Objective: To investigate the therapeutic effect of Yuchang suppository on experimental ulcerative colitis rats and the effect of PPARγ/NF-KB signaling pathway. Methods: The UC rat model was replicated by 2.4.6-trini...Objective: To investigate the therapeutic effect of Yuchang suppository on experimental ulcerative colitis rats and the effect of PPARγ/NF-KB signaling pathway. Methods: The UC rat model was replicated by 2.4.6-trinitrobenzenesulfonic acid (TNBS)/ethanol method and randomly divided into normal control group, model group, high-dose group of Yuchang suppository, middle dose group , Low-dose group and sulfasalazine group, 8 rats in each group. After 14 days of treatment, the general condition of the rats was observed and the disease activity index was scored. The changes of serum TNF-α, IL-1β and IL-6 levels were detected by ELISA. The colonic mucosal injury index (CMDI) score and colon were observed by colon specimens. Histopathological changes;RT-PCR and Western blot were used to detect the expression of PPARγ and NF-KB genes and proteins in colon tissue. Results: Compared with the normal control group, the DAI and CMDI scores in the model group and the levels of serum TNF-α, IL-1β, IL-6, NF-κB p65 mRNA and protein in colon tissue were significantly increased, PPAR. - γ mRNA and protein expression levels were significantly reduced. The levels of IL-1β, IL-6, TNF-α and the expression of NF-κB p65 mRNA and protein in colon tissue were lower than those in the model group, and the expression levels of PPARγ mRNA and protein were high. In the model group. In the improvement of NF-κBp65 and PPAR-γ gene and protein expression in rat colonic mucosa, the high-dose group and the middle-dose group were significantly better than the low-dose group. Conclusion:Yuchang suppository can significantly improve the symptoms and histopathology of UC model rats. The mechanism may be through activation of PPARγ, blocking the activation of NF-κB signaling pathway, and down-regulating inflammatory factors such as TNF-α and IL-1β. The expression is such that the inflammatory response is alleviated or eliminated, thereby achieving the therapeutic effect of UC.展开更多
Objective: To explore a simple, economical and feasible method for establishing type 2 diabetes mellitus and its complication model. Method: SD rats were randomly divided into two groups: normal group (15 rats) normal...Objective: To explore a simple, economical and feasible method for establishing type 2 diabetes mellitus and its complication model. Method: SD rats were randomly divided into two groups: normal group (15 rats) normal diet, model group (20 rats) with high glucose and high fat diet. After 2 weeks of feeding, model group was injected low dose(30mg/Kg) streptozotocin in the abdominal cavity, once a day for 6 days, normal group was injected with the same dose of citric acid buffer. Observe the changes of rat diet, body, hair, spirit, urine volume, and monitor weight, blood glucose. After 6 weeks, fast insulin, blood lipid, serum calcium, phosphorus and other biochemical indexes of rats, after HE staining observe morphologic variations changes of pancreas and kidney using microscope, and the changes of femoral bone in SD rats. Results: Compared with the normal group, the model group showed obvious symptoms, drink more, eat more, polyuria, emaciation, hyperglycemia, low calcium, low phosphorus, hyperlipidemia and other metabolic abnormalities, pancreatic atrophy, tissue fibrosis, glomerular area increased, basement membrane thickening, osteoporosis. Conclusion:High glucose and high fat diet combined with repeated intraperitoneal injecti on of low dose STZ can be successfully established the model of type 2 diabetes, and its high successful rate, low mortality rate, relatively simple, economical and feasible, has a certain significance of research on diabetes and its complications.展开更多
