Uric Acid as a Predictor of Immunoglobulin A Nephropathy Progression: A Cohort Study of 1965 Cases.

BACKGROUND: The role of serum uric acid (SUA) level in the progression of Immunoglobulin A nephropathy (IgAN) remains controversial. METHODS: In a cohort of 1,965 cases with biopsy-proven IgAN, we examined the associations of SUA concentration with the primary outcome of a composite of all-cause mortality or kidney failure (defined as a reduction of estimated glomerular filtration rate [eGFR] by 40% from baseline, requirements for dialysis and transplantation), or the outcome of kidney failure alone, assessed using Cox and logistic regression models, respectively, with adjustment for confounders. RESULTS: At baseline, the mean age was 33.37 ± 11.07 years, eGFR was 101.30 ± 30.49 mL/min/1.73 m2, and mean uric acid level was 5.32 ± 1.76 mg/dL. During a median of 7-year follow-up, 317 cases reached the composite outcome of all-cause mortality (5 deaths) or kidney failure (36 cases of dialysis, 5 cases of renal transplantation, and 271 cases with reduction of eGFR by 40% from baseline). After adjustment for demographic and IgAN specific covariates and treatments, a higher quartile of uric acid was linearly associated with an increased risk of the primary outcome (highest versus lowest quartile, hazard ratio [HR] 2.39; 95% CI 1.52-3.75) and kidney failure (highest versus lowest quartile, HR 2.55; 95% CI 1.62-4.01) in the Cox proportional hazards regression models. In the continuous analysis, a 1 mg/dL greater uric acid level was associated with 16% increased risk of primary outcome (HR 1.16, 95% CI 1.07-1.25) and 17% increased risk of kidney failure (HR 1.17, 95% CI 1.08-1.27), respectively, in the fully adjusted model. The multivariate -logistic regression analyses for the sensitive analyses drew consistent results. In the subgroup analyses, significant interactions were detected that patients with mean arterial pressure (MAP) < 90 mm Hg or mesangial hypercellularity had a higher association of SUA with the incidence of the primary outcome than those with MAP ≥90 mm Hg or those without mesangial hypercellularity respectively. Hyperuricemia was not significantly associated with the risk of developing the primary outcome in elder patients (≥32 years old), patients with eGFR < 90 mL/min or with tubular atrophy/interstitial fibrosis. CONCLUSIONS: SUA level may be positively associated with the progression of IgAN. It was noticeable that the association of hyperuricemia with IgAN progression was less significant in patients with elder age, lower eGFR, or tubular atrophy/interstitial fibrosis, which may be due to some more confounders in association with the IgA progression in these patients. Future prospective studies are warranted to confirm these findings and to investigate the underlying mechanisms.

[Screening and Nitrogen Removing Characteristics of Heterotrophic Nitrification-Aerobic Denitrification Bacteria SLWX2 from Sea Water].

In this study, an efficient heterotrophic nitrifying-aerobic denitrifying bacteria strain SLWX2 was screened from 7 strains isolated from Stichopus japonicus culture ponds, with removal rates of NH4+-N, NO2--N and NO3--N up to 100%, 99.5% and 85.6% within 24 h, respectively. Through morphologic observation, physiological characteristics and 16S rDNA sequence analysis, strain SLWX2 was identified as Bacillus hwajinpoensis. The results of nitrogen removal characterization experiments indicated that, when NH4+-N, NO2--N and NO3--N existed at the same time, SLWX2 utilized NH4+-N firstly, then utilized NO2--N and NO3--N, and removed almost all the inorganic nitrogen within 72 h, suggesting that it could achieve simultaneous nitrification and denitrification itself. The results of nitrogen tolerance examination indicated that strain SLWX2 showed perfect nitrogen removal ability when the ammonia load was not above 500 mg·L-1, nitrite load was not above 100 mg·L-1 and nitrate load was not above 200 mg·L-1, the maximal removal of ammonia nitrogen, nitrite nitrogen and nitrate nitrogen withinn 96 h reached 180 mg, 30 mg and 120 mg, respectively. Moreover, there was no NO2--N accumulation during nitrification. This strain showed great potential in biological nitrogen removal of wastewater with high salt and nitrogen from mariculture and industries.

[Bushen Huoxue Fang promotes the apoptosis of epithelial cells in the prostatic ductal system of rats with benign prostatic hyperplasia].

