Prognostic factor analysis of elderly patients with small-cell lung cancer / 中华老年医学杂志

Objective@#To retrospectively analyze clinical data of elderly patients with small-cell lung cancer(SCLC)in order to investigate their prognostic factors.@*Methods@#Clinical data of SCLC patients aged 65 years and over in our hospital from January 2006 to February 2017 were analyzed.Survival data were analyzed by Kaplan-Meier method.Univariate analysis of prognosis was conducted by Log rank test.Multivariate analysis was performed by Cox regression.@*Results@#A total of 143 patients were enrolled, the median overall survival(OS)was 17.9 months, with 21.3 months for limit stage(LD)and 9.6 months for extensive stage(ED). For LD patients, age(HR=18.688, 95%CI: 3.237-107.889), smoking index(HR=2.783, 95%CI: 1.196-6.475), thoracic irradiation(HR=0.305, 95%CI: 0.120-0.779), chemotherapy efficacy(HR=0.210, 95%CI: 0.065-0.685)were the independent risk factors for the prognosis.For ED patients, chemotherapy cycles(HR=0.461, 95%CI: 0.229-0.927)and performance status(HR=0.422, 95%CI: 0.218-0.818)were the independent risk factors for prognosis.@*Conclusions@#Smoking index, tumor stage and treatment mode can influence the survival of SCLC patients.The LD patients, who were aged less than 75 years, with smoking index less than 1000, receiving thoracic irradiation and achieving remission with chemotherapy, show a longer OS.For ED patients, a good performance status and sufficient chemotherapy can predict an improved OS.

Application of mini-clinical evaluation exercise on standardized training of residents in department of nephrology / 中华医学教育探索杂志

Objective@#To observe the effectiveness of mini-clinical evaluation exercise (Mini-CEX) on the standardized training of residents in the department of nephrology.@*Methods@#Mini-CEX was used to evaluate the 80 residents who received clinical standardized training in the department of nephrology from March 2017 to March 2018 in our hospital. The assessment mainly contained seven aspects: medical history taking, physical examination, clinical diagnosis, therapeutic regimen, doctor-patient communication, humanistic care, and overall clinical ability. Meanwhile, a Mini-CEX questionnaire was conducted among 9 teachers and 80 residents, including their viewpiont and satisfaction degree on Mini-CEX. The SPSS 21.0 was used for statistical analysis and the independent sample t-test was used for comparison between the two groups.@*Results@#Through the Mini-CEX assessment, every aspect of clinical competence of residents at the end of this program was significantly higher than that at the early period, and the difference was statistically significant (P<0.05). The most obvious improvement in residents was their treatment plan, overall clinical ability and physical examination. About the assessment of therapeutic regimen, the average score at the end of the training was (7.525±1.062), which was better than before (5.175±1.035), and the difference was statistically significant (P=0.000). Besides, clinical diagnosis and humanistic care were significantly better than those at the beginning (P<0.05). About the assessment of clinical diagnosis, the average score after the training was (6.925±1.071), which was better than before (5.425±1.238), and the difference was statistically significant (P=0.000). According to results of Mini-CEX questionnaire, teachers thought that Mini-CEX was a better way of assessment (88.9%) and could promote self-learning (77.8%), while residents believed that Mini-CEX was close to clinical practice and the ward-or-practice-based assessment was relatively comprehensive, which could significantly improve clinical skills (85.0%) and comprehensive quality (87.5%), with a satisfaction degree of 92.5%.@*Conclusion@#Mini-CEX is applied in the standardized training of residents in the department of nephrology, which can effectively improve clinical comprehensive ability of residents and improve Self-learning of teachers.

Application of mini-clinical evaluation exercise on standardized training of residents in department of nephrology / 中华医学教育探索杂志

