Objective To investigate the clinical implication of human leukocyte antigen(HLA)matching in sensitized recipients of renal transplantation.Methods Recipient's panel reactive antibody (PRA) was detected by using micro-complement-dependent-lymphocytotoxicity test with Lambda cell tray.Donor and recipient HLA class Ⅰ typing was performed with special monoclonal tray and HLA class Ⅱ gene typing with micro-sequence-specific-primers (Micro-SSP).Results PRA positive rate in 17 recipients was 5.1% to 80% with an average of 37.9%;patients with 0,1 or 2 mismatch (MM) of HLA crossreactive antigen group(CREGs) were 5(29%),8(47%)and 4(24%)cases respectively according to the rule of CREGs matching and no cases had 3-6 MM,however the cases of 0,1 or 2 MM were 1(6%),1(6%)and 8(47%) respectively by the standard of conventional HLA antigen matching and 7(41%)cases had 3-4 MM. Only 3 patients developed acute rejection and were reversed by OKT3 treatment.Renal function retumed normal in all patients.Conclusions The possibility of good matching was greatly enhanced by the CREGs matching.Good HLA matching plays an important role in reducing the incidence of acute rejection and in improving the survival of renal transplants.

Paclitaxel is one of the most effective broad-spectrum chemotherapeutic agents in the treatment of cancers.However,its clinical application has been limited due to its poor water solubility.Its current clinical administration results in serious side effects and has undesired pharmacokinetics and biodistribution.Therefore,it is need to develope alternate drug delivery systems of paclitaxel to enhance its solubility,permeability and stability,furthermore to promote a sustained,controlled and targeted delivery.Hyaluronic acid as the carrier of drug delivery system can solve the problems.Hyaluronic acid-paclitaxel nanoparticles have high anticancer efficiency in drug encapsulation and tumor cellular uptake,due to their appropriate size,surface modification and interaction with CD44.This review focuses on recent applications of hyaluronic acid-paclitaxel nanoparticles in a variety of malignant tumors.

Objective To investigate the significance of human leukocyte antigen (HLA) matching in highly sensitized recipients of renal transplantation. Methods 18 highly sensitized recipients preexisting panel reactive antibody IgG (PRA IgG) and their specificities were detected by enzyme linked immunosorbent assay (ELISA) with lambda antigen tray (LAT and LATM). Donors and recipients HLA class I typing was performed using complement dependent cytotoxicity (CDC) test with special monoclonal tray (SMT) and HLA class II gene typing by micro sequence specific primers polymerase chain reaction (Micro PCR SSP). Results PRA IgG positive rate in 18 highly sensitized recipients was between 40%～96% with an average of 56%, patients with 0～1 or 2～3 mismatch (MM) of HLA A,B,DR antigen were 28%(5/18) and 72% (13/18) respectively according to the standard of conventional HLA antigen matching.Whereas cases with 0～1 or 2～3 MM of HLA crossreactive antigen groups (CREGs) were 11 (61%) and 7 (39%) respectively by the rule of CREGs matching and the cases with 0～1 MM increased 33%. Only 4 (22%) cases of posttransplantation developed acute rejection and was reversed by OKT 3 treatment. Conclusions The allocation based on CREGs matching should result in a significantly higher percentage of well matched between donors and recipients. Good HLA matching plays an important role in reducing the incidence of acute rejection and in improving the survival of grafts.

