[Six Cases of Philips Ingenuity CT Maintenance].

The article describes the failure phenomenon, analysis and processing process of the high-voltage generator module, FRC unit, rack tilt circuit and slip ring system in the daily use of Philips Ingenuity CT, so as to sum up the experience, discuss with the medical staff, and further Deepen the understanding of Philips Ingenuity CT's structure and working principle, and jointly improve the maintenance skills of CT and other large equipments.

[Several Cases Troubleshooting of SIEMENS AVANTO 1.5 T MR].

This article describes the SIEMENS AVANTO 1.5 T MR in the daily use of the fault maintenance examples, so as to provide some references for maintenance workers.

[Role of M-type phospholipase A2 receptor and its antibody in hepatitis B virus-associated membranous nephropathy].

OBJECTIVE: To examine levels of M-type phospholipase A2 receptor (PLA2R) and its antibody in the patients with hepatitis B virus-associated membranous nephropathy (HBV-MN), and to explore the correlation of PLA2R with laboratory parameters and pathological characteristics.
 Methods: A total of 49 adult patients with biopsy-proved HBV-MN were enrolled in this study. Levels of anti-PLA2R antibody in serum and PLA2R in renal tissue were detected. Patients were assigned into two groups: a positive PLA2R group and a negative PLA2R group. Differences in laboratory parameters and pathological characteristics were compared between the two groups.
 Results: Of 49 patients with HBV-MN, 17 had positive PLA2R expression in renal tissues. In the positive PLA2R group, 10 patients were positive for serum anti-PLA2R antibody. Patients with positive PLA2R expression in renal tissues showed higher levels of 24 hour urinary protein [(4.6±3.9) g/d], serum HbsAg (70.5%) and renal HbsAg expression (71%), while lower level of serum albumin [(24.1±7.5) g/L] than those of the negative group.
 Conclusion: PLA2R is expressed in the renal tissues and serum anti-PLA2R antibody can be detected in some HBV-MN patients. Positive PLA2R expression in renal tissue might be related to HbsAg deposition in serum and renal tissues. Patients with positive PLA2R expression in renal tissue have more severe glomerular sclerosis.

Neutrophil-lymphocyte ratio in systemic lupus erythematosus disease: a retrospective study.

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. Lupus nephritis (LN) is an important cause of morbidity and even mortality in patients with SLE. Some evidences suggest that neutrophil-lymphocyte ratio (NLR) associated with different inflammatory malignancies, ischemic injury and cardiovascular disease. Few scholars have investigated the relationship between NLR and SLE. This study aims to evaluate the role of NLR in SLE without nephritis and LN patients. METHODS: A total of 228 subjects were participated in this study. 79 diagnosed with SLE in patients group and 149 healthy age-and sex-matched in control group. In patient team, 20 of them were diagnosed with LN. RESULTS: The SLE without nephritis group showed significantly higher NLR than control group (control=2.00±0.76, SLE=4.26±3.38, P<0.001), and the NLR values of the patients with LN were higher than those of the patients without LN (SLE=4.26±3.38, LN=7.21±6.01, P<0.001). Receiver-operating characteristics analysis (ROC) of NLR to predict SLE showed that the area under the curve (AUC) was 0.757. The cutoff value using the ROC curve was 3.13 (sensitivity, 0.574; specificity, 0.926; 95% confidence interval (CI), 0.668-0.845; P<0.001). While ROC analysis of NLR to predict LN showed that the AUC was 0.828). Logistic regression analysis showed that SLE without nephritis and LN were independently related to NLR. CONCLUSION: NLR is independently associated with SLE, and it may be a promising marker that reflects renal involvement in patients with SLE.

[Influential factors for theraputic effect of steroid on adult primary nephrotic syndrome].

