Objective To investigate the prevalence of BK virus(BKV) infection in renal transplant recipients and the methods for its clinical diagnosis and treatment.Methods The urine and blood samples of 64 renal transplant recipients were taken for the BKV cytological and PCR tests.Five clinical factors were investigated to find the etiologic risks of BKV infection in renal transplant recipients.Four BKV infected recipients received experimental treatment.Results The occurrence of urine decoy cell,BKV viruria and viremia in all patients was(28.7 %),(17.2 %) and(6.3 %),respectively.The occurrence of urine decoy cell in serum creatinine(SCR) level elevated recipients was higher than that in SCR stable recipients(P=(0.04)).No significant relationships were found between the five clinical factors(gender,age,induction therapy,acute rejection episode,renal function after transplantation) and the occurrence of urine decoy cell,viruria and viremia.Ganciclovir treatment showed effective in four BKV infected recipients.Conclusions BKV monitoring is necessary for those recipients with evaluated SCR levels after renal transplantation.BKV viremia test can be used as a screening test.The efficacy of ganciclovir in the treatment of BKV infection should be further investigated.

Objective To investigate the possibility of inducing anergy by blocking the CD40/CD154 and B7/CD28 costimulatory pathways and the reversal condition of anergic cells. Methods Splenocyte proliferation in primary mixed lymphocyte reaction (MLR) consisting of BALB/c as responder and C3H as stimulator was measured by the addition of different levels of anti-CD154 and anti-CD80 monocolonal antibody (mAb). To test the reversal condition of anergic cells induced by combined anti-CD154 and anti-CD80 mAbs blocking, C3H or C57BL/6J spleenocytes were irradiated, or different concentrations of recombinant mouse interleukin-2 (rmIL-2), or both C3H splenocytes and rmIL-2 were added to the anergic cells. Results The proliferation of anergic cells treated with both mAbs in the primary MLR was strongly inhibited in a dose-dependent manner. The cells proliferated in response to third party (C57BL/6J) stimulator. The cells did not respond to original (C3H) stimulator, and they also failed to proliferated in response to the addition of exogenous IL-2. Furthermore, the anergic state was reversed by both original (C3H) stimulator and the addition of exogenous rmIL-2. Conclusion The blockade of CD40/CD154 and B7/CD28 costimulatory pathways induces alloantigen-specific anergy, and the anergic state can be reversed by both antigen restimulation and the addition of exogenous IL-2.

Objective:To investigate alloantigen-specific immunoregulatory function and phenotype of anergic cells induced by combined anti-CD154 and anti-CD80 monocolonal antibody(mAb) blocking.Methods:Anergic cells were generated in vitro by the addition of anti-CD154 and anti-CD80 mAbs to primary MLR (mixed lymphocyte reaction) consisting of BALB/C as responder and C3H as stimulator. Anergic or control cells were added to a newly formed MLR of naive BALB/C spleenocytes against the original (C3H) stimulator spleenocytes in assessing the regulatory capacity of anergic cells .Antigen specificity of the regulatory phenomenon was examined in MLR performed with third-party stimulator spleenocytes(C57BL/6J). To test the reversal condition of anergic cells,irradiated C3H spleenocytes,or recombinant mouse interleukin-2 (rmIL-2),or both C3H spleenocytes and rmIL-2 were added to the anergic cells. Anergic cells were phenotypically analyzed by double labeling procedure. Results:Anergic cells strongly suppressed the proliferation of naive BALB/C spleenocytes against the original (C3H) stimulator spleenocytes in a dose-dependent manner,but they failed to suppress the proliferation of naive BALB/C spleenocytes against the third-party stimulator spleenocytes(C57BL/6J).The anergic state was reversed by both original(C3H)stimulator and the addition of exogenous IL-2. There was an increased number of CD25 +CD4 +T cells observed in anergic cells,whereas there was no difference of CD45RB low CD4 + and CD28-CD8 +T cells between anergic and control cells.Conclusion:Anergic cells induced by the blockade of CD40-CD154 and CD28-B7 costimulatory pathways possess the alloantigen-specific immunoregulatory function and suppress the lymphocyte proliferation via infectious tolerance.

CpG oligodeoxynucleotides (ODN) have potent immunostimulatory effects and can enhance the anti-cancer activity of cancer treatments. CpG ODN directly induced the activation and maturation of plasmacytoid dendritic cells, stimulated the secretion of Th1-type cytokines, and enhanced the differentiation of B cells into antibody-secreting plasma cells. CpG oligodeoxynucleotides as vaccine adjuvants can enhance both the humoral and cellular responses to antigens in some clinical trails. CpG ODN was applied in several clinical trials as an adjuvant of tumor vaccine. CpG ODN alone had anti-tumor activity and had synergistic effects with other anti-tumor therapies including monoclonal antibodies, chemotherapy, radiotherapy, cytokines, etc. Compared with standard regimen, in the phase Ⅲ clinical trial CpG ODN did not prolong the median survival time and induced severe adverse reaction in the treatment of ⅢB-Ⅳ stage non-small cell lung cancer. But CpG ODN had definite anti-cancer activity in other clinical trials. The safety and efficacy of CpG ODN in anti-tumor therapy needs to be further verified in clinic.

In vitro diagnostic ( IVD) manufacturers were important suppliers of external servicesto medical laboratories .There equipment , reagents , calibration and maintenauce services played an important role in ensuring the quality of medical laboratory tests .It is also helpful for IVD manufacturers to establish and maintain a good reputation and credibility .ISO 15189:2012“Medical laboratories -Requirements for quality and competence” was issued onNovember 1, 2012, which replaced the second edition (ISO 15189:2007).Requirements related to IVD manufacturers are involved in the new edition standard .The article aimed to help medical laboratories and IVD manufacturers understand the requirements ; therefore , laboratories would know how to select suppliers based on their ability to supply external services , IVD manufacturers would know how to meet the needs of laboratories , and the cooperation between IVD manufacturers and laboratories would be facilitated .

