Human Gingival Stem Cells Prevent Diabetes in NOD Mice by Reducing Follicular B Cells / 中山大学学报(医学科学版)

BackgroundType 1 diabetes is caused by a chronic immune response that destroys islet beta cells， resulting in elevated blood glucose. Mesenchymal stem cells can prevent and treat the development of diabetes and its complications. However， little is known about the effects and potential mechanisms of Gingival mesenchymal stem cells （GMSCs） in preventing diabetes. The aim of this study is to investigate the mechanism of GMSCs in preventing type 1 diabetes in mice and to find targets for clinical treatment of diabetes. MethodsWe injected human GMSCs into NOD mice to observe the trend of blood glucose， observed the survival of pancreatic β-cells by immunohistochemistry， and detected the change of immune cells in the spleen of mice by flow analysis. Finally， the immune cells in NOD mice were transfused into NOD-SCID mice to observe the onset of diabetes in NOD-SCID mice. ResultsGMSCs significantly reduced the incidence of diabetes in NOD mice， with 64% of control mice developing diabetes at 27 weeks of age compared with 35% in the GMSC group， P=0.013. The percentage of Follicular B cells（FO B cell） in the spleen of GMSCs-treated mice decreased from （52.2±4.1）% to （43.2±5.3）%， P=0.008， while other types of immune cells did not change significantly. The immunohistochemical results showed that GMSCs could effectively improve the survival of pancreatic β-cells， which could continuously produce insulin to control blood glucose. Finally， we found the spleen cells transfusion could prevent the development of diabetes in NOD-SCID mice. ConclusionGMSCs can reduce diabetes in mice by reducing FO B cells in the spleen.

Potent Antihyperuricemic Triterpenoids Based on Two Unprecedented Scaffolds from the Leaves of Alstonia scholaris.

Two rearranged triterpenoids, representing new subtypes of pentacyclic triterpenoids, with unique 6/6/6/7/5 and 6/6/5/6/6/6 ring systems were isolated from Alstonia scholaris. Their structures were established by spectroscopic analysis, single-crystal X-ray diffraction, and electronic circular dichroism calculations. Both compounds exhibited potent antihyperuricemic bioactivity in vitro and in vivo.

Myrothins A-F from Endophytic Fungus Myrothecium sp. BS-31 Harbored in Panax notoginseng.

Endophytic fungi play important roles for host's stress tolerance including invasion by pathogenic microbes. Small molecules are common weapons in the microbe-microbe interactions. Panax notoginseng is a widely used traditional Chinese medicinal plant and harbors many endophytes, some exert functions against pathogens. Here, we report six new compounds named myrothins A-F (1-6) produced by Myrothecium sp. BS-31, an endophyte isolated from P. notoginseng, and their antifungal activities against pathogenic fungi causing host root-rot disease. Their structures were elucidated with analysis of spectroscopic data including 1D and 2D NMR, HR-ESI-MS. Myrothins B (2) and E (5) showed the weak activity against Fusarium oxysporum and Phoma herbarum, and myrothins F (6) showed weak activity against F. oxysporum.

Amycolatopsis panacis sp. nov., isolated from Panax notoginseng rhizospheric soil.

A novel Gram-positive bacterium, designated strain YIM PH21725T, was isolated from a sample of rhizospheric soil of Panaxnotoginseng cultivated in Anning, Yunnan. The strain contained meso-diaminopimelic acid in the cell-wall peptidoglycan. The main fatty acids identified were C17 : 0, iso-C15 : 0, iso-C16 : 0 and C16 : 0. The main menaquinone was MK-9 (H4). The polar lipids included phosphatidylethanolamine, diphosphatidylglycerol, phosphatidylinositol mannoside, phosphatidylinositol, phospholipids and phospholipids of an unidentified structure containing glucosamine. The G+C content of genomic DNA was 69.43 mol%. On the basis of its 16S rRNA gene sequence, strain YIM PH21725T should belong to the genus Amycolatopsis, and was closely related to Amycolatopsis sulphurea DSM 46092T (98.57 %), Amycolatopsis jejuensis JCM13280T (97.27 %), Amycolatopsis jiangsuensis KCTC 19885T (96.88 %) and Amycolatopsis ultiminotia JCM 16989T (96.8 %). The phenotypic, chemotaxonomic, phylogenetic and digital DNA-DNA hybridization results clearly indicated that strain YIM PH21725T represents a novel species of the genus Amycolatopsis, for which the name Amycolatopsispanacis sp. nov. is proposed. The type strain is YIM PH21725T (=CCTCC AA 2017044T=KCTC 49031T=DSM 105902T).

