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OBJECTIVE@#To explore the clinical characteristics and genetic basis for a child with X-linked lissencephaly with abnormal genitalia (XLAG).@*METHODS@#A child with XLAG who had presented at the Third Affiliated Hospital of Zhengzhou University in May 2021 was selected as the study subject. Peripheral blood samples of the child and his parents were collected and subjected to high-throughput sequencing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the result was analyzed by using bioinformatic software.@*RESULTS@#The child was found to have harbored a hemizygous c.945_948del variant in exon 2 of the ARX gene, which as a frameshifting variant has resulted in a truncated protein. His mother was found to be heterozygous for the variant, whilst his father was of wild type. The variant was unreported previously.@*CONCLUSION@#The hemizygous c.945_948del variant of the ARX gene probably underlay the XLAG in this patient. Above finding has provided a basis for the diagnosis and genetic counseling for this family.
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Humanos , Niño , Lisencefalias Clásicas y Heterotopias Subcorticales en Banda , Exones , Biología Computacional , Asesoramiento Genético , Genitales , Factores de Transcripción , Proteínas de HomeodominioRESUMEN
Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.
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Objective:To summarize the clinical manifestations of a case of combined oxidative phosphorylation deficiency 28 (COXPD-28) caused by the mutations of the SLC25A26 gene, thus providing references for the diagnosis and genetic counseling of the disease. Methods:Clinical data of a case of COXPD-28 treated in the Third Affiliated Hospital of Zhengzhou University in October 2020 were retrospectively analyzed.In addition, The retrieval words " Combined oxidative phosphorylation deficiency 28, SLC25A26 gene" were used to search domestic and foreign databases.The clinical characteristics of combined phosphorylation deficiency 28 and the variation characteristics of SLC25A26 gene were summarized. Results:(1) A female patient full-term delivered after 30 min presented with groaning breath was admitted.Her main manifestations included pale complexion, groaning breathing, metabolic acidosis, and high lactate and pyruvate levels.Symptomatic support treatment like anti-infection and assisted ventilation were given, but her condition gradually worsened and died of respiratory and circulatory failure on the day of admission.The child was compound heterozygous mutation of SLC25A26 gene, the terminating mutation of exon 5 c. 403G>T caused the protein change to p. E135, and the non-synonymous mutation of exon 4 c. 212A>G caused the protein change to p. Y71C.(2) A total of 3 cases of COXPD-28 were searched in online databases, and no cases were reported in China.Through literature review, clinical features of COXPD-28 mainly included respiratory and circulatory fai-lure, elevations of lactate and pyruvate, and reductions of complexes Ⅰ, Ⅲ and Ⅳ in muscle biopsy.Two types of mutations in the SLC25A26 gene were detected, including 3 cases of missense mutations and 1 case of splicing mutation. Conclusions:COXPD-28 is an autosomal recessive genetic disease involving multiple systems and mitochondrial dysfunction.Mutations in the SLC25A26 gene is the pathological cause of COXPD-28.
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Objective:To study the clinical features, diagnosis and treatment of Bacillus cereus sepsis in premature infants.Methods:From February 2011 to February 2021, 10 cases of Bacillus cereus sepsis in premature infants admitted to the Department of Neonatology of our hospital were retrospectively analyzed.Results:The 10 cases of premature infants with Bacillus cereus sepsis included 5 males and 5 females, with gestational age 27 +2~35 +2 weeks, birth weight 940~2 430 g and the age of onset 7~35 days. At the beginning, all the infants showed lethargy and recurrent apnea as the onset symptoms. 8 cases had gray color skin, 7 cases had fever, 7 cases experienced septic shock, 5 cases had neonatal seizures and 4 cases showed abdominal distension. 7 cases were complicated with purulent meningitis and 3 cases with necrotizing enterocolitis. 9 cases had significantly decreased white blood cells and platelets and significantly increased C-reactive protein and procalcitonin at the onset. Among the 7 cases of purulent meningitis, 5 cases had multiple encephalomalacia. During follow-up of all the infants, 4 cases died, 3 cases cured and 3 cases survived with severe neurological sequelae. Conclusions:Bacillus cereus sepsis is a serious infectious disease for premature infants with acute onset, rapid progress and high mortality. Complication of purulent meningitis and serious neurological sequelae are common.