Objective:To study the effect of mechanism of high glucose on apoptosis and cell cycle arrest of isletβcells via p27 pathway.Methods:Islet INS-1 cells were cultured and divided into groups.The control group was treat...Objective:To study the effect of mechanism of high glucose on apoptosis and cell cycle arrest of isletβcells via p27 pathway.Methods:Islet INS-1 cells were cultured and divided into groups.The control group was treated with ordinary medium,the high glucose group was treated with high glucose medium containing 25mmol/L glucose,the high glucose+si-NC group was treated with high glucose medium and transfected with NC siRNA,and the high glucose+si-P27 group was treated with high glucose medium and transfected with p27 siRNA.After 24 hours treatment,MTS assay was used to detect the cell viability A490,TUNEL assay was used to detect apoptosis rate,flow cytometry was used to detect the cell cycle distribution and western blot was used to detect the expression levels of P27,caspase-8 and cyclinD1.Results:Compared with those in the control group,the A490,the ratio of S phase and G2/M phase as well as the expression level of CyclinD1 decreased,while the apoptosis rate,the ratio of G0/G1 phase as well as the expression levels of P27 and caspase-8 increased in the high glucose group(P<0.05);compared with those in the high glucose group,the A490,cell cycle as well as the expression levels of P27,caspase-8 and cyclinD1 were not different from those in the high glucose+si-NC group(P>0.05);compared with those in the high glucose group and high glucose+si-NC group,the A490,the ratio of S phase and G2/M phase as well as the expression levels of cyclinD1 increased,while the apoptosis rate,the ratio of G0/G1 phase as well as the expression levels of p27 and caspase-8 decreased in the high glucose+si-P27 group(P<0.05).Conclusion:The apoptosis and cell cycle arrest induced by high glucose are related to P27 pathway activation.展开更多
Background:Vascular resistance and flow rate during hypotherrnic machine perfusion (HMP)of kidneys is correlated with graft function. We aimed to determine the effects of increasing HMP pressure versus maintaining the...Background:Vascular resistance and flow rate during hypotherrnic machine perfusion (HMP)of kidneys is correlated with graft function. We aimed to determine the effects of increasing HMP pressure versus maintaining the initial pressure on kidney transplantation outcomes. Methods:We retrospectively reviewed the data of 76 primary transplantation patients who received HMP-preserved kidneys from 48 donors after cardiac death between September 1,2013,and August 31,2015.HMP pressure was increased from 30 to 40mmHg (1mmHg =0.133kPa)in kidneys with poor flow and/or vascular resistance (increased pressure [IP]group;36 patients);otherwise,the initial pressure was maintained (constant pressure group;40 patients).Finally,the clinical characteristics and transplantation outcomes in both groups were assessed. Results:Delayed graft function (DGF)incidence,1-year allograft,patient survival,kidney function recovery time,and serum creatinine level on day 30 were similar in both groups,with improved flow and resistance in the IP group.Among patients with DGF,kidney function recovery time and DGF duration were ameliorated in the IP group.Multivariate logistic regression analysis revealed that donor hypertension (odds ratio [OR]:1.43,95%confidence interval [CI]:1.02-2.06,P =0.035),donor terminal serum creatinine (OR:1.27,95%C7:1.06-1.62,P =0.023),warm ischemic time (OR:3.45,95%CI:1.97-6.37,P =0.002),and terminal resistance (OR:3.12,95%CI:1.76-6.09,P =0.012)were independent predictors of DGF.Cox proportional hazards analysis showed that terminal resistance (hazard ratio:2.06,95%C1:1.32-5.16,P =0.032)significantly affected graft survival. Conclusion:Increased HMP pressure improves graft perfusion but does not affect DGF incidence or 1-year graft survival.展开更多
