Status of clinical research in HCV-negative recipients undergoing kidney transplantation from HCV-positive renal allografts / 器官移植

Antiviral therapy for chronic hepatitis C virus (HCV) infection has entered the era of direct antiviral agent (DAA), and up to 95% of patients could be clinically cured. Under this circumstance, HCV infection has gradually changed from relative contraindication to surgical indication for kidney transplantation. However, at present, the number of kidney transplantation from HCV-infected donors or recipients has been rarely reported in China. The short-term follow-up data of HCV-negative recipients undergoing kidney transplantation from HCV-positive renal allografts in other countries have confirmed that DAA yields high cure rate and safety in the treatment of HCV infection, and recipients could obtain favorable short-term survival and allograft outcome. However, the long-term safety of HCV-infected kidney transplantation remains to be validated by clinical trials with large sample size and long-term follow-up. In this article, the virological clearance, allograft outcome and safety of DAA use in HCV-negative recipients undergoing kidney transplantation from HCV-positive renal allografts under the intervention of DAA were investigated, aiming to evaluate clinical safety and efficacy of this pattern of kidney transplantation and deepen the understanding of safe use of HCV-positive organs.

Study progress in erectile dysfunction after radical pelvic surgery / 中华泌尿外科杂志

Radical pelvic surgery is a surgical method mainly used to treat tumors in the pelvic cavity, and erectile dysfunction (ED) is a common sexual dysfunction after surgery. The incidence of ED after radical pelvic surgery is not uniformly understood due to differences in surgical approaches and methods of investigation. The main causes of postoperative ED include intraoperative neurovascular injury, psychosomatic factors and preoperative patient characteristics, with intraoperative injury to the neurovascular bundle being the most common. Studies have shown that the occurrence of postoperative ED can be prevented by active intervention, but still lack of effective treatment measures. This article reviews and summarizes the clinical epidemiological features and research progress in recent years on ED after radical pelvic surgery, and discusses specific measures for the prevention and treatment of postoperative ED.

Convolutional neural network human gesture recognition algorithm based on phase portrait of surface electromyography energy kernel / 生物医学工程学杂志

Surface electromyography (sEMG) is a weak signal which is non-stationary and non-periodic. The sEMG classification methods based on time domain and frequency domain features have low recognition rate and poor stability. Based on the modeling and analysis of sEMG energy kernel, this paper proposes a new method to recognize human gestures utilizing convolutional neural network (CNN) and phase portrait of sEMG energy kernel. Firstly, the matrix counting method is used to process the sEMG energy kernel phase portrait into a grayscale image. Secondly, the grayscale image is preprocessed by moving average method. Finally, CNN is used to recognize sEMG of gestures. Experiments on gesture sEMG signal data set show that the effectiveness of the recognition framework and the recognition method of CNN combined with the energy kernel phase portrait have obvious advantages in recognition accuracy and computational efficiency over the area extraction methods. The algorithm in this paper provides a new feasible method for sEMG signal modeling analysis and real-time identification.

The mechanism of USP7 in prostate cancer / 中华泌尿外科杂志

The traditional androgen deprivation therapy has been challenged since the appearance of castration resistant prostate cancer (CRPC). More and more researches are focusing on searching the proper molecular target to inhibit the progression of tumors. Ubiquitin specific protease 7(USP7), as an important deubiquitinating enzyme, regulates the half-life or subcellular localization of key proteins via posttranslational modification. It has been reported recently that prostate cancer cells are suppressed by USP7 inhibitors, but the complicated mechanisms remain to clarify. In this paper, we review the mechanism of USP7 in prostate cancer, suggesting the potential value of USP7 inhibitors in the treatment of CRPC.

