有氧运动加螺旋藻补充对2型糖尿病大鼠肾脏TLR4/NF-κB-p65的表达及炎性因子的影响

本文旨在研究有氧运动加螺旋藻补充对2型糖尿病大鼠肾脏TLR4/NF-κB-p65的表达及炎性因子的影响,以TLR4/NF-κB-p65炎症信号通路为靶点探讨运动加螺旋藻补充改善2型糖尿病大鼠肾脏损伤的可能机制。采用4周高脂饲料喂养和低剂量STZ腹腔注射的方法建立2型糖尿病大鼠实验模型,成模后将大鼠随机分为糖尿病安静对照组(DM)、糖尿病运动组(DE)、糖尿病+螺旋藻组(DS)、糖尿病运动+螺旋藻组(DES),另设正常安静对照组(NC)。运动方式采用8周的无负重游泳训练。实验末,测随机血糖、微量白蛋白、肾脏测TNF-α、TLR4和NF-κB-p65蛋白表达,并采用光镜观察肾脏微细结构的改变。结果表明:(1)光镜下可见DE组、DS组和DES组大鼠肾小球毛细血管袢面积增加;肾小管扩张、上皮细胞空洞变性、细胞聚集增加和炎症细胞稍浸润等病理变化均较DM组有所改善。(2)DE组、DS组和DES组大鼠的血糖浓度、尿微量白蛋白含量均较DM组降低(P<0.05或P<0.01);与DES组比较,DE组和DS组的血糖浓度、尿微量白蛋白含量均升高明显(P<0.05或P<0.01)。(3)DE组、DS组和DES组大鼠肾脏TNF-α、TLR4和NF-κB-p65蛋白表达均明显降低,与DM组比较,差异均呈显著性(P<0.01);与DES组比较,DE组和DS组的肾脏TNF-α、TLR4和NF-κB-p65蛋白表达明显增加(P<0.05或P<0.01)。因此,有氧运动、螺旋藻及两者联合使用有降低2型糖尿病大鼠血糖,改善肾功能,减轻肾脏损害的功效,但两者联合使用效果要好于单独使用,其机制可能与有氧运动联合螺旋藻降低TLR4/NF-κB-p65信号蛋白表达发挥抗炎作用的效果要好于单纯的有氧运动或螺旋藻使用。

血清半胱氨酸蛋白酶抑制剂C在重度子痫前期诊断中的临床意义

目的探讨血清半胱氨酸蛋白酶抑制剂C(Cys C)在重度子痫前期诊断中的临床意义。方法采集进行围产期保键检查的797例不同孕期的正常孕妇(正常妊娠组)、95例重度子痫前期患者和216名健康体检未孕妇女(正常未孕组)的血清样本,测定其血清Cys C和肌酐(Cr)浓度,采用受试者工作特征(ROC)曲线评价Cys C和Cr对重度子痫前期的诊断价值。结果与正常未孕组相比,孕妇血清Cys C浓度从妊娠中期开始升高(P<0.05),28周以后升高更为明显(P<0.01);与相同孕期的正常妊娠组比较,早发型及晚发型重度子痫前期孕妇血清Cys C均升高(P<0.01),早发型重度子痫升高更为明显;而Cr在早发型和晚发型组仅轻度升高(P>0.05)。Cys C诊断重度子痫前期的ROC曲线下面积(AUC)为0.96。结论血清Cys C能反映孕妇肾脏受损的实际情况,对诊断重度子痫前期有较高的价值。

Role of adhesion molecules and dendritic cells in rat hepatic/renal ischemia-reperfusion injury and anti-adhesive intervention with anti-P-selectin lectin-EGF domain monoclonal antibody

AIM: To investigate the role of P-selectin, intercellular adhesion molecule-1 (ICAM-1) and dendritic cells (DCs)in liver/kidney of rats with hepatic/renal ischemiareperfusion injury and the preventive effect of anti-Pselectin lectin-EGF domain monoclonal antibody (anti-PsLEGFmAb) on the injury.METHODS: Rat models of hepatic and renal ischemiareperfusion were established. The rats were then divided into two groups, one group treated with anti-PsL-EGFmAb(n = 20) and control treated with saline (n = 20). Both groups were subdivided into four groups according to reperfusion time (1, 3, 6 and 24 h). The sham-operated group (n = 5) served as a control group. DCs were observed by the microscopic image method, while P-selectin and ICAM-1 were analyzed by immunohistochemistry.RESULTS: P-selectin increased significantly in hepatic sinusoidal endothelial cells and renal tubular epithelial cells 1 h after ischemia-reperfusion, and the expression of ICAM-1 was up-regulated in hepatic sinusoid and renal vessels after 6 h. CD1a+CD80+DCs gradually increased in hepatic sinusoidal endothelium and renal tubules and interstitium 1 h after ischemia-reperfusion, and there was the most number of DCs in 24-h group. The localization of DCs was associated with rat hepatic/renal function.These changes became less significant in rats treated with anti-PsL-EGFmAb.CONCLUSION: DCs play an important role in immune pathogenesis of hepatic/renal ischemia-reperfusion injury.Anti-PsL-EGFmAb may regulate and inhibit local DC immigration and accumulation in liver/kidney.

