Efficacy and safety of Flos Abelmoschus manihot (Malvaceae) on type 2 diabetic nephropathy: A systematic review / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Flos Abelmoschus manihot (Malvaceae) on type 2 diabetic nephropathy (DN).</p><p><b>METHODS</b>The Cochrane Library, PubMed/MEDLINE, Excerpta Medical Database, Chinese electronic literature databases, and the references of relevant articles were searched in March 2012 for randomized controlled trials (RCTs) that reported the effects of Flos A. manihot on type 2 DN patients with overt but subnephrotic-range proteinuria (500-3,500 mg/24 h). The quality of trials was evaluated using the Cochrane-recommended method. The results were summarized as risk ratios (RRs) for dichotomous outcomes or mean differences (MDs) for continuous outcomes.</p><p><b>RESULTS</b>Seven trials (531 patients) were included. Flos A. manihot significantly decreased proteinuria [MD -317.32 mg/24 h, 95% confidence interval (CI) [-470.48, -164.17],P<0.01]. After excluding a trial that only included patients with well-preserved renal function, Flos A. manihot was associated with a significant decrease in serum creatinine (MD -11.99 μmol/L, 95% CI [-16.95, -7.04],P<0.01). Serious adverse events were not observed. The most common adverse event was mild to moderate gastrointestinal discomfort; however, patients receiving this herb did not have an increased risk for tolerated gastrointestinal discomfort (RR 1.48, 95% CI [0.39, 5.68],P=0.57).</p><p><b>CONCLUSIONS</b>Flos A. manihot may be considered as an important adjunctive therapy with the first-line and indispensable therapeutic strategies for type 2 DN. High-quality RCTs are urgently needed to confirm the effect of Flos A. manihot on definite endpoints such as end-stage renal disease.</p>

Pathogenesis of focal segmental glomerulosclerosis and morphogenesis underlying its pathological variants / 第二军医大学学报

Focal segmental glomerulosclerosis (FSGS) is defined as a clinicopathological entity of different etiologies and pathogeneses. The clinical manifestations include proteinuria, usually of nephritic range, and are associated with lesions of focal segmental glomerular sclerosis and foot process effacement. The Columbia classification of FSGS based on light microscopic assessment includes five subtypes: collapsing variant, tip variant, cellular variant, perihilar variant, and not otherwise specified. Columbia classification emphasizes the association of clinical with pathologic characteristics. However, both the physiopathology of FSGS and morphogenesis underlying the five morphologic variants are not fully described in Columbia classification. Over the past few years, significant progress has been made in the pathogenesis of FSGS and morphogenesis of diverse variants of FSGS. This review recapitulates recent important advances in the pathogenesis of FSGS and morphogenesis basis underlying the pathological variants of FSGS.

Systematic review of TCF2 anomalies in renal cysts and diabetes syndrome/maturity onset diabetes of the young type 5 / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>There is a paucity of published works that systematically evaluate gene anomalies or clinical features of patients with renal cysts and diabetes syndrome (RCAD)/maturity onset diabetes of the young type 5 (MODY5). The purpose of this review was to systematically assess the detection rate, genetic and phenotypic implications of heterozygous autosomal dominant TCF2 anomalies.</p><p><b>DATA SOURCES</b>MEDLINE database was searched to select articles recorded in English from 1997 to 2008. The focus was monoallelic germline TCF2 gene mutations/deletions. Biallelic inactivation, polymorphisms, DNA modification (hypomethylation and hypermethylation), loci associated with cancer risk, and somatic TCF2 anomalies were all excluded.</p><p><b>STUDY SELECTION</b>After searching the literature, 50 articles were selected.</p><p><b>RESULTS</b>The detection rate of TCF2 anomalies was 9.7% and varied considerably among MODY (1.4%), renal structure anomalies (RSA) (21.4%) and RSA with MODY (41.2%) subgroups. Mutations were strikingly located within the DNA binding domain and varied among exons of the DNA binding domain: exons 2 and 4 were the hottest spots, while mutations were sporadically distributed in exon 3. The consistent phenotypes were RSA (89.6%) and diabetes mellitus (DM) (45.0%). However, the concurrence of RSA and DM was relatively low (27.5%), which hinders the optimal performance of genetic testing and obtainment of timely diagnosis. Other organ involvements were complementary and necessary for the early identification of patients with TCF2 anomalies. Analysis of phenotypes of TCF2 point mutations showed significant differences in the detection rates of RSA, impaired renal function (IRF) and DM according to mutation type but not mutation location.</p><p><b>CONCLUSION</b>These valuable features of TCF2 anomalies that previously did not receive sufficient attention should not be neglected.</p>

Expression of survivin and NF-kappaB in peripheral T-cell lymphoma and its significance / 中国实验血液学杂志

This study was aimed to explore the expression of survivin and NF-kappaB in the peripheral T-cell lymphoma and its significance. Immunohistochemistry method was used to detect the expressions of survivin and NF-kappaB in 26 cases of lymphosarcoma. 30 cases of benign reactive lymphohistiocytosis were selected as control tor analysis. The results showed that the expression of survivin in 21 patients with lymphoma was positive, the positive rate reached to 80.8%; the expression of NF-kappaB in 17 cases was positive, the positive rate reached to 65.4%. Compared with the control group, the difference was statistically significant (p < 0.01). In the experimental group, the expression level of survivin was positively correlated with the positive rate of NF-kappaB. It is concluded that survivin and NF-kappaB widely expressed in lymphoma cells and they play an important role in enhancing proliferation and inhibiting apoptosis of tumor cells.