Curcumin has exhibited a protective effect against development of renal fibrosis in animal models, however, its underlying molecular mechanisms are largely unclear. Therefore, we investigated the anti-fibrosis effects of curcumin in transforming growth factor-β1 (TGF-β1)-induced epithelial-to-mesenchymal transition (EMT), and the mechanism by which it mediates the phosphatidylinositol 3-kinase (PI3K)/Akt pathway. Human kidney tubular epithelial cells (HKCs) were treated with TGF-β1 or curcumin alone, or TGF-β1 in combination with curcumin. The effect of curcumin on cell proliferation was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Expression of E-cadherin, cytokeratin, vimentin, alpha smooth muscle actin (α-SMA), fibroblast-specific protein 1 (FSP1) and key proteins of Akt/mammalian target of rapamycin (mTOR) pathway were analyzed by immunocytochemistry, real-time PCR and Western blot. Low dose curcumin (3.125 and 25 µmol/L) effectively promoted HKC proliferation. When HKCs were co-incubated with TGF-β1 and curcumin for 72 h, curcumin maintained the epithelial morphology in a dose-dependent manner, decreased expression of vimentin, α-SMA and FSP1 normally induced by TGF-β1, and increased expression of E-cadherin, cytokeratin. Importantly, we found that curcumin reduced Akt, mTOR and P70S6K phosphorylation, effectively suppressing the activity of the Akt/mTOR pathway in HKCs. Curcumin also promoted HKC proliferation, and antagonized TGF-β1-driven EMT through the inhibition of Akt/mTOR pathway activity, which may suggest an alternative therapy for renal fibrosis.

目的 探讨姜黄素抗肾纤维化的分子生物学机制,为临床治疗提供可靠的实验依据.方法 以人肾小管上皮细胞(HKC)为研究对象,采用不同浓度的姜黄素(0、0.780、1.563、3.125、6.250、12.500、25.000、50.000和100.000 μmol/L)刺激HKC 72 h,倒置相差显微镜下观察细胞形态变化,并应用MTT比色法检测姜黄素对HKC生长的影响;应用不同浓度TGF-β1(0、1、5、10 ng/mL)单独或联合姜黄素(6.250、12.500、25.000、50.000 μmol/L和100.000 μmol/L)共同刺激HKC细胞72 h,观察细胞形态变化,应用逆转录PCR(RT-PCR)检测TGF-β1、骨形态发生蛋白-7(BMP-7)和Ⅰ型胶原基因表达变化.结果 HKC贴壁生长,呈铺路石样外观.姜黄素刺激对细胞形态无影响;TGF-β1刺激能明显促进细胞由上皮样形态向纤维样细胞形态转化,且发生形态转变的细胞数量和TGF-β1基因表达呈TGF-β1浓度依赖性增加(P＜0.05,P＜0.01);MTT结果显示:姜黄素在3.125～25.000 tmol/L浓度范围内,能显著促进HKC增殖(P＜0.05,P＜0.01);姜黄素能对抗TGF-β1诱导的细胞形态转变,以12.500～50.000 μmol/L的姜黄素作用最明显,同时,下调TGF-βi基因和蛋白的表达,相反上调BMP-7基因和蛋白表达,并伴随着Ⅰ型胶原基因和蛋白的表达下降(P＜0.05,P＜0.01).结论 姜黄素能促进HKC增殖并维持其表型,能对抗TGF-β1诱导的HKC向梭形细胞转化,抑制细胞上皮TGF-β1和Ⅰ型胶原的表达,而促进BMP-7表达.

