Overlapping Epstein-Barr virus encephalitis and autoimmune glial fibrillary acidic protein astrocytopathy

We describe three cases of overlapping Epstein-Barr virus (EBV) Encephalitis and Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy (GFAP-A). The three cases all presented with initial symptoms of fever, headache, coma, and posture tremor of the upper limbs, then followed by limb weakness and dysuria. All of the three cases were on ventilators. Case 1 and 2 improved dramatically after intravenous methylprednisoloneand immunoglobulin treatment. However, case 3 presented dyspneic, and died from gastrointestinal hemorrhage. The GFAP-A triggered by EBV intracranial infection could initially masquerade as EBV encephalitis only, and the detection of GFAP antibody is essential for differentiation.

Screening and Identification of Potential Abscisic Acid Catabolites by Chemical Labeling-Assisted Ultrahigh-Performance Liquid Chromatography Coupled with High-Resolution Mass Spectrometry

In this study, a screening strategy was established based on ultrahigh-performance liquid chromatography coupled with high-resolution mass spectrometry assisted by chemical isotope labeling (CIL-UPLC-HRMS) for screening and identifying abscisic acid (ABA) catabolites. Based on the structures of known ABA catabolites, this strategy first proposed the structures of catabolites to be discovered. Afterward, a pair of isotope reagents N,N-2-dimethylaminoethylamine (DMED) and d₄-DMED were used as labeling reagents to label the carboxyl groups in ABA and its catabolites. Then, the mass-to-charge ratio (m/z) of DMED- and d₄-DMED-labeled ABA catabolites was calculated based on the labeling schema. In light of the characteristic fragmentation patterns of the DMED-labeled standards of ABA and its catabolites, screening criteria were formulated. Using our strategy, ABA, t-ABA, and 18 ABA catabolites were identified from seven plant samples. Of the identified catabolites, 16 were known, and to our knowledge, 2 were previously unidentified. Our findings contribute to ABA catabolic network improvement.

Risk factors for metachronous peritoneal carcinomatosis after radical resection for patients with nonmetastatic pT3-4 colon cancer

BACKGROUND

Patients with nonmetastatic pT3-4 colon cancers are prone to develop metachronous peritoneal carcinomatosis (mPC). Risk factors for mPC and the influence of mutant kirsten rat sarcoma viral oncogene (KRAS)/neuroblastoma rat sarcoma (NRAS)/v-raf murine sarcoma viral oncogene homolog B1 (BRAF) and DNA mismatch repair (MMR) status on mPC remain to be described in these patients.

METHOD

All enrolled patients were identified from the prospectively collected colorectal cancer database of a tertiary referral hospital between 2013 and 2018. Multivariate analysis was used to identify risk factors associated with mPC.

RESULTS

Of the 1689 patients with nonmetastatic pT3-4 colon carcinoma, 8.4% (142/1689) progressed to mPC. Endoscopic obstruction (HR = 3.044, p < 0.001), elevated CA125 (HR = 1.795, p = 0.009), pT (T4a vs. T3, HR = 2.745, p < 0.001; T4b vs. T3, HR = 3.167, p = 0.001), pN (N1 vs. N0, HR = 2.592, p < 0.001; N2 vs. N0, HR = 4.049, p < 0.001), less than 12 lymph nodes harvested (HR = 2.588, p < 0.001), mucinous or signet ring cell carcinoma (HR = 1.648, p = 0.038), perineural invasion (HR = 1.984, p < 0.001), and adjuvant chemotherapy (HR = 1.522, p = 0.039) were strongly related to mPC but that mutant KRAS/NRAS/BRAF and MMR status was not associated with mPC.

CONCLUSION

This study identified the high-risk factors for mPC in patients with nonmetastatic pT3-4 colon carcinoma, and these factors should be considered in selective preventive therapy and close follow-up for patients subsequently deemed to have high risk for mPC.

