40%)were observed in HLA CREGs matching and outcome of post-transplantation.Results Patients with 0,1,2 or 3 mismatching(MM) of HLA CREGs+DR were 4(28%), 6(44%)and 4(28%)cases respectively according to the the rule of CREGs matching and no case had 3～6 MM.However the cases of 0,1,2,3 and 4 MM were 1(7%),3(21%),5(36%)and 5(36%)respectively by the standard of conventional HLA antigen matching,without 4～6 MM and only 4 cases had shared 0～1MM.Only 9 patients were developed into acute rejection, and were reversed by OKT3 treatment after transplantation.Renal function was returned to normal in all patients.Conclusions Using CREGs matching criteria would significantly increase the chance of recipients to receive well-matched kidney and provide more chance for waiting recipients.Suitable HLA matching could play an important role in reducing the incidence of acute rejection and improving graft survival in sensitized patients.

Objective To observe the role of preoperative single administration of zenapax in the prevention of acute rejection after kidney transplantation, and evaluate its safety. Methods A total of 80 renal transplant recipients during the same period were divided into treatment and control groups, each group containing 40 patients. There were no difference between the two groups in treatment regime except the preoperative single administration of zenapax in the treatment group. Results Acute rejection rate was significantly lower in the treatment group(7.5%) than the control group(25%) within 6 months after kidney transplantation(P

Objective To investigate immunoadsorption in the prevention of hyperacute rejection in highly sensitized recipients of renal allografts.Methods Immunoadsorption treatment was performed on 10 patients whose panel reactive antigen (PRA) was more than 40 %. The adverse effect and hyperacute rejection were observed.Results Two cases of acute rejection of renal allografts were found in highly sensitized recipients and reversed by the therapy of immunoadsorption and adjusting immuno-suppressive drugs.Conclusion Immunoadsorption treatment could effectively and safely prevent highly sensitized recipients from hyperacute rejection post-transplantation.

Objective To investigate the etiological diagnosis and therapy of liver function lesion after kidney transplantation.Methods By analyzing the etiological factor of 82 cases of liver function lesion,we provided a reasonable and operative therapy scheme in kidney post-transplantation.Results Of 82 cases,the number of drug toxicity and viral hepatitis B which result in liver functional lesion were 70 cases(85 5%) and 12 cases(14 5%) respectively.The former were all cured,8 cases in the latter were cured and the other 4 cases were died from acute hepatic failure.Conclusions The liver function lesion of post-transplantation should be diagnosed carefully and treated particularly.Morever,the adjustment of immuno-suppressive drugs and monitoring circlosporin A concentration should be done for the patients with liver function damaged.

Objective To explore the effect of hypoxia-inducible factor 1α(HIF-1α)in pathological scar and its specific mechanism,and the therapy target of pathological scar.Methods Real time PCR and Western blot was used to test the expression of HIF-1αin normal tissue and pathological scar,meanwhile to detect the effect of hypoxic environment on the expression of HIF-1α.Fibroblasts activity in pathological scar and normal tissue under different oxygen concentration(20%,10%,5%,2% and 1%)was determined by MTT method.Determine the different expression of HIF-1αmRNA and protein in normal environment(20% oxygen) and hypoxic environment(5%oxygen).The changes of the number of fibroblasts after the silence of HIF-1αby HIF-1αshRNA virus using flow cytometer.Results The Real time PCR and Western blot results showed that the expressions of HIF-1αmRNA and protein in fibroblasts of pathological scar was significantly higher than that in normal tissue(P<0.05),and the activity of the keloid fibroblasts in hypoxia environment(5%,2% and 1%)was also higher than that in normal tissue(P<0.05).The expressions of HIF-1αmRNA and protein in keloid fiber cells were higher in hypoxia environment(5% oxygen)than those in normal environment(20% oxygen),but when silence the expression of HIF-1αin keloid fibroblasts,the apoptosis of fibroblast in hypoxia environment(5%oxygen)were significantly higher than control group[(0.021 ±0.001)%vs.(3.739 ± 0.039)%,P<0.05].Conclusion HIF-1αincreases significantly in the pathological keloid fibroblasts and could promote the proliferation of fibroblasts and its vitality,which could accelerate the formation of pathological scar.

