120 results on '"Xianding Wang"'
Search Results
2. Plasma proteome analysis implicates novel proteins as potential therapeutic targets for chronic kidney disease: A proteome-wide association study
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Yang Xiong, Tianhong Wang, Wei Wang, Yangchang Zhang, Fuxun Zhang, Jiuhong Yuan, Feng Qin, and Xianding Wang
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Chronic kidney disease ,Mendelian randomization ,Plasma proteomes ,Estimated glomerular filtration rate ,Blood urea nitrogen ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Chronic kidney disease (CKD) is prevalent globally with limited therapeutic drugs available. To systemically identify novel proteins involved in the pathogenesis of CKD and possible therapeutic targets, we integrated human plasma proteomes with the genome-wide association studies (GWASs) of CKD, estimated glomerular filtration rate (eGFR) and blood urea nitrogen (BUN) to perform proteome-wide association study (PWAS), Mendelian Randomization and Bayesian colocalization analyses. The single-cell RNA sequencing data of healthy human and mouse kidneys were analyzed to explore the cell-type specificity of identified genes. Functional enrichment analysis was conducted to investigate the involved signaling pathways. The PWAS identified 22 plasma proteins significantly associated with CKD. Of them, the significant associations of three proteins (INHBC, LMAN2, and SNUPN) were replicated in the GWASs of eGFR, and BUN. Mendelian Randomization analyses showed that INHBC and SNUPN were causally associated with CKD, eGFR, and BUN. The Bayesian colocalization analysis identified shared causal variants for INHBC in CKD, eGFR, and BUN (all PP4 > 0.75). The single-cell RNA sequencing revealed that the INHBC gene was sparsely scattered within the kidney cells. This proteomic study revealed that INHBC, LMAN2, and SNUPN may be involved in the pathogenesis of CKD, which represent novel therapeutic targets and warrant further exploration in future research.
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- 2024
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3. The association between circadian syndrome and chronic kidney disease in an aging population: a 4-year follow-up study
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Yang Xiong, Qian Zhong, Yangchang Zhang, Zhihong Liu, and Xianding Wang
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aging ,chronic kidney disease ,circadian syndrome ,CHARLS ,Chinese ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
IntroductionCircadian syndrome (CircS) is proposed as a novel risk cluster based on reduced sleep duration, abdominal obesity, depression, hypertension, dyslipidemia and hyperglycemia. However, the association between CircS and chronic kidney disease (CKD) remains unclear. To investigate the cross-sectional and longitudinal association between CircS and CKD, this study was performed.MethodsA national prospective cohort (China Health and Retirement Longitudinal Study, CHARLS) was used in this study. To define CKD, the estimated glomerular filtration rate (eGFR) was calculated based on the 2012 CKD-EPI creatinine-cystatin C equation. Participants with eGFR
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- 2024
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4. Discovery of a glucocorticoid receptor (GR) activity signature correlates with immune cell infiltration in adrenocortical carcinoma
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Zhihong Liu, Xiang Li, Xianding Wang, Kan Wu, Jiayu Liang, and Yuchun Zhu
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background Adrenocortical carcinoma (ACC) is a rare and highly aggressive endocrine malignancy, of which >40% present with glucocorticoid excess. Glucocorticoids and glucocorticoid receptor (GR) signaling have long been thought to suppress immunity and promote tumor progression by acting on immune cells. Here, we provide new insights into the interaction between GR signaling activity and the immune signature of ACC as a potential explanation for immune escape and resistance to immunotherapy.Methods First, GR immunohistochemical staining and immunofluorescence analysis of tumor-infiltrating lymphocyte (CD4 T, CD8 T cells, natural killer (NK) cells, dendritic cells and macrophages) were performed in 78 primary ACC tissue specimens. Quantitative data of immune cell infiltration in ACC were correlated with clinical characteristics. Second, we discovered a GR activity signature (GRsig) using GR-targeted gene networks derived from global gene expression data of primary ACC. Finally, we identified two GRsig-related subtypes based on the GRsig and assessed the differences in immune characteristics and prognostic stratification between the two subtypes.Results GR was expressed in 90% of the ACC tumors, and CD8+ cytotoxic T lymphocytes were the most common infiltrating cell type in ACC specimens (88%, 8.6 cells/high power field). GR expression positively correlated with CD8+ T cell (Phi=0.342, p
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- 2023
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5. Transplant outcomes of 100 cases of living-donor ABO-incompatible kidney transplantation
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Saifu Yin, Qiling Tan, Youmin Yang, Fan Zhang, Turun Song, Yu Fan, Zhongli Huang, Tao Lin, Xianding Wang, and Yuanyuan Ji
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Medicine - Abstract
Abstract. Background:. Although ABO-incompatible (ABOi) kidney transplantation (KT) has been performed successfully, a standard preconditioning regimen has not been established. Based on the initial antidonor ABO antibody titers, an individualized preconditioning regimen is developed, and this study explored the efficacy and safety of the regimen. Methods:. From September 1, 2014, to September 1, 2020, we performed 1668 consecutive living-donor KTs, including 100 ABOi and 1568 ABO-compatible (ABOc) KTs. ABOi KT recipients (KTRs) with a lower antibody titer (≤1:8) were administered oral immunosuppressive drugs (OIs) before KT, while patients with a medium titer (1:16) received OIs plus antibody-removal therapy (plasma exchange/double-filtration plasmapheresis), patients with a higher titer (≥1:32) were in addition received rituximab (Rit). Competing risk analyses were conducted to estimate the cumulative incidence of infection, acute rejection (AR), graft loss, and patient death. Results:. After propensity score analyses, 100 ABOi KTRs and 200 matched ABOc KTRs were selected. There were no significant differences in graft and patient survival between the ABOi and ABOc groups (P = 0.787, P = 0.386, respectively). After using the individualized preconditioning regimen, ABOi KTRs showed a similar cumulative incidence of AR (10.0% υs. 10.5%, P = 0.346). Among the ABOi KTRs, the Rit-free group had a similar cumulative incidence of AR (P = 0.714) compared to that of the Rit-treated group. Multivariate competing risk analyses revealed that a Rit-free regimen reduced the risk of infection (HR: 0.31; 95% CI: 0.12–0.78, P = 0.013). Notably, antibody titer rebound was more common in ABOi KTRs receiving a Rit-free preconditioning regimen (P = 0.013) than those receiving Rit. ABOi KTRs with antibody titer rebound had a 2.72-fold risk of AR (HR: 2.72, 95% CI: 1.01–7.31, P = 0.048). ABOi KTRs had similar serum creatinine and estimated glomerular filtration rate compared to those of ABOc KTRs after the first year. Conclusions:. An individualized preconditioning regimen can achieve comparable graft and patient survival rates in ABOi KT with ABOc KT. Rit-free preconditioning effectively prevented AR without increasing the risk of infectious events in those with lower initial titers; however, antibody titer rebound should be monitored.
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- 2022
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6. Incidence, risk factors, and clinical outcomes of HBV reactivation in non-liver solid organ transplant recipients with resolved HBV infection: A systematic review and meta-analysis.
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Saifu Yin, Fan Zhang, Jiapei Wu, Tao Lin, and Xianding Wang
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Medicine - Abstract
BackgroundCurrent guidelines do not recommend routine antiviral prophylaxis to prevent hepatitis B virus (HBV) reactivation in non-liver solid organ transplant (SOT) recipients with resolved HBV infection, even in anti-hepatitis B surface antigen (anti-HBs)-negative recipients and those receiving intense immunosuppression. This systematic review and meta-analysis aimed to determine the incidence, risk factors, and clinical outcomes of HBV reactivation in non-liver SOT recipients.Methods and findingsThree databases (PubMed, Embase, and Cochrane Library) were systematically searched up to December 31, 2022. Clinical studies reporting HBV reactivation in non-liver SOT recipients were included. Case reports, case series, and cohort studies with a sample size of less than 10 patients were excluded. Random-effects analysis was used for all meta-analyses. We included 2,913 non-liver SOT recipients with resolved HBV infection from 16 retrospective cohort studies in the analysis. The overall HBV reactivation rate was 2.5% (76/2,913; 95% confidence interval [95% CI 1.6%, 3.6%]; I2 = 55.0%). Higher rates of reactivation were observed in recipients with negative anti-HBs (34/421; 7.8%; 95% CI [5.2%, 10.9%]; I2 = 36.0%) by pooling 6 studies, experiencing acute rejection (13/266; 5.8%; 95% CI [2.3%, 14.5%]; I2 = 63.2%) by pooling 3 studies, receiving ABO blood type-incompatible transplantation (8/111; 7.0%; 95% CI [2.9%, 12.7%]; I2 = 0%) by pooling 3 studies, receiving rituximab (10/133; 7.3%; 95% CI [3.4%, 12.6%]; I2 = 0%) by pooling 3 studies, and receiving anti-thymocyte immunoglobulin (ATG, 25/504; 4.9%; 95% CI [2.5%, 8.1%]; I2 = 49.0%) by pooling 4 studies. Among recipients with post-transplant HBV reactivation, 11.0% (7/52; 95% CI [4.0%, 20.8%]; I2 = 0.3%) developed HBV-related hepatic failure, and 11.0% (7/52; 95% CI [4.0%, 20.8%]; I2 = 0.3%) had HBV-related death. Negative anti-HBs (crude odds ratio [OR] 5.05; 95% CI [2.83, 9.00]; p < 0.001; I2 = 0%), ABO blood type-incompatible transplantation (crude OR 2.62; 95% CI [1.05, 6.04]; p = 0.040; I2 = 0%), history of acute rejection (crude OR 2.37; 95% CI [1.13, 4.97]; p = 0.022; I2 = 0%), ATG use (crude OR 3.19; 95% CI [1.48, 6.87]; p = 0.003; I2 = 0%), and rituximab use (crude OR 3.16; 95% CI [1.24, 8.06]; p = 0.016; I2 = 0%) increased the risk of reactivation. Adjusted analyses reported similar results. Limitations include moderate heterogeneity in the meta-analyses and that most studies were conducted in kidney transplant recipients.ConclusionsNon-liver SOT recipients with resolved HBV infection have a high risk of HBV-related hepatic failure and HBV-related death if HBV reactivation occurs. Potential risk factors for HBV reactivation include rituximab use, anti-thymocyte immunoglobulin use, anti-HBs negative status, acute rejection history, and ABO blood type-incompatible transplantation. Further research on monitoring and routine antiviral prophylaxis of non-liver SOT recipients at higher risk of HBV reactivation is required.
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- 2023
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7. Highly individual- and tissue-specific expression of glycoprotein group A and B blood antigens in the human kidney and liver
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Xianding Wang, Fan Zhang, Yamei Jiang, Zilin Xu, Xiaobing Feng, Linde Li, Yu Fan, Turun Song, Yunying Shi, Zhongli Huang, and Tao Lin
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ABO incompatible transplantation ,Blood group antigen ,Kidney ,Liver ,Western blot ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Background Currently, research on the quantitative distribution of ABO antigens in different organs and tissues remains limited. We aimed to examine the individual characteristics of blood group glycoprotein A and B antigen expression in human kidneys and livers. Methods We obtained human samples, including the renal artery, renal vein, renal tissue, hepatic artery, hepatic vein, portal vein, and hepatic tissue, from 24 deceased organ transplant donors. The expression of the blood group antigens glycoprotein A and B was analysed and compared by Western blotting. Results There was no significant difference in the expression between blood group glycoprotein A and B antigens at any of the seven sites (p > 0.05). The expression of both A and B antigens was highest in renal tissue and the portal vein and was lowest in the renal artery. A large difference in glycoprotein antigen expression was observed among various donors or different regions of the same individual. Univariate analysis revealed that glycoprotein A/B antigens were affected by the age and sex of donors and were significantly higher in males and in young people. Conclusions Our study found that blood group glycoprotein antigen expression showed certain trends and distinct distribution in the kidney, liver, and vessels among individuals and in different regions of the same individual, which may explain the different clinical outcomes of patients who received ABO-incompatible transplantation.