The effect of TGF-β/ILK pathway in endothelial-mesenchymal transition induced by parathyroid hormone in human vascular endothelial cells / 重庆医学

Objective To investigate the molecular mechanism of endothelial-mesenchymal transition (EndMT) induced by uremic toxin,parathyroid hormone (PTH),in vascular endothelial cells.Methods PTH (1 × 10-8 mol/L) was used to induce EndMT in human aortic endothelial cells (HAECs).TGF-β signaling inhibitor,including SB431542 and pirfenidone (PFD),and integrin-linked kinase (ILK) inhibitor Cpd22 were used to investigate the potential mechanism of EndMT induced by PTH in HAECs.Then the vascular endothelial cell markers VE-cadherin and CD31,and the mesenchymal marker α-SMA were detected by western blot.Results PTH reduced the expression levels of vascular endothelial cell marker CD31 and VE-cadherin (P＜0.05),while significantly increased the expression level of fiber cell marker α-SMA(P＜0.05).Furthermore,the TGF-βsignaling inhibitors (SB431542 and PFD) and ILK inhibitor (Cpd22) were able to partially reverse the EndMT induced by PTH in HAECs,which reversed the effect of PTH on reducing vascular endothelial cell marker expression and increasing fiber cell marker expression.Conclusion PTH could induce EndMT in HAECs via TGF-β/ILK pathway.

Retrospective analysis of primary hyperparathyroidism combined with papillary thyroid carcinoma / 中国医师进修杂志

Objective To evaluate the differences of the malignant rate of thyroid nodules between primary hyperparathyroidism (PHPT) patients and health examination population, and analyze the clinical characteristics of PHPT combined with papillary thyroid carcinoma (PTC). Methods The clinical data of 158 PHPT patients who had underwent parathyroidectomy and 468 thyroid nodule patients who had underwent fine-needle aspiration (FNA) from 2009 to 2014 were retrospectively analyzed, and the detection rate of PTC in patients with thyroid nodule was recorded. Results Of the 158 patients with PHPT, 61 patients had thyroid nodules, the incidence of PHPT with thyroid nodule was 38.6% (61/158), and postoperative pathologically proved PTC was in 12 cases (19.7%). Of the 468 thyroid nodule patients who had underwent FNA, postoperative pathologically proved PTC was in 19 patients (4.1% ). The malignant rate of thyroid nodules in PHPT patients was significantly higher than that in health examination population (P＜0.01). The adjusted serum calcium in patients with PHPT combined with PCT was significantly lower than that in patients with PHPT combined with benign thyroid nodules and patients with PHPT without thyroid nodules: (2.63 ± 0.26) mmol/L vs. (2.92 ± 0.32) and (2.93 ± 0.47) mmol/L, and there was statistical difference (P＜0.05). Conclusions The malignant rate of thyroid nodules in PHPT patients is significantly higher than that in patients from health examination population, which suggests that PHPT might be a risk factor for the malignancy of thyroid nodules. A lower level of serum calcium may predict the existence of PCT in PHPT patients with thyroid nodules.

Genetic diagnosis of 6 patients with fibrous dysplasia of bone / 中华内分泌代谢杂志

To explore the detection of GNAS1 gene mutation from peripheral blood and non-involved bone marrow in patients with fibrous dysplasia of bone(FD). Both peripheral blood and non-involved bone marrow collected from six FD patients were used for genetic diagnosis by next generation sequencing and direct sequencing respectively. Two patients were found to have common gene mutation(positive) by next generation sequencing, accounting for 33.3% of total six people: p.R201H(CGT>CAT) was detected in both peripheral blood and bone marrow of patient No.3, and p.R201C(CGT>TGT) was detected in both tissues of patient No.6. While direct sequencing only found p.R201H(CGT>CAT) mutation in peripheral blood and bone marrow of patient No.3. Detection of GNAS1 gene mutation may contribute to the diagnosis of FD. Hot spot mutations of GNAS1 are present in peripheral blood and non-involved bone marrow samples from some Chinese FD patients, but the diagnostic value and sensitivity of GNAS1 gene mutation in non-involved tissues of FD patients is low by next generation sequencing or direct sequencing.

