Objective:To explore the risk factors affecting the incidence of acute kidney injury(AKI)after liver transplantation(LT).Methods:From November 2019 to November 2022, clinical data were retrospectively reviewed for 105 recipients of classic orthotopic LT.There are 89 males and 16 females with an age range of(50.52±10.35)years.They are assigned into two groups of AKI(66 cases)and non-AKI(39 cases)according to the AKI diagnostic and staging criteria of Global Kidney Disease Prognosis Organization in 2012.General profiles and clinical data(e.g.previous medical history, MELD score, total bilirubin, albumin, serum creatinine level, coagulation function, anhepatic phase and time to surgery)of two groups of recipients are compared.The factors with statistically significant differences are included into multivariate Logistic regression analysis for obtaining independent risk factors for early AKI post-LT.Results:Among them, 66 patients developed AKI within 7 days post-operation with an incidence rate of 62.86%(66/105).The clinical stages of AKI are Ⅰ(46 cases, 69.70%), Ⅱ(10 cases, 15.15%)and Ⅲ(10 cases, 15.15%).Statistically significant inter-group differences exists in age, abdominal surgery history, preoperative serum level of creatinine, operative duration, anhepatic phase and intraoperative plasma transfusion(all P<0.05).Multivariate Logistic regression analysis indicated that abdominal surgery history( OR=5.803, 95% CI: 1.008~33.401, P=0.049), anhepatic phase( OR=1.054, 95% CI: 1.008~1.101, P=0.020)and preoperative serum level of creatinine( OR=0.968, 95% CI: 0.943~0.994, P=0.016)are independent risk factors for early AKI after classical orthotopic LT recipients. Conclusions:Abdominal surgery history, anhepatic phase, and preoperative serum level of creatinine are independent risk factors for early AKI in classic orthotopic LT recipients.

Background: Studies have shown that abnormal expression of circular RNA (circRNA) is closely related to the development, progress and prognosis of a variety of tumors, and is an ideal diagnostic indicator and therapeutic target. However, the role of circRNA in the development and progress of pancreatic cancer needs to be further explored. Aims: To investigate the expression of circ-RANBP1 in pancreatic cancer tissue and its effect on pancreatic cancer cell proliferation, migration and invasion. Methods: The expression of circ-RANBP1 in pancreatic cancer tissue and normal para-cancerous tissue was detected by in situ hybridization. MIA PaCa-2 cells and SW 1990 cells were cultured, and transfected with knockdown oligomer and overexpressed plasmid of circ-RANBP1, respectively, and corresponding control groups were served. Expression of circ-RANBP1 in pancreatic cancer cells was detected by qRT-PCR. EdU method was used to detect the effect of circ-RANBP1 on cell proliferation. Transwell assay was used to detect the effect of circ-RANBP1 on cell migration and invasion. Western blotting and immunofluorescence were used to detect the effect of circ-RANBP1 on epithelial-mesenchymal transition (EMT). Angiogenesis assay was used to explore the effect of circ-RANBP1 on angiogenesis ability. Results: The expression of circ-RANBP1 was significantly increased in pancreatic cancer tissue when compared with paired normal tissues, and was closely associated with poor prognosis of patients. Circ-RANBP1 knockdown inhibited the proliferation of MIA PaCa-2 cells, while overexpression of circ-RANBP1 promoted the proliferation of SW 1990 cells. Compared with control group, circ-RANBP1 knockdown suppressed the migration and invasion of MIA PaCa-2 cells, and overexpression of circ-RANBP1 promoted the migration and invasion of SW 1990 cells. Knockdown of circ-RANBP1 could inhibit EMT, while circ-RANBP1 overexpression showed opposite effect. Inhibition of circ-RANBP1 significantly reduced angiogenesis, while overexpression of circ-RANBP1 significantly enhanced angiogenesis. Conclusions: Circ-RANBP1 is highly expressed in pancreatic cancer tissue, and can promote the proliferation, migration, invasion, EMT and angiogenesis of pancreatic cancer cells.

