Objective To investigate the role of biopsy kidney allograft in the early diagnosis and differential diagnosis of acute and chronic rejection and other diseases involving renal allograft,and to determine the optimal time for early biopsy in chronic allograft rejection.Methods Non-random biopsy of renal allograft was performed in 44 kidney transplant recipients with the clinical manifestation of diagnosis-unconfirmed allograft diseases,in the presence increased in serum creatinine,microalbuminuria or/and proteinuria,glomerular hematuria and so on.Another 6 kidney transplant recipients received routine allograft biopsy 1 month after operation.Pathological evaluation was performed in all sections according to Banff 97 classification and based on clinical data.Results Chronic allograft rejection was discovered in the renal allograft specimens of 31.3%,76.5% and 88.2% recipients,respectively,in the 1st year,the 2nd to 3rd year and over 3 years after operation,and most of them showed no obvious clinical manifestation.A part of recipients with clinical diagnosis of acute rejection also showed pathological manifestations of chronic rejection and/or glomerulonephritis and chronic cyclosporine nephropathy.A part of recipients with clinical diagnosis of chronic rejection showed pathological manifestations of acute rejection and/or glomerulonephritis and chronic cyclosporine nephropathy.Pathological features of acute or chronic rejection,glomerulonephritis and chronic cyclosporine nephropathy were observed respectively in recipients with disorders of kidney allograft with unknown diagnosis.No obvious clinical symptoms were observed in nearly half of the patients with pathological diagnosis of glomerulonephritis.Good therapeutic effect was obtained in these recipients who were correctly treated on the basis of definite pathological diagnosis.Conclusions It is indicated that optimal time for early diagnosis in chronic renal allograft rejection might be the 2nd and 3rd year after transplantation,and routine biopsy should be performed in this period.It is suggested that biopsy of renal allograft is of importance value for rectification of clinical diagnosis and for recipients with clinically undefined renal allograft diseases.It is also indicated that there might be coexistence of acute,chronic rejection and/or glomerulonephritis and chronic cyclosporine nephropathy.

Objective To investigate the differential expression of microRNAs(miRNAs) in transplanted kidney undergoing chronic rejection by the technique of RNA microarray.Methods Four biopsy specimens from transplanted kidney undergoing chronic rejection were harvested as test group(CR),and 3 biopsy specimens were obtained from normal renal cortex as normal control group(NC).Total RNA of each sample was extracted using Trizol reagent.miRNAs were isolated and differential expression of miRNAs were screened by miRNA array analysis.The results of miRNA array were validated by RT-PCR.The quantity and quality of all the RNA samples were checked by gel electrophoresis and absorbance at A260/280,respectively.Results It was confirmed that the isolated RNA was of appropriate quality.The results of miRNA array analysis showed that there were 63 differential expression miRNAs in CR group,of which 35 were up-regulated and 28 down-regulated.There were 9 differential expression miRNAs which distributed in 3 gene clusters: 14q32.31,22q11.21 and xq27.3.The miRNAs hsa-miR-637,hsa-miR-648 and hsa-miR-516-5p were randomly selected for relative quantification by real-time PCR.It was showed that the expression ratios of hsa-miR-637,hsa-miR-648 and hsa-miR-516-5p in AR/NC,when detected by RT-PCR,were 0.034,2.670 and 7.846,while the ratios were 0.035,2.660 and 7.857 when analyzed by miRNAs array.The results from two methods were not significantly different,so the method of miRNAs array was reliable.Conclusions It is notable that the differential expression of miRNAs existed in the transplanted kidney undergoing chronic rejection.miRNAs might be helpful in protecting the patients undergoing kidney transplantation against chronic rejection.

ABSTRACT:Objective To investigate the anti-metastatic effect of allicin on glioma cell line U87 and related mechanisms.Methods In this study,we employed MTT assay to test the anti-proliferative effect of allicin. Transwell assay was used to test the anti-metastatic ability of allicin.Real-time PCR and Western blotting were employed to test the effect of allicin on the expressions of matrix metalloproteinase-2 (MMP-2 ) and matrix metalloproteinase-9 (MMP-9).Western blotting was employed to test the phosphorylated level of p38.Results Allicin could significantly inhibit the proliferation and invasion of U87 cells (concentration>8 μg/mL,P <0.05). Meanwhile allicin (concentration<8μg/mL)could inhibit the invasion of U87 cells.After treatment with allicin for 24 hours,the expressions of MMP-2 and MMP-9 were decreased significantly (P < 0.05 ).Moreover,allicin treatment decreased the phosphorylated level of p38 obviously (P < 0.05 ).Conclusion Allicin inhibits the invasion and migration of glioma cell line U87 by reducing the expressions of MMP-2 and MMP-9 via suppressing the activity of p38 signal pathway,suggesting that allicin is a potential therapeutic agent for glioma.

