Independent effect of the triglyceride-glucose index on all-cause mortality in critically ill patients with chronic obstructive pulmonary disease and asthma: A retrospective cohort study.

BACKGROUND: The triglyceride-glucose (TyG) index serves as a reliable proxy for insulin resistance (IR). IR has been linked to heightened incidence, prevalence, or severity of chronic obstructive pulmonary disease (COPD) and asthma. Prior research indicates that critically ill patients are prone to developing IR. Nevertheless, few studies have delved into the correlation between IR and all-cause mortality in critically ill patients with COPD and asthma. Therefore, the aim of this study is to explore the association between the TyG index and all-cause mortality in patients with COPD and asthma, with the goal of assessing the impact of IR on the prognosis of this patient population. METHODS: This is a retrospective study, and all data are from the Medical Information Mart for Intensive Care IV (MIMIC-IV) critical care database. This study included 684 ICU patients with COPD and asthma and divided them into quartiles based on TyG index levels. The primary outcomes of this study were all-cause mortality during follow-up, encompassing mortality at 30 days, 90 days, and 180 days. The Kaplan-Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality in critically ill patients with COPD and asthma. Restricted cubic spline analysis was used to assess potential nonlinear association between the TyG index and the primary outcome. RESULTS: A total of 684 patients (53.9% female) were included. The 90-days all-cause mortality rate and 180-days all-cause mortality were 11.7% and 12.3%, respectively. Kaplan-Meier analysis revealed a significant association between the TyG index and both 90-days all-cause mortality (log-rank p = .039) and 180-days all-cause mortality (log-rank p = .017). Cox proportional hazards analysis revealed a significant association between the TyG index and 90-days all-cause mortality in both the unadjusted model (HR, 1.30 [95% CI 1.08-1.57] p = .005) and the model adjusted for age, gender, and diabetes (HR, 1.38 [95% CI 1.15-1.67] p < .001). Similarly, the TyG index was associated with 180-days all-cause mortality in the unadjusted model (HR, 1.30 [95% CI 1.09-1.56] p = .004) and the model adjusted for age, sex, and diabetes (HR, 1.38 [95% CI 1.15-1.66] p < .001). The restricted cubic splines (RCS) regression model indicated a significant nonlinear association between the TyG index and both 90-days and 180-days all-cause mortality. Specifically, TyG index >4.8 was associated with an increased risk of mortality at both 90 days and 180 days. CONCLUSIONS: In summary, our results extend the utility of the TyG index to critically ill patients with COPD and asthma. Our study shows that the TyG index is a potential predictor of all-cause mortality in critically ill patients with COPD and asthma. In addition, in patients with a TyG index exceeding 4.8, there was a heightened risk of mortality. Measuring the TyG index may help with risk stratification and prognosis prediction in critically ill patients with COPD and asthma. Further prospective studies are needed to confirm our findings.

Prostatic abscess due to carbapenem-resistant K. pneumonia: A case report.

RATIONALE: Due to the widespread use of broad-spectrum antibiotics, the morbidity of prostate abscesses (PA) has declined dramatically. However, under special circumstances, such as invasive procedures and immunosuppressive conditions, some patients are more likely to develop this disease. Here, we present the case of a 21-year-old man, diagnosed with PA, with a history of chronic steroid use and a long-term indwelling urinary catheter. The pathogen was confirmed as carbapenem-resistant Klebsiella pneumoniae, a rare bacterium. This case indicates that immunodeficiency and invasive catheter use may be risk factors for PA and opportunistic bacterial infections. PATIENT CONCERNS: A 21-year-old young man presented with sudden onset of high fever (39.7°C). The patient had a history of long-term use of steroids and long-term indwelling urinary catheter. Digital rectal examination revealed obvious swelling and tenderness of the prostate. Subsequent pelvic magnetic resonance imaging showed a high signal lesion measuring 2.1 × 2.9 × 2.8 cm with T1 enhancement and T2 enhancement. DIAGNOSES: On the 8th day of hospitalization, the patient underwent a PA drainage procedure and a pus culture was conducted. Subsequent pus and urine cultures showed the presence of Klebsiella pneumoniae, which exhibited resistance to all injectable carbapenems, cephalosporins, aminoglycosides, piperacillin-tazobactam, and quinolone drugs. INTERVENTIONS: On the 8th day of hospitalization, the patient underwent PA drainage surgery under general anesthesia to drain the abscess and relieve obstruction. After the surgery, the patient received a 2-week treatment of doxycycline. OUTCOMES: Finally, the patient was discharged after recovery and did not experience recurrence during the 6-month follow-up period. LESSONS: PA is not commonly found, but some patients are more susceptible to this disease under certain host conditions. Immunodeficiency and invasive catheter use may be risk factors for PA and opportunistic bacterial infections. The use of omadacycline for the treatment of carbapenem-resistant Klebsiella pneumoniae infections appears to be effective.

