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30 September 2012, Volume 16 Issue 40 Previous Issue    Next Issue

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BK virus associated nephropathy after kidney transplantation BK virus associated nephropathy after kidney transplantation 2012, 16 (40):  7411-7416.  doi: 10.3969/j.issn.2095-4344.2012.40.001 Abstract ( 343 )   PDF (568KB) ( 465 )   Save BACKGROUND: Polyomavirus infection is an important cause of BK virus associated nephropathy (BKVAN) and renal allograft dysfunction. OBJECTIVE: To investigate pathological features and clinical characteristics of BKVAN. METHODS: Polyomavirus large T antigen staining of 121 transplant renal biopsy showed that nine cases were positively diagnosed as having BKVAN. Clinical, pathologic, immunofluorescence and immunohistochemistry observation of BKVAN patients were performed by anti-SV40 large T antibody staining. RESULTS AND CONCLUSION: Mycophenolic acid-AUC 0-12 and tacrolimus blood concentration in the BKVAN group were higher than those in the no BKVAN group (P < 0.05). SV-40 large T antigen staining of nine cases of biopsy showed that there were scattered positive tubular polyomaviruses in the renal cortex and medulla. Immunofluorescence staining showed the negative expression of IgG, IgM, IgA, C3, C4, C1q and C4d. All the renal histopathological observation showed that a large number of CD3, CD4 and CD8, CD68-positive cells were aggregated in the renal interstitial. In one case of merge rejection, human leukocyte antigen DR and interleukin-2 receptor were highly expressed. However, the expressions of human leukocyte antigen DR and interleukin-2 receptor in non-merge rejection patients were almost less than 5%. The follow-up of nine cases of BKVAN was more than 6 months, one case of renal allograft dysfunction, three cases improved, two cases of stable and three cases of deterioration. Immunohistochemistry with SV-40 large T antigen staining is used as an indirect method to document the presence of BKVAN. There is an extremely important clinical value of kidney allograft C4d, interleukin-2 receptor and human leukocyte antigen DR detection in the diagnosis of BKVAN. Related Articles | Metrics

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Clinical treatment of central nervous system complications after kidney transplantation Cui Yong, Wang Guang-ce, Chen Zhu, Wang Suo-gang, He Wei 2012, 16 (40):  7417-7420.  doi: 10.3969/j.issn.2095-4344.2012.40.002 Abstract ( 253 )   PDF (354KB) ( 409 )   Save BACKGROUND: Currently, the reports at home or abroad on central nervous system complications after kidney transplantation are rare. OBJECTIVE: To investigate the clinical treatment of central nervous system complications after kidney transplantation. METHODS: A retrospective analysis was performed on 15 cases with central nervous system complications after kidney transplantation among the 277 cases that received in the First Affiliate Hospital of Henan College of Traditional Chinese Medicine between January 2008 and August 2010. RESULTS AND CONCLUSION: Among the 15 (5.41%) cases that suffered from central nervous system complications: diffuse encephalopathy in 7 cases (2.52%), cerebrovascular accident in 4 cases (1.44%), epilepsy in 3 cases (1.08%), central nervous system infection in 1 case (0.36%). The reasons of central nervous system complications after kidney transplantation are more complex, including infection, hypoxia, metabolic, electrolyte imbalance, postoperative rejection and immunosuppressive agents (calcineurin inhibitors). Related Articles | Metrics

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Small-dose trimethoprim-sulfamethoxazole prevents pneumocystis pneumonia after renal transplantation Liu Wen-jie, Zhao Ming 2012, 16 (40):  7421-7425.  doi: 10.3969/j.issn.2095-4344.2012.40.003 Abstract ( 274 )   PDF (422KB) ( 466 )   Save BACKGROUND: Kidney Disease: Improving Global Outcomes guidelines in 2009 recommend that all renal recipients should receive trimethoprim-sulfamethoxazole to prevent pneumocystis pneumonia. OBJECTIVE: To observe the effect of small-dose trimethoprim-sulfamethoxazole to prevent pneumocystis pneumonia in early stage of renal transplantation. METHODS: Clinical data from renal transplant recipients during 2006 and 2009 were collected retrospectively in accordance with certain exclusion criteria, such as, regularly follow-up with complete data, hepatitis, and secondary transplant, reactive antibody-positive and lost follow-up after transplantation. The gender, age, immune induction protocols, immune maintenance protocols, rash, damaged liver and renal function, acute rejection and pneumocystis pneumonia were recorded. The recipients receiving trimethoprim-sulfamethoxazole treatment were considered as prevention group and the recipients without treatment were considered as non-prevention group. Pneumocystis pneumonia was diagnosed by medical history, clinical manifestation, computed tomography and laboratory inspection. RESULTS AND CONCLUSION: There was no significant difference of age, gender, immune reduction protocols (selection of biological agents), immune maintenance protocols, blood creatinine content at 1 month after transplantation between prevention group and non-prevention group in perioperative period (P > 0.05), while there was no significant difference of acute rejection, cytomegalovirus, renal function indicators at 1 year post-transplantation, and as well as bone marrow suppression, liver function, drug-induced rash between two groups after 1-year follow-up (P >0.05); the incidence of pneumocystis pneumonia in prevention group was significantly decreased when compared with that in the non-prevention group (P < 0.05). Small dosage of trimethoprim-sulfamethoxazole takes significant prevention effect on pneumocystis pneumonia. Related Articles | Metrics

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Anti-virus efficacy of cyclosporine in renal transplant recipients with hepatitis C virus-RNA positive Liu Tie-shi, Li Xiao-gong, Zhao Xiao-zhi, Liu Guang-xiang, Guo Hong-qian 2012, 16 (40):  7426-7432.  doi: 10.3969/j.issn.2095-4344.2012.40.004 Abstract ( 270 )   PDF (378KB) ( 451 )   Save BACKGROUND: The selection of immunosuppressants and anti-hepatitis C virus drug is currently the focus for the hepatitis C virus-positive patients after receiving renal transplantation. OBJECTIVE: To investigate the anti-virus replication effect of cyclosporine in hepatitis C virus-RNA positive renal transplant recipients in addition to its anti-rejection effect. METHODS: Eleven hepatitis C virus-RNA positive renal transplant recipients were enrolled and treated with cyclosporine, prednisone and mizoribine. Hepatitis C virus-RNA level, hemoglobin, liver functions and renal functions were evaluated before treatment and at 6 and 12 months after treatment. RESULTS AND CONCLUSION: The median of hepatitis C virus-RNA in 11 patients before treatment, and at 6 and 12 months after treatment were 1.22×107 copies/mL, 1.11×104 copies/mL and 4.19×106 copies/mL respectively. At 6 months after treatment, 8 cases of hepatitis C virus-RNA were negative (hepatitis C virus-RNA < 500 copies/mL), and the total response of hepatitis C virus-RNA was 73%, and the sustained virological response was 55% (6/11) at the final follow-up. There was no significant difference of alanine transaminase, serum creatinine and serum uric acid levels before and after treatment (P > 0.05), and the hemoglobin level was increased after treatment. During the follow-up, acute rejection only occurred in one patient and was controlled within 3 days after methylprednisolone pulse therapy. Cyclosporine-based treatment would be a better choice for renal transplant recipients combined with hepatitis C virus infection for both the anti-virus replication and anti-rejection effect. Related Articles | Metrics