Objective To evaluate comparability of two different assay system for detecting CRP.Methods Following the profile of Clinical and Laboratory Standard Institute (CLSI)document EP9-A2,50 blood samples with anti-coagulant ED-TA-2K were collected from emergency patients at Changhai Hospital.The test result of samples by the i-CHROMA Reader was compared and evaluated with those by Beckman Immage 800.Results The linear regression equation for plasma CRP was:Y=1.076 5X-3.031 5,R2=0.986.The linear regression equation for whole blood CRP was:Y=0.882 6X-1.180 8, R2=0.931 1.For whole blood samples with low HCT (<30.45%).Used correction equation:CRP (after corrected)=CRP (before corrected)/(1-HCT).The regression equation (after corrected)was:Y=1.006 8X-3.612 2,R2=0.950 9.Con-clusion CRP concentration detected by i-CHROMA showed good correlation and comparability compared to laboratory ref-erence system by using plasma samples.Results form whole blood samples with low HCT should be corrected to improve comparability.

0.5ug/ml in 34 patients(79.1%).Postoperative survival rate and recover of the work ability in group T were significantly higher than those in group C.Conclusions EPTT before RT for the type I diabetes patients with renal disorder can improve the results of RT.

Objective To summary the clinical data of pediatric renal transplantation from multiple renal transplant centers in China,and analyze the factors influencing the therapeutic outcomes of pediatric renal transplantation.Methods From March 1986 to May 2010,the clinical data of 138 children who underwent renal transplantation in eight centers of renal transplantation in China were retrospectively analyzed.Results The one-year patient and graft survival rate was 99.3％ and 95.7％respectively.Acute rejection episodes occurred in 38 cases (27.5％),15 cases suffered delayed graft function (DGF),and graft functions were returned to normal in all recipients within one month.Moreover,other complications included transplant renal artery stenosis in 8 cases (5.8％),ureteral necrosis in 2 cases (1.4％),urinary fistula in 5 cases (3.6％),hypertension in 57 cases (41.3 ％),hyperlipidemia in 38 cases (27.5％),hirsutism in 32 cases (23.2％),drug-induced liver damage in 26 cases (18.8％),urinary tract infection in 25 cases (18.1％ ),gingival hyperplasia in 22 cases (15.9％),pulmonary infection in 21 cases (15.2％),bone marrow suppression in 12 patients (8.7％),herpes simplex in 10 cases (7.2％),and diabetes in 8 cases (5.8％).The body weight was increased by 4 to 13 kg and the body height was increased by 2 to 7 cm during the first year posttransplantation. Conclusion The careful perioperative management, rational use of immunosuppressive agents,strengthening the follow-up management of children and social support,and improving compliance were the key points to obtain good outcomes in pediatric renal transplantation.

Objective To investigate the risk factors of insulin resistance(IR)and its relationship with metabolic syndrome in patients after lenal transplantation.Methods 133 renal transplant redpients who had not undergone acute rejection,calcinurine intoxication and severe infection,and had normal renal function and no proteinuria at the 6th month post-transplantation,were involved in the study.They had a history of chronic glomerulonephritis as the primary disease of ESRF but rio diabetes mellitus.108 recipients(CsA group)were treated with CsA,mycophenolate mofetil(MMF)and prednisone after transplantation,19 recipients(Tac group)with tacrolimns(Tac),MMF and prednimne,and 6 recipients with Simlimus,respectively.One year later,blood and urine biochemical tests and physical examinations were performed on the recipients,and HOMA calculated.200 cormnunity residents were randomly selected as controls.Results The incidence of MS in the recipients was 33.1%,significantly higher than controls(15.0%).There was no significant difference in the incidence of obesity and overweight between recipients(29.3%)and controls(37.5%).In recipients with obesity or overweight,the insulin-resistance level and urine albumin level,and the incidence of MS weree significantly higher than those without obesity or overweight.The insulin-resistance level in Tac-treated recipients was markedly higher than CsA-treated recipients,and there was a positive correlation between the blood concentration of Tac and insulin-resistance levd.Microalbuminufia-positive recipients had higher insulin-resistance levels.Metabolic syndrome-complicating recipients had higher insulin-resistance levels than those without metabolic synawme,and higher insulinresistance levels existed in recipients with hypertriglyceridemia or hyperchcllesterolemia,hypertension.Conclusion Obesity or overweight,Tac(especially when blood concentration was higher)were risk factors resulting in imulin-resistanee in kidney transplant recipients.It is suggested that insulin-resistance might be involved in the pathogenesis of metabolic syndrome including hypertrglyceridmaia,hypercbolestemlemia and hypertenion.

