器官移植是终末期器官功能衰竭最有效的替代治疗手段,提高移植物及移植受者的长期生存率是器官移植学科的主要研究目标,免疫抑制剂是维持移植物存活的最关键环节.移植肾丢失率以每年约5％的速度递增,影响移植肾存活的很多关键因素都与免疫抑制剂有关.免疫抑制剂是对机体免疫反应具有抑制作用的药物,能影响移植免疫相关细胞(主要是T细胞和B细胞)的增殖及功能,降低免疫应答以达到维持移植物存活的目的.因此,优化的免疫抑制策略指针对免疫应答不同阶段、不同靶点联合使用免疫抑制剂,协同免疫抑制效果,与此同时可降低免疫抑制剂量,降低感染风险,减少移植相关并发症.

Objective To explore the application of enhanced recovery after surgery (ERAS) in intravenous fluid infusion after renal transplantation. Methods The clinical data of 124 renal transplantation recipients in the First Hospital Affiliated to Army Medical University were retrospectively analyzed. The recipients were divided into group A, group B and group C. The 24-hour intravenous fluid infusion was 2 500 -<4 000 mL in group A, and the recipients took fluids 6 hours after the surgery. The 24-hour intravenous fluid infusion was 4 000-6 000 mL in group B, and the recipients took fluids after anus exhaust. The 24-hour intravenous fluid infusion was more than 6 000 mL in group C, and the recipients took fluids after anus exhaust. The indexes between the 3 groups including central venous pressure (CVP), heart rate, blood pressure, urine volume and blood glucose 1 week after renal transplantation, and serum creatinine 1 month after renal transplantation, and the mean time in intensive care unit and average length of stay were compared with one-way analysis of variance. The gender of recipients, type of donor kidney, and the incidence of hyperglycemia, delayed wound healing and delayed graft function (DGF) after transplantation between the 3 groups were compared with chi-square test. Results The serum creatinine of the recipients between the 3 groups 1 month after transplantation were (110±23), (114±22) and (118±22) μmol/L respectively, which had no statistic difference (F=1.19, P>0.05). The CVP, systolic pressure, urine volume and blood glucose of the recipients in group A 1 week after transplantation were all lower than group B and C (P all 0.05). The incidence of delayed wound healing of group A was lower than group C (χ2=7.303, P<0.017). Only 1 recipient in group C died of heart failure and pneumonedema. Conclusions ERAS was applied to recipients after renal transplantation. Taking fluids as soon as possible and reducing the amount of infusion in the situation of normotension or slight hypertension were conducive to reduce postoperative complications, and is beneficial to postoperative recovery. Key words: Enhanced recovery after surgery; Renal transplantation; Fluid infusion

Objective To investigate the clinical efficacy and safety of low-dose tacrolimus (TAC) in combination of glucocorticoid in treatment of IgA nephropathy with moderate proteinuria.Methods A total of 64 patients IgA nephropathy with moderate proteinuria (1.0 ～ 3.5 g per 24 h) diagnosed by renal biopsy and clinical data who admitted in our department from January 2012 to January 2015 were enrolled in this study.According to therapeutic schemes,the patients were divided into low-dose TAC + glucocorticoid group [n =34,TAC 0.02 ～ 0.05 mg/(kg · d),orally twice per day,with trough concentration being maintained at 3 ～5 ng/mL;oral administration of prednisone with an initial dose of 0.5 mg/(kg · d) and maximal dose not exceeding 40 mg/d] and hormone group [n =30,oral administration of prednisone with an initial dose of 1 mg/(kg · d) and maximal dose not exceeding 70 mg/d].The clinical data before treatment and at 1,3 and 6 months after treatment were collected and analyzed,and their adverse reactions were also recorded.The 24-hour urinary protein,serum creatinine (Scr) and serum albumin (ALB) were selected as primary endpoints.Results There were no significant differences between 2 groups in their clinical baseline data (P ＞ 0.05).The 24-hour urinary protein was obviously decreased while ALB increased in both 2 groups in 6 months after treatment (P ＜ 0.05),and the reduction was more notably in the low-dose TAC + glucocorticoid group at 1,3 and 6 months after treatment than the hormone group (P ＜ 0.05).No statistically differences were seen in complete remission rate and total effective rate between the 2 groups at each time point (P ＞ 0.05).As for adverse reactions,in the monitoring of leukocyte,hemoglobin and platelet,no phenomenon of bone marrow suppression and infection was observed in the low-dose TAC group.There were 4 cases of blood glucose elevation,3 cases of liver function impairment,1 case of gastrointestinal reaction and 1 case of recurrent oral ulcer occurred in the low-dose TAC + glucocorticoid group.But for the hormone groups,the numbers of cases were increased to 5,4 and 2 cases respectively.Though there was no case of recurrent oral ulcer in the latter group,no statistical difference was seen between the 2 groups (P ＞ 0.05).Both groups had no significant difference in Scr level and eGFR in 6 months after treatment compared with the values before treatment (P ＞0.05).Conclusion In the treatment of IgA nephropathy with moderate proteinuria,low-dose TAC +glucocorticoid is more efficiently in reduction of urinary protein than simple use of enough hormones,and has no effect on the increase of side effects.But it shows no benefits in higher clinical complete remission rate and total effective rate.