探讨超声引导下肾活检所致出血并发症的相关因素，对出血原因进行分析，以减少并发症的发生。方法：在超声引导下以美国 BARD 16G 自动活检装置对1010肾脏病患者行肾穿刺活检，从肾实质厚度、肾穿刺针数、肾穿时血压水平、肾脏功能等几方面进行分析。结果：在1010例肾穿活检中，肾实质厚度在0．8O ～1．5 cm、肾穿刺针数大于2次、肾穿刺中血压≥140／90mmHg、肾功能 Scr ＞110 umol ／L 或 GFR ＜60 ml ／min 的病人出现出血并发症比例明显增高（P ＜O．05）。

目的 观察大鼠缺血再灌注损伤模型中,瞬时受体电位通道M7 (trallsient receptor potential melastatiIl related 7,TRPM7)的表达变化及其与肾组织病理损伤、程序性坏死标志物RIP1、聚腺苷酸二磷酸核糖转移酶-1(PARP-1)表达变化的关系,初步探讨TRPM7在肾脏缺血再灌注损伤细胞程序性坏死中的作用及其可能的机制.方法 55只雄性SD大鼠建立缺血再灌注模型后,于再灌注后24、48 h、5、7d取动脉血检测大鼠血肌酐、尿素氮水平;肾组织标本HE染色观察肾组织病理损伤;免疫组化和Western blot检测肾组织TRPM7、PARP-1、RIP1定位及表达变化.结果 对照组和假手术组相比,血肌酐尿素氮水平、肾脏组织形态无明显变化;与对照组、假手术组相比,缺血再灌注后大鼠血肌酐尿素氮水平明显升高,再灌注后24 h达到最高值,随后逐渐下降,7d左右降至接近正常.HE染色显示肾组织在再灌注24、48 h均出现明显急性肾小管损伤,5d时开始修复,至第7天基本修复.免疫组化及Western blot显示,TRPM7主要在肾小管上皮细胞表达,再灌注后TRPM7表达显著升高,其中24 h达高峰,随后逐渐下降.PARP-1、RIP1的表达变化有相似的趋势.相关性分析显示TRPM7表达变化与肾小管急性损伤评分呈正相关(r=0.71,P＜0.05).结论 瞬时受体电位通道M7可能参与了肾脏缺血再灌注损伤,通过下游钙依赖的信号传导途径调控PARP-1、RIP1影响程序性坏死发挥作用.

Objective To evaluate the clinical significance of renal pathology combining with functional imaging on evaluating the residual renal function of patients with chronic kidney disease(CKD).Methods 105 cases of chronic nephritis combining with chronic renal insufficiency were collected,and tested by renal needle biopsy and 99Tcm-DTPA renal dynamic imaging(ECT),then we evaluated the CKD residual renal function,and determined the therapeutic regimen and observed the CKD progress dynamically,retrospective validated the reliability of the two inspection methods to the CKD residual renal function judgment.Results In the 105 cases of CKD,kidney pathology displayed glomerular sclerosis and renal tubulointerstitium chronic degree,in the most situations(92%),it was conformity to the judgment of ECT evaluating the CKD residual renal function,but 8% of the cases were not conformity.According to the result of morphology and function study,all the 2-5 stage CKD,105 cases were treated proportionally,making a follow-up visit 2-3 years until now,35 cases underwent dialysis.Conclusion Besides of the etiological diagnosis of CKD,the pathological diagnosis of renal tissue and the diagnosis of kidney function can not substitute mutually,they are inseparable.Judging CKD residual renal function only by the pathological diagnosis of renal tissue has the limitation.Combined with the renal functional imaging,the correct evaluation on the treatment value of protecting the CKD residual kidney function has the important clinical guiding significance to decide the therapeutic regimen of CKD.

Objective To determine the effects of atorvastatin on the translocation of NF-κB p65 into the nuclear induced by LPS in abdominal macrophage isolated from apolipoprotein E knockout(ApoE-/-) mouse.Methods Abdominal macrophage were isolated and purified from ApoE-/-mouse,and then cultivated and treated by atorvastatin(10 μmol/L),LPS(10 ng/ml),and atorvastatin(1,5 and 10 μmol/L) combined with LPS treatment.The nuclear translocation of NF-κB p65 was observed by laser scanning confocal microscopy and Western blotting,while the IL-6 levels in culture supernatants was measured by ELASA.Results Laser scanning confocal microscopy and Western blotting showed that TRITC-labeled NF-κB p65 was mainly located in the plasma of macrophage and mildly expressed in the nuclear in atorvastatin group(3.71±0.26),but was mainly located in the nuclei and strongly expressed in LPS group(16.12±1.28,P<0.05).When macrophage were cultivated and induced by LPS and different concentrations atorvastatin,NF-κB p65 was expressed in the nuclear in a negative dose-dependent manner(10.95±0.71,7.61±0.73,and 4.56±0.39,respectively,P<0.05).At the same time,the IL-6 levels in culture supernatants was also reduced in a negative dose-dependent manner in atorvastatin intervention groups(P<0.05).Conclusion Atorvastatin inhibits the nuclear translocation of NF-κB p65 and secretion of inflammatory mediators IL-6 in abdominal macrophage of ApoE-/-mouse induced by LPS.

