Successful Treatment for BK Virus Nephropathy by Leflunomide in a Kidney Transplant Patient: A Case Report

IntroductionThe immunosuppressant agents in kidney transplantation (KT) may lead to various complications such as opportunistic infections and malignancies. BK virus associated nephropathy is a significant complication following KT, and it can result in graft failure. BK virus causes tubulointerstitial nephritis, ureter stenosis, and even graft failure in KT recipients with impaired immune system. We described a 63-year-old woman, who was a hepatitis C carrier and on dialysis for 22 years before KT, who received cadaveric-donor KT 2 years previously. She reported decreasing urine output and general weakness. The serum creatinine level was slightly increased from 2.94 to 4.38 mg/dL.MethodsImmunosuppressant medications including prednisolone, everolimus, cyclosporin, and mycophenolate sodium were continued as maintenance therapy post KT. Kidney biopsy was performed due to deterioration of graft function.ResultsThe kidney biopsy showed consistent results with early-stage polyomavirus nephropathy, characterized by focal viral cytopathic changes with positive immunohistochemical signals and mesangial proliferative glomerulonephritis, immune-complex-mediated (Fig 1 and Fig 2). Negative C4d staining at peritubular capillary was reported. The dosage of mycophenolate sodium was tapered from 720 to 360 mg daily and that of everolimus increased from 0.5 to 1.0 mg daily due to BK viral infection with BK nephropathy. The serum creatinine level was 2.75 mg/dL after treatment.ConclusionEarly detection of BK nephropathy and decreasing immunosuppressant agents are the mainstay of treatment. Substituting leflunomide for mycophenolate sodium and increasing dosage of everolimus has been proposed to solve BK nephropathy. We presented that the use of leflunomide in such situation is in a timely manner.     

降糖灵1号降血糖的实验研究

目的　验证降糖灵 1号的降血糖作用。方法　以大、小白鼠为实验动物 ,分别与空白对照、高血糖对照及降糖甲片组和消渴丸组进行对照。研究降糖灵 1号对肾上腺素性和四氧嘧啶性高血糖的药理作用。结果　降糖灵 1号组除与消渴丸组对糖尿病差异无显著性意义 (P >0 0 5 )外 ,与其他各组差异均有显著性意义 (P <0 0 5 ,P <0 0 1)。结论　降糖灵 1号具有明显的降血糖作用     

巯亚硝基血红蛋白在小鼠体内产生一氧化氮的作用

本文用Ｂａｌｂ／ｃ小鼠观察了巯亚硝基蛋白在体内产生一氧化氮的量效关系，结果发现，ＳＮＯ－Ｈｂ在体内可剂量信赖地产生ＮＯ。     

硝酸铋与丙磺舒合用对顺铂肾毒性的防护作用

毒性剂量的顺铂（ＣＰ３０μｍｏｌ·ｋｇ－１ｉｐ）可引起血尿素氮（ＢＵＮ）升高。硝酸铋（ＢＮ）５μｍｏｌ·ｋｇ－１于ＣＰ前４８和２４ｈｓｅ，丙磺舒（Ｐｒｏ）７００μｍｏｌ·ｋｇ－１于ＣＰ前１５，１ｈ及ＣＰ后５ｈｉｇ，或ＢＮ与Ｐｒｏ二者半量合用，按上述给药，均能抑制ＣＰ引起的ＢＵＮ升高，尤以ＢＮ＋Ｐｒｏ组抑制作用显著。肾脏光镜和电镜标本显示，ＣＰ使肾小管受损严重；ＢＮ组，Ｐｒｏ组和ＢＮ＋Ｐｒｏ组均使ＣＰ引起的肾小管受损减轻，尤以ＢＮ＋Ｐｒｏ组减轻明显。ＢＮ２．５－２０μｍｏｌ·ｋｇ－１剂量依赖性地诱导小鼠肾脏金属硫蛋白合成。Ｐｒｏ可使ＣＰ后２４ｂ肾铂含量明显降低；Ｐｒｏ或Ｐｒｏ＋ＢＮ使尿铂累积排出量增加，血浆铂浓度降低。提示ＰＦＯ防护ＣＰ肾毒性与其减少肾铂分布，增加尿铂排出有关。     

Effects of Nephritis No.3 Recipe on Nitric Oxide,Nitric Oxide Synthase Secreted by Cultured Mesangial Cells in Rats and the Gene Expression of Inducible Nitric Oxide Synthase

Objective:To explore the effect of the Nephritis No.3(N-3)recipe on nitric oxide(NO),nitric oxide synthase(NOS)secreted by cultured mesangial cells(MC)and its gene expression of the in-ducible nitric oxide synthase(iNOS).Methods:The drug(nephritis No.3)-containing serum was preparedwith serum pharmacological technique,and then was applied to react on mesangial cells cultured In fetalcalf serum(FCS)and cells cultured in FCS plus lipopolysaccharide.To observe the secretion of NO andNOS and the gene expression of iNOS by means of RT-PCR.Results:Under the two kinds of culture con-ditions,the content of NO and NOS in the groups with drug-containing serum were higher than thosewithout drug-containing serum(P<0.05,P<0.01),and the expression of iNOS mRNA was up-regula-ted too.Conclusion:The N-3 could significantly promote the secretion of NO and NOS and the mRNA ex-pression of iNOS in rats.     

