Objective To explore the expressions of regulatory T cell (Treg) and T helper cell 17 (Th17) during perioperative period of liver transplant (LT) in children of biliary atresia (BA).Methods Peripheral blood samples were harvested from children of surgical observation group at 1 week pre-LT,2 weeks and 4 weeks post-LT respectively.And recipients were followed up for ＞1 year post-LT and healthy controls were designated.The proportions of Treg and Th17 cells in peripheral blood pre-and post-LT were analyzed by flow cytometry.Results The proportions of CD4+ T lymphocytes at different time-points preand post-LT were higher in BA patients than those in healthy control group (P ＜ 0.05).The Treg proportion was higher during pre-LT period (4.04％ ±0.71％) than that at 2 weeks (4.04％ ±0.71％) and 1 month (2.16％ ±0.72％).No difference existed between 2 weeks and 1 month (P＞0.05).The Treg proportions were lower in pediatric receipients than those in health control group (5.06％ ± 1.33％,P＜ 0.05).And the Th17 proportions were higher at 2 weeks (1.43％ ± 0.45％) and 1 month (1.17％ ±0.47％) than those in health control group (0.76％ ± 0.30％,P＜0.05).However,no difference in Th17 proportion existed between pre-LT (1.09％ ± 0.46％) and health control group (P＞0.05).The Treg proportion in recipients at ＞1 year post-LT was higher than that during early post-LT period (P＜0.01).However,no inter-group difference existed in Th17 proportion (P＞0.05).Conclusions The proportion of Treg cells is lower at pre-LT in pediatric BA patients and there is a declining trend at 1 month post-LT.However,the proportion of Th17 cells is higher at pre-LT and it is rising during this period.This change is probably correlated with an immune imbalance and inflammatory response stimulated by a new graft post-LT.

Objective To study the expressions of regulatory T cell (Treg) and T helper cell 17 (Thl7) in post liver transplantation (LT) acute rejection in pediatric recipients diagnosed with biliary atresia.Methods 12 pediatric recipients with post-LT acute rejection in Tianjin First Center Hospital from July 2016 to April 2017 were included in the rejection group,and 22 patients with normal graft functions for more than 1 year post-LT were included in the stable group.The pre-LT primary disease in all the recipients was biliary atresia with cholestatic cirrhosis.Ten healthy children were included in the control group.Peripheral blood samples were taken before and at 1 week after anti-rejection treatment in the rejection group.Blood samples were taken during follow-up in the stable group and in the normal control.The proportions of Treg cell and Th17 cell were detected by flow cytometry.Results The proportions of Treg cells in the rejection group and the stable group were both significantly lower than the control group (P＜0.05).There was no significant difference between the rejection group and the stable group (P＞0.05).The proportion of Th17 cells in the rejection group was significantly higher than the stable group (P＜0.05) and the control group (P＜ 0.05),respectively;and the proportion in the stable group was significantly higher than the control group (P＜0.05).Meanwhile,there was also significant increase in the proportion of CD3+CD8+CD28+T in the rejection group (P＜0.05).After anti-rejection therapy,the proportions of Treg cell and Th17 cell became significantly lower than before therapy (P＜0.05).Conclusions The balance in Treg/Th17 cells occurred in the acute phase of rejection post-LT in pediatric recipients with biliary atresia,which persisted into the early period after anti-rejection therapy.

目的 分析肾移植术后供者特异性抗体(DSA)阳性对受者肾功能预后的影响.方法 回顾性分析本院2013年1月至2016年4月首次进行肾移植手术,并且术后定期规律性复查的127例受者.根据受者术后PRA水平分为:PRA阴性组(n=73);DSA阴性组(n=25);DSA阳性组(n=29).利用SPSS13.0软件对3组术后1年的肾功能和移植物存活率进行统计分析,并对DSA阳性组的DSA类别和平均荧光强度值(MFI)进行统计.结果 3组受 者术后1、3、6、12个月的血清肌酐:PRA阴性组和DSA阴性组(P＞0.05);DSA阳性组和PRA阴性组血清肌酐均数差分别为126.91、247.53、268.62、358.4,(P＜0.05),DSA阳性组和DSA阴性组血清肌酐均数差分别为127.74、207.21、260.84、342.57(P＜0.05).3组术后移植肾12个月存活率:PRA阴性组和DSA阴性组(P＞0.05);DSA阳性和其它两组相比x2值为53.68,(P＜0.01).DSA阳性组中HLA-Ⅰ DSA有3例,HLA-ⅡDSA有23例,HLA-Ⅰ、ⅡDSA有3例.HLA-DQ阳性的DSA总计18例(62.1％).结论 DSA阳性可造成受者术后移植肾功能降低和移植肾存活率下降,术后DSA以HLA-ⅡDQ抗体为主.