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 estimate the hand dose of occupational staff in five procedures of interventional radiology.Methods The thermoluminescence ring dosimeter(TLD,LiF:Mg,Ti)calibrated in dose equivalent Hp(0.07) was used to monitor the radiation dose to the both hands in five procedures of interventional radiology in four hospitals.Meanwhile,the tube voltage and current and the fluoroscopy time,accumulated doses,DAPs (Dosed-Area Product) and photographic frames were also recorded for statistical analysis(SPSS 18.0).Results In this study,five interventional procedures were monitored in 119 cases.The doses to the left and right hands of occupational personnel in the five interventional procedures were analyzed,and the difference was statistically significant (t =1.99,P＜ 0.05).The differences in the dose to the left hand and the right hand of the first operator with different interventional procedures were statistically significant (F =455.83,116.45,P＜0.01).Tube voltage,current,fluoroscopy time,and photographic frames in influence factor analysis were statistically significant (r =0.570,0.712,0.564,0.711,P＜ 0.05),indicating that four factors might affect the operator's hand doses.In addition,increasing these four factors directly led to increase in the operator's hand doses.The variables with statistical significance in the above single factor analysis were introduced into the multiple linear regression equation and the stepwise regression method was used to fit the equation.The fitting equation was y=225.763+ 1.862x1-98.125x2 (F=22.726,P＜0.05).Where,x1 was the fluoroscopy time and x2 was the photographic frames which showed that they were the main factors affecting the hand dose.Conclusions The dose to the hands of the primary operator was the highest,followed by the second operator,the assistant or nurses.The order of average doses to the hands of the primary operator was PM＞RFA＞CA＞ PTCA+PCI ＞ ITCA in the five procedures.The annual equivalent dose to primary operator's hands may exceed the dose limit for hands in practicing large amount of the PM procedures.

Objective To investigate the expression of CCL2 in colorectal cancer and its carcinogenesis mechanism associated with macrophages.Methods The expression level of CCL2 mRNA in 17 cases of colorectal cancer tissues and corresponding adjacent tissues were analyzed by PCR,and the phenotypes of macrophages in tumor infiltrating lymphocytes (TIL) were analyzed by flow cytometry.Human peripheral blood mononuclear cells were isolated and induced to differentiate into macrophages.After 12 h incubation with CCL2,the phenotypic changes of macrophages were analyzed by flow cytometry.The expression level of VEGF,COX-2 and IL-6 in the supernatant were measured by ELISA assay.Results The expression level of CCL2 in colorectal cancer tissues was significantly higher than that in corresponding adjacent mucosal tissues (t =4.017,P ＜ 0.05),and the macrophages in TIL had a high proportion of CCR2 phenotype.CCL2 was shown to induce increased CCR2 expression in macrophages (t =5.070,P ＜ 0.05),and promote the secretion of the tumor growth-associated factors such as VEGF,COX-2 and IL-6 (all P ＜ 0.05).Conclusion The levels of CCL2 in colorectal cancer were up-regulated suggesting that CCL2 may play a key role in tumor promotion by recruiting macrophages and influencing their function.

Nursing performance management is one of the significant elements in nursing administration. An effective nursing performance management would guide, coordinate, and inspire clinical nursing practice. Nursing performance management plays an important role in current hospital system reform and optimizing nursing care program. This paper clarified relative concepts about performance management and nursing performance management, and summarized common nursing performance management applied in China. Moreover, the clinical value of performance management, and problems in it were also mentioned. To perfect nursing performance management system and accelerate the development of domestic nursing career, suggestions about how to improve nurse performance management were put forward in the end of this paper.

