RÉSUMÉ
Diabetic nephropathy (DN) is a common and serious clinical complication of diabetes and presently there are no effective ways to prevent its occurrence and progression. Recent studies show that pentoxifylline (PTX) can improve renal hemodynamics, reduce urinary protein excretion, and alleviate or delay renal failure in DN patients. In this study, we focused on the anti-oxidative stress effect of PTX on alleviating renal damages of DN using rat models. DN rats were established with injection of streptozotocin. Blood glucose, urinary protein excretion, serum cystatin C, renal biopsy, superoxide dismutase (SOD) and malondialdehyde (MDA) in serum and renal homogenate and renal nitrotyrosine levels were analyzed before and 12 weeks after the treatment of PTX. Before treatment, all the DN rats had elevated blood glucose, increased urinary protein excretion and elevated serum cystatin C. Morphologically, DN rats exhibited renal tissue damages, including swelling and fusions of foot processes of podocytes under electron microscope. Masson staining revealed blue collagen deposition in glomeruli and renal interstitium. With treatment of PTX, symptoms and renal pathological changes of DN rats were alleviated. Furthermore, the MDA levels were increased and the SOD levels were decreased in the serum and kidneys of DN rats, and these changes were reversed by PTX. The expression of nitrotyrosine was up-regulated in DN rat model and down-regulated by PTX, indicating that PTX was able to inhibit oxidative reactions in DN rats. PTX could alleviate renal damage in DN, which may be attributable to its anti-oxidative stress activity.
Sujet(s)
Animaux , Rats , Marqueurs biologiques , Diabète expérimental , Traitement médicamenteux , Anatomopathologie , Néphropathies diabétiques , Traitement médicamenteux , Métabolisme , Anatomopathologie , Régulation de l'expression des gènes , Rein , Métabolisme , Anatomopathologie , Malonaldéhyde , Sang , Stress oxydatif , Pentoxifylline , Pharmacologie , Streptozocine , Superoxide dismutase , Métabolisme , Tyrosine , MétabolismeRÉSUMÉ
Diabetic nephropathy (DN) is a common and serious clinical complication of diabetes and presently there are no effective ways to prevent its occurrence and progression. Recent studies show that pentoxifylline (PTX) can improve renal hemodynamics, reduce urinary protein excretion, and alleviate or delay renal failure in DN patients. In this study, we focused on the anti-oxidative stress effect of PTX on alleviating renal damages of DN using rat models. DN rats were established with injection of streptozotocin. Blood glucose, urinary protein excretion, serum cystatin C, renal biopsy, superoxide dismutase (SOD) and malondialdehyde (MDA) in serum and renal homogenate and renal nitrotyrosine levels were analyzed before and 12 weeks after the treatment of PTX. Before treatment, all the DN rats had elevated blood glucose, increased urinary protein excretion and elevated serum cystatin C. Morphologically, DN rats exhibited renal tissue damages, including swelling and fusions of foot processes of podocytes under electron microscope. Masson staining revealed blue collagen deposition in glomeruli and renal interstitium. With treatment of PTX, symptoms and renal pathological changes of DN rats were alleviated. Furthermore, the MDA levels were increased and the SOD levels were decreased in the serum and kidneys of DN rats, and these changes were reversed by PTX. The expression of nitrotyrosine was up-regulated in DN rat model and down-regulated by PTX, indicating that PTX was able to inhibit oxidative reactions in DN rats. PTX could alleviate renal damage in DN, which may be attributable to its anti-oxidative stress activity.
RÉSUMÉ
<p><b>OBJECTIVE</b>To explore the clinical indication of N3 lymph node biopsy during mediastinoscopy for non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Cervical mediastinoscopy was performed in 89 patients with clinical stage I-IIIA non-small cell lung cancer prior to thoracotomy. Of those, 12 underwent cervical medistinoscopy combined with right scalene lymph node biopsy and 10 with anterior mediastinotomy.</p><p><b>RESULTS</b>Nine patients were found to have lymph node metastasis (N3 disease) during mediastinosopy. Of those, 6 had contralateral mediastinal lymph node metastasis and 3 cases with right scalene lymph node metastasis. The incidence of N3 disease in the patients with adenocarcinoma, serum CEA > 5 ng/ml and multi-station mediastinal lymph node metastasis was significantly higher than that in those with non-adenocarcinoma, CEA < 5 ng/ml and ipsilateral uni-station mediastinal lymph nodes metastasis (P < 0.05).</p><p><b>CONCLUSION</b>Biopsy of scalene lymph node or contralateral mediastinal lymph node should be performed during mediastinoscopy in order to exclude N3 disease for potentially operable NSCLC patients with adenocarcinoma, serum CEA >5 ng/ml and ipsilateral multi-station mediastinal lymph nodes metastasis.</p>
Sujet(s)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Adénocarcinome , Sang , Anatomopathologie , Biopsie , Antigène carcinoembryonnaire , Sang , Carcinome pulmonaire non à petites cellules , Sang , Anatomopathologie , Études de suivi , Tumeurs du poumon , Sang , Anatomopathologie , Noeuds lymphatiques , Anatomopathologie , Métastase lymphatique , Médiastinoscopie , Médiastin , Muscles du cou , Stadification tumoraleRÉSUMÉ
<p><b>OBJECTIVE</b>To evaluate the value of mediastinoscopy in preoperative staging of non-small cell lung cancer (NSCLC) based on survival analysis.</p><p><b>METHODS</b>152 cases of potentially operable NSCLC were enrolled in this study. All cases underwent CT scan and mediastinoscopy for assessment of the mediastinal lymph node status before initial treatment. The definitive treatment was decided on the basis of mediastinoscopy and the survival rate was analyzed with a median follow-up of 30.5 months. Survival analysis was conducted by comparing the lymph node status which was determined by final pathology (groups pN0, pN1, pN2, pN3), CT scan (group cN0-1, cN2-3) and mediastinoscopy (group mN0-1, mN2, mN3).</p><p><b>RESULTS</b>The 5-year survival rates in group pN0, pN1, pN2 and pN3 were 61.7%, 75.0%, 32.4% and 16.1%, respectively. Both groups pN0 and pN1 had significantly higher survival rates than those in groups pN2 and pN3 (P < 0.05). There were not significant differences between survival rates in groups cN0-1 and cN2-3 (P = 0.670), while the survival rate in group mN0-1 was significantly higher than that in groups mN2 and mN3 (P < 0.05).</p><p><b>CONCLUSION</b>Mediastinoscopy is of great value in preoperative staging of NSCLC. Not only does it detect lymph node metastasis more precisely but also better predict the prognosis than CT scan.</p>