BACKGROUND: It remains poorly understood regarding the incidence of panel reactive antibody (PRA) production and its influence to renal function and long-term survival in China. OBJECTIVE: To investigate the incidence of PRA after living renal transplant, so as to provide reference for predicting long-term renal survival. METHODS: A total of 54 patients who received living renal transplantation in Beijing Friendship Hospital from March 2005 and October 2007, were selected. PRA, serum creatinine and urea nitrogen level were detected 1-2 years after transplantation. PRA assay was conducted using One Lambda ELISA HLA-Ⅰ +Ⅱ antigen tray. Serum creatinine and urea nitrogen data were offered by clinical laboratory. RESULTS AND CONCLUSION: A total of 12.96% (7/54) patients showed PRA positive after transplantation, with HLA-Ⅱ antibody positive in 6 patients, and HLA-Ⅰ + Ⅱ antibody positive in 1 patient. In these 7 patients, 6 underwent primary transplantation, and PRA negative before transplantation; 1 patient underwent transplantation for the second time, and HLA-Ⅱ antibody positive before transplantation. Creatine and urea nitrogen level were abnormal in 1 patient with HLA-Ⅰ + ⅠⅡ antibody positive and 2 patients with HLA-Ⅱ antibody highly positive. Creatinine and urea nitrogen levels were normal in 4 patients with low level HLA-Ⅱ antibody. Results show that HLA-Ⅰ +Ⅱ antibody positive and high level HLA-Ⅱ antibody affect renal function in living renal recipients, but low level HLA-Ⅱ antibody has no effect on renal function.

BACKGROUND: It is confirmed that panel reactive antibody (PRA) and its immune level is closely related to rejection activation, renal survival rate and the realization of the renal function. Study addressing the relation PRA level and acute rejection has great clinical significance for forecasting acute rejection and improving the renal survival rate.OBJECTIVE: To analyze the relation of PRA and acute rejection prior to and after transplantation by detecting PRA level combined with patient rejection.DESIGN, TIME AND SETTING: Retrospectively case analysis was performed at the Affiliated Beijing Friendship Hospital of Capital University of Medical Sciences from September 1998 to May 2005.PARTICIPANTS: A total of 633 patients receiving renal transplantation were collected, including 348 males and 285 females, aged 16-67 years.METHODS: Company Lymphocyte Tray produced by One Lambda and Biotest were used for this study, serum PRA level was detected prior to and within 2 months after transplantation.MAIN OUTCOME MEASURES: Pre- and post-transplant PRA level and clinical rejection.RESULTS: Totally 591 patients were PRA negative in pre-transplant assay, and 164 patients were positive, 10.32% (61/591) patients occurred acute rejection; 42 patients were PRA positive in pre-transplant assay, and 71.42% (30/42) patients occurred acute rejection. The difference between PRA negative or positive and acute rejection had significance (P < 0.001). 427 patients were PRA negative in both pre- and post- transplant assay, 5.6% (24/427) patients occurred acute rejection. 164 patients were PRA negative in pre-transplant assay, but positive in post-transplant, 42.7% (70/164) patients occurred acute rejection. The comparison of PRA negative pre-transplant and PRA positive post-transplant combined with acute rejection had difference (P < 0.001). The correlation coefficient of pre-transplant PRA and acute rejection was 0.612, which was 0.658 between post-transplant PRA and acute rejection, there was obvious association when P=0.01.CONCLUSION: PRA plays an important role in forecasting renal rejection. The acute rejection probability is higher in patients with positive PRA; in other hand, the probability is lower in patients with negative PRA.

Objective To compare the Panel reactive antibody (PRA) producing incidence in living and cadaveric transplant for forecasting long term survival. Methods Retrospectively analyze post-transplant PRA of 48 living transplant patients ( December 2003-Sepdtember 2007 ), and 258 cadaveric transplant patients( Feburary 2003-June 2007 ), which in both groups were all PRA negative in pre-transplant. PRA was detected using LAT-1240 (OneLambda) and QUICKSCREE&BSCREEN (GTI). Serum creatine/urea nitrogen level was provided by clinical laboratory. Results Four recipients in 48 living transplant patients showed PRA positive(8.33% ), while 62 receipients in 258 cadaveric transplant patients showed PRA positive(24.03% ) ( P ＜0.05 ). Three recipients in 35 male living donor transplant patients showed PRA positive(8.57% ) ,while 23.03% PRA positive in male cadaveric transplant patients (P ＜0.05). In females, 1out of 13 living donor transplant patients showed HLA-Ⅱ positive, whereas 20 out of 106 in cadaveric transplant patients( 18.87% ) ( P ＜ 0. 05). Conclusion The incidence of HLA antibody production was much higher in cadaveric transplant patients than that in those of living donor transplant.

