The effects of bitter gourd saponins on the expression of podocin and nephrin in renal tissues of rats with renal damage induced by salt-sensitive hypertension / 中国医师杂志

Objective To study the therapeutic effect of bitter gourd saponins on salt-sensitive kidney injury induced by high salt diet and its possible mechanism.Methods 50 Sprague Dawley (SD) rats were randomly divided into normal group,model group and low-dose,middle-dose and high-dose treatment group after 10 days of adaptive feeding.Each group had 10 rats.Except the normal group,the other four groups were given high salt diet (4.0％ high salt diet) to induce salt-sensitive kidney damage in rats.The normal group and the model group were given 1.0 m/(kg · d) normal saline,and the three dosage groups of total saponins of balsam pear were given 10 mg/(kg · d),20 mg/(kg · d) and 40 mg/(kg · d) respectively.After 8 weeks of treatment,rats were sacrificed and collect the 24-hour proteinuria,creatinine.Serum creatinine,serum aldosterone,serum sodium and serum potassium were measured,and renal histopathology and the expression of podocin and nephrin were detected.Results Pathological examination of model group showed obvious glomerular sclerosis and renal interstitial fibrosis,and glomerular sclerosis in the treatment group was obviously improved by bitter gourd saponins;The systolic pressure in the model group was 170 mmHg,significantly higher than that of the normal and treatment groups,the systolic blood pressure of the treatment groups were obvious decreased when treated by bitter gourd saponins (P ＜ 0.05);Compared with normal group,serum creatinine and 24 h proteinuria / urine creatinine in model group were significantly increased (P ＜ 0.05),while creatinine clearance rate and aldosterone were significantly decreased (P ＜ 0.05),and the above indexes in bitter gourd saponins treatment group were significantly improved;Compared with the model group,the protein and mRNA expression of podocin and nephrin were significantly decreased (P ＜ 0.05),while the two indexes can be revered by bitter gourd saponins in treatment group (P ＜ 0.05).Conclusions The bitter gourd saponins can significantly improve the symptoms of salt-induced hypertensive nephropathy in rats,which may be related with the expression of podocin and nephrin in renal tissue,thereby inhibiting glomerulosclerosis and improving renal interstitial fibrosis.

The value of symmetrical ambulatory arterial stiffness index should be noted in prediction of early renal impairment in patients with essential hypertension / 中国医师杂志

Objective To investigate the predictive value of symmetrical ambulatory arterial stiffness index (S-AASI) in detecting early renal impairment of patients with essential hypertension.Methods Totally 245 consecutive out-patients were confirmed with essential hypertension,and were divided into group A (56 cases),group B (64 cases),group C (72 cases),and group D (53 cases) according to the quartile of S-AASI.The combination testing of serum cystatin C,serum β2-microglobulin as well as urine microalbumin to creatinine ratio were implemented as laboratory diagnosis index of renal impairment in early stage and 109 essential hypertension patients were diagnosed with early renal impairment.The parameters were compared among 4 groups.Pearson correlation analysis and partial correlation analysis were performed to confirm the relationship between the markers of early renal impairment and S-AASI.The predictive value of S-AASI to detect early renal injury was evaluated by analyzing Receiver Operating Characteristic (ROC) curve.Results With the rising of S-AASI,age as well as 24 hours mean systolic blood pressure (24 h SBP),serum cystatin C,serum β2-microglobulin,urine microalbumin to creatinine ratio and the incidence rate of early renal injury went notably higher while estimated glomerular filtration rate (eGFR) decreased significantly.After controlling for age,correlation test showed S-AASI was positively correlated with24hSBP,serum cystatin C,serumβ2-microglobulin,urine microalbumin to creatinine ratio(r =0.392,0.627,0.514 and 0.643 respectively,P ＜ 0.05) and negatively correlated with eGFR(r =-0.312,P ＜ 0.05).The 24 hours mean diastolic blood pressure (24 h DBP) was uncorrelated with S-AASI.Area under ROC curve of S-AASI for diagnosis of hypertensive renal impairment was 0.885.The critical value of S-AA-SI was 0.17,the sensitivity,specificity,positive predictive value,and negative predictive value were 92.7％,65.2％,68.5％,and 91.7％,respectively.Conclusions When S-AASI was detected above 0.17,patients with hypertension had a higher risk of renal impairment.Higher S-AASI was correlated with worse early renal impairment laboratory indexes.The predictive accuracy of S-AASI for early hypertensive renal impairment was medium.

