Objective To investigate the role of PD-L1 in the pathogenesis of acute allograft rejection (AR) and its correlation with PD-1 and the degree of tubulointerstitial lesions. Methods A total of 20 patients admitted by our hospital and Daping hospital from 1999 to 2003 were included, 12 male and 8 female, aged 18-40 years old (average 32.2?4.5). All of them were diagnosed as acute rejection by renal biopsy. Fifteen specimens from the mismatched donor kidney and the normal tissues from the resected kidney served as normal control. Immunohistochemistry was used to detect the expression of PD-L1 and PD-1 in renal tissues of AR and normal control. Results Both PD-L1 and PD-1 expression were significantly higher in AR than that in normal control. The intensity of PD-L1 positive in renal tissues of AR showed a positive correlation with PD-1 expression and a negative correlation with the degree of tubulointerstitial lesions. Conclusion Increased expression of PD-L1 and PD-1 in renal tissues of AR has an important effect on the degree of tubulointerstitial lesions.

Objective To evaluate the inhibiting effect of antisense vascular smooth muscle alpha adenovirus vector on tubular epithelial myofibroblast transdifferentiation induced by TGF-?1.Methods The pAdanti-?-SMA was constructed and identified.The ?-SMA expression in tubular epithelial cells(TEC) was detected by immunofluorescence and Western blot.Five groups were designed as control(A),TEC transfected by 2 ?l pAdanti-?-SMA(B),TEC induced by TGF-?1(C),TEC induced by TGF-?1 and transfected by 2 ?l pAdanti-?-SMA(D),TEC induced by TGF-?1 and transfected by 10 ?l pAdanti-?-SMA(E).Results The pAdanti-?-SMA was successfully constructed.The expression of ?-SMA in TEC induced by TGF-?1 was inhibited by pAdanti-?-SMA.Conclusion Tubular epithelial myofibroblast transdifferentiation can be inhibited by pAdanti-?-SMA.

A digitized hospital is one with network management as its basic mode, information as the primary driving force of its development, information technology as a prop to enhance its technological strength, information culture as a way to change the ways of peoples education and work and their ideological concepts, and construction of information systems as a new growth point of its advancement. While construction of digitized hospitals is a natural trend of historical development and is presently viable, construction of information systems in domestic hospitals must be based on Chinas realities so as to build digitized hospitals with Chinese characteristics. In light of their hospitals experience in building itself into a digitized hospital, the authors point out that it is necessary to formulate in the first place an overall objective in view of the requirements of digitized hospitals and then proceed step by step according to plan.

The authors sum up the experience of their hospital in the construction of the information system, pointing out that the key to success in this aspect lies in the clarification of objectives and the formulation of a master plan. Then they give a further account of ways for doing a good job of the master plan and its implementation from the perspectives of the software, hardware, and cultivation of talents.

Objectives:To discuss the observation of patients receiving simultaneous pancreas-kidney transplantation for insulin-dependent diabetes mellitus complicated with end-stage renal failure.　Methods:The patient received simultaneous pancreas-kidney transplantation with enteric drainage of exocrine pancreatic secretions.　Results:The important aspects were as follows: monitoring the functions of the transplanted pancreas and kidney, observing the early characteristics of rejection, especially the pancreas, preventing thrombosis of blood vessels of the transplanted pancreas, digestive tract hemorrhage，pancreatitis, and preventing duodenal fistula. 　Conclusion:By careful clinical observation, postoperative complications could be found earlier, which aided the treatment and improved the prognosis.

Objective To investigate the expression of programmed death-ligand 1 (PD-L1) and programmed death-1(PD-1) in the kidney tissue of acute allograft rejection (AR) and the correlation between PD-L1 expression and PD-1 expression and the degree of tubulointerstitial lesions.Methods Immunohistochemistry and in situ hybridization were used to detect the expression of PD-L1 and PD-1 in renal tissue of normal control and AR confirmed by biopsy.Results Both PD-L1 and PD-1 expression were significantly higher in AR than in the normal renal tissue (P

Objective To investigate clinical feature, diagnosis and treatment of tuberculosis infection in renal transplant patients. Methods To analyze clinical data of 13 patients suffering from tuberculosis infection after renal transplantation retrospectively. Results Twelve patients got lung tuberculosis while only one lymphoid tuberculosis. They were unequivocally diagnosed as tuberculosis by radiological plain film, searching acid-fast bacilli in sputum repeatedly, detecting DNA of Bacillus tuberculosis by PCR and biopsy, 4 of whom had mixed infection in lung. Eleven patients recovered after standard antituberculosis therapy, but 2 died. Hepatic function lesion was main adverse reaction in treatment, but it could get normal after adjustment of immunodepressant. Conclusion Tuberculosis incidence rate in renal transplant patients increased obviously. Standard antituberculosis therapy is effective, but immunodepressant should be adjusted in time according to the change of hepatic function and renal function.

Objective To evaluate the soothing effects of hemodiafiltration on patients with refractoriness nephrotic edema and its influence on prognosis of nephrotic syndrome.Methods All the 15 cases involved had undergone hemodiafiltration periodically during acme edema and administered with the same standard loading dose of prednisone for 8 weeks.Meanwhile,clinical and lab indexes (urine volume,Cr,Bun,urinary protein,albumin) were measured.Results All patients improved in urine volume and renal function gradually after the treatment of hemodiafiltration for 1 to 3 times.By the 8th week of post-hemodiafiltration,urinary protein 24 h declines obviously[(6.42?2.31)g/d to (0.87?1.24)g/d].Conclusion Hemodiafiltration is an effective treatment in relieving retention of water,increasing the remission rate of protein urine,recovering patients' renal function and improving their prognosis to nephritic syndrome patients with severe refractory edema.

Objective To explore the pathological changes of the middle-small arteries and veins of uremic patients in early stage.Methods Forty patients with chronic kidney disease at Ⅴ stage were randomly subjected in our study.Radial artery and cephalic vein about 0.5 to 1 cm in length were obtained by arteriovenous fistula operations.Cephalic veins from 4 trauma patients were taken as control group.Immunohistochemisty with anti-?-SMA(smooth muscle actin-alpha),BMP-2(bone morphology protein-2) and BMP-7(bone morphology protein-7) antibodies,alizarin Bordeaux staining,HE staining and Masson trichrome staining were carried out to investigate calcification and fibrosis.Results Compared with control group,the expressions of ?-SMA and BMP-2 were up-regulated obviously.Masson trichrome staining indicated fibrosis in the vein from uremic patients.Conclusion Fibrosis may be one of the early pathologic changes in the vein from uremic patients,suggesting the venous alterations may be related to cardiovascular disease of uremic patients.

Objective To isolate and identify advanced oxidation protein products from human serum albumin (AOPP-HSA), expecting to search for a method of preparing highly purified and bioactive AOPP-HSA. Methods AOPP-HSA crude products were prepared in vitro by exposing HSA to HOCl. AOPP-HSA was isolated by gel chromatography and ion-exchange HPLC. Its structural features and biological activities were characterized by UV and fluorescence spectrum, SDS-PAGE, and the experiment of TNF-? release from monocytes. Results The isolated protein was purified up to 99.4% and was dityrosine-containing protein cross-linking products with molecular weight of 700?10 3. It possessed the ability of triggering the considerable release of TNF-? from monocytes. Conclusion Highly purified and bioactive AOPP-HSA can be successfully prepared by above-mentioned two-step chromatography from AOPP-HSA crude products, which builds a basis for further study of AOPP.