This paper describes the clinical epidemiologic features, main pathogenesis, early diagnostic biomarkers and managements of septic acute kidney injury in children. It is suggested that pediatric clinicians should increase awareness of the treatment of septic acute kidney injury in children.

Objective To investigate the effects of malnutrition,nephrosis itself and glucocorticoid therapy on serum thyroid hormone,illustrate the relationship between serum thyroid hormone and renal IGF-I/IGFBPs autocrine/paracrine in nephrotic rats.Methods Twenty-four male Sprague-Dawley(SD) rats were randomly divided into control,pair-fed,doxorubicin(5mg/kg)-induced nephrotic and dexamethasone treated nephrotic(des-treated) rats.Serum T 3,T 4 and GH were measured by RIA,renal GHR and IGF-I/IGFBPs mRNA were analyzed by radioreceptor assay and RT-PCR respectively.Results ⑴Serum thyroid hormone levels were decreased by degrees according normal rats,pair-fed rats,nephrotic rats and lowest in des-treated rats except for high serum T 4 in pair-fed rats showed increasing trendency.⑵Reduced serum thyroid hormone was parallel well with decreased renal GHR and IGFBP-2 mRNA,and correlated negatively with increased renal IGFBP-3 mRNA.⑶There was some significant correlation positively between nose-tail length or weight and serum thyroid hormone.Conclusions The hypothyroidism is a possible mechanism of IGFBPs autocrine/paracrine disorder and further growth retardation in nephrotic syndrome.

Objective To investigate the effects of malnutrition, nephrosis itself and glucocorticoid therapy on serum IGF-l and liver IGF-l mRNA, and illustrate relationship between growth failure in nephrotic rats and turbulence of serum IGF-l. Methods Twenty-four male SD rats were randomly divided into control, pair-fed, doxorubincin-induced nephrotic(nephrotic) and dexamethasone-treated nephrotic (des-treated) rats. Serum IGF-1 and liver IGF-l mRNA were measured by RIA and RT-PCR respectively. Results 1. Serum IGF-l was reduced and liver ICF-l mRNA was increased in pair-fed and nephrotic rats, but no significant difference was found between two groups. 2. Serum IGF-l and liver IGF-l mRNA were lower in des-treated rats than in nephritic rats. 3. There was a positive correlation of serum IGF-l with nose-tail length and weight. Conclusions Reduced serum IGF-1 induced by secondary malnutrition is the cause of growth failure in nephrotic syndrome. Glucocorticoid therapy deteriorates growth failure in nephrotic syndrome by further decreased liver IGF-1 synthesis.

Objective To investigate the effects of malnutrition, nephrosis itself and glucocorticoid therapy on serum growth hormone binding protein(GHBP) and liver growth hormone receptor(GHR), and elucidate the relationship between growth failure in nephrotic rats and serum GHBP or liver GHR. Methods Twenty-four male Sprague-Dawley(SD) rats were randomly divided into control, pair-fed, doxoruhincin-induced nephrotic (nephrotic) and dexamethasone-treated nephrotic (des-treated ) rats. Serum GHB P, GHB P- 1 and liver GHR were measured by dextran-coated charcoal technique, gel filtration and radioreceptor assay respectively. Results (1) Serum GHBP and liver GHR were reduced in nephrotic and des-treated rats compared with control and pair-fed rats, but no significant difference was found between control and pair-fed rats or between nephrotic and des-treated rats. (2)Serum GHBP-1 was lower in pair-fed rats, even lower in nephrotic rats and lowest in des-treated rats than in control. (3) There was some significantly positive correlations between nose-tail length or weight and serum GHBP or liver GHR. Conclusion GH resistance, due to decreasd liver GHR, is an important cause of growth failure induced by secondary malnutrition and nephrosis itself Glucocorticoid therapy deteriorates growth failure by further decreased hepatic GHR.

catechin plus dexamethasone-treated group. Compared with nephrotic group, the renal pathologic score were significantly different among the nephrotic group and the catechin-treated group (6 80?0 84,P

Objective To explore the relationship between the pathological classification and clinical manifestations of lupus nephritis(LN)in children by renal biopsy and laboratory examination. Methods Renal biopsy and routine laboratory tests were performed in 35 cases of LN . The pathological classification of LN was made according to the criteria of WHO1982. Results Type Ⅳ of LN was most common(37.4%), and type Ⅴ(31.7%) and type Ⅲ(20.0%) were next. Type Ⅳ and type Ⅴ usually appeared as nephritic syndrome, while Type Ⅱ and Ⅲ mainly appeared as nephritis syndrome. The frequency of hypertension and renal dysfuction was the highest in type Ⅳ. Generally the renal interstitial injury of LN was mild, but that of type IV of LN was relatively obvious. There was a positive correlation between serum creatinine level and the degree of renal interstitial injury. Conclusion Lupus nephritis in childhood possessed some features in renal pathological change and clinical manifestations. Renal biopsy was important to diagnosis, treatment and prognosis evaluation of lupus nephritis.

