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Objective:To investigate the characteristics of cardiac structure and function changes in maintenance hemodialysis (MHD) patients.Methods:The information of 363 MHD patients with dialysis age ≥3 months who were registered in Huadu District People′s Hospital of Guangzhou City before January 2020 was collected, and the echocardiographic screening was performed to analyze the changes in cardiac structure and function.Results:The most common abnormal changes of heart structure and function in MHD patients were valve regentation (69.7%), left ventricular hypertrophy (LVH) (51.8%), left ventricular diastolic dysfunction (29.8%), valve calcification (11.6%), and left ventricular systolic dysfunction (10.2%). With the increase of age, the left ventricular ejection fraction of MHD patients decreased, and the proportion of left ventricular diastolic dysfunction, left atrial enlargement and pulmonary hypertension increased (all P<0.05). Among 363 MHD patients, 188(51.8%) had LVH. It was found that LVH patients had higher average single ultrafiltration volume, higher brain natriuretic peptide (BNP) level, more type 2 diabetes, lower left ventricular ejection fraction (all P<0.05), and were more prone to chest tightness, chest pain, post activity shortness of breath, heart failure and other symptoms compared with the non-LVH patients (all P<0.05). Conclusions:Most MHD patients have different degrees of cardiac structural changes. Early intervention, reduction of single ultrafiltration volume and control of blood glucose are beneficial to improve the dialysis quality of MHD patients and reduce the occurrence of cardiovascular events.
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Objective:To report a case of acute kidney injury caused by rhabdomyolysis and summarize its etiology, pathogenesis, and treatment strategy.Methods:The clinical data of a case of rhabdomyolysis complicated by acute kidney injury admitted to Affiliated Huadu Hospital of Southern Medical University on August 30, 2020, were collected, including clinical manifestation, auxiliary examination, and disease outcome. Referring to the previous literature reports of rhabdomyolysis complicated by acute kidney injury, this paper discusses its etiology, monitors and analyzes some indicators such as serum creatinine, blood urea nitrogen, creatine kinase, myoglobin, and 24-hour urine volume during the treatment, and summarizes the clinical diagnosis and treatment ideas of the disease.Results:This case developed an intestinal infection after an unclean diet, which induced rhabdomyolysis and acute kidney injury. Renal pathology after renal biopsy showed that renal biopsy result was consistent with an acute tubulointerstitial injury caused by myoglobin tubular nephropathy. The biochemical indexes such as creatine kinase and myoglobin decreased rapidly after ordinary hemodialysis, but the levels of serum creatinine and blood urea nitrogen did not decrease markedly, and there was continuous oliguria. After switching to hemodialysis filtration and continuous intensive dialysis treatment, the levels of serum creatinine and blood urea nitrogen decreased rapidly, the amount of urine increased gradually, and finally, the renal function recovered.Conclusion:For acute kidney injury caused by rhabdomyolysis, early sufficient blood purification can accelerate the clearance of myoglobin, promote the recovery of the injured kidney, and improve the prognosis of the disease.
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Neisseria elongata is a normal group of bacteria in human oropharynx and a kind of gram-negative bacillus that cause disease, and its pathogenicity is rarely reported in China. In a few cases, it can cause septicemia, osteomyelitis and infective endocarditis. There are a few reports of other Neisseria causing peritonitis at home and abroad. The paper reported a case of Neisseria elongata-caused peritonitis and reviewed the literature. The patient was initially treated with ceftazidime combined with cefzolin overnight for 3 days, but the effect was not good. The subsequent peritoneal dialysis fluid culture results indicated Neisseria elongata, and the patient was cured and discharged after treatment with levofloxacin combined with drug sensitivity test, hoping to attract clinical workers' attention to the pathogenicity of Neisseria.
