Objective To investigate the expression of human leukocyte antigen-G5 (HLA-G5) in healthy Chinese people and the recipients of renal and liver transplantation. The regulating mechanism of the expression of HLA-G5 was discussed by comparing the expression of HLA-G5 in the healthy people with that in renal and liver transplantation recipients. Furthermore, the changing regularity with time was studied by kinesis supervising the expression of HLA-G5 in renal and liver transplantation recipients. Methods The peripheral blood samples (3ml) from 30 health people, 50 recipients of liver transplantation (liver function was stable 3 months after liver transplantation) and 50 recipients of renal transplantation (renal function was stable 3 months after renal transplantation) were collected. Peripheral blood samples were also collected in same amount from 33 recipients of renal and liver transplantation before operation and 1, 4 and 12 weeks and 1 year after operation. The HLA-G5 of all serum samples was analyzed by ELISA. Results For 30 healthy people, the OD value of HLA-G5 in 28 people was below 0.5, for which the contents were defined as 0.0ng/ml according to standard and the contents for the other 2 people were 8ng/ml and 9ng/ml, respectively. 16 of 50 recipients undergone liver transplantation were positive for the expression of HLA-G5, the positive ratio was 32%. The contents in 4 recipients were higher than 30ng/ml. 10 of 50 recipients of renal transplantation were positive in the expression of HLA-G5, the positive ratio was 20%. The contents in one recipient were higher than 25ng/ml. The average contents in sera of healthy people, recipients of liver or renal transplantation were 0.56?0.20ng/ml, 8.34?1.50ng/ml and 3.26?0.25ng/ml, respectively. For 33 recipients of liver or renal transplantation, the expression of HLA-G5 was detected by ELISA, and it was found that one recipient the expression of HLA-G5 was positive before operation and within 1 week after operation; expression of HLA-G5 was positive in 4 recipients within 4 weeks after operation; expression of HLA-G5 was positive within 12 weeks after operation in 12 recipients; and the expression of HLA-G5 was positive within 1 year after operation in 11 recipients. Conclusion The expression of HLA-G5 in healthy people is low. There are correlation between the expression of HLA-G5 and immunotolerance to transplants. In minor rejection condition after transplantation, there are different expression levels of HLA-G5, and it is higher after liver transplantation than!renal transplantation. The time for expression of HLA-G5 corresponds with the time for mRNA of HLA-G5 transcription into protein, and it is about 15-60 days, with 60 days as the peak time.

Objective Based on the detection of soluble leukocyte-associated immunoglobulin-like recepter-1 (sLAIR-1) in the serum of the recipient after transplantation, the role of sLAIR-1 in graft rejection was analyzed. Methods Serum sLAIR-1 level was determined by double mAb sandwich enzyme linked immunosorbent assay (ELISA) in 20 healthy volunteers and 162 patients of liver or kidney transplantation, and the results were analyzed and compared. Results In the healthy volunteers and 98 recipients with normal graft function, the sLAIR-1 were detected at the low levels of 4.3?2.3?g/L and 6.3?3.7?g/L, which showed no significant difference (P=0.054). In the 6 cases of acute rejection of liver transplantation, 20 cases of acute rejection of renal transplantation, and 5 cases of graft loss, serum sLAIR-1 was found to be increased remarkably to high levels of 47.2?35.9, 36.3?14.7 and 28.8?19.4?g/L, and they had significant differences compared with that of the healthy volunteers and with the recipients with normal graft function (P

To study the interrelationship between serum sPTA1 level and actue allograft rejection in renal transplantation, solid-phase lig-and ELISA method was used to analyze serum sPTAl level in renal transplantation. Five out of 19 patients after renal transplantation were confirmed haying actue allograft rejection by pathologic examination. The level of serum sPTA1 increased remarkably and the change in serum sP-TA1 level occurred earlier than appearance of clinical symptoms and in histopathologic manifestation. It decreased rapidly after enhancement of immune therapy. The allografts did not show any signs of acute rejection by clinic symptom and/or histopathology until the activation reached to a certain level. Therefore, the level of serum sPFA1 is a credibable guideline to recognize and monitor allograft renal transplantation. Its result is consistent with that of histopathological examination.

