Objective:To investigate gut microbiota differences between individuals with and without colorectal adenoma(CRA)and to identify gut microbes associated with CRA.Methods:This cross-sectional study analyzed the gut microbiota of 100 patients with CRA and 68 individuals without CRA(aged 40-75 years)who underwent colonoscopies between March 2021 and March 2022 at Tianjin Nankai Hospital.Fecal samples were sequenced for the V3-V4 region of the bacterial 16S rRNA gene using the Illumina NovaSeq platform.Results:Compared to the non-CRA group,the CRA group exhibited reduced relative abundances of identified and unidentified Lachnospiraceae,with increased Faecalibacterium and Streptococcus.In the non-CRA group,the relative abundances of Coprococcus,unidentified Clostridiaceae,and Clostridium were higher.LEfSe analysis revealed significant enrichment of Gammaproteobacteria,Proteobacteria,Enterobacteriales,and Faecalibacterium in the CRA group,while the non-CRA group was enriched for Moraxellaceae,Acinetobacter,and Anaerostipes.Conclusions:These findings suggest a discernible disparity in the gut microbiota structure between CRA patients and individuals without adenoma.The enrichment of potential pathogenic taxa,such as Faecalibacterium and Streptococcus,in the CRA group suggests a possible association with adenoma development.

Objective:To investigate gut microbiota differences between individuals with and without colorectal adenoma(CRA)and to identify gut microbes associated with CRA.Methods:This cross-sectional study analyzed the gut microbiota of 100 patients with CRA and 68 individuals without CRA(aged 40-75 years)who underwent colonoscopies between March 2021 and March 2022 at Tianjin Nankai Hospital.Fecal samples were sequenced for the V3-V4 region of the bacterial 16S rRNA gene using the Illumina NovaSeq platform.Results:Compared to the non-CRA group,the CRA group exhibited reduced relative abundances of identified and unidentified Lachnospiraceae,with increased Faecalibacterium and Streptococcus.In the non-CRA group,the relative abundances of Coprococcus,unidentified Clostridiaceae,and Clostridium were higher.LEfSe analysis revealed significant enrichment of Gammaproteobacteria,Proteobacteria,Enterobacteriales,and Faecalibacterium in the CRA group,while the non-CRA group was enriched for Moraxellaceae,Acinetobacter,and Anaerostipes.Conclusions:These findings suggest a discernible disparity in the gut microbiota structure between CRA patients and individuals without adenoma.The enrichment of potential pathogenic taxa,such as Faecalibacterium and Streptococcus,in the CRA group suggests a possible association with adenoma development.

Humans ; COVID-19 ; Quarantine ; Renal Dialysis ; SARS-CoV-2 ; Hospitals

Objective:We aimed to evaluate the predictive value of pre-implantation biopsy combined with Lifeport for the short-term prognosis of kidney allograft from donation after citizen death (DCD).Methods:Data from a total of 34 patients who had undergone kidney transplantation in Jinling Hospital from December 2017 to December 2019 were retrospectively analyzed. Histopathological data from pre-implantation biopsy , Lifeport parameters and recipient kidney transplant function at 3 months post-surgery were collected. The performances of histopathological indexes , and Lifeport parameters to predict delayed graft function (DGF) and estimated glomerular filtration rate (eGFR) at 3 months post-surgery were observed evaluated.Results:13 cases of DGF occurred, accounting for 38.2%. Serum creatinine at death and resistance index (RI) at 0.5 h, 1 h, 2 h and 4 h after Lifeport hypothermic machine perfusion (HMP) in the DGF group was significantly higher than that in the non-DGF group. Histologically, the acute tubular injury (ATI) score of the DGF group was higher than that of the non-DGF group, whereas the Remuzzi score was not statistically different between the two groups. The eGFR at 3 months post-transplant was moderately correlated with the RI at 4 h HMP and the Remuzzi score (RI: r=-0.48, P<0.001; Remuzzi score: ρ=-0.42, P=0.01), but no correlated with ATI score of the donor kidney. Although Remuzzi score was not correlated with kidney allograft recovery time (ρ=-0.25, P=0.16), it was inversely correlated with eGFR at 3 months post-transplant (ρ=-0.42, P=0.01). Combined use of Lifeport HMP 4-hour RI and ATI score increased the sensitivity and specificity of predicting DGF to 100% (95% CI: 75.3%-100%) and 90.5% (95% CI: 69.6%-98.8%) respectively. Conclusions:The serum creatinine at death, Lifeport RI, and ATI score of the DGF group were significantly higher than those of the non-DGF group, and the eGFR at 3 months post-transplant was correlated with the Lifeport RI and Remuzzi score. Combined use of ATI score and RI at 4 hours of Lifeport perfusion improved the sensitivity and specificity of predicting DGF .