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Objective:To investigate the prevalence of chronic constipation in maintenance hemodialysis (MHD) patients and analyze the risk factors of chronic constipation.Methods:Using the cross-sectional survey method, patients who received MHD in Huadu District People′s Hospital of Guangzhou from September 1, 2021 to September 30, 2021 were enrolled as the research objects. The patient′s demographic, general data and laboratory results were collected. The anxiety level and quality of life were assessed by questionnaires. The patients were divided into constipation group and non-constipation group according to whether they had chronic constipation. The Rome Ⅳ criteria was used to diagnose chronic constipation, and the differences of clinical data between the constipation group and the non-constipation group were compared. The risk factors of chronic constipation in MHD patients were analyzed by logistic regression analysis method.Results:A total of 321 MHD patients were enrolled in this study, with 168 males, 153 females and age of (59.5±13.4) years old (ranged from 29 to 87 years old). There were 160 patients (49.8%) with chronic constipation. The proportions of males, long dialysis age, taking sevelamer and lanthanum carbonate, diabetic nephropathy, and diabetes in the constipation group were higher than those in the non-constipation group, and the differences between the two groups were statistically significant (all P<0.05). The serum calcium, serum phosphorus, calcium-phosphorus product, anxiety scores, average weekly ultrafiltration volume/dry weight in the constipation group were significantly higher than those in the non-constipation group (all P<0.05), and the serum albumin, serum magnesium, urea clearance index (Kt/V) and geriatric nutritional risk index were significantly lower than those in the non-constipation group (all P<0.05). The results of logistic regression analysis showed that moderate to severe anxiety (moderate, OR=3.233, 95% CI 1.339-7.805, P=0.009; severe, OR=5.103, 95% CI 1.906-13.663, P=0.001), existed risk of nutrition (low risk, OR=3.705, 95% CI 1.440-9.533, P=0.007; moderate risk, OR=5.638, 95% CI 2.557-12.430, P<0.001; severe risk, OR=15.097, 95% CI 4.112-55.436, P<0.001), >60 years old (≤40 years old as a reference, OR=4.050, 95% CI 1.366-12.006, P=0.012), diabetes history ( OR=2.224, 95% CI 1.253-3.946, P=0.006), taking sevelamer ( OR=2.290, 95% CI 1.207-4.346, P=0.011), and calcium-phosphorus product ( OR=1.704, 95% CI 1.329-2.186, P<0.001), intact parathyroid hormone ( OR=1.013, 95% CI 1.003-1.022, P=0.007), blood urea nitrogen ( OR=1.092, 95% CI 1.002-1.189, P=0.045) and serum magnesium ( OR=0.042, 95% CI 0.006-0.294, P=0.001) were the independent influencing factors for chronic constipation in MHD patients. Conclusions:The prevalence of chronic constipation in MHD patients is 49.8%. Adequate dialysis, improving calcium and phosphorus metabolism, improving nutritional status, relieving anxiety, and increasing serum magnesium level may help to reduce the risk of chronic constipation in MHD patients.
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Objective:To analyze the incidence of malignant tumors and its risk factors in patients on maintenance hemodialysis.Methods:Clinical data of 627 hemodialysis patients in Huadu District People′s Hospital of Guangzhou who met the inclusion criteria and exclusion criteria from January 2015 to December 2020 were retrospectively collected. Clinical characteristic of patients with malignant tumors was summarized. Multivariate logistics regression analysis was performed to explore the related factors of malignant tumors.Results:Among the 627 patients, 19(3.03%) developed malignant tumors. There were 14 males and 5 females with a mean age of (65.7±13.7)years. Their mean dialysis duration was (45.16±38.18)months. Gastrointestinal tumor was the most common tumor type (9/19). Univariate analysis showed that the age of the patients combined with malignant tumors was significantly higher, and the serum prealbumin was significantly lower than those patients without malignant tumors (all P<0.05). Logistic regression analysis showed that age was the independent risk factor of developing cancers after adjusting dialysis age, hemoglobin, albumin and parathyroid hormone ( P<0.05). Conclusions:The incidence of malignant tumor is significantly higher in maintenance hemodialysis patients than that in the general population. Age is the risk independent risk factor. Therefore, we should strengthen the monitoring of elderly hemodialysis patients, discover the disease in time, and take measures to improve the prognosis.
