AIM:To study the effect of mistletoe lectins on cell proliferation and apoptosis in HT-29 human colon cancer cell.METHODS:The effect of mistletoe lectins on cell viability in HT-29 cell was evaluated by MTT assay.Cell apoptosis was observed by DNA ladder analysis and Tunel.RESULTS:Mistletoe lectins(eg.,1-4 mg/L) inhibited cell growth in a dose and time dependent way in HT-29 cells.HT-29 cells apoptosis can be induced when exposed to mistletoe lectins(eg.,1-4 mg/L).CONCLUSION:Mistletoe lectins can inhibits proliferation and induces apoptosis in HT-29 cells in vitro.

Objective Little research has been done on the risk factor analysis of BK virus(BKV) infection in renal transplant recipients in Chinese population.The article aimed to investigate BKV infection and analyze its risk factors in renal transplant recipients in China.Methods Renal transplant recipients who had received the detection of BKV DNA in urine and blood samples in Nanjing General Hospital from June 2015 to July 2016 were selected, while the patients with uremia hemodialysis and healthy living donors were included as control group.According to the detection results of BKV DNA in urine and blood samples, renal transplant recipients were divided into BKV DNA positive group(n=89, positive urine or blood and urine BKV DNA) and BKV DNA negative group(n=359, negative blood and urine BKV DNA).Analysis was made on BKV infection in renal transplant recipients in order to investigate the effects of factors including clinical condition, postoperative complications and immunosuppressive regimen on BKV infection.Results The positive rate of BKV DNA in urine samples of renal transplant recipients was 19.9%, which was higher than those of patients with dialysis and healthy living donors(6.3% and 4.2% respectively, P<0.001).Multivariate logistic regression analysis showed BKV infection was associated with pulmonary infection(OR[95%CI], 3.468[1.227-9.802];P=0.019) , acute rejection (OR[95%CI], 2.645[1.142-6.127];P=0.023), and FK506 (OR[95%CI], 2.408[1.104-5.254];P=0.027).Conclusion The incidence of BKV infection in renal transplant recipients increases significantly.Pulmonary infection, acute rejection and FK506-based immunosuppressive regimen are risk factors leading to BKV infection.

Objective BK virus-associated nephropathy ( BKVAN) after kidney transplantation is a key factor that influence the prognosis of transplant kidney .To our knowledge , it is believed to be associated with immune suppression .We observed the cura-tive effect and influencing factorsof anti-rejection scheme that Leflunomide was administered instead of Mycophenolate Mofetil ( MMF) on transplant kidney BKVAN .. Methods This study included 15 kidney transplant recipients with pathologically confirmed BKVAN in Nanjing General Hospital of Nanjing Military Region form March 2007 to March 2013 .Leflunomide was administered instead of Myco-phenolate Mofetil ( MMF) .Serum creatinine level , renal allograft loss rate and side effects of leflunomide were monitored after medica-tion switch.The patients were divided into two groups , which were renal allograft loss group and renal allograft survival group , for fur-ther analyses . The differences between each groups in clinical characteristics as well as histochemical features of the transplanted kidneys were analyzed to determine the cause of renal allograft loss in patients with BKVAN . Results Six patients experienced renal al-lograft loss after switching to leflunomide and needed hemodialysis , and 9 patients had stable renal allograft function , renal allograft loss rate was 40.0%.Hyperuricemia occurred in 8 patients in the period before the medication switch and in 5 patients after the switch;a decrease in blood white cell orplateletcount was found in 2 patients during both periods;an increase in Alanine aminotransferase ( ALT) level occurred in one patient after the medication switch .There were no statistically significant differences in any of the above parame-ters before and after the medication switch.Compared to allograft survival group, serum creatinine level[(1.80 ±0.53)mg/dL vs (2.74 ±0.58)mg/dL, P=0.007], the number of B lymphocytes [(206.44 ±144.96) vs (439.67 ±267.77), P=0.047] and CD68[(588.44 ±271.80) vs (944.67 ±259.32), P=0.025] in renal allograft tissue were significantly higherin the allograft loss group. ConclusionLeflunomide is a safe and effective medication for BKVAN .Patients with significantly increased serum creatinine level might have a poorer prognosis .Significantly increased B lymphocytes and CD 68 cells in renal allograft tissue might indicate a poor prognosis.

