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Nicotinamide adenine dinucleotide phosphate (NADPH)-cytochrome P450 reductase (CPR), a crucial electron-transfer partner of P450 systems, is required for various biological reactions catalyzed by P450 monooxygenase. Our previous study indicated that enhanced P450 enzyme detoxification and CYP6ER1 overexpression contributed to sulfoxaflor resistance in Nilaparvata lugens. However, the association between CPR, sulfoxaflor resistance, and neonicotinoid cross-resistance in N. lugens remains unclear. In this study, the sulfoxaflor-resistant (SFX-SEL) (RR = 254.04-fold), resistance-decline (DESEL) (RR = 18.99-fold), and susceptible unselected (UNSEL) strains of N. lugens with the same genetic background were established. Real-time quantitative polymerase chain reaction (RT-qPCR) revealed that the N. lugens CPR (NlCPR) expression level in the SFX-SEL strain was 6.85-fold and 6.07-fold higher than in UNSEL and DESEL strains, respectively. NlCPR expression was significantly higher in the abdomens of UNSEL, DESEL, and SFX-SEL fourth-instar nymphs than in other tissues (thoraxes, heads, and legs). Additionally, sulfoxaflor stress significantly increased NlCPR mRNA levels in the UNSEL, SFX-SEL and DESEL strains. NlCPR silencing by RNA interference (RNAi) dramatically increased the susceptibility of the UNSEL, DESEL, and SFX-SEL strains to sulfoxaflor, but the recovery of SFX-SEL was more obvious. Furthermore, NlCPR silencing led to a significant recovery in susceptibility to nitenpyram, dinotefuran, clothianidin, and thiamethoxam across all strains (UNSEL, DESEL, and SFX-SEL), with the greatest degree of recovery in the sulfoxaflor-resistant strain (SFX-SEL). Our findings suggest that NlCPR overexpression contributes to sulfoxaflor resistance and neonicotinoid cross-resistance in N. lugens. This will aid in elucidating the significance of CPR in the evolution of P450-mediated metabolic resistance in N. lugens.
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Hemípteros , Inseticidas , Animais , Inseticidas/farmacologia , NADPH-Ferri-Hemoproteína Redutase/genética , Neonicotinoides/farmacologia , Sistema Enzimático do Citocromo P-450/metabolismo , Hemípteros/metabolismo , Nitrocompostos/farmacologia , Resistência a Inseticidas/genéticaRESUMO
Clothianidin is a second-generation neonicotinoid insecticide that can effectively prevent piercing-sucking pests, such as white-backed planthopper (WBPH), Sogatella furcifera (Horváth). In this study, the sublethal effects of clothianidin on the biological traits of S. furcifera were evaluated via the age-stage, two-sex life table procedure. Our results exhibited that the female adult longevity, fecundity and hatchability of F0 generation were significantly decreased after LC10 and (or) LC30 of clothianidin exposure compared to the control. Transgenerational effects showed that the pre-adult period, female adult longevity, total longevity, oviposition days (Od), fecundity and mean generation time (T) of F1 generation were significantly decreased in the LC10 and LC30 groups compared to the control. Moreover, the development times of the third- and fifth-instar nymphs, total preoviposition period (TPOP) and doubling time (DT) were significantly shorter in the LC10 group than in the control and LC30 groups. Furthermore, the intrinsic rate of increase (ri) and finite rate of increase (λ) values of the LC10 group were significantly higher than those of the control group. However, there was no significant difference in the male adult longevity, adult preoviposition period (APOP) and net reproductive rate (R0) between the treated groups and the control. Enzyme activity and gene expression results showed that the P450 enzyme activity and mRNA levels of many P450 genes were significantly increased by clothianidin treatment. In addition, the knockdown of CYP4CE3 and CYP6FJ3, which showed the highest inducing levels, by RNA interference (RNAi) dramatically increased the toxicity of clothianidin against S. furcifera. These results indicated that sublethal concentrations of clothianidin showed a stimulatory effect on the development, but it could adversely affect the survival and reproduction of S. furcifera. Additionally, CYP4CE3 and CYP6FJ3 might play an important role in the detoxification and evolution of clothianidin resistance in S. furcifera.