Objective To evaluate the clinical application of HLA matching in highly sensitized recipients of renal allografts.Methods Recipient's panel reactive antibody (PRA) was detected by using ELISA test with Lambda antigen tray (LAT).Donor and recipient HLA classⅠtyping was performed with special monoclonal tray,and HLA classⅡgene typing with micro-sequence specific primers (Micro-SSP).Results There were 104 recipients with anti-HLA class-ⅠIgG antibody,76 with anti-HLA class-ⅡIgG antibody,and 44 with both anti-HLA class-1 and anti HLA class-ⅡIgG antibody respectively in 136 sensitized recipients.HLA class-ⅠIgG antibody positive rate was 11%-97 %,with an average of 49.6%?23.8%;The common public epitopes antibody was not found in each recipient of 13 cases with PRA＜20%,but was found in I2 recipients in 44 cases with PRA be- tween 20%-50%,and 39 recipients in 47 cases with PRA＞50%.HLA class-ⅡIgG antibody posi- tive rate was 17%-100%,with an average of 28.2%?63.8%.The number of cases of 0,1,2,3, 4 MM was 7 (5.1%),26 (19.1%),47 (34.6%),39 (28.7%) and 17 (12.5%) respectively by the standard of conventional HLA antigen matching;however the number of the recipients with 0,1, 2,3 MM was 31 (22.8%),53 (39.0%),36 (26.5%) and 16 (11.7%) respectively according to the rule of HLA CREGs matching and none with 4 MM.Rates of acute rejection in sensitized recipi- ents with 2MM and 3MM HLA-CREGs were 25.0% and 37.5% respectively and were significantly higher than those with 0MM (P＜0.05,＜0.05 respectively).Kidney year-survival was decreased when the number of MM of HLA CREGs matching increased.Conclusion The HLA CREGs matching can improve the ratio of well-matched significantly.Good HLA matching can reduce the incidence of acute rejection in sensitized recipients and increase the survival rate of grafts.

The level of HLA-antibody and sensitization can be predicated by the determination of panel reactive antibody(PRA)which is of great significance in preventing hyperaeute and accelcrated rejection.The sensitivity of PRA is markedly higher than CDC.The level of PRA(positive rate above 50%)is closely relevant,to the degree of rejection and the decrease of graft survival.Although plasma exchange(PE)can be used to decrease the level of PRA before transplantation to prevent hyperacute and accelerated rejection,good HLA-matching is more important in securing a successful graft patient.Control study between random panel lymphocytotoxicity test(RPLT)and PRA showed that RPLT is a simpler and more dependent and more easily practised method to predict the sensitivity of recipients of renal transplantation.

Objective To evaluate the level of specific anti human leukocyte antigen IgG antibodies and its effect on renal transplantation Methods Specific anti HLA IgG antibodies of 685 serum samples were measured by the micro enzyme linked immunosorbent assay with Lambda Antigen Tray and Lambda Antigen Tray Mixed Results There were 12% positive recipients of anti HLA IgG antibodies among 685 renal transplantation patients The rates of allografts rejection after transplantation were 50% and obviously higher in the sensitized recipients than in non sensitized ones ( P

Objective:To study the effects and safety of triamcinolone acetonide oral ointment in the treatment of erosive oral lichen planus(EOLP).Methods:62 cases with EOLP were randomly divided into 2 groups.The patients in test group(n =29) were treated by local application of triamcinolone acetonide oral ointment (TAOO),oral administration of hydmxychloroquine(HCQ) and gargle with cetylpyridinium chloride buccal tablets(CCBT),in control group (n =33) by HCQ and CCBT.The patients were followed up for 4 weeks.The changes of the erosion area and the VAS pain degree of the patients were analysed at the first visit,the second week and the fourth week follow-up respectively.The safety indexes were examined at the first visit and the fourth week follow-up respectively.Results:TAOO accelerated the erosion surface healing of EOLP in 2 weeks(P ＜ 0.05),and reduced the pain index of the patients (P＜0.05),but after 4 week treatment,no significant difference was observed between 2 groups (P ＞ 0.05).Fungal infection was found in 4 cases in test group.Conclusion:Local application of TAOO combined with oral administration of HCQ and gargle with CCBT is more effective than HCQ and CCBT in the treatment of EOLP,attention should be paid to prevent fungal infection.

Objective To investigate the possible mechanisms of acute humoral rejection (AHR) after renal transplantation and the significance of early diagnosis and prevention.Methods The clinical data of 296 cases receiving renal transplantations from January 2006 to December 2010 were retrospectively analyzed. After renal transplantation,the dynamic changes of panel reactive antibodies (PRA) and donor specific antibodies (DSA) in peripheral blood were monitored by using ELISA,and C4d deposition and molecular markers of infiltrating lymphocytes in biopsy tissue were observed by using immunohistochemistry.The AHR was diagnosed according to Banff 2005 criteria and clinical related indexes. Results Among 296 patients,25 were diagnosed as AHR after transplantation with the incidence being 8.4％ (25/296).The AHR incidence after transplantation in patients positive and negative for PRA before transplantation was 23.1 ％ (6/26) and 7.0％ (19/270) respectively (P＜0.01).The DSA positive rate in the recipients with AHR and without AHR after transplantation was 80.0％ (20/25) and 6.7％ (4/60) respectively.Thcrc was significant difference in DSA and C4d positive rate between AHR and non-AHR patients (P＜0.001).By adjusting several therapies, such as the immunosuppressive program and (or) application of intravenous immunoglobulin,plasmapheresis,antithymocyte globulin and rituximab monoclonal antibody, 19 cases of AHR were reversed,and the remaining 6 cases had rupture of renal allograft due to ineffective treatment,leading to the removal of the transplanted kidney.Conclusion PRA and DSA were important for AHR after renal transplantation.Immediately monitoring of the PRA and DSA after transplantation is recommended in order to achieve the purposes of prevention,early diagnosis and rational treatment for AHR,thus improving the survival of the transplanted kidney.

