BACKGROUNDIn addition to the well-known antibodies against human leukocyte antigens (HLA)-induced kidney-graft rejection, polymorphic major-histocompatibility-complex (MHC) class I-related chain A (MICA) antigens can elicit antibodies and have been suggested to play a role in the antibody-mediated allograft rejection (AMR). We carried out a prospective study of MICA antibodies in post-renal transplant patients to determine the association between MICA antibodies, C4d staining, histological features, and graft outcome.

METHODSWe tested 52 patients who had biopsy results due to graft dysfunction. The MICA antibodies in concurrent sera were determined by Luminex. All patients were followed up for one year after renal biopsy. The influence of antibody production on the function of graft was analyzed.

RESULTSAntibodies against MICA were positive in 15 out of the 52 patients (28.9%). The presence of MICA antibodies was associated with renal-allograft deterioration. During one-year follow-up, the estimated glomerular filtration rate (eGFR) decreased (24.0 ± 3.4)% among recipients with anti-MICA antibodies. However, among recipients without anti-MICA antibodies, the eGFR has declined only (8.4 ± 3.0)% (P = 0.017). The association between C4d staining, histological features and MICA antibody production was found no significant difference.

CONCLUSIONBesides anti-HLA antibodies, the presence of post-transplant MICA antibody is associated with poor graft outcome and increases the risk of graft failure.

Adult ; Antibodies ; blood ; immunology ; Female ; Histocompatibility Antigens Class I ; immunology ; Humans ; Kidney Transplantation ; immunology ; Male ; Middle Aged ; Prospective Studies ; Transplantation, Homologous ; immunology

OBJECTIVE: To observe the effect of sevoflurane on the induction and maintenance of anaesthesia in children, and to evaluate its safety and effectiveness. METHODS: Forty child patients who conformed to the selection standard were operated under anaesthesia with intubation.Without premedicant, all the patients inhaled 100% oxygen(1L/min) and sevoflurane by mask, and escalated the concentration of sevoflurane (to the maximum concentration 7%) until the lash reflex disappeared, and the maintenance concentration was controlled under 4%. All the patients were intubated, together with vecuronium 0.1mg/kg. RESULTS: With little tract excretion, the achievement ratio of induction by sevoflurane was 100%, and the children tolerated well. With stable hemodynajmics,1% approximately 4.0% maintenance concentration of sevoflurane during the operation showed effective anaesthesia, no decreased heart rate or blood pressure appeared, and all the patients' body temperature was normal. CONCLUSION Sevoflurane for children induction can bring fewer stimuli in the respiratory tract,less cardiac vascular inhibition and palinesthesia time. Anaesthesia in children induced by sevoflurane is safe and effective.
Anesthesia ; methods ; Anesthesia, Inhalation ; Anesthetics, Inhalation ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Male ; Methyl Ethers ; administration & dosage ; Sevoflurane ; Treatment Outcome

Objective:To investigate the relationships of C4d,HLA antibody,and MⅠCA antibody with renal pathology.Methods:Totally 52 patients with complete pathological data were included and followed up for one year.The C4d was stained with indirect immunofluorescence,the levels of HLA antibody and MⅠCA antibody in peripheral blood were detected by Luminex method.The relationships of C4d with antibodies in peripheral blood and pathology of renal graft were analyzed,and their influences on renal function were exposed.Results:The positive rate of HLA antibody was 88.9 ％ in cases with positive C4d and 40％ in the cases with negative C4d.The positive rate of HLA antibody was higher in patients with positive C4d than that in patients with negative C4d(P=0.003).The proportion of glomerulitis was higher in cases with positive C4d (P=0.023),and vasculitis and arterial intimal thickening of transplanted renal were more common in cases with positive HLA antibody than those with negative HLA antibody (P＜0.05),while no correlations between histological features and MⅠCA antibody were found.There was no difference in glomerular filtration rate (GFR) between cases with positive and negative C4d,but in patients of positive C4d with positive HLA antibody or MⅠCA antibody,the GFR decreased more remarkably compared with those of single positive C4d (P＜0.05).Conclusions:For patients of acute rejection,positive C4d combined with positive antibodies of HLA and MⅠCA in peripheral blood has better predictive value for graft survival compared with single positive C4d.

OBJECTIVETo study the effects of Jinmaitong Capsule (JMT) on the expression of NGF and NGF mRNA in STZ-induced diabetic rats.