Background:Hypothermic machine perfusion (HMP)is being used more often in cardiac death kidney transplantation;however,the significance of assessing organ quality and predicting delayed graft function (DGF)by HMP para...Background:Hypothermic machine perfusion (HMP)is being used more often in cardiac death kidney transplantation;however,the significance of assessing organ quality and predicting delayed graft function (DGF)by HMP parameters is still controversial.Therefore, we used a readily available HMP variable to design a scoring model that can identify the highest risk of DGF and provide the guidance and advice for organ allocation and DCD kidney assessment. Methods:From September 1,2012 to August 31,2016,366 qualified kidneys were randomly assigned to the development and validation cohorts in a 2:1 distribution.The HMP variables of the development cohort served as candidate univariate predictors for DGF.The independent predictors of DGF were identified by multivariate logistic regression analysis with a P <0.05.According to the odds ratios (ORs)value,each HMP variable was assigned a weighted integer,and the sum of the integers indicated the total risk score for each kidney.The validation cohort was used to verify the accuracy and reliability of the scoring model. Results:HMP duration (OR =1.165,95% confidence interval [CI]:1.008-1.360,P =0.043),resistance (OR =2.190,95% CI:1.032-10.20,P <0.001),and flow rate (OR =0.931,95%CI:0.894-0.967,P =0.011)were the independent predictors of identified DGF.The HMP predictive score ranged from 0 to 14,and there was a clear increase in the incidence of DGF,from the low predictive score group to the very high predictive score group.We formed four increasingly serious risk categories (scores 0-3,4-7,8-11,and 12-14) according to the frequency associated with the different risk scores of DGF.The HMP predictive score indicates good discriminative power with a c-statistic of 0.706 in the validation cohort,and it had significantly better prediction value for DGF compared to both terminal flow (P =0.012)and resistance (P =0.006). Conclusion:The HMP predictive score is a good noninvasive tool for assessing the quality of DCD kidneys,and it is potentially useful for physicians in making optimal decisions about the organs donated.展开更多
Objective: To explore the effects of cytomegalovirus (CMV) infection on rejection-related gene expression in the endothelial cells of renal transplantation recipients. Methods: Endothelial cells (ECs) were cultured an...Objective: To explore the effects of cytomegalovirus (CMV) infection on rejection-related gene expression in the endothelial cells of renal transplantation recipients. Methods: Endothelial cells (ECs) were cultured and stimulated by a variety of factors: A,normal control group; B,inactivated human cytomegalovirus (HCMV) infection group; C,HCMV infection group; D,HCMV supernatant infection group; and E,ganciclovir HCMV group. Expression of intercellular adhesion molecule-1 (ICAM-1) and major histocompability complex (MHC) class I and class II antigens was detected by flow cytometry (FCM) and immunohistochemistry. Results: We found characteristic CMV-infected ECs in this study. There were no significant differences among groups A,B and D (P>0.05). Although the expression levels of ICAM-1 were not significantly different between groups C and E (P>0.05),the ICAM-1 expression in these two groups was significantly higher than that in group A (P<0.05). ICAM-1 expression was detected in groups C and E,while there was no expression in groups A,B and D. Furthermore,there was no significant difference of ICAM-1 mRNA expression between groups C and E (P>0.05). Human leucocyte antigen (HLA)-ABC expression was detected in all the groups,while HLA-DR expression was only detected in groups C and E. There were no significant differences of HLA-ABC and HLA-DR expression among groups A,B and D (P>0.05). However,the HLA-ABC and HLA-DR expression levels in groups C and D were higher than those of the remaining groups previously reported (P<0.05). Meanwhile,the HLA-ABC and HLA-DR expression levels in group E were lower than those of group C (P<0.05). Conclusion: CMV could up-regulate the expression levels of ICAM-1 and MHC antigens,which was closely related to allograft rejection.展开更多
