Transplantation is regarded as the only therapeutic choice for end-stage organ failure,however,rejection restricted its efficacy after transplantation.MSCs exhibit several desirable characteristics,which may advocate their use in organ transplantation.This includes the capacity to suppress alloreactive and autoimmune T-cell responses,and pro mote a cytokine environment which is likely to be graft protective.This review describes the recent research of MSCs used in organ transplant.

Objective To study the effect of variant concentrations of lidocaine on voltage-dependent sodium current in dissociated hippocampal neurons of the ratMethods Voltage-dependent sodium currents in dissociated hippocampal neurons of the rat were recorded by whole-cell configuration of the patch clamp when a series of doses of lidocaine (10 -5mol/L-10 -2mol/L) were appliedResults Lidocaine reduced the amplitude of sodium current in a dose-dependent manner, with EC50 of (039?005)mmol/LConclusions Voltage-dependent sodium channel is related to cerebral protective effect of lidocaine, but has nothing to do with its nervous toxicity

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.

ObjectiveTo study the clinicopathologic features of post-transplant lymphoproliferative disorders (PTLD).Methods Three cases of PTLD in renal transplant recipients were studied.The clinical data,diagnosis and differential diagnosis,and relevant literatures were also reviewed.Results All the 3 cases studied had received cyclosporine A or Tac after transplantation.The duration between organ transplantation and diagnosis of PTLD was 10 years,4 years and 2 months respectively.Two cases were suffered from monomorphic PTLD and 1 from plasmacytic hyperplasialike PTLD in morphology.Two cases of monomorphic PTLD died within one year after diagnosis.Conclusion PTLD is a lymphoproliferative disease with distinctive morphologic and clinical characteristics.The main treatments included the dosage reduction of immunosuppressive agents,radiotherapy and chemotherapy.The prognosis of monomorphic PTLD was poor.

Objective To compare the efficacy of Holmium:YAG laser and pneumatic lithotripsy in the treatment of ureteral calculi.Methods From February 2002 to February 2007,totally 1035 patients with ureteral calculi underwent ureteroscopic lithotripsy with Holmium:YAG laser or pneumatic lithotripsy in our hospital.The data of the patients were analyzed retrospectively.Results The success rate of primary lithotripsy was 99.1%(328/331)in the patients received holmium laser,and 97.6%(687/704)in those who underwent pneumatic lithoclast(?2=2.703,P=0.100).Stone-free rate at 3 weeks was 98.2%(322/328)in the Holmium laser group,which was significantly higher than that in the pneumatic lithoclast group 88.1%(605/687),?2=28.639,P=0.000].However,significantly more ureteroscopes were damaged in the Holmium laser group than the pneumatic lithoclast group(11 vs 6,?2=8.509,P=0.004).Conclusions The stone-free rate in holmium laser group is higher than that in pneumatic lithoclast group.However,more ureteroscopes are damaged by holmium laser.

Objective To explore the differentiation of human bone marrow measenchymal stem cells (hMSCs) into neuron-like and dopaminergic neuron-like cells in vitro.Methods The hMSCs were isolated from adult human bone marrow and expanded on the flask undifferentiated state for 2 passages. After pretreatment with WHI-P131 for 48 h, the hMSCs were cultured at the medium containing 10 ng/ml basic fibroblast growth factor for 24 h, then incubated with all-trans-retinoic acid and glial-derived neurotrophic factor in serum-free media for 5 h. The surface markers of differentiated neuron were detected by immunocytochemical method and the transdifferentiation process was observed under light microscope.Results Under induction conditions, hMSCs progressively resumed typical neuronal morphological characteristics. After hMSCs were incubated in induction medium for 5 h, the percentage of NSE, nestin, GFAP, TH and DAT positive cells were (77.0?5.7)%, (54.2?3.7)%,(8.8?2.4)%, (36.5?15.8)% and (26.0?14.2)%, respectively. There were no positive expressions in the control group.Conclusion The hMSCs are able to differentiate into neuron-like and dopaminergic neuron-like cells in vitro.

