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Autophagy is a highly conserved intracellular catabolic process used to degrade cytoplasmic components. In recent years, it has attracted much attention because of its importance in the pathogenesis and targeted therapy of acute and chronic kidney disease. Autophagy plays an important role in maintaining renal homeostasis under physiological and pathological conditions. The study of conditional autophagy related gene knockout specific to various renal cells has gradually revealed the role of autophagy in renal diseases. Recent studies have found that autophagy deficiency may play a key role in different pathological states of the kidney. Activated autophagy shows cytoprotective function in both glomerulus and renal tubulointerstitium, suggesting that the up regulation of autophagy may become a potential therapeutic strategy. However, there is also contrary evidence that autophagy may be harmful, which poses a great challenge to the development of therapeutic strategies for up-regulated autophagy.
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Purpose@#Vascular calcification (VC) is a common complication of end-stage renal disease (ESRD). This study aimed to examine changes in the expression of miR-21-5p in ESRD patients with VC and to explore its clinical value in predicting the occurrence and progression of uremic VC. @*Materials and Methods@#120 ESRD patients were divided into patients without VC group (n=38) and patients with VC group (n=82). All patients were followed up for 2 years to evaluate VC progression. qRT-PCR was used to detect serum miR-21-5p levels.Receiver operating characteristic curves were constructed to assess diagnostic value. Kaplan-Meier and log-rank methods were utilized to calculate associations between VC progression and risk factors. @*Results@#Serum miR-21-5p levels were significantly higher in ESRD patients with VC than in those without VC and increased progressively with increasing disease severity. Serum miR-21-5p levels were able to distinguish patients with VC from those without VC, with an area under the curve value of 0.883, a sensitivity of 81.7%, and a specificity of 84.2%. After 2 years of follow-up, miR-21-5p expression had increased in patients with worse VC severity, compared with those with stable VC severity. Patients with high miR-21-5p levels were more likely to develop more severe VC, indicating an association between miR-21-5p and VC progression (log-rank p=0.002). Multivariable Cox regression analysis suggested that serum miR-21-5p is an independent predictive factor of VC progression in ESRD patients (hazard ratio=2.064, 95% confidence interval=1.225–3.478, p=0.006). @*Conclusion@#miR-21-5p is overexpressed in the serum of ESRD patients with VC. Our results suggest that overexpression of miR-21-5p is closely associated with VC progression.
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Objective To evaluate laparoscopic right hepatectomy through the right incisura or the right groove for hepatic benign disease.Methods This study enrolled 32 patients of hepatic benign lesions within the right lobe of the liver including hepatic hemangioma (n =7),hepatic focal nodular hyperplasia (n =2),right intra-hepatic bile duct stones (n =23) with concomitant extra-hepatic bile duct stones in 19 cases.Results Laparoscopic procedures were successful in 28 patients,while 4 patients were converted to laparotomy.Time of operation was 235 to 405 min,time for right hemihepatectomy was (305 ±41) min on average.Time for right hemihepatectomy and biliary tract exploration and removal of stones was (326 ± 48)min on average.The intraoperative blood loss was (573 ±219) ml on average.On postoperative follow-up,patients with hepatic hemangioma and focal nodular hyperplasia had no residual lesions.2 cases suffered calculus residue,residual stones were removed by repeat choledochoscopy with primary stones clearence rate of 91.3％ (21/23).Bile leakage occurred in 3 cases and pleural effusion in 7 cases.The gastrointestinal function recovered (2.8 ± 0.71) days after surgery.The hospital stay was (11.5 ± 2.98) days.28 patients were followed up for (32 ± 8) months.Conclusion The laparoscopic anatomical right hemihepatectomy through the right incisura or the right groove is a satisfactory surgical procedure.
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Objective To understand the changing trends of immune-related diseases.Disease patterns from both pre-and post-immunization plan and after the immunization program were described,in order to provide evidence for the formulation and revision of immunization program and policy,in Ningxia Hui Autonomous Region.Methods According to the time order descriptive method was used to analyze and compare the reported data on infectious diseases in Ningxia,between 1958 and 2014.Results From 1958 to 2014,both incidence and mortality of infectious diseases and four diseases related to the immunization programs,in Ningxia appeared significantly low.Since the implementation of the immunization plan,the incidence and mortality of the 4 diseases declined significantly,with the average annual total incidence as 176.12/100 000 before the immunization plan dropped to 2.56/100 000 when the expanded immunization plan was put into practice.The incidence also showed a downward trend.Among diseases that under the immunization program,the incidence of measles appeared the highest,followed by pertussis.However,none of the case on diphtheria or polio appeared which was caused by the wild strains,in 1983 and 1994.Conclusion After the implementation of the immunization plan,the immune-related diseases seemed to have been under well controlled.and with remarkable social benefit.Immunization programs appeared the most effective measures to control and eliminate the acute infectious diseases in the region.
