Ethics -related issues are the main problems encountered in living- donor renal transplantation in China.The most important ethical problems are informed fact,voluntary decision and informed consent for donors and recipients.Three problems need to be determined including content and limitation of informed fact,judgment of intellectual ability of the donor and recipient sides,and voluntary consent. Flexible principles and countermeasures should be well employed in different and comphcated clinical cases.For example,people with intellectual or mental disability and minors are not permitted to be donor in order to protect their legal rights and benefits.To draw a conclusion,it's necessary to give ethical interfere,legal control and social supervision to living -donor renal transplantation.The key - point of social and ethical interfere is to enhance the sense of socio - ethical responsibility among medial staffs.Hospital ethics committee should play their expected role in clinical application.

Objective To observe the changes in endothelin(ET), nitric oxide(NO) and C-reactive protein(CRP) before and after the rosiglitazone therapy in patients with impaired glucose tolerance(IGT). Methods 72 IGT patients were divided randomly into 2 groups: rosiglitazone group(n=45) and placebo group(n=27). 15 weeks later, the efficacy of rosiglitazone was compared. Results The levels of ET, CRP were decreased and NO increased significantly in rosiglitazone group compared with those before treatment (ET 54.8±10.0 pg/ml vs 72.8±24.3 pg/ml, P<0.01;CRP 4.58±0.38 mg/L vs 5.99± 0.85mg/L, P<0.01 ; NO 41.0±10.0 μmol/L. vs 31.3±9.0 μmol/L, P<0. 01)). However, the levels of ET,CRP and NO in placebo group did not change singnificantly (P>0. 05). Conclusions Rosiglitazone can singnificantly improve ET, NO, CRP level in IGT patients, which means an additional effect of rosiglitazone on the correlation of inflammation and endothelial disturbance.

Objective　To observe the therapeutic effects and safety of angiotensin-converting enzym e (ACE)-inhibitors in the treatment of the secondary erythromatosis following ren al transplantation.Methods　Twenty-four patients with erythromatosis following renal transplantation recei ved the treatment with ACE-inhibitors. During the administration of ACE-inhibi tors, the hemoglobin, hematocrit and the side effects were observed. Results　All the patients were recovered except one who ha d to be stopped the treatment of ACE-inhibitors because of the depressing of th e blood pressure. The time of producing the effects was 7-20 days. The side effe cts included lower blood pressure accompanied by dizzy in 3 cases, anemia in 2 cases and damage to renal function in 2 cases. Conclusions　ACE-inhibitors were effective in the treatme nt of secondary erythromatosis following renal transplantation. It was important to monitor the hemogram and the renal function of the patients.

Objective To explore the clinical effect of renal artery embolization for renal graft dysfunction.Methods A total of 17 patients with renal graft dysfunction were treated by embolizing the renal graft artery.Coil embolization was performed on 7 of the cases,and gelfoam combined with coil was used in the other 10.Results Among the 17 patients,14 discontinued immunosuppressant in 3 weeks after the embolization,and 2 discontinued after receiving low-dose cortisones for about 6 months,and showed good recovery during follow-up.The other patient underwent resection of the renal graft because of continuous fever and graft pain.After the embolization,14 cases developed 'post-embolization syndrome'.Coil migration occurred in 1 case during the procedure.One patient experienced angina during the operation,and developed myocardial infraction the day after the embolization.Conclusions Renal artery embolization is safe and effective for patients with renal graft dysfunction.By using the method,open surgery can be avoided.Attention should be paid to potential complications.

OBJECTIVE:To discuss the effect of anti-tuberculosis therapy on plasma concentration of calcineurin phosphatase inhibitors in renal transplant recipients.METHODS:The change in plasma concentration of calcineurin phosphatase inhibitors in 2 renal transplant recipients who were complicated with tuberculosis infection before or after renal transplantation was analyzed.The patients were routinely treated with cyclosporine(CsA)or tacrolimus(FK506)+ mycophenolate mofetil(MMF)+ prednisolone(Pred).Monoclone fluorescence polarization immunoassay(FPIA)was employed to determine the concentration of CsA or FK506 in different time point before and after administration of antituberculosis drugs.RESULTS:Plasma concentration of CsA was down-regulated significantly by Rifampicin,and the daily dose of CsA has to be increased to more than 3 times the previous concentration before meeting the target concentration.The concentration of FK506 was slightly down-regulated by rifapentine.CONCLUSION:The concentration of CsA or FK506 and the adverse effect of antituberculotic drugs should be closely monitored for renal transplant recipients complicated with tuberculosis infection.