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Uric acid nephrolithiasis after renal transplantation Xing Li, Jiang Xin, Wang Zhen-pu, Miao Shu-zhai, Qu Qing-shan 2012, 16 (40):  7433-7437.  doi: 10.3969/j.issn.2095-4344.2012.40.005 Abstract ( 321 )   PDF (432KB) ( 334 )   Save BACKGROUND: Hyperuricemia is a common complication after renal transplantation, if the hyperuricemia caused uric acid nephrolithiasis can not be treated in a timely manner, it may causes the renal allograft loss function after transplantation. OBJECTIVE: To investigate the diagnosis and treatment program of uric acid nephrolithiasis after renal transplantation. METHODS: The data of 19 patients with uric acid nephrolithiasis after renal transplantation were collected for the retrospective summary. All the patients had hyperuricemia, eight patients underwent surgical incision for the stone and received the ureter-bladder re-anastomosis, and 11 patients received the conservative treatment. RESULTS AND CONCLUSION: Sixteen patients had stone at the transplanted lower ureteral, two cases suffered the renal pelvis stone of transplanted renal and hydronephrosis, one case suffered from renal allograft severe hydronephrosis and the entire section of ureteral stone. After treatment, the function and urine output of 18 patients returned to normal; one patient had renal allograft loss function and renal resection. The patients with elevated blood uric acid after renal transplantation should receive the drugs conservative treatment as soon as possible, once the conservative treatment does not work, we should take the surgery way timely in order to reduce postrenal caused renal allograft loss function. Related Articles | Metrics

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Clinical application of rituximab in antibody mediated rejection after renal transplantation Liu Tian-lai, Liu Yong-guang, Li Min, Guo Ying, Li Liu-yang, Zhao Ming 2012, 16 (40):  7438-7443.  doi: 10.3969/j.issn.2095-4344.2012.40.006 Abstract ( 348 )   PDF (611KB) ( 700 )   Save BACKGROUND: Foreign literatures show that the application of rituximab in antibody mediated rejection after renal transplantation has significant efficacy and good safety. But there still lacks of report and research of these in China. OBJECTIVE: To investigate the efficacy and safety of rituximab in the treatment of antibody mediated rejection after renal transplantation. METHODS: Eighteen patients who diagnosed with antibody mediated rejection after renal transplantation were divided into two groups, and all the patients in two groups received immunosuppressive therapy. Patients in the experimental group (n=8) received single dose rituximab treatment; patients in the control group (n=10) were treated without single dose rituximab treatment. RESULTS AND CONCLUSION: After treated for 6 and 12 months, the creatinine level in the experimental group was lower than that in the control group (P < 0.05). After 6-12 months follow-up, in experimental group, one patient with cytomegaoviyns, one patient with urinary tract infection, no life-threatening infection during the follow-up period, and the patient/graft survival rate was 100%. It indicates that rituximab for the treatment of antibody mediated rejection after renal transplantation has significant efficacy and good safety. Related Articles | Metrics

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Desensitization of highly sensitized renal transplant recipients by plasmapheresis and intravenous immunoglobulin Cheng Li, Luo Zheng-mao, Zhang Xiao-liang 2012, 16 (40):  7444-7449.  doi: 10.3969/j.issn.2095-4344.2012.40.007 Abstract ( 356 )   PDF (486KB) ( 456 )   Save BACKGROUND: As there is no unified program about intravenous immunoglobulin in highly sensitized renal transplant recipients before transplantation, so it is not widely used in domestic. OBJECTIVE: To evaluate the feasibility and efficacy of plasmapheresis plus low-dose intravenous immunoglobulin for the desensitization therapy of highly sensitized renal transplant recipients. METHODS: Twenty-eight cases of renal transplant patients performed with human leukocyte antigen crossmatch and received plasmapheresis plus intravenous immunoglobulin, and then the rejection rate, graft survival time and functions of the transplanted kidney were observed. RESULTS AND CONCLUSION: In desensitization group, no hyperacute acute occurred in the 28 desensitization patients. There were nine (32%) cases of acute rejection, including five (18%) cases of acute humoral rejection. All rejection episodes were reversed. With a follow-up of (50±24) months, the serum creatinine levels at 12 and 24 months were (112±18) μmol/L and (130±38) μmol/L, respectively. The survival rate at 12 and 48 months was 95.0% and 78.0% respectively. The desensitization therapy by plasmapheresis plus intravenous immunoglobulin is effective for highly sensitized renal transplant recipients. High rate of acute humoral rejection is the major defect of this protocol. The short-term graft survival rate after this protocol is acceptable but the long-term survival rate needs to be defined. Related Articles | Metrics

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Sixteen cases of malignant tumor after renal transplantation: Clinical report and literature review Long Wei, Yang Guang-ting, Jiang Wei, Liu Yan-bin, Pei Xiang-ke, Bai Yu-mei 2012, 16 (40):  7450-7454.  doi: 10.3969/j.issn.2095-4344.2012.40.008 Abstract ( 406 )   PDF (417KB) ( 494 )   Save BACKGROUND: There is multiple reasons for malignant tumor after the renal transplant, its high morbidity rate is closely related to the long term utilize of large dose of immunosuppressant. OBJECTIVE: To discusses the relativity between tumors and the immunosuppressant by retrospective analysis the utilize of immunosuppressant after renal transplantation, the morbidity rate of malignant tumor, the time of tumor occurrences and its characteristics, as well as other related factors. METHODS: Sixteen patients with malignant tumors were selected from 512 renal transplant patients to perform the retrospective analysis. Fifteen patients were treated with mycophenolate mofetil+cyclosporine A+methylprednisolone, and one patient treated with mycophenolate mofetil+azathioprine+methylprednisolone. After renal transplantation, 12 patients were treated with surgery, one patient was treated with chemotherapy alone, and three patients had metastases in the advanced stage or gave up the treatment. RESULTS AND CONCLUSION: The tumor incidence rate of the patients after renal transplantation was 3.13%, among them, six cases with urinary tumors (37.5%), four cases of gastrointestinal tumors (25.0%, two cases of colon cancer, one case of rectal cancer and one case of gastric cancer), three cases of liver cancer (18.75%), one case of lung cancer (6.25%), one case of ovarian cancer (6.25%) and one case of skin cancer (6.25%). Among the renal transplant patients, the most commonly malignant tumor is urinary tumor and followed by gastrointestinal tumor. For the renal transplant patients, reducing the dose of immunosuppressant is one of the primary key factors that can help to prevent the occurrences of tumor after the renal transplant and increase the long term survival rate of renal transplant patients. Related Articles | Metrics

