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简介：ToinvestigatetheimbalancestateofhelperTlymphocytes(Th)andcytotoxicTlympho-cytes(Tc)andtherolesofTh1/Th2/Th3andTc1/Tc2cellsinrenaltransplantationrejection,theper-centagesofthesecellsinperipheralbloodof24casesofrenaltransplantationrecipientswithacutere-jectionandthedynamicchangesoftheCD4/CD8ratioweredeterminedbyflowcytometryanalysis,while30casesofhealthyindividualsweresetupascontrols.Inthesehealthycontrols,thepercentagesoftheTh1,Th2andTh3cellswere(10.45±8.15)%,(5.05±4.15)%and(3.90±3.21)%,andthoseofTc1andTc2cellswere(9.83±7.03)%and(4.51±2.17)%,respectively.However,thepercentagesofTh1andTclcellsinperipheralbloodofthestablerecipientsaftertransplantationwere(7.29±5.62)%and(7.04±5.15)%,showingdefinitereduction,whilethoseofTh2,Th3andTc2cellsshowedsignificantincrease,(6.34±5.67)%,(4.94±4.14)%and(6.86±4.42)%,respectively.Incaseofrecipientswithacuterejection,thepercentagesofTh1andTc1cellsappearedtobe(18.55±13.21)%and(15.84±11.72)%,alsoshowingsignificantincrease,butthoseofTh2,Th3andTc2cellsappearedtobereduced,(4.19±3.62)%,(3.02±2.83)%and(3.88±1.63)%,respectively.Significantdifferencescouldbedetectedamongthesethreegroups(P<0.05).TheCD4/CD8ratioincaseswithacuterejectionwashigherthanthoseofstablerecipients(2.24±0.59vs1.95±0.45),butthatofthestablerecipientsandhealthycontrols(1.98±0.31)showednoanysignificantdifference.Fromtheaboveobservation,itisevidentthatimbalancebetweenTh1,Th2andTh3withTc1andTc2cellsmayexistafterrenaltransplantationandprobably,theim-muneimbalancemaybeinducedthroughthesecretionofcytokinesINF-γbyTh1orTc1cells,Ⅱ-4byTh2andTc2cellsandTGF-βbyTh3.

简介：Extrapulmonarysmallcellcarcinoma(EPSCC)isarareneoplasmcomprising2.5%to5%ofsmallcellcarcinomas(SCCs).BladderSCCisthemostcommonsiteofgenitourinarytract.PrimaryrenalSCCisextremelyrare.WereportacaseofprimarySCCofthekidneywhichisrarelyreportedintheurinarytractandpresentsanaggressiveclinicalpicture.A59-year-oldfemalevisitedaurologicclinicwithcomplaintofpersistentleftflanksoreness10yearsafterundergoingrenaltransplantation.Abdominalcomputedtomographyshowedaleftrenalpelvistumor.Afterthepatientreceivedleftnephroureterectomywithbladdercuffresection,herpathologyresultsshowedSCC.Aftersurgery,shereceivedadjuvantsystemicchemotherapy,andherrecoveryhasbeenuneventfulasof8months.PrimaryrenalSCCpresentswithanadvancedtumorstageandashortmediansurvivalperiod,thereforeearlyinterventionandclosefollow-uparerecommended.

