Outcomes for primary kidney transplantation from donation after Citizens' death in China: a single center experience of 367 cases.

BACKGROUND: The cases of donation after brain death followed by circulatory death (DBCD) and donation after cardiac death (DCD) have been increased year by year in China. Further research is needed to understand in the outcomes and risk factors of delayed graft function (DGF) in order to minimize the risk of DGF and ameliorate its potential impact on long-term outcomes. This study was to explore the differences in outcomes between DBCD and DCD transplant and the main risk factors for DGF in DBCD. METHODS: Retrospective analysis of the clinical data of 367donations after citizens' death kidney transplant procedures (donors and recipients) between July 2012 and August 2015 at our center. RESULTS: During the study period, the donation success rate was 25.3%. 164 cases of DBCD and 35 cases of DCD had been implemented and 367 kidneys were transplanted. The incidence of DGF in DBCD group were significantly lower than that of DCD group (12.0% vs. 27.0%, p = 0.002). The 1-year percent freedom from acute rejection (AR) was significantly higher in DBCD group compared with it of DCD group (94% vs. 82%, p = 0.036). Multivariate logistic regression analysis of the kidney transplants revealed that the high risk factors for DGF after renal transplantation in DBCD were history of hypertension (Odds Ratio [OR] = 5.88, 95% CI: 1.90 to 18.2, p = 0.002), low blood pressure (BP < 80 mmHg) (OR = 4.86, 95% CI: 1.58 to 14.9, p = 0.006) and serum creatinine of donor (OR = 1.09, 95% CI: 1.03 to 1.16, p = 0.003) before donation. CONCLUSIONS: The outcomes of DBCD could be better than DCD in DGF and AR. The main risk factors for DGF in DBCD kidney transplants are donors with a history of hypertension, low blood pressure, and serum creatinine of donor before donation.

Distribution and drug resistance of pathogenic bacteria isolated from cancer hospital in 2013.

OBJECTIVE: To understand distribution and drug resistance of pathogenic bacteria from a specialized cancer hospital in 2013 in order to provide a basis for rational clinical antimicrobial agents. METHODS: Pathogenic bacteria identification and drug sensitivity tests were performed with a VITEK 2 compact automatic identification system and data were analyzed using WHONET5.6 software. RESULTS: Of the 1,378 strains tested, 980 were Gram-negative bacilli, accounting for 71.1%, in which Klebsiella pneumonia, Escherichia coli and Pseudomonas aeruginosa were the dominant strains. We found 328 Gram-positive coccus, accounting for 23.8%, in which the amount of Staphylococcus aureus was the highest. We identified 46 fungi, accounting for 4.1%. According to the departmental distribution within the hospital, the surgical departments isolated the major strains, accounting for 49.7%. According to disease types, lung cancer, intestinal cancer and esophagus cancer were the top three, accounting for 20.9%, 17.3% and 14.2%, respectively. No strains were resistant to imipenem, ertapenem or vancomycin. CONCLUSIONS: Pathogenic bacteria isolated from the specialized cancer hospital have different resistance rates compared to commonly used antimicrobial agents; therefore antimicrobial agents to reduce the morbidity and mortality of infections should be used.

Sirt6 promotes DNA damage repair in osteoarthritis chondrocytes by activating the Keap1/Nrf2/HO-1 signaling pathway.