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- 2021
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8. Serum uric acid as a risk factor for rejection after deceased donor kidney transplantation: A mono-institutional analysis of paired kidneys
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Fuxun Zhang, Jiayu Liang, Yang Xiong, Fan Zhang, Kan Wu, Wei Wang, Jiuhong Yuan, Tao Lin, and Xianding Wang
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kidney transplantation ,donor ,recipient ,rejection ,risk factor ,Immunologic diseases. Allergy ,RC581-607 - Abstract
BackgroundDeceased donor kidney transplantation (DDKT) is a major therapeutic option for patients with end-stage renal diseases. Although medical techniques improved in recent years, acute or chronic rejection after DDKT is not uncommon and often results in poor graft survival. Therefore, the determination of risk factors is very important to stratify patients and to improve outcomes. This study aims to evaluate the risk factors for treated rejection (TR) of patients after DDKT.MethodsClinical data of deceased donors and corresponding recipients were retrospectively collected. The primary outcome was TR defined as the treatment for rejection within 24 months after DDKT. Univariate comparisons of baseline characteristics were performed with Chi-square test, t-test, and Mann–Whitney U test. Logistic regression was constructed to analyze potential risk factors. Receiver operating characteristic (ROC) curve and Jordan index were generated to determine the optimal cutoff value. The association between continuous variables and TR was examined and visualized by using restricted cubic spline (RCS) models.ResultsData of 123 deceased donors and 246 recipients were obtained and analyzed. The median age was 41 (4–62) years for recipients and 39 (1–65) years for donors. The recipients who died or suffered graft loss during the follow-up period were 8 (3.3%) and 12 (4.9%), respectively. After univariate analysis and subsequent multivariate analysis, the preoperative serum uric acid (OR, 2.242; 95% CI, 1.037–4.844; P = 0.040), platelet (OR, 2.163; 95% CI, 1.073–4.361, P = 0.031), absolute neutrophil count (OR, 2.183; 95% CI, 1.025–4.649; P = 0.043), and HLA-DQ mismatch (OR, 2.102; 95% CI, 1.093–4.043; P = 0.026) showed statistical significance. RCS models showed that patients with higher levels of uric acid had increased risk of TR.ConclusionsSerum uric acid and other three indicators were found to be the independent risk factors for TR, which may contribute to stratify patients and develop personalized regimen in perioperative period.
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- 2022
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9. Clinicopathological characteristics and outcomes of synchronous renal cell carcinoma and urothelial carcinoma: A population-based analysis
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Kan Wu, Xu Liu, Yaohui Wang, Xianding Wang, and Xiang Li
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renal cell carcinoma ,urothelial carcinoma ,concurrent tumor ,survival outcome ,Surveillance Epidemiology and End Results (SEER) database ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundTo better understand the characteristics, and survival outcomes of synchronous renal cell carcinoma (RCC) and urothelial carcinoma (UC), we described and analyzed the clinical features, factors, and prognosis of patients with synchronous RCC and UC using a large population-based database.MethodsWithin the Surveillance, Epidemiology, and End Results (SEER) database (2004–2016), we identified patient with concurrent RCC and UC at initial diagnosis. Their clinicopathological features and prognosis were evaluated. A logistic regression model was used to examine risk factors for the occurrence of concomitant RCC and UC, and Kaplan-Meier survival curves were used to estimate overall survival.ResultsA total of 61,454 RCC patients were identified from the SEER database, 704 (1.1%) patients presented with synchronous RCC and UC. Among these patients, concurrent bladder tumors (566/704) are more common. Subsequently, subgroup analysis based on the location of UC indicated that patients with concurrent RCC and upper tract urothelial carcinoma (UTUC) had unfavorable UC characteristics (higher tumor stage and grade), compared with patients with concomitant bladder cancer. An increased risk of concurrent UC was observed among older age, male sex, and white race. Meanwhile, papillary RCC histology [odds ratio (OR) 3.23; 95% confidence interval (CI) 2.13–4.90], and smaller tumor (OR 6.63; 95% CI 4.46–9.87) were independent risk factors for concomitant UTUC. In addition, we found that synchronous RCC and UTUC was associated with worse survival by using Kaplan-Meier and multivariable analysis [hazard ratio (HR) 2.36, 95% CI 1.89–2.95]. However, concomitant bladder cancer did not affect survival outcomes of patients with RCC (HR 1.00, 95% CI 0.86–1.17).ConclusionWe found that synchronous concurrent RCC and UC is relatively uncommon and mostly located in the bladder. Older age, male sex, and white race increase the risk of synchronous RCC and UC. Meanwhile, patients with papillary RCC histology, and smaller tumors are more likely to have concomitant RCC and UTUC. Furthermore, our findings suggest that synchronous RCC and UTUC has a worse prognosis, while, concomitant bladder tumor did not affect the oncological outcomes of RCC.
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- 2022
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10. Association between preoperative serum albumin and prognosis in patients with adrenocortical carcinoma after primary resection: a retrospective study
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Fuxun Zhang, Zhihong Liu, Jiayu Liang, Shengzhuo Liu, Kan Wu, Fan Zhang, Chuan Zhou, Yiping Lu, Yuchun Zhu, and Xianding Wang
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Adrenocortical carcinoma ,Prognosis ,Resection ,Albumin ,Nutrition ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a poor prognosis. Given the limited treatment options, prognostic assessment of ACC is increasingly crucial. In this study, we aim to assess the correlation between preoperative serum albumin and prognosis in patients with ACC after primary resection. Methods We retrospectively collected and reviewed medical information about 71 ACC patients who underwent primary resection. Survival analysis was performed by Kaplan–Meier analysis with log-rank test or Breslow test. Receiver operating characteristic (ROC) curve and Jordan index was generated to explore optimal cut-off value of albumin. Univariate and multivariate analysis was conducted using Cox’s hazards model. Statistical significance was defined as P
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- 2021
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11. Cuprotosis-related signature predicts overall survival in clear cell renal cell carcinoma
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Fan Zhang, Junyu Lin, Dechao Feng, Jiayu Liang, Yiping Lu, Zhihong Liu, and Xianding Wang
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cuprotosis ,ccRCC ,signature ,cell death ,prognosis ,Biology (General) ,QH301-705.5 - Abstract
Background: Cuprotosis is a new form of programmed cell death induced by copper. We explored the correlation of cuprotosis with clear cell renal cell carcinoma (ccRCC) and constructed a cuprotosis-related signature to predict the prognosis of patients with ccRCC.Methods: The clinical and transcriptomic data of ccRCC patients were downloaded from The Cancer Genome Atlas (TCGA), cBioPortal, and GEO databases, and cuprotosis-related gene sets were contained in the previous study. A cuprotosis-related signature was developed based on data from TCGA and verified by data from cBioPortal and GEO databases. The immune cell infiltrates and the corresponding signature risk scores were investigated. Two independent cohorts of clinical trials were analyzed to explore the correlation of the signature risk score with immune therapy response.Results: A signature containing six cuprotosis-related genes was identified and can accurately predict the prognosis of ccRCC patients. Patients with downregulated copper-induced programmed death had a worse overall survival (hazard ratio: 1.90, 95% CI: 1.39–2.59, p < 0.001). The higher signature risk score was significantly associated with male gender (p = 0.026), higher tumor stage (p < 0.001), and higher histological grade (p < 0.001). Furthermore, the signature risk score was positively correlated with the infiltration of B cells, CD8+ T cells, NK cells, Tregs, and T cells, whereas it was negatively correlated with eosinophils, mast cells, and neutrophils. However, no correlation between cuprotosis and response to anti-PD-1 therapy was found.Conclusion: We established a cuprotosis signature, which can predict the prognosis of patients with ccRCC. Cuprotosis was significantly correlated with immune cell infiltrates in ccRCC.
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- 2022
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12. Identification of an amino acid metabolism-associated gene signature predicting the prognosis and immune therapy response of clear cell renal cell carcinoma
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Fan Zhang, Junyu Lin, Daiwen Zhu, Yongquan Tang, Yiping Lu, Zhihong Liu, and Xianding Wang
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ccRCC ,amino acid metabolism ,signature ,anti-PD-1 therapy ,prognosis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
BackgroundThe upregulation of amino acid metabolism is an essential form of metabolic reprogramming in cancer. Here, we developed an amino acid metabolism signature to predict prognosis and anti-PD-1 therapy response in clear cell renal cell carcinoma (ccRCC).MethodsAccording to the amino acid metabolism-associated gene sets contained in the Molecular Signature Database, consensus clustering was performed to divide patients into two clusters. An amino acid metabolism-associated signature was identified and verified. Immune cell infiltrates and their corresponding signature risk scores were investigated. Two independent cohorts of clinical trials were analyzed to explore the correspondence between the signature risk score and the immune therapy response.ResultsTwo clusters with different amino acid metabolic levels were identified by consensus clustering. The patients in the two clusters differed in overall survival, progression-free survival, amino acid metabolic status, and tumor microenvironment. We identified a signature containing eight amino acid metabolism-associated genes that could accurately predict the prognosis of patients with ccRCC. The signature risk score was positively correlated with infiltration of M1 macrophages, CD8+ T cells, and regulatory T cells, whereas it was negatively correlated with infiltration of neutrophils, NK cells, and CD4+ T cells. Patients with lower risk scores had better overall survival but worse responses to nivolumab.ConclusionAmino acid metabolic status is closely correlated with tumor microenvironment, response to checkpoint blockade therapy, and prognosis in patients with ccRCC. The established amino acid metabolism-associated gene signature can predict both survival and anti-PD-1 therapy response in patients with ccRCC.
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- 2022
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13. Integrated Analysis of Energy Metabolism Signature-Identified Distinct Subtypes of Bladder Urothelial Carcinoma
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Fan Zhang, Jiayu Liang, Dechao Feng, Shengzhuo Liu, Jiapei Wu, Yongquan Tang, Zhihong Liu, Yiping Lu, Xianding Wang, and Xin Wei
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bladder cancer ,prognosis ,metabolic status ,nonogram ,signature ,Biology (General) ,QH301-705.5 - Abstract
Background: Bladder urothelial carcinoma (BLCA) is the most common type of bladder cancer. In this study, the correlation between the metabolic status and the outcome of patients with BLCA was evaluated using data from the Cancer Genome Atlas and Gene Expression Omnibus datasets.Methods: The clinical and transcriptomic data of patients with BLCA were downloaded from the Cancer Genome Atlas and cBioPortal datasets, and energy metabolism-related gene sets were obtained from the Molecular Signature Database. A consensus clustering algorithm was then conducted to classify the patients into two clusters. Tumor prognosis, clinicopathological features, mutations, functional analysis, ferroptosis status analysis, immune infiltration, immune checkpoint-related gene expression level, chemotherapy resistance, and tumor stem cells were analyzed between clusters. An energy metabolism-related signature was further developed and verified using data from cBioPortal datasets.Results: Two clusters (C1 and C2) were identified using a consensus clustering algorithm based on an energy metabolism-related signature. The patients with subtype C1 had more metabolism-related pathways, different ferroptosis status, higher cancer stem cell scores, higher chemotherapy resistance, and better prognosis. Subtype C2 was characterized by an increased number of advanced BLCA cases and immune-related pathways. Higher immune and stromal scores were also observed for the C2 subtype. A signature containing 16 energy metabolism-related genes was then identified, which can accurately predict the prognosis of patients with BLCA.Conclusion: We found that the energy metabolism-associated subtypes of BLCA are closely related to the immune microenvironment, immune checkpoint-related gene expression, ferroptosis status, CSCs, chemotherapy resistance, prognosis, and progression of BLCA patients. The established energy metabolism-related gene signature was able to predict survival in patients with BLCA.