Objective To observe the effectiveness of mini-clinical evaluation exercise (Mini-CEX) on the standardized training of residents in the department of nephrology. Methods Mini-CEX was used to evaluate the 80 residents who received clinical standardized training in the department of nephrology from March 2017 to March 2018 in our hospital. The assessment mainly contained seven aspects: medical history taking, physical examination, clinical diagnosis, therapeutic regimen, doctor-patient communication, humanistic care, and overall clinical ability. Meanwhile, a Mini-CEX questionnaire was conducted among 9 teachers and 80 residents, including their viewpiont and satisfaction degree on Mini-CEX. The SPSS 21.0 was used for statistical analysis and the independent sample t-test was used for comparison between the two groups. Results Through the Mini-CEX assessment, every aspect of clinical competence of residents at the end of this program was significantly higher than that at the early period, and the difference was statistically significant (P<0.05). The most obvious improvement in residents was their treatment plan, overall clinical ability and physical examination. About the assessment of therapeutic regimen, the average score at the end of the training was (7.525 ±1.062), which was better than before (5.175 ±1.035), and the difference was statistically significant (P=0.000). Besides, clinical diagnosis and humanistic care were significantly better than those at the beginning (P<0.05). About the assessment of clinical diagnosis, the average score after the training was (6.925 ±1.071), which was better than before (5.425 ±1.238), and the difference was statistically significant (P=0.000). According to results of Mini-CEX questionnaire, teachers thought that Mini-CEX was a better way of assessment (88.9％) and could promote self-learning (77.8％), while residents believed that Mini-CEX was close to clinical practice and the ward-or-practice-based assessment was relatively comprehensive, which could significantly improve clinical skills (85.0％) and comprehensive quality (87.5％), with a satisfaction degree of 92.5％. Conclusion Mini-CEX is applied in the standardized training of residents in the department of nephrology, which can effectively improve clinical comprehensive ability of residents and improve Self-learning of teachers.

Prognostic factor analysis of elderly patients with small-cell lung cancer / 中华老年医学杂志

Objective To retrospectively analyze clinical data of elderly patients with small-cell lung cancer(SCLC)in order to investigate their prognostic factors.Methods Clinical data of SCLC patients aged 65 years and over in our hospital from January 2006 to February 2017 were analyzed.Survival data were analyzed by Kaplan-Meier method.Univariate analysis of prognosis was conducted by Log rank test.Multivariate analysis was performed by Cox regression.Results A total of 143 patients were enrolled,the median overall survival(OS)was 17.9 months,with 21.3 months for limit stage(LD)and 9.6 months for extensive stage(ED).For LD patients,age(HR =18.688,95 ％CI:3.237-107.889),smoking index (HR =2.783,95％ CI:1.196-6.475),thoracic irradiation (HR =0.305,95 ％ CI:0.120-0.779),chemotherapy efficacy (HR =0.210,95 ％ CI:0.065-0.685) were the independent risk factors for the prognosis.For ED patients,chemotherapy cycles (HR =0.461,95 ％ CI:0.229 0.927)and performance status (HR =0.422,95 ％ CI:0.218-0.818) were the independent risk factors for prognosis.Conclusions Smoking index,tumor stage and treatment mode can influence the survival of SCLC patients.The LD patients,who were aged less than 75 years,with smoking index less than 1000,receiving thoracic irradiation and achieving remission with chemotherapy,show a longer OS.For ED patients,a good performance status and sufficient chemotherapy can predict an improved OS.

Efficacy of S-1 in Advanced Non-small Cell Lung Cancer Patients Treated with More Than Two Lines of Chemotherapy / 中国肺癌杂志

BACKGROUND@#There is no standard treatment for advanced non-small cell lung cancer (NSCLC) after the failure of two lines of chemotherapy, S-1 as the third generation of fluorouracil derivate with well safety and low toxicity, presented some efficacy in lung cancer treatment. The aim of this study is to explore the efficacy of S-1 for advanced NSCLC patients treated with two or more prior chemotherapy regimens.@*METHODS@#We performed a retrospective analysis of 105 NSCLC patients treated with S-1 monotherapy or S-1 contained chemotherapy as the third or more line of treatment in our hospital from January 2014 to April 2017. S-1 was administrated orally twice daily for 2 weeks, followed by one week of rest, the dose of drug was determined by body surface area (<1.25 m2, 80 mg/d; 1.25 m2-1.5 m2, 100 mg/d; ≥1.5 m2, 120 mg/d), platinum or the third-generation chemotherapy drugs could be combinedly used. Clinical response was assigned every cycle according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, Kaplan-Meier analysis was used to estimate progression-free survival (PFS).@*RESULTS@#42 patients received S-1 monotherapy, the other 63 patients received combined regimens, the median treatment line was 4 (3-11) and the median treatment cycle was 2 (1-14). No complete response (CR) were observed, there were 4 patients with partial response (PR), 34 patients with stable disease (SD) and 67 patients with progressive disease (PD), the objective response rate (ORR) was 3.81%, disease control rate (DCR) was 36.19%. The median PFS was 1.90 months (0.67 months-10.83 months), no difference between monotherapy and combined group (DCR: 28.56% vs 41.27%, P=0.185), the liver metastasis showed poorer PFS (1.40 months vs 1.93 months , P=0.042).@*CONCLUSIONS@#S-1 presented some activity in advanced NSCLC treated with more than two lines of treatment. The addition of other drugs cannot improve efficacy. S-1 monotherapy can be used as a choice for heavily-treated patients.

