BACKGROUND: Hepatitis B virus(HBV)-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not cl...BACKGROUND: Hepatitis B virus(HBV)-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than60 years.METHODS: The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups: those equal or older than 60 years(older group,n60) and those younger than 60 years(younger group, n305).Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.RESULTS: Except for age and preexisting chronic disease(P0.05),no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence(P0.05). The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group(P0.05). Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group(odds ratio=3.615, P0.014).CONCLUSIONS: Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.展开更多
BACKGROUND Postherpetic neuralgia(PHN)is the most frequent and a difficult-to-treat complication of herpes zoster(HZ).Its symptoms include allodynia,hyperalgesia,burning,and an electric shock-like sensation stemming f...BACKGROUND Postherpetic neuralgia(PHN)is the most frequent and a difficult-to-treat complication of herpes zoster(HZ).Its symptoms include allodynia,hyperalgesia,burning,and an electric shock-like sensation stemming from the hyperexcitability of damaged neurons and varicella-zoster virus-mediated inflammatory tissue damage.HZ-related PHN has an incidence of 5%–30%,and in some patients,the pain is intolerable and can lead to insomnia or depression.In many cases,the pain is resistant to pain-relieving drugs,necessitating radical therapy.CASE SUMMARY We present the case of a patient with PHN whose pain was not cured by conventional treatments,such as analgesics,block injections,or Chinese medicines,but by bone marrow aspirate concentrate(BMAC)injection containing bone marrow mesenchymal stem cells.BMAC has already been used for joint pains.However,this is the first report on its use for PHN treatment.CONCLUSION This report reveals that bone marrow extract can be a radical therapy for PHN.展开更多
BACKGROUND:Dendritic cells(DCs) can initiate the expansion of regulatory T cells(Tregs),which play an indispensable role in inducing transplantation tolerance.Some studies have investigated the effect of the immunosup...BACKGROUND:Dendritic cells(DCs) can initiate the expansion of regulatory T cells(Tregs),which play an indispensable role in inducing transplantation tolerance.Some studies have investigated the effect of the immunosuppressant rapamycin(Rapa) on Tregs in vitro.However,the in vivo effect of Rapa combined with immature DCs(iDCs) on Tregs is unknown.This study was undertaken to determine whether allogenic iDCs combined with a short course of Rapa have the ability to selectively expand the CD4 + CD25 + Foxp3 + Tregs in a rat model.METHODS:Brown Norway rats were injected intravenously with 2×10 6 Lewis iDCs followed by 1 mg/kg per day Rapa intraperitoneally for 7 consecutive days.On day 8,the levels of CD4 + CD25 + Foxp3 + Treg cells in peripheral blood and spleen cells were analyzed by flow cytometry.IL-2,IL-4,TGF-β1,and IFN-γ levels in serum were assessed by ELISA.The experimental animals were divided into four groups:control,Rapa-treated,iDC-treated,and combination-treated.RESULTS:CD4 + CD25 + Foxp3 + Tregs comprised 7%-8% of CD4 + T cells in control rats.Rapa combined with iDCs enhanced this percentage in the peripheral blood and spleen.However,the levels of Tregs did not significantly change after treatment with Rapa or iDCs alone.The levels of CD4 + CD25 Foxp3 + T cells and CD4 + CD25 + Foxp3 T cells in CD4 + T cells did not significantly change in the combined group.The TGF-β1 level in serum from the combined group increased significantly compared with the other groups.CONCLUSIONS:A significantly higher percentage of CD4 + CD25 + Foxp3 + Tregs was found in rats treated with allogenic iDCs and a short course of Rapa,along with an increase in the TGF-β1 level in serum.This improved protocol may be a promising therapeutic strategy to increase Tregs,which are beneficial to the induction of peritransplant tolerance.展开更多
Hemophagocytic syndrome (HPS) is recognized as a disorder characterized by a variety of symptoms including fever,jaundice,skin rash,lymphadenopathy,and hepatosplenomegaly related to uncontrolled systemic T-cell activa...Hemophagocytic syndrome (HPS) is recognized as a disorder characterized by a variety of symptoms including fever,jaundice,skin rash,lymphadenopathy,and hepatosplenomegaly related to uncontrolled systemic T-cell activation.1 Two forms of HPS have been characterized:primary/familial hemophagocytic lymphohistiocytosis and secondary/reactive HPS.Reactive HPS was first described in 1979 by Risdall et al.展开更多
Background:Although the use of expanded-criteria donors(ECDs)alleviates the problem of organ shortage,it significantly increases the incidence of delayed graft function(DGF).DGF is a common complication after kidney t...Background:Although the use of expanded-criteria donors(ECDs)alleviates the problem of organ shortage,it significantly increases the incidence of delayed graft function(DGF).DGF is a common complication after kidney transplantation;however,the effect of DGF on graft loss is uncertain based on the published literature.Hence,the aim of this study was to determine the relationship between DGF and allograft survival.Methods:We conducted a retrospective,multicenter,observation cohort study.A total of 284 deceased donors and 541 recipients between February 2012 and March 2017 were included.We used logistic regression analysis to verify the association between clinical parameters and DGF,and Cox proportional hazards models were applied to quantify the hazard ratios of DGF for kidney graft loss.Results:Among