Background:The complement system plays an important role in the immune response to transplantation,and the diagnostic significance of peritubular capillary(PTC)C4d deposition(C4d+)in grafts is controversial.The study ...Background:The complement system plays an important role in the immune response to transplantation,and the diagnostic significance of peritubular capillary(PTC)C4d deposition(C4d+)in grafts is controversial.The study aimed to fully investigate the risk factors for PTC C4d+and analyze its significance in biopsy pathology of kidney transplantation.Methods:This retrospective study included 124 cases of kidney transplant with graft biopsy and donor-specific antibody(DSA)testing from January 2017 to December 2019 in a single center.The effects of recipient pathological indicators,eplet mismatch(MM),and DSAs on PTC C4d+were examined using univariate and multivariate logistic regression analyses.Results:In total,35/124(28%)were PTC C4d+,including 21 with antibody-mediated rejection(AMR),eight with renal tubular injury,three with T cell-mediated rejection,one with glomerular disease,and two others.Univariate analysis revealed that DSAs(P<0.001),glomerulitis(P<0.001),peritubular capillaritis(P<0.001),and human leukocyte antigen(HLA)B eplet MM(P=0.010)were the influencing factors of PTC C4d+.According to multivariate analysis,DSAs(odds ratio[OR]:9.608,95%confidence interval[CI]:2.742–33.668,P<0.001),glomerulitis(OR:3.581,95%CI:1.246–10.289,P=0.018),and HLA B eplet MM(OR:1.166,95%CI:1.005–1.353,P=0.042)were the independent risk factors for PTC C4d+.In receiver operating characteristic curve analysis,the area under the curve was increased to 0.831 for predicting PTC C4d+when considering glomerulitis,DSAs,and HLA B eplet MM.The proportions of HLA I DSAs and PTC C4d+in active antibody-mediated rejection were 12/17 and 15/17,respectively;the proportions of HLA class II DSAs and PTC C4d+in chronic AMR were 8/12 and 7/12,respectively.Furthermore,the higher the PTC C4d+score was,the more serious the urinary occult blood and proteinuria of recipients at the time of biopsy.Conclusions:PTC C4d+was mainly observed in AMR cases.DSAs,glomerulitis,and HLA B eplet MM are the independent risk factors for PTC C4d+.展开更多
文摘Objective: To investigate the therapeutic effect of Yuchang suppository on experimental ulcerative colitis rats and the effect of PPARγ/NF-KB signaling pathway. Methods: The UC rat model was replicated by 2.4.6-trinitrobenzenesulfonic acid (TNBS)/ethanol method and randomly divided into normal control group, model group, high-dose group of Yuchang suppository, middle dose group , Low-dose group and sulfasalazine group, 8 rats in each group. After 14 days of treatment, the general condition of the rats was observed and the disease activity index was scored. The changes of serum TNF-α, IL-1β and IL-6 levels were detected by ELISA. The colonic mucosal injury index (CMDI) score and colon were observed by colon specimens. Histopathological changes;RT-PCR and Western blot were used to detect the expression of PPARγ and NF-KB genes and proteins in colon tissue. Results: Compared with the normal control group, the DAI and CMDI scores in the model group and the levels of serum TNF-α, IL-1β, IL-6, NF-κB p65 mRNA and protein in colon tissue were significantly increased, PPAR. - γ mRNA and protein expression levels were significantly reduced. The levels of IL-1β, IL-6, TNF-α and the expression of NF-κB p65 mRNA and protein in colon tissue were lower than those in the model group, and the expression levels of PPARγ mRNA and protein were high. In the model group. In the improvement of NF-κBp65 and PPAR-γ gene and protein expression in rat colonic mucosa, the high-dose group and the middle-dose group were significantly better than the low-dose group. Conclusion:Yuchang suppository can significantly improve the symptoms and histopathology of UC model rats. The mechanism may be through activation of PPARγ, blocking the activation of NF-κB signaling pathway, and down-regulating inflammatory factors such as TNF-α and IL-1β. The expression is such that the inflammatory response is alleviated or eliminated, thereby achieving the therapeutic effect of UC.
