Clinical characteristics and etiologic analysis of scabies-associated glomerulonephritis / 重庆医学

Objective To understand the incidence and clinical characteristics of scabies-associated glomerulonephritis and to investigate its pathogenesis.Methods The patients with scabies from Qijiang District People's Hospital.were collected from the outpatient department and divided into the simple scabies group (A) and glomerulonephritis group (B) according to whether complicating glomerulonephritis.The general clinical indicators and serum C-reactive protein(CRP),complement components C3 and C4,immunoglobulin,TNF-α,IL-6,IL-1β and IL-18 in the early stage of the disease were determined and compared between the two groups.The differences of above indicators were collected and compared between before and after clinical cure in the patients with scabies-associated glomerulonephritis.Results Among 376 cases of scabies,16 cases developed glomerulonephritis.The clinical manifestations included glomerular hematuria and/or mild-moderate proteinuria.The kidney injury manifestations in 12 cases were completely disappeared at 2-6 months after scabies cure.The levels of serum CRP,IgG,TNF-α,IL-6,and IL-18 in the group B were significantly increased and the serum C3 level was significantly decreased compared with the group A,the differences were statistically significant(P＜0.05).The levels of serum IgG,hs-CRP,TNF-α,IL-6 and IL-18 after cure in 12 cases of clinically cured scabies-associated glomerulonephritis were significantly decreased and the serum C3 level was significantly increased,and the difference was statistically significant compared with the early onset stage(P＜0.05).Conclusion The majority of prognosis in scabies-associated glomerulonephritis is good.Its occurrence is closely correlated with immune and inflammatory reactions induced by sarcoptes mites irffection.

Clinical characteristic and correlative factors of maintenance hemodialysis patients with restless legs syndrome / 中华肾脏病杂志

Objective To explore the prevalence and the correlative factors of restless legs syndrome (RLS) in maintenance hemodialysis (MHD) patients.Methods The basic information and clinical laboratory results of 307 MHD patients were collected.The international RLS study group (IRLSSG) diagnostic criteria were applied to assess the presence and the severity of RLS.Binary logistic analysis was used for exploring correlative factors of RLS.Results The prevalence of RLS was 12.1％ in the MHD patients,with 73.0％ patients having mild-to-moderate symptoms and 83.8％ having chronic RLS.There was no significant difference between MHD patients with and without RLS in age,gender,dialysis age,daily urine,Kt/V,history of smoking,drinking,hemoglobin,serum creatinine,urea nitrogen,uric acid,calcium,phosphorus,magnesium,potassium,intact parathyroid hormone (iPTH),prealbumin,albumin and alkaline phosphatase.But the frequency of daily exercise in RLS group is significantly lower than that in non-RLS group (Z=-4.114,P ＜ 0.001).Logistic regression analysis showed that daily exercise was a correlative factor of RLS (B=-2.203,OR=0.111,95％CI 0.033-0.371,P ＜ 0.001).Conclusions RLS is a common complication in MHD patients,with chronic state and mild-to-moderate symptoms.RLS is correlated with daily exercise,which may be a scientific approach to treat or prevent this disease.

Study on Expressions of HIF-1α and Renal Tubular Injury on Contrast-induced Nephropathy of Rats / 现代生物医学进展

Objective:To investigate the expression of HIF-1α in serum of rats with contrast induced nephropathy and its effect on renal tubular injury.Methods:45 SD rats were randomLy divided into three groups (n=15).The rats in the blank control group (group A)were treated with 12 h (Sodium Chloride Injection) for three 0.5 mL after fasting water for a period of about 15 minutes.Contrast nephropathy group (B group) rats after fasting 12 h,in the tail vein with 10 mg/kg injection ofindomethacin,15 minutes after the injection of 10 mg/kg nitro-L-arginine methyl ester (L-NAME),15 minutes after the injection ofiobitridol (3 G I/kg).Atorvastatin group (C group) rats in the first 3 days of the experiment started feeding atorvastatin calcium tablets,continuous feeding for 3 days,at a dose of 80 mg/kg/d,and fasting 12 h,making contrast nephropathy model,with the steps of contrast nephropathy group.The changes of renal function indexes (BUN,Cr),HIF-1α expression and renal tubular injury in three groups were observed and compared.Results:The level of BUN in rats with contrast induced nephropathy was lower than that in atorvastatin calcium group and blank control group,but the level of Scr was higher than that of atorvastatin calcium group and blank control group,the difference was statistically significant (P＜0.05).The level of BUN in atorvastatin calcium group was lower than that in blank control group,but Scr level was higher than that in blank control group,the difference was statistically significant (P＜0.05).Compared with the blank control group,the renal tubular injury in the rats with contrast induced nephropathy group was higher than that in atorvastatin calcium group and blank control group,the difference was statistically significant (P＜0.05).Compared with the control group,the expression of HIF-1 was significantly higher in rats with contrast induced nephropathy than that in atorvastatin calcium group and blank control group.The expression of HIF-1 was significantly higher than that in the control group (P＜0.05).Conclusions:It is suggested that the statins could prevent the contrast-induced nephropathy.However,the ending mechanism of statins should be further studied in the clinical practices.

