OBJECTIVE: To investigate the effect of high glucose on the expression of c-met in human kidney fibroblasts in vitro, and to explore the regulation of Radix Astragali. METHODS: A cell culture system of human kidney fibroblasts was developed in vitro. The human kidney fibroblasts were divided into normal control group, high glucose group and mannitol group. Expressions of c-met and transforming growth factor-beta1 (TGF-beta1) mRNAs were detected by reverse transcription polymerase chain reaction (RT-PCR) and the expressions of c-met protein were analyzed by Western blot method after 6-, 12-, 24-, 48- and 96-hour culture. The human kidney fibroblasts were also cultured with 10% Radix Astragali containing serum; the expressions of c-met mRNA and protein were detected after 24- and 48-hour culture. RESULTS: Compared with the normal control group, expression of c-met mRNA in the high glucose group was significantly increased after 12-hour culture (P<0.05), arriving at the peak after 24-hour culture (P<0.01). The level of TGF-beta1 mRNA was higher in the high glucose group than that in the normal control group after 24-hour culture (P<0.05), arriving at the peak after 96-hour culture (P<0.01). Forty-eight hours after treating with 10% Radix Astragali containing serum, the levels of c-met mRNA and protein in fibroblasts were increased, and were higher than those in the high glucose group (P<0.01, P<0.05). CONCLUSION: High glucose can induce the expressions of c-met mRNA and protein in earlier period, and then inhibit the expressions. Radix Astragali can up-regulate the expressions of c-met mRNA and protein of human kidney fibroblasts, which may be one of its action mechanisms in delaying the progression of diabetic nephropathy.

Objective To examine the expression of hepatocyte growth factor(HGF) receptor (c-met) and investigate the changes in activity of the HGF/c-met system in human kidney fibroblast by high glucose. Methods HGF and c-met mRNA levels in fibroblast induced by high glucose were detected by RT-PCR. C-met protein was examined by Western blotting. At the same time, the expression of TGF-? and c-met in the exogenous HGF and treating with anti-c-met antibody in vitro were measured. Results Extremely rapid induction of HGF and c-met mRNA was observed at the first six hours by high glucose. On the other hand, both c-met mRNA and c-met protein were markedly increased. HGF (50 ng/ml) induced the expression of c-met ( P

OBJECTIVE: To investigate the impact of environment and message information for the treatment efficacy of children with allergic rhinitis (AR). METHOD: To choose 100 cases of children diagnosed with AR. The parents of children record daily symptom scores of AR of children everyday. While the doctors send the short message to the parents by using meteorological environment warning forecast technology to tell the parents the risk of AR attacks. We observe the morbidity of AR of the children and the treatment efficacy of children for 1 year. The 100 cases control group children diagnosed AR, their parents do not record daily symptom scores of AR and the doctors do not give the short message. We also observe the morbidity of AR of the control group children and the treatment efficacy of the children for 1 year. RESULT: The 100 cases intervention group children with AR, there are 11 cases refused to participate the group. We included a total 89 cases, 74 cases of children did a full year of intervention, 15 cases of children gave up. The control group 100 cases, nine cases refused to participate, 91 cases were included. The average episodes in the intervention group was 4. 67 times, the control group was 8. 12 times,--there were significant differences between the groups statistically. The execution rate on the prescribed clinic date in the intervention group visits was 91. 5%, while in the control. group, was only 67%. The compliance of parents of children to complete course of medication in the intervention group was 95. 6%, while the control group was 74.1%. Both sets of data are statistically significant differences. The children with sinusitis in intervention group was 26.97%, significantly lower than the 64.04% in the control group. The incidence in the intervention group and the control group of secretory otitis media was 8.99% and 6.60%, there was no statistically significant differences. CONCLUSION It can significantly increase the degree of attention of parents of children with AR that the parents of children record daily symptom scores of AR of children everyday, while the doctors send the short message to the parents by using meteorological environment warning forecast technology to tell the parents the risk of AR attacks. It can also improve the execution rate on the prescribed clinic date and improve compliance of parents of children to complete course of medication. It can significantly reduce seizure frequency and severity of episodes of AR, thereby improving the quality of life of children with AR, reduce the economic burden on families and society.
Child ; Humans ; Parents ; Quality of Life ; Rhinitis, Allergic ; prevention & control ; therapy ; Sinusitis ; Text Messaging ; Treatment Outcome

Objective To observe high glucose induced expression of hepatocyte growth factor (HGF) and c met in human kidney fibroblast. Methods The effects of glucose concentrations on expression of HGF, c met and plasminogen activator inhibitor (PAI) 1 in cultured human kidney fibroblasts were observed by RT PCR. In the same system, the effect of exogenous HGF on the expression of PAI 1 was investigated. Results Human kidney fibroblasts cultured in high glucose concentration (25 mmol/L) showed higher HGF and c met expressions in the early stage and then manifested a gradient decrease of HGF and c met expressions, but PAI 1 expression was gradiently increased. Exogenous HGF resulted in inhibiting PAI 1 expression. Conclusion HGF is a potential anti fibrogenic factor and activates matrix degradation pathways in diabetic kidney by reducing PAI 1 expression.