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Pathological and clinical analysis of the kidney puncturation biopsy in 72 cases Hong Xin, Li Zhou-li, Wang Shuang, Bi Jian-long, Cai Ming 2012, 16 (40):  7455-7459.  doi: 10.3969/j.issn.2095-4344.2012.40.009 Abstract ( 453 )   PDF (441KB) ( 426 )   Save BACKGROUND: Chronic rejection after kidney transplantation and a variety of transplant nephropathy are the common causes of graft loss function, but, to assess the transplant kidney accurately is often very difficult, and biopsy is still the primary method currently. OBJECTIVE: To investigate the pathological results to diagnosis and treat of kidney puncturation biopsy for postoperative complications after the renal transplantation. METHODS: Seventy-two renal allograft biopsies were performed. Pathological diagnosis and classification was performed and the data was analyzed. RESULTS AND CONCLUSION: Among the 72 cases, 35 cases suffered from acute cell-mediated rejection, 12 cases suffered from acute antibody-mediated rejection, 10 cases suffered from renal allograft acute drug toxicity damage, 6 cases suffered from chronic T cell-mediated rejection, 2 cases suffered from chronic antibody-mediated rejection, 4 cases suffered from acute tubular necrosis, and 3 cases suffered from chronic allograft nephropathy. The coincidence between pathological replacement of nephridial tissue after transplantation and clinical diagnosis before puncturation was more than 75%. There was no visible adverse effect after the renal allograft biopsies. Renal graft biopsy is safe and reliable, which guiding significance to find complications of the kidney impaired after transplantation that are difficult to discover on the basis of clinical dates and to choose a more better treatment prescription. Related Articles | Metrics

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Histological changes in rats after implantation of vitreous-cryopreservation tissue engineered tendon Peng Qiang, Zhu Ming-hua, Sun Tao, Zeng Yi, Wang Lin, Liu Cheng-jun, Qin Ting-wu 2012, 16 (40):  7460-7464.  doi: 10.3969/j.issn.2095-4344.2012.40.010 Abstract ( 232 )   PDF (601KB) ( 495 )   Save BACKGROUND: The technique of vitreous cryopreservation applied to preserve tissue engineered tendon has the practicability and application prospects, and is required for further research. OBJECTIVE: To investigate the effects of in vivo implantation of vitreous-cryopreservation tissue engineered tendon on repairing the tendon defects of the rats. METHODS: Sixty-four adult Sprague Dawley rats were randomly divided into two groups, vitreous-cryopreservation tissue engineered tendons and fresh tissue engineered tendons without cryopreservation were implanted respectively. The 5 mm tendon defects models were prepared in the middle part of Achilles tendons of the rats, and the tissue engineered tendons were implanted. At 2, 4, 6 and 8 weeks after surgery, the general morphology and histological changes of the implanted tendons and surrounding tissues were observed. RESULTS AND CONCLUSION: No significant differences in general morphology and histological change of the implanted tendons and surrounding tissues were observed between two groups. At 2 and 4 weeks after surgery, the implanted tendon materials were degraded gradually, and were infiltrated and surrounded by a large number of inflammatory cells and proliferous fibrous connective tissues. At 6 and 8 weeks after surgery, the implanted tendons were degraded and replaced by a large number of regenerative collagenous fiber tissues; the morphology and orientation of the collagenous fiber tissues were similar to those of normal tendon tissues. The tendon defects of the rats were repaired basically. The results indicate the in vivo implantation of vitreous-cryopreservation tissue engineered tendons can repair the tendon defects of the rats. Related Articles | Metrics

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Clinical evaluation of potential living-related kidney donors Gao Hong-jun, Luo Xiang-dong, Liang Tai-sheng, Lu Shang-guang, Liang Fang-fang, Tan Zhen, Wu Zhen 2012, 16 (40):  7465-7469.  doi: 10.3969/j.issn.2095-4344.2012.40.011 Abstract ( 390 )   PDF (283KB) ( 404 )   Save BACKGROUND: With the extensive development of the renal transplants from living-related donors, how to protect the donors’ long-term survival get more and more attention. OBJECTIVE: To summarize our clinical experience of 79 potential living-related kidney donors, and to evaluate the effects and reliability of the procedure. METHODS: We analyzed clinical data from 79 potential living-related kidney donors assessed at the Department of Transplantation and Urology, Affiliated Ruikang Hospital of Guangxi University of Chinese Medicine from June 2007 to August 2010. And the clinical effect was analyzed. RESULTS AND CONCLUSION: A total of 38 patients were assessed for qualified. The operating time for all donors ranged from 1 to 2 hours. The warm ischemia time of the donated kidney was about 15 seconds, and the cold ischemia time was 1-2 hours. No surgical or medical complications occurred during the perioperative period. All donors have survived to date, with kidney function in the normal range. Rigorous assessment is important for ensuring the long-term survival of living kidney donors. Related Articles | Metrics

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Effect of frozen carriers on the outcomes of blastocysts freezing-thawing in the expanding period Gong Xiao-yun, Long Mei, Hu Bo, Zhao Jing, Wang Peng, Li Xia 2012, 16 (40):  7470-7474.  doi: 10.3969/j.issn.2095-4344.2012.40.012 Abstract ( 865 )   PDF (424KB) ( 577 )   Save BACKGROUND: Blastocyst freezing-thawing has great significance to the development of the human assisted reproductive technology; favorable frozen carrier can reduce the frozen toxic and improve refrigeration efficiency, which has been considered as the hot spot in improving the outcome of blastocyst freezing-thawing. OBJECTIVE: To discuss the effects of different frozen carriers on the outcomes of Kunming mice blastocyst vitrification freezing-thawing in expanding period. METHODS: The fresh Kunming mouse blastocysts in the expanding period were considered as the control group, and then the mouse embryo were randomly selected from the same period for the vitrification thawing, and before frozen, artificial shrinkage was performed by the laser line; the vitrification method was used for freezing and thawing, and the embryos were divided into cryoloop group, closed pulled straw group and self-made straw-leaf group according to different experiment carriers. The duration of contact cryoprotectant before input liquid nitrogen were < 40 seconds, 40-60 seconds and 60-90 seconds in cryoloop group and self-made straw-leaf group; after thawing, 10% serum replacement was added in to the blastocyst medium supplemented for the micro-drop culture in embryonic sac period. The effects of the vitrified mouse blastocysts were assessed by the lost rate, recovery rate and hatched rate after cultured for 24 hours. RESULTS AND CONCLUSION: Compared with closed pulled straw group, the lost rate of the blastocysts was reduced and the recovery rate of the embryo was increased in cryoloop group and self-made straw-leaf group (P < 0.05), while the hatched rate after cultured for 24 hours in the freezing groups was lower than that in the control group (P < 0.05). There was no significant difference of the recovery rate and hatched rate in cryoloop group and self-made straw-leaf group when the duration of contact cryoprotectant before input liquid nitrogen was 90 seconds. These findings indicate that cryoloop carrier and self-made straw-leaf carrier has a good effect on blastocyst vitrification freezing-thawing in the expanding period. Related Articles | Metrics

