There is currently a huge worldwide demand for donor kidneys for organ transplantation. Consequently, numerous marginal donor kidneys, such as kidneys with microthrombi, are used to save patients' lives. While some studies have shown an association between the presence of microthrombi in donor kidneys and an increased risk for delayed graft function (DGF) (McCall et al., 2003; Gao et al., 2019), other studies have demonstrated that microthrombi negatively impact the rate of DGF (Batra et al., 2016; Hansen et al., 2018), but not graft survival rate (McCall et al., 2003; Batra et al., 2016; Gao et al., 2019). In contrast, Hansen et al. (2018) concluded that fibrin thrombi were not only associated with reduced graft function six months post-transplantation but also with increased graft loss within the first year of transplantation. On the other hand, Batra et al. (2016) found no significant differences in the DGF rate or one-year graft function between recipients in diffuse and focal microthrombi groups. To date, however, the overall influence of donor kidney microthrombi and the degree of influence on prognosis remain controversial, necessitating further research.
Humans ; Thrombotic Microangiopathies ; Transplantation, Homologous ; Tissue Donors ; Kidney ; Allografts

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective To assess the clinical application value of vector flow mapping (VFM) in evaluating the left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns.Methods One hundred and sixty-nine patients with hypertension and 50 healthy volunteers were enrolled.Hypertensive patients were divided into four groups with different ventricular configurations according to ASE guide line in 2005:normal geometry group,concentric remodeling group,concentric hypertrophy group and eccentric hypertrophy group.The quantitative parameters,including average energy loss(aEL) and circulation were measured.Difference was evaluated among five groups at apical,mid and basal segments and at different periods.The correlationship was analyzed between aEL,circulation and E/e',respectively.Results ① Compared to control group,aEL was higher in four hypertension groups at three segments of atrial systole(P ＜0.05).aEL in eccentric hypertrophy group was higher than those in control group,normal geometry group or concentric remodeling group at apical and mid segments of atrial systole,and higher than those in other hypertensive groups at basal segment (P ＜ 0.05).In four hypertension groups,circulations in rapid filling phase of anterior mitral valve were lower than that in control group,but circulations in slow filling phase of posterior mitral valve were higher than that in control group(P ＜0.05).The circulation in slow filling phase of posterior mitral valve in concentric remodeling group was higher than that in normal geometry group,and that in eccentric hypertrophy group was higher than those in normal geometry group and concentric remodeling group(P ＜0.05).②When intra-group comparison,aEL were different in different segments of same phase or at different phases of same segment(P ＜0.05).③aEL had a good correlation with E/e'at basal segment of atrial systole in four hypertension groups(r =0.66,P ＜0.01).Conclusions VFM can be utilized to analyze left ventricular hemodynamics features of hypertensive patients with different left ventricular geometric patterns,it may be a good supplement for assessing cardiac diastolic function and reflect the extent of damage.

Background and purpose:Epithelial ovarian cancer has the highest mortality rate of gynecologic cancers and overall survival rates have improved little in the last 20 to 30 years. CXXC ifnger protein 5 (CXXC5) plays an important role in AML (acute myeloid leukemia) and MDS (myelodysplasia). However, little is known about its clinical signiifcance and biological function in epithelial ovarian cancer. This study aimed to investigate the expression of the CXXC5 in ovarian cancer and the effect of the CXXC5 on ES-2 cell proliferation. Methods:①The alteration of CXXC5 in cancer genomics data of TCGA (Cancer Genome Atlas) was analyzed.②The CXXC5 protein in the tissue chips was detected containing 37 benign ovarian cyst and 173 malignant tumor samples. The relationship between the expression of the CXXC5 with the clinicopathological features of patients with ovarian cancer was analyzed by SPSS software;③The cells with the highest CXXC5 expression quantity from 5 ovarian cancer cells were selected by re-al-time quantitative PCR (qRT-PCR) and Western blot.④ES-2 cells with shRNA stable transfection were construted us-ing the strategy of lentivirus infection and analyzed cell proliferation by cell counting kit-8(CCK8). Results:①Through the TCGA database, CXXC5 ampliifcation was found in 7 of 563 cases.②The CXXC5 expression in ovarian malignant carcinoma (39.3%) was higher than that in benign ovarian cyst (13.5%, P=0.003), the histologic type was highly asso-ciated with CXXC5 (43%in serous, 22.9%in mucinous, 23.5%in endometrioid, 67%in clear cell, P=0.014) and there was a signiifcant correlation between CXXC5 and lymph node metastasis (positive vs negative, P=0.022).③The ES-2 cells with shRNA stable transfection had a growth disadvantage (P<0.05). Conclusion:The CXXC5 gene might have an advantage in proliferation of epithelial ovarian carcinoma and be expected to become the biomarker of poor prognosis.

