Objective To study the expression of interleukin-13(IL-13) in renal tissues of several common pathologic types of primary glomerulonephritis(PGN).Methods Immunohistochemistry was used to examine the expression of IL-13 in renal tissues of 81 patients with PGN and 10 normal control cases.The correlation analysis was performed with biochemical and pathological indicators.Results Extensive expression of IL-13 was found in renal tissues of patients with PGN.The expression of IL-13 in renal tissues was positively correlated with the concentration of blood urea nitrogen,serum creatinine,the quantitation of urine protein and the crescent formation in glomerular(r=0.325,0.275,0.291,0.231,respectively).It was negatively correlated with glomerular filtration rate and serum albumin(r=-0.448,-0.296,respectively).Conclusion IL-13 participates in the process of inflammation reaction and crescent formation in the renal tissues in patients with PGN,and is correlated with the progression of renal function and the level of urea protein.

Objective To study the concentration alteration of serum vascular endothelial growth factor (VEGF) in patients with primary and secondary glomerular diseases (GD), the effect of immune inhibitors on the concentration, and analyze the relationship between VEGF concentration and some clinical indexes. Methods Serum VEGF concentration of GD patients was determined by sandwich ABC-ELISA. Results All of the GD patients had higher level of serum VEGF than the control group. Of the 5 groups divided according to the clinical classification, patients of chronic glomerulonephritis(CGN) group, latent glomerulonephritis(LGN) group, Henoch-Schonlein purpura nephritis(HSPN) group and lupus nephritis(LN) group had higher serum VEGF level than the control group, respectively, with no difference among the above groups. The patients without taking immune inhibitors had higher serum VEGF level than the control group,while no difference was observed between the patients taking immune inhibitors and the control group.Patients with glomerulonephritis had a significantly lower serum VEGF level after receiving immunosuppression aggressive therapy than before. The serum VEGF level of nephrotic syndrome in nephrotic phase was higher than in remission stage. In membranous glomerulonephritis serum VEGF correlated positively with 24-hour proteinuria excretion. The serum VEGF level correlated positively with anti-dsDNA Ab titer and the concentration of ? globulins in LN. Conclusion Cytokine VEGF is involved in the pathogenesis of glomerulonephritis, and in the occurrence and progression of proteinuria. Immunosuppression therapy can inhibit the expression of VEGF. In LN patients, the serum VEGF level is related to LN activity.

Objective To investigate the clinical significance of urine transferrin in the type 2 diabetic nephropathy and primary chronic glomerular disease. Methods The level of TRF and UAER in the urine of 114 patients with type 2 diabetes mellitus (T2DM), 108 patients with CGD and 30 healthy patients was measured by rate nephelometry and analyzed. Results Urine TRF significantly increased earlier than ALB at the early stage of DN; Linear correlation was found by correlation analysis between the level of TRF in urine level and the quantity of protein in urine. Conclusion TRF in urine obviously increased at the early stage of DN. It was more sensitive than UAER to reflect the early renal injury of DM. A statistically significant correlation was found between the TRF level and the quantity of protein in the urine.