[Study on determination of 2-thioxothiazolidine-4-carboxylic Acid in urine by high performance liquid chromatography]

Objective: To establish a high performance liquid chromatography method for the determination of 2-thioxothiazolidine-4-carboxylic acid (TTCA) in urine. Methods: After acidification with hydrochloric acid, TTCA in urine was first extracted by ethyl acetate with excessive sodium chloride, then gradient separated by a symmetry C18 column and then detected by a diode array detector. The quantification was based on a working curve of external standard method. Results: The linear relationship of TTCA in urine was good in the range of 0.03-10.00 mg/L, and the correlation coefficient was 0.9999. The detection limit and minimum quantitative concentration of TTCA in urine were 0.008 mg/L and 0.027 mg/L. The intra-assay precision of the method was 0.9%-1.4%, the inter-assay precision was 1.3%-3.5%, and the average recovery was 85.0%-92.7% while the concentrations of TTCA in urine was 0.8, 2.0 and 8.0 mg/L, respectively (n=6) . Conclusion: The gradient elution high performance liquid chromatography method has simple operation and high sensitivity, and it is suitable for the determination of TTCA on a low level in urine for occupational workers exposure to carbon disulfide.

[Attention should be paid to the establishment and management of glaucoma records]

Glaucoma is the world's leading cause of irreversible blindness. As a chronic disease, it requires lifelong follow-up and management. In the long-term follow-up of glaucoma patients, a diagnosis and treatment management system is helpful. Despite the availability of various means of informationalized record management, there remain problems and challenges, like a lack of unified file management standards, data incompatibility, and barriers to inter-hospital data sharing, which lead to the failure to establish a comprehensive and standardized glaucoma record for patients. It is necessary to form a standardized management system so as to improve the efficiency and accuracy of the diagnosis and treatment of glaucoma, better maintain the visual function of patients and reduce the burden on society and family.

Suture ligation for submucosal hemostasis during hand-sewn side-to-side duodeno-ileostomy in simultaneous pancreas and kidney transplantation

BACKGROUND

Enteric anastomotic (EA) bleeding is a potentially life-threatening surgical complication associated with enteric anastomosis during simultaneous pancreas and kidney transplantation (SPKT).

AIM

To investigate whether suture ligation (SL) for submucosal hemostasis during hand-sewn enteric anastomosis could decrease the morbidity of early EA bleeding in SPKT.

METHODS

We compared the outcomes of 134 patients classified into SL (n = 44) and no SL (NSL) groups (n = 90). This study adheres to the declarations of Istanbul and Helsinki and all donors were neither paid nor coerced.

RESULTS

During the first postoperative week, the EA bleeding rate in the SL group was lower than that in the NSL group (2.27% vs 15.56%; P = 0.021); no relationship was found between EA bleeding and donor age, mean pancreatic cold ischemia time, platelet count, prothrombin time international normalized rate, activated partial thromboplastin time, and thrombin time. Anastomotic leakage was observed in one case in the SL group at postoperative day (POD) 14 and in one case at POD 16 in the NSL group (P = 0.754). No significant difference was found between the two groups in the patient survival, pancreas graft survival, or kidney graft survival.

CONCLUSION

SL for submucosal hemostasis during hand-sewn enteric anastomosis in SPKT can decrease the morbidity of early EA bleeding without increasing the anastomotic leakage rate.

[Determination of five phenolic compounds in workplace air by composite sampling tube-high performance liquid chromatography]

Objective: To develop a method for simultaneous determination of Dydroquinone, Resorcinol, Pyrocatechol, 4-Nitrophenol and 2, 4-Dinitrophenol in workplace air by high performance liquid chromatography. Methods: Air samples were collected by composite tube (front end glass fiber filter membrane, back section silica gel) , 10% methanol was desorbed, separated by C18 chromatographic column, detected by photo-diode array (PDA) detector, and quantitatively determined by external standard method at the wave-length of 230 nm. Results: The linear relationship of 5 phenolic compounds was good (r>0.999) . The detection limit of glass fiber filtration membrane and silica gel adsorbent were 0.13-0.41 g/ml and 0.16-1.04 g/ml respectively. The quantitative limit of glass fiber filtration membrane was 0.44-1.36 g/ml, and the silica gel adsorbent was 0.52-3.46 g/ml. The average desorption efficiency of glass fiber membrane and silica gel adsorbent were 97.5%-100.1% and 86.9%-100.3%, respectively. In and between batches, the precision glass fiber filtration membrane was 0.71%-4.88%, 0.91%-4.82%, silica gel adsorbent was 0.47%-4.62%, 0.76%-5.52%. Samples can be stored for at least 30 days at -20 ℃. The possible co-existing interferences of aniline, phenol, p-nitrochlorobenzene, o-nitrophenol and trinitrophenyl did not interfere with the determination. Conclusion: The sensitivity, precision, accuracy and linear range of this method all meet the requirements of the specification. The collection and preservation of samples can also meet the requirements of the limits. It is suitable for the simultaneous determination of hydroquinone, resorcinol, hydroquinone, hydroquinone, hydroquinone, p-nitrophenol and 2, 4-dinitrophenol in the air of the workplace.

Kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma: A case report

BACKGROUND

There are few reported cases of allograft nephrectomy due to malignancy followed by successful renal re-transplantation two years later. In this paper, we report a patient who underwent kidney re-transplantation after living donor graft nephrectomy due to de novo chromophobe renal cell carcinoma (ChRCC) involving the allograft kidney.

CASE SUMMARY

A 34-year-old man underwent living kidney transplantation at the age of 22 years for end-stage renal disease. Maintenance immunosuppression consisted of tacrolimus, mycophenolate mofetil (MMF), and prednisone. Six years post-transplantation, at another hospital, ultrasonography revealed a small mass involving the upper pole of the graft. The patient declined further examination and treatment at this point. Seven years and three months post-transplantation, the patient experienced decreasing appetite, weight loss, gross hematuria, fatigue, and oliguria. Laboratory tests showed anemia (hemoglobin level was 53 g/L). Contrast-enhanced computed tomography revealed a large heterogeneous cystic-solid mass involving the upper pole of the renal allograft. Graft nephrectomy was performed and immunosuppressants were withdrawn. Histological and immunohistochemical features of the tumor were consistent with ChRCC. One year after allograft nephrectomy, low doses of tacrolimus and MMF were administered for preventing allosensitization. Two years after allograft nephrectomy, the patient underwent kidney re-transplantation. Graft function remained stable with no ChRCC recurrence in more than 2-years of follow-up.

CONCLUSION

De novo ChRCC in kidney graft generally has a good prognosis after graft nephrectomy and withdrawal of immunosuppression. Kidney re-transplantation could be a viable treatment. A 2-year malignancy-free period may be sufficient time before re-transplantation.

[The controversy and value of the combination of hydrocortisone, ascorbic acid and thiamine in treating sepsis]

Sepsis is a common cause of death in intensive care unit. Some retrospective studies had shown the combination of hydrocortisone, ascorbic acid and thiamine (HAT therapy) could lower mortality rate of patients with sepsis or septic shock. Recently, multiple randomized controlled trials(RCTs) related to the efficacy of combination therapy don't reach a consensus. Though one meta-analysis indicated beneficial effect of HAT regimen on decreasing mortality rate of patients with sepsis or septic shock, improving SOFA score and reducing use of vasopressor. However, controversy still exist in the target population, timing, dose and duration of HAT regimen. Thus, the optimized RCTs are needed to provide more definitive evidence.

Human parvovirus B19-associated early postoperative acquired pure red cell aplasia in simultaneous pancreas-kidney transplantation: A case report

BACKGROUND

Acquired pure red cell aplasia (aPRCA) related to human parvovirus B19 (HPV B19) is rarely reported in simultaneous pancreas-kidney transplantation (SPKT) recipients; there has yet to be a case report of early postoperative infection. In this current study, we report the case of a Chinese patient who experienced the disease in the early postoperative period.

CASE SUMMARY

A 63-year-old man, with type 2 diabetes and end-stage renal disease, received a brain dead donor-derived SPKT. Immunosuppression treatment consisted of tacrolimus, prednisone, enteric-coated mycophenolate sodium (EC-MPS), and thymoglobulin combined with methylprednisolone as induction. The hemoglobin (Hb) level declined due to melena at postoperative day (POD) 3, erythropoietin-resistant anemia persisted, and reticulocytopenia was diagnosed at POD 20. The bone marrow aspirate showed decreased erythropoiesis and the presence of giant pronormoblasts at POD 43. Metagenomic next-generation sequencing (mNGS) of a blood sample identified HPV B19 infection at POD 66. EC-MPS was withdrawn; three cycles of intravenous immunoglobulin (IVIG) infusion therapy were administered; and tacrolimus was switched to cyclosporine. The HPV B19-associated aPRCA resolved completely and did not relapse within the 1-year follow-up period. The diminution in mNGS reads was correlated with Hb and reticulocyte count improvements.

