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It is difficult to insert long-term dialysis catheters after severe stenosis or occlusion of the internal jugular vein and innominate vein. We used REcanalisation and balloon-oriented puncture for Re-insertion of dialysis catheter in nonpatent central veins (REBORN) in seven patients with severe central venous lesions, and all patients were inserted with long-term dialysis catheters successfully. None had severe complications such as pneumothorax, hemothorax, or pulmonary embolism during operation. All catheters functioned well after postoperative follow-up of 2 months. REBORN provides a novel approach to establish difficult dialysis pathways.
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Objective To discuss the differences of immunofluorescence pathological test results in four types of syndromes for lupus nephritis(LN) patients. Methods A retrospective study was carried out in 116 LN patients who had performed renal biopsy. The patients were differentiated into four syndrome patterns of excessive heat-toxicity, liver-kidney yin deficiency, qi-yin deficiency, and spleen-kidney deficiency. The results of immunofluorescence pathological tests were recorded for the analysis of the differences among the four patterns. Results (1)Of 116 LN patients, 59 were classified into spleen-kidney deficiency, 30 into excessive heat-toxicity, 14 into liver-kidney yin deficiency, and 13 into qi-yin deficiency. (2)The positive expression rate of IgA, IgG, IgM, C3, and Fi fluorescen ce antibody differed in the 4 syndrome patterns of LN patients(P0.05). Conclusion The immune complex deposition in LN patients is dominated by IgA and C3 antibodies deposition, and the“full-house” immunofluorescence staining is commonly seen in the syndrome of excessive heat-toxin type. But the results of immunofluorescence pathological tests can not be used as the evidence to tell the differences in the 4 syndrome patterns of LN patients.
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Objective To observe the effect of tanshinone ⅡA on renal transforming growth factor beta 1 (TGF-β1) and nuclear factor-kappa B (NF-κB) p65 mRNA and protein expression in diabetic nephropathy (DN) rats, thus to evaluate the therapeutic effect and mechanism of tanshinone ⅡA. Methods SD rats were used as the experimental animal. DN rat model was induced with 40 mg/kg of streptozocin ( STZ) . The rats were randomized into normal group, model group, and tanshinone ⅡA ( 10 mg·kg -1·d -1, im) group. On the experimental day 30, we examined the body weight, water in-take volume, 24-hour urine protein, fasting glucose ( Glu) , serum creatinine ( Cr) , blood urea nitrogen ( BUN) , total protein ( TP) and albumin ( Alb). Renal slices after periodic acid Schiff staining ( PAS) were used for the observation of renal pathology. Semi-quantitative reverse transcription polymerase chain reaction ( RT-PCR) was used for the detection of renal TGF-β1 and NF-κB p65 mRNA expression, and Western blotting method was used for the measurement of TGF-β1 and NF-κB p65 protein expression in rats of different groups. Results Compared with the normal group, body weight was decreased, water in-take volume and 24-hour urine protein were increased, serum Glu, Cr, and BUN levels were elevated, TP and Alb levels were decreased, renal pathological damage occurred, and renal TGF-β1 and NF-κB p65 mRNA and protein expressin were promoted in the model group (P<0.05 or P<0.01). Tanshinone ⅡA group had an effect on decreasing water in-take volume, 24-hour urine protein, serum levels of Glu, Cr and Bun, increasing TP and Alb levels, relieving renal pathological damage, and reducing the protein and mRNA expression of renal TGF-β1 and NF-κB p65 ( P<0.05 or P<0.01 compared with the model group). Conclusion Tanshinone ⅡA has protective effect on kidney probably through inhibiting renal TGF-β1 and NF-κB p65 expression in DN rats.
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Objective To screen the sensitive plasma molecular markers in diabetic nephropathy ( DN) patients with kidney yang deficiency. Methods Two-dimensional fluorescence difference gel electrophoresis (2-D DIGE) was used to analyze the plasma which was sampled from 4 early DN patients with kidney yang deficiency and 4 healthy adult volunteers. Proteins that showed differential expression with an over 1.5-fold change were analyzed by MALDI-TOF/TOF mass spectrometry. Results Two-dimensional electrophoresis (2-DE) maps of plasma proteins in DN patients with kidney yang deficiency and healthy adults were established successfully. We validated 9 differentially expressed proteins, including complements C3 and C4, apolipoprotein E and ubiquitination factor. Conclusion Proteomic analysis by 2-D DIGE can objectively reveal the differences of plasma protein expression in DN patents with kidney yang deficiency and healthy adult volunteers. The obtained 9 proteins have potential to provide plasma molecular markers for the early clinical diagnosis and for the research of traditional Chinese medical patterns of DN.