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Effects of lycium barbarum polysaccharides on fetal ovarian tissue cryopreservation Cai Yu-fang, Wang Yan-rong, Kong Bing, Cui Xiu, Shen Xin-sheng 2012, 16 (40):  7475-7479.  doi: 10.3969/j.issn.2095-4344.2012.40.013 Abstract ( 434 )   PDF (616KB) ( 554 )   Save BACKGROUND: The application of antioxidant plays a key role in improving the viability of frozen-thawed ovarian tissue. OBJECTIVE: To explore the effects of lycium barbarum polysaccharides on fetal ovary tissue cryopreservation by observe the developmental condition of cryopreserved fetal ovarian tissue xenografts after transplanted into nude mice kidney capsule. METHODS: The experiment was divided into four groups. ①Fresh transplanted group: the fresh fetal ovary tissue was transplanted directly. ②Cryopreservation control group: the cryoprotectant solution was the base fluid. ③β-mercaptoethanol group: the cryoprotectant solution was the basic fluid with 100 μmol/L β-mercaptoethanol. ④Lycium barbarum polysaccharides group: the cryoprotectant solution was the basic fluid with 400 μmol/L lycium barbarum polysaccharides. The ovarian cortex block was transplanted into the nude mice kidney capsule after freezing thawing, and the specimen was obtained at 12 weeks after transplantation. RESULTS AND CONCLUSION: There was no significant difference of the survival rate in the grafts among groups (P > 0.05). The cryopreservation control group had the most follicle (P < 0.05). As for the survival rate of follicles, there was significant difference among groups; it was lowest in cryopreservation control group and highest in lycium barbarum polysaccharides group. Preservation of ovarian ultrastructure in β-mercaptoethanol and lycium barbarum polysaccharides group was better than that in the cryopreservation control group. Lycium barbarum polysaccharides with concentration of 400 mg/L and β-mercaptoethanol with concentration of 100 mg/L is benefit to the ovarian tissue cryopreservation and can significantly improve the survival ratio of cryopreserved ovarian tissue after transplantation. Related Articles | Metrics

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Evaluation on opening status of the mechanical heart valve in vitro under pulsatile flow Chu Yin-ping, Cheng Jin-lian, Liu Ai-jun, Gao Qi-ying, Zhang Yu, Zhang Dong 2012, 16 (40):  7480-7485.  doi: 10.3969/j.issn.2095-4344.2012.40.014 Abstract ( 306 )   PDF (487KB) ( 613 )   Save BACKGROUND: During the estimation of mechanical heart valve prosthesis, many studies related to cardiac output, regurgitant volume, effective orifice area, pressure differences and shear stresses and flow fields, and cavitation phenomenon. OBJECTIVE: To carry out visual observation and evaluation on the opening status of the leaflets to three kinds of mechanical artificial heart valve prostheses. METHODS: The pulsatile flow testing experiments were conducted by installing the testing heart valve prosthesis (US-made CarboMedics bileaflet valve, China-made Jiuling bileaflet valve and C-L tilting disc valve) in the aortic position of the physiological mock flow loop. The testing condition was set at pulse frequency of 75 beats/min and a constant cardiac output of 4 L/min and contraction of the cycle time of under 46.2%, respectively. The opening status of the disc valves in 10 continuous pulse cycles was observed by a high-speed camera installed light above the simulated cycle device of arterial lumen upper part. With self designed image processing software package, a picture of the biggest opening angle of the disc valve was shot and it was used as a datum to calculating its biggest opening area and angle for each valve. RESULTS AND CONCLUSION: The disc valves fluttering were observed when 25 mm CarboMedics bileaflet valve, 25 mm and 23 mm Jiuling double leaflet disc opened to the maximum angle, but 27 mm C-L disc valve was not. The measurement of disc mouth by different calculating methods showed that actual area mouth provided by manufacturers was the biggest, and that the opening area of disc calculated by Green formula was the second, and that the effective opening area calculated by Gorin formula was the smallest. The opening angle of disc valves that calculated by Triangle Law demonstrated that the opening angle of two disc leaflet was inconsistent and less than the inherent opening angle for Jiuling valves and CarboMedics valves. And the opening angle of C-L valve did not reach its inherent opening angle either. The disc leaflets of the mechanical artificial heart valve did not open synchronously and was fluttering in view, the disc leaflets opened incompleted. Related Articles | Metrics

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Establishing a C57BL/6J mouse immunosuppressive model induced by cyclophosphamide Yang Xian-yong 2012, 16 (40):  7486-7490.  doi: 10.3969/j.issn.2095-4344.2012.40.015 Abstract ( 542 )   PDF (459KB) ( 870 )   Save BACKGROUND: The immunosuppressive models are commonly used in the research of immunostimulants, but how to establish the immunosuppressive models is the key for the evaluation of immunostimulants. OBJECTIVE: To establish C57BL/6J mice immunosuppressive model induced by cyclophosphamide. METHODS: Normal C57BL/6J mice were randomly divided into six groups (n=4). Group 1 was normal control group, group 2 was injected with 50 mg/kg cyclophosphamide for 5 days, group 3 was injected with 80 mg/kg cyclophosphamide for 3 days, group 4 was injected with 80 mg/kg cyclophosphamide for 5 days, group 5 was injected with 100 mg/kg cyclophosphamide for 5 days, and group 6 was injected with 100 mg/kg cyclophosphamide every 2 days. Mice in group 1 were intraperitoneal injected with 0.1 mL normal saline and lasted for 5 days. Mice in group 2, 3, 4, 5 were intraperitoneal injected with 50, 80, 80 and 100 mg/kg cyclophosphamide, respectively, and lasted for 5, 3, 5 and 5 days, respectively. Mice in group 6 were intraperitoneal injected with 100 mg/kg cyclophosphamide every two days and total injected for three times. RESULTS AND CONCLUSION: Compared with group 1, the CD3+T, CD3+CD4+T and CD3+CD8+T levels in the peripheral blood in the other five groups were significantly decreased (P < 0. 05); the contents of alanine aminotransferase (except for group 2 and group 3), aspartate aminotransferase and blood urea nitrogen in the other five groups were significantly increased (P < 0. 05), especially in group 4, 5 and 6. Intraperitoneal injection of cyclophosphamide can establish the immunosuppressive model with decreased level of CD3+T, CD3+CD4+T and CD3+CD8+T, and intraperitoneal injection of 50 mg/kg and 80 mg/kg cyclophosphamide for 5 and 3 days has less kidney and liver damage. Related Articles | Metrics

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Prokaryotic expression and purification of mouse secondary lymphoid-tissue chemokine Zhang Li-dan, Luo Yan-yan, Lin Qing, Ren Xiang-rong, Su Shao-bo, Lin You-kun 2012, 16 (40):  7491-7495.  doi: 10.3969/j.issn.2095-4344.2012.40.016 Abstract ( 497 )   PDF (478KB) ( 465 )   Save BACKGROUND: Secondary lymphoid-tissue chemokin (CCL21) is a recently discovered chemotactic factor with a broad range of immunoregulatory activities and anti-tumor effects. OBJECTIVE: To establish the prokaryotic expression vector of mouse CCL21, and highly express the recombinant protein in Escherichia coli. METHODS: Lymph node cells in C57BL/6 mice were collected and subsequently stimulated using Poly(I:C) in vitro, then its extracted RNA was reverse-transcripted. This cDNA was used as template in polymerase chain reaction amplification to collect CCL21 coding sequence. The gene was cloned into the prokaryotic expression vector pBEn-CCL21 and was expressed in Escherichia coli BL21 on the induction of isopropy-β-D-thiogalactoside. Then the recombinant protein expression were analyzed by TRICINE-SDS-PAGE electrophoresis and purified by streptevidin affinity chromatography. RESULTS AND CONCLUSION: The prokaryotic expression vector pBEn-CCL21 of mouse CCL21 gene was successfully constructed, and the fusion protein was obtained. The experiment proves that CCL21 can be highly expressed in Escherichia coli BL21, and the CCL21 target protein can be obtained by streptevidin affinity chromatography. Related Articles | Metrics