Objective: To investigate whether adipose-derived stem cells (ASCs) from allogeneic diabetic rats can promote wound healing in diabetic rats or not and the mechanism. Methods: (1) Fifty-six male Wistar rats aged 12-16 weeks were divided into diabetic group and healthy group according to the random number table (the same grouping method below), with 28 rats in each group. Rats in healthy group were not treated with any treatment. Rats in diabetic group were injected with 10 g/L streptozotocin 60 mg/kg intraperitoneally in one time to establish the diabetic model. Four rats in diabetic group and 4 rats in healthy group were selected according to the random number table, and the adipose tissue in the inguinal region was taken to culture and purify ASCs, so as to obtain healthy rat-derived ASCs (hereinafter referred to as nASCs) and diabetic rat-derived ASCs (hereinafter referred to as dASCs). The third passage of nASCs (n=3) and dASCs (n=3) were taken, and the positive expression rates of cell surface differentiation antigens CD105, CD31, CD34, and CD44 were detected with flow cytometer for defining ASCs purity. (2) The rest 24 rats in healthy group and 24 rats in diabetic group were used to make three round full-thickness skin defect wounds with a diameter of 12 mm on the back of each rat. Immediately after injury, phosphate buffer saline (PBS), nASCs of 2×10⁷/mL, and dASCs of 2×10⁷/mL each in the volume of 0.5 mL were subcutaneously injected into three wounds and their margins of each rat, respectively. On post injury day (PID) 1, 3, 7, and 12, 6 rats in each group were selected according to the random number table to calculate the wound area, and the wound tissue was stained with hematoxylin-eosin to observe the histological morphology of the wound. (3) Human ASCs (hASCs) were subcultured, and the 4th to 7th passage of cells were used for the subsequent experiments. The hASCs were divided into 7 groups, with 12 samples in each group. Cells in blank control group were cultured with mesenchymal stem cell culture medium, and cells in simple advanced glycation end products (AGEs) group, simple protein group, simple high glucose group, simple high osmotic pressure group, AGEs-high glucose combination group, and protein-high osmotic pressure combination group were cultured with mesenchymal stem cell culture medium containing a final mass concentration of 100 mg/L AGEs, 100 mg/L bovine serum albumin (BSA), 28 mmol/L D-glucose, 28 mmol/L mannitol, 100 mg/L AGEs+ 28 mmol/L D-glucose, 100 mg/L BSA+ 28 mmol/L mannitol, respectively. Cell proliferation was detected by cell counting kit 8 at post culture hour (PCH) 2 and on post culture day (PCD) 2, 4 and 6. (4) The hASCs were divided into blank control group, simple AGE group, simple high glucose group, and AGE-high glucose combination group, with 12 samples in each group, which were treated the same as corresponding groups in experiment (3). On PCD 0, 2, 4, and 6, the positive expression rates of cell surface differentiation antigens CD105, CD44, and CD45 were detected by flow cytometer to estimate their homeostasis. (5) The hASCs were divided into AGE-high glucose combination group and protein-high osmotic pressure combination group, with 9 samples in each group, which were treated the same as corresponding groups in experiment (3). On PCD 2, 4, and 6, the expression of intracellular protein was detected by cyanine 3-streptavidin double-antibody sandwich technique. Data were processed with analysis of variance for factorial design, least significant difference test, and Bonferroni correction. Results: (1) The positive expression rates of CD44 in nASCs and dASCs were both higher than 96%, the positive expression rates of CD31 and CD34 were low, and the positive expression rates of CD105 were about 40%, which basically met the purity requirements. (2) The areas of wounds treated by three methods in rats of healthy group and diabetic group were similar on PID 1 (P>0.05). In healthy group, compared with (0.682 1±0.078 9), (0.314 3±0.113 7), and (0.064 3±0.002 1) cm² of the PBS-treated wounds in rats, the area of nASCs-treated wounds in rats decreased significantly on PID 3, 7, and 12 [(0.464 1±0.092 6), (0.223 9±0.072 7), and (0.034 3±0.012 5) cm², P<0.05], the area of dASCs-treated wounds in rats decreased significantly on PID 3 and 12 [(0.514 1±0.124 1) and (0.043 7±0.032 8) cm², P<0.05] but was not obviously changed on PID 7 [(0.274 2±0.062 5) cm², P>0.05]. Compared with those of the dASCs-treated wounds of rats within the same group, the area of the nASCs-treated wounds of rats in healthy group decreased significantly on PID 3 and 7 (P<0.05) but was not obviously changed on PID 12 (P>0.05). In diabetic group, compared with (0.853 5±0.204 8), (0.670 5±0.164 8), and (0.131 4±0.074 4) cm² of the PBS-treated wounds in rats, the area of nASCs-treated wounds in rats decreased significantly on PID 3, 7, and 12 [(0.633 4±0.132 5), (0.331 8±0.023 5), and (0.074 2±0.003 8) cm², P<0.05], the area of dASCs-treated wounds in rats decreased significantly on PID 3 [(0.773 6±0.182 2) cm², P<0.05] but was not obviously changed on PID 7 and 12 [(0.510 6±0.192 2) and (0.114 4±0.003 1) cm², P>0.05]. Compared with the dASCs-treated wounds of rats within the same group, the area of the nASCs-treated wounds of rats in diabetic group was not obviously changed on PID 3 and 7 (P>0.05) but decreased significantly on PID 12 (P<0.05). There was no obvious difference in histological morphology of the wounds treated with three methods in rats of each group on PID 1. On PID 3, a small amount of microvessels were formed in the wounds treated with nASCs and dASCs of rats in both groups, but microvessel formation was almost undetected in the PBS-treated wounds. On PID 7, more small blood vessels and fibroblasts (Fbs) were observed in the wounds treated with nASCs and dASCs of rats in both groups, but the small blood vessels and Fbs were slightly less in the PBS-treated wounds. On PID 12, the wounds treated with nASCs and dASCs of rats in the two groups were covered by epithelial tissue, the granulation tissue in the PBS-treated wounds of rats in healthy group was not obvious, and the PBS-treated wounds of rats in diabetic group were not completely epithelialized. (3) Compared with those of blank control group, the cell number of hASCs in simple AGEs group decreased significantly on PCD 2, 4, and 6 (P<0.05), which increased significantly on PCD 2 and 4 in simple high glucose group (P<0.05), and that in AGEs-high glucose combination group decreased significantly on PCD 4 and 6 (P<0.05). (4) Compared with that on PCD 4 within the same group, the positive expression rate of CD105 in hASCs decreased significantly in blank control group, simple AGEs group, and AGEs-high glucose combination group on PCD 6 (P<0.05). The positive expression rate of CD44 was higher than 95%, and that of CD45 was less than 2% in hASCs of each group at each time point. (5) Detection values of 7 proteins were located in the confidence interval. The expression levels of basic fibroblast growth factor and tissue inhibitor of metalloproteinase-1 in hASCs of AGEs-high glucose combination group and protein-high osmotic pressure combination group showed increasing trend with the prolongation of culture time. The expression level of human monocyte chemoattractant protein 1 (MCP-1) in hASCs of AGEs-high glucose combination group showed increasing trend with the prolongation of culture time, while the expression level of growth-regulated oncogene (GRO) on PCD 6 was significantly higher than that on PCD 4 within the same group (P<0.05); the expression levels of MCP-1 and GRO in hASCs of protein-high osmotic pressure combination group showed decreasing trend with the prolongation of culture time. The expression level of follistatin in hASCs of protein-high osmotic pressure combination group decreased obviously on PCD 4, while that in hASCs of AGEs-high glucose combination group was significantly lower on PCD 6 than that on PCD 4 (P<0.05). The expression level of vascular endothelial growth factor (VEGF) in hASCs of protein-high osmotic pressure combination group decreased gradually with the prolongation of culture time, while that in hASCs of AGEs-high glucose combination group on PCD 4 decreased significantly as compared with that on PCD 2 (P<0.05). The expression level of urokinase-type plasminogen activator receptor in hASCs of protein-high osmotic pressure combination group on PCD 6 was significantly higher than that on PCD 4 within the same group (P<0.05) and that of AGEs-high glucose combination group on PCD 6 (P<0.05). Conclusions Both nASCs and dASCs can promote wound healing in rats with simple defect injury, but dASCs have no significant effect on wound healing in rats with diabetes mellitus, which may be related to the inhibition of ASCs proliferation and the influence of high glucose and AGEs intervention on their homeostasis and secretory function.

