[Expression and role of soluble epoxide hydrolase in renal tissue of two kidneys one clip hypertension rats model].

OBJECTIVE: To investigate renal expression of soluble epoxide hydrolase (sEH) in 2-kidney-1-clip rats and explore the role of sEH in renal arterial stenosis hypertensive development. METHODS: Hypertensive models were established in Sprague-Dawly rats by chronic partial occlusion of left renal artery. In the study,16 male Sprague-Dawly rats were randomized into sham operation group and 2-kidney-1-lip (2K1C) group (n=8, each group), and were observed for 40 days. Before operation and every ten days after operation, systolic blood pressure (SBP) was measured and twenty-four-hour urine was collected. At the end of the observation, the blood and kidneys were harvested. The serum Na,24-hour urine protein excretion were measured. Renin activity and angiotensin II concentrition in plasm and renal tissue were evaluated by radioimmunoassay (RIA).The expression of sEH, peroxisome proliferator-activated receptor-γ (PPARγ) in kidneys were assessed by immunohistochemistry and Western blotting. Histology was analysed after kidney sections were stained by Grocott-Gomori methenamine-silver nitrate. RESULTS: After surgery, the systolic blood pressure in 2K1C group gradually became higher than that in sham group. Urine protein excretion was statistically increased in 2K1C group on the 30 th and 40 th days, while serum sodium was of no significant difference from those of the two groups. Renin-angiotensin system in both clipped and nonclipped kidneys were also invoked by the 2K1C surgery. Both sEH and PPARγ were upregulated in renocortex and renomedulla in 2K1C group. The two groups were compared: in SBP,on the 10 th day, (106.70±7.71) vs.(124.04±6.79) mmHg, P<0.001,and on the 40 th day,(107.80±10.01) vs. (150.40±11.76) mmHg, P<0.001; Urine protein excretion,on the 30 th day,(206.81±37.61)vs.(292.33±20.53)mg/d, P=0.005; Serum sodium, (179.76±29.20) vs. (157.72±51.00)mmol/L, P=0.44; Renin activity[plasm(50.00±13.66) vs.(132.90± 31.22)ng/(L×h),P=0.03; clipped kidney(128.40±36.88)vs.(324.90±56.66)ng/(g×h), P=0.01; nonclipped kidney(103.00±19.87)vs.(345.10±42.68)ng/(g×h), P<0.001]; Ang II [plasm(4 810.00±1 164.00)vs. (10 470.00±1 760.00) ng/L,P=0.02, clipped kidney(735.90±154.40)vs.(2 094.00±372.20)ng/g, P=0.005, nonclipped kidney(648.10±217.90)vs.(1 774.00±206.60)ng/g, P=0.002]; the expression of sEH (sEH/ß-actin) in renocortex [clipped kidney (0.33±0.08) vs. (1.73±0.12), P<0.001, nonclipped kidney (0.43±0.09)vs. (0.70± 0.05), P=0.04]; the expression of PPARγ (PPARγ/ß-actin) in renocortex [clipped kidney(0.17±0.05) vs. (0.89±0.11), P=0.002, and nonclipped kidney(0.27±0.07) vs. (0.56±0.07), P=0.04]. Clipped kidney showed more severe glomerulosclerosis and tubular atrophy in 2K1C group than in sham group. CONCLUSION: sEH probably plays an important role in the development of hypertension in the rat models of renovascular hypertension. The activation of PPAR-γ and RAAS by renal arterial stenosis are associated with sEH upregulation, suggesting that they might regulate sEH expression and take part in hypertensive development.

Prognostic factors and staging systems of multiple myeloma:.

BACKGROUND: Previous studies found a range of prognostic factors but no consensus about the proper staging system for multiple myeloma has been achieved. This study explored the prognostic factors to find a staging system for multiple myeloma most suitable for Chinese patients. METHODS: Between February 1990 to August 2004, 206 patients (138 men and 68 women, mean aged (59 +/- 11) years) who were initially diagnosed as multiple myeloma in Changzheng Hospital (Shanghai, China) and had followup records were enrolled in this study. Potential prognostic factors were evaluated by univariate and multivariate analyses. Four staging systems were applied to compare their suitability for the patients. RESULTS: The median survival time of the patients was 33 months. The 1-, 3- and 5-year survival rates were 80.18%, 48.08% and 33.7% respectively. Factors identified as adversely affecting survival were older age, severe bone lesions, low haemoglobin, low platelet, low serum calcium, low serum albumin, high proportion of plasma cells in marrow, high serum creatinine, high serum beta(2) microglobulin and high C-reactive protein. Among these, only C-reactive protein, beta(2) microglobulin, albumin and age were the independent prognostic factors. There were statistically significant survival differences among the three groups in Durie Salmon staging system and Bataille staging system, but not in British Medical Research Council staging system or International Staging System. CONCLUSIONS: High beta(2) microglobulin, high C-reactive protein, low albumin and old age are independent prognostic factors of multiple myeloma. Bataille staging system appears to be optimal for Chinese multiple myeloma patients.

[Prognostic analysis and assessment on the clinical staging systems of multiple myeloma--a report of 206 cases].

BACKGROUND & OBJECTIVE: Multiple myeloma (MM) is a heterogeneous disease of plasma cell tumor with poor prognosis. This study was to explore the prognostic factors of MM in China, and find the most suitable clinical staging systems. METHODS: Univariate and multivariate analyses were carried out on 18 clinical and laboratory indexes from 206 MM patients. These MM patients were classified according to 4 staging systems to compare their survival status. RESULTS: Of the 206 patients, 138 were men and 68 were women, with median age of 59 years (ranged 27-90 years) and median survival time of 33 months. The 2-and 5-year survival rates were 64.7% and 33.7%. Univariate analysis identified 10 prognostic factors: age, the amount of bone marrow plasma cells, hemoglobin, platelet count, adjusted serum calcium, albumin, creatinine, beta2 microglobulin, C-reactive protein, and skeletal disease stage. Multivariate analysis showed that C-reactive protein, beta2 microglobulin, albumin, age were independent prognostic factors. Significant differences of survival period existed among the 3 groups classified according to Durie Salmon staging system and Bataille staging system as well as between group I and group II of International staging system. However, no significant difference was found among the 3 groups classified according to British Medical Research Council staging system and between group II and group III of International staging system. CONCLUSIONS: High level of C-reactive protein, high level of beta2 microglobulin, low level of albumin and old age are correlated to poor prognosis. Durie Salmon staging system and Bataille staging system are suitable for Chinese MM patients.