Current status of pediatric kidney transplantation in China: data analysis of Chinese Scientific Registry of Kidney Transplantation

Background Kidney transplantation （KTx） is the primary therapy for children with renal failure.Unlike KTx in adult patients,it is commonly agreed that pediatric KTx in China is far behind that of America.There has been no systematic analysis of Chinese pediatric KTx reported.This study aimed to demonstrate the current status of pediatric KTx in China.Methods Registry data of pediatric KTx （1983-2012） from Chinese Scientific Registry of Kidney Transplantation （CSRKT） were retrospectively analyzed.Results There were 851 pediatric KTx from 102 transplant units.The recipients were （15.4±2.5） years of age,93.9％ of who were over 10 years old.Chronic glomerulonephritis and pyelonephritis accounted for 75.6％ of recognized primary diseases.Allografts were from deceased donors （72.2％） or living donation （27.7％）.The patient survival for 1,3,5,and 10 years was 96.9％,94.2％,92.3％,and 92.3％ and the graft survival was 94.6％,91.4％,86.3％,and 79.2％,respectively.The majority of post-transplant complications were acute rejection and infections.Annual transplant reached the peak in 2008 （n=114）,and decreased sharply in 2006 （n=41） and 2010 （n=57）.The percentage of pediatric KTx in total KTx was highest in 2007 （1.95％） and decreased to trough level in 2010 （1.0％）.Living donation increased by 32.5-folds from 2004 to 2008 and then decreased by 86.6％ till 2010.The percentage of living donation in pediatric or total KTx dynamically changed in a similar manner,while living donation ratio in pediatric KTx was much higher.Conclusions Kidney transplant can provide long-term benefits to pediatric recipients.Rejection and infections are worthy of concern during follow-up.Pediatric kidney transplant in China is very much lagging behind that in developed countries.Living donation played an important role in its development in the past decades.New strategies for implementation are encouraged to increase the priority of uremic children in organ allocation so as to promote its progress in China.     

In vitro and in vivo antibacterial activity of Pogostone

Background Our pervious antibacterial studies on several traditional Chinese medicines have found that Patchouli oil from Pogostemon cablin had significant antibacterial activity against methicillin-resistant Staphylococcus aureus （MRSA）,which has spread worldwide and infected innumerable people.In order to find the more active natural substances in Patchouli oil,one of the major components,Pogostone,was isolated and its antibacterial activity was evaluated in vitro and in vivo in this study.Methods In vitro test,Pogostone was screened for antimicrobial properties against 83 bacteria comprising 35 gram positive and 48 gram negative bacteria strains via the agar double dilution method.In vivo test,specific pathogen free （SPF） strain of both male and female white Kunming mice,weighing 18-22 g,were used to test the protective ability of Pogostone after being injected with the median lethal doses （MLDs） of the tested strains.Results In vitro test,Pogostone could inhibit both gram negative bacteria （0.098-1 600 μg/ml） and gram positive bacteria（0.098-800 μg/ml）.For Corynebacterium xerosis and some Chryseobacterium indologenes,the minimum inhibitory concentration （MIC） values of Pogostone were extremely low （＜0.098 μg/ml）.It was significant that Pogostone was also active against some drug-resistant bacteria like MRSA.Furthermore,Pogostone showed antibacterial activity in vivo against Escherichia coli （E.coli） and MRSA via intraperitoneal injection.Ninety percent of the mice infected with E.coil could be protected at the concentrations of 50 and 100 mg/kg,and 60％ of the mice at 25 mg/kg,while the rate of protection for the mice infected with MRSA was 60％ and 50％ at doses of 100 and 50 mg/kg,respectively.Conclusion Pogostone could be developed as a potential antibacterial agent for clinical therapy.     

Expression and Role of BAG-1 in Eosinophilic and Non-eosinophilic Chronic Rhinosinusitis with Nasal Polyps

The pathogenesis of human eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP and nECRSwNP) remains undetermined. We aimed to investigate the expression and role of Bcl-2-associated athanogene-1 (BAG-1) and heat shock protein 70 (Hsp70) in ECRSwNP and nECRSwNP. BAG-1 protein expression was investigated by immunohistochemistry and western blotting, and messenger RNA (mRNA) expression of BAG-1 and Hsp70 was assessed by real-time polymerase chain reaction (PCR) in 27 subjects with ECRSwNP, 28 subjects with nECRSwNP, and 23 control subjects. Moreover, the effects of various stimulators with different concentrations and time on BAG-1 were evaluated on a nasal explant culture. Results showed that significant elevations in total visual analog scale (VAS) score, endoscopy score, CT score, and rate of positive skin prick test (SPT) were found in the ECRSwNP group compared with the nECRSwNP group. BAG-1 and Hsp70 were overexpressed in CRSwNP, especially in ECRSwNP, and BAG-1 expression was closely related to Hsp70. BAG-1 mRNA was augmented by IL-4, IL-17A, and IL-1β, but suppressed by IFN-γ, respectively. In conclusion, eosinophils triggered a more severe form of inflammation in CRSwNP compared with non-eosinophilic inflammatory cells. The expressions of BAG-1 and Hsp70 were upregulated in CRSwNP, especially in ECRSwNP. IL-4, IL-17A, and IL-1β may be critical for BAG-1 gene expression.     

Primary myelolipoma in posterior mediastinum

Myelolipoma in posterior mediastinum is indeed rare. As a benign tumor, it consists of mature fat with scattered foci of haematopoietic elements resembling bone marrow. The computed tomography (CT) and magnetic resonance imaging (MRI) are effective methods to detect them, while the definite diagnosis still depends on pathological diagnosis. Up to now, there is no standard treatment for this disease. Surgery is thought to be the best choice in some literatures reports. In this paper, two patients with primary posterior mediastinal tumor are reported, both of whom were underwent Video-assisted thoracoscopic surgery (VATS). Postoperative pathological diagnosis was myelolipoma.