OBJECTIVE: To analyze the possible effects of meteorological and environmental factors on the subjective symptoms of allergic rhinitis (AR) in children. METHOD: According to the daily subjective symptom records in AR children, the relationship between the subjective symptoms of AR in children and the meteorological environmental factors was analyzed. Mixed model was used to analyze the data. RESULT: The temperature and humidity had a negative correlation with symptoms score. Every 1 degrees C of temperature decrease was linked to 0.04 points increase in subjective symptoms scores (P < 0.01). Every 10% e in humidity decrease was linked to 0.04 points increase in subjective symptoms scores (P < 0.05). There was positive relationship between PM2.5, PM10 and symptom scores. Every 10 μg/m3 increase of PM2.5 or PM10 was linked to 0.02 (P = 0.0246) or 0.03 (P = 0.0293) points increase in subjective symptoms scores, indicating that air pollution could aggravate the symptoms of children in AR. CONCLUSION It suggested that higher temperature and higher humidity may induce lower sympotem while PM2. 5 and PM10 may induce higher sympotem in AR children.
Air Pollution ; Child ; Humans ; Humidity ; Rhinitis, Allergic ; physiopathology ; Temperature

ObjectiveTo investigate the outcome and risk factors for kidney involvement by analyzing 64 patients with anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis.MethodsData analyzed including the demographic information,survival status,renal survival status and laboratory parameters such asserum albumin level,serum creatinine level,urinary protein excretion level,hematuria,high sensitivity C-reactive protein(CRP),ANCA titer,and the Birmingham vasculitis activity score (BVAS).Logistic regression analysis,Cox regression analysis and ROC curve were used to evaluate the risk factors of patients with renal involvement and all-event survival.ResultsTotally 64 patients were enrolled [24 females with the average age of (59.9±2.0) years] and followed up for a median of (38±16) months.The morality rate was 14％,and the prevalence of end stage renal disease was 39％.Compared with those who had better outcomes,patients who died or with end stage renal disease had higher serum creatinine level [ (624±246),(245±127 ) μ mol/L,respectively,t=7.17,P＝0.005 ] and erythrocyte sediment rate [ (112±24),(76±48) mm/1 h,respectively,t=3.74,P＜0.01 ],but lower serum albumin level [(294±31 ),(316±42) g/L,respectively,t=-2.27,P=0.01 ] and hemoglobin level [ (79±13),(99±33) g/L,respectively,t=-3.23,P＜0.01 ] at baseline.Logistic regression analysis found that serum creatinine level and erythrocyte sediment rate at baseline were associated with poor outcome and Cox regression analysis further confirmed this result[Scrβ=1.004,95％CI1.002～1.006,P＜0.01; ESR β=l.018,95％CI 1.000～1.037,P=0.046].ROC curve analysis showed that serum creatinine and erythrocyte sediment rate were predictors for AAV patients' prognosis and their AUC were 0.95 and 0.80,the sensitivity of these parameters was both 94％,and the specificity was 93％ and 70％respectively.ConclusionThe intensity of initial treatment should be based on disease severity and activity in order to improve the prognosis of those with ANCA-associated vasculitis with renal involvement.Increased serum creatinine and erythrocyte sediment rate may serve as predictors for poor prognosis in this patient cohort.

Objective To investigate the stroke occurrence of chronic kidney disease (CKD) and its related factors, especially the carotid atherosclerosis. Methods The data of stroke occurrence in 700 CKD patients hospitalized in Renji Hospital during 2007 were analyzed retrospectively. The incidences of stroke were compared among CKD [Ⅰ-Ⅱ, CKD Ⅲ-Ⅴ non-dialysis patients and dialysis patients. Carotid atherosclerosis of 409 CKD patients was examined by color Doppler ultrasound. The related factors were selected by Spearmnan correlation analysis and Logistic regression analysis. Results Of 700 CKD patients, 67 cases (9.57%) experienced at least one episode of stroke, which was much higher than that of general population. The related factors of stroke in CKD included GFR, age, SBP, CRP, Lpa, serum glucose, pre-albumin, HDL and carotid atherosclerosis. Logistic regression revealed that SBP (β=1.021, P=0.042), CRP (β=1.008, P=0.024) and carotid atherosclerosis (β =3.456, P=0.025) were risk factors of stroke in CKD. Incidence of carotid atherosclerosis was high (50.37%) in CKD patients, besides it was significantly higher in CKD patients with stroke history as compared to those without stroke history (80.0% vs 47.4%, P<0.01). Conclusions The incidence of stroke is quite high in CKD patients, which is closely associated with hypertension, inflammation and glyeolipid metabolism disorder. Carotid atherosclerosis is common in CKD patients with stroke, which may be helpful in screening cerebrovascular diseases in CKD patients.

