OBJECTIVE:To observe and probe into the effects and mechanism of action of calcium dobesilate on the con?tents of vasoactive substances in the remnant kidneys of rats with chronic renal failure.METHODS:The rats were randomly divided into sham operation,model and calcium dobesilate therapy group.Except the sham operation group,the rest two groups underwent nephrectomy and were established as chronic renal failure models.One week later either drink water or calcium dobesilate were irrigated into the stomachs of the rats in all three groups.And the effects of calcium dobesilate on renal function,contents of part vasoactive substances and the renal pathological changes of remnant kidney were examined.RESULTS:In calcium dobesilate therapy group,urine protein decreased,and the renal function improved,as compared with the model group.The contents of Thromboxane A 2 in the renal cortex significantly decreased and the pathological changes of remnant kidney lessen significantly.CONCLUSIONS:Calcium dobesilate may protect kidney by decreasing the content of Thromboxane A 2 in the remnant kidney.

Objective To investigate the clinical therapeutic effect of the vacuum-sealing drainage (VSD) combining with skin graft in a deep burn wound.Methods Sixty one patients were divided into two groups according to treatment method.Thirty tree patients were assigned as the VSD treatment group,which was treated by VSD after debridement; their wounds were transplanted by the split thickness skins binding up by VSD when they were fitted.Twenty eight patients were assigned as the routine treatment group,which was treated by means of traditional regular dressing change to remove necrotic tissue and promote granulation tissue; their wounds were transplanted by the split thickness skins binding up by packing when they were fitted.Results After treatment by VSD,there are no systemic hypersensitivity reactions and abnormal bleeding.Thirty three cases of VSD treatment group were treated by VSD for 7 ～ 10 days,the other 2 cases were treated by VSD for another 7 ～ 10 days because of granulation tissue badly.Until their granulation was fresh,skin grafting technique was used and the skin survived well.The treatment time before skin grafts,the pain score,and the cost of ablative therapy for wound were ( 8 ± 0.9) day,(5.7 ± 1.6) point,and ( 1.5 ± 0.4) ten thousand yuan in VSD group vs.( 14 ± 1.2) day,(3.1 ± 1.1 ) point,and (0.6± 0.2)ten thousand yuan in control group.The survival rate and the wound germiculture positive rate were 97.0％ and 6.5％ in the VSD group vs 75.0％ and 28.6％ in the control group.The differences between groups were statistically significant ( P ＜ 0.05 ).Conclusions VSD is a simple method that is easy to grasp,and that can promote granulation tissue growth,reduces the wound germiculture positive rate,shortens the wound healing period,increases the survival rate of skin grafts,and relieves patients 'pain.It is worth popularizing and applying in the deep burn wound therapy.

The safety of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) used in hemodialysis (HD) patients was evaluated. Medline, Embase, the Cochrane Library, some databases of clinical trial registries, grey literatures, other reference lists of eligible articles and review articles for the randomized clinical trials (RCTs) on comparison of ACEIs/ARBs or placebo in HD patients were retrieved. RCTs reporting the risk of hyperkalemia by using ACEIs/ARBs in HD patients were selected. Eight articles met the eligibility criteria and were subjected to meta-analysis by using the Cochrane Collaboration's RevMan 4.2 software package. The results showed that there was no significant difference in hyperkalemia in HD patients between ACEIs or ARBs group and control group (ACEIs vs. control: RD=0.03, 95% CI=-0.13-0.18, Z=0.34, P=0.73; ARBs vs. control: RD=-0.02, 95% CI=-0.07-0.03, Z=0.75, P=0.45). However, there was no significant difference in the serum potassium between ACEIs or ARBs group and control group in HD patients (ACEIs vs. control: WMD=0.10, 95% CI=0.06-0.15, Z=4.64, P<0.00001; ARBs vs. control: WMD=-0.24, 95% CI=-0.37-0.11, Z=3.58, P=0.0003). The use of ACEIs or ARBs could not cause an increased risk of hyperkalemia in HD patients, however the serum potassium could be increased with use of ACEIs in HD patients. Therefore the serum potassium concentration should still be closely monitored when ACEIs are taken during the maintenance HD.

