Based on the analyses of the basic structure and operational principle of H+-ISFET sensor, the relationship between current and voltage of the sensor is discussed with PSPICE simulation, and different pH values, channel sizes, temperatures adopted.

Objective To evaluate the efficacy and safety of CsA substituted by tacrolimus(FK506) combined with MMF and prednisone in prevention of rejection in renal transplant recipents with hepatic dysfunction. Methods Eight patients with hepatic dysfunction received the treatment of FK506 substituting for CsA. FK506 was administeted at least 24 h after the last dose of cyclosporine.The initial dose of FK506 was based on body weight,the degree of hepatic dysfunetion and the period after operation of the patients.After administration of one week.the dose of FK506 was subsequently adjusted to maintain its whole blood trough levels between 5～15μg/L. Results Substitute of tacrolimus for cycbsporin resulted in a markedly reduced blood index,direct-bilirubin from(22.66±17.19)μmol/L to(7.05±2.32)μmol/L(P＜0.05), indirect-bilirubin from(42.15±34.15)μmol/L to(14.54±2.59)μmol/L(P＜0.05), sAL T from (83.00±93,14)IU/L to(29,50±15.41)IU/L(P＞0.05),Cr from (177.91±86.41)μmol/L to(135.92±34.05)μmol/L(P＞0.05)in one month.The ascites of 3 patients disappeared in one month. Astriction,anorexia,upper limbs trembling appeared only in one patient.Conclusion It is effective and safe to substitute CsA by FK506 combined with MMF and prednisone in prevention of rejection in renal transplant recipients with hepatic dvsfunction.

The renal artery stenosis is a common complication in renal transplantation.Therenal failure can be easily caused if treatment is not effective.4 cases of renal artery stenosis in re-nal transplantation were treated in our department from Dec.1995 tO Jan.1997.Three cases weretreated by implanted renal artery stent and the remaining one received the stripping of adhesive tis-sue.After operation,blood pressure and renal function in the 4 patients recovered normally.Long-term effect was satisfactory.It is concluded that the above tWO methods are effective for thetreatment of renal artery stenosis in renal transplantation.

The analysis of the results of the renal replacement therapies,renal transplantation for 23 cases,hemodialysis for 33 cases,in 56 elderly patients with chronic renal function failure was performed.The total mortality in transplanted group with a higher early mortality is lower than that in hemodialysis group.The living quality of transplanted group was better than of the hemodialysis group.The associated diseases prior to the replacement therapies were the contributions to the death.It was believed that the age has not been served as a limitation for elderly patients receiving renal transplantation. As a replacement therapies the operation should be choosed first by elderly patients.A strictly preoperative physical examination should be done and a postoperatively special cure plan that is suited to the elderly drawn up.

Objective　To investigate the infection of hepatitis virus and spirochete in renal transplant donors and recipients to study the relationship between infection and human/kidney survival rate following renal transplantation. Methods　A total of 361 donors and 300 recipients were investigated on infection of HBV, HCV, HGV, CMV, EBV, HSV, HIV and RPR. Results　Of the 361 donors, 31 cases (8.6!%), 9 cases (2.5!%) and 2 cases (0.6!%) were found having HBV, HCV, HGV infection respectively. In the 231 recipients, the percentage of CMV, EBV, HSV, HIV and RPR carriers was 16.9!%, 11.7!%, 16.0!%, 0.4!% and 0.8!% respectively. Among the 300 grafting recipients, the infective rate of HBV, HCV and HBV plus HCV was 68.7!%, 34.7!% and 25.0!% respectively. Forty patients were randomly selected from the 300 patients, it was found that 10 (25.0!%) patients were positive for anti-HGV, 10 (25.0!%) for HGV and HBV, 5 (12.5!%) for all HGV, HBV and HCV. The percentage of CMV, EBV, HSV, HIV, RPR carriers among the 300 recipients was 49.0!%, 32.7!%, 42.0!%, 0 and 0.3!% respectively. Conclusion　Viral infectious status of the donors and recipients before operation might contribute to the occurrence of viral infection in the recipients after transplantation.