OBJECTIVE: To determine the factors associated with the eff ect of steroid on adult primary nephrotic syndrome. METHODS: The general information, laboratory examination and renal pathological type of 425 patients with primary nephrotic syndrome were retrospectively analyzed. RESULTS: Th ere were significant differences in the response to steroid among the pathological types of minimal change disease, focal segmental glomerulosclerosis and IgA nephropathy. Th e patients in the age of 14-24 years old showed the strongest response to steroid (P<0.05). Th e IgA level in the steroid resistance group was lower than that in the non-steroid resistance group (P<0.05). There was no significant difference in urine protein in 24 hour quantitation in the steroid resistance group between pre- and post-treatment (P>0.05), while there was significant difference in urine protein in 24 hour quantitation in the non-steroid resistance group between pre- and post-treatment (P<0.05). CONCLUSION: Pathological types and ages of the patients are related to the steroid curative effect. The decrease in IgA probably affects the effect of steroid on primary nephrotic syndrome.

HPLC determination and clinical significance of serum prednisone in patients with nephrotic syndrome.

AIM: A rapid protocol is necessary to determine the serum concentrations of prednisone. METHODS: The HP1100 high-performance liquid chromatographic (HPLC) system was employed. The HP Lichrosphere C8 column (250 mm × 4 mm, i.d., 5 µm particle size) was used. The mobile phase was methanol, tetrahydrofuran and water in the ratio 25:25:50. The flow rate was 1.0 ml/min. The sample was monitored by UV absorbance at 240 nm. Acetanilide was used as the internal standard, and methanol was added into the serum for depositing the protein. RESULTS: The chromatography was effective and was not interfered with by the serum components. Good linearity was observed, within the range of 10-500 µg/L for prednisone, and the detection limit was 5 µg/L. The serum concentrations of prednisone between the nephrotic syndrome (NS) group and the control group were significantly different (P < 0.05), while there was no significant difference between the females and males of the NS group (P > 0.05). The serum ncentration of prednisone in the steroid-resistant group was lower than that in the steroid-sensitive group (P < 0.05). CONCLUSIONS: HPLC is a practical and reliable method to determine the serum concentration of prednisone with high accuracy, precision, linearity and repeatability.

Influencing factors for saliva urea and its application in chronic kidney disease.

OBJECTIVES: To analyze possible influencing factors on concentration of saliva urea (SaU) and to validate its application in chronic kidney disease(CKD). DESIGN AND METHODS: Level of SaU in patients and normal subjects was researched. RESULTS: The concentration of SaU did not vary with sampling time and genders, but was related to ages and level of serum urea (U). CONCLUSION: SaU concentration is stable and it is useful in application in CKD.

[Evaluation of dialysis in patients with end-stage renal disease by salivary urea, creatinine and uric acid].

OBJECTIVE: To explore the changes of saliva urea, creatinine (Cr), and uric acid (UA) before and after hemodialysis in patients with end-stage renal disease (ESRD), and to evaluate the clearing effect of Urea, Cr, and UA. METHODS: Saliva and serum (2 mL) were collected from the dialysis patients. The concentrations of Urea, Cr, and UA in both samples were measured by biochemical analyzer. The concentrations of Urea, Cr, and UA in the saliva and the serum, and their correlation were analyzed. Before and after the hemodialysis, the reduction ratio (RR) of Urea, Cr, and UA in the saliva and the serum was calculated. RESULTS: In ESRD dialysis patients, the levels of Urea, Cr, and UA in the saliva and the serum were highly correlated (correlation coefficients were 0.979, 0.973, and 0.948, respectively). The concentrations of Urea, Cr, and UA in the saliva and the serum before the dialysis were lower than those after the dialysis, with significant difference (P<0.05). The RR of Urea, Cr, and UA in the saliva and the serum did not differ statistically (P>0.05). CONCLUSION: The clearing effect of salivar Urea, Cr, and UA is similar to that of the serum. Saliva is expected to replace the serum to evaluate hemodialysis efficacy and monitor the renal disease in ESRD patients.

[Clinical significance of saliva urea, creatinine, and uric acid levels in patients with chronic kidney disease].

