75.91 ± 4.51), (75.67 ± 4.99), (79.21 ± 4.90) points, respectively, higher than those in the control group (71.62 ± 5.19), (73.33 ± 4.91), (73.48 ± 4.24), (75.48 ± 4.24) points, with statistically significant differences ( t values were from 2.05 to 3.75, all P<0.05); the pressure levels of caregivers in the observation group at discharge and one month after discharge were (7.51 ± 2.48), (6.28 ± 1.99) points, respectively, lower than those in the control group (8.76 ± 2.55), (7.45 ± 2.36) points, with statistically significant differences ( t=-2.29, -2.48, both P<0.05); the unplanned readmission rate of patients in the observation group one month after discharge was 7.0% (3/43), lower than the control group′s 23.8% (10/42), with statistically significant difference ( χ2=4.65, P<0.05). Conclusions:The implementation of dyadic intervention on elderly stroke patients and caregivers can make their discharge preparation process more adequate, thus reducing the caregiver′s care pressure, reducing the unplanned readmission rate of patients, and improving their health outcomes.