Over-expression of ROBO4 reduces permeability of human renal glomerular endothelial cells in high glucose medium / 解放军医学杂志

Objective To investigate the effect of over-expression of ROBO4 on permeability of human renal glomerular endothelial cells (HRGECs) in high glucose medium.Methods HRGECs infected with recombinant lentiviral vector ROBO4 were cultured in high glucose or low glucose medium in vitro.The protein levels of ROBO4 and ARF6 in each group were detected by Western blotting.The endothelial permeability was measured by the effiux of fluorescein isothiocyanate-dextran (FITC-Dextran)permeated through the monolayer endothelial cells using Transwell cell model system.The cell viability after lentivirus transfection was measured by CCK8 assay.Results The transfection rate of lentiviruses in HRGECs reached 80％ 72h after,and obvious overexpression of ROBO4 protein was in transformed cells compared with the empty vector group (P＜0.05).The lentivirus-mediated ROBO4 transfection did not affect cell viability of HRGECs.Compared with the low glucose group,the expression of ROBO4 increased obviously after 12h,but declined after 24h (P＜0.05),and reached to minimun after 72h (P＜0.05).On the contrary,the expression of ARF6 increased after 12h,and the increase reached to the maximum after 72h (P＜0.05).Furthermore,the vascular permeability increased gradually after 24h,and reached to the maximum after 72h (P＜0.05) in high glucose group.Compared with the empty vector group,the over-expression of ROBO4 inhibited the expression of ARF6 significantly,and the FITC-Dextran permeability reduced obviously.Conclusion Over-expression of ROBO4 may significantly enhance the barrier functions of HRGEC in high glucose medium,and ROBO4 activation may be a potential therapeutic approach in diabetic nephropathy.

Erlotinib versus vinorelbine therapy in chemotherapy-naive elderly patients with advanced non-small-cell lung cancer and EGFR mutation: a randomized, controlled trial / 中华老年医学杂志

Objective To compare the efficacy and adverse effects of erlotinib versus vinorelbine naive patients with advanced non-small cell lung cancer (NSCLC) and epidermal growth factor receptor (EGFR) mutation.Methods Totally 46 elderly patients with histologically confirmed advanced NSCLC and EGFR mutations (exon 19 dclction or L858R point mutation) were enrolled.Patients were randomly divided into two groups:erlotinib group (43 cases,150mg per day until disease progression or unacceptable toxicities) and control group (21 cases,vinorelbine-based chemotherapy,single vinorelbine chemotherapy or vinorelbine-based double chemotherapy).Results Response rates and disease control rates were significantly improved with erlotinib compared with vinorelbine (78.6％ and 88.1％ vs.38.1％ and 61.9％,respectively,P＜ 0.05).There was a significant difference in median progression-free survival (11.6 months vs.5.6 months,P＜0.05),while no statistical difference in median overall survival with erlotinib compared with vinorelbine (19.0months vs.16.5 months,P=0.193).The most frequent adverse effects were grade Ⅰ or Ⅱ and no patients stopped treatment due to adverse effects and no drug-relatcd death.The primary adverse effects were skin rash (71.4％),diarrhea (31.0％)and liver dysfunction (23.8％) in the erlotinib group and neutropenia (66.7％),nausea or vomit (47.6％),anemia (42.9％),platelet decline (33.3％),constipation (33.3％) and peripheral neuritis (23.8％) in the vinorelbine group.Vinorelbine group versus erlotinib group have more 3-4 level adverse reactions (15/21 vs.7/42)(x2=1.69,P=0.193).Conclusions Erlotinib treatment has advances in PFS,ORR and DCR and tolerability compared with vinorelbine-based chemotherapy in elderly patients with advanced NSCLC and EGFR mutation,while overall survival is in no difference.Erlotinib may be a reasonable first-line treatment option for elderly patients with advanced NSCLC and sensitive EGFR mutation.

