L-Carnitine Ameliorates the Decrease of Aquaporin 2 Levels in Rats with Cisplatin-Induced Kidney Injury.

BACKGROUND: It has been found that L-carnitine ameliorated cisplatin-induced acute kidney injury (AKI) in rats. However, the detailed role of L-carnitine in improving the renal urinary concentration function in cisplatin-induced AKI is not fully understood. METHODS: In this study, 30 Sprague-Dawley rats were divided randomly into 5 groups: control, cisplatin (CIS), L-carnitine (CAR), L-carnitine plus cisplatin (CAR + CIS), and cisplatin plus L-carnitine (CIS + CAR) groups. Cisplatin (7 mg/kg) and L-carnitine (300 mg/kg) were injected intraperitoneally. Urine (24 h) and blood samples were collected to analyze renal urinary concentrating function. Immunoblotting, confocal laser microscopy, and enzyme-linked immunosorbent assays were used to assess the level and localization of the water channel aquaporin (AQP) 2, and levels of stimulatory G protein α subunit (GSα protein), arginine vasopressin (AVP) receptor 2, adenylyl cyclase and serum AVP. RESULTS: Renal urinary concentrating function was improved by L-carnitine in rats with cisplatin-induced AKI. AQP2 expression, which decreased after cisplatin treatment, was improved by L-carnitine in different regions of the kidney. Moreover, our data indicated that L-carnitine could increase AQP2 accumulation at the apical plasma membranes of the renal-collecting ducts. Finally, intervention with L-carnitine effectively improved the expression of AQP2 upstream signaling proteins, such as GSα protein, adenylyl cyclase, and serum AVP levels in rats with cisplatin-induced AKI. CONCLUSION: L-carnitine resolves the cisplatin-induced urinary concentration defect, which may occur by increasing AVP/cyclic adenosine monophosphate/AQP2 levels, indicating the potential use of L-carnitine to ameliorate the renal urinary concentration effect in cancer patients treated with cisplatin.

Timing of initiation of renal replacement therapy for acute kidney injury: a systematic review and meta-analysis of randomized-controlled trials.

BACKGROUND: The effects of early renal replacement therapy (RRT) on mortality and renal recovery in patients with acute kidney injury (AKI) remain controversial. A systematic review and meta-analysis of randomized-controlled trials (RCTs) was performed. METHODS: MEDLINE, EMBASE and the Cochrane Library database (Cochrane Central Register of Controlled Trials) were searched to identify RCTs, investigating the effects of early RRT on patients with AKI. RESULTS: Six studies with a total of 1257 participants were included in this meta-analysis. Compared to late RRT, early RRT did not reduce the risk of mortality (RR 0.93, 95 % CI 0.68-1.26) or affect renal recovery (RR 0.88, 95 % CI 0.48-1.62) or composite endpoint (death or dialysis dependence) (RR 0.91, 95 % CI 0.71-1.17). There was no significant difference in adverse events in the analysis, between the early RRT and late RRT arms. CONCLUSIONS: Early initiation of RRT for patients with AKI is not associated with decreased overall mortality or a delayed renal recovery rate. The optimal time to initiate RRT remains uncertain. Large scale and adequately powered RCTs are needed to detect the effects of early initiation of RRT in AKI patients.

[Current status of advanced schistosomiasis in Pukou District, Nanjing City, 2013].

OBJECTIVE: To understand the current status of advanced schistosomiasis in Pukou District, Nanjing City, so as to provide the evidence for its appropriate treatment. METHOD: An epidemiological investigation and medical examinations were carried out based on the national standard for the people who either had been already identified as advanced schistosomiasis or were new suspects. RESULTS: There were 55 cases of advanced schistosomiasis in Pukou District, 2013. Among them, 51 cases (92.73%) were splenomegaly type and 4 cases (7.27%) were ascites type. Fifty-three cases (96.36%) were clinically cured, 1 case (1.82%) was in the stable condition and 1 case (1.82%) still needed further treatment. In terms of the age, the youngest was 49 years and the oldest was 86 years. The gender distribution was male accounting for 58.18% (32 cases) and female 41.82% (23 cases). CONCLUSION: The condition of patients with advanced schistosomiasis in Pukou District, Nanjing City is complicated. The investigation and treatment to the patients should be conducted regularly.

Uremia and thrombotic microangiopathy: conditions that may havethe same manifestation.

In this article, we present the case of a man with uremia. Laboratory testing revealed thrombocytopenia, erythrocyte fragmentation, elevated lactate dehydrogenase, and malignant hypertension, manifestations that are similar to thrombotic microangiopathy (TMA). Thromboasthenia, manifested as a decrease in the platelet aggregation rate, was also noted. Regular hemodialysis (3 times per week) improved the patient's thrombocytopenia and thromboasthenia. This case supports the conclusion that uremic toxin, which can be removed by hemodialysis, inhibits the quantity and quality of platelets. We believe that the platelet aggregation rate can be a useful tool in distinguishing uremia from TMA.

First one-pot stereoselective synthesis of cis-2,3-dihydro-4-perfluoroalkyl-1H-1,5-benzodiazepines via a catalyst-free three-component reaction.

cis-2,3-Dihydro-4-perfluoroalkyl-1H-1,5-benzodiazepines were stereoselectively synthesized using a one-pot, catalyst-free, three-component reaction. This novel, efficient and convenient approach was used to synthesize 22 related products in moderate to excellent yields, demonstrating the scope and potential economic impact of the reaction.