The aim of this study was to explore the effect and mechanism of Sirt6 on DNA damage repair in OA chondrocytes. Cartilage tissues were collected from OA patients with knee arthroplasty and traumatic amputation patients without OA. Besides, 7-week-old male C57BL/6 mice were randomly divided into Control and OA groups; CHON-001 cells of corresponding groups were treated with 10 ng/ml interleukin (IL)-1ß, respectively. Subsequently, Sirt6 or siNrf2 was over-expressed in CHON-001 cells to observe the effect of Sirt6 on DNA damage and senescence of chondrocytes by IL-1ß through the nuclear factor E2-related factor 2 (Nrf2) signaling pathway. The expression level of Sirt6 in human and mouse OA cartilage tissues was significantly decreased. However, 24 h of treatment with IL-1ß significantly decreased the expression of Sirt6 in chondrocytes, induced DNA damage, and promoted cellular senescence. In addition, over-expression of Sirt6 promoted DNA damage repair and inhibited cellular senescence in IL-1ß-induced chondrocytes. Moreover, the overexpression of Sirt6 activated the Keap1/Nrf2/HO-1 signaling pathway in chondrocytes, while knockdown of Nrf2 expression inhibited the DNA damage repair and anti-senescence effects of Sirt6 on IL-1ß-treated chondrocytes. Sirt6 may reduce DNA damage and cellular senescence in OA chondrocytes induced by IL-1ß through activating the Keap1/Nrf2/HO-1 signaling pathway.

PLXNC1 interference alleviates the inflammatory injury, apoptosis and extracellular matrix degradation of IL-1ß-exposed chondrocytes via suppressing GRP78 expression.

BACKGROUND: Osteoarthritis (OA) is a frequently encountered debilitating joint disorder. Whether plexin C1 (PLXNC1) is implicated in OA is far from being investigated despite its well-documented pro-inflammatory property in human diseases. The goal of this study is to expound the specific role of PLXNC1 in OA and elaborate the probable action mechanism. METHODS: Firstly, PLXNC1 expression in the cartilage tissues of patients with OA was examined with GEO database. In interleukin-1beta (IL-1ß)-induced OA cell model, RT-qPCR and western blotting tested the expression of PLXNC1, glucose-regulating protein 78 (GRP78) and extracellular matrix (ECM) degradation-related factors. Cell viability and inflammation were respectively judged by CCK-8 assay and RT-qPCR. TUNEL and western blotting estimated cell apoptosis. The potential binding between PLXNC1 and GRP78 was corroborated by Co-IP assay. Western blotting also tested the expression of endoplasmic reticulum stress (ERS)-associated proteins. RESULTS: As it turned out, PLXNC1 expression was elevated in the cartilage tissues of patients with OA and IL-1ß-treated chondrocytes. When PLXNC1 was depleted, the viability injury, inflammation, apoptosis and ECM degradation of chondrocytes exposed to IL-1ß were obstructed. Besides, GRP78 bond to PLXNC1 in IL-1ß-treated chondrocytes. The ascending GRP78 expression in the chondrocytes exposed to IL-1ß was depleted after PLXNC1 was silenced. Meanwhile, the impacts of PLXNC1 deficiency on the viability, inflammatory response, apoptosis, ECM degradation as well as ERS in IL-1ß-exposed chondrocytes were abolished by GRP78 up-regulation. CONCLUSION: In summary, PLXNC1 silencing might interact with and down-regulate GRP78 to mitigate the apoptosis, inflammation, and ECM degradation of IL-1ß-insulted chondrocytes in OA.

Effect of advanced nursing care on psychological disorder in hypertensive retinopathy of pregnancy: A protocol of systematic review.

BACKGROUND: This study will assess the effect of advanced nursing care (ANC) on psychological disorder (PD) in hypertensive retinopathy of pregnancy (HTRP). METHODS: This study will search electronic databases from inception to the present (Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, CNKI, and Chinese Biomedical Literature Database), and other sources. All literature sources will be searched without limitations to language and study status. All eligible case-controlled study (CCS) will be included in this study. Two authors will independently carry out literature selection, data collection, and study quality assessment. Any confusion will be solved by a third author through discussion. Statistical analysis will be conducted using RevMan 5.3 software. In addition, a narrative synthesis will be elaborated if it is necessary. RESULTS: This study will summarize most recent high quality evidence to appraise the effect of ANC on PD in HTRP. CONCLUSION: The results of this study will seek to identify the effect of ANC on PD in HTRP among pregnancy population. OSF REGISTRATION: osf.io/hgp93.

