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Zhao H.-Q.,Chinese Peoples Liberation Army | Liu H.-R.,Chinese Peoples Liberation Army | Xiao L.,Military Organ Transplantation Center | Zheng F.,Chinese Peoples Liberation Army | Li W.-M.,Chinese Peoples Liberation Army
Aging Clinical and Experimental Research

Objective: We sought to investigate the impact of laparoscopic cholecystectomy (LC) on the inflammatory response and immunological function of elderly patients compared with that on the younger ones. Methods: Between June 2012 and June 2013, this prospective study investigated a total of 112 patients having the surgery of LC due to symptomatic cholelithiasis or polyps, among whom 52 were elderly patients with the age beyond 65 years old and the remaining 60 were younger than the age. Peripheral venous blood samples were taken from these patients prior to surgery and on post-operative days 1, 3 and 7, respectively. The perioperative clinical outcomes and immunological function results were analyzed and compared between the two groups divided by age. Results: The demographics of the two groups did not differ except for the age. Surgical trauma seemed more serious for elderly patients as illustrated by the longer operating time, hospital stay and more quantity of patients got complication. Both groups indicated changes in inflammatory and immune aspects. Compared with the younger ones, elderly patients showed less quantity of preoperative basic immune cells, delayed immune responses after the surgical trauma of LC and hyporeactivity of inflammatory response when accepting LC. Conclusions: An examination of the inflammatory reaction and immune response after LC demonstrated that there are significant differences observed in two groups divided by age. Further studies with more samples are required to determine the exact relationship of perioperative immune change and higher adverse outcome rate of aged people. © 2015, Springer International Publishing Switzerland. Source

Zhan S.-L.,Military Organ Transplantation Center | Ming C.,Military Organ Transplantation Center | Shi B.-Y.,Military Organ Transplantation Center | Li Z.-L.,Military Organ Transplantation Center | And 4 more authors.
Journal of Clinical Rehabilitative Tissue Engineering Research

BACKGROUND: Removal of immunosuppressants in patients with recurrent tumor in long-term following organ transplantation is always a hot controversial point in academic circles. To further elevate clinical efficiency, people began to invent new immunosuppressant and studied immune efficiency of various immunosuppressant component. They tried to reduce the application of cyclosporin A (CsA). OBJECTIVE: To analyze the CsA safe withdrawal of a case of kidney recipients, at 18 years after renal transplantation, who developed bladder carcinoma and renal pelvic carcinoma at 11 years and 18 years after transplantation, respectively. METHODS: After identified diagnosis, we performed transurethral resection of bladder tumor (TURBt) and total nephro-ureterectomy merobladder excision. Pathologic examination revealed grade I -II of bladder and renal pelvic transitional cell carcinoma. After the operation, patient was treated with immune suppression program of CsA withdrawal gradually in 12 days. Within 12 days, 5 mg CsA was decreased every 3 days, and complete withdrawal was done at 12 days. The dosage of azathioprine tablets and prednisone acetate tablets was not changed. Serum creatinine levels were rechecked every 3 days during drug withdrawal, and blood pressure, urine volume, physical symptom of patients and ultrasound of transplanted kidney were observed. RESULTS AND CONCLUSION: During the three months of CsA withdrawal, the blood creatinine levels were from 65 to 70 μmol/L; urinary volume was 2 500-3 000 mL every day. There was no acute rejection or tumor relapse, diversion. These indicated that the CsA gradually withdrawal of a case of kidney recipients after renal transplantation, who developed transitional cell carcinoma and was performed transurethral resection of bladder tumor (TURBt) and total nephro-ureterectomy merobladder excision, was safe. No tumor relapse or diversion was found. Source

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