Objective To investigate the role of PD-L1 in the pathogenesis of acute allograft rejection (AR) and its correlation with PD-1 and the degree of tubulointerstitial lesions. Methods A total of 20 patients admitted by our hospital and Daping hospital from 1999 to 2003 were included, 12 male and 8 female, aged 18-40 years old (average 32.2?4.5). All of them were diagnosed as acute rejection by renal biopsy. Fifteen specimens from the mismatched donor kidney and the normal tissues from the resected kidney served as normal control. Immunohistochemistry was used to detect the expression of PD-L1 and PD-1 in renal tissues of AR and normal control. Results Both PD-L1 and PD-1 expression were significantly higher in AR than that in normal control. The intensity of PD-L1 positive in renal tissues of AR showed a positive correlation with PD-1 expression and a negative correlation with the degree of tubulointerstitial lesions. Conclusion Increased expression of PD-L1 and PD-1 in renal tissues of AR has an important effect on the degree of tubulointerstitial lesions.

Objective To evaluate the inhibiting effect of antisense vascular smooth muscle alpha adenovirus vector on tubular epithelial myofibroblast transdifferentiation induced by TGF-?1.Methods The pAdanti-?-SMA was constructed and identified.The ?-SMA expression in tubular epithelial cells(TEC) was detected by immunofluorescence and Western blot.Five groups were designed as control(A),TEC transfected by 2 ?l pAdanti-?-SMA(B),TEC induced by TGF-?1(C),TEC induced by TGF-?1 and transfected by 2 ?l pAdanti-?-SMA(D),TEC induced by TGF-?1 and transfected by 10 ?l pAdanti-?-SMA(E).Results The pAdanti-?-SMA was successfully constructed.The expression of ?-SMA in TEC induced by TGF-?1 was inhibited by pAdanti-?-SMA.Conclusion Tubular epithelial myofibroblast transdifferentiation can be inhibited by pAdanti-?-SMA.

Objectives:To discuss the observation of patients receiving simultaneous pancreas-kidney transplantation for insulin-dependent diabetes mellitus complicated with end-stage renal failure.　Methods:The patient received simultaneous pancreas-kidney transplantation with enteric drainage of exocrine pancreatic secretions.　Results:The important aspects were as follows: monitoring the functions of the transplanted pancreas and kidney, observing the early characteristics of rejection, especially the pancreas, preventing thrombosis of blood vessels of the transplanted pancreas, digestive tract hemorrhage，pancreatitis, and preventing duodenal fistula. 　Conclusion:By careful clinical observation, postoperative complications could be found earlier, which aided the treatment and improved the prognosis.

The authors sum up the experience of their hospital in the construction of the information system, pointing out that the key to success in this aspect lies in the clarification of objectives and the formulation of a master plan. Then they give a further account of ways for doing a good job of the master plan and its implementation from the perspectives of the software, hardware, and cultivation of talents.

Objective To investigate the effects of HO-1 on renal allografts after HO-1 gene transfection in rat chronic allograft nephropathy model. Methods Twenty F344 and twenty-six Lewis rats were included in this experiment. They were divided into 3 groups at random. Six Lewis rats were in pseudo-operation group, 10 Lewis were in empty carrier group (transfected with adenovirus) and 10 Lewis were in the gene transfection group (transfected with Ad-HO-1 adenovirus). The expression of HO-1 protein was detected by WB at the 1st ,2nd,3rd and 4th week. The content of creatinine in blood was assayed at the 4th,8th, 12th and the 16th week. The weight of rat, the value of patholiogical changes and the expression of ?-SMA,TGF-?1 and PDGF-B were analysized at the 16th week. Results The weight of rats in 3 groups had not any changes at 16th week. The content of creatinine in blood of gene transfection group were lower than those in the empty carrier group. The expression of HO-1 protein were very high in the 1st and 2nd week and decreased at 3rd and 4th week. The Banff value of kidney in the gene transfer group was better than that of the empty carrier group at the 16th week. The level of ?-SMA, TGF-?1 and PDGF-B in the gene transfection group were significantly lower than those in the empty carrier group. Conclusions Ad-HO-1 could efficiently transfer HO-1 gene into rat donor kidney. The prevention of chronic allograft nephropathy may have relationship with the decreasing expression of ?-SMA, TGF-?and PDGF-B.