Objective To investigate antibiotics resistant characteristics and carbapenemases genotype of Acinetobacter baumannii in Intensive Care Unit (ICU),so as to provide theoretical basis for clinical prevention and treatment.Methods Retrospective study was made on 90 non-duplicated clinical isolates of Acinetobacter baumannii,which were collected From January 2013 to January 2014 in three tertiary hospitals of Qingdao.All strains were identified by VITEK2 automated microbiology analyzer;K-B method was used to do drug susceptibility test;polymerase chain reaction (PCR) was used to amplify the OXA-23,OXA-24,OXA-51,OXA-58,KPC-2,VIM,IMP genes,and the positive products of genes were sequenced;the chi-square test was used to compare the difference of the resistance rates.Results The detection rate of multi-drug resistant A.baumannii (MDRAB)and Pan-drug resistant A.baumannii (PDRAB)was 61.11% (55/90) and 17.78% (16/90).In the 32 strains of imipenem-resistant Acinetobacter baumannii,the resistant rates to Cefoperazone/sulbactam,Polymyxin B was lower,while the resistant rates to other drugs tested were more than 85%.The difference of the resistance rates to 9 drugs between imipenem resistant group and Imipenem sensitive group were statistically significant (P≤0.05).PCR result showed: 32 strains detected OXA-51 gene,28 strains detected OXA-23 gene,and 3 strains detected VIM gene,the detection rates of which were 100%,87.50% and 9.38% respectively.All strains were not detected OXA-24,OXA-58,KPC-2 and IMP genes.The sequenced results were absolutely homology with the corresponding genes in genbank.Conclusions The resistance of A.baumannii in ICU is serious in this region,especially imipenem-resistant A.baumannii,which were nearly no-sensitive to most of the drugs commonly used in clinical.The gene existence of carbapenemase and carbapenemase producing is one of the main resistance mechanism of Acinetobacter baumannii to carbapenem antibiotics.OXA-23 was the major genotypes in this region.

