Quality control of postoperative radiotherapy for non-small cell lung cancer: A study of mediastinal shift.

PURPOSE: This study aimed to assess the shifting patterns of the mediastinum, including the target volume and the isocenter point during the postoperative radiotherapy (PORT) process of non-small cell lung cancer (NSCLC), and to observe the occurrence of radiation injury. Additionally, we investigated the significance of mid-term assessment during the implementation of the PORT process. MATERIAL AND METHODS: We established coordinate axes based on bone anatomy and measured the mediastinum's three-dimensional direction and the shift of the isocenter point's shift in the PORT process. Statistical analysis was performed using Wilcoxon, Kruskal-Wallis, and the Chi-square test. P<0.05 was considered statistically significant. RESULTS: In this study, the analysis of patients revealed that the shift of anterior and posterior mediastinum (X), left and right mediastinum (Y), upper and lower mediastinum (Z), anterior and posterior isocenter point (Xi), and the left and right isocenter points (Yi) in the PORT process were 0.04-0.53, 0.00-0.84, 0.00-1.27, 0.01-0.86, and 0.00-0.66cm, respectively. The shift distance of the mediastinum was Z>Y>X, and the shift distance of the isocenter point was Xi>Yi. According to the ROC curve, the cut-off values were 0.263, 0.352, 0.405, 0.238, and 0.258, respectively, which were more significant than the cut-off values in 25 cases (25%), 30 cases (30%), 30 cases (30%), 17 cases (17%), and 15 cases (15%). In addition, there was a significant difference in the shift of the mediastinum and the isocenter point (all P=0.00). Kruskal-Wallis test showed no statistically significant difference between mediastinal shift and resection site in X, Y, and Z directions (P=0.355, P=0.239, P=0.256), surgical method (P=0.241, P=0.110, P=0.064). There was no significant difference in the incidence of RE and RP in PORT patients (P>0.05). No III-IV RP occurred. However, the incidence of ≥ grade III RE in the modified plan cases after M-S was significantly lower than in the original PORT patients, 0% and 7%, respectively (P=0.000). CONCLUSION: In conclusion, this study provides evidence that mediastinal shift is a potential complication during the PORT process for patients with N2 stage or R1-2 resection following radical resection of NSCLC. This shift affects about 20-30% of patients, manifesting as actual radiation damage to normal tissue and reducing the local control rate. Therefore, mid-term repositioning of the PORT and revision of the target volume and radiation therapy plan can aid in maintaining QA and QC during the treatment of NSCLC patients and may result in improved patient outcomes.

[Urban-rural differentials in the relationship between personality traits and changes in depressive symptoms].

OBJECTIVE: The prevalence of depressive symptoms has become a significant public health issue in China. Research on the relationship between personality traits and changes in depressive symptoms, as well as further exploration of urban-rural differences, not only benefits for the understanding of the prevalence trend of depression in China, but also provides a useful reference for the government to develop personalized mental health prevention strategies. METHODS: Based on the data from the China Family Panel Studies in 2018 and 2020, a univariate analysis was conducted on 16 198 Chinese residents aged 18 years and above. Five dimensions of personality traits were conscientiousness, extraversion, agreeableness, neuroticism and openness. In the study, 16 198 residents were divided into "keep good group", "better group", "worse group" and "keep bad group" according to the changes in depressive symptoms in 2018 and 2020. After controlling for factors, such as gender and education, multinomial Logistic regression analysis was used to examine whether personality traits were associated with changes in depressive symptoms. In addition, we evaluated whether urban-rural and personality traits interacted to influence depressive symptoms. RESULTS: The five dimensions of personality traits were significantly correlated with changes in depressive symptoms. Conscientiousness, extroversion, and agreeableness were negatively associated with depressive symptoms, while neuroticism and openness were positively related. Urban and rural differences moderated the relationship between personality traits and depressive symptoms. Compared with urban residents, rural residents showed stronger correlations between neuroticism (OR=1.14; 95%CI: 1.00-1.30) and the group of depression-recovery, as well as conscientiousness (OR=0.79;95%CI: 0.68-0.93) and the group of persistent-depression. CONCLUSION: The study finds that personality traits have a significant correlation with changes in depressive symptoms, with certain traits showing a negative or positive relationship. Specifically, higher levels of conscientiousness, extraversion, and agreeableness are associated with lower levels of depressive symptoms, while higher levels of neuroticism and openness are associated with higher levels of depressive symptoms. In addition, the study finds that rural residents have a stronger association between their personality traits and persistent or improved depressive symptoms, which highlights the need for tailoring mental health intervention and prevention programs that should take into account personality traits and urban-rural differences in China. By developing targeted strategies that are sensitive to personality differences and geographic disparities, policymakers and mental health professionals can help prevent and reduce the incidence of depressive symptoms, ultimately improving the overall well-being of Chinese adults. Meanwhile, additional studies in independent populations are needed to corroborate the findings of this study.