目的 探讨姜黄素抗肾纤维化的分子生物学机制,为临床治疗提供可靠的实验依据.方法 以人肾小管上皮细胞(HKC)为研究对象,采用不同浓度的姜黄素(0、0.780、1.563、3.125、6.250、12.500、25.000、50.000和100.000 μmol/L)刺激HKC 72 h,倒置相差显微镜下观察细胞形态变化,并应用MTT比色法检测姜黄素对HKC生长的影响;应用不同浓度TGF-β1(0、1、5、10 ng/mL)单独或联合姜黄素(6.250、12.500、25.000、50.000 μmol/L和100.000 μmol/L)共同刺激HKC细胞72 h,观察细胞形态变化,应用逆转录PCR(RT-PCR)检测TGF-β1、骨形态发生蛋白-7(BMP-7)和Ⅰ型胶原基因表达变化.结果 HKC贴壁生长,呈铺路石样外观.姜黄素刺激对细胞形态无影响;TGF-β1刺激能明显促进细胞由上皮样形态向纤维样细胞形态转化,且发生形态转变的细胞数量和TGF-β1基因表达呈TGF-β1浓度依赖性增加(P＜0.05,P＜0.01);MTT结果显示:姜黄素在3.125～25.000 tmol/L浓度范围内,能显著促进HKC增殖(P＜0.05,P＜0.01);姜黄素能对抗TGF-β1诱导的细胞形态转变,以12.500～50.000 μmol/L的姜黄素作用最明显,同时,下调TGF-βi基因和蛋白的表达,相反上调BMP-7基因和蛋白表达,并伴随着Ⅰ型胶原基因和蛋白的表达下降(P＜0.05,P＜0.01).结论 姜黄素能促进HKC增殖并维持其表型,能对抗TGF-β1诱导的HKC向梭形细胞转化,抑制细胞上皮TGF-β1和Ⅰ型胶原的表达,而促进BMP-7表达.

Objective:To explore the correlation between elevated transplant renal artery velocities and transplant renal artery stenosis in patients undergoing transplantation six months postoperatively.Method:The doppler ultrasound image examination,clinical data and follow-up results of 102patients undergoing renal transplantation in recent five years were reviewed retrospectively.We compared the peak systolic velocity(PSV),blood pressure and graft function of all patients.Result:In 102patients,there were 27cases experienced high PSV,including four cases with persistent increased PSV.These four patients had been diagnosed with transplant renal artery stenosis(TRAS)through the transplant renal artery angiography,and then underwent percutaneous transluminal renal artery stenting(PTRAS).PSV and blood pressure returned to normal after the operation.No recurrence of stenosis in the following six to thirteen months follow-up period was detected.Conclusion:The transplant renal artery blood flow velocity may not be a symbol of TRAS within six months after renal transplantation.Regular follow-up plan ia regarded as a primary treatment measure when doppler ultrasound reveals persistent increased PSV,especially associated with resistant hypertension.Angiography is necessary for diagnosis of TRAS.Furthermore,PTRAS is a safe and effective choice for the treatment of TRAS.