医患关系是医务人员与患者在医疗过程中产生的特定医治关系,是医疗人际关系中的关键。近年随着医改的深入,社会整体法律意识的增强,医患关系日益成为全社会关注的话题。中国消费者协会的统计表明[1]:2004年全国消费者对医疗和药品的投诉比上年增加了近30%,近年医患关系更是整个医务界乃至社会关系的缩影[2]。医患关系处理不好,对医生、患者和社会都会后患无穷。搞好医患关系最主要的是从医

Through electrodepositing Prussian blue (PB) and chitosan (CS), then casting Pt hollow nanospheres (HN-Pt) and assembling CA19-9 antibody on the electrode surface, an immunosensor was achieved. A new signal amplification strategy based on PB and HN-Pt toward the electrocatalytic reduction of H2O2 was employed when performing the determination. The resulting immunosensor showed a high sensitivity, broad linear response to carbohydrate antigen 19-9 (CA19-9) in two ranges from 0.5 to 30 and 30 to 240 U mL(-1) with a low detection limit of 0.13 U mL(-1) (S/N = 3). Moreover, it displayed good reproducibility and stability, and would be potentially attractive for clinical immunoassay of CA19-9.

Objective To retrospectively investigate the quality of life(QOL) of renal transplantation recipients and its related influence factors.Methods QOL of 93 renal transplantation recipients who received operation from 1998 to 2008 was respectively investigated with SF-36,ESRD-SCL,HAD and self-made general information scales.Another 68 patients with chronic renal dysfuction who had recieved hemodialysis for(19.86±13.57) months served as control.Results The QOL of renal transplantation recipients was much better than that of hemodialysis patients(P<0.01).Males,members with a higher income or a higher education level,and those who returned to work had a better QOL.Various symptoms occurred in patients after renal transplantation(13.37±7.41).The number of symptoms in patients was closely related with their QOL(P<0.05).The anxiety and depression levels were lower in renal transplantation recipients than in hemodialysis patients(P<0.01).Multi-factor regression analysis demonstrated that symptom was the most efficient factor that influenced the physical health and mental health of QOL(standard partial regression coefficient 0.477 and 0.649 respectively).Anxiety and depression were the most important factors on mental health of QOL(standard partial regression coefficient 0.281).Conclusion The QOL of renal transplantation recipients is better than that of hemodialysis patients.However,it can be influenced by many factors,which should there be investigated with standard scales and closely concerned.Symptoms,anxiety and depression are the most important factors influencing the QOL of renal transplantation recipients.

Objective To prepare and identify the monoclonal antibodies (McAb) against advanced oxidation protein products (AOPPs). Methods BALB/c mice were immunized with purified AOPPs-human serum albumin ( HAS) , and then McAbs against AOPPs-HSA was produced by hybridoma technique. Indirect ELISA and Western blot analysis were used to identify the immunoglobin specificity and subtype. Results Three novel McAbs only against AOPPs-HSA and one against both AOPPs-HSA and HSA were harvested. The subclass of 3 McAbs were determined as IgG1 and 1 McAb as IgG2b. McAbs reacted strongly and specifically to protein of nature and HOCL-treated AOPPs by Western blot analysis. Conclusion The 4 McAbs against AOPPs are prepared and identified successfully, which provide an important tool for biological properties of AOPPs and for its detection clinical laboratory.