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Objective:To compare the results of three detection methods, single antigen-bead assay(SAB), Luminex screening assay(LMX), and ELISA assay for detecting HLA antibody, and compares the two screening methods, LMX and ELISA with SAB detection as a reference method to provide a reference for organ transplantation laboratories to choose a reasonable HLA antibody test strategy.Methods:A lot of 124 consecutive samples were tested using SAB, ELISA, and LMX methods at the same time, and analyze the differences of these results. SAB testing was used as a reference method to analyze the sensitivity and specificity of the two screening assays. Chi-square analysis was used to compare the two methods, and P<0.05 was considered statistically significant. Results:Both ELISA and LMX methods showed low sensitivity of 34.4% and 31.3% for HLA class I, and 29.7% and 51.3% for class Ⅱ. Otherwise, the specificity of the ELISA and LMX method was much higher. For class, I both was 98.9%, and for class Ⅱ were 100% and 91.9% respectively. Out of 124 samples, the number of SAB(+ )ELISA(-)LMX(-) results was 17, and SAB(-)ELISA(+ )LMX(+ ) results was zero indicating that there were considerably screening assays probably with missed detection. In the cases of SAB(+ )ELISA(-)LMX(-), the distribution of MFI value of SAB assay ranges from 750 to 7000.Conclusions:Because the sensitivity of the two screening methods is relatively low, there is a greater risk of missed antibody detection in the scheme of testing for specific antibodies after the screening test is positive. This should be paid attention to, especially for patients with a history of sensitization. For negative screening test results, SAB or other assays should be considered to check the result. It could provide more accurate results when SAB which is recognized as higher sensitivity and specificity is directly used as an initial test. At the same time, the MFI value of the SAB test can serve as an indicator to determine whether to add other assays to check the ASB result.
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Objective To compare the differences of different endovascular treatment strategies for intracranial aneurysms in radiation dose, operation time, and fluoroscopy time. Methods From April 2011 to September 2016, patients with intracranial aneurysm who underwent endovascular treatment in the Department of Neurosurgery, Shangluo Central Hospital were enrolled retrospectively. According to different endovascular treatment strategies, they were divided into exclusive coil embolization (COIL) group, balloon- assisted coiling (BAC) group, stent-assisted coiling (SAC) group, and flow diverting technology (FDT)group. The demographic and aneurysm data were collected, and the related evaluation indicators were tested and compared. Results A total of 119 patients with intracranial aneurysm received endovascular treatment were enrolled, 41 in COLI group, 32 in BAC group, 30 in SAC group, and 16 in FDT group. There were no significant differences in gender, age, and maximum diameter of aneurysms among the 4 groups. There were significant differences in the shape and location of aneurysms (all P < 0. 05 ). The operation time,fluoroscopy time and radiation dose in the SAC group were the longest or largest, and the difference was statistically significant compared with the other 3 groups (all P < 0. 05). However, there were no significant differences among the other 3 groups. Three months of follow-up showed no adverse reactions of skin erythema or hair loss in all patients. Conclusion In various endovascular treatment techniques, SAC has the longest operation time and fluoroscopy time, and the radiation dose is the highest, so attention should be paidto radiation safety when selecting this method.