Objective To investigate renal dialysis patients' resilience and influencing factors for clinical teaching. Methods Connor-Davidson resilience scale(CD-RISC),simplified coping style questionnaire (SCSQ), perceived social support scale (PSSS) and positive and negative affect scale (PANAS) were used for a survey of 160 renal dialysis patients in Xinan Hospital and Xinqiao Hospital (156 valid questionnaires) and the questionnaire information was put into the computer by the two-input mode and was made the questionnaire data analysis, single factor analysis and variance and re-gression analysis of by SPSS 18.0. Results Renal dialysis patients' resilience has no significant differ-ence in gender, frequency of kidney dialysis and kidney dialysis time (P>0.05), but resilience and positive coping scores of the age group between 31 to 40 were significantly higher than those of the group between 41-50 group(P=0.000). Taking the education background into consideration, resilience and positive coping scores of junior high school or above education were significantly higher than those of primary school education (P=0.000,P=0.000). Positive emotion, positive coping, and social support were positively correlated with resilience and negative emotions were negatively correlated with resilience in linear regression analysis. Conclusion Kidney dialysis patients who are over the age of 40 and less educated may have lower resilience, and less positive coping, more prone to nega-tive emotions, which is not conducive to the rehabilitation and treatment of disease. For kidney dialysis patients, improving their positive response, perceived social support and positive mood, and reducing their negative emotions are beneficial to the improvement of their resilience.

Objective:To explore the security,practicability,and clinical value of C-arm X-ray machine combined ultrasound in the guidance of PCNL treatment of complicated renal calculus.Method:A total of 206cases of C-arm X-ray machine combined ultrasound in the guidance of PCNL treatment of complicated renal calculus were retrospectively analyzed.The patients' data including operation time,blood transfusion rate,calculi clearance of stageⅠ,intraoperative complications were analyzed.Result:C-arm X-ray machine combined ultrasound guidance accurate channels were set up in all cases ideally.The mean operative time was 74min.Intraoperative and postoperative blood transfusion rate was 13.5%.Calculi clearance rate was 92.2%.Postoperative phaseⅡlithotripsy or extracorporeal shock wave lithotripsy treatment accounted for 7.8%.Conclusion:C-arm X-ray machine combined ultrasound in the guidance of PCNL treatment of complicated renal calculus is a safe,practical,efficient prcedure with high calculi clearance of stageⅠand less intraoperative and postoperative complications.

Objective: To study the experience of Practolol oral liquid on capillary opening number and microcirculatory blood flow conditions of microcirculation disturbance in mouse model induced by epinephrine.Methods: 18-21 g mice,50,male and female in half,were randomly divided into 5 groups.Irrigation respectively take larg,medium and small dose result under Practolol oral liquid and Qiliqiangxin capsule suspension,with physiological saline volume.Use automatic image analyzer to observe mice auricle fine artery(A),fine vein(V) diameter,blood flow velocity and the number of open capillary.Results: The Practolol oral liquid groups can be significantly against artery and vein diameter contraction induced by adrenaline(P < 0.01) and significantly improve microcirculation blood flow conditions(P < 0.01).Conclusion: Practolol oral liquid can improve the auricle microcirculation in microcirculation disturbance in mouse model induced by epinephrine.