BACKGROUND: Advanced oxidation protein products (AOPPs) are a crucial pathogenic link to such long-term uremic complications in hemodialysis patients as immune system dysregulation, accelerated atherosclerosis, dialysis-related amyloldosis and so on. However, basic studies on AOPPs are relatively few, and one of the main reasons is the fact that it is difficult to obtain AOPPs with high pudty and biological activity.OBJECTIVE: To prepare, pudfy and indentify AOPPs, with the hope of searching for a method of preparing AOPPs with high purity and biological activity.DESIGN, TIME AND SETTING: A single sample observation was completed in the Clinical Biochemistry Section of Ecsomatics Department, Third Military Medical University of Chinese PLA from September to November in 2008. MATERIALS: Human serum albumin (HSA) was provided by Chengdu Rongsheng Company Ltd. Hitrap 26/60 sephacryl S-300 was purchased from GE Healthcare.METHODS: Hypochloric acid was used in the oxidation of purified HSA to prepare in vitro the AOPPs-modified HSA (AOPPs-HSA), which was then isolated by Hitrap 26/60 sephacryl S-300. Relative molecular mass was determined by sodium dodecyl sulfate polyacrylamide gel electropheresis (SDS-PAGE), native polyacrylamide gel electrophoresis (PAGE) and molecular weight standards. Structural features and biological activities were identified in the experiment of tumor necrosis factor α (TNF-α) release from monocytes.MAIN OUTCOME MEASURES: ①The purification and gel electrophoresis results of HSA. ②The purification and gel electrophoresis results of AOPPs. ③The dose-effect relationship between AOPPs-HSA and TNF-α release from monocytes. RESULTS: The relative molecular mass of AOPPs-HSA was 670 000 according to SDS-PAGE, native PAGE and molecular weight standards. Moreover, AOPPs-HSA could encourage the release of TNF-α from monocytes. The time effects showed that TNF-α release volume significantly increased after 6 hours of stimulation by AOPPs-HSA (1 g/L) and reached a peak at hour 12. CONCLUSION: Highly purified and bioactive AOPPs can be successfully prepared by the above-mentioned method, which builds a basis for further study on AOPPs.

晚期氧化蛋白产物(advanced oxidation protein products,AOPPs)是Witko-Sarsat在1996年提出的作为慢性肾功能衰竭(chrinoc renal failure,CRF)患者氧化应激和促炎症介质的标志[1],是CRF患者免疫功能紊乱、动脉粥样硬化性、透析相关性淀粉样变等CRF长期并发症发生过程中的重要致病环节[2].

Objective To analyze the risk factors of preeclampsia in pregnant women with chronic kidney disease and to provide the evidences for differential diagnosis.Methods The pregnancy cases were analyzed retrospectively.The patients were grouped into preeclampsia group(n=30) and control group(n=45).The data between the two groups were compared and the risk factors of preeclampsia onset were analyzed by a regression model.Results The ratio of age,categories of basal glomerular diseases,levels of blood pressure,proteinuria before or 20 weeks after pregnancy and levels of uric acid were significant different between the two groups.Conclusion Pregnancy at inadequate age,uncontrolled chronic kidney disease prior to pregnancy and immune-associated glomerular diseases,such as IgA nephropathy and lupus nephritis,are all risk factors for preeclampsia.The women with these factors are at high risk to develop preeclampsia when they have more severe hypertension more than grade 2,doubled proteinuria and increased levels of uric acid.

ObjectiveTo compare the effects of reduced glutathione by predisposing dialyser and/or taken orally on oxidative stress and microinflammatory state in patient with maintenance hemodialysis (MHD). MethodsFifty-one MHD patients visiting our hospital from January to June 2006, were randomly assigned to receive oral reduced glutathione, predisposing dialyser with reduced glutathione or both for 6 weeks. Ten healthy subjects from out-patient clinic for physical examination served as control. The levels of malondialdehyde (MDA), advanced oxidation protein products (AOPP), high-sensitivity C-reactive protein (hs-CRP), interleukin (IL-6), tumor necrosis factor (TNF-α) in plasma were measured before and after the treatment. ResultsThe levels of hs-CRP, IL-6, TNF-α, AOPP, MDA 6 weeks after treatment of either therapy were all lower than those before treatment. The combined therapy of reduced glutathione achieved the best therapeutic effect. ConclusionEither reduced glutathione taken orally or by predisposing improves oxidative stress and microinflammatory state in MHD patients, but their combination achieves better therapeutic effect, without apparent side effect.