OBJECTIVE: To explore the changes and clinical significance of saliva urea, creatinine (Cr), uric acid (UA) in both healthy people and chronic kidney disease (CKD) patients, and to provide a noninvasive, quick, accurate and reliable test to diagnose kindey disease. METHODS: Urea, Cr and UA in the saliva and serum collected from both healthy people and the CKD patients were measured by biochemical analyzer. We calculated the correlation coefficient of Urea, Cr and UA between the saliva and serum, compared the levels of saliva Urea, Cr and UA among CKD patients in different periods, drew the receiver operation characteristic (ROC) curve and analyzed the sensitivity and specificity of saliva Urea, Cr and UA to predict CKD patients in various periods. RESULTS: The concentrations of Urea, Cr and UA in both the saliva and the serum were positively correlated in healthy individuals and CKD patients (r = 0.918, 0.932, 0.840 and 0.984, 0.971, 0.920). The levels of saliva Urea, Cr and UA in the CKD patients were significantly higher than those of healthy people (P<0.05). Saliva Urea, Cr and UA concentrations of middle and late stage CKD patients were obviously higher than those of healthy people and early stage CKD patients (P<0.05). Areas under the curve (AUC) of the ROC of Urea, Cr and UA to diagnose diverse periods of CKD were 0.898, 0.897 and 0.848. The sensitivity was 0.806, 0.776 and 0.704; and the specificity was 0.968, 0.989 and 0.871. CONCLUSION: The levels of Urea, Cr and UA between the saliva and the serum are closely related. The concentration of saliva Urea, Cr and UA can reflect the renal damage, monitor kidney function of the CKD patients, and help diagnose middle to late stage CKD patients. It is a simple, nonivasive and quick method.

[Correlation studies between urinary retinol binding protein and renal tubular damage].

OBJECTIVE: To study correlation between urinary retinol binding protein (RBP) content and renal tubular damage. METHODS: A total of 1 353 healthy people and 186 patients with renal tubular damage diagnosed by renal biopsy were enrolled. The indicators such as endogenous creatinine clearance rate (Ccr), creatinine(Cr), urinary retinol binding protein(RBP), urinary ß(2)-microglobulin(ß(2)-MG), urinary N-acety1-beta-D-glucosaminidase (NAG), urine specific gravity(SG), urine osmolality of the 2 groups were examined and compared. Score of tubulointerstitial impairing and all indicators were analyzed by Spearman rank correlation analysis, and the sensitivity and specificity of indicators were calculated. RESULTS: Renal tubular damage was positively correlated with urinary RBP, ß2-MG, NAG (r=0.863, P<0.001; r=0.777, P<0.001; r=0.374, P=0.002, respectively), while negatively correlated with urine osmolaling, SG (r=-0.519, P<0.001; r=-0.624, P<0.001, respectively). The specificity and sensitivity for renal tubular damage of RBP were 91.03% and 72.06%. CONCLUSION: RBP is an idea marker for renal tubular damage, and is useful to diagnose renal tubular damage and assess the extent of the damage.

p66Shc mediates high-glucose and angiotensin II-induced oxidative stress renal tubular injury via mitochondrial-dependent apoptotic pathway.

p66Shc, a promoter of apoptosis, modulates oxidative stress response and cellular survival, but its role in the progression of diabetic nephropathy is relatively unknown. In this study, mechanisms by which p66Shc modulates high-glucose (HG)- or angiotensin (ANG) II-induced mitochondrial dysfunction were investigated in renal proximal tubular cells (HK-2 cells). Expression of p66Shc and its phosphorylated form (p-p66Shc, serine residue 36) and apoptosis were notably increased in renal tubules of diabetic mice, suggesting an increased reactive oxygen species production. In vitro, HG and ANG II led to an increased expression of total and p-p66Shc in HK-2 cells. These changes were accompanied with increased production of mitochondrial H(2)O(2), reduced mitochondrial membrane potential, increased translocation of mitochondrial cytochrome c from mitochondria into cytosol, upregulation of the expression of caspase-9, and ultimately reduced cell survival. Overexpression of a dominant-negative Ser36 mutant p66Shc (p66ShcS36A) or treatment of p66Shc- or PKC-ß-short interfering RNAs partially reversed these changes. Treatment of HK-2 cells with HG and ANG II also increased the protein-protein association between p-p66Shc and Pin1, an isomerase, in the cytosol, and with cytochrome c in the mitochondria. These interactions were partially disrupted with the treatment of PKC-ß inhibitor or Pin1-short interfering RNA. These data suggest that p66Shc mediates HG- and ANG II-induced mitochondrial dysfunctions via PKC-ß and Pin1-dependent pathways in renal tubular cells.

