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1.
Objective To investigate the prediction of anti-human leukocyte antigen antibodies (HLA) and anti-major histocompatibility complex class I-related chain A antibodies (MICA) to the development of acute rejection (AR) and kidney allograft function. Methods Forty-one kidney transplant patients were prospectively tested for anti-HLA and anti-MICA. Thirty-seven patients were screened using Luminex/single-antigen beads to determine the HLA and MICA-specific antibody levels at 0,30,90, 180,360,720 and 1080 days post-transplantation. The patients and donors of HLA and MICA allele typing were determined by PCR-SSOP, and donor specific antibody (DSA) and non-donor specific antibody (NDSA) were identified.Simultaneously,their serum creatinine (SCr) levels and clinical data were analyzed. Results Nine patients (21.95 % ,9/41 ) had pre-existing anti-HLA and(or) anti-MICA, including 6 cases of anti-MICA,2 cases of anti-HLA, and one case of anti-MICA and anti-HLA. Nine patients had pre-existing DSA and NDSA. In the 37 patients, 6 patients (16.2% ) developed de novo anti-HLA, and 3 (8.1%) developed de novo antiMICA. In patients positive for de novo anti-HLA, the titer of antibody was gradually increased during the follow-up of three years. Four patients out of 9 patients with pre-existing antibodies were suffered from AR (44.4%); In 6 patients positive for de novo anti-HLA,three cases (50.0%) were suffered from AR; In three patients positive for de novo anti-MICA,no AR occurred (P<0.05). In two patients positive for DSA of HLAⅡ antibody detected at the third and seventh day after transplantation, the renal grafts were renovecd due to rejection. The Scr levels in patients positive for pre-existing MICA with AR were higher than in those positive for pre-existing MICA without AR at each scheduled time point during the follow-up period (P<0.05). The Scr levels in patients negative for antibodies pre-transplantation and having AR were higher than in those having no AR at each scheduled time point during the follow-up period (P<0. 01 ). The Scr levels in patients positive for de novo HLA and MICA and having AR one month following transplantation were higher than in those negative for antibodies and having no AR (P<0.01 ). Conclusion Pre-existing and de novo anti-HLA were the irnportant factors for the development of AR, but the mismatch of HLA and MICA alleles in donors and patients was primary causes for generation of de novo antibodies.  相似文献   
2.
目的 探讨术前白蛋白碱性磷酸酶比值(AAPR)与前列腺癌(PCa)根治术后生化复发(BCR)的关系。方法 收集苏州大学附属第一医院2012年5月至2015年10月收治的137例PCa患者的临床资料,根据患者有无发生BCR分为发生BCR组及未发生BCR组,比较两组间年龄、体质指数(BMI)、前列腺特异性抗原(PSA)、AAPR、高血压、糖尿病、Gleason评分、病理分期、辅助内分泌治疗(AHT)、BCR及随访时间的差异,并对有统计学差异的因素进行分层分析。取AAPR的三分位点0.5、0.64分为低AAPR组、中AAPR组及高AAPR组。根据Gleason评分分为低分组(6分),中分组(7分)及高分组(8~10分),参照TNM分期分为低分期组(Ⅱ期),中分期组(Ⅲ期),高分期组(Ⅳ期)。通过多元Logistic分析筛选出发生BCR的独立危险因素。采用Kaplan-Meier法绘制生存曲线,比较低AAPR组、中AAPR组及高AAPR组间BCR的差异。结果 本研究随访时间8~93个月,中位时间55个月,137例患者中有45例发生BCR。发生BCR组与未发生BCR组间AAPR、Gleason评分、病理分期、AHT差异有统计学意义(P<0.05),且低AAPR组BCR发生率高于中AAPR组及高AAPR组(P<0.05),高分组BCR发生率高于中分组及低分组(P<0.05),高分期组BCR发生率高于中分期组及低分期组(P<0.05)。多因素Logistics回归分析结果显示,AAPR为BCR的独立危险因素(P<0.05)。AAPR与Gleason评分及病理分期无关(P>0.05)。生存曲线结果表明,高、中、低AAPR组患者PCa根治术后未发生BCR生存时间具有反向关系,即AAPR水平越高,BCR越延迟发生(P<0.05)。结论 AAPR与PCa根治术后BCR的发生有关,且与未发生BCR生存时间相关,随着AAPR的升高,BCR发生率下降,无BCR生存时间延长。  相似文献   
3.
