Massive Proteinuria-Induced Injury of Tubular Epithelial Cells in Nephrotic Syndrome is Not Exacerbated by Furosemide.

BACKGROUND/AIMS: Massive proteinuria, a significant sign of nephrotic syndrome (NS), has the potential to injure tubular epithelial cells (TECs). Furosemide is widely used for the treatment of edema, a common manifestation of NS. However, whether furosemide treatment affects massive proteinuria-induced TEC injury in patients with NS is unknown. METHODS: The effect of furosemide on TEC damage was investigated in vitro. In addition, a clinical study was conducted to study whether the short-term treatment of nephrotic edema with furosemide could exacerbate TEC injury. RESULTS: The proliferation of in vitro human kidney-2 (HK-2) cells exposed to massive urinary protein (8 mg/mL) significantly decreased (P<0.05), while the levels of kidney injury molecule-1 (Kim-1) and neutrophil gelatinase associated lipocalin (NGAL) in the supernatants significantly increased (P<0.05). Importantly, furosemide treatment did not further increase the expression of Kim-1 and NGAL in HK-2 cells upregulated by massive proteinuria. For the clinical study, 26 patients with NS, all prescribed the recommended dosage of prednisone (1 mg/kg/day), were randomly assigned to two groups. One group (n=13) received furosemide (60-120 mg/day, intravenously) for 1 week; the remaining participants (control group) did not receive furosemide or any other diuretics. The results showed that the 24-h urine volume in the furosemide-treated group was slightly, but not significantly, higher than that in the control group (P>0.05). In addition, serum levels of BUN, Scr, Cys C, and urinary Kim-1 and NGAL were not significantly different between the two groups (all P>0.05). Twenty-three patients underwent a renal biopsy. Of these, 22 patients exhibited vacuolar degeneration of the TECs; 8 patients showed brush border membrane shedding of the TECs; and 12 patients showed protein casts. However, there were no significant differences between the two groups (all P>0.05). CONCLUSION: In summary, massive proteinuria induced the injury of TECs in patients with NS, and furosemide treatment did not aggravate this injury.

[Real-time transrectal ultrasonography in seminal vesiculoscopy].

OBJECTIVE: To compare three different pathways for transurethral seminal vesiculoscopy (SVS) and investigate the reliability and efficiency of transrectal ultrasonography (TRUS)-guided SVS (TRUS-SVS). METHODS: We retrospectively analyzed 90 cases of seminal vesiculoscopy conducted directly through the ejaculatory duct or prostatic utricle or under the guide of TRUS. We compared the success rate and complications among the three approaches. RESULTS: Operations were successfully performed in 87 (96.67%) of the 90 cases, 30 through the ejaculatory duct, 37 via the prostatic utricle, and 20 under the guide of TRUS, the operation time ranging from 25 to 75 minutes. Sperm was detected from the seminal vesicle fluid in (92.06%) of the azoospermia patients (58/63) during the surgery and in 77.78% of them (49/63) in semen analysis at 1 week postoperatively. Fifteen hematospermia and 12 spermatocystitis patients were cured. Postoperative follow-up found 20 cases of water-like semen and 3 cases of orchiepididymitis, but no such complications as retrograde ejaculation, incontinence, or rectourethral fistula. CONCLUSIONS: Transejaculatory duct and transprostatic utricle pathways are two common approaches to SVS, while TRUS-SVS may achieve a higher success rate and avoid injury of both the prostate and the rectum.

[Study of lanthanide complexes-doped silica gels and the Co-fluorescence effect by photoacoustic spectroscopy in situ].

Silica matrices, due to their good optical, thermal and chemical properties, are suitable candidates for the hosts of luminescent lanthanide complexes. However, lanthanide complexes would be unstable in the most common sol-gel precursor solution. It is important to study the coordination environment of lanthanide ions and the formation of lanthanide complexes in silica gels. In the present work, lanthanide complexes Ln(Sal)3 x H2O(Ln3+:La3+, Nd3+ and Tb3+; Sal:salicylic acid) were incorporated into silica gels via a sol-gel process. PA technique was firstly used to monitor the formation of lanthanide complexes in silica gels. Upon heat treatment at 110 degrees C, PA intensity of the ligand increased for Tb3+, La3+ and Nd3+ complexes in silica gels, respectively, while this difference could not be observed for the wet gels (samples without heat treatment). By comparison with fluorescence spectra, experimental data indicate that lanthanide complexes decompose in wet gels. The formation of lanthanide complexes in silica gels is discussed from two aspects: radiative and nonradiative processes. Co-luminescence effect was found for lanthanide complexes with aromatic carboxylic acid doped silica gels for the first time. For Tb0.8 Ln0.2 (Sal)3 x H2O (Ln3+:Gd3+ or Nd3+)-doped silica gel, the addition of Gd3+ increased the luminescence efficiency of Tb3+, while the luminescence of Tb3+ was quenched remarkably with the addition of Nd3+. Possible mechanism behind the co-luminescence phenomena of lanthanide complexes-doped silica gels is discussed.