Objective To investigate the hemostatic function of biological glue in renal trauma.Methods Establishment of rab-bit kidney scratch,partial nephrectomy and renal injury penetrating wound models were available with a biological glue and hemo-static powder processing,observed and recorded the amount of bleeding and bleeding time.Tissue sample were transected from the wound of kidneys in each group after a month,and the renal wound healing condition was observed by pathological examination.Re-sults The hemostatic function of biological glue was better than styptic powder,the amount of bleeding in biological glue group and hemostatic powder group of kidney scratched model were(1.39±0.09)mL,(1.77±0.44)mL,the difference was not statistically significant(P =0.115);the bleeding time were(5.02 ±0.23)s,(66.40± 7.35)s,the difference was statistically significant(P <0.01);the amount of bleeding in two models of partial nephrectomy and renal penetrating wound were(2.07±0.25)mL,(11.42± 1.33)mL;(2.01 ± 0.36)mL,(3.95 ± 0.39)mL and bleeding time were(6.16 ± 0.69)s,(139.38 ± 8.97)s;(7.68 ± 0.80)s, (144.26±9.27)s,the differences were statistically significant(P <0.01).Pathology results showed that the wounds healed well. Conclusion The hemostatic function of biological glue in renal trauma were remarkable and stable,and was worth to be further promoted.

This article describes a novel Multifunctional and Transparent Urinary System Model (MTUSM), which can be applied to anatomy teaching, operational training of clinical skills as well as simulated experiments in vitro. This model covers kidneys, ureters, bladder, prostate, male and female urethra, bracket and pedestal, etc. Based on human anatomy structure and parameters, MTUSM consists of two transparent layers i. e. transparent organic glass external layer, which constraints the internal layer and maintains shape of the model, and transparent silica gel internal layer, which possesses perfect elasticity and deformability. It is obvious that this model is preferable in simulating the structure of human urinary system by applying hierarchical fabrication. Meanwhile, the transparent design, which makes the inner structure, internal operations and experiments visual, facilitates teaching instruction and understanding. With the advantages of simple making, high-findelity, unique structure and multiple functions, this model will have a broad application prospect and great practical value.
Female ; Humans ; Kidney ; Male ; Models, Anatomic ; Models, Biological ; Prostate ; Ureter ; Urethra ; Urinary Bladder ; Urogenital System ; anatomy & histology

Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy ( RLP) combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was (2. 8 ± 0. 9) cm in diameter,operational time was (89 ± 24) min,blood loss was (21. 3 ± 7. 7) mL,post-operative hospital stay was (6. 8 ± 1. 7) d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.

Objective To explore the feasibility of mediating recipient lymphocyte reaction with donor dendritic cells (DCs) in renal allograft recipients. Methods Donor bone marrow monocytes (BMMCs) were isolated and cryopreserved in liquid nitrogen before kidney transplantation. At 0 day, 1month,3 month, 6 month and 9 month post-operation, CD34+ cells which were isolated from frozen BMMCs and cultured into DCs as well as the peripheral blood lymphocytes (PBLs) of donors were used as the stimulating cells to the PBLs of recipients and healthy volunteers. The number of viable DCs from frozen- and room temperature-preserved BMMCs was counted and the reactions of recipients'and healthy volunteers' lymphocytes to DCs and donor PBLs were measured. Results 6. 8 × 107BMMCs were isolated from each 10 ml of donor bone marrow on average while (4. 10 ± 0. 58) × 105CD34+ cells were isolated by magnetic active cell sorting (MACS). There was no significant difference in the isolating rate of recovered CD34+ cells at each observation point postoperatively. The percentage of viable BMMCs and CD34+ was decreased significantly at 1 month after surgery, then, decreased slowly and progressively. The decreasing rate of BMMCs was higher than CD34+. The rate of viable DCs was maintained stable (93. 2%-94. 8% ) in each group. The reactions of recipients' and healthy volunteers' lymphocytes to DCs were stronger than those to donor PBLs (P＜0. 05). The reactions of healthy volunteers' lymphocytes to DCs were maintained stable while those of recipients' were fluctuating. Conclusion Bone marrow-derived DCs are superior to PBLs in mediating long-term lymphocyte reaction after kidney transplantation due to their stable viability and stimulating ability to lymphocytes. Only once collection of a small quality of bone marrow of donors is needed to meet the demand of immune monitoring at any time after transplantation.

