[Prevention and Treatment of Shenkang Injection for Contrast-induced Nephropathy in Elder Patients with Chronic Kidney Disease].

Objective To explore the safety and effectiveness of Shenkang Injection (SI) for con- trast-induced nephropathy (CIN) in elderly patients with chronic kidney disease (CKD). Methods Totally 206 elderly CKD patients who were scheduled to undergo coronary angiography (CAG) were assigned to three groups according to random digit table, i.e., the rehydration therapy group (67 cases) , the SI group (71 cases) , and the control group (68 cases). Patients in the rehydration therapy group received intrave- nous dripping of normal saline 12 h before and after CAG. Patients in the SI group received intravenous drip- ping of SI, while those in the control group received intravenous dripping of 5% glucose injection. SI and 5% glucose injection was respectively used 3 days before CAG and 4 days after CAG, once per day. The inci- dence rate of CIN, and levels of creatinine, blood urea nitrogen (BUN) , serum cystatin C (CysC), kidney injury molecule-1 (KIM-1), and P2-microglobulin (P2-MG) were detected before CAG, 24 h and 96 h after CAG, respectively. Age, sex, SI, contrast dose, pre-CAG indicators of renal function were compared. Their correlations with changed 24-h creatinine value (the difference between the value at post-CAG 24 h and pre-CAG) and CIN incidence rate were analyzed using Sperman correlation and Logistic regression analy- ses. Results Compared with the rehydration therapy group and the control group, the incidence rate of CIN was significantly lower in the SI group (x2 = 5. 32, P <0. 05). Compared with before treatment in the same group, levels of creatinine and CysC were all elevated in the 3 groups after 24-and 96-h treatment (P <0. 05) ; the KIM-1 level increased in rehydration therapy group and the control group (P <0. 05) ; P2-MG level increased in the SI group (P <0.05). Compared with the control group, post-CAG P2-MG level in- creased in the SI group (P <0. 05). There was no statistical difference in other index (P >0. 05). SI was neg- atively with the incidence rate of CIN and changed 24-h creatinine value (r = -0. 612, -0. 517, P <0. 05). The contrast dose was positively with the incidence rate of CIN and changed 24-h creatinine value (r = 0. 644, 0. 562, P <0. 05). Increased contrast dose could elevate the incidence rate of CIN (P <0. 05). SI could obviously lower the incidence rate of CIN (P <0. 05). Conclusion SI could lower the incidence rate of CIN in elder CKD patients by playing certain roles in prevention and treatment.

[The effect of simvastatin on the expression of high mobility group box-1 protein in atherosclerotic rats].

OBJECTIVE: To observe the effect of simvastatin on the expression of high mobility group box-1 protein (HMGB1) and morphology of atherosclerotic plaques in atherosclerotic rats, to ascertain whether HMGB1 plays a role in the preventive mechanism of simvastatin from atherosclerosis (AS). METHODS: Sixty Wistar rats were divided randomly into three groups: control group, model group and simvastatin treatment group. Gastric gavage of vitamin D3 with high fat food was used to reproduce atherosclerotic rat model. The rats in the treatment group were treated with simvastatin of 2.5 mg x kg(-1) x d(-1) (gastric perfusion) 8 weeks after fat diet. The expression of the histopathology and protein of HMGB1 in atherosclerotic plaques of the aorta was observed by immunohistochemistry at 10 weeks and 12 weeks. The gene expression of HMGB1 at atherosclerotic plaques of aorta was observed with real time-polymerase chain reaction (RT-PCR). The morphology of the atherosclerotic plaques was observed. RESULTS: The expression of HMGB1 increased significantly in atherosclerotic plaques in model group, and simvastatin could evidently inhibit the expression of HMGB1, and it was more obvious in 12-week group. Compared with control group, the HMGB1 mRNA expression was upregulated in all atherosclerotic model groups (10 weeks: 19.695+/- 1.418 vs. 2.981+/-0.753, 12 weeks: 20.542+/-1.132 vs. 3.219+/-0.332, both P<0.01). In the simvastatin treatment group, the gene expression of HMGB1 was lower than the age-match model group at 10 weeks (15.798+/-0.891) and 12 weeks (12.641+/-0.734), and in the 12-week treatment group it was lower than that in the 10-week treatment group (P<0.05 or P<0.01). In the model group, the ring-shape calcified atherosclerotic plaques were extensively found in the wall of the aorta. Simvastatin could obviously inhibit the formation of the atherosclerotic plaques, and the effect was more obvious in the 12-week treatment group than that of the 10-week treatment group. CONCLUSION: Simvastatin can alleviate the formation of the atherosclerotic plaques in the atherosclerotic rats, decrease the protein and mRNA expression of HMGB1. The results suggest that the vessels are protected from forming AS through alleviating inflammatory reaction.

Tissue lipopolysaccharide-binding protein expression in rats after thermal injury: potential role of TNF-alpha.

Recent studies have suggested that levels of lipopolysaccharide-binding protein (LBP) might play a harmful role by up-regulating the host's sensitivity to endotoxin. Our previous studies demonstrated that local endotoxin could up-regulate LBP expression after acute insults, however, the definite molecular mechanisms downstream of endotoxin action remain unclear. This study investigates whether tumor necrosis factor (TNF-alpha) might be responsible for the LBP formation during endogenous endotoxemia postburn. Wistar rats were anesthetized, and a 35% TBSA full-thickness burn was created. Animals were randomly divided into normal control, thermal injury and anti-TNF-alpha mAb treatment group. A significant elevation of plasma endotoxin concentration was observed after acute insults. TNF-alpha levels in plasma also rapidly increased after thermal injury. Meanwhile, LBP mRNA expression markedly increased in liver, lungs, kidneys and intestine postburn. There was no detectable TNF-alpha in the plasma of anti-TNF-alpha mAb treated animals. Treatment with anti-TNF-alpha mAb also resulted in significantly lower concentrations of LBP mRNA in local tissues. Additionally, several organ function parameter levels in plasma significantly decreased in treatment group. These results demonstrated that an increase of plasma TNF-alpha levels caused by burns might be associated with a marked elevation of tissue LBP mRNA expression, which could contribute to the development of multiple organ damage.