Elevation of hsa-miR-7-5p level mediated by CtBP1-p300-AP1 complex targets ATXN1 to trigger NF-κB-dependent inflammation response.

Nuclear factor-κB (NF-κB)-mediated inflammation is a major cause of acute respiratory distress syndrome (ARDS). However, the regulatory mechanisms by which NF-κB transactivates proinflammatory cytokines remain unclear in the pathogenesis of ARDS. Herein, we report that the activating protein 1 (AP1) transcription factor recruits a histone acetyltransferase p300 and a transcriptional regulator C-terminal binding protein 1 (CtBP1) to assemble the CtBP1-p300-AP1 complex, which transactivates the expression of hsa-miR-7-5p in ARDS biopsies. Overexpressed hsa-miR-7-5p binds to the three prime untranslated regions (3'-UTRs) of ataxin 1 (ATXN1), suppressing its expression. Decreased ATXN1 expression relieves its repression of NF-κB, causing the induction of proinflammatory cytokine genes and triggering an inflammatory response. Depletion of CtBP1 or treatments with two CtBP1 inhibitors (NSC95397 and 4-methylthio-2-oxobutanoate (MTOB)) in human macrophages impairs the assembly of the CtBP2-p300-AP1 complex, resulting in decreased hsa-miR-7-5p levels, upregulation of ATXN1, and attenuation of proinflammatory cytokines. A similar regulatory mechanism was observed in lipopolysaccharide-treated mice. Our results reveal that increased hsa-miR-7-5p level mediated by the CtBP1-p300-AP1 complex targets ATXN1 to trigger an NF-κB-dependent inflammatory response. Interfering with this signaling pathway to block the inflammatory response may be a strategy for treating ARDS. KEY MESSAGES : The transcription factor AP1 recruits p300 and CtBP1 to form a transcriptional complex, which transactivates the expression of hsa-miR-7-5p in ARDS biopsies. Overexpressed hsa-miR-7-5p binds to the 3'-UTR of ATXN1, suppressing its expression. The decreased ATXN1 impaired its suppression of NF-κB, causing the induction of proinflammatory cytokine genes and triggering inflammation response. Disruption of the assembly of CtBP2-p300-AP1 complex upregulates ATXN1 and attenuates inflammation.

Influence of humic acid and fluvic acid on the altered toxicities of arsenite and arsenate toward two freshwater algae.

Arsenic pollution in freshwater poses a serious threat to aquatic organisms. However, dissolved organic matter (DOM) in water can modulate arsenic environmental toxicity by either suppressing or promoting its bioaccumulation. In this study, we investigated the toxicity, bioaccumulation, and biotransformation of inorganic arsenic (arsenite AsIII and arsenate AsV) combined with two types of DOM, i.e., humic acid (HA) and fulvic acid (FA), in the algae Chlamydomonas reinhardtii and Ochromonas danica. C. reinhardtii has a cell wall and cannot bioaccumulate arsenic complexation, whereas O. danica has no cell wall. Without DOM, AsV was more toxic than AsIII for C. reinhardtii, and AsV was less toxic than AsIII for O. danica. HA and FA addition reduced AsV and AsIII toxicities; the larger molecular weight (Mw) of HA contributed to the reduction in toxicity to an even greater extent, and reduced arsenic accumulation while promoting the biotransformation ability of C. reinhardtii, which has a cell wall. However, HA and FA addition increased AsV and AsIII toxicities and arsenic accumulation while relatively enhancing the biotransformation ability of O. danica, which has no cell wall. Coupling toxicity, bioaccumulation, and biotransformation, DOM (HA and FA) contributed to the altered toxicity of freshwater algae to AsV and AsIII through reduced/increased arsenic accumulation and enhanced biotransformation. Overall, our study considered the combined toxicity of inorganic arsenic and DOM in phytoplankton, helping estimate the potential environmental risk of arsenic in aqueous environments.