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Icariin alleviates renal ischemia-reperfusion injury in rats through inhibition of inflammation Feng Gui-wen, Liu Long-shan, Shang Wen-jun 2012, 16 (40):  7496-7502.  doi: 10.3969/j.issn.2095-4344.2012.40.017 Abstract ( 282 )   PDF (566KB) ( 480 )   Save BACKGROUND: The renal ischemia-reperfusion injury is inevitable during renal transplantation, reducing the damage by drugs can help to improve the short- and long-term efficacy of renal transplantation. Icariin has a good effect on the treatment of myocardial and cerebral ischemia, but the effect on the renal ischemia reperfusion is not clear. OBJECTIVE: To investigate the protection mechanism of icariin on renal ischemia-reperfusion injury. METHODS: Fifty-four Sprague Dawley rats were randomly divided into sham-operation group, icariin group and model group, rats in the icariin group and model group were used to establish the unilateral renal ischemia reperfusion injury model, and rats in the sham-operation only received the renal pedicle freeing without blocking the renal vascular. In icariin group and model group, icariin (100 mg/kg) and 0.3% sodium carboxymethyl cellulose (1 mL/kg) were orally administrated by gavage daily from 2 days before modeling to 12 days after modeling. RESULTS AND CONCLUSION: Compared with sham-operation group, the serum creatinine level was significantly increased and the creatinine clearance rate was decreased after renal ischemia-reperfusion injury in icariin group and model group, and the decreased creatinine clearance rate resulted in the pathological injury of renal tissue. In the icariin group, the expression level of inducible nitric oxide synthase mRNA and protein was decreased, and the expression levels of pro-inflammatory cytokines (tumor necrosis factor α, interleukin-1β, interleukin 6), chemokines (interferon-inducible protein 10, monocyte chemoattractant protein 1, macrophage cell inflammatory protein-2) mRNA in the renal tissue were decreased; at 6 hours after renal ischemia-reperfusion injury, the content of plasma nitrite/nitrate and myeloperoxidase in icariin group reached to peak and then decreased gradually; the content of plasma nitrite/nitrate and myeloperoxidase in icariin group was lower than that in the model group (P < 0.05). Icariin can attenuate renal ischemia-reperfusion injury through inhibiting inducible nitric oxide synthase expression and downstream inflammation cascades. Related Articles | Metrics

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Rhein effects on apoptosis of glomerular mesangial cells cultured with high glucose in Sprague Dawley rats Guo Yu, Li Yan, Fang Hui, Yin Xiao-xing, Wei Qun-li 2012, 16 (40):  7503-7507.  doi: 10.3969/j.issn.2095-4344.2012.40.018 Abstract ( 293 )   PDF (481KB) ( 556 )   Save BACKGROUND: Our previous study has already manifested that Chinese medicine Xiaokening containing Rhein can effectively control the development of early diabetic nephropathy. OBJECTIVE: To investigate the effect of Rhein on apoptosis of glomerular mesangial cells (GMCs) of Sprague Dawley rats cultured with high glucose. METHODS: The GMCs cultured with high glucose were stimulated by different concentrations of Rhein (20, 40, 80 μmol/L). Morphology of GMCs was discriminated by hematoxylin-eosin staining. Karyon apoptosis was examined by fluorescence staining of 4’,6-diamidino-2-phenylindole (DAPI). Cell apoptosis rate was detected by flow cytometry. RESULTS AND CONCLUSION: The outcome of hematoxylin-eosin staining and 4’,6-diamidino-2-phenylindole staining indicated that Rhein could obviously induce apoptosis of GMCs in a dose- and time-dependent manner. The apoptosis rate had significant difference among different groups (P < 0.05). This result shows that Rhein can obviously induce apoptosis of GMCs cultured with high glucose and in a dose- and time-dependent manner. Related Articles | Metrics

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Effects of tetramethylpyrazine in rats with unilateral ureteral obstruction renal fibrosis Li Jian-zhi, Yu Jiang-dong, Liang Yu, Liu Yu-ming, Hu Li, Yang Bo, Zhou Xiu-tian 2012, 16 (40):  7508-7513.  doi: 10.3969/j.issn.2095-4344.2012.40.019 Abstract ( 374 )   PDF (772KB) ( 453 )   Save BACKGROUND: Renal interstitial fibrosis is related to the imbalance between matrix metalloproteinase-2 and tissue inhibitors of matrix metalloproteinase-2. OBJECTIVE: To establish the unilateral ureteral obstruction renal fibrosis model and to observe the pathological changes of renal interstitial and the expression of matrix metalloproteinase-2 and tissue inhibitor of matrix metalloproteinase-2 after treated with tetramethylpyrazine. METHODS: Twenty-four female Sprague Dawley rats were randomly divided into three groups: sham-operation group, model group and tetramethylpyrazine group. The rats in the model group and tetramethylpyrazine group were performed with left ureter ligation to establish the unilateral ureteral obstruction model. Rats in the tetramethylpyrazine group were performed with intragastric administration at 1 day before surgery, 40 mg/(kg•d) once per day and lasted for 2 weeks. All rats were sacrificed at 14 days after surgery. The pathological changes of the obstruction renal tissues were examined by hematoxylin-eosin staining and Masson staining. Immunohistochemistry and reverse transcription-polymerase chain reaction were applied to detect the protein and mRNA expression of matrix metalloproteinase-2 and tissue inhibitors of matrix metalloproteinase-2. RESULTS AND CONCLUSION: Tetramethylpyrazine could significantly reduce the expansion and contraction of the tubular, the proliferation of renal interstitial fibrous tissue and inflammatory cell infiltration. Compared with sham-operation group, the protein and mRNA expression of matrix metalloproteinase-2 and tissue inhibitors of matrix metalloproteinase-2 was significantly increased in model group (P < 0.01). The protein and mRNA expression of matrix metalloproteinase-2 and tissue inhibitors of matrix metalloproteinase-2 in tetramethylpyrazine group was smaller than that in the model group (P < 0.01). Tetramethylpyrazineon could relieve the renal intersitial fibrosis by decreasing expression of matrix metalloproteinase-2 and tissue inhibitors of matrix metalloproteinase-2. Related Articles | Metrics

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Effects of erythropoietin on renal tubulointerstitial fibrosis after renal ischemia-reperfusion injury in mice Chen Ying, Wu Duo-jiang, Yang Yi-bin, Ke Gui-bao, Zhang Fu-xiang, Rong Song 2012, 16 (40):  7514-7519.  doi: 10.3969/j.issn.2095-4344.2012.40.020 Abstract ( 385 )   PDF (603KB) ( 548 )   Save BACKGROUND: Erythropoietin can relieve inflammation, anti-apoptosis and have a protective effect on renal ischemia-reperfusion induced injury. OBJECTIYE: To investigate effect of erythropoietin on apoptosis and renal tubulointerstitial fibrosis renal ischemia-reperfusion-induced injury in mice. METHODS: The tubulointerstitial fibrosis model was established by unilateral renal ischemia-reperfusion injury. All mice were divided into four groups: sham-operation group, ischemia-reperfusion group, low and high doses erythropoietin group. The renal pathological changes were observed by hematoxylin-eosin staining and Masson staining. Meanwhile, the expression of Bcl-2 and Bax protein in renal tissue was assessed by immunohistochemical method. The expression of Capase-3 was analyzed by Western Blot. RESULTS AND CONCLUSION: Compared with ischemia-reperfusion group, the pathological changes of tubules and interstitium in low and high doses erythropoietin groups were significantly improved. Compared with the sham-operation group, the levels of Bcl-2 and Bax expression were remarkably increased in ischemia-reperfusion group and erythropoietin groups, and most significant in ischemia-reperfusion group; the ratio of Bcl-2/Bax in ischemia-reperfusion group was remarkably lower than that in the sham-operation group, and the ratio in the erythropoietin groups was higher than that in the sham-operation group. The Caspase-3 expression in erythropoietin groups was significantly higher than that in the ischemia-reperfusion group, but lower than that in the sham-operation group. It shows that the development of renal tubulointerstitial fibrosis after ischemia-reperfusion induced injury is related with the cell apoptosis, and the expression of Bcl-2/Bax and Caspase-3 plays an important role. Low dose erythropoietin can attenuate the renal tubulointerstitial fibrosis after renal ischemia-reperfusion injury. Related Articles | Metrics