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Objective To understand the changing trends of immune-related diseases.Disease patterns from both pre-and post-immunization plan and after the immunization program were described,in order to provide evidence for the formulation and revision of immunization program and policy,in Ningxia Hui Autonomous Region.Methods According to the time order descriptive method was used to analyze and compare the reported data on infectious diseases in Ningxia,between 1958 and 2014.Results From 1958 to 2014,both incidence and mortality of infectious diseases and four diseases related to the immunization programs,in Ningxia appeared significantly low.Since the implementation of the immunization plan,the incidence and mortality of the 4 diseases declined significantly,with the average annual total incidence as 176.12/100 000 before the immunization plan dropped to 2.56/100 000 when the expanded immunization plan was put into practice.The incidence also showed a downward trend.Among diseases that under the immunization program,the incidence of measles appeared the highest,followed by pertussis.However,none of the case on diphtheria or polio appeared which was caused by the wild strains,in 1983 and 1994.Conclusion After the implementation of the immunization plan,the immune-related diseases seemed to have been under well controlled.and with remarkable social benefit.Immunization programs appeared the most effective measures to control and eliminate the acute infectious diseases in the region.
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Objective To evaluate left liver anatomical resection via left vertical groove by laparoscope.Method Among 103 patients with left intrahepatic biliary calculi,39 cases underwent left lateral hepatectomy,20 cases did left liver anatomical resection via left vertical groove by laparoscope,29 cases underwent left lateral hepatectomy via left liver diaphragmatic surface,15 cases did left liver anatomical resection via the first porta.Result In the 103 cases of laparoscopic left liver anatomical resection,101 cases were successful and two cases were conversed to open surgery.In the success group,total laparoscopic anatomical left lateral lobectomy was performed (Ⅱ,Ⅲ section) in 68 cases.Compared with the approach via left liver falciform ligament diaphragmatic surface,the operatve time via left vertical groove was significantly shorter(t =-2.723,P =0.008,intraoperative blood loss was significantly smaller (t =-5.399,P =0.000),while the differences in postoperative hospital stay (t =-0.168,P =0.867) and postoperative complications (x2 =0.664,P =0.415) were of no statistical significance between the 2 groups.In the 33 cases of left hemihepatectomy (Ⅱ,Ⅲ,Ⅳ section),those performed via left vertical groove compared with through the first porta hepatic,used shorter operation time(t =-3.144,P =0.004),while blood loss was similar(t =-1.049,P =0.302),as well as the length of hospital stay(t =0.784,P =0.439).There was no postoperative bleeding and intractable bile leakage,nor postoperative air embolism.Flatus on an average of (2.5 ± 1.2) days.Patients were discharged from hospital 5-17 (9.98 ±2.98) days post-op.96 cases were followed up in the 101 cases undergoing successful total laparoscopic left hemihepatectomy.The followed-up time were 3-52 (32.6 ± 5.7) months.Postoperative review found no residue stone.One case in first porta hepatis group,caudate lobe atrophy was found by postoperative CT.Conclusions Left liver anatomical resection via left vertical groove by laparoscope is less traumatic,quick recovery with satisfactory clinical curative effect for the treatment of left hepatolithiasis.
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Objective To explore the effect of total flavonoids of astragalus (TFA) on the apoptosis of endothelial cells induced by serum of uremia patient .Methods The serum of 22 healthy volunteers and 25 uremia patients receiving regularly hemodialysis were enrolled in the study .HUVECs were used as research objects ,which were divided into control group(adding serum of healthy people when cell synchronized) and uremia group (adding serum of uremia patient when cell synchronized ) .Low dose ,moderate dose and high dose group were prepared by adding 0 .5 ,1 .0 ,2 .0 mg/mL TFA respectively 6 h before cell synchronization .After 24 hours′culture since the serum were added ,the morphological change of endothelial cells were observed by microscopy ,proliferation activities were tested by using MTT ,SOD activities were tested by using xanthine oxidase method ,NO levels were measured by u-sing nitrate reductase colorimetric method ,DNA damage was detected by using comet assay ,the morphological change of apoptosis was observed by using TUNEL method .Results Compared with the control group ,the proliferation activity ,SOD activity ,NO lev-els were lower in uremia group(P< 0 .01) ,DNA tailing rate ,apoptosis index(AI) significantly increased (P<0 .01) .Compared with cells of uremia group ,cell proliferation activity of all the TFA intervention groups increased (P<0 .05) ,NO levels also in-creased (P<0 .01) .Compared with uremia group ,moderate and high dose group′s SOD activity increased (P<0 .05) ,DNA damage tailing rate decreased (P<0 .05) .Conclusion Total flavonoids of astragalus reduces apoptosis of HUVECs induced by serum of uremia patient ,the possible mechanism is associated with the decrease of oxidative stress .