METHODFifty SZT-induced diabetic rats were randomly divided into 5 groups including model group, low-dose JMT group (treated with JMT similar to the quintupling dose of adult recommended dosage), middle-dose JMT group (treated with JMT similar to the decuple dose of adult recommended dosage), high-dose JMT group (treated with JMT similar to the twenty-fold dose of adult recommended dosage) and Neurotropin group (treated with Neurotropin similar to the decuple dose of adult recommended dosage). Ten normal rats matching with weight and age served as normal control group. All rats were given intragastric administration for 16 weeks and then killed. Body weight and blood glucose were detected before and at the 4, 8, 12, 16th week after treatment. The hydrothermal tail-flick and pain threshold to mechanical stimulation with Von Frey filament were carried out before death. The expression of NGF and NGF-mRNA in sciatic nerve were detected by SABC immunohistochemical method and real-time fluorogenetic quantitative PCR respectively.

RESULTThe blood glucose levels of STZ-DM rats were much higher than those of normal rats (P < 0.01). In all the treated groups, there were no significant differences among them compared each other or compared with model group. And it got the same result when concerning about body weight no matter how the rats were dealt with. Hydrothermal tail-flick test: The tail-flick latency of STZ-DM rats were much longer than those of normal rats (P < 0.01 or P < 0.05). Compared with model group, the time shortened significantly in low, middle-dose of JMT groups and Neutrophin group. Compared with normal group, the pain thresholds of model group decreased extremely (P < 0.01). Compared with model group, the threshold values of low-dose, middle-dose JMT group and neutrophin group raised strikingly (P < 0.05). The levels of NGF-mRNA expression in STZ-DM rats were much lower than those of the normal rats (P < 0.01). Compared with model group, NGF-mRNA expression of middle-dose JMT group and Neurotropin group upregulated noticeably (P < 0.01). The integrated option density of NGF expression in STZ-DM rats was much lower than the normal (P < 0.01 or P < 0.05). And the levels of NGF in all the treated groups increased notably compared with model group (P < 0.05 or P < 0.01). There were no significant differences among middle-dose JMT group and Neutrophin group.

CONCLUSIONTraditional Chinese medicine JMT could up-regulate the expression of NGF and NGF-mRNA in sciatic nerve.

Animals ; Capsules ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Immunohistochemistry ; Male ; Mice ; Nerve Growth Factor ; genetics ; metabolism ; Polymerase Chain Reaction ; Random Allocation ; Rats ; Rats, Wistar ; Sciatic Nerve ; drug effects ; metabolism

Objective This paper aims to construct a system integrating mixed reality technology with artificial algo-rithm and to evaluate its effectiveness in vascular localization during anterolateral thigh perforator flap surgery to provide new insights for clinical practice.Methods Twenty patients undergoing anterolateral thigh perforator flap repair were selected.After attaching positioning devices on the lower limb,CT angiography(CTA)scans were performed.The 2D data obtained were converted into a 3D model of the positioning device and vessels.Mixed reality technology was uti-lized to achieve 3D visualization of perforator vessels.An artificial algorithm was developed in HoloLens 2 to match the positioning device automatically with its 3D model intraoperatively to overlap the perforator vessels with their 3D mod-els.The number of perforator vessels identified within the flap harvesting area and the actual number detected during sur-gery were recorded to calculate the accuracy rate of vessel identification based on CTA data reconstruction.The distance between the perforator vessel exit points located by the system and the actual exit points was measured,and the error val-ues were calculated.The surgical time required for the system to harvest the anterolateral thigh perforator flap was docu-mented and compared with the surgical time required by conventional methods.The clinical applicability of the system was discussed.Results The CTA data reconstruction identified 30 perforator vessels,while the actual number found during surgery was 32,resulting in an identification accuracy rate of 93.75％.The average distance between the perfora-tor vessel exit points located by the system and the actual exit points was(1.65±0.52)mm.The average surgical time for flap harvesting with the assistance of the system was(43.45±4.6)min compared with(57.6±7.9)min required by conven-tional methods.All perforator flaps survived the procedure.One case of flap infection occurred seven days postoperative-ly,and one case of partial flap necrosis was treated with symptomatic therapy,resulting in delayed healing.Conclusion The system constructed in this paper can achieve 3D visualization of perforator vessels through mixed reality technology and improve the accuracy of perforator vessel localization using artificial algorithms,hence demonstrating potential ap-plication in anterolateral thigh perforator flap harvesting surgeries.

