Reactive oxygen species (ROS) is an important regulator in cellular signaling transduction, and many previous studies have indicated that acute ROS stimulation improves insulin sensitivity in skeletal muscle. In the study, we found that chronic ROS treatment caused serious insulin resistance in C2C12 myotubes. Glucose uptake and consumption assay indicated that pretreatment with 80 μM H2O2 for 2 h inhibited insulin-stimulated glucose uptake in C2C12 myotubes, and the reason for it, is that chronic H2O2 treatment decreased insulin-induced glucose transporter 4 (GLUT4) translocation from cell plasma to cell membrane. Moreover, Akt2 phosphorylation depended on insulin was reduced in C2C12 myotubes of chronic H2O2 treatment. Together, this study provides further demonstration that chronic ROS stress is associated with insulin resistance of skeletal muscle in the progression of type 2 diabetes.

Background The value of Fas ligand (FASL) as a diagnostic immune marker for acute renal rejection is controversial; this meta-analysis aimed to clarify the role of FASL in acute renal rejection. Methods The relevant literature was included by systematic searching the MEDLINE, EMBASE, and Cochrane Library databases. Accuracy data for acute rejection (AR) and potential confounding variables (the year of publication, area, sample source, quantitative techniques, housekeeping genes, fluorescence staining, sample collection time post-renal transplantation, and clinical classification of AR) were extracted after carefully reviewing the studies. Data were analyzed by Meta-DiSc 1.4, RevMan 5.0, and the Midas module in Stata 11.0 software. Results Twelve relevant studies involving 496 subjects were included. The overall pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, and diagnostic odds ratio, together with the 95% CI were 0.64 (0.57-0.70), 0.90 (0.85-0.93), 5.66 (3.51-9.11), 0.30 (0.16-0.54), and 30.63 (14.67-63.92), respectively. The area under the summary receiver operating characteristic curve (AUC) was 0.9389. Fagan's nomogram showed that the probability of AR episodes in the kidney transplant recipient increased from 15% to 69% when FASL was positive, and was reduced to 4% when FASL was negative. No threshold effect, sensitivity analyses, meta-regression, and subgroup analyses based on the potential variables had a significant statistical change for heterogeneity. Conclusions Current evidence suggests the diagnostic potential for FASL mRNA detection as a reliable immune marker for AR in renal allograft recipients. Further large, multicenter, prospective studies are needed to validate the power of this test marker in the non-invasive diagnosis of AR after renal transplantation.

Objective To evaluate the expression of CD44 in rats with renal ischemia-reperfusion injury (IRI) and the implication.Methods Thirty male Sprague-Dawley (SD) rats were divided into three groups.In control group (n =10) left renal artery was exposed but not blocked,and 1 h later left nephrectomy was done (sham operated group).In IRI-1 h group (n =10),left laparotomy was done after 1 h renal ischemia followed by 1 h reperfusion.In IRI-24 h group (n =10) left laparotomy was done after 1 h renal ischemia followed by 24 h reperfusion.The contents of soluble CD44 in plasm and the immunohistochemical expression of CD44 in ischemic and reperfused rat kidneys were examined.Results CD44 was expressed in both IRI-1 h and IRI-24 h groups but not in control gontrol.The mean immunohistochemical staining percentages of rat kidneys in control group,control group,IRI-1 h group and group were (0.00 ±0.00)％,(35.50 ±4.50)％ and (23.20 ±6.33)％,and the contents of soluble CD44 in plasm were (0.32 ± 0.06),(13.25 ± 3.22) and (8.41 ± 1.76) μg/L,respectively.The immunohistochemical staining was stronger in IRI-1 h group than in IRI-24 h group (P ＜ 0.01).Conclusion The expression of CD44 in renal tubuloepithelial cells was prominently increased after IRI.The increase in CD44 expression was more significant during the early phase of IRI and started to descend after 24 h of reperfusion.

