Objective To investigate the relationship of the clinical characteristics and the Oxford classification of IgA nephropathy.Methods Clinical presentation (age,gender,course of disease,blood pressure,hematuria,24-hour proteinuria,serum creatinine,serum albumin,triglyceride,cholesterol,and estimated glomerular filtration rate (eGFR)),pathological data (mesangial hypercellularity,endocapillary hypercellularity,segmental sclerosis or adhesions,tubular atrophy or interstitial fibrosis,artery score,and cellular + fiberocellular crescents) and their correlation of 192 patients with IgA nephropathy patients were analyzed.Results (1)Clinically,hematuria + albuminuria type was the most common among 192 the patients with IgA nephropathy (72 cases,37.5％) followed by nephrotic syndrome (42 cases,21.9％),renal insufficiency (29 cases,15.1％),hypertension (72 cases,37.5％).(2)M1 was 60.0％,E1 was 55.2％,S1 was 46.9％,T0,T1,T2 were 59.9％,22.9％,and 17.2％,respectively,small artery thickening was 46.9％,patients with cellular + fiberocellular crescents wais 48.5％.Some pathology features were related to age.(3)Proteinuria was associated with the mesangial hypercellularity score,endocapillary hypercellularity,segmental sclerosis or adhesions,and tubular atrophy or interstitial fibrosis and cellular + fiberocellular crescents.Blood pressure and renal function were associated with segmental sclerosis or adhesions,tubular atrophy or interstitial fibrosis,small artery thickening and cellular + fiberocellular crescents.Conclusions The Oxford classification has a good clinical guide of treatment and prognosis of IgA nephropathy.

Objective To observe the clinical effects and safety degree of treating children's cough variant asthma for mite allergy with Montelukast sodium combined with Flixotide. Methods Forty cases of infant patients with cough variant asthma for mite allergy in Guangzhou Women and Children's Medical Center from February 2012 to Octo-ber 2013 were taken as research subjects and randomly divided into treatment group and control group,each group 20 cases. The control group was treated with Flixotide aerosol;the treatment group took extra medicine Montelukast sodium chewable tablets. The treatment period covered half a year. After treatment both groups were observed for 3 months. During the treatment period the recovery process of clinical symptoms and adverse reaction of all the infant patients were observed and recorded. The data was analyzed with statistical software SPSS 17. 0. Results The duration of cough im-proved and solved in treatment group in the acute phase was(5. 82 ± 0. 90)d,much shorter than that of the control group[(6. 54 ± 1. 30)d],and the difference was of statistical significance(P ﹤ 0. 05). In the procedure,4 times of cough scores of treatment group[(3. 90 ± 0. 90)scores,(0. 90 ± 0. 30)scores,(0. 70 ± 0. 30)scores,(1. 90 ± 0. 70) scores]declined apparently more than those of control group[(4. 10 ± 0. 70)scores,(1. 20 ± 0. 40)scores,(1. 30 ± 0. 50)scores,(2. 40 ± 0. 80)scores];the difference was of statistical significance(all P ﹤ 0. 05);and the both were rebounded after 3 months without medicine. In terms of pulmonary function PD20,the patients in treatment group [(0. 46 ± 0. 08)mg vs(1. 76 ± 0. 07)mg]showed better improvement than those in control group[(0. 46 ± 0. 07) mg vs(1. 70 ± 0. 07)mg],and the difference was of statistical significance(P ﹤ 0. 05). Conclusions Treating chil-dren's cough variant asthma for mite allergy with Montelukast sodium combined with Flixotide is of good therapy effect in the acute phase and the control phase,worthy of further clinical application.

Objective To investigate the effects of vitamin E (VE) on renal ischemia/reperfusion (I/R) injury of rats.Methods A total of 18 male Wistar rats were randomly divided into sham-operated group,I/R group,VE + I/R group,and each group of 6 rats.All the animals were killed at the end of 24 h of reperfusion.Nephridial tissue were examined by light microscopy,and the level of blood urea nitrogen(BUN) and serum creatinine (SCr) were measured.The protein expressions of tumor necrosis factor α (TNF-α) were detected by Western blotting.Results Compared with sham-operated group,tubulointerstitial pathological injury in I/R group was significantly aggravated,which was shown by HE and PAS stain.Compared with I/R group,the degree of morphological changes as well as renal dysfunction in VE + I/R group were obviously lessened.Meanwhile,the levels of BUN,SCr in I/R group,VE + I/R group were (10.13 ± 2.14) mmol/L and (7.67 ± 1.63) mmol/L,(80.33 ±7.15) μmol/L and (63.67 ±5.40) μ mol/L,significantly higher than those in shamed-operated group ((3.85 ± 0.21) mmol/L,(48.67 ± 3.61) μmol/L;P ＜ 0.05).And the level of BUN and SCr in VE + I/R group were significant lower than those in I/R group(P ＜0.05).Western Blotting showed that the protein expressions of TNF-α in VE + I/R group were obviously lower compared with those in group of I/R without VE treatment (P ＜ 0.05).Conclusion Vitamin E can attenuate over-expressions of TNF-α in kidney following I/R,thus protect against structural damages and renal dysfunction in I/R rat models.