Objective To investigate the clinical practice pressure and mental health of medical students with type D personality.Methods Type D Scale-14 (DS14) and Beck-Srivastava Stress Inventory (BSSI) test were applied to 371 medical students to assess the personality types and pressure.The symptom checklist 90 (SCL-90) was used to evaluate the psychological health.Results ①The detection rate of type D personality of medical students was 36.39％.②The average score in BSSI of medical students of type D personality was (99.27± 10.51),which was higher than medical students of non-type D personality (87.60± 11.37),and the difference was statistically significant (t=9.9711,P=0.0000).The medical students' score of type D personality in SCL-90 of 9 factors were all higher than medical students of non-type D personality,but the statistically significant difference were only in the score of depression,anxiety and psychosis-like symptoms (t=2.4409,P=0.0151;t=2.8662,P=0.0044;t=2.7783,P=0.0057).Conclusion In face of the same pressure of medical clinical practice,the medical students of type D personality are more likely to have a heavier psychological burden,and the college should pay special attention to the problem and try to intervene the problem,so as to reduce the pressure caused by a variety of psychological problems.

Objective To explore the effect of relative warm ischemia (RWI) on bile nature and component in rats self-liver transplantation.Methods Thirty two rats were randomly divided into group Ⅰ (control group),group Ⅱ (RWI 0 min),group Ⅲ (RWI 30 min),and group Ⅳ (RWI 60 min).The levels of bile phospholipids (PL),total bile acids (TBA),and PL/TBA ratio were detected early after self-liver transplantation.The concentration changes of hydrophilic and hydrophobic bile acids were examined.Results Only PL concentration of group Ⅱ seemed to be lower than that of group Ⅰ (P ＜ 0.05),without any change for other indexes.Compared with group Ⅱ,only the PL and TBA concentrations of the group Ⅲ were decreased significantly (P ＜ 0.05),and no significant difference was found between two groups on PL/TBA ratio and mole fractions of bile acids (P ＞ 0.05).Compared to group Ⅱ,the concentrations of PL and TBA,PL/TBA ratio,and the mole fraction of taurocholic-β-mouse acid (T-β-MC) were much lower in group Ⅳ (P ＜ 0.05),and the mole fraction of taurocholic acid (TC) were higher in group Ⅳ (P ＜ 0.05).Conclusions RWI caused changes of PL/TBA ratio,hydrophilicity and hydrophobicity of bile early after liver transplantation,and the changes were directly proportional to the RWI time.The property of bile in early transplantation seemed not to be changed when the relative warm ischemia time was less than 30 min.When the RWI time was longer than 60 min,the bile component was changed obviously and the toxicity was increased.In liver transplantation,arterial anastomosis should be completed as soon as possible,and the RWI time should be less than 30 min.

Objective To comparatively study the ischemia-reperfusion injuries caused by heterogeneity of different positions of the biliary system and different construction patterns of the peribiliary vascular plexus. Methods Thirty rats were randomly divided into 3 groups: Group Ⅰ , sham operated; Group Ⅱ , 1h ischemia in biliary tract followed by 1h reperfusion; Group Ⅲ, 1h ischemia in biliary tract followed by 2h reperfusion. TUNEL assay, pathomorphology score determination and ultrastructural quantitative analysis were performed on epithelium of the hilar bile duct, proximal common bile duct and interlobular bile duct. Results In groupⅡ , TUNEL assay and pathomorphology score showed no statistical difference between proximal common bile duct and interlobular bile duct (P＞0.05) but showed significant differences in the hilar bile duct(P＜0.05). Mean volume (V) of mitochondria and area density of microvilli were obviously serious in the hilar bile duct but obviously slight in the proximal common bile duct(P＜0. 05). In group Ⅲ, the results of the above detections showed that the most severe was in hilar bile duct, followed by the interlobular bile duct and proximal common bile duct(P＜0. 05). Conclusion Different injuries in various parts of the biliary system are caused by heterogeneity of biliary epithelial cells and construction patterns of the peribiliary vascular plexus. It also provides the experimental basis to explain the higher incidences of hilar bile duct stricture. It could be taken as the best position when the bile duct is anastomosed.

