[Establishment of a prediction model for colorectal cancer immune cell infiltration based on the cancer genome atlas (TCGA) database].

OBJECTIVE: To study the correlation between immune cell infiltration in colorectal cancer tissue and clinical prognosis and to explore the levels of some immune cell genes for predicting the prognosis of patients with glioma colorectal cancer. METHODS: In this study, we extracted colorectal cancer data from the cancer genome atlas (TCGA). Based on a deconvolution algorithm (called CIBERSORT) and clinically annotated expression profiles, the analysis assessed the infiltration patterns of 22 immune cells in colorectal cancer tissue to determine the association between each cell type and survival. Differences in five-year survival rate effectively illustrate the clinical prognostic value of each immune cell proportion in colorectal cancer, using a bar graph, correlation-based heatmap to represent the proportion of immune cells in each colorectal cancer sample. RESULTS: A total of 473 colorectal cancer tissues and 41 normal control tissues were extracted from the TCGA database, and the comparative analysis showed that there were differences in the proportion of various TIICs in colorectal cancer tissues, which could characterize individual differences and have prognostic value. Among the cell subsets studied, the proportions of memory B cells, plasma cells, CD4+ T cells, natural killer (NK) cells, M0 macrophages, M2 macrophages, and activated mast cells were significantly different between normal and cancer tissues. Resting NK cells, CD8+ T cells, and plasma cells were associated with T phase, activated dendritic cells were associated with N phase, and eosinophils, M1 macrophages, and activated mast cells were associated with M phase. Survival analysis showed that activated dendritic cells were positively associated with five-year survival rate in colorectal cancer patients. Naive CD4+ T cells were inversely associated with five-year survival rate. CONCLUSION: There are different degrees of immune cell infiltration in colorectal cancer tissues, and these differences may be important determinants of prognosis and treatment response. We conducted a new gene expression-based study of immune cell subtype levels and prognosis in colorectal cancer, which has potential clinical prognostic value in colorectal cancer patients.

[Adenocarcinomas with mesonephric features in gynecologic tract: a clinicopathological analysis of seven cases].

Objective: To investigate and compare the histologic characteristics of adenocarcinomas with mesonephric features located in different parts of the gynecologic tract. Methods: Two cases of mesonephric adenocarcinomas (MA) of the cervix and 5 cases of mesonephric-like adenocarcinomas (MLA) of the uterus and ovary were collected in Women's Hospital, School of Medicine, Zhejiang University from January 2018 to October 2020. Hematoxylin-eosin staining, immunohistochemistry and KRAS mutation testing were performed together with review of literature. Results: MA of the cervix as well as MLA of the uterus and ovary had similar morphologic features, showing an admixture of glandular, tubular, papillary and solid growth patterns. However, both MA cases were located in cervical stroma, which demonstrated residual mesonephric ducts present at the periphery. All four uterine MLA cases extensively involved the endometrium and myometrium. The ovarian MLA case was associated with endometriosis. No residual mesonephric ducts were present in the MLA cases. Immunohistochemically, GATA3 was positive in all seven MA/MLA cases. TTF1 was expressed only in 4/5 MLA cases. ER and PR were negative and p53 was wild-type in all cases. KRAS mutation was detected in all five cases. During the 6-32 months of follow-up, one patient developed recurrence and the others were tumor-free. Conclusions: In the gynecologic tract, both MA in cervix and MLA in uterus and ovary have similar morphologic features, immunohistochemical expression and KRAS mutation. However, distinct from MA that originates from mesonephric remnant, MLA is closely related to Mullerian epithelium.

[Laparoscopic radical resection of rectal cancer with preservation of the left colic artery: anatomical basis and surgical experience].