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- 2022
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14. Ameliorating Metabolic Profiles After Kidney Transplantation: A Protocol for an Open-Label, Prospective, Randomized, 3-Arm, Controlled Trial
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Saifu Yin, Ming Ma, Zhongli Huang, Yu Fan, Xianding Wang, Turun Song, and Tao Lin
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metformin ,empagliflozin ,kidney transplantation ,metabolic disorders ,clinical trial ,Medicine (General) ,R5-920 - Abstract
Aim: High prevalence of metabolic disorders causes higher risk of cardiovascular diseases after kidney transplantation (KT), which remains the main burden impairing short-term and long-term survival. This open-label, prospective, randomized, 3-arm, controlled trial will evaluate the safety, tolerability and efficacy of metformin and empagliflozin in ameliorating metabolic profiles after KT.Methods: After a screening assessment, eligible patients with an estimated glomerular filtration rate (eGFR) >45 mL/min/1.73m2 are randomly assigned to standard triple immunosuppression alone, standard immunosuppression plus metformin (500 mg twice daily), standard immunosuppression plus empagliflozin (25 mg once daily) from discharge. The primary endpoint is the differences in the visceral-to-subcutaneous fat area ratio over 12 months, evaluated by magnetic resonance imaging (MRI). Secondary outcomes include kidney graft function, glycometabolism, lipid metabolism, and inflammatory parameters. The trial will enroll 105 kidney transplant recipients, providing 90% power to detect the difference at 5% significance.
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- 2021
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15. Conversion From Calcineurin Inhibitors to Mammalian Target of Rapamycin Inhibitors in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Jun Zeng, Qiang Zhong, Xiaobing Feng, Linde Li, Shijian Feng, Yu Fan, Turun Song, Zhongli Huang, Xianding Wang, and Tao Lin
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calcineurin inhibitor ,mammalian-target-of-rapamycin inhibitor ,kidney transplantation ,conversion ,meta-analysis ,Immunologic diseases. Allergy ,RC581-607 - Abstract
BackgroundA systematic review and meta-analysis were performed to investigate the efficacy and safety of conversion from calcineurin inhibitors (CNIs) to mammalian target of rapamycin inhibitors (mTORi) in kidney transplant recipients (KTRs).MethodsMEDLINE, EMBASE, PubMed, and Cochrane Library were searched to identify randomized controlled trials (RCTs) that compared the continuation of CNI with conversion to mTORi therapy.ResultsTwenty-nine RCTs (5,747 KTRs) were included in our analysis. Meta-analysis of the glomerular filtration rate (SMD 0.20; 95%CI 0.10–0.31; P
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- 2021
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16. Effect of Donor and Recipient ABH-Secretor Status on ABO-Incompatible Living Donor Kidney Transplantation
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Fan Zhang, Saifu Yin, Yu Fan, Turun Song, Zhongli Huang, Jiayu Liang, Jiapei Wu, Youmin Yang, Tao Lin, and Xianding Wang
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kidney transplantation ,ABO blood-group system ,blood group incompatibility ,graft function ,accommodate ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionABO blood group antigens within grafts are continuously exposed to anti-A/B antibodies in the serum of recipients after ABO-incompatible (ABOi) kidney transplantation and are instrumental in antibody-mediated rejection. Some individuals secrete soluble blood group antigens into body fluids. In this study, we investigated the effect of donor and recipient secretor status on the outcomes of ABOi kidney transplantation.MethodsData of a total of 32 patients with ABOi living donor kidney transplantation were retrospectively collected between 2014 and 2020 in West China Hospital. The genotype and phenotype of both donors and recipients were examined and evaluated with post-transplantation anti-A/B titer changes, graft function, and rejection.ResultsOf the 32 recipients and 32 donors, 23 (71.9%) recipients and 27 (84.4%) donors had secretor genotypes, whereas 9 (28.1%) recipients and 5 (15.6%) donors did not. Anti-A/B titers after ABOi kidney transplantation were not significantly influenced by the secretor status of either donors or recipients. The post-transplantation serum creatinine (Scr) levels and estimated glomerular filtration rate (eGFR) was better in weak- or non-secretor recipients at day 30 (Scr P = 0.047, eGFR P = 0.008), day 90 (Scr P = 0.010, eGFR P = 0.005), and month 9 (eGFR P = 0.008), and recipients from secretor donors had a lower incidence of graft rejection in the first year after ABOi transplantation (P = 0.004).ConclusionsA weak secretor status phenotype was found in both genotypes, i.e., individuals who secreted soluble antigens as well as those who did not. The recipient ABH-secretor status may have an influence on early posttransplant renal function, and the donor ABH-secretor status might affect the incidence of graft rejection.
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- 2021
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17. A Nomogram Model to Predict Prognosis of Patients With Genitourinary Sarcoma
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Linde Li, Jiayu Liang, Turun Song, Saifu Yin, Jun Zeng, Qiang Zhong, Xiaobing Feng, Zihao Jia, Yu Fan, Xianding Wang, and Tao Lin
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genitourinary sarcoma ,histology ,surgery ,chemotherapy ,prognosis ,nomogram ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
ObjectivesThe aim of this study is to evaluate the significant factors influencing the overall survival (OS) and recurrence free survival (RFS) and make an attempt to develop a nomogram for predicting the prognosis of patients with genitourinary sarcoma (GS).MethodsData on adult GS from 1985 to 2010 were collected. The impact of clinical factors on OS and RFS were estimated by Kaplan–Meier (KM) analysis, and differences between groups were analyzed by the log-rank test. To establish a nomogram, all patients were randomly divided into a training set (n = 125) and a testing set (n = 63). Cox proportion hazard model was utilized to assess the prognostic effect of variables. Then, a nomogram was established to estimate 1-, 3-, and 5-year OS based on Cox regression model. Subsequently, the nomogram was validated by a training set and a validation set.ResultsA total of 188 patients were enrolled into our study. Male patients with bladder sarcoma had better OS rather than RFS when stratified by gender (P = 0.022). According to histological subtypes, patients with leiomyosarcoma (LMS) undergoing chemotherapy were associated with favorable OS (P = 0.024) and RFS (P = 0.001). Furthermore, LMS in kidney sarcoma were associated with lower recurrence rate in comparison to rhabdomyosarcoma (RMS) (P = 0.043). Margin status after surgical excision markedly influenced the OS and RFS of GS patients and negative margins presented optimal prognosis. Chemotherapy was associated with improved OS for patients without surgery (P = 0.029) and patients with positive margins (P = 0.026). Based on the multivariate analysis of the training cohort, age, gender, surgery status, histological subtype, and chemotherapy were included in our nomogram for prediction of OS. The nomogram had sufficient power with concordance index (C-index) of OS: 0.770, 95%CI: 0.760–0.772 and area under curve (AUC) of OS: 0.759, 95%CI: 0.658–0.859 in the training set and with C-index of OS: 0.741, 95%CI: 0.740–0.765, and AUC of OS: 0.744, 95%CI: 0.576–0.913 in the validation set.ConclusionsAdults GS is a group of extremely rare tumors with poor prognosis. Of all histological types, LMS is sensitive to chemotherapy. We highlighted the cardinal role of surgical resection and the importance of achieving negative margins. We identified the efficacy of chemotherapy for patients with positive margins and those without surgery as well. A nomogram is validated as an effective tool predicting short-term outcomes.
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- 2021
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18. Increased circulating Tfh to Tfr ratio in chronic renal allograft dysfunction: a pilot study
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Lin Yan, Yamei Li, Yi Li, Xiaojuan Wu, Xianding Wang, Lanlan Wang, Yunying Shi, and Jiangtao Tang
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T follicular helper cells ,T follicular regulatory cells ,cTfh to cTfr ratio ,CXCL13 ,Chronic renal allograft dysfunction ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Background T follicular helper (Tfh) cells play a control role in contribution of B cell differentiation and antibody production. T follicular regulatory (Tfr) cells inhibit Tfh-B cell interaction. Methods To identify whether circulating Tfh (cTfh) and Tfr (cTfr) cells contribute to chronic renal allograft dysfunction (CAD), 67 kidney transplant recipients (34 recipients with CAD, 33 recipients with stable function) were enrolled. The frequency of cTfh and cTfr cells, the level of serum CXCL13 were measured. Results The frequency of cTfr cells in CAD group was significantly lower than that in stable group (0.31% vs 0.68%, P = 0.002). The cTfh to cTfr ratio in CAD group was significantly higher than that in stable group (55.4 vs 25.3, P = 0.013). Serum CXCL13 in CAD group was significantly higher than stable group (30.4 vs 21.9 ng/ml, P = 0.025). After linear regression analysis, the cTfh to cTfr ratio was an independent risk factor for estimated glomerular filtration rate (eGFR) in recipients (standardized coefficient = − 0.420, P = 0.012). After logistic regression analysis, the cTfh to cTfr ratio was an independent risk factor for CAD (OR = 1.043, 95%CI = 1.004–1.085, P = 0.031). Conclusion The imbalance between cTfh and cTfr cells contribute to the development of CAD.
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- 2019
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19. The Role of CD276 in Cancers
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Shengzhuo Liu, Jiayu Liang, Zhihong Liu, Chi Zhang, Yang Wang, Alice Helen Watson, Chuan Zhou, Fan Zhang, Kan Wu, Fuxun Zhang, Yiping Lu, and Xianding Wang
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CD276 ,B7-H3 ,therapeutic target ,tumor ,progression ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
ObjectiveAberrant expression of the immune checkpoint molecule, CD276, also known as B7-H3, is associated with tumorigenesis. In this review, we aim to comprehensively describe the role of CD276 in malignancies and its potential therapeutic effect.Data SourcesDatabase including PubMed, EMbase, Cochrane Library, CNKI, and Clinical Trails.gov were searched for eligible studies and reviews. Study selection: Original studies and review articles on the topic of CD276 in tumors were retrieved.ResultsCD276 is an immune checkpoint molecule in the epithelial mesenchymal transition (EMT) pathway. In this review, we evaluated the available evidence on the expression and regulation of CD276. We also assessed the role of CD276 within the immune micro-environment, effect on tumor progression, and the potential therapeutic effect of CD276 targeted therapy for malignancies.ConclusionCD276 plays an essential role in cell proliferation, invasion, and migration in malignancies. Results from most recent studies indicate CD276 could be a promising therapeutic target for malignant tumors.