Objective To explore the relationship between cytotoxin associated protein A (cagA), cytotoxin associated protein E(cage), vacuolating cytotoxin A (vacA) genotypes of Helicobacter pylori (Hp) and the upper digestive tract diseases. Methods A total of 112 patients with upper gastrointestinal diseases were selected. The cagA, cagE, vacA genotypes of Hp strains in gastric mucosa of the patients were detected and analyzed. Results All Hp strains in the gastric mucosa samples of patients were found with both cagA gene and cagE gene expression, and the positive rate was 100%. The positive rates of vacA s1/m2 genotype in the patients were the highest with 54.1% and 60.5% respectively, followed by the vacA s1/mlb genotype and vacA s1/m- phenotypes, and the positive rates were from 13.2% to 21.1%. The differences of positive rates of each genotypes in Hp genes between the patients with peptic ulcer and chronic gastritis were not significant (P>0.05). Conclusion Hp strains in gastric mucosa patients with upper gastrointestinal diseases show the advantage expressions of cagA, cagE, vacA s1/m2 subtypes, which refers that such virulence phenotypes may play important roles in initiation and promotion process of upper gastrointestinal diseases by Hp, but the correlation with the type of upper digestive tract diseases is not proved.

Objective To explore the relationship between cytotoxin associated protein A (cagA), cytotoxin associated protein E(cage), vacuolating cytotoxin A (vacA) genotypes of Helicobacter pylori (Hp) and the upper digestive tract diseases. Methods A total of 112 patients with upper gastrointestinal diseases were selected. The cagA, cagE, vacA genotypes of Hp strains in gastric mucosa of the patients were detected and analyzed. Results All Hp strains in the gastric mucosa samples of patients were found with both cagA gene and cagE gene expression, and the positive rate was 100%. The positive rates of vacA s1/m2 genotype in the patients were the highest with 54.1% and 60.5% respectively, followed by the vacA s1/mlb genotype and vacA s1/m- phenotypes, and the positive rates were from 13.2% to 21.1%. The differences of positive rates of each genotypes in Hp genes between the patients with peptic ulcer and chronic gastritis were not significant (P>0.05). Conclusion Hp strains in gastric mucosa patients with upper gastrointestinal diseases show the advantage expressions of cagA, cagE, vacA s1/m2 subtypes, which refers that such virulence phenotypes may play important roles in initiation and promotion process of upper gastrointestinal diseases by Hp, but the correlation with the type of upper digestive tract diseases is not proved.

