Objective To assess the detection of urinary neutrophil gelatinase associated lipocalin (NGAL) and blood prohibitin (PHB) levels in early diagnosis of children with acute kidney injury (AKI).Methods One hundred and twenty children with severe allergic purpura,sepsis,kidney disease or heart disease admitted from June 2011 to June 2013 in our hospital were enrolled,including 60 cases with AKI and 60 cases without AKI;and 60 healthy children were selected as the control group.The urinary NGAL and blood PHB levels were measured with ELISA method.Results At d1 after diagnosis,the urinary NGAL level in severe AKI group [(146.76 ±61.22) μg/L] was higher than that in non-AKI group [(21.79 ± 17.31) μg/L] and control group [(17.42 ± 13.11) μg/L] (t =15.430 and 22.216,P ＜ 0.01).At d2 after diagnosis,the urinary NGAL level in severe AKI group [(82.31 ± 44.76) μg/L] was higher than that in non-severe AKI group [(21.56 ± 28.56) μg/L] (t =8.863,P ＜0.01).At d1 of diagnosis,the blood PHB level in severe AKI group was higher than that in non-severe AKI group [(14.03 ±6.43) vs.(8.01 ± 6.13),t =11.271,P =0.004];blood PHB in severe AKI group was higher than that in non-AKI group [(10.63 ± 4.21) vs.(8.00 ± 4.76),t =7.051,P =0.017].The levels of urinary NGAL and serum PHB gradually decreased over time in children with severe AKI.The area under the ROC curve (AUC) of urinary NGAL and blood PHB for diagnostic of AKI were 0.833 and 0.952 (P ＜ 0.01),respectively.The diagnostic rate of the combination of the two parameters was 100％.Conclusions The diagnostic value of PHB alone or NGAL in AKI still may be improved.The detection of PHB combined with NGAL can make up each other and improve the diagnosis of AKI,which contribute to the early diagnostic of AKI for clinical workers and provide effective intervention measures,and then reduce the mortality.

Abdomen ; Acupuncture Points ; Acupuncture Therapy ; Arthritis, Rheumatoid/therapy* ; Blood Sedimentation ; Humans ; Rheumatoid Factor ; Treatment Outcome

OBJECTIVE: To observe the effect of acupuncture at "Baihui" (GV 20) through "Qubin" (GB 7) on NLRP3 inflammatory corpuscle in rats with intracerebral hemorrhage (ICH), and to explore the action mechanism of acupuncture on promoting the recovery of neural function in rats with ICH. METHODS: Forty SPF six-week-old male SD rats were randomly divided into a sham operation group, a model group, a non-acupoint group and an acupuncture group, 10 rats in each group. The rats in the model group, non-acupoint group and acupuncture group were intervened with autologous blood injection to prepare ICH model, while the rats in the sham operation group were only intervened with operation but not injection with autologous blood. About 3 hours after the establishment of the model, the rats in the acupuncture group were intervened with acupuncture at "Baihui" (GV 20) through "Qubin" (GB 7), once every 12 hours, for 7 days; the rats in the non-acupoint group were intervened with acupuncture at the non-acupoint [parallel to the "Baihui" (GV 20), 1 cm next to the midline] on the affected side, and other treatment was the same as the acupuncture group. At the end of the intervention, the composite nerve function score of each group was evaluated; the histomorphology of the hemorrhage penumbra was observed by HE staining; the expression of NLRP3 inflammatory corpuscle in the brain was detected by immunohistochemistry; the relative protein expression levels of NLRP3, interleukin-1β (IL-1β) and interleukin-18 (IL-18) in brain were detected by the method of Western blot. RESULTS: Seven days into intervention, compared with the sham operation group, each item score and total score of composite nerve function in the model group were significantly reduced (<0.01, <0.05). There was edema and karyopyknosis in brain neuron as well as necrocytosis and inflammatory cell infiltration in the model group. Compared with the model group and the non-acupoint group, the total score of composite nerve function and the scores of symmetrical movement of limbs (LS) and proprioception of tentacles (VP) in the acupuncture group were increased (<0.01, <0.05), and the cell necrosis and inflammatory cell infiltration were relieved. Compared with the sham operation group, NLRP3 inflammatory corpuscle expression and the relative protein expression levels of NLRP3, IL-1β and IL-18 in brain tissue in the model group were increased (<0.01); compared with the model group and the non-acupoint group, NLRP3 inflammatory corpuscle expression and the relative protein expression levels of NLRP3, IL-1β and IL-18 in brain tissue in the acupuncture group were reduced (<0.01). CONCLUSION Acupuncture at "Baihui" (GV 20) through "Qubin" (GB 7) could downregulate the expression of NLRP3, IL-1β and IL-18 in the brain tissue of ICH rats, inhibit the inflammatory response, and promote the recovery of neural function.
Acupuncture Points ; Acupuncture Therapy ; Animals ; Brain ; Cerebral Hemorrhage ; metabolism ; therapy ; Interleukin-18 ; metabolism ; Interleukin-1beta ; metabolism ; Male ; NLR Family, Pyrin Domain-Containing 3 Protein ; metabolism ; Rats ; Rats, Sprague-Dawley