CONCLUSION

HPV B19-associated aPRCA can occur at an early period after SPKT. An effective therapy regimen includes IVIG infusion and adjustment of the immuno-suppressive regimen. Moreover, mNGS can be used for the diagnosis and to reflect disease progression.

Cross electro-nape-acupuncture ameliorates cerebral hemorrhage-induced brain damage by inhibiting necroptosis

BACKGROUND

Receptor interacting protein kinase 1 (RIPK1)-mediated cell death, including apoptosis and necroptosis, belongs to programmed cell death. It has been reported that RIPK1-mediated necroptosis exists in lesions of cerebral hemorrhage (CH). Electroacupuncture, a treatment derived from traditional Chinese medicine, could improve neurological impairment in patients with brain injury.

AIM

To investigate the protective role of cross electro-nape acupuncture (CENA) in CH, and clarify the potential mechanism.

METHODS

CH rat models were established, and CENA was applied to the experimental rats. Neurological functions and encephaledema were then measured. Necrotic cells in the brain of rats with CH were evaluated by propidium iodide staining. Necroptosis was assessed by immunofluorescence. Activation of the necroptosis-related pathway was detected by western blot. Extraction of brain tissue, cerebrospinal fluid and serum samples was conducted to measure the expression and secretion of inflammatory cytokines by quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay.

RESULTS

The necroptotic marker p-MLKL was detectable in the brains of rats with CH. Next, we found that CENA could ameliorate neurological functions in rat models of CH. Moreover, the upregulation of RIPK1-mediated necroptosis-related molecules in the brains of rats with CH were inhibited by CENA. Further investigation revealed that CENA partially blocked the interaction between RIPK1 and RIPK3. Finally, in vivo assays showed that CENA decreased the expression of the inflammatory cytokines tumor necrosis factor-α, interleukin-6 and interleukin-8 in CH rat models.

CONCLUSION

These findings revealed that CENA exerts a protective role in CH models by inhibiting RIPK1-mediated necroptosis.

[Association of low serum indirect bilirubin level with all-cause mortality in maintenance hemodialysis patients]

Objective: To investigate the association of low serum indirect bilirubin (IBIL) level with all-cause mortality in maintenance hemodialysis (MHD) patients. Methods: A multicenter retrospective cohort study was conducted in seven hemodialysis centers of Guizhou province. The adult outpatients who underwent hemodialysis for more than 3 months were included between June 2015 and June 2016. Demographics, baseline clinical and laboratory test results were collected. Patients were divided into 4 groups according to their baseline serum IBIL levels (interquartile range), and followed up until June 30, 2018. Kaplan-Meier method was used to compare the survival rate of each group. Cox regression model was used to analyze the association of IBIL with all-cause mortality. Results: A total of 885 hemodialysis dialysis patients with baseline IBIL data were enrolled in this study, with age of (55.4±16.2) years old, among whom 57.9% (512/885) were male. Median IBIL was 4.8 μmol/L and interquartile range was 3.3-7.0 μmol/L. The comparison between IBIL quartile groups showed that the differences in proportion of diabetics, hemoglobin, serum albumin, platelet, serum calcium, alanine aminotransferase (ALT), uric acid and urea nitrogen were statistically significant (all P<0.05). After a median follow-up of 24 months, 210 patients died, and 96 cases became lost to follow-up. Kaplan-Meier curves showed higher all-cause mortality in patients with IBIL≤3.3 μmol/L (Q1 group) (65/219, P=0.015). After adjusting for age, gender, comorbidities, and biochemical indicators, taking baseline IBIL Q2 level (IBIL 3.4~4.8 μmol/L) as a reference, the hazard ratio for all-cause death in patients with IBIL≤3.3 μmol/L was 1.661 (95%CI: 1.114-2.476, P=0.013). Kaplan-Meier survival curve showed that there was no significant difference in mortality between the quartile groups according to total bilirubin (TBIL) or direct bilirubin (DBIL) (P=0.167, 0.156). Conclusion: Baseline low serum IBIL in maintenance hemodialysis patients is associated with all-cause mortality.