To investigate expression of the novel membrane molecule p140 on activated T cell in patients after renal transplantation, im-munofluoescence staining and FCM analysis were utilized to monitor the expression of p140, and transplanted renal biopsy was employed to confirm acute allograft rejection. p140 is a transplantion antigen-induced molecule on activated T cells. It expresses weakly on T cells in patients after renal transplantation, but expresses remarkably during actue allograft rejection.

Objective To study the effect of basiliximab,an anti-IL-2R monoclonal antibody,on the prevention of acute rejection and promoting graft survival in renal allograft recipients.Methods Published literature regarding the effects of basiliximab used for the prevention of acute rejection and promoting renal graft survival was reviewed,and Meta analysis was employed to analyze the results.Odds ratio(OR)and its 95% confidence interval(95%CI)were used as the parameters to evaluate the therapeutic effects.The statistical analyses were performed with RevMan 4.2 software.Results A total of 13 pertinent research articles were reviewed,including 2 papers written by Chinese authors and 11 by foreign authors.Meta-analysis of pooled results indicated that basiliximab prevented the recipients of kidney transplantation from acute rejection effectively with half-year prevention of OR 0.49 and 95%CI 0.28-0.87(P=0.01),and one-year prevention of OR 0.48,95%CI 0.35-0.65(P

Objective To observe the therapeutic effect of folic acid on transient ischemic attack(TIA)patients with homocysteinaemia (Hcy ). Methods 129 patients of primary TIA with Hcy were divided into two groups randomly. The observation group ( n = 65 )was administered with conventional therapy and folic acid, and the control group ( n=64 ) was only given conventional therapy. The variances of the plasma HCA level three months later were compared, and remission rate of TIA and complete stroke incidence one year later were analyzed between two groups. Results The Hcy incidence rate of TIA patients was up to 41.4%. Three months later, the plasma HCA level of observation group was lower than control group( ( 14.27 ± 6. 13 ) μmol/L vs (24.99 ± 6.87 )μmol/L, t=2.799, P＜0. 01 ) ,and much lower than that of the control group post-treatment ( ( 14. 27 ±6. 13)μmol/L vs (24.68 ± 6.89) μmol/L, t = 2.735, P ＜ 0.01 ). One year later, the complete stroke incidence of TIA in observation group was lower than that of the control group(9.8% vs 25.0%, P＜0.05 ) ,and complete remission rate was higher than the latter(73.8% vs 50.0%, P ＜ 0. 01 ). Conclusion Folic acid can decrease the plasma HCA level of TIA patients with Hcy efficiently,and improve the prognosis of such patients.

Objective To explore the clinical characteristics and management of acute myocardial infarction (AMI) early after kidney transplantation (＜3 months).Method Five cases of AMI early posttransplantation among 122 kidney transplant recipients from June 2011 to December 2012 were retrospectively reviewed.Results Of 5 AMI patients,there were 2 cases within one week postoperatively,one case at 11 th day postoperation,and the other two at 29th day and 46th day after operation respectively.Acute left heart failure was complicated in 3 cases within first two weeks.All the AMI patients had elevated TnⅠ levels which declined subsequently.The climax of TnⅠ levels in all the 5 AMI patients were above 5 ng/mL,and more than 20 ng/mL in two AMI patients within one week.Given by symptomatic and supportive treatment,antiplatelet and anticoagulation therapies and cardioprotective medications,all the five AMI patients were improved.Low molecular heparin was additionally administrated to the 2 cases within first week according to the severe conditions.New emerged small volume of hematocele was proved by ultrasound after 3 days and low molecular heparin was ceased.All the 5 patients survived and neither thrombolysis nor percutaneous coronary intervention therapy was given to them.Conclusion In addition to general prevention against AMI in kidney recipients with high risk factors,managing anemia and hypertensiorn,and improving graft function and systematic status are also important to decrease the risk of AMI.Moreover,cardioprotective therapy including antiplatelet therapies,beta-blockers,angiotensin-converting enzyme inhibitors (ACEI)/angiotensin-2 receptor blockers and statins,which are recommended to the general population with AMI,will also profit to the kidney transplant recipients with AMI.However,aggressive intervention therapies might be more prudent to be used in this population.