Analysis of reproductive damage in earthworms (Amynthas corticis) exposed to cypermethrin.

Cypermethrin contamination was a potential threat to soil organisms. In the present work, reproductive damage in earthworms (Amynthas corticis) exposed to cypermethrin was investigated. It was found that earthworms could absorb and accumulate residual cypermethrin in soil, and also earthworm activities helped accelerate the degradation of cypermethrin in soil. The accumulation of cypermethrin in earthworms induced sperm damage, and cypermethrin not only caused the imbalance of calcium homeostasis in earthworm sperm cells by inhibiting earthworm sperm Ca2+-ATP and Ca2+-Mg2+-ATP enzyme activities but also caused barriers in acrosome reaction. It also affected sperm energy supply of earthworms by inhibiting the activity of Na+-K+-ATPase and Mg2+-ATPase of earthworm sperm. Meanwhile, the inhibition of acrosome enzyme activity of earthworm sperm by cypermethrin led to hinder fertilization and reduced cocoon production of earthworms, and the damage of cypermethrin to sperm of earthworm was a significant cause of its reproductive toxicity. The results of the evaluation of IBR index showed that reproductive toxicity of cypermethrin to earthworms reduced with the increasing time. The decreased reproductive toxicity of cypermethrin to earthworms at the later stage of exposure (42-56 d) might be due to a combination of reduced absorption of cypermethrin in soil by earthworms, decreased accumulation of cypermethrin in the body, and improved sperm capacitation.

[PARP10 Influences the Proliferation of Colorectal Carcinoma Cells, a Preliminary Study].

PARP10 is an intracellular mono-ADP ribosyltransferase and recent reports suggest that it regulates proliferation of some cell types. However, its effect on the proliferation of colorectal carcinoma cells has not yet been systematically reported. We explored the influence of PARP10 on the proliferation of several colorectal carcinoma cell types and carried out initial studies on the underlying mechanisms. Inhibition of the enzymatic activity of PARP10 led to significantly decreases in proliferative ability in LoVo cells and CT26 cells in vitro and suppressed growth of CT26 tumours in the subaxilliary region in Balb/c mice in vivo. Cell-cycle arrest accompanied these observations. Expression of the nuclear transfer factor ß-catenin and it trans-location to the nucleus were also affected and the expression of its associated signal proteins Axin2 and c-Myb were increased and decreased, respectively. We demonstrate that PARP10 promotes proliferation of those colorectal carcinoma cells which express significant levels of PARP10. This promotion is suppressed when the enzymatic activity is inhibited. ß-Catenin is likely to be the mediator of the antiproliferative effect.

[The clinical significance of Th17 cells in patients with myelodysplastic syndrome and iron overload].

Objective: To study the significance of Th17 cells in patients with myelodysplastic syndrome (MDS) and iron overload. Methods: A total of 77 patients with MDS admitted to Guangzhou First People's Hospital were enrolled from January 2017 to December 2018,who were divided into iron overload group (37 cases) with serum ferritin (SF) over 1000 µg/L and non-ferrous overload group(40 cases). CD(4)(+)T cells in peripheral blood (PB) and bone marrow (BM) were sorted by flow cytometry. The ratio of Th17 cells and cells with abnormal karyotype were compared. IL-17 and IL-6 protein and RNA expression were detected by ELISA and quantitative real-time PCR(qRT-PCR). Results: The proportions of Th17 cells in PB and BM in iron overload group were significantly higher than those in non-iron overload group [(41.06±0.96)% vs. (26.80±1.21)%; (47.39±1.60)% vs. (34.29±1.03)%; P<0.01]. The Th17 positive cells with abnormal karyotype in iron overload group were more than those in non-iron overload group[(4.96±0.53)% vs. (3.67±0.12)% in PB; (10.06±1.67)% vs. (4.36±0.43)% in BM; P<0.01]. Similarly,the protein levels as well as mRNA expression of IL-6 and IL-17 in patients with iron overload were significantly higher than those in non-iron overload group (P<0.01 both in PB and BM). Conclusions: As hematopoietic regulators secreted by Th17 cells, the expression of IL-6 and IL-17 in MDS patients with iron overload are elevated. This may predict the influence of these factors to the differentiation of Th17 cells.

