1.Relationship between microvessel density and recurrence of hepatocellular carcinoma after hepatic resection in the elderly
Gengwen HUANG ; Yiming TAO ; Xiang DING ; Weiqun LU ; Heli LIU
Chinese Journal of Geriatrics 2009;28(2):116-118
Objective To study the effect of age on the recurrence-free survival rate after hepatic resection for hepatocellular carcinoma(HCC)and the relationship between microvessel density (MVD)and recurrence of HCC in the elderly. Methods Severty one cases of elderly patients with HCC were analyzed retrospectively with 352 cases of non-elderly HCC patients as control,and the effect of age on the recurrence-free survival rate was studied.The expressions of CD34 and endocan in HCC tissues were detected by immunohistochemistry in 30 elderly and 30 non-elderly patients.Results The 1-,3- and 5-year recurrence free survival rates were 75.7%,43.0% and 43.0% in the elderly group respectively,which were higher than those in the non-elderly group(53.6%,38.5% and 33.4%,respectively,Log Rank value=10.25,P<0.05).The positive rate of alpha fetoprotein (AFP)in the elderly group was 47.9%,which was lower than that in the non-elderly group(62.2%)(X2=23.68,P<0.05).The median survival times in the high CD34-MVD group and high endocan MVD group were shorter than those in the low CD34-MVD group and low endocan-MVD group(260 d vs.850 d,360 d vs.800 d,Log Rank value was 22.18 and 20.56 respectively,both P<0.05).Conclusions The long-term prognosis of hepatic resection for HCC is better in elderly patients than in non-elderly patients.The recurrence of HCC in the elderly is closely related with angiogenesis.
2.The changes of D-D, t-PA and PAI in acute renal failure patients during blood purification and its clinical significance
Yan TENG ; Wujun XUE ; Yazhuo JIANG ; Heli XIANG ; Hongli JIANG
Journal of Xi'an Jiaotong University(Medical Sciences) 1982;0(04):-
Objective To study the dynamic changes and clinical significance of D-D, t-PA and PAI in patients with acute renal failure during the process of different methods of blood purification. Methods Thirty-seven ARF patients were divided into three groups: HD group, HDF group and HF group. Plasma D-D level, t-PA and PAI activity were determined 1 hour, 4 hours before and after treatment. Normal control group consisted of fourteen healthy people. Results ① Plasma D-D level and PAI activity in ARF patients were obviously higher than those in control group, while t-PA activity was lower(P0.05). ③ After 4 hours of the treatment, compared with HD group, HDF and HF groups had significant difference in plasma D-D level, t-PA and PAI activity(P
3.The study of protective role of PR-39 on renal ischemia-reperfusion injury in rats
Jing LIU ; Wujun XUE ; Heli XIANG ; Jin ZHENG ; Yanlong ZHAO
Chinese Journal of Organ Transplantation 2017;38(3):178-183
Objective To explore the protective role of PR-39 on the ischemia reperfusion injury renal tissue of rats.Methods 60 male SD rats were enrolled and randomly divided into experimental KP group and negative control KE group.The rats orthotopic renal transplantation model were established.The recombinant adenoviral vectors containing promoter KSP and PR-39 gene (KP) or none (KE) were injected via renal artery.HE staining,immunohistochemistry and TUNEL staining were performed on the rats' renal tissues at 2 days after IRI modeling,and the renal tubular interstitial injury score and peritublar capillary rarefaction was also evaluated.The renal function related factors of rats was monitored before and after IRI,and the blood urea nitrogen and creatinine level was also compared between KP and KE groups.Results Blood urea and creatinine concentration was increased,part of glomerular and tubular injury in renal tissue were also visible in rats underwent renal IRI,which proved the rat orthotopic renal transplantation model were successfully estabilshed.PR-39 gene specifically expressed in renal interstitial tissue,but not in glomerular.The degree of kidney tublar injury and the number of apoptotic cells were lower in KP groups by comparing with negative control KE groups.Renal tubular injury was significantly decreased in group KP than in group KE.Peritubular capillary rarefaction index is smaller in KP than in KE group.The blood urea nitrogen and creatinine level in KP group were significantly lower than those in KE group,and the renal function were also recovered more quickly.Conclusion The specific expressed PR-39 in renal interstitial and tubule,can inhibit the apoptosis of renal tubular epithelial cells and promote the angiogenesis of peritubular capillary,so as to exert its protective role on IRI renal tissue.
