Objective To investigate the changes of panel reaction antibody (PRA) and the effects of HLA sensitized paths in patients waiting for renal transplantation.Methods PRA of 10 555 samples from 8926 renal transplant recipients in 51 transplant centers was analyzed.In 1991-1998 group,PRA was by using NIH-CDC technique,and in 1999-2010 group,PRA was detected by using ELISA.The effects of blood transfusion,pregnancy and transplantation on the PRA positive rate were analyzed.Results There were 1324 recipients positive for PRA in 8926 (14.83 ％ ).The average PRA positive rate in 1991 1998 group and 1999-2010 group was 18.17％ (513/2823) and 13.29％ (811/6103) repectively (P＜0.01).Among 1324 PRA positive recipients,the number of recipients with PRA of 1％-30％ and PRA of ≥30％ respectively accounted for 71.83％ and 28.17％.There were statistically significant differences in the PRA positive rate between the recipients receiving blood transfusion and those without blood transfusion (31.77％ vs 1.21％,P ＜ 0.01 ),between the recipients having pregnancy history and those without pregnancy history (24.64％ vs 7.19％,P＜ 0.01 ),and between primary transplant and re-transplant recipients (13.35 ％ vs 40.62％,P＜0.01).Conclusion In last 20 years, PRA in majority of PRA positive recipients was ＜ 30％ (low sensitized).Renal transplantation and blood transfusion were the important influencing factors that led to positive PRA,and pregnancy history was a related factor.

Objective To explore the best opportunity of termination of pregnancy and conservative therapy in the treatment of lata trimester of pregnancy combining hypertension or preeclampsia.Methods The clinical data of 198 patients with pregnancy combining hypertension or preeclampsia were studied retrospectively.Among the total patients,107 patients performed conservative therapy (conservative therapy group),91 patients performed termination of pregnancy (termination of pregnancy group).The prognosis of two groups was compared,including maternal and neonatal complications and morbidity and mortality.ResultsThe cesarean section rate of conservative therapy group was 54.2％ (58/107),termination of pregnancy group was 51.6％(47/91 ),there was no significant difference between two groups(P＞0.05 ).The perinatal complication rate of conservative therapy group and termination of pregnancy group was 15.9％(17/107) and 17.6％( 16/91 ),there was no significant difference between two groups(P＞0.05).The rate of placental abruption,low platelet disease,hypoproteinemia,postpartum hemorrhage between two groups had no significant difference (P＞0.05).Conservative therapy group had 3 cases neonatal asphyxia,1 case neonatal death.Termination of pregnancy group had 7 cases neonatal asphyxia,1 case neonatal death.The rate of adverse events of conservative therapy group had no significant difference compared with termination of pregnancy group (P＞0.05 ).The perinatal average weight of conservative therapy group was (2.635 ± 0.446)kg,termination of pregnancy group was (2.014 ±0.721) kg,there was significant difference (P＜0.05).Conclusion Under the premise of control blood pressure,spasmolysis,ensure maternal and neonatal safety,expectant monitoring can give more chances for fetuses to get more mature so decrease the complications.

Objective To analyze the association between pre-pregnancy body mass index,pregnancy weight gain and gestational diabetes(GDM).Methods The pre-pregnancy body mass index,pregnancy weight gain and the incidence data of 345 gestational diabetes with full-term primiparae were analyzed.Results The GDM ratio of low-weight,ideal weight group,over-weight was 2.78％,2.96％,16.04％,respectively over-weight GDM pregnancy was significantly higher than the ideal weight group( x2 =4.269,P ＜0.05),and GDM over-weight before pregnancy was significantly higher than the low weight group the incidence of GDM,the difference was statistically significant( x2 =17.299,P ＜0.01 ) ;Pregnant women in different pregnancy weight gain A( ＜ 11.0kg),B( 11.0 ～ 17.9kg),C( 18.0～24.9kg),D(≥25.0kg) range,the GDM were 0％,1.75％,6.60％,11.02％,that GDM of A,B,C,D group were statistically different( P ＜ 0.05 ).Rate of weight gain during pregnancy on pregnancy size was proportional to the impact of diabetes.Conclusion Pre-pregnancy body mass index,pregnancy weight gain had clinical significance in evaluation of gestational diabetes.