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Hemípteros , Animais , Masculino , Feminino , Neonicotinoides/toxicidade , Reprodução , Sistema Enzimático do Citocromo P-450/genética , Sistema Enzimático do Citocromo P-450/metabolismoRESUMO
Acetamiprid is widely used in paddy fields for controlling Nilaparvata lugens (Stål). However, the risk of resistance development, the cross-resistance pattern and the resistance mechanism of acetamiprid in this pest remain unclear. In this study, an acetamiprid-resistant strain (AC-R) was originated from a field strain (UNSEL) through successive selection with acetamiprid for 30 generations, which reached 60.0-fold resistance when compared with a laboratory susceptible strain (AC-S). The AC-R strain (G30) exhibited cross-resistance to thiamethoxam (25.6-fold), nitenpyram (21.4-fold), imidacloprid (14.6-fold), cycloxaprid (11.8-fold), dinotefuran (8.7-fold), sulfoxaflor (7.6-fold) and isoprocarb (8.22-fold), while there was no cross-resistance to etofenprox, buprofezin and chlorpyrifos. Acetamiprid was synergized by the inhibitor piperonyl butoxide (2.2-fold) and the activity of cytochrome P450 monooxygenase was significantly higher in the AC-R strain compared with the AC-S strain, suggesting the critical role of P450. The gene expression results showed that the P450 gene CYP6ER1 was significantly overexpressed in AC-R compared with the AC-S and UNSEL strains. In addition, the RNA interference (RNAi) of CYP6ER1 significantly increased the susceptibility of AC-R to acetamiprid. Molecular docking predicted that acetamiprid and CYP6ER1 had close binding sites, and the nitrogen atoms had hydrogen bond interactions with CYP6ER1. These results demonstrated that the overexpression of CYP6ER1 contributed to acetamiprid resistance in N. lugens.
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Hemípteros , Inseticidas , Animais , Hemípteros/genética , Resistência a Inseticidas/genética , Inseticidas/farmacologia , Simulação de Acoplamento Molecular , Neonicotinoides , Nitrocompostos/farmacologiaRESUMO
In light of the exponential growth in information volume, the significance of graph data has intensified. Graph clustering plays a pivotal role in graph data processing by jointly modeling the graph structure and node attributes. Notably, the practical significance of multi-view graph clustering is heightened due to the presence of diverse relationships within real-world graph data. Nonetheless, prevailing graph clustering techniques, predominantly grounded in deep learning neural networks, face challenges in effectively handling multi-view graph data. These challenges include the incapability to concurrently explore the relationships between multiple view structures and node attributes, as well as difficulties in processing multi-view graph data with varying features. To tackle these issues, this research proposes a straightforward yet effective multi-view graph clustering approach known as SLMGC. This approach uses graph filtering to filter noise, reduces computational complexity by extracting samples based on node importance, enhances clustering representations through graph contrastive regularization, and achieves the final clustering outcomes using a self-training clustering algorithm. Notably, unlike neural network algorithms, this approach avoids the need for intricate parameter settings. Comprehensive experiments validate the supremacy of the SLMGC approach in multi-view graph clustering endeavors when contrasted with prevailing deep neural network techniques.