Objective To study the expression of herpes virus entry mediator(HVEM) and CD160 in different CD4+ T cell subsets under different function states and the influences of HVEM-CD160 pathway on CD4+CD25+ regulatory T cells(Tregs).Methods Flow cytometry was used to detect HVEM and CD160 expression in CD4+CD25+ Tregs and CD4+CD25-T cells from 3 different individuals at 0,3,and 5 d after stimulation by 1 000 IU/ml human IL-2 and magnetic beads(with equal number to the cells) coated with monoclonal antibodies against CD3 and CD28.Tregs from 4 different individuals were treated with HSV1 gD protein(0,1.25,2.5,and 5 μg/ml separately),mixed with equivalent CD4+CD25-T cells and the magnetic beads and 300 IU/ml IL-2 in vitro,and cultured for 7 d.3H-TdR was added to the culture liquid 18 h before stopping the culture,and CPM value was detected.Tregs from 5 different individuals were treated with 5 μg/ml gD proteins,adjusted to a concentration of 5×106,transferred to a 6-well plate,and cultured with 500 IU/ml IL-2 for 7 d.Treg Foxp3 gene expression was detected by real-time RT-PCR.Results HVEM expression was at a medium level on naive CD4+CD25+ Treg surfaces with an average expression rate of 42%,and was up-regulated along with Treg activation.CD160 expression was at a low level on naive CD4+CD25-T cell surfaces with an average expression rate of 7%,and was up-regulated along with CD4+CD25-T cell activation.Tregs treated with 2.5 and 5 μg/ml HSV1 gD protein had significantly lowered and concentration-dependent inhibition effects on CD4+CD25-T cell proliferation(average CPM value 2 014±202 and 6 535±531) as compared with Tregs without treatment(average CPM value 276±35,P<0.05).RT-PCR results showed that Tregs treated with 5 μg/ml gD protein had a decreased Foxp3 gene expression rate,only 48% that of Tregs without treatment(P<0.01).Conclusion After immunostimulation,up-regulated HVEM in activated Tregs and up-regulated CD160 in activated CD4+CD25-effector T cells(Teffs) interact to promote Treg Foxp3 gene expression,resulting in Treg's inhibition effects on Teff activation and proliferation.HVEM-CD160 pathway is important for Treg's inhibitory function.

Objective To investigate the role of the proportion of CD4+CD25+FoxP3+Treg in peripheral blood in evaluating immune state of pro-kidney transplant recipients with the trans-vivo delayed type hypersensitivity(trans vivo-DTH) assay.Methods A total of 30 donors and their corresponding recipients who received living related kidney transplantation during 2005 to 2008 in Southwest Hospital were randomly selected.All these recipients had sound transplantation and regular of follow-up.Trans vivo-DTH assay was used to divide the patients into tolerance group and rejection group.After the recipients' PBMCs and donors' antigen were injected into the footpads immunodeficient mice,the swelling was measured to evaluate the cellular immune response of the recipients to donors.The proportion of CD4+CD25+FoxP3+Treg in the peripheral blood of the recipients was detected by flow cytometry.Results According to the results of trans vivo-DTH assay,there were 23 patients in tolerance group and 7 patients in rejection group.The inflammatory swelling of the footpads were(1.72±0.44)×10-2 and(8.05±2.26)×10-2 mm respectively in the mice from tolerance group and rejection group,with the former significantly lower than the later(P<0.05).The proportion of CD4+CD25+FoxP3+Treg were(9.23±1.79)% and(1.03±1.04)% respectively in the tolerance group and rejection group.Significant difference was found in the proportion of CD4+CD25+FoxP3+Treg(P<0.05).The inflammatory swelling of mouse footpads of the tolerance group and rejection group was negative correlated with the proportion of CD4+CD25+FoxP3+Treg in peripheral blood(P<0.05,r=0.82 and 0.87).Conclusion The proportion of CD4+CD25+FoxP3+Treg in recipients' peripheral blood can reflect the immunoreactions of recipient T cells to donors' antigen.The proportion of CD4+CD25+FoxP3+Treg in peripheral blood can be used as a reference to indicate tolerance after renal transplantation.

