RESUMO
IgA nephropathy (IgAN) is one of the common primary glomerulonephritis, which is also an important risk factor for end-stage renal disease. Kidney transplantation is the optimal treatment for end-stage renal disease induced by IgAN, whereas there is still a risk of recurrence of IgAN after kidney transplantation. At present, research progress upon IgAN recurrence after kidney transplantation is relatively lacking. The pathogenesis of IgAN recurrence remains elusive, and its pathological manifestations are not specific. The diagnosis of IgAN recurrence still depends on renal biopsy. Besides, no effective prevention and treatment are available for recurrent IgAN. In this article, research progress on IgAN recurrence after kidney transplantation was illustrated from the perspectives of pathogenesis, diagnosis, risk factors and treatment, aiming to provide reference for clinical prevention and treatment of IgAN recurrence after kidney transplantation and improve clinical prognosis of kidney transplant recipients.
RESUMO
@#Bicyclo [1.1.1] pentane (BCP) is a kind of bridged ring skeleton with a three-dimensional structure. As a bioisostere of benzene ring, tert-butyl and alkyne, it has been widely used in the field of medicinal chemistry.With the expansion of its application, the synthesis of BCP and its derivatives has become an increasingly attractive research hotspot for scientists.Based on this, the present article summarizes the main synthetic strategies and methods of BCP derivatives, in the hope of providing some reference for drug discovery researchers and some insight for new synthetic methods of such compounds.
RESUMO
@#With the development of medicinal and organic chemistry, more and more classical and non-classical bioisosteres are used in the design of novel drugs.Bicyclo[1.1.1] pentane (BCP), as a bioisostere of benzene, t-butyl and alkyne moieties,has recently received extensive attention from medicinal and organic chemists.This paper briefly reviews its application in drug design to provide reference for drug discovery researchers.
RESUMO
@#This study aims to discuss the therapeutic effect of magnesium isoglycyrrhizinate on hepatitis B virus(HBV)transgenic mouse and its effect on cellular immunity and liver inflammation. The changes of serum aspartate aminotransferase(AST)and alanine aminotransferase(ALT)activity, the difference of serum hepatitis B surface antigen(HBsAg), liver tissue HBsAg mRNA, and the pathological morphological changes of liver tissue were detected to investigate the hepatic inflammatory lesions and the efficacy of magnesium isoglycyrrhizinate in HBV transgenic mouse. Peripheral blood lymphocytes were classified by flow cytometry, and serum cytokines were detected by cytometric bead array(CBA)to explore the mechanism of magnesium isoglycyrrhizinate to reduce hepatic inflammatory lesions in HBV transgenic mouse. After grouping HBV transgenic mouse with serum transaminase activity and 35 days of continuous administration, serum transaminases level in magnesium isoglycyrrhizinate ［15 mg/(kg ·d)］ group was significantly lower than that in control group(P< 0. 05), serum HBsAg protein and liver tissue HBsAg mRNA increased with time, but there was no significant difference between the two groups. The main pathological changes of liver were liver cell swelling, necrosis and focal inflammatory cell infiltration, and the pathological changes of liver in magnesium isoglycyrrhizinate group were lighter than those in control group. The number of CD8+ cells in the blood of magnesium isoglycyrrhizinate group was significantly less than that in the control group(P< 0. 05)and the CD4+/CD8+ cell ratio was significantly higher than that in the control group(P< 0. 05). The content of inflammatory cytokines in serum of magnesium isoglycyrrhizinate group decreased significantly(P< 0. 05). Magnesium isoglycyrrhizinate can regulate the immune function of HBV transgenic mouse, decrease the infiltration of inflammatory cells in hepatic tissue and hepatocyte injury, but do not affect the expression of hepatocyte HBsAg.
RESUMO
Vorapaxar,a novel antagonist of the protease-activated receptor 1 (PAR-1 ),can inhibit the clotting process. Deuterium-labeled vorapaxar was required for the analysis of clinical sample as an internal stand-ard. Starting for unlabeled vorapaxar,four-step reactions including hydrolysis,condensation,transesterification and hydrogen-deuterium exchange were carried out to synthesize [D8]vorapaxar effectively for the first time. All intermediates and final products were confirmed by NMR and high resolution mass spectrometry (HRMS).Impor-tantly,the prepared [D8]vorapaxar could meet the requirements of sample analysis as the internal standard.
RESUMO
@#The genome, replication mode and nosogenesis of duck hepatitis B virus are similar to those of human hepatitis B virus. In addition, the natural host of duck hepatitis B virus is readily available, cheap and has a high success rate of infection. Therefore, duck hepatitis B virus-infected models have been widely used for drug screening, pharmacological and pathological studies. For drug screening, the model is easy to obtain with high infection success rate and good stability. In the pharmacological research, the model can maintain high levels of viral DNA replication in the hepatocytes and exhibit significant damaged liver phenotypes which can reflect the pharmacological effects of drugs with different mechanisms. Also in the pathologic mechanisms research, the model has entire virus life cycle and maintains a pool of covalent closed-loop DNA in the hepatocytes, which can help scientific researchers better understand human hepatitis B virus. This article reviews the applications of duck hepatitis B animal model in drug screening, pharmacological and pathological studies, also outlooks the application prospect of this model.