Effect of autophagy on necroptosis of renal tubular epithelial cells in sub-total nephrectomy rats / 中国病理生理杂志

[ ABSTRACT] AIM: To explore whether autophagy is involved in the excessive death of renal tubular epithelial cells in subtotal nephrectomy ( SNx) rats and the relationship between autophagy and necroptosis in the kidney of SNx rats. METHODS:Male Sprague-Dawley rats were randomly assigned to control group ( n=6 ) and SNx group ( n=42 ) .The rats in SNx group were subjected to SNx.Sham surgery was performed in the rats in control group.The rats in SNx group were divided into subgroups at 0, 4, 8 and 12 weeks ( n=6) and the other rats in SNx group were divided into SNx+vehi-cle group, SNx+necrostatin-1 (Nec-1) group and SNx+3-methyladenine (3-MA) group.The expression of RIP1, RIP3, LC3 and beclin-1 at mRNA and protein levels was measured at 0, 4, 8 and 12 weeks by qPCR and immunohistochemistry. The effects of Nec-1 or 3-MA on the protein expression of LC3-I, LC3-II and beclin-1, and production of reactive oxygen species ( ROS) in the rat kidney were determined by Western blot and DCFH-DA staining.The death of renal tubular epi-thelial cells in the SNx rats was observed by TUNEL staining and electron microscopy.Finally, the effects of Nec-1 and 3-MA on blood urea nitrogen ( BUN) , serum creatinine ( SCr) and the pathological changes of the renal tissues were ana-lyzed.RESULTS:The highest mRNA and protein levels of RIP1, RIP3, LC3 and beclin-1 appeared at the 8th week after SNx (P cells were decreased in the SNx rats treated with Nec-1 and 3-MA (P<0.01), but 3-MA did not reduce the increased con-centration of ROS.In addition, treatment with Nec-1 and 3-MA obviously reduced BUN, SCr (P<0.05), glomeruloscle-rosis index and tubulointerstitial injury score (P<0.01).CONCLUSION:Autophagy participates in the excessive death of renal tubular epithelial cells in SNx rats.Inhibition of autograph prevents necroptotic cell death of renal tubular cells, and alleviates chronic renal injury in SNx rats.

Assessment of quality of life and its influence factors in maintenance hemodialysis patients / 中华肾脏病杂志

Objective To investigate the quality of life (QOL) of maintenance hemodialysis (MHD) patients and its influencing factors.Methods A total of 257 MHD patients in our hospital were recruited in this study.Clinical data of the patients were collected,and the QOL was assessed by MOS 36 item short form health survey(SF-36).Nutritional status of patients was evaluated by modified quantitative subjective global assessment (MQSGA).Univariate analysis of variance,pearson correlation analysis and multiple linear stepwise regression analysis were performed to determine the effect of related factors on QOL scores.Results The scores of all scales of SF-36 evaluation in MHD patients were relatively lower than that of general population as reported before.Their physiological component summary (PCS) score decreased gradually as age grew,nevertheless,the mental component summary (MCS) score was highest in the group aged 41-60.The score was lower in patients with moderate to severe malnutrition or diabetic nephropathy when compared with other patients.Univariate analysis of variance also revealed that high SF-36 scores associated with higher education or income.Multivariate analysis indicated that PCS score and total SF-36 score of MHD patients were positively correlated with body mass index (BMI) and cholesterol,but negatively correlated with diabetic nephropathy,pulmonary artery systolic pressure and MQSGA score (all P ＜ 0.05).There was positive correlation between MCS score and income,yet negative correlation between MCS score and MQSGA score (all P ＜ 0.05).Conclusion MHD patients had relatively poor QOL.Primary diseases and nutritional status were probably the main influencing factors.Age,educated level,family income and pulmonary artery systolic pressure might also have effects on their QOL.