OBJECTIVE: To investigate the effects of Bushen Huoxue Fang (BSHX) on the apoptosis of epithelial cells in the prostatic ductal system of rats with benign prostatic hyperplasia (BPH) and its possible action mechanism. METHODS: One hundred 3- month-old male Wistar rats were randomly divided into four groups of equal number (control, castrated, BPH model, and BSHX). BPH models were made by subcutaneous injection of testosterone following castration; the rats in the BSHX group were treated intragastrically with BSHX at 2.34 g/ml after modeling, while those in the other two groups with equal volume of saline, all for 37 days. On the 38th day, all the rats were sacrificed and their prostates harvested for detection of the distribution of TGF-beta1 and alpha-actin and the count of positive cells in the prostatic ductal system by immunohistochemical staining. The apoptosis rate of epithelial cells in the prostatic ductal system was determined by TUNEL assay. RESULTS: The expression of TGF-beta1 was significantly increased in the rats of the BSHX group as compared with the BPH models in both the proximal prostatic duct ([15.28 +/- 4.30]% vs [36.42 +/- 8.10]%, P < 0.01) and the distal prostatic duct ([4.42 +/- 2.07]% vs [8.71 +/- 2.28 ]%, P < 0.05), while the expression of alpha-actin in the proximal duct was remarkably higher in the BSHX-treated rats than in the models ([28.14 +/- 7.43]% vs [18.28 +/- 4.07]%, P < 0.01), but lower than in the control animals ([33.57 +/- 6.85]%, P < 0.05). Compared with the control group, the BPH models and BSHX-treated rats both exhibited markedly decreased apoptosis of epithelial cells in the proximal prostatic duct ([39.42 +/- 9.20]% vs [3.86 +/- 1.34]%, P < 0.01, and [31.14 +/- 5.64]%, P < 0.01) and distal prostatic duct ([17.60 +/- 4.86]% vs [3.07 +/- 1.14]%, P < 0.01, and [12.37 +/- 2.25]%, P < 0.05). The apoptosis rate of epithelial cells in the prostatic ductal system was significantly higher in the BSHX-treated rats than in the BPH models (P < 0.01). CONCLUSION: By upregulating the expression of TGF-beta, BSHX can suppress the reduction of smooth muscle cells in the proximal prostatic duct, promote the apoptosis of prostatic epithelial cells, and thus effectively inhibit benign prostatic hyperplasia.

[Analysis of the changes of microbial community structure on bio-carrier of recirculating aquaculture systems (RAS)].

In order to study the variation of microbial community structure and the mechanism of denitrification on bio-carrier in recirculating aquaculture systems (RAS) during the periods of bio-film formation and operation the systems, traditional microbiological methods were applied to count the quantity of heterotrophic bacteria, ammonia oxidize bacteria and nitrite oxidize bacteria. The amplified products of variable V3 region of bacterial 16S rDNA were separated by using denaturing gradient gel electrophoresis (DGGE). And bacterial community DNA fingerprint was obtained. The sequences retrieved from the DGGE bands were used for homology analysis and construction of phylogenetic tree. It presented a trend that the quantity of the three types of bacteria increased gradually to a top and then fallen slowly to a stable level. The composition of microbial community of bio-carrier was very abundant in all periods, and the Shannon index was 1.53, 1.44, 1.57, 1.08, 1.27 and 1.30, respectively. During different periods, there was a certain shift in the microbial community structure, while the C(s) value (similar index) in two adjacent periods was high, indicating the variation and succession of the microbial community was slow and regular. Several bacteria had an effect on removal of pollutants for farming water and the effluent water quality could meet the requirements of high-density culture. Among them, Proteobacteria and Flavobacteria were main communities. The Nitrosomonas and some other facultative anaerobic bacteria (Flavobacteriaceae bacterium) were identified, which indicated that there may be coexisted pathways of nitrification and denitrification in bio-filter.

[Effect of combination of bushen jianpi recipe and erythropoietin on serum tumor necrosis factor alpha in patients with anemia].

OBJECTIVE: To study the effect of treatment of renal anemia by combination of Bushen Jianpi Recipe (BJR, a Chinese experience recipe for supplementing Shen and supporting Pi) and low dosage erythropoietin (EPO), and the influence of treatment on change of serum tumor necrosis factor alpha (TNF-alpha) so as to explore the possible mechanism of integrative Chinese and western medicine (ICWM) in treating renal anemia. METHODS: Patients with renal anemia were randomly divided into two groups, the ICWM group and the control group, symptomatic and supporting treatment such as dialysis, supplementing of ferrous, foliac acid and vitamin B12, was given to both groups. Additionally, to the ICWM group, 50 IU/kg of EPO subcutaneous injection for twice every week, and oral intake of BJR, one dose per day taken in two parts, were given, and to the control group, EPO alone, 50 IU/kg by subcutaneous injecting, 3 times per week, was given. The therapeutic course for two groups was 3 months. Blood levels of hemoglobin (Hb), hematocrit (Hct), TNF-alpha were measured before treatment and the therapeutic effect was observed. RESULTS: After treatment, the levels of Hb and Hct increased significantly in both groups (P < 0.01), comparison between the two groups in Hb and Hct after being treated for 3 months showed significant difference (P < 0.05). The serum level of TNF-alpha was markedly higher than normal range in both groups before treatment, it significantly lowered after treatment in the ICWM group (P < 0.05), but unchanged in the control group. CONCLUSION: Combination of BJR and EPO could significantly inhibit the production of TNF-alpha, this may be an important factor for ICWM in effectively improving sensitivity to EPO.