A comparison of two sources of methionine supplemented at different levels on heat shock protein 70 expression and oxidative stress product of Peking ducks subjected to heat stress.

The aim of this study was to examine the effects of different sources and levels of methionine (Met) on Heat shock proteins HSP70 expression and protein carbonylation in liver, HSP70 expression and malondialdehyde (MDA) concentration in intestine under heat stress conditions during summer. A total of 720 (4 days old) Peking ducks were placed 20 per pen into six replicates for each of the six treatments with a 2 × 3 factorial arrangement, such that two sources of Met (DL-methionine [DLM] and DL-2-hydroxy-4-methylthiobutyrate [HMTBA] were supplemented at three different levels (0.05%, 0.20%, or 0.35% on as-fed basis respectively). The experiment was divided into a starter (day 4-16) and a grower (day 17-35) period. Diet supplemented with 0.35% Met significantly up-regulated the HSP70 mRNA expression in duodenum, jejunum and ileum on day 16 and 35 as well as in liver on day 35 (p < .05) of ducks. HMTBA-supplemented diets increased the HSP70 mRNA expression in duodenum, jejunum, ileum and liver on day 35 (p < .01). An increased MDA concentration was detected in jejunum of birds in 0.35% DLM-supplemented treatment on day 16 (p < .05). And decreased protein carbonylation concentration was found in DLM-supplemented treatment on day 16 (p < .01). The birds fed with 0.35% Met supplemental diet displayed lower hepatic protein carbonylation on day 16 (p < .05). In conclusion, supplementation of 0.35% Met in the duck diet showed up-regulated HSP70 expression in small intestine and liver, which may provide new perspective to the mechanism of Met function. At the same time, DLM supplemented in diet may ameliorate oxidative status of liver, while HMTBA supplementation may partially improve the intestinal oxidative status of Peking ducks.

Detection of hereditary hearing loss gene by DNA microarray.

OBJECTIVE: Screening genes in patients suffering clinically sporadic deafness, using DNA microarray, and evaluating the application value of the clinical detection. PATIENTS AND METHODS: DNA extracted from patients' venous blood was amplified by PCR, and hybridization was carried out in a myriad class clean room. Nine mutation sites of four deaf genes commonly seen in Chinese people were tested. RESULTS: Among 24 patients, 7 cases with mutations were detected, with a positive rate of 29.17%. These include 4 cases with GJB2 gene mutation (16.67%), of which 1 case with 176 del 16 site heterozygous mutation; 1 with 235 del C site homozygous mutation; 2 with 299 del AT site heterozygous mutation; 1 with SLC26A4 gene IVS7-2A>G site heterozygous mutation (4.17%), 2 with mitochondrion 12SrRNA gene1555A>G site homogeneous mutation (8.33%). No GJB3 gene mutation was detected. CONCLUSIONS: Gene chip technology of hereditary hearing loss can detect related mutation sites of hearing loss rapidly and with high-throughput, which meets the demands of clinical deaf gene detection.

Inhibition of microRNA-214-5p promotes cell survival and extracellular matrix formation by targeting collagen type IV alpha 1 in osteoblastic MC3T3-E1 cells.