Objective:To study the expression of caveolin-1 in colorectal adenocarcinoma tissues and its correlation with microlymphatic vessel density (LMVD), and to investigate the clinical pathological prognostic significance of caveolin-1 and LMVD in patients with colorectal cancer.Methods:The expression of caveolin-1 and LMVD in 45 specimens of normal colorectal tissues, and 90 specimens of colorectal adenocarcinoma tissues were detected by immunohistochemistry technique. The correlation between their expression and the clinicopathologic features was analyzed. Muhivariable Cox regression was used to analyze the association between the laboratory indices and overall survival time.Results:The positive rates of caveolin-1 in colorectal adenocarcinoma tissues were significantly higher than those in normal colorectal tissues (P<0.01). LMVD in colorectal adenocarcinoma tissues were significantly higher than those in normal colorectal tissues (P<0.01). Mean LMVD in group with caveolin-1 positive was significantly higher than in that with caveolin-1 negative. The median survival time was 26.7 months. Cox regression analysis showed that the caveolin-1 expression, invation depth, lymph nodemetastasis, TNM stage, liver metastasis and LMVD were independent risk factors of overall survival time of patients with colorectal carcinoma. Conclusions:Caveolin-1 may contribute to the lymphangiogenesis in the tumor. During the occurrence and development of colorectal adenocarcinoma, there is a close relationship between the expression of caveolin-1 and lymphatic microvessel of tumor. Caveolin-1 expression and microlymphatic vessel density are significant prognostic value of colorectal carcinoma.

OBJECTIVETo realize the oxidative damage of kidney mitochondrial complex in obese rats induced by high-fat diet and investigate the protective effects of sulforaphane against the damage.

METHODSEighty-eight adult male SD rats were used, after 1 week adaptability feeding, 8 rats were selected as control group and given low-fat diet. The other 80 rats were given high-fat diet. After 2 weeks, the 32 diet-induced obesity models were choosen whose weight gain was higher than 40%. The 32 rats were randomly divided into 4 groups, i.e. high fat group, high fat+sulforaphane low dose group, high fat+sulforaphane middle dose group and high fat+sulforaphane high dose group. The rats in the sulforaphane low, middle and high dose groups were orally administered with sulforaphane 5, 10 and 20 mg/kg, all the 4 groups were kept feeding high-fat diet for 5 weeks. All rats were sacrificed and their kidneys were removed to assay the index of oxidative damages.

RESULTSThe content of ROS (0.26 ± 0.04) and MDA((0.87 ± 0.05) U/mg) in the hight-fat group were significantly higher than those in the control group((0.20 ± 0.02),(0.57 ± 0.08) U/mg)(t values were -3.02 and -4.72, P < 0.05). The activity of T-AOC((0.43 ± 0.04) U/mg) and MMP (12.09 ± 1.56) were lower than the control group ((0.48 ± 0.04 U/mg, (16.08 ± 3.12) )(t values were 2.06 and 2.28, P < 0.05). Gavage intervention with sulforaphane, the MDA amount ((0.67 ± 0.05), (0.55 ± 0.05), (0.56 ± 0.07) U/mg) in the sulforaphane low, middle and high dose groups were lower than the hight-fat group ((0.87 ± 0.05) U/mg (t values were 3.65, 5.71 and 5.60. P < 0.05). The activity of T-AOC ((0.49 ± 0.05), (0.55 ± 0.05), (0.54 ± 0.04) U/mg), T-SOD ((61.07 ± 2.79), (55.95 ± 2.39), (60.26 ± 6.02) U/mg) and the level of MMP ((17.17 ± 2.52), (18.24 ± 2.54), (18.21 ± 3.65)) were higher than in the high-fat group ((0.43 ± 0.04) U/mg,(47.22 ± 2.43) U/mg,(12.09 ± 1.56)) (tT-AOC values were -2.36, -4.83 and -4.30; tT-SOD values were -6.37, -4.71 and -5.99; tMMP values were -2.90, -3.52 and -3.50, P < 0.05). The activity of GSH-Px in the sulforaphane low and middle dose groups ((69.12 ± 8.63), (64.43 ± 6.58) U/mg) were higher than those in the high-fat group((53.03 ± 5.70) U/mg)(t values were -3.82 and -2.71, P < 0.05). But there were no significant difference between the high dose group ((60.02 ± 7.05) U/mg) and the high-fat group (t = -1.66, P > 0.05).