the 284 deceased donors,65(22.8%)donors were ECD.Of the 541 recipients,107(19.8%)recipients developed DGF,and this rate was higher with ECD kidneys than with standard-criteria donor(SCD)kidneys(29.2%vs.17.1%;P=0.003).The 5-year graft survival rate was not significantly different between SCD kidney recipients with and without DGF(95.8%vs.95.4%;P=0.580).However,there was a significant difference between ECD kidney recipients with and without DGF(71.4%vs.97.6%;P=0.001),and the adjusted hazard ratio(HR)for graft loss for recipients with DGF was 1.885(95%confidence interval[CI]=1.305–7.630;P=0.024).Results showed that induction therapy with anti-thymocyte globulin was protective against DGF(odds ratio=0.359;95%CI=0.197–0.652;P=0.001)with all donor kidneys and a protective factor for graft survival(HR=0.308;95%CI=0.130–0.728;P=0.007)with ECD kidneys.Conclusion:DGF is an independent risk factor for graft survival in recipients with ECD kidneys,but not SCD kidneys.展开更多
Coronavirus disease 2019(COVID-19)is an infectious disease caused by a newly discovered coronavirus and has rapidly spread to most of the world and resulted in a global pandemic.However,there is a paucity of informati...Coronavirus disease 2019(COVID-19)is an infectious disease caused by a newly discovered coronavirus and has rapidly spread to most of the world and resulted in a global pandemic.However,there is a paucity of information available to characterize the immunodeficient population in the COVID-19 pandemic,especially information that focuses on patients after renal transplantation as the typical representative of this population.展开更多
基金supported by grants from the Major State Basic Research Development Program of China(973 Program)(2009CB522404)Science Technology Research Development Program of Guangdong Province(2011B031800060)Science Technology Research Development Program of Guangzhou(2011Y1000332)
文摘BACKGROUND: Hepatitis B virus(HBV)-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than60 years.METHODS: The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups: those equal or older than 60 years(older group,n60) and those younger than 60 years(younger group, n305).Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.RESULTS: Except for age and preexisting chronic disease(P0.05),no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence(P0.05). The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group(P0.05). Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group(odds ratio=3.615, P0.014).CONCLUSIONS: Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.
文摘BACKGROUND Postherpetic neuralgia(PHN)is the most frequent and a difficult-to-treat complication of herpes zoster(HZ).Its symptoms include allodynia,hyperalgesia,burning,and an electric shock-like sensation stemming from the hyperexcitability of damaged neurons and varicella-zoster virus-mediated inflammatory tissue damage.HZ-related PHN has an incidence of 5%–30%,and in some patients,the pain is intolerable and can lead to insomnia or depression.In many cases,the pain is resistant to pain-relieving drugs,necessitating radical therapy.CASE SUMMARY We present the case of a patient with PHN whose pain was not cured by conventional treatments,such as analgesics,block injections,or Chinese medicines,but by bone marrow aspirate concentrate(BMAC)injection containing bone marrow mesenchymal stem cells.BMAC has already been used for joint pains.However,this is the first report on its use for PHN treatment.CONCLUSION This report reveals that bone marrow extract can be a radical therapy for PHN.
基金supported by grants from the Major State Basic Research Development Program of China(973 Program) (2009CB522404)the National Natural Science Foundation of China (30801112,30972915,and 81000190)the National Twelfth Five-Year Science and Technology Plan Major Projects of China (2012ZX10002-017)
文摘BACKGROUND:Dendritic cells(DCs) can initiate the expansion of regulatory T cells(Tregs),which play an indispensable role in inducing transplantation tolerance.Some studies have investigated the effect of the immunosuppressant rapamycin(Rapa) on Tregs in vitro.However,the in vivo effect of Rapa combined with immature DCs(iDCs) on Tregs is unknown.This study was undertaken to determine whether allogenic iDCs combined with a short course of Rapa have the ability to selectively expand the CD4 + CD25 + Foxp3 + Tregs in a rat model.METHODS:Brown Norway rats were injected intravenously with 2×10 6 Lewis iDCs followed by 1 mg/kg per day Rapa intraperitoneally for 7 consecutive days.On day 8,the levels of CD4 + CD25 + Foxp3 + Treg cells in peripheral blood and spleen cells were analyzed by flow cytometry.IL-2,IL-4,TGF-β1,and IFN-γ levels in serum were assessed by ELISA.The experimental animals were divided into four groups:control,Rapa-treated,iDC-treated,and combination-treated.RESULTS:CD4 + CD25 + Foxp3 + Tregs comprised 7%-8% of CD4 + T cells in control rats.Rapa combined with iDCs enhanced this percentage in the peripheral blood and spleen.However,the levels of Tregs did not significantly change after treatment with Rapa or iDCs alone.The levels of CD4 + CD25 Foxp3 + T cells and CD4 + CD25 + Foxp3 T cells in CD4 + T cells did not significantly change in the combined group.The TGF-β1 level in serum from the combined group increased significantly compared with the other groups.CONCLUSIONS:A significantly higher percentage of CD4 + CD25 + Foxp3 + Tregs was found in rats treated with allogenic iDCs and a short course of Rapa,along with an increase in the TGF-β1 level in serum.This improved protocol may be a promising therapeutic strategy to increase Tregs,which are beneficial to the induction of peritransplant tolerance.