Effect of Complement C5a/C5aR pathway on autophagy induced by renal ischemia-reperfusion injury / 中华器官移植杂志

Objective To investigate the expression of autophagy and the effect of complement C5a/C5aR pathway on autophagy induced by renal ischemia reperfusion injury (IRI).Methods MaleWT and C5aR gene knockout (BALB/C background) mice were selected.The model of renal IRI was established by occluding bilateral renal pedicles with microaneurysm clamps.Mice were divided into wild type BALB/C (WT) group and C5aR gene knock out (C5aRKO) group.The pathology of kidney was assessed by HE staining.The levels of BUN and KIM-1 were detected 24 h after reperfusion.The expression of the autophagy-associated protein (LC3 Ⅱ/LC3 Ⅰ and P62) was measured by Western blotting and immunofluorescence.In vitro,human renal tubular epithelial cells (HK2) were cultured.The expression of LC3 in HK2 cells was investigated by immunofluorescence and Western blotting after being treated with recombinant C5a or C5a combined with C5aR antagonist (C5aRA).Results As compared with WT group,the severity of kidney injury was obviously reduced in C5aRKO group (P＜0.05).After ischemia-reperfusion,the expression of autophagy-related protein LC3 gradually increased with the reperfusion time prolonged.The level of autophagy induced by ischemia-reperfusion was significantly reduced in C5aRKO group as compared with WT group (P＜0.05).In addition,the expression of autophagy-related protein LC3 Ⅱ in HK2 cells was increased with the augment of C5a stimulation concentration in vitro.Blockage of C5aR pathway by C5aRA led to a significant decrease in autophagy (P ＜ 0.05).Conclusion Complement C5a/C5aR pathway promotes renal IRI-induced autophagy.

A preliminary study on the pregnancy outcomes of pregnant women with positive thyroid peroxidase antibody / 中华内分泌代谢杂志

Objective To explore the correlation between simple thyroid peroxidase antibody (TPOAb) positive (higher than the normal reference value) and the adverse pregnancy outcomes;and to discuss the necessity of clinical intervention on TPOAb positive and the characteristic of gestational thyroid peroxidase antibody changes.To study wether clinical intervention affects its direction.Methods Subjects were selected from TPOAb positive pregnant women during June 2012 to February 2015.They were registered regularly for thyroid function during pregnancy and 6 weeks postpartum,and timely treated for abnormal thyroid function.They were grouped according to the thyroid function:Group 1 (n =122),simple TPOAb positive group;Group 2 (n =67),patients with elevated TSH and positive TPOAb who accept the levothyroxine (L-T4) intervention;Group 3 (n =120),TPOAb negative healthy pregnant women.They were regularly tested for thyroid function during pregnancy,and with follow-up until 6 weeks postpartum.Results When Group 1 compared with Group 3:the risk of premature rupture of membranes,abnormal amniotic fluid,and fetal distress rate increased,the relative risk (RR) were 3.066,4.782,2.605,all P ＜0.01,while the gestational diabetes,gestational hypertension,preterm birth,abnormal gestation and birth showed no statistical differences (P＞0.05).When Group 2 compared with Group 3,the risk of premature rupture of membranes,abnormal amniotic fluid,and fetal distress increased (RR were 3.830,5.537,3.600 respectively,all P ＜ 0.01).While gestational diabetes,gestational hypertension,preterm birth,abnormal gestation and birth did not show any statistical difference (P＞0.05).Compared with Group 2,Group 1 had no statistical difference between the above observational parameters.The levels of TPOAb from stage T1 (the first trimester) to T3(the third trimester) showed a overall downward trend in Group 1 and Group 2,rise again six weeks after child birth.Comparison of the two groups (Group 1 and Group 2),the median value during this period did not reveal any significantly statistical differences (P＞ 0.05).Conclusion In simple TPOAb positive pregnant women,premature rupture of membranes,abnormality in amniotic fluid,and fetal distress were significantly higher than those in healthy pregnant women;even with thyroid function correction the TPOAb positive pregnant women still cannot reduce the adverse pregnancy outcomes.Levels of TPOAb from T1 to T3 presented the overall downward trend and to rise again six weeks after pregnancy.L-T4 intervention for TPOAb positive pregnancy did not show any significant effect.