Objective Sirolimus ( SRL) is a potent immunosuppressive drug used to prevent acute allograft rejection after re-nal transplantation.Nevertheless, the occurrence of proteinuria has recently been recognized among patients treated with SRL-based therapy.The aim of this study was to investigate the therapeutic effect of tripterygium wilfordii hook F ( T II) on proteinuria caused by SRL in renal transplant recipients who were treated by trilogy immunosuppressive therapy of sirolimus combined with mycophenolate and hormone. Methods 52 recipients were divided into 2 groups randomly:TⅡgroup (n=27) and valsartan group (n=25).The TⅡgroup was administered 1 mg/kg/d, and the valsartan group 80-160 mg/d for consecutive 12 months.Based on primary trilogy immu-nosuppressive therapy of sirolimus combined with mycophenolate and hormone, the dosage of sirolimus was adjusted according to the target concentration 6-10 ng/ml( ELASA approach) and mycophenolate was administered 750 mg twice per day, adjusting dosage ac-cording to the mycophenolate AUC 0-12 level(35-45 mg· h/L).The evaluation of therapeutic effect includes: complete remission, proteinuria decreased by>50%; partial remission, proteinuria decreased by 20% to 50%; ineffective, proteinuria decreased by<20%. Results During the 12 month follow-up, the total effective rates in the TⅡgroup and the valsartan group were 95.2%and 86.7%respectively, in which the TⅡ group decreased more significantly (P<0.01).The total cholesterol level and triglyceride level in TⅡgroup were obviously lower than those in valsartan group(P<0.01). The total cholesterol level and triglyceride level in valsartan group increased ([6.60±0.2]mmol/L vs [7.11±1.13]mmol/L, [2.47± 1.48]mmol/L vs [2.49±0.32] mmol/L).The serum protein level in TⅡ group was obviously higher than that in valsartan group ([41.1±1.2]g/L vs [37.9±4.2]g/L, P<0.05).At 3 month, 6 month and 12 month follow-up, the average serum creatinine levels in TⅡgroup were obviously lower than those in valsartan group ([1.5±0.4]mg/dl vs [1.6±0.3]mg/dl, P<0.05), ([1.3±0.3]mg/dl vs [1.8±0.5]mg/dl, P<0.05), ([1.1±0.4]mg/dl vs [2.1±0.5]mg/dl, P<0.05).The incidence rate of adverse reaction in valsartan group was obviously greater compared with TⅡgroup( P<0.05) . Conclusion Both tripterygium wilfordii multiglycosides and valsar-tan can reduce proteinuria caused by SRL in renal transplant patients,while the application of TⅡhas more remarkable effect.

Objective To discuss the clinicopathological characteristics and prognosis of the recurrence of IgA nephropathy (IgAN)after renal transplantation.Methods A total of 1 48 patients,pathologically diagnosed with IgAN which progressed into end-stage renal failure,undergoing renal transplantation in National Clinical Medical Research Center of Kidney Diseases,Nanjing General Hospital of Nanjing Military Command from January 1 996 to April 2009,were included in this study.According to whether IgAN recurred,all patients were assigned into recurrence (n =46)and non-recurrence groups (n =1 02).Urinary red blood cell (U-RBC)count,24 h urinary protein level,renal function including serum creatinine (Scr)and glomerular filtration rate (GFR)at 0,1 ,2,3 and 5 years after renal transplantation were statistically compared between two groups.The incidence of histopathological renal injury and survival rate of transplant kidneys was compared between two groups.Results In recurrence group,U-RBC count and 24 h urinary protein level were gradually elevated and renal function steadily declined.Compared with non-recurrence group,U-RBC count at 2-,3-and 5-year after renal transplantation significantly increased,and renal function was significantly aggravated at postoperative 5 years (all in P<0.01 -0.001 )in recurrence group.Renal pathological findings revealed that compared with non-recurrence group,the incidence of cellular crescent formation,glomerulus adhesion,mesangial cell proliferation,increased mesentery matrix, glomerulosclerosis,segmental glomerulosclerosis,glomerular dysfunction and tubulointerstitial fibrosis was significantly higher in recurrence group (all in P <0.001 ).After renal transplantation,chronic kidney injury index in recurrence group was 7.7 ±2.3,which was significantly higher than 4.6 ±1 .4 in non-recurrence group (P <0.01 ).Compared with non-recurrence group,the incidence of chronic rejection,glomerulopathy of transplant kidney (without IgAN)and positive C4d deposition was significantly higher in recurrence group (P <0.01 -0.001 ).At 1 -and 3-year after renal transplantation, survival rates of transplant kidney did not significantly differ between recurrence and non-recurrence groups (93.8% vs.86.7%,95.6% vs.88.3%,both in P >0.05).However,the survival rate at 5 years after transplantation was 51 .4% in recurrence group,significantly lower compared with 83.8% in non-recurrence group (P <0.001 ).In recurrence group,1 0 patients (22%)presented with renal failure after renal transplantation,and 9 patients (9%)in non-recurrence group.Conclusions After renal transplantation,the recurrence of IgAN characterized by asymptomatic microscopic hematuria, albuminuria and progressive aggravation of renal function reduce long-term survival rate of renal graft and indicate poor prognosis.