Objective To evaluate the clinical value of adenosine triphosphate (ATP) determination in CD4+ cells in cytomegalovirus pneumonia after renal transplantation.Methods The ATP level of CD4+ T cells was measured by ImmuKnowTM kit.The ATP levels were determined in 187 renal transplant recipients before and 30,60,90,180 days after operation,and at the time of CMV pneumonia and 4 weeks after treatment of CMV pneumonia.The associations between ATP levels and CMV pneumonia were analyzed.Analysis of variance (ANOVA),Pearson-Spearman and relative risks were used for data analysis.Results 17 cases out of 187 renal transplant recipients were diagnosed as CMV pneumonia (9.1％),and the onset of CMV pneumonia started on the (2.8 ±1.2)month after renal transplantation.ATP concentrations in CD4+ T cells were significantly lower after operation than those before operation (P＜0.01).ATP concentrations reached the lowest on the about postoperative day 90 (P＜0.05),then increased gradually.In 17 recipients with CMV pneumonia,the ATP levels before and 30,90 days after operation,at the time of CMV pneumonia and 4th week after treatment of CMV pneumonia were (376 ±182),(283 ± 146),(196 ± 112),(145 ± 102) and (236 ± 117) μg/L respectively.ATP levels at the time of CMV pneumonia were significantly lower than any other time points (P＜0.05).There was close correlation between ATP levels and CMV pneumonia.Conclusion The determination of ATP in CD4+ cells could reflect the status of cell-mediated immunity in renal transplant recipients,and could evaluate the severity and prognosis of CMV pneumonia and guide the clinical treatment.

Objective To explore the clinical effect of renal transplant from donation after citizen's death (DCD) donors with acute kidney injury (AKI).Methods This was an observational retrospective study of 622 patients who underwent renal transplantation from 312 DCD donors' kidneys at the First Affiliated Hospital of Xi'an Jiaotong University from December 2011 to December 2016.The transplant patients were divided into AKI group and non-AKI group according to the Acute Kidney Injury Network (AKIN) criteria based on initial and terminal creatinine values.We evaluated and compared transplant outcomes of these two groups.Results There were 131 donors with AKI,and the incidence of AKI was 42.0 ％.AKI group and non-AKI group recipients respectively had DGF in 20.2％ and 7.2％ of cases (P＜0.01),153.6 ± 56.2 and 119.3 ± 40.7 μmol/L of serum creatinine (SCr) levels at 1st month (P＜0.01),and 38.5 ± 14.1 and 57.6 ± 23.4 ml· min-1 (1.73 m2)-1 of eGFR at 1st month (P＜0.01).There was no significant difference in SCr and eGFR between two groups at 1st year after transplantation.Conclusion Most of kidneys from DCD donors with AKI can be considered for transplantation.Renal transplantation of organs from DCD donors with AKI showed greater DGF but good outcomes.

Objective To evaluate the effect of hypoxic-ischemic time on reduction of hypoxic-ischemic brain injury by sevoflurane postconditioning in neonatal rats.Methods Two hundred and ten 7-day-old Sprague-Dawley rats (105 male,105 female),weighing 13-17 g,were randomly divided into 7groups (n=30 each) using a random number table:sham operation group (group Sham),hypoxia-ischemia group (group HI),and sevoflurane postconditioning at different hypoxic-ischemic time point groups (P0,P3,P6,P 12 and P24 groups).Immediately after ligation of the left common carotid artery,and at 3,6,12 and 24 h after ligation,the rats inhaled the mixed gas containing 2％ sevoflurane for 30 min in P0,P3,P6,P13 and P24 groups,respectively.The fatality was recorded within 7 days after establishment of the model.At 7 days after establishment of the model,the rats were sacrificed,the brains were removed,and the right and left cerebral hemispheres were weighed separately,and the left/right cerebral hemisphere weight ratio was calculated.The hippocampal CA1 region and posterior cingulate gyrus were isolated,and the ratio of density of normal neurons in the left to the right was calculated.Results Compared with group Sham,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal neurons were significantly decreased,and the fatality rate was increased in the other six groups (P＜0.05).Compared with group HI,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal ncurons were significantly increased in P0,P3 and P6 groups (P＜0.05),and no significant change was found in the parameters mentioned above in P12 and P24 groups (P＞0.05).Compared with group P6,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal neurons were significantly increased in P0 and P3 groups (P＜ 0.05).There was no significant difference in the parameters mentioned above between group P0 and group P3 (P＞0.05).Conclusion Sevoflurane postconditioning performed within 6 h of hypoxia-ischemia can reduce hypoxic-ischemic brain injury,and it provides no cerebral protection if exceeding 12 h.