In order to increase the blood supply of anastomosis, surgeons choose to preserve the left colon artery (LCA) during the laparoscopic radical resection of rectal cancer. However, surgeons are always ailed by hemorrhage and incompletely dissection of No. 253 lymph nodes. One reason is the shortage of understanding the relationship between inferior mesenteric artery (IMA), LCA, and inferior mesenteric vein before surgery. Another reason is that surgeon always remove the lymph nodes around LCA, while don't normatively resect No. 253 lymph nodes, which affect the overall survival rate. Therefore, the "medial-to-lateral approach" for laparoscopic preservation with LCA radical resection in rectal cancer was suggested in this article. The CT technique could be used to analyze the IMA classification, which contribuated to the standard conservation of LCA. Laparoscopic radical resection of rectal cancer could be completed of high quality, through accurate definition and exactly dissection of the No. 235 lymph nodes.

Using latent class analysis to identify money boys at highest risk of HIV infection.

OBJECTIVES: Limited research has been conducted to investigate the characteristics of money boys (MBs) in China. This study was aimed to identify the subgroups of MBs based on sexual behaviors, Net-based venue sex-seeking, and substance abuse. STUDY DESIGN: Cross-sectional study. METHODS: Convenience sampling was used to recruit MBs from December 2014 to June 2015 in Tianjin, China. Face-to-face interviews were conducted for 330 MBs, and trained interviewers collected data. RESULTS: The laboratory-confirmed human immunodeficiency virus (HIV)-positive rate was 11.52% among 330 MBs. Four classes were identified through latent class analysis (LCA) method: 'relatively safe behavior' group, 'higher sexual risk' group, 'multiple sexual-partners' group, and 'unprotected sex and substance abuse' group, and there is a significant difference based on the HIV status. Significant differences were found in original residence, monthly income, duration in sex trade, employment, history of sexually transmitted infection (STI), HIV testing, knowledge of free antiviral treatment policy, and awareness of free AIDS testing between the four latent classes (P < 0.05). MBs who used Net-based venues to seek sexual partners; who have inconsistent condom use, substance abuse, a longer duration in sex trade, multiple sexual clients, and multiple anal sex; and who were full-time employed had the highest risk of HIV infection. CONCLUSIONS: The utility of LCA to identify subgroups based on risky behaviors attributes to formulating targeted intervention strategy.

Okur-Chung neurodevelopmental syndrome: Eight additional cases with implications on phenotype and genotype expansion.

Okur-Chung syndrome is a neurodevelopmental condition attributed to germline CSNK2A1 pathogenic missense variants. We present 8 unreported subjects with the above syndrome, who have recognizable dysmorphism, varying degrees of developmental delay and multisystem involvement. Together with 6 previously reported cases, we present a case series of 7 female and 7 male subjects, highlighting the recognizable facial features of the syndrome (microcephaly, hypertelorism, epicanthic fold, ptosis, arched eyebrows, low set ears, ear fold abnormality, broad nasal bridge and round face) as well as frequently occurring clinical features including neurodevelopmental delay (93%), gastrointestinal (57%), musculoskeletal (57%) and immunological (43%) abnormalities. The variants reported in this study are evolutionary conserved and absent in the normal population. We observed that the CSNK2A1 gene is relatively intolerant to missense genetic changes, and most variants are within the protein kinase domain. All except 1 variant reported in this cohort are spatially located on the binding pocket of the holoenzyme. We further provide key recommendations on the management of Okur-Chung syndrome. To conclude, this is the second case series on Okur-Chung syndrome, and an in-depth review of the phenotypic features and genomic findings of the condition with suggestions on clinical management.

[A survey on high-risk behaviors and HIV infection among men having sex with men who use drugs in Tianjin in 2016].

