Objective To investigate the concentration changes and clinical significance of hepatocyte growth factor (HGF) during the development of acute kidney injury (AKI). Methods The serum concentrations of HGF in 62 patients with AKI were measured every two days, and the relation between HGF and glomerular filtration rate (eGFR) ,the renal failure index,course of diseases,numbers of viscera injury,and short-term prognosis were an-alyzed. Results The serum concentrations of HGF were progressively rising along with the course of diseases and the amount of viscera injury (P=0.000), reached peak at the 9th day, and then decreased, which was was elevated in the death group than renal function failure group, but which in the latter group was elevated than in renal function recovery group (P<0.05 for each). AKI with liver injury patients were obviously higher than without liver injury pa-tients(P<0.05 for each). The serum concentrations of HGF were positively correlated with the renal failure index (r=0.580～0.821) but negatively correlated with eGFR(r=-0.943～-0.703) (P<0.05 for each). Conclu-sion The serum concentrations of HGF are abnormally rising in the patients of AKI ,which reflects the state of dis-ease and short-term prognosis of AKI.

Objective To observe the mechanism of elevated parathyroid hormone(PFH) leading to erythrocytes life span shortened in the patients with chronic kidney disease(CKD).Methods Serum samples of 30 healthy people and 75 CKD patients were collected.Patients were divided into three groups according to their renal function.Intact parathyroid hormone(iPTH)was detected by immunochemiluminometry.The erythrocytes phosphatidylserine (PS) exposure and intracellular calcium concentration ([Ca2+]i)were measured by flow cytometry. Results (1)Levels of serum iPTH,[Ca2+]i and erythrocytes PS exposure increased gradually with the decline of renel function in stages 3 to 5 of CKD,the differences were significant with CKD 1 to 2 stages and healthy control group(all P＜0.05).(2)Pearson correlation analysis revealed,during CKD 3 to 5 stages,Hb was negatively correlated with iPTH and erythrocyte PS exposure respectively (r=-0.830 and-0.791,all P＜0.01);iPTH was positively correlated with[Ca2+]i and erythrocyte PS exposure (r=0.882 and 0.924,all P＜0.01),whereas negatively correlated with serum Ca respectively(r=-0.544,P＜0.01);erythrocyte PS exposure was positively correlated with[Ca2+]i(r=0.923,P＜0.01)and not correlated with serum Ca(r=-0.138,P=0.365).(3)The linear regression equation of[Ca2+]i(Y)for iPTH(X)was Y=3.327+0.213X(F=21.529,P＜0.05).The multiple linear regression equation of erythrocytes PS exposure(Y)for PTH (X1)and[Ca2+]i(X2)was Y=-0.303+0.283X2+0.139X1(F=6.59,P＜0.01). Conclusions By increasing intracellular calcium,iPTH can lead to an increase of the erythrocyte PS exposure.which will cause the occurrence of erythrocytes life span being shortened.As a result,the renal anemia will become more severe.

Objective To investigate the effects of long-term glucocorticoid therapy on bone mineral density(BMD) in the patients with glumerulose disease. Methods 41 patients with glumerulose disease were prospectively studied. The BMD of lumbar spine (L 2-4 ) and femur was measured using dual-energy X-ray absorptiometry at base line, and at every 3 to 6 months interval after receiving glucocorticoid therapy. Vitamin D receptor (VDR) gene polymorphism was detected using PCR-RFLP. Results ⑴ Every measured site BMD decreased(29 9～83 8)mg/cm 2 after 15-month administration of glucocorticorids, and BMD decrease in L 2-4 and femoral trochanter was significantly greater (P

Objective To investigate the clinicopathological relation between the TNF-? and IgA nephropathy. Methods TNF-? levels in serum, urine and renal tissues of 50 patients with IgA nephropathy were measured, and 10 patients with minimal change nephrotic syndrome(MCNS) and 10 healthy subjects served as negative control group. Results The serum and urine levels of TNF-? in the patients with IgA nephropathy were significantly higher than those in the patients with MCNS and healthy subjects, and had a significant positive correlation with the degree of proteinuria and renal demage. TNF-? expression was mainly localized in the cytoplasm of the proximal renal tubular epithelial cells, and the interstitium with more monocyte-macrophages infiltration. Conclusion TNF-? took part in the onset of hematuria and proteinuria, was correlated with the degree of renal damage, and played an important role in the aggravation of IgA nephropathy.