Effects of tanshinone ⅡA sulfonate on nerve regeneration after cryopreserved sciatic nerve allograft in rats / 中国中药杂志

In order to investigate the protective effect of tanshinone ⅡA sulfonate on the sciatic nerve activty in rats after cryopreservation as well as the nerve regeneration and functional recovery after allograft and its possible mechanism, Sprague-Dawley (SD) rats were divded into four groups at different doses of tanshinone ⅡA sulfonate (A 0 mg·L⁻¹, B 80 mg·L⁻¹, C 160 mg·L⁻¹, D 480 mg·L⁻¹) cryopreserved at -80 °C for 24 weeks. Fresh control group nerve segments were harvested without cryopreservation. The ultrastructure and the viable cells of the nerve segments after cryopreservation were observed by electron microscopy, calcein-AM/propidium iodide staining, respectively. The expression of Bax and Bcl-2 was detected by Western blot. After cryopreservation, the nerve segments were cultured in vitro for one week, the mRNA and protein level of NGF and GDNF were detected by PCR and Western blot respectively. In addition, the above four cryopreserved groups transplanted to the Wistar rats by allografting (A', B', C', D'). At 16-week postoperation, muscle compound action potential latency and nerve conduction velocity were examined by electrophysiological. The number and the thickness of myelinated nerve fibers were analyzed by toluidine blue staining. The ultrastructure of the sciatic nerve by electron microscopy was observed. According to the results, after the cryopreserved for 24 weeks, compared with groups A and B, the nerve demyelination and vacuolation were weak, and the more viable cells, the decreased Bax and increased Bcl-2, the increased NGF and GDNF in group C and D. At 16-week poseoperation, the results demonstrated that the more larger and thickly regenerated myelinated axons, the shorter latency of muscle compound action potentials and higher nerve conduction velocity in groups C' and D' compared with groups A' and B'. According to these results, tanshinone ⅡA sulfonate exerted a significant protective effect on the viability of the nerves during cryopreservation at -80 °C and promoted nerve regeneration and functional recovery after transplantation especially in middle- and high-dose of tanshinone ⅡA sulfonate.

Application value of standard curve of K+ concentration in dialysis solution in personalized dialysis therapy / 医疗卫生装备

Objective To investigate the linear relationship and standard curve equation between acidic concentrated solution added KCl and the changes of K+ concentration in dialysate,and to apply it in personalized dialysis.Methods The speed of concentrated liquid pump of Fresenius 4008S hemodialysis machine was calibrated,the ratio of the concentration solution to the reverse osmosis water was determined,KCl was added to the concentrated A solution by an equal increment method to detect K+ concentration in the corresponding dialysate,and the K+ concentration standard curve of dialysate was mapped.This study is based on blood K+ concentration of adams-stokes syndrome patients before dialysis,referring to the standard curve,the most suitable dialysate K+ concentration was selected to personalized dialysis,the blood K+ concentration of the patients was measured after dialysis,and ECG monitoring and clinical symptoms observation were carried out.Results There was a linear relationship between acidic concentrated solution added KCl and the changes of K+ concentration in dialysate,the curve equation was y =0.384 lx + 0.002 3,R2 =0.999 4.There was no obvious change in the concentration of other electrolyte ions in the dialysate.Referring to the standard curve,the concentration of dialysate K+ could be adjusted accurately.The blood K+ concentration of adams-stokes syndrome patients could be corrected in time after several times of K+ concentration of personalized dialysis,and ECG recovered eventually,and arrhythmia,syncope,chest tightness and other symptoms disappeared.Conclusion There is a linear relationship between the concentration of dialysate K + and the concentration of KCl added in acidic concentrated solution in the Fresenius 4008S hemodialysis machine.Personalized dialysis is performed by the standard curve with obvious clinical application value,and references are provided for precise regulation of dialysate ion concentration.

