AIMS To investigate the relationship between the liver function- al impairment and sodium and water retention. METHODS Acute liver damage model was established with carbon tetrachloride (CCl_4) administration to male ...AIMS To investigate the relationship between the liver function- al impairment and sodium and water retention. METHODS Acute liver damage model was established with carbon tetrachloride (CCl_4) administration to male Sprague-Daw- ley rats. Twenty-four and 48 hours later after CCl_4 administration, the excretion of acute sodium and water load was examined,and 24 hours later after normal saline administration,the excretion of acute sodium and water load was examined in control group. The concentration of plasma caffeine was analysed with high pressure liquid chromatograph (HPLC). The half life time of plasma caffein (Caft 1/2) sewed as a quantitative index of hepatic function. Plasma ALT was measured with Reitman method. The hepatic tis- sue was sectioned in the same site for water content measurement and pathological observation. The serumal and urinary sodium was measured with flame photometry. RESULTS Twenty-four hours later after CCl_4 administration, plasma alanine aminotransferase (ALT,n=6,37.5±12.6→ 189.4±34.4U,P<0.01) and water content of hepatic tissue (n =6,70.0%±1.1%→73.0%±1.0%,P<0.01) rose significantly,Caft 1/2 was prolonged significantly (94.9±18.9→ 326.4±85.8 minutes,P<0.01 ). The renal function of excretion of acute salt and water load declined obviously (n=6,Na^+: 92.4%±14.1%→50.1%±13.1%,P<0.01;H_2O:86.3%± 14.3%→42.1%±8.8%,P<0.01). Forty-eight hours later, the indexes above somewhat recovered,but were still markedly different from those of the control. Furthermore,the relationships betweenCaft 1/2 andALT (r=0.752,P<0.01),and between Caft 1/2 and excretory rate of sodium (r=-0.634,P<0.05) and water were still significant (r=-0. 612,P<0.01). CONCLUSIONS Caft 1/2 is a good index to assess the degree of hepatic damage. The hepatic dysfunction may be a factor caus- ing the renal excretory impairment to the acute sodium and water load.展开更多
Diabetes mellitus is categorized as a major metabolic disease. Hyperglycemia is the populest mediator. The oxygen radicals＇ production or the peroxide production in the mitochondria is preceded as a possible mechanis...Diabetes mellitus is categorized as a major metabolic disease. Hyperglycemia is the populest mediator. The oxygen radicals＇ production or the peroxide production in the mitochondria is preceded as a possible mechanism. TGF-beta is characterized as the main protagonist. TGF-b is a molecular mediator with adherent and hypertrophic properties in diabetic nephropathy. 20 Balb/c male and female mice were used. They were separated in two age groups, one of 4 weeks old （childhood, n= 10） and one of 6 weeks old （puberty, n=10）. An immunochemical study for TGF-beta was undertaken. The basal petal of the external membrane of Bowmen is thickened. In significant percentage the basal membrane was thickened and the peduncles merge together. Mature sperm cells were not normal. The two age groups did not present significant differences in morphology of the exocrine pancreatic cells. The augmented levels of TGF-beta expression promote the increased proliferation of the pancreatic glandular cells, the derangement of differentiation and the apoptosis rhythm. The renal function is diminished sooner than the clinical manifestations. The testicles are less influenced concerning principally the spermiogenesis.展开更多