Objective To explore the validity and security of Simulect (basiliximab) induction immunosuppressive therapy in terms of prevention of acute allograft rejection in sensitive recipients.Methods Thirty-six adult recipients of cadaveric kidney transplant with panal reactive antibody 30 %～ 50 % were assigned randomly in a 1∶1 ratio to receive either two doses Simulect or matching placebo. Both patient groups also received baseline triple immunosuppression with the cyclosporine microemulsion, MMF and steroids. A total 40 mg Simulect was given in two doses of 20 mg eachon day 0 about 2 h before transplantation and the day 4 after transplantation respectively.Results No hyperacute rejection and delayed graft function occurred in the two groups. No apparent adverse and toxic events were recorded in the Simulect group. The incidence of acute rejection 3 months after transplantation was 11.1 % in Simulect group compared with 50 % in the placebo group ( 77.8 % reduction, P

Objective To evaluate monocyte chemotactic peptide-1 (MCP-1) excretion levels in urine of renal transplant recipients and study the relation between urinary MCP-1 levels and acute rejection.Methods Urinary MCP-1 levels were determined by avidin biotin complex-enzyme linked immunosorbent reaction (ABC-ELISA).Results The urinary MCP-1 levels were significantly higher in recipients with acute rejection than in clinically stable ones (P

0.05).The graft function of high dose group returned to normal within 3 to 7 days after operation.Delayed recovery of graft function occurred in 2 cases of routine dose group;in 1 case it returned to normal on the 21st day after operation, in the other the serum creatinine level fell down to 300 ?mol/L on the 45th day.There was no severe adverse event such as fever,chill,headache,heart-throb,dyspnea during ATG intravenous perfusion.And no serious infection occurred in the 2 groups during the first 3 months postoperatively.Hepatic function damage occurred in 1 case of high dose group.Follow-up ranged from 4 to 14 months.All recipients of high dose group survived with good graft function;5 of them could do housework. Only one graft lost its function in routine dose group. Conclusions On the basis of optimal selection of the donor and recipient,preoperative single-bolus high-dose ATG is effective and safe for the sensitive recipients as immune induction therapy, which may become one of the new induction treatments before transplantation.

Objective To explore the significance of peritubular capillary C4d deposition in the diagnosis, treatment and prognosis of the patients with acute renal allograft rejection.Methods 86 allograft biopsies obtained from 78 kidney transplants were examined by immunohistochemistry on routine paraffin sections using anti-C4d polyclonal antibody. The relationship of C4d and functions, therapies and prognoses of allografts was analyzed. Results There were 32 allograft biopsies with Banff type Ⅰ rejection, 51 with Banff type Ⅱ rejection and 3 with Banff type Ⅲ rejection. Thirty biopsies were positive in C4d deposition. For 28 patients, at least one biopsy exhibited peritubular C4d deposition. There was no significant difference between type Ⅰ and type Ⅱ rejection ( 21.9 % vs 39.2 % , P= 0.101 ). The C4d~ + group had proportionately more patients with pregnant history (P= 0.020 ), more patients with high panel-reactive antibody levels (P= 0.013 ), and more retransplanted patients (P= 0.016 ). Mean serum creatinine was significantly higher in C4d positive patients than in negative patients[( 312.56 ? 196.26 ) ?mol/L vs ( 210.97 ? 136.59 ) ?mol/L, P= 0.0115 ]. Patients with C4d deposition were more commonly resistant to antirejection therapy with bolus steroids ( 75.0 % vs 28.0 % , P= 0.000 ) and ATG ( 66.7 % vs 12.5 % , P= 0.027 ). More patients with peritubular C4d deposition lost their grafts during the study period (64.3 % vs 90.0 %, P= 0.006 ).Conclusion Acute rejection with C4d deposition were resistant to antirejection therapy with steroids and/or ATG, and associated with inferior graft outcome.