Objective To raise the awareness of acute kidney injury (AKI) and improve the level of diagnosis.Methods All the hospitalized adult patients in the Affiliated People's Hospital of Shanxi Medical University from January 2012 to July 2013 were screened.Those patients diagnosed as AKI were retrospectively analyzed in terms of incidence,the rate of missed diagnosis,etiology,distribution and prognosis of AKI.Results (1) The incidence of AKI in the patients was 0.67％ (381/56 835),the ratio of male to female was 1.91 ∶ 1,and the average age was (63.45±16.95) years.(2)There were 321 cases diagnosed as pre-renal AKI (84.25％),42 cases diagnosed as renal AKI (11.02％) and 18 cases diagnosed as post-renal AKI (4.72％).(3)There were 189 cases(49.61％) missed diagnosed among all the screened cases.The rates of missed diagnosis in neurosurgery,general surgery and cardiac surgery department was 62.96％,59.09％ and 50.00％,in cardiology,respiratory and neurology department was 50.00％,50.00％ and 45.45％ respectively.(4) Multivariate Logistic regression analysis showed that hypertension [odds ratio(OR)=1.631],renal replacement therapy(RRT)(OR=23.256) and oliguria history (OR=1.936) were independent risk factors of missed AKI diagnosis.Conclusion The missed diagnosis rate of AKI is high and has certain characteristics in different departments.Hypertension,RRT and oliguria history are independent impact factors of missed AKI diagnosis.

Objective To investigate the pathological characteristics of lymph nodes,liver and bone morrow in adult-onset still' s disease (AOSD).Methods The clinical data of three AOSD patients were collected and their biopsy of enlarged lymph nodes,liver and bone marrow were analyzed by histology and immunohistochemistry.Results In AOSD lymphadenopathy,there were high lymph node hyperplasia,partial architecture damage and an intense paracortical hyperplasia along with diffused infiltration of large immunoblasts,activated lymphocytes,Langerhans cells,histocytes,neutrophils and chronic inflammatory cells.Bone marrow biopsy showed a significant increase in the proportion of granulocytes and erythrocytes,with apparently increased segmented neutrophils.Hepatic biopsy showed hepatocellular spotty necrosis.Meanwhile,there was some infiltration of lymphocytes and neutrophils in the periportal fibrosis area.Immunohistochemical staining showed CD21 expression in lymphoid follicle remnants and B cell markers with few T markers in most of immunoblasts.Conclusion The pathological characterizations of lymph nodes,liver and bone marrow provide important clues to the diagnosis of AOSD as well as its differential diagnosis.

Four different strains of Leptospira were subcultured in CGM in contrast with in Korthof medium for three years. The antigenic components of these Leptospira grown in the two medium were analysed by the methods of MAT, CIE and SDS-PAGE. The results showed that:1, the antigenic components of Leptospira were very complex and had more than twenty bands stained with Coomassie brilIiant blue in SDS-FAGE pattern; 2. the antigenicity of Leptospira subcultured in CGM for many generations was relative stability and the same as that in Korthof medium.

Objective To assess the efficacy of different sequential therapy regimens according to the theory of cell cycle on adriamycin-induced nephropathy (AIN) rats. Methods SD rats were randomly divided into five groups:control group (n=8),AIN model group (n=8),MP+ CsA+MMF group (n=8),MP+CsA+CTX treated group (n=8) and MP+FK506+Rapa group (n=8).The levels of 24-hour urinary protein,serum total protein (TP),albumin (Alb),cholesterin (Chol),triglyeride (TG),serum urea nitrogen (BUN),serum creatinine (Scr) were measured.The renal pathological changes were observed by light microscope.The expressions of nephrin and podocin were analyzed by immunohistochemistry and real-time PCR.The expression of CTGF was detected by Western blotting. Results (1)Compared with control group,the levels of 24-hour urinary protein in AIN model group were obviously increased at 2nd,4th,8th and 12th week (all P＜0.01).The level of 24-hour urinary protein were obviously decreased in treatment groups at 8th and 12th week than those in AIN model group (all P＜0.05). (2)The levels of TP and Alb were significantly lower in AIN model group than those in control group (all P＜0.01),and the levels of TG and Chol were significantly higher in AIN model group than that in control group (all P＜0.01).The levels of TP and Alb were significantly higher and the levels of TG and Chol were significantly lower in treatment groups than those in AIN model group (all P ＜0.05). (3)The results of immunohistochemistry indicated the expressions of nephrin and podocin in treatment group rats were obviously higher than those in AIN model group (all P＜0.01). (4)The results of Western blotting indicated the expression of CTGF in treatment group rats was higher than that in AIN model group (P＜0.05).The effect of inhibitting fibrous degeneration in MP +FK506 +Rapa group was more greater than other treatment groups. Conclusions Sequential combined regimens according to the cell cycle can improve the pathological change in adriamycin-induced nephropathy rats,reduce the urine protein,increase the levels of TP and Alb,decrease the levels of TG and Chol,increase the expression of nephrin and podocin,and ameliorate kidney fibrosis.