Objective To investigate the influence of immunosuppression strategy optimization on the outcomes of the renal transplant recipients in the last decades. Methods Data from 404 renal transplant recipients from Jan. 1st, 2001 to Dec. 31st, 2010 were analyzed retrospectively. The patients were divided into early transplant group (n = 260) and late transplant group (n= 144). The change of immunosuppression strategy included a low dose antithymoglobin (ATG) induction, a quick corticosteroid reduction and mycophenolate mofetil therapeutic monitoring with calcineurin inhibitor minimization. Recipients' gender,age, donor type, induction therapy, immunosuppression regime, occurrences of biopsy-proven acute rejection (BPAR), severe pulmonary infection and patient/allograft survival were compared between groups. A Cox regression model was used to investigate the factors that influenced the allograft survival. Results The follow-up rate was 98. 3 % in this study. The median follow-up period was 65 month (1-112 months). The proportion of ATG induction in late transplant group was significantly higher than in early transplant group (78. 5 % versus 31. 9 %, P<0. 01). The severe pulmonary infection rate was lower in late transplant group, while the BPAR rate was comparable between two groups. The allograft survival rate was significantly higher in late transplant group. Severe pulmonary infection was correlated with patient/allograft survival in Cox regression model. Conclusion The improvement of outcome in renal transplant recipients in our center is related to the optimization of immunosuppression strategy that reduces the severe pulmonary infection rate with no increase in BPAR.

Objective To investigate the adjunctive therapeutic effects and safety of intravenous immunoglobin (IVIG) for treating pneumonia following kidney transplantation.Methods Sixteen cases of pulmonary infection after kidney transplantation were divided into two groups.Twenty-eight cases were subjected to IVIG therapy (0.2 g·kg-1 ·day-1) for 7-10 days besides the standard specific anti-bacterial,anti-fungal,and anti-virus treatment and regular immunosuppressive regimen with dose adjustment (IVIG group),and the control group was only treated with standard specific anti-pathogen therapy.The incidence and mortality ofsevere pulmonary infection,levels of serum IgG,T lymphocyte subsets,and creatinine in the two groups were observed.Results The effective power of IVIG group and control group was 100 ％ and 93.75 ％ (P＜0.05).The incidence of severe pneumonia in IVIG and control groups was 0 and 12.5％,respectively (P＜0.05),with the mortality being 0 and 6.25％,respectively (P＜ 0.05).The levels of serum IgG were significantly increased in IVIG group as compared with that before treatment and in control group.There were no significant adverse reactions associated with IVIG infusion.Conclusion As an adjunctive therapy,IVIG treatment for pulmonary infection can reduce the incidence of severe pulmonary infection and mortality after kidney transplantation,further increase the survival rate of patients after kidney transplantation.

ISO 15189:2012Medical laboratories-Requirements for quality and competence was issued on November 1,2012,which replaced the second edition (ISO 15189:2007 Medical laboratoriesParticular requirements for quality and competence).A study on changes in new edition standard will facilitate medical laboratories,regulatory authorities,accreditation bodies to have a good understanding of requirements of this new edition.An implementation of new edition will assist medical laboratory to improve their management to continually meet requirements of international standards.To enable stakeholders mentioned above have a good understanding and application of this new edition,changes in new edition were discussed in depth in this article.

Objective To explore the effect of standardized rehabilitation training and acupuncture therapy on knee osteoarthritis(KOA).Methods One hundred KOA patients were evenly divided into the treatment group and the control group by random digits table.The control group were treated by acupuncture plus general functional exercise guidance and the treatment group by standardized rehabilitation training and treatment for 3 courses(10 d as 1 treatment course).After 3 courses,the two groups were observed in terms of knee joint pain,joint function improvement and clinical curative effect.Result After treatment,the treatment group was significantly better than the control group in terms of knee joint pain,joint function improvement and clinical curative effect(all P<0.05 ).Conclusion The standardized rehabilitation training combined with acupuncture therapy may be effective in the reduction of the knee pain and improvement of knee function for patients with osteoarthritis.

BACKGROUND:The self-ligating bracket is superior to the conventional bracket in orthodontic treatment, but there are a lot of controversies. At present, researchers have different views on the function of self-ligating brackets. OBJECTIVE:To summarize the comparative study of self-ligating brackets and conventional brackest with the direction and development in recent years. METHODS:A computer-based search of PubMed (2000-2014) and CNKI (2000-2014) databases was done for relevant articles, using the key words of “self-ligating brackets; conventional orthodontic brackets” in English and Chinese, respectively. RESULTS AND CONCLUSION:Self-locking brackets saves chair side time, which has been confirmed and accepted. There are different views for the issue that self-ligating brackets can reduce friction in orthodontic treatment. It is widely accepted that, the self-ligating brackets using thin round wire had less friction than the conventional brackets; whether the friction of self-ligating brackets in the closed gap and fineness adjustment stages is less than the conventional brackets stil remains unclear, which need further clinical comparative studies. The self-ligating brackets showed no significant difference with the conventional brackets in arch expansion, reducing anchorage loss and root adsorption. The majority of relevant studies is performedin vitro, and cannot exactly simulate the dental conditions. A large-size experiment with the uniform criteria for therapeutic efficacy is needed to objectively evaluate self-ligating brackets.