Species Distribution and Antifungal Susceptibility of Invasive Candidiasis: A 2016-2017 Multicenter Surveillance Study in Beijing, China.

OBJECTIVE: Invasive candidiasis (IC), a life-threatening fungal infection prevalent among hospitalized patients, has highly variable regional epidemiology. We conducted a multicenter surveillance study to investigate recent trends in species distribution and antifungal susceptibility patterns among IC-associated Candida spp. in Beijing, China, from 2016 to 2017. MATERIALS AND METHODS: A total of 1496 non-duplicate Candida isolates, recovered from blood and other sterile body fluids of IC patients, were identified using matrix-assisted laser desorption/ionization time of flight mass spectrometry combined with ribosomal DNA internal transcribed spacer (ITS) region sequencing. Broth microdilution-based susceptibility testing using six antifungal agents was also conducted. RESULTS: Candida albicans was the most frequently isolated species (49.9%), followed by Candida tropicalis (15.5%), Candida glabrata (14.7%) and Candida parapsilosis (14.2%). No significant differences in species distribution were observed when compared with a 2012-2013 dataset. Overall, the rates of susceptibility to fluconazole and voriconazole were high among C. albicans (98% and 97.2%, respectively) and C. parapsilosis species complex (91.1% and 92%, respectively) isolates but low among C. tropicalis (81.5% and 81.1%, respectively) isolates. In addition, the rate of azole resistance among C. tropicalis isolates increased significantly (1.8-fold, P<0.05) compared with that observed in 2012-2013, while micafungin resistance rates were <5% for all tested Candida species. CONCLUSION: Our results suggest that species distribution has remained stable among IC-associated Candida isolates in Beijing. Resistance to micafungin was rare, but increased azole resistance among C. tropicalis isolates was noted. Our study provides information on local epidemiology that will be important for the selection of empirical antifungal agents and contributes to global assessments of antifungal resistance.

Epidemiology and antifungal susceptibilities of yeast isolates causing invasive infections across urban Beijing, China.

AIM: To investigate the species distribution and antifungal susceptibility profiles of yeast isolates causing invasive infections across Beijing. MATERIALS & METHODS: A total of 1201 yeast isolates recovered from blood and other sterile body fluids were correctly identified by matrix-assisted laser desorption/ionization TOF MS supplemented by DNA sequencing. Antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute broth microdilution method. RESULTS: Candida (95.5%) remained the most common yeast species isolated; Candida albicans (38.8%) and Candida parapsilosis (22.6%) were the leading species of candidemia. Azole resistances were mainly observed in Candida glabrata and Candida tropicalis isolates. CONCLUSION: This study outlined the epidemiologic data of invasive yeast infections and highlighted the need for continuous monitoring of azole resistances among C. glabrata and C. tropicalis isolates in Beijing.

Serum leptin, bone mineral density and the healing of long bone fractures in men with spinal cord injury.

Previously reported fracture rates in patients with spinal cord injury range from 1% to 20%. However, the exact role of spinal cord injury in bone metabolism has not yet been clarified. In order to investigate the effects of serum leptin and bone mineral density on the healing of long bone fractures in men with spinal cord injury, 15 male SCI patients and 15 matched controls were involved in our study. The outcome indicated that at 4 and 8 weeks after bone fracture, callus production in patients with spinal cord injury was lower than that in controls. Besides, bone mineral density was significantly reduced at 2, 4 and 8 weeks. In addition, it was found that at each time point, patients with spinal cord injury had significantly higher serum leptin levels than controls and no association was found between serum leptin level and bone mineral density of lumbar vertebrae. Moreover, bone mineral density was positively correlated with bone formation in both of the groups. These findings suggest that in early phases i.e. week 4 and 8, fracture healing was impaired in patients with spinal cord injury and that various factors participated in the complicated healing process, such as hormonal and mechanical factors.

Current attitudes toward organ donation after cardiac death in northwest China.