Objective: To analyze the characteristics of high risk sexual behaviors and HIV infectious status among men who have sex with men (MSM) who use drugs in Tianjin in 2016. Methods: From April to December in 2016, MSM who use drugs in Tianjin were targetedly and extensively mobilized to receive testing by snowball sampling method. The inclusion criteria were as follows: men aged 18 years old and above; have had oral or anal sex with men in the last 6 months; have had drug abuse history in the last 6 months, including the use of rush poppers, 5-Methoxy-diisopropyltryptamine (5-MeO-DiPT), and Methamphetamine Synthesis substances; and with no mental disorder or mental deficiency. In this study, 302 MSMs were recruited to collect information of social demographic characteristics, drug abuse situation, sexual behavior after drug use, HIV test and the infectious status was collected through the online questionnaire, and the descriptive analysis was conducted. Results: From January to December 2016, a total of 302 subjects were recruited, among whom 194 (64.2%) aged 21-30 years old, 223 (73.8%) were unmarried and 28 (9.3%) were students. In the past 6 months, 297 (98.3%) used rush poppers, 31 (10.3%) used 5-MeO-DiPT, and 14(4.6%) used Methamphetamine Synthesis substances. The proportion of having sex after using the three types of drugs were 87.9% (n=261), 83.9% (n=26) and 92.9% (n=13), 85.5% (n=254), 87.1% (n=27) and 92.9% (n=13) of the subjects reported the sexual pleasure and sexual desire increased after using drugs, respectively. After using the three types of the drugs,58.6% (n=174), 83.9% (n=26) and 92.9% (n=13) of the subjects reported the duration of each sexual activity prolonged. In the past 3 months,48.3% (n=146) had stable sexual partners, 72.5% (n=219) had temporary sexual partners and 12.3% (n=37) had group sexual behaviors. 41 out of 302 subjects were HIV positive with the HIV positive rate at 13.6%. Conclusion: Most of the MSM who use drugs were young, and always had sex when they use drugs. There is a relatively high HIV prevalence in this population.

[Characteristics of baseline viral load before antiretroviral therapy in newly reported HIV-infected patients in Tianjin, 2019-2022].

Objective: To understand the baseline viral load (VL) of newly reported HIV- infected patients before antiretroviral therapy and related factors in Tianjin. Methods: Data were obtained from the China Disease Control and Prevention Information System, and the study subjects were HIV-infected patients before the first antiretroviral therapy in Tianjin from 2019 to 2022, and the information about their socio-demographic characteristics, baseline CD4+T lymphocyte (CD4) counts before antiretroviral therapy and baseline VL test results were collected, the baseline high VL was defined as ≥100 000 copies/ml. The effect of different factors on viral load were analyzed. Software SPSS 24.0 was used for statistical analysis. Results: A total of 1 296 newly reported HIV-infected patients were included in the study, in whom 15.89% (206/1 296) had high baseline VL, and multifactorial logistic regression analysis showed that those with history of STD (aOR=1.45, 95%CI:1.00-2.08) were more likely to have high baseline VL. Compared with those with baseline CD4 counts <200 cells/µl, those with baseline CD4 counts 200-350 cells/µl (aOR=0.40, 95%CI: 0.27-0.57), 351-500 cells/µl (aOR=0.32, 95%CI: 0.20-0.49), and >500 cells/µl (aOR=0.30, 95%CI: 0.18-0.49) were less likely to have high baseline VL. Conclusions: The proportion of HIV-infected patients with high baseline VL before antiretroviral therapy was low in Tianjin during 2019-2022. History of STD and baseline CD4 counts <200 cells/µl were associated with high baseline VL in HIV-infected patients, to which close attention needs to be paid in AIDS prevention and control.

[Survey on the awareness rate of mpox knowledge and related factors among men who have sex with men in China].