Renal expression of RANK-RANKL in a rat model of puromycin aminonucleoside nephropathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate RANK-RANKL expression in the kidneys of a rat model of puromycin aminonucleoside nephropathy (PAN).</p><p><b>METHODS</b>Thirty-six SD rats were randomly divided into PAN model group and normal control group. PAN was induced by a single intravenous injection of 100 mg/kg puromycin aminonucleoside. Serum creatinine and 24-hour urinary protein were measured on days 3, 7, and 14 after the injection, and renal pathologies were assessed with optical and immune transmission electron microscopy. The expression of RANK and RANKL in the kidneys was examined using reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.</p><p><b>RESULTS</b>The PAN model rats showed massive proteinuria and elevated serum creatinine on day 3, which peaked on day 7. RANK-RANKL protein and mRNA expressions in PAN model group was higher than those in the control group. In the PAN rats, RANK was expressed mainly on the top cell membrane and in the cytoplasm of renal podocytes with a significantly increased expression level compared with that in the control group.</p><p><b>CONCLUSION</b>The PAN rat model shows aberrant RANK and RANKL expressions in the podocytes, indicating their contribution to podocyte injury in PAN.</p>

Features of ambulatory blood pressure in aged patients with hypertension complicated coronary heart ;disease / 心血管康复医学杂志

Objective:To observe features of ambulatory blood pressure in aged patients With hypertension complicated coro-nary heart disease (CHD)and explore the relationship betWeen abnormal ambulatory blood pressure and coronary athero-sclerosis.Methods:According to coronary angiographic results,a total of 220 aged patients With hypertension (>60 years) Were divided into hypertension+ CHD group (n=124)and single hypertension group (n=96).Both groups received 24h ambulatory blood pressure monitoring (ABPM),24h blood pressure (BP),BP variability,pulse pressure and circadian rhythm of blood pressure Were recorded.Results:Compared With single hypertension group,there Were significant increase in 24h,daytime,nighttime mean systolic blood pressure (SBP),SBP variability [dSSD (14.01±4.26)vs. (17.54± 5.51),nSSD (15.05±4.01)vs. (19.32±3.71)],pulse pressure [dPP (56.66±7.43)mmHg vs. (66.32±13.62) mmHg,nPP (55.71±6.62)mmHg vs. (63.86±7.52)mmHg] (P<0.05 all)and percentage of non-dipper rhythm (60.32% vs.82.45%)in hypertension+CHD group,P<0.01.Conclusion:There are significant increase in systolic blood pressure,SBP variability and pulse pressure,percentages of abnormal circadian rhythm in aged patients With hyper-tension complicated coronary heart disease, these abnormality may be related to occurrence and development of coronary atherosclerosis in aged patients With hypertension.

Gastric Perfusion of Vitamin D3 with Different Diets Induce the Atherosclerotic Rat Model / 中国康复理论与实践

@#ObjectiveTo investigate the optimun approach to induce the atherosclerotic rat model.MethodsThree methods were used to induce atherosclerotic model, including: simple high fat diet feeding, high fat diet feeding with gastric perfusion of Vitamin D3, and gastric perfusion of Vitamin D3 with common rat food (splashed oil on the normal rat food with yolks and peanuts). Histopathology change of the atherosclerotic plaques in aorta was observed by normal and histopathologic sections and Hematoxylin staining.ResultsThe endarterium of aorta of the rats with simple high fat diet was smooth without atherosclerotic plaques after 2 months. 2 rats with high fat diet feeding and gastric perfusion of Vitamin D3 had formed miliary atherosclerotic plaques. In the rats with vitamin D3 and common rat food, the ring-shape calcified atherosclerotic plaques were found in the all endarterium of aorta.ConclusionGastric perfusion of Vitamin D3 once a week (3 times) combined with common rat diet could induce the atherosclerotic model successfully and decrease the mortality rate.