基金This study was supported by grants from the Major State Basic Research Development Program （973 Program） of China （No. 2003CB515500）, the National Natural Science Foundation of China （No. 30571769 and No. 30772044）, Sci-tech Research Development Program of Guangdong Province （No. 2007A032000001 and No. 2007B060401033）, and the Teamwork Projects Funded by Guangdong Natural Science Foundation （No. 05200177）.
基金The project was supported by grants from the Major State Basic Research Development Program （973 Program） of China （No. 2003CB515507）, the Guangdong Provincial Natural Science Foundation of China （No. 04105344）, and the Guangdong Provincial Science Technology Project （No. 2005B30501005）.
基金This study was supported by the grants from the Major State Basic Research Development Program (973 Program) of China (No.2003CB515500)the National Natural Science Foundation of China (No. 30571769)+1 种基金Sci-tech Research Development Program of Guangdong Province (No. 2004B35001003)the Teamwork Projects Funded by Guangdong Natural Science Foundation (No.05200177)
文摘Hemophagocytic syndrome (HPS) is recognized as a disorder characterized by a variety of symptoms including fever,jaundice,skin rash,lymphadenopathy,and hepatosplenomegaly related to uncontrolled systemic T-cell activation.1 Two forms of HPS have been characterized:primary/familial hemophagocytic lymphohistiocytosis and secondary/reactive HPS.Reactive HPS was first described in 1979 by Risdall et al.
基金supported by grants from the National Key R&D Program of China(No.2018YFA0108804)the National Natural Science Foundation of China(No.81770753)+1 种基金the Science and Technology Project of Guangdong Province(No.2015B020226005)the Science and Technology Project of Guangzhou City(No.201604020086).
文摘Background:Although the use of expanded-criteria donors(ECDs)alleviates the problem of organ shortage,it significantly increases the incidence of delayed graft function(DGF).DGF is a common complication after kidney transplantation;however,the effect of DGF on graft loss is uncertain based on the published literature.Hence,the aim of this study was to determine the relationship between DGF and allograft survival.Methods:We conducted a retrospective,multicenter,observation cohort study.A total of 284 deceased donors and 541 recipients between February 2012 and March 2017 were included.We used logistic regression analysis to verify the association between clinical parameters and DGF,and Cox proportional hazards models were applied to quantify the hazard ratios of DGF for kidney graft loss.Results:Among the 284 deceased donors,65(22.8%)donors were ECD.Of the 541 recipients,107(19.8%)recipients developed DGF,and this rate was higher with ECD kidneys than with standard-criteria donor(SCD)kidneys(29.2%vs.17.1%;P=0.003).The 5-year graft survival rate was not significantly different between SCD kidney recipients with and without DGF(95.8%vs.95.4%;P=0.580).However,there was a significant difference between ECD kidney recipients with and without DGF(71.4%vs.97.6%;P=0.001),and the adjusted hazard ratio(HR)for graft loss for recipients with DGF was 1.885(95%confidence interval[CI]=1.305–7.630;P=0.024).Results showed that induction therapy with anti-thymocyte globulin was protective against DGF(odds ratio=0.359;95%CI=0.197–0.652;P=0.001)with all donor kidneys and a protective factor for graft survival(HR=0.308;95%CI=0.130–0.728;P=0.007)with ECD kidneys.Conclusion:DGF is an independent risk factor for graft survival in recipients with ECD kidneys,but not SCD kidneys.
基金This work is funded by a Key Project of Health and Family Planning Commission of Hubei Province of China(No.WJ2019Z007)the National Key Research&Development Program of China(2018YFA0108804)+3 种基金the National Natural Science Foundation of China(Nos.81970650 and 81770753)the Youth Program of National Natural Science Foundation of China(No.81800661)the Fundamental Research Funds for the Central Universities(No.20ykpy34)the China Postdoctoral Science Foundation Funded Project(No.2020M683083).
文摘Coronavirus disease 2019(COVID-19)is an infectious disease caused by a newly discovered coronavirus and has rapidly spread to most of the world and resulted in a global pandemic.However,there is a paucity of information available to characterize the immunodeficient population in the COVID-19 pandemic,especially information that focuses on patients after renal transplantation as the typical representative of this population.