Objective To study the immune regulation of Galectin-9 on the active CD4+T cells and demonstrate the mechanisms.Methods Lymphocytes were harvested from wild-type C57BL/6 mouse,from which na(i)ve CD4+T cells were separated via MACS and then stimulated with anti-CD3 antibody(Ab) (2.5 μg/ml),anti-CD28 Ab(5 μg/ml) and IL-2(100 ng/ml) for 3 days.The active CD4+T cells were divided into 3 groups:Control group,Galectin-9 group and Galectin-9+α-lactose group.We detected the cell proliferation level by CFSE fluorescence intensity and then dynamically observed the cell morphological changes.The proportion of CD4+CD69+T cell,Th1,Th2 and Th17 cell was valued; Meanwhile,ELISA was used to detect the cytokine levels of IFN-γ,IL-4,IL-10,IL-12,IL-17A and TGF-β1 secreted by lymphocytes.Also Western blot was used to observe the changes of T cell differentiation regulatory protein such as T-bet,GATA-3 and ROR-γt.Results Compared with control group and Galectin-9+α-lactose group,in Galectin-9 group,the cell morphology began to change at 2 h.Moreover the proportions of CD4+CD69+ T cell,Th1 and Th17 cells decreased (P＜0.05),but no significant differences in Th2 cells.The level of IFN-γ,IL-12,IL-17A and TGF-β1 from the supernatant decreased (P＜0.05),while Th2-type cytokines IL-4 and IL-1O did not change.In addition,the expressions of T-bet and ROR-γt were significantly down-regulated (P＜0.05).Conclusion Galectin-9 inhibited Th1 and Th17-type immune response,while had no effect on Th2-type immune response.The mechanism of the immune regulation may be related to affect the expression of Th1 and Th17 specific transcription factors at transcription level.

The safety of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) used in hemodialysis (HD) patients was evaluated. Medline, Embase, the Cochrane Library, some databases of clinical trial registries, grey literatures, other reference lists of eligible articles and review articles for the randomized clinical trials (RCTs) on comparison of ACEIs/ARBs or placebo in HD patients were retrieved. RCTs reporting the risk of hyperkalemia by using ACEIs/ARBs in HD patients were selected. Eight articles met the eligibility criteria and were subjected to meta-analysis by using the Cochrane Collaboration's RevMan 4.2 software package. The results showed that there was no significant difference in hyperkalemia in HD patients between ACEIs or ARBs group and control group (ACEIs vs. control: RD=0.03, 95% CI=-0.13-0.18, Z=0.34, P=0.73; ARBs vs. control: RD=-0.02, 95% CI=-0.07-0.03, Z=0.75, P=0.45). However, there was no significant difference in the serum potassium between ACEIs or ARBs group and control group in HD patients (ACEIs vs. control: WMD=0.10, 95% CI=0.06-0.15, Z=4.64, P<0.00001; ARBs vs. control: WMD=-0.24, 95% CI=-0.37-0.11, Z=3.58, P=0.0003). The use of ACEIs or ARBs could not cause an increased risk of hyperkalemia in HD patients, however the serum potassium could be increased with use of ACEIs in HD patients. Therefore the serum potassium concentration should still be closely monitored when ACEIs are taken during the maintenance HD.
Aged ; Angiotensin Receptor Antagonists ; adverse effects ; therapeutic use ; Angiotensin-Converting Enzyme Inhibitors ; adverse effects ; therapeutic use ; Female ; Humans ; Hyperkalemia ; chemically induced ; Male ; Middle Aged ; Renal Dialysis

Objective:To explore the influence on the willingness to seek medical treatment by revising the recommendations for prevention and treatment in the medical examination report.Methods:Revising the prevention and treatment recommendations for four diseases, including proteinuria, hyperuricemia, hydronephrosis and renal insufficiency to clearly inform the etiology and prognosis of them. Using a cross-sectional study method, pre-revision prevention and treatment recommendations (version A) and post-revision prevention and treatment recommendations (version B) questionnaires were randomly distributed to medical examiners and at the health management center of our hospital in Wuhan. An ordinal logistic regression model and a binary logistic regression model were used to analyze the correlation of the understanding of diseases and the willingness to seek medical treatment with different connotation of the prevention and treatment recommendations, respectively.Results:A total of 530 valid questionnaires were collected, of which 267 were from version A and 263 from version B. There was no significant difference in the socio-demographic profile of respondents between version A and version B. For the four high risk factors of kidney diseases mentioned above, version B was better than version A in terms of understanding and willingness to seek medical treatment ( P<0.001). The level of understanding OR(95% CI) were 3.691(2.570, 5.301), 2.238(1.511, 3.320), 4.293(6.353, 2.903) and 5.275(7.877, 3.529) respectively. The willingness to seek medical treatment OR(95% CI) were 3.554(2.441, 5.175), 2.850(1.975, 4.114), 5.144(3.457, 7.654) and 4.225(2.868, 6.224) respectively. All the P values were lower than 0.001. Conclusions:Improving the connotation of prevention and treatment recommendations in the medical examination report can help increase the willingness for early medical consultation.