Icariin induced proliferation and differentiation of MC3T3-E1 osteoblasts via ERK and JNK signaling coupled with estrogen receptor / 中华内分泌代谢杂志

Objective To explore the detailed underlying molecular and signaling mechanisms in the effects of icariin on bone formation by an in vitro cell model. Methods The proliferation of MC3T3-E1 osteoblast-like cells was evaluated by MTT, and gene expression of cell cycle related proteins in MC3T3-E1 cells after icariin treatment was detected by real-time PCR. The phosphorylation of MAPK signals, including ERK, P38, and JNK was determined by Western blot, and then the inhibitors of MAPK signals were used to treat cells with icariin alone or together to determine the role of MAPKs in the process of icariin treatment on MC3T3-E1 cell proliferation. Alkaline phosphatase and Alizarin red staining were used to detect the formation of mineralization nodules, and gene expressions of alkaline phosphatase, type Ⅰ collagen, and osteocalcin in osteoblasts after being treated by icariin were evaluated by real-time PCR. ICI182780, and nilutamide was used to decide the participation of estrogen and androgen receptor signals in the process of icariin treatment on the differentiation and mineralization of MC3T3-E1 cells. Results Treatment with icariin promoted MC3T3-E1 cell growth in a time- and dose-dependent manner. This treatment also revealed that icariin increased the expression of mRNAs encoding both cyclin E and PCNA, positive regulators of cell growth, but decreased levels of mRNAs encoding Cdkn2b, a negative regulator of cell cycle progression. When MC3T3-E1 cells were cultured in a differentiated condition, icariin enhanced mineralized nodule formation and increased the expression of mRNAs encoding alkaline phosphatase, type Ⅰ collagen, and osteocalcin. Treatment with icariin significantly induced phosphorylation of both ERK and JNK and this phosphorylated effect occurred very rapidly within 5 minutes and reached peak at 15 minutes. Furthermore, the stimulated effects of icariin on proliferation and gene expression of cyclin E, PCNA, and Cdkn2b in MC3T3-E1 cells were dramatically attenuated by treatment with both U0126 and SP600125, inhibitors of MAPKs. Interestingly, such stimulating effects of icariin were at least partly reduced by treatment with ICI182780, an inhibitor of estrogen receptor. Icariin induced mineralized nodule formation and gene expression of alkaline phosphatase, type Ⅰ collagen, and osteocalcin in MC3T3-E1 cells were also partly reduced when the cells were treated with ICI182780. Conclusions Our findings indicate that the anabolic effect of icariin on bone formation is, at least partly, mediated through the MAPK signaling pathway in order to modulate osteoblast proliferation and differentiation.

The progress in the treatment of fibrodysplasia ossificans progressiva / 中华内分泌代谢杂志

Fibrodysplasia ossificans progressiva(FOP) is a rare debilitating genetic disorder characterized by malformation of the great toes during embryonic skeletal development as well as progressive heterotopic ossification postnatally. There is no known definite treatment. Here presented a review of the recent advances in the potential FOP therapies.

The intervention study of atorvastatin on the effect of proliferation and differentiation and the expression of low density lipoprotein receptor-related protein 5, dickkopf-1 mRNA of osteoblasts caused by low density lipoprotein / 中华内分泌代谢杂志

Objective The aim of this study was to explore the effect of low density lipoprotein ( LDL) on the proliferation and differentiation of MC3T3-E1 osteoblasts, as well as the expression of low density lipoprotein receptor-related protein 5(LRP5) and dickkopf-1(DKK1) mRNA of MC3T3-E1 osteoblasts. The possible mechanisms of the treatment of atorvastatin on LDL expression in MC3T3-E1 osteoblasts were also investigated. Methods Proliferation, osteocalcin expression, LRP5, and expression of DKK1 mRNA of MC3T3-E1 with interaction of LDL at 0. 05, 0. 10, 0. 20 mg/ml levels after 24 h, 48 h, 72 h were detected by CCK8, ELISA, and fluorescence quantitative PCR. Furthermore, proliferation, osteocalcin expression, LRP5 and DKK1 mRNA of MC3T3-E1 after the treatment of atorvastatin of 10-6 mol/L and 10-5 mol/L were also be studied, respectively. Results The effect of LDL on proliferation, expression of osteocalcin and expression of LRP5 and DKK1 mRNA in MC3T3-E1 osteoblasts was the most obvious under LDL with 0. 20 mg/ml level. Under that level, atorvastatin (10-6 mol/L or 10-5 mol/L) was able to make the proliferation of MC3T3-E1 osteoblasts in 48 h and 72 h be decreased, while significantly caused upregulation of osteocalcin, LRP5 mRNA expression; and down regulated DKK1 mRNA expression ( all P<0. 05). Conclusions Atorvastatin can reduce the inhibitory effect of LDL on the proliferation and differentiation of osteoblasts. The mechanisms of atorvastatin on osteoblasts are possibly related to the osteoblast proliferation and expression of LRP5 mRNA and DKK1 mRNA of osteoblasts of wnt signal pathway.