Mast cell infiltration is involved in renal interstitial fibrosis in a rat model of protein-overload nephropathy.

AIMS: The present study investigated the relationship between mast cells (MCs) and the protein expression of stem cell factor (SCF) and transforming growth factor-ß1 (TGF-ß1) in the regions of renal interstitial fibrosis with protein-overload nephropathy, in order to provide a good animal model to study the mechanism of renal fibrosis induced by proteinuria. METHODS: 60 male Sprague-Dawley rats were divided into a bovine serum albumin (BSA) group and a control group. The intensity of MCs infiltration was examined by toluidine blue and chymase and tryptase staining. The protein expression of SCF and TGF-ß1 was respectively examined by immunohistochemical and immunofluorescence staining. RESULTS: Severe proteinuria was induced in rats of the BSA group. Expression of SCF and TGF-ß1 was detected in the tubular and the interstitial cells. The number of MCs positively correlated with the severity of interstitial lesions and the expression of SCF and TGF-ß1. CONCLUSION: Our results demonstrated that in protein-overload nephropathy, MCs infiltrated into the kidney, and the expression of SCF and TGF-ß1 gradually increased. They might play important roles in the development of renal interstitial fibrosis, but the underlying mechanism needs to be further studied.

[Risk factors for acute kidney injury following 5100 cardiac surgeries with extracorporeal circulation].

OBJECTIVE: To determine the incidence and risk factors associated with acute kidney injury (AKI) in patients after cardiac surgery with extracorporeal circulation. METHODS: A retrospective case control study was done in patients who underwent cardiac surgery from 2003 to 2007 in Second Xiangya Hospital, with 340 patients in an AKI group and the other 4 760 patients without AKI as a control group. All variables were analyzed by univariate analysis, Mann-Whitney U test and logistic regression. RESULTS: AKI occurred in the 340 patients (6.7% incidence). Univariate analysis revealed that age, preoperative serum creatinine, preoperative ejection fraction (EF), preoperative beta2-microglobulin, preoperative blood albumin, preoperative blood uric acid, intraoperative cardiopulmonary bypass time, intraoperative aortic cross-clamp time, and dosage of mannitol were significantly related to AKI following cardiac surgery with extracorporeal circulation. Logistic multivariate regression analysis showed that preoperative serum creatinine (P<0.001), preoperative ejection fraction (EF) (P<0.001), preoperative beta2-microglobulin (P=0.002), preoperative blood uric acid (P=0.015), intraoperative cardiopulmonary bypass time (P<0.001), and intraoperative aortic cross-clamp time (P<0.001) were independent risk factors for AKI. CONCLUSION: The incidence of AKI after cardiac surgery with extracorporeal circulation is closely related with a variety of perioperative risk factors. Our data suggest that patients planning to accept cardiac surgery with extracorporeal circulation should be more comprehensively assessed and monitored, thereby preventing the occurrence of AKI.

[Expression of plasma thrombospondin-1 in renal interstitial fibrosis].