Objective　To investigate the outcome of renal transplantation in the patients with systemi c autoimmune disease. Method　The clinical data of 25 patients with autoimmune disease undergoing renal transp lantation were retrospectively analyzed. Results　 The survival rate for 1 year, 3 years, 5 years after renal transplantation in t he patients with autoimmune disease and without autoimmune disease were 88 .0 %, 80.0 %, 72.0 % and 88.9 %, 84.4 %, 77.8 % r espectively. The graft survival rate for 1 year,3 years, 5 years after renal tra nsplantation in the patients with autoimmune disease and without autoimmune dise ase were 84.0 %, 72.0 %, 60.0 % and 86.2 %, 77.0 %, 66.4 % respectively. The average intervals of dialysis pre-transplantati on b etween the patients with recurrent underlying diseases (4 patients) and with out recurrent underlying diseases (21 patients) was not difference. Among the 4 p atients with positive ANA and elevated anti-dsDNA serology pre- and post-tr ansp lant, 2 patients had recurrent underlying diseases. Conclusions　Renal transplantation should be offered to th e patients with autoimmune diseases because relapses of underlying diseases after renal transplantation seem to be rare. The patient and graft survival rate was not significantly differen t in the patients with autoimmune diseases and without autoimmune diseases.

ObjectiveTo study the diagnosis and treatment of acute focal bacterial nephritis ( AFBN). MethodsBetween 1987 and 1999, we treated 18 patients with AFBN.The diagnosis,treatment and late follow up results were studied and reviewed.13 men and 5 woman,aged 16～56 years with an average of 32 years.The left kidneys in 13 patients,the right kidneys in 4 patients and both kidneys in 1 patient were affected.All of the patients presented a fever and persistent flank pain on affected side.Ultrasound showed local enlarged renal volume and space-occupying masses with low level echoes.CT scans demonstrated focal enlargement of affected kidneys and low-density solid space-occupying lesions.CT reconstruction showed wedge-shaped masses.ResultsIn 16 of the 18 cases,the clinical symptoms and the renal mass disappeared following anti-infection treatment.2 patients required operations,with draining the abscessin for one and nephrectomy for the other one.ConclusionsEarly diagnosis and prompt treatment are essential to AFBN,early and rational anti-infection treatment is effective.

In order to observe the pharmacological action and clinical effects of Implanta (from Hanmi Pharm. Co. Ltd) on renal transplantation, 30 patients receiving renal transplantation were treated with Implanta. Among the 30 patients, 12 patients (group A) just underwent renal transplantation, the remaining 18 cases underwent the operation 0.5 to 4 years ago and administered Sundimin or Cyspin. The results showed that the blood concentration, the effcets of inhibiting the rejection, the function recovery of transplanted kidney and side effects of Implanta were the same as those of Sundimin or Cyspin. It was conlcuded that Implanta was safe and effective.

The aim of this procedure is to reconstruct the defecation and urinary functions in paraplegic patients. In 30 patients, two normal vascularized intercoastal nerves above the paraplegic level were isolated and their distal ends divided. They were transferred to the vertebral canal through a submuscular tunnel. The sural nerve was harvested with enough length and separated into two segments, which were sutured as a bridge with S 2-4 nerve roots by interfascicular neurorrhaphy in patients with spinal cord injury above T 11 or with S 2-4 nerve roots outside of the vertebral canal in patients with spinal cord injury below T 12. After 2 to 11-year (mean 5 years) follow-up, 26 (86.6%) patients regained partial micturition reflex and defecation reflex, and partial sensation (S1-2) in buttock, perineal and vulva regions. In 23 (76.7%) patients had also recovery of the function of voluntary urination, and 8 (27%) of them showed partial recovery of function of the detrusor muscle, urethral sphincter, and anal sphincter. The results showed that the procedure described above could be used as an alternative method to reconstruct the function of defecation and urination, and also partial sensation of perineal and vulval region in a part of paraplegic patients.

Objective To observe the clinical effects of combined islet cell and kidney transplantation in the treatment of insulin-dependent diabetes mellitus associated with end-stage renal failure.Methods Four patients with type I diabetes and ESRD received combined renal and islet cells transplantation.Clinical and metabolic data were studied during the follow-up.Results The cultured human adults islet cells were infused into the portal vein system of the 4 patients.Immunosuppression included CsA.azathioprine and prednisone.Metabolic follow-up comprised assessment of daily fasting and non-fasting blood glucose,basal C-peptide secretion,HbAIc,renal function and blood cell counts.Islet isolation yielded 25 000～48 000 equivalents(single or multiple donors).No adverse effects were seen subsequent to islet transplantation.Basal C-peptide secretion maintained at normal levels.and blood glucose and HbAIc levels were normalized throughout the observation period.The dosage of insulin were decreased by over 25% in all 4 patients after transplantation.Conclusions Combined adult islet cells and renal transplantation has a good effect in the treatment of the patients with type Ⅰ diabetes and ESRD and can be used as an effective way for treating ESRD secondary to the type Ⅰ diabetes.Postoperative efficacy is related not only to the quantlty and quality of the islet cells,but also to the rejection of the grafts.