Catheters ; Humans ; Metals ; Trachea ; Tracheotomy

Objective To obtain a global view of cytokine profile in lupus nephritis (LN), and to co-mpare the pattern of cytokine profile in patients with different renal lesions, primarily diffuse proliferative lupus nephritis (Ⅳ-LN) and membranous lupus nephritis (Ⅴ-LN). Methods Thirtypatients with biopsy proven active LN (class Ⅳ, n=15; class Ⅴ, n=15) and 15 healthy controls were enrolled in this study. Serum conc-entration of Th1 cytokines (IFN-γ, IL-1, IL-2, and TNF-α) and Th2 cytokines (IL-4, IL-5, IL-6, IL-10, IL-13) were simultaneously analyzed using Fast Quant Human Th1/Th2 protein array. Results ① Cytokine profiling: in patients with class Ⅳ-LN, the levels of most of the detected cytokines elevated marked compared to normal controls, including both Th1 (IL-2, INF-γ and TNF-α) and Th2 (IL-4, IL-6, IL-10 and IL-13) cytokines. Among them, both Th1 (INF-γ and TNF-α) and Th2 (IL-6, IL-10 and IL-13) cytokines were 10 times higher than normal controls. However, patients with class Ⅴ LN demonstrated a different cytokine pro-filing compared to class Ⅳ LN. Only 4 out of 9 cytokines were significantly increased. In addition to IL-2, all of those cytokines produced by Th2 (IL-4, IL-10 and IL-13) as well as IL-10 was 10 times higher than normal controls. The main difference of cytokines between patients with class Ⅳ LN and patients with class Ⅴ LN was among Th1 cytokines (IFN-γ, IL-2 and TNF-α). There was a significant correlation between clinical manifestations and cytokines in class Ⅳ LN, especially among Th2 cytokine. There was positive correlation between IL-5 and anti-dsDNA titer(r=0.708, P<0.05), IL-5 and creatinin(r=0.681, P<0.05) and IL-10 and SLEDAI scores (r=0.877, P<0.0 ). On the other hand, there was also negative correlation between some Th2 cytokines and clinical manifestations. There was negative correlation between IL-5 and complement C3 level (r=-0.643, P<0.05), IL-10 and proteinuria(r=-0.659, P<0.O5), IL-10 and hemoglobin level (r=-0.856, P<0.001), as well as IL-13 and proteinuria (r=-0.769, P<0.05). In addition, IL-1 was positive correlated with SLEDAI, while it was negatively correlated with bemoglobulin level. As for class Ⅴ LN, there was positive correlation between IL-1 and creatinin level (r=0.784, P<0.05), but negative correlation between IL-4 and proteinuria (r=-0.754, P<0.05). Conclusion Patients with class Ⅳ renal lesion have shown a broad changes of cytokine activity, while up-regulation of Th2 cytokines is more predominant in patients with class Ⅴ LN. These suggest that the expression of different cytokines may be associated with different patterns of lupus renal lesions. These findings may shed light on the further exploring of the underlying mechanisms that mediate different patterns of renal lesions, as well as designing a rational therapeutic strategy for the treatment of LN.

Objective To investigate the effect of Notch signaling during bone marrow mesenchymal stem cells (BMSC) differentiating into islet in vitro.Methods The specific inhibitor of γ-secretase DAPT was used to inhibit the Notch signaling pathway.Mter induction,DTZ staining,indirect immunofluorescence staining,RT-PCR and Westenn blotting were used to detect the expression of insulin,glucagon,Pdx-1 and Ngn3.Results (1) Identification of BMSCs:Indirect immunofluorescence staining showed that BMSCs could express CD59 and CD90,which both were makrers of mesenchymal stem cells.Besides,BMSCs could express nerve culluar markers such as NSE,GFAP,suggesting multi-directional differentiation.(2) The result of MTT showed DAPT could inhibit the cell proliferation in a time-dependent manner and a dose-dependent mannar.Besides,DAPT could inhibit the expression of target gene of Notch signal pathway in a time-dependent manner and a dosedependent mannar.After treated by 1,5,20 μmol DAPT,the expression of Hes1 had reached to 92.06％,71.40％ and 46.89％ of controls respectively,suggesting efficiency of inhibition on Notch reached 7.94％,28.6％ and 53.11％ respectively (all P＜ 0.05).(3) Indirect immunofluorescence staining showed the expression of pancreas-specific markers such as insulin and glucagon were much higher in DAPT treated BMSCs than that in controls,which was confirmed by RT-PCR and Western blotting analyses.The proportion of insulin-producing cells differentiated from DAPT treated BMSCs was (74.03 ± 3.96)％,which was higher than that from controls[(36.49 ± 3.24)％,P＜ 0.05].(4)Furthermore,RT-PCR and Western blotting analysis showed that the expressions of Pdx-1 and Ngn3 were earlier than that of insulin and glucagon,and the expressions of Pdx-1 and Ngn3 were higher in DAPT treated BMSCs than that in controls.Conclusions Notch signaling pathway plays a role in the differentiation of BMSCs into islet in vitro.Pharmacological interference with Notch signaling pathway may provide a novel method to obtain islet for therapeutic use.