Objective To study the correlation between transplanted kidney dysfunction and oc-currence of the panel reactive antibody ( PRA, also referred as anti-HLA antibody ) and anti-Major-Histo-compatibility-Complex class Ⅰrelated chain A (MICA) antibody.Methods The tests for detecting PRA and anti-MICA antibody were performed on 679 renal transplant patients from December , 2009 to June, 2010 who received transplantation before 2008 in Beijing Friendship Hospital .Enzyme-Linked Immunosor-bent Assay ( ELISA) was used to detect anti-HLA antibody using LAT-1240 ( OneLambda Inc .) .MICA Ab-Scan Kit was adopted to detect anti-MICA antibody .Continuous observation of graft function was conducted . Results 108 out of 679 patients showed anti-HLA antibody and/or anti-MICA antibody positive results . Among them, 81 patients were positive only for anti-HLA antibody, 18 patients were positive only for anti-MICA antibody and other 9 patients showed anti-HLA and anti-MICA antibodies double positive .Among all of the kidney transplant patients with a failed or decreased renal function , 71 patients were positive for anti-HLA antibody;16 patients were positive for anti-MICA antibody;and other 9 patients were positive for both anti-HLA and anti-MICA antibodies .The results demonstrated that anti-HLA and anti-MICA antibodies af-fected the renal functions in patient with renal transplantation (χ2 =353.92, P <0.001).Conclusion Anti-HLA and MICA antibodies showed significant positive correlations with chronic allograft failure in the patients with renal transplantation .

Objective To investigate the HLA antibody incidence and type renal recipients with different age, and to study the echaracteristics in different age patients, for clinical reference to forecast renal rejection in different age patients. Methods With serum dated from January 2006 to June 2008, patients were classified into three groups: young group, with age below 35 years; middle age group, with age from 36 to 50 years; and old group, with age above 50 years. Penel reactive antibody (PRA) were detected using ELISA. Results Pretransplant HLA antibody incidences in the young, middle age, old group were 18.18%, 23.00% and 6.19%, respectively. In young group, HLA antibody incidences were 5.59% and 8.51% in male and female respectively. In middle age group, they were 21.30% and 25.38% in male and female respectively. In old group, they were 11.36% and 25.00% respectively. HLA Ⅰ and HLA Ⅰ + Ⅱ antibodies were mainly found in all the three groups in pretansplant. Conclusion HLA Ⅰ and HLA Ⅰ + Ⅱ antibodies were mainly found in pretransplant. Antibody incidence was higher in patients who had more than once renal transplant than that in transfusion and pregnancy female. Antibody incidence is higher in female than that in male.

BACKGROUND:Tissue engineered skin has been used to repair defect skin, but it is not as good as to completely replace permanent skin. OBJECTIVE: To explore the biological characteristics and clinical application of various types of tissue engineered skin. METHODS: Pubmed data (1990-01/2005-12) was retrieved by computer with the key words of "tissue-engineered skin". CNKI database (2002-01/2007-12) was retrieved with the same key words. RESULTS AND CONCLUSION: Totally 226 literatures were primarily selected. After reading titles and Abstracts, studies addressing irrelative objective or repetitive content were excluded, and 11 literatures were included. The aim of skin tissue engineering is to create skin substitute that close to human.skin in histology and functional characteristics. There were many mature tissue engineered skin in clinic, and various artificial skins were developed. Their structure was similar to human, but only had skin barrier function and lack of skin appendages, so they did not have complete skin function, and did not reach skin reestablishment. Ideal skin substitute should process cuticular layer and dermial layer. The dermial layer can reach rapid vascularization and nerve redistribution, can promote physiological wound repair. The cuticular layer can rapidly obtain full barrier and protection function, which can be fully integration with wound surface. A good dermial carrier has good histocompatibility, and a certain physical and chemical properties, such as strength, scratchability, elasticity, gas permeation, water vapor permeability. These can provide a good adherence between dermis and wound surface, offer an ideal fiber stent for cell growth, and finally promote autologous skin growth. Tissue engineered skin has good prospect, but there are many problems that should be solved in biocompatibility and skin function reestablishment.

Objective To analyze the sensitized factors in urinemia patients who waiting for renal transplantation.Methods 2429 patients with urinemia from April 2002 to December 2008 were subjected to the detection of panel reactive antibody, and classified into 5 groups according to their clinical data:(A) no history disease group (n = 1097) who never experienced transfusion, pregnancy and transplantation; (B) Transfusion group (n = 361) who received transfusion more than 200 ml; (C) Pregnancy group (n = 481) who experienced pregnancy; (D) Transfusion+ pregnancy group (n= 294) who experienced both pregnancy and transfusion; (E) Re-transplantation group (n = 196) who experienced failed transplantation before, and waited for the second renal transplantation.Results All the males in group A were negative for PRA, and females were weakly positive for HLA Ⅱ antibody.The incidence of PRA production in group B was 15.24 % (55/361).Thirty-nine patients were positive for PRA in group C with the incidence being 8.11 % (39/481).The PRA positive rate in groups D and E was 30.61 % (90/294) and 70.92 % (139/196) respectively.PRA intensity was more than 60 % in 72 patients in group E.Conclusion Transfusion and pregnancy caused lower incidence of PRA positive rate.The incidence was much higher in transfusion + pregnancy patients than that in patients with transfusion or pregnancy alone.Graft caused the higher incidence of PRA than by transfusion and pregnancy.