Objective To investigate the value of brain natriuretic peptide(BNP)in differential diagnosis of dyspnea in renal transplant recipients.Methods A total of 25cases of renal transplant recipients,admitted from Sep.2007to Mar.2010,developing dyspnea were reviewed retrospectively.All the patients accepted ultrasoundcardiogram examination,and serum BNP was determined,at the onset of dyspnea and 48hafter symptomatic treatment.According to the International Expert consensus document on BNP in 2008,the ideal content of serum BNP was less than 100pg/ml,and once the serum BNP exceeded 400pg/ml it was considered to be a premonitory sign of to cardiac insufficiency or excessive volume loading.Based on the results of serum BNP determination,all the patients were divided into two groups.19cases with serum BNP higher than 400pg/ml were referred as the groupⅠ,while 6cases with BNP lower than 400pg/ ml were categorized as the groupⅡ.Results The serum BNP in groupⅠwas considerably elevated reaching 1893.21?350.34pg/ml. Ultrasoundcardiogram results demonstrated impaired heart function with lower left ventricular ejection fraction(LVEF)(42.38%? 6.74%).Among the 19patients with acute heart dysfunction,12were attributed to excessive fluid loading,and in 7cases it was induced by graft dysfunction complicated by severe infection.Dyspnea was ameliorated with decreased serum BNP(305.35?45.21pg/ml)and increased LVEF(55.36%?6.26%)in groupⅠ48hafter treatment for heart failure.Serum BNP in groupⅡwas 78.52?23.26pg/ml,which was much lower than that in groupⅠ.Ultrasoundcardiogram results demonstrated that the patients in groupⅡhad better LVEF (59.72%?4.92%)than that in groupⅠ.Five of the patients in groupⅡhad normal graft renal function but severe pneumonia,and in the remaining one dyspnea was caused by allergic response when anti-lymphocyte antibody was given as an induction therapy against rejection. Symptomatic treatment did not show evident effects on both BNP and LVEF in groupⅡ.Conclusions Fast detection of serum BNP is an effective index of blood volume,beneficial in the differential diagnosis of cardiac or non-cardiac dyspnea,and provides a valuable reference to the blood volume control in patients after renal transplantation.

Objective To analyze and discuss the dynamics of cellular immune response to persistent infection with BK virus after renal transplantation.Methods The recipients of renal transplantation in our center were selected and BK virus load in urine and blood was regularly observed.The victims of persistent infection with BK virus (defined as two successive positive results of BK virus load in urine or blood) were followed up and peripheral blood mononuclear cells (PBMCs) were collected for mixed cultivation with overlapping peptide pool,which contained peptide fragments (VP1,VP2,VP3,LT-Ag and st-Ag) extracted from BK virus.Flow cytometry was used to examine the in vitro proliferation of IFN-γ/IL-2/TNF-ininduced T cells and analyze the dynamics of cellular immune response to BK virus.Results A total of 46 recipients of renal transplantation were enrolled and 6 victims of persistent viruria were identified.Of the 6 victims,3 were complicated with persistent viremia,and 2 were diagnosed as BK virus nephropathy by biopsy,presenting with persistent viruria and viremia.The victims of persistent BK viremia after renal transplantation showed a significantly decreasing trend in cellular immune response to 5 BKV-specific proteins,according to the proliferation of TNF-γ/IL-2/TNF-α-induced T cells.However,this trend was not observed in the victims of persistent BK viruria.Conclusion At the stage of viremia,the victims of BKV infection after renal transplantation have seriously inhibited specific immune response to BKV.Thus,if the antiviral mechanisms are not restored in time,these recipients suffering persistent viremia are prone to virus nephropathy (BKVN),delayed graft function,and even graft loss.