Objective To compare the successful rate and security of percutaneous renal biopsy under transient intravenous anesthesia and traditional local anesthesia in children. Methods Clinical and pathological data of children patients (less than 12 years old) undergoing ultrasound-guided renal biopsy with intravenous anesthesia from June 1, 2006 to May 30, 2007 in our department (Painless group) were compared with those of traditional local anaesthesia for renal biopsy from January 1, 1999 and May 30, 2006 (local anaesthesia group). In painless group, fentanyl citrate (50 μg for less than 60 kg in body weight, and 75 μg for those over 60 kg) were injected intravenously, then diprivan was injected intravenously till the end of lash reflex (usually 140-150 mg), and the puncture was performed when the child got complete narcosis. In local anaesthesia group, 2% lidocaine was applied for local anaesthesia, rapid puncture was performed when the children were asked to hold the breath. Successful rate (those getting more than 15 glomeruli) and the complications were observed. Results The punctures in painless group were done successfully with glomeruli number of 8 to 49 [mean (23.3±10.0)], and only 1 case got 8 glomeruli; while in local anesthesia group, the glomerulus number was 0-40 [mean (23.2±9.4)], with no difference between the 2 group. But in local anesthesia group, 2 biopsies were abandoned due to bad cooperation caused by supertension, and 2 cases obtained less than 15 glomeruli. Successful rate was 96.3% and 82.6% respectively in the 2 groups. The complications of anaesthesia in 2 groups: the analepsia time in painless group was 2-5 min, and respiratory depression took place in 1 case who got better soon after the oxygen intake was increased and the respiratory tract was unobstructed; 2 cases in local anesthesia group presented discomfort of chest distress, sweat, and fluster etc. which got better after rest. There was no difference in the incidence of gross hematuria and perirenal hematoma. Conclusion Compared with traditional renal biopsy in local anesthesia, transient intravenous anesthesia is safe and reliable to perform for renal biopsy in children.

供体肾结石因其潜在的导致尿路梗阻的风险,既往曾作为亲属供肾的明确禁忌证.近年来,随着腔内泌尿外科技术的发展,供肾结石有可能通过输尿管镜下取石和弹道碎石得到清除,从而有效扩大供肾来源,促进亲体肾移植的开展.

报告1例应用超选择性肾动脉栓塞抢救肾活检后大出血成功,提示在肾活检率逐年提高、肾活检人数逐渐增多的今天,即使发生严重的大出血,不再必须切除肾脏,介入治疗可以取得良好效果,而且能够尽可能地保护残存的肾功能。

<正>目的探讨抗病毒联合免疫抑制剂对HBsAg阳性肾病综合征(NS)治疗的疗效和安全性。方法回顾性分析我科2003年8月至2006年10月第三军医大学西南医院肾科收治的64例HBsAg阳性的NS患者的治疗方案、疗效及其安全性。所有病例均符合NS诊断标准,排除HBV相关

<正>目的通过观察螺内酯联合厄贝沙坦与单用厄贝沙坦治疗早期糖尿病肾病患者微量白蛋白尿的疗效比较,探索醛固酮受体拮抗剂联合血管紧张素II受体拮抗剂在治疗早期糖尿病肾病中的价值。方法2007年4—9月西南医院接受治疗的早期糖尿病肾病患者28例,随机分为厄贝沙坦组、螺内酯联合厄贝沙坦组进行12周治疗。分组如下:.A

Objective To explore the effects of allograft nephrectomy on erythropoietin resistance in the patients returning to dialysis with a failed transplant.Methods All patients were treated with erythropoietin and enough iron,folic acid,vitamin B12 before and after allograft nephrectomy;haemoglobin value,serum C reactive protein,serum ferritin were measured.Results Before allograft nephrectomy the recipients returning to dialysis with failed transplant reacted poorly to erythropoietin treatment,with serum C reactive protein at high level;but 3 months after allograft nephrectomy haemoglobin value raised markedly,with serum C reactive protein returned to normal level.Conclusion Allograft nephrectomy can reverse erythropoietin resistance in the patients returning to dialysis with failed transplant.