Objective To investigate the effect of Kang Shueling gel on the degree of inflammation in the patients with Ⅱ degree burns. Methods 86 patients with Ⅱ degree burns from July 2014 to July 2016 in our hospital were divided into the control group and the experimental group by lottery method with 43 cases in each group. The control group was treated with silver sulfadiazine, the experimental group was treated with Kang Shuling gel, the two groups of clinical curative efficacy, inflammatory factors, visual analogue scale (VAS), wound healing rate and wound healing time, wound infection rate and adverse drug reactions were compared. Results After treatment, the total effective rate of the experimental group was 95.34% higher than that of the control group 72.09%, the difference was statistically significant (P<0.05). The tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) levels of the experimental group was lower than the control group, the difference was statistically significant (P<0.05). The VAS of the experimental group was lower than the control group, the difference was statistically significant (P<0.05).The wound healing rate of the experimental group was higher than that of the control group on the seventh day and the fourteenth day, and the wound healing time was better than that of the control group, the difference was statistically significant (P<0.05). The wound infection rate of the experimental group was lower than that of the control group (P<0.05). There was no significant difference in adverse drug reactions between the two groups. Conclusion The curative effect of Kang Shuling gel on the treatment of Ⅱ degree burns patients worthy of affirmation, could reduce serum inflammatory factors level.

Objective To study the effect of tranilast on cyclosporine A (CsA)-induced epithelial-to-mesenchymal transition in human renal tubular epithelial cells, and investigate the mechanism of its antifibrotic effect. Methods Cultured HK-2 cells were divided into four groups: (1)In the control group, cells were treated without any medicine; (2) The cell were treated with CsA (4. 2μmol/L) for 72 h; (3) The cells were treated with a combination of CsA (4. 2 μmol/L) and tranilast (100μmol/L); (4) The cells were treated with tranilast (100 μmol/L) alone for 72 h.Morphological changes of the cells were assessed by phase-contrast microscopy. The immunofluorescence and Western blotting were adopted to detect the expression of E-cadherin, α-SMA and OPN mRNA and proteins respectively. Results Tranilast could markedly ameliorate the morphological changes of HK-2 cells stimulated by CsA. The irmmunofluorescence staining revealed the expression of E-cadherin was markedly decreased in HK-2 cells stimulated with CsA for 72 as compared with the control group, while the expression of α-SMA and OPN was significantly higher in CsA group than the control group. The expression of E-cadherin in the CsA + Tranilast group was higher than the CsA group, while the expression of α-SMA and OPN in the CsA + Tranilast group was lower than the CsA group. Western blotting showed that protein expression level of E-cadherin in CsA group was dramatically lower than that in the control group (P＜0. 05), while that of α-SMA and OPN in CsA group was significantly higher than in the control group (P＜0.05). The protein expression level of E-cadherin in HK-2 cells in the CsA + Tranilast group was markedly higher than in the CsA group (P＜0.05), and that of α-SMA and OPN in CsA + Tranilast group was significantly lower than in the CsA group (P＜0. 05). Conclusion Tranilast can block the CsA-induced epithelialto-mesenchymal transition in HK-2 cells probably by suppressing the expression of OPN.

Objective To investigate the clinical value of spinal nonfusion interspinous Coflex system for the degenerative lumbar spinal stenosis.Methods From March 2008 to August 2009,26 patients with degenerative lumbar spinal stenosis were treated by decompression with posterior spinous process and interspinous implant Coflex folder method,including 11 males and 15 females,with the mean age of 65.4years(range,45-78 years).L3,4 segment in 7 cases,L4,5 segment in 13 cases,concomitant L3,4,L4,5 segment stenosis in 6 cases.Patients were scanned by MRI and CT confirmed L3,4 and(or)L4,5 segments of the ligamentum flavum thickening,proliferation of small-joint bone,merger disc herniation causing central tube and lateral fossae stricture,nerve root or coccygeal plexus compression.Lumbar anteroposterior,lateral and flexion-extension X-ray films preoperatively,and at follow-up were used to measure the following parameters by eFilm and CAD software:the anterior and posterior disc space height,the range of motion at surgical level,and the segment of the spinal canal area of responsibility.Postoperative standard Japanese Orthopaedic Association(JOA)score for preoperative and postoperative scores.Results Patients were followed up 12-24months.The pain relieved in all patients.The JOA scores improved from(15.46 ±4.30)preoperatively to (24.50±1.58)postoperatively,the vertebral canal area of the affected segment was(218.4±16.2)mm2 before the operation,(264.6±9.9)mm2 after the operation.Single segment anterior disc space height did not change significantly,the difference was not statistically significant.The disc space posterior height increased compared with the preoperative height,and gradually decreased with time.No patients suffered Coflex loosening,fracture and emerge.Conclusion The treatment of lumbar spinal stenosis with Coflex system has satisfactory effect in minimal invasiveness and high security,which provides a safe and effective therapy for degenerative lumbar spinal stenosis.

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.