基金Wuhan municipal health and family planning research fund (WZ14A02)
文摘Objective: To explore a simple, economical and feasible method for establishing type 2 diabetes mellitus and its complication model. Method: SD rats were randomly divided into two groups: normal group (15 rats) normal diet, model group (20 rats) with high glucose and high fat diet. After 2 weeks of feeding, model group was injected low dose(30mg/Kg) streptozotocin in the abdominal cavity, once a day for 6 days, normal group was injected with the same dose of citric acid buffer. Observe the changes of rat diet, body, hair, spirit, urine volume, and monitor weight, blood glucose. After 6 weeks, fast insulin, blood lipid, serum calcium, phosphorus and other biochemical indexes of rats, after HE staining observe morphologic variations changes of pancreas and kidney using microscope, and the changes of femoral bone in SD rats. Results: Compared with the normal group, the model group showed obvious symptoms, drink more, eat more, polyuria, emaciation, hyperglycemia, low calcium, low phosphorus, hyperlipidemia and other metabolic abnormalities, pancreatic atrophy, tissue fibrosis, glomerular area increased, basement membrane thickening, osteoporosis. Conclusion:High glucose and high fat diet combined with repeated intraperitoneal injecti on of low dose STZ can be successfully established the model of type 2 diabetes, and its high successful rate, low mortality rate, relatively simple, economical and feasible, has a certain significance of research on diabetes and its complications.
基金National Natural Science Foundation of China(No.81970668)Shaanxi Science and Technology Planning Project(No.2019JM-116)。
文摘Objective:To study the effect of mechanism of high glucose on apoptosis and cell cycle arrest of isletβcells via p27 pathway.Methods:Islet INS-1 cells were cultured and divided into groups.The control group was treated with ordinary medium,the high glucose group was treated with high glucose medium containing 25mmol/L glucose,the high glucose+si-NC group was treated with high glucose medium and transfected with NC siRNA,and the high glucose+si-P27 group was treated with high glucose medium and transfected with p27 siRNA.After 24 hours treatment,MTS assay was used to detect the cell viability A490,TUNEL assay was used to detect apoptosis rate,flow cytometry was used to detect the cell cycle distribution and western blot was used to detect the expression levels of P27,caspase-8 and cyclinD1.Results:Compared with those in the control group,the A490,the ratio of S phase and G2/M phase as well as the expression level of CyclinD1 decreased,while the apoptosis rate,the ratio of G0/G1 phase as well as the expression levels of P27 and caspase-8 increased in the high glucose group(P<0.05);compared with those in the high glucose group,the A490,cell cycle as well as the expression levels of P27,caspase-8 and cyclinD1 were not different from those in the high glucose+si-NC group(P>0.05);compared with those in the high glucose group and high glucose+si-NC group,the A490,the ratio of S phase and G2/M phase as well as the expression levels of cyclinD1 increased,while the apoptosis rate,the ratio of G0/G1 phase as well as the expression levels of p27 and caspase-8 decreased in the high glucose+si-P27 group(P<0.05).Conclusion:The apoptosis and cell cycle arrest induced by high glucose are related to P27 pathway activation.
基金grants from the Fundamental Research Funds for the Central Universities (No.xjj2018091)Major Clinical Research Projects of the First Affiliated Hospital of Xi'an Jiaotong University (No.XJTU 1AF-CRF-2015-005)+1 种基金Scientific and Technological Breakthrough in Social Development of Shaanxi Province (No.2016SF-246)National Natural Science Foundation of China (No.81670681and 81760137).
