Objective To discuss the optimal occasions for CsA withdrawal after kidney transplantation. Methods Thirty-eight cases of kidney transplantations in out-clinic were included in this study. CsA was withdrawn in their immunosuppressive regimen owing to different reasons after operation.All patients were followed up at least 2 years after operation, and followed up more than 12 months after CsA withdrawal. All patients were divided to two groups: Group A (18 cases), control group; group B (20cases), the CsA withdrawal owing its side effects. Acute rejection rate, SCr, uromicroprotein and side effects were analyzed in order to find the optimal occasions for CsA withdrawal Results CsA was re-administered in 9 cases (50 0/4) owing to different reasons in Group A. In group B, CsA was withdrawn due to gradually increased Scr and proteinuria in 12 cases, CsA related acute toxidty in 2 cases, hepatic injury in 8 cases and other reasons in 2 cases, After withdrawal of CsA, renal function was improved and hepatic injuries were recovered. Conclusion The suitable opportunity for CsA withdrawal for long-term survival patients should be at the beginning of gradually increased Scr and/or proteinuria. For the patients with normal and stable renal function and having no CsA related side effects, small dosage (1.5-2. 0 mg/kg)of CsA was the choice for the maintenance therapy.

Objective To study the use of immunosuppressives for the patients with virus C hepatitis(HCV)after renal transplantation.Methods Twenty-five cases of HCV-RNA(+)and 30 cases of HCV-RNA(-)as control group were analyzed.All patients were divided into the Aza group(n=12),MMF group(n=8)and MP(MMF+Pred)group(n=5).Results Eight casGS revealed abnormal liver function in the Aza group and 2 in MMF group.After stopping the use of CsA and Aza,the liver function all revealed good outcome in the MP group.During one week 30 cases of HCV-RNA(-)recovered due to the readjustment of the dosage of immunosupprexsives(CsA,Aza)in the control group.Conclnsions The therapy of MMF+CsA+Pred is necessary for the patients with HCV-RNA(+)and the function of the renal and liver can be stabilized by MMF.

In order to compare the therapeutics of combined use of MMF with low dose of cyclosporine A (CsA) in renal transplantation, 16 cases were randomly divided into 3 groups:MMF 2.0g group receiving MMF 2.0g per day, MMF 1.5g group receiving MMF 1.5g per day,and Aza group. All the patients in the 3 groups were given the low dosage of CsA and steroid.The results showed that no patients in MMF 2.0g group experienced acute rejection. One patient (20%) in MMF 1.5g group occurred twice acute rejections. In Aza group 3 out of 5 patients (60%) experienced acute rejections. Six months after transplantation, serum Cr level and the used dose of CsA in MMF 2.0g group was obviously lower than that of Aza group. It was concluded that the combined use of 2.0g MMF per day with low dosage of CsA and steroid was safe and efficacy for renal transplanted patients. The clinical results of MMF 2.0g group were superior to those of Aza group.

Objective:Study on a kind of meet the war wounded, public emergency safety, first aid and transportation of severely injured patients with safe, simple, and without lifting height of the liquid infusion apparatus. Methods:The negative pressure of transfusion bag from the eletrical air pump transfusion (blood) pipe extrusion, The transfusion apparatus weight, bubble, drop speed, sound, light alarm device parameters input to the control system by the sensor, according to the parameters set to safely complete transfusion or stop. Steps:Infusion apparatus mounted on the liquid and the transfusion pipe for infusion after stetting the number of drops of liquid infusion, the remaining parameters such as. Results:Infusion apparatus can be placed in any position, the peripheral infusion tube length range without the suspension liquid device and changing the existing infusion (blood) products and procedures, which create convenient, comfortable infusion conditions without position limitation The controllable range of the infusion speed is 50ml-1000ml/h,which can monitor the infusion and the air in the pipeline, liquid flow rate, the remaining amount, According to the set alarm timely and automatically stop the transfusion. Conclusion:To improve the safety of transfusion, save human resources. and it’s dual-use, small volume, easy to carry.

Objective To investigate the efficacy and safety of anti CD25 Ab (Zenapax;Daclizumab) induction therapy in 62 patients following renal transplantation. Methods Sixty-two renal transplant recipients treated with Daclizumab induction therapy were analyzed retrospectively from Sep. 1999 to May 2004. Main immunosuppressive therapy regimen consisted of steroids cyclosporine and mycophenolate mofetil in all recipients after operation. According to Daclizumab dosage, these recipients were divided into 1-dose group, 2-dose group and over 2-dose group. All patients received Daclizumab 1 h before operation.Results The patients subject to Daclizumab were followed up from 3 months to 57 months. Seven of them had acute rejection ( 11.3 %) at intervals for 10.3 months, from 2 months to 14 months. Patient who had acute rejection at 10th month after operation lost his graft at 13th month after transplantation for graft dysfunction. The incidence of acute rejection was 15.6 % among 45 patients followed up over 12 months. Conclusions Induction therapy of Daclizumab could decrease the incidence of acure rejection, delay the time of acute rejection and relieve the severity of rejection. More graft can be long-survival. We can lower the dosage of CsA effectively and safely after induction of Daclizumab.

