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BACKGROUND:Abnormal immunological function is possibly observed after cardiac valve replacement. However, effect of continuous venovenous hemofiltration on immunological function after cardiac valve replacement is rarely reported. OBJECTIVE:To observe the effect of continuous venovenous hemofiltration on the cellular immune function in patients with multiple organ dysfunction syndrome after cardiac valve replacement. METHODS:Thirty-one patients with multiple organ dysfunction syndrome after cardiac valve replacement in Xijing Hospital, the Fourth Military Medical University of Chinese PLA, from August 2008 to July 2009, were included in this study. They were treated with continuous venovenous hemofiltration using AV600 hemofilter and were divided into two groups:survival group (17 survivors) and death group (14 deaths). In addition, 16 healthy blood donors served as the control group. RESULTS AND CONCLUSION:The duration of acute renal failure before continuous venovenous hemofiltration of survival group was significantly lower than that of death group (P<0.05). Before continuous venovenous hemofiltration, the CD4+/CD8+ratio and Th1/Th2 ratio of survival group and death group were lower than that of control group (P<0.05), and lymphocyte apoptosis rate and Fas/FasL antigen expression were higher than that of control group (P<0.05). This evidence suggested the presence of immunosuppression state and Th1/Th2 disbalance. During continuous venovenous hemofiltration, the CD4+/CD8+ratio and Th1/Th2 ratio of survival group were gradual y increased (P<0.05), while lymphocyte apoptosis rate and Fas/FasL antigen expression were gradual y decreased (P<0.05) at 24 hours. The above changes were observed in both survival group and death group, but emerged latter in death group. Continuous venovenous hemofiltration can improve cellular immune function, maintain the balance of T lymphocyte subsets and Th1/Th2, down-regulate Fas/FasL expression on the surface of lymphocyte membrane, and decrease lymphocyte apoptosis rate in patients with multiple organ dysfunction syndrome after cardiac valve replacement. Early continuous venovenous hemofiltration can improve patients’ prognosis.
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Objective To investigate the effects of preconditioning with repeated electroacupuncture (EA)at Shenshu acupoint on renal ischemia-reperfusion (I/R) injury in rats.Methods Fifty adult male Sprague-Dawley rats,weighing 260-320 g,were randomly divided into 4 groups:sham operation group (n =5),I/R group,pentobarbital sodium + I/R group (PB + I/R group) and repeated EA at Shenshu acupoint + I/R group (EA + I/R group).The model of renal I/R injury was established by occlusion of bilateral renal pedicles for 45 min followed by reperfusion.Pentobarbital sodium 30 mg/kg was injected intraperitoneally everyday for 5 consecutive days and I/R was induced 24 h after the last injection in PB + I/R group.The animals received EA at Shenshu acupiont 30min per day for 5 consecutive days under pentobarbital sodium anesthesia and I/R was induced 24 h after the last preconditioning in EA + I/R group.Blood samples were taken at 1,3 and 7 days after I/R to determine the levels of serum blood urea nitrogen (BUN) and creatinine (Cr).The animals were then sacrificed and the kidney was isolated.The histological changes of the kidney was scored.The apoptosis in renal tubular epithelial cells was measured using TUNEL at 3 days after I/R.Apoptosis index (AI) was calculated.The expression of proliferating cell nuclear antigen (PCNA),Bcl-2,Bax,Fas and FasL in renal tubular epithelial cells was measured by immuno-histochemistry at 3 days after I/R.Results Compared with group S,the levels of serum BUN and Cr,and histological score were significantly increased at 1,3 and 7 days after I/R in I/R and PB + I/R groups,and at 1 and 3 days after I/R in EA + I/R group,the expression of PCNA,Bcl-2,Bax,Fas and FasL was up-regulated in I/R,PB + I/R and EA + I/R groups,and Bax/Bcl-2 ratio was significantly increased in I/R and PB + I/R groups (P ＜0.05).Compared with I/R and PB + I/R groups,the levels of serum BUN and Cr,and histological score were significantly decreased at 3 and 7 days after I/R,AI and the expression of Bax,Fas and FasL were significantly decreased,and the expression of PCNA and Bcl-2 was up-regulated in EA + I/R group (P ＜ 0.05).Conclusion Preconditioning with repeated EA at Shenshu acupoint can attenuate the renal I/R injury in rats by promoting the proliferation of renal tubular epithelial cells and reducing the apoptosis in cells.
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Objective To investigate the effects of mesenchymal stem cells(MSCs) on the recovery of gentamicin-induced acute renal failure(ARF),and explore its possible mechanism.Methods MSCs were isolated from a male SD rat and labeled with DAPI before injection.ARF rat model was reproduced by hypodermic injection of gentamicin.At the time that gentamicin was injected,MSCs were injected through tail vein.Thirty SD rats were randomly divided into three groups(10 each): MSCs injection group(group M),DMEM-F12 infusion group(group D) and control group(group C).Rats were sacrificed on day 7 after gentamicin injection.The levels of serum Scr and BUN were determined,and the renal tissue was sampled for pathological observation.Cell apoptotic index(AI) was calculated after terminal deoxynucleotidyl transferase mediated d-UTP nick end labeling(TUNEL).The expressions of Bcl-2,Fas and FasL proteins and PCNA were determined by immunohistochemical technique.The distribution of DAPI positive MSCs in kidney of recipient SD rats was examined by immunohistochemistry.Results HSK score(5.5?0.8 vs 10.2?0.8,P