Objective To differentiate proteinuria due to non-diabetic renal diseases(NDRD)from that of diabetic nephropathy(DN)in type 2 diabetic patients,and to evaluate the prevalence of NDRD.Methods A retrospective analysis was performed on diabetic patients who had undergone renal biopsy between Jan 1,2003 and Dec 3 1,2006.The data including history of diabetes,cardiac color ultrasound,color Doppler ultrasound of the carotid artery,retinal changes,examination of ocular fundus,giomerular filtration rate,hepatic and renal function,lipid profile,blood glucose,HbA1c,and urine protein were collected.Results Among 46 patients,22 cases (47.8%)were distinctly diagnosed as diabetic nephropathy(DN),while the other 24(52.2%)as NDRD.Focal segmental glomeruloselerosis Was the most common lesion found in patients with NDRD.In DN group,the fasting blood glucose was higher than that of NDRD group,as well as ejection fraction,carotid plaque,and intimamedia thickness(IMT)showed significant differences between 2 groups.Patients with NDRD were less frequently associated with diabetic retinopathy.Diabetic retinopathy showed hiigh sensitivity(72.7%)and specificity (91.7%)in diagnosing DN.Conclusions Blood glucose,ejection fraction,carotid plaques and IMT,and retinopathy may be helpful in differential diagnosis of diabetic patients with overt proteinuria.Renal biopsy is an important step lo establish the diagnosis.

Objective To evaluate the value of immunofecal occult blood test (IFOBT) as a prognostic indicator in CKD patients with colorectal impairment.Methods A total of 176CKD patients and 180 healthy adults as control were enrolled.Serum biochemistry was measured at baseline and gastrointestinal bleeding was determined by IFOBT.All the CKD patients were followed up for 4.5 years.Renal replacement therapy or death was defined as end-point event.The Logistic regression analysis was used for risk factors.Kaplan-Meier analysis and COX regression model were used for survival analysis.Results The positive rate of IFOBT in CKD patients was significantly higher than healthy control (17％ vs 5.3％,χ2=13.236,P＜0.01).When comparing with IFOBT negitive patients,IFOBT positive patients were older [(62.030±15.544) years old vs (48.660±19.018)years old,P＜0.01],had higher ESR [(71.800±31.657) mu/h vs (57.210±32.712) mm/h,P＜0.05],C-reactive protein [6.230 (3.000～14.148) mg/L vs 3.000 (3.000～6.833)mg/L,P＜0.05],serum creatinine [419.100 (103.200～546.625) μmol/L vs 175.100 (68.150～462.950) μmol/L,P＜0.05],and had lower hemoglobin level [(97.970±20.590) g/L vs (107.170±27.988) g/L,P＜0.05] and eGFR [11.400 (8.671～53.544) ml·min1·(1.73 m2)1 vs 35.274(10.961～82.145) ml·min-1·(1.73 m2)-1,P＜0.01].There was a negative correlation between IFOBT value and eGFR in CKD patients (r=-0.20,P＜0.01).Positive correlations of IFOBT value with age (r=0.175,P＜0.05) and serum creatinine (r=0.171,P＜0.05) were found.Logistic regression and COX regression analysis showed that IFOBT value,eGFR and ESR were important factors that influenced the prognosis of CKD patients.Kaplan-Meier analysis revealed that IFOBT value ＞100μg/L predicted progression of renal function.Conclusions The prevalence of gastrointestinal bleeding disorder is high in patients with CKD.Value of IFOBT independently predicts decline in renal function of CKD patients.

Objective To evaluate the values of urinary liver-fatty acid binding protein (uL-FABP) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) in diagnosis of acute kidney injury (AKI) caused by obstructive nephropathy and in the prediction of renal prognosis.Methods Clinical data of 30 patients with obstructive nephropathy were collected prospectively.uL-FABP and uNGAL were measured by ELISA at various time points.Risk factors of the renal outcome were evaluated.The patients were followed up for at least one year.Results Patients with AK1 had higher levels of uL-FABP and uNGAL compared to those without AKI [700.00(154.62-1216.14) μg/g· Cr vs 26.90 (16.77-41.38) μg/g·Cr; 1266.69 (671.57-3396.07) μg/g·Cr vs 179.12 (90.98-215.16) μg/g·Cr,all P ＜ 0.01].Positive correlations of uL-FABP and uNGAL with serum creatinine were found (r =0.552,0.553,all P ＜ 0.01).The AUCs of uL-FABP and uNGAL to detect AKI were 0.925 and 0.900.Patients with non complete renal recovery had higher levels of uL-FABP before operation and 72-hour after operation compared to those with complete renal recovery (all P ＜ 0.01).Before operation,the AUC of uL-FABP to detect renal prognosis was 0.948,sensitivity was 85.7％ and specificity was 90.9％.72-hour after operation,the AUC of uL-FABP to detect renal prognosis was 0.935,sensitivity was 85.7％ and specificity was 90.9％.Kaplan-Meier analysis revealed that uL-FABP before operation over 366.57 μg/g · Cr or uL-FABP 72-hour after operation over 223.60 μg/g · Cr were closely related to the poor progression of renal function.Conclusions uL-FABP and uL-NGAL have good accuracy in detecting AKI.The level of uL-FABP before operation and 72-hour after operation is helpful to predict the renal outcome of obstructive nephropathy.