RESUMO
Objective To investigate the safety and efficacy of flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal stones in patients with a solitary kidney.Methods Between May 2014 and June 2016,Clinical records of 17 cases of stones in a solitary kidney who underwent flexible ureteroscopy and holmium laser lithotripsy were reviewed.10 of these cases were male and the others female;mean age of these cases was 45.8 (32-67) years.9 were on the left side while 8 were on the right.6 cases were with functional solitary kidney (with the GFR of the contralateral kidney less than 10ml/min),while 11 others were with anatomical solitary kidney (6 due to tumor,2 due to tuberculosis,3 being congenital).All cases underwent BUS,KUB as well as CTU to confirm diagnosis before surgery,with 8 diagnosed with renal pelvis calculi,5 were with upper or middle calyx calculi,and 4 were with subrenal calyx calculi.The mean ± SD size of the stones was 1.2 ± 0.3 cm.Clinical m anifestations were asymptomatic in 10cases,backache in 5 cases and fever in 2 cases.All patients underwent exams of CBC,urinalysis,liver and kidney function,coagulation function,ECG,chest X-ray as well as cleaning midstream urine cultivation after admission.Results Mean ± SD operation time among all cases was (74.2 ± 23.6) min,the amount of bleeding during surgery was 5-15 (mean:8) ml,duration of hospitalization was 3-12 (mean:4.5)days,ureteral stents are kept for an average time of 4 weeks after surgery.3 patients developed fever after operation,1 developed urosepsis;all these patients recovered after active anti-infection treatment.No post-operative complications such as fever,renal colic,hematuresis,ureteral perforation,active bleeding as well as sepsis were found among the other patients.The preoperative and postoperative serum creatinine had statistical difference (P ＜0.05).14 patients were proved to be stone-free by KUB or CTU.The stone-free rate after a single operation was 82.3％ (14/17).Residual stone were found in the 3 patients,who subsequently underwent a second flexible ureteroscopy and holmium laser lithotripsy.The stone-free rate after a second operation was 94.1％.Conclusions Flexible ureteroscopy and holmium laser lithotripsy is a safe and effective method for the treatment of nephrolithiasis in patients with a solitary kidney with a lower procedure-related injury rate,smaller amount of bleeding,a lower complication rate and a shorter time required to recover after surgery.
RESUMO
The paper introduced to the integration and synergy of knowledge bases upon workflow management technology.With existing medical knowledge bases as starting point,this method first developed knowledge services for each knowledge base,then orchestrated these services using workflow management technology,and finally achieved coordinated decision support applications.Such support system has found clinical uses in tertiary hospitals in China with proven outcomes.
RESUMO
Objective To investigate the clinical manifestations, pathologic features, treatment and prognosis of oncogenic osteomalacia (OO). Methods A 17-year-old male patient was admitted.The patient presented with a 4-year history of progressive lower limb weakness, muscle atrophy and joint pain. Lab tests demonstrated hypophosphatemia. Lumbar and pelvic X-ray showed wedging of the lumbar spine and decreased pelvic bone density. Ultrasonography revealed a low-echo and bloodrich mass measuring 15.1 cm× 14.5 cm× 13.2 cm located at the lower pole of left kidney. Computed tomography showed a voluminous enhanced tumor, supplied by the left renal artery, vice renal artery and a branch of the inferior mesenteric artery. A tortuous vein at the lower part of the tumor drained into the left renal vein. A radioactive octreotide scan was used to study an increased radionuclide-uptake lesion which was initially suspected on the CT scan. The patient was preoperatively diagnosed with left malignant kidney tumor and oncogenic osteomalacia. During a left radical nephrectomy performed through a transperitoneal anterior subcostal incision, a round diameter 15 cm tumor covered by twisted veins was found. The patient recovered well postoperatively. Results The histological diagnosis was renal clear cell carcinoma. Immunohistochemical staining detected Vimentin and RCC were positive and Ki-67antigen index was about 2 %. After lesion removal, the paraneoplastic syndrome resolved. At the 11-month follow-up, no recurrence of the disease was observed. Conclusions Oncogenic osteomalacia is rare and OO with renal cell carcinoma has not been reported so far. OO or rickets should be suspected in those patients who presented with metabolic bone disease associated with hypophosphatemia and inappropriate phosphaturia. If OO syndrome was suspected, in addition to past medical history and imaging, a standard meticulous examination should be initiated promptly. Surgical treatment is still necessary once confirmed. And all of them achieved a good prognosis.