Gefitinib in first-fine therapy for 34 cases of advanced non-small cell lung cancer / 中国癌症杂志

Background and purpose: It has been proven that gefitinib can be safely and efficiently used to treat advanced non-small cell lung cancer (NSCLC) as a molecule targeted drug. This research was aimed to investigate the efficacy and toxicity of gefitinib as the first-line therapy for advanced NSCLC. Methods: A total of 34 pathologically-confirmed NSCLC patients who were not willing to receive or tolerate traditional cytotoxic drug chemotherapy were enrolled into the study. Gefitinib was orally administered 250 mg daily until disease progression or the occurrence of intolerable toxicity. Results: The objective response rate of gefitinib was 29.4%. The disease control rate was 61.8%. The rate of symptom relief was 47.1%. The median progression-free survival was 3.0 months. The median overall survival was 10.2 months. One-year survival rate was 35.3%. The objective response rate of nun-smoker was higher than smoker (P=0.023). The disease control rate for the patients with rash toxicity after administration of the drug were higher than those without rash (P=0.005). Logistic regression showed that rash was an independent disease control factor (P=0.003). The most common drug-related adverse events were rash and diarrhea. Conclusion: Gefitinib provided another choice to patients who are unwilling or unable to be treated by chemotherapy.

Clinical nursing reseach in prevention of intradialytic hypotension with hemodiaffitration / 中国实用护理杂志

Objective To compare the effect of hemodiafiltration(HDF) on the incidence rate of intradialytie hypotension. Methods We followed up eighteen patients with symptomatic hypotension history and divided them into group A and group B.Group A was treated with conventional hemodialysis(CHD) and HDF, Group B adopted HDF with low temperture hemodialysis. The number of hypotensive episodes, blood temperature during cardiopulmonary bypass, energy transfer rates were assessed. Results The incidence of symptomatic hypotension of patients was found lower in CHD (40%) than in HDF (6%),P<0.01. Energy transfer rates were founded higher in CHD than in HDF and low temperture hemodialysis, P<0.01. Conclusions HDF significantly reduced hemodialysis-related side effects and increased the tolerance ability of patients.

A randomized controlled clinical trial on irinotecan/cisplatin versus gemcitabine/cisplatin as the first-line treatment in advanced non-small cell lung cancer / 中国癌症杂志

0.05).The incidence rate of diarrhea in IP group was 48.4% it was significantly higher than GP group(P

localization and changes of expressions of Smad2, Smad3, Smad4, and Smad7 proteins in the 5/6 subtotally nephrectomized rat kidney / 第三军医大学学报

Objective To investigate the localization of Smad2, Smad3, Smad4, and Smad7 proteins and their expression changes in the 5/6 subtotally nephrectomized rat kidney. Methods The rat model of chronic renal failure was established by performing 5/6 subtotally nephrectomy (SNx) and rats in the control group underwent sham-operation. The rats were sacrificed at 4, 8, and 12 week after operation. The sites and levels of expressions of Smad2, Smad3, Smad4, and Smad7 proteins were examined by immunohistochemical staining. Renal fibrosis was assessed by measuring tissue hydroxyproline. Results Immunohistochemical staining indicated that Smad2, Smad3, and Smad4 proteins were mainly expressed in glomeruli and renal tubular cells, while Smad protein 7 was expressed in glomeruli, but rarely in proximal renal tubular cells. Expressions of Smad2, Smad3, and Smad4 proteins in glomeruli were significantly increased during 4-12 weeks after 5/6 nephrectomy, but the expression level of Smad protein 7 was significantly decreased, but accompanied increase of hydroxyproline content in the renal tissues. Conclusion These results indicate that TGF-?/Smad signaling is involved in the progress of chronic glomerulosclerosis. The high level expressions of Smad2, Smad3, and Smad4 proteins and the down-regulation of Smad7 protein may be the major cause of the glomerulosclerosis in this model.

Mechanism of aristolochic acid induced injury in human renal tubular epithelial cells in vitro / 第三军医大学学报