Objective To explore the clinical function of biofeedback training in patients with high risks of postpartum depression,and to provide a new method to decrease the risk of postpartum depression.Methods From May 1,to December 31,2010,in Bayi Children's Hospital,General Hospital of Beijing Military Area Command of Chinese PLA,60 pregnant women with Edinburgh Postnatal Depression Scale (EPDS) evaluation score of 6 to 12 at 12～14 gestational weeks were randomly divided into the biofeedback training group (n=30) and the control group (n=30).The control group learned prenatal care knowledge in pregnant women's school.Moreover,the biofeedback training group received Self-generate Physiological Coherence System training till one week before delivery.Both groups were evaluated with the EPDS at baseline,and 3 days,6 weeks,3 months postpartum.Differences between the two groups were compared with mixed effect model.Results Totally,there were 51 pregnant women finished the study,including 25 women in the biofeedback training group and 26 in the control group.There were no statistical difference in EPDS score at 12～14 gestational weeks between the biofeedback training group and control group [8.5±2.0 vs 8.5±1.9,t=0.03,P=0.97].At 3 days,6 weeks and 3 months postpartum,the EPDS score of biofeedback training group was 4.1 ± 1.8,4.7 ± 2.0 and 4.6 ± 1.8 respectively,which was lower than those in the control group (6.5 ± 2.4,7.0 ± 2.5and 6.9±2.4) (interaction effect F=4.35,P=0.01).On each postpartum time-point,OR value and 95％CI was 0.12 (0.03-0.45),0.21 (0.06-0.68) and 0.23 (0.07-0.77),P＜0.05 respectively.Cohen's d value were 1.17,0.99 and 1.06 respectively.Compared with the baseline value,the total EPDS scores in each study stage declined with varied degrees in both groups,and the score-reducing level were obvious in the biofeedback training group than in the control group.Conclusion Biofeedback training could effectively relieve the depression symptoms in pregnant women with high risks of postpartum depression,and decrease the risk of postpartum depression.

Objective To determine the definite effec ti ve therapy for localized prostate cancer. Methods A data -base of 317 patients with prostate cancer treated with different therapies be tween 1969 and 1999 were analyzed.Overall survival and disease specific survival rates for patients with different stage,grade,and regimen were analysed by Kap lan-Meier method.Predictive factors impacted on disease specific survival were also analyzed by using log-rank test and Cox proportional hazards model. Results Overall survival rates at 5-,10- and 15-year were 7 3.1%,51.8% and 35.3%,corresponding disease specific survival rats of 85.1%、72.9 % and 72.9%,respectively.Disease specific survival rate at 10-year was 100.0% i n 36 patients treated with radical prostatectomy,78.0% in 57 patients treated wi th local radiotherapy.Multivariate analysis by Cox model showed that stage ( RR =2.17,CI 1.43～3.28, P =0.0000) and grade( RR =2.54,CI 1.37～4.68, P = 0. 0003)were significantly impacted on disease specific survival. Conc lusions Radical prostatectomy and local radiation provide effective treatment for patient with organ-confined prostate cancer.Adjuvant hormonal the rapy may effect on patient’s survival.Clinical stage and grade of prostate canc er are independent factors impacting on survival significantly.

To explore the role of Fas,FasL in pathogenesis of prostatic cancer (Pca), expression of Fas and FasL in 49 cases of Pca, 22 cases of BPH and 14 cases of normal prostate(NP) was detected by immunohistochemical SP method. The results were as follows: ①Fas, FasL were expressed in all the examined tissues; ②The expression of Fas was strongest in BPH specimens and weekest in Pca tissues ( P 0 05);④The expression of Fas in 17 cases of androgen dependent Pca tissues was more marked than that in 9 cases of androgen independent Pca tissues( P