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Objective:To explore the safety and effectiveness of modified lower costa surgical approach (mLS) for transversus abdominis plane block (TAPB) combined with rectus sheath block (RSB) in surgical incision peritoneal dialysis catheterization (PDC).Methods:Forty chronic kidney disease of stage 5 patients scheduled for PDC from January to December 2018 in Huadu District People′s Hospital of Guangzhou City were selected. The patients were divided into 3 groups by random digits table method, among whom 13 cases used mLS for TAPB combined with RSB (TAPB combined with RSB group), 13 cases used lateral approach combined with hip approach for TAPB (TAPB group), and 14 cases used local anesthesia (LA group). The mean arterial pressure, heart rate and pain visual analogue score (VAS) at skin incision (T 0), separation of rectus abdominis (T 1), peritoneal dialysis catheter placement (T 2) and suture of skin and subcutaneous tunnel (T 3) were recorded; and the total operation and anesthesia time, cases of rescue anesthesia, surgeon′s satisfaction with anesthesia, surgical and anesthesia related complication were recorded. Results:The VAS from T 0 to T 3 in TAPB combined with RSB group and TAPB group was significantly lower than that in LA group: (1.92 ± 0.95) and (3.00 ± 1.08) scores vs. (5.07 ± 0.62) scores, (1.31 ± 0.63) and (2.54 ± 0.66) scores vs. (3.86 ± 0.77) scores, (0.85 ± 0.69) and (1.77 ± 0.93) scores vs. (3.71 ± 0.61) scores, (1.38 ± 0.77) and (1.38 ± 0.87) scores vs. (3.64 ± 0.17) scores, the VAS of T 1 in TAPB combined with RSB group was significantly lower than that in TAPB group, and there were statistical differences ( P<0.05). There were no statistical differences in mean arterial pressure and heart rate among 3 groups ( P>0.05). The surgeon′s satisfaction with anesthesia from T 0 to T 3 in TAPB combined with RSB group and TAPB group were significantly higher than that in LA group: (3.12 ± 0.76) and (3.11 ± 0.65) scores vs. (2.09 ± 0.61) scores, (3.09 ± 0.82) and (2.68 ± 0.75) scores vs. (1.99 ± 0.66) scores, (3.35 ± 0.82) and (3.31 ± 0.75) scores vs. (2.37 ± 0.73) scores, (3.02 ± 0.82) and (3.01 ± 0.75) scores vs. (2.35 ± 0.63) scores, surgeon′s satisfaction with anesthesia of T 1 in TAPB combined with RSB group was significantly higher than that in TAPB group, and there were statistical differences ( P<0.05). The rescue anesthesia in LA group was in 2 cases. The total operation and anesthesia time in TAPB combined with RSB group was significantly shorter than that in TAPB group and LA group: (45.08 ± 9.62) min vs. (74.46 ± 7.29) and (69.71 ± 13.25) min, that in LA group was significantly shorter than that in TAPB group, and there were statistical differences ( P<0.05). The patients of 3 groups had no surgical and anesthesia related complication. Conclusions:In surgical incision PDC with mLS for TAPB combined with RSB, the effectiveness of intraoperative anesthesia is accurate, the operation time is short, the surgeon′s satisfaction with anesthesia is high, the blood pressure and heart rate are stable, and the security is high.
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Nutcracker syndrome complicated with chronic kidney disease is easy to be missed clinically.We report a case of nutcracker syndrome (NCS) complicated with IgA nephropathy, and summarize the clinical features of nutcracker syndrome complicated with chronic kidney disease.Through literature search, we found that Nutcracker with chronic kidney disease is not rare.We think that we should pay attention to the possibility of chronic kidney disease when Nutcracker (+ ) is combined with persistent or massive proteinuria, and percutaneous renal biopsy is helpful for the diagnosis and treatment.
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Objective:To explore the application of peritoneal dialysis routine examination in reducing the incidence of peritonitis associated with peritoneal dialysis.Methods:From July 2018 to June 2019, 191 patients with peritoneal dialysis who were followed up regularly in the nephrology department were selected as the study subjects.Using convenient sampling method, outpatient follow-up on Tuesday were selected as control group(95 cases) and fixed outpatient follow-up on Thursday were selected as observation group(96 cases). Routine follow-up was performed in the control group, and routine examination of peritonitis was performed in the observation group during the follow-up.Intervention was given immediately when the problems were found to the naked eye and the examination results were abnormal.The incidence of peritonitis in the two groups was compared.Results:Peritonitis occurred in 24 cases in the control group(25.26%), and 9 cases in the observation group(9.38%). The incidence of peritonitis in the observation group was lower than that in the control group, and the difference was statistically significant(χ 2=5.972, P<0.05). Conclusion:The occurrence of peritoneal dialysis-related peritonitis is related to a variety of factors.Paying attention to the routine examination of peritonitis and observing the color of peritonitis, strengthening the aseptic fluid exchange operation, and following up the patients can effectively reduce the occurrence of peritonitis and improve the quality of dialysis.
