Clinical analysis of the inconsistency of antineutrophil cytoplasmic antibodies test results between indirect immune fluorescence and enzyme-linked immunosorbent assay in 589 cases / 中华风湿病学杂志

Objective To analyze the clinical significance and features of patient s' with inconsistent antineutrophil cytoplasmic antibodies (ANCA) test results between indirect immune fluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA).Methods ANCA were detected with IIF and ELISA method jointly among 12 386 in-patients and a retrospective analysis on the proportion of clinical features and significance was made in 589 cases with inconsistent results using Microsoft Excel 2007 statistical software.Results Among the 589 patients,68 (11.5％) were diagnosed as vasculitis,in which 51 cases as ANCA-associated vasculitis,and 521(88.4％) were diagnosed as non-vasculitis including 181 connective disease and 340 non-connective diseases in which hypertension and cardiopathy were common.The common inconsistent results of ANCA were p-ANCA/ELISA (-),IIF (-)/anti-MPO (+),IIF (-)/anti-PR3 (+),IIF (-)/anti-PR3 (+) anti-MPO (+) accounted for 24.4％ (144/589),29.5％ (174/589),15.9％ (94/589),18.5％ (108/589) respectively,these accounted for 88.3％(520/589) of total inconsistency.Conclusion The spectrum of diseases and clinical characteristics varies widely and often presents with multiorgan involvement in patients with inconsistent ANCA results.These reasons make it easy to be misdiagnosed.Attention should be paid to identify and different these inconsistency.

Study on transdifferentiation-acquiring tissue stem cell potency during renal tubular epithelial cells inflammatory damage / 国际检验医学杂志

Objective To study the potency of transdifferentiated renal tubular epithelial cells for acquiring the tissue stem cells during renal fibrosis.Methods The in vitro cellular model of renal tubular epithelial cells(NRK-52E)transdifferentiation under the inflammatory environment of the local renin-angiotensin (AngⅡ)system was established.The expression and change situation of the embryonic kidney developmental gene Pax2 and the tissue stem cell surface marker CD133 were observed.Results Local high concentration of AngⅡcould stimulate the NRK-52E cells to express Pax2 and CD133 molecule,its effect demonstrated the dose-and time-dependent relation.Conclusion The inflammatory damage leads to the transdifferentiated renal tubular epithelial cells po-tency to acquire the tissue stem cell.

Expression of p110, phosphorylation-protein kinase B and protein kinase B in hemangioma vascular endothelial cell in vitro / 中华实用儿科临床杂志

Objective To study the expression of phosphatidy linositol-3-kinase(PI3K) p110 catalytic subunit and phosphorylation-protein kinase B(p-Akt),protein kinase B(Akt) in cultured vascular endothelial cells,then the level of PI3K p110,p-Akt and Akt expression and the correlation with hemangioma vascular endothelial cell cycle and apoptosis were analyzed.Methods The hemangioma vascular endothelial cells which came from the sterile hemangioma were cultured by using tissue culture method and then synchronized cultured endothelial cells,P13K p110,p-Akt and Akt of them were detected by way of Western blot,meanwhile cell cycle and cell apoptosis were examined by using flow cytometry technique,then the level of PI3K p110,p-Akt and Akt expression and the correlation with hemangioma vascular endothelial cell cycle and apoptosis were analyzed.Results The percentage of vascular endothelial cell was (94.00 ± 3.00) ％ in the G0/G1 phase and the apoptosis rate was (11.24 ± 2.34) ％ when p110 and p-Akt protein expression level were lower (0.19 ±0.01,0.09 ±0.02),and they were (61.00 ±6.00)％ and (0.51 ±0.03)％ when p110 and p-Akt protein expression level were higher (0.37 ±0.04,0.22 ±0.01).The percentage of vascular endothelial cell in the G0/G1 phase and the apoptosis rate were different in 2 groups(t =-8.42,-35.48,all P ＜0.01).But Akt protein expression level was not changed (0.72 ± 0.00).Conclusions p110,p-Akt and Akt protein were expressed in the cultured hemangioma vascular endothelial cells in vitro.PI3K p110,p-Akt may be involved in cultured hemangioma vascular endothelial cells apoptosis in vitro.

