[Therapeutic effect of tonsillectomy on IgA nephropathy after kidney transplantation].

Objective: To observe the clinical effect of tonsillectomy on IgA nephropathy (IgAN) after renal transplantation. Methods: From March 2011 to July 2018, 201 kidney transplantation recipients who were diagnosed of IgAN by transplant renal biopsy in the Department of Organ Transplantation of the First Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed, of which 18 patients underwent tonsillectomy after renal biopsy. The clinical data of the 18 patients were collected, patient and kidney survival time and function of the transplanted kidney were analyzed. Results: Of the 18 recipients, 13 were male and 5 were female, with an average age of (36.0±10.9) years. All 18 patients survived during follow-up. Two patients returned to dialysis treatment 10 months and 14 months after tonsillectomy, respectively. The creatinine was 94 (78, 133) µmol/L, 95 (74, 139) µmol/L, 106 (87, 158) µmol/L and 95(81, 147) µmol/L before tonsillectomy, 3 months, 1 year and 2 years after tonsillectomy, respectively (P=0.206). Urinary protein quantification was 0.31 (0.16, 1.38) g/24 h, 0.34 (0.10, 1.42) g/24 h, 0.33 (0.11, 0.56) g/24 h and 0.25 (0.10, 0.50) g/24 h at the same time points, respectively (P=0.104). The two patients who returned to dialysis were diagnosed of IgAN by transplant renal biopsy because of elevated creatinine, proteinuria and hematuria, 9 years and 4 years after kidney transplant respectively. Renal biopsy suggested that glomerular and segmental sclerosis were 7/24, 5/24 and 1/6, 2/6, respectively. Additionally, interstitial fibrosis and tubular atrophy (IF/TA) were both occupied 30% in the biopsies, and tonsillectomy was performed 461 days and 1 077 days after diagnosis of IgAN, respectively. Conclusions: Tonsillectomy can maintain the stability of renal function and prevent the aggravation of proteinuria in IgAN patients after renal transplantation. However, if pathology suggests obvious glomerulosclerosis or IF/TA, tonsillectomy may not be effective.

The Impacts of Contact Etch Stop Layer Thickness and Gate Height on Channel Stress in Strained N-Metal Oxide Semiconductor Field Effect Transistors.

The stress induced by strain in the channel of metal oxide semiconductor field effect transistors (MOSFET) is an effective method to boost the device performance. The geometric dimensions of spacer, gate height, and the contact etch stop layer (CESL) are important factors among the feasible booster. This study utilized the mismatch of the thermal expansion coefficients of stressors to simulate the process-induced stress in the N-MOSFET. Different temperatures are applied to different region of the device to generate the required strain. The analysis was performed by well-developed finite element package. The composite spacers with variant width of inserted silicon nitride (SiO2/SiN/SiO2, ONO) were proposed and their impacts on channel stress were compared. Two aspects of the impacts of those factors on the channel stress in the longitudinal direction for N-MOSFET with variant channel length were investigated. Firstly, the channel stresses of device without CESL for different gate heights were studied. Secondly, with stress applied to CESL and ONO spacers, the induced stresses in the channel were analyzed for long/short gate length. Two conclusions were drawn from the results of simulation. The N-MOSFET device without CESL shows that the stressed spacer alone generates compressive stress and the magnitude increases along with higher gate height. The channel stress becomes tensile for device with CESL and increases when the thickness of CESL and the height of gate increase, especially for device with shorter gate length. The gate height plays more significant role in inducing channel stress compared with the thickness of CESL. The channel stress can be used to quantify the mobility of electron/hole for strained MOSFET device. Therefore, with the guideline disclosed in this study, better device performance can be expected for N-MOSFET.