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- 2021
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20. Increasing Time in Therapeutic Range of Tacrolimus in the First Year Predicts Better Outcomes in Living-Donor Kidney Transplantation
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Turun Song, Saifu Yin, Yamei Jiang, Zhongli Huang, Jinpeng Liu, Zhiling Wang, Linde Li, Jun Zeng, Yu Fan, Xianding Wang, Xingxing Li, and Tao Lin
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tacrolimus ,time in therapeutic range ,kidney transplantation ,development and validation ,acute rejection ,infection ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: The aim of the present study was to investigate the impact of time in therapeutic range TTR on long-term outcomes of living kidney transplants.Methods: We included 1,241 living kidney transplants and randomized them into development and validation cohorts with a ratio of 2:1. The tacrolimus TTR percentage was calculated by linear interpolation with a target range (5–10 ng/ml months 0–3, 4–8 ng/ml months 4–12). The optimal TTR cutoff was estimated by the receiver operating characteristic curve analysis on the basis of acute rejection (AR) within 12 months in the development cohort. Outcomes were analyzed between patients with high TTR and low TTR in the development and validation cohorts, respectively. The TTR was also compared with other tacrolimus measures.Results: The optimal TTR cutoff value was 78%. In the development cohort, patients with TTR > 78% had significantly higher rejection- and infection-free survival. TTR < 78% was an independent risk factor for AR (OR: 2.97, 95%CI: 1.82–4.84) and infection (OR: 1.55, 95%CI: 1.08–2.22). Patient and graft survival were significantly higher in those with TTR>78%, and TTR
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- 2019
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21. miR-17-92 ameliorates renal ischemia reperfusion injury
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Turun Song, Mianzhi Chen, Zhengsheng Rao, Yang Qiu, Jinpeng Liu, Yamei Jiang, Zhongli Huang, Xianding Wang, and Tao Lin
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Medicine (General) ,R5-920 - Abstract
There is limited information on the role of miR-17-92 in renal tubular pathophysiology. Therefore, the present study was performed to determine whether miR-17-92 plays a role in ischemia-reperfusion injury (IRI)-induced acute kidney injury. We originally demonstrated that miR-17-92 is up-regulated following IRI in vivo. To explore the roles of miR-17-92 in the IRI process, we first generated a renal proximal tubule-specific miR-17-92 deletion (PT-miR-17-92−/−) knockout mouse model with Cre driven by the Kap promoter. We found that PT-deficient miR-17-92 mice had more severe renal dysfunction and renal structures than their littermates. Compared with sham-operated mice, both wide-type (WT) mice and PT-miR-17-92−/− mice showed increased serum levels of creatinine and urea. However, the levels of serum urea and creatinine in PT-miR-17-92−/− mice after the IRI operation were significantly higher than the levels in WT mice. In addition, PT-miR-17-92−/− mice showed higher levels of serum potassium and phosphonium after the IRI operation. Histological analysis revealed that PT-miR-17-92−/− mice had substantial histopathologic changes, such as tubular dilation and tubular necrosis. Overexpression of miR-17-92 could partially reverse the side-effects of IRI on the proximal tubules in vivo. Furthermore, we employed a quantitative proteomic strategy and identified 16 proteins as potential targets of miR-17-92. Taken together, our findings suggested that miR-17-92 may ameliorates IRI-induced acute kidney injury. Our results indicate that pharmacologic modulation of these miRNAs may have therapeutic potential for acute kidney injury. Keywords: Acute kidney injury, Ischemia reperfusion injury, miR-17-92
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- 2018
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22. Impact of remaining kidney volume to body weight ratio on renal function in living kidney donors
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Turun Song, Zhengsheng Rao, Yang Qiu, Jinpeng Liu, Zhongli Huang, Xianding Wang, and Tao Lin
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Body weight ,Kidney function ,Kidney volume ,Living donor ,Proteinuria ,Medicine (General) ,R5-920 - Abstract
To investigate whether the ratio of remnant kidney volume to body weight (V/W ratio) can impact renal function in donors, 45 living kidney donors were enrolled. Kidney volume was analyzed by magnetic resonance imaging. Renal function was compared between donors with a V/W ratio of < 2.0 mL/kg (n = 23) or ≥ 2.0 mL/kg (n = 22). Donors in both V/W groups showed similar serum creatinine levels and estimated glomerular filtration rates (eGFRs) at 7 days and 1 year, whereas donors with a V/W ratio of < 2.0 mL/kg had significantly higher 24-hour urine protein levels at 1 year (0.54 ± 0.23 g/d vs. 0.33 ± 0.19 g/d, p = 0.028). Multivariate analysis revealed no correlation between the V/W ratio and eGFR at 7 days or 1 year, and a V/W ratio of < 2 mL/kg was not associated with an increased incidence of eGFR < 60 mL/min/1.73 m2 at 1 year (risk ratio 1.73, 95% confidence interval 0.10–29.47). The V/W ratio correlated inversely with 24-hour urine protein (r = −0.377, p = 0.021) at 1 year, and donors with a V/W ratio of < 2.0 mL/kg were more likely to show 24-hour urine protein >300 mg (risk ratio 1.70, 95% confidence interval 1.08–2.67) at 1 year. Donors with lower V/W ratios have higher 24-hour urinary protein levels at 1 year after transplantation. These findings suggest that the V/W ratio may be useful for kidney selection.
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- 2016
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23. Antidepresivos para el síndrome de ovario poliquístico
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Jing Zhuang, Xianding Wang, Liangzhi Xu, Taixiang Wu, and Deying Kang
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Medicine - Abstract
Antecedentes: La prevalencia de depresión en pacientes con síndrome de ovario poliquístico (SOPQ) es alta; un estudio ha revelado que supera en cuatro veces la de las pacientes sin SOPQ. Por lo tanto, es importante la evaluación sistemática de la efectividad y la seguridad de los antidepresivos para las pacientes con SOPQ. Objetivos: Evaluar la efectividad y la seguridad de los antidepresivos en cuanto al tratamiento de la depresión y otros síntomas en pacientes con SOPQ. Métodos de búsqueda: Se realizaron búsquedas en las siguientes bases de datos desde su inicio hasta junio de 2012: el registro de ensayos del Grupo Cochrane de Trastornos Menstruales y Subfertilidad (Cochrane Menstrual Disorders and Subfertility), el Registro Cochrane Central de Ensayos Controlados (Cochrane Central Register of Controlled Trials), MEDLINE, EMBASE, PsycINFO y Chinese National Knowledge Infrastructure, el metaRegister of Controlled Trials (controlled-trials.com), el National Institute of Health Clinical Trials register (clinicaltrials.gov) y en el portal de búsqueda de la World Health Organization International Trials Registry Platform (www.who.int/trialsearch/Default.aspx). Criterios de selección: Sólo se incluyeron en la revisión los ensayos controlados aleatorios (ECA) que estudiaban la efectividad y la seguridad de los antidepresivos en pacientes con SOPQ. Obtención y análisis de los datos: La calidad metodológica de los ensayos fue evaluada de forma independiente por dos revisores, de forma paralela a la extracción de datos. El riesgo de sesgo en los estudios incluidos se evaluó en seis dominios: 1. generación de secuencia: 2. ocultación de la asignación; 3. cegamiento de los participantes, personal y evaluadores de resultados; 4. completitud de los datos de resultado; 5. informe selectivo de los resultados; 6. otras fuentes potenciales de sesgo. Resultados principales: No se encontraron estudios que informaran ninguno de los resultados primarios de la revisión (puntuaciones de la depresión y del trastorno del estado de ánimo relacionado, calidad de vida y eventos adversos). Sólo un estudio con 16 mujeres era elegible para la inclusión. Este estudio comparó sibutramina versus fluoxetina en pacientes con SOPQ, e informó sólo resultados endócrinos y metabólicos. Estuvo poco claro si las participantes tenían problemas psicológicos al inicio. No se hallaron diferencias significativas entre los grupos para ninguno de los resultados medidos. Conclusiones de los autores: No existen pruebas sobre la efectividad y la seguridad de los antidepresivos para el tratamiento de la depresión y otros síntomas en pacientes con SOPQ.
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- 2013
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24. Emphysematous pyelonephritis in a patient with chronic pancreatitis and diabetes
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Kan, Wu, Fuxun, Zhang, and Xianding, Wang
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General Medicine - Published
- 2023
25. Early Monitoring and Subsequent Gain of Tacrolimus Time-In-Therapeutic Range May Improve Clinical Outcomes After Living Kidney Transplantation
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Yu Fan, Zhiling Wang, Zhongli Huang, Turun Song, Tao Lin, Xianding Wang, and Saifu Yin
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Graft Rejection ,endocrine system ,medicine.medical_specialty ,Multivariate analysis ,Urology ,Time in therapeutic range ,Tacrolimus ,medicine ,Humans ,Pharmacology (medical) ,Risk factor ,Kidney transplantation ,Retrospective Studies ,Pharmacology ,biology ,business.industry ,Graft Survival ,Hazard ratio ,Living kidney transplantation ,nutritional and metabolic diseases ,medicine.disease ,Kidney Transplantation ,Transthyretin ,biology.protein ,business ,Immunosuppressive Agents - Abstract
Background The early identification of recipients at high risk of graft loss is clinically relevant after kidney transplantation. The authors explored whether the earlier monitoring of tacrolimus (Tac) time-in-therapeutic range (TTR) is predictive of and a subsequent gain in TTR improves transplant outcomes. Methods The TTR within 3, 6, 9, and 12 months was evaluated. Multivariate Cox analyses were performed to explore when TTR was predictive of transplant outcomes. Patients were divided into 3 groups based on incremental TTR change [TTR gain (increase >10%), TTR stable (maintained within 10%), and TTR loss (decrease >10%)] and 4 groups based on predefined cutoff values [low-low (LL), low-high (LH), high-low (HL), and high-high (HH)] using 6- and 12-month TTRs. Death-censored graft loss and patient death were primary outcomes. Results Nonlinear associations were observed between 6-, 9-, and 12-month TTR and death-censored graft and patient survival rates. In multivariate analysis, every 10% increase in 6-, 9-, and 12-month TTRs was associated with reduced patient death [hazard ratio (HR): 0.83; HR: 0.68; HR: 0.61, respectively] and graft loss (HR: 0.88; HR: 0.73; HR: 0.66, respectively). A nonlinear relationship was observed between transplant outcomes and incremental changes in TTR. TTR gain and stable TTR contributed to higher graft survival (HR: 0.20; HR: 0.21) and patient survival (HR: 0.14; HR: 0.15) rates than TTR loss, whereas the former 2 had comparable outcomes. Furthermore, compared with those in the HH group, the LL and HL groups had inferior graft survival (HR: 3.33; HR: 5.17) and patient survival (HR: 5.15; HR: 8.94) rates, whereas the LH group had similar outcomes (P = 0.63, P = 0.97). Nonadherence was the main controllable risk factor for low TTR. Conclusions The 6-month TTR identified patients at higher risk of worse outcomes. The subsequent gain of TTR may contribute to better transplant outcomes.
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- 2021
26. Macrophage-Specific Cathepsin as a Marker Correlated with Prognosis and Tumor Microenvironmental Characteristics of Clear Cell Renal Cell Carcinoma
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Fan Zhang, Jiayu Liang, You Lu, Yongquan Tang, Shengzhuo Liu, Kan Wu, Fuxun Zhang, Yiping Lu, Zhihong Liu, and Xianding Wang
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Immunology ,Immunology and Allergy ,Journal of Inflammation Research - Abstract
Fan Zhang,1,* Jiayu Liang,1 You Lu,2,* Yongquan Tang,3 Shengzhuo Liu,1 Kan Wu,1 Fuxun Zhang,1 Yiping Lu,1 Zhihong Liu,1 Xianding Wang1 1Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, Peopleâs Republic of China; 2Department of Pediatrics, West China Second University Hospital, Chengdu, Sichuan University, Chengdu, 610041, Peopleâs Republic of China; 3Department of Pediatric Urology, West China Hospital, Sichuan University, Chengdu, 610041, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Xianding Wang; Jiayu Liang, Email xiandingwang66@126.com; drliangjiayu@163.comBackground: Cathepsin Z (CTSZ) is a cathepsin family member that plays a dual role in the adhesion and migration of immune and tumor cells.Methods: The expression pattern of CTSZ in clear cell renal cell carcinoma (ccRCC) was observed by immunohistochemistry and validated by using double-labeling immunofluorescence. Publicly available single-cell sequencing data was used to further define the cell type-specific CTSZ expression in ccRCC. Methylation modification, immune infiltration, and tumor-related signaling enrichment analyses involving CTSZ were performed using multi-omics data. Data from two independent cohorts of anti-programmed death-1 (PD-1) therapeutic clinical trials were used to investigate correlations between CTSZ levels and treatment responses.Results: CTSZ was upregulated in ccRCC tissues compared with adjacent normal tissues at the RNA but not in ccRCC cells. Immunohistochemistry indicated that CTSZ was expressed in tumors infiltrated with lymphocytes. Double immunofluorescence demonstrated that CTSZ was co-expressed with CD68 but not CD8. Single-cell transcriptome data showed macrophage-specific expression of CTSZ in ccRCC. High CTSZ expression was significantly correlated with the enrichment of interferon-γ, epithelialâtoâmesenchymal transition, cell cycle, apoptosis pathways, and B cell, macrophage, neutrophil, and dendritic cell infiltrations, as well as the expression of immune checkpoints CTLA4, LAG3, HAVCR2, PDCD1LG2, PDCD1, TIGIT, and SIGLEC15. Hypomethylation modification of cg02744249, cg02744249, and cg22145559 were negatively correlated with CTSZ expression, suggesting an epigenetic mechanism for the regulation of CTSZ expression. Clinically, CTSZ levels were associated with the prognosis of patients with ccRCC (hazard ratio=1.5, P=0.007). Notably, patients with higher CTSZ expression had a worse prognosis with anti-PD-1 monotherapy (hazard ratio=1.51, P=0.039).Conclusion: Macrophage-specific CTSZ was associated with activation of epithelialâtoâmesenchymal transition, cell cycle signatures, and a higher infiltration level of B cells, macrophages, neutrophils, and dendritic cells in the tumor microenvironment. High expression of CTSZ could be considered as a prognostic and treatment response biomarker for patients with ccRCC receiving anti-PD-1 immunotherapy.Keywords: ccRCC, CTSZ, macrophage, single-cell, prognosis
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- 2022
27. Magnesium Depletion Score is Associated with Long-Term Mortality in Chronic Kidney Diseases: A Prospective Population-Based Cohort Study
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Saifu Yin, Zhaoxia Zhou, Tao Lin, and Xianding Wang
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Nephrology - Abstract
Magnesium deficiency is common in patients with chronic kidney diseases (CKD) due to restricted magnesium intake and impaired magnesium reabsorption. Based on pathophysiological risk factors influencing kidney magnesium reabsorption, a magnesium depletion score (MDS) was developed. Using MDS as a novel indicator for assessing body magnesium status, we hypothesized that it was associated with clinical prognosis.We conducted a prospective population-based cohort study using data from the National Health and Nutrition Examination Survey 1999-2014 to explore the impact of MDS on the clinical outcomes of CKD patients. Propensity score-matched analyses were conducted to increase comparability. The primary outcome was all-cause mortality, and the secondary outcomes were cardiovascular-cause and cancer-cause mortality.After propensity score matching, 3294 CKD patients were divided into 2 groups: MDS ≤ 2 (N = 1647), and MDS 2 (N = 1647). During a median follow-up of 75 months, Kaplan-Meier analyses showed that MDS 2 was associated with worse 5- and 10-year overall survival (78.5% vs 73.4%; 53.1% vs 43.1%, P 0.001). After adjusting for confounding variables, MDS was found to be an independent risk factor for all-cause mortality (HR:1.34, 95% CI 1.20-1.50, P 0.001). MDS 2 was also associated with higher cardiovascular-cause mortality (16.2% VS 11.6%, P = 0.005). Multivariate competing risk analysis revealed that MDS 2 was an independent risk factor (HR: 1.33, 95% CI 1.06-1.66, P = 0.012). Subgroup analyses reported that MDS 2 increased all-cause mortality and cardiovascular-cause mortality only in patients with inadequate magnesium intake (P 0.001, P 0.001) but not in those with adequate intake (P = 0.068, P = 0.920).A magnesium depletion score 2 was independently associated with higher long-term cardiovascular-cause and all-cause mortality in CKD patients.