Objective:To explore the clinicopathologic features and renal prognosis of patients with post-transplant membranous nephropathy (MN).Methods:Patients with allograft biopsy-proven MN were reviewed retrospectively and divided into unknown etiology group (A, n=12) and recurrent membranous nephropathy (rMN) group (B, n=7). Their clinicopathological data and renal prognosis were assessed and compared.Results:No differences existed in the proportion of living-related donor or post-transplant allograft function. Group B had recurrence at 16.4 months after transplantation and it was significantly shorter than group A. Allograft impairment manifested as proteinuria, nephrotic syndrome and/or renal insufficiency in both groups. The positive rate of serum anti-PLA2R antibody and renal PLA2R staining was significantly higher in group B than that in group A. Similarly, the intensity of IgG4 subtype staining was also stronger in group B than that in group A. The 5-year cumulative renal survival rates from end-stage renal disease (ESRD) were 77.8% and 66.7% in groups A and B respectively. No significant inter-group difference existed in renal prognosis.Conclusions:Anti-PLA2R antibody plays an important role in the recurrence of rMN after renal allografting. PLA2R staining is useful for detecting primary disease and its sensitivity is higher than that of serum anti-PLA2R antibody. Rituximab is an effective treatment for post-transplant MN. Follow-up studies with a larger sample size are required for further verification.

Objective:To explore the long-term prognosis of chronic active antibody-mediated rejection(cABMR)and independent risk factors for prognosis.Methods:A single-center retrospective cohort with biopsy-proven cABMR was examined. Renal biopsies were scored according to the criteria of Banff 2017. The primary outcome was death-censored graft failure defined as resuming dialysis or estimated glomerular filtration rate(eGFR)decreased to <15 ml·(min·1.73m 2) -1. The prognostic significance of clinical and histopathologic parameters were determined by a Cox proportional hazard model. Results:Clinical data from 149 cases were available for analysis with a median follow-up of 28(15~51)months. In a multivariable model, ci + ct score(HR 3.0; 95 % CI 1.9~4.7), cg score(HR 1.9; 95 %CI 1.1~3.1), eGFR(HR 2.0; 95 % CI 1.3~3.2)and proteinuria(HR 2.0; 95 %CI 1.3~3.2)were independent predictors of primary outcome.Conclusions:eGFR, proteinuria, Banff ci + ct and Banff cg are independent risk factors for the prognosis of cABMR.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective: To evaluate the efficacy and safety of bortezomib in kidney transplant recipients with chronic active antibody-mediated rejection (cABMR). Methods: A retrospective study wad conducted in patients(n=136)fulfilling the Banff 2017 criteria for cABMR from January 2004 to July 2017, including 29 patients bortezomib group and 97 patients in control group. Identified cABMR patients were dichotomized into bortezomib and control groups with a 1∶1 match using the propensity score matching method. The primary outcome was initiation of replacement therapy or an estimated glomerular filtration rate(eGFR)declined to <15 ml·min^-1·(1.73m²)^-1. The prognosis and adverse reactions of two groups were analyzed and evaluated. Results: No significant inter-group differences existed in age, sex ratio, immunosuppressive regimen, allograft age, serum creatinine, eGFR, urine protein, serum albumin, hemoglobin or HCV positive rate(all P>0.05). There were no significant inter-group differences in Banff scores (g, i, t, v, ah, mm, ci, ct, cv, ptc, c4d, all P>0.05). The median survival for bortezomib group and control group was 40.7 months and 36.9 months respectively. No statistically significant difference in graft survival between the two groups was observed(P=0.83), even after propensity score adjustment(P=0.29). The incidence of nausea, diarrhea and thrombocytopenia in bortezomib group was higher than those in control group (P<0.05). Conclusions Bortezomib does not seem to improve the prognosis of cABMR while is associated with higher incidence of adverse reactions.