Application of electronic flexible ureteroscope in treatment of larger kidney stones / 局解手术学杂志

Objective To investigate the efficacy and safety of electronic flexible ureteroscope Holmium laser lithotripsy in the treatment of kidney stones larger than 2. 0 cm. Methods From October 2012 to December 2013,43 cases of kidney stones larger than 2. 0 cm in diam-eter were treated with holmium laser lithotripsy under electronic flexible ureteroscope. A double-J stent was indwelled in ureter for 1~2 weeks before operation in each patient. Ureteral catheter guide wire was firstly put into the ureter with F8. 0/9. 8 semi-rigid ureteroscope,and the ac-cess sheath was put along the wire. Then,the electronic flexible ureteroscope(Olympus V5) was introduced into the pelvis. Stones were frag-mented with holmium laser,and greater than 3 mm crushed stones were removed with a set of stone basket. Results The diameter of the stones of the 43 patients ranged from 2~3. 2 cm,with an average of 2. 4 cm. The operation time ranged from 35~120 min,with an average of 68 min. Three patients complicated with chills,fever and other symptoms of infection,who were improved by active anti-infective treatment. No serious complications occurred. Postoperative hospital stay was 2~4 d,with an average of 3. 2 d. After 12 weeks of follow-up,stone clearance rate was 86% (37/43). Conclusion It is safe and efficacy to treat kidney stones larger than 2. 0 cm with electronic flexible ureteroscope, especially for the elderly,solitary kidney,and patients with a previous incision or percutaneous nephrolithotomy.

Application of flexible ureteroscopic lithotripsy in treatment of medullary sponge kidney stones / 局解手术学杂志

Objective To investigate the clinical efficacy and safety of flexible ureteroscopic lithotripsy ( FURL) using holmium laser for medullary sponge kidney stones. Methods A flexible ureteroscope was placed into renal calyx via a ureteral access sheath ( UAS) . The stones underlying the mucosa were found,and then broken by holmium laser following incision of renal papillary mucosa. The stone fragments were washed or clamped out. The remission of clinical symptoms and incidence of perioperative complications were observed,and a KUB plain film was rechecked postoperatively. Results Stones underlying mucosa were found and broken successfully in all 14 patients and there was no serious bleeding. Back pain symptoms of patients were relieved in 3 to 7 days postoperatively or after the removal of double J stent. The stone fragments were mainly discharged spontaneously. The rechecking KUB showed the amount of stones of most patients was significantly re-duced three months after operation. Conclusion FURL using holmium laser is effective for the treatment of medullary sponge kidney stones as it can significantly reduce the loads of stones without serious complications. It’ s a minimally invasive,effective,safe and suitable way which is suitable for further spread of clinical application.

Effects of glycated low density lipoprotein on the proliferation and differentiation and expression of low-density lipoprotein receptor-related protein-5 mRNA, dickkopf-1 mRNA in mouse osteoblasts / 中华内分泌代谢杂志

