Objective To study the effect of genomic HLA-DR compatibility on long-term survival in renal transplantation.Methods A retrospective study was performed on 518 first-cadaver renal transplants by using genotyping technique.Results More than 10%recipients shared HLA-DR matching at DNA level.half of 1 DR mismatches.The recipients with HLA-DR matched transplants showed a significant decrease of acute rejection episodes and a smooth recovery of early renal function as compared with those of DR mismatching kidneys.The 1 to 5 year-person survival rate was increased by 17%to 37.7% (P＜0.01)respectively.Multivariate analysis of 10 variables by Cox regression model revealed that DR mismatching was the most important factors influencing the long-term graft survival.Conclusion Genomic HLA-DR compatibility had a significant impact on long-term survival of first-cadaver kidney transplantation.

Objective To evaluate the short-term safety and efficacy of transurethral plasma kinetic enucleation of the prostate (PKEP)for benign prostatic hyperplasia (BPH)larger than 60 ml. Methods A retrospective analysis was carried out on clinical data and treatment outcomes of 87 cases of BPH with prostate volume larger than 60 ml in Fuzhou General Hospital of Nanjing Military Command from September 2013 to August 2015.The patients were divided into either PKEP group (45 cases)or plasma kinetic resection of prostate (PKRP)group (42 cases).The operation time,resected adenoma weight,decline in hemoglobin 1 day after operation,and catheterization and irrigation duration were recorded and analyzed.The international prostate symptom score (IPSS), quality of life score (QOL),post-void residual urine volume (PVR),maximum urinary flow rate (Qmax)before surgery and 1 ,3,6 months after operation respectively were evaluated. Results As compared with the PKRP group,the PKEP group excelled in greater resected prostate weight [(52.4 ±15.2)g vs.(40.0 ±14.1 )g,t =3.94,P =0.00],less decline in hemoglobin [(9 ±4)g /L vs. (17 ±6)g /L,t =-7.36,P =0.00],shorter irrigation duration [(1 .1 ±0.3)d vs.(1.4 ±0.5)d,t =-3.42,P =0.00],and shorter catheterization duration [(3.3 ±0.5)d vs.(5.5 ±0.5 )d,t =-20.50,P =0.00].There were no significant differences between the two groups in terms of operation time and operative complications such as transient incontinence and hematuria (P >0.05).Postoperative improvements in IPSS,QOL,PVR,and Qmax were similar between the two groups (P >0.05)but significantly improved as compared with before operation (P <0.05). Conclusion PKEP is a new,safe,and effective minimal invasive surgical option for the treatment of BPH larger than 60 ml.

Objective:To explore the role of peripheral blood lymphocyte (PBL) of the renal transplant recipients during the acute rejection phase by gene chips.Methods:The 8 patients with acute rejection (AR) after renal transplantation were collected peripheral blood before operation (as control samples) and renal biopsy (as experimental samples).By Ficoll method,PBL was collected.Total RNA were extracted by one-step technique and purified.The total RNA were labeled with Cy5-dUTP (experimental samples) or Cy3-dUTP (control samples),then to label the cDNA probe by reverse transcript way.The gene chip (419 genes) was hybridized and scanned.Then fluorescent signal value of gene expressing was obtained,and differential expression genes were sifted.Results:There were differential expression 49 immunological genes in peripheral blood lymphocyte (PBL) of the renal transplant recipients during the acute rejection phase,including up-regulated 25 and down-regulated 24.Conclusion:Peripheral blood lymphocyte was involved in various stages during the acute rejection,and immunosuppressants influenced on these stages in various degrees. [

Objective To study the relationship of cytokines and cytokine receptors gene polymorphism with acute rejection in kidney transplantation recipients,whose 21 single nucleotide polymorphisms in 5 kinds of cytokines and their receptors were tested with cytokine oligonucleotide array.Methods According to the allele sequences of 21 gene polymorphisms of IL-4,IL-6,IL-10,TNF-?,TGF-?_1 and their receptors,58 oligonucleotide probes were synthesized. A pair of group special primers labeled by the Cy5 were designed and were used in the PCR. The labeled PCR products with Cy5 were hybridized with array. The signals were scanned by a scanner and analyzed by image software. Genomic DNA samples from the peripheral blood lymphocytes of 144 kidney transplant recipients were tested by this array. The distribution of 21 single nucleotide polymorphism in cytokines and cytokine receptors was compared between two groups according to the presence or absence of acute renal rejection.Results In recipients,the gene polymorphism distribution in rejection group and non-rejection group showed significant difference (P

Objective To explore the single point target concentration for Neoral at 2 h postdose (C2) in Chinese renal transplantation recipients for the first 3 months following surgical procedures. Methods Neoral trough levels (C0) and C2 monitoring were measured by fluorescence polarization immunoassay (TDX) in 114 cases of cadaver renal transplants treated with Neoral (6～7 mg?kg -1 ?d -1 ), mycopherolate mofetil (MMF,1.0～1.5 g/d) and steroids for the first 3 months after renal transplantation.The effectiveness of the new monitoring method in predicting the acute rejection and side effects was retrospectively analyzed. Results The acute rejection rate of 114 transplants for the first 3 months was 15.8%(18/114).The incidence of side effects was 30.7% (35/114),including hepatoxicity(26.3%) and nephrotoxicity(7.0%).The results of 234 pairs of Neoral C0, C2 monitoring showed that the difference was not statistically significant between C0 levels of rejection and non rejection,while the difference between C2 levels [(921.55 ?431.31) vs (1 185.17?358.86)ng/ml) ] was significant.There was also no statistically significant between C0 levels of the recipients with side effects and those without side effects,but statistically significant difference was found between C2 levels [(1 302.59?450.21) vs (1 105.23? 371.64 )ng/ml].Analysis of the relationships between C2 levels and the incidences of acute rejection and side effects showed that no acute rejection and side effects rate of 4.3% were observed in the Neoral C2 interval from 1 250 ng/ml to 1 500 ng/ml. Conclusions Neoral C2 monitoring is a more sensitive predictor not only for acute rejection but also for side effect rate.The optimal C2 target level of Chinese renal transplantation recipients is 1 250 ～1 500 ng/ml for the first 3 months post transplantation.