CONCLUSIONHigh-fat diet can induce the mitochondrial oxidative dysfunction in kidney, and sulforaphane shows protective effect on the kidney mitochondrial complex from oxidative damage in obese rats induced by high-fat diet.

Animals ; Diet ; Diet, High-Fat ; Isothiocyanates ; Kidney ; Male ; Mitochondria ; Obesity ; Oxidative Stress ; Rats ; Rats, Inbred Strains

Objective:To investigate the protective effect of Yiqi Huazhi recipe Quqian granules on rat renal tubular cell apoptosis induced by lead poisoning. Methods:Totally 60 Wistar rats were divided into 2 groups, 12 in the control group and the others in the model group. Chronic lead poisoning model was made by drinking 0. 02% lead acetate water for 60 days. Then the lead poisoning rats were randomly divided into four groups, high-dose Quqian granules group (3. 0 g·kg-1·d-1), low-dose Quqian granules group (0. 6 g·kg-1 ·d-1 ) , positive control group ( calcium disodium edentate plus procaine, im, 50 mg·kg-1 ·d-1 ) and model group. Seven treatment courses were carried out in the first three groups with every 4-d as one course and 4-d withdrawal period between every two courses. After 60 days, the change of lead in blood and kidney was observed by atomic absorption spectrometry,the apoptosis of kidney tissues was studied by TUNEL, the expression of Bcl-2 protein was detected by immunohistochemical methods and the expression of p53 was studied by Western Blotting. Results:Compared with the control group, the body weight, hemoglobin and the expression of Bcl-2 in the model group were decreased significantly(P<0.01)those in, and Pb in blood(0.990 ±0.443)μg·ml-1, Pb in kidney(51.33 ± 5. 16)μg·ml-1 , the apoptosis of tubular epithelial cell(4. 148 ± 0. 414) and the expression of p53 protein (1. 868 ± 0. 139) were significantly higher (P<0. 05). Compared with the those in model group, the body weight, hemoglobin and Bcl-2 in high-dose group were increased significantly(P<0.01), and the blood lead level (0.082 ±0.015)μg·ml-1, the kidney lead level (6.38 ±0.97)μg ·ml-1 , the apoptosis of tubular epithelial cell(1. 412 ± 0. 109) and p53 protein expression(1. 164 ± 0. 172) were significantly lower (P<0. 05). Conclusion:Lead may induce high expression of p53,low expression of Bcl-2 and promote the apoptosis of renal tubular epithelial cells. It is proven that Yiqi Huazhi recipe Quqian granules can inhibit the expression increase of p53 and the expression de-crease of Bcl-2 resulting in the reduction of the renal tubular apoptosis to allivate the renal injury caused by lead.

Objective To measure the peak skin dose (PSD) in two cardiovascular interventional procedures,including coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) using radiochromic film.Methods Gafchromic XR-RV3 film was selected to measure PSD in two hospitals.The films were placed on the table underneath the patient during interventional surgery.The kV,mA,fluoroscopy time,dose-area product (DAP),and cumulative dose at reference point and other relevant information were recorded for all cases.Using the Epson V750 flatbed scanner for scanning and analyzing film,FilmQA software was chosen to analyze the pixel value of red,green and blue color channels.The PSD was determined using red channel data.The correlation and linear regression analysis between PSD and device-displayed parameters was carried out.Results PSD were measured using XR-RV3 film for 26 CA and 19 CA + PTCA procedures.For CA procedures,maximum fluoroscopy time,cumulative dose and DAP were 17.62 min,1 498.50 mGy and 109.68 Gy · cm2,respectively.The maximum PSD was 361.20 mGy.However,for CA + PTCA procedures,maximum fluoroscopy time,cumulative dose and DAP were 64.48 min,6 976.20 mGy and 5 336.00 Gy· cm2,respectively.One patient with CA + PTCA procedures was found to have received the PSD value more than 2 Gy,up to 2 195.70 mGy.DAP was found to be a good indicator (R2 =0.815,P ＜0.05) of PSD for CA procedure,and correlated with cumulative dose (R2 =0.916,P ＜ 0.05) for CA + PTCA procedures.Conclusions The PSD value of some patients in cardiac interventional procedures would exceed 2 Gy,the threshold of deterministic effects recommended by ICRP.The dose-related parameters value showed on DSA device can only used to estimate PSD roughly.Using XR-RV3 film accurate measurement of the PSD in interventional projects is a very fast and effective method.