OBJECTIVE: To observe the expression of plasma thrombospondin-1(TSP-1) at different time in protein-overload rats and to analyze the relationship between plasma TSP-1 expression and renal interstitial fibrosis. METHODS: Forty-five male Sprague-Dawley rats were randomly divided into a bovine serum albumin (BSA) group and a control group after uninephrectomization. Rats with protein overload nephropathy induced by intraperitoneally injected BSA were used as a model (control group received saline). At the 1st, 5th, and 9th weekend, the level of 24 h proteinuria and renal function was assessed. Pathological changes were observed by electron and fluorescent microscopy. The expression of plasma TSP-1 was detected by Western blot. The relationship between plasma TSP-1 and tubulointerstitial lesions (TIL) score was analyzed. RESULTS: Twenty-four hour proteinuria and blood urea nitrogen (BUN) significantly increased in protein-overload rats compared with those in the control group. While protein-overload rats developed more severe fibrosis in the tubular and interstitium. Glomerulosclerosis index and TIL score were upregulated compared with those in the control group. The expression of TSP-1 increased significantly at the 5th and 9th weekend. The expression of TSP-1 was positively correlated with TIL score (r=0.836, P<0.01). CONCLUSION: Plasma TSP-1 expression is positively correlated with renal interstitial fibrosis in protein-overload rats. Plasma TSP-1 may be used for an important biomarker of renal interstitial fibrosis.

[Effect of glucose peritoneal dialysates on the transmesothelial electrical resistance and cellular migration of monolayer human peritoneal mesothelial cell].

OBJECTIVE: To investigate the effect of different concentrations of glucose peritoneal dialysates (PDS) on monolayer transmesothelial electrical resistance (TER) and migration ability of cultured human peritoneal mesothelial cells (HPMCs) to clarify the cause of peritoneal hyperpermeability state and ultrafiltration failure during prolonged peritoneal dialysis. METHODS: HPMCs were cultured in a 1:1 mixture of DMEM and PDS containing 1.5%, 2.5%, and 4.25% glucose. Methyl thiazolyl tetrazolium (MTT) assay and TER were measured to determine the effect of glucose PDS on the proliferation and permeability of human peritoneal mesothelial monolayers, respectively. Wound-healing assay was used to confirm whether glucose could do harm to the migration of cells. RESULTS: Proliferation of HPMCs was significantly suppressed by different glucose concentrations at 24 hours. TER decreased in a time- and concentration-dependent manner after culture with different concentrations of glucose PDS. Cells lost migration in the presence of high glucose after 24 hours, and most cells lost their normal morphology and became detached from plates after 48 hours of wounding. CONCLUSION: High glucose in PDS can cause peritoneal damage by suppressing cell proliferation, inducing increase in paracellular permeability of HPMCs and inhibiting cell migration after damage, which may be responsible for peritoneal hyperpermeability and the development of ultrafiltration failure.

[Multiple analysis of lead concentration in the air and renal function of lead exposure workers].

OBJECTIVE: To determine the lead concentration in the air (pbA) at the workplace and the renal function of lead exposure workers. METHODS: The lead concentration in the air of 11 printing plants, 4 smelteries and 2 lead mines were measured. Screening urinalysis was performed in 1190 long term lead exposed workers with urine sugar, protein and sigements. It one of the three was abnormal, the workers were given examination of renal function. The relationship between pbA and renal function were confirmed by mutiple linear. RESULTS: The concentrations of pbA in the printing plants, smelteries and lead mines were 0.07 mg/m3, 0.26 mg/m3 and 0.66 mg/m3 respectively. Altogether 157 cases had one and more abnormal renal function. The correlation of concentration PbA in the workplace and the renal function of lead exposure workers was shown (R = 0.894, P < 0.001, R2 = 0.799). The correlation coefficient of skewness of showed that PbA and Bpb. Upb. Bun Scr Usug. Ubeta2MG were positively correlated (P < 0.01 approximately 0.001); Ccr was negatively correlated (P =0.05). Upro, UNAG and Ualb were nonsignificant. CONCLUSION: The lead concentration in the air at the workplace is related to the renal functions of lead exposure workers. It is important to decrease the lead environment and to prevent renal damage.