Substitutes for Endangered Animal Medicinal Materials： A Review / 中国实验方剂学杂志

Endangered animal medicine is an important part of traditional Chinese medicine， which is distinctive in the treatment of diseases. At present， the rare and endangered medicinal materials such as tiger bone， rhinoceros horn， pangolin， antelope horn， bear bile are listed as national key protected animals， so their clinical application is limited， the current solution is mainly based on the ideas and methods of similar pharmacological effects， close genetic relationships， artificial breeding， and artificial synthesis to find and develop alternatives for endangered animal medicinal materials. Although artificially cultured bear bile and musk， and artificially synthesized tiger bone， bezoar and musk can solve the shortage of endangered animal medicines to a certain extent， there are still some problems such as difficult breakthroughs in breeding technology and incomplete recognition in the substitute industry. According to this， based on summarizing the existing substitutes for endangered animal medicines， our group proposed the concept of homology， homogeneity and equivalent of substitutes， and constructed a new idea to develop and evaluate substitutes by combining frontier biotechnology with multi-omics detection， so as to provide some support for protecting rare and endangered animals and solving the shortage of endangered animal medicines.

Similarities and differences in the pathogenesis of Henoch-Sch?nlein nephritis and IgA nephropathy / 国际儿科学杂志

IgA vasculitis is a common autoimmune disease mediated by IgA in childhood, which can involve many systems.Henoch-Sch?nlein purpura nephritis(HSPN)is one of the main complications.Both HSPN and IgA nephropathy(IgAN)are common glomerulonephritis in children, but the former is the most common secondary glomerulonephritis and the latter is one of the most persistent diseases in primary glomerulonephritis.There are differences in clinical phenotype and prognosis.This article reviews the relevant literature, and summarizes the similarities and differences in the pathogenesis of HSPN and IgAN, so as to better understand the two diseases.

Evaluation on drug therapy of acute kidney injury in children / 中华实用儿科临床杂志

Acute kidney injury(AKI)in children is a common critical illness.It is increasing in incidence and associated with poor prognosis.Other than supportive care,no specific therapy exists for AKI.Current drugs for AKI are still in the research stage.This article analyzes the effectiveness of drug therapy for AKI,to provide guidance for the prevention and treatment of AKI.

Pathogenesis, diagnosis and treatment of systemic juvenile idiopathic arthritis / 中华实用儿科临床杂志

The typical clinical manifestations of systemic juvenile idiopathic arthritis (sJIA) are fever,rash,arthralgia,polyserositis,hepatomegaly and/or splenomegaly.It is a subtype of JIA,the morbidity is 6.6/100 000-15.0/100 000,but the disability and mortality account for more than 2/3 of JIA.Its symptoms and signs are often not quite typical,therefore,it is often difficult to diagnose.The pathogenesis of sJIA is unclear at present,it is considered to be a self inflammatory response syndrome,rather than classical autoimmune arthritis.But,self inflammatory disease has a clear pathogenic gene and family history,the pathogenic gene of sJIA is still inconclusive,it also doesn't have obvious familial inheritance,this is the greatest difference.The traditional treatment for sJIA includes non steroidal anti-inflammatory drugs,glucocorticoids and disease modifying antirheumatic drugs.But,it is still dangerous and easy to relapse,what's more,it is prone to result in fatal complications-macrophage activation syndrome.This article will review the etiology,pathogenesis,clinical manifestations,diagnosis,new biomarkers,differential diagnosis and treatment of sJIA.

Epidemiology of acute kidney injury in children / 中华实用儿科临床杂志

In recent years,it is a tendency to substitute acute kidney injury (AKI) foracute renal failure (ARF)in the aspect of international nephrology and emergency medicine.Compared with the past,the causes for AKI in children at present has been transferred from primary kidney disease to multi-factors,moreover,the morbidity and mortality of AKI is staying at a high level.From the perspective of epidemiology this paper briefly analyses the common cause,mortality and morbidity of AKI in children.

Do immunoglobulin A vasculitis and immunoglobulin A nephropathy belong to one desease / 中华实用儿科临床杂志

The immunopathogenesis of IgA vasculitis and IgA nephropathy both demonstrate IgA deposition,and abnormal glycosylation of IgAl molecule is their major pathogenesis.Therefore,it is clinically controversial that they are actually one disease.The present text will delineate their similarities and differences from aspects of epidemiology,clinic,pathology,mechanism and prognosis.

Treatment and diagnosis of anti-neutrophil cytoplasmic antibodies-associated vasculitis / 中国小儿急救医学

Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) includes granulomatosis with polyangiitis,microscopic polyangiitis,eosinophilic granulomatosis with polyangiitis,which are known for this name because the common involvement of ANCA in the serum.New revise have been made in the Chapel Hill consensus conference 2012 about the nomenclature and definition of vasculitides,including the AAV.AAV can be misdiagnosed and delay diagnosed very easily for the variety and lack of specificity of clinical manifestations,and a early diagnosis and timely treatment is the key for a better prognosis.