目的:回顾性分析并总结妊娠合并上尿路结石的诊治经验,评估保守治疗与手术干预两种治疗手段的安全性.方法:2011年12月～2015年3月,46例孕妇因肾绞痛在我院接受治疗,治疗方法包括保守治疗、双J支架管置入术、经皮肾穿刺造瘘术(PCN)、输尿管镜碎石术(URSL).其中31例接受解痉、镇痛及保胎等保守治疗,9例接受膀胱镜输尿管内双J管置入术,5例接受URSL,1例接受PCN.结果:31例保守治疗患者症状明显缓解,直至足月妊娠.15例采取手术干预的患者中,1例行PCN治疗者病情缓解,胎儿体征稳定;9例行双J支架管置入术者支架放置正确;5例行URSL者术后无残余碎片或残留碎片直径均小于3 mm.分娩后,3例行经皮肾镜钬激光碎石术(PCNL),9例行URSL,8例接受体外冲击波碎石术(ESWL),以去除残留结石.所有患者均足月妊娠,母子平安,未出现严重并发症.结论:对于妊娠期上尿路结石患者,首先采取保守治疗,缓解肾绞痛等症状;当保守治疗无效时,根据患者基础情况选择双J管置入术、PCN或URSL;对于双J支架管置入术和PCN术无法解除症状的患者,URSL(特别是钬激光碎石术)更有效,应作为首选.

Objective To investigate the diagnosis and surgical management of ureteral obstruction after renal transplantation.Method A respective study was performed on 15 cases of ureteral obstruction who received renal allografts.All of the cases were confirmed,including 5 cases of stenosis of ureterovesical junction,4 cases of stenosis of distal ureter,2 cases of blood clot blockage,2 cases of edema due to perforation of distal ureter,1 case of ureteral calculi,and 1 case of extrinsic compression of hematoma.All 14 patients underwent open surgical management to reestablish ureter with D-J catheter as stent for 12-16 weeks.One patient was subjected to percutaneous nephrostomy followed by percutaneous ureteroscopy,the obstructed site was identified at ureterovesical junction and antegrade balloon dilation and D-J stent in ureter were performed subsequently.Result Fifteen patients were diagnosed as ureteral obstruction by colour Doppler ultrasound and MRU.All of the patients were resolved the obstructions after surgical managements and the renal function got improved.No reobstruction occured during one year follow-up period.Conclusion Colour Doppler ultrasound and MRU can definitely be used to diagnose ureteral obstruction after renal transplantation.Early diagnosis and surgical management are very important.Open surgical management of the obstructed ureter is an effective method.Antigrade balloon dilation is a therapeutic approach to treat ureteral obstruction.

Objective To explore the clinical features,possible transfer mechanisms,and treatment options of renal cell carcinoma with urinary bladder metastasis.Methods The detail of the clinical information of a renal cell carcinoma case with bladder metastasis was reported and the related literatures were reviewed.Result Urinary bladder metastasis of renal cell carcinoma is very rare.The metastasis occurring only in urinary bladder is rarer.Most of the bladder metastasises involve with other organs' metastasis.Conclusions Urinary bladder metastasis of renal cell carcinoma may be hematogenous,lymphatic,and intraluminal seeding as potential mechanism of metastasis.Renal cell carcinoma metastasis occurring only in urinary bladder should be treated with a surgery.

Objective To explore the efficacy of tacrolimus in treating experimental autoimmune prostatitis (EAP) in rat model and the possible mechanism.Methods SD rats were randomly divided into 4 groups:normal control group,EAP model group,low-dose treatment group,high-dose treatment group.According to administration durations,each group was further divided into two subgroups:2-week group and 4-week group.After successful modeling,rats in low-dose treatment group and high-dose group underwent gastric perfusion with 0.2 mg/(kg·day) and 0.8 mg/(kg·day) tacrolimus respectively for 2 and 4 weeks in a successive way.Concentrations of interleukin (IL)-2 and macrophage inflammatory protein-1α (MIP-1α) in the homogenate of prostatic tissue and serum were tested.Histomorphological changes of prostatic tissue,spleen and thymus gland were observed,with their viscera coefficients being calculated.Results After the intervention of tacrolimus,a decrease in inflammatory cells in prostatic tissue was revealed histomorphologically and glandular cavity wall was repaired to some extent.The concentrations of IL2 were ( 156.80 ± 19.11 ),( 124.56 ± 17.20) and ( 114.46 ± 20.65) ng/L in the serum of M2W,L2W and H2W groups,and MIP-1 α concentrations were ( 164.99 ± 22.25 ),( 112.03 ± 19.90) and ( 104.91 ± 11.91 ) ng/L,respectively.As for the homogenate of prostatic tissue,IL-2 and MIP-1α levels stood at (219.26±23.11),(191.56±19.08),(186.63 ±20.90) ng/L,and (216.46 ±18.50),(196.55 ±17.84),( 194.74 ± 18.14) ng/L respectively.In comparison,in M4W,LAW and H4W groups,concentrations of the two substances were ( 156.23 ± 19.83),( 129.27 ± 17.25),( 134.26 ± 16.11 ) ng/L and (157.93 ±34.55),(159.09 ±29.17),(154.54 ±29.85) ng/L,respectively.In the homogenate of prostatic tissue,data were (217.92 ±23.23),(186.07 ± 11.56),(180.37 ± 18.26) ng/L and (209.66 ±14.65),( 186.17 ± 17.79),( 186.16 ± 18.27) ng/L,respectively.All differences were statistically significant except MIP-1α level in the serum of 4-week subgroup.Conclusion Tacrolimus can reduce the number of inflammatory cells in prostatic tissue in EAP rat model,which may be related to its suppression of the production of IL-2 and activation of T cells.