Application value of standard curve of K+ concentration in dialysis solution in personalized dialysis therapy / 医疗卫生装备

Objective To investigate the linear relationship and standard curve equation between acidic concentrated solution added KCl and the changes of K+ concentration in dialysate,and to apply it in personalized dialysis.Methods The speed of concentrated liquid pump of Fresenius 4008S hemodialysis machine was calibrated,the ratio of the concentration solution to the reverse osmosis water was determined,KCl was added to the concentrated A solution by an equal increment method to detect K+ concentration in the corresponding dialysate,and the K+ concentration standard curve of dialysate was mapped.This study is based on blood K+ concentration of adams-stokes syndrome patients before dialysis,referring to the standard curve,the most suitable dialysate K+ concentration was selected to personalized dialysis,the blood K+ concentration of the patients was measured after dialysis,and ECG monitoring and clinical symptoms observation were carried out.Results There was a linear relationship between acidic concentrated solution added KCl and the changes of K+ concentration in dialysate,the curve equation was y =0.384 lx + 0.002 3,R2 =0.999 4.There was no obvious change in the concentration of other electrolyte ions in the dialysate.Referring to the standard curve,the concentration of dialysate K+ could be adjusted accurately.The blood K+ concentration of adams-stokes syndrome patients could be corrected in time after several times of K+ concentration of personalized dialysis,and ECG recovered eventually,and arrhythmia,syncope,chest tightness and other symptoms disappeared.Conclusion There is a linear relationship between the concentration of dialysate K + and the concentration of KCl added in acidic concentrated solution in the Fresenius 4008S hemodialysis machine.Personalized dialysis is performed by the standard curve with obvious clinical application value,and references are provided for precise regulation of dialysate ion concentration.

Sciatic nerve preserved by vitrification solution contains Shenfu Injection repaired allogenic nerve defects in a rat model / 中草药

Objective: To investigate the feasibility of improving sciatic nerve vitrification preservation using Shenfu Injection in rats. Methods: At -80℃, SPF male SD rat sciatic nerve segments were preserved in the vitrification solution containing Shenfu Injection (0%, 5%, 10%, 30%, groups A, B, C and D) for 4 weeks. The sciatic nerves were observed by transmission electron microscope (TEM), the biological activity of the nerve was detected by laser scanning confocal microscope (LSCM) after Calcein-AM and PI double staining, and the expressions of Bcl-2 and Bax of the sciatic nerves were tested by Western blotting. 10 mm sciatic nerve defect of the Wistar rats (groups A', B', C' and D') was repaired using the corresponding SD rats sciatic nerves preserved for 4 weeks, the gross appearance and sciatic nerve function index (SFI) were detected at different periods after the surgery, the histological and electrophysiological changes of regenerating nerve were detected at 16 weeks post transplantation. Results: The results of TEM showed that demyelination of the sciatic nerve in group A was severe, and in groups B, C and D were mild. The results of LSCM showed that there were strong green fluorescent and weak red fluorescent in groups B, C and D, and weak green fluorescent and strong red fluorescent in group A. The expression of Bcl-2 and Bax of the sciatic nerves, there were significant differences between groups B, C, D and group A, and between groups C, D and group B (P 0.05). The SFI at different periods after the transplantation, the results of electrophysiological detection, the number of myelinated nerve fibers, and the thickness of myelin at 16 weeks after the surgery, there were significant differences between groups C', D' and groups A', B' (P 0.05). At 16 weeks after the surgery, the results by TEM observation showed that there were fewer fibers, smaller diameter, sparse distribution, thinner myelin sheath in group A' and group B', but the number of regenerated fibers was more, the distribution was extensive, and the myelin sheath was thicker in group C' and group D'. Conclusion: Shenfu Injection has protective effect on sciatic nerve preserved by vitrification, and can improve nerve regeneration after allograft in rats.