Fluid resuscitation with balanced crystalloids versus normal saline in critically ill patients: a systematic review and meta-analysis.

BACKGROUND: Intravenous fluids are used commonly for almost all intensive care unit (ICU) patients, especially for patients in need of resuscitation. The selection and use of resuscitation fluids may affect the outcomes of patients; however, the optimal resuscitative fluid remains controversial. METHODS: We systematically searched PubMed, Embase, and CENTRAL. Studies comparing balanced crystalloids and normal saline in ICU patients were selected. We used the Cochrane Collaboration tool to assess the risk of bias in studies. The primary outcome was mortality at the longest follow-up. Secondary outcomes included the incidence of acute kidney injury (AKI) and new renal replacement therapy (RRT). RESULTS: A total of 35,456 patients from eight studies were included. There was no significant difference between balanced crystalloid solutions and saline in mortality (risk ratio [RR]: 0.96; 95% confidence interval [CI]:0.92-1.01). The subgroup analysis with traumatic brain injury (TBI) showed lower mortality in patients receiving normal saline (RR:1.25; 95% CI 1.02-1.54). However, in patients with non-TBI, balanced crystalloid solutions achieved lower mortality than normal saline (RR: 0.94; 95% CI 0.90-0.99). There was no significant difference in moderate to severe AKI (RR: 0.96; 95% CI 0.90-1.01) or new RRT (RR: 0.94; 95% CI 0.84-1.04). CONCLUSIONS: Compared with normal saline, balanced crystalloids may not improve the outcomes of mortality, the incidence of AKI, and the use of RRT for critically ill patients. However, balanced crystalloids reduce the risk of death in patients with non-TBI but increase the risk of death in those with TBI. Large-scale rigorous randomized trials with better designs are needed, especially for specific patient populations.

[Therapeutic effect of acupoint catgut embedding on balance function and plantar pressure in hemiplegic patients].

OBJECTIVE: To investigate the therapeutic effect of acupoint catgut embedding on balance function and plantar pressure in hemiplegic patients. METHODS: A total of 98 hemiplegic patients were equally randomly assigned to routine treatment group and acupoint catgut embedding group. The patients in the routine treatment group were given routine medical treatment, routine acupuncture and rehabilitation training. And those in the catgut embedding group were given catgut embedment at Shenshu (BL23), Xinshu (BL15), Ganshu (BL18), Pishu (BL20), Guanyuan (CV4) and Qihai (CV6) in addition to the treatment in the routine treatment group. The course of treatment was 3 weeks for both groups. The plantar pressure as well as the Berg balance scale (BBS) score were measured before and after treatment. RESULTS: (1) After 3 weeks treatment, the percentage of static plantar pressure of the affected foot was significantly increased in the two groups compared with their own pre-treatment (P<0.05, P<0.01), and it was significantly higher in the catgut embedding group than in the routine treatment group after one week treatment (P<0.01). (2) After 3 weeks treatment, the peak pressures of the following parts in the catgut embedding group increased significantly in comparison to its own pre-treatment (P<0.05, P<0.01), which were 1) the first toe (affected foot), 2) the first metatarsal bone (affected foot), 3) the third metatarsal bone (affected foot), 4) the middle of foot (affected foot), 5) the medial heel (affected foot). After 3 weeks treatment, the peak pressures of the first metatarsal bone and the medial heel of the affected foot in the routine treatment group were significantly higher than those before treatment (P<0.05). After 1 week treatment, the peak pressure of the first toe of the affected foot in the embedding group was significantly higher than that in the routine treatment group (P<0.05). The peak pressures of the first metatarsal bone and the middle of the affected foot in the catgut embedding group were significantly higher than those in the routine treatment group after one and two weeks treatment (P<0.01, P<0.05). After 1, 2 and 3 weeks treatment, the peak pressure in the middle of the healthy foot in the embedding group was significantly lower than that in the routine treatment group (P<0.01). (3) After 3 weeks treatment, the BBS scores of the two groups were significantly higher than those before treatment (P<0.05), and the BBS score of the embedding group was significantly higher than that of the routine treatment group (P<0.05). CONCLUSION: Acupoint catgut embedding can effectively improve the plantar pressure and balance function of stroke patients with hemiplegia.

[Impact of abdominal moxibustion in a period of day from 7 am to 9 am on improvement in post-stroke lower limb spasticity and muscle architecture parameter].