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Objective To explore the relationship between traditional Chinese medicine (TCM) syndromes of state of evil domination and clinical and laboratory indicators of IgA nephropathy. Methods A prospective study was used to collect data on clinical and laboratory examination of IgA nephropathy in multi clinical centers. Patients’ TCM syndrome types were determined according to the national diagnostic criteria at the same time. Totally 266 patients with IgA nephropathy were included in the study to establish a database for analyzing the relationship between TCM syndrome of state of evil domination and clinical and laboratory indicators. Results In the relationship between syndromes of state of evil domination distribution and clinical subtypes, patients of wind-heat syndrome had more macroscopic hematuria;patients of phlegm-damp syndrome had more nephrotic syndrome;patients of damp-heat syndrome had more chronic nephritis type Ⅰ;patients of blood stasis syndrome had more chronic nephritis type Ⅱ. In the relationship between syndrome of state of evil domination distribution and clinical manifestation, the incidence of hypertension was higher in patients of blood stasis syndrome than in other three types. It was more serious for hematuresis in the patients of wind-heat syndrome. For patients of phlegm-damp syndrome, the incidence of heave proteinuria was highest. In the relationship between syndrome of state of evil domination distribution and laboratory examination, 24-hour urinary protein quantification was higher than in patients of wind-heat and damp-heat syndrome, but the level of blood albumin was lowest. For patients of blood stasis syndrome, serum creatinine level was significantly higher than in other three types;the level of eGFR was just the opposite. The levels of blood cholesterol and triglyceride in patients of phlegm-damp syndrome were higher than in other three types. The activated partial thromboplastin time (APTT) levels in patients of blood stasis and phlegm-damp syndrome were lower than in other patients, but the FIB level was the exact opposite of APTT. In the relationship between syndrome of state of evil domination distribution and the stages of chronic kidney disease (CKD), patients of wind-heat syndrome were more in the first stage of CKD;patients of blood stasis syndrome were more in the third stage of CKD. Conclusion There is relative correlation between TCM syndromes of state of evil domination and clinical and laboratory indicators in IgA nephropathy, which would provide some reference to narrow the gap in the information of the four methods of TCM with clinical and laboratory indicators to enhance accurate diagnosis of TCM syndrome.
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Objective To study the feasibility and efficacy of intraoperative choledoscopy combined with laparoscopic left liver resection to treat intrahepatic lithiasis.Method In 49 patients with biliary stone,laparoscopic left lateral sectionectomy/left medial sectionectomy/left hepatectomy combined with intraoperative choledochoscopy and stone retrieval were carried out.Results Laparoscopic left lateral sectionectomy was carried out in 29 patients,left medial sectionectomy in 2 patients and left hepatectomy in 18 patients.In all the patients,combined choledoscopy and stone retrieval were carried out.A concomitant laparoscopic cholecystectomy (LC) was carried out in 11 patients.The average operative time was 226 min.When LC was carried out,the mean operative time was 243 min.The mean intraoperative blood loss was 378 ml.There was no bile leak or postoperative bleeding.Flatus was passed 1-3 days after surgery.The patients were discharged home 7-10 days after surgery.Postoperative MRI/MRCP did not reveal any residual stone.On a mean follow up of 16 months for 47 patients,the patients did well and there was no recurrent stone.Conclusion Choledochoscopy combined with laparoscopic left liver resection for bile duct stone resulted in minimal trauma to the patient.The recovery was quick and there was a high stone clearance rate.The treatment was safe,efficacious,and it is a viable minimally invasive treatment option.