The therapeutic efficacy of cyclosporin A in the children with refractory nephrotic syndome / 中国医师杂志

Objective To evaluate the efficacy of cyclosporine A plus prednisone in the treatment of refractory nephrotic syndrome in children.Methods The 26 refractory nephrotic syndrome children were treated with CsA plus prednisone,3 ～6 mg/(kg d),Po.The duration of treatment was 3 to 27 months (12.69 ± 6.44) mos.The 24 h quantitative urinary proteins,serum cholesterol,urea nitrogen,plasma creatinine,N-acetyl beta amino glycosidase enzymes cystatin C were detected before and after treatment,and the adverse drug reactions were accessed.Results Among 26 cases,12 cases of steroid-resistant NS,6 cases of steroid-dependent NS,and 8 cases of frequent relapse NS were included.16 patients (61.54％) were complete remission,8 patients (30.77％) partial remission,2 cases (7.69％) were non-remission,The total remission rate was 92.31％.The 24 hours urine protein was 3.01 g and 0.63 g before treatment and after treatment,respectively,with a statistically significant difference (P ＜0.01); serum cholesterol was (7.72 ± 3.86) mmol/L and (7.15 ± 3.23) mmol/L; nitrogen urea was (3.93 ± 1.44) mmol/L and (4.04 ± 1.27) mmol/L,creatinine (33.38 ± 13.16) μmol/L and (35.64 ± 3.53) μmol/L serum N-acetyl beta amino glycosidase enzymes was (18.96 ±4.86) u/L and (20.45 ±5.85)u/L before treatment and after treatment,respectively,without a statistically significant difference (P ＞ 0.05).The response to CsA was no significant difference in SRNS,SDNS and FRNS.Children complete remission,follow-up to 6 months,9 months,12 months and 18 months of the recurrence rate was 37.5％,31.25％,18.75％ and 12.5％.Eight cases ended treatment 3 ～ 6 months,all cases were not recurrence.The main adverse effects of CsA included hirsutism,tremble,gastrointestinal reaction and so on,and liver kidney toxicity was not obvious during the therapy course.Conclusions The treatment of CsA in combination with prednisone to children refractory nephrotic syndrome had a significant curative effect,which could obviously minimize the dosage of glucocorticoids and reduce the recurrence after at least one year of maintenance treatment of CsA.

Podocalyxin expression in renal tissues and correlation with the number of urinary podocytes in children with Henoch-Sch(o)nlein purpura nephritis / 中南大学学报(医学版)

Objective:To analyze the podocalyxin (PCX) expression in the kidney and the number of urinary podocytes in different pathological grades of Henoch-Sch(o)nlein purpura nephritis (HSPN),and to determine whether the number of urinary podocytes reflects the renal damage in HSPN.Methods:Fifty-six children diagnosed with HSPN in our hospital were enrolled in the study and classified into 4 groups by renal pathology:grade Ⅱ (Ⅱa+Ⅱb) (n=10),grade Ⅲ (Ⅲa+Ⅲb) (n=21),grade Ⅳ (n=16),and grade Ⅴ (n=9).Four kidney autopsy specimens without histomorphologic lesions and 8 urine samples from healthy children served as controls.With immunofluorescence assay,the PCX expression in 4 normal renal tissues and in the renal tissues of the 56 HSPN children was detected and quantitatively analyzed.Positive rate and the number of urinary podocytes were detected in the 8 healthy children and 56 HSPN children.Results:In the renal tissues of the normal control group and grade Ⅱ (Ⅱa+Ⅱb) HSPN group,the PCX expression was complete.The percentage of the PCX positive area out of the total glomerular area in the renal tissues of 2 groups had no significant difference (P＞0.05).In the renal tissues of grade Ⅲ (Ⅲa+Ⅲb),Ⅳ,and Ⅴ HSPN groups,the PCX expression showed various degrees of loss,decreasing in turn from grade Ⅱ (Ⅱa+Ⅱb),Ⅲ (Ⅲa+Ⅲb),Ⅳ to Ⅴ,with significant differences between each group (P＜0.01).For HSPN with grade Ⅲ (Ⅲa+Ⅲb) or higher,positive PCX expression was found in the urine,suggesting the presence of enough podocytes in the urine.The percentage of fluorescence positive area out of the total glomerular area of PCX in the renal tissues was negatively correlated with the total number of urinary podocytes (r=-0.637,P＜0.01).Conclusion:Podocyte injury plays a certain role in the pathological progression of HSPN.The urinary detection ofpodocytes can reflect the degrees of pathological damage in HSPN.

