Objective To observe the expression of ?-smooth muscle actin(?-SMA)in rats with tubulointerstitial fibrosis and explore the possible mechanism of renal-protecting of ?-SMA.Methods Sixty male Sprague-Dawley(SD)rats,aged 3 months,were randomly divided into 2 groups:control group(n=30)and model group(n=30).The renal tubulointerstitial fibrosis model was established by gavage with 150 mg/(kg?d)adenine solved by a solution of 20 g/L starch and the same volume starch was given to the rats from control group.At the 7th,12th,17th week,10 rats of every group were killed,the urinary protein,N-acetyl-?-D-glucosaminidase(NAG)in the urine and renal profile including BUN and serum Cr were examined.The histological changes of kidney were observed by light microscopy,and the expression of transforming growth factor-beta 1(TGF-?1)and ?-SMA were examined by immunohistochemistry staining.Results At the 7th,12th and 17th week,the value of urinary protein,urinary NAG,serum BUN and Cr of rats from model group were higher than those of controls(Pa

Objective To investigate the clinical characteristics of radiographic contrast-induced nephropathy(RCIN) in children for improving the knowledge of this disease.Method The clinical data of 6 hospitalized children with RCIN collected from Oct.1998 to Dec.2007 were evaluated retrospectively.Results Of 92 patients who had cardio-angiography,intravenous pyelography,renal arteriography,cerebral angiography,and CT with contrast medium,6 cases(2 girls and 4 boys,aged 2-17 years old) had RCIN.Among the 6 children,5 cases [serum creatinine(Scr) was from 168.3 to 249.7 ?mol/L] showed non-oliguria-type acute renal failure;1 case(Scr was 583.1 ?mol/L) showed oliguria-type acute renal failure,and renal biopsy pathology findings showed that renal tubular epithelial cells were vacuolar degene-ration,striated border fell off,renal tubular epithelial cells were necrotic mulifocally,while the glomeruli were normal.Hematuria in 2 cases with primary disease aggravated;2 cases showed microscopic hematuria;1 case had proteinuria(+),1 case appeared microscopic hematuria and proteinuria(+).Five patients with non-oliguria-type acute renal failure were cured successfully after the medication of 10-21 days.Another case with oliguria-type acute renal failure was well after interrupted hematodialysis for 13 days and medication.Conclusion Children suffering RCIN usually manifest non-oliguria-type acute renal failure,and most of them can be cured by hematodialysis and medication mostly.

Objective To observe the expression of matrix metalloproteinase-9(MMP-9)/tissue inhibitor of metalloproteinase-1(TIMP-1) in tubulointerstitial fibrosis(TIF) rats and explore the effects of MMP-9 and TIMP-1 in TIF.Methods Forty-eight male Sprague-Dawley(SD) rats were randomly divided into sham-operated group(n=24) and model group(n=24).Results Tubulointerstitial fibrosis model was established via unilateral ureteral obstruction(UUO). Histological changes were observed in tubulointerstitium injury under microscope and immunohistochemistry staining was performed to investigate both the expression of MMP-9 and TIMP-1 in TIF by semiquantitative score at d7, d14, d21 after experiment onset.The expressions of TIMP-1 in rats from sham-operated group were lower than those of mo-del group rats at d7, d14, d21 (Pa

Objective To study the feasibility and indication of liver injury in children treated nonoperatively.Methods Ninteen(cases) with liver injury who underwent nonoperative management(NOM) were analyzed retrospectively.Patients with obvious trauma were reviewed.The main cause of trauma was due to traffic accident.Eleven cases(57.9%) had subcapsular hematoma and 8 cases(42.1%)had intrapararenchymatous hematoma.The treatment procedure included blood transfusion,hemostasis and monitoring the hemodynamic parameters.Results Seventeen cases(89.5%)were cured nonoperatively;2 cases underwent the operation later.Followed up for 10-24 months,patients were well recovered.Conclusions Most of cases with liver injury in children can be cured by NOM due to the physicalogical and anatomic features of children.During treatment,it is very important for the doctors to observe the vital signs closely,and(mana)-ge the combined injuries effectively and take regular imaging measurement.