Objective To investigate the expressions of vascular endothelial growth factor receptor (VEGF) and chemokine receptor 4 (CXCR4) and their relationship in rabbit model of atherosclerotic plaques in order to explore the role of CXCR4 in atherosclerosis angiogenesis and its possible mechanism.Methods The 15 rabbit model of atherosclerotic plaques was established through aortic balloon injury and high cholesterol diet.Levels of CXCR4 protein and VEGF gene was detected by Western blotting and fluorescent quantitative PCR(FQ-PCR),respectively at 4,8 and 12 weeks,and the results were analyzed statistically.Immunohistochemical staining was used to detect the expression and location of atherosclerotic plaque CXCR4 and CD34.Results At the 3 time points,the level of CXCR4 was 0.46±0.03,0.58±0.05,0.65±0.07,and the level of VEGF mRNA was 1.04±0.24,1.99±0.21,3.97±0.75,respectively.The level of CXCR4 was positively correlated with that of VEGF(correlation coefficient r=0.869,P<0.05).Immunohistochemical staining showed that CXCR4 was expressed in the vascular intima and plaque.CD34-positive staining was seen in vascular endothelial cells.There were rich new blood vessels in arterial intima plaque with CD34 expression.Conclusion The expression of CXCR4 is positively related with that of VEGF in the plaque progression,suggesting it may play an important role in angiogenesis.

Objective To investigate the GL-7 targeted microbubble contrast agent binding to abdominal aorta intima in vivo and in vitro in high cholesterol diet rabbits. Methods Rabbit models of abdominal aorta injury were established through high cholesterol diet in 14 New Zealand white rabbits. Four weeks after establishment of the models,contrast-enhanced ultrasound (CEUS) were performed with both the targeted and the non-targeted microbubbles contrast agent for in vivo evaluation of the models,respectively. The performance of contrast enhancement of abdominal aorta intima by these two contrast agents was assessed with video-density method. The rabbit abdominal aorta specimens were observed under fluorescence microscope after CEUS. The fluorescence staining in rabbit abdominal aorta intima was observed after dropping two kinds of contrast agents,and the fluorescence intensity was analyzed statistically. Results A significant increased visual density could be detected after using both agents. Statistical significant difference of the peak video intensity of intima was found between targeted microbubbles and non-targeted microbubbles (P0.05). Green fluorescence was observed in group of targeted microbubbles,while only weak expression of green fluorescence was seen in group of non-targeted microbubbles (P0.05). The same phenomenons were observed in frozen sections of arteries.. Conclusion GL-7 targeted microbubbles bind to rabbit arterial intima both in vivo and in vitro,being able to significantly enhance imaging of rabbit abdominal aorta intima.

Objective To investigate the effect and mechanism of IL-15 converting CD4+CD25-T cells into CD4+CD25+ regulatory T cells(Tregs).Methods CD4+CD25-T cells were isolated from human peripheral blood mononuclear cells in 2 steps by magnetic cell sorting system.The purity rate of the sorted cells was measured by flow cytometry(FCM).CD4+CD25-T cells were divided into 4 groups: control group(without cytokines),IL-15 group(IL-15),antagonism I group(IL-15 and STAT5a blocking peptide was added at the first day) and Antagonism Ⅱ group(IL-15 was added at the first day,but STAT5a blocking peptide at the third day).FCM was used to detect the changes of CD4+CD25-T cells,the incorporation of -thymidine was used to evaluate the suppressive function of the IL-15-induced Tregs(iTregs) on the Teff and Western blot analysis was used to observe the expression of p-STAT5.Results Compared with CD4+CD25-T cells cultured without cytokines,IL-15 was able to promote CD25 and Foxp3 expression of CD4+CD25-T cells and IL-15-induced CD4+CD25+ regulatory T cells exerted weak suppressor activity.Addition of IL-15 up-regulated the expression of p-STAT5 in CD4+CD25-T cells significantly.After STAT5a blocking peptide was added,IL-15-induced CD25 and Foxp3 expression of CD4+CD25-T cells was significantly down-regulated.Conclusion IL-15 significantly converts naive CD4+ CD25-T cells into CD4+CD25+ regulatory T cells in vitro and up-regulated p-STAT5 may be involved in this process.