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Objective To study the relationship of serum 25-hydroxy vitamin D [25-(OH) D] and vitamin D binding protein (DBP) in premature infants with bronchopulmonary dysplasia (BPD) and their clinical significance.Method From March 2017 to September 2018,the premature infants with gestational age (GA)<32 weeks admitted to the neonatal department of our hospital were prospectively studied.All the premature infants were given 800 IU/d vitamin D supplement from one week after birth.Venous blood sample were collected at birth and 28 d after birth to measure 25-(OH) D aud DBP levels.The infants were evaluated for BPD at 28 d after birth and then assigned into the BPD group and the non-BPD group.The differences of 25-(OH) D and DBP levels were compared.Result A total of 170 premature infants (GA<32 weeks) were included,including 56 cases in the BPD group and 114 cases in the non-BPD group.The BPD group had 34 males,the GA was (29.8±1.2) weeks,the birth weight (BW) was (1 198± 157) g.The non-BPD group had 95 males,the GA was (30.2± 1.5) weeks,the BW was (1 243± 146) g.No significant differences existed in GA,BW and male gender proportion between BPD group and non-BPD group (P>0.05).The BPD group had a lower levels of serum 25-(OH) D at birth [(27.8±5.9) nmol/L vs.(30.4±1.1) nmol/L,P<0.05].The levels of serum 25-(OH) D in moderate/severe BPD group were significantly lower than mild BPD group [(25.3±4.9) nmol/L vs.(29.7±5.9) nmol/L,P<0.05];25-(OH) D in BPD group was still lower than the non-BPD group at 28 days after birth (after vitamin D supplement) [(77.5±11.7) nmol/L vs.(83.8±11.6) nmol/L,P<0.05].Comparison of serum DBP levels between the two groups showed that,DBP at 28 d after birth in BPD group were significantly lower than the non-BPD group,and DBP in moderate/severe BPD group were significantly lower than the mild BPD group [(373.9± 19.1) μg/ml vs.(391.4±23.6) μg/ml],the differences were both statistically significant (P<0.05).Multivariate analysis showed that the high serum 25-(OH)D level at birth (OR=0.827,95%CI0.693~0.987) was protective factors for BPD,while neonatal pneumonia (OR=4.331,95%CI 1.269~14.784) and neonatal sepsis (OR=4.020,95%CI 1.153~14.015) were risk factors for BPD.Conclusion The high serum 25-(OH) D level at birth in preterm infants was protective factors for BPD,while neonatal pneumonia and sepsis were the risk factors for BPD.Moreover,low serum 25-(OH) D level at birth and low serum DBP level at 28 d after birth maybe useful indicators for the severity of BPD.
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Nutrition treatment plays an important role in the treatment and follow - up management of pediatric inflammatory bowel disease (IBD). The theory of specific carbohydrate diet(SCD),first presented in 1951,is a strict diet limitation focused on the sorts of carbohydrate:monosaccharide is the only kind of carbohydrate that is permitted, disaccharide and most complex carbohydrate like polysaccharide and starch are eliminated,intake of protein and fat is not limited,and processed meat and other processed food are cut down appropriately. Currently,mechanism of SCD diet′s treatment efficacy on IBD is not elucidated clearly. The hypothesis of this theory is:(1)Bowel inflammation of IBD patients leads to the decline of disaccharidase′s function,thus glucose,galactose and fructose are the only kinds of car-bohydrate that can be absorbed. (2)Occurrence of IBD is related to the disorder of bowel bacteria. The change of diet may regulate the bowel bacteria,which may be helpful to the symptoms of IBD. Retrospective case studies and case re-ports preliminarily indicated the efficacy of SCD in improving pediatric IBD symptoms and maintenance of clinical re-mission. However,high level evidence is still required to support the hypothesis. The limitation of carbohydrate by SCD would be the clue for the diet of pediatric IBD patients. However,the menu should be formulated according to the eating habits and the available food,as well as the requirement of the growth and development in children.