Risk factor analysis of chronic kidney disease in hospitalized petients with essential hypertension in Nanjing / 中国医师杂志

Objective To investigate the prevalence of chronic kidney disease (CKD) in hospitalized patients with essential hypertension (EH) and analyze the related risk factors.Methods A retrospectivc analysis of chronic kidney disease and its influencing factors was taken from March 2014 to March 2015 in the Second Affiliated Hospital of Nanjing Medical University.People were diagnosed EH patients (1 020 cases).Results (1) The detection rates of proteinuria,estimated glomerular filtration rate (eGFR) and CKD in patients with EH were 22.3％,13.3％,and 26.1％,respectively.The ratio of CKD in male and female was 26.8％ vs 25.5％ (P＞0.05);(2) With the increase in systolic blood pressure levels (as the systolic blood pressure increased 20 mmHg),the constituent ratio of CKD increased with statistically significant difference (P ＜ 0.05);(3) The risk factors of essential hypertension complicated with chronic kidney disease were high uric acid,the history of diabetes,SBP ≥ 140 mmHg and the age (OR =2.682,2.224,1.932,1.065).Conclusions The detection rate of CKD in patients with hypertension in was high,and the blood pressure,blood glucose,and serum uric acid should be controlled to prevent and delay the occurrence and development of CKD.

Risk factor analysis of chronic kidney disease in hospitalized petients with essential hypertension in Nanjing / 中国医师杂志

Objective To investigate the prevalence of chronic kidney disease (CKD) in hospitalized patients with essential hypertension (EH) and analyze the related risk factors.Methods A retrospectivc analysis of chronic kidney disease and its influencing factors was taken from March 2014 to March 2015 in the Second Affiliated Hospital of Nanjing Medical University.People were diagnosed EH patients (1 020 cases).Results (1) The detection rates of proteinuria,estimated glomerular filtration rate (eGFR) and CKD in patients with EH were 22.3％,13.3％,and 26.1％,respectively.The ratio of CKD in male and female was 26.8％ vs 25.5％ (P＞0.05);(2) With the increase in systolic blood pressure levels (as the systolic blood pressure increased 20 mmHg),the constituent ratio of CKD increased with statistically significant difference (P ＜ 0.05);(3) The risk factors of essential hypertension complicated with chronic kidney disease were high uric acid,the history of diabetes,SBP ≥ 140 mmHg and the age (OR =2.682,2.224,1.932,1.065).Conclusions The detection rate of CKD in patients with hypertension in was high,and the blood pressure,blood glucose,and serum uric acid should be controlled to prevent and delay the occurrence and development of CKD.

Clinical analysis of plasma cystatin-C levels in patients with primary hypertension and obstructive sleep apnea syndrome / 中国医师杂志

