严重烧伤后早期大鼠肾脏细胞粘附分子1和白介素6的表达与肾功能损害的相关性研究

Objective To clarify the mechanism and provide the basis for prevention and treatment of the early injuries of kidney after severe burn in rats.We observed the expression of intercellular adhesion molecule 1 and interleukin 6 and the early pathological changes in different time.Method Early pathological changes in the kidney were observed by LM and EM.The expression of ICAM 1 were observed by immunohistochemistry,in situ hybridization.The expression of IL 6 was also observed.Result From 5 min to 72 h after burn,the early changes in the kidney included edema,hemorrhage, and congestion,injury of capillary epithelium cells.2ICAM 1 and IL 6 were higher in the kidney 30 min after burn,and from 2 h to 24 h,they were strongest positive,but on 72 h,they were negative.Conclusion ICAM-1 and IL 6 may play important roles in mechanisms of kidney injury,and the major target cells may be the endothelium cells.

The Global Role of Kidney Transplantation

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness.Anything that is both cheaper and better,but is not actually the dominant therapy,must have other drawbacks that prevent replacement of all dialysis treatment by transplantation.The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which,in some countries place transplantation,appropriately,at a lower priority than public health fundamentals such as clean water,sanitation and vaccination.Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients,but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical,surgical and nursing workforces with the required expertise.These problems have solutions which involve the full range of societal,professional,governmental and political environments.World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.

血清、尿TIMP-1浓度对肾脏病病程的判断价值

目的:探讨血清、尿金属蛋白酶组织抑制因子-1(TIMP-1)浓度对肾脏纤维化的诊断价值.方法: 以酶联免疫吸附检测(ELISA)方法检测健康者及肾脏病患者血清、尿TIMP-1浓度.结果: ①以血清TIMP-1浓度显著增高来判断肾组织有无纤维化敏感性为89%,特异性为94%,与肾活检符合率为85%.②尿TIPM-1浓度与尿蛋白呈正相关(r=0.53,P＜0.01).结论: 血清TIMP-1浓度可作为判断慢性肾脏病人肾纤维化的无损伤性检查指标.

茶多酚抑制环孢菌素A诱导的慢性肾毒性大鼠转化生长因子-β1的表达

AIM: To investigate the inhibitory effect of tea polyphenols (TP) on the transforming growth factor-β1 (TGF-β1)expression in rat model of cyclosporine A (CsA)-induced chronic nephrotoxicity. METHODS: The rat model of CsA-induced chronic nephrotoxicity was used, 4 groups of rats were respectively treated with vehicle (0.1 mL .kg-1.d-1 At the end of day 28 of treatment, serum and urine are analyzed for creatinine clearance, kidney tissue for pathologic analysis. The TGF-β1 mRNA and its protein expression were detected by RT-PCR, immunohistochemistry,and Western blot. RESULTS: CsA-treated rats had increased renal expression of TGF-βl mRNA and its protein,compared with the vehicle- or TP- treated controls. The renal function and interstitial fibrosis were ameliorated and renal expression of TGF-β1 mRNA and its protein was decreased in animals treated with CsA plus TP, compared with aminals treated with CsA alone (P＜0.05). CONCLUSION: TP significantly inhibits renal expression of TGFβ1 in rat model of cyclosporine-induced chronic nephrotoxicity, suggesting that the decreased renal expression of TGF-β1 exerted by TP is one of mechanisms to protect renal function and tissue structure.

Objective:　To investigate the diagnosis and treatment of renal trauma. 　　Methods:　Retrospective analysis of 298 patients with renal trauma was carried out. Among them, 272 (91.3%) had blunt renal injuries and 26 (8.7%) had penetrating injuries; 123 (41.3%) had multiple complicated intraabdominal injuries and 56 (18.8%) had concomitant shock. Normal-dose-IVU examination was used in 39 patients and double-dose-IVU in 44 patients, ultrasonography in 109 patients, and CT in 45 patients. Conservative and supportive therapy was done in 193 patients (64.8%) and operation in 105 patients (35.2%). 　　Results:　The positive rate was 48.7% by the normal-dose-IVU examination and 90.9% by double-dose-IVU, 78.8% by ultrasonography, and 95.6% by CT. One hundred and eighty-three patients were cured by conservative therapy and 101 by operation. Fourteen patients died. 　　Conclusions:　B-ultrasound can be conveniently used for primary assessment of renal injuries, while CT shows rapid, accurate and proper condition of a renal trauma patient. The treatment depends on the severity of the injury. The conservative therapy is employed in most cases which present slight or moderate injury and no evident massive bleeding. Severe injury requires surgical exploration. The operative approach is by using a transabdominal incision, which makes it relatively easy to explore intraabdominal organs and control the injured kidney. It is also very important to control shock and prevent other severe complications in the early stage of the treatment.