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Objective To study the effect of hydrogen sulfide (H2S) on iNOS/NO in neonatal rats with hyperoxia-induced lung injury.Method Eighty full-term neonatal SD rats were randomly assigned into 4 groups (each group 20 rats including control group,hyperoxia group,NaHS + hyperoxia group,PPG + hyperoxia group.Rats in NaHS + hyperoxia group had 90 μmol/kg NaHS injected intraperitoneally,those in PPG + hyperoxia group had PPG 50 mg/kg injected,and those in the other 2 groups had the same amount of 0.9% normal saline injected.Except for the control group that exposed to air,the other three groups were exposed to 95% O2 for 7 days.Then pulmonary histopathology was studied by HE staining,the ratios of lung wet/dry weight (W/D) were determined as measurement of the severity of pulmonary edema,maleic dialdehyde (MDA),iNOS activity and NO levels in lung tissue were measured using commercial kits,iNOS mRNA expression was detected by Real-time PCR.Analysis of variance and LSD-t test were used for statistical analysis.Result (1) Compared with control group,the hyperoxia group showed erythrocyte extravasation and leukocyte infiltration in the alveoli with inflammatary cell infiltrations,alveolar septum edema,whereas pathological injury changes induced by hyperoxia were alleviated by NaHS and the damage was exacerbated by PPG.(2) In hyperoxia group,H2S was decreased compared with control group (117.6±20.4 μmol/L vs.184.3 ± 13.7 μmol/L).In NaHS + hyperoxia group,H2S was apparently increased compared with the hyperoxia group (247.3 ±32.4 μmol/L vs.117.6 ±20.4 μmol/L),while in PPG + hyperoxia group H2S was decreased compared with the hyperoxia group (89.2 ± 8.3 μmol/L vs.117.6 ±20.4 μmol/L) (P <0.01).(3) In the hyperoxia group,the ratios of lung W/D (5.81 ±0.22),the contents of MDA (1.69 ± 0.14) nmol/ml,iNOS activity (2.24 ± 0.19) U/mg prot,NO levels (22.37 ±3.04) × 10-3 μmol/g prot,iNOS mRNA expression (1.43 ±0.09) showed significant increase respectively (P < 0.01) compared with the control group (5.06 ± 0.15),(0.78 ± 0.08)nmol/ml,(1.18 ± 0.18) U/mg prot,(7.49 ± 1.91) × 10-3 μmol/g prot,(0.90 ± 0.08).NaHS administration showed a significant decrease in lung W/D,lung tissue MDA content,iNOS activity,NO level,iNO SmRNA expression (5.59 ±0.19),(1.44±0.11) nmol/ml,(1.84 ±0.27) U/mg prot,(14.23 ±2.00)× 10-3 μmol/g prot,(1.28 ±0.10) compared with the hyperoxia group (P <0.01).The above markers were significantly increased after PPG administration (6.18 ± 0.26),(1.99 ± 0.19) nmol/ml,(2.66 ± 0.23) U/mgprot,(30.94 ±3.31) × 10-3 μmol/g prot,(1.73 ±0.06) (P <0.01).Conclusion Exogenous H2S can relieve hyperoxia-induced lung injury by down-regulating the expression of iNOS mRNA,decreasing iNOS activity and decreasing NO production.
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Objective@#To identify the epidemiological characteristics of the common diarrhea-related virusesof children under 5 years of age in Chengdu area, and provide the objective evidences for prevention and control of diarrhea.@*Methods@#Fecal specimens collected from children with acute gastroenteritis between March 2006 and June 2015 were sent to Center for Disease Control and Prevention(CDC) of Sichuan province for detection of viral RNA. Clinical data were also documented. Enzyme-linked immunosorbent assay(ELISA) and/or Reverse transcriptase-polymerase chain reaction(RT-PCR) were used to detect and classify rotavirus, human calicivirus, adenovirus and astrovirus.@*Results@#A total of 2 331 fecal specimens from children (1 446 male and 885 female) under 5 were collected. 1 351 were identified as having viral gastroenteritis with the overall positive rate of 58.0%. Children at the age from 7 to 12 months were the susceptible population. Rotavirus was detected in 659 specimens (28.3%) with epidemic time from November to December. Human calicivirus was detected in 542 specimens (23.3%) and September was its epidemic time. Norovirus GII was the main strain of the virus, but no outbreak was observed in our study. Prevalence of rotavirus declined after 2007, while the detection rate of calicivirus was increasing, which led it to be one of the primary pathogens related to viral gastroenteritis in children under 5. Astrovirus was detected in only 35 patients (1.5%) mainly identified from January to March. Adenovirus was detected in 118 patients (5.1%) mainly from May to August with limited epidemic in 2011. Most patients had acute progress(91.2%), none have chronic progress. Mild dehydration was the most common symptom among all the children, followed by moderate dehydration, while none of the patient had severe symptom. Digestive symptoms are usually accompanied by extra-intestinal symptoms in both virus infection. However, extra-intestinal symptoms had higher incidences in rotavirus infection than in calicivirus infection, while the patients with these symptoms recovered during the follow-up period.@*Conclusions@#Virus infection is the common cause of acute gastroenteritis in children under 5. Rotavirus and human calicivirus were the leading pathogens in Chengdu area.
