Objective To investigate the expression of Netrin-1 protein in human renal clear cell carcinoma (RCCC) and the relationships between Netrin-1,pathology and prognosis.Methods Fortyeight cases of RCCC and their adjacent tissues were selected for study,including 26 males and 22 females.The median age was 62 years (range,26 to 83 years).All 48 patients were onset for the first time,confirmed by pathology.All cases had no radiotherapy,chemotherapy or biological treatment before operation.Fuhrman grade:6 cases in grade Ⅰ,6 cases,in grade Ⅱ,27 cases in grade Ⅲ and 9 cases in grade Ⅳ.The AJCC staging in 2010:20 cases in stage Ⅰ-Ⅱ],28 cases in stage Ⅲ-Ⅳ.The expression of Netrin-1 protein was detected by immunohistochemical staining and its clinical significance was analyzed.All cases were followed up for more than 5 years.Survival analysis lines were made by Kaplan-Meier method and the difference between groups was tested by the Log-rank test.Results The expression of Netrin-1 protein was higher in renal cancers [71％ (34/48)] than that in the adjacent normal tissues [17％ (8/48)] (P＜0.05).Netrin-1 protein expression rates were 42％(5/12) in Fuhrman Ⅰ-Ⅱ tumors and 81％ (29/36) in Fuhrman Ⅲ-Ⅳ tumors,while 55％ (11/20) in stage Ⅰ-Ⅱ and 82％ (23/28) in stage Ⅲ-Ⅳ,respectively (P＜0.05).The 5-year survival rate in high protein expression group and in low protein expression group was 62％ (21/ 34) and 79％ (11/14).The survival curve had different trend,with no significant difference between groups (P＞0.05).Conclusions Netrin-1 protein plays an important role in the development of RCCC.It might be a new specific tumor marker of RCCC,and might become a new target in treatment of RCCC.

Objective To summarize risk factors for clinical outcomes in heart transplantation patients, evaluate the characters of Chinese patients by comparing with international data, and introduce new clinical strategies. Methods We performed 200 heart transplantations from Jun. 2004 to May 2010. The clinical information was recorded and all patients were followed up. By analyzing 160 patients with a follow-up period of more than one year, we summarized clinical outcomes and risk factors of early and late results of heart transplant patients. Results Of 160 patients, 8. 1 % received postoperative extracorporeal membrane oxygenation (ECMO) support and 10% continuous renal replacement therapy. In 550 cases/times of endomyocardial biopsies, the incidence of rejection with grades more than Ⅱ (concluding grade Ⅱ ) was 14. 9%. In-hospital mortality was 3. 8%. Smoking,preoperative diastolic pulmonary arterial pressure, PAWP, total serum protein level and albumin level were risk factors of peri-operative mortality, and preoperative diastolic pulmonary arterial pressure,primary heart diseases, pulmonary hypertension and implantations of ICD, MCS and ECMO were risk factors of late mortality. Postoperatively, 1-, 3- and 5-year survival rate was 94. 4%, 91.9% and 88. 8%, respectively. Compared with UNOS data, the rate of primary heart diseases, pulmonary hypertension, and implantation of ICD, MCS and ECMO were different, and the long-term survival rate of 160 patients was higher than that reported by ISHLT. Conclusion The risk factors of mortality of Chinese heart transplant patients are different with their counterparts from western countries. Our corresponding peri-operative treatments and clinical strategies have produced satisfactory clinical outcomes.