BACKGROUND: A large number of researches have confirmed that hypertension, vascular nephrosclerosis and chronic systemic inflammatorome were the importance factors of chronic allograft dysfunction. Hyperuricemia is associated with primary hypertension and vascular nephrosclerosis, and can result in chronic systemic inflammatorome, but it was uncertain whether post-transplantation hyperuricemia and its lesion influence the long term graft function. OBJECTIVE: To investigate the prevalence of hyperuricemia in renal transplant recipients (RTRs) before and after transplantation and the influence of hyperuricemia on long term graft function. METHODS: A total of 216 renal transplant recipients [146 males with the mean age of (40.98±11.09) years and 70 females with mean age of (40.01±11.62) years]with normal renal function after transplantation were selected from PLA Center of Kidney Transplantation and Dialysis, the 181 Hospital of Chinese PLA. In order to compare the influence of different hyperuricemia status on the long term graft function, the patients were divided into 4 groups according their pre-transplant baseline and post-transplant serum uric acid (SUA) levels, SUA normal group, pre-transplant high SUA group, post-transplant high SUA group and both pre-transplant and post-transplant high SUA group. The patients were also divided into 3 groups according to their post-transplantation SUA level to study the influence of SUA on the long term graft function, normal SUA group, hyperuricemia (SUA < 500 μmol/L) group and hyperuricemia (SUA > 500 μmol/L) group. Effects of hyperuricemia and SUA levels pre-and post-transplantation on long term graft function were observed. RESULTS AND CONCLUSION: Hyperuricemia existed in 34.2% male RTRs and 37.7% females before transplantation, while it existed in 36.2% male RTRs and 42.4% females at the first month post-transplantation when they had normal Scr levels. The incidence rate of post-transplant hyperuricemia in female RTRs was significantly higher than male RTRs (P < 0.05). The average post-transplantation SUA levels in both male and female RTRs were significantly higher than those before transplantation (P < 0.01). At follow-up end, the pre-transplantation SUA levels did not significantly influence on the long term graft function (P > 0.05), meanwhile the RTRs with continuous post-transplant hyperuricimia had poorer long term graft function than those with normal post-transplantation SUA levels. It is indicated that hyperuricemia is more common in post-transplantation recipients, especially in female RTRs, when compared to pre-transplantation, and post-transplantation hyperuricemia often existed in renal transplant recipients with normal graft function. Furthermore it is suggested that post-transplantation hyperuricimia, but not pre-transpiantation hyperuricemia, could also act as a factor inducing chronic renal allograft dysfunction.

Objective To explore the outcomes of the transplanted kidney as donor for clinical renal transplantation and summarize experience in combination with related literature.Method This study retrospectively analyzed the clinical documents of one case of uremia receiving renal allograft transplantation with the transplanted kidney as the donor in one case of renal transplantation after brain death in February,2015.The donor was a 31-year-old man who received renal transplantation for uremia in November,2014 and obtained normal renal function.Two months later,the patient was brain dead because of neurologic disorder and donated his transplanted kidney.The serum creatinine of the donor was 167 μmol/L,and the glomerular filtration rate was about 35 mL/min befor donation.The recipient was 27 years old who needed transplantation because of chronic renal function failure and uremia.Preoperation tests showed that PRA was negative,and serum creatinine was 1 353 μmol/L.After separating and dissecting the donor kidney carefully,we perfused and compensated the kidney by Lifeport Organ Perfusion and Preservation Conveyor.The warm ischemia time was about 15 min.The renal vein of the donor was anastomized with right external iliac vein of the receptor,artery with right external iliac artery,and ureter with right centrifugal ureter.Result The operating time was more than 3 h.Postoperatively,the recipient was given the immunosuppressive regimen as tacrolimus,mycophenolate mofetil and methylprednisolone to prevent rejection.At 1 st day postoperation,the 24-h urine volume of the receptor was 5 000 mL,serum creatinine was declined gradually to a minimum of 180μmol/L,and there was trace urine protein.The renal function of patient recovered well by now.Meanwhile,the patient was still under the follow-up.Conclusion It is practical that using transplanted kidney as donor kidney for re-transplantation.There were certain clinical significance for shortening the waiting time of renal transplantation in uremia patients and relieving the shortage of transplant kidney.

0.05).But its incidence was higher in females than in males after transplantation(P