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简介：AbstractBackground:This study aims to observe the dynamic changes of renal artery (RA) disease and cortical blood perfusion (CBP) evaluated by contrast-enhanced ultrasound (CEUS) after percutaneous transluminal renal artery stenting (PTRAS) in patients with severe atherosclerotic renal artery stenosis (ARAS) and to analyze the relationship between CBP and prognosis.Methods:This was a single-center retrospective cohort study. A total of 98 patients with unilateral severe ARAS after successful PTRAS in Beijing Hospital from September 2017 to September 2020 were included. According to renal glomerular filtration rate (GFR) detected by radionuclide imaging at 12 months after PTRAS, all patients were divided into the poor prognosis group (n = 21, GFR decreased by ≥20% compared with baseline) and the control group (n = 77, GFR decreased by < 20% or improved compared with baseline). Renal artery stenosis was diagnosed by digital subtraction angiography, and renal CBP was evaluated by CEUS using TomTec Imaging Systems (Germany) before PTRAS, at 6 months and 12 months after discharge. The receiver operating characteristic (ROC) curve with area under the curve (AUC) was used to analyze the predictive value of CBP parameters, including area under ascending curve (AUC1), area under the descending curve (AUC2), rising time (RT), time to peak intensity (TTP), maximum intensity (IMAX), and mean transit time (MTT) for poor prognosis.Results:Among the 98 patients, there were 52 males (53.1%), aged 55-74 years old, with an average age of 62.1 ± 8.7 years, and an average artery stenosis of 82.3 ± 12.9%. The poor prognosis group was associated with significantly increased incidence of diabetes (76.2% vs. 41.6%), and lower levels of GFR of the stenotic kidney (21.8 mL/min vs. 25.0 mL/min) and total GFR (57.6 mL/min vs. 63.7 mL/min) (all P < 0.05), compared with the control group (P < 0.05). In addition, the rate of RA restenosis was significantly higher in the poor prognosis group than in the control group (9.5% vs. 0, χ2 = 9.462, P = 0.002). Compared with the control group, the poor prognosis group was associated with significantly decreased baseline AUC1 and AUC2, and extended duration of TTP and MTT (P < 0.05). At 6 months and 12 months of follow-up, patients in the control group were associated with markedly increased AUC1, AUC2, and IMAX, and shorter duration of RT and MTT (P < 0.05). The ROC curve showed that the predictive values of AUC1, AUC2, RT, TTP, IMAX, and MTT for poor prognosis were 0.812 (95% CI: 0.698-0.945), 0.752 (95% CI: 0.591-0.957), 0.724 (95% CI: 0.569-0.961), 0.720 (95% CI: 0.522-0.993), 0.693 (95% CI: 0.507-0.947), and 0.786 (95% CI: 0.631-0.979), respectively.Conclusions:Preoperative renal CBP in severe ARAS patients with poor prognosis is significantly reduced, and does not show significant improvement after stent treatment over the first year of follow-up. The parameter AUC1 may be a good predictor for renal dysfunction after PTRAS in severe ARAS patients.Trial Registration:ChiCTR.org.cn, ChiCTR1800016252.

简介：AIMTo把主要、周期性的pterygium外科的长期的结果与三种不同技术作比较：联合结膜自体移植和覆盖羊膜的膜移植(有AMT的猫)，结膜自体移植移植(猫)独自一个、羊膜的膜移植(AMT)alone.METHODSIn这回顾的研究，142个pterygium病人的142只眼睛(104主要，38周期性)经历了猫(组A)，AMT(组B)或有AMT(组C)的猫分别地后面的外科的切除基于复发和手术后的complications.RESULTSThe数字被考察并且比较一样的描述在下面)，18(10，8)并且2(1，1)在组A，B，和C分别地；干燥眼睛是22(16，6)，27(18，9)并且7(3，4)；结膜发炎是30(17，13)，27(16，11)并且11(6，5)。在组C(主要或周期性的任何一个或两个)的病人主要在组A或B比那些显示出显著地更好的结果(P<0.05)关于上述临床的effects.CONCLUSIONCombined猫并且过分AMT比猫或AMT为主要、周期性的pterygium外科有复发和手术后的复杂并发症的显著地更低的率独自一个。