BACKGROUND: Studieshave shown that long time of warm ischemia or cold preservation would injury the biliary tract in liver transplantation. However, whether relative warm ischemia (RWI) of biliary tract would result in bile component changes is unclearly. OBJECTIVE: To establish auto-liver transplantation bile ducts RWI models, observe the effects of RWI on the bile salts and phospholipid concentration secreted by the donor liver, and to study the correlation between the total bile salt/phosphoUpid ratio (TBA, PL ratio) and billary tract injury. METHODS: A total of 32 SD rats were selected for auto-liver transplantation models with bile ducts RWI, and the rats were randomly divided into 4 groups (n=8). In Group Ⅰ (sham operation group), rats only received liver dissociation without any cold reperfusion. The RWI time of Group Ⅱ,Ⅲ, and Ⅳ were 0 minutes, 30 minutes and 60 minutes, respectively. The concentration of TBA in bile was measured with enzymatic cycling assay, andPL with enzymic colorimetric. Pathological observation with light microscope and ultrastructural observation with transmission electron microscope were performed on the hilar bile duct. The endothelial cell apoptosis was detected with TUNEL assay. The correlation between TBA, PL ratio and biliary injury was analyzed. RESULTS AND CONCLUSION: One rat died, the other 31 rats were included in the final analysis. RWI could change the composition of bile secreted by donor liver, raise the TBA/PL ratio, and increase the bile toxicity. These changes had a positive correlation to RWI time, and the changes were obviously with time prolonged. In addition, the changes are closely related to the biliary tract injury. This study shows an important mechanism of the biliary tract injury caused by RWI-injury.

OBJECTIVE To investigate the rate of the clinical isolation of ESBLs positive Escherichia coli and the resistance in intensive care units(ICU).METHODS We isolated E.coli from 2003 to 2004 in our hospital ICU,phenotypic confirmatory test was applied to detect ESBLs.Bacterial drug susceptibility test was performed by standard Kirby-Bauer method.RESULTS The isolation rate of ESBLs positive E.coli was 74.36% in 2003 and 81.58% in 2004.ESBLs positive bacteria had high resistance to antibacterial drugs,but the resistance rate did not rise.ESBLs negative bacteria were more susceptible to antibacterial drugs(P=0.001);but ESBLs negative bacteria in 2004 had higher resistance than in 2003(?2=84.511,P=0.001).CONCLUSIONS It is very important for ICU to use ESBLs detection test in time,and antibacterial drugs in reason.

BACKGROUNDCisplatin plus navelbine (NO) is a standard combination chemotherapy regimen for non-small cell lung cancer (NSCLC), but severe toxicities due to cisplatin often influence the quality of life in the patients, such as nausea and vomiting. The aims of this study are to evaluate the efficacy and toxicity of combined chemotherapy of oxaliplatin and cisplatin plus navelbine in treatment of advanced NSCLC.

METHODSA total of 168 patients were randomly divided into NO group (n=83) and NP group (n=85).

RESULTSThe overall response rate was 38.6% in NO group and 40.0% in NP group respectively. 1-year survival rate was 33.7% in NO group and 31.8% in NP group. There was no significant difference in response rate and 1-year survival between the two groups (P > 0.05). The major side effects were myelosuppression, nausea/vomiting and neurotoxicity in the two groups. Incidences of leukopenia and nausea/vomiting were significantly lower in NO group than those in NP group (P < 0.05), but neurotoxicity in NO group was more obvious than that in NP group (P < 0.001).

CONCLUSIONSThe efficacy and 1-year survival of combined chemotherapy of oxaliplatin and cisplatin plus navelbine are similar in the treatment of advanced NSCLC. However, the side effects of oxaliplatin plus navelbine are lower except for neurotoxicity.