To offer the reference and method for salt damage in the cultivation of Marsdenia tenacissima, the seeds of M. tenacissima collected from Maguan city ( Yunnan province) were taken as the test materials to study the effects of different priming materials on improving germination and growth under high-level salt stress condition. Four different treatments, which were GA3, KNO3-KH2PO4, PEG-6000, NaCl, combined with ANOVA were applied to test the performance of germination energy, germination percentage, germination index, MDA, SOD, and CAT. The results showed that the seed germination was obviously inhibited under salt stress and the soaked seeds with different priming materials could alleviate the damage of salt stress. Under these treatments, the activities of SOD, CAT the content of soluble protein significantly increased. While the content of MDA significantly decreased. The maximum index was obtained when treated with 1.20% KNO3-KH2PO4, the germination percentage increased from 52.67% to 87.33% and the activity of SOD increased from 138.01 to 219.44 respectively. Comparing with the treatment of 1.20% KNO3-KH2PO4, the germination percentage of treating with 300 mg x L(-1) GA3 increased from 52.67% to 80.67%, while the activity of SOD increased from 138.01 to 444.61.
Germination ; drug effects ; physiology ; Marsdenia ; drug effects ; growth & development ; Nitrates ; pharmacology ; Polyethylene Glycols ; pharmacology ; Potassium Compounds ; pharmacology ; Seeds ; drug effects ; growth & development ; Sodium Chloride ; pharmacology ; Stress, Physiological ; Xanthones ; pharmacology

Objective To summarize the incidence and treatment experience of the effectiveness and adverse reactions of the different immunosuppressive protocols and to increase the long-term survival rate in kidney recipients. Methods Single-center retrospective analysis was performed on 3102 cases of kidney transplant recipients in effectiveness and adverse reactions of different immunosuppressive protocols. The immunosuppressive protocols were as follows: CsA + Aza + Pred,low dose CsA + MMF + Pred, low dose Tac + MMF + Pred, low dose CsA + SRL + Pred, and low dose Tac+ SRL+ Pred. Results The 1-, 5-, 10-year survival rate of patients/kidney in low dose CsA + MMF + Pred protocol was higher than that in CsA + Aza + Pred protocol. The incidence of adverse reactions, such as hypertension, hyperuricemia, kidney and liver toxicity, and leukopenia was significantly lower, but the incidence of diarrhea was significantly higher in CsA + MMF + Pred protocol than in CsA + Aza + Pred protocol (all P＜0. 01). The incidence of hyperglycemia was significantly higher (P＜0. 05), and that of hairy and gingival hyperplsia was significantly lower (P＜0. 05) in low dose Tac+ MMF+ Pred than in low dose CsA+ MMF+ Pred protocol. The incidence of hyperlipidemia in low dose CsA (or Tac)+ SRL + Pred was significantly higher than in CsA (or Tac)+ MMF+ Pred protocol (P＜0. 05). The incidence of hirsutism in low dose Tac + SRL + Pred was significantly lower than that in CsA + SRL + Pred protocol (P ＜ 0. 05). The incidence of hyperglycemia in low dose Tac + SRL + Pred was significantly higher than that in low dose CsA + SRL + Pred protocol. Conclusion The triple drug protocol with a low dose of CsA (or Tac)+ MMF+ Pred significantly improved the survival of renal transplant recipients and graft, and reduced the incidence of adverse reactions, especially Tae + MMF + Pred protocol. Adjustment of the immunosuppressant dosage and protocol, improvement of eating habits, exercise, reduction of blood pressure, reduction of blood lipid, and control of blood glucose were particularly important in preventing and controlling adverse reactions during kidney transplantation.

Animals ; Glutathione ; therapeutic use ; Liver ; metabolism ; physiopathology ; Male ; NF-kappa B ; biosynthesis ; Pancreatitis, Acute Necrotizing ; drug therapy ; metabolism ; physiopathology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo explore the effects of Triptolide (TP) on TNFalpha-induced cell proliferation and expressions of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS) and their inducing products PGE2, NO in human rheumatoid arthritis synovial fibroblasts (RASF).

METHODSFibroblasts (RASF) were obtained from synovial tissue of patients with RA and were cultured in vitro. RASF were stimulated with TNFalpha(20 microg/L) in the presence or absence of TP(0 - 100 microg/L) for 20 h. The RASF proliferation was determined by (3)H-TdR incorporation, and the productions of PGE2 and NO in culture supernatants of RASF were detected with competitive ELISA and enzyme reduction of nitrate. Expressions of COX-2 and iNOS mRNA in RASF were analyzed by semi-quantitative RT-PCR. Expressions of COX-2 and iNOS protein were estimated by Western-blot method and cellular enzyme immunoassay in synovial fibroblasts. NF-kappaB activity in whole-cell extract of RASF was also measured by an ELISA-based method.

RESULTSTP (>20 microg/L) down-regulated markedly TNFalpha-induced COX-2 and iNOS mRNA and protein expression, and their inducing products PGE2 and NO of synovial fibroblasts. This effect was positively correlated with TP concentrations. NF-kappaB activity in TNFalpha-stimulated synovial cells was suppressed profoundly by TP treatment (IC(50) approximately 35microg/L). The activity of NF-kappaB was correlated with the levels of COX-2 and iNOS expression in TNFalpha-stimulated RASF. No change was observed in proliferation of synovial cells after treatment of TP.

CONCLUSIONTP could significantly down-regulate TNFalpha-induced COX-2, iNOS expression and production of PGE2, NO in human RASF, which is associated with the suppression of NF-kappaB activity.