Objective: To understand the awareness rate of mpox knowledge and related factors among men who have sex with men (MSM) in China. Methods: The survey was conducted among men aged ≥18 years who had sex with men in the past year, using the convenience sampling method. The estimated sample size was 4 312. With the assistance of social organizations of MSM in 30 provinces in China, an online questionnaire survey was conducted using anonymous self-designed questionnaires powered by www.wjx.cn during 10-14 August 2023 to collect information on socio-demographic characteristics, awareness of mpox knowledge, travel history, and sexual behaviors of the respondents. The software SAS 9.4 was used for statistical analysis. Results: There were 7 725 respondents, and the age of the respondents was (31.6±9.0) years. The results revealed that the awareness rate of mpox knowledge was 50.1% (3 872/7 725). The main routes to acquire mpox knowledge were mainly new media, including WeChat, Weibo, TikTok, and Blued social software (88.4%,6 827/7 725), while official media report was the most trusted way to acquire related knowledge (79.3%,6 129/7 725). Multivariate logistic regression analysis revealed that the factors indicated a higher awareness rate of mpox knowledge, including living in the western region or the eastern region, people were over 26 years old in early adulthood and midlife, college-educated or with higher degrees, living in towns or urban periphery, being in homosexual or in bisexual relationships, 1-5 homosexual times/months in the past 3 months, knowing their HIV infection status, paying attention to mpox knowledge very often, occasionally or rarely, and convenient ways to acquire mpox knowledge from new media and social organizations. Conclusions: The awareness rate of mpox knowledge was low among MSM in China. Efforts should be made to improve the awareness rate of mpox knowledge among those who are young, less educated, or sexually active, with targeted health education via new media and social organizations.

Mechanism studies for relativistic attosecond electron bunches from laser-illuminated nanotargets.

To find a way to control the electron-bunching process and the bunch-emitting directions when an ultraintense, linearly polarized laser pulse interacts with a nanoscale target, we explored the mechanisms for the periodical generation of relativistic attosecond electron bunches. By comparing the simulation results of three different target geometries, the results show that for nanofoil target, limiting the transverse target size to a small value and increasing the longitudinal size to a certain extent is an effective way to improve the total electron quantity in a single bunch. Then the subfemtosecond electronic dynamics when an ultrashort ultraintense laser grazing propagates along a nanofoil target was analyzed through particle-in-cell simulations and semiclassical analyses, which shows the detailed dynamics of the electron acceleration, radiation, and bunching process in the laser field. The analyses also show that the charge separation field produced by the ions plays a key role in the generation of electron bunches, which can be used to control the quantity of the corresponding attosecond radiation bunches by adjusting the length of the nanofoil target.

[Estimate the population size of transgender women based on the capture-recapture method in Tianjin].

Objective: To investigate the population size of transgender women (TGW) in Tianjin and analyze the characteristics of their sexual behaviors to provide a basis for AIDS prevention and control. Methods: To estimate the population size of TGW in Tianjin using the capture-recapture method. At the same time, an anonymous questionnaire was collected to conduct a multi-factor logistic analysis of the TGW population's sexual behavior. Results: A total of 213 TGW were investigated. Tianjin's estimated TGW population size was 599 (95%CI: 407-792). Multivariate logistic analysis of the use of condoms consistently showed that compared with TGW without regular sex partners, those with regular sex partners had a lower proportion of consistent condom use (aOR=0.44, 95%CI: 0.23-0.82) and had received HIV tests in the last year were more likely to adhere to condom use than those who had not been tested (aOR=2.73, 95%CI: 1.06-6.99). Conclusion: It is necessary to strengthen HIV mobilization testing among the TGW population and their regular sexual partners to improve condom use.

[Sexually active status and its correlates among community-based older adults in Tianjin].

Objective: To understand the sexually active status among community-based older adults aged ≥50 years in Tianjin, China, and to explore the potential correlates. Methods: A cross-sectional survey using multistage sampling among community-based older adults aged ≥50 was conducted between June 2020 and December 2022. The estimated sample size was 735. The survey collected questionnaire information through face-to-face interviews with investigators, including sociodemographic, health, and sexual lifestyle characteristics. The multivariable logistic regression model was used to assess correlates of sexually active status. Results: A total of 776 study participants (510 males and 266 females) were included, whose major age distribution was 50-59 years (45.9%). The overall sexual activity prevalence of the participants was 45.6%. Older age (60-69: aOR=0.67, 95%CI: 0.45-0.99; ≥70: aOR=0.12, 95%CI: 0.07-0.21), being male (aOR=1.93, 95%CI: 1.32-2.82), living in urban area (aOR=0.18, 95%CI: 0.12-0.28), living with spouse/married (aOR=2.80, 95%CI: 1.41-5.58), living alone (aOR=0.51, 95%CI: 0.27-0.96), having difficulty climbing stairs or walking (aOR=0.55, 95%CI: 0.31-0.97), having chronic diseases (one chronic disease: aOR=0.55, 95%CI: 0.36-0.85; two or more chronic diseases: aOR=0.53, 95%CI: 0.33-0.84) were associated with sexually active status among older adults. Conclusions: Many community-based older adults remained sexually active. There was an association between physical health and sexually active status among community-based older adults. Incorporating sexual health services into healthcare services for community-based older adults could be advocated, with a concurrent emphasis on enhancing the awareness and competence of providing sexual health services among community-based healthcare workers.

