Appearance of new CDC-reactive antibodies in patients waiting for kidney transplantation

BackgroundPatients awaiting kidney transplantation are regularly screened for HLA-antibodies, but there is scarce data about the optimal interval.MethodsResults from Complement-dependent cytotoxicity testing (CDC) for waitlisted patients were reviewed for increases in panel reactive antibodies (PRA) by at least 10%-points. Clinical records were screened for historic immunizing events and possible trigger factors preceding the PRA-increase. Additionally, non-pretransplanted men tested negative for HLA antibodies by solid-phase assays (SPA) out of their first two samples on the waiting list (“non-immunized men”) were evaluated for detection of HLA antibodies by SPA during their further stay on the waiting list.Results15,360 samples from 1928 patients tested by CDC were analyzed for changes in PRA. PRA-increases occurred most frequently in patients waitlisted recently for retransplantation (annual incidence 6%). Removal of previous transplants, severe infections and/or reduced immunosuppression triggered 65% of PRA-increases during the first year after waitlisting. Transfusions accounted for 55% of PRA-increases in later years. Leucocyte-reduced red blood cell units not only boosted historic antibodies, but even induced primary immunization. In the second part of the study, 6780 samples tested by SPA from 703 non-immunized men were evaluated for development of HLA-antibodies. Only 9 men (1.3%) turned HLA antibody-positive (annual incidence 0.4%).ConclusionA uniform screening interval does not fit all: Frequencies should be highest in patients newly waitlisted for re-transplant and lowest in non-immunized men. Transfused patients should be monitored closely for development of HLA-antibodies even if leukoreduced products are used.     

急性胰腺炎与内皮素、一氧化氮和氧自由基关系研究

目的　研究急性胰腺炎 (AP)与内皮素 (ET)、一氧化氮 (NO)和氧自由基关系。方法　急性胰腺炎 71例 ,应用放射免疫分析法测定血浆ET、NO和超氧化物歧化酶 (SOD) ,并与健康体检者 15例作对照。结果　急性胰腺炎血浆ET、NO明显升高 ,而SOD明显降低 ,与健康对照组比较差异显著 (P <0 0 1) ;且重症胰腺炎的ET和NO增高、SOD降低尤为明显 ,与轻症胰腺炎相比较有统计学意义 (P <0 0 1)。结论　血浆的ET、NO和SOD异常消长在急性胰腺炎发生、发展过程中具有重要作用。     

Association of genetic polymorphisms and haplotypes in hMLH1 and hMSH3 gene with the risk of papillary thyroid carcinoma

OBJECTIVE: To explore the relationship of the genetic polymorphisms and the haplotypes in hMLH1 and hMSH3 gene with the risk of papillary thyroid carcinoma (PTC) in Chinese Hans. METHODS: A hospital based 1:1 matched case-control study was carried out. The polymorphisms for 204 pairs of PTC cases and healthy controls were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele specific oligonucleotide (PCR-ASO) assays. RESULTS: (1) The PTC risk was marginally increased in the hMLH1 1151TA genotype, with odds ratio (OR) of 2.15 (95%CI: 0.99-4.85); the PTC risk was significantly increased in the mutant genotype 1151TA+AA, with OR of 2.15 (95%CI: 1.02-4.69); (2) The haplotypes of -93G, 1151A, 655A in the hMLH1 gene could increase the PTC risk, with OR of 2.67 (95%CI: 1.16-6.53, P=0.011), compared with the haplotype of -93G, 1151T, 655A; (3) Compared to 3124A, 2835G haplotype in hMSH3 gene, the 3124G, 2835A haplotype could increase the PTC risk marginally, with OR of 3.08 (95%CI: 0.92-13.25). CONCLUSION: The 1151T/A polymorphism in hMLH1 was associated with PTC; both the haplotype of -93G, 1151A, 655A in hMLH1 and the 3124G, 2835A haplotype in hMSH3 were associated with PTC.     

剖宫产产后出血相关因素

目的 :探讨剖宫产出血危险因素及防治措施。方法 :回顾性分析剖宫分娩 494例中发生产后出血的30例。结果 :产程延长、胎盘娩式、流产及妊娠并发症等是剖宫产产后出血相关因素。结论 :加强孕期宣教工作 ,产前检查注意易出血因素及适时施行剖宫产术是减少剖宫产产后出血的良好措施。     

慢性鼻窦炎手术方法的探讨

目的：探讨治疗慢性鼻窦炎的手术方法及中鼻甲前端部分切除术在治疗慢性鼻窦炎中的作用。方法：对87例(155侧)慢性鼻窦炎患者，根据其发病原因及病情不同分为3类，采用相应的手术方法进行治疗。结果：第l类43侧，治愈39侧，好转4侧；第2类8l侧，治愈69侧，好转l0侧，无效2侧；第3类3l侧，治愈17侧，好转9侧，无效5侧。总治愈率为80．6％，有效率为95．5％。结论：对慢性鼻窦炎的手术治疗应因病因、病情不同，采用不同的手术方法，中鼻甲前端部分切除术对治疗慢性鼻窦炎具有重要作用。     