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Monitoring imaging of beef liver lesions using high intensity focused ultrasound based on empirical mode decomposition and subtraction method Song Wei-dong 2012, 16 (40):  7520-7527.  doi: 10.3969/j.issn.2095-4344.2012.40.021 Abstract ( 283 )   PDF (587KB) ( 601 )   Save BACKGROUND: After focused ultrasound irradiation, focused regional organizations will form the strong echo phenomenon in the corresponding position of the B-mode images, which may form acoustic impedance difference in the soft tissue and may disrupt the damage detection. OBJECTIVE: To propose an imaging method based on the empirical mode decomposition and subtraction method for the detection of tissue lesion induced by high intensity focused ultrasound. METHODS: Combined the advantage of empirical mode decomposition with that of subtraction method, ultrasonic echo signal was decomposed adaptively by empirical mode decomposition method, and then, subtraction method was executed to the denoised. Finally, monitoring image of lesions was completed after Hilbert transformation and log conversion. RESULTS AND CONCLUSION: The experiments of bovine liver in vitro were implemented. The differential images combined with the empirical mode decomposition were acquired as well as corresponding B-mode images and the differential images. The results of experiment showed that the proposed method can characterize the high intensity focused ultrasound induced lesions in soft tissue effectively. It can identify the smaller lesions which can not be detected in B-mode images and offer higher contrast and resolution than that of the differential images. Related Articles | Metrics

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Expression of tight junction protein Occludin in chorionic villus and its significance Feng Ya-ling, Qi Guan-nan, Zhou Chang-ju 2012, 16 (40):  7528-7532.  doi: 10.3969/j.issn.2095-4344.2012.40.022 Abstract ( 310 )   PDF (441KB) ( 394 )   Save BACKGROUND: The role of Occludin protein in the embryo implantation during early pregnancy has never been reported. OBJECTIVE: To investigate the expression of Occludin in the chorionic villus and to explore its significance. METHODS: The mRNA and protein expression of Occludin in chorionic villus from 30 normal women of early pregnancy and 30 missed abortion patients were measured by semi-quantitative reverse transcription-PCR, Western blot and immunohistochemistry methods. RESULTS AND CONCLUSION: Occludin was showed in endochylema, cell nucleus and little stroma of syneytiotrophoblast cell of external chorionic villus and showed low expression in the cytotrophoblast. Semi-quantitative reverse transcription-PCR, Western blot and immunohistochemistry staining found that the Occludin expressed in chorionic villus in normal early pregnancy women and missed abortion patients, the expression in normal early pregnancy was lower than that in missed abortion patients, but there was no significant difference (P > 0.05). There was expression of Occludin in the chorionic villus. The lower expression of Occludin in cytotrophoblast might be one of the reasons for the polarity disappearance of cytotrophoblast cell and participated in the formation of infiltrated capacity of cytotrophoblast. Inadequate cytotrophoblast invasion ability was not the only reason for the embryo development stagnation. Related Articles | Metrics

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Effects of tetramethylpyrazine and silencing transforming growth factor-beta 1 by small interfering RNA on expression of connective tissue growth factor of rat hepatic stellate cells Xiang Ying, Li Jun, Jia Qian, Yang Hong, Li Xiao-sheng 2012, 16 (40):  7533-7538.  doi: 10.3969/j.issn.2095-4344.2012.40.023 Abstract ( 292 )   PDF (487KB) ( 408 )   Save BACKGROUND: Our previous studies have demonstrated that tetramethylpyrazine can anti-hepatic fibrosis via inhibiting hepatic stellate cells proliferation, inhibiting p38 mitogen-activated protein kinase signal pathway, as well as down-regulating the expression of connective tissue growth factor, and so on. Generally, transforming growth factor-β1 is the foremost cell factor in promoting hepatic fibrosis, and connective tissue growth factor is the downstream effect medium of transforming growth factor-β1, small interfering RNA targeting transforming growth factor-β1 can be a new way in the treatment of hepatic fibrosis. OBJECTIVE: To investigate the effect of tetramethylpyrazine and chemosynthesis small interfering RNA transforming growth factor-β1 on the expression of connective tissue growth factor of rat hepatic stellate cells. METHODS: Hepatic stellate cells were cultured in vitro, an effective segment of gene silencing was screened out from three segments of small interfering RNA transforming growth factor-β1, then it was transfection group utilizing lipsome transfection reagent to transfect together the cells which have been cultured for 24 hours, and blank control group, transfection reagent group, tetramethylpyrazine group, and union treatment group were designed. RESULTS AND CONCLUSION: Compared with blank control group, the expression of collagen type Ⅰ, collagen type Ⅲ and connective tissue growth factor mRNA were reduced in transfection group, tetramethylpyrazine group and union treatment group (P < 0.05). The connective tissue growth factor protein expression was down-regulated in transfection group, tetramethylpyrazine group and union treatment group (P < 0.05); contents of collagen type Ⅰ and collagen type Ⅲ in the supernatant were reduced (P < 0.05). Result show that the small interfering RNA silencing transforming growth factor-β1 can reduce the expression of collagen type Ⅰ and collagen type Ⅲ and down-regulate the expression of connective tissue growth factor. The expression of connective tissue growth factor can be down-regulated by tetramethylpyrazine, but it is more pronounced to the inhibiting expression of collagen type Ⅰ and collagen type Ⅲ, cluing that the anti-hepatic fibrosis of tetramethylpyrazine may be multifarious action targets. Related Articles | Metrics

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Differential proteomic research of liver ischemia-reperfusion injury undergoing resection of hepatocellular carcinomas Huang Chuan-zhong, Lin Ke-can, Wang Bin, Huang Ai-min, Chen Hui-jing, Tao Xuan, Liu Jing-feng, Ye Yun-bin 2012, 16 (40):  7539-7543.  doi: 10.3969/j.issn.2095-4344.2012.40.024 Abstract ( 362 )   PDF (530KB) ( 515 )   Save BACKGROUND: The ischemia reperfusion injury undergoes resection of hepatocellular carcinomas may promote the occult metastatic invasion and metastasis, and induce mitochondrial damage. OBJECTIVE: To reveal the protein expression changes of normal liver tissue after ischemia reperfusion injury undergoes resection of hepatocellular carcinomas, and to screen the hepatic ischemia reperfusion injury stress related protein and to explore the possible mechanism. METHODS: Normal liver tissue proteins and mitochondrial protein expression profiles were established in 20 liver cancer patients with hepatic ischemia reperfusion before and after perfusion for 15 minutes by isoelectric focusing/polyacrylamide gel electrophoresis, and the difference was analyzed. The matrix-assisted laser desorption inoization-time of flight mass spectrometry was used to identified different expression proteins, and the bioinformatic analysis was performed. RESULTS AND CONCLUSION: Under the same condition, two-dimensional electrophoresis of each whole cell and mitochondrial protein samples were performed for three times. Different proteins appeared in each pair profile were analyzed. In the whole cell protein profiles, a total of 5 different proteins were identified and no significant difference of protein in mitochondrial profiles was identified. Liver ischemia reperfusion 15 minutes during hepatocellular carcinoma resection operation can change the expression of the cell protective protein such as cytoskeletal proteins and heat shock proteins, and can promote tumor metastasis risk and the preventive measures should be taken to reduce the impact. However, no changes happen in mitochondrial. Related Articles | Metrics