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Objective To observe the effect of aralia saponins on the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in the kidney of diabetic nephropathy mice.Methods After 10 days of adaptive feeding,90 clean Kunming mice were randomly divided into the normal group (n =10) and 5 model groups (model group,positive drug benazepril intervention group,aralia saponins low,middle and high doses treatment groups).Excepted the normal group,the kidney damage model of type 2 diabetes mellitus in mice was induced by high-fat and high-sugar diet for one month plus disposable streptozotocin (STZ).The model was successfully constructed and killed after 6 weeks of treatment.A total of 25 mice failed to establish the model.And totally 55 mice were randomly divided into 5 groups with 11 mice in each group.The serum changes of blood urea nitrogen (BUN),serum creatinine (SCr),insulin,inflammatory factors interleukin-1α (IL-1α),interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in each group were detected.The expression of vascular endothelial growth factor and MMP-9 protein in renal tissue were detected by immunohistochemistry and Western blot.Results Compared with the normal group,the levels of blood glucose,insulin,BUN,SCr,IL-1α,IL-6 and TNF-α in the model group were significantly increased (P ＜ 0.05).The above indexes were decreased in positive drug group and aralia saponins treatment groups.The contents of insulin,BUN and SCr in the high dose of aralia saponins group were significantly lower than those parameters in benazepril group (P ＜ 0.05).In addition,the contents of blood glucose,IL-1α,IL-6 and TNF-α in the three dose aralia saponins groups were significantly lower than those parameters in the benazepril group (P ＜ 0.05).Compared with the normal group,the expression level of VEGF protein in the model group was significantly higher (P ＜ 0.05),and the expression level of MMP-9 protein was significantly lower (P ＜ 0.05).Compared with the model group,both benazepril and aralia saponins can reduce VEGF (P ＜ 0.05),increase MMP-9 (P ＜ 0.05).In addition for VEGF and MMP-9,the high dose of aralia saponins group and benazepril group was basically same.Conclusions Aralia saponins can significantly reduce blood glucose,insulin and serum inflammatory factors,while downregnlate VEGF and increase MMP-9 protein levels,thereby protecting the kidneys of diabetic nephropathy mice.
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Objective To investigated the protective effect and immunology mechanism of Astragaloside Ⅳ(Ast) on rat renal ischemia-reperfusion injury model. Methods The SD rats were randomly divided into four group as the control, sham-operation, renal ischemia-reperfusion injury, and Ast treatment groups. Rat serum and urine were collected and detective for kidney function and interleukin cytokines. The kidney tissue was collected for histology exam. The rats in astragaloside group were intraperitoneally injected with 100 mg/kg astragaloside, and the other three groups were intraperitoneally injected with an equal volume of normal saline. The models of renal ischemia-reperfusion injury were prepared to generate in model and astragaloside groups, after 30 minutes of astragaloside injection. The rats with renal ischemia-reperfusion injury model were sacrificed after 24 hours, and the level of blood-urine creatinine, neutrophil gelatinase-associated lipocalin and Kidney damage molecule-1 were determined. The level of Th1 type cytokines (TNF-α, IFN-γ, IL-2) and Th2 type cytokines (IL-4, IL-5, IL-10) in serum were measured by using ELISA. The protein and gene expression of TNF-α, IFN-γ, IL-2, IL-4, IL-5, IL-10 in renal tissue were tested by western blot and PCR, respectively. The pathological changes and apoptosis of renal tissue in each group were detected by HE staining and TUNEL staining, respectively. The expression of CD20 protein in renal tissue was determined by immunohistochemistry. Results Compared with the model group, Ast treatment reduced serum creatinine (58.74 ± 9.44 μmol/L vs. 85.03 ± 23.48 μmol/L), increased creatinine clearance rate (0.81 ± 0.13 ml/min vs. 0.37 ± 0.08 ml/min), and reduce urine neutrophil gelatinase-associated lipocalin (NGAL) (579.34 ± 11.70 pg/ml vs. 827.60 ± 14.48 pg/ml), kidney injury molecule-1 (KIM-1) (105.06 ± 2.10 pg/ml vs. 151.67 ± 3.06 pg/ml) (P<0.05). Compared with the model group, Ast treatment alleviated renal tubular epithelial cell injury and significantly decreased the apoptosis (14.36 ± 1.36% vs. 28.63 ± 2.03%) (P<0.05), and significantly decreased the serum TNF-α (361.44 ± 9.66 pg/ml vs. 515.93 ± 10.61 pg/ml), IFN-γ (64.11 ± 1.21 pg/ml vs. 93.51 ± 2.15 pg/ml), IL-2 (388.33 ± 1.21 pg/ml vs. 557.82 ± 15.29 pg/ml), IL-4 (60.89 ± 1.21 pg/ml vs. 95.56 ± 2.75 pg/ml), IL-5 (94.02 ± 2.81 pg/ml vs. 147.07 ± 3.50 pg/ml), and IL-10 (52.62 ± 2.51 pg/ml vs. 78.22 ± 3.24 pg/ml) (P<0.01). Compared with the model group, Ast treatment significantly decreased the kidney TNF-α mRNA (1.89 ± 0.59 vs. 2.87 ± 0.97), IFN-γ mRNA (3.11 ± 1.02 vs. 5.98 ± 1.52), IL-2 mRNA (1.68 ± 0.44 vs. 4.09 ± 1.65), IL-4 mRNA (2.41 ± 0.81 vs. 4.69 ± 1.62), IL-5 mRNA (1.56 ± 0.19 vs. 2.92 ± 0.55), IL-10 mRNA (1.45 ± 0.14 vs. 2.85 ± 0.32) (P<0.01). The ratio of IL-4 to IFN-γ was basically restored to the level of sham operation group (1.05 ± 0.02 vs. 1.02 ± 0.06) (P<0.01), and CD20 cells in renal tissue was reduced. Conclusions The Th1 and B lymphocytes play an important role in renal ischemia reperfusion injury, and Th2 cells play a protective role. Astragaloside can regulate the imbalance of Th1/Th2 in the early stage after acute renal injury, and alleviate renal tubular injury.