OBJECTIVE: To compare the therapeutic effect on post-stroke lower limb spasticity between the combined treatment of abdominal moxibustion from 7 am to 9 am and rehabilitation training and the simple rehabilitation training. METHODS: A total of 100 patients with post-stroke lower limb spasticity were randomized into an observation group (50 cases, 3 cases dropped off) and a control group (50 cases, 4 cases dropped off ). In the control group, the basic treatment of internal medicine and rehabilitation training of the limbs were adopted. In the observation group, on the basis of the treatment in the control group, at the time zone from 7 am to 9 am, moxibustion on the abdomen with "eight-trigram" moxa box [the central moxa box accurately facing Shenque (CV 8)] was given, lasting for 2 h, once every two days. Both groups were treated for 6 weeks. Separately, before and after treatment, the score of Fugl-Meyer assessment of the lower extremity (FMA-LE) and the grade of modified Ashworth scale (MAS) of ankle joint were evaluated on the affected side in patients of the two groups. Muscle skeleton ultrasound (MSUS) was adopted to determine the first layer muscle thickness (MT) anterior to the tibia, the number of pennation angle (PA) and the length of muscle fibers in the medial head of gastrocnemius muscle on the affected side. Besides, after treatment, the therapeutic effect was evaluated in the two groups. RESULTS: After treatment, the score of FMA-LE and the grade of MAS of ankle joint on the affected side were both improved as compared with those before treatment in patients of the two groups (P<0.01, P<0.05). The improvements in the observation group were better than those in the control group (P<0.01, P<0.05). After treatment, MT anterior to the tibia, the number of PA and the length of muscle fibers in the medial head of gastrocnemius muscle on the affected side were all increased as compared with before treatment in patients of the two groups (P<0.01). The increase degree in the observation group was larger than that in the control group (P<0.01). The total effective rate was 93.6% (44/47) in the observation group, better than 80.4% (37/46) in the control group (P<0.05). CONCLUSION: The combined treatment of abdominal moxibustion from 7 am to 9 am and rehabilitation training effectively relieves post-stroke lower limb spasticity and improves the limb functions and muscle structure. The total effective rate of this combined treatment is better than that of simple rehabilitation training.

Efficacy of Moxifloxacin against Mycobacterium abscessus in Zebrafish Model in vivo.

OBJECTIVE: Moxifloxacin (MFX) shows good in vitro activity against Mycobacterium abscessus and can be a possible antibiotic therapy to treat M. abscessus infection; however, other studies have shown a lower or no activity. We aimed to evaluate MFX activity against M. abscessus using zebrafish (ZF) model in vivo. METHODS: A formulation of M. abscessus labeled with CM-Dil was micro-injected into ZF. Survival curves were determined by recording dead ZF every day. ZF were lysed, and colony-forming units (CFUs) were enumerated. Bacteria dissemination and fluorescence intensity in ZF were analyzed. Inhibition rates of MFX and azithromycin (AZM, positive control) were determined and compared. RESULTS: Significantly increased survival rate was observed with different AZM concentrations. However, increasing MFX concentration did not result in a significant decrease in ZF survival curve. No significant differences in bacterial burdens by CFU loads were observed between AZM and MFX groups at various concentrations. Bacterial fluorescence intensity in ZF was significantly correlated with AZM concentration. However, with increasing MFX concentration, fluorescence intensity decreased slightly when observed under fluorescence microscope. Transferring rates at various concentrations were comparable between the MFX and AZM groups, with no significant difference. CONCLUSION: MFX showed limited efficacy against M . abscessus in vivo using ZF model. Its activity in vivo needs to be confirmed.

[Comparative study on function and surface electromyograpgy in patients of lumbar disc herniation treated with acupunctrue and moxibustion].