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- 2022
28. Development and validation of routine clinical laboratory data derived marker-based nomograms for the prediction of 5-year graft survival in kidney transplant recipients
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Huan Xu, Cuili Yang, Lin Yan, Yi Li, Xiaojuan Wu, Xianding Wang, Ji-Wen Fan, Zhengli Wan, Lanlan Wang, Shumeng Hu, Yunying Shi, Yamei Li, and Yangjuan Bai
- Subjects
Adult ,Male ,Oncology ,Aging ,medicine.medical_specialty ,Multivariate statistics ,Concordance ,kidney transplantation ,Risk Assessment ,routine laboratory test data ,Kidney transplant ,nomogram ,5-year renal graft survival ,Lasso (statistics) ,Internal medicine ,medicine ,Humans ,Kidney transplantation ,business.industry ,Graft Survival ,Univariate ,prediction ,Cell Biology ,Nomogram ,Prognosis ,medicine.disease ,Transplant Recipients ,Nomograms ,Female ,Graft survival ,business ,Research Paper - Abstract
Background To develop and validate predictive nomograms for 5-year graft survival in kidney transplant recipients (KTRs) with easily-available laboratory data derived markers and clinical variables within the first year post-transplant. Methods The clinical and routine laboratory data from within the first year post-transplant of 1289 KTRs was collected to generate candidate predictors. Univariate and multivariate Cox analyses and LASSO were conducted to select final predictors. X-tile analysis was applied to identify optimal cutoff values to transform potential continuous factors into category variables and stratify patients. C-index, calibration curve, dynamic time-dependent AUC, decision curve analysis, and Kaplan-Meier curves were used to evaluate models' predictive accuracy and clinical utility. Results Two predictive nomograms were constructed by using 0-6- and 0-12- month laboratory data, and showed good predictive performance with C-indexes of 0.78 and 0.85, respectively, in the training cohort. Calibration curves showed that the prediction probabilities of 5-year graft survival were in concordance with actual observations. Additionally, KTRs could be successfully stratified into three risk groups by nomograms. Conclusions These predictive nomograms combining demographic and 0-6- or 0-12- month markers derived from post-transplant laboratory data could serve as useful tools for early identification of 5-year graft survival probability in individual KTRs.
- Published
- 2021
29. Pre-transplant donor HBV DNA+ and male recipient are independent risk factors for treatment failure in HBsAg+ donors to HBsAg- kidney transplant recipients
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Yu Fan, Yunying Shi, Yuan-Hang Lv, Turun Song, Shi-jian Feng, Zhongli Huang, Li Wang, Jinpeng Liu, Xianding Wang, Zilin Xu, Xiaohong Li, Tao Lin, and Liyu Chen
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Adult ,Male ,medicine.medical_specialty ,HBsAg ,Hepatitis B virus ,030230 surgery ,medicine.disease_cause ,Kidney ,Gastroenterology ,Treatment failure ,Serology ,lcsh:Infectious and parasitic diseases ,Kidney transplantation ,03 medical and health sciences ,0302 clinical medicine ,Medical microbiology ,Postoperative Complications ,Immunity ,Risk Factors ,Internal medicine ,medicine ,Humans ,lcsh:RC109-216 ,Treatment Failure ,Seroconversion ,Hepatitis B Antibodies ,Aged ,Retrospective Studies ,Hepatitis B Surface Antigens ,business.industry ,HBsAg- recipients ,virus diseases ,Donor-derived HBV transmission ,Middle Aged ,medicine.disease ,Hepatitis B ,Hepatitis B Core Antigens ,Tissue Donors ,Transplant Recipients ,digestive system diseases ,Infectious Diseases ,DNA, Viral ,030211 gastroenterology & hepatology ,Female ,business ,HBsAg+ living donors ,Research Article - Abstract
Background In order to reduce the burden on organ shortage around the world, using potential infectious donor might be an option. However, scarce evidences have been published on kidney transplantation (KTx) from hepatitis B surface antigen (HBsAg) + donors to HBsAg- recipients [D (HBsAg+)/R(HBsAg-)] without hepatitis B virus (HBV) immunity. Here, we reported the results of D(HBsAg+/HBV DNA- or +)/R(HBsAg-) living KTx recipients with or without HBV immunity. Methods We retrospectively identified 83 D(HBsAg+)/R(HBsAg-) living KTx recipients, and 83 hepatitis B core antibody (HBcAb) + living donors to HBcAb- recipients [D(HBcAb+)/R(HBcAb-)] were used as control group by reviewing medical archives and propensity score matching. Treatment failure (defined as any HBV serology conversion, liver injury, graft loss, or recipient death) is the primary endpoint. Results Twenty-four donors (28.9%) were HBV DNA+, and 20 recipients had no HBV immunity in the D(HBsAg+)/R(HBsAg-) group pre-transplantation. HBV prophylaxis was applied in all D(HBsAg+)/R(HBsAg-) recipients, while none was applied in the D(HBcAb+)/R(HBcAb-) group. We observed a significant higher treatment failure in D(HBsAg+)/R(HBsAg-) than D(HBcAb+)/R(HBcAb-) group (21.7% vs. 10.8%, P Conclusion D(HBsAg+)/R(HBsAg-) should be considered for living kidney transplantation, but with extra caution on donors with HBV DNA+ and male candidates.
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- 2021
30. Effect of donor kidney morphology parameters on the prognosis in living kidney transplantation recipients
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Yu Fan, Turun Song, Xianding Wang, Zhongli Huang, Yamei Jiang, Yang Qiu, Tao Lin, and Jinpeng Liu
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Body surface area ,medicine.medical_specialty ,Creatinine ,Receiver operating characteristic ,business.industry ,Urology ,030232 urology & nephrology ,Renal function ,Retrospective cohort study ,Nephron ,030230 surgery ,Transplantation ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine.anatomical_structure ,Reproductive Medicine ,chemistry ,medicine ,Original Article ,business ,Body mass index - Abstract
Background The effect of donor kidney morphology parameters on the prognosis of renal transplant recipients remains unclear. Methods We conducted a retrospective cohort study consisting of 290 pairs of donors and recipients who underwent living related renal transplantation in our center between December 2013 and December 2015. The donor kidney morphology parameters, demographic characteristics and renal function of the included participants were collected and analyzed. Results The univariate linear regression analysis revealed that the donor kidney weight (DKW)/recipient body weight (RBW), DKW/recipient body surface area (RBSA), DKW/recipient body mass index (RBMI), donor kidney volume (DKV)/RBW, DKV/RBSA, DKV/RBMI, and donor body weight (DBW)/RBW were significantly correlated with estimated glomerular filtration rate (eGFR) and serum creatinine in recipients within two years of transplantation. In our multivariate linear regression analysis, DKW/RBW and donor age significantly correlated with eGFR at 6, 12, 18 and 24 months after transplantation. DKW/RBW had the best prediction performance for good renal allograft function at 12 months after transplantation. We found that when the age of the donor was 55 years and above, the prediction performance of the nephron dosing to the recipient's metabolic demands mismatch was elevated. After grouping according to the donor's age and DKW/RBW, the allograft function from different donor ages improved as DKW/RBW increased. The number of recipients who were rejected in the high DKW/RBW group was significantly fewer than those in the low and medium groups the 1, 2, and 3-year graft and patient survival rates were comparable among these groups. Furthermore, we also identified that when the age of the donor was 55 years and above, the threshold of DKW/RBW was 3.09 g/kg via the receiver operating characteristic curve, which predicted a good renal function 12 months after transplantation. Conclusions The donor kidney morphology parameters were significantly associated with early renal allograft function, especially when the age of the donor was 55 years and above.
- Published
- 2020
31. Contrasting effects of B cell depletion on CD4+ and CD8+ memory T cell responses generated after transplantation
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Xianding Wang, Bruno Gonzalez-Nolasco, Gilles Benichou, Jose Marino, and William Orent
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Transplantation ,business.industry ,medicine.medical_treatment ,T cell ,030230 surgery ,Cell biology ,03 medical and health sciences ,Haematopoiesis ,Tolerance induction ,0302 clinical medicine ,medicine.anatomical_structure ,Antigen ,Immunology and Allergy ,Medicine ,Pharmacology (medical) ,business ,Memory T cell ,CD8 ,Allotransplantation - Abstract
Alloreactive memory T cells play a key role in transplantation by accelerating allograft rejection and preventing tolerance induction. Some studies using µMT mice, which are constitutionally devoid of B cells, showed that B cells were required for the generation of memory T cells after allotransplantation. However, whether B cell depletion in normal adult mice has the same effect on memory responses by CD4+ and CD8+ T cells activated after transplantation has not been thoroughly investigated. In this study, we tested the effect of anti-CD20 antibody-mediated B cell depletion on CD4+ and CD8+ memory T cell alloresponses after skin transplantation in wild-type mice. We found that B cell depletion prevented the development of memory alloresponses by CD4+ T cells but enhanced that of CD8+ memory T cells. Next, we tested the influence of B cell depletion on hematopoietic chimerism. In OT-II CD4+ anti-OVA TCR transgenic mice sensitized to ovalbumin antigen, B cell depletion also impaired allospecific memory T cell responses and thereby enhanced donor hematopoietic chimerism and T cell deletion after bone marrow transplantation. This study underscores the complexity of the relationships between B and T cells in the generation and reactivation of different memory T cell subsets after transplantation.