4.Construction and identification of recombination expression vector Ksp-Cadherin-Gpx1-Kik1
Liyi XIE ; Wujun XUE ; Heli XIANG ; Sunkai MA
Journal of Pharmaceutical Analysis 2008;20(4):217-220,255
Objective To construct and identify the Gpx1-Klk1 vector which contains kidney-specific promoter (Ksp-cadherin). Methods Through PCR amplification, the human Gpx1, Klk1, and Ksp-cadherin eDNA were obtained by taking Gpx1 cDNA, Klk1 eDNA, and Ksp-cadherin BAC as templates. After being testified, the PCR products were inserted into the expressive vector pIRES-EGFP step-by-step to produce a recombinant vector Ksp-cadherin-Gpx1-Klk1. This vector was examined by restriction enzyme digestion and sequence analysis. Results The recombinant expressive vector Ksp-cadherin-Gpx1-Klk1 was successfully constructed. Conclusion The construction of the recombinant vector Ksp-cadherin-Gpx1-Kik1 laid foundations for investigations in establishing transgenic animal models, the over-expression of Gpx1 and Kikl in mammal kidney, and gene therapy for ischemia-reperfnsion injury during kidney transplantation.
5.The cell-mediated immune status of patients with cytomegalovirus pneumonia after renal transplantation
Heli XIANG ; Wujun XUE ; Puxun TIAN ; Xiaoming DING ; Xiaoming PAN ; Hang YAN ; Jun HOU ; Xinshun FENG
Chinese Journal of Organ Transplantation 2011;32(10):592-595
Objective To evaluate the clinical value of adenosine triphosphate (ATP) determination in CD4+ cells in cytomegalovirus pneumonia after renal transplantation.Methods The ATP level of CD4+ T cells was measured by ImmuKnowTM kit.The ATP levels were determined in 187 renal transplant recipients before and 30,60,90,180 days after operation,and at the time of CMV pneumonia and 4 weeks after treatment of CMV pneumonia.The associations between ATP levels and CMV pneumonia were analyzed.Analysis of variance (ANOVA),Pearson-Spearman and relative risks were used for data analysis.Results 17 cases out of 187 renal transplant recipients were diagnosed as CMV pneumonia (9.1%),and the onset of CMV pneumonia started on the (2.8 ±1.2)month after renal transplantation.ATP concentrations in CD4+ T cells were significantly lower after operation than those before operation (P<0.01).ATP concentrations reached the lowest on the about postoperative day 90 (P<0.05),then increased gradually.In 17 recipients with CMV pneumonia,the ATP levels before and 30,90 days after operation,at the time of CMV pneumonia and 4th week after treatment of CMV pneumonia were (376 ±182),(283 ± 146),(196 ± 112),(145 ± 102) and (236 ± 117) μg/L respectively.ATP levels at the time of CMV pneumonia were significantly lower than any other time points (P<0.05).There was close correlation between ATP levels and CMV pneumonia.Conclusion The determination of ATP in CD4+ cells could reflect the status of cell-mediated immunity in renal transplant recipients,and could evaluate the severity and prognosis of CMV pneumonia and guide the clinical treatment.