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Objective To observe the effect of Kangfuxin liquid combined with mupirocin on exit -site granulation tissue hyperplasia in peritoneal dialysis patients. Methods From January 2012 to December 2017, 35 peritoneal dialysis patients with exit-site granulation tissue hyperplasia in the People's Hospital of Huadu District were selected and randomly assigned into treatment group (15 cases) and control group(20 cases). The control group was given conventional treatment, the treatment group received a sterile dressing moistened with Kangfuxin liquid. Before and after treatment,the exit-site granulation tissue outcome and the incidence of complications were recorded and compared. Results The recovery time of the control group was (8. 58 ± 1. 36)d,which was longer than (3. 43 ± 0. 85)d of the treatment group (t=3. 57,P<0. 05). Exit-site exudation was found in 3 patients of the control group. No complications were observed in the treatment group. Conclusion Kangfuxin liquid combined with mupiro-cin can shorter the recovery time of exit-site granulation tissue hyperplasia in peritoneal dialysis patients,and reduce the side effect,which is worthy of clinical application.
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Objective To study the effect of aralia total saponins on renal function of type 2 diabetic mice, and its effect on the Bax and Bcl-2 protein in renal tissues, in order to provide some references for the development of aralia total saponins. Methods The mice were divided into the normal group, model group, positive control group, low, medium and high dose aralia total saponins group by random number method. Except the normal group, the others were received with high-fat diet for one month+one-time large dose of streptozotocin (STZ) to induce type 2 diabetic model, and then the mice in the normal group and the model group were intragastrically administered with the same volume of normal saline, and the mice in the positive control group was given 1 mg/kg of benazepril solution, and the low, medium and high dose groups were given 30, 60, 120 mg/kg aralia total saponins. The body weight of 1 ml/kg mice was intragastrically administered once a day. After treatment for 6 weeks they were sacrificed, and the serum insulin, and SOD and MDA levels were measured, the urine creatinine (Cr), urea nitrogen (UN), and uric acid (UA) levels were also measured. The immunohistochemistry and Western blot were used to detect the Bax and Bcl-2 protein expression in kidney tissues. Results Compared with the model group, the blood glucose and insulin resistance index in the low, medium and high doses aralia total saponins group were significantly decreased (P<0.05); the levels of urine UN, Cr and UA significantly decreased (P<0.05); The serum SOD level increased and the MDA level significantly decreased (P<0.05). The average gray value of Bcl-2 increased (92.26 ± 11.36, 107.17 ± 9.26, 132.65 ± 8.45 vs. 56.42 ± 16.24) in kidney tissue. The average gray value of Bax (152.62 ± 9.86, 124.48 ± 10.36, 92.29 ± 10.10 vs. 171.38 ± 15.18) significantly decreased ( P<0.05); Bax protein (0.81 ± 0.06, 0.75 ± 0.07, 0.52 ± 0.09 vs. 2.02 ± 0.09) significantly decreased, but Bcl-2 protein (0.92 ± 0.08, 0.94 ± 0.12, 1.27 ± 0.07 vs. 0.30 ± 0.09) significantly increased (P<0.05). Conclusions The aralia total saponins can reduce blood sugar levels, meanwhile improve renal function in type 2 diabetic mice. The mechanism may be may be that aralia total saponins could improve the antioxidant capacity and inhibition of renal cell apoptosis.