Objective To demonstrate the efficacy and safety of Hangzhou tacrolimus capsule(Saishi Tac capsule, Hangzhou Zhongmei Huadong Pharmaceutical Co. Ltd, China) in Chinese kidney transplant recipients. Methods Multicenter, randomized open-labeled, prospective controlled clinical trial was performed in de novo Chinese kidney transplant recipients. According to including and excluding criterions, 65 kidney recipients from 9 transplant centers were enrolled. The mean age of recipients was (36.53 ± 5.71 ) years, and 8 received living donor transplantion. The time of cold ischemia and warm ischemia was (4.08 ± 5.43) h and (3.90 ± 2.15) min respectively. The number of mismatched HLA was (2.1 ± 0.8). The recipients accepted Saishi Tac capsule + mycophenolate steroid 60 days, followed by 5-10 μg/L until the terminal observation time point (12 weeks after transplantation). The efficacy and safety were estimated during the period. The primary efficacy endpoint of the study was the incidence of biopsy-confirmed acute rejection. Graft survival and renal function (evaluated by serum creatinine) were the secondary endpoints. Safety was assessed by monitoring laboratory parameters and adverse events reported over the course of the study, such as infection, hepatic damage, hypertension, hyperlipema, diabetes mellitus and other adverse affairs.Results The dose of Tac at 1 st, 2nd, 4th and 8th week postoperation was (6.54 ± 1.69), (6.39 ±1.45),(6.73± 1.25), (6.25 ± 1.02) and (6.03 ± 1.16) mg, corresponding values to the C0 were (8.24±2.09),(9.39± 1.35),(9.93± 1.87),(7.23± 1.16) and (6.43± 1.26) μg/L. During 12weeks of follow-up, the incidence of biopsy-confirmed acute rejection was 12.3% (8/65), among which 6 cases were reversed by implosive therapy. The survival rate of graft kidney was 96.9% (63/65). The incidence of hypertension and hepatic damage was both 7.7% and morbidity of lung infection was 7.6%. There were 3 patients (4.6%) complicated with hyperlipema and diabetes mellitus respectively. Conclusion During the first 3 months of treatment Saishi Tac capsule was safe and effective to Chinese kidney transplant recipients.

ObjectiveTo explore the feasibility of mediating recipient lymphocyte reaction with donor dendritic cells (DCs) in renal allograft recipients to guide individualized inmunosuppressive therapy. Methods From Jan. 2008 to Jan. 2010, 30 recipients received living related kidney transplantation were successively and divided into 2 groups according to the strategies of the correction of the dosage of immunosuppressant, 15 in each group. The strategy of immunosuppressive therapy in both groups was Tac + MMF + Pred. The correction of the dosage of immunosuppressant in experimental group was conducted by recipient lymphocyte reaction with donor DC (LR) combined with Tac and MPA blood concentration monitoring. Only blood concentration monitoring of drugs was applied in control group. Examinations of liver and renal function, blood and urine routine as well as blood sugar were done monthly for 1 year. ResultsDuring the follow-up period, the rate of acute rejection in experimental group and control group was 13. 3 ％ and 46. 7 ％ respectively (P＜0. 05) ;the rate of infection in experimental group and control group was 6. 7％ and 40. 0％ (P＜0. 05)respectively; the adverse reaction rate in experimental group and control group was 13. 3％ and 46. 7％(P＜0. 05). There was no significant difference in the serum creatinine level between the two groups at each observation point. ConclusionThe application of combined recipient LR with donor DC and blood concentration monitoring of drugs in individualized irnmunosuppressive therapy is more comprehensive and accurate.