6.Adjustment of immunosuppressant in pulmonary infection following renal transplantation
Xiaohui LUO ; Wujun XUE ; Hang YAN ; Puxun TIAN ; Xiaoming DING ; Heli XIANG ; Yang LI ; Yong SONG
Chinese Journal of Organ Transplantation 2010;31(9):524-527
Objective To explore the relationship between adjustment of immunosuppressant and prognosis in renal transplantation recipients with pulmonary infection. Methods The clinical data of 98 patients with pulmonary infection following renal transplantation were retrospectively analyzed.Patients were divided into two groups: conventional group (n = 45) and immunosuppressant adjustment group (n = 53). The mortality, recovery time and rejection rate in two groups were analyzed under the statement of serious infection (SOFA≥12) and slight infection (SOFA< 12) by sequential organ failure assessment (SOFA) score. Results When the SOFA scores ≥ 12, the mortality and recovery time in immunosuppressant adjustment group were significantly lower than in conventional group (P<0.05), but there was no significant difference in the rejection rate between two groups (P>0.05). When the SOFA scores <11, there was no significant difference in mortality and recovery time between the two groups (P>0.05). The incidence of rejection in immunosuppressant adjustment group was significantly higher than in conventional group (P<0.05).Conclusion Mortality could be decreased and course of anti-infection treatment could also be shortened by adjusting the immunosuppressant in renal transplantation recipients with serious pulmonary infection (SOFA≥12). Immunosuppressant agent was proposed to maintain the original treatment protocol when the infection was slight (SOFA<12).
7.Expression of ILT3 and ILT4 in dendritic cells of kidney transplantation recipients and its significance
Lining JIA ; Puxun TIAN ; Wujun XUE ; Xiaoming DING ; Xiaoming PAN ; Heli XIANG ; Zhankui JIN
Chinese Journal of Organ Transplantation 2010;31(8):478-480
Objective To study the expression of immunoglobulin-like transcripts 3 (ⅡT3) and ILT4 in peripheral blood dendritic cells (DC) of kidney transplantation recipients and to analyze its significance in immunity hyporesponsiveness of transplantation. Methods Twenty kidney allograft recipients who were survived more than five years were recruited to two groups: renal function stable groups, chronic rejection groups, and 10 healthy volunteers served as a control group. The peripheral blood mononuclear cells (PBMC) were stimulated with granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin 4 (IL-4) and immature DC were obtained. The expression of ILT3 and ILT4 was detected by using flow cytometry. The level of HLA-G5 in serum was determined by using enzyme linked immunosorbent assay. Results ILT3 expression in renal function stable group was increased and decreased in chronic rejection groups as compared with control group (P<0.05),but ILT4 expression had no significant difference among all groups. HLA-G5 in serum was significantly increased in renal function stable group as compared with other groups. Conclusion Expression of ILT3 and HLA-G was increased in the kidney transplantation recipients with stable renal function and long-term survival, suggesting that they may play an important role in inducing and maintaining periphery immune tolerance.
8.The clinical value of enzyme-multiplied immunoassay technique monitoring the plasma concentrations of cyclosporine A after renal transplantation
Xiaohui LUO ; Wujun XUE ; Puxun TIAN ; Xiaoming DING ; Hang YAN ; Heli XIANG ; Yang LI
Journal of Pharmaceutical Analysis 2011;01(2):139-142
The feasibility and the clinical value of the enzyme-multiplied immunoassay technique (EMIT) monitoring of blood concentrations of cyclosporine A (CsA) in patients treated with CsA were investigated after kidney transplantation.The validation method was performed to the EMIT determination of CsA blood concentration,the CsA whole blood trough concentrations (Co) of patients in different time periods after renal transplantation were monitored,and combined with the clinical complications,the statistical results were analyzed and compared.EMIT was precise,accurate and stable,also with a high quality control.The mean postoperative blood concentration of CsA was as follows:<1 month,(281.4± 57.9)ng/mL; 2 - 3 months,(264.5 ± 41.2)ng/mL; 4 - 5 months,(236.4 ± 38.9)ng/mL; 6 - 12 months,(206.5 ± 32.6)ng/mL; >12 months,(185.6 ± 28.1)ng/mL.The toxic reaction rate of CsA blood concentration within the recommended therapeutic concentration was 14.1%,significantly lower than that of the none-recommended dose group (37.2%) (P<0.05); the transplantation rejection rate was 4.4%,significantly lower than that of the nonerecommended dose group (22.5%) (P<0.05).Using EMIT to monitor the blood concentration of CsA as the routine laboratory method is feasible,and is able to reduce the CsA toxicity and rejection significantly,leading to achieving the desired therapeutic effect.