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Objective To explore the sensitive blood plasma molecular markers in diabetic nephropathy (DN) .Methods Two-di-mensional fluorescence difference gel electrophoresis (2D-DIGE) was used to analyze early DN patients plasma (n=8) and normal plasma ,proteins that showed differential expression of a 1 .5 fold change were analyzed by MALDI-TOF/TOF mass spectrometry . Results 2D-DIGE maps of plasma proteins in patients with DN and normal plasma were established successfully .We validated 13 differentially expressed proteins detected by 2D-DIGE ,including complement component C3、complement component C4、apolipopro-tein E ,etc .Conclusion Proteomic analysis can objectively revealed the differences of protein expression between the two kinds of blood plasma .The 13 proteins might be the potential plasma molecular markers for the clinical diagnosis of diabetic nephropathy .
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Objective To observe the effect of human serum containing Niaoduqing Capsule(NC)on proliferation and transdifferentiation of human renal tubular epithelial cells(HK-2).Methods The in-vitro cultured HK-2 were divided into 6 groups according to the culture media: normal control group,uremic serum groups(at the concentration of 5% and 10%), NC-containing serum groups(at the concentration of 5% and 10%),and Monopril group(at the concentration of 10-6mmol/L).Cell proliferation was measured by methylene blue assay.Cell life cycle and the percentage of cells with ?-smooth muscle actin(?-SMA)expression positive in every group were evaluated by flow cytometry.Results The optical absorption value in uremic serum groups was higher than that in the normal control group(P
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Objective To observe the effect of Niaodu Qing Capsule(NQC) and its separated prescriptions on renal transforming growth factor ?1(TGF-?1)mRNA expression in rats with chronic renal failure(CRF).Methods SD rat models of CRF were induced by 5/6 nephrectomy,and then the CRF rats were randomized into model group,Huangqi(Radix Astragali,1.5 g?kg-1?d-1) group,Danshen(Radix Salviae Miltiorrhizae,1 g?kg-1?d-1) group,Dahuang(Radix et Rhizoma Rhei,1 g?kg-1?d-1) group,Huangqi Danshen Dahuang(1 g?kg-1?d-1) group,NQC group(1 g?kg-1?d-1).Except the model group,the rats in other groups received gastric gavage of corresponding medicine according to the experimental design.After treatment for six weeks,the levels of blood urea nitrogen(BUN) and serum creatinine(SCr) were detected,and the expression level of renal TGF-?1 mRNA was examined by reverse transcription polymerase chain reaction(RT-PCR).Results The levels of BUN and SCr were decreased in the medicated groups(P
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[Objective] To observe the effect of Xiangdan injection with the actions of activating blood and removing stasis for the treatment of acute tubular necrosis (ATN) after kidney transplantation. [Methods] Twenty-six patients with ATN after kidney transplantation were randomized into groups A and B. The two groups were treated with triple immuno-suppressive agents of cyclosporin A, prednisone and mycophenolic acid, with medicines for protecting liver function and gastric mucosa, and with preventive measures from infection. Additionally, group A (n = 16) was treated with Xiangdan injection, while group B ( n = 10) was not. After treatment, time for hemodialysis, renal function and renal flow resistance index of the transplanted kidney were compared between the two groups after the occurrence of ATN. [Results] Compared with group B, time for hemodialysis was shortened, the decrease of serum creatine (SCr) in the transplanted kidney quickened, and renal flow resistance index (RI) of the transplanted kidney decreased (P 0.05). [Conclusion] Xiangdan injection with the actions of activating blood and removing stasis can promote the early recovery of ATN after kidney transplantation.