OBJECTIVE: To compare the differences in the clinical function and lumbar and abdominal myodynamia in patiants of lumbar disc herniation treated with moxibustion at Dazhui (GV 14) and Guanyuan (CV 4) and acupuncture. METHODS: Forty cases were randomized into a moxibustion group and an acupuncture group, 20 cases in each group. In the moxibustion group, the warm moxibustion was applied alternatively at Dazhui (GV 14) and Guanyuan (CV 4) once every other day, 1 h each time, once every day. In the acupuncture group, acupuncture was applied to the corresponding acupoints based on the affected lumbar vertebras, such as Jiaji (EX-B 2), Shens-hu (BL 23), Dachangshu (BL 25) and Huantiao (GB 30), etc. , once evey day 30 min each time. The treatment for 3 weeks was taken as one session in each group. Totally, one session treatment was required. Surface electromyography (SEMG) of bilateral paraspinal muscle and rectus muscle, and JOA score of low back pain were observed in the two groups. RESULTS: (1) JOA score: the score of subjective symptoms, score of activity of daily living (ADL) and total score were improved obviously as compared with those before treatment in the two groups (P<0.01, P<0.05). The results of subjective symptoms score, score of ADL and total score in the acupuncture group were superior to those in the moxibustion group after treatment (6.95+/-0.94 vs 5.50 +/-0.89,10. 90+/-1.86 vs 8.90+/- 1. 92,22.50 +/- 2.82 vs 19.35 +/- 2. 70, all P<0. 05). (2) SEMG comparison: root-mean-square value (RMS) was all reduced in SEMG of the anteflexion, rear protraction, orthostatism, bilateral bending and neck and leg rear flexion for strengthening lumbar muscle as compared with those before treatment in the two groups (P< 0.05, P<0. 01). RMS of the anteflexion and bilateral bending in the acupunture group were reduced much obviously as compared with the moxibustion group. In terms of sitting position anteflexion, rear protraction, orthostatism, bilateral bending and neck and leg rear flexion for strengthening lumbar muscle, median frequency (MF) after treatment was all improved as compared with that before treatment in the two groups (P<0. 05, P<0. 01). In terms of anteflexion, the electrode MF after treatment was improved much obviously in the acupuncture group(P<0. 05). CONCLUSION: Moxibustion at Dazhui (GV 14) and Guanyuan (CV 4) and conventional acupuncture all improve muscle function, relieve muscle fatigue, increase the ability of anti-muscle fatigue, strengthen lumbar vertebral stability, release subjective symptoms and improve ADL. But, the effects of moxibustion are slightly lower than those of acupuncture.

HLA-G expression in the peripheral blood of live kidney transplant recipients.

BACKGROUND: The human leukocyte antigen-G (HLA-G) has been considered to be an important tolerogeneic molecule playing an essential role in maternal-fetal tolerance, upregulated in the context of transplantation, malignancy, and inflammation, and has been correlated with various clinical outcomes. The aim of this study was to investigate the clinical relevance of the expression of membrane HLA-G (mHLA-G), intracellular HLA-G (iHLA-G), and soluble HLA-G (sHLA-G) in the peripheral blood of live kidney transplant recipients. METHODS: We compared the expression of the three HLA-G isoforms in three groups, healthy donors (n=20), recipients with acute rejection (n=19), and functioning transplants (n=30). Flow cytometry was used to detect the expression of mHLA-G and iHLA-G in the T lymphocytes of peripheral blood from subjects in the three groups. Enzyme-linked immunosorbent assays were used to detect sHLA-G in the plasma from the three groups. RESULTS: There were no significant differences in mHLA-G and intracellular HLA-G among the three groups, but the sHLA-G plasma level was higher in the functioning group than in the acute rejection or healthy group. We found a subset of CD4(+)HLA-G(+) and CD8(+)HLA-G(+) T lymphocytes with low rates of mHLA-G expression in the peripheral blood of kidney transplantation recipients. Intracellular expression of HLA-G was detected in T lymphocytes. However, there was no correlation between acute rejection and the mHLA-G or intracellular HLA-G expression. CONCLUSION: sHLA-G was the major isoform in the peripheral blood of live kidney transplant recipients and high sHLA-G levels were associated with allograft acceptance.

[Up-regulation of the sHLA-G5 level by human-mouse chimeric anti-IL-2R monoclonal antibody treatment in kidney transplantation].

