The trouble with kidneys derived from the non heart-beating donor: a single center 10-year experience

BACKGROUND: The demand for renal transplantation has increasingly outstripped the supply of donor organs especially over the past 10 years. Although related and unrelated live donation is being promoted as one option for increasing the donor pool, it is unlikely that this will in itself be able to bridge the gap. Non-heart beating donors (NHBD) can provide an alternative supply of organs, which should substantially increase the donor pool. METHODS: In Newcastle, NHBD kidneys have been used for transplantation for a period of 10 years. In the early period (1988-1993) excellent results were obtained (90.5% success); however, these donors were controlled NHBD, Maastricht category III. In the second phase (1994-1998) increasing numbers of donors were obtained from the Accident and Emergency Department unit. These were failed resuscitation for cardiac arrest (category II). The rates of success in this period were poor (45.5% success) and the program was halted. The third phase of the program used machine perfusion of the kidneys and glutathione S transferase enzyme analysis to assess viability. RESULTS: Using such approaches renal transplants from largely category II donors produced a success rate of 92.3% which was significantly better than the phase II period of the program (P=0.023, Fisher two-tail test). CONCLUSION: Machine perfusion and viability assessment of NHB kidneys in phase III of the program has increased our donor pool as well as improved the graft survival. This is particularly relevant for the use of the category II NHB donor where the incidence of primary nonfunction was high, illustrated by phase II where machine perfusion/viability assessment was not used.     

Overexpression of oncogenic STK15/BTAK/Aurora A kinase in human pancreatic cancer.

PURPOSE: Multiple chromosome abnormalities, including gain of chromosome20q, have been detected frequently in human pancreatic cancers. Overexpression of the STK15/BTAK/Aurora A gene located on chromosome 20q13, which encodes a centrosome-associated serine/threonine kinase, has been shown to induce chromosomal instability, leading to aneuploidy and cell transformation in multiple in vitro experimental systems. The purpose of this study was to investigate the expression and copy number alteration of STK15 in pancreatic cancer. EXPERIMENTAL DESIGN: STK15 expression at both the mRNA and protein levels together with the copy number of STK15 gene was measured in nine pancreatic carcinoma cell lines: (a) HPAF-II; (b) Aspc-1; (c) Panc-1; (d) Panc-3; (e) Panc-28; (f) Panc-48; (g) HS766T; (h) MIAPaCa-2; and (i) BxPc3. STK15 protein expression was also examined in normal pancreatic tissues and tumors by Western blotting and immunohistochemistry. RESULTS: STK15 was overexpressed in all of the nine cell lines examined, but gene amplification was infrequent. Western Blot analysis of primary tumor tissues revealed 2-10 times overexpression of STK15 protein compared with normal adjacent tissues from pancreatic cancer patients. Concurrent overexpression of cdc20, an STK15-associated protein, and reduced expression of cdc25, a mitosis-activating protein phosphatase, were detected in the same tumor samples. Elevated STK15 protein expression was detected in 22 of 38 tumor sections (58%) from pancreatic cancer patients. The extent of STK15 expression was not significantly correlated with the size, degree of differentiation, and metastasis status of the tumors. CONCLUSIONS: These results show that STK15 is overexpressed in pancreatic tumors and carcinoma cell lines and suggest that overexpression of STK15 may play a role in pancreatic carcinogenesis.     

有机化学中的学习障碍及教学策略

通过对学生在有机化学学习过程中的障碍分析，实施相应的教学策略，以提高有机化学的教学质量和学生的学习水平。     

粘附分子CD_(44)剪接变异体在宫颈癌中的表达及其意义

目的：探讨细胞表面粘附分子CD44的表达在宫颈癌浸润和转移中的作用。方法：应用敏感的RT-PCR法检测62例行广泛根治术的宫颈癌组织及痛分组织CD44剪接变异体的表达情况，结合相应的临床病理资料探讨其与宫颈癌侵袭转移的关系。结果：62例宫颈癌CD44VmRNA总阳性率为90.3％，其中有淋巴结转移的宫颈癌CD44表达率显著高于无淋巴结转移者（P＜0.05），并且癌旁组织表达高于癌组织本身的占54.8％结论：CD44剪接变异体可能赋予宫颈癌更强的侵袭转移潜能，并且痛分组织CD44VmRNA的表达可能较单纯癌组织的表达更有意义。     

芪丹煎对动脉粥样硬化家兔载脂蛋白的影响

目的观察益气活血中药复方芪丹煎对实验性动脉粥样硬化(AS)家兔的影响,探讨该方防治AS导致心肌缺血的机制。方法采用酶法测定血清三酰甘油(TG)、总胆固醇(TC)、载脂蛋白AI(ApoAI)和载脂蛋白B(ApoB),电镜观察胸主动脉的病理改变。结果与模型组比较,芪丹煎可以明显降低血清TG(P<0.05)、TC和ApoB(P<0.01)水平,增加ApoAI含量(P<0.01)。结论降低血脂、调节载脂蛋白含量可能是芪丹煎抑制AS的机制。     