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Objective To study the therapeutic effect of bitter gourd saponins on salt-sensitive kidney injury induced by high salt diet and its possible mechanism.Methods 50 Sprague Dawley (SD) rats were randomly divided into normal group,model group and low-dose,middle-dose and high-dose treatment group after 10 days of adaptive feeding.Each group had 10 rats.Except the normal group,the other four groups were given high salt diet (4.0％ high salt diet) to induce salt-sensitive kidney damage in rats.The normal group and the model group were given 1.0 m/(kg · d) normal saline,and the three dosage groups of total saponins of balsam pear were given 10 mg/(kg · d),20 mg/(kg · d) and 40 mg/(kg · d) respectively.After 8 weeks of treatment,rats were sacrificed and collect the 24-hour proteinuria,creatinine.Serum creatinine,serum aldosterone,serum sodium and serum potassium were measured,and renal histopathology and the expression of podocin and nephrin were detected.Results Pathological examination of model group showed obvious glomerular sclerosis and renal interstitial fibrosis,and glomerular sclerosis in the treatment group was obviously improved by bitter gourd saponins;The systolic pressure in the model group was 170 mmHg,significantly higher than that of the normal and treatment groups,the systolic blood pressure of the treatment groups were obvious decreased when treated by bitter gourd saponins (P ＜ 0.05);Compared with normal group,serum creatinine and 24 h proteinuria / urine creatinine in model group were significantly increased (P ＜ 0.05),while creatinine clearance rate and aldosterone were significantly decreased (P ＜ 0.05),and the above indexes in bitter gourd saponins treatment group were significantly improved;Compared with the model group,the protein and mRNA expression of podocin and nephrin were significantly decreased (P ＜ 0.05),while the two indexes can be revered by bitter gourd saponins in treatment group (P ＜ 0.05).Conclusions The bitter gourd saponins can significantly improve the symptoms of salt-induced hypertensive nephropathy in rats,which may be related with the expression of podocin and nephrin in renal tissue,thereby inhibiting glomerulosclerosis and improving renal interstitial fibrosis.
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Objective To study the protective effect of total trans retinoic acid (ATRA) on renal injury induced by ischemia-reperfusion in rats.Methods 24 Sprague Dawley (SD) rats were divided into 4 groups of (1) Normal control group,(2) Sham operation group,(3) Model group:the model of renal ischemia-reperfusion was established.(4) Retinoic acid treatment Group:ATRA were given by gavage for 7 consecutive days.The rats were killed 24 hours after the model,and the serum and renal tissue were collected.Serum creatinine,tumor necrosis factor-α (TNF-αx) and interferon-γ (IFN-γ) levels,kidney biopsy,renal tubular score,renal damage and renal tissue apoptosis were detected.Results Compared with the model group,the serum creatinine level decreased and the creatinine clearance rate increased in ATRA treated group (P ＜ 0.05);the damage of renal tubular epithelial cells was alleviated in the pathological slices;and the apoptosis rate of renal tubular epithelial cells was decreased (P ＜ 0.05).Serum levels of TNF-α and IFN-γ decreased (P ＜ 0.05).Conclusions ATRA can protect the renal ischemia-reperfusion injury through inhibiting inflammatory reaction and apoptosis.
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Objective To observe the expression of interferon induced protein (IP)-10 and the role of nuclear factor-kappaB (NF-κB) signaling pathway in rat peritoneal mesothelial cells (RPMCs) under the action of lipopolysaccharide (LPS).Methods RPMCs were harvested from Sprague-Dawley rat peritoneal cavity and cultured under defined in vitro conditions.The cells were exposed respectively to different concentrations of LPS (0,10,100,1 000,10 000 ng/ml) for 3 h or treated with LPS (100 ng/ml)for different time points (0,1,3,6,12,24,48 h).For observing the effect of LPS on the expression of p-p65 and p65,the RPMCs were treated with LPS (100 ng/ml) for different time points (0,15,30,60,120 min).For observing the effect of BAY11-7085 on the expression of IP-10 mRNA,the RPMCs were treated by LPS or pretreated with BAY11-7085 (5 μ mol/L) for2 h,then treated with LPS for another 3 h,respectively.Expression of IP-10 mRNA was examined by reverse transcription-polymerase chain reaction (RT-PCR).Expression of NF-κB and p-NF-κB protein was detected by Western blot.The secretion of IP-10 was determined by enzyme-linked immunosorbent assay (ELISA).Results Compared with the control group,stimulation of RPMCs with 10 ng/ml LPS resulted in a significant increase in the expression of IP-10 mRNA (P ＜0.05).1 000 ng/ml LPS has the strongest effect on IP-10 expression compared with that of 10 ng/ml and 100 ng/ml LPS.Treatment with 100 ng/ml LPS resuhed in time-dependent increase in the gene level of IP-10,with the peak at 3 h.However,after that time point,the gene level of them was gradually attenuated.Following treatment with LPS (100 ng/ml),the level of p-NF-κB began to increase at 15 min,gradually reached the peak at 1 hour,and then decreased.But the level of which at 2 h is still significant higher than that of medium control.5 μmol/L BAY11-7085 significantly decreased the up-regulation of IP-10 induced by LPS.Conclusions LPS enhanced the expression of IP-10 on RPMCs in a concentration-dependent and a time-dependent manner.LPS induced expression of IP-10 depended on the NF-κB signal transduction pathway.