Non-medical use of psychoactive drugs in relation to suicide tendencies among Chinese adolescents.

INTRODUCTION: To investigate the prevalence of non-medical use of psychoactive prescription drug (NMUPD) among adolescents and to explore the associations between non-medical psychoactive prescription drug use and depressive symptoms, poor sleep quality, deliberate self-harm, and suicide. METHODS: A two-stage stratified cluster sample design produced a representative sample of 12-19-year-old students in grades 1-6 who attended public middle schools in Guangdong province. Prevalence estimates (SE) of non-medical psychoactive prescription drug use were calculated, and logistic regression was used to examine its association with depressive symptoms, poor sleep quality, deliberate self-harm, and suicide. RESULTS: Overall, 7.5% of adolescents reported non-medical use of opioids, and 4.8% of adolescents reported non-medical use of sedatives. Lifetime, last-year, and last-month non-medical use of opioids and sedatives were positively associated with depressive symptoms, poor sleep quality, deliberate self-harm, suicidal ideation, and suicidal attempts among different gender and age-group adolescents. Those who reported last month non-medical use of opioids and sedatives had the greatest odds of reporting depressive symptoms, poor sleep quality, deliberate self-harm, suicidal ideation, and suicidal attempts. Males who were last month non-medical users of opioids or sedative had 8.9 or 10.7 times greater odds of reporting a suicidal attempt, and 8.8 or 9.8 times greater odds of reporting a suicidal attempt were observed among adolescents aged 16-19 who were last-month non-medical users of opioids or sedatives. CONCLUSIONS: These findings provide evidence for improving adolescents' suicide prevention strategy by targeting supervision on high risk current non-medical users of psychoactive drug.

Impact of percutaneous coronary intervention on plasma brain natriuretic peptide levels and ventricular remodeling in patients with acute right ventricular myocardial infarction combined with left ventricular inferior wall or anterior wall myocardial infarction / 第二军医大学学报

Objective To investigate the impact of percutaneous coronary intervention (PCI) on plasma brain natriuretic peptide (BNP) levels and ventricular remodeling in patients with acute right ventricular myocardial infarction (ARVMI) combined with left ventricular inferior wall myocardial infarction (LVIWMI) or anterior wall myocardial infarction (LVAWMI). Methods Totally 207 patients with ARVMI combined with LVAWMI or LVIWMI were included in the present study. The patients were divided into two groups: ARVMI plus LVIWMI (n = 159) and ARVMI plus LVAWMI(n = 48). The plasma BNP levels, myocardium enzyme, hemodynamic indices and coronary artery disease were compared between the two groups. The plasma BNP level, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDd) were observed in patients before and after primary PCI or delayed PCI treatment and in those receiving no PCI. Results We found that the plasma BNP level, CK and CK-MB peak value, pulmonary artery systolic pressure, degree of infarct-related coronary artery and incidence of 2-branch involvement in ARVMI plus LVAWMI group were significantly higher than those in the ARVMI plus LVIWMI group (P<0. 05). The plasma BNP levels and LVEDd were significantly decreased in patients after treatment with primary PCI or delayed PCI (P<0. 05), and the plasma BNP level was significantly lower and improvement of LVEDd was significantly greater in receiving primary PCI.