Objective To realize the oxidative damage of kidney mitochondrial complex in obese rats induced by high-fat diet and investigate the protective effects of sulforaphane against the damage . Methods Eighty-eight adult male SD rats were used , after 1 week adaptability feeding , 8 rats were selected as control group and given low-fat diet.The other 80 rats were given high-fat diet.After 2 weeks, the 32 diet-induced obesity models were choosen whose weight gain was higher than 40%.The 32 rats were randomly divided into 4 groups, i.e.high fat group, high fat +sulforaphane low dose group , high fat +sulforaphane middle dose group and high fat +sulforaphane high dose group.The rats in the sulforaphane low, middle and high dose groups were orally administered with sulforaphane 5, 10 and 20 mg/kg, all the 4 groups were kept feeding high-fat diet for 5 weeks.All rats were sacrificed and their kidneys were removed to assay the index of oxidative damages .Results The content of ROS (0.26 ±0.04) and MDA((0.87 ± 0.05) U/mg) in the hight-fat group were significantly higher than those in the control group ((0.20 ± 0.02),(0.57 ±0.08) U/mg) (t values were -3.02 and -4.72, P <0.05).The activity of T-AOC ((0.43 ±0.04) U/mg) and MMP (12.09 ±1.56) were lower than the control group ((0.48 ± 0.04 U/mg,(16.08 ±3.12) ) (t values were 2.06 and 2.28,P <0.05).Gavage intervention with sulforaphane , the MDA amount ( ( 0.67 ±0.05 ) , ( 0.55 ±0.05 ) , ( 0.56 ±0.07 ) U/mg ) in the sulforaphane low , middle and high dose groups were lower than the hight-fat group ( ( 0.87 ±0.05 ) U/mg (t values were 3.65,5.71 and 5.60.P<0.05).The activity of T-AOC((0.49 ±0.05),(0.55 ±0.05), (0.54 ±0.04) U/mg), T-SOD((61.07 ±2.79), (55.95 ±2.39), (60.26 ±6.02) U/mg) and the level of MMP((17.17 ±2.52), (18.24 ±2.54), (18.21 ±3.65)) were higher than in the high-fat group ((0.43 ±0.04) U/mg,(47.22 ±2.43) U/mg,(12.09 ±1.56))(tT-AOC values were -2.36, -4.83 and-4.30;tT-SOD values were -6.37, -4.71 and -5.99; tMMP values were -2.90,-3.52 and -3.50, P<0.05 ).The activity of GSH-Px in the sulforaphane low and middle dose groups ( ( 69.12 ±8.63 ) , (64.43 ±6.58) U/mg) were higher than those in the high-fat group((53.03 ±5.70) U/mg)(t values were -3.82 and -2.71,P<0.05).But there were no significant difference between the high dose group ((60.02 ±7.05) U/mg) and the high-fat group (t=-1.66,P>0.05).Conclusion High-fat diet can induce the mitochondrial oxidative dysfunction in kidney , and sulforaphane shows protective effect on the kidney mitochondrial complex from oxidative damage in obese rats induced by high -fat diet.