[HIV infection status in male outpatients in sexually transmitted disease clinics in Tianjin, 2016-2020].

Objective: To understand the HIV infection status in male outpatients in sexually transmitted disease (STD) clinics in Tianjin from 2016 to 2020. Methods: According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted between April and June during 2016-2020 to collect the information about the awareness of AIDS related knowledge, related sex behaviors, HIV infection, syphilis prevalence and HCV infection of male STD outpatients in Tianjin with a sample seize of 400 in each sentinel clinic. Results: From 2016 to 2020, a total of 4 000 male STD outpatients were surveyed. The HIV positive rate increased from 1.13% (9/800) to 2.25% (18/800) (trend χ2=14.22, P<0.001), the positive rate of syphilis increased from 9.38% (75/800) to 13.00% (104/800) (trend χ2=7.30, P=0.007) in this population during this period. The overall HCV positive rate was 0.45% (18/4 000). Multivariate logistic regression analysis showed that compared with those who were unmarried, had registered residence in Tianjin, had no temporary sexual behavior in the past 3 months, had no anal sex and had negative syphilis test result, the risk factors of HIV infection in the male STD outpatients included cohabitation (aOR=7.53, 95%CI:2.13-26.62), being from other provinces (aOR=3.64,95%CI:1.58-8.38), having temporary sexual behavior in the past 3 months (aOR=2.24,95%CI:1.03-4.89), having homosexual anal sex (aOR=85.99,95%CI:38.76-190.74) and suffering from syphilis (aOR=6.06,95%CI:3.18-11.56). Conclusion: The detection rates of HIV infection and syphilis in male STD outpatients in Tianjin showed upward trends from 2016 to 2020. Having temporary sexual behavior and anal sex, and suffering from syphilis were the main risk factors of HIV infection in male STD outpatients.

[Analysis on psychoactive substances use in men who have sex with men in Tianjin].

Objective: To understand the use of psychoactive substances and its related factors in men who have sex with men (MSM) in Tianjin. Methods: A cross-sectional survey was conducted in MSM recruited in Tianjin by snowball sampling from September 2017 to December 2020, the information about their social demographic information, use of psychoactive substances and behavioral characteristics were collected, meanwhile the blood samples were taken from them for HIV/syphilis detections. Multivariate logistic regression was used to explore related factors about psychoactive substances use. Results: A total of 9 218 MSM were included in the study, in whom 43.5% (4 013/9 218) had ever used psychoactive substances, including 92.6% (3 718/4 013)who used Rush and 17.2% (692/4 013) who used multi substances. Multivariate analysis showed that, the OR of psychoactive substances use in MSM who were in Han ethnic group was 0.68 (95%CI:0.51-0.91) compared with those who were in minor ethnic group; the OR of psychoactive substances use in MSM who were married or cohabited, divorced or widowed were 0.65 (95%CI: 0.57-0.71), 0.80 (95%CI: 0.65-0.97) respectively compared with those who were unmarried; the OR of psychoactive substances use in MSM who had the first homosexual sex at age of ≥30 years was 0.57 (95%CI: 0.44-0.74) compared with those who had the first homosexual sex at age of <30 years; the OR of psychoactive substances use in local MSM in Tianjin was 1.12 (95%CI: 1.03-1.23) compared with those who were not local residents in Tianjin; the OR of psychoactive substances use in MSM with education level of college or above was 1.29 (95%CI: 1.12-1.49) compared with those with education level of junior middle school or below; the OR of psychoactive substances use in MSM who had anal sex in the past six months was 1.93 (95%CI: 1.34-2.77) compared with those who had no anal sex; the OR of psychoactive substances use in MSM who had >2 homosexual partners in the last week was 1.62 (95%CI: 1.41-1.87) compared with those who had ≤2 homosexual partners; the OR of psychoactive substances use in MSM who had homosexual commercial sex in the past six months was 1.99 (95%CI: 1.62-2.45) compared with those who had no homosexual commercial sex; the OR of psychoactive substances use in MSM who had sexually transmitted diseases in the last year was 2.39 (95%CI: 1.82-3.12) compared with those who had no sexually transmitted diseases and the OR of psychoactive substances use in MSM who received peer education services in the last year was 1.63 (95%CI: 1.50-1.78) compared with those who received no peer education services. Conclusion: The prevalence of psychoactive substances use is high in MSM in Tianjin, and there are many influencing factors. It is necessary to conduct targeted interventions according to the influencing factors.