[Effect of data missing on population based viral load survey in HIV infected men who have sex with men sampled in 16 large cities, China]

Objective: To analyze the effect of missing data in population based viral load (PVL) survey in HIV infected men who have sex with men (MSM) sampled in 16 cities in China. Methods: The database of 3 virus load sampling survey conducted consecutively in HIV infected MSM population in 16 large cities (Beijing, Shanghai, Nanjing, Hangzhou, Wuhan, Chongqing, Kunming, Xi'an, Guangzhou, Shenzhen, Nanning, Urumuqi, Harbin, Changchun, Chengdu and Tianjin) during 2013-2015 was used. SPSS 17.0 software was used to describe distribution of the missing data and analyze associated factors. Results: A total of 12 150 HIV infected MSM were randomly selected for the surveys, in whom, 9 141 (75.2%) received virus load tests, while 3 009 (24.8%) received no virus load tests, whose virus load data missed. The virus load data missing rates in MSM with or without access to antiretroviral therapy (ART) were 11.5% (765/6 675) and 39.4% (2 060/5 223) respectively, and the virus load data missing rates were 21.9% (1 866/8 523) and 28.4% (959/3 374), respectively, in local residents and non-local residents (migrants). Conclusions: The analysis indicated that the data missing occurred in the virus load survey in HIV infected MSM population. ART status and census registering status were the main influencing factors. Data missing could influence the accurate evaluation of community viral load (CVL) and population viral load(PVL) levels in HIV infected MSM in China.

[Data distribution and transformation in population based sampling survey of viral load in HIV positive men who have sex with men in China]

Objective: To understand the distribution of population viral load (PVL) data in HIV infected men who have sex with men (MSM), fit distribution function and explore the appropriate estimating parameter of PVL. Methods: The detection limit of viral load (VL) was ≤ 50 copies/ml. Box-Cox transformation and normal distribution tests were used to describe the general distribution characteristics of the original and transformed data of PVL, then the stable distribution function was fitted with test of goodness of fit. Results: The original PVL data fitted a skewed distribution with the variation coefficient of 622.24%, and had a multimodal distribution after Box-Cox transformation with optimal parameter (λ) of-0.11. The distribution of PVL data over the detection limit was skewed and heavy tailed when transformed by Box-Cox with optimal λ=0. By fitting the distribution function of the transformed data over the detection limit, it matched the stable distribution (SD) function (α=1.70, β=-1.00, γ=0.78, δ=4.03). Conclusions: The original PVL data had some censored data below the detection limit, and the data over the detection limit had abnormal distribution with large degree of variation. When proportion of the censored data was large, it was inappropriate to use half-value of detection limit to replace the censored ones. The log-transformed data over the detection limit fitted the SD. The median (M) and inter-quartile ranger (IQR) of log-transformed data can be used to describe the centralized tendency and dispersion tendency of the data over the detection limit.

[Comparison of different methods in dealing with HIV viral load data with diversified missing value mechanism on HIV positive MSM]

Objective: To compare results of different methods: in organizing HIV viral load (VL) data with missing values mechanism. Methods We used software SPSS 17.0 to simulate complete and missing data with different missing value mechanism from HIV viral loading data collected from MSM in 16 cities in China in 2013. Maximum Likelihood Methods Using the Expectation and Maximization Algorithm (EM), regressive method, mean imputation, delete method, and Markov Chain Monte Carlo (MCMC) were used to supplement missing data respectively. The results: of different methods were compared according to distribution characteristics, accuracy and precision. Results HIV VL data could not be transferred into a normal distribution. All the methods showed good results in iterating data which is Missing Completely at Random Mechanism (MCAR). For the other types of missing data, regressive and MCMC methods were used to keep the main characteristic of the original data. The means of iterating database with different methods were all close to the original one. The EM, regressive method, mean imputation, and delete method under-estimate VL while MCMC overestimates it. Conclusion: MCMC can be used as the main imputation method for HIV virus loading missing data. The iterated data can be used as a reference for mean HIV VL estimation among the investigated population.