Objective To observe the correlation between the C-myc expression and pathologic lesions of kidney to explore the role of C-myc re-expression in children's primary nephrotic syndrome(CPNS). Methods The C-myc expression of renal tissue in 30 cases of CPNS was detected using immunohistochemical method, and the correlation between C-myc expression and renal pathological lesions was analyzed. Results There were various degrees of C-myc positive staining in the renal tissue of all patients with CPNS, while no C-myc positive expression in the renal tissue of control group. C-myc expression was mainly located in podocytes and less in endothelial cells of glomeruli. There was high level of C-myc expression in nephric tubules, especially in proximate tubules. There was no C-myc expression in the Henle's loop,tubulous matrix and vessel areas. There was no obvious difference in C-myc expression level in the podocytes and proximate tubules among the different pathological types of CPNS. The level of focal segmental glomerulosclerosis(FSGS) in proximate tubules obviously reduced compared with mesangil proliferative glomerulonephritis(MsPGN) and minimal change disease(MCD)(P

Objective To research Henoch-Schonlein purpura purpura (HSP) and renal pathology in children.Methods 31 hospitalized HSP children that with normal urine routine and accepted renal biopsy in our hospital.Results There were different levels of kidney pathological damage in this group of 31 cases,the results of light microscope were from grade Ⅱ to grade Ⅵ The proportion was grade Ⅱ(35.48％,11 of 31),grade Ⅲ (54.83％,17 of 31),and grade Ⅳ,Ⅴ and Ⅵ (each 1 case of 31,3.23％ ).lmmunofluorescence pathology results were showed as following:merely IgA depositional (48.38％,15 of 31 ),IgA + IgG depositional ( 19.36％,6 of 31 ),IgA + IgM depositional ( 19.36％,6of 31 ),IgA + igG + IgM depositional ( 12.90％,4 of 31 ).Microalbuminuria had been founded in 14 cases,and the microalbuminuria level of 10 cases were higher than normal value( 10 of 14,71.43％ ).Conclusions HSP children had renal pathologic dysfunction,even the urine routine were normal,and the detection of urine microalbumin was a significant marker in the early stage.

Objective To explore the relationship between vascular endothelial growth factor (VEGF) concentration in urine and renal vascular damage in children with Henoch Schonlein purpura nephritis (HSPN).Methods The kidney pathological lesion of 78 biopsy-proven HSPN children was assessed with renal vascular damage, glomerular pathological damage, and tubulointerstitial pathological damage semi-quantitative points. The children were divided into 3 groups (light, medium, and heavy group) according to the renal vascular, glomerular, tubulointerstitial, glomerular and tubulointerstitial total pathological points. Blood and urine vascular endothelial growth factor concentration was detected by enzyme linked immunosorbent assay;the localized renal VEGF expression and microvessel density were detected by immunohistochemistry assay in the kidneys. Results The semi-quantitative points of glomerular, tubulointerstitial, renal vascular, and glomerular and tubulointerstitial total points in different groups had significant difference (all P＜0.01);the minor renal vascular damage, the higher light microvessel density, blood and kidney concentration of VEGF, and the VEGF excretion in the urine were also lower in different groups, and there were significant differences (all P＜0.01). Glomerular points were positively related with tubular points, vascular points, kidney total score (r=0.596,0.612, and 0.728;P＜0.05, 0.05, and 0.01 respectively). Microvessel density was highly positively related with blood VEGF and renal VEGF, and negatively rela-ted with urine VEGF (r=0.601, 0.696, and -0.639,all P＜0.01). Conclusion The urinary excretion of VEGF leads to the decrease of local kidney VEGF concentration resulting in the renal vascular injury, which may be the important reason for renal vascular damage and pathology chronic progress in HSPN children.

A homozygous A to G transition (AGT to GGT) in codon 16 of growth hormone receptor (GHR) gene was found in one patient with idiopathic short stature(ISS), resulting in an amino acid change(Ser16Gly). This may be a novel GHR gene mutation; and another novel Arg43Gln GHR gene polymorphism was found in Chinese people.