Objective To observe the removal of tumor necrosis factor-? (TNF-? ), interleukin-6 (IL-6) and endothelin-1 (ET-1) in continuous renal replacement therapy (CRRT) on hemorrhagic fever with renal syndrome (HFRS) patients, and investigate the effect of inflammatory mediators on HFRS. Methods A total of 40 patients with moderate or more severe HFRS were divided into two groups randomly. Continuous venous-venous hemofiltration (CVVH) was applied to the 20 cases in CVVH group, and hemodialysis (HD) was applied to the 20 cases in HD group. The levels of TNF-? and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA), and ET-1 level was measured by radioimmunoassays (RIA). Results ① In comparing CVVH and HD groups, the days of oliguria (3.0?2.1, 6.0?3.4), incidence of complications (25%, 40%), and mortality (15%, 25%) had significant differences (P0.05). ④ In CVVH group, IL-6 and ET-1 could be detected constantly in filtrate, but TNF-? was not detectable. TNF-?, IL-6 and ET-1 were not detectable in dialysate. Conclusion Continuous blood purification can remove plasma inflammatory mediators. Therefore, it is helpful in recovering renal function, improving the prognosis of HFRS, and decreasing complications and mortality. CVVH is one of the best methods to treat HFRS.

10.3969/j.issn.1007-3969.2013.04.002

Objective To study the effects of cytokines Th1 and Th2 in Class V lupus nephritis (V-LN). Methods Serum concentration of Th1 cytokines (IFN-γ, IL-1, IL-2 and TNF-α) and Th2 cytokines (IL-4, IL-5, IL-6, IL-10 and IL-13) were simultaneously analyzed using fast quant human Th1/Th2 protein array, and Pearson analysis was used to evaluate the association between cytokines and clinical parameters. Results ① Cytokine profiling: Among the 9 cytokines detected simultaneously by fast quant human Th1/Th2 protein array, the expression of four cytokines was up-regulated obviously, namely, Th1 cytokines (IL-2) and Th2 cytokines (IL-4, IL-10 and IL-13); that of IL-10 was 10 times above the normal control. ② Pearson correlation analysis: There was a positive correlation between IL-10 and SLEDAI (r=0.877, P<0.01), but a negative correlation between IL-10 and hemoglobin concentration (r=-0.856, P<0.01). There was also a negative correlation between IL-4 and 24h urine protein (r=-0.754, P<0.05), between IL-13 and 24h urine protein (r=-0.769, P<0.05). Besides, IL-1 and creatinine were positively correlated (r=0.784, P<0.05). Conclusion There were extensively abnormal Th2 cytokines in V-LN patients, suggesting that anti-Th2 therapy may produce a marked effect on V-LN.

Objective To explore the clinical and pathological features of primary IgA nephrology in patients of different gender.Methods The clinical manifestations,laboratory examination and renal pathology results were compared in 192 IgA nephrology patients.Results Not only the onset age of the male patients was older than that of the female ones (P<0 .05 ),but also the course of disease before the kidney biopsy of male patients was longer than that of the female ones (P<0.05).Besides,the proportion of edema in the male patients was lower (P<0.05).The mean arterial pressure,hemoglobin and 24 h urine protein levels were higher in the male patients at the time of kidney biopsy.Besides,the proportions of high blood pressure,hyperuricemia and hypertriglyceridemia were all higher in the male patients.Furthermore,eGFR of the male patients was lower than that of the female ones (P<0 .05 ).There was a significant difference in the gender distribution of clinical and pathological types (χ2=12.666,P<0.05),and the male and female patients also significantly differed in the 24 h urine protein and CKD grouping (Z=-3.118,Z=-3.246,P<0.05).However,there was no significant sex difference in Lee pathology grading or immunofluorescence type (Z=-1.881,χ2 =-0.187,P>0.05 ).Patients of different gender significantly differed in the renal-interstitial lesions grading (Z=-3.0432,P<0.05);to be more specific,the scores of glomerulosclerosis and renal tubule interstitia were higher in the male patients (P<0.05).Conclusion Patients of different gender differ in the clinical and pathological features of primary IgA nephrology.And clinical pathology of male patients is worse than that of female ones.