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【Objective】To explore the therapeutic effect of TCM syndrome differentiation and treatment for immunoglobulin A(IgA) nephropathy.【Methods】The selected 123 patients with IgA nephropathy were divided into two groups(in the proportion of 3∶1) by number randomization.Group A(n=86) was given Tripterygium Glycosides tablets and differential treatment according to syndrome patterns,and Group B(n=37) was given routine western medicine including anti-inflammation drugs,drugs for controlling blood pressure and glucocorticoid hormone.The two groups received a 3-month treatment course and received one more course according to individual cases.The total therapeutic effect,effect for TCM syndrome patterns,and toxic and side effects were observed.The changes of TCM syndrome scoring were compared before and after treatment.【Results】In group A,symptoms were completely relieved in 29,markedly relieved in 30,relieved in 15 and un-relieved in 12 patients,the total effective rate being 86.05%,while respectively in 4,5,10 and 18 of patients in group B,the total effective rate being 51.35%.The total effect was better in group A than that in group B(P0.05).The improvement on TCM syndrome scoring in group A was superior to that in group B(P
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To explore the synergistic action of Kangshen Tablet (KT), which has the functions of nourishing kidney, invigorating spleen, eliminating stasis and turbidity, in maintenance hemodialysis for chronic renal failure (CRF).Eighty cases of CRF were randomly allocated to Group A (maintenance hemodialysis alone) and Group B (KT combined with maintenance hemodialysis).Serum creatine (SCr) and blood urea nitrogen (BUN) levels, average times of hemodialysis per week, adequacy of hemodialysis, nutrition status, cellular immune function, survival rate and serum electrolyte levels were observed.After treatment, SCr and BUN levels were decreased, average times of hemodialysis per week reduced, adequacy of hemodialysis raised, nutrition status improved, cellular immune function promoted, survival rate increased and hyperphospheremia decreased in Group B (P
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【Objective】To explore the relationship of pathological changes,clinical manifestations and results of laboratory examination with TCM syndromes in patients with IgA nephropathy.【Methods】With parameters in Memphis renal biopsy accessing system and principle syndromes and complicated syndromes in differentiation criteria of chronic nephritis as reference,pathological changes and clinical manifestations of IgA nephropathy were classified by principle component analysis and factor analysis.The regression equations of different syndromes were established after a regression analysis of the principle components of pathological changes and clinical manifestations with the standard syndromes.【Results】(1)With the parameters in Memphis renal biopsy accessing system as reference,the principle components(reflecting over 85% information of glomerular changes)of pathological changes in 123 IgA nephropathy patients were glomerulosclerosis,crescent,stroma,immunofluorescence IgA and complement 3(C_3).With principle syndromes and complicated syndromes in differentiation criteria of chronic nephritis as reference,the principle components(reflecting over 90% information of syndrome manifestations)were lassitude and weakness for deficiency syndrome,cold limbs,white tongue and slippery fur and deep-thready pulse for yang-deficiency syndrome,and dry mouth and throat,red tongue and thready pulse for yin-deficiency syndrome.For liver-stagnation syndrome,the principle components were impatience and irritability,bitterness in mouth,frequent sighing and wiry pulse;for bloodstasis syndrome,the principle components was purple tongue with ecchymosis;for phlegm-damp syndrome,the principle components were heaviness of limbs,greasy fur,abdominal distension and impaired appetite;for heat-toxic syndrome,the principle components were sore throat,purulent sore and yellowish tongue with dry fur;for damp-heat syndrome,the principle components were bitterness and stickiness in mouth,and yellowish greasy fur.(2)The regression equations of syndromes of yin deficiency,yang deficiency,yin-yang deficiency,blood stasis,phlegm damp and liver stagnation were obtained.(3)The results of non-conditional Logistic regression analysis showed that yang-deficiency syndrome was correlated with edema,the incidence of yang deficiency in edema patients being 1.6 times of that in patients without edema;yin-deficiency syndrome was positively correlated with gross hematuria,the incidence of yin deficiency in patients with gross hematuria being 1.5 times of that in patients without gross hematuria;pain in waist and back was the common signs in patients with yin deficiency,yang deficiency and yin-yang deficiency.【Conclusion】Parameters of glomerulosclerosis,crescent,stroma,immunofluorescence IgA and C_3 reflect over 85% information of glomerular changes in IgA nephropathy patients;there exists a relationship of TCM syndrome with pathological changes and clinical manifestations;yang-deficiency syndrome is correlated with edema and yin-deficiency syndrome is correlated with gross hematuria.
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[Objective] To observe the effects of Niaoduling Granule (NG) on renal function in rats with chronic renal failure (CRF) and its relationship with renal transforming growth factor (TGF) ?1. [Methods] CRF rat models were established by 5/6 subtotal nephrectomy and then the model rats were randomized into model group (Group B), NG group (Group C) and placebo control group (Group D) and other 8 rats served as mimic operation group (Group A) . Biochemical indexes, metabolic parameters and pathological features in kidney were examined and expression of renal transforming growth factor (TGF) ?1 was determined by immunohistochemical assay. [Results] Renal hypofunction, disorder of electrolyte, decrease of hemoglobin and CRF features were found in Group B. After treatment, renal function was improved and glomerulus-sclerosis index (GSI) and expression of renal TGF ?1 were decreased in Groups C and D (P