OBJECTIVES: This study aimed to investigate the functional effects of microRNA (miR)-214-5p on osteoblastic cells, which might provide a potential role of miR-214-5p in bone fracture healing. METHODS: Blood samples were obtained from patients with hand fracture or intra-articular calcaneal fracture and from healthy controls (HCs). Expression of miR-214-5p was monitored by qRT-PCR at day 7, 14 and 21 post-surgery. Mouse osteoblastic MC3T3-E1 cells were transfected with antisense oligonucleotides (ASO)-miR-214-5p, collagen type IV alpha 1 (COL4A1) vector or their controls; thereafter, cell viability, apoptotic rate, and the expression of collagen type I alpha 1 (COL1A1), type II collagen (COL-II), and type X collagen (COL-X) were determined. Luciferase reporter assay, qRT-PCR, and Western blot were performed to ascertain whether COL4A1 was a target of miR-214-5p. RESULTS: Plasma miR-214-5p was highly expressed in patients with bone fracture compared with HCs after fracture (p < 0.05 or p < 0.01). Inhibition of miR-214-5p increased the viability of MC3T3-E1 cells and the expressions of COL1A1 and COL-X, but decreased the apoptotic rate and COL-II expression (p < 0.05 or p < 0.01). COL4A1 was a target of miR-214-5p, and was negatively regulated by miR-214-5p (p < 0.05 or p < 0.01). Overexpression of COL4A1 showed a similar impact on cell viability, apoptotic rate, and COL1A1, COL-II, and COL-X expressions inhibiting miR-214-5p (p < 0.01). CONCLUSION: Inhibition of miR-214-5p promotes cell survival and extracellular matrix (ECM) formation of osteoblastic MC3T3-E1 cells by targeting COL4A1.Cite this article: Q. S. Li, F. Y. Meng, Y. H. Zhao, C. L. Jin, J. Tian, X. J. Yi. Inhibition of microRNA-214-5p promotes cell survival and extracellular matrix formation by targeting collagen type IV alpha 1 in osteoblastic MC3T3-E1 cells. Bone Joint Res 2017;6:464-471. DOI: 10.1302/2046-3758.68.BJR-2016-0208.R2.

Genetic effects influencing risk for major depressive disorder in China and Europe.

Major depressive disorder (MDD) is a common, complex psychiatric disorder and a leading cause of disability worldwide. Despite twin studies indicating its modest heritability (~30-40%), extensive heterogeneity and a complex genetic architecture have complicated efforts to detect associated genetic risk variants. We combined single-nucleotide polymorphism (SNP) summary statistics from the CONVERGE and PGC studies of MDD, representing 10 502 Chinese (5282 cases and 5220 controls) and 18 663 European (9447 cases and 9215 controls) subjects. We determined the fraction of SNPs displaying consistent directions of effect, assessed the significance of polygenic risk scores and estimated the genetic correlation of MDD across ancestries. Subsequent trans-ancestry meta-analyses combined SNP-level evidence of association. Sign tests and polygenic score profiling weakly support an overlap of SNP effects between East Asian and European populations. We estimated the trans-ancestry genetic correlation of lifetime MDD as 0.33; female-only and recurrent MDD yielded estimates of 0.40 and 0.41, respectively. Common variants downstream of GPHN achieved genome-wide significance by Bayesian trans-ancestry meta-analysis (rs9323497; log10 Bayes Factor=8.08) but failed to replicate in an independent European sample (P=0.911). Gene-set enrichment analyses indicate enrichment of genes involved in neuronal development and axonal trafficking. We successfully demonstrate a partially shared polygenic basis of MDD in East Asian and European populations. Taken together, these findings support a complex etiology for MDD and possible population differences in predisposing genetic factors, with important implications for future genetic studies.

Analysis of 23andMe antidepressant efficacy survey data: implication of circadian rhythm and neuroplasticity in bupropion response.

Genetic predisposition may contribute to the differences in drug-specific, class-specific or antidepressant-wide treatment resistance. Clinical studies with the genetic data are often limited in sample sizes. Drug response obtained from self-reports may offer an alternative approach to conduct a study with much larger sample size. Using the phenotype data collected from 23andMe 'Antidepressant Efficacy and Side Effects' survey and genotype data from 23andMe's research participants, we conducted genome-wide association study (GWAS) on subjects of European ancestry using four groups of phenotypes (a) non-treatment-resistant depression (n=7795) vs treatment-resistant depression (TRD, n=1311), (b) selective serotonin reuptake inhibitors (SSRI) responders (n=6348) vs non-responders (n=3340), (c) citalopram/escitalopram responders (n=2963) vs non-responders (n=2005), and (d) norepinephrine-dopamine reuptake inhibitor (NDRI, bupropion) responders (n=2675) vs non-responders (n=1861). Each of these subgroups was also compared with controls (n ~ 190 000). The most significant association was from bupropion responders vs non-responders analysis. Variant rs1908557 (P=2.6 × 10(-8), OR=1.35) passed the conventional genome-wide significance threshold (P=5 × 10(-8)) and was located within the intron of human spliced expressed sequence tags in chromosome 4. Gene sets associated with long-term depression, circadian rhythm and vascular endothelial growth factor (VEGF) pathway were enriched in the bupropion analysis. No single-nucleotide polymorphism passed genome-wide significance threshold in other analyses. The heritability estimates for each response group compared with controls were between 0.15 and 0.25, consistent with the known heritability for major depressive disorder.