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Objective: To explore a feasible work mode of clinical pharmacist for chronic disease management in TCM orthopedics hospital so as to provide new ideas for the optimization of pharmaceutical service. Methods: In view of clinical practice, the work mode and feature of clinical pharmacist in TCM orthopedics hospital were summarized in order to find the key questions, and according-ly provide the effective proposals. Results and Conclusion: The concept of pharmacy service mode is a patient-based idea and rational drug use in TCM orthopedics hospital, which can promote the level improvement of pharmacy service.
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Objective To investigate the effect of bitter gourd saponins on the salt -sensitive hypertension caused kidney damage in rats ,and analyze the mechanism of its therapeutic effect .Methods 50 SD rats were fed for 10 days with normal diet ,and then based on random number method ,the rats were randomly divided into 5 groups:the normal control group,model control group and the low total saponins bitter,medium and high dose treatment group,10 rats in each group.Then,the rats in the normal control group and the model control group were given 1mL· kg-1 · d-1 normal saline,and the rats in bitter gourd saponins groups were given high salt diet 8 weeks to establish the model .After 4 weeks,the total saponins of bitter gourd treatment groups were given 10,20 and 40mg· kg-1· d-1.8 weeks later, the rats were sacrificed and the renal pathology was detected by HE staining .The changes of blood pressure , heart rate,urinary function and blood renal function were also analyzed .At last,Western blot and semi -quantitative PCR were used to detect the endothelin -1 (ET-1) in renal tissue.Results For the systolic blood pressure,in whole of treatment,the normal control group maintained at about 120 mmHg, while the model control group maintained at 170mmHg,which of the bitter gourd saponins three doses groups compared to the model control group was significantly lower (t=1.765,1.982,2.126,all P<0.05),further improved.And the heart rate had no statistically significant difference among the groups(all P>0.05).Compared with the normal control group,the blood urea nitrogen (BUN), creatinine (Cr),uric acid (UA),urine volume,urinary protein and N -acetyl beta -D-Glucosaminidase (NAG) levels in the model control group were significantly increased (t=28.703,33.932,29.298,4.695,10.989,10.871, all P<0.05),which in the bitter gourd saponins treatment groups were significantly decreased (all P<0.05).HE staining showed that the rats in the normal group were normal ,and the model control group had obvious glomerular sclerosis and renal interstitial fibrosis , after bitter gourd saponins treatment , the condition was significantly improved .Immu-nohistochemistry,Western blot and semi-quantitative PCR showed that normal control group had almost a little expression of ET-1,and compared with the normal control group ,which of the model control group was significantly increased ( t=14.650,11.387,all P<0.05),and the ET-1 expression in the bitter gourd saponins treatment groups significantly decreased.Conclusion The bitter gourd saponins can significantly improve the symptoms of hypertension and renal damage induced by high salt diet in rats ,which may be related with regulation of ET -1 expression in renal tissue .