Objective To retrospectively investigate the quality of life(QOL) of renal transplantation recipients and its related influence factors.Methods QOL of 93 renal transplantation recipients who received operation from 1998 to 2008 was respectively investigated with SF-36,ESRD-SCL,HAD and self-made general information scales.Another 68 patients with chronic renal dysfuction who had recieved hemodialysis for(19.86±13.57) months served as control.Results The QOL of renal transplantation recipients was much better than that of hemodialysis patients(P<0.01).Males,members with a higher income or a higher education level,and those who returned to work had a better QOL.Various symptoms occurred in patients after renal transplantation(13.37±7.41).The number of symptoms in patients was closely related with their QOL(P<0.05).The anxiety and depression levels were lower in renal transplantation recipients than in hemodialysis patients(P<0.01).Multi-factor regression analysis demonstrated that symptom was the most efficient factor that influenced the physical health and mental health of QOL(standard partial regression coefficient 0.477 and 0.649 respectively).Anxiety and depression were the most important factors on mental health of QOL(standard partial regression coefficient 0.281).Conclusion The QOL of renal transplantation recipients is better than that of hemodialysis patients.However,it can be influenced by many factors,which should there be investigated with standard scales and closely concerned.Symptoms,anxiety and depression are the most important factors influencing the QOL of renal transplantation recipients.

The aim of our study is to investigate the effects of IL-15 on the apoptosis of CD4+CD25+ regulatory T cells(Tregs) and the mechanism.We isolated Tregs from the human peripheral blood mononuclear cells in two steps by magnetic cell sorting system,and measured the purity rate of the sorted cells was by flowcytometry(FC).Then the prepared Tregs were co-cultured with Dynabeads CD3/CD28 T cell expander and divided into 3 groups(control group,IL-2 group,and IL-15 group) without or with IL-2(100 U/ml) and IL-15(50 ng/ml).FC was used to detect the Tregs apoptosis;the incorporation of [3H] thymidine was used to evaluate the suppressive function of the Tregs on the Teff in the presence of IL-2 or IL-15;Western blotting was used to observe the expression of Bcl-2,Bcl-xl,and p-Bad(ser112).FC showed that the purity of sorted CD4+ CD25+ T cells was 95.2 %;the intracellular staining indicated that the expression rate of Foxp3 was 94.2% in Tregs.Compared with Tregs cultured without cytokines,IL-15 and IL-2 were able to promote survival of activated Tregs.IL-2 profoundly reversed the Tregs-mediated suppression of Teff proliferation,however IL-15 had almost no effects on Tregs-mediated suppression.We also found that addition of IL-15 and IL-2 did not affect Bcl-2 expression.In contrast,Bcl-xl and p-Bad(ser112) was selectively up-regulated by IL-15 and IL-2 in Tregs.All the results indicated that IL-15 can reduce the Tregs apoptosis,which maybe associated with up-regulating the Bcl-xl and p-Bad(ser112) expression.Furthermore,IL-15 could maintain Tregs suppression function.

Objective To compare different immune-characteristics of Tregs by direct antigen recognition and indirect antigen recognition. To explore whether the indirect way plays the key role in inducing Tregs in immune-tolerance. Methods Recipient peripheral blood mononuclear cells (PBMCs) were isolated by density gradient centrifugation with Ficoll Hypaque. One part were cultured with rhGM-CSF 75 ng/ml, rhIL-4 25 ng/ml for 4 days to induce human dendritic cells (DCs) ; and then another 3 days after loading with donor antigen. The CD4~+ CD25~- T cells were purified from another part of recipient PBMCs by autoMACS using the human CD4~+ CD25~+ regulatory T cell isolation kits. Two kinds of cells were culture with IL-2 and rapamycin for 5 days to induce antigen-specific CD4~+ CD25~+ regulatory T cells (Tregl) by indirect antigen recognition. At the same time donor PBMCs as antigen presenting cells (APCs) were cultured with recipient CD4~+ CD25~- T cells to induce antigen-specific CD4~+ CD25~+ regulatory T cells ( Treg2) by direct antigen recognition. The immune-characteristics of the 2 Tregs was compared by lymphocyte proliferation inhibition reaction. Results Tregl has a proliferation inhibiting rate of 63. 5% , higher than Treg2's proliferation inhibiting rate of 45. 8%. Conclusion Indirect antigen recognition plays a very important role in the induction of Tregs than others. Natural Tregs may not meet the need in immune-tolerance after organ transplantation.