文摘Background:Vascular resistance and flow rate during hypotherrnic machine perfusion (HMP)of kidneys is correlated with graft function. We aimed to determine the effects of increasing HMP pressure versus maintaining the initial pressure on kidney transplantation outcomes. Methods:We retrospectively reviewed the data of 76 primary transplantation patients who received HMP-preserved kidneys from 48 donors after cardiac death between September 1,2013,and August 31,2015.HMP pressure was increased from 30 to 40mmHg (1mmHg =0.133kPa)in kidneys with poor flow and/or vascular resistance (increased pressure [IP]group;36 patients);otherwise,the initial pressure was maintained (constant pressure group;40 patients).Finally,the clinical characteristics and transplantation outcomes in both groups were assessed. Results:Delayed graft function (DGF)incidence,1-year allograft,patient survival,kidney function recovery time,and serum creatinine level on day 30 were similar in both groups,with improved flow and resistance in the IP group.Among patients with DGF,kidney function recovery time and DGF duration were ameliorated in the IP group.Multivariate logistic regression analysis revealed that donor hypertension (odds ratio [OR]:1.43,95%confidence interval [CI]:1.02-2.06,P =0.035),donor terminal serum creatinine (OR:1.27,95%C7:1.06-1.62,P =0.023),warm ischemic time (OR:3.45,95%CI:1.97-6.37,P =0.002),and terminal resistance (OR:3.12,95%CI:1.76-6.09,P =0.012)were independent predictors of DGF.Cox proportional hazards analysis showed that terminal resistance (hazard ratio:2.06,95%C1:1.32-5.16,P =0.032)significantly affected graft survival. Conclusion:Increased HMP pressure improves graft perfusion but does not affect DGF incidence or 1-year graft survival.
基金grants from the Fundamental Research Funds for the Central Universities (No.xjj2018091)Major Clinical Research Projects of the First Affiliated Hospital of Xi'an Jiaotong University (No.XJTU1 AF-CRF-2015-005)+1 种基金Scientific and Technological Breakthrough in Social Development of Shaanxi Province (No.2016SF-246) National Natural Science Foundation of China (No.81670681 and 81760137).
文摘Background:Hypothermic machine perfusion (HMP)is being used more often in cardiac death kidney transplantation;however,the significance of assessing organ quality and predicting delayed graft function (DGF)by HMP parameters is still controversial.Therefore, we used a readily available HMP variable to design a scoring model that can identify the highest risk of DGF and provide the guidance and advice for organ allocation and DCD kidney assessment. Methods:From September 1,2012 to August 31,2016,366 qualified kidneys were randomly assigned to the development and validation cohorts in a 2:1 distribution.The HMP variables of the development cohort served as candidate univariate predictors for DGF.The independent predictors of DGF were identified by multivariate logistic regression analysis with a P <0.05.According to the odds ratios (ORs)value,each HMP variable was assigned a weighted integer,and the sum of the integers indicated the total risk score for each kidney.The validation cohort was used to verify the accuracy and reliability of the scoring model. Results:HMP duration (OR =1.165,95% confidence interval [CI]:1.008-1.360,P =0.043),resistance (OR =2.190,95% CI:1.032-10.20,P <0.001),and flow rate (OR =0.931,95%CI:0.894-0.967,P =0.011)were the independent predictors of identified DGF.The HMP predictive score ranged from 0 to 14,and there was a clear increase in the incidence of DGF,from the low predictive score group to the very high predictive score group.We formed four increasingly serious risk categories (scores 0-3,4-7,8-11,and 12-14) according to the frequency associated with the different risk scores of DGF.The HMP predictive score indicates good discriminative power with a c-statistic of 0.706 in the validation cohort,and it had significantly better prediction value for DGF compared to both terminal flow (P =0.012)and resistance (P =0.006). Conclusion:The HMP predictive score is a good noninvasive tool for assessing the quality of DCD kidneys,and it is potentially useful for physicians in making optimal decisions about the organs donated.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 81670681） and major clinical research projects of the First Affiliated Hospital of Xi＇an Jiao Tong University （No. XJTU 1AF-CRF-2015-005）.
基金This work was supported by grants from the major clinical research projects of the First Affiliated Hospital of Xi＇an Jiaotong University （No. XJTU 1AF-CRF-2015-005） and the National Natural Science Foundation of China （No. 81670681）.