BACKGROUND: the development of magnetic separation technique,it is feasibility to in vitro sort and amplify CD4+CD25+Treg cells for transplantation; however,the application dosage and immune tolerance have been less reported yet.OBJECTIVE: To investigate dose-effect relationship of CD4+CD25+Treg cells during allograft transplantation.METHODS: SD rats which were considered as the donors and Wistar rats as receptors were used to establish allograff kidney transplantation models.CD4+CD25+Treg cells were separated from splenic cells of Wistar rats and induced phenotype of donor antigenic specificity in vitro.According to the quantities of CD4+CD25+Treg cells injecting through tail vein during the operation of allograft kidney transplantation,models were rolled into four experiment groups: group 1(2×105),group 2(5×105),group 3(1×106),and group 4(2×106).The models out injection were considered as controls.Survival status of kidney was detected at day 15 postoperatively; creatinine level and pathological changes were detected at days 4,9 and 15 according to Banff Schema diagnostic standard; semi-quantitative scores were measured Watanabe technique.RESULTS AND CONCLUSION: The death rate was the highest in control group(83.3%),and then group 1(66.7%),group 4(58.3%),and group 2(33.3%); but rats in the group 3 were all survival.Creatinine level in experimental groups was significantly less than control group at days 4,9,and 15 postoperatively(P<0.05,P<0.01); the creatinine levels in the group1 and group 2 were significantly greater than in the group 3 and group 4 at days 9 and 15 postoperatively(P<0.05),Semi-quantitative scores demonstrated that there was no significant difference between group 2 and group 1; but the scores in the group 3 and group 4 were significantly greater than control group(P < 0.05).The results indicated that CD4+CD25+Treg cells could improve kidney function following transplantation,and prolong survival time of transplanted kidney.The 1×106 was the best dosaae for application.

BACKGROUND: Previous studies showed that donor systemic injection of B7/CD28 costimulatory blocker cytotoxic T lymphocyte associated antigen 4 immunoglobulin (CTLA-4Ig) needed in T cell activation can markedly prolong the survival time of rat renal allografts, which, however, has limitations, such as high dose, extensive influence, poor specificity, systemic adverse reactions.OBJECTIVE: In order to improve the targeting of CTLA-4Ig, we modified the dendritic cells of donors and recipients in vitro with CTLA- 4Ig and observed the influence of two kinds of dendritic cells applied alone or together on the survival of renal allografis in rats.DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed between April 2003 and July 2004 at Laboratory of Department of Urinary Surgery, Xinqiao Hospital, the Third Military Medical University, Chongqing, China.MATERIALS: Kidney donor: inbred Brown-Norway rats, kidney recipient: inbred Lewis rats, unrelated lymphocyte donor: Wistar rats.METHODS: Bone marrow derived dendritic cells of Lewis and Brown Norway rats were modified with CTLA- 4Ig gene recombinant adenovirus in vitro. Animal models of kidney transplantation were built with Brown Norway rats as donors while Lewis rats as recipients. The modified dendritic cells were injected into Lewis rats through femoral vein 24 hours before kidney transplantation alone (group 1 (n=8), donor dendritic cells; group 2 (n=8), recipient dendritic cells) and in combination (group 3 (n=8), donor and recipient dendritic cells). While the recipients without injection were used as control (group 4 (n=6)).MAIN OUTCOME MEASURES: Survival time of renal allografts; the reaction degrees of splenocytes to donor and unrelated antigen determined by MTT method on day 20 postoperation.RESULTS: Survival time of renal allografts in group 2 was not prolonged compared with group 4 while the survival time was markedly prolonged in group 3 (P < 0.01). The response of rat splenocytes to donor antigen in group 1 and group 3 was obviously lower than that in group 4 (P < 0.01), while the response to unrelated antigen was similar to group 4.CONCLUSION: Donor dendritic cells modified with CTLA- 4Ig can significantly prolonged survival time of rat renal allografts and the administration of both donor and recipient dendritic cells modified with CTLA- 4Ig can induce a longer survival time of renal allografts. Recipient dendritic cells cannot prolong the survival time of renal allografts.

0.05) and the histopathological results of the test group did not show any inflammatory reaction in incisions of liver and kidney tissues.Muscular tissues allowed a little inflammatory cells infiltrate at two days,after four days,there was not inflammation or fibrous tissue envelope.CONCLUSION:The prepared PHS granules have good biocompatibility without any acute or chronic toxicity,reject reaction,immunological reaction and anaphylactic response in animals.

0.05). Phagocytic index of RPE cells was (28.7?1.9)% in the presence of 10 ?mol?L~ -1 DIDS,10 ?mol?L~ -1 DIDS significantly inhibited the nonspecific phagocytic process of human RPE cells(P