Giant cell polymyositis associated with myasthenia gravis and thymoma

We report a case of a 40-year-old woman who developed generalized muscle weakness over a period of 2 months. Physical examination revealed palpable masses in her arms and hands. Serum creatine kinase levels were elevated. Electromyography showed myopathic changes and 3 Hz repetitive nerve stimulation revealed a decremental pattern on repetitive nerve stimulation. Muscle MRI demonstrated increased signal intensity in the biceps brachii on T1-weighted images. Chest CT scan showed a mediastinal mass suggestive of thymoma. Muscle biopsy revealed giant cell polymyositis. The patient was treated with cholinesterase inhibitors and corticosteroids with improvement of strength, and subsequently underwent thymectomy followed by radiotherapy.     

Inhibition of the miR-155 and protein prenylation feedback loop alleviated acute graft-versus-host disease through regulating the balance between T helper 17 and Treg cells

MicroRNA-155(miR-155) and protein prenylation have been reported to participate in acute graft-versus-host disease (aGVHD) through modulating T lymphocyte differentiation, however the mechanism remains elusive. In this study, we found that the expression of miR-155 and protein prenyltransferases in peripheral blood T lymphocytes of aGVHD mice was significantly increased. Suppression of miR-155 by antagomir-155 could remarkably reduce prenyltransferases mRNA and protein expression in T lymphocytes of aGVHD mice. Conversely, prenyltransferase inhibitors significantly reduced the level of miR-155. Inhibition of this feedback loop of miR-155 and protein prenylation in aGVHD mice led to improved survival and lower aGVHD histopathology scores and significantly induced T cell deficient differentiation towards T helper 17 (Th17) cells and titled differentiation towards CD4⁺CD25^hi regulatory T (Treg) cells. Furthermore, the immunoregulatory effects and protection from aGVHD of prenyltransferase inhibitors could be reversed by the addition of miR-155. The dual treatment of prenylation inhibitors and antagomir-155 showed synergistic effects on T polarization and protection from aGVHD. Consistent with the in vivo changes, inhibition of this feedback loop of miR-155 and protein prenylation affected Th17 and Treg cell polarization in vitro. Our data suggest that miR-155 and protein prenylation may constitute a feedback loop that amplifies immune and inflammatory responses in subjects with aGVHD, and they may serve as potential targets for aGVHD prophylaxis and treatment.     

针刺和聚焦冲击波疗法对肩袖肌腱病的止痛作用:一项回顾性临床研究

ObjectiveThe purpose of the study is to evaluate whether the clinical effects of focused extracorporeal shockwave therapy (f-ESWT) and acupuncture anticipate the clinical response in patients with rotator cuff tendinopathy in the short term.DesignAn observational retrospective clinical study.Setting/LocationPhysical Medicine and Rehabilitation Unit, Sant'Andrea University Hospital in Rome, Italy.Subjects/InterventionsWe analyzed retrospectively thirty patients (22 females and 8 males) with rotator cuff tendinopathy.Fifteen patients underwent f-ESWT and acupuncture combined therapy (Group A) and fifteen patients underwent only f-ESWT therapy (Group B).Outcome measuresThe outcome measures were the Visual Analogic Scale (VAS), Assessment Shoulder and Elbow Scale (ASES) and Roles and Maudsley Score (RMS). The follow-ups were T0 (pre-treatment), T1 (3 weeks after the start of the treatment), and T2 (at 8 weeks). In order to compare groups, the ANOVA and Friedman tests were adopted.Group A patients had a more rapid and statistically significant improvement trend in VAS (P <0.001), ASES scale (P <0.001), and a higher level of satisfaction to treatment assessed by RMS (P<0.001) than group B in the short term.ConclusionsThe study showed that combined treatment decreases the recovery time of the shoulder involved in terms of pain and motor function in the short term. However, these results shall be confirmed by controlled randomized studies.     

Succès du traitement par paclitaxel d’une rechute viscérale d’un sarcome de Kaposi après transplantation rénale

We report the observation of a patient who presented with post-transplant Kaposi's sarcoma after a delay of eight months with a dual cutaneous and palatal localisation. The reduction in immunosuppressive treatment and the introduction of Rapamune® allowed good clinical progress initially with regression of the skin lesions. He subsequently presented later a skin relapse with visceral localisation. Chemotherapy was conducted based on weekly paclitaxel infusions allowing partial remission and maintenance of renal graft function with good clinical tolerance.