Objective To study the preventive effect of spironolactone on renal tubulointerstitial fibrosis of diabetic nephropathy (DN)in rats.Methods Sixty adult SD rats were random divided into sham operation group(C),diabetic nephropathy group(D)and spironolactone interventional group(A).After diabetes WaS induced by administrating strep tozotocin(STZ),spironolactone was perfused into the stomach of rats in group A.On the 7th,14th,21st,28th days after treatment,rats were put to death,their kidneys were removed to observe the expressions of TGF-β1 and MMP-9 by immunohistochemistry method.The blood potassium,natrium,glucose, serum creatinine,cholesterol,triglyceride and urinary albumin quantification were measured.Results Urine protein in group A wag lower than that in group D.The blood potassium,natrium,glucose,serum creatinine,cholesterol and triglyceride had no difference between group A and group D(P＞0.05).Compared with group D,the expressions of TGF-β1 in group A Was decreased(P＜0.01),the expressions of MMP-9 in group A was hisher than that in group D(P＜0.01).Conclusion Spironolactone could decrease the expression of TGF-β1 and increase the expression of MMP-9 in the tubulointerstitial of diabetic nephropathy,which may delay the progress of renal tubulointerstitial fibrosis.

Objective To investigate the value of subdural intracranial pressure (ICP) monito-ring in post-operative patients with severe brain injury. Methods A total of 100 patients with severe brain injury treated with craniotomy were randomly divided into ICP monitoring group (n=50) and rou-tine treatment group (n = 50). In ICP monitoring group, the treatment methods were adjusted according to the changes of ICP, whereas the patients in routine treatment group underwent general treatment ac-cording to standard neurosurgical protocol. Results Patients in ICP monitoring group received mannitol for eight days, with the average dosage of 950 g. Marmitol was administered to patients in routine treat-ment group for 12 days, with average dosage of 1 450 g. There was statistical difference in aspects of time duration and mannitol dosage between two groups (P <0.01). Of all patients in ICP monitoring group, four were found with electrolyte disturbance (8%), seven with acute renal failure (14%), four with stress ulcer (8%) and eight with pulmonary infection (16%). The corresponding numbers of patients in routine treatment group were nine (18%), 14 (28%), five (10%) and nine (18%), respectively. The occurrence of electrolyte disturbance and acute renal failure between two groups showed significant statistical difference (P < 0.05), while the occurrence of stress ulcer and pulmonary infection were be-yond of statistical difference between two groups (P > 0.05). The post-operative initial ICP level was positively correlated with mortality rate (P <0.01). All patients were followed up for three months post-operatively. In ICP monitoring group, 27 patients (26%) obtained good prognosis without any disability (54%), 13 were under mild disability, two (4%) under severe disability, three (6%) under vegeta-tive state and five (10%) died . In the routine treatment group, 17 patients (34%) were with good prognosis without any disability , six (12%) with mild disability , six (12%) with severe disability, eight (16%) under vegetative state and 13 (26%) died. The ICP monitoring group had better prognosis than the routine treatment group(P < 0.05). Conclusion Continuous ICP monitoring postoperatively in severe brain injury patients is valuable in reducing mortality, complication and improving the prognosis.