Kidney transplantation has achieved significant success in treating end-stage renal disease. Nevertheless, it still faces a series of complex and significant challenges after surgery, such as infection, rejection, ischemia-reperfusion injury and chronic renal allograft dysfunction, etc. With the development of science and technology, including biomaterials, gene sequencing and other emerging technologies, Chinese researchers have launched a series of remarkable research in the field of kidney transplantation, aiming to solve these thorny issues. In 2023, relevant research of kidney transplantation in China not only focused on resolving the above challenges, but also highlighting on expanding novel technologies and concepts to build a brighter future of kidney transplantation. In this article, academic achievements of Chinese research teams in the field of kidney transplantation in 2023 were systematically reviewed, covering the frontiers of basic and clinical research and the application of emerging technologies, aiming to provide novel ideas and strategies for major clinical problems in the field of kidney transplantation from the local perspective and accelerate the advancement of kidney transplantation in China to a higher peak.

Allografts ; COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Kidney Transplantation/adverse effects* ; SARS-CoV-2

Objective To investigate the risk factors of bloodstream infection-related death after liver transplantation.Methods The retrospective case-control study was adopted.The clinical data of the 107 patients with bloodstream infection from 365 liver transplantation patients who were admitted to the Third Xiangya Hospital of Central South University (220 patients) and South Central Hospital Affiliated to Wuhan University (145 patients) from January 1,2002 to December 31,2015 were collected.The patients received modified piggyback liver transplantation.The second or third generation celphalosporin or carbapenems antibiotics were preventively used against infection according to the bacterial culture results before surgery,and the immune inhibitor basic program after surgery was FK506 + prednisone.The observation indicators included:(1) the bloodstream infection status after liver transplantation:incidence of bloodstream infection,frequency of bloodstream infection,inadequate antiinfection treatment,primary infection position,microorganism infection type,bacterial culture results and bloodstream infection-related mortality.(2) The risk factors of blood stream infection-related death after liver transplantation in univariate and multivariate analyses in cluded:the gender,age,resource of donor,usage of immune inhibitor,time between infection and liver transplantation,infection temperature,primary infection position(intraperitoneal or biliary infection),pathogenic microorganism type,nosocomial infection,inadequate antibiotic usage,serum creatinine level,serum albumin (Alb) level,white blood cell (WBC) in peripheral blood,lymphocyte in peripheral blood,platelet (PLT) in peripheral blood and septic shock indexes.The patients were followed up by outpatient examination and telephone interview up to January 31,2016,the follow-up contents included the survival status of the patients,vital signs,using status of immune inhibitor,immune inhibitor concentration,blood routine,biochemical indexes,surgery,other infection-related complications and acute rejection.Continuous variables with normal distribution were represented as ~ ± s.The univariate analysis was done by the Chi-square test.The multivariate analysis was done by the Logistic regression model.Results (1) The bloodstream infection status after liver transplantation:186 bloodstream infections were happened in 107 patients undergoing liver transplantation,with a total incidence of bloodstream infection of 29.32％ (107/365).The incidence of bloodstream infection was 28.18％ (62/220) in the Third Xiangya Hospital of Central South University and 31.03％ (45/145) in the South Central Hospital Affiliated to Wuhan University,with no statistical difference (x2=0.186,P ＞0.05).Of 107 patients,56 patients had once bloodstream infection,31 had twice bloodstream infection and 20 had three times or more bloodstream infection (frequency of the most bloodstream infection was 6).The inadequate anti-infection treatment was applied to the 41.12％ (44/107)of patients with liver transplantation and bloodstream infection.The number of patients with primary infection positions in abdomen,lung,urethra,intravascular catheter and unknown sites were 40,39,3,1 and 24,respectively.The Gram positive bacteria,Gram negative bacteria,fungus and mixed infection of microorganism infection type were detected in 28,24,4 and 51 patients,respectively.There were 102 patients with nosocomial infection.Bacteria culture results in 186 strains of blood sample illustrated:84 strains were Gram positive bacteria as major pathogenic bacteria,among which enterococcus (31 strains) and staphylococcus aureus (23 strains) were dominant strains.The bloodstream infection-related mortality was 37.38％ (40/107),including 35 patients dying of septic shock.(2) The univariate analysis showed that the gender,resource of the donor,infection temperature,type of microorganism,serum creatinine level,serum Alb level,WBC in peripheral blood,PLT in peripheral blood and septic shock were the risk factors affecting bloodstream infection-related death after liver transplantation (x2=5.801,5.920,13.047,12.776,11.366,7.976,25.173,9.289,51.905,P ＜0.05).The multivariate analysis showed that serum Alb level ＜ 30 mg/L and septic shock were the independent risk factors affecting bloodstream infection-related death after liver transplantation (OR =5.839,44.983,95 ％ confidence interval:1.145-29.767,12.606-160.514,P ＜ 0.05).Conclusion It is prone to happen bloodstream infection after liver transplantation,and serum Alb level ＜ 30mg/L and septic shock are the independent risk factors affecting bloodstream infection-related death after liver transplantation.