Hypertensive disorders in pregnancy

Renal injury or failure may occur in the context of pre-gnancy requiring special considerations with regard to fetal and maternal health. The condition of pregnancy itself may be a major factor in such injuries. In addition,for many young women previously known to be healthy, pregnancy may be the frst presentation for routine urine and blood testing which may yield previously subclinical renal disease. As such, pregnancy may add complexity to considerations in the management of renal disease presenting coincidentally requiring knowledge of the physiologic changes and potential renal disorders that may be encountered during pregnancy.

Acute kidney injury from different poisonous substances

AIM To report our experience of acute kidney injury(AKI) developed after exposure to poisonous substance.METHODS Retrospective study where data was collected from case records of patients coming to this institute during January 1990 to May 2016.This institution is a tertiary care center for renal care in the metropolitan city of Karachi,Pakistan.History of ingested substance,symptoms on presentation,basic laboratory tests on arrival,mode of treatment and outcome were recorded from all patients and are presented here.Patients developing AKI after snake envenomation or scorpion stings are not included in this study.RESULTS During studied period 184 cases of AKI developing after poisoning were seen at our institution.The largest group was from paraphenyline diamine poisoning comprising 135 patients,followed by methanol in 8,organophosphorus compounds in 5,paraquat in 5,copper sulphate in 5,tartaric acid in 4,phenobarbitone in 3 and benzodiazipines,datura,rat killer,fish gall bladder,arsenic,boiler water,ammonium dichromate,acetic acid and herbs with lesser frequency.In 8 patients multiple substances were ingested in combination.Renal replacement therapy was required in 96% of patients.Complete recovery was seen in 72.28% patients,20% died during acute phase of illness.CONCLUSION It is important to report poisonous substances causing vital organ failure to increase awareness among general population as well as health care providers.

Efficacy and safety of a novel multi-electrode radiofrequency ablation catheter for renal sympathetic denervation in pigs

Objective To investigate the safety and efficacy of a self-developed novel multi-electrode radiofrequency ablation catheter （Spark） for catheter-based renal denervation （RDN）. Methods A total of 14 experimental miniature pigs were randomly divided into four groups （55°＆ 5-watt, 55°＆ 8-watt, 65°＆ 5-watt, and 65° ＆ 8-watt groups）. Spark was used for left and right renal artery radiofrequency ablation. Blood samples collected from renal arteries and veins as well as renal arteriography were performed on all animals before, immediately after, and three months after procedure to evaluate the effects of Spark on the levels of plasma renin, aldosterone, angiotensin I, and angiotensin II as well as the pathological changes of renal arteries. Results One pig died of an anesthetic accident, 13 pigs successfully underwent the bilateral renal artery ablation. Compared with basic measurements, pigs in all the four groups had significantly decreased mean arterial pres- sure after procedure. Histopathological analysis showed that this procedure could result in intimal hyperplasia, significant peripheral sympa- thetic nerve damage in the renal arteries such as inflammatory cell infiltration and fibrosis in perineurium, uneven distribution of nerve fibers, tissue necrosis, severe vacuolization, fTagmented and unclear nucleoli myelin degeneration, sparse axons, and interruption of continuity. In addition, the renal artery radiofrequency ablation could significantly reduce the levels of plasma renin, aldosterone, angiotensin I, and angio- tensin II in pigs. Conclusions The results suggest that this type of multi-electrode catheter-based radiofrequency ablation could effectively remove peripheral renal sympathetic nerves and reduce the activity of systemic renin-angiotensin system in pigs, thus facilitating the control of systemic blood pressure in pigs.

Effects of taurine and housing density on renal function in laying hens

This study investigated the putative protective effects of supplemental 2-aminoethane sulfonic acid（taurine） and reduced housing density on renal function in laying hens. We randomly assigned fifteen thousand green-shell laying hens into three groups： a free range group, a low-density caged group, and a high-density caged group. Each group was further divided equally into a control group（C） and a taurine treatment group（T）. After 15 d, we analyzed histological changes in kidney cells, inflammatory mediator levels, oxidation and anti-oxidation levels. Experimental data revealed taurine supplementation, and rearing free range or in low-density housing can lessen morphological renal damage, inflammatory mediator levels, and oxidation levels and increase anti-oxidation levels. Our data demonstrate that taurine supplementation and a reduction in housing density can ameliorate renal impairment, increase productivity, enhance health, and promote welfare in laying hens.