【Objective】 To investigate the nursing care experience of renal transplant perinatal recipients.【Methods】 Collected four times pregnancy-clinical data in three cases of female recipients between 2005 to 2011 after renal transplantation.All patients used cyclosporine A or tacrolimus,mycophenolate mofetil,prednisone triple anti-rejection treatment before and after pregnancy.【Results】 The 1st patient terminated pregnancy after 12 weeks gravidity because of fetal hypoplasia.The 2nd patient terminated pregnancy after 23 weeks gravidity because conservative treatment is not ideal,with blood pressure 183/120 mmHg,edema,and urinary protein(+++).The 3rd patient miscarried spontaneously for 2 times due to urinary tract infection.【Conclusion】 Female recipients are generally pregnant after renal transplant for 2 years.But this situation is still considered high-risk and must be carried out in the preconception guidance and perinatal health care close custody.

Objective To study the relationship between the expression of sCD20 and the graft acute rejection,and the relationship between the level of sCD20 in peripheral blood and prognosis of the transplant kidney.Methods Fifty patients who had received renal transplantation from 2007 to 2010 were retrospectively reviewed.The expression of sCD20 in the blood was detected by enzyme linked immunosorbent assay (ELISA).Results The expression levels of sCD20 were higher in acute renal rejection group (1750.60±359.59) ng/L than those in non-rejection group (936.96 ± 181.71 ) ng/L before transplantation (P ＜0.05).After transplantation the expression levels of sCD20 were (2516.20 ±511.33) ng/L in acute renal rejection group and (988.40 ± 215.78 ) ng/L in non-rejection group ( P ＜ 0.05 ).Conclusion The expression of sCD20 in blood is correlated with clinical renal acute rejection and prognosis of the transplant kidney.

目的 探讨肾移植术后泌尿系感染的特点.方法 回顾性分析2009年1月至12月在暨南大学附属第一医院进行肾移植的38例患者(男性24例,女性14例)的临床资料,对其术后1年内尿常规、尿培养结果及其他临床资料进行总结分析.结果 38例患者肾移植术后1年内共查尿常规次数787例次,其中尿常规阴性结果为633例次,标本污染53例次,细菌尿次数101例次,其中71例次发生肾移植术后半年内.101例次泌尿系感染中,无症状性菌尿为68例次,上尿路感染19例次,下尿路感染14例次,并发脓毒血症者3例次.38例患者中,共有25例(男14例、女11例)患者出现细菌尿,有19例患者出现不少于2次泌尿系感染.最常见的致病菌为大肠埃希菌(36例次),其次是粪肠球菌(26例次).肾移植术前血液透析患者术后感染率为70%.36例术后7 d内拔出尿管和双J管的患者肾移植术后感染率64%,而2例肾移植术后7 d后拔出尿管和双J管患者均发生感染.术后出现膀胱输尿管反流的3例患者均出现泌尿系感染.结论 肾移植术后泌尿系感染具有高发性、反复发作的特点,最常见的致病菌为大肠埃希菌.女性、尿管和双J管的长时间留置、术后膀胱输尿管反流、术前长时间血液透析等都会诱发肾移植术后的泌尿系感染.