[Effect of laboratory referencing on data analysis of community viral load in HIV positive MSM from 15 cities, China]

Objective: To compare the community viral load (CVL) among MSM in 15 cities in China using standardized national reference sources. Methods: The study analyzed the existing database of National Major Science and Technology Project of China. The database was established with serial random survey of MSM HIV CVL among MSM in 15 cities from 2013 to 2015. VL tests were conducted in 15 laboratories with different equipment and methods, including RT-PCR, nucleic acid sequence based amplification (NASBA), branched DNA testing (bDNA) and Abbott M2000 RealTime system (M2000). Based on proficiency test for 15 laboratories conducted by National HIV Reference Laboratory, VL test values detected with EasyQ, bDNA and M2000 were converted and standardized into resultant values of TaqMan 2.0. Software SPSS 17.0 was used to produce descriptive statistics for the dataset. Results: From 2014 to 2015, the 15 testing sites were found to use a number of different viral load detection techniques. In 2014, the community viral load values were (2.38±1.47) and (2.99±1.31) in 15 testing sites, while in 2015 these values were found to be (2.07±1.34) and (2.72±1.19). The measurement of community VL was done using standard benchmarks of ≤200 copies/ml, ≤400 copies/ml and ≤1 000 copies/ml, that were used for reference for now. Conclusion: It is necessary to use standard detection method to improve the comparability of annual results. Using a standardized rate of ≤400 copies/ml or ≤1 000 copies/ml for successful control of VL was found with high stability for the result comparison among different areas.

[Development of HIV infection risk assessment tool for men who have sex with men based on Delphi method]

Objective: To develop a HIV infection risk assessment tool for men who have sex with men (MSM) based on Delphi method. Methods: After an exhaustive literature review, we used Delphi method to determine the specific items and relative risk scores of the assessment tool through two rounds of specialist consultation and overall consideration of the opinions and suggestions of 17 specialists. Results: The positivity coefficient through first and second round specialist consultation was 100.0% and 94.1%, respectively. The mean of authority coefficients (Cr) was 0.86. Kendall's W coefficient of the specialist consultation was 0.55 for the first round consultation (χ(2)=84.426, P<0.001) and 0.46 for the second round consultation (χ(2)=65.734, P<0.001), respectively, suggesting that the specialists had similar opinions. The final HIV infection risk assessment tool for MSM has 8 items. Conclusions: The HIV infection risk assessment tool for MSM, developed under the Delphi method, can be used in the evaluation of HIV infection risk in MSM and individualized prevention and intervention. However, the reliability and validity of this risk assessment tool need to be further evaluated.

[Exploration on the 24 hour intraocular pressure fluctuation in glaucoma patients]

Intraocular pressure is the most important and most easily controlled clinical parameters of glaucoma. It has a fluctuation and circadian rhythm. The 24 hours intraocular pressure measurement can better reflect the changes of intraocular pressure. It is clear that peak IOP is an independent risk factor for the progression of glaucoma, but the effect of IOP on glaucoma progression is worth exploring. This article focuses on whether IOP fluctuation is an independent risk factor for glaucoma progression, how to obtain the 24-hour intraocular pressure curve, the future direction of 24-hour intraocular pressure monitoring and other issues in order to cause clinical concern. (Chin J Ophthalmol, 2017, 53: 85-88).

Ductilizing bulk metallic glass composite by tailoring stacking fault energy

Martensitic transformation was successfully introduced to bulk metallic glasses as the reinforcement micromechanism. In this Letter, it was found that the twinning property of the reinforcing crystals can be dramatically improved by reducing the stacking fault energy through microalloying, which effectively alters the electron charge density redistribution on the slipping plane. The enhanced twinning propensity promotes the martensitic transformation of the reinforcing austenite and, consequently, improves plastic stability and the macroscopic tensile ductility. In addition, a general rule to identify effective microalloying elements based on their electronegativity and atomic size was proposed.

Kidney transplant for autosomal dominant polycystic kidney disease: the superiority of concurrent bilateral nephrectomy

OBJECTIVE

To assess the transplant outcome of patients who underwent concurrent bilateral nephrectomies (CBN) during kidney transplantation (KT) owing to autosomal dominant polycystic kidney disease (ADPKD).

METHODS

The study included 67 ADPKD patients, 4 of whom were excluded, and the rest, 63 patients, were divided into two groups: KT with CBN (group A, n = 31) and KT without CBN (group B, n = 32). Demographic factors, transplant-related factors, posttransplant complications and patient survival were compared.

RESULTS

There was no statistical difference in demographic or transplant-related factors between the two groups, though group A patients required more operation time (300 ± 30.85 vs. 120 ± 20.78 min, p < 0.01), needed more blood transfusion (4.31 ± 1.05 vs. 1.35 ± 0.23 U, p < 0.01) and had more adjacent organ injury during operation (22.58 vs. 0%, p < 0.01) compared with group B. However, group A patients had better relief from arterial hypertension persistence and lower urinary tract infection postoperation than group B (16/24 vs. 22/24, 6.45 vs. 31.25%, p < 0.05). Patient survival in the two groups was similar at 1 and 5 years (p > 0.05).

