Objective:To compare the efficacy of single kidney transplantation (KT) from pediatric donors between donors aged <2 and 2- 18 years.Methods:Between August 2016 and May 2023, 127 single pediatric kidney transplantations involving pediatric donors were conducted. They were assigned into two subgroups based upon age of small pediatric donors (n=22, SPD, donors aged <2 years) and normal pediatric donors (n=105, NPD, donors aged 2-18 years). A retrospective analysis was performed to compare recipient/donor baseline characteristics, postoperative complications and recipient/graft survival rates between two groups.Results:Significant inter-group differences existed in donor age[11.0 (10.0, 15.0) vs 121.0 (74.0, 166.0) month], donor weight[8.3 (8.0, 9.4) vs 30.0 (20.0, 50.0) kg]and graft-to-recipient weight ratio[0.3 (0.2, 0.5) vs 1.0 (0.6, 1.5) ] ( P<0.001). Conversely, no significant inter-group differences existed in donor gender/type, warm/cold ischemic time, human leukocyte antigen mismatch number, estimated glomerular filtration rate, recipient gender/age/weight, number of transplants, preoperative dialysis, preoperative induction therapy, panel-reactive antibody or primary disease ( P>0.05). The incidence of vascular thrombosis was 9.1% (2/22) and 0 in SPD and NPD groups with statistically significant differences ( P=0.029) ; the incidence of post-transplant hemorrhage was 13.6% (3/22) and 1.9% (2/105) with statistically significant difference ( P=0.036). However, no statistically significant inter-group differences existed in recurrent renopathy, delayed graft function or 1-year cumulative incidence of acute rejection ( P>0.05). Six recipients (27.3%) in SPD group lost allografts due to recurrent or primary nonfunction (n=1), vascular thrombosis (n=2), post-transplant hemorrhage (n=2) and thrombotic microangiopathy (n=1). In comparison, three recipients (2.9%) in NPD group lost allografts due to rejection (n=2) and infectious rupture of transplanted renal artery (n=1). Three-year recipient survival rates were 100% and 99.0% in SPD and NPD groups with no statistically significant differences ( P=0.600). And 3-year death-censored graft survival was significantly lower in SPD group than that in NPD groups (77.3% vs 91.5%) ( P<0.001, HR=8.3, 95% CI: 2.0-34.2) . Conclusions:Early postoperative vascular complications after single pediatric KT from pediatric donors aged under 2 years are frequent and predispose to graft loss.

Objective:To compare the efficacy of single kidney transplantation (KT) from pediatric donors between donors aged <2 and 2- 18 years.Methods:Between August 2016 and May 2023, 127 single pediatric kidney transplantations involving pediatric donors were conducted. They were assigned into two subgroups based upon age of small pediatric donors (n=22, SPD, donors aged <2 years) and normal pediatric donors (n=105, NPD, donors aged 2-18 years). A retrospective analysis was performed to compare recipient/donor baseline characteristics, postoperative complications and recipient/graft survival rates between two groups.Results:Significant inter-group differences existed in donor age[11.0 (10.0, 15.0) vs 121.0 (74.0, 166.0) month], donor weight[8.3 (8.0, 9.4) vs 30.0 (20.0, 50.0) kg]and graft-to-recipient weight ratio[0.3 (0.2, 0.5) vs 1.0 (0.6, 1.5) ] ( P<0.001). Conversely, no significant inter-group differences existed in donor gender/type, warm/cold ischemic time, human leukocyte antigen mismatch number, estimated glomerular filtration rate, recipient gender/age/weight, number of transplants, preoperative dialysis, preoperative induction therapy, panel-reactive antibody or primary disease ( P>0.05). The incidence of vascular thrombosis was 9.1% (2/22) and 0 in SPD and NPD groups with statistically significant differences ( P=0.029) ; the incidence of post-transplant hemorrhage was 13.6% (3/22) and 1.9% (2/105) with statistically significant difference ( P=0.036). However, no statistically significant inter-group differences existed in recurrent renopathy, delayed graft function or 1-year cumulative incidence of acute rejection ( P>0.05). Six recipients (27.3%) in SPD group lost allografts due to recurrent or primary nonfunction (n=1), vascular thrombosis (n=2), post-transplant hemorrhage (n=2) and thrombotic microangiopathy (n=1). In comparison, three recipients (2.9%) in NPD group lost allografts due to rejection (n=2) and infectious rupture of transplanted renal artery (n=1). Three-year recipient survival rates were 100% and 99.0% in SPD and NPD groups with no statistically significant differences ( P=0.600). And 3-year death-censored graft survival was significantly lower in SPD group than that in NPD groups (77.3% vs 91.5%) ( P<0.001, HR=8.3, 95% CI: 2.0-34.2) . Conclusions:Early postoperative vascular complications after single pediatric KT from pediatric donors aged under 2 years are frequent and predispose to graft loss.

Objective To describe the chnical, neuroimagine, pathological and genetic features in a case with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS)/Leigh overlap syndrome.Methods The ease was a 22-year-old woman with recurrent headache, loss of visual acuity and general seizures over 11 years.MRI demonstrated symmetrical high T2-weighted signals in occipital and parietal lobes, in the late stage of the disease, the above imagine changes on MRJ were also shown in the bilateral basal ganglion and brainstem.She died of status epilepticus at age of 22.Brain autopsy and mitochondrial DNA (mtDNA) analysis were performed in the patient.Results The main neuropathological findings were muhifocal and lamilar spongiform in the cortex of the whole brain, the basal ganglion and middle brain.Gliosis, macrophagie reaction and capillary endothelial proliferation were observed in these areas.All 6 layers of the cortex and subcortical white matter in occipital and parietal lobes were severely affected.GI3513A mutation was found in the gene of mitochondria encoded NADH dehydrogenase subunit 5 (MTNDS).Conclusions MELAS/Leigh overlap syndrome presents the symptoms predominantly affecting the cerebral cortex.Neuroimagines suggested that the lesion initially involves the cerebral cortex and in the late stage implicates the basal ganglion and the brainstem, possibly caused by pathological changes of spongiform with capillary proliferation in these areas.

AIM: To investigate the processing and HPLC fingerprint of Radix Scutellariae processed with wine,and to set up appropriate quanlity control standard. METHODS: chromatographic condition of HPLC-UV fingerprint consisted of Hypersil C_18 column(200 mm?5.0 mm,5 ?m),mixture of methanol,0.4% phosphoric acid and acetonitrile as a mobile phase in a gradient mode.Flow rate was 1.0 mL/min and detection wavelength was set at 277 nm. RESULTS: There were no evident differences among fingerprints of Radix Scutellariae that was normatively processed from the production areas. CONCLUSION: The process is feasible,and can be used to provide a basis for quanlity control of Radix Scutellariae.