Personalized diagnosis of chronic kidney disease / 中华检验医学杂志

Three strategies for nephrologists are to recognize the signs of early diagnosis of chronic kidney disease ( CKD),to identify and treat risk factors of progression of CKD and to cure or slow-down the progress of end-stage renal disease (ESRD). The idea of individual therapies obtaining optimal clinical results in tumor treatment urged people to find and apply biomarkers for personalized diagnosis of the risk factors of CKD susceptibility and progression,which provide a rationale for pursuing personalized medicine.(Chin J Lab Med,2012,35:784-789)

Role of angiotensin II and JAK2 signal pathway in transdifferentation of renal tubular cells in mice after acute ischemic followed by reperfusion / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the effect of angiotensin (Ang)II and its Janns-activated kinase-2 (JAK2) signal pathway in transdifferentiation of renal tubular cells under the challenge of acute ischemic reperfusion injury.</p><p><b>METHODS</b>Models of acute ischemic reperfusion injury were established and the level of local AngII, a key element of renin-angiotensin system (RAS), in kidney was measured using radioimmunity technique. The expression of alpha-smooth muscle actin (alpha-SMA), a phenotype of mesenchymal cells, was detected by RT-PCR and immunohistochemistry methods. Renal tubule cells (NRK-52E) were cultured with various concentration of AngII, followed by blocking of PD123319, AngII receptor 2 antagonist, and AG490, an inhibitor of JAK2 signal pathway.</p><p><b>RESULTS</b>AngII of kidney tissue increased immediately after acute ischemic-reperfusion injury, in time dependent fashion. Expression of alpha-SMA in renal tubule cells was found at 48 hours after ischemic-reperfusion injury and in NRK-52E cells treated by high concentration of AngII and was dose and time dependent. The peak of alpha-SMA expression was seen after 30 minute treatment at the dose of 10(-9) mol/L, which was interrupted by both of PD123319 and AG490.</p><p><b>CONCLUSIONS</b>Transdifferentiation of renal tubular epithelial cells occurs under acute ischemic-reperfusion injury. Local renin-angiotensin system may play a role in the transdifferentiation of TEC through AT2 receptor and its JAK2 signal pathway.</p>

Application value of serum thyroid peroxidase in screening thyroid dysfunction in pregnancy / 国际检验医学杂志

Objective To research the clinical value of serum thyroid peroxidase (TPOAb) in screening thyroid dysfunction in pregnancy.Methods The concentration of serum TPOAb and TSH(thyroid-stimulating hormone) was detected by MEIA and CMIA in 75 cases of pregnant women with thyroid disfunction,and 145 cases of pregnant women without tyhroid dysfunction (as control group).Results There were significant differences in both TSH and TPOAb levels between pregnant women with and without thyroid dysfunction(P0.05). So the normal serum TSH could not completely exclude the thyroid dysfunction in pregnant women.Conclusion TPOAb can be used as a prenatal screening marker for early diagnosis of thyroid dysfunction in pregnancy. From the diagnostic point, TSH can not completely substitute for TPOAb and the abnormal TPOAb can indicate the possibility and risk for autoimmune thyroid disease in pregnant women.

Self-quenched Probe Fluorescent Quantitative PCR Detective Method for Polyoma virus BK:Its Development and Clinical Application / 中华医院感染学杂志

OBJECTIVE To develop a new rapid method of real time fluorescence quantitative Polymerase chain reaction(PCR) to detect Polyoma virus BK(BKV) with high sensitivity,specificity,stability and lower price using the self-quenched probe.METHODS DNA segment of BKV was cloned into the vector pGEM-11Zf.The recombinant vector pGEM-11Zf-BK was used as standard template.The self quenched probe was designed according to the cloned gene sequence.The PCR reaction system was optimized and the method established was evaluated.RESULTS Restriction maps showed that the structure of recombinant plasmid pGEM-11Zf-BK was the same as expected.Methodology analysis suggested that self-quenched probe fluorescent quantitative PCR detective method of BKV be successfully established with high sensitivity,specificity and accuracy.CONCLUSIONS The self-quenched probe fluorescence quantitative PCR detective method for BKV has been developed successfully with high sensitivity,specificity and accuracy.

Exploration on teaching quality management system in laboratory medicine / 中华医学教育探索杂志

To establish a set of perfect teaching quality management system in laboratory medicine based on ISO 9000 standard and teaching reality in laboratory medicine will be helpful to the improvement of teaching quality and management ability and sustainable development of laboratory medicine.