艾迪注射液配合放射治疗鼻咽癌的临床观察

目的比较艾迪注射液加放疗与单纯放疗对鼻咽癌的疗效、毒副反应及免疫功能的影响.方法将71例鼻咽癌患者随机分为两组.治疗组（A组）放疗同时加用艾迪注射液50～80ml静脉滴入,1次/d,连用30d.对照组（B组）单用放疗.结果 A组有效率为83.3%,B组为80%,差异无统计学意义,P〉0.05.A组白细胞减少、贫血、口腔溃疡发生率明显低于B组,差异有统计学意义,P〈0.05.A组治疗后NK细胞活性、CD4/CD8比值明显升高,P〈0.01.A组治疗后的生存质量评分高于B组,P〈0.05.结论艾迪注射液配合放射治疗鼻咽癌,可减轻毒副反应,增强机体免疫功能,改善患者的生存质量.     

18F-FDG PET用于头颈部肿瘤疗效评价和预后分析的研究进展

正电子发射型计算机断层显像(positron emission tomograph,PET)通过探测肿瘤标准摄取值(standard uptake value,SUV)的大小来判断肿瘤的良恶性、生物学行为、监测放化疗的疗效和早期发现肿瘤的复发等.18F-脱氧葡萄糖(18F-FDG)是目前最常用的PET显像药物,主要反映细胞的葡萄糖代谢情况,18F-FDG的吸收与肿瘤生物学行为、代谢特征、病理学类型及分化程度的相关性为临床判断肿瘤的恶性程度提供了一定的依据,进而为反映肿瘤的预后提供了分子基础.综述了18F-FDG PET在头颈部肿瘤疗效评价和预后分析的研究进展.     

盖诺加吡柔比星治疗晚期乳腺癌的临床观察

目的观察盖诺联合吡柔比星治疗晚期乳腺癌的疗效及安全性。方法对28例晚期乳腺癌患者,盖诺25mg/m2,静脉滴入,第1、8天;吡柔比星40mg/m2,静脉注射第1天,21天为一周期,全组化疗共86周期。结果有效率71.4%(20/28),CRO例,PR20例。结论盖诺加吡柔比星治疗晚期乳腺癌,疗效较好,且毒性可耐受,值得临床使用。     

卡巴胆碱对烧伤延迟复苏大鼠免疫功能的影响

Objective To explore the changing trend of Ia on monocyte, lymphocyte apoptosis rate, TNF-α and IL-6 in abdominal aorta of burned rats with delayed resuscitation and the influence of application of carbachol on them. Methods Adult male Wistar rats were randomly divided into normal control group(n =8), scald group(n =48) and scald with carbachol treatment group(n =48). In latter two groups, rats were inflicted with 30% total body surface area (TBSA) full-thickness scald and delayed fluid resuscitation. All scald rats were sacrificed at the 6th hours or 1st, 2nd, 3rd, 7th, 14th day after scald, with 8 rats at each time point. Expression of Ia antigen on monocyte and lymphocyte apoptosis rate were determined by direct immunofluorescence on a flow cytometer, and TNF-α and IL-6 was measured by ELISA. Results Expression of la on monocyte was obviously lower than that of controls. The lowest levels were recorded on the 6th hours and 1st day after scald. Subsequently, Ia was elevated gradually, but still lower than that of normal rats(P <0. 01). After administration of carbachol, Ia expression was obviously promoted, compared with the simple scald group (P <0. 01). Lymphocyte apoptosis rate, TNF-α and IL-6 was higher than that of controls(P <0. 01). After administration of cavachol, , lymphocyte apoptosis rate and TNF-α and IL-6 was obviously down-regulated on the 6th hours, 1st day, 2nd day and 3rd day after scald injury, compared with the simple scald group (P < 0. 01 or 0. 05). Conclusion After severe burn with delayed fluid resuscitation, there is a low la expression, high lymphocyte apoptosis rate and increased releasing of proinflammatory cytokine. Immune function was suppressed. Carbacho] could improve the immune function of scald rats with delayed fluid resuscitation.     

用DNA microarray快速检测淋球菌耐喹诺酮类药物基因突变

研究DNA microarray的制备及其检测淋球菌耐喹诺酮类药物基因突变的准确性。方法根据淋球菌药敏及测序结果分别对淋球菌gyrA和parC基因的序列设计特异引物和探针并制作DNA microarray。对淋球菌临床拭子进行PcR扩增并荧光标记包含gyrA和parC基因的目的DNA片段，与芯片杂交，同时以测序法进行双盲淋球菌耐喹诺酮类药物基因突变的检测。结果87份泌尿生殖道试子全部可用DNA microarray检测出来，芯片检测结果与药敏结果符合率为100％，与测序结果符合率为97．7％。结论用DNA microarray来检测淋球菌gyrA和parC基因突变快速、特异性高和灵敏度高，可以应用于临床耐药性检测。