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Objective To study whether amputation of the tail extremity could induce change of Fos protein expression in mice ACC neurons , and explore the role of NK?1 receptor in the change. Methods Immunohistochemistry technique was adopted to study Fos protein expression change in mice ACC neurons at 0.25 h,0.5 h,1 h,2 h after amputation of the tail extremity 2.5 cm,and also the effect of NK?1 receptor antagonist GR82334(iv)or GR82334(ith)in the change. Results Fos protein expression in mice ACC neurons was significantly increased at 0.25 h,0.5 h after the amputation,and reached its peak at 1 h after the amputation,then started to decrease at 2 h after the amputation. GR82334(iv)com?pletely antagonized the significant augment in Fos protein expression in mice ACC neurons after the amputation ,but the antagonism of GR82334 (ith)was incomplete. Conclusion Amputation of the tail extremity could significantly increase the Fos protein expression of mice ACC neurons in a time?dependent manner. Both peripheral and central NK?1 receptors were involved in the process. However ,there are also central conduction pathways of other receptors and neurotransmitters involved in the significant augment in Fos protein expression in mice ACC neurons after amputa?tion.
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Objective To perform a comparative study on membrane electrical properties of visceral and somatic nociceptive neurons of anterior cin?gulate gyrus(ACG)in cats,so as to provide the experimental basis for elucidating the mechanism of differences in perceptual qualities between vis?ceral pain and somatic pain from the membrane electrical aspects. Methods A total of 77 adult cats,female or male,weighting 2.0 to 3.5 kg were selected for the study. According to the properties of the greater splanchnic nerve(GSN)or saphenous nerve(SN)evoked responses of neurons in ACG and effect of morphine on the evoked responses,visceral nociceptive neurons(VNNs)having the long latency(≥50 ms)GSN evoked re?sponses or somatic nociceptive neurons(SNNs)having the long latency(≥50 ms)SN evoked responses were detected. With a glass microelectrode in vivo,a series of polarizing current of different intensity from-5 nA to+5 nA with a 50 ms duration were injected to these neurons in ACG,and the membrane electrical responses of these neurons were recorded. Finally,the membrane electrical parameters of these neurons were calculated. Re?sults Totally 254 VNNs and 172 SNNs were recorded in ACG. GSN evoked response threshold of VNNs were higher than SN evoked response threshold of SNNs. Compared with SNNs,the membrane resistance,the membrane capacity and the time constant of VNNs were larger. Conclusion Our data proved that there are some differences in the membrane electrical properties between VNNs and SNNs in ACG,which might be the mem?brane electrical basis for differences in perceptual qualities between visceral pain and somatic pain.