Objective To construct eukaryotic expression vector encoding rat IMD gene and deliver it into rat renal tissue via ultrasound-mircobubbles. Methods IMD gene was inserted into pCDNA3.1 ( + )between Hind Ⅲ and EcoRI enzyme sites. The recombinant plasmid designated as IMD-pCDNA 3.1 wasconfirmed by restrictive enzyme digestion and sequencing. Eighteen male Wistar rats were randomized into 3groups, which were treated with no transfection, empty vector transfection and IMD transfection, respectively, in renal tissue via ultrasound-microbubbles. RT-PCR and Western blotting were applied to detect the expression level of IMD. Results Enzyme- digestion and sequencing data showed that IMD-pCDNA 3.1 was correctly constructed. The differences in ALT, AST, BUN and SCr were not significant; No obvious damage in the glomerular, tubular and interstitial was observed in all the treated groups;Compared with non-transfection group and empty vector-transfection group, IMD mRNA and protein expression in IMD transgenic renal tissue were significantly increased. Conclusion IMD-pCDNA 3.1 expression vector was successfully constructed and well expressed in rat kidney.

Objective To investigate the expressions of intermedin /adrenomeduliin 2 (IMD/AM2) and its receptor calcitonin receptor-like receptor (CRLR) in the kidney of rats after renal ischemia reperfusion injury(IRI). Methods Male Wistar rats were divided randomly into two groups: sham group and operation group. Renal IRI model was induced by clamping both renal arteries. Blood and kidney were harversted at 0 h, 6 h, 12 h, 24 h, 48 h, 72 h after reperfusion, respectively. Renal histological changes were semi-quantitated. Expressions of IMD and CRLR in the kidney were detected by Western blot, and the content of IMD in serum was measured by radioimmunity at 12 h, 48 h, 72 h after repeffusion. Results Kidneys of renal IRI model rats displayed significant pathologic changes, and the changes were much severer at 48 h after reperfusion. The expressions of IMD and CRLR in kidney were significantly up-regnlated at 12 h, 48 h, 72 h after renal IRI (P<0.01). The level of IMD in serum increased at 12 h, 48 h, 72 h after renal IRI (P<0.05). Conclusion The expressions of IMD and its receptor are up-regulated in the kidney after renal IRI, which may participate in the pathophysiological changes induced by renal IRI.

Objective To investigate the effect of intermedin (IMD) on renal ischemia/ reperfusion (I/R) injury after the up-regulation of IMD. Methods A total of 24 healthy Wistar male rats were randomly divided into four groups,sham-operated group,I/R group,IMD gene transfection +I/R group and empty plamid +I/R group.All the animals were killed at the end of 24 h of reperfusion.Histological changes and renal function were estimated.The expression and site of IMD were determined by Immunohistochemistry method,semi-quantitative RT-PCR and Western blotting.The protein expressions of endothelin 1 (ET-1),tumor necrosis factor αt (TNF-α) were detected by Western blotting. Results Compared with sham-operated group,tubulointerstitial pathological injury was significant aggravated in I/R group (7.6±2.3) and empty plamid +I/R group (7.0±1.8),and such injury was improved in IMD+I/R group (1.5±0.8) (P＜0.05).Compared with I/R group and empty plamid +I/R group,the renal dysfunction of IMD +I/R group was obviously lessened [BUN:(7.73±1.03) mmol/L vs (10.13±2.14) mmol/L,(9.77±1.92) mmol/L; Scr:(58.50±3.27) μmol/L vs (80.33±7.15) μmol/L, (75.67±7.58) μmol/L,all P＜0.05].IMD expression was weak in the plasma of tubulointerstitial cells in sham-operated group,and was up-regulated in I/R group. Compared with I/R group, immunohistochemical IMD expression increased obviously (262.03±67.89 vs 175.57±48.06,P＜0.01).The mRNA expression of IMD in IMD+I/R group was up-regulated significantly by 60.7％,66.1％ and the protein expression of IMD in IMD+I/R group increased significantly by 51.4％,55.9％ as compared to I/R and empty plasmid +I/R group.Meanwhile,the protein expressions of ET-1 and TNF-αt in IMD+I/R group were obviously lower compared with those in I/R group (ET-1:0.08±0.02 vs 0.17±0.02; TNF-α:0.21±0.04 vs 0.35± 0.02,all P＜0.05). Conclusion IMD gene transfected into kidneys of rats prior to I/R surgery can attenuate the over-expressions of both ET-1 and TNF-o in I/R injured rat kidneys as well as the damages to the structure and function of the kidneys.