Liver resection without hilus preparation and with selective intrahepatic hilus stapling for benign tumors and liver metastasis

Background Nowadays, liver resection is a routine operative procedure in surgical centers, and strategies must be aimed at avoiding additional risk factors. Extrahepatic isolation of portal vein, hepatic artery and hepatic duct, as well as lymphadenectomy of the liver hilum are generally accepted steps of liver resection, even for metastatic and benign indications. Our primary aim was to analyze the feasibility, blood loss, blood transfusion requirements, incidence of complications, and outcome using the approach for intrahepatic devascularization leaving the extrahepatic hilus untouched. Materials and methods Thirty-eight consecutive patients with resection for metastases and benign liver tumors were selected. After hilar examination, the extrahepatic structures remain intact, and during parenchyma dissection, the whole right or left or the appropriate bi-segmental pedicle is isolated intrahepatically and then transected using a stapler device. Results The used technique was feasible in all cases, and no intra- or postoperative surgical complications were observed. To date, no tumor recurrence was found in the hilum during the follow-up period. Conclusion The intrahepatic pedicle stapling technique appears to be feasible and safe in liver resection. Hilar dissection can, thus, be avoided in liver metastasis and benign liver tumors.     

酵母菌2号培养最佳条件的选择

成人特发性乳糖酶缺乏症的发生率极高，这些人进食牛奶后会出现胃肠胀气、腹痛、腹泄等对牛奶不耐受的消化不良症状。为解决这一问题，自１９８９年起，国内外不少学者是主张有产替代疗法，即将人工培养制备纯化的乳糖酶直接加入牛奶中以水解其中的乳糖来弥补成人乳糖酶的缺乏。     

Glucose preferences in wild and domestic guinea pigs

Male wild (Cavia aperea) and domestic (C. porcellus) guinea pigs were tested in two-bottle choice tests for preferences between glucose solutions of different concentrations and de-ionized water. Wild males showed significant preferences for concentrations between 0.025 and 0.4 M glucose while domestic males preferred only the 0.2 M glucose solution to de-ionized water. C. aperea males also consumed significantly greater volumes of liquid per kg body $\text{wt.}{}^{\mathrm{<mtext>3</mtext><mtext>4</mtext>}}$ during the glucose tests than did the C. porcellus males. These comparative results contrast sharply with those obtained by other authors with wild and domestic Norway rats.     

Molecular mechanisms underlying IFN-{gamma}-mediated tumor growth inhibition induced during tumor growth inhibition induced during tumor immunotherapy with rIL-12

The present studnt Investigates the molecular by which IFN-produced as a result of in vitroIL-12 addministration exertsits anty-tumor,rIL-12 was administered three or five times intomice bearing CDA1M fibrosarcoma, OV-HM ovarian carcinoma orMCH-1-A1 fibosarcoma. This regimen induced complete regressionof CSA1M and OV-HM tumors but only transient growth inhibitionof MCH-1-A1 tumors. The anty-tumor effects of Il-12 were associatatedwith enhanced induction of IFN-becouse these effects were abrogatedby pretreatment of hosts with anti-IFN- antibody.Exposure inin vitro of the three types of tumor cells to rIFN- resultedin moderate to potent inhibition of tumor cell growth.IFNstimulatedthe expression of mRNAs for an inducible type of NO synthasa(INOS)in CSA1M cells and indoleamine 2,3-dioxygenasa (IDO),an enzyme capable of degrading tryptophan, in OV-HM cells ,but induced only marginal levels of these mRNAs in MCH-I-ALcells. In association withiNOS gene expression, INF--stimulatedCSA1M cells produced a large amount of NO which functioned toinhibit their own growth in vitro. Although OV-HM and MCH-1-A1cells did not produce NO, they also exhibited NO susceptibility.Whereasthe tumor masses from IL-12-treated CSA1M-bearing mice inducedhigher levels of INOS (for CSA1M) or IDO and iNOS (for OV-HM)mRNAs,the MCH-1-A1 tumor mass expressed lower levels of iNOS mRNAalone.Moreover, massive infiltration of CD4⁺and CD8⁺ T cellsand Mac-1⁺ cells was seen only in the CSA1M and OV-HM tumors.Thus, these results indicate that IFN- produced after IL-12treatment induces the expression of various genes with potentialto modulate tumor cells and growth by acting directly on tumorecells or stimulating tumor-infiltrating lymphold cells and thatthe effectiveness of IL12 therapy is assoiated with the operation if these mechanisms.