CONCLUSION

CBN could be safely performed during KT for patients with ADPKD. The patients could benefit from reduction of the operative procedures, better relief from arterial hypertension persistence and lower urinary tract infection posttransplantation.

Simultaneous pancreas-kidney transplantation in a single center: 10-year retrospective analysis

BACKGROUND

Simultaneous pancreas-kidney transplantation (SPKT) is the best treatment option for diabetic patients with advanced chronic renal failure. The current study aimed to analyze the surgical indications, treatments and prognosis of SPKT.

METHODS

We retrospectively analyzed 40 cases of SPKT performed between December 1999 and January 2010 in our center, including the survival rate, complications and the reasons of reoperation.

RESULTS

Of all the 40 SPKT cases, the one-year survival rates of the recipients, kidney and pancreas transplant graft were 97.6%, 97.6% and 92.7%, while 97.6%, 91.1%, 92.7% at 3 years and 83.6%, 78.0%, 79.4% at 5 years, respectively. After SPKT, 10 patients need reoperation because of surgical complications (14 operations). The reoperation rate was 25%, including 2 patients (4 operations) with hematuria, 4 patients with abdominal hemorrhage, 2 patients (3 operations) with abdominal infection, 1 patient with pancreatic venous thrombosis, 1 patient with anastomotic leakage, and 1 patient with fistula.

CONCLUSION

Although SPKT provides a successful and effective treatment for diabetics with end-stage renal disease, how to reduce the complications of this treatment still need further effort.

[FTIR analysis of oil shales from Huadian Jilin and their pyrolysates]

Thermochemical conversion is the key technology for the comprehensive utilization of Chinese oil shale resources. Oil shales from three mining areas of Huadian Jilin were pyrolyzed at 500 degrees C in a quartz tube reactor and their pyrolyzed cokes and shale oil were derived. One oil shale was also pyrolyzed at 600 degrees C and 700 degrees C to assess the influence of temperature on pyrolysates. FTIR analysis was carried out to study the raw shales and their products. The results showed that shale oil had similar functional groups as the organic matter of oil shale, mainly aliphatic hydrocarbon, and the shale oil contained more of it than the raw material. The shale with more aliphatic oil yielded more oil. That with less aliphatic and more aromatic one yields less oil, and its coke is rich in condensed aromatics. Pyrolysis was almost completed at 500 degrees C. Oil yield did not increase further with temperature, but secondary pyrolysis strengthened. At 700 degrees C carbonates began to decompose.

Preconditioning of pancreatic graft with isoproterenol reduces posttransplant ischemia/reperfusion injury in rats

AIM: To determine the protective effects of isoproterenol preconditioning (IPC) against ischemia/reperfusion injury in rats after pancreas transplantation and to explore mechanisms involved.

METHODS: The expression of heat shock protein 70 (HSP70) in the pancreas of rats undergoing IPC was detected at different time points after IPC. A rat model of posttransplant pancreatic ischemia/reperfusion injury was established. The donor rats that showed high expression of HSP70 in the pancreas were used as experiment group, while donor rats that did not undergo IPC were used as control group. The blood and pancreatic samples were taken 6 h after pancreas transplantation. The expression of HSP70 in the pancreas was detected by Western blot and immunohistochemistry. The expression of TNF-α in the pancreas was detected by immunohistochemistry. Serum amylase was determined by iodine colorimetry. The apoptosis rate of pancreatic cells was determined by flow cytometry.