Objective To investigate the possible injury mechanism of human kidney proximal tubular epithelial cell-2 (HK-2) induced by aristolochic acid (AA). Methods Cultured HK-2 cells were divided into 4 groups:normal control,treated by AA at the concentration of 30,60 and 120 ?mol/L for 48 h respectively. The morphological changes were observed by inverted phase contract microscopy. The cell viability was measured by the Cell Counting Kit-8 (CCK8) assay. Apoptotic cells were identified by flow cytometry. Expression of active Caspase-3 was measured by Western blot analysis. Automatic biochemical analyzer was used to detect the contents of LDH and ?-N-Acetylglucosaminidase (NAG) in the supernatant. The expression of E-cadherin and a-SMA was detected with laser scanning confocal microscope (LSCM). Enzyme linked immunosorbent assay (ELISA) was used to measure the levels of TGF-?1 and collagen Ⅲ in the supernatant quantitatively. Results AA inhibited HK-2 cells proliferation,induced cell apoptosis and activated Caspase-3 expression,and increased the LDH and NAG levels. All of these were in a concentration-dependent manner. AA at the concentration of 60 ?mol/L inhibited E-cadherin expression,increased ?-SMA expression and TGF-?1 and collagen Ⅲ secretion. Conclusion AA inhibits cell proliferation,induces apoptosis and epithelial-mesenchymal transition (EMT) in HK-2 cells. AA at relatively low concentration (≤60 ?mol/L) mainly induces EMT in HK-2 cells,while,that at high concentration (≥120 ?mol/L) causes apoptosis and cytotoxicity.

Transfection and expression of Smad7 inhibits transforming growth factor-?_1 effects on renal tubular cells / 第三军医大学学报

Objective To explore the effect of Smad7 gene transfer on tubular cell cycle arrest, tubular apoptosis and fibronectin (FN) synthesis by transforming growth factor ? 1(TGF ? 1) induced. Methods Mouse Smad7 gene was transfected into renal tubular cells in primary cell culture by using Tfx 50 cationic liposome. Tubular cell proliferation was measured by MTT and cell cycle was observed by flow cytometry. The level of FN secretion in the supernatant was determined by ELISA. Results At 48 h after administration of 10 ng/ml TGF ? 1 to renal tubular cells, cell proliferation declined, G 0/G 1 arrested in cell cycle, and cell FN secretion increased significantly. These abnormalities were attenuated by liposome mediated Smad7 gene transfection. Conclusion Transfection and expression of Smad7 can markedly inhibit TGF ? 1 responses in renal tubular cells, which is helpful for further studies of Smad7 gene therapy in vivo .

EXPRESSION OF BMP4 IN CNS NEURONS OF THE DEVELOPING RAT / 解剖学报

Objective To examine the expression of BMP4 in CNS of the developing rat. Methods In situ hybridization histochemistry(ISHH) was carried out on tissue sections using specific digoxigenin\|labeled oligonucleotide probe. Results It showed that BMP4 mRNA positive cells were located mainly in cerebellum and olfactory at E16.Strong positive signal was seen in hypoglossal nucleus,and moderate signal also seen in spinocerebellar tract and spinal lemniscus at P1\|2.The number of BMP4 mRNA positive cells was increased in the frontal cortex,parietal cortex,and hippocampus subiculum at P1W.The peak of BMP4 expression was in cortex and periamydaloid cortex.Widely distributed BMP4 mRNA positive cells were detected in cortex and hippocampus of rats at P1M,strong positive signal was observed in temporal CNS at P3M,strong positive signal was observed in hippocampus,temporal corex and periamydaloid cortex,lateral nucleus of thalamus and paraventricular nucleus of hypothalamus.BMP4 mRNA positive cells were also found in corex,hippocampus,hypothalamus and thalamus at P18M.Conclusion\ These results indicated that BMP4 could play an important role in CNS development of rats.

EFFECTS OF IL-1 AND IL-4 ON THE EXPRESSION OF p27 AND CDK_2 IN RAT GLOMERULAR MESANGIAL CELLS IN VITRO / 解放军医学杂志

To evaluate the effects of interleukin-1 and interleukin-4 on the expression of p27 (one of the negative cell-cycle proteins) and CDK 2 (cell-cycle depending kinase, one of the positive cell-cycle proteins) on renal mesangial cells of rat in vitro, and to analyze their significance. The results showed that the proliferation of mesangial cells was induced markedly by interleukin-1, while the expression of p27 was down-regulated and that of CDK 2 was up-regulated. All of above changes were prevented by interleukin-4. The results suggested that the responses of rat renal mesangial cells to interleukin-1 and interleukin-4 were closely related to the changes in the expression of p27 and CDK 2.