目的:调查上海地区维持性血液透析患者慢性肾脏病矿物质和骨异常(chronic kidney disease-mineral and bone disorder,CKD-MBD)的管理现况,了解CKD-MBD的临床实践变迁。方法:选取截至2019年3月上海市血液透析质量控制中心单位64家医院进...目的:调查上海地区维持性血液透析患者慢性肾脏病矿物质和骨异常(chronic kidney disease-mineral and bone disorder,CKD-MBD)的管理现况,了解CKD-MBD的临床实践变迁。方法:选取截至2019年3月上海市血液透析质量控制中心单位64家医院进行CKD-MBD问卷调查,并与2011年相应的调查结果对比。调查问卷内容包括:各透析中心维持性血液透析和腹膜透析患者的人数、CKD-MBD指南执行情况、CKD-MBD指南学习情况、CKD-MBD生化指标检测的开展和分布、高磷血症的治疗、继发性甲状旁腺功能亢进和肾性骨病的治疗、透析液钙离子浓度。结果:共63家医院参与本研究。上海市血液透析中心共有维持性血液透析患者10168例,维持性腹膜透析患者4610例。84.1%(53/63)的医院执行指南过程顺利,与2011年(55.6%)相比,指南执行顺利的比例提高了28.5%。二级和三级医院指南执行顺利比例分别为83.3%(25/30)和84.8%(28/33),与2011年(39.3%和73.1%)相比,分别提高了44.0%和11.7%。所有医院均开展了血钙、血磷的检测,甲状旁腺素、总碱性磷酸酶、骨特异性碱性磷酸酶、25羟维生素D和其他骨代谢相关指标检测的比例分别为98.4%(62/63)、90.5%(57/63)、19.0%(12/63)、90.5%(57/63)和42.9%(27/63);冠状动脉CT、腰椎侧位片、超声心动图、骨密度和血管超声检测的比例分别为68.3%(43/63)、74.6%(47/63)、100.0%(63/63)、68.3%(43/63)和69.8%(44/63)。开展甲状旁腺素、总碱性磷酸酶、骨特异性碱性磷酸酶、25羟维生素D、冠状动脉CT、腰椎侧位片和超声心动图的检测比例分别较2011年提高2.1%、1.6%、0.5%、47.9%、14.6%、20.9%和1.9%。血液透析患者生化指标分布调查结果显示,血磷0.80~1.45 mmol/L(KDIGO指南)、血磷0.80~1.78 mmol/L(KDOQI指南)、血钙2.10~2.54 mmol/L和甲状旁腺素150~300 ng/L的患者比例分别为37.0%(3323/8969)、50.7%(4571/9018)、60.2%(5568/9244)和33.2%(3018/9087),理想的血磷(0.80~1.78 mmol/L)和血钙(2.10~2.54 mmol/L)水平分别较2011年(39.6%、53.5%)提高了11.1%和6.7%,甲状旁腺素150~300 ng/L的比例较2011年(34.1%)降低了0.9%。使用非含钙磷结合剂的医院比例(碳酸镧从1.9%升高至87.3%,碳酸司维拉姆从14.8%升高至63.5%)和外科手术治疗继发性甲状旁腺功能亢进的医院比例(从38.9%升高至68.3%)显著升高。结论:随着CKD-MBD药物的可及性增加和肾脏专科医生对CKD-MBD的认知不断深入、管理不断加强,CKD-MBD各指标检测开展情况、生化指标的达标率均较2011年明显改善。但上海地区CKD-MBD的综合管理仍面临巨大挑战,仍需进一步提高血磷、全段甲状旁腺素的达标率,为终末期肾病患者的综合管理及钙磷代谢异常的防治提供更多的参考依据和管理策略。展开更多
文摘AIMS To investigate the relationship between the liver function- al impairment and sodium and water retention. METHODS Acute liver damage model was established with carbon tetrachloride (CCl_4) administration to male Sprague-Daw- ley rats. Twenty-four and 48 hours later after CCl_4 administration, the excretion of acute sodium and water load was examined,and 24 hours later after normal saline administration,the excretion of acute sodium and water load was examined in control group. The concentration of plasma caffeine was analysed with high pressure liquid chromatograph (HPLC). The half life time of plasma caffein (Caft 1/2) sewed as a quantitative index of hepatic function. Plasma ALT was measured with Reitman method. The hepatic tis- sue was sectioned in the same site for water content measurement and pathological observation. The serumal and urinary sodium was measured with flame photometry. RESULTS Twenty-four hours later after CCl_4 administration, plasma alanine aminotransferase (ALT,n=6,37.5±12.6→ 189.4±34.4U,P<0.01) and water content of hepatic tissue (n =6,70.0%±1.1%→73.0%±1.0%,P<0.01) rose significantly,Caft 1/2 was prolonged significantly (94.9±18.9→ 326.4±85.8 minutes,P<0.01 ). The renal function of excretion of acute salt and water load declined obviously (n=6,Na^+: 92.4%±14.1%→50.1%±13.1%,P<0.01;H_2O:86.3%± 14.3%→42.1%±8.8%,P<0.01). Forty-eight hours later, the indexes above somewhat recovered,but were still markedly different from those of the control. Furthermore,the relationships betweenCaft 1/2 andALT (r=0.752,P<0.01),and between Caft 1/2 and excretory rate of sodium (r=-0.634,P<0.05) and water were still significant (r=-0. 612,P<0.01). CONCLUSIONS Caft 1/2 is a good index to assess the degree of hepatic damage. The hepatic dysfunction may be a factor caus- ing the renal excretory impairment to the acute sodium and water load.
文摘Diabetes mellitus is categorized as a major metabolic disease. Hyperglycemia is the populest mediator. The oxygen radicals＇ production or the peroxide production in the mitochondria is preceded as a possible mechanism. TGF-beta is characterized as the main protagonist. TGF-b is a molecular mediator with adherent and hypertrophic properties in diabetic nephropathy. 20 Balb/c male and female mice were used. They were separated in two age groups, one of 4 weeks old （childhood, n= 10） and one of 6 weeks old （puberty, n=10）. An immunochemical study for TGF-beta was undertaken. The basal petal of the external membrane of Bowmen is thickened. In significant percentage the basal membrane was thickened and the peduncles merge together. Mature sperm cells were not normal. The two age groups did not present significant differences in morphology of the exocrine pancreatic cells. The augmented levels of TGF-beta expression promote the increased proliferation of the pancreatic glandular cells, the derangement of differentiation and the apoptosis rhythm. The renal function is diminished sooner than the clinical manifestations. The testicles are less influenced concerning principally the spermiogenesis.