Changes in prostatic stromal composition and benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate whether there are different stromal compositions in the prostate tissue of patients with benign prostatic hyperplasia (BPH) and evaluate their significance in the course of the disease.</p><p><b>METHODS</b>Forty-three surgical or bioptic prostatic specimens of BPH and 5 autoptic normal prostatic specimens were stained by the Masson method to display the elements of the muscle fiber and collagen. The relationship of the changes in the prostatic stromal composition was analyzed with the degree of bladder outlet obstruction (BOO) , IPSS and medication results.</p><p><b>RESULTS</b>The mean ratio of muscle fiber to collagen in the normal prostate tissue was (3.2 +/- 0.2):1, significantly higher than that of the BPH patients (1: [4.7 +/- 3.1] ) (P < 0.01); that in the BPH patients with BOO was 1: (5.4 +/- 3.7) markedly lower than in those without BOO (1: [2.5 +/- 1.1] ) (P = 0.02); that in the BPH patients with severe prostatic symptoms was 1: (9.1 +/- 2.9), remarkably lower than in those with moderate (1: [5.3 +/- 3.4]) and mild prostatic symptoms (1: [2.8 +/- 1.7]) (P < 0.01); and that in the BPH patients with satisfactory medicinal therapeutic results was 1:(2.3 +/- 1.9), significantly higher than in those with poor therapeutic results (1: [7.6 +/- 4.3]) (P < 0.01).</p><p><b>CONCLUSION</b>The stromal composition in the prostatic tissue of BPH patients undergoes different degrees of changes. More obvious BPH symptoms and poorer therapeutic results are associated with a bigger proportion of collagens and a smaller proportion of muscle fibers in the prostatic tissue. These changes may play an important role in the development and progression of BPH.</p>

Arteriosclerotic risk factors and benign prostatic hyperplasia / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the correlation between arteriosclerotic risk factors and the severity of benign prostatic hyperplasia (BPH).</p><p><b>METHODS</b>A total of 877 patients with diagnosed BPH were selected according to the inclusion criteria. The weight of the prostate was estimated by transrectal ultrasonography, the degree of bladder outlet obstruction determined by urodynamic examination, and the symptoms quantified by the International Prostate Symptom Score (IPSS). Arteriosclerotic risk factors included age, hypertension, dyslipidemia, type 2 diabetes mellitus, and smoking. Comparative studies were made on the data obtained by univariate and multivariate analyses.</p><p><b>RESULTS</b>The severity of BPH was increased with the increase in the severity of the risk factors and the incidence of the disease. The logistic regression analysis showed that type 2 diabetes mellitus was a prominent predictor of the prostate volume, IPSS and degree of bladder outlet obstruction (OR = 3.179, 3.862 and 2.847, P < 0.001), while the level of serum triglyceride was not (P > 0.05). Age, hypertension, high LDL, low HDL and smoking were all prominent predictors of the severity of BPH.</p><p><b>CONCLUSION</b>Arteriosclerotic risk factors are obviously correlated with the development and severity of BPH, among which type 2 diabetes mellitus is the most important.</p>

Living-related kidney transplantation: report of 175 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the clinical characteristics of living-related kidney transplantation (LRKT).</p><p><b>METHODS</b>From January, 2004 to December, 2008, 175 LRKT were performed including 63 cases (36%) of parent-child relations and 49 cases (28%) of sibling relations between the recipients and donors. Out of 175 donors, 52 were 50 years old or above, 4 had microscopic hematuria (including 2 with also hypertension), 2 had kidney stone, and 2 had high body mass index (BMI). Zero-point graft biopsy was performed in 59 donors, and abnormalities were found in 15 of them. The recipients were at the age of 33-/+10.5 years, and the primary diseases are mainly dominant glomerular nephritis (72.6%, 127/175), and with a few cases of diabetes (4%, 7/175) and hypertensive nephropathy (4%, 7/175).</p><p><b>RESULTS</b>Serum creatinine of the donors was 102-/+22.5 micromol/L at 7 days postoperatively, and 92-/+19.1 micromol/L at one month. One recipient died of severe pulmonary infection. Two recipients underwent graft nephrectomy due to anastomotic stenosis with concomitant acute graft rejection and renal arterial embolism. The one-year survival rates of the patients and grafts were 99.3% and 98.2%, respectively. The incident rates of accelerated rejection and acute rejection were 1.1% and 14.9%, respectively. Other complications included impaired liver function (22.3%), infection (9.7%) and leucopenia (4.6%). The renal arterial stenosis occurred in 2.3% (4/175) of the recipients.</p><p><b>CONCLUSIONS</b>The recipients of living-related and cadaveric kidney transplant have different primary kidney disease spectrums. Differential diagnosis and treatment of acute rejection and renal artery or anastomotic stenosis can be of vital importance. Marginal donor kidneys with appropriate inclusion criteria can be safely used for transplantation. With good short-term patient and graft survival, LRKT needs further study to evaluate its long-term effect.</p>