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Algoritmos , Análise por Conglomerados , Redes Neurais de Computação , Humanos , Aprendizado ProfundoRESUMO
We aimed to analyze the risk factors and construct a new nomogram to predict non-sentinel lymph node (NSLN) metastasis for cT1-2 breast cancer patients with positivity after sentinel lymph node biopsy (SLNB). A total of 830 breast cancer patients who underwent surgery between 2016 and 2021 at multi-center were included in the retrospective analysis. Patients were divided into training (n = 410), internal validation (n = 298), and external validation cohorts (n = 122) based on periods and centers. A nomogram-based prediction model for the risk of NSLN metastasis was constructed by incorporating independent predictors of NSLN metastasis identified through univariate and multivariate logistic regression analyses in the training cohort and then validated by validation cohorts. The multivariate logistic regression analysis revealed that the number of positive sentinel lymph nodes (SLNs) (P < 0.001), the proportion of positive SLNs (P = 0.029), lymph-vascular invasion (P = 0.029), perineural invasion (P = 0.023), and estrogen receptor (ER) status (P = 0.034) were independent risk factors for NSLN metastasis. The area under the receiver operating characteristics curve (AUC) value of this model was 0.730 (95% CI 0.676-0.785) for the training, 0.701 (95% CI 0.630-0.773) for internal validation, and 0.813 (95% CI 0.734-0.891) for external validation cohorts. Decision curve analysis also showed that the model could be effectively applied in clinical practice. The proposed nomogram estimated the likelihood of positive NSLNs and assisted the surgeon in deciding whether to perform further axillary lymph node dissection (ALND) and avoid non-essential ALND as well as postoperative complications.
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Neoplasias da Mama , Metástase Linfática , Nomogramas , Biópsia de Linfonodo Sentinela , Linfonodo Sentinela , Humanos , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Metástase Linfática/patologia , Pessoa de Meia-Idade , Biópsia de Linfonodo Sentinela/métodos , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia , Estudos Retrospectivos , Idoso , Adulto , Fatores de Risco , Curva ROC , Linfonodos/patologia , Linfonodos/cirurgiaRESUMO
Introduction: Developmental engineering based on endochondral ossification has been proposed as a potential strategy for repairing of critical bone defects. Bone development is driven by growth plate-mediated endochondral ossification. Under physiological conditions, growth plate chondrocytes undergo compressive forces characterized by micro-mechanics, but the regulatory effect of micro-mechanical loading on endochondral bone formation has not been investigated. Methods: In this study, a periodic static compression (PSC) model characterized by micro-strain (with 0.5% strain) was designed to clarify the effects of biochemical/mechanical cues on endochondral bone formation. Hydrogel scaffolds loaded with bone marrow mesenchymal stem cells (BMSCs) were incubated in proliferation medium or chondrogenic medium, and PSC was performed continuously for 14 or 28 days. Subsequently, the scaffold pretreated for 28 days was implanted into rat femoral muscle pouches and femoral condylar defect sites. The chondrogenesis and bone defect repair were evaluated 4 or 10 weeks post-operation. Results: The results showed that PSC stimulation for 14 days significantly increased the number of COL II positive cells in proliferation medium. However, the chondrogenic efficiency of BMSCs was significantly improved in chondrogenic medium, with or without PSC application. The induced chondrocytes (ichondrocytes) spontaneously underwent hypertrophy and maturation, but long-term mechanical stimulation (loading for 28 days) significantly inhibited hypertrophy and mineralization in ichondrocytes. In the heterotopic ossification model, no chondrocytes were found and no significant difference in terms of mineral deposition in each group; However, 4 weeks after implantation into the femoral defect site, all scaffolds that were subjected to biochemical/mechanical cues, either solely or synergistically, showed typical chondrocytes and endochondral bone formation. In addition, simultaneous biochemical induction/mechanical loading significantly accelerated the bone regeneration. Discussion: Our findings suggest that microstrain mechanics, biochemical cues, and in vivo microenvironment synergistically regulate the differentiation fate of BMSCs. Meanwhile, this study shows the potential of micro-strain mechanics in the treatment of critical bone defects.