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Blood pump in heart assistant and replacement devices Zhang Tian-yi, Hu Zhao-yan 2012, 16 (40):  7544-7552.  doi: 10.3969/j.issn.2095-4344.2012.40.025 Abstract ( 347 )   PDF (1087KB) ( 1367 )   Save BACKGROUND: The blood pumps for heart replacement have rapidly developed. They are not only structurally classified as portable auxiliary type or implantable type, but also have good physical compatibility in performance after generations of improvement. OBJECTIVE: To introduce the blood pump of a heart-lung machine used in heart visualization operation, various assist blood pumps for mechanical replacement during heart terminal treatment, and the total artificial heart. And to look forward the development trend of artificial hearts in future. METHODS: The VIP database, IEEE Xplore Database, Springer Link Database, Google Scholar and related books were retrieved for articles by computer. The key words were “blood pump, artificial heart”. RESULTS AND CONCLUSION: A total of 43 articles were included. Blood pump offers possibility for the realization of the heart visualization surgery and has a very high clinical value. But the structure design and control system are need to be improved, while good biocompatibility materials for manufacture and control system of physiological parameters remain the key points for the development of blood pump. Related Articles | Metrics

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Olfactory ensheathing cells transplantation for the treatment of spinal cord injury: Issues and looking forward Wang Xiang-dong, Wan Li-ping, Liu Ceng-xu 2012, 16 (40):  7553-7557.  doi: 10.3969/j.issn.2095-4344.2012.40.026 Abstract ( 296 )   PDF (652KB) ( 397 )   Save BACKGROUND: The treatment of spinal cord injury is always a stubborn problem for neurosurgeons because nerve cell cannot regenerate by itself and the glia scar can prevent the axonal regeneration. Olfactory ensheathing cells have characteristics of both Schwann cells and astrocytes. They can secrete a variety of nerve growth factors and neurotrophic factors, and can improve the local microenvironment, induce axonal regeneration and myelination, and promote the function recovery. OBJECTIVE: To review the advanced research results of olfactory ensheathing cells transplantation for the treatment of spinal cord injury, and to review the combination of advanced research and research thinking. METHODS: We searched the PubMed database for the articles published from January 1990 to January 2012 with the key words of “olfactory ensheathing cell, transplantation, spinal cord injury” in English. Meanwhile, we searched the CNKI database for articles published from January 2000 to January 2012 with the key words of “olfactory ensheathing cell, transplantation, spinal cord injury” in Chinese. Articles related with olfactory ensheathing cells transplantation for the treatment of spinal cord injury were included and the repetitive articles were eliminated. RESULTS AND CONCLUSION: A total of 372 articles were included after initial screening according to the exclusion criteria, and 23 articles were selected for the reciew. Experimental evidence from animal models and clinical studies suggest that olfactory ensheathing cells transplantation can improve the morphologic and functional recovery of spinal cord injury which provides a new way for the clinical treatment of spinal cord injury. The clinical application of olfactory ensheathing cells transplantation for spinal cord injury is limited by the source of olfactory ensheathing, avoiding immunological rejection during allotransplantation and the safety of heterotransplantation. Therefore, autotransplantation of olfactory ensheathing cells for the treatment of spinal cord injury is effective and it maybe a focus in the future. Related Articles | Metrics

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Fetal hepatic stem cells transplantation for the treatment of liver diseases Wan Zhen, Zhang Xiao-gang, Lü Yi 2012, 16 (40):  7558-7563.  doi: 10.3969/j.issn.2095-4344.2012.40.027 Abstract ( 343 )   PDF (575KB) ( 439 )   Save BACKGROUND: Fetal hepatic stem cells (FHSCs) transplantation draws much attention recently in the treatment of acute and chronic liver failure and metabolic liver diseases and expected to replace the liver transplant therapy. OBJECTIVE: To review the advances on the isolation and identification of FHSCs, FHSCs mediated therapeutic liver repopulation and clinical trial of FHSCs transplantation. METHODS: A computer-based online retrieval of PubMed database and CBM database was performed with the key words of “fetal hepatic stem cell, transplantation” in both English and Chinese from January 2000 to December 2011. A total of 168 articles were obtained. Following reading titles and abstracts, original articles closely related to FHSCs transplantation with reliable argument and evidence were included. Reviews and articles of repetitive studies and poor quality were excluded. And finally, 31 articles were enrolled in the review according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION: A unique and specific marker for FHSCs has not been assigned, which brings difficult to the isolation and identification of FHSCs. FHSCs were often enriched by fluorescence-activated cell sorting or magnetic-activated cell sorting techniques. FHSCs had the bipotential differentiation capacity and could extensively repopulate the host liver for a long time without preconditioning. Moreover, FHSCs had low immunogenicity and was resistant to cryopreservation injury which provide theoretical basis for the clinical application. The therapeutic effects of FHSCs transplantation for the treatment of liver cirrhosis have been confirmed. FHSCs as a new source of seed cells have a broad application prospects in the treatment of acute and chronic liver failure and metabolic liver diseases Related Articles | Metrics

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Acute rejection after renal transplantation and application of immunosuppressive agents Rong Song 2012, 16 (40):  7564-7571.  doi: 10.3969/j.issn.2095-4344.2012.40.028 Abstract ( 367 )   PDF (775KB) ( 548 )   Save BACKGROUND: Acute rejection after renal transplantation is common in clinic, and the immunosuppressive agents can promote and facilitate the improvement of the quality of the renal transplantation, while the reasonable application of immunosuppressive agents is important for the patients with renal transplantation and has become the important factors that affecting the survival rate of patients. OBJECTIVE: To multi-level analyze the literatures on the acute rejection after renal transplantation and the immunosuppressive agents. METHODS: A computer-based search was performed on Web of Science database for the literatures on the acute rejection after renal transplantation and the immunosuppressive agents from 202 to 2011, the key words were “renal transplantation, acute rejection, immunosuppressive agents”. The acute rejection after renal transplantation was classified to study the types of the immunosuppressive agents after renal transplantation and to analyze the characteristics of various immunosuppressive agents. RESULTS AND CONCLUSION: A total of 6 105 literatures on the acute rejection after renal transplantation and the immunosuppressive agents between 2002 and 2011 were screened out from the Web of Science database, and the number of the literature is in an increasing trend. Transplantation Proceedings journal mainly publishes the research on the acute rejection after renal transplantation and the immunosuppressive agents. And the majority of related studies are from the United States, followed by Germany. Among the top 10 literatures arranged according to the cite frequency from high to low, four literatures from The New England Journal of Medicine. In the past 10 years, the number of the included literatures in China is the No. 9, and a total of 238 literatures have been published, among the literatures, there are 17 literatures are supported by the National Natural Science Foundation. Related Articles | Metrics