[Advances in researches on neoadjuvant therapy for resectable colorectal liver metastasis].

Surgery is recognized as the core treatment for colorectal liver metastasis (CRLM), while its recurrence rate remains relatively high, even for resectable CRLM. This hints that the efficacy of treatment involves not only technological factors of surgery, but also biological behavior of tumor. For resectable CRLM, neoadjuvant therapy is beneficial to eliminate the micro-metastasis, reduce postoperative recurrence rate, screen tumor biological behavior and improve prognosis. However, questions about which kind of CRLM patients fits for neoadjuvant therapy and what regimen should be used are still debatable. This paper reviews stratified management of resectable CRLM, choice of neoadjuvant regimen, especially the application value of targeted therapy, based on the latest guidelines and studies.

Prognostic role of MUC-2 expression in patients with gastric carcinoma: a systematic review and meta-analysis.

OBJECTIVE: This meta-analysis aimed to assess the association of MUC-2 expression with clinicopathological parameters in gastric carcinoma (GC) patients. MATERIALS AND METHODS: Clinical databases based on the study aim were searched in detail. The relative risk ratios (RRs) and associated 95% confidence intervals (95% CIs) were computed after eligible trials were included in the study. RESULTS: Nineteen trials involving 2,363 GC patients were included in this meta-analysis. The expression of MUC-2 showed correlation with clinical stage (I/II vs. III/IV) (RR = 1.09, 95% CI: 1.00-1.18, I2 = 24%, p = 0.194), and lymphatic invasion (present vs. absent) (RR = 0.83, 95% CI: 0.72-0.95, I2 = 22.3%, p = 0.252). However, no significant association was identified between the MUC-2 expression and other clinicopathological parameters, including gender (male vs. female), tumor size (>5 vs. ≤5 cm), Lauren's classification (intestinal vs. diffuse), tumor differentiation (poorly vs. well and moderately), lymph node metastasis (present vs. absent), vascular invasion (present vs. absent), and 5-year survival (yes vs. no) of GC patients. CONCLUSIONS: Our meta-analysis findings suggested that MUC-2 positive cases were correlated with lower tumor stage and lower rate of lymphatic invasion. Further clinical studies are warranted to confirm the role of MUC-2 in clinical practice.

[A cohort study on the incidence of HIV infection in drug abusers among men who have sex with men in Shanghai and Tianjin].