Schwannomas of female genitalia from a gynaecologist's perspective: report of two cases and review of the literature.

BACKGROUND: Pelvic schwannomas are extremely rare. However, when located in the pelvic cavity, schwannomas are often encountered by a gynaecologist, not a general surgeon, and are misdiagnosed as gynaecologic masses. CASE REPORT: Here, the authors present two cases of pelvic schwannomas that were preoperatively misdiagnosed as broad ligament fibroid. One schwannoma occurred completely in the left broad ligament and was resected by laparoscopy without any complications. The other lesion was located in the retroperitoneum and had densely adhered to the surrounding tissues; this lesion was excised by laparotomy with considerable blood loss. CONCLUSIONS: Schwannomas of female genitalia are very scarce and difficulty to diagnose preoperatively. Literature review revealed 63 schwannomas arising from the female genital tract in total, 73.02% (46 cases) were located in the lower genital tract, and 26.98% (17 cases) were located in upper genital tract. The treatment modality is unique depending on the location of the tumor. Complete excision is benefical for diagnosis and treatment. The procedure can be performed safely under laparoscopy.

Mechanism of rat osteosarcoma cell apoptosis induced by a combination of low-intensity ultrasound and 5-aminolevulinic acid in vitro.

We investigated the killing effect of low-intensity ultrasound combined with 5-aminolevulinic acid (5-ALA) on the rat osteosarcoma cell line UMR-106. Logarithmic-phase UMR-106 cells were divided into a control group, ultrasound group and 5-ALA group. The cell apoptotic rate, production of reactive oxygen species, and the change in mitochondrial membrane potential were analyzed by flow cytometry; ultrastructural changes were observed by transmission electron microscopy. Using low-intensity ultrasound at 1.0 MHz and 2.0 W/cm(2) plus 5-ALA at a concentration of 2 mM, the apoptotic rate of the sonodynamic therapy group was 27.2 ± 3.4% which was significantly higher than that of the control group, ultrasound group, and 5-ALA group (P < 0.05). The production of reactive oxygen species was 32.6 ± 2.2% and the decrease in mitochondrial membrane potential was 39.5 ± 2.5%. The 33342 staining showed nuclear condensation and fragmentation in the ultrasound group and 5-ALA group. Structural changes in the cell membrane, mitochondria, Golgi apparatus, and other organelles observed by transmission electron microscopy included formation of apoptotic bodies. The killing effect of low-intensity ultrasound combined with 5-ALA on UMR-106 cells was significant. Cell apoptosis played a vital role in the killing effect, and the mitochondria pathway contributed to the apoptosis of UMR-106 cells.

A pilot study of conformal radiotherapy combined with erlotinib-based multimodality therapy in newly diagnosed metastatic non-small-cell lung cancer.

OBJECTIVE: Lung cancer is the leading cause of cancer-related death in the world, particularly in major cities in China. We aimed to determine the benefit of survival and toxicity of Conformal Radiotherapy (CRT) combined with erlotinib-based multimodality therapy in newly diagnosed metastatic non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Newly diagnosed metastatic NSCLC patients were treated with CRT and erlotinib, with or without chemotherapy matched protocol. The patients received CRT with a dose of 30-66 Gy. Erlotinib was used at least one 28-day cycle. The primary end point was overall survival (OS). RESULTS: Thirty-two patients were analyzed. The median OS was 517 days. Patients with only one metastasis showed longer survival than patients with multi-metastases (986 vs. 380 days, n = 8 vs. 24, p = .009). Patients with multiple metastases in brain conferred worse survival for patients without and with sole brain metastasis (321 vs. 700 days, n=11 vs 21, p = .006). There was no significant difference in median survival whether erlotinib was used as a first-, second- or third-line therapy (380 vs. 700 vs. 310 days, n = 10 vs. 15 vs 7, respectively. p = .179). Patients with TTCRT > 90 days had longer OS than patients with TTCRT ≤ 90 days (749 vs. 322 days, n = 11 vs. 21, p = .012). Patients tolerated treatment with limited Grade 1/2 toxicity. CONCLUSIONS: In this study, patients with newly diagnosed metastatic NSCLC had survival benefits when erlotinib was used combined with CRT. Further prospective trials are needed to derive maximal benefit from the drug treatment.