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Objective To investigate the protective effects of astragalosides Ⅳ (ASI) on high glucose-induced renal proximal tubular epithelial cells (NRK-52E).Methods NRK-52E were cultured and divided randomly into three groups:control group,high glucose group (HG in short),ASI groups (with various doses).Cells were treated with increasing concentrations of ASI (20,40,80 and 100 μg/ml) for 24 h in high glucose and we also stimulated cells in ASI 100 μg/ml with high glucose for various lengths of time.The apoptosis rate was detected by flow cytometric analysis.The mRNA and protein expression of transforming growth factor-β1 (TGF-β1),a-smooth muscle actin (α-SMA),Smad2,Smad3 and their phosphorylated forms were detected by real-time polymerase chain reaction (PCR) and Western blot,respectively.Results Compared with the control group,apoptosis was increased in the high glucose group (P ＜ 0.01).However,ASI inhibited high glucose-induced cell apoptosis in a dose-dependent manner,with a maximal inhibitory effect achieved at 100 μg/ml (P ＜ 0.05).The significant inhibition caused by ASI was observed at 8h after the start of pretreatment (P ＜ 0.05) and increased in a time-dependent manner.ASI can inhibit the expression of TGF-β1,α-SMA,Smad2,Smad3 both at mRNA and protein level.Conclusions ASI inhibited NRK-52E cells apoptosis induced by high glucose and reduced expression of TGF-β1,α-SMA,Smad2,Smad3 both at the mRNA and protein level in NRK-52E cells,thus delayed epithelial-to-mesenchymal transition progress.
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Objective To evaluate the effect of isosceles right angle triangulation on deep vein puncture under ultrasound localization. Methods In this prospective randomized case-controlled clinical study, the enrolled patients who required deep veins puncture to establish transient hemodialysis pathway were randomly divided into treatment group treated with ultrasound localization puncture based on isosceles right triangle theory, and control group treated with traditional localization puncture following exploration of blood vessels using color doppler ultrasound, with 46 cases in each group. The differences in gender, age, causes for hemodialysis, puncture sites, successful rate of initial puncture, rates of complications and cathetering-consuming time were compared between two groups. Results The differences in gender, age, causes for hemodialysis and puncture sites between two groups were not statistically significant. In control group, 30 patients received puncture through internal jugular veins, among whom 16 received successful initial puncture, with the successful rate of initial puncture of 53.33%, and the cathetering-consuming time of (545.5 ± 120.3) s; and 16 patients received puncture through femoral veins, among whom 8 received successful initial puncture, with the successful rate of initial puncture of 50.00%, and the cathetering-consuming time of (500.6 ± 120.6) s. Meanwhile, in control group, 3 patients had hematoma in puncture sites, and another 3 had arterial mis-puncture, with the total rate of complications of 13.04%(6/46). In treatment group, 32 patients received puncture through internal jugular veins, among whom 31 received successful initial puncture, with the successful rate of initial puncture of 96.88%, and the cathetering-consuming time of( 99.5 ± 34.8) s;and 14 patients received puncture through femoral veins, among whom 14 succeed in initial puncture, with the successful rate of initial puncture of 14/14, and the cathetering-consuming time of (99.8 ± 44.8) s. None in treatment group had hematoma in puncture sites or arterial mis-puncture. Both groups finished deep veins puncture intubation successfully. Treatment group was markedly higher in the successful rate of initial puncture (P<0.05), notably shorter in cathetering-consuming time (P<0.05), and prominently lower in the total rate of complications than control group (P<0.05), and all differences were statistically significant. Conclusions Ultrasound localization based on isosceles right triangle theory has superiority to traditional B-ultrasound localization in deep veins puncture in that it can promote the successful rate of initial puncture and shorten cathetering-consuming time without increasing the occurrence rates of complications, and can be completely operated by single clinical physician independently, thus deserving to be popularized in clinical practice.
RESUMO
OBJECTIVE:To explore the feature and regularity of ADR induced by animal bone polypeptide medicine,so as to provide reference for rational use of these drugs in clinical practice. METHODS:In retrospective analysis,96 cases of ADR oc-curred in our hospital during Jan. 2009-Jun. 2016 were analyzed statistically in terms of patients'gender and age,drugs involved, occurrence time,route of administration,organs and systems involved,association,prognosis,etc. RESULTS:Among 96 cases (including 17 serious ADR),the ratio of male to female was 1.34 : 1,and 56.25% of them were above 40 years old. ADR mainly occurred within 15 minutes after medication(39.58%)dominated by intravenous drip. Organs/systems involved in ADR were main-ly lesion of skin and its appendants(34.81%),followed by respiratory system damage(18.35%)and systemic damage(16.46%). In aspect of ADR association,41 were probable(42.71%)and 55 were possible(57.29%). After suffering from ADR,43 patients (44.79%)were cured after drug withdrawal or corresponding treatment,and 53 patients(55.21%)were recovered. CONCLU-SIONS:Medical staff should master the regularity and characteristics of ADR induced by animal bone polypeptide medicine,while strengthen rational drug use management and monitoring to ensure the safety and effectiveness of clinical drug use.