AIM: To determine the dissolution of Longdan Xiegan Pills(Radix et Rhizoma Gentianae,Radix Scutellariae,Fructus Gardeniae,etc.) on the basis of markers such as gentiopicroside,baicalin and geniposide. METHODS: According to Appendix ⅩCⅢ of Chinese Pharmacopoeia 2005 edition VolⅡ,dissolution medium was 100 mL 0.5% SDS aqueous solution and rotating speed was 100 r/min.The dissolution solution of pill was taken and analyzed by HPLC method.A column of Kromasil C_(18)(4.6 mm?250 mm,5 ?m) was used.The mobile phase composed of A acetonitrile,B 1% glacial acetic acid aqueous solution,gradient eluation.The flow rate was 1.0 mL/min with the detection wavelength at 254 nm. RESULTS: The average dissolution of three batches of gentiopicroside,baicalin and geniposide exceeded the marker amount by factor of 0.75 time in 4 h. CONCLUSION: A reliable and qualitative method is established with good reproducibility for determination of dissolution of Longdan Xiegan Pills.

Objective To evaluate the efficacy and safety of different doses of prednisone combined with cyclosporine A(CSA) on the treatment of idiopathic membranous nephropathy (IMN). Methods The data of 64 patients with nephrotic syndrome (NS) diagnosed as IMN by renal biopsy were retrospectively analyzed. Median follow?up time was 10 (7, 19) months. The subjects were divided into 2 groups according to different prednisone dosage. Thirty?two cases were in the low?dose group:prednisone 0.15 mg·kg-1·d-1+CSA, and 32 cases in the moderate?dose group:prednisone 0.4?0.5 mg· kg-1·d-1+CSA. Clinical and laboratory data were collected at baseline, 1, 3, and 6 months after treatment. During follow?up, cumulative recurrence rate and adverse reactions after treatment were recorded. Results Serum albumin (sALB) were significantly increased and 24 h urinary protein (24hUP) significantly decreased after treatment for 1, 3, 6 months compared with baseline data in the two groups. Serum creatine (Scr) increased after treatment with time. The elevation of sALB and the reduction of 24hUP in the moderate?dose group were higher than that of low?dose group at 6 months after treatment (P<0.05). The effective rate of the low?dose and moderate?dose group was 65.6% and 87.5% at 6 months after treatment, respectively (χ2=4.267, P=0.039). Comparison of different doses of CSA in two groups at 6 months after treatment, in low?dose group: the effective rates of CSA<3 mg· kg-1·d-1 and >3 mg·kg-1·d-1 subgroup were 76.5% and 53.3%, respectively (P=0.296); In moderate?dose group:the effective rates of CSA<3 mg·kg-1·d-1 and>3 mg·kg-1·d-1 subgroup were 89.5%and 84.6%, respectively (P=0.077); there were similar effects in patients treated with different dose CSA in the two groups. About 20.4% of the total patients relapsed when followed up for 18 months (low dose group vs moderate?dose group: 9.5% vs 28.6%, P=0.136), which most occurred after prednisone withdrawal or during the reduction of cyclosporine. Renal function decreased in 57.8% patients (low dose group vs moderate?dose group:50%vs 65.6%), mainly in the elderly (9/11) and the long course of treatment of CSA. There was no significant difference on adverse reactions between the two groups (P>0.05). Renal function in patients with high Scr or high blood trough concentration of cyclosporine was difficult to fully recover. Conclusions Remission rate is lower in low?dose prednisone combined with cyclosporine than the moderate?dose group in the treatment of IMN for 6 months. The recurrence rate of IMN or the incidence of adverse reactions are similar between the two groups. Induction therapy of IMN with cyclosporin<3 mg·kg-1·d-1 is safe and effective. The incidence of renal function reduction in the elderly is high, and the renal function is difficult to restore in patients with Scr exceeding normal upper limits.