Anatomy character of renal artery and treatment of living-donor renal transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To study the anatomy characters of renal artery and the treatment of multiple arteries in living donor renal grafts.</p><p><b>METHODS</b>Records of 142 living donors were analyzed in our center. We analyzed the anatomic structure of renal arteries by DSA and CTA pre-transplantation. Thirty-one kidneys with multiple arteries were transplanted after reconstruction. Then clinical effects were compared between multiple-renal-arteries group (n=31) and single-renal-artery group (n=111).</p><p><b>RESULTS</b>The incidence of multiple renal artery was 30.99%, and there was no difference between both sides (left kidney 22.54%, right kidney 22.13%). If the multiple artery occurred in left or right kidney, the incidence of the multiple artery occurred in the other side was 56.25% and 60.00%, respectively. The diameter of left main renal artery was more magnanimous (P=0.001) and the first branch was more closed to abdominal aorta (P=0.004). Operation time and warm/cool ischemia time were longer in the multiple-renal-arteries group. However, estimated blood loss, delayed graft function, acute rejection and flow rate of arcuate artery were similar in both groups, the same as serum creatinine and serum creatinine clearance rate on day 7, 1 month and 3 month post-operation. It was shown by repeated measures ANOVA that graft with multiple arteries didn't affect the tendency of renal function at early time post-operation.</p><p><b>CONCLUSION</b>Comprehending the character of renal artery and accurate treatment of multiple artery anastomosis are critical for the effect of the living kidney transplantation.</p>

[Effects of penetration enhancers on percutaneous permeability of geniposide in Xiao'er Ninhuang tuire cataplasms].

OBJECTIVE: To investigate the different permeation enhancers on the transdermal permeation of Xiao'er Niuhuang tuire cataplasms (XNTC). METHOD: Using improved franz-type diffusion cell with excised rat skin in vitro as the transdermal barrier, the content of permeated geniposide was determined by HPLC to study the kinetic parameters such as cumulative permeation quantity and permeation rate. RESULT: The result showed that the process of penetrating of geniposide in XNTC through skin could be in accordance with zero-rade releasing equation and XNTC was stable during the course of experiment. CONCLUSION: 5% Propylene glycol (PG)-azone (2:3) has the best permeation-enhancing effect, and the results provided a primary basis for the future research on Xiao'er Niuhuang tuire cataplasms.

Expression of cTnT in rabbit hearts during myocardial ischemia and its postmortem stability / 法医学杂志

OBJECTIVE@#To study the postmortem stability of cTnT as well as its expression alteration, and to evaluate it in the diagnosis of early myocardial ischemia in forensic practice.@*METHODS@#Animal model of early myocardial ischemia was established by rabbit coronary artery ligation. The expression of cTnT in myocardium at different postmortem intervals was detected using immunohistochemistry and analyzed using imaging technique and statistics. The results were then compared between the experimental and control groups.@*RESULTS@#In ischemic myocardium, the expression of cTnT showed prominent focal or flaky depletion in myocardial cytoplasm with no expression detected in interstitium. The expression level showed a linear decrease with prolonged postmortem interval, and disappeared completely on day 14 after death while stored at 4 degrees C. However, there were significant differences in the expression levels of cTnT between experimental and control groups from day 1 to day 7 after death.@*CONCLUSION@#Immunohistochemical detection of cTnT for diagnosis of early myocardial ischemia in corpses stored at 4 degrees C must be performed within 7 days after death.

The expression of ubiquitin in the healing process of incised wounds of rat's skin and its significance to forensic medicine / 法医学杂志

OBJECTIVE@#To evaluate the changes of ubiquitin expression in incised wounds of the rat skin.@*METHODS@#The testing rat groups were subjected to incised skin wounds, with normal rat skin used as control. The expression level of ubiquitin was assessed using immunohistochemistry and imaging analysis technique on skin samples taken at 1, 3, 6, 12h, and on day 1, 3, 6, 10, and 14d after injury.@*RESULTS@#The expression level of ubiquitin was low in the skin of normal control group. Increased level of ubiquitin expression could be observed 1 h after injury. The expression level of ubiquitin reached its peak on day 6 and started to decline on day 10, and then returned to its normal level on day 14 d after injury.@*CONCLUSION@#Ubiquitin may serve as a potentially useful marker for forensic determination of the skin wound age.