Objective To compare the successful rate and security of percutaneous renal biopsy under transient intravenous anesthesia and traditional local anesthesia in children. Methods Clinical and pathological data of children patients (less than 12 years old) undergoing ultrasound-guided renal biopsy with intravenous anesthesia from June 1, 2006 to May 30, 2007 in our department (Painless group) were compared with those of traditional local anaesthesia for renal biopsy from January 1, 1999 and May 30, 2006 (local anaesthesia group). In painless group, fentanyl citrate (50 μg for less than 60 kg in body weight, and 75 μg for those over 60 kg) were injected intravenously, then diprivan was injected intravenously till the end of lash reflex (usually 140-150 mg), and the puncture was performed when the child got complete narcosis. In local anaesthesia group, 2% lidocaine was applied for local anaesthesia, rapid puncture was performed when the children were asked to hold the breath. Successful rate (those getting more than 15 glomeruli) and the complications were observed. Results The punctures in painless group were done successfully with glomeruli number of 8 to 49 [mean (23.3±10.0)], and only 1 case got 8 glomeruli; while in local anesthesia group, the glomerulus number was 0-40 [mean (23.2±9.4)], with no difference between the 2 group. But in local anesthesia group, 2 biopsies were abandoned due to bad cooperation caused by supertension, and 2 cases obtained less than 15 glomeruli. Successful rate was 96.3% and 82.6% respectively in the 2 groups. The complications of anaesthesia in 2 groups: the analepsia time in painless group was 2-5 min, and respiratory depression took place in 1 case who got better soon after the oxygen intake was increased and the respiratory tract was unobstructed; 2 cases in local anesthesia group presented discomfort of chest distress, sweat, and fluster etc. which got better after rest. There was no difference in the incidence of gross hematuria and perirenal hematoma. Conclusion Compared with traditional renal biopsy in local anesthesia, transient intravenous anesthesia is safe and reliable to perform for renal biopsy in children.

Objective To evaluate the inhibiting of renal fibrosis progression of 5/6 nephrectomized rats transfected by Transgene of Antisense Vascular Smooth Muscle Alpha Actin(pAdanti-α-SMA).Methods To transfect 5/6 nephrectomized rats by the pAdanti-α-SMA.Rats survival rate,weight,renal function and renal tissues pathology were assessed.Expression of α-SMA,TGF-β1 and PDGF-BB in kidney were detected by immunohitochemistry and analyzed by Tiger 920.Results 5/6 nephrectomized rats were successfully transfected by pAdanti-α-SMA.The survival rate of 5/6 nephrectomized rats transfected by pAdanti-α-SMA was higher than that of rats which were not transfected.The renal function and renal tissues pathology of the transfected rats was better than that of rats which were not transfected.Quantity of α-SMA+ cells in rats transfected was higher than that in rats which were not transfected ,while the quantity of the TGF-β1+ and PDGF-BB+ cells both showed no difference in the same experiment.Conclusion The RFB progression of 5/6 nephrectomized rats transfected by pAdanti-α-SMA is inhibited.

供体肾结石因其潜在的导致尿路梗阻的风险,既往曾作为亲属供肾的明确禁忌证.近年来,随着腔内泌尿外科技术的发展,供肾结石有可能通过输尿管镜下取石和弹道碎石得到清除,从而有效扩大供肾来源,促进亲体肾移植的开展.

报告1例应用超选择性肾动脉栓塞抢救肾活检后大出血成功,提示在肾活检率逐年提高、肾活检人数逐渐增多的今天,即使发生严重的大出血,不再必须切除肾脏,介入治疗可以取得良好效果,而且能够尽可能地保护残存的肾功能。