BACKGROUND:Immunologic injury is a main pathogenesis of chronic rejection,and it is related to multiple immunological associated-gene polymorphism,in particular,transforming growth factor-β1 gene polymorphism.Recently,there are a lot of researching results of the relationship between TGF-β1 gene polymorphism and chronic rejection.OBJECTIVE:To study the relationship between TGF-β1 genotypes and the chronic renal allograft rejection in recipients and donors.DESIGN:Prospective case analysis.SETTING:Department of Urinary Surgery,Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA;General Organ Transplantation Center.PARTICWANTS:A total of 144 recipients and 65 out of 114 donors(another 30 cases did not have the blood preparation)were selected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from Jane 2000 to May 2001.The surgical program was approved by the local ethics committee.METHODS:The TGF-β1 genotypes were detected in 144 recipients before renal transplantation and 65 out of 114 donors by sequence-specific primer polymerase chain reaction.The follow-up lasted for 5 years in recipients after surgery to survey chronic renal allografi rejection;furthermore,the effects of genotypes of recipients,genotypes of donors,and the genotype combination on transplanted renal function were analyzed.MAIN OUTCOME MEASURES:(1)Inciderce of chronic renal allograft reiection in recipients and donors with difierent TGF-β1 genotypes;(2)incidence of chronic renal allograft rejection in recipients and donors with TGF-β1 genotype combination.RESULTS:(1)Incidence of chronic renal allograft rejection in recipients with high-secretory TGF-β1 genotype was significantly higher than that in those with moderate-secretory or low-secretory TGF-β1 genotypes(x2=10.091,P<0.01).There were no significant differences in chronic renal allograft rejection among donors with different TGF-β1 genotypes(x2=0.002,P>0.05).(2)Chronic renal allograft rejection occurred in the recipients with high-secretory TGF-β1 genotype,whose donors also had high-secretory TGF-β1 genotype,and the incidence of chronic renal allograft rejection was significantly higher than that in other recipients with TGF-β1 genotype combination(x2=4.352,P<0.05).While the incidence of chronic renal allograft rejection in the recipients with moderate-secretory and low-secretory TGF-β1 genotypes,whose donors also had moderate-secretory and low-secretory TGF-β1 genotypes was significantly lower than that in other recipients with TGF-β1 genotype combination (x2=4.134,P<0.05).CONCLUSION:The TGF-β1 gene polymorphism is detected in the recipients and donors before renal transplantation to benefit for along-term prognostic factor for chronic renal allograft ejection and an ideal genotype combination between recipients and donors.

Objective To explore the influence of renal allograft donor's and recipient’s SNP of recipient cytokine and cytokine receptor on the infection after renal transplantation and to provide some useful information for preventing and managing infection.Methods 129 cases of cadaveric renal allograft recipients were divided into infection group and no infection group. The distribution of 21 polymorphisms in cytokines and cytokine receptors gene were compared between two groups by oligonucleotide array. Previous positive gene polymorphisms were compared between infection group and no infection group. With the help of SPSS 11.5 software, association was assessed using Krusakal Wallis test where appropriate.Results The frequency of gene distribution was significantly different between the infection group and the no infection group as follows: the genotype IL-6R (-183G/A, GG), IL-10 (-824C/T, -597C/A), TNF-? (-308GG, G/A), and the allele IL-10R1 (1112G/A), IL-6R (-183G/A), IL-4R(1902A/G), TNF-? (-308G/A), TGF-?_1 (+869T/C) respectively.Conclusion The susceptibility of infection after renal transplantation may be predicted by the SNP of recipient cytokine and cytokine receptors such as these genotypes IL-6R(-183GG), IL-10(-824CT, -597CA), TNF-?(-308GG), and the allele IL-4R(1902A).

Objective To compare oligoneucleotide arrays with sequence specific primer polymerase chain reaction (PCR-SSP) for HLA-DR genotyping in order to develop a new technique of genotyping for donors and recipients in kidney transplantation. Methods Sixty DNA samples of donors and recipients were subjected to HLA-DR typing by oligoneucleotide arrays and PCR-SSP simultaneously. The results of the two typing techniques were analyzed.Results Of 60 samples using the two above-mentioned typing techniques, the results in 56 samples were identical with the accordance rate being 93 %, and in the remaining 4 unidentified samples verified by the other laboratory, oligoneucleotide arrays made 1 allele miss typing for 2 samples , 1 allele mistaking for 1 and PCR-SSP made 1 allele miss typing for 1 sample. Among the total, 20 samples retyping was made and its reproduction rate was 96 %. Conclusion The oligoneucleotide arrays technique for HLA genotyping has advantage of high sensitivity, high efficiency, high level standard and it is incomparable.