简介：Overthepastdecade,percutaneousrenaldenervationhasbeenvigorouslyinvestigatedasatreatmentforresistanthypertension.TheSYMPLICITYradiofrequencycathetersystem(MedtronicCardioVascularInc.,SantaRosa,CA,USA)isthemosttesteddeviceinclinicaltrials.AfterthepositiveresultsofsmallphaseIandIIclinicaltrials,SYMPLICITYHTN-3(aphaseIII,multi-center,blinded,sham-controlledrandomizedclinicaltrial)wascompletedin2014,butdidnotshowsignificantbloodpressureloweringeffectwithrenaldenervationcomparedtomedicaltherapyandcausedtheinvestigatorsandindustrytorevisitboththebasicscienceelementsofrenaldenervationaswellasthedesignofrelatedclinicaltrials.ThisreviewsummarizestheSYMPLICITYtrials,analyzestheSYMPLICITYHTN-3data,andprovidesinsightsgainedfromthistrialinthedesignofthemostrecentclinicaltrial,theSPYRALHTNGlobalclinicaltrial.Otherthanhypertension,theroleofrenaldenervationinthemanagementofotherdiseaseprocessessuchassystolicanddiastolicheartfailure,metabolicsyndrome,arrhythmia,andobstructivesleepapneawiththecommonpathophysiologicpathwayofsympatheticoveractivityisalsodiscussed.

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简介：Livertransplantation（LT）isalife-savingtreatmentforpatientswithend-stageliverdiseaseandforpatientswithlivercellcancerrelatedtoliverdisease.Acuteandchronicliverdiseasesrelatedtohepatitisvirusesarebetweenthemainindicationsforlivertransplantation.Theriskofviralreinfectionaftertransplantationisthemainlimitingfactorintheseindications.Beforetheavailabilityofantiviralprophylaxis,hepatitisBvirus（HBV）recurrencewasuniversalinpatientswhowereHBVDNA-positivebeforetransplantation.ThenaturalhistoryofrecurrentHBVwasacceleratedbyimmunosuppression,anditprogressedrapidlytograftfailureanddeath.Introductionofpost-transplantprophylaxiswithimmunoglobulinalonefirst,andassociatedtoantiviraldrugslater,drasticallyreducedHBVrecurrence,resultinginexcellentlong-termoutcomes.Onthecontrary,recurrenceofhepatitisCisthemaincauseofgraftlossinmosttransplantprograms.Overall,patientandgraftsurvivalafterLTforhepatitisCvirus（HCV）-associatedcirrhosisisinferiorcomparedwithotherindications.However,successfulpretransplantorposttransplantantiviraltherapyhasbeenassociatedwithincreasedgraftandoverallsurvival.Untilrecently,thecombinationofpegylatedinterferonandribavirinwasthestandardofcareforthetreatmentofpatientswithchronichepatitisC.Highlyactiveantiviralcompoundshavebeendevelopedoverthepastdecade,thankstonewinvitrosystemstostudyHCVentry,replication,assembly,andrelease.

简介：Treated50casesofrenalcolicwithelectroacupunctureandcomparedtheresultswiththoseintwocontrolgroups.Totaleffectiverateinthetreatmentgroup,controlgroupⅠandcontrolgroupⅡwas98.0%,90.0%and92.0%respectively.

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简介：Arecentreportintroducedthephosphodiesterase-5inhibitionbyvardenafilasanoveltreatmentofportalhypertensioninpatientswithcirrhosis.Inthehereinpresented'lettertotheeditor',theadministrationoftadalafildidnotinfluenceportalhaemodynamicsbutimpairedsystemichaemodynamicsinpatientswithcirrhosis.OurobservationsconcurwiththeresultsofareportinapreviousissueofWorldJournalofGastroenterology(October2008).Moreover,tadalafiladverselyaffectedrenalfunctioninpatientswithdecompensatedliverdisease.

