The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

Objective To explore the predictive factors of axillary lymph node metastasis in breast cancer,and to provide a basis for clinical decision-making under the DIP payment mode of medical insurance.Methods A total of 715 patients with breast cancer were divided into the metastasis group(n=309)and the non-metastasis group(n=406)according to the postoperative paraffin pathological results.Data of age＞60 years old,menopausal status,body mass index(BMI)＞24 kg/m2,hyperglycemia(GLU＞6.1 mmol/L),high triglycerides(TG＞1.7 mmol/L),maximum diameter of the tumor,the distance between the tumor and nipple and the quadrant where the tumor located were compared between the two groups.The expression levels of estrogen receptor(ER),progesterone receptor(PR),nuclear proliferation antigen(Ki-67)and human epidermal growth factor receptor-2(Her-2)in breast cancer tissue samples were detected by histological grading and immunohistochemistry.The consistency,sensitivity and specificity of chest CT and breast ultrasound were examined,taken the pathological diagnosis as the gold standard.Results Compared with the non-metastatic group,the proportion of maximum diameter of tumor＞2 cm,histological grade Ⅲ,high Ki-67 and high ER expression,tumor located in the outer upper quadrant,the distance＞3 cm between tumor and nipple were increased in the metastatic group,and the proportion of high level of TG was decreased in the metastatic group(P＜0.05).The consistency between chest CT and pathological diagnosis was better than that of breast ultrasound(Kappa was 0.493 and 0.353 respectively,P＜0.05).Logistic regression analysis showed that histological grade Ⅲ,high expression of ER,maximum diameter of tumor＞2 cm,and chest CT diagnosis were risk factors for axillary lymph node metastasis(P＜0.05).Conclusion The combined application of the predictive factors of axillary lymph node metastasis of breast cancer could provide certain reference for clinical decision-making under the background of DIP payment mode of medical insurance.

Objective To investigate the incidence and risk factors of postcholecystectomy syndrome (PCS), and provide theoretical basis for the prevention of PCS. Methods A total of 338 patients with PCS were randomly selected in our hospital from May 1st 2013 to April 30th 2014, in which 316 cases were successful followed up including 101 males and 215 females. The data were collected from the 7 aspects including blood type, drinking history, smoking history, diabetes history, mental anxiety, dietary tendence and preoperative symptoms, and which were analyzed by binary-logistic regression analysis. Results According to the PCS diagnostic criteria, 115 patients were diagnosed with PCS (36.39%). The anxiety status and preoperative discomfort were closely related to the occurrence of PCS, with statistically significant difference (P<0.05). Conclusion The diagnosis and treatment of PCS are more complicated. We should focus on the prevention of PCS according to its risk factors, and pay attention to preoperative communication and individualized analysis of patients in order to reduce the occurrence of PCS.

Objective To study the effect of embolization of gastric coronary and short veins on the control of hemorrhage from gastric fundal varices. Methods Thirty-two patients with liver cirrhosis and hemorrhage from esophagus and fundal varices, who still had variceal bleeding after endoscopic banding or sclerosing of esophageal varices were included in the study. Gastric coronary and short veins were (embolized) by percutaneous, transhepatic embolization with absolute alcohol, steel ring, or gelfoam. The follow-up of 3 to 11 months was carried out after embolization. Results The follow-up endoscopy showed that the varices of gastric fundus disappeared completely in 21 of 29 patients (72.4%), and (eleminated) partially in 8 patients (27.6%). Only one patient (3.1%) had re-bleeding due to portal (hypertensive) gastropathy in the follow-up period. No obvious complication was found in these patients. Conclusions The varices of gastric fundus could be obliterated by percutaneous, transhepatic embolization of gastric coronary and short veins.

Objective To evaluate the efficacy and complication of endoscopic dense ligation for bleeding esophageal varices(EV). Methods 128 cases of EV experienced varcies ligation, and 16～22 points(average 18.8 points) of the varices were ligated by using dense ligation, while only 5～6 points were ligated in common ligation (common method) for varices. All patients got one to two times of ligation therapy. Results In dense ligation group, the rate of prompt hemostasis was 96.9%, rate of elimination of EV was 92.2% with one therapy, and 96.9% with twice therapy, while the rate of bleeding was 0.8%. In common method the rates were 95.7%, 42.6%, 64.7% and 7.1% respectively. Between the two groups, the rate of elimination of EV and rebleeding had significant difference (P

Objective:To investigate the effects of mucosal strengthening treatment on preventing recurrence of closedvarices. Methods: In 264 patients with esophageal varices obliteration by banding ligation and sclerotherapy, of 136 patientswere gone on to treat with strengthening mucosa, and 128 patients without strengthening treatment. All patients had beenobserved out of hospital for 1-13 years. Results: There were no recurrence and rebleeding of esophageal varices in the groupwith strengthening treament. But in the group without strengthening treatment, 25 patients (19. 5%) had isolated or strip-like varices with red colour signI small veins grew thick and part of mucosa appeared clear hyperaemia in 21 patients(16.4% ); 6 patients (4.7% ) rebleeded. There were significant differences between two groups (P