Objective To study the clinical characteristics,cardiac magnetic resonance (CMR)features,and genetype of hypertrophic cardiomyopathy (HCM) in neonates.Method HCM newborns diagnosed at pediatric department of Anzhen Hospital Affiliated to Capital Medical University from January 2015 to December 2018 were retrospectively collected.The clinical manifestations,imaging features and genetype were analyzed.Result During the study period,there were 11 227 deliveries and 11 397 live births.52 of the parturient women were diagnosed as HCM before or during pregnancy (0.46％,52/11 227).54 neonates were delivered from HCM mothers.Among them,5 were diagnosed as HCM (5/11 397,0.04％).In addition,there was another infant patient who was admitted from another hospital.In total,6 HCM infants were included in this study,with 4 males and 2 females.The average gestational age of the infants was (36.6 ± 1.2) weeks,with 3 preterm infants,and the others were full-term infants.The median age of diagnosis was 1 day.The clinical manifestation was that 4 patients needed rest in the course of suckling,3 of them also had accompanied symptoms,with pale face,cyanosis while crying and sweating in each case.CMR showed that the ventricular septum was (6.80 ± 1.78)mm,ejection fraction was (60.0 ± 2.8)％.All six patients showed septal thickening on CMR,including a case with right ventricular myocardial hypertrophy,another with left ventricular outflow tract obstruction and late gadolinium-enhanced.The infants were all treated with metoprolol.They were followed up until 6 months to 2 years old.Among them,4 cases had no progress in myocardial thickening.Two cases had progressive myocardial thickening,one of them was diagnosed as end-stage HCM at 2 year-old.Three MYBPC3 mutations,one MYH7 gene mutation,one MYH7 gene mutation combined with TMPO gene mutation and one RYR2 gene mutation were detected.Conclusion The neonatal HCM is characterized by thickening of ventricular septum,outflow tract obstruction and delayed enhancement of CMR.The most common HCM mutations were MYBPC3 and MYH7,the most common clinical symptoms were breast feeding interruption,followed by cyanosis,pale and sweating.It is suggested that beta-blockers should be recommended for neonates with hypoxic episodes or outflow tract obstruction.

Objective To analyze the epidemiological characteristics and influence factors of human brucellosis in Jilin Province and provide scientific basis for enacting prevention and control strategy to brucellosis in the new period.Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics (regional distribution,time distribution,population distribution,etc.),influencing factors (risk factors,protective measures and epidemic prevention),epidemic links,detection methods,clinical stages and prognosis of reported brucellosis cases in Jilin Province from 2011 to 2017.Results From 2011 to 2017,12 116 cases of brucellosis were reported in Jilin Province,with an average incidence of 6.30/100 000.The annual incidence rates were 7.51/100 000,7.11/100 000,7.36/100 000,6.58/100 000,5.90/100 000,5.38/100 000 and 4.24/100 000,respectively.The reported cases were mainly distributed in Songyuan City and Baicheng City,accounting for 73.29％ (8 880/12 116) of the total number of reported cases;the time was from January to July,and the peak was from March to May.The age of onset ranged from 20 to 70 years old,mainly in young and middle-aged adults,accounting for 95.86％ (11 615/12 116) of the total number of reported cases.The following factors were studied:to take protective measures rate,human and animal mixed live,the same water source,colony house housing disinfection,manage abortion,buy animal quarantine,raise livestock immunity,and the proportion of these factors in each year was 24.38％ to 43.33％,3.11％ to 17.35％,63.68％ to 76.58％,25.40％ to 35.07％,21.66％ to 34.49％,9.32％ to 29.66％,26.09％ to 45.45％,respectively.The main infection source was sick sheep,accounting for 96.72％ (11 718/12 116).Skin mucosa was the main route of transmission,followed by digestive tract,accounting for 61.55％ (7 458/12 116) and 34.17％ (4 140/12 116),respectively.The main transmission factors were apoblema and flying dust,accounting for 55.68％ (6 746/12 116) and 35.62％ (4 316/12 116),respectively.The number of reported cases of brucellosis was 90.55％ (10 971/12 116) through passive monitoring.The clinical stage was mostly acute,accounting for 92.01％ (11 148/12 116).Healing and improvement accounted for 60.80％ (7 367/12 116) and 37.93％ (4 596/12 116),respectively.Conclusions Brucellosis has dropped slightly in Jilin Province in 2011-2017,but remains high;the epidemic situation is still grim.We should further strengthen monitoring,health education and health promotion,team construction,in order to effectively control the occurrence of human brucellosis.