Objective To investigate the therapeutic effect of rapamycin in the treatment of malignancies after kidney transplantation (KT).Methods Of the 23 inoperable patients with malignancies after KT, 8 (RPM group) received Rapamycin as treatment as well as there immunosuppressive regimens were modulated, and the remaining 15 (non-RPM group) were treated only by immunosuppressive regimen modulation, some of whom also received chemotherapy. The survival of the patients in the two groups was compared.Results In RPM group, the median survival time was (14.5) months and no acute rejection (AR) occurred during whole follow-up period. There are still 7 patients alive at the end of this study. One recipient with Kaposi’s sarcoma developed AR because of RPM dose reduction, and finally died of transplanted kidney failure and pulmonary infection. In non-RPM group, the median survival time was (3.0) months, and all of them died during the follow-up period. The 12- and 20-month survival rates were respectively (75.0) % and (37.5) % in RPM group, while (7.1) % and 0 in non-RPM group with the difference being statistically significant (P

Objective To evaluate the significance of immediate early 1 (IE) mRNA detection by nucleic acid sequence-based amplification (NASBA) in the diagnosis of human cytomegalovirus (HCMV) infection after renal transplantation.Methods The expression of IE-mRNA and pp67-(mRNA) was detected by NASBA in 55 patients after renal transplantation, and pp65 antigenemia (assays) were done for all cases.Results Twenty cases were positive for IE-mRNA. Thirteen cases were suffered from CMV disease with symptoms. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of IE-mRNA by NASBA were 92.3 %, 80.9 %, 60.0 % and 97.1 %, respectively. Time to first IE-mRNA positive detection after transplantation was shortest, compared with pp67 and antigenemia (P

Objective To investigate the diagnosis and treatment of vascular complications after allograft kidney transplantation.Methods The clinical data of 34 patients with vascular complications after renal allograft transplantation were retrospectively studied,and the characteristics,diagnosis and therapeutics were analyzed.Results Among the 34 patients,there were 13 cases of allograft renal(artery) obstruction,8 cases of allograft renal artery hemorrhage,7 cases of arterial anastomosis(rupture),4 cases of allograft renal vein obstruction,1 case of external iliac artery aneurysm and 1 case of external iliac vein thrombosis.Diagnosis was made in 21 patients by color Doppler flow imaging(CDFI),among whom 10 received further examination of magnetic resonance angiography(MRA).In the 5 cases of allograft renal artery stenosis(TRAS),3 came out with well renal function after the placement of endovascular stents.During the follow-up duration of 8,10 and 14 months,their serum creatinine(Scr) maintained between 115 and 135 ?mol/L.TRAS patient's allograft renal artery which had been anastomosed end-to-end with internal iliac artery was shifted to end-to-side style with(external) iliac artery at the second time,and came out with normal Scr one month postoperation.One TRAS patient received conservative treatment because MRA examination indicated only mild stenosis,and his Scr has been decreasing for 21 days till now.Three patients with allograft renal vein(obstruction) was treated with surgery,in whom one died of heart failure,and the other 2 patients'(renal) function recovered well during the follow-up of respectively 13 and 36 months.One patient with external iliac vein thrombus died of allograft rupture.All the other patients underwent allograft(resection).Conclusion Vascular complications after renal transplantation progresses fast once(developed) with a poor prognosis,so early diagnosis is essential for graft as well as survival and(effective) management should be administrated accordingly.CDFI could be the first choose for screening.

Objective To estimate the prevalence of thyroid dysfunction among the retired staffs of a petrochemical corporation in Ningbo. Methods The 1709 retired staffs at 60 years of age and over were enrolled in the census. Their medical history were investigated by questionnaires,and blood samples were collected for thyroid function detection. Results In this elderly cohort, the morbidity of diagnosed thyroid diseases was 3.8% (65/1709), with 6.7% (39/584) in females and 2. 3% (26/ 1125) in males. The morbidity of unrecognized thyroid dysfunctions was 6.7% (110/1644), with 9.7% (53/545) in females and 5.2% (57/1099) in males. The prevalence of total thyroid dysfunctions was 10. 2%(175/1709), with 15.8% (92/584) in females and 7.4% (83/1125) in males. Subclinical hypothyroidism accounted for 87. 3% of unrecognized thyroid dysfunctions. Conclusions The prevalence of thyroid dysfunctions is over 10. 2% in the elderly retired staffs of the petrochemical corporation in Ningbo. Subclinical hypothyroidism is the most popular form in all kinds of unrecognized thyroid functional disorders, and its prevalence is higher in females than in males.

BACKGROUND:The immune cells of renal al ograft recipients have always been the hot spot of research. However, there are few studies addressing the immune cellsubsets in renal al ograft recipients before operation. OBJECTIVE:To investigate the proportional distribution of immune cellsubsets in renal al ograft recipients before operation. METHODS:Fifteen de novo living-related renal transplant recipients were enrol ed in this study with 15 healthy volunteers, aged 18-40 years, as healthy controls. Flow cytometry was employed to observe the proportion of the immune cellsubsets by extracting peripheral venous blood of al participants. RESULTS AND CONCLUSION:In the renal al ograft recipients, the proportions of CD4+CD25+T cells, the proportion of CD4+CD25+/CD4+T cells, CD19+B cells, CD19+CD5+B cells, CD19+CD27+B cells, NKG2A/NK cells, and NKG2A/NKG2 cells were al lower than those in the healthy controls;however, the proportion of CD38+IgD-/CD19+B cells and NKG2D cells were higher than those in the healthy controls. The difference of the proportion of immune cellsubsets aforementioned between the two groups was statistical y significant (P<0.05), while no difference was observed in other subsets. Immune cellsubsets in renal al ograft recipients before operation could be used to assess the immune status of the recipients, and also could be seen as the basal control for postoperative immunological monitoring.