The changes of plasma neuropeptide Y and neurotensin levels in patients with heart failure / 中国医师进修杂志

Objective To observe the changes of plasma neuropeptide Y (NPY) and neurotensin (NT) levels in patients with heart failure and investigate their clinical significance. Methods The levels of plasma NPY, NT of 76 patients with heart failure and 28 normal controls were determined by radioimmunoassay (RIA). The color echocardiogram was used to evaluate the cardiac structure, function and left ventricular ejection fraction (LVEF). Results The level of plasma NPY in patients with heart failure [(159.7 ± 56.3) ng/L] was higher than that in normal controls [(120.8 ± 51.9) ng/L] (P < 0.05), the level of plasma NT [(69.5 ± 29.6) ng/L] was significantly lower than that in normal controls [(99.1 ± 19.3) ng/L] (P < 0.01). Following the severity of heart failure, the level of plasma NPY increased, and the level of plasma NT decreased. The level of LVEF had negative correlative relationship with the level of plasma NPY (γ = -0.31, P < 0.05) and positive correlative relationship with the level of plasma NT (γ = 0.28, P < 0.05). The level of plasma NPY and NT in patients with heart failure had negative correlative relationship (γ = -0.26, P < 0.05). Conclusions The levels of plasma NPY, NT in patients with heart failure are unbalanced. This unbalance may participate in the damage of cardiac function.

Comparison of Myocardial Bridges Imaging with Multi-slice Spiral CT and Coronary Angiography / 中国康复理论与实践

@#Objective To evaluate the clinical value of Multi-slice Spiral CT(MSCT) and coronary artery imaging in diagnosing coronary artery myocardial bridges (MBs). Methods Image data of 285 patients from July 2005 to July 2008 who accepted both the MSCT and coronary angiography CAG at our hospital were collected. Diagnostic performance of the two Methods were analysed and the diagnostic accuracy were compared. Results In 285 cases of patients with MSCT examinations, 82 coronary artery were diagnosed in 59 cases, the detection rate of which was 20.7%. In contrast, 16 cases were diagnosed by CAG and the detection rate was 5.6%. In the 82 coronary artery diagnosed by MSCT, 42 coronary artery were single vessel, the proportion was 71.19%. Others were two vessels or three vessels. There were 67 in left anterior descending artery (LAD),in which 52 were near the middle and 15 were distal. 26 MBs diagnosed by MSCT were included in the 28 MBs diagnosed by CAG. Put CAG as the gold standard of myocardial bridge detecting, then MSCT's sensitivity was 92.86%. Conclusion MSCT coronary artery imaging can accurately show the anatomical relationship between coronary artery and myocardial and it is one of the preferred method of diagnosing coronary artery.

Effect of Adipose Tissue-Derived Mesenchymal Stem Cells Transplanted by Different Methods on Cardiac Function of Rabbits with Dilated Cardiomyopathy / 中国康复理论与实践

@#Objective To investigate the effect of adipose tissue-derived mesenchymal stem cells (ADMSCs) transplanted by different Methods on cardiac function of rabbits with dilated cardiomyopathy.Methods 50 white ears rabbits were given doxorubicin by intraperitoneal injection to induce dilated cardiomyopathy, and randomly divided into the model group 1, model group 2 and control group. The ADMSCs isolated and cultured in vitro were transplanted into dilated cardiomyopathy rabbits of model group 1 through multi-points injection in myocardium, and were transplanted into rabbits of model group 2 through coronary artery transplant. Those in the control group were treated with IMEM medium of the same volume through multi-points injection in myocardium. Rabbits were fed for 4 week successively and then were killed to obtain heart sample, and the survival and differentiation of transplanted cells were observed through fluorescence microscope. Before transplantation and 4 weeks after transplantation, all rabbits received ultrasonic cardiogram test and haemodynamics test to determine cardiac function.Results After transplant through the two different Methods , ADMSCs could survive and differentiate in myocardial cells. 4 weeks after transplantation, the left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV) reduced more significantly in the model group 2 compared with the model group 1 ( P<0.05～0.01), and LVSV, ejection fraction (EF), left ventricular systolic pressure, +dp/dtmax, -dp/dtmax increased more significantly ( P<0.05～0.01).Conclusion Transplanted ADMSCs can survive and differentiate in myocardial cells, and improve the heart function in rabbits with dilated cardiomyopathy. It is more conducive to the effectiveness of ADMSCs to improve the heart function through the method of coronary artery transplant.