Informed consent is one of the basic ethical rules for living related kidney transplantation.Doctors have obligations of informing before kidney transplantation.The advantages and disadvantages of each treatment should be introduced to uremic patients and their relatives to let them know that kidney transplantation is not the only choice for treating uremia.Both donors and recipients of living kidney transplantation should be informed of the clinical effects,all kinds of complications and their risks,and the importance of treatment compliance after operation.Donors should be notified with the interests,complications and risks in period of donating operation and long-term after operation,and should be notified with the interests and risks in some special conditions for exchanging donation.Voluntary donation should fulfill that donators make the decision of donation under a fully understanding of the risks of living kidney transplantation and being fully assessed by themselves,and cheating,luring and sealing kidneys for economic interests are ruled out in making consent.Persons with incapability can not be donors even if they had made the consents of donation.In order to make sure that the decision of donation is made under the condition that living donors and recipients have known the fact thoroughly,ethics committee should inspect the "consent of kidney transplantation of living donation" and "consent of operation" offered to donors and recipients by hospital to make sure that donors and recipients have been fully notified with the current situation,clinical effects and possible complications of living kidney transplantation by doctors.This measure can make sure that donors and recipients make the decision based on knowing the fact thoroughly and sign the consent personally.

Lactate and succinate were produced by Corynebacterium acetoacidophilum from glucose under oxygen deprivation conditions. To construct knockout mutant, lactate dehydrogenase gene (ldh) of C. acetoacidophilum was deleted by double-crossover chromosome replacement with sacB gene. Comparing with the wild strain ATCC13870, ldhA-deficent mutant produced no lactate with glucose consumption rate decreased by 29.3%, while succinate and acetate concentrations were increased by 45.6% and 182%, respectively. Moreover, the NADH/NAD+ rate was less than 1 (about 0.7), and the activities of phosphoenolpyruvate carboxylase and acetate kinase of the ldhA-deficent mutant were enhanced by 84% and 12 times, respectively. Our studies show that succinicate and acetate production pathways are strengthened by blocking lactate synthesis. It also suggests that improving NADH supply and eliminating acetate generation are alternative strategies to get high succinate-producer.
Corynebacterium glutamicum ; genetics ; metabolism ; Glucose ; Industrial Microbiology ; L-Lactate Dehydrogenase ; genetics ; metabolism ; Lactic Acid ; metabolism ; Oxygen ; metabolism ; Phosphoenolpyruvate Carboxylase ; Succinic Acid ; metabolism

OBJECTIVETo evaluate the colorectal cancer incidence among compliers and non-compliers in the population of colorectal cancer screening area, and to provide scientific basis for health economic evaluation of cancer screening.

METHODSBy screening different years build queue, to retrospectively compare the data of colorectal cancer screening from January 1, 2008 to December 31, 2013 and the data of cancer registration, and to analyze the colorectal cancer incidence rates among screening compliers and non-compliers, and to compare the average intervals between the end of screening and clinical cancer diagnosis using SPSS 19 statistical software. Mantel-Haenszel test was performed with a statistical significance level of α = 0.05.

RESULTSThe non-compliance rate was 38.24% among males and 28.49% among females (P < 0.001). The non-compliance rate was highest in the 40-44 and 70-74 years age groups and lowest in the 50-59 years age group. The compliers of the screening were followed up for 476,049 person-years, and there were 51 cases of colorectal cancer, with an incidence rate of 10.71/100,000. The non-compliers of the screening were followed up for 259 183 person-years, and there were 66 cases of colorectal cancer, with an incidence rate of 25.46/100,000, which was 1.38 times higher than that of the compliance group (χ2 = 21.699, P < 0.001). The incidence rate of colorectal cancer among subjects who were positive in initial screening but refused to receive an electronic colonoscopy was as high as 164.40/100,000, and the average delay time was 20.8 ± 16.8 months.

CONCLUSIONSThe colorectal cancer screening adherence among women is better than among men, and that of 50-54 years and 55-59 years age groups is better than in other age groups. The subsequent incidence rate of colorectal cancer in the non-compliance group is significantly higher than that of the compliance population.

Adult ; Age Factors ; Aged ; China ; epidemiology ; Cohort Studies ; Colonoscopy ; Colorectal Neoplasms ; diagnosis ; epidemiology ; Early Detection of Cancer ; Female ; Humans ; Incidence ; Male ; Mass Screening ; statistics & numerical data ; Middle Aged ; Patient Compliance ; statistics & numerical data ; Retrospective Studies ; Sex Factors

AIM: To investigate the key molecular mechanism of inflammatory response in alveolar epithelial cells induced by nontypeable haemophilus influenzae(NTHi).METHODS: A549 cells were co-cultured with NTHi(multiplicity of infection,MOI: 10) and harvested 15 min and 30 min after stimulation.The phosphorylation of p38 mitogen activated protein kinase(p38 MAPK) in A549 cells was detected by Western blotting.The intracellular expression of nuclear factor-?B(NF-?B) p65 was examined by flow cytometry 4 h after stimulation.A549 cells were preincubated with p38 inhibitor(SB203580) or NF-?B inhibitor(PDTC) for 1 h and then stimulated with NTHi for 24 h.The level of interleukin 8(IL-8) in the supernatants was determined by enzyme-linked immunosorbent assay(ELISA).RESULTS: The phosphorylation of p38 MAPK was rapidly induced by NTHi stimulation.The expression of NF-?B p65 in A549 cells after NTHi stimulation was significantly up-regulated compared with control group(P