Objective To review the diagnosis of prostatic cancer in 317 cases encountered between 1969 and 1999. Methods The clinical data of the 317 cases were retrospectively analysed. Results Prostatic cancer constituted 2.2% of the inpatients of the urology department,9.8% of genito urological tumors.In recent 10 years,the new cases of prostatic cancers hospitalized was 4.2 folds more than 20 years before.Since the use of PSA assessment,the diagnosis rate of prostatic cancer especially the T 1 and T 2 cases was significantly elevated (60.2% vs 50.0%). The diagnoses rate of DRE and TRUS was 86.1% and 89.1% whereas if combined with PSA assessment the diagnosis rate of either DRE or TRUS was increased to 99.0%. Serum PSA level was intimately correlated with the grade and stage of prostatic cancer. Conclusions The prostatic cancer inpatients tends to increase.Serum PSA assessment is of important value in detecting early cases of prostatic cancer.PSA,DRE and TRUS are the cardinal means for the screening of prostatic cancer and when used combinedly the diagnosis rate and accuracy are elevated.

BACKGROUND:Various gene-delivery strategies have be used to transfer targeted genes into damaged bone tissues. As the most efficient gene vector, viral delivery systems have been used in bone tissue engineering research. OBJECTIVE: To thoroughly discuss the applications of different viral vectors in gene-enhanced bone tissue engineering. METHODS:A computer-based online search was performed in PubMed database for the related articles from January 2002 to January 2015. This review centered on viral vector transduction methods and their use in bone tissue engineering. Adenovirus, retrovirus, adeno-associated virus and chimeric virus were al discussed. Advantages and limitations of different vectors and their applicability toward bone tissue engineering were presented in this article. A total of 24 articles were included for review. RESULTS AND CONCLUSION:Current viral vectors for gene delivery in gene-enhanced bone tissue engineering are summarized, including recent work where combinatorial gene therapy is used to express groups of genes to stimulate bone regeneration. Future directions for this field are discussed, where viral vectors mediated gene expression systems wil be combined with cels such as mesenchymal stem cels seeded in synthetic scaffolds to repair bone loss. Gene-enhanced bone tissue engineering has more advantages than traditional tissue engineering; viral vectors contribute to higher gene transfection efficiency than normal vectors. Long-term clinical observation is needed for the safety of viral vectors used in gene-enhanced tissue engineering in the body. Viruses are stil the most efficient means by which exogenous genes can be introduced into seeds cels.

Objective To study the preoperative treatment and prognosis observation? in sensitized recipients of kidney transplantation.Method Forty-one recipients positive for preoperative PRA accepted renal allograft transplantation from January 2007 to July 2012.All recipients were given immunosuppressant or immune induction by anti-CD25rnAb in advance,and plasma exchange,immunoadsorption and intravenous high-dose immune globulin were administered.Meanwhile,donor HLA antigens had to avoid all stored HLA antibodies of the recipient,and lymphocyte cytotoxicity cross test (CDC) had to be negative.Anti-human lymphocyte globulin (ATG) was used to strengthen the immune induction,and tacrolimus + mycophenolate mofetil (MMF) + corticosteroids triple immunosuppressive regimen was adopted after transplantation.Then intravenous micafungin would be given after transplanted kidney function was normal,and ganciclovir and sulfamethoxazole were taken orally to prevent infection.Result In 41 recipients positive for preoperative PRA,13 cases were positive for only HLA class Ⅰ antibodies,15 cases for only HLA class Ⅱ antibodies,and there existed 13 cases of both HLA class Ⅰ and class Ⅱ antibodies also with PRA≥50％.Fifteen patients achieved normal serum creatinine in one week,and no hyperacute rejection and accelerated rejection occurred.Fourteen recipients experienced an episode of acute rejection (34.15％,14/41): 12 recovered by steroids bolus therapy,and the other two reversed in 3-5 days by cyclophosphamide or ATG treatment.One case died of mycotic pneumonia in 4 months later.One-year recipient/kidney survival rate was 97.6％ (40/41).Conclusion The recipients positive for preoperative PRA only can accept renal allograft transplant while the donor's HLA antigens had to avoid all stored HLA antibodies of recipients themselves and CDC test was negative.After that the combination of desensitization therapy,immune induction therapy and postoperative potent immunosuppressant can prevent acute rejection effectively and increase postoperative recipient/kidney survival rate.