Objective The aim of this study was to investigate the possible effect of glycated low density lipoprotein ( LDL ) on the proliferation, differentiation, and expression of low-density lipoprotein receptor-related protein5(LRP5)mRNA,dickkopf-1(DKK1)mRNAinmouseosteoblasts(MC3T3-E1cells). WhethertheWnt signaling pathway was involved in the above process was explored else. Methods Mouse MC3T3-E1 cells were culturedwithvariousconcentrationsofglycatedLDL(glycatedLDLlevelwas2.4%,5.3%,8.7%,13.9%)for24, 48, 72 h. Proliferation of MC3T3-E1 cell was measured by CCK-8, the osteocalcin level in the medium was determined by ELISA and the expression of LRP5 mRNA, DKK1 mRNA was measured by realtime PCR. Results After cells being incubated with 5. 3% of glycated LDL for 24 h, the inhibition of MC3T3-E1 cells was more marked than that in control group(P<0. 01). The higher glycated LDL level, the severer the inhibition. The effect of LDL on the MC3T3-E1 cell proliferation was time- and dose-dependent under certain conditions. Osteocalcin level in cell culture fluid with glycated LDL was lowered significantly compared with control group. Meanwhile, the expression of DKK1 mRNA was increased significantly but expression of LRP5 mRNA decreased (P<0. 01) in MC3T3-E1 cells cultured with 5. 3% of glycated LDL for 24 h. Conclusions Proliferation and differentiation of the osteoblasts in mice can be inhibited significantly by glycated LDL. The possible mechanism in the role played by glycated LDL on the proliferation and differentiation in MC3T3-E1 cells seems to be related to expression of LRP5 mRNA, DKK1 mRNA in the Wnt signaling pathway.

Dynamic MRI for assessment of the anatomical and functional significance of the bladder and urethra in female stress urinary incontinence / 局解手术学杂志

Astract:Objective To assess the anatomical and functional significance of the bladder and urethra in female SUI by dynamic MRI and urodynamic. Methods The clinical data were retrospectively analysed on 60 cases of female stress urinary incontinence from Feb 2011 to Nov 2013. All the women received pelvic floor dynamic MRI and Urodynamic study. Measured the urethral angle,the distance of the H line, M line and the descent of the bladder,cervical,anorectal junction from the PCL in the mid-sagittal dynamic MR image of the pelvic. Pearson 's correlation coefficient was used to examine the association among the distance of the H line,M line and the urethral angle,the descent of the bladder,cervical,anorectal junction from the PCL and the Urodynamic data. Results The distance of the H line,M line were significantly and positively associated with urethral angle and the descent of the bladder,cervical,anorectal junction from the PCL. The distance of the H line,M line were significantly and negatively associated with functional profile length, maximum urethral closure pressure,VLPP and detrusor opening pressure. Conclusion Pelvic floor dynamic MRI combined with Urodynamic study is useful for assessing the anatomical and func-tional significance of the bladder and urethra in female SUI.

Randomized controlled study of flexible ureteroscopic lithotripsy and mini-percutaneous nephrolithotomy for treating upper ureteral calculi / 重庆医学

Objective To compare the safety and efficacy of flexible ureteroscopic lithotripsy (F-URS) and mini-percutaneous nephrolithotomy(MPCNL) for treating upper ureteral calculi by the randomized controlled clinical trial .Methods 120 cases of up-per ureteral calculi treated in this hospital from May to September 2013 were randomized into the F-URS group and the MPCNL group with 60 cases in each group .The postoperative clinical curative effects were compared between the two groups .Results The initial stone clearance rates of the F-URS group and the MPCNL group were 68 .33% and 95 .00% respectively ,and the difference was statistically significant (P0 .05) .The operating time of the F-URS group and the MPCNL group was (35 .33 ± 11 .57)min and (53 .75 ± 17 .31)min respectively ,the average hospital stay after operation was(3 .05 ± 0 .62)d and (5 .43 ± 1 .84)d respectively ,and the average visual analogue scale(VAS) score on first postoper-ative day was 1 .70 ± 1 .37 and 3 .68 ± 1 .57 respectively .These indicators had statistically significant differences between the two groups(P0 .05) .Conclusion For upper ureteral calculi with surgical indication ,the effect of F-URS is equivalence to MPCNL in the aspect of the stone clearance rate ,but F-URS has high-er security and shorter postoperative hospital stay .In the department with the condition to conduct F-URS ,F-URS should be ranked as the preferred treatment method for upper ureteral calculi .