9.Clinical research of renal transplant from donation after citizen's death (DCD) donor with acute kidney injury
Heli XIANG ; Wujun XUE ; Puxun TIAN ; Xiaoming DING ; Xiaoming PAN ; Hang YAN ; Jun HOU ; Xinshun FENG
Chinese Journal of Organ Transplantation 2017;38(3):131-135
Objective To explore the clinical effect of renal transplant from donation after citizen's death (DCD) donors with acute kidney injury (AKI).Methods This was an observational retrospective study of 622 patients who underwent renal transplantation from 312 DCD donors' kidneys at the First Affiliated Hospital of Xi'an Jiaotong University from December 2011 to December 2016.The transplant patients were divided into AKI group and non-AKI group according to the Acute Kidney Injury Network (AKIN) criteria based on initial and terminal creatinine values.We evaluated and compared transplant outcomes of these two groups.Results There were 131 donors with AKI,and the incidence of AKI was 42.0 %.AKI group and non-AKI group recipients respectively had DGF in 20.2% and 7.2% of cases (P<0.01),153.6 ± 56.2 and 119.3 ± 40.7 μmol/L of serum creatinine (SCr) levels at 1st month (P<0.01),and 38.5 ± 14.1 and 57.6 ± 23.4 ml· min-1 (1.73 m2)-1 of eGFR at 1st month (P<0.01).There was no significant difference in SCr and eGFR between two groups at 1st year after transplantation.Conclusion Most of kidneys from DCD donors with AKI can be considered for transplantation.Renal transplantation of organs from DCD donors with AKI showed greater DGF but good outcomes.
10.The clinical value of enzyme-multiplied immunoassay technique monitoring the plasma concentrations of cyclosporine A after renal transplantation
Xiaohui LUO ; Wujun XUE ; Puxun TIAN ; Xiaoming DING ; Hang YAN ; Heli XIANG ; Yang LI
Journal of Pharmaceutical Analysis 2011;01(2):139-142
The feasibility and the clinical value of the enzyme-multiplied immunoassay technique (EMIT) monitoring of blood concentrations of cyclosporine A (CsA) in patients treated with CsA were investigated after kidney transplantation. The validation method was performed to the EMIT determination of CsA blood concentration, the CsA whole blood trough concentrations (Co) of patients in different time periods after renal transplantation were monitored, and combined with the clinical complications, the statistical results were analyzed and compared. EMIT was precise, accurate and stable, also with a high quality control. The mean postoperative blood concentration of CsA was as follows: 〈1 month, (281.4± 57.9)ng/mL; 2 - 3 months, (264.5 ± 41.2) ng/mL; 4 - 5 months, (236.4 ± 38.9) ng/mL; 6 - 12 months, (206.5± 32.6)ng/mL; 〉12 months, (185.6± 28.1)ng/mL. The toxic reaction rate of CsA blood concentration within the recommended therapeutic concentration was 14.1%, significantly lower than that of the none-recommended dose group (37.2%) (P〈0.05); the transplantation rejection rate was 4.4%, significantly lower than that of the none- recommended dose group (22.5%) (P〈0.05). Using EMIT to monitor the blood concentration of CsA as the routine laboratory method is feasible, and is able to reduce the CsA toxicity and rejection significantly, leading to achieving the desired therapeutic effect.