Objective To find out the risk factors of early pulmonary infections after renal transplantatioa Methods The data were collected from 96 patients receiving renal transplantation between Oct. 2006 and Oct 2010, including 48 cases of early lung infection after renal transplantation as infection group, and 48 patients receiving immunosuppressive regimen at the same period as-control group. Taking the factors of lung infecition as variables, t test or chi-square test was used in univariate analyses whereas logistic regression was used in multivariate analyses. Results Single factor analysis showed that induction therapy, albumin levels, dose of steroid in 1 month after operation,family income and prophylactic SMZ treatment were related to lung infectioa Analysis of multiple variables logistic regression revealed that induction therapy, albumin levels, dose of steroid in 1 month after operation and prophylactic SMZ treatment were related to lung infection. Conclusion The correlation analysis indicated that induction therapy and dose of steroid in 1 month after operation have positive correlations with pulmonary infection, while albumin levels and prophylactic SMZ treatment have negative correlations with pulmonary infection.

Objective To evaluate the efficacy and safety of Simulect for the prevention of acute rejection in renal allograft recipients receiving Neoral-based immunosuppressive regimen. Methods A prospective,multicenter and open-label clinical trial was conducted from March to October 2001.A total of 33 patients [20 men and 13 women; age range,18-63 years;mean age,(42.6?11.6) years] who received first kidney allograft were enrolled.Thirty-two cases had panel-reactive antibody

AIM:To investigate the expression and potential role of complement 5a receptor (C5aR) in chro-nic graft-versus-host disease (cGVHD).METHODS:The expression of C5aR on lymphocytes and the frequency of CD4+CD25+ Foxp3+ regulatory T cells (Tregs) in 20 cGVHD patients and 9 healthy donors was detected by flow cytometry.The correlation between the expression of C5aR and the percentage of Tregs in the cGVHD patients was analyzed.In addition, the splenocytes from the mice were cultured in vitro, and stimulated these splenocytes with recombinant mouse C5a protein (rmC5a).The peripheral blood mononuclear cells (PBMCs) from cGVHD patients were cultured in vitro, which was inhibited by C5aR antagonist (C5aRA).The frequency of Tregs in these splenocytes and the PBMCs were evaluated by flow cytometry.RESULTS:The expression of C5aR on the lymphocytes was significantly increased in the cGVHD patients compared with the healthy donors, while the percentage of Tregs was markedly lower in the cGVHD patients.The expression of C5aR was negatively correlated with the percentage of Tregs.Furthermore, the development of Tregs was suppressed by rmC5a stimulation, but was promoted by C5aRA in vitro.CONCLUSION:C5aR elevation is associated with Treg reduction in cGVHD, indicating that C5aR may play a potential role in suppressing Tregs, resulting in the incidence of cGVHD.

Estrogen has anti-colorectal cancer effects which are thought to be mediated by mismatch repair gene (MMR) activity. Estrogen receptor (ER) expression is associated with microRNA (miRNA) expression in ER-positive tumors. However, studies of direct link between estrogen (especially estradiol E2), miRNA expression, and MMR in colorectal cancer (CRC) have not been done. In this study, we first evaluated the effects of estradiol (E2) and its antagonist ICI182,780 on the expression of miRNAs (miR-31, miR-155 and miR-135b) using COLO205, SW480 and MCF-7 cell lines, followed by examining the association of tissue miRNA expression and serum E2 levels using samples collected from 18 colorectal cancer patients. E2 inhibited the expressions of miRNAs in COLO205 cells, which could be reversed by E2 antagonist ICI 182.780. The expression of miR-135b was inversely correlated with serum E2 level and ER-beta mRNA expression in CRC patients' cancer tissues. There were significant correlations between serum E2 level and expression of ER-beta, miR-135b, and MMR in colon cancer tissue. This study suggests that the effects of estrogen on MMR function may be related to regulating miRNA expression via ER-beta, which may be the basis for the anti-cancer effect in colorectal cells.
Adaptor Proteins, Signal Transducing/genetics/metabolism ; Adult ; Aged ; Cell Line, Tumor ; Colorectal Neoplasms/*genetics/metabolism ; DNA Mismatch Repair/*genetics ; Estradiol/analogs & derivatives/blood/*pharmacology ; Estrogen Antagonists/pharmacology ; Estrogen Receptor beta/genetics/*metabolism ; Female ; *Gene Expression Regulation, Neoplastic ; Humans ; Male ; MicroRNAs/genetics/*metabolism ; Middle Aged ; MutS Homolog 2 Protein/genetics/metabolism ; Nuclear Proteins/genetics/metabolism ; RNA, Messenger/biosynthesis

Objective To document the impact of conversion to mycophenolate mofetil (MMF)at different time points after transplantation on the renal function of renal function.Methods A longterm,multicenter,non-interventional and observational study was done.Two cohorts were included:One was Switch cohort (340 cases) including renal allograft recipients who switched to MMF at least 6 months after renal transplantation and followed up for 4 years after switch; The other was Stay cohort (123 cases),including renal allograft recipients who received MMF treatment after transplantation and followed up for 4 years after enrollment.Results GFR values of patients in Switch cohort was significantly increased after switch,and the change in GFR slope was 3.1 mL· min-1 · year-1 (P＜0.01).GFR values of patients in Stay cohort kept steady before and after enrollment,and the change in GFR slope was 0.44 mL·min-1 ·year-1 (P＞0.05).Statistically significant difference in the onset time of GFR decline (defined as 20％ decline from the baseline) was observed among subgroups within Switch cohort (P＜0.01),but there was no significant difference among subgroups within Stay cohort (P＞0.05).Stay cohort was 12％ higher than in Switch cohort every year.Conclusion Conversion to MMF ＞6 months or even many years after transplantation can obviously improve the renal function of recipients.The earlier conversion can benefit improvement of the renal function.