前列腺癌是男性生殖系统肿瘤的常见病,在欧美等国家前列腺癌是男性发病率最高的恶性肿瘤,占癌症死亡率的第二位[1].随着老龄化人口的发展及诊疗水平的不断提高,前列腺癌在中国的发病率及检出率也呈显著增长趋势,是威胁老年男性健康的一个重要因素[2].目前前列腺癌实验室早期诊断指标主要是血清前列腺特异性抗原(PSA),但是血清PSA作为前列腺特异性而非前列腺癌特异性标志物,在有关前列腺各种检查(直肠指诊和经直肠超声)及非肿瘤状态下(如良性前列腺增生、前列腺炎)也有表达.临床上将PSA＞4 ng/ml作为前列腺癌诊断的临界值,但是当PSA值在4～10 ng/ml 时,前列腺癌的检出率仅在25%左右,活检阴性率占70%～80%,阴性的活检结果并不能完全排除恶性肿瘤存在的可能性[3].因此寻找敏感性、特异性高的生物标志物仍是目前研究的重点,本文就近几年研究较为热点的几种标志物予以综述.

Objective To investigate the expression of Engrail-2 (EN2) and its significance in different prostate cancer cell lines and normal human prostate epithelial cell line.Methods The expression of EN2 was detected in prostate cancer cell lines (PC3,DU145,LNCAP) and normal prostate epithelial cell line RWPE-1 by using reverse transcription-polymerase chain reaction (RT-PCR),enzyme linked immunosorbent assay (ELISA) and immunofluorescence.Results The EN2 mRNA and protein expression levels in Pca cell lines ( LNCAP,PC3,DU145 ) were 1.65 ± 0.19/8.74 ± 0.34,1.08 ± 0.12/3.07 ±0.24,and 1.15 ±0.53/2.86± 0.26 respectively,which was significantly higher than in normal prostate epithelial cell line RWPE-1 (0.42 ± 0.11/0.86 ± 0.99 ) ( P ＜ 0.05 ).The EN2 level was higher in LNCAP cells than in PC3 and DU145 cells (P ＜ 0.05).Conclusion The expression of EN2 in 3 prostate cancer cell lines is higher than in RWPE-1 and EN2 protein can be secreted by prostate cancer cells.It is important for the further study on the EN2 potential roles in the occurrence and development of prostate carcinoma.

Objective To study the diagnosis and treatment of stones in transplanted kidneys and ureters after renal transplantation.Methods We retrospectively reviewed the clinical data of 15 cases with stones in transplanted kidney or ureters after renal transplantation from 1995 to 2007,including 11 cases of renal stones and 4 cases of ureteral stones.Results Of the 11 patients with renal stones,two was treated with extra shock wave lithotripsy(ESWL) and stones disappeared,which turned out to had complications of hematuria and increased level of serum creatinine;Eight patients were treated with minimally percutaneous nephrostolithotomy(mini-PCNL) successfully,and one was treated by medicines with the stone discharged.Of the four patients with ureteral stones,two received Mini-PCNL with satisfactory results;Another two were treated by ureteroscopic lithotomy(URL),in which one succeed and another failed.Conclusion Patients should choose different treatment according to their specific situation.Mini-PCNL is a safe and effective mean for patients with stones in transplanted kidneys or ureters.URL can be chosen for treatment of ureter stone by experienced doctor.

妊娠合并上尿路结石是孕妇腰腹部疼痛最常见的非产科因素,可引起泌尿系梗阻和感染,甚至发生败血症,如处理不当可危及母婴生命.现就其流行病学特点、诊断与治疗作一概述如下. 1 妊娠合并尿路结石的流行病学特点 妊娠合并尿路结石的发病率波动在0.03%～0.53%[1～3],其中有症状患者为1/1500～1/2500[4].妊娠合并有症状结石的发病率与未妊娠女性出现有症状结石的发病率相同,这两类人群的结

肾移植术后并发肺部感染是造成受者死亡的主要原因之一,病死率达40％～78％[1],发展成重症肺炎后治疗难度加大,病死率更高.本文对2000年1月至2010年12月我院收治的40例肾移植术后并发肺部感染者的临床资料进行了回顾性分析,现报告如下.

