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Objective:To explore the clinical characteristics, causes, diagnosis and treatment of transplant renal artery stenosis after pediatric-to-adult kidney transplantation.Methods:Between July 2014 and March 2019, clinical data were retrospectively reviewed for 25 en-bloc and 27 single kidney transplant cases.Results:One en-bloc(4.0%)and two single kidney recipients(7.4%)were diagnosed as renal artery stenosis at Month 13-23 months post-transplantation.It was higher than the rate of stenosis in adult-to-adult transplant cases(1.1%)during the same period.As compared with recipients without stenosis, stenotic ones had younger pediatric donors( P<0.05)and yet similar body weight of donors as well as recipients( P>0.05). The inner diameters of stenonotic sites were(1.40-1.63)mm and predominant stenotic site was proximal renal artery rather than anastomotic site.The remaining parts of major renal arteries varied from 2.31 to 4.93 mm in diameter.It was normal in children with a corresponding age.All three cases responded well to percutaneous transluminal angioplasty and stenting. Conclusions:The cause of stenosis may be an undeveloped local artery diameter due to extensive tissue dissection around artery.Therefore cautious selections of infantile single renal graft for adult recipients and preserving surrounding tissue of renal artery assist in the prevention of graft arterial stenosis.
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Objective:To summarize the clinical experiences of pediatric en-bloc kidney transplantation (EBKT) at a single center and explore the measures of improving its efficacy.Methods:Clinical data and outcomes retrospectively analyzed for 38 EBKT children between September 2014 and November 2019 from Department of Urology Affiliated Union Hospital Tongji Medical College Huazhong University of Science & Technology. The pediatric donors were aged (63.6±5.7) days with a weight of (4.1±0.2) kg. And the transplant recipients were aged (28.1±1.4) years with a weight of (48.7±4.9) kg. Serum levels of creatinine and basic profiles of both donors and recipients were recorded at Day 0/7/30/90/80/360 post-EBKT. The postoperative occurrences of such complications such as thrombosis, urine leakage, delayed graft function (DGF), proteinuria and hematoma were measured.Results:The one-year graft survival rate was 76.3%(29/38) and the recipient survival rate 100.0%(38/38). Among 29 recipients with long-term graft survival, no dialysis was required at Week 2 post-EBKT and the serum level of creatinine dropped to normal at Year 1. Thrombosis was a major post-EBKT complication with an incidence of 18.4%(7/38). The other complications included urine leakage (20.7%, 6/29), hematoma (6.9%, 2/29) and primary non-functioning kidney (2.6%, 1/38).Conclusions:As an effective way of expanding the pool of donors, pediatric EBKT is clinically feasible.
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Objective To explore the clinical value of echocardiography in evaluating the cardiovascular safety of drugs for AIDS patients treated by highly active antiretroviral therapy(HAART).Methods 45 HIV-infected patients accepted three times of echocardiography respectively before the treatment,and after 48 weeks of HAART and 96 weeks of HAART.All kinds of echocardiographic parameters were measured.Results There were statistically significant differences among baseline group pretreatment [V-LVOT:( 115.0 ± 13.8 ) cm/s,EDT:(166.8 ± 26.7) cm/s,E':(26.8±6.7)cm/s],48 weeks [V-LVOT:( 113.0 ± 12.9)cm/s,EDT:(172.9±31.0)cm/s,E':(23.8 ±5.0)cm/s] of HAART and96 weeks[V-LVOT:(107.0±13.3)cm/s,EDT:(140.4 ± 19.3)cm/s,E':(22.7±6.4)cm/s]of HAART for parameters of V-LVOT,EDT and E'( all P ＜ 0.05 ),other echocardiographic parameters showed no statistically significant differences(all P＞0.05).Conclusion Short-term of HAART was provided with cardiovascular safety,the invasive echocardiography could accurately evaluate the cardiac function and structure of AIDS patients with HAART.
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Objective To study a kind of quantitative diagnosis method with ultrasound tissue characterization on liver fibrosis of the patients with chronic hepatitis B.Methods Measuring the gray scales of the two dimensional ultrasonography of the patients and compare the gray scales with the fibrosis degrees on histopathology of the patients and finding the differences among every two groups.Results The differences of the gray scales compared with the fibrosis degrees on histopathology were meaningful on statistics( F = 34.3, P
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OBJECTIVE:To study the pharmacodynamic action of Kanggan granules(KG).METHODS:After KG was administered i.g.to experiment animals,the antifebrile effect by using pyretic rats induced by fresh beer-yeast,anti-in?flammation effect by using auricle swelling in mice caused by bimethylbenzene and antitussive effect by using cough-model in mice caused by ammonia were observed and the quantity of phenolred secreted from the mouse's trachea were determined. RESULTS:KG could evidently decrease the temperature of febrile rats,lighten the auricle swelling in mice,delay the cough incubation period and reduce the cough frequency in mice,and markedly promote the secretion of phenolred from the mouse's trachea.CONCLUSION:KG has evident effects of antifebrile,anti-inflammation,antitussive and expectorant.