[ ABSTRACT] AIM: To investigate the seroprevalence of neutralizing antibodies to human adenovirus type 5 (AdHu5) , human adenovirus type 26 (AdHu26) and chimpanzee adenovirus type 68 (AdC68) in the patients with chro-nic hepatitis B ( CHB) and the patients with primary liver cancer ( PLC) , and to provide guidance for developing safe and effective biotherapy vectors against CHB and PLC.METHODS:The blood samples from 196 patients with CHB and 193 patients with PLC were examined to assess the presence of neutralizing antibodies against AdHu5, AdHu26 and AdC68 by adenovirus neutralization assays.RESULTS:The seroprevalence rates of neutralizing antibodies to AdHu5, AdHu26 and AdC68 in the CHB patients were 84.7%, 58.2%and 39.8%, respectively.Among the patients with PLC, the prevalence rates of neutralizing antibodies were as follows:AdHu5, 75.1%;AdHu26, 66.8%;AdC68, 32.1%.CONCLUSION:The prevalence rates and titers of neutralizing antibodies against AdC68 were the lowest among the 3 adenoviruses.There-fore, AdC68 serves as more suitable biological therapy vectors for CHB and PLC than AdHu5 and AdHu26.

PI3K/Akt pathway is a biological signal transduction pathway activated by phosphatidylinositol 3-kinase (PI3K).It plays a key role in cell proliferation,cell-cycle regulation,apoptosis initiation,and angiogenesis.In addition,the PI3K/Akt pathway is closely associated with the protection mechanisms of central nervous system damage.In-depth study of PI3K/Akt,downstream molecules and their regulation mechanisms,can provide some new ideas and methods for the treatment of brain injury.

Objective:To investigate the clinical manifestation and determine the distribution of pathogens and their characteristics of drug susceptibility to bloodstream infections (BSIs), and provide evidence for clinical anti-infection treatments after renal transplantation.
Methods:Totally 81 episodes of BSIs occurred in 71 patients between July 2003 and June 2013. We retrospectively analyzed the pathogens and their drug susceptibility characteristics with BD microbiological assay system. We also collected the clinical and laboratory data of the patients . Results:The main pathogens were gram negative bacteria (67.90%), followed by gram positive bacteria (28.40%) and fungi (3.70%). The most common gram negative bacillus was Escherichia coli.While for gram positive bacteria, the main bacillus was coagulase-negative staphylococci. The gram negative bacteria were relatively sensitive to aminoglycosides and carbapenem. The gram positive bacteria were sensitive to glycopeptides and oxazolidone.
Conclusion:The clinical manifestations included high body temperature, onset in the early period after kidney transplantation and high mortality. Though gram positive coccus plays an important role, most infections are caused by gram negative bacteria in BSIs after the renal transplantation. The antibiotic resistant rate for gram negative bacteria is very high as well as gram positive bacteria.

There were a lot of differences between the American and Chinese medical education.Students in American should obtain bachelor's degree of humanities or science before reciveing medical doctor's degree at graduation.High altitude militray medicine is a characteristic discipline of the third military medical university,aming at training general doctors for the plateau.During the designing of high altitude militray medicine curriculum and its teaching process,we actively learned from the advanced experiences of American based on the reality,optimizd currulum,improved teaching methods,greatly cultivated the students' protential in order to increase the qualify of high altitude militray medicine personnel.