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Objective To explore the effects of hydrogen sulfide (H2S) on hyperoxia-induced lung injury in neonatal rats.Methods Eighty full-term Sprague-Dawley rats within 12 hours after birth were randomly divided into control group,hyperoxia group,sodium hydrosulfide (NaHS) + hyperoxia group (NaHS 90 μmol/kg injected intraperitoneally) and propargylglycine (PPG) +hyperoxia group (PPG 50 mg/kg injected intraperitoneally).Except for the control group,the other three groups were exposed to 95% O2 for seven days.Pulmonary histopathology was observed after HE staining,numeration of leukocyte and albumin in bronchoalveolar lavage fluid (BALF) were processed by optical microscope and Lowry methods.The plasma H2S concentration,activity of cystathionine-γ-lyase (CSE) and contents of malondialdehyde (MDA) in lung tissues were also detected.Analysis of variance and LSD-t test were used for statistics.Results (1) Compared with the control group,alveolar hemorrhage,interstitial edema,inflammatory cell infiltration were observed in the hyperoxia group.The number of white blood cells,neutrophils and albumin content in BALF increased in the hyperoxia group [(130.2± 15.3) × 107/L vs (15.1 ±2.5) × 107/L; (64.6± 12.4) × 107/L vs (2.1 ±0.5) × 107/L; (934.6± 106.4) mg/L vs (254.3±50.7) mg/L,respectively.LSD-t=-14.65,5.78 and 2.97,all P<0.01],but the plasma H2S concentration and the activity of CSE in lung tissue decreased [(112.6± 20.4) μmol/Lvs (182.3±15.7) μ mol/L,LSD-t=-9.90; (3.4±0.4) μmol/ (min·g) vs (6.8± 1.4) μ mol/ (min · g),LSD-t=-4.59; both P<0.01].However,the contents of MDA increased [(1.7± 0.3) nmol/ml vs (0.9±0.1) nmol/ml,LSD-t=3.03,P<0.01].(2) Compared with the hyperoxia group,inflammatory exudation and structural disorder of lung tissue were alleviated in the NaHS+hyperoxia group.White blood cells [(56.3± 11.6) × 107/L],neutrophils [(34.8±7.8) × 107/L] and albumin content [(753.8± 89.6) mg/L] in BALF decreased significantly (LSD-t=-9.66,-11.81 and-5.78,P<0.01).The plasma H2S concentration [(235.7±32.7) μ mol/L] and the activity ofCSE [(5.8± 1.1) μ mol/(min · g)] increased significantly (LSD-t=11.34 and 5.98,P<0.01) in the NaHS+hyperoxia group.(3) Compared with the hyperoxia group,inflammatory exudation and structural disorder of lung tissue were more severe in PPG+ hyperoxia group.White blood cells,neutrophils and albumin content in BALF increased significantly (LSD-t=5.52,6.37 and 8.23,P<0.01),the plasma H2S concentration and the activity of CSE decreased (LSD-t=-4.29 and-3.97,P<0.01),the contents of MDA increased (LSD-t=3.02,P<0.01).Conclusions H2S is involved in the pathophysiological process of hyperoxia-induced lung injury in neonatal rats.Exogenous H2S can alleviate the pulmonary injury by inhibiting inflammatory reaction and oxidative stress.
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Objective To study the role of anti-HLA-IgG antibodies levels in serum before renal transplantation.Methods Anti-HLA-IgG antibodies levels were detected by means of ELISA-LATM in 184 patients before renal transplantation from Jan. 1999 to Dec 2002. Acute rejection occurrence was compared between anti-HLA-IgG class-Ⅰantibody positive group and anti-HLA-IgG class-Ⅱantibody positive group, and between both class-Ⅰand class-Ⅱantibody positive groups and anti-HLA-IgG antibody negative group, respectively. Results In the 155, 7, 9 and 13 cases respectively negative for Anti-HLA-IgG antibodies, positive for anti-HLA-IgG class-Ⅰantibodies, anti-HLA-IgG class-Ⅱantibodies and both class-Ⅰand class-Ⅱantibodies, there were 18, 2, 4, 8 cases of acute rejection with the occurrence rate being 11.6?% , 28.57?% , 44.44?% , 61.53?% , respectively ( P