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Fusarium equiseti (JMF-01), as an entomopathogenic fungus, can effectively control agricultural pests and has the potential to be a biocontrol agent. To promote mycelial growth and sporulation, we investigated the optimal submerged culture conditions for F. equiseti. In this study, we used the single-factor method and Box-Behnken design and determined the virulence of the submerged culture against Myzus persicae after optimization. As a result, the highly significant factors affecting the spore concentration of strain JMF-01 were the primary inoculum density and the initial pH, and the highly significant factor affecting the mycelial biomass was the medium-to-flask ratio. The highest mycelial biomass value was 0.35 g when the incubation time was 5.68 days, the initial pH was 5.11, the medium-to-flask ratio was 0.43, and 1 mL of the primary inoculum with spore density of 0.97 × 107 conidia/mL was added. When the incubation time was 6.32 days, the initial pH was 4.46, the medium-to-flask ratio was 0.35, the primary inoculum density was 1.32 × 107 conidia/mL of 1 mL, and the highest spore concentration of 6.49 × 108 blastospores/mL was obtained. Compared with the unoptimized medium conditions, the optimized submerged culture had the highest mycelial biomass and spore concentration, which were 3.46 and 2.06 times higher, respectively. The optimized submerged culture was highly pathogenic toward M. persicae, reaching a 95% mortality rate. Our results provide optimal submerged culture conditions for F. equiseti and lay the basis for later research to expand production for pest control.
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Microcystin-leucine arginine (MC-LR), a potentially carcinogenic toxin, is produced by Cyanobacteria such as Microcystis and Ananabacteria during water bloom. Increasing evidence demonstrated that MC-LR induces male reproductive toxicity, mainly by inducing germ cell apoptosis, destroying cell cytoskeleton, interfering with DNA damage repair pathway, and damaging blood-testicular barrier (BTB), which eventually lead to male sterility. Testicular Sertoli cells are the somatic cells that directly contact with spermatogenic cells in seminiferous tubules. They not only regulate immune response to maintain testicular immune homeostasis by secreting a variety of cytokines and immunosuppressive factors, but also provide the protective effects of spermatogenic cells by forming BTB. MC-LR induces inflammation and apoptosis of Sertoli cells, and destroys the integrity of the BTB, and then causes spermatogenesis dysfunction.
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Arginina , Células de Sertoli , Masculino , Humanos , Leucina/metabolismo , Leucina/farmacologia , Arginina/metabolismo , Arginina/farmacologia , Microcistinas/toxicidade , Microcistinas/metabolismo , ImunidadeRESUMO
Perfluorooctanoic acid (PFOA), a man-made chemical widely used in consumers, could cause male reproductive toxicity by disrupting blood-testis barrier (BTB) integrity. Autophagy in Sertoli cells is essential for regulation of spermatogenesis and BTB. However, it remains a mystery that whether PFOA-induced BTB injury is associated with autophagy in Sertoli cells. In this study, we found that PFOA dose-dependently disrupted tight junction (TJ) function in Sertoli cells in vivo and in vitro. Furthermore, the results from transmission electron microscopy, Western blot and immunofluorescence analysis revealed that PFOA induced the accumulation of autophagosome in testicular Sertoli cells as well as TM4 cells. Further study confirmed that autophagosome accumulation resulted from the blockage of autophagic degradation because of disruption of autophagosome and lysosome fusion via downregulation of the expression of α-SNAP. In parallel, the overexpressed MMP9 was also observed in vivo and in vitro. Conversely, overexpression of α-SNAP inhibited the expression of MMP9 in TM4 cells. In conclusion, PFOA blocks autophagic flux through downregulating the expression levels of α-SNAP in Sertoli cells, and then induces the accumulation of MMP9 leading to disruption of TJ function. This finding will provide clues for effective prevention and treatment of PFOA-induced male reproductive toxicity.