Objective To explore the influence of obstruction sleep apnea syndrome (OSAS) on plasma cystatin C (CC) levels in patients with primary hypertension.Methods A total of 244 cases of primary hypertension patients was chosen.The patients were divided into observation group (with OSAS) and control group (without OSAS) according to apnea hypopnea index (AHI).The observation group was then divided into three subgroups:mild OSAS group,moderate OSAS group,and severe OSAS group.The levels of CC were compared.Results First,the plasma CC levels in patients with primary hypertension had no statistical significance in the differences among different grades of hypertension (P ＞ 0.05).Second,CC levels of observation group were significantly higher than control group (P ＜ 0.05).Third,CC levels of the severe group were higher than the moderate group,and the plasma CC levels of the moderate group were also higher than the mild group and control group.Rank correlation analysis and comparison of CC levels and AHI showed that CC levels were positively correlated with AHI (r =0.585,P ＜ 0.01).However,there were no statistically significant differences between CC levels of the mild OSAS group and control group (P ＞ 0.05).Conclusions The patients with OSAS and primary hypertension had higher levels of CC,and aggravated with the progress of the degree of obstruction.CC may be involved in the progression of the disease,a high level of CC may aggravate the condition,it should be early prevention and treatment.

Hypertension, depression and cognitive function impairment in elderly / 中国医师杂志

Objective To investigate the relationship between hypertension, depression and cognitive function in elderly. Methods General conditions and health status were surveyed in 207 individuals, which were divided into hypertension group, depression group, hypertension and depression group and controls. Patients cognitive function was assessed by the mini-mental state examination (MMSE), depression severity was detected by Hamilton rating scale for depression (HAMD) , other relative data were collected. Results Elderly patients with depression were more inclined to live alone. Comparing with control, hypertension patients had lower attention and calculation. Depression patients had lower orientation, attention, calculation and linguistic ability ( P < 0.05). Compared with hypertension patients, patients combined with depression had significantly lower MMSE scores, orientation, recall and language ( P <0. 05). Patients with hypertension and depression had lower attention and calculation, compared with hypertension a-lone patients ( P <0. 05 ). MMSE scores of depressed patients were negatively related to HAMD scores ( r = -0. 706, P <0.01). Logistic regression revealed depression or combination of hypertension and depression were related to impairment of cognitive ability ( P < 0.01). Conclusion Both hypertension and depression in the elderly impaired cognitive function. The cognitive function impairment in elderly was closely associated with hypertension and depression. Prevention and control of hypertension and depression might be helpful in slowing down impairment of cognitive function in elderly.

The relationship between metabolic syndrome and nonalcoholic fatty liver disease in non-obese hypertensive patients / 中国医师杂志

Objective To investigate the relationship between metabolic syndrome(MS)and nonalcoholic fatty liver disease (NAFLD)in non-obese and non-diabetic hypertensive patients.Method 84 non-obese and non-diabetic hyperlensive patients were divided into 42 hypertensive patients with NAFLD and 42 hypertensive patients without NAFLD by abdominal ultrasonography examination.Body mass index(BMI),blood pressure,fast and OGGT 2 hour plasma glucose,fast and OGGT 2 hour plasma insulin,plasma lipids and aminotransferase were measured in the two groups.Multivariate logistic regression analysis was used to identify the variables independently associated with MS.Result BMI,triglycerides,fast insulin,2 hour insulin,aminotransferase,HOMA-IB and MS prevalence rate in the group with NAFLD were significantly higher than these in the group without NAFLD.Multivariate logistic regression analysis(forward LR)showed NAFLD:were independently associated with MS.Conclusion MS play a role not only in occurrence of NAFLD but also in liver injury.

Relationship between carotid stiffness and coronary angiography in elderly patients of coronary heart disease complicated with hypertension / 中国医师杂志

Objective To observe the relationship between carotid stiffness and coronary angiography in elderly patients of coronary heart disease (CHD) complicated with hypertension.Methods The patients were divided into three groups.Coronary angiography was performed in 40 elderly patients of CHD complicated with hypertension.The carotid stiffness was measured by ultrasound.Results There were significant differences on hypertension in arterial stain,arterial distensibility and arterial stiffness.There was significant correlation between coronary angiography score and carotid stiffness among three groups(r=-0.353,-0.125,0.376,P<0.01).Conclusion There is close relationship between carotid atherosclerosis and coronary atherosclerosis in elderly patients of CHD complicated with hypertension.