简介：Objective:Toinvestigatenephroprotectiveeffectsofamixtureof8L-aminoacidsonrenalischemia-reperfusioninjuryanditseffectsonrenalendothelin-1(ET-1).Methods:Themixtureof8L-aminoacidsincludesglycine,alanine,threonine,serine,valine,leucine,isoleucineandproline.Acuteischemicrenalinjurywasinducedbyclampingrenalpediclefor45minutesinrats.SixtymaleSprague-Dawieyratswererandomlydividedinto3groups:asham-operatedgroup(GroupA,n=8),acontrolgroup(GroupB,n=26)andanaminoacid-treatedgroup(GroupC,n=26).Aminoacidswereinfusedatarateof1mi·100g-1·h-1Ihourbeforeischemiaandduring3hoursofthewholereperfusion.Theserumcreatininevalues,BUNlevels,creatiulneclearance,urinesodium&potassiumexcretion,urinelactatedehydrogenase(LDH),therateofurineflowandhistologicalexaminationweremeasured.RenalET-1levelswereassayedwithradioimmunologicalassay(RIA)Results:Thecreatinineclearancewas471.0μl/min±121.5pi/maininGroupCand227.0μl/min±27.0μl/mininGroupB3hoursafterreperfnsion,P＜0.01).Theurineflowratewas63.6pi/min±15.2μl/mininGroupCand24.3μl/min±7.7μl/mininGroupB,P＜0.01)1.5hoursafterreperfusion.Theserumcreatininewas85.0μl/min±7.7μmol/LandBUNoncentration11.4mmol/L±3.9mmol/LinGroupCand112.7μmol/L±19.5μmol/Land20.7mmol/L±6.6mmol/LrespectivelyinGroupBafter24hoursofreperfusion(P＜0.05).ThemeanhistologicalscorebystandardsofPallerinkidneyswas108.7±15.7inGroupC,and168.8±14.8inGroupB(P＜0.01).TherenalET-1levels15minuteand3hoursafterreperfusionwere7.2pg/mg±0.8pg/mgand9.6pg/ml±1.0pg/mlinGroupC,and10.1pg/ml±2.8pg/mland13.0pg/ml±2.7pg/miinGroupB(P＜0.01).Conclusions:Themixtureof8L-aminoacidscanprovideremarkableprotectionagainstrenalisehemia-reperfusioninjuryinrats.Thismayassociat

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简介：Alcoholicliverdiseaseisanestablished,yetcontroversial,indicationforlivertransplantation.Althoughanabstinenceperiodofupto6mopriortotransplantationismandatory,alcoholrelapseaftertransplantationisacommonevent.Incaseofrecurrenceofheavydrinking,graftsurvivalissignificantlyimpaired.Guidelinesondetectionandsurveillanceofalcoholconsumptioninthispatientcohortarelacking.Thisreviewsummarizesthechallengeofpatientselectionaswellasthecurrentknowledgeonestablishedandnovelalcoholbiomarkerswithspecialfocusonlivertransplantcandidatesandrecipients.

简介：Transplantrejection,liketolerance,isaTcell-dependentevent.ThereiscompellingevidencetosuggestthatinductionoftransplanttoleranceisanactivelylearnedprocessinwhichTcellsneedtoengagewiththealloantigensinordertolearntotoleratetheallograft.AfamilyofcytokineswhosereceptorsusethesameIL-2receptorγcchain(alsocalledthecommonγc)playsanimportantroleinregulatingmultipleaspectsoftheallograftresponse(I.e.Rejectionvs.Tolerance).ItisundeniablethatγccytokinescandriveclonalexpansionandeffectormaturationofalloreactiveTcells,andtherefore,targetingsuchcytokinesortheirreceptorcomponentsremainsanattractivewayofblockingtransplantrejection.However,wejuststartedtoappreciatethatγccytokinesalsoregulatetheacquisitionoftransplanttoleranceviaprogrammingactivatedTcellsforapoptoticcelldeathandviaguidingtheevolutionofregulatoryTcells.Thus,understandingpreciselytheroleofγccytokinesinregulatingTcellhomeostasisandTcellregulationiscriticallyimportantintheinductionoftransplanttolerance.

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