Idiopathic collapsing glomerulopathy in children: report of two cases / 中华儿科杂志

<p><b>OBJECTIVE</b>Idiopathic collapsing glomerulopathy (ICG) is a clinically and pathologically distinct variant of focal segmental glomerulosclerosis, which is characterized by proteinuria (often nephrotic range) and rapid progression to end-stage renal failure. The typical pathological changes are global/segmental glomerular collapse, hypertrophy and hyperplasia of podocytes and severe tubulointerstitial lesions. Most ICG patients who have been reported in previous published papers are adults. ICG in children is rare. The study aimed to analyze and investigate clinical manifestations, renal histopathological findings, treatment and outcomes of ICG in children.</p><p><b>METHODS</b>Data of two cases of ICG, a 7-year-old boy and a 12-year-old girl, were analyzed. Both of them were Chinese and Han. Clinical characteristics, results of laboratory tests, renal histopathological findings, treatment, outcomes and prognosis of the two children with ICG were retrospectively analyzed. Results were compared with published data.</p><p><b>RESULTS</b>These two children presented typical clinical features of nephrotic syndrome. The quantity of 24 hr urine protein was 7.6 g/d (0.47 g/kg x d for boy) and 10.67 g/d (0.35 g/kg x d for girl). Both of them had hypertension (blood pressure ranged from 130/90 to 150/110 mmHg) and hypercholesterolemia (15.4 mmol/L for the boy and 11.3 mmol/L for the girl). The serum albumin was 12 g/L for girl and 23 g/L for boy. The creatinine clearance rate gradually decreased from normal range to 30 ml/min for the girl. The histopathological changes in renal biopsy of them were focal segmental or global glomerular collapse, hypertrophy and hyperplasia of podocytes and severe tubulointerstitial lesions. These two cases were steroid-resistant and were treated with pulse intravenous methylprednisolone and pulse intravenous cyclphosphamade in one case, who rapidly progressed to end-stage renal failure and died half a year later. Another one was treated with cyclosporine. He showed continuous hypertention and heavy proteinuria for eight months.</p><p><b>CONCLUSION</b>ICG in the 2 children was a severe disease which presented steroid-resistant nephrotic syndrome and rapidly progressive renal failure. The pathological characteristics was global/segmental glomerular collapse, hypertrophy and hyperplasia of podocytes and severe tubulointerstitial lesions. In children with ICG treatment was difficult and the prognosis was poor.</p>

Vasculitic lesion in idiopathic IgA nephropathy / 中华肾脏病杂志

Objective To analyze the pathological and clinical characteristics of patients with idiopathic IgA nephropathy accompanied by vasculitic/crescentic lesion (IgA-V/C). Methods Data of 222 patients diagnosed as idiopathic IgA nephropathy by renal biopsy, among them 87 cases with vasculitic/crescenlic (V/C)lesion, from our department in 2004 were analyzed retrospectively. Clinical and pathological data from patients with IgA-V/C were compared to those of non-IgA-V/C patients and of lupus nephritis (LN) patients with V/C lesion. Results Vasculitic/crescentic lesion was found in 39.19% (87/222) patients with idiopathic IgA nephropathy.And about( 14.08?12.75)% of the glomeruli was affected. It should be taken into account that there was no significant differences of clinical manifestations including blood pressure, urinary protein excretion between IgA-V/C group and non-IgA-V/C group .except serum creatinine(Scr)level which was significantly higher in IgA-V/C group. In addition, only 37.9% of IgA-V/C patients presented high Scr level,thus the lesion of V/C in idiopathic IgA nephropathy was easily overlooked. Patients with idiopathic IgA nephropathy were found to have higher percentage of glomerular sclerosis (64.86% vs 40.00%) and ratio of sclerostic glomeruli to total glomeruli [ (26.98 ?24.68)% vs (16.10 ?18.80)% ]as compared to LN group, which further predicated the progressing characteristics of IgA nephropathy. Conclusions Vasculitic/crescentic lesion is a quite common finding in idiopathic IgA nephropathy and often associated with no dramatically symptoms. It is possible for vasculitic/crescentic lesion to induce unmarked lose of nephron slowly and continually, so as to accelerate IgA nephropathy progression to end-stage renal failure.

Lipoprotein glomenllopathy - a new type glomenllopathy with progressive sclerosis / 中华肾脏病杂志

To report a Chinese female adult suffering with lipoprotein glomerulopathy. Methods Light , electron microscopy and immunofluorescence were performed with renal tissue from biopsy. Results Mass proteinuria and nephrotic syndrome were seen as clinical features in this patient. Obvious expansion of glomerular capillary cavities, full of positive sudan 3 lipoprotein thrombi, was observed. Electron microscopy demonstrated cavities were full of various foaming lipid deposition in cluster and layer arrangement. Repeat renal biopsy after two months found expansive cavities decreased remarkably and lipoprotein thrombi were replaced by mesangial proliferation and sectional sclerosis gradually. Conclusion This case is diagnosed by pathology.