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- 2020
32. Development of nanotechnology in andrology
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Zheng-Ju Ren, Fuxun Zhang, Fan Zhang, Zhihong Liu, Shengzhuo Liu, Dechao Feng, Jiayu Liang, Yiping Lu, Kan Wu, Chuan Zhou, and Xianding Wang
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Andrology ,Applications of nanotechnology ,Engineering ,Reproductive Medicine ,business.industry ,Urology ,Nanotechnology ,Review Article ,business - Abstract
Since first introduced in 1980s, nanotechnology has always been the eye-catching point as its providing us with new approaches to explore the microscopic world. Many nanotechnology-associated novel technologies have been brought into clinical use in the past decades and uncountable patients benefited from them, which convinces us of a bright prospect of nanotechnology in the field of medicine. In this review, literatures concerning nanotechnology applications in andrology were retrieved and we made a comprehensive discussion on drug delivery, gene therapy and stem cell therapy use in andrology, which calls for the engagement of nanotechnology.
- Published
- 2020
33. Efficacy and safety of stratified versus routine prophylaxis in living kidney transplantation from HBsAg+ donors to HBsAg− recipients: protocol for a multicentre, prospective, observational study
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Xianding Wang, Saifu Yin, Turun Song, Zhongli Huang, Yu Fan, Hongtao Liu, Wenjun Shang, Honglan Zhou, Xiaohong Li, and Tao Lin
- Subjects
Infectious Diseases ,virus diseases ,General Medicine ,renal transplantation ,infection control ,digestive system diseases - Abstract
IntroductionIt remains unclear whether kidney transplantation (KT) from hepatitis B surface antigen (HBsAg) +donors to HBsAg− recipients (D(HBsAg+)/R(HBsAg−)) provides comparable transplant outcomes without hepatitis B virus (HBV) transmission compared with D(HBsAg−)/R(HBsAg−) KT. Moreover, no consensus has been reached for standardised prophylaxis regimens to prevent HBV transmission after D(HBsAg+)/R(HBsAg−) KT. We developed stratified prophylaxis regimens, including pretransplant antiviral treatment of donors, and pretransplant hepatitis B vaccination and post-transplant antiviral treatment of recipients, based on donors’ and recipients’ HBV serological characteristics. However, the safety and efficacy of stratified prophylaxis regimens remains unknown.Methods and analysisWe are conducting a prospective, multicentre, observational study. Between September 2020 and December 2023, 100 cases of (D(HBsAg+)/R (HBsAg−)) KT will be recruited from four university-affiliated hospitals with a follow-up at least 2 years. They will naturally receive stratified prophylaxis regimens or routine prophylaxis based on clinical experience to compare the efficacy and safety of these two regimens in (D(HBsAg+)/R(HBsAg−)) KT. The primary outcome will be post-transplant HBV infection to evaluate safety, defined as post-transplant HBsAg−→+or HBV DNA−→+. The composite endpoint of prevention failure will be also an endpoint of safety (any one of HBsAg−→+, HBV DNA−→+, HB e antigen−→+, HB e antibody−→+ and HB c antibody−→+). The efficacy will be evaluated by transplant outcomes, including death-censored graft survival, patient survival, acute rejection, delayed graft function and kidney graft function.Ethics and disseminationThis study will be registered as a clinical audit at each participating hospital and has obtained approval from the Ethics Committee of West China Hospital (reference: 2020-683, 8 September 2020).Trial registration numberNCT04562051.
- Published
- 2021
34. Minimally Invasive Kidney Transplantation Had Better Cosmetic Effect and Comparable Safety: A Randomized Controlled Trial
- Author
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Haohan Zhang, Qiling Tan, Zhongli Huang, Linde Li, Jun Zeng, Yu Fan, Xianding Wang, Tao Lin, and Turun Song
- Subjects
Transplantation ,Postoperative Complications ,Treatment Outcome ,Patient Satisfaction ,Operative Time ,Humans ,Surgery ,Kidney Transplantation - Abstract
To prospectively evaluate short-term outcomes between a novel minimally invasive kidney transplantation (MIKT) technique and conventional kidney transplantation (CKT).From March 2018 to February 29, 2019, 148 patients were randomized into MIKT and CKT groups. All patients were followed up for 12 months.The MIKT group had a significantly shorter incision length (5.6 ± 0.4 vs 11.4 ± 0.4 cm, P.001). There was no difference in operation time, blood loss, acute rejection, infection, and wound dehiscence between MIKT and CKT groups. Both groups had comparable pain scores and analgesic requirements in the first 3 days after transplantation and comparable renal function at 12 months. The MIKT group had higher satisfaction than the CKT group during follow-up (9.3 ± 0.3 vs 8.1 ± 0.5, P.001; 9.5 ± 0.2 vs 8.5 ± 0.3, P.001; 9.4 ± 0.3 vs 8.5 ± 0.3, P.001; 9.2 ± 0.3 vs 8.5 ± 0.4, P = .003 for posttransplant months 1, 3, 6, and 12, respectively). The MIKT group had a significantly lower Vancouver Scar Scale score (4.1 ± 0.4 vs 5.2 ± 0.5, P.001; 4.3 ± 0.4 vs 6.1 ± 0.4, P.001; 5.2 ± 0.6 vs 6.7 ± 0.5, P.001; 7.7 ± 0.7 vs 8.9 ± 0.5, P = .009 for posttransplant months 1, 3, 6, and 12, respectively).MIKT has demonstrated equivalent safety and improved patient satisfaction compared to CKT. This technique may be an appropriate choice for selected patients.
- Published
- 2021
35. Integrated Analysis of Energy Metabolism Signature-Identified Distinct Subtypes of Bladder Urothelial Carcinoma
- Author
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Fan Zhang, Jiayu Liang, Dechao Feng, Shengzhuo Liu, Jiapei Wu, Yongquan Tang, Zhihong Liu, Yiping Lu, Xianding Wang, and Xin Wei
- Subjects
Cell Biology ,Developmental Biology - Abstract
Background: Bladder urothelial carcinoma (BLCA) is the most common type of bladder cancer. In this study, the correlation between the metabolic status and the outcome of patients with BLCA was evaluated using data from the Cancer Genome Atlas and Gene Expression Omnibus datasets.Methods: The clinical and transcriptomic data of patients with BLCA were downloaded from the Cancer Genome Atlas and cBioPortal datasets, and energy metabolism-related gene sets were obtained from the Molecular Signature Database. A consensus clustering algorithm was then conducted to classify the patients into two clusters. Tumor prognosis, clinicopathological features, mutations, functional analysis, ferroptosis status analysis, immune infiltration, immune checkpoint-related gene expression level, chemotherapy resistance, and tumor stem cells were analyzed between clusters. An energy metabolism-related signature was further developed and verified using data from cBioPortal datasets.Results: Two clusters (C1 and C2) were identified using a consensus clustering algorithm based on an energy metabolism-related signature. The patients with subtype C1 had more metabolism-related pathways, different ferroptosis status, higher cancer stem cell scores, higher chemotherapy resistance, and better prognosis. Subtype C2 was characterized by an increased number of advanced BLCA cases and immune-related pathways. Higher immune and stromal scores were also observed for the C2 subtype. A signature containing 16 energy metabolism-related genes was then identified, which can accurately predict the prognosis of patients with BLCA.Conclusion: We found that the energy metabolism-associated subtypes of BLCA are closely related to the immune microenvironment, immune checkpoint-related gene expression, ferroptosis status, CSCs, chemotherapy resistance, prognosis, and progression of BLCA patients. The established energy metabolism-related gene signature was able to predict survival in patients with BLCA.
- Published
- 2021
36. miR-17-5p attenuates kidney ischemia-reperfusion injury by inhibiting the PTEN and BIM pathways
- Author
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Xianding Wang, Turun Song, Ming Ma, Tao Lin, Zihao Jia, Qiang Zhong, Zhongli Huang, Lei Fu, and Yu Fan
- Subjects
Kidney ,biology ,Chemistry ,Autophagy ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Downregulation and upregulation ,Apoptosis ,biology.protein ,Cancer research ,medicine ,PTEN ,Tensin ,Original Article ,Protein kinase B ,Reperfusion injury - Abstract
BACKGROUND: Kidney ischemia-reperfusion (I/R) injury is an independent risk factor for delayed graft function after kidney transplantation with long-term graft survival deterioration. Previously, we found that the upregulated expression of miR-17-5p exerts a protective effect in kidney I/R injury, but the mechanism has not been clearly studied. METHODS: A kidney I/R injury model was induced in adult C57BL/6 male mice (20–22 g) by clamping both kidney pedicles for 30 min. The miR-17-5p agomir complex was injected into mice 24 h before surgery via the tail vein at a total injection volume of 10 µL/g body weight. The mice were euthanized on post-I/R injury day 2, and kidney function, apoptosis, autophagy, and related molecules were then detected. Human kidney-2 (HK-2) cells, which underwent hypoxia/reoxygenation, were treated with the miR-17-5p agomir, miR-17-5p antagomir, and small interfering ribonucleic acids (siRNAs). Cell viability, apoptosis, autophagy, and molecules were also examined. RESULTS: Autophagy, miR-17-5p expression, and kidney function damage were significantly more increased in the I/R group than in the sham group. In the cultured HK-2 cells underwent hypoxia/reoxygenation, the miR-17-5p agomir directly inhibited the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and Bcl-2 like protein 11 (BIM), and attenuated apoptosis and autophagy. Further, miR-17-5p inhibited autophagy by activating the protein kinase B (Akt)/Beclin1 pathway, which was suppressed by siRNAs. Additionally, the administration of miR-17-5p agomir greatly improved kidney function in the I/R mice group by inhibiting autophagy and apoptosis. CONCLUSIONS: These findings suggest a new possible therapeutic strategy for the prevention and treatment of kidney I/R injury. The upregulation of miR-17-5p expression appears to inhibit apoptosis and autophagy by suppressing PTEN and BIM expression, which in turn upregulates downstream Akt/Beclin1 expression.
- Published
- 2021
37. Tacrolimus variability score outperforms coefficient of variation in predicting clinical outcomes of living kidney transplantation
- Author
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Xianding Wang, Tao Lin, Yu Fan, Turun Song, Saifu Yin, and Zhongli Huang
- Subjects
Graft Rejection ,Multivariate statistics ,medicine.medical_specialty ,Multivariate analysis ,Coefficient of variation ,Urology ,030226 pharmacology & pharmacy ,Tacrolimus ,Correlation ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Kidney transplantation ,Retrospective Studies ,Pharmacology ,Univariate analysis ,business.industry ,Hazard ratio ,Graft Survival ,medicine.disease ,Kidney Transplantation ,Confidence interval ,business ,Immunosuppressive Agents - Abstract
Intrapatient variability (IPV) was previously defined as coefficient of variation (CV) or standard deviation of tacrolimus (Tac) exposure while none of them was easily being interpreted and translated into clinical practice after kidney transplantation.We developed a novel Tac variability score (TVS) to evaluate IPV by calculating the frequency of clinically significant changes of Tac trough levels after kidney transplantation. Multivariate Cox proportional analyses were conducted to compare the impact of TVS and CV on transplant outcomes.A total of 1343 patients were divided into high TVS (0.30) and low TVS (0.30) groups, and low CV (0.30) and high CV (0.30) groups. Univariate analyses showed that high TVS (hazard ratio [HR]: 2.323, 95% confidence interval [CI]: 1.455-3.709) and high CV (HR: 1.606, 95%CI: 1.044-2.471) were associated with inferior graft survival. However, only TVS was an independent predictor for graft failure in multivariate analyses (HR: 1.972, 95%CI: 1.2-3.24), and the correlation maintained in high CV (P = .020) and low CV (P = .037) subgroups, while CV failed to predict graft loss in neither low (P = .387) nor high TVS (P = .600) subgroups. In addition, TVS had a higher correlation with graft survival in patients with Tac exposure within the therapeutic range and the correlation was less influenced by mean Tac trough levels.TVS is a novel measure of Tac IPV with higher correlation with graft survival and more convenience in clinical use than CV after kidney transplantation.