Objective: Cold ischemia injury represents an independent risk factor which favors chronic allograft nephropathy (CAN). In order to investigate the role of transforming growth factor-beta I( (TGF-beta 1) in the progression of CAN, we studied the relationship between the expression of TGF-beta 1 and cold ischemia injury in the renal tubular epithelia of rat donor kidney. Methods: A total of 24 Wistar rats were used in this study. In terms of the time of cryopreservation of donor kidney, the 24 Wistar rats were randomly divided into 3 groups: Oh group(control group), 24h group, 48h group. A block removal of donor kidney with in situ perfusion of cooling HC-A preservation solution was adopted. The rat kidney was preserved Oh, 24h and 48h at 0-4 degrees C respectively. The morphologic changes of proximal tubular epithelial cells in different cryopreservation time were observed under light microscope and transmission electron microscope. The expression of TGF-beta 1 mRNA and protein in proximal tubular epithelial cells of different cryopreservation time group were detected by in situ hybridization and immunohistochemistry analysis. Results: 1. In 24h group, part of the proximal tubular epithelial cells showed slight degeneration. In 48h group, the proximal tubular epithelial cells demonstrated severe hydropic degeneration and part of the cells developed necrosis and effluxion. 2. Only a small amount of TGF-beta 1 protein and mRNA were expressed in the renal tubular epithelial cells of Oh group. The positive unit (PU) value of TGF-beta 1 protein and mRNA were 6.37 +/- 2.77 and 5.29 +/- 2.15, respectively. As the cold ischemia time prolonged, the PU value of TGF-beta 1 protein increased at 24h group (10.20 +/- 3.27) and 48h group (17.17 +/- 3.96). The PU value of TGF-beta 1 mRNA also increased at 24h group (11.31 +/- 3.34) and 48h group (19.01 +/- 3.53). There was the significant difference of TGF-beta 1 protein PU value or mRNA PU value among these groups(P<0.05). Conclusion: There was the significant correlation between the expression of TGF-beta 1 and the degree of cold ischemia injury. The results suggest that TGF-beta 1 might play the key role in regeneration and reparation of renal tubular epithelial cell injury. The overexpression of TGF-beta 1 might be one of the mechanisms that initiate chronic allograft nephropathy. (C) 2009 Elsevier Inc. All rights reserved.

Objective:To study the relationship between the renal graft expression of CD44 and the graft acute rejection.Methods:Retrospectively reviewed patients who had performed renal transplantation from 2005 to 2009 and identified 28 patients with acute renal rejection.The expression of CD44 of the graft was detected with immunohist -ochemical method.Results:The expression levels of graft with CD44 were significantly higher in acute renal rejection group than those in chronic renal rejection group and normal group.There were significant differences in the expression of CD44 in these groups.Conclusions:The expression of CD44 in grafts is correlated with clinical renal rejection,Examining the expression of CD44 in graft is helpful to the diagnosis and treatment of acute rejection in clinic.CD44 can be a high sensitivity and specificity predictor to acute rejection.

Objective To study the relationship between the expression of sCD44 and hyaluronic acid and the graft acute rejection.Methods We retrospectively reviewed 123 patients who were subjected to renal transplantation from 2005 to 2009 and identified 28 patients with acute renal rejection.The expression of sCD4 and hvaluronic acid in the blood was detected.Results The expression levels of sCD44 and hyaluranic acid were significantly higher in acute renal rejection group than those in non-rejection rejection group and normal group.There were significant differences in the expression of sCD44 and hyaluronic acid among these groups.Conclusion The expression of sCD44 and hyaluronic acid in blood is correlated with clinical renal acute rejection.CD44 can be a predictor with hish sensitivity and specificity to acute rejection.

目的探讨活体肾移植供者的术后最佳护理措施。方法对16例亲属活体肾移植供者术后的临床护理进行回顾性分析。结果 16例亲属活体肾移植供者经适当的治疗、有针对性的心理护理、细致的病情观察、及时的对症处理和正确的饮食指导,术后恢复好,均顺利出院。结论优质护理可以减少活体肾移植供者术后并发症的发生,利于术后康复。