Sympathetic nervous system level and ambulatory blood pressure in children with primary nephrotic syndrome / 中南大学学报(医学版)

OBJECTIVE@#To explore the change in ambulatory blood pressure monitoring (ABPM) value and the sympathetic nervous system (SNS) level in children with primary nephrotic syndrome(PNS) and their relationship.@*METHODS@#ABPM and casual blood pressure(CBP) were tested in 114 children with PNS and 12 normal children as a control group. The 24-h urine noradrenaline(NA), adrenaline(A) and dopamine(DA) content were detected through high-performance liquid chromatography with electrochemical luminescence and the correlation with ABP was analyzed.@*RESULTS@#Among 114 children with PNS, 101 had elevated blood pressure (88.6%), 45 showed high incidence of masked hypertension (39.5%), and 80 non-dipper blood pressure (70.2%). Systolic blood pressure level and blood pressure load were greater than diastolic blood pressure. NA, A, and DA levels of the PNS group were significantly higher than those of the control group, while those of the elevated blood pressure group were significantly higher than those of the normal blood pressure group in PNS children. SNS levels were positively correlated with blood pressure levels and blood pressure load, and negatively correlated with night BP decreasing rates.@*CONCLUSION@#Children with PNS have high incidence of hypertension with large proportion of masked hypertension and non-dipper blood pressure. Severe masked hypertension classification should be set up. In PNS children, SNS activity is elevated that might evaluate the blood pressure level and decrease blood pressure circadian rhythm.

Nephroprotective effects of subcapsular transplantation of metanephric mesenchymal cells on acute tubular necrosis rats / 中华肾脏病杂志

ObjectiveTo evaluate the nephroprotective effects of transplanting metanephric mesenchymal cells (MMCs) into the renal subcaspsule of rats with acute tubular necrosis (ATN) induced by gentamicin. MethodsMMCs were expanded in culture and immunocytochemistry was used to characterize the cells. After gentamicin-induced ATN, fluorescence-labeled cells were transplanted and traced in kidney tissues by fluorescence microscopy. Serum creatinine (Scr) and N-acetyl-b-D-glucosaminidase (NAG) were tested. Kidney pathology was studied by hematoxylin-eosin staining. Apoptosis was examined by the TUNEL assay. Ki-67 and Bcl-2 expression was examined by immunohistochemistry. ResultsMMCs were expanded in culture and the phenotype of the cells was vimentin-positive and keratin-negative. Compared with other ATN groups, in the MMCs-treated group, Scr and NAG clearly decreased[14d Scr: (101.38±20.46) μmol/L vs (248.78±23.15), (252.98±33.52), (229.08±18.18) μmol/L;NAG: (14.83±7.74) U/L vs (33.33±14.88), (29.62±10.54), (30.22±10.94) U/L, P<0.05, respectively];the histopathoiogic lesion scores were lower (P<0.05);the Ki-67 antibody and apoptosis of renal tubular epithelial cells were improved or reduced respectively;the expression of Bcl-2 protein was up-regulated (P<0.05). ConclusionThe subcapsular transplantation of MMCs can ameliorate renal function and repair kidney injury.

Effect of bone marrow stem cells mobilization by SCF combined with G-CSF on renal regeneration and repair in UUO rats / 中华肾脏病杂志

Objective To investigate the effect and possible mechanism of bone marrow stem cell mobilized by stem cell factor (SCF) with granulocyte colony-stimulating factor(G-CSF)on renal peritubular capillary, fibrosis and renal function in unilateral ureteral obstruction (UUO) rats. Methods One hundred and twenty eight healthy male Wistar rats were randomly divided into four groups: Sham group, SCF-G group, UUO group and UUO+SCF-G group. Eight rats of each group were randomly selected and killed on the 5th, 14th, 21st and 28th day. Serum creatinine, CD34 positive cells and factor Ⅷ positive cells in renal interstitium, histopathologic lesion scores of interstitial fibrosis and interstitial pathology in kidney were measured. The mRNA expression of vascular endothelial growth factor (VEGF). and thrombospondin-1 (TSP-1) in the renal cortex was detected. Results (1) The renal interstitial fibrosis anti the loss of peritubular capillary were observed in UUO group after two weeks. (2) The number of bone marrow stem cells homing to renal interstitium in UUO +SCF-G group was significantly higher than that in UUO and Sham groups (P<0.05). (3) The loss of peritubular capillary in UUO+SCF-G group appeared later than that in UUO group (P<0.05). (4) The interstitial fibrosis and tubule injury was milder in UUO+SCF-G group than that in UUO group (P<0.05). (5) The decrease of VEGF mRNA expression of renal cortex in UUO +SCF-G group was seen later than that in UUO group. VEGF mRNA expression in UUO+SCF-G group was higher than that in UUO group. (6) The increase of TSP-1 mRNA expression of renal cortex in UUO+SCF-G group was seen later than that in UUO group. TSP-1 mRNA expression in UUO+SCF-G group was lower than that in UUO group (P<0.05). (7) In UUO and UUO+SCF-G groups, peritubular capillary index was negatively correlated with serum creatinine, interstitial fibrosis and interstitial lesion scores. VEGF mRNA expression of renal cortex was positively correlated with peritubular capillary index, and TSP-1 mRNA expression of renal cortex was positively correlated with peritubular capillary index. Conclusions (1)The loss of peritubular capillary is found in UUO group, and is correlated with interstitial fibrosis and interstitial lesion. (2) Application of SCF with G-CSF can effectively motivate stem cells to injured renal tissue, contribute to decrease the loss of peritubular capillary, lessen interstitial fibrosis and interstitial lesion, and ameliorate renal function. (3) Application of SCF with G-CSF can up-regulate VEGF mRNA expression and down-regulate TSP-1 mRNA expression, which may contribute to promote the repair of endothelial cells and protect peritubular capillary.

