Objective To evaluate whether serum cystatin C (SCys C) could be used as an ideal index to assess renal function of renal transplant recipients during posttransplant follow-up.Methods Seventy patients who were followed up for at least 6 months after renal transplantation in our centre were recruited in the study. SCys C and serum creatinine (SCr) were determined during the follow-up period, and glomerular filtration rate (GFR) was measured using an isotope Tc99m DTPA.The correlation between SCys C, SCr and GFR was analyzed. The performance of SCys C and SCr in diagnosing the mild impairment of renal allgraft function (GFR ＜ 1 ml/s) was evaluated using ROC curve. Results Both SCys C and SCr had a linear negative correlation with GFR (r = -0. 82 and -0. 66 respectively, P＜0. 01 ). The sensitivity, specificity and positive predictive values (PPV) of SCys C for diagnosing the mild impairment of renal allgraft function were higher than those of SCr,but the AUC of SCys C did not differ from that of SCr significantly (0. 935 vs. 0. 877, P＞0. 05).Conclusion SCys C could be used an ideal index to evaluate the allograft renal function for its better correlation with actual GFR.

Objective To explore the correlation between 18F-FLT SUVmax and intratumoral microvessel density (MVD) in NSCLC patients.Methods From January 2008 to December 2010,68 patients (48males and 20 females; age ranging from 36 to 84 years) with NSCLC underwent 18F-FLT PET/CT followed by surgery within two weeks.Tumor proliferation was evaluated in terms of Ki67 labeling index (LI) with SP.MVD was determined using anti-CD31 mAb (CD31-MVD),anti-CD34 mAb (CD34-MVD) and anti-CD105 mAb (CD105-MVD) for each resected tumor.Linear correlation analysis was used to analyze data.Results The mean values of CD31-MVD,CD34-MVD and CD105-MVD were 159.6,166.1,and 38.0 per view field,respectively.Tumor SUVmax was 4.1±2.9,and Ki67 LI was (37.0± 14.5) ％,both of which had significantly correlations with CD105-MVD (r=0.550,0.633 ; both P＜0.05),but there was no significant relationship between SUVmax and CD31-MVD,CD34-MVD (r=0.228,0.235; both P＞0.05).Conclusion 18F-FLT PET/CT imaging has a positive relationship with CD105-MVD of NSCLC,and it could reflect the ability of tumor angiogenesis.

Objective To analyze the changes of proportion of Th1/Th2/Th17 cells in colonic mucosa and peripheral blood in pathogenesis of ulcerative colitis (UC) and its significance. Methods Twenty patients with UC were enrolled according to the criterion established in Jinan in 2007 and 16 patients were served as controls. The phenotypes of the colonic mucosa and peripheral blood were analysis by using flow cytometry. The variation of proportion of Th1/Th2/Th17 in colonic lamina propria mononuclear cells (cLPMCs) and peripheral blood mononuclear cells (PBMCs) were compared between two groups. Results The proportion of Th17 cell in cLPMCs was increased in UC group compared with controls [3.75% (6.93%)vs. 1.25 (3.70%), P<0.05], whereas it was 1.40%(2.15%) in UC group and 0.70%(0.33%) in controls in PBMCs with significant difference (P<0.05). The proportion of Th17 cell in cLPMCs was positively correlated with clinical parameters of the disease (r=0.34, P<0.05). No difference was found in proportion of Th1 or Th2 cells in cLPMCs or PBMCs between UC group and controls. Conclusions Among three helper T cells, Th17 cell in UC patients is predominant both in colonic mucosa and peripheral blood, which can be used as an effective target for treatment.

Objective To summarize the clinical experience of combined liver and kidney transplantation (CLKT). Methods CLKT was performed on 22 patients. The orthotopic liver transplantation (LT) was preceded with the classic fashion in 10 patients and piggyback fashion in 12 patients. The renal allograft was implanted to the iliac fossa routinely. After operation, the patients received an induction therapy with anti-CD25 monoclonal antibody or antithymocyte globulin ( ATG) and a maintenance therapy with tacrolimus (Tac), mycophenolate mofetil and prednisone. Results The CLKT was successfully performed on all 22 patients, and the graft function was restored well postoperation. During the perioperative period, an acute rejection episode of liver occurred in one patient and acute renal allograft rejection episode in 2 patients. The Tac toxicity occurred in one patient. The hemorrhage of digestive tract occurred in one recipient and the hemorrhage of peritoneal cavity in one patient. The pleural effusion occurred in 6 recipients. The pneumonia occurred in 2 cases and the peritoneal infection in one patient During a follow-up period of 6 months to 7 years 11 months, three patients died because of cytomegalovirus pneumonia in 2 patients and acute myocardial infarction in, one patient, The 1-, 3-, 5-year survival rate of recipients was 86,4 %, 81.3 %, 72.7 % respectively. Conclusion The CLKT is an effective method for treatment of patients with end-stage liver djsease and chronic renal failure.