Objective To investigate clinical feature, diagnosis and treatment of tuberculosis infection in renal transplant patients. Methods To analyze clinical data of 13 patients suffering from tuberculosis infection after renal transplantation retrospectively. Results Twelve patients got lung tuberculosis while only one lymphoid tuberculosis. They were unequivocally diagnosed as tuberculosis by radiological plain film, searching acid-fast bacilli in sputum repeatedly, detecting DNA of Bacillus tuberculosis by PCR and biopsy, 4 of whom had mixed infection in lung. Eleven patients recovered after standard antituberculosis therapy, but 2 died. Hepatic function lesion was main adverse reaction in treatment, but it could get normal after adjustment of immunodepressant. Conclusion Tuberculosis incidence rate in renal transplant patients increased obviously. Standard antituberculosis therapy is effective, but immunodepressant should be adjusted in time according to the change of hepatic function and renal function.

Objective To evaluate the soothing effects of hemodiafiltration on patients with refractoriness nephrotic edema and its influence on prognosis of nephrotic syndrome.Methods All the 15 cases involved had undergone hemodiafiltration periodically during acme edema and administered with the same standard loading dose of prednisone for 8 weeks.Meanwhile,clinical and lab indexes (urine volume,Cr,Bun,urinary protein,albumin) were measured.Results All patients improved in urine volume and renal function gradually after the treatment of hemodiafiltration for 1 to 3 times.By the 8th week of post-hemodiafiltration,urinary protein 24 h declines obviously[(6.42?2.31)g/d to (0.87?1.24)g/d].Conclusion Hemodiafiltration is an effective treatment in relieving retention of water,increasing the remission rate of protein urine,recovering patients' renal function and improving their prognosis to nephritic syndrome patients with severe refractory edema.

Objective To isolate and identify advanced oxidation protein products from human serum albumin (AOPP-HSA), expecting to search for a method of preparing highly purified and bioactive AOPP-HSA. Methods AOPP-HSA crude products were prepared in vitro by exposing HSA to HOCl. AOPP-HSA was isolated by gel chromatography and ion-exchange HPLC. Its structural features and biological activities were characterized by UV and fluorescence spectrum, SDS-PAGE, and the experiment of TNF-? release from monocytes. Results The isolated protein was purified up to 99.4% and was dityrosine-containing protein cross-linking products with molecular weight of 700?10 3. It possessed the ability of triggering the considerable release of TNF-? from monocytes. Conclusion Highly purified and bioactive AOPP-HSA can be successfully prepared by above-mentioned two-step chromatography from AOPP-HSA crude products, which builds a basis for further study of AOPP.

Objective To observe the cytotoxicity of Ad-HO-1 and its capacity of mediating the expression of HO-1 in cultured HK-2 cells. Methods The HK-2 cells were infected by Ad-HO-1 with 100, 200 and 400 MOI for 3 h, followed by the green fluorescence observation 2 days later. The live cells ratio was detected 2 and 4 days later. The expression of HO-1 and GFP in HK-2 were detected under laser scan confocal microscope. The expression of HO-1 was detectee by Western blot analysis. 3H-TdR was used to assay the ability of HO-2 cells infected with Ad-HO-1 to inhibit the PBMC proliferation. Results Over 90% HK-2 cells expressed green fluorescence after infected by Ad-HO-1 (MOI 200) for 2 days. The live cell ratio at 2 and 4 days had not any difference from those of the control group. The expressions of HO-1 and GFP in the Ad-HO-1 transfected HK-2 cells were determined under laser scan confocal microscope. The locations of these two proteins were the same. HK-2 cells infected by Ad-HO-1 had protein immune blot strap combined with HO-1 antibody. When the MOI of Adv-HO-1 was 0.01, 0.1, 1 and 10, the proliferative capacity of PBMC was inhibited significantly. Conclusion The stable expression of HO-1 mediated by Ad-HO-1 in cultured tubular epithelial cells can inhibit the cell proliferation of PBMC.

Objective To explore the pathological changes of the middle-small arteries and veins of uremic patients in early stage.Methods Forty patients with chronic kidney disease at Ⅴ stage were randomly subjected in our study.Radial artery and cephalic vein about 0.5 to 1 cm in length were obtained by arteriovenous fistula operations.Cephalic veins from 4 trauma patients were taken as control group.Immunohistochemisty with anti-?-SMA(smooth muscle actin-alpha),BMP-2(bone morphology protein-2) and BMP-7(bone morphology protein-7) antibodies,alizarin Bordeaux staining,HE staining and Masson trichrome staining were carried out to investigate calcification and fibrosis.Results Compared with control group,the expressions of ?-SMA and BMP-2 were up-regulated obviously.Masson trichrome staining indicated fibrosis in the vein from uremic patients.Conclusion Fibrosis may be one of the early pathologic changes in the vein from uremic patients,suggesting the venous alterations may be related to cardiovascular disease of uremic patients.