Regulation effect of complement C5a on interleukin-17 during renal allograft rejection / 重庆医学

Objective To investigate the expression of proinflammatory cytokine interleukin-17(IL-17) and complement cleavage fragment C5a and the regulation effect of C5a on the expression of IL-17 during renal allograft rejection .Methods The frequency of IL-17+ T cell in peripheral blood and the expression of IL-17 in renal tubular epithelial cells (HK2) after C5a stimulation in renal transplant recipients were measured by flow cytometry and the changes of serum C5a level was detected by ELISA ,respectively .Im-munohistochemistry was applied to detect and compare the expression of IL-17 and the deposition of C5b-9 in normal renal tissues and renal tissues with allograft rejection .The difference of IL-17 expression in HK2 cells before and after the recombinant C5a stimulation was detected by immunocytochemistry .Results Both the percentage of IL-17+ T cells and serum C5a levels were sig-nificantly increased after the allogeneic renal transplantation .Compared with normal renal tissues ,both the deposition of C5b-9 and the IL-17 expression in renal tissues with allograft rejection was remarkably up-regulated ,which showed the positive correlation be-tween them .The expression of IL-17 in HK2 was obviously up-regulated by the recombinant C5a stimulation .Conclusion C5a may positively regulate the expression of IL-17 by tubular epithelial cells during the renal allograft rejection .

Immunological function variation of peripheral dendritic cell from bladder cancer patients after blocking PD-L1 pathway / 中华泌尿外科杂志

Objective To investigate the immunological function variation of peripheral dendritic cell(DC)from bladder cancer patients after blocking PD-L1 pathway.Methods DC from normal control and patient with bladder cancer were cultured with rhGM-CSF,rhIL-4 in vitro and treated with PD-L1 monoclonal antibody.The expression of CD1a,HLA and CD83 were examined by flow cell meter.The effect of DC induced lymphatic cellular proliferation and its capability of secreting IL-10,IL-12 were determined by MTT and ELISA.Results Blocking PD-LI pathway did not infuluence the maturation of DC.But the DCs from bladder cancer patient signifcantly boosted the lymphatic cellular proliferating(4.00 ± 1.28 versus 1.49 ±0.45)and IL-12 secretion capability(108.30 ± 21.89 versus 37.17 ± 14.89 ng/L),and yet it also decreased the secretion of IL-10(108.90 ± 21.77 versus 14.99 ± 54.99 ng/L)after blocking PD-L1 pathway (P ＜ 0.05).Conclusion Blocking PD-LI pathway on the DC from bladder cancer patient may improve its anticancer immunological function.

Clinical efficacy of sunitinib as post-operative adjuvant therapy in patients with high-risk renal cell carcinoma / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of sunitinib as post-operative adjuvant therapy in patients with high-risk renal cell carcinoma (RCC).Methods A total of 60 patients with resected,histologically confirmed clear cell RCC were enrolled in this study.Patients received orally sunitinib either at a dose of 50 mg on treatment schedule (once daily for 4 weeks followed by 2 weeks off) or at a dose of 37.5 mg once daily for three 6-week cycles from 1 month after surgery.Results All the 60 patients tolerated Sunitinib treatment well and no patient discontinued treatment due to adverse events.Most adverse events were grade Ⅰ to Ⅱ.The most frequently reported adverse events were neutropenia (56.7％),thrombocytopenia (53.3％),leucopenia (48.3％),hand-foot syndrome (46.7％) and hypertension (36.7％).The most frequently reported grade 3 or 4 toxicities were thrombocytopenia (25.0％),neutropenia (15.0％),hand-foot syndrome (11.7％) and leucopenia (8.3％).The majority of adverse events occurred within the first 1-2 cycles of sunitinib treatment,and was ameliorated 1 month after 3 cycles finished.No irreversible adverse event was observed.As of April 5,2012,no recurrence occurred in patients except one death due to cerebrovascular accident unrelated to treatment,with both 6-month and 9-month disease-free survival rate of 100％.Conclusions Myelosuppression occurred less frequently in high-risk RCC patients treated with sunitinib as operative adjuvant therapy than in advanced RCC patients,with a better benefit trend.However,long-term follow-up data are needed to further confirm the efficacy of sunitinib in the adjuvant setting.