Objective To evaluate the curative effects of conversion from mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium (EC-MPS) on MMF-related chronic diarrhea in the renal transplant (RT) recipients of long-term stage following transplantation.Methods Twenty-six RT recipients with persistent and severe diarrhea,diagnosed as MMF-related diarrhea after a systemic examining procedure including macroscopic and microscopic examinations of the upper and lower gastrointestinal tracks,serology of the blood for CMV and culture of stool for the bacteria.In all the 26 recipients,the dosage of MMF was reduced to 250 mg,twice every day for 2 weeks.Those without significant improvement at the end of this period were shifted to EC-MPS at a dose of 180 mg,twice every day for 2 weeks.The EC-MPS dose was increased to 360 mg,twice every day if the symptoms were improved significantly at the third week after conversion,or EC-MPS was withdrawn if the diarrhea still existed.The dosage of EC-MPS would be reduced to 180 mg,twice every day if the diarrhea recurred in the next 3 months. The clinical symptoms,biological parameters and renal function were observed for 3 months after the conversion.Results ( 1 ) All the 26 recipients were switched to EC-MPS because of the persistent existence of diarrhea after reduction of MMF.After conversion,the diarrhea disappeared completely in 19 out of the 26 recipients in 2 weeks and 2 patients also showed significantly improvement of diarrhea with the total efficiency being 80.8％ (21/26).In the rest 5 cases,EC-MPS was withdrawn at the second week; (2) The disturbance of internal environment was improved significantly following the EC-MPS conversion.Serum potassium,sodium and TCO2 were elevated to normal level.The benefit was predominantly observed in the recipients with moderate to severe proteinuria.The 24-h urinary protein secretion was significantly reduced from 0.76±0.48 to 0.46±0.53 (g/24 h) (P＜0.05) at the third month.Conclusion In RT recipients with MMF-related chronic diarrhea after long-term stage following renal transplantation,switching MMF to EC-MPS can significantly alleviate the diarrhea and rectify the imbalance of internal environment of the recipients.

Objective To explore the effects of cyclosporin A (CsA) and tacrolimus (Tac) on biological behaviors of lung cancer A549 cells in nude mice.Methods Thirty-six models of transplanted tumor in Balb/c mice were established by using lung cancer A549 cells and divided into three groups:control group,without given any immunosuppressant; CsA group,intraperitoneally given CsA; Tac group,intraperitoneally given Tac.The transplanted tumor growth curve was drawn according to the transplanted tumor volume,and the influencing ratio was calculated according to the final tumor weight.The changes in cell migration ability were observed by using Transwell system.Terminal deoxynucleotidyl transferase mediated UTP nick end labeling (TUNEL) assay was used to examine the apoptosis index of the transplanted tumor.Quantitative RT-PCR was used to detect the expression levels of Bcl-2 mRNA and Bax mRNA.Results The growth of transplanted tumor in CsA and Tac groups was faster than in control group.Final tumor volume and final tumor weight in CsA and Tac groups were greater than those in control group.The influencing ratio in CsA and Tac groups was 19％ (P＜0.05) and 25％ (P＜0.05),respectively.The migration ability was greater in CsA and Tac groups than in control group (P＜0.01).The apoptosis index of the transplanted tumor in CsA and Tac groups was lower than in control group (P＜0.05).The expression level of Bcl-2 mRNA was higher in CsA and Tac groups than in control group (P＜0.05),and that of Bax mRNA was lower in CsA and Tac groups than in control group (P＜0.05).Conclusion Both CsA and Tac can promote the growth of transplanted tumor in nuce mice bearing 549 cells and enhance the invasion forces,which is probably related with the apoptosis induction of tumor cells.