RESULTS: The expression level of HSP70 in the pancreas of donor rats reached the peak at 24 h after IPC, which was significantly higher than those at other time points (0.92 ± 0.25 vs 0.24 ± 0.04, 0.34 ± 0.06, 0.58 ± 0.07, 0.62 ± 0.11 and 0.25 ± 0.09, respectively; all P < 0.05). The expression levels of HSP70 in the experimental group at 6, 12, 24 and 36 h after IPC were significantly higher than those in the control group at corresponding time points (0.34 ± 0.06 vs 0.28 ± 0.07, 0.58 ± 0.07vs 0.25 ± 0.04, 0.92 ± 0.25 vs 0.27 ± 0.05 and 0.62 ± 0.11 vs 0.25 ± 0.06, respectively; all P < 0.05) but returned to normal level at 48 h. No significant differences were noted in the expression levels of HSP70 among each time point in the control group. HSP70 was mainly expressed in pancreatic acinar cells and the vessel wall. The expression level of TNF-α, apoptosis rate, neutrophil count and serum amylase significantly increased in the control group when compared with those in sham-operated group (all P < 0.01). However, the levels of these parameters significantly decreased in the experiment group when compared with those in the control group (11 929 ± 1 220 vs 46 111 ± 3 127, 26.7% ± 4.5% vs 37.4% ± 4.7%, 3 308 ± 531 vs6 668 ± 1 506 and 1 057 IU/L± 148 IU/L vs 1 408 IU/L± 195 IU/L, respectively; all P < 0.05).

CONCLUSION: Isoproterenol preconditioning reduces ischemia/reperfusion injury in rats after pancreas transplantation perhaps by inducing the production of HSP70.

(1H-Imidazole-κN) {N-[1-(2-oxidophenyl-κO)ethyl-idene]-l-phenyl-alaninato-κN,O}copper(II)

In the title compound, [Cu(C₁₇H₁₅NO₃)(C₃H₄N₂)], the Cu^II atom is four-coordinated by two O atoms and the N atom of the tridentate Schiff base ligand, and one N atom from the imidazole ligand in a distorted square-planar geometry. In the crystal structure, mol­ecules are linked into dimers by inter­molecular N—H⋯O hydrogen bonds.

Epidermal growth factor regulates intestinal glutamine uptake during total parenteral nutrition

Sprague Dawley rats were randomised into three groups: group I (chow) were fed rat chow and water ad libitum, group II total parenteral nutrition (TPN) received a standard formula of TPN, and group III (TPN--epidermal growth factor (EGF)) received the same TPN as group II and injections of EGF (0.1 microg/gm body weight) subcutaneously twice daily. Glutamine (GLN) concentrations in tissues and blood were measured by reversed phase high performance liquid chromatography. Gut GLN extraction was calculated by dividing the difference in GLN concentrations (Conc) between the carotid artery (ART) and portal vein (PV) by the arterial concentration [(ART Conc - PV Conc)/ART Conc]. TPN induced a marked reduction of GLN concentration in tissues and blood, and also reduction of gut GLN extraction. When EGF was administered along with TPN, gut GLN concentration did not fall and gut GLN extraction was increased by 15% (TPN - EGF 1 week, P < 0.05). Arterial blood concentration of GLN was increased when TPN and EGF were used for 1 week (P < 0.05 vs control). But EGF did not prevent the GLN concentration of other tissues decreasing during TPN. Our results suggest that EGF can regulate intestinal uptake of GLN during TPN.

Effect of arginine on gastrointestinal immunity during total parenteral nutrition

It has been well recognized that the prolonged use of total parenteral nutrition (TPN) leads to intestinal immunodeficiency and bacterial translocation (BT). Arginine (ARG) is known to have immunostimulatory effects. But its effects on gut immunity are unknown. This experiment was designed to evaluate the effects of arginine on gut immunity during TPN. Male Sprague Dowley rats were randomized to three groups: group I (chow) was fed rat chow and water ad libitum, group II (TPN) received a standard formula of TPN and group III (TPN-ARG) received the same formula of TPN as group II with the amino acid composition containing 0.5% arginine. With the duration of TPN, the rates of BT increased and interleukin 2 (IL-2) production decreased in TPN group. The results in TPN-ARG group were partly reversed. When TPN was administered for 2 weeks, the rate of BT decreased significantly (P < 0.05) and IL-2 production increased markedly (P < 0.01) in the TPN-ARG group compared with those in the TPN group. Our results suggest that arginine can decrease BT and increase IL-2 production in rats during prolonged TPN.

[Trace element contents in the transparent lens and the senile cataract lens]

The contents of trace elements Zn, Mn, Cu and Fe in 38 senile cataract lenses and 37 transparent lenses were determined by atomic absorption spectrophotometry. It was found that the contents of the elements in senile cortical cataract lenses were markedly different from those in transparent lenses. Comparing transparent lenses with senile nuclear cataract lenses, there was only difference in the content of Mn. It was therefore inferred that the occurrence of senile cataract was directly related to the deficiency of trace elements.