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Detection of cytomegalovirus infection after renal transplantation Jin Chun-ming 2012, 16 (40):  7572-7579.  doi: 10.3969/j.issn.2095-4344.2012.40.029 Abstract ( 587 )   PDF (774KB) ( 437 )   Save BACKGROUND: Due to the decreasing cellular immunity and humoral immunity after renal transplantation, the patients may suffer various types of infection easily, and cytomegalovirus infection is more common with high morbidity and mortality. The early and accurate detection is conducive to guide clinical treatment. OBJECTIVE: To multi-level explore and analyze the articles on the detection of cytomegalovirus infection after renal transplantation. METHODS: A computer-based search was performed in CNKI database from January 2002 to December 2011 for the articles on the detection of cytomegalovirus infection after renal transplantation. The key words were “renal transplantation, cytomegalovirus, BK virus” in Chinese and English. Cytomegalovirus was the main pathogens for the infection after renal transplantation, and was closely related with the occurrence of pneumonia and hepatitis after renal transplantation, retinitis and the acute and chronic rejection after renal transplantation. RESULTS AND CONCLUSION: The method for the detection of cytomegalovirus infection after renal transplantation is continuously improved and there are various detection methods. To data, there is no ideal way to early and accurate detect the active cytomegalovirus infection. The method for diagnosing the cytomegalovirus infection after renal transplantation is mainly the combination of serological testing, fluorescence immunoassay mark detection, detection of antigen-antibody and genetic testing. Detection of the cytomegalovirus late antigen (pp65) is developed rapidly, which improve the specificity and sensitivity of detection of cytomegalovirus infection, and provide an important reference for the clinical diagnosis and preventive treatment. Related Articles | Metrics

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Perioperative application of ultrasonography in renal transplantation Li Jian-feng, Qu Hong, Zheng Chang-hong, Tang Hong-tao, Xing Chun-sheng 2012, 16 (40):  7580-7587.  doi: 10.3969/j.issn.2095-4344.2012.40.030 Abstract ( 399 )   PDF (658KB) ( 441 )   Save BACKGROUND: Ultrasonography is one of the important tools for clinical diagnosis, with advantages of safe to use, fast speed to image, cheap and easy to control in clinical diagnosis. It has guiding significance for clinical treatment because of differential diagnosis in kidney transplantation. OBJECTIVE: To explore the value of ultrasonography in the renal transplantation. METHODS: A retrieval was performed for articles related to the ultrasonography in renal transplantation, using key words of “ultrasonography, kidney transplantation, complication, Doppler ultrasonography, three-dimensional ultrasonography, ultrasonic contrast, contrast media” between 2002-01 and 2011-12 in Science Citation Index (SCI) database. RESULTS AND CONCLUSION: With the development of ultrasonography, some of the new techniques used in preoperative and postoperative complications of kidney transplantation show a good prospect. The color Doppler ultrasonography for dynamic observation of blood perfusion situation and blood flow indicators facilitates early detection of postoperative complications, and effective guiding for clinical therapy in renal transplantation has important significance. Related Articles | Metrics

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Flap transplantation and immunoregulation Wang Hai-han, Wang Jia, Long Teng-he 2012, 16 (40):  7588-7595.  doi: 10.3969/j.issn.2095-4344.2012.40.031 Abstract ( 223 )   PDF (700KB) ( 446 )   Save BACKGROUND: Skin lesions are very common, and flap transplantation is a kind of treatment method for skin lesions, and has been widely applied. Design reasonable flap transplantation and suppress the rejection after transplantation can improve the survival status of the transplanted flap. OBJECTIVE: To research the immunoregulation mechanism and inhibitory factor after flap transplantation, and to provide reference information for the research of immunoregulation after flap transplantation. METHODS: The Wanfang database was searched for the related articles on the immunoregulation after flap transplantation from 2002 to 2011 and the in-depth analysis was performed. The experimental data analysis was performed to analyze the feasibility of the establishment of flap transplantation models, the effect of nitric oxide and fibroblast growth factor on flap transplantation, as well as the microcirculation protection after flap transplantation, in order to indentify the influential factors of the survival of transplanted flap, and to regulate, extend the survival of the transplanted flap and improve the state of survival after flap transplantation. RESULTS AND CONCLUSION: The rat model with flap transplantation is a good flap transplantation animal model, it can be used to establish the model with various flap transplantation, and can be used for the experimental research on the immunity and the microcirculation of flap transplantation. During the immunoregulation after flap transplantation, both nitric oxide and fibroblast growth factor has regulation effect on the immune response, while the propofol and papaverine hydrochloride substances play a important role in microcirculation protection after flap transplantation. Related Articles | Metrics

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Orthotopic liver transplantation for hepatocellular carcinoma and portal vein thrombosis: Refractory bleeding treated with stage Ⅰ vascular anastomosis plus stage Ⅱ biliary-enteric anastomosis Chen Kai, Zhao Ji, Deng Xiao-fan, Zhang Yu, Yang Hong-ji 2012, 16 (40):  7596-7600.  doi: 10.3969/j.issn.2095-4344.2012.40.032 Abstract ( 408 )   PDF (452KB) ( 508 )   Save BACKGROUND: Refractory bleeding often occurred in orthotopic liver transplantation, with difficultly treatment and high operation failure rate, but its effective means for the treatment was not yet reported today. OBJECTIVE: To investigate the effectiveness of surgical approach with stage Ⅰ vascular anastomosis and gauze packing hemostasis for the treatment of refractory bleeding in orthotopic liver transplantation for hepatocellular carcinoma and portal vein thrombosis, and the feasibility of plus stage Ⅱ biliary-enteric anastomosis completed orthotopic liver transplantation in stage. METHODS: One patient with refractory bleeding in orthotopic liver transplantation for hepatocellular carcinoma and portal vein thrombosis was treated with stage Ⅰ vascular anastomosis, gauze packing hemostasis and stage Ⅱ biliary-enteric anastomosis. In this study, we observed the effectivity of this hemostasis and recovery after liver transplantation. RESULTS AND CONCLUSION: In this study, the bleeding was stopped at 2 days after treated with stage Ⅰ vascular anastomosis and gauze packing hemostasis, and the liver function and coagulation function were improved significantly; acute rejection after stage Ⅱ biliary-enteric anastomosis was not obvious, and liver function and coagulation function were improved significantly at 3 days after transplantation. Ultrasonography of the portal vein showed that the lumen of the main portal vein and its branches open and perfusion well. Hepatorenal syndromes such as oliguria, massive ascites and impaired renal function happened at 2 weeks after transplantation. And the hepatorenal syndromes were then gradually restored after treated with Terlipressin. Upper gastrointestinal bleeding caused by stress ulcer was appeared at 2 weeks after transplantation, and cured by the mediccal hemostatic treatment. The patient was discharged at 34 days after treatment. The results of this study show that stage Ⅰ vascular anastomosis and gauze hemostasis hemostasis are effectiveness for the treatment of refractory bleeding in orthotopic liver transplantation for hepatocellular carcinoma and portal vein thrombosis, and plus stage Ⅱ biliary-enteric anastomosis is entirely feasible to complete orthotopic liver transplantation in stage. Related Articles | Metrics