Recent advancement in relationship between DNA degradation and postmortem interval / 法医学杂志

Determination of postmortem interval (PMI) is one of the most valuable subjects in forensic practice. It, however, is often very difficult to accurately determine the PMI in daily practice. Forensic DNA technology has recently been used to estimate the PMI. It has certain advantage to traditional methods. This article reviews this technology with respect to its invention, development, advantage, disadvantage, and potential future applications with emphasis on correlation of DNA degradation and PMI.

Clinical diagnosis of BK virus infection in renal transplant recipients / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the clinical diagnosis of BK virus (BKV) infection in renal transplant recipients.</p><p><b>METHODS</b>Urine and peripheral blood samples were taken from 234 renal transplant recipients for BKV detection with cytological test and real-time PCR.</p><p><b>RESULTS</b>The occurrence rate of urine decoy cells, BKV viruria and viremia in these patients was 33.3 %, 33.3% and 16.2%, respectively, and the median level of urine decoy cells was 6/10 HPF, with the median level of urine and peripheral blood BKV of 7.62 x 10(3) copy/ml and 7.61 x 10(3) copy/ml, respectively. The positivity rate of BKV in the urine samples were significantly higher than that in peripheral blood samples (P=0.000). The amount of decoy cells was related to BKV load in the urine samples (gamma=0.59, P=0.000), but the BKV load in the urine samples was not related to that in peripheral blood samples (P=0.14).</p><p><b>CONCLUSION</b>Renal transplantation is associated with increased BKV shedding, indicating the necessity of BKV monitoring in renal transplant recipients with urine cytology, which is convenient and sensitive and indicates renal histological changes indirectly. Urine and peripheral blood BKV DNA detection is of value in identifying BKV activation to prevent irreversible graft damage of BKV-associated nephropathy.</p>

Therapeutic effect of sirolimus against chronic allograft nephropathy in kidney transplant recipients / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of sirolimus in management of chronic allograft nephropathy (CAN).</p><p><b>METHODS</b>A retrospective study was conducted involving 31 CAN patients followed up since March 2002, who experienced a change from a calcineurin inhibitor (CNI)-based regimen to a SRL-based regimen. Serum creatinine (Cr) in these patients was compared before and after the regimen change, and the adverse events associated with SRL were analyzed.</p><p><b>RESULTS</b>Till March 2007 when the study closed, 15 patients reached the primary endpoint for resuming dialysis, 8 had improved and 8 had stable renal function. In patients with high Cr(0)(> or =3 mg/L, n=12), 9 resumed dialysis and 2 had improved renal function, but one of the patients with renal improvement eventually died due to infection; in the patients with low Cr(0)(<3 mg/L, n=19), 5 resumed dialysis, 8 had stable renal function and 6 had improved renal function, showing significant difference between the 2 groups (P=0.003). Altogether 14 patients reached the secondary endpoint for ceasing SRL for severe infection (5 patients, of whom 4 resumed dialysis and 1 died of infection) or adverse events associated with SRL (9 patients, of whom 4 resumed dialysis, 2 had stable and 3 had improved renal function). Hyperlipidemia (51.6%), leukocytopenia (41.9%), mouth ulcer (29.0%) and liver function lesion (16.1%) were the commonest adverse events in these patients, and totalling 13 severe adverse events were recorded, including 2 fatal cerebral hemorrhage, 3 fatal infection episodes, and 8 pulmonary and urinary infections that require hospitalization.</p><p><b>CONCLUSION</b>Conversion from a CNI-based to SRL-based regimen can be effective for some CAN cases, especially for those with Cr(0) below 3 mg/L. Attention must be given to adverse events like hyperlipidemia and leukocytopenia, as well as the related cerebral vascular accidents and infections.</p>