Objective To investigate the value of dialysis and ethics of withdrawal dialysis.Method Through analysis of some typical cases of ESRD patients,to investigate the value of dialysis.Conclusion A lot of ESRD patients can survive through dialysis,thanks to the improvement of medical science in last 30 years.On the other hand,it can also keep some patients with no living calculation surviving,becoming the burdensome of families,hospitals and societies.Our object is to discuss the ethics of withdrawal dialysis in our country.

To study the affection of blood on protein determining in urine, different volumes of blood from healthy volunteers was added to urine samples of varied osmolatites. Specimens were analyzed for protein concentration by the method of 3% sulfosalicylic acid. Microscopic hematuria was not associated proteinuria. In hypertonic urines, the protein of gross hematuria is low (30mg/100ml for the urine with 3% RBC, 32. 4mg/100ml for the urine with 1% blood), while in iso and hypotonic urines gross hematuria produced marked proteinuria (225—1090mg/100ml). Urine protein electrophoreses identified hemoglobin as the responsible protein. The protein concentration in urine may he used to distinguish glomerular hematuria from nonglomerular hematuria.

60 years.

Using the IL—6 dependent hybridoma cell line KD83, we investigated the relationship between KNA—anti—DNA immune complexes(DNA—anti—DNAICs)from the sera of lupus nephritis patients and interleukin 6 (IL—6) production by mouse glomerular mesangial cells cultured in vitro. The results show that DNA—anti—DNA IgM and DNA—anti—DNA IgG and DNA—anti—DNA IgM all enhance IL—6 production by mesangial cells; of those DNA—anti—DNA IC, the effect of DNA—anti—DNA IgM on IL—6 production by mesangial cells was significant. This enhanced production of IL—6 by mesangial cells was dependent on concentration of DAN—anti—DNA ICs.

Objective To study the role of fibroblasts in the pathomechanisms of renal interstitial fibrosis(RIF). Methods Growth behavior and apoptos, of renal interstitial fibroblasts in cultures, established using renal biopsies of casts with and without RIF, were studied. Results There were significant alterations in the growth behavior, the differentiation pattern of potentially mitotic fibroblast populations and programmed cell death in cultures derived from kidneys with RIF, as compared with cultures of normal origin. Conclusion The abnormal growth and apoptosis of fibroblasts may play an im-portant role in RIF. Inhibiting the proliferation and promoting the programmed death of fibroblasts may be benificial to patients with RIF.

To investigate the best intennittence and reasonable dosage of CDC pulse therapy on different activity degree of lupus nephritis (LN). Methods 96 severe LN cases were divided into three groups. Croup A; CTX pusle treatment (IV-CTX), once 2 weeks, 8- 12 mg'kg'Vd for two days; Group B: IV-CTX once a month, 0.5 - 1.0/m2; Group C: IV-CTX once 3 months, 0.5 - 1.0/m2. Prednisone was given to three groups simultaneously. Results The time taking effect was shorter significantly in Group A than that in Group B and C. Remission rate was higher significantly in Group A than that in Group B and C ( P 0. 05). Intermittence of 15 cases (23.8%) from Group Ek C was changed to once 2 weeks and then the disease activity had been controlled since these patients became worse during the treatment. Intennittence of 3 patients (9% ) from Group A was delayed a week because of the decreasing of WBC counting. There was no significantly difference between three groups in side effect and its incidence. Conclusion A reasonable IV-CTX should be choosen according to the disease activity. IV-CTX 8 - 12 mg'kg'Vd for two days, once 2 weeks should be used for acute and severe LN. When disease becomes mild, IV-CTX can be changed to 0.5 - 1.0/m2, once a month. After LN activity is controlled basically, 0.5- 1.0/m2, once a month is recommended.

Objective In order to investigate the reversibility of uremia in patients with lupus nephritis(LN). Methods 37 uremic patients with IN who underwent dialysis were treated with a progressive protocol of combined glucocorticoid and cyclophosphamide (CTX) during the last 15 years. Results 83.8% of patients withdrawed from dialysis, with an average withdrawal period of 40.6 ?21.5 months, and with serum creatinine of 179.36 ?88.24 fjiaoVL at least half year after the withdrawal. Conclusion Uremic patients with LN who should be dialysed are not necessarily in end stage of their renal diseases, and those who are indicated for immunosuppressants and probable to be reversed should be treated properly and promptly.

Objective To investigate the role of NF-?B in the pathogenesis of lupus nephritis (LN). Methods A microwave-based immunohistochemistry (APAAP) was used to detect the expression of NF-?B p65 and C-myc protein in renal tissue of LN and normal control. At the same time, the correlation between expression of NF-?B and renal injuries in LN was examined. Results The expression of NF-?B in LN was higher than that of normal control, the highest one was type Ⅳ LN. The number of positive cells expressing NF-?B in renal tissue of LN showed a strong correlation with C-myc protein expression, kidney activity of LN, histological changes and functional lesion in LN, respectively. Conclusions NF-?B may play an important role in the pathogenesis of LN, and the number of positive cells expressing NF-?B may be considered as a predictor for the kidney activity and progressive renal injury in LN.

Objective To determine whether peritoneal mesothelial cells express CD40 and to investigate potential mechanism by which CD40-CD40 ligand(CD40L) interaction may be involved in the inflammation of peritoneal membrane. Methods Rat peritoneal mesothelial cells (MC) were harvested from peritoneal cavity and maintained under defined in vitro conditions. Expression of CD40 on MC under normal culture or stimulation with interferon-?(IFN-?), tumor necrosis factor-?(TNF-?), interleukin(IL)-1 was examined by RT-PCR and FACS analysis. After activation with CD40 mAb, the expression of intercellular adhesion molecule-1 (ICAM-1) on MC was analyzed by FCAS. Results MC cultured in vitro expressed CD40 constitutively. The expression of CD40mRNA and CD40 protein up-regulated markedly following the stimulations with IFN-?, but not with IL-1, TNF-?. The expression of ICAM-1 on MC was significantly increased after activation of CD40 with IFN-? and CD40mAb. Conclusions MC functionally expresses CD40. The interaction of CD40 on MC and CD40L+ cells in peritoneal cavity may play an important role in peritoneal local defense and may be involved in the inflammation process of peritoneum.

Objective To define which hyaluronan synthase (HAS), of three hyaluronan synthesizing enzymes HAS-1, HAS-2, and HAS-3, is primarily responsible for hyaluronan synthesis and extracellular matrix/extracellular coat formation in human peritoneal mesothelial cells (HPMCs) . Methods As a prerequisite study, the expression of each HAS mRNA in cultured HPMCs was measured by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). Only the expression of HAS-2 and HAS-3 mRNA could be detected. The level of HAS-2 mRNA expression was about 10 fold higher than that of HAS-3. HAS-2 specific antisense oligonucleotide was then transfected into cultured HPMCs by lipofectamine. After 0, 8, 24, and 48 hours, the expression of HAS-2 mRNA was detected by RT-PCR and the extracellular coat was measured by particle exclusion test. Results 8 hours and 24 hours after transfection, the expression of HAS-2 mRNA in HPMCs decreased by 58% and 89% respectively; 48 hours after transfection, the expression of HAS-2 mRNA in HPMCs partially restored to 25% of the normal level. Correspondingly, 24 hours after transfection, the extracellular matrix/extracellular coat in HPMCs almost completely disappeared. However, as control, sense and reverse oligonucleotides showed no effect. Conclusion HAS-2 plays a leading role in HPMCs hyaluronan synthesis and the formation of extracellualr matrix/extracellular coat.