Diameter-controlled synthesis of α-Mn2O3 nanorods and nanowires with enhanced surface morphology and optical properties.

Single crystalline α-Mn(2)O(3) nanorods, and nanowires with and without nanoparticles on them have been successfully synthesized by a template-free hydrothermal route. The variation in hydrothermal temperature has not only affected the diameter of the nanostructure but also noticeably affected the morphology and optical properties of the α-Mn(2)O(3) nanostructure. The influence of temperature on the diameter, crystallinity, surface morphology and optical properties of the α-Mn(2)O(3) nanostructure have been characterized by x-ray diffraction, scanning electron microscopy, energy dispersive x-ray analysis, transmission electron microscopy, high resolution transmission electron microscopy, Raman spectroscopy and UV-visible spectroscopy and photoluminescent (PL) spectroscopy. The results showed in our experimental conditions that single crystalline nanorods of the α-Mn(2)O(3) were obtained at a temperature of 180 °C, while single crystalline nanowires were obtained by increasing the temperature to 240 and 300 °C. Nanowires with nanoparticles on them were obtained by increasing the temperature to 240 °C and nanowires without nanoparticles on them were obtained by increasing the temperature to 300 °C. The nanorods and nanowires obtained had a well-defined morphology. The nanowires synthesized at 300 °C exhibited an intense orange band PL spectrum.

Heme oxygenase-1 expression and its significance for acute rejection following kidney transplantation in rats.

OBJECTIVE: To analyze rejection and antiapoptotic effects of heme oxygenase-1 (HO-1) in kidney transplantations, to investigate the protective effects of endogenous HO-1 induced by hemin on acute rat kidney allograft rejection. METHODS: We selected 27 Brown-Norway rats and 27 male Lewis rats as donors and recipients, respectively, randomly dividing them into three groups: kidney transplantation alone, hemin treatment group, and cyclosporine (CsA) group (n = 18). Six recipient rats were harvested on the first, fifth, or seventh days after operation among each group to examine histopathologic changes in renal tissue, HO-1 protein expression, and acute rejection as well as to measure serum creatinine values. RESULTS: HO-1 expression in both the kidney transplantation model group and the hemin-induced groups were higher compared with the CsA group (P < .05-.01). The expression increased with the aggravation of rejection; the expression in the CsA group also increased after transplantation but was obviously lower than that of the hemin-induced group (P < .01). The rejection process was relatively mild as indenset by histopathologic examination. The serum creatinine levels among the hemin-induced group were lower compared to the kidney transplantation control group (P < .05), but higher compared to the CsA group (P < .05). CONCLUSION: HO-1 provided protection of allografts against rejection in rats, but such effects were poorer than those achieved using potent immunosuppressive agents like CsA.

The effect of cytochrome P2C19 and interleukin-1 polymorphisms on H. pylori eradication rate of 1-week triple therapy with omeprazole or rabeprazole, amoxycillin and clarithromycin in Chinese people.

WHAT IS KNOWN AND OBJECTIVE: Genetic polymorphism of interleukin (IL)-1ß and IL-1 receptor antagonist (IL-1rα) are associated with efficacy of acid suppression, whereas cytochrome P (CYP) 2C19 polymorphism influences the metabolism of proton pump inhibitor family. Thus, CYP2C19 and IL-1 polymorphisms may affect the efficacy of H. pylori eradication therapy. We compared the efficacies of omeprazole and rabeprazole on eradication of H. pylori in relation to CYP2C19, IL-1B and IL-1RN genotypes in Chinese people. METHODS: Two hundred and forty Chinese with peptic ulcer disease were randomly assigned to the following regimens: amoxicillin and clarithromycin together with omeprazole (OAC) or rabeprazole (RAC). CYP2C19*2 and *3, IL1B-511, IL1B-31, IL1B+ 3954 and intron 2 of the IL-1RN genotypes were analyzed by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: The intention-to-treat-based cure rate of the OAC regimen was significantly lower than that of the RAC regimen in the CYP2C19 wild-type homozygotes (P = 0·014). No significant differences in the cure rates were observed among the IL-1RN and the IL-1B genotype groups. WHAT IS NEW AND CONCLUSIONS: The rabeprazole-based triple regimen was better than the omeprazole in Chinese patients with the CYP2C19 extensive metabolizer genotype. The effectiveness of the PPI/AC regimen is unrelated to IL-1B and IL1-RN genetic polymorphism.