Treatment of metanephric mesenchymal cells transplantation for adriamycin-induced chronic nephropathy rats / 中华肾脏病杂志

Objecfive To detect the functional repair of metanephric mesenchymal cells (MMCs) transplantation in adriamycin (ADR)-induced glomerulopathy rats. Methods A total of 90 Sprague-Dawley female rats were randomly divided into three groups:ADR group (n=40,rats were injected via the tail vein with O.25 mg ADR/100 g body weight on days 1 and 21),ADR- MMCs group(n=40,rats were injected via the tail vein with 5×10~6-7×10~6 MMCs 8 weeks after the second ADR administration),control(n=10).All the rats were scarified 8 weeks after MMCsinjection.Pathology and collagen IV expression in renal tissue were examined.Moreover,matrix metalloproteinases 2 (MMP-2) and matrix metallopmteinases 9 (MMP-9) expression in the renal tissue were also detected with immunohistochemistry,and quantity analysis of protein and gene was further demonstrated with Westem blot and RT-PCR analysis,respectively. Results There were no significant differences in tubulointerstitial injury score and glomerulosclerosis degree between ADR group and ADR-MMCs group(P>0.05).Compared with ADR group,collagen Ⅳ and MMP-2 expression decreased, MMP-9 expression incrased in renal tissue of ADR-MMCs group, and the difference was significant (P<0.05). Conclusion MMCs transplantation may have potentially therapeutic effect on renal tissue fibrosis of adriamyein-induced glomerulopathy in rats, and the signaling pathways of MMPs appear to be involved in these processes.

Regulation of intercellular adhesion molecule-1 expression in murine glomerular mesangial cells by lipoprotein(a) / 中国医师杂志

Objective To investigate the effects of Lp(a)on proliferation GMCs of rat model induced by lipopolysaccharide and explore the possible mechanism of Lp(a)in the proliferation of rat GMCs.Methods To observe the effects of Lp(a)on proliferation of GMCs,different dosage of Lp(a)were used,The research were divided into three groups:Control group,LPS group,Lp(a)group.After culture(at the end of 12h,24h,48h,60h and 72h),the cultured GMCs and suspension were collected to observe the rate of GMCs proliferation by MTT,the positive rate of proliferation cell nuclear antigen(PCNA)by immunohistochemisty,and the level of intercellular adhesion molecule-1(ICAM-1)by ELISA respectively.Results Compared with control and LPS group,MTT,positive rate of PCNA and ICAM-1 of GMCs were increased more significantly in Lp(a)group.MTT ,the positive rate of PCNA and ICAM-1 of GMCs were increased as Lp(a)dosage increased,a maximal effect was seen when Lp(a)was 2.5 μg/L or 5.0μg/L.When the dosage continue increased,MTT,the positive rate of PCNA and ICAM-1 activity of GMCs began to decrease in Lp(a)group.ICAM-1 showed positive correlation with MTT and the positive rate of PCNA.Conclusion Lp(a)can significantly affect the rate of GMCs proliferation,and this affection is in a dosage-and timedependent manner.Low dosage stimulates GMCs proliferation, and high dosage inhibits GMCs proliferation.ICAM-1 shows positive correlation with MTT and the positive rate of PCNA.The effect of Lp(a)on GMCs may be through ICAM-1.

Experience of pediatric practice teaching in seven-year program / 中华医学教育探索杂志

High medical education of seven-year program is to cultivate better medical talents who have master degree.We gained some experience of pediatric practice teaching in sevenyear program:to actualize special teachers'supervision system,adopt multi-means teaching(case,enlightening,questing,multimedia,sick-centered clinic observation and thinking),cultivate clinic ideation,improve the teaching,enhance doctor-patient communication,treat skillfully the relationship between the sick child and its parents and cultivate pupils scientific thinking and innovation spirit.