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Metaloproteinase 9 da Matriz , Células de Sertoli , Humanos , Masculino , Metaloproteinase 9 da Matriz/metabolismo , Junções Íntimas , Proteínas de Ligação a Fator Solúvel Sensível a N-Etilmaleimida/metabolismo , Proteínas de Ligação a Fator Solúvel Sensível a N-Etilmaleimida/farmacologia , Testículo , Espermatogênese , Autofagia , Barreira HematotesticularRESUMO
Background: Psoriasis is a chronic noncommunicable dermatological condition, and psoriasis vulgaris is the most common phenotype. Acitretin is the most widely used systemic retinoid in the treatment of psoriasis. This review evaluates the clinical therapeutic effects of Xiaoyin granule, a Chinese herbal medicine, combined with acitretin capsule in the treatment of psoriasis vulgaris. Methods: Six databases including PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wan Fang, and China Biology Medicine disc (CBM) were searched for published studies on Xiaoyin granule and/or acitretin capsule in psoriasis vulgaris. The Cochrane Collaboration risk-of-bias instrument was used to assess the quality of the included RCTs. STATA 14.0 was used to conduct the statistical analysis. Results: Twenty-eight trials with 3281 patients were included in this meta-analysis. The results of this study show that the combined treatment of Xiaoyin granule and acitretin capsule could improve the total effective rate (TER) and cure rate (CR) when compared with acitretin capsule (TER: RR = 1.15, 95% CI (1.10, 1.21); CR: RR = 1.8, 95% CI (1.62, 2.00)) or Xiaoyin granule (TER: RR = 1.24, 95% CI (1.11, 1.39); CR: RR = 1.75, 95% CI (1.54, 1.98)) alone. The combined therapy could decrease the PASI score (mean difference = -1.45, 95% CI (-2.09, -0.80)) and inhibit inflammation (IL-10: mean difference = 1.16, 95% CI (0.94, 1.38); IL-17: mean difference = -2.06, 95% CI (-2.60, -1.51)) in psoriasis vulgaris patients. Conclusions: The combination of Xiaoyin granule and acitretin capsules could be a novel therapeutic strategy in the treatment of psoriasis vulgaris. However, the quality of trials in this study limited the conclusion, and more high-quality RCTs are needed for further evaluation.
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Medicamentos de Ervas Chinesas , Psoríase , Acitretina/uso terapêutico , Doença Crônica , Terapia Combinada , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Psoríase/tratamento farmacológicoRESUMO
Pure plant extract luteolin has been demonstrated to possess numerous biological and immunological effects. However, how luteolin affects mice alveolar macrophages' self-renewal and polarization closely related to inflammatory and immunomodulatory is still unknown. In our study, the transcriptomic analysis showed that several self-renewal-related pathways in luteolin-pretreated alveolar macrophages were inhibited compared to the granulocyte-macrophage colony-stimulating factor (GM-CSF)-treated group. Ki-67 staining and EdU assay indicated that luteolin inhibited GM-CSF-induced alveolar macrophage proliferation. Moreover, GM-CSF-induced expressions of c-Myc and KLF4 were significantly suppressed by luteolin at transcriptional and protein levels. Besides, we found that luteolin promoted M1 macrophage polarization induced by LPS plus IFN-γ. At the same time, it inhibited M2 macrophage polarization induced by IL-4 in both alveolar and bone marrow-derived macrophages by detecting macrophage polarization-related gene expressions at mRNA and protein levels. We found that luteolin inhibited self-renewal and altered the polarization of primary alveolar macrophages. Taken together, our data will aid in a better understanding of the immunomodulatory effects of luteolin on the primary alveolar macrophages.
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Fator Estimulador de Colônias de Granulócitos e Macrófagos , Macrófagos Alveolares , Animais , Fator Estimulador de Colônias de Granulócitos e Macrófagos/metabolismo , Fator Estimulador de Colônias de Granulócitos e Macrófagos/farmacologia , Luteolina/metabolismo , Luteolina/farmacologia , Macrófagos/metabolismo , CamundongosRESUMO
The technique bottleneck of repairing large bone defects with tissue engineered bone is the vascularization of tissue engineered grafts. Although some studies have shown that extracellular vesicles (EVs) derived from bone marrow mesenchymal stem cells (BMSCs) promote bone healing and repair by accelerating angiogenesis, the effector molecules and the mechanism remain unclear, which fail to provide ideas for the future research and development of cell-free interventions. Here, we found that Nidogen1-enriched EV (EV-NID1) derived from BMSCs interferes with the formation and assembly of focal adhesions (FAs) by targeting myosin-10, thereby reducing the adhesion strength of rat arterial endothelial cells (RAECs) to the extracellular matrix (ECM), and enhancing the migration and angiogenesis potential of RAECs. Moreover, by delivery with composite hydrogel, EV-NID1 is demonstrated to promote angiogenesis and bone regeneration in rat femoral defects. This study identifies the intracellular binding target of EV-NID1 and further elucidates a novel approach and mechanism, thereby providing a cell-free construction strategy with precise targets for the development of vascularized tissue engineering products.