目的:研究代谢综合征及其各组分与肾脏透明细胞癌分级和分期之间的关系。方法:筛选2018年1月—2019年12月本院收治的153例病理确诊为肾透明细胞癌患者的资料进行回顾性分析,收集年龄、性别、吸烟、饮酒、体重指数、血压、空腹血糖、血脂水平、肿瘤直径、分级及分期等信息。肿瘤分级采用1982年Fuhrman四级分类,将Ⅰ、Ⅱ级合并成高分化组,Ⅲ、Ⅳ级合并成低分化组。根据2010年TNM分期标准,将T1a、T1b期作为低分期组,T2a、T2b期作为高分期组。计量资料比较采用t检验进行统计学分析;计数资料比较使用χ2检验;使用Logistic回归分析寻找独立危险因素。结果:肾透明细胞癌的病理分级和分期与代谢综合征有关(P < 0.05),高血压、糖尿病、高血脂与肾透明细胞癌的病理分级、分期有关(P < 0.05)。多因素Logistic回归分析结果表明,高血压、糖尿病、高血脂是肿瘤病理分级的独立危险因素(P < 0.05),而糖尿病和高血脂是肿瘤分期的独立危险因素(P < 0.05)。结论:肾透明细胞癌合并代谢综合征患者的Fuhrman分级、TNM分期更高。  相似文献   
4.
目的探讨前列腺特异性抗原(PSA)及相关新参数在前列腺癌(PCa)早期筛查的诊断作用。方法回顾性分析苏州大学附属第一医院2015年6月至2018年9月行前列腺穿刺患者的临床资料,比较新参数前列腺游离抗原比值比前列腺特异性抗原密度[(f/t)/PSAD]、PSA质量(PSAM)、PSA质量比(PSAMR)与总PSA(tPSA)、游离PSA(fPSA)、PSA游离抗原比值(f/t PSA)、前列腺特异性抗原密度(PSAD)等指标对PCa筛查的预测作用。结果本研究共纳入717例患者,其中病理确诊PCa317例,BPH 400例。当PSA在0~20ng/mL时,tPSA、f/t PSA、PSAD、(f/t)/PSAD、PSAM及PSAMR在PCa组和BPH组中差异具有显著性统计学意义(P0.05)。当PSA在20~100ng/mL时,除f/t PSA外(P0.05),tPSA、PSAD、(f/t)/PSAD、PSAM及PSAMR在两组中差异具有显著性统计学意义(P0.05)。结论 (f/t)/PSAD在PSA灰区时诊断效能最高,取截点为0.475时,灵敏度为72.28%,特异度为61.07%。PSAMR在灰区外诊断效能较好,取截点为0.135时,灵敏度为66.17%,特异度为55.95%。而PSAM对于前列腺癌的诊断作用不强。  相似文献   
5.
“镜面人”,又称“镜子人”或“镜像人”,即全内脏反位(situs inversus viscerum,SIV),其内脏位置与正常相反,恰好如同常人在镜子中的影像一样,是十分少见的先天性畸形,“镜面人”合并外科疾病需要行手术治疗的病例在临床上更为罕见。现将本院1例全内脏反位行腹腔镜左侧肾上腺肿瘤切除术病例结合文献复习报道如下。  相似文献   
6.
前列腺恶性肿瘤95%以上是腺癌,移行细胞癌(TCC)少见.我院2008年11月收治1例经病理证实的原发性前列腺TCC,结合文献复习,报道如下.患者,男,48岁.因间断性无痛性肉眼血尿2个月就诊,直肠指诊(DRE):前列腺稍大,质韧,表面光滑,中央沟存在,没有明显硬质结节.  相似文献   
7.
Objective To investigate the prediction of anti-human leukocyte antigen antibodies (HLA) and anti-major histocompatibility complex class I-related chain A antibodies (MICA) to the development of acute rejection (AR) and kidney allograft function. Methods Forty-one kidney transplant patients were prospectively tested for anti-HLA and anti-MICA. Thirty-seven patients were screened using Luminex/single-antigen beads to determine the HLA and MICA-specific antibody levels at 0,30,90, 180,360,720 and 1080 days post-transplantation. The patients and donors of HLA and MICA allele typing were determined by PCR-SSOP, and donor specific antibody (DSA) and non-donor specific antibody (NDSA) were identified.Simultaneously,their serum creatinine (SCr) levels and clinical data were analyzed. Results Nine patients (21.95 % ,9/41 ) had pre-existing anti-HLA and(or) anti-MICA, including 6 cases of anti-MICA,2 cases of anti-HLA, and one case of anti-MICA and anti-HLA. Nine patients had pre-existing DSA and NDSA. In the 37 patients, 6 patients (16.2% ) developed de novo anti-HLA, and 3 (8.1%) developed de novo antiMICA. In patients positive for de novo anti-HLA, the titer of antibody was gradually increased during the follow-up of three years. Four patients out of 9 patients with pre-existing antibodies were suffered from AR (44.4%); In 6 patients positive for de novo anti-HLA,three cases (50.0%) were suffered from AR; In three patients positive for de novo anti-MICA,no AR occurred (P<0.05). In two patients positive for DSA of HLAⅡ antibody detected at the third and seventh day after transplantation, the renal grafts were renovecd due to rejection. The Scr levels in patients positive for pre-existing MICA with AR were higher than in those positive for pre-existing MICA without AR at each scheduled time point during the follow-up period (P<0.05). The Scr levels in patients negative for antibodies pre-transplantation and having AR were higher than in those having no AR at each scheduled time point during the follow-up period (P<0. 01 ). The Scr levels in patients positive for de novo HLA and MICA and having AR one month following transplantation were higher than in those negative for antibodies and having no AR (P<0.01 ). Conclusion Pre-existing and de novo anti-HLA were the irnportant factors for the development of AR, but the mismatch of HLA and MICA alleles in donors and patients was primary causes for generation of de novo antibodies.  相似文献   
8.