BACKGROUND: Pneumocystis carinii pneumonia(PCP)is a severe and life-threatening complication in renal transplantation patients.It is associated with high mortality,occult onset and rapid progression,so the clinicians who care organ transplant patients need in-depth study and understanding the law of occurrence,development and therapy of the disease to achieve the better outcome.OBJECTIVE: To retrospective analyze the etiopathogenisis,clinical characteristics,diagnosis,as well as the prognoses of PCP in renal transplant recipients.METHODS: A total of 36 patients who suffered complication of PCP after renal transplantation in the Organ Transplantation Center,Zhujiang Hospital,were retrospective analyzed.The general information of cases,clinical manifestation,therapeutic regimen,and prognoses were analyzed.The diagnosis and intervention measures were summarized.RESULTS AND CONCLUSION: Among 36 patients,22 were male and 14 were female.Three patients died of complicated acute respiratory distress syndrome,the rest were cured with good renal graft functions.Among 36 PCP patients,31 cases were occurred within 6 months,and 5 in 7-18 months.Pneumocystis carinfiwas examined in bronchoalveloar lavage fluid or lung tissues of 15 cases(41.7%),which was not be checked out in the other 21 cases.Most of patients were cured and the transplanted renal function was well after reducing immunosuppressive agent doses,administrating compound sulfamethoxazole and supportive treatment.The findings demonstrated that PCP common occurred with 6 months after renal transplantation,with typical clinical symptom but indiscoverable pathogen.Its early stage diagnosis was based on clinical history,symptom,and image examination.Among organ transplantation cases,PCP is a severe opportunistic infection,but with early diagnosis and proper treatment the prognosis remains good.

BACKGROUND:The rate of tuberculosis infection was high in patients after renal transplantation. Clinical manifestation is not typical, which brings inconvenience to diagnose.
OBJECTIVE:To summarize the diagnosis and therapeutic methods of tuberculosis infection after al ograft renal transplantation.
METHODS:Relevant diagnosis and therapeutic method of 13 patients with tuberculosis infection after renal transplantation were retrospectively analyzed in the Department of Organ Transplantation, Zhujiang Hospital of Southern Medical University from January 2010 to October 2013.
RESULTS AND CONCLUSION:The onset time was 4-120 months after operation;62%(8/13) patients within 18 months after transplantation. Patients affected long-period fever, mainly low-grade fever. Four cases were identified according to the history, imaging data in combination with positive pathogenic diagnosis. Five cases were identified according to the history, imaging data combined with lung biopsy histopathology. The remaining four cases were identified according to the history, imaging data with experimental effective anti tuberculosis treatment. Early pulmonary symptom was not obvious. Chest CT was helpful in early diagnosis and differential diagnosis. Al patients fol owed early, law, ful , right amount, combined with principles of anti-tuberculosis treatment, and treatment usual y lasted for 6-10 months. They were given combined anti-tuberculosis infection drugs, adjustment of immunosuppressive agents and five-ester capsule for liver protection therapy. Thirteen patients were alive, no deaths. Two cases with early infection without timely treatment suffered from acute rejection, leading to loss of graft function and returned to hemodialysis. The others were cured and left hospital. Renal function was normal after 6-month fol ow-up (serum creatinine). Results indicated that after renal transplantation, patients with pulmonary tuberculosis should be early detected, early diagnosed and early treated. CT guided biopsy can be used as an effective and feasible means for diagnosis and identification of smear negative pulmonary tuberculosis after renal transplantation. Adjustment of immune scheme, anti-tuberculosis treatment and five-ester capsule significantly reduced calcineurin inhibitor dose, and lessened their adverse reactions.