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Impaired tight junction (TJ) function and autophagy and the activated p38 mitogen-activated protein kinase (MAPK)/matrix metalloproteinase 9 (MMP9) pathway in Sertoli cells cause spermatogenic disorders. However, it is unclear whether reduced TJ barrier function and autophagy and the activated p38 MAPK/MMP9 pathway in Sertoli cells are closely associated with age-related testicular dysfunction. Thus, we evaluated these changes in Sertoli cells using 6-, 12-, 18-, and 24-month-old Sprague-Dawley rats. The results showed that testicular morphology gradually degenerated, as evidenced by increased exfoliated germ cells, decreased seminiferous tubule diameter and seminiferous epithelium height, and reduced the numbers of spermatogonia, primary spermatocytes and spermatids during the process of aging. In addition, the TJs formed by adjacent Sertoli cells were progressively destroyed accompanied by an abnormal ultrastructure and decreased expression of the TJ proteins zonula occludens-1 (ZO-1), occludin, and claudin-11 with aging. Furthermore, the expression of phosphorylated p38MAPK and MMP-9 in Sertoli cells and testis gradually increased, and the expression of occludin co-localizated with MMP-9 progressively decreased. Meanwhile, autophagy levels also gradually decreased, including decreased autophagic vacuole formation and weak expression of light chain 3 (LC3) and autophagy-related 5 (Atg5) in Sertoli cells. Taken together, our results indicate that aging causes impaired TJ barrier function and degeneration of seminiferous tubules. The mechanism might be related to the activated p38MAPK/MMP9 pathway and inactivated autophagy in Sertoli cells.
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Células de Sertoli , Junções Íntimas , Envelhecimento , Animais , Autofagia , Masculino , Metaloproteinase 9 da Matriz , Ratos , Ratos Sprague-Dawley , Células de Sertoli/metabolismo , Células de Sertoli/ultraestrutura , Testículo , Junções Íntimas/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismoRESUMO
As the monoplex network has its limitations in describing the real world, a new framework called the multiplex network is put forward and has received much attention in recent years. This paper focuses on synchronization of the multiplex network with multiple delays and stochastic perturbations. Due to the complexity, pinning control of the multiplex network is of particular interest. Based on the LaSalle-type invariance principle for stochastic differential delay equations and the Lyapunov stability theory, some control schemes and synchronization criteria are obtained. It is concluded that under some mild conditions, one can determine which nodes should be pinned in a multiplex network. In addition, it is found that the number of pinned nodes increases with the varying interval of noise and time delay, and decreases with the varying interval of intralayer coupling strength. Some two-layer and three-layer networks are employed to validate the effectiveness of the proposed algorithm.
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Visual feature learning, which aims to construct an effective feature representation for visual data, has a wide range of applications in computer vision. It is often posed as a problem of nonnegative matrix factorization (NMF), which constructs a linear representation for the data. Although NMF is typically parallelized for efficiency, traditional parallelization methods suffer from either an expensive computation or a high runtime memory usage. To alleviate this problem, we propose a parallel NMF method called alternating least square block decomposition (ALSD), which efficiently solves a set of conditionally independent optimization subproblems based on a highly parallelized fine-grained grid-based blockwise matrix decomposition. By assigning each block optimization subproblem to an individual computing node, ALSD can be effectively implemented in a MapReduce-based Hadoop framework. In order to cope with dynamically varying visual data, we further present an incremental version of ALSD, which is able to incrementally update the NMF solution with a low computational cost. Experimental results demonstrate the efficiency and scalability of the proposed methods as well as their applications to image clustering and image retrieval.