Humans ; Blast Crisis/genetics* ; Leukemia, Promyelocytic, Acute/genetics* ; Oncogene Proteins, Fusion/genetics* ; Tretinoin

OBJECTIVETo analyze the number of myeloid-derived suppressor cells(MDSC) and the level of prostaglandin E2(PGE2) in the bone marrow of adult ITP patients, and to explore their possible mechanisms involved in the pathogenesis of this disease.

METHODSTwenty-five patients of newly diagnosed ITP, 25 patients of complete remission group and 15 patients of control group were selected. The number of MDSC in the bone marrow between 3 groups was detect by flow cytometry (FCM). The serum level of prostaglandin E2 (PGE2) in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The relative expression of IFN-γ mRNA in bone marrow mononuclear cells was measured by real time fluorescence quantitative polymerase chain reaction (RT-qPCR) in each groups.

RESULTSThe number of MDSC in the complete remission group was significantly higher than that in the control group (P<0.05); the number of MDSC in the newly diagnosed group was higher than that in the control group; the number of MDSC in the complete remission group was higher than that in the newly diagnosed group. The serum level of PGE2 in bone marrow of ITP patients in the newly diagnosed group was higher than that of the control group（P<0.05）. The serum level of PGE2 in the bone marrow of ITP patients of the complete remission group was higher than that of the control group (P<0.05）. The level of PGE2 in bone marrow serum of ITP patients of the newly diagnosed group was lower than that in the complete remission group(P<0.05）. The relative expression level of IFN-gamma in bone marrow mononuclear cells of the ITP patients in newly diagnosed group was higher than that in the control group and the complete remission group（P<0.001）. The relative quantification (RQ) of IFN-γ in bone marrow mononuclear cells was 2.60 between the newly diagnosed group and the complete remission group.

CONCLUSIONWhen adult ITP disease is remitted, the number of MDSC rises and correlates with the therapeutic response and PGE2 level in the bone marrow.

Adult ; Bone Marrow ; Flow Cytometry ; Humans ; Myeloid-Derived Suppressor Cells ; Purpura, Thrombocytopenic, Idiopathic ; RNA, Messenger

OBJECTIVE: To study the correlation of IL-37 with T lymphocytes subsets and NK cells in ITP patients, and to explore its possible mechanisms involved in the pathogenesis of ITP. METHODS: Forty-five patients with newly diagnosed ITP(newly diagnosed group), 32 patients of complete remission (remission group) and 22 healthy persons(control group) were selected. The serum level of IL-37 in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The mRNA expression of IL-37, IL-17 and IL-18 in peripheral blood mononuclear cells（PBMNC） in 3 groups was measured by real-time fluorescence quantitative polymerase chain reaction (PCR). The number of IL-18RαCD4 T cells and Tim-3NK cells in the peripheral blood in 3 groups was detected by flow cytometry (FCM). RESULTS: The serum level of IL-37 in the peripheral blood of ITP patients in the newly diagnosed group was significantly higher than that in the control group and the remission group(P＜0.01) . The expression level of IL-37 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group(P＜0. 05). The expression level of IL-17 and IL-18 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group(P＜0. 01); the expression of IL-18Rα in CD4 T cells in newly diagnosed group was significantly higher than that in both the control and the remission group(P＜0.01).The expression of Tim-3 in NK cells in ITP patients was significantly lower than that in the control group (P＜0. 01). In ITP patients, the serum IL-37 level and IL-18RαCD4T cells ratio both negatively correlated with Plt count (r=-0.58, r=-0.48) moreo-ver the serum IL-37 level also negatively correlated with amount of CD4 T cells and NK cells (r=-0.29, r=-0.28), but positively correlated with amount of CD8 T cells (r=0.329). CONCLUSION The IL-37 and its receptors may play an immunoregulatory role in CD4 T cells and NK cells, the IL-37 may be a therapeutic target for ITP patients.
CD8-Positive T-Lymphocytes ; Flow Cytometry ; Humans ; Interleukin-1 ; immunology ; Killer Cells, Natural ; Leukocytes, Mononuclear ; Purpura, Thrombocytopenic, Idiopathic ; T-Lymphocyte Subsets