Association between VDR gene FokI polymorphism and renal function in patients with IgA nephropathy.

BACKGROUND: Studies have shown that the occurrence and development of IgA nephropathy (IgAN) are genetically susceptible, but the relationship between vitamin D receptor (VDR) gene polymorphisms and renal function in IgAN patients is unclear. METHODS: We investigated the relationship between VDR FokI (rs2228570) single nucleotide polymorphism (SNP) and renal function and related clinicopathologic parameters in IgAN patients. Clinical and pathological data of 282 IgAN patients treated at the First Affiliated Hospital of Guangxi Medical University were collected, and FokI genotypes were determined by PCR and direct sequencing. Patients were divided into the renal dysfunction group and normal renal function (control) group by estimated glomerular filtration rate (eGFR) and serum creatinine level. RESULTS: Frequencies of TT genotype and T allele in the renal dysfunction group were higher than those of the control group. Blood urea nitrogen, serum phosphorus (P), proportions of mesangial cell proliferation, interstitial fibrosis/tubular atrophy and crescents in T allele carriers were higher than those in non-T allele carriers, while eGFR and 25-Hydroxyvitamin D3 were lower in T allele carriers than non-T allele carriers. Multiple linear regression analysis showed that eGFR was affected by FokI genotypes in IgAN patients. Logistics regression analysis showed that middle and elderly age, elevated P, intact parathyroid hormone and TT genotype were independent risk factors for renal dysfunction in IgAN patients; the odds ratio of carrying the TT genotype was as high as 84.77 (P < 0.05 for all). CONCLUSIONS: IgA nephropathy patients carrying the VDR FokI TT genotype have an increased risk of renal dysfunction. VDR FokI SNP is closely related to renal function, calcium-phosphate metabolism, and related pathological damage in IgAN patients.

[Clinical observation on the treatment of hand dysfunction after stroke with chicken-claw needling at Shangbaxie (Extra) and Hegu (LI 4) combined with acupuncture at Houxi (SI 3)].

OBJECTIVE: To observe the difference in clinical efficacy between chicken-claw needling at Shangbaxie (Extra) and Hegu (LI 4) combined with acupuncture at Houxi (SI 3) and the conventional acupuncture at the 3 points for the treatment of hand dysfunction after stroke. METHODS: Forty-two patients were divided into an observation group and a control group according to the random number table, 21 cases in each one. The chicken-claw needling was used at Shangbaxie (Extra) and Hegu (LI 4) on the affected side combined with acupuncture at Houxi (SI 3) in the observation group. The conventional acupuncture was performed at the same point as the observation group in the control group, once a day, 6 days for a course, 1 day of interval after a course, and the therapeutic effect was observed after 5 courses. The simplifying Fugl-Meyer Motor Function Rating Scale (FMA), the modified Barthel index and the Brunnstrom grading criteria were used to evaluate the hand function of the two groups before and after treatment. RESULTS: The FMA score, Barthel index and Brunnstrom grade were improved after treatment in the two groups (all P<0.05), and the FMA score, Barthel index and Brunnstrom grade in the observation group were better than those in the control group (all P<0.05). CONCLUSION: Chicken-claw needling at Shangbaxie (Extra) and Hegu (LI 4) combined with acupuncture at Houxi (SI 3) can effectively treat hand dysfunction after stroke, and the curative effect is better than the conventional acupuncture at the 3 points.

[Clinical significance of venous return disturbance in patients with osteonecrosis of femoral head].

OBJECTIVE: To evaluate the correlation of venous return disturbance (VRD), bone marrow edema (BME) and the amount of joint fluid with clinical symptoms in osteonecrosis of the femoral head (ONFH). METHODS: Twenty patients (25 hips) with ONFH proved by pathology were parallelly examined by 1.5 T MR and medullograph. RESULT: In total 25 hips VRD was observed in 16 hips with medullograph and 13 hips with the clinical symptoms (P <0.05). BME was found in 17 with MRI (P <0.01), and the was found in 15 hips with MRI (Spearman=0.949). VRD were found in 16 hydrarthrus. CONCLUSION: ONFH patients with clinical symptoms have VRD, BME and the hydrarthrus. The medullograph is of value in monitoring the development of ONFH.

Relationships among magnetic resonance imaging, histological findings, and IGF-I in steroid-induced osteonecrosis of the femoral head in rabbits.

OBJECTIVE: To study the relationships among magnetic resonance imaging (MRI), histological findings, and insulin-like growth factor-I (IGF-I) in steroid-induced osteonecrosis of the femoral head in rabbits. METHODS: Thirty rabbits were randomly divided into experimental Group A (n=15) and control Group B (n=15). The 7.5 mg/kg (2 ml) of dexamethasone (DEX) and physiological saline (2 ml) were injected into the right gluteus medius muscle twice at one-week intervals in animals of Groups A and B, respectively. At 4, 8 and 16 weeks after obtaining an MRI, the rabbits were sacrificed and the femoral head from one side was removed for histological study of lacunae empty of osteocytes, subchondral vessels, and size of fat cells under microscopy, and the femoral head from the other side was removed for enzyme-linked immunoadsorbent assay (ELISA) for IGF-I. RESULTS: At 4, 8 and 16 weeks after treatment, no necrotic lesions were detected in Group B, while they were detected in Group A. Light microscopy revealed that the fat cells of the marrow cavity were enlarged, subchondral vessels were evidently decreased, and empty bone lacunae were clearly increased. The IGF-I levels in Group A were significantly higher than those in Group B. At 8 weeks after the DEX injection, the MRI of all 20 femora showed an inhomogeneous, low signal intensity area in the femoral head, and at 16 weeks, the findings of all 10 femora showed a specific "line-like sign". The MRI findings of all femora in Group B were normal. CONCLUSION: MRI is a highly sensitive means of diagnosing early experimental osteonecrosis of the femoral head. However, the abnormal marrow tissues appeared later than 4 weeks when the expression of IGF-I increased. This reparative factor has an early and important role in response to steroid-induced osteonecrosis of the femoral head, and provides a theoretical foundation for understanding the pathology and designing new therapies.