Objective To asses the value of fluorescence in situ hybridization (FISH) in diagnosis of transitional cell carcinoma of bladder in the urine using directly labeled DNA probes to the pericentromeric regions of chromosomes 3 , 7 and 17 and to the region of P16 tumor suppressor gene. Methods Chromosomal and gene abnormalities were detected using directly labeled DNA probes to the pericentromeric regions of chromosomes 3 , 7, and 17 and to the region of P16 tumor suppressor gene. The sensitivity of FISH and Cytology in diagnosing transitional cell carcinoma of bladder was also compared. Results The sensitivity of FISH and Cytology in diagnosing the disease was 85.5% and 34.2%, respectively. The sensitivity of FISH was prior to that of Cytology( P ＜0.05 ) and increased with increasing tumor pathologic grade but not clinical staging. Conclusions High sensitivity of FISH in diagnosing transitional cell carcinoma of bladder was obtained and it might be a potent method to diagnose bladder cancer in Chinese people in the future.

Objecfive To study the clinical characteristics of acute inferior myocardial infarction.Methods 100 patients with acute inferior infarction were divided into 2 groups according to coronary angiography:group A (n=76) with right coronary artery occlusion;group B(n=24) with left circumflex artery occlusion.Results The frequencies of Electrocardiogram(ECG) ST segment elevation ST Ⅲ>ST Ⅱ and ST segment depression STAVL>STI in group A was significantly higher than that in group B(P<0.05);The frequency of ECG ST segment elevation STⅢO.1 mV in group A was significantly higher than that in group B(P<0.05);The number of ECG with precor-dial lcads V1～6 ST segment depression >0.1 mv with lesion of left anterior descending coronary was more significant than that without precordial Vl-6 leads ST segment depression (P<0.05).Left ventricular ejection fraction (LVEF)(51%±14%) in group A was significant lower than that in group B(57%±10%)(P<0.05);The patients in group A with right ventricular infarction were more significant than those in group B(P<0.05);The total hospital mortality of patients with acute inferior myocardial infarction was 6%,and they were all in group A.But there was no significance between the two groups about cardiogenic shock,heart failure,Ⅱ degree and Ⅲ degree atrial ventricular b1ock,ventrieular tachycardia/ventrieular fibrillation and the hospital mortality.The mortality with cardiogenic shock was 83.3%.Conclusion The changes of ECG ST segment in Ⅲ,Ⅱ,Ⅰ,AVL and V4R leads can predict relatedinfarct coronary artery with acute inferior myocardial infarction.The patients with precordial Vl～6 leads ST segment depression indicates lesion of LAD.The LVEF of patients with RCA occlusion is lower than that with LCX occlusion. The primary cause of death is eardiogenic shock.

Objective To explore the therapeutic effect of erythropoietin (EPO)combined oral iron in patients with chronic congestive heart failure( CHF)accompanied by anemia. MethodsNinety six patients with CHF accompanied by anemia, whom were consecutively hospitalized from January 2007 to December 2009, were enrolled into this study. They were randomly divided into treatment group accepted routine anti-heart failure therapy combined EPO and oral iron, and control group solely accepted routine anti-heart failure therapy. After 6 months follow up, the changes of hemoglobin ( Hb ), cardiac function classification, left ventricular ejection fraction(LVEF) ,6-minute walking distance,readmission rate of CHF and cardiac death were compared between two groups. ResultsCompared with those before therapy, we found significant improvements of hemoglobin level ( [ 120. 12 ± 10. 42 ] g/L vs [ 86.40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2. 65 ± 0. 67 vs 3. 13 ±0. 61, P ＜ 0. 01 ), LVEF ( [ 37.21 ± 4. 96 ]％ vs [ 33. 92 ± 7. 28 ]％, P ＜ 0. 01 ), 6-minute walking distance ( [ 443.52 ± 97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in treatment group after EPO combined oral iron administration. After 6 months follow up, we also found significant improvements of Hb level ( [ 120. 12 ±10. 42 ] g/L vs [ 86. 40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2.65 ± 0. 67 vs 2. 98 ± 0. 81,P＜0.01),LVEF([37.21 ± 4.96]％ vs [34.67 ±4.10]％,P ＜ 0. 01),6-minute walking distance ( [443.52 ±97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in the comparison between treatment and control group. The readmission rate of CHF fell significantly in treatment group compared to control (20. 83％ vs 39. 58％ ,P ＜ 0. 05 ). However, we found no significant difference in cardiac death rate ( 0％ vs 4. 17％, P ＞0. 05). ConclusionTreatment of EPO combined oral iron could significantly improve the cardiac function,increase exercise tolerance,lower the readmission rate of CHF in patients with chronic congestive heart failure (CHF)accompanied by anemia.