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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 investigate the effects and adverse reactions of apatinib in advanced gastric cancer patients.Methods Two hundred and forty cases of advanced gastric cancer patients who had failed chemotherapy were collected from January 30,2016 to November 1,2017 in the First Hospital of Zibo City of Shandong Province and the Central Hospital of Zibo City of Shandong Province.All patients took oral apatinib mesylate,850 mg/time,1 time/d,and 28 d as 1 cycle of treatment,during which clinical efficacy,adverse reaction and progression free survival (PFS) and overall survival period (OS) were evaluated.Adopting Cox regression model to analyze risk factors of PFS and OS.Results Of all 240 patients,no patient reached complete response (CR) standard,25 patients (10.4％) reached partial response (PR) standard,113 patients (47.1％) reached stable disease (SD) standard,and 102 patients (42.5％) reached progressive disease (PD) standard.Objective response rate (ORR) and disease control rate (DCR) were 10.4％ (25/240) and 57.5％ (138/240) respectively.When apatinib was taken as a 2nd line treatment,ORR and DCR were 62.5％ (5/8) and 75.0％ (6/8) respectively;as 3rd line treatment,the result came to 13.9％ (20/144) and 67.4％ (97/144);as 4th line treatment,it was 0 and 52.4％ (33/63);as 5th line treatment,it was 0 and 8.0％ (2/25).Among the various adverse effects of apatinib,the most common ones observed were skin lesion (65.8％,158/240),fatigue (57.9％,139/240),gastrointestinal reaction (45.4％,109/240),and hypertension (38.8％,93/240).Cox multivariate analysis showed that the change of treatment time (HR =5.028,95％CI:1.130-15.771,P =0.005) and body mass index (HR =21.069,95％CI:4.521-127.116,P ＜ 0.001) were the independent risk factors of PFS.BMI change (HR =6.550,95％ CI:1.080-38.455,P =0.039) was independent risk factor of OS.Conclusion For patients with advanced gastric cancer who failed with 2nd line and above chemotherapy,oral atatinib still obtain certain DCR and survival gain.Apatinib adverse reactions are various,involving a wide range of organ systems,however are generally controllable.
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OBJECTIVE:To optimize the extract technology of the total Favonoids from the fruits of Polygonum viviparum L.METHODS: The content of Flavonoids was computed with rutin as standard substance, and the influence of different factors and levels on the extract technology were investigated by means of simple factor experiment and orthogonal experiment. RESULTS: The optimum extraction technology was as follows: with water-bath temperature at 80℃, the ratio of liquid to solid material at 8∶1 and the concentration of ethanol at 50%, reflux extracting total Favonoids twice(1 h at each time). Under this condition, the content of total Flavonoids was 9.6%. CONCLUSION: The extraction method is appropriate, simple and feasible, and it provided theoretic basis for the production of this product.