Objective To explore the clinical efficacy and safety of modified Ponticelli regimen in treating patients with idiopathic membranous nephropathy (IMN).Methods A retrospective analysis was performed in 90 patients with IMN (type Ⅰ / Ⅱ,79/11 respectively) diagnosed by clinical data and renal biopsy.The patients were divided into modified Ponticelli group (n =23),steroid plus cyclophosphamide (CTX) (CTX group,n =39) and steroid plus cyclosporine A(CsA) (CsA group,n =28) according to the treatment.Liver function,renal function,serum lipid,proteinuria were recorded before and after treatment.Efficacy and adverse reactions were evaluated in three groups.Results (1) In all three groups,the quantity of proteinuria after treatment for 3 months [(3.33 ± 1.53) g/d,(4.70 ± 2.97) g/d,(3.92 ± 2.57) g/d],6 months [(1.60 ± 1.10) g/d,(2.34 ± 1.61) g/d,(2.25 ± 1.78) g/d] was significantly decreased compared with baseline level[(7.26 ± 2.06) g/d,(7.50 ± 2.55) g/d,(7.54 ± 2.70) g/d;P ＜ 0.05].Serum albumin levels at 3 months [(31.42 ± 3.86) g/d,(30.59 ± 5.79) g/d,(30.90 ± 7.87) g/d],6 months [(36.25 ± 4.20) g/d,(34.70 ± 6.70) g/d,(35.36 ± 8.29) g/d] were significantly increased compared with baseline levels [(24.13 ± 2.61) g/d,(23.98 ± 3.79) g/d,(22.94 ± 4.57) g/d;P ＜ 0.05],whereas serum creatinine at 3 and 6 months had no significant changes (P ＞ 0.05).(2) After treatment for 3 months,partial remission rates in modified Ponticelli group,CTX group and CsA group were 39.1％,35.9％,35.7％ respectively and complete remission rates were 8.7％,5.1％,10.7％,which were not statistically significant in all three groups (P ＞ 0.05).At 6 months,partial remission rates in three groups were 56.5％,41.0％,42.9％ respectively and complete remission rates were 21.7％,20.5％,28.6％,which did not suggested significant difference in all three groups either (P ＞ 0.05).(3) In modified Ponticelli group,steroid diabetes,impaired liver dysfunction,infections and gastrointestinal adverse events occurred in 1,1,2 and 2 patients,respectively.In CTX group,steroid diabetes,infections and gastrointestinal adverse events occurred in 5,8 and 2 patients,respectively.In CsA group,steroid diabetes and infections occurred in 1 and 3 patients,respectively.Conclusion Modified Ponticelli regimen to treat patients with IMN has a trend of better outcome than classic CTX regimen.The efficacy is not inferior to CsA regimen with fewer side effects.

Objective To explore the expression of BID protein and the relation ship of cell proliferation with apoptosis at different stages of IgAN.Methods The expression of BID protein、PCNA and FN in renal tissue was detected by immunohistochemistry,TUNEL and light microscopy were used to detect apoptotic cells.Results With the progress of IgAN,the expression of BID protein、PCNA、the number of apoptotic cells and FN increased gradually(P

Objective To investigate the effect of hyperlipidemia on glomerulus podocyte injury with IgA nephropathy.Methods Fifty-one IgA nephropathy patients with biopsy-proven were selected.Immunohistochemistry was applied to detect the expression of WT1,a marker of podocyte,in the renal tissue of patients with IgA nephropathy.The density of podocyte per glomerulus wascalculated using specific software.Results Triglyceride (TG) was positively correlated with glomerulus podocyte injury,serumcreatinine and glomerulosclerosis in IgA nephropathy (r =0.549,0.770,0.698,P ＜ 0.05 or ＜ 0.01 ),and there was no correlation with 24 h proteinuria.The expression of WT1 was significantly decreased in glomerulus of patients with IgA nephropathy (P ＜ 0.01 ).There was no correlation between the expression of WT1 and 24 h proteinuria,but the expression of WT1 was positively correlated with serum creatinine and glomerulosclerosis (r =0.765,0.679,P ＜0.01).Conclusion Hyperlipidemia may induce glomerulus podocyte injury in IgA nephropathy,and it may contribute to the progression of IgA nephropathy.

Objective To explore the expression and significance intergrin alphavbeta3(art33)in the kidney of patients with IgA nephropathy(IgAN).Methods lmmunohistochemistry wag applied to detect the expression of avl33。fibronectin(Fn)and Connective tissue growth factor(CTGF)in the kidney of patients with IgAN.and correlation analysis was done with pathology and clinic index.Result With the development of the disease,the expression of etvl33 was gradually increased in the glomemlar capillary endothelial cell.and mesansial cell as well as glomerular crescent.The positive area ratio of αvβ33 in renal glomerulus was(16.18±o.98,19.58±0.99,28.35±1.99,17.72±2.17)％respectively in grade I～Ⅳ pathological changes.Among all the groups,the expression of αvβ33 was the strongest in grade Ⅲ,while decreased in grade Ⅳ(P