Acute femoral neuropathy following renal transplantation: a retrospective, multicenter study in China.

BACKGROUND: We investigated the relationship between the mode and duration of iliac artery anastomosis and acute femoral neuropathy (AFN). METHODS: A retrospective analysis was performed for 83 AFN cases from 6 transplantation centers in China. The incidence and nature of dysfunction of AFN were classified based upon the duration of iliac arterial anastomosis. No prisoners were used, and no organs from prisoners were used to obtain the data. RESULTS: The incidence of AFN was 3.6% (53/1,449) in internal iliac anastomosis (group 1), 3.1% (11/346) in external iliac anastomosis (group 2) (P > .05 vs. group 1), and was 54.2% (19/35) in internal iliac ligation with external iliac anastomosis (group 3 P < .01 vs. groups 1 and 2). In group 1, the duration of the arterial anastomosis was 20 minutes in 52 cases (98.1%). In group 2, the duration of arterial anastomosis was 20 minutes in 10 cases (91%). In group 3, the duration of the arterial anastomosis was >20 minutes in all cases; 20 cases showed injury to the iliolumbar or deep iliac circumflex artery. CONCLUSION: The incidence of AFN was associated with the selection of iliac arteries, the duration of the arterial anastomosis, and an injury to the iliolumbar or deep iliac circumflex artery.

Urological complications in 1,223 kidney transplantations.

INTRODUCTION: Urological complications after kidney transplantation may lead to graft loss. In this study, we retrospectively reviewed urological complications in 1,223 kidney transplantations that were performed at our institution. MATERIALS AND METHODS: The occurrence of urological complications such as urine leakage, ureteral obstruction and vesicoureteral reflux (VUR) according to the different way of urinary tract reconstruction, ureteroneocystostomy (U-C) and ureteroureterostomy (U-U), was studied. RESULTS: Urological complications were encountered in 92 (7.5%) cases, including urine leakage (n = 43, 3.5%), ureteral obstruction (n = 35, 2.9%) and VUR (n = 14, 1.1%). 75 cases (7.9%) were in the U-C group and 17 cases (6.2%) in the U-U group. 91 recipients were successfully treated, and 1 patient lost the graft due to kidney pelvis and ureteral necrosis. There was no recipient loss due to these complications. For recipients with urological complications, the 1- and 3-year survival rates were 90 and 88% for recipients and 87 and 82% for grafts, respectively. CONCLUSIONS: After U-U, the same number of overall incidences of urological complications is observed as after U-C; however, a decrease in the number of incidences of urine leakage is apparent. Therefore, U-U is a good first option with a greater success rate of resolving ureteral stenosis with endourology and no risk of VUR.

Treatment of urinary fistula after kidney transplantation.

Urinary fistula is a common complication after kidney transplantation and may lead to graft loss and patient death. Its current incidence ranges from 1.2% to 8.9%. From December 1993 to April 2007, 1223 kidney transplant procedures were performed by our kidney transplantation team. In 948 recipients (group 1), we performed an extravesical ureteroneocystostomy, and in 275 recipients (group 2), a terminoterminal ureteroureterostomy (UU). We observed urinary fistulas in 43 patients (3.5%), with mean onset at 6 days (range, 3-20 days) posttransplantation. Urinary fistula was significantly more common in group 1 compared with group 2 (4.1% and 1.5%, respectively; P < .05). The distal ureteral necrosis was the major frequent cause of urinary fistula (n = 34; 76.7%), which required either a second ureteroneocystostomy or UU using the native ureter. Of these 21 fistulas, including 10 recurrent fistulaes, were successfully treated with pedicled omentum covering the anastomotic stoma. Conservative treatment with a stent and Foley catheter drainage for 1 to 2 weeks was successful in 8 patients. All patients with a urinary fistula regained normal graft function except 1 in whom transplant nephrectomy was necessary because of pelvic and ureteral necrosis. There was no recipient loss secondary to urinary fistula. In conclusion, UU can decrease the incidence of urinary fistula after kidney transplantation. Most urinary fistulas require surgical management; and pedicled omentum is useful to repair the fistula.