OBJECTIVE: To explore the risk factors for septic shock in patients with solid organ transplantation and complication of bacteremias. METHODS: Clinical data of 98 solid organ transplant cases with complication of bacteremias were retrospectively studied. All episodes of bacteremias met the CDC criteria. Six possible risk factors contributing to septic shock were evaluated by univariate analysis and multivariate logistic regression analysis. RESULTS: Among the 98 patients, 133 times of bacteremias have been reported and 39 patients developed septic shock. Among the 39 patients with septic shock, 43.5%, 38.5%, 15.4% and 2.6% of bacteremias were induced by multiple bacteria, gram-negative bacteria, gram-positive bacteria and fungi, respectively. The lung was the main source of bacteremias (41.8%), followed by intraabdominal/ biliary focus (24.5%). Risk factors for developing septic shock included the bacteremias happened in the 2nd to 8th week post transplant (P=0.014), polymicrobial etiology (P=0.001), intra-abdominal/ biliary focus (P=0.011), and liver transplant (P=0.002). Only bacteremias occurred in the 2nd to 8th week post transplant and polymicrobial etiology were significant risk factors by multivariate analysis. CONCLUSION Risk factors for developing septic shock in bacteremias after SOT are early-onset (the 2nd-8th week post transplant) and polymicrobial etiology.
Bacteremia ; complications ; Humans ; Multivariate Analysis ; Organ Transplantation ; adverse effects ; Retrospective Studies ; Risk Factors ; Shock, Septic ; complications

OBJECTIVE: To investigate the possible risk factors for death among liver or kidney recipients with bloodstream infections (BSIs). METHODS: A retrospective study of 138 episodes of bloodstream infections documented in 103 patients was conducted to assess potential risk factors for mortality. The risk factors were identified by logistic regression analysis. RESULTS: The mean age of the patients was 12-66 (42.3±12.7) years. The majority of infections were nosocomial (78.6%). The BSIs-related mortality rate was 39.8% (41/103). The following variables were identified as risk factors for BSIs-related mortality by univariate analysis: intraabdominal/ biliary focus (P=0.003), polymicrobial infection (P<0.001), liver transplant (P<0.001), platelet count <50000/mm3 (P<0.001), and septic shock (P<0.001). Platelet count < 50000/mm3 (P=0.002) and septic shock (P<0.001) showed significantly difference between the mortality group and the survival groups in the multivariate logistic regression analysis. CONCLUSION Decreased platelet count and septic shock are risk factors for increased
Adolescent ; Adult ; Aged ; Bacteremia ; epidemiology ; etiology ; mortality ; Cause of Death ; Child ; China ; epidemiology ; Female ; Gram-Negative Bacterial Infections ; epidemiology ; etiology ; mortality ; Humans ; Kidney Transplantation ; adverse effects ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Shock, Septic ; epidemiology ; Thrombocytopenia ; epidemiology ; Young Adult

Background: With the increase of troops entering the plateau for a variety of missions, the occurrence of de-adaptation increased significantly when the army returned to the plains, however, until now, there has been no effective treatment for de-adaptation to high altitude. Objective: To observe the interventional effects of compound Chinese herbal preparations (Sankang Capsule, Rhodiola Rosea Capsule and Shenqi Pollen Capsule) on de-adaptation to high altitude, and provide scientific evidence for appropriate treatment methods in the army health care for future missions. Design, setting, participants and interventions: A randomized, single-blind, placebo-controlled trial design was used. Soldiers of a returning army unit who exhibited de-adaptation response symptoms were selected for observation after participating in earthquake relief at high altitude. A total of 543 soldiers were divided into a Sankang Capsule group, a Rhodiola Rosea Capsule group, a Shenqi Pollen Capsule group and a placebo group for drug intervention and administered with corresponding drugs. The course of treatment was 15 days. A self-evaluation scale for de-adaptation to high altitude was used to measure the signs and symptoms exhibited by the soldiers. Main outcome measures: Effective rate of signs and symptoms of de-adaptation to high altitude was analyzed after a 15-day treatment and the differences of improvement rate of symptoms between groups were compared to evaluate the efficacy of the drugs. Results: All three drugs improved the symptoms of de-adaptation to high altitude. Compared with the placebo group, symptoms of de-adaptation to high altitude in the drug-treated groups were remitted (P<0.05). Compared with placebo, Sankang Capsule mainly had well-marked effects on dizziness, fatigue, palpitations, cough, sputum and sore throat (P<0.05); Rhodiola Rosea Capsule significantly reduced the symptoms of fatigue, drowsiness, chest tightness, palpitations, vertigo, lack of attention and memory loss (P<0.05); Shenqi Pollen Capsule significantly reduced the symptoms of dizziness, fatigue, weakness, chest tightness, palpitations, cough, sputum, sore throat, memory loss, unresponsiveness and limb numbness (P<0.05). The symptom improvement rate of Shenqi Pollen Capsule was significantly higher than those of the other two drugs. Conclusion: All the three drugs played an evident role in ameliorating symptoms of de-adaptation, and the use of Shenqi Pollen Capsule was more effective than Rhodiola Rosea Capsule and Sankang Capsule.