OBJECTIVE: To find whether the up-regulation of soluble human leucocyte antigen-G5 (sHLA-G5) levels is a new function mechanism of anti-interleukin-2 receptors (anti-IL-2R) monoclonal antibody treatment in kidney transplantation. METHODS: A total of 215 recipients at our centre from January 2006 to December 2007 were divided into antibody use group (n = 141) and antibody non-use group (n = 74) and another healthy group (n = 69). The sHLA-G5 level in peripheral blood was detected by enzyme-linked immunosorbent assay (ELISA). And the expression of HLA-G5 was confirmed by Western blot and Real-time polymerase chain reaction (PCR). RESULTS: sHLA-G5 levels was (56 ± 30) µg/L in using anti-IL-2 receptor monoclonal antibody before transplantation, It was higher than that before use antibody [(34 ± 20) µg/L], also higher than healthy group [(35 ± 17) µg/L] and antibody non-use group [(36 ± 19) µg/L, P < 0.05, respectively]. At Day 1, Day 4, Week 1, Week 2 post-transplantation, the level of sHLA-G5 of recipients with antibody use was significantly higher than that of those with antibody non-use. The values were as follows: (95 ± 35) µg/L vs (54 ± 16) µg/L, (131 ± 24) µg/L vs (75 ± 22) µg/L, (167 ± 44) µg/L vs (62 ± 17) µg/L, (172 ± 35) µg/L vs (45 ± 16) µg/L (all P < 0.01). And the results of Western blot and RT-PCR corresponded to those of ELISA. CONCLUSION: The preoperative use of first dose of anti-IL-2R monoclonal antibodies results in the up-regulated level of sHLA-G5. Thus it is beneficial for protecting the kidney survival and reducing the risks of acute rejection.

[Identification and functional study of Tim-1(+)CD19(+) regulatory B cell in kidney transplantation recipients].

OBJECTIVE: To observe the ratio of Tim-1(+)CD19(+) B cell in the peripheral blood of kidney transplantation recipients and elucidate its functions. METHODS: From December 2009 to June 2010, a total of 35 pairs of kidney transplant recipients were selected and divided into 3 groups: healthy donors as control (n = 35), pre-transplantation (n = 35) and post-transplantation (n = 35). The profiles of Tim-1(+)CD19(+) B cell in kidney transplantation donors and recipients were analyzed and sorted by flow cytometry (FCM). Mixed lymphocyte culture (MLC) was carried out between kidney transplantation donors and recipients. After the additions of Tim-1(+)CD19(+) and Tim-1(-)CD19(+) B cells, there were 3 groups: Tim-1(+), Tim-1(-) and blank. Lymphocyte proliferation and inhibition status were evaluated by propidium iodide uptake and Annexin V binding. And the cytokine levels were detected by FCM. RESULTS: The absolute values of peripheral CD19(+)B cells were (170 ± 90), (202 ± 99), (155 ± 71) cells/µl in the pre-transplantation, post-transplantation and control groups respectively, post-transplantation group were higher than control group (P = 0.0300). The Tim-1(+)CD19(+) cell ratios were (2.20 ± 0.98)%, (35.46 ± 10.66)% and (1.95 ± 0.95)% in three groups. And the differences were statistically significant (both P < 0.01). Tim-1(+)CD19(+) B and Tim-1(-)CD19(+) B cells were added into MLC respectively. The early apoptotic cells of the Tim-1(+) group were higher than those in the Tim-1(-) group [(45.31 ± 12.37)% vs (10.92 ± 2.14)%, P < 0.05] and significantly higher than the blank group [(1.93 ± 0.26)%, P < 0.01]. Late apoptotic and dead cells of the Tim-1(+) group were higher than those in the Tim-1(-) group [(21.32 ± 5.67)% vs (2.32 ± 0.31)%, P < 0.01] and the blank group [(1.27 ± 0.19)%, P < 0.05]. The interleukin 10 levels in MLC supernatant of the Tim-1(+) group were significantly higher than those in the Tim-1(-) group [(5.32 ± 0.37) pg/ml vs (2.46 ± 0.25) pg/ml, P = 0.0001]. However, the interferon-γ levels were lower than those in the Tim-1(-) group [(1.51 ± 0.22) pg/ml vs (4.69 ± 0.32) pg/ml, P = 0.0015]. CONCLUSION: Present in the peripheral blood of kidney transplantation recipients, Tim-1(+)CD19(+) B cell has the capacity of promoting lymphocytic apoptosis. As a new regulatory subset of B cells, it plays important roles in the immune responses of transplantation.

[Applications of monitoring human leukocyte antigen G and its inhibitory receptors in post-renal transplantation].

