Objective:To explorethe the clinical manifestations, treatment and prognosis of anastomotic pseudoaneurysm after renal transplantation caused by infection.Methods:Clinical data of 1 recipient with pseudoaneurysm after renal transplantation due to Pseudomonas aeruginosa infection were retrospectively analysed and combined with a literature review. Results:At Month 2 post-transplantation, the recipient developed right lower abdominal pain, and contrast-enhanced ultrasound examination showed a pseudoaneurysm at the artery anastomosis. Anti-infection and anti-rejection therapy had no obvious effect, and therefore next surgical exploration was performed. A size4.0 cm×3.5cm pseudoaneurysm was found intraoperatively at the graft renal artery anastomosis.After graft was evaluated as having no preservation value, the transplanted kidney and pseudoaneurysm were resected. Bacterial culture indicated Pseudomonas aeruginosa infection.The recipient recovered well and waited for next transplantation. Conclusions:Pseudoaneurysm of transplanted kidney is a very rare complication after renal transplantation, and caused by infection of Pseudomonas aeruginosa is more rarer, It has not been reported in mainland China.This type of recipient has the characteristics of high graft inactivation rate and high mortality rate. Timely surgical resection can effectively prevent the deterioration of disease.

BACKGROUNDGejiu in Yunnan Province is a region where the incidence of lung cancer is high among the miners of tin mine. Our previous research team successfully induced the malignant transformation of immortalized human bronchial epithelial cells (BEAS-2B) by Gejiu mineral powder in vitro. The objective of this study is to explore the role of survivin and proliferating cell nuclear antigen (PCNA) in the pathway of the malignant transformation of BEAS-2B induced by Gejiu mineral powder.

METHODSProtein expression of survivn and PCNA in BEAS-2B cells and its malignant transformation cells was respectively evaluated by immunofluorescence cytochemistry staining technique and immunohistochemistry.

RESULTS(1)The expression of survivin protein was negative in BEAS-2B cells and was positive in its malignant transformation cells by immunofluorescence cytochemistry staining techniques. And the protein level of PCNA was low in BEAS-2B cells and high in its malignant transformation cells. (2)The positive expression of survivin protein in BEAS-2B cells (0/20) was significantly lower than that in its malignant transformation cells (85%, 17/20) by immunohistochemistry (P < 0.001). And the labelling index (LI) of PCNA in BEAS-2B cells was significantly lower than that in its malignant transformation cells (P < 0.001). LI of PCNA in the malignant transformation cells of BEAS-2B with positive expression of survivin was significantly higher than that with negative expression of survivin (P < 0.001).

CONCLUSIONS(1)The up-regulation expression of survivin in malignant transforma- tion cells of BEAS-2B suggests that survivin may play an important role in the pathway of malignant transformation in BEAS-2B cells induced by Gejiu mineral powder. It may give a proof for revealing the carcinogenesis of lung cancer in Gejiu miner. Survivin may be identified as a novel potential diagnostic and therapeutic target of lung cancer in Gejiu miner. (2)The up-regulation expression of PCNA in malignant transformation cells of BEAS-2B suggests that cell proliferation may play an important role in the pathway of malignant transformation. (3)Survivin may promote cell proliferation mediated by PCNA. Survivn and PCNA may play synergetic roles in the process of malignant transformation in BEAS-2B cells induced by Gejiu mineral powder.