Risk factors of hypertension in IgA nephropathy / 中华内科杂志

Objective To explore the risk factors of hypertension in patients with IgA nephropathy in South China. Methods The clinical and renal pathological data of 280 primary IgA nephropathy patients diagnosed by biopsy were analyzed to extinguish the risk factors of hypertension. Results A total of 96 patients were suffered with hypertension (34.3%). A single-variable analysis showed that the age (≥40 years), body weight (≥60 kg), absence of macrohematuria, duration of disease (≥60 months), blood urea nitrogen≥8 mmol/L, serum creatinine (≥133 μmol/L), hyperuricaemia, degree of 24 h-proteinuria (≥1.5 g), segmental glomerular lesions (≥25% ), globe glomerular sclerosis (≥10%), tubular atrophy (≥25%), interstitial fibrosis (≥25%), interstitial inflammation (≥25% ) and arteriole hypertrophy (≥10% ) were all risk factors related to hypertension; multivariate logistic regression analysis showed that serum creatinine, age, arteriole hypertrophy, body weight and 24 h-proteinuria were the independent risk factors. Conclusion Many factors were related the hypertension in patients with IgA nephropathy, while serum creatinine, age, arteriole hypertrophy, body weight and 24 h-proteinuria were the independent risk factors of hypertension.

Changes of plasma neuropeptide Y and neurotensin levels and damages of cardiac function in patients with essential hypertension / 中国医师进修杂志

Objective To observe the changes of plasma neuropeptide Y(NPY) and neurotensin(NT) levels in patients with essential hypertension and the relationship between those changes and damage of cardiac function. Methods Eighty patients of essential hypertension and 28 normal controls were chosen. The cardiac function was divided into 3 classes on the standard of New York Heart Association(NYHA). The plasma NPY,NT concentration was determined by radioimmunoassay. Results The level of NPY in hypertension patients was higher than that of the normal controls(P

A retrospective study on pulmonary embolism:a report of 67 cases / 解放军医学杂志

Objective To retrospectively analyze the clinical features,diagnostic experience and therapy of pulmonary embolism for reduction of misdiagnosis and missed diagnosis,and for improving the cure rate.Methods The data of clinical features,findings by auxiliary examination and therapeutic efficacy of 67 patients with pulmonary embolism admitted to the First Affiliated Hospital of General Hospital of PLA were summarized.The usual clinical manifestations were summarized based on the clinical symptoms of and the frequency of objective signs in the patients with the correct diagnosis.Auxiliary examinations included routine and sophisticated examinations such as CT pulmonary angiography(CTPA) and emission computed tomography(ECT),which were specially emphasized for summing up and optimizing the diagnosis.Comparisons were made of the therapeutic efficacy and complications between the treatment with thrombolysis combined with anticoagulation and simple anticoagulation.Results The primary clinical manifestations of the patients with pulmonary embolism included dyspnea,cough,chest pain,fever and hemoptysis,etc.Findings of D-Dimer assay might serve as a sensitive but not specific indicator in screening the suspected patients.For the sophisticated examinations,CTPA confirmed the diagnosis in 28 out of 31(90.32%) patients,and ECT confirmed the diagnosis in 39 out of 51(76.47%).All the patients who had undergone lung angiography received the final diagnosis,but the majority of them were reluctant to accept this examination because of potential risk of the technique.The total cure rate of thrombolysis combining anticoagulation was 90.62%(29/32),in which the administration of recombinant tissue-type plasminogen activator(rt-PA)-2h was most efficacious(with 100% of cure rate).Simple anticoagulation therapy gave a lower cure rate(68.57%,24/35) but a higher incidence of hemorrhagic complication(31.25%).After the administration of thrombolysis combined with anticoagulation therapy,both PaO2 and CTPA examinations showed significant changes for the better after the treatment compared with that before the treatment(P

Clinical and coronary angiographic features of non-Q wave myocardial infarction in the elderly / 中华老年医学杂志

Objective To evaluate the clinical and coronary angiographic features of non-Q wave and Q wave myocardial infarction in the elderly. Methods The clinical history(including hypertension and diabetes), complication and in-hospital mortality, blood lipid, serum CK-Mb, LVEF, and the record of the coronary stenosis by angiography 3-4 weeks after infarction were investigated in non-Q wave and Q wave myocardial infarction patients. Results The clinical history and blood lipid did not differ significantly between the NQMI and QMI patients. NQMI patients had a significantly lower maximal peak 〔(68.7?18.6) mmol/L vs (108.6?17.3)mmol/L, P0.05), but occlusion rate of infarct-related vessels in NQMI patients were lower. Conclusions Prognosis of NQMI patients is better than that of QMI patients in acute-phase, and the occlusion rate of infarct-related vessels in NQMI patients were lower.