Therapeutic effects of mycophenolate mofetil in refractory nephrotic syndrome / 中国临床药理学与治疗学

AIM:To approach the therapeutic effects of mycophenolate mofetil(MMF)in hormonal resistance nephrotic syndromes.METHODS:Patients were diagnosed as nephrotic syndrome and treated with prednisone at the dose of 1 mg?kg-1?d-1 for over 8 weeks,and 24 patients with unsatisfactory results or were palindromic were selected,and several patients in the 24 patients had been treated with cyclophosphamide or cyclosporine A.All patients were treated with MMF combined with low dose hormone.The initial dose of MMF was 1.0-1.5 g/d for 3 months,later the dose were reduced,and the maintenance dose of MMF was 0.5-1.0 g/d,the dose of prednisone was 5-20 mg/d,the follow-up visit period more than six months.The changes on urine protein,serum albumin,liver function,renal function were compared before and after treatment.RESULTS:Before and after treatment,urine protein decreased from(3.4?1.7)g/d to(0.9?0.2)g/d,serum albumin increased from(19.6?5.4)g/L to(36.1?7.7)g/L.serum creatinine level decreased from(105.7?6.4)?mol/L to(90.1?5.8)g/L.20 patients(83.3%)pathogenetic condition were relieved,15 patients(65.2%)were with complete remission.5 patients(20.8%)were partially recovered,and 4 patients(16.6%)had no response.The adverse effects were observed,including gastrointestinal events(n=8,33.3%),bacterial pneumonia(n=4,16.6%),herpes zoster(n=1,4.1%),hepatic function mild damage(n=3,12.5%).CONCLUSION:It is safe and effective to combine MMF with low dose hormone in treatment of hormonal resistance nephrotic syndrome,which could become a therapeutic option for refractory nephrotic syndrome(RNS).

PAI-1,TIMP-1 gene expression in renal tubulointerstitial fibrosis of ureteral obstruction and the interfering effects of HGF treatment / 中国病理生理杂志

AIM: The aim of this study was to determine the relationship between PAI-1,TIMP-1 gene expression and renal tubulointerstitial fibrosis(TIF) of ureteral obstruction ,and the interfering effects of hepatocyte growth factor (HGF) treatment. METHODS: Sixty rats were divided into normal control, sham operation,unilateral ureteral obstruction(UUO),and rhHGF treated groups (received 0 5 mg?kg -1 ?d -1 HGF for twenty-one days), and were sacrificed at postoperative day 3, 7, 14, 21. The levels of PAI-1, TIMP-1 mRNA were measured by RT-PCR. MMP2 and MMP9 activities were detected by substrate zymography, and renal fibrosis was assessed by measuring tissue hydroxyproline. RESULTS: Compared to controls, expression levels of PAI-1,TIMP-1 mRNA were significantly increased in UUO rats, and this was accompanied by decreased activities of MMP2 and MMP9 and increase in tissue hydroxyproline content. HGF treatment significantly decreased expressions of PAI-1, TIMP-1 mRNA, increased MMP2 and MMP9 activities,and decreased tissue hydroxyproline content in the obstructive kidney. CONCLUSIONS: These results indicate that the increases in PAI-1, TIMP-1 mRNA expression may be the major cause of sustained decreased matrix degradation during the development of tubulointerstitial fibrosis after unilateral ureteral obstruction. rhHGF efficiently ameliorates renal tubulointerstitial injury by the reduction of PAI-1,TIMP-1 mRNA expression, and increasing MMP2, MMP9 activities. [

Localization of Smad 2, 3, 6, 7 and their changes of expression in experimental interstitial fibrosis model in rats / 中华肾脏病杂志

Objective To investigate the localization of Smad protein 2, 3, 6, 7 and their changes of expression in experimental interstitial fibrosis model in rats. Methods Thirty-six rats were divided into normal control, sham operation, and unilateral ureteral obstruction(UUO) groups, and were sacrificed at postoperative day 3, 7, 14, 21. The level of TGF-?1 mRNA was examined by RT-PCR. The sites and levels of expression of Smad protein 2, 3, 6, 7 were examined by immunohistochemistry staining and Western blot . Renal fibrosis was assessed by measuring tissue hydroxyproline. Results Compared to sham operation group, TGF-?1 mRNA was significantly increased in UUO rats, and this trend was positively correlated to increased hydroxyproline content. Immunohistochemistry staining studies indicated that Smad protein 2, 3 mainly expressed in renal tubular cells, rarely in glomeruli, and Smad protein 6, 7 were presented in both the glomeruli and proximal renal tubular cells. Expression of the Smad protein 2, 3 were significantly increased from day 3 to 21 after UUO, while the Smad protein 6, 7 were significantly reduced in the obstructive kidney. Conclusions TGF-?1/Smad signaling is involved in the progression of renal tubulointerstitial fibrosis. The absence of up-regulation of these anti-Smads proteins may be the major cause of the interstitial fibrosis in this model.