Journal of the Chinese Medical Association : JCMA
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Chronic graft-versus-host disease (cGVHD) is one of the most frequent and serious complications of allogeneic hematopoietic stem cell transplantation (HSCT). Nephrotic syndrome (NS) is an uncommon and underrecognized manifestation of cGVHD. We report a patient who developed NS 18 months after allogeneic bone marrow transplantation. ⋯ Monitoring of renal parameters, especially proteinuria, is important in cGVHD patients. Our case indicated that post-transplant NS, occurring without history of tapering or following immunosuppressant withdrawal, presents a more severe activity of cGVHD and a relatively severe clinical course. IVIG may modify and control the refractory GVHD-related NS, and can be one of the choices of treatment.
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Three ghrelin gene-derived peptides, acyl ghrelin, des-acyl ghrelin and obestatin, are implicated in the regulation of feeding, adipogenesis and glucose metabolism, as well as gut motility. The effects of ghrelin gene-derived peptides on lower esophageal sphincter motility, however, were unknown. ⋯ Since the contractile effects of carbachol and relaxant responses of papaverine on the lower esophageal sphincter were confirmed, our results demonstrate that acyl ghrelin, des-acyl ghrelin and obestatin have no direct effects on rat lower esophageal sphincter motility in vitro.