目的 探讨术前白蛋白与碱性磷酸酶的比值(AAPR)与局限性阴茎癌(T1~3N0M0)术后复发的关系。方法 收集苏州大学附属第一医院2012年1月—2017年1月收治的93例局限性阴茎癌患者的临床资料,比较术后复发组与非复发组间年龄、体质指数(BMI)、AAPR、高血压、糖尿病、肿瘤直径、术后病理分级及分期的差异。Cox回归分析术后发生复发的独立危险因素。采用Kaplan-Meier法绘制生存曲线,比较高、低AAPR组间术后发生复发的差异。结果 复发组较非复发组有较高的WHO/国际泌尿外科病理学学会(ISUP)病理分级(P=0.018)和病理分期(P=0.012)、较低的AAPR(P=0.001)。Cox回归结果显示,AAPR为术后发生复发的独立危险因素(P=0.041)。生存曲线结果表明,高、低AAPR组患者与术后未发生复发的生存时间负相关(P=0.028)。结论 术前AAPR是局限性阴茎癌术后复发的独立危险因素,且与未发生复发时间相关。随着AAPR的升高,复发发生率下降,无进展生存时间延长。  相似文献   
9.
目的研究新型前列腺癌标志物PCA-M对PSA灰区患者的诊断效能。方法筛选本院2018年6月—9月行前列腺穿刺的患者41例,收集并比较PCA-M(PRKY和TGIF2LY)与PSA相关指标的诊断效能。结果病理确诊前列腺癌18例,前列腺增生23例,两组间年龄、PSA及PRKY甲基化差异无明显统计学意义(P 0.05),而DRE、MRI诊断、f/tPSA、PSAD及TGIF2LY甲基化差异有明显统计学意义(P 0.05)。TGIF2LY基因甲基化水平(75.61%)与DRE(68.29%)、MRI诊断(68.29%)、f/tPSA(73.17%)、PSAD(65.85%)的诊断符合率比较未见明显差异(P 0.05)。结论前列腺癌患者中TGIF2LY基因甲基化水平明显减少,其诊断符合率相较于其他指标有一定的参考价值,可以作为前列腺穿刺的指征之一。  相似文献   
10.
背景:研究表明部分肾移植受者在移植前就产生了MHC-I类链相关基因A(MICA)抗体,包括部分自身抗体,其急性排斥反应发生率明显高于抗体阴性者.目的:探讨外源性抗原对内皮细胞MICA表达的影响.方法:分别以5,10和25 μg/L 3个剂量,将MICA重组蛋白分为M5,M10,M25组,将热休克蛋白分为H5,H10,H25组,对人脐静脉内皮细胞予以诱导培养48 h,对照组加入等量的磷酸盐缓冲液.结果与结论:用MICA重组蛋白诱导48 h后,各实验组(M5,M10,M25)内皮细胞MICA mRNA和MICA蛋白的表达量与对照组比较均有显著增加(P < 0.05).M5组和M10组MICA mRNA和MICA蛋白均高于M25组 (P < 0.05).MICA膜蛋白表达以M10组最高,并与M5组、M25组之间差异有显著性意义(P < 0.05).各实验组(M5,M10,M25)可溶性MICA水平较对照组显著下降(P < 0.05).热休克蛋白组内皮细胞MICA基因的表达和可溶性MICA水平均无明显改变.结果表明外源性MICA抗原能够诱导内皮细胞自身MICA mRNA和蛋白表达上调,尤其是细胞膜蛋白增加明显,但可溶性MICA水平显著下降.  相似文献   
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