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OBJECTIVES: Orthotopic liver transplantation (OLT) is an accepted therapy for selected patients with advanced liver diseases. However, the early mortality rate after OLT remains relatively high due to the poor selection of candidates with various serious conditions. The aim of this study is to assess the value of pretransplantation artificial liver support treatment in reducing the pre-operation risk factors relating to early mortality after OLT. METHODS: 50 adult patients in various stages of different etiologies who underwent OLT procedures had been treated with molecular adsorbent recycling system (MARS) preoperatively. The study was designed in two parts: the first one was to evaluate the effectiveness of a single MARS therapy by using some clinical and laboratory parameters which were supposed to be therapeutical pretransplantation risk factors. The second part was to study the patients undergoing OLT by using the regression analysis on preoperation risk factors relating to early (within 30 d after OLT) mortality rate. RESULTS: Among the 50 patients, a statistically significant improvement of the biochemical parameters was observed (pretreatment vs posttreatment). 8 patients cancelled their scheduled LTXs due to significant improvements in their clinical conditions or recovery of their failing liver functions. 8 patients died and 34 patients successfully underwent LTX. The immediate outcome (within 30 postoperative days) of these 34 patients was that 28 were kept alive and 6 died. CONCLUSIONS: Preoperation sequential organ failure assessment (SOFA), level of creatinine, INR, TNFalpha, and IL-10 are the main preoperative risk factors relating to early death after an operation. MARS treatment before a transplant operation can relieve these factors significantly, hence improve survival rate of liver transplantation or even make the transplantation unnecessary.
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Cirrose Hepática/cirurgia , Transplante de Fígado , Fígado Artificial , Idoso , Análise Fatorial , Feminino , Humanos , Interleucina-10/sangue , Neoplasias Hepáticas/cirurgia , Transplante de Fígado/métodos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Fatores de Risco , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangueRESUMO
OBJECTIVE: To evaluate the risk factors of the over 55-year-old donor and the safety and efficacy of the donor, and the recipient with the immediate and long-term of the kidney. METHODS: The living-related donor kidney transplantation in 15 cases was performed in our unit from October 1999 to April 2002. Of these, 12 donors were over 55 with age ranging from 55 to 73 years-old and mean age of 62, 75 years. 5 donors were male and 7 were female. Father in 5 cases and 6 and 1 were mother and grandmother, respectively. The donors were evaluated depending on general state of health, hypertension, diabate and important organa in condition; and renal function by creatinine (Cre), creatinine clearance (Ccr), Glomerular filtration rate (GFR), B ultrasound and renal arteriograph prior to operation. The all receipients with ages ranging from 14 to 46 years with end-stage renal diseases (ESRD) from and their mean age was 32.9 years. The donor' left nephrectomy was performed in 10 cases and right nephrectomy in 2. Warm-ischemia time was from 70 s to 170 s (mean time, 92 s). Cold-ischemia time was from 60 minutes to 120 minutes and mean 84 minutes. The follow-up is from 12 to 42 months and mean 20, 84 months. RESULTS: All the 12 donors were perfectly recovered during operation and postoperation. During their 11-day stay in the hospital no complications was observed. The donor' creatinine was raised to about 12 to 34 micro mol/L (mean, 22 micro mol/L). One recipient died from lung infection at 28 days postoperative and 1 died due to liver failure with normal graft function after transplanted 6 months and yet one recipient with delayed graft function had recovered by 12 times dialysis. The remain recipient had a better recovered. CONCLUSION: Aged (>or= 55 years-old) donor renal transplantation can be carried out as the poor supply of can be used kidney but must to controled the indication and the prepare to be accomplished seriously.