Arthritis, Rheumatoid ; drug therapy ; metabolism ; Cyclooxygenase 2 ; Diterpenes ; pharmacology ; Epoxy Compounds ; Fibroblasts ; metabolism ; Gene Expression Regulation ; drug effects ; Humans ; Isoenzymes ; analysis ; genetics ; Membrane Proteins ; NF-kappa B ; metabolism ; Nitric Oxide Synthase ; analysis ; genetics ; Nitric Oxide Synthase Type II ; Phenanthrenes ; pharmacology ; Prostaglandin-Endoperoxide Synthases ; analysis ; genetics ; RNA, Messenger ; analysis ; Synovial Membrane ; cytology ; metabolism ; Tumor Necrosis Factor-alpha ; pharmacology

Objective To explore the clinical significance of switch between ciclosporin A (CsA) and tacrolimus (TAC) in the triple immunosuppressive protocol including calcineurin inhibitors (CNI),mycophenolate mofetil (MMF),and prednisone (Pred) after renal transplantation.Methods The data of 148 patients with CNI switch were collected from Jan.2000 to Dec.2010,including 51patients with Tac switching to CsA (group A) and 97 patients with CsA switching to Tac (group B).The clinical indexes were analyzed by paired t-test.Results In group A,the serum creatinine,urea and blood glucose were significantly reduced,and hemoglobin,bilirubin,cholesterol significantly increased as compared with those before switch (P＜0.05).In group B,the serum creatinine and urea began were significantly reduced from 4th and 2nd week respectively after switch (P＜0.05).Platelet counts began significantly dropping from 20th week after switch (P＜0.05).Albumin,globulin and bilirubin were significantly increased from 20th,12th and 36th week respectively after switch (P＜0.05).Blood glucose and cholesterol were significantly decreased from 12th and 3rd week respectively after switch (P＜0.05).The trough concentrations of CNI and MMF AUC kept stable before and after switch.Conclusion The renal function of all patients was improved to varying degrees by CNI switch between CsA and Tac no matter what reason.The switch of immunosuppressive agents has benefits to alleviate adverse reactions.

Objective To investigate the effects of HLA matching on long survival of patients with kidney transplantation. Methods In 2508 cases of renal transplants, based on Ag M standard, in 0 MM-6 MM (7 groups), the effects of HLA matching on the survival rate of 1 year, 5 years and 10 years, and the incidence of renal acute rejection (AR) in renal allografts were analyzed. Results Only 7 cases had 0-missmatches, and most cases had 2 or 3 missmatches. In the group of zero antigen mismatches, the incidence of renal AR was 5 %, lower than other groups (P＜0. 01); in the group of six antigen mismatches, the incidence of AR was 23 %, obviously higher than other groups (P＜0. 01). The 1-year, 5-year and 10-year survival rate was 97 %, 90 %, 88 % in the group of zero antigen mismatches; 94 %, 86 %, 83 % in the group of one antigen mismatches; 94 %, 84 %, 82 % in the group of two antigen mismatches; 93 %,85 %, 81% in the group of three antigen mismatches; 91%, 82 %, 74 % in the group of four antigen mismatches; 90 %, 81%, 72 % in the group of five antigen mismatches; 88 %, 80 %, 70 % in the group of six antigen mismatches. Conclusion Good HLA matching can significantly reduce the incidence of AR of renal allografts and increase the survival rate. If recipients are offered to choose those with HLA antigen mismatches ≤3, it is good for the effective use of donor kidneys, the prevention of rejection, and the improvement of the transplantation results.

Objective To analyze the risk factors affecting long-term survival of recipients and renal allografts.Methods From January 1979 to December 2001,the clinical data of 1380 renal allograft recipients were retrospectively analyzed.The clinical and complication data of kidney transplantation were reviewed.Thirteen relative factors were analyzed by SAS statistical software.A Kaplan-Meier rank analysis was used to estimate the 10-year allograft survival rate.Proportional hazards regression analysis (with Cox model) was used to assess and rank the relative risk of potential variable.Results (1) As of Dec.31,2001,utility visiting rate was 93.62％,989 recipients survived over 10 years.The complications were as follows:acute rejection (191 cases),infection (112 cases),liver damage (106 cases).The postoperational 10-year survival rate of recipients and renal allografts was 71.67％ and 62.25％ respectively.(2) CAN,acute rejection,DGF,infection,diabetic mellitus,PRA ＞10％ and HLA mismatch＞3 were the independent risk factors resulting in the reduced survival rate of the renal allografts (P＜0.05).Immunosuppressive regimen with MMF could significantly increase long-term survival rate (P＜ 0.01); (3) The cardiocerebral vascular diseases,liver insufficiency,infection,tumor and diabetic mellitus were independent risk factors for long-term survival (P＜0.01).Conclusion The ideal HLA match is the key step in increasing survival rate; Low dosage of calcineurin inhibitor with MMF and Pred is the ideal regimen of immunosuppressive therapy for long-term survival; active prevention and treatment of cardiocerebral vascular diseases/CAN,infection,diabetic mellitus,and tumor are the main points focused during the follow-up period.