Myasthenia gravis (MG) is an immune-mediated disorder of the neuromuscular junction that is characterized by fluctuating muscle weakness.Acetylcholine receptor antibody (AchR-Ab) is the first MG specific antibody being elucidated,however,the discovery of many other MG specific or related antibodies enriches its immunopathogenesis greatly.The detection of antibodies is very important for the diagnosis and classification of MG.It can be used to guide the clinical management and evaluate the response to treatment as well.With the development of laboratory medicine,the methods of antibody detection are also being optimized.In this paper,we will review the serum antibodies closely associated with MG and their mechanisms,detection methods and clinical significance.

OBJECTIVETo investigate the role of ATP-binding cassette transporter G1 (ABCG1) in endothelial dysfunction induced by high glucose.

METHODSHuman aortic endothelial cells (HAECs) were incubated in the presence of 5.6 or 30 mmol/L glucose for 24-72 h with or without a 2-h pretreatment with the LXR agonist 22(R)-hydroxycholesterol. Real-time PCR and Western blotting were used to measure the mRNA and protein expressions of ABCG1; the intracellular cholesterol efflux and endothelial nitric oxide synthase (eNOS) activity were measured by scintillation counting.

RESULTSHigh glucose time-dependently suppressed ABCG1 expression and cholesterol efflux to HDL in HAECs. High glucose also decreased eNOS activity. ABCG1 down-regulation induced by high glucose, along with decreased cholesterol efflux and eNOS activity, was abolished by treatment of the cells with the LXR agonist.

CONCLUSIONEndothelial dysfunction induced by high glucose is associated with decreased ABCG1 expression.

ATP Binding Cassette Transporter, Sub-Family G, Member 1 ; ATP-Binding Cassette Transporters ; genetics ; metabolism ; Aorta ; cytology ; Cell Line ; Down-Regulation ; drug effects ; Endothelial Cells ; cytology ; metabolism ; physiology ; Glucose ; pharmacology ; Humans

Objectives To evaluate the results and efficacy of gas-insufflated retroperitoneoscopic necrosectomy (GIRN) for proven infected necrotizing pancreatitis (INP).Methods 24 patients presenting proven infected pancreatic necrosis during course of acute pancreatitis were prospectively offered minimally invasive necrosectomy.A descriptive explanation of the GIRN was given together with the results of a retrospective analysis of all patients.Results All 24 patients who underwent retroperitoneoscopic necrosectomies survived.Postoperative hospitai stay ranged from 7 to 105 d (median,29 d).In 14 patients,GIRN yielded excellent results and avoided complementary treatment after a single session.7 patients underwent only one repeated session and the other 3 patients underwent 3 times.3 patients finally underwent laparotomy and necrosectomy due to remaining infected necroses in the peritoneal cavity.Conclusion GIRN has been found safe and is associated with a high success rate in our limited number of patients,and it should be regarded as a first-choice surgical option for INP.

In 1989, Fitz defined and classified severe acute pancreatitis (SAP) and he thought that surgical treatment of SAP is feasible. Since then, the strategy of treating SAP was a controversial issue over past decades. Currently, relevant literatures reported that medical or minimally invasive treatments are superior to surgical treatment, while it is too early to make the final conclusion because of the complexity of SAP. From 1989 to 2008, 1852 patients with acute pancreatitis were treated at the General Hospital of PLA, and the clinical data of 18 patients who died of SAP were retrospectively analyzed. Based on the analysis, we concluded that medical conservative therapy and surgical operative therapy should not be opposed to each other. Selecting ideal timing and appropriate operation on the basis of pathological changes of retroperitoneum and pancreatitis should be considered seriously, and the new concept of "miniaturization of trauma" should also be introduced in treating SAP.