[Objective]To investigate the value of degree centrality(DC),a novel resting-state fMRI parameter,in voxel-wise whole-brain functional networks analysis in primary insomnia(PI)after acupuncture therapy.[Methods]The resting state fMRI were performed in 29 PI patients and 22 age,education,and sex-matched normal healthy subjects. Analysis of DC map changes between the two patient groups and the control group were performed by two sample t test.(threshold at P<0.05).[Results]Compared with the control group,patients with PI showed significantly reduced DC value in middle temporal gyrus(MTG. R);hippocampus(HIP. B);parahippocampal gyrus(PHG. R);putamen(PUT. R);cuneus(CUN. L).[Conclusions]Changes of DC value occurred in some region of brain in the PI patient groups when compared with the control group. It was indicated that DC ,as a novel resting-state fMRI parameter in the voxel-wise whole-brain functional networks ,might be an appealing alternative approach for further study on pathologic and neuropsychological states of PI.

Objective To assess the change of the CD4~+ CD25~+ Treg after the transplant nephrectomy in recipients suffering from chronic allograft nephropathy (CAN) with normal PRA level.Methods Thirty recipients suffering from CAN,aged 20-55 years old,with norlTlal PRA level,were divided into two groups:removal group (n=17) and preserving group(n=13).CD4~+ CD25~(high)/CD4~+,CTLA-4 and Foxp3 in peripheral blood were tested at two time ends:O month and 2 months after the transplant nephrectomy operation.Results (1) Ratio of CD4~+ CD25~(high)/CD4~+ at the Oth and 2nd month in the removal group was(1.47±0.19)%,(1.08±0.16)%,and that was(1.44±0.25)% and (1.77±0.24)%,at the same time in the preserving group (P<0.01).(2) The expression of CTLA-4 at the Oth and 2nd month in the removal group was (76.82±5.31)% and (72.56±4.99)%,and that was (76.20±4.22)% and (75.24±4.26)% in the preserving group (P>0.05).(3)The expression of Foxp3 was (79.77±1.59)% and (69.07±4.37)% in the removal group,and that was (79.56±1.75)% and (79.09±2.05)% in the preserving group.The expression rate of Foxp3 at the 2nd month in the removal group was significantly lower than in the preserving group (P<0.01).Conclusion Remoral of the graft can reduce the ratio of CD4~+ CD25~(high)/CD4~+ and the expression of Foxp3,suggesting that the removal of the renal graft may inhibit the activity of CD4~+ CD25~+ Treg.

Trichinella spiralis infection in rodents is a well-known model of intestinal inflammation associated with hypermotility. The aim of the study was to use this experimental model to elucidate if Th17 cells are involved in the development of gastrointestinal hypermotility. Colonic smooth muscle contractility was investigated in response to acetylcholine. The levels of IL-17, IL-23 and TGF-beta1 in colon were measured by Western blotting. Flow cytometric detection of intracellular IFN-gamma/IL-4/IL-17 cytokine production was used to analyze the proportions of CD4+ T cells subsets in colon. Our results showed that colonic muscle contractility was increased 2 weeks post infection (PI) and stayed high 12 weeks PI when no discernible inflammation was present in the gut. The proportion of Th17 cells and the expression of IL-17 were up-regulated in colon 2 weeks PI and returned to normal 8 weeks PI. The content of IL-17 was correlated with the colonic smooth muscle hypercontracility 2 weeks PI. Meanwhile, TGF-beta1 was increased 2 weeks PI, while IL-23 was normal. Our results suggest that Th17 cells affect the colonic muscle contractility in mice infected with Trichinella spiralis at intestine stage but not at muscle stage and the effect of Th17 cells on muscle contractility might be induced by TGF-beta1. Other cytokines might be involved in the hypercontracility of colonic smooth muscle at muscle stage.

This study compared two techniques of artery anastomoses,renal artery to the ex- ternal iliac artery (ESA) and to the internal iliacartery (EEA) in renal transplantation.The operation time and the incidence of anastomotic stenosis was cut down significantely in ESA group.The blood flow in grafts has no difference in two groups with normal renal function.The utilization rate of grafts with multiple arteries was higher (94.4%) in ESA group.Back bench surgery for artery repain,cold ischemia time and renal damage were reduced in ESA group.