基金Project supported by the National Natural Science Foundation of China (No. 30772096)the Clinical Key Disciplines of National Public Health Department, the Major Scientific and Technological Special Projects of Shannxi Province (No. 2007ZDKG-67)the Natural Science Foundation of Shaanxi Province (No. 30571799), China
文摘Objective: To explore the effects of cytomegalovirus (CMV) infection on rejection-related gene expression in the endothelial cells of renal transplantation recipients. Methods: Endothelial cells (ECs) were cultured and stimulated by a variety of factors: A,normal control group; B,inactivated human cytomegalovirus (HCMV) infection group; C,HCMV infection group; D,HCMV supernatant infection group; and E,ganciclovir HCMV group. Expression of intercellular adhesion molecule-1 (ICAM-1) and major histocompability complex (MHC) class I and class II antigens was detected by flow cytometry (FCM) and immunohistochemistry. Results: We found characteristic CMV-infected ECs in this study. There were no significant differences among groups A,B and D (P>0.05). Although the expression levels of ICAM-1 were not significantly different between groups C and E (P>0.05),the ICAM-1 expression in these two groups was significantly higher than that in group A (P<0.05). ICAM-1 expression was detected in groups C and E,while there was no expression in groups A,B and D. Furthermore,there was no significant difference of ICAM-1 mRNA expression between groups C and E (P>0.05). Human leucocyte antigen (HLA)-ABC expression was detected in all the groups,while HLA-DR expression was only detected in groups C and E. There were no significant differences of HLA-ABC and HLA-DR expression among groups A,B and D (P>0.05). However,the HLA-ABC and HLA-DR expression levels in groups C and D were higher than those of the remaining groups previously reported (P<0.05). Meanwhile,the HLA-ABC and HLA-DR expression levels in group E were lower than those of group C (P<0.05). Conclusion: CMV could up-regulate the expression levels of ICAM-1 and MHC antigens,which was closely related to allograft rejection.
基金the Clinical Research Award of the First Affiliated Hospital of Xi’an Jiaotong University,China(No.XJTU1AF-CRF-2018-026)the Natural Science Foundation of China(No.82070768).
文摘Background:The complement system plays an important role in the immune response to transplantation,and the diagnostic significance of peritubular capillary(PTC)C4d deposition(C4d+)in grafts is controversial.The study aimed to fully investigate the risk factors for PTC C4d+and analyze its significance in biopsy pathology of kidney transplantation.Methods:This retrospective study included 124 cases of kidney transplant with graft biopsy and donor-specific antibody(DSA)testing from January 2017 to December 2019 in a single center.The effects of recipient pathological indicators,eplet mismatch(MM),and DSAs on PTC C4d+were examined using univariate and multivariate logistic regression analyses.Results:In total,35/124(28%)were PTC C4d+,including 21 with antibody-mediated rejection(AMR),eight with renal tubular injury,three with T cell-mediated rejection,one with glomerular disease,and two others.Univariate analysis revealed that DSAs(P<0.001),glomerulitis(P<0.001),peritubular capillaritis(P<0.001),and human leukocyte antigen(HLA)B eplet MM(P=0.010)were the influencing factors of PTC C4d+.According to multivariate analysis,DSAs(odds ratio[OR]:9.608,95%confidence interval[CI]:2.742–33.668,P<0.001),glomerulitis(OR:3.581,95%CI:1.246–10.289,P=0.018),and HLA B eplet MM(OR:1.166,95%CI:1.005–1.353,P=0.042)were the independent risk factors for PTC C4d+.In receiver operating characteristic curve analysis,the area under the curve was increased to 0.831 for predicting PTC C4d+when considering glomerulitis,DSAs,and HLA B eplet MM.The proportions of HLA I DSAs and PTC C4d+in active antibody-mediated rejection were 12/17 and 15/17,respectively;the proportions of HLA class II DSAs and PTC C4d+in chronic AMR were 8/12 and 7/12,respectively.Furthermore,the higher the PTC C4d+score was,the more serious the urinary occult blood and proteinuria of recipients at the time of biopsy.Conclusions:PTC C4d+was mainly observed in AMR cases.DSAs,glomerulitis,and HLA B eplet MM are the independent risk factors for PTC C4d+.