Objective: To analyze the incidence of HIV infection and identify associated risk factors in drug abusers among men who have sex with men (MSM) in Tianjin and Shanghai through a cohort study and provide a basis for HIV prevention in this population. Methods: A prospective cohort study was conducted among MSM who had a history of drug abuse in the past six months from June 2016 to June 2018 in the two cities. MSM were investigated to obtain information on sociodemographic characteristics, HIV-related sexual behaviors, and drug abuse. Follow-up investigation and HIV testing were carried out based on the baseline survey and testing. Cox regression analysis was conducted to identify the risk factors for HIV infection. Results: There were 455 eligible subjects, and 16 new HIV infection cases were identified in the 2-year follow-up survey. The cumulative follow-up time was 586.08 person-years, and the incidence of HIV infection was 2.73/100 person-years. The multivariate Cox regression analysis results showed that compared with those aged ≥25 years, consistent condom use during anal sex with men in the past six months, without mixed-use of drugs, these aged <25 years (HR=5.01, 95%CI: 1.09-23.11), inconsistent condom use during anal sex with men in the past six months (HR=1.58, 95%CI: 1.04-2.41) and mixed-use of drugs (HR=1.92, 95%CI: 1.08-3.40) were significantly associated with HIV infection in this cohort. Conclusions: The younger age, inconsistent condom use during anal sex with men, and mixed drug use appeared as risk factors of new HIV infection in drug abusers among MSM. HIV prevention and intervention in this population should be further strengthened.

[Clinical and prognosis analysis of children with kidney retransplantation].

Objective: To analyze the clinical and prognosis of children with kidney retransplantation. Methods: Clinical data of 11 children who underwent kidney retransplantation from January 2011 to December 2020 in Department of Nephrology, Children's Hospital of Fudan University were retrospectilely analyzed. The clinical data including demographic parameters, primary diagnosis, characteristics in the follow-up of renal allograft were analyzed. Results: Totally 11 cases received secondary renal transplantation (male 6, female 5). They were initially diagnosed with chronic kidney disease at the age of 11.9 (7.4, 13.3) years. The median duration of dialysis was 22.1 (3.5, 36.5) months. In the first transplantation, recipient age was 13.9 (11.1, 15.2) years. Ten cases received donation from cardiac death donor (DCD) (9 cases received donors aged less than one year, 5 of them received whole kidney transplantation and one case received donor aged one to three years) and 1 case with living-related donor. Ten graft failures occurred within 1 month after renal transplantation and the other one occurred at the fifth month after transplantation. The causes included vascular factors (9 cases), rejection (1 case) and primary non-function (1 case). In the second transplantation, recipient age was 14.7 (11.7, 16.2) years. All the 11 children received dialysis (7 with PD and 4 with HD) and successfully completed the second transplantation. The median time between the two transplants was 210 (16, 1 041) days. Donors were all DCD donors from 3 years of age or older. The mean follow-up duration was (42±15) months. The estimated glomerular filtration rate was (85±34)ml/(min·1.73 m2) when the last investigation after kidney retransplantation with the kidney and patient all survived. Conclusions: Kidney retransplantation may have better prognosis in children. Dialysis transition during waiting period and DCD donor from 3 years of age or older can effectively ensure the success of kidney retransplantation.

Antimicrobial resistance and molecular characterization of Staphylococcus haemolyticus in a Chinese hospital.

The aim of this study was to perform the molecular characterization of methicillin-resistant Staphylococcus haemolyticus (MRSH) from clinical specimens of patients in a Chinese hospital. One hundred and thirty-three strains of S. haemolyticus collected from April 2002 to April 2003 were analyzed. Antimicrobial susceptibility to 15 antimicrobial agents was determined by the broth microdilution method. The resistant rates to penicillin G and oxacillin were higher than 90%. There were no isolates resistant to linezolid or vancomycin, and only 6.0% of the strains were resistant to teicoplanin. The positivity rate for mecA genes was 90.2% by polymerase chain reaction (PCR). Ninety MRSH (isolated from inpatients and mecA-gene-positive) were genotyped by pulsed-field gel electrophoresis (PFGE) after SmaI digestion. Twenty-five different PFGE patterns (A approximately Y) were found and a major clone (type A; n = 36) with five subtypes was identified. Clone A was detected during a 1-year period. Identical PFGE types were found in different wards and patients. The results of this study suggest the clonal spread of MRSH within our hospital. This emphasizes the need for control and prevention measures.