Relationship Between Serum DNA Replication, Clinicopathological Characteristics and Prognosis of Hepatitis B Virus-associated Glomerulonephritis with Severe Proteinuria by Lamivudine Plus Adefovir Dipivoxil Combination Therapy

Objective To explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods 102 patients with HBV-GN were divided into 3 groups, according to the serum titer of the HBV DNA. 24-h urine protein excretion, and other parameters were measured. Renal biopsy were performed. The association between HBV DNA and the pathological stage of membranous nephropathy was analyzed in 78 patients with HBV-MN. 24-h urine protein excretion was used for the evaluation of the prognosis, and the relationship between HBV DNA and prognosis were analyzed. Results Several findings were demonstrated with the increase of serum HBV DNA： 24-h urine protein excretion, plasma cholesterol, and triglycerides increased significantly（P〈0.05）, while the plasma level of albumin decreased significantly（P〈0.05）; The changes of serum creatinine, C3 and C4 were found but no statistical significance. Glomerular deposition of HBVAg increased, and the pathological injury was more severe. The clinical remission rate was lower in the high replication group after treatment as compared with the low replication group（P〈0.01）. Conclusion With the increase of serum HBV DNA, the urine protein excretion and the kidney injury were more severe, and the clinical remission rate was decreased.

RANK-RANKL在2型糖尿病肾病大鼠肾脏表达的研究

目的观察RANK/RANKL在STZ诱导的2型糖尿病肾病大鼠肾脏中的表达。方法采用高糖高脂喂养加STZ腹腔注射法建立2型糖尿病动物模型(T2DM),大鼠造模成功后随机分为糖尿病肾病组(DK)和正常对照组(NC)。分别于4周、8周、12周末各处死6只老鼠,检测血糖、胰岛素、血脂、尿蛋白、肌酐。HE染色观察肾脏病理改变,免疫组化法检测肾脏中RANK、RANKL的表达分布,Western印迹法检测RANK、RANKL。组间比较采用T检验,组内比较采用单因素方差进行统计学分析。结果与NC组比较,DK组大鼠肾脏病理改变较重,血糖等生化指标及肾脏中RANK、RANKL蛋白表达在给药4周末时表达开始升高,差异具有统计学意义(P<0.05),8周末、12周末时表达显著升高,差异有统计学意义(均P<0.01)。结论 STZ诱导的2型糖尿病肾病大鼠肾脏中存在RANK/RANKL的激活表达,可能参与了糖尿病肾病早期的发病。