- Published
- 2021
38. A comprehensive study of risk factors for post-operative pneumonia following resection of meningioma
- Author
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Yuling Liu, Yufan Xiang, Man Li, Mingrong Zuo, Qing Mao, Yiliang Yang, Xianding Wang, Shangfu Zhang, and Ruofei Liang
- Subjects
Adult ,Erythrocyte Indices ,Male ,0301 basic medicine ,China ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,Blood transfusion ,genetic structures ,Neutrophils ,medicine.medical_treatment ,lcsh:RC254-282 ,Resection ,Meningioma ,Leukocyte Count ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,Meningeal Neoplasms ,Genetics ,medicine ,Humans ,Post-operative pneumonia ,Lymphocytes ,Post operative ,Aged ,Retrospective Studies ,Systemic complication ,business.industry ,Pneumonia ,Middle Aged ,medicine.disease ,Hematological indicators ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,030104 developmental biology ,Oncology ,Risk factors ,030220 oncology & carcinogenesis ,Preoperative Period ,Regression Analysis ,Female ,business ,Biomarkers ,Research Article - Abstract
Background Post-operative pneumonia (Pop) following meningioma surgery is the dominant systemic complication which could cause serious threats to patients. It is unclear whether hematological biochemical markers are independently associated with the Pop. This study attempted to perform a more comprehensive study of taking both clinical factors and hematological biomarkers into account to promote the management of patients after meningioma surgery. Methods We collected clinical and hematological parameters of 1156 patients undergoing meningioma resection from January 2009 to January 2013. According to whether the symptoms of pneumonia had manifested,patients were divided into the Pop group and the Non-Pop group. We analyzed the distinctions of clinical factors between the two groups. We successively performed univariate and multivariate regression analysis to identify risk factors independently associated with the Pop. Results 4.4% patients infected with the Pop (51 of 1156). The median age at diagnosis of the Pop patients was significantly older than the Non-Pop group (p = 0.002). There were strike distinctions of post-operative hospital stays between two groups, with 21 days and 7 days each (p
- Published
- 2019
39. Protective effect of bone marrow mesenchymal stem cells modified with klotho on renal ischemia-reperfusion injury
- Author
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Xi Chen, Rui Jiang, Yiping Lu, Xianding Wang, Bo Chen, and Li-Bo Xie
- Subjects
Male ,klotho ,030232 urology & nephrology ,FOXO1 ,030204 cardiovascular system & hematology ,Kidney ,Critical Care and Intensive Care Medicine ,urologic and male genital diseases ,Rats, Sprague-Dawley ,0302 clinical medicine ,Laboratory Study ,Medicine ,Cell Engineering ,Renal ischemia reperfusion ,Klotho ,Glucuronidase ,hemic and immune systems ,General Medicine ,Transfection ,Up-Regulation ,Treatment Outcome ,Nephrology ,Reperfusion Injury ,hormones, hormone substitutes, and hormone antagonists ,Signal Transduction ,renal ischemia-reperfusion injury ,gene transfection ,Down-Regulation ,Nerve Tissue Proteins ,Mesenchymal Stem Cell Transplantation ,Bone marrow mesenchymal stem cells ,Cell Line ,03 medical and health sciences ,stomatognathic system ,Animals ,Humans ,Klotho Proteins ,Superoxide Dismutase ,business.industry ,bone marrow mesenchymal stem cells ,Mesenchymal Stem Cells ,Coculture Techniques ,Diseases of the genitourinary system. Urology ,Rats ,Disease Models, Animal ,Cancer research ,foxo1 ,RC870-923 ,business - Abstract
Objective: To detect the combination protective effect of bone marrow mesenchymal stem cells (BMSCs) and Klotho gene on the renal ischemia-reperfusion injury (RIRI). Methods: BMSCs isolated from rats were transfected with Klotho gene to form BMSCKl. We injected BMSCKl to allogenic rat RIRI model. After 24 h and 72 h, we detected the serum creatinine (SCr), malondialdehyde (MDA), and superoxide dismutase (SOD) in renal tissue, Hematoxylin-eosin (HE) staining, and TUNEL of renal pathology. The expression of FoxO1 and p-FoxO1 in post-hypoxia tubular epithelial cells of normal rat kidney (NRK-52E) were detected by Western blot after cocultured with BMSCKl. Results: Comparing with BMSCCon group, Rats in BMSCKl group had lower SCr and MDA but higher SOD. Both HE and TUNEL score of renal tissue in BMSCKl group were lower than that of BMSCCon group. Western blot indicated that FoxO1 was upregulated, while p-FoxO1 was downregulated in post-hypoxia NRK-52E cells. Conclusions: BMSCs transfected with Klotho gene can further ameliorate RIRI. The possible mechanism may be attributed to the upregulation of SOD in NRK-52E caused by Klotho-FoxO1 axis.
- Published
- 2019
40. Risk factors for rejection after deceased donor kidney transplantation: a mono-institutional analysis of paired kidneys
- Author
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Changjing Wu, Jiayu Liang, Kan Wu, Fan Zhang, Yiping Lu, Yang Xiong, Zhihong Liu, Fuxun Zhang, Tao Lin, and Xianding Wang
- Subjects
Deceased donor kidney ,Transplantation ,medicine.medical_specialty ,Text mining ,business.industry ,Internal medicine ,Medicine ,business - Abstract
Background Deceased donor kidney transplantation is an important therapeutic option for end-stage renal diseases. Adverse events including acute rejection after deceased donor kidney transplantation are not uncommon and result in poor transplant outcomes. Exploration of risk factors and patient stratification is increasingly significant to improve graft survival. This study aim to evaluate and identify the risk factors for treated rejection of patients after deceased donor kidney transplantation. Methods Clinical and immunological data of deceased donors and corresponding recipients between 2015 and 2018 in West China Hospital were retrospectively collected. The Kolmogorov-Smirnov test was used to indicate distribution of variables. Univariate comparisons of baseline characteristics were made with Chi-square, t and Mann-Whitney U tests. Logistic regression was constructed to analysis potential risk factors. Receiver operating characteristic curve and Jordan index were generated to determine optimal cut-off value for continuous variables. Results Data of 123 deceased donors and 246 recipients were obtained. The median (range) age was 41(4–62) years in recipients and 39 (1–65) years in donors. The recipients who died or suffered graft loss during the follow-up period were 8 (3.3%) and 12 (4.9%) respectively. After univariate analysis and subsequent multivariate analysis, some preoperative hemato-biochemical and transplantation-related parameters including uric acid (HR 2.132, 95%CI: 1.016–4.476, P = 0.045), platelet (HR 2.202, 95%CI:1.051–4.617, P = 0.037), absolute neutrophil count (HR 2.164, 95%CI:1.018–4.599, P = 0.045) and HLA-DQ mismatch (HR 2.197, 95%CI:1.119–4.317, P = 0.022) showed statistical significance and could be considered as independent predictors for treated rejection. Conclusions Including unexpected serum uric acid, several hemato-biochemical and transplantation-related parameters were found to be independent risk factors for rejection, which may contribute to stratify patients and develop personalized regimen in perioperative period.
- Published
- 2021
41. Interferon-Gamma Releasing Assay is Predictive in Active Tuberculosis Infection in Kidney Recipients and Guides Precise Prophylaxis
- Author
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Jun Zeng, Daiwen Zhu, Haohan Zhang, Qiang Zhong, Yu Fan, Zhongli Huang, Xianding Wang, Tao Lin, and Turun Song
- Subjects
History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2021
42. FOXM1 Promotes Tumor Progression by Targeting CDCA5 in Adrenocortical Carcinoma
- Author
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Shengzhuo Liu, Jiayu Liang, Xianding Wang, Zhihong Liu, Chi Zhang, Xinmiao Zhou, Fan Zhang, Kan Wu, Kaiyuan Niu, Fuxun Zhang, Yiping Lu, and Yuchun Zhu
- Subjects
History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2021
43. Benefit of Postoperative Radiotherapy for Patients With Nonmetastatic Adrenocortical Carcinoma: A Population-Based Analysis
- Author
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Kan Wu, Xu Liu, Zhihong Liu, Yiping Lu, Xianding Wang, and Xiang Li
- Subjects
Survival Rate ,Oncology ,Adrenocortical Carcinoma ,Humans ,Radiotherapy, Adjuvant ,behavioral disciplines and activities ,Adrenal Cortex Neoplasms ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies - Abstract
Background: Adrenocortical carcinoma (ACC) is an aggressive cancer with high recurrence rates and poor prognosis, even after radical surgery. The survival benefit of adjuvant radiotherapy (RT) in patients with ACC has not been well explored. The aim of this study was to evaluate the effect of adjuvant RT on the survival outcome of patients with ACC. Patients and Methods: All patients with nonmetastatic ACC who underwent complete resection were identified from the SEER database (2004–2016). Overall survival (OS) was estimated using the Kaplan-Meier method. Multivariable Cox regression analysis was performed to identify prognostic factors associated with survival. Results: Of 365 patients with nonmetastatic ACC, 55 (15.1%) received adjuvant RT and the remainder underwent surgery alone. Patient characteristics were similar between the 2 groups, but those with a higher disease stage were more likely to receive adjuvant RT. Overall, patients receiving RT seemed to have better survival compared with the non-RT group (3-year OS rate, 63.1% vs 52.8%; PP=.023) for all patients. In addition, adjuvant RT may confer a survival benefit only in patients with a high risk of recurrence (3-year OS rate, 55.1% vs 40.0%; P=.048) rather than in those with low/moderate-risk ACC (P=.559). Conclusions: Our findings suggest that adjuvant RT may be associated with improved survival in patients with nonmetastatic ACC who underwent radical surgery, especially those with high risk of recurrence.
- Published
- 2020
44. Pre-Transplant Donor HBV DNA+ and Male Recipient are Independent Risk Factors for Treatment Failure in HBsAg+ Donors to HBsAg- Kidney Transplant Recipients
- Author
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Xianding Wang, Shijian Feng, Jinpeng Liu, Turun Song, Zhongli Huang, Yu Fan, Yunying Shi, Liyu Chen, Zilin Xu, Xiaohong Li, Li Wang, and Tao Lin
- Subjects
virus diseases ,digestive system diseases - Abstract
Background: In order to lighten the burden of organ shortage around the world, using potential infectious donor might be an option. However, scarce evidences have been published on Kidney transplantation (KTx) from hepatitis B surface antigen (HBsAg)+ donors to HBsAg- recipients [D(HBsAg+)/R(HBsAg-)] without hepatitis B virus (HBV) immunity. Here, we reported the results of D(HBsAg+/HBV DNA- or +)/R(HBsAg-) living KTx recipients with or without HBV immunity.Methods: We retrospectively identified 83 D(HBsAg+)/R(HBsAg-) living KTx recipients, and 83 hepatitis B core antibody (HBcAb)+ living donors to HBcAb- recipients [D(HBcAb+)/R(HBcAb-)] were used as control group by reviewing medical archives and propensity score matching. Treatment failure (defined as any HBV serology conversion, liver injury, graft loss, or recipient death) is the primary end-point.Results: 24 donors (28.9%) were HBV DNA+, and 20 recipients had no HBV immunity in the D(HBsAg+)/R(HBsAg-) group pre-transplantation. HBV prophylaxis was applied in all D(HBsAg+)/R(HBsAg-) recipients, however, we did not use any in D(HBcAb+)/R(HBcAb-) group. We observed a significant higher treatment failure in D(HBsAg+)/R(HBsAg-) than D(HBcAb+)/R(HBcAb-) group (21.7% vs. 10.8%, PConclusion: D(HBsAg+)/R(HBsAg-) should be considered for living kidney transplantation, but with extra caution on donor with HBV DNA+ and male candidates.