Objective To investigate the clinical features of pediatric renal transplantation and improve the effect of pediatric renal transplantation. Methods Clinical data of 23 children (3 17 years old) who underwent renal transplantation were retrospectively analyzed. Results In these 23 recipients, 4 cases suffered from pulmonary infection, 2 from heart failure and 2 from transplanted renal vein echmasis. Two patients' liver function was injured and one suffered from acute tubular necrosis. The incidence of acute rejection (AR) was 30.4 % (7/23) and that of chronic rejection (CR) was 8.7 % (2/23). During the follow up of 5 days to 72 months (average of 26.1 months), one died of heart failure and severe pulmonary infection. The 1 year patient and graft survival rate was respectively 93.3 % and 86.6 % . Conclusion Different from renal transplantation in adult, pediatric renal transplantation has special treatment in the operation process. HLA well matching is necessary for a good effect of pediatric renal transplantation. In spite of its high AR incidence, pediatric renal transplantation is an effective treatment with its satisfactory one year graft survival rate. Nevertheless, its long term effect should be improved much more.

Objective To study the relationship between the prevalence of hyperuricemia and thyroid dysfunction. Methods 10 405 active and retired workers aged 21 to 89 years in a Petrochemical Corporation in Ningho area of Zhejiang Province were included. Serum thyroid-stimulation hormone (TSH), free thyroxine thyroid diseases, the prevalence of thyroid dysfunction was 4.2%, 2.9% in male and 7.2% in female. The percentage of subjects with low TSH concentration was 0.4% in male and 0.9% in female,the percentage of TSH subjects,the serum uric acid was significantly increased in subjects with high TSH (P<0.05) and not an independent factor associated with hyperuricemia (OR=1.61 for male and 1.72 for female, P value was less than 0.01 for both). Conclusion The prevalence of hyperuricemia is significantly associated with increased TSH concentration. Overt or subclinical hypothyroidism may be risk factors for hyperuricemia.

[Objective]This study was designed to investigate capability of the conditioned media that originated from Renca cells to convert CIM~+ CD25~- T cells into CD4~+ CD25~+ T cells,which can exert immunosuppressive effect on effector T cells in vitro and in vivo.[Methods]The common media were mixed with the conditioned media at different ratios,and fresh enriched CD4~+ CD25~- T cells with MACS were cultured in mixed media for 7 days.At end-point of culture,the cells were collected and detected phenotypes in flow cytometer.Moreover,we detected immunosuppressive effect of converted CD4~+ CD25~+ T cells on effeetor T cells proliferation in one-way mixed lymphocytes reaction by using CCK-8,and we observed survival time and histology of grafts.The delayed type hypersensitivity was determined 14 days after transplantation.[Results]The mixed media could increase ratio of CD4~+ CD25~+ Foxp3~+ T cells in conditioned media ratio-dependent(P＜0.05),compared with control groups,when the mixed media contained no mote than 75% of conditioned media.The converted CD4~+ CD25~+ T cells significantly suppress proliferation of effector T cells in vitro,and prolong survival time of grafts,which were(29.6±1.4)d in converted CD4~+ CD25~+ T cells treated groups(P＜0.05),compared with that in untreated groups(9.8±0.6 d)or PBS treated groups(10.9±0.6 d).Moreover,delayed-type hypersensitivity reaction were conducted at day 14 after transplantation in the recipients,and the results showed that less pad swelling in the group treated with converted CD4~+ CD25~+ T cells than other control groups was found,according to measurement of pad swelling.In addition,progressed to complete necrosis of grafts were exhibited in the mice treated with PBS and untreated mice,whereas better healing of grafts and less lymphocytes infiltration were displayed in the mice treated with converted CD4~+ CD25~+ T cells,which were similar to the mice treated with natural regulatory T cells.[Conclusion]The converted CD4~+ CD25~+ T cells with Renca conditioned media play suppressive role in vitro and in vivo.

Objective To discuss the value of CR and CT to diagnose early ankylosing spondylitis. Methods Clinical data and the signs of CR and CT of eighteen cases which were diagnosed as early ankylosing spondylitis were analyzed. Results Both CR and CT imaging could show the diseased region, morphous change, and the extent of diseased joint. CT imaging could show the tiny change of diseased articular facet. Conclusion CR plain is the first choice to diagnose early ankylosing spondylitis. As doubtful case, CR combination with CT scan can raise the accuracy rate of diagnosis to early ankylosing spondylitis.

Objective To establish a high-performance liquid chromatography method for simultaneous determination of mycophenolic acid(MPA) and its 7-O-glucuronide metabolite (MPAG) in human plasma and to study pharmacokinetics of MPA in Chinese renal transplant recipients after administration of mycophenolate mofetil( MMF). Methods Plasma protein was precipitated with metlianol: 5% ZnSO4 ( 70∶30, V∶ V), using naproxen as internal MPA and MPAG after 1.5g/d administration of MMF in 6 early-stage renal transplant recipients were as follows :Tmax was(1.08±0.74)h and(2.58±1.24)h,Cmax was(21.33±8.61)mg/L and(106.98±31.91)mg/L,AUCO-t was (58.73 ±16.26)mg ? L-1 ? h-1 and(833.32±215.03)mg ? L-1 ? h-1,respectively.Conclusion This method was accurate, sensitive and specific and it was successfully applied in therapeutic drug monitoring (TDM) of mycophenolate mofetil in early-stage renal transplant recipients.