BACKGROUND: People's attitude toward organ donation after cardiac death (DCD) has not come to an agreement in different countries and regions. Influenced by the local culture in China for thousands of years, the general public has different ideas about this issue. The purpose of this study was to investigate the current attitudes trend and characteristics of transplantation with organs donated after cardiac death in northwest China. METHODS: This largest single-center cohort study was performed by an interview or by telephone using a questionnaire. The family members of potential DCD donors were recruited from the First Affiliated Hospital, medical college of Xi'an Jiaotong University located in a metropolitan area of northwest China. The 12-item attitude questionnaire was specifically developed from the literature review with coordinator, physician, and donor's family feedback. The participants were asked to rate the queries on a 5-point Likert intensity scale. RESULTS: The 174 participants included 56 (32.2%) women and 118 (67.8%) men. Most people were aged between 41 and 50 years (n = 63, 36.2%), 31 and 40 years (n = 59, 33.9%), and less than 30 years (n = 36, 20.7%). The top five attitudes of participants were the best person to suggest organ donation to a family was ranked as the DCD coordinator of Red Cross Organization (RCO, n = 160, 92%), donor is a hero (n = 143, 82.2%), honor to be a donor's family member (n = 136, 78.2%), improved relationship with colleagues (n = 124, 71.3%), and with recipient after donation (n = 123, 70.7%). The best person to suggest organ donation to a family was ranked as the coordinator of RCO (n = 160, 92%), doctor unrelated to transplantation (n = 104, 59.8%), social worker (n = 36, 20.7%), and doctor related to transplantation (n = 25, 14.4%). The top two reasons for non-consent to donation were that the family insisted on intact body after patient death and did not want to have surgery again (n = 51, 41.5%), and feared that they would be misunderstood by neighbors, relatives, and friends about donation (n = 28, 22.8%). CONCLUSIONS: This study revealed initial attitudes toward DCD in China. Some data afford insight into the decision-making procedure. The concerns of potential DCD donors and their families may help professionals provide better interventions in the future.

[Donations after cardiac death kidney transplantation in northwest China].

OBJECTIVE: To explore the effect of donations after cardiac death (DCD) kidney transplant performed in northwest China and the measures for management of delayed graft function (DGF). METHODS: In the period of 2011-2013, a total of 51 families of DCD donor gave their consent to organ donation by signing the informed consent with the help by a Red Cross Organization (ROC) coordinator, and 102 kidneys were retrieved by organ procurement organization (OPO) teams. Ninety-four operations of renal transplantation were carried out in our hospital. All the patients were followed-up and based on the occurrence of DGF after transplantation, they were divided into DGF group and non-DGF group for comparative studies. RESULTS: The success rate of donation after cardiac death was 29.3%, and the incidence of post-transplantation DGF was 27.7%. The 1-year human/kidney survival rate was 98.9%/95.7%. Within six months after the transplant, the values of eGFR in DGF group were significantly lower and serum creatinine significantly higher than those in non-DGF group (P<0.05), but no significant differences were found between the two groups thereafter (P>0.05). The occurrence of DGF in LifePort mechanical perfusion cohorts was significantly lower than that in the simple cold preservation group (21.5% vs. 41.4%, P<0.05). CONCLUSION: The overall effect of DCD kidney transplant is good despite a high incidence of early DGF, and we recommend the use of low-temperature mechanical perfusion for storage and transportation of DCD donor kidney.

Tiliroside-derivatives enhance GLUT4 translocation via AMPK in muscle cells.

Tiliroside isolated from Chinese herb Potentilla chinensis showed therapeutic activities in diabetes. We synthesized 7 tiliroside-derivatives and examined their effects on surface GLUT4myc levels in muscle cells. Derivatives 2a and 3 increased surface GLUT4myc levels, and derivative 3 has the greatest potential. AMPK may be involved in tiliroside-derivatives-regulated GLUT4myc traffic.