Study on Fu-Fang-Jin-Qian-Cao Inhibiting Autophagy in Calcium Oxalate-induced Renal Injury by UHPLC/Q-TOF-MS-based Metabonomics and Network Pharmacology Approaches.

INTRODUCTION: Fu-Fang-Jin-Qian-Cao is a Chinese herbal preparation used to treat urinary calculi. Fu-Fang-Jin-Qian-Cao can protect renal tubular epithelial cells from calcium oxalateinduced renal injury by inhibiting ROS-mediated autopathy. The mechanism still needs further exploration. Metabonomics is a new subject; the combination of metabolomics and network pharmacology can find pathways for drugs to act on targets more efficiently. METHODS: Comprehensive metabolomics and network pharmacology to study the mechanism of Fu-Fang-Jin-Qian-Cao inhibiting autophagy in calcium oxalate-induced renal injury. Based on UHPLC-Q-TOF-MS, combined with biochemical analysis, a mice model of Calcium oxalateinduced renal injury was established to study the therapeutic effect of Fu-Fang-Jin-Qian-Cao. Based on the network pharmacology, the target signaling pathway and the protective effect of Fu- Fang-Jin-Qian-Cao on Calcium oxalate-induced renal injury by inhibiting autophagy were explored. Autophagy-related proteins LC3-II, BECN1, ATG5, and ATG7 were studied by immunohistochemistry. RESULTS: Combining network pharmacology and metabolomics, 50 differential metabolites and 2482 targets related to these metabolites were found. Subsequently, the targets enriched in PI3KAkt, MAPK and Ras signaling pathways. LC3-II, BECN1, ATG5 and ATG7 were up-regulated in Calcium oxalate-induced renal injury. All of them could be reversed after the Fu-Fang-Jin-Qian- Cao treatment. CONCLUSIONS: Fu-Fang-Jin-Qian-Cao can reverse ROS-induced activation of the MAPK signaling pathway and inhibition of the PI3K-Akt signaling pathway, thereby reducing autophagy damage of renal tubular epithelial cells in Calcium oxalate-induced renal injury.

An extramedullary plasmacytoma in the kidney of a 14-year-old girl: Case report and review of the literature.

RATIONALE: Extramedullary plasmacytoma (EMP) a rare plasma cell disorder and is frequently associated with plasma cell bone marrow infiltration. Most EMPs involve mucosal lymphoid tissue, especially in the nasopharyngeal area, respiratory tract, and head and neck region. Primary involvement of the kidney is exceedingly rare. PATIENT CONCERNS: A 14-year-old girl was admitted in our hospital with intermittent right upper quadrant pain for 1 month and recent (1 day) progressive deterioration. There was a mass found by ultrasonography in the right kidney and subsequent abdominal computed tomography scan revealed a 3 cm mass within the right kidney. DIAGNOSES: Pathology revealed typical histology of plasmacytoma and immunohistochemistry revealed the expression of CD138, CD45, vimentin, and Kappa light chain. INTERVENTIONS: The patient successfully underwent radical nephrectomy with an uneventful recovery. She received no chemotherapy or radiotherapy after surgery. OUTCOMES: There was no recurrence or metastasis during a 22-month follow-up. LESSONS: Our case study demonstrated that renal EMP with a relatively indolent clinical course, if detected at an early stage, can be treated by radical nephrectomy without adjuvant therapy. Generally, the clinical outcome and prognosis of EMP are favorable.