- Published
- 2020
45. Highly individual- and tissue-specific expression of glycoprotein group A and B blood antigens in the human kidney and liver
- Author
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Yu Fan, Xiaobing Feng, Fan Zhang, Xianding Wang, Linde Li, Zilin Xu, Tao Lin, Yamei Jiang, Zhongli Huang, Yunying Shi, and Turun Song
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Immunology ,Blood group antigen ,Western blot ,Kidney ,ABO Blood-Group System ,Young Adult ,Renal Artery ,Sex Factors ,Antigen ,Species Specificity ,ABO blood group system ,medicine.artery ,medicine ,Humans ,Renal artery ,Vein ,ABO-incompatible transplantation ,business.industry ,Research ,Age Factors ,Organ Transplantation ,RC581-607 ,Transplantation ,ABO incompatible transplantation ,medicine.anatomical_structure ,Treatment Outcome ,Liver ,Organ Specificity ,Histocompatibility ,Immunologic diseases. Allergy ,Renal vein ,business - Abstract
Background Currently, research on the quantitative distribution of ABO antigens in different organs and tissues remains limited. We aimed to examine the individual characteristics of blood group glycoprotein A and B antigen expression in human kidneys and livers. Methods We obtained human samples, including the renal artery, renal vein, renal tissue, hepatic artery, hepatic vein, portal vein, and hepatic tissue, from 24 deceased organ transplant donors. The expression of the blood group antigens glycoprotein A and B was analysed and compared by Western blotting. Results There was no significant difference in the expression between blood group glycoprotein A and B antigens at any of the seven sites (p > 0.05). The expression of both A and B antigens was highest in renal tissue and the portal vein and was lowest in the renal artery. A large difference in glycoprotein antigen expression was observed among various donors or different regions of the same individual. Univariate analysis revealed that glycoprotein A/B antigens were affected by the age and sex of donors and were significantly higher in males and in young people. Conclusions Our study found that blood group glycoprotein antigen expression showed certain trends and distinct distribution in the kidney, liver, and vessels among individuals and in different regions of the same individual, which may explain the different clinical outcomes of patients who received ABO-incompatible transplantation.
- Published
- 2020
46. Association between reduced preoperative serum albumin and prognosis in patients with adrenocortical carcinoma after primary resection: A retrospective study
- Author
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Fuxun Zhang, Zhihong Liu, Jiayu Liang, Shengzhuo Liu, Kan Wu, Fan Zhang, Chuan Zhou, Yiping Lu, Yuchun Zhu, and Xianding Wang
- Abstract
Purpose To assess the correlation between preoperative serum albumin level and prognosis in patients with adrenocortical carcinoma after primary surgery. Methods We reviewed medical information of 71 included patients with diagnosis of ACC who underwent primary resection. Univariate and multivariate analysis were performed using Cox’s proportional hazards model. Survival analysis was conducted by Kaplan–Meier method with log-rank test. Receiver operating characteristic (ROC) curve and Jordan index were generated to explore cut-off value for serum albumin. Statistical significance was defined as P
- Published
- 2020
47. Extravasation of Urine Into the Superficial Perineal Space Due to Ureteral Necrosis after Kidney Transplantation: A Case Report
- Author
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Turun Song, Qiang Zhong, Zhongli Huang, Xianding Wang, Tao Lin, and Yu Fan
- Subjects
medicine.medical_specialty ,surgical procedures, operative ,Necrosis ,Extravasation of urine ,business.industry ,medicine ,Urology ,medicine.symptom ,medicine.disease ,Superficial perineal space ,business ,Kidney transplantation - Abstract
Background: Urinary fistula is a common complication of kidney transplantation. It may cause severe complications like graft loss and patient death.Case presentation: Here we present a recipient who developed graft ureteral necrosis with leakage of urine into the superficial perineal space but not into the peri-graft or the retroperitoneal space, as an unusual clinical feature. This may be due to dense adhesions in the peri-graft region and dam-like effect of adhesive spermatic cord and inferior epigastric vessels traversing across the graft ureter. Urine leaking out with high pressure extravasates through the potential gaps in the incision of aponeurosis at the lateral margin of the rectus abdominis and into the superficial perineal space. The proximal ureter of the graft was end-to-end anastomosed to the right ureter. Both the recipient and graft recovered well.Conclusions: Comparing the creatinine levels in the leaking fluid and serum is an effective way to confirm urinary fistula. Early aggressive management is a rational option for treatment of urinary fistula.
- Published
- 2020
48. Operative intervention for recurrence of adrenocortical carcinoma: A single-center experience
- Author
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Shenzhuo Liu, Zhihong Liu, Yongquan Tang, Xianding Wang, Kan Wu, Chuan Zhou, Fan Zhang, Jiayu Liang, Fuxun Zhang, and Yiping Lu
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,China ,Adolescent ,030230 surgery ,Malignancy ,Single Center ,Complete resection ,Resection ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,medicine ,Adrenocortical Carcinoma ,Adrenocortical carcinoma ,Humans ,In patient ,Child ,Aged ,Retrospective Studies ,business.industry ,Proportional hazards model ,Adrenalectomy ,Middle Aged ,medicine.disease ,Primary tumor ,Adrenal Cortex Neoplasms ,Surgery ,030220 oncology & carcinogenesis ,Child, Preschool ,Female ,Neoplasm Recurrence, Local ,business - Abstract
Introduction Adrenocortical carcinoma is a rare endocrine malignancy with a high recurrence rate. The aim of this study was to evaluate the role of surgery for patients with local or distant recurrent adrenocortical carcinoma and to attempt to identify prognostic features related to survival benefit in patients undergoing resection of recurrence. Methods The data of 47 patients with recurrent adrenocortical carcinoma in West China Hospital, Sichuan, China, between 2009 and 2019 were retrospectively collected. These patients were divided into 2 groups according to whether resection of recurrence was performed. The correlation between overall survival after recurrence and reoperation was evaluated. Kaplan-Meier and univariate/multivariate Cox regression methods were used to identify any prognostic factors. Results Included in our study were 21 patients who underwent reoperation and 26 patients who underwent nonoperative treatments were. The operation group had a better median overall survival after recurrence than the nonoperation group (19 months versus 6.5 months; P = .007). In the operated group, disease-free interval >12 months (P = .002), complete resection of recurrent adrenocortical carcinoma (P = .041), and R0 resection of the primary tumor (P = .005) were associated with prolonged survival after recurrence. Conclusions Reoperation plays an important role in the management of selected patients with recurrent adrenocortical carcinoma. Disease-free interval, preoperative evaluation for complete resection, and R0 resection of the primary tumor are important prognostic characteristics for the resection of recurrent adrenocortical carcinoma. The overall survival after recurrence was significantly improved for patients who had a disease-free interval >12 months, and initial R0 resection or complete resection of recurrent adrenocortical carcinoma is feasible.
- Published
- 2020
49. P1674KIDNEY TRANSPLANTATION FROM HBSAG+ LIVING DONORS TO HBSAG- RECIPIENTS: CLINICAL OUTCOMES AT A HIGH-VOLUME CENTER
- Author
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Tao Lin, Jinpeng Liu, and Xianding Wang
- Subjects
Hepatitis B virus ,Transplantation ,medicine.medical_specialty ,HBsAg ,business.industry ,Treatment outcome ,virus diseases ,Hepatitis B ,medicine.disease ,medicine.disease_cause ,Graft loss ,Hepatitis b surface antigen ,digestive system diseases ,Hepatitis b core antibody ,Nephrology ,Internal medicine ,medicine ,business - Abstract
Background and Aims Data on kidney transplantation (KTx) from hepatitis B surface antigen (HBsAg)+ donors to HBsAg- recipients [D(HBsAg+)/R(HBsAg-)] are limited. We aimed to report the outcomes of D(HBsAg+)/R(HBsAg-) KTx in recipients with or without hepatitis B surface antibody (HBsAb). Method Eighty-three D(HBsAg+)/R(HBsAg-) living KTx cases were retrospectively identified. The 384 cases of KTx from hepatitis B core antibody (HBcAb)+ living donors to HBcAb- recipients [D(HBcAb+)/R(HBcAb-)] were used as the control group. Primary endpoint was post-transplant HBsAg -→+. Results Before KTx, 24 donors (28.9%) in the D(HBsAg+)/R(HBsAg-) group were hepatitis B virus (HBV) DNA+, and 20 recipients were HBsAb-. All eighty-three D(HBsAg+)/R(HBsAg-) recipients received HBV prophylaxis, while no D(HBcAb+)/R(HBcAb-) recipients received prophylaxis. After a median follow-up of 36 months (range 6-106) and 36 months (range 4-107) for the D(HBsAg+)/R(HBsAg-) and D(HBcAb+)/R(HBcAb-) groups, respectively, 2/83 (2.41%) D(HBsAg+)/R(HBsAg-) recipients and 1/384 (0.26%) D(HBcAb+)/R(HBcAb-) became HBsAg+, accompanied with HBV DNA+ (P=0.083). The three recipients with HBsAg-→+ were exclusively HBsAb-/HBcAb- before KTx. Recipient deaths were more frequent in the D(HBsAg+)/R(HBsAg-) group (6.02% vs. 1.04%, P=0.011), while liver and graft function, rejection, infection, and graft loss were not significantly different. In univariate analyses, pre-transplant HBsAb-/HBcAb- combination in the D(HBsAg+)/R(HBsAg-) recipients carried a significantly higher risk of HBsAg-→+, HBV DNA-→+, and death. Conclusion Living D(HBsAg+)/R(HBsAg-) KTx in HBsAb+ recipients provides excellent graft and patient survivals without HBV transmission. HBV transmission risks should be more balanced with respect to benefits of D(HBsAg+)/R(HBsAg-) KTx in HBsAb-/HBcAb- candidates.
- Published
- 2020
50. P1709THE ROLE OF CXCL9 AND CXCL13 IN PREDICTION OF POSTTRANSPLANT INFECTION IN KIDNEY TRANSPLANT RECIPIENTS
- Author
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Lin Yan, Lanlan Wang, Yunying Shi, Xianding Wang, Yi Li, Yamei Li, and Yangjuan Bai
- Subjects
Transplantation ,medicine.medical_specialty ,Nephrology ,business.industry ,Internal medicine ,Posttransplant infection ,medicine ,CXCL9 ,CXCL13 ,business ,Kidney transplant ,Gastroenterology - Abstract
Background and Aims Chemokines are deeply involved in the process of inflammatory and immune responses. Interferon-γ-inducible chemokines C-X-C motif chemokine 9 and 10 (CXCL9 and CXCL10) are significantly associated with Th1 cells and monocytes and rise rapidly during early episode of renal allograft rejection and various infectious diseases. CXCL13 is one of the most potent B cells and T follicular helper (Tfh) cells chemoattractants when acts through its cognate receptor CXCR5. Recent work of CXCL13 indicated a critical immune regulatory role in both multiple infectious diseases and kidney transplantation. Additionally, C-C motif chemokine 2 (CCL2) is shown to be is critical for chronic kidney diseases. The aim of this study was to identify the predictive role of serum CXCL9, CXCL10, CXCL13 or CCL2 on kidney posttransplant infection. Method 95 kidney transplant recipients (KTRs) were enrolled in this study. 31 recipients experienced at least once infection episodes within the first posttransplant 12 months and 64 KTRs did not experience any infection episode during the follow-up period. Serum CXCL9, CXCL10, CXCL13 and CCL2 at the time points of pre-transplantation and post-transplant 30 days (POD 30) were analyzed with Bio-Plex® suspension array system. Results It was found that serum level of POD 30 CXCL9 and POD 30 CXCL13 was associated with infection within one year after transplantation (P=0.021, P=0.002, respectively, shown in Figure 1). The serum level of CXCL9 and CXCL13 before surgery, the serum level of CCL2 and CXCL10 before and after surgery were not associated with infection within posttransplant one year (P>0.05, shown in Figure 1). The combination of POD 30 CXCL9 plus POD 30 CXCL13 provided the best results with AUC of 0.721 (95%CI, 0.591-0.852), sensitivity of 71.4% and specificity of 68.5% at the optimal cut-off value of 52.72 pg/ml (shown in Figure 2). Conclusion Chemokines CXCL9 and CXCL13 as important chemokines could be used to predict the occurrence of infection within posttransplant one year in kidney transplant recipients.
- Published
- 2020
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