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<p><b>OBJECTIVE</b>To investigate the effects of fushenkeli on the expression of TAK1 in the proliferation of the renal tubular epithelial cells induced by TGF-beta1 and its possible mechanism.</p><p><b>METHOD</b>Human renal tubular epithelial (HK-2) cells were divided into five groups:blank control group, TGF-beta1 group (5 microg x L(-1)), intervention group 1 (5 microg x L(-1) of TGF-beta1 + 100 mg x L(-1) of fushenkeli), intervention group 2 (5 microg x L(-1) of TGF-beta1 + 500 mg x L(-1) of fushenkeli) and intervention group 3 (5 microg x L(-1) of TGF-beta1 + 1 g x L(-1) of fushenkeli). HK-2 proliferation was detected by methyl thiazolyl tetrazolium (MTT) assay. Type IV collagen in the supernatants of the cultured HK-2 was detected by ELISA at 12, 24, 48 hours respectively. The protein and mRNA expressions of TAK1 was measured by Western blot and real-time quantitative PCR.</p><p><b>RESULT</b>1) The cell proliferation and the expression of type IV collagen were increased compared with the control group (P<0.05, P<0.01), but they were decreased in intervention group. 2) The expressions of protein and mRNA of TAK1 in TGF-beta1 group were upregulating significantly compared with control group (P<0.01), but they were downregulating in intervention group, especially in intervention group 3.</p><p><b>CONCLUSION</b>Fushenkeli could inhibits TAK1 expression induced by TGF-beta1 in the proliferation of HK-2 cell.</p>
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Humans , Cell Line , Cell Proliferation , Collagen Type IV , Metabolism , Drugs, Chinese Herbal , Pharmacology , Epithelial Cells , Metabolism , Kidney Tubules , Cell Biology , MAP Kinase Kinase Kinases , Metabolism , RNA, Messenger , Metabolism , Transforming Growth Factor beta1ABSTRACT
Objective To discuss the pathogeny,treatment and prophylactic measures of postcholecystectomy syndrome (PCS).Methods The clinical data of 150 patients with laparoscopic PCS in our department from October 2000 to March 2009 were analyzed.Results Etiological factors were found in 131 patients:one hundred and twelve cases were due to the reasons of biliary system,including bile duct residual stones after cystic resection,the injury bile duct stenosis,a long residual cystic canal,nipple benign stricture,bile duct tumor etc;Nineteen examples were due to other reasons,including gallbladder stone merger reflux gastritis,gastroduodenal ulcer,diverticulum beside duodenal nipple,and so on,which resulted in the symptoms un-release after cystic resection.Nineteen cases were not found organic lesion.In ones whose etiological factors were definite,117 cases were treated with different surgeries according to different etiological factors;another 33 cases were treated with conservative treatment.Total 145 cases were followed up,and 139 cases in them were cured or relieved at different degrees.Conclusion Careful preoperative examination,normalized operation avoiding damaging bile duct and leaving behind bile duct stones can effectively prevent laparoscopic PCS.
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Objective To investigate the effect of fosinopril on the expression of transforming growth factor (TGF)-activated kinase 1 (TAK-1) in the kidney of rats with unilateral ureteral obstruction (UUO),and its protective effect on renal interstitial fibrosis (RIF).Methods UUO model was induced by ligating the left ureter in rats.A total of 72 male Sprague-Wistar rats were randomly divided into 3 groups:sham-operated group (n=24),UUO model group (n=24) and UUO+fosinopril group (n=24).The rats were treated with 10 mg/(kg?d) by gastric gavage in the fosinopril treated group from 2 d after the operation,and the rats were treated with the identical dose of normal saline in the other 2 groups.Eight rats of each group were sacrificed at 7,14 and 21 d after UUO.Pathological changes of the renal tissue were observed by HE and Masson staining,and the mRNA and protein expression of TAK1 was detected by in situ hybridization,real-time PCR and Western blot analysis.Results The renal interstitial damage index of UUO group was increased compared with that of the sham-operation group (P
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<p><b>OBJECTIVE</b>To study the epidemiological transition of injuries in Ningxia.</p><p><b>METHODS</b>Demographic and mortality data during 1990s in Ningxia were collected and analyzed for temporal trend with linear regression model.</p><p><b>RESULTS</b>During the past decade, mortality of injury raised by 28.22% among the residents in Ningxia and ranked the 3rd place in the causes of deaths. In 1999, the top four leading causes of injury deaths were traffic accident, suicide, drowning and poisoning. Overall injury mortality and mortalities of traffic accident and suicide increased, but mortality of drowning decreased during the past decade. As predicted, suicide will rank the 1st place in the causes of deaths among the residents in Ningxia by 2005.</p><p><b>CONCLUSIONS</b>Injury was one of major risk factors influencing health and death among the residents in Ningxia, with a temporal trend in its incidence. Effective research, prevention and control of traffic accident, suicide, drowning and poisoning should be focused.</p>
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Humans , Accidents, Traffic , Cause of Death , China , Epidemiology , Drowning , Mortality , Poisoning , Suicide , Survival Rate , Wounds and Injuries , Epidemiology , MortalityABSTRACT
Objective To investigate the risk factors leading to complications in patients undergoing laparoscopic cholecystectomy (LC). Methods Clinical data of 11?974 patients undergoing LC from Mar. 1991 to June 2003 were collected and analyzed retrospectively. Fifteen clinical factors were recruited for the study in relation to surgical complications. Data were analyzed by ?2 test and Logistic regression. Results The overall operative complication rate was 1.896%. The procedure was shifted to open surgery in 2.389% of all cases, Logistic regression analysis revealed that Calot triangle adhesion, stage, expertise of the team, gallbladder wall thickness, gallbladder and vicinity adhesion were important risk factors for complications. Conclusion LC complications can be prevented by good training, strictly following protocol, and timely shifting to open surgery.