OBJECTIVE: to study the feasibility of human leucocyte antigen-G (HLA-G) as a post-transplantation prognostic biomarker and discuss the correlation of its receptor expression and the mechanisms. METHODS: a total of 215 recipients in our centre from February 2006 to June 2008 were divided into stable kidney function group (n = 173) and acute rejection group (n = 42). The soluble human leucocyte antigen-G5 (sHLA-G5) level in peripheral plasma was detected by ELISA. And the HLA-G receptor ILT-2, KIR2DL4 on T, B, NK lymphocytes were analyzed by flow cytometry (FCM). The sHLA-G5 cutoff level by ROC curve was employed to predict the events of acute post-transplantation rejection. And regression analysis was used to determine the association of sHLA-G5 with acute rejection. RESULTS: an optimal cutoff value of 139.0 microg/L could be defined for sHLA-G5 (sensitivity: 63.6%, specificity: 82.1%, AUC: 0.780). Binary regression analysis showed that sHLA-G5 played an independent role on acute rejection (P = 0.019, OR = 0.039, 95%CI: 2.091 - 5.661). The rate of HLA-G receptor ILT-2 on CD4(+)T cell, CD8(+)T cell and B cell in acute rejection group was statistically lower than that in stable kidney function group (21% ± 7% vs 52% ± 17%, 23% ± 6% vs 39% ± 16%, 21% ± 7% vs 39% ± 16%, all P < 0.05). The expression of KIR2DL4 on NK cells in acute rejection group was statistically lower than that in stable kidney function group (31% ± 10%vs 57% ± 21%, P < 0.05). CONCLUSION: sHLA-G5 level may be predicted for acute rejection with a high sensitivity and specificity. The up-regulated expression of ILT-2 and KIR2DLT may contribute to immunology tolerance in peripheral circulation.

[Expression of human leucocyte antigen G in peripheral blood of kidney transplantation recipients].

OBJECTIVE: To investigate the expression of non-classical major histocompatibility complex (MHC)-I molecule, human leucocyte antigen (HLA) G, including membrane-bound HLA-G (mHLA-G), intracellular HLA-G (iHLA-G) and soluble HLA-G (sHLA-G), in peripheral blood of surviving kidney transplantation recipients and understand the relevance between HLA-G and the function of transplanted organ, as well as the onset of acute rejection. METHODS: A longitudinal study was performed on 175 kidney transplantation recipients. Three groups were involved in this study, including acute rejection group (n = 36), function stable group (n = 139) and healthy control group (n = 30). The expression of mHLA-G1 and iHLA-G1 in the T lymphocytes of peripheral blood was detected by flow cytometry analysis and the sHLA-G5 level detected by ELISA. RESULTS: The average rate of CD4(+)mHLA-G1(+), CD8(+)mHLA-G1(+), CD4(+)iHLA-G1(+), CD8(+)iHLA-G1(+) in T lymphocytes of healthy control group was 0.43% +/- 0.19%, 1.23% +/- 0.41%, 27% +/- 13% and 36% +/- 14% respectively. That of acute rejection group was 0.57% +/- 0.34%, 1.31% +/- 0.56%, 26% +/- 8% and 37% +/- 17%; that of function stable group was 0.61% +/- 0.43%, 1.39% +/- 0.47%, 26% +/- 9% and 37% +/- 17% respectively. There was no significant difference among the three groups (all P > 0.05). The average of sHLA-G5 levels in plasma of control group was (25 +/- 14) ng/ml, acute rejection group (24 +/- 15) ng/ml (pre-operative) and (34 +/- 21) ng/ml (post-operative), function stable group (25 +/- 11) ng/ml (pre-operative) and (56 +/- 32) ng/ml (post-operative). There was no significant difference among the three groups (pre-operative, P > 0.05). The average of sHLA-G5 levels in plasma of function stable group was higher than that of acute rejection group (post-operative, P < 0.05). CONCLUSION: There is a subset of CD4(+)HLA-G1(+) and CD8(+)HLA-G1(+)T lymphocytes with low percentage in peripheral blood of those surviving kidney transplantation recipients. The expressions of mHLA-G1 and iHLA-G1 have no relevance with the onset of acute rejection. sHLA-G5 is correlated with acute rejection in peripheral blood of surviving transplantation recipients.

Organotin decomposition by pyochelin, secreted by Pseudomonas aeruginosa even in an iron-sufficient environment.

A triphenyltin (TPT)-decomposing strain, Pseudomonas aeruginosa CGMCC 1.860, was screened out. It secreted an unknown TPT-decomposing factor into the medium, later shown to be pyochelin, even in the presence of 100 muM iron. To our knowledge, this is the first report of organotin decomposition by pyochelin.