China ; Occupational Health Services ; methods ; organization & administration

Objective To observe the effect of lovastatin on plasminogen activator inhibitor -1 (PAI-1) and collagen type Ⅳ in rats with glomerularsclerosis induced by adriamycin,and to discuss its mechanism of protective effects on kidneys.Methods Twenty-four male Wistar nephritic rats induced by adriamycin were randomly divided into 3 groups:control,hyperlipidemia and lovastatin treatment group.They were fed 12 weeks.Urinary protein excretion and serum lipid were assayed,then renal glomerularsclerosis index,the expression of PAI-1 and collagen type Ⅳ were observed.Results Serum total cholesterol,triglycerides,low-density lipoprotein,urinary protein excretion,renal glomerularsclerosis index were significantly lower in treatment group than those in hyperlipidemia group.Expression of PAI-1 and collagen type Ⅳ,and number of foamcells were also sharply lower in treatment group than those in hyperlipidemia group.Conclusions Lovastatin not only reduces proteinuria,improves renal function,but also modulates glomerularsclerosis by inhibiting activity of PAI-1 and decreasing accumulation of collagen type Ⅳ.The mechanism of renal protective effect is independent of a reduction of circulating cholesterol.

OBJECTIVETo investigate the effects of locking plate fixation through lateral deltoid approach for proximal humeral fracture combined with micro-invasive percutaneous plating (MIPPO) technique.

METHODSFrom April 2009 to March 2012,26 patients with proximal humeral fractures were treated with proximal humeral locking system plate fixation through lateral deltoid approach, including 17 males and 9 females with an average age of 58 years old ranging from 28 to 76 years old. The time from injury to operation was 3 to 10 days (averaged 5.6 days). According to Neer typing for the proximal humeral fractures, 7 cases had 2 parts of fracture,15 had 3 parts of fracture,and 4 had 4 parts of fracture. The Neer score for shoulder function was evaluated.

RESULTSAll patients were followed up,and the duration ranged from 10 to 21 months (averaged 13.6 months). All patients were achieved bony union,the average healing time was 12.5 weeks (ranged from 10 to 21 weeks). No humeral head necrosis and axillary nerve injury occurred. According to Neer scoring system,the total score was 88.36 +/- 7.82, pain 30.82 +/- 3.24, function 23.76 +/- 5.71, activity 17.59 +/- 5.36, anatomical position 7.03 +/- 2.39; the result was excellent in 18 cases, good in 5 cases, fair in 2 cases, poor in 1 case.

CONCLUSIONLateral deltoid approach combined with locking plate fixation for treatment of proximal humeral fracture has advantages of small invasion,less blood lossing, short operative time, stable fixation, high rate of fracture healing, and satisfactory functional recovery.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Treatment Outcome

Objective To explore the effect of Bailing capsule on epithelial-mesenchymal transition( EMT) in rats with adenine-in-duced tubulointerstitial fibrosis. Methods Tubulointerstitial fibrosis animal models were established and SD rats were divided into mo-del group ( n = 30), treatment group ( n = 30) and control group( n = 30), randomly. Experimental rats were harvested at 7 w, 12 w,17 w after onset of experiment and functional evaluations were performed. Histology, immunohistology were examined to investigateboth histolopathology changes and the expression of bone morphogenic protein-7 (BMP-7), transforming growth factor-β1 (TGF-β1 )and a-smooth muscle actin (α-SMA) in kidneys at three time points mentioned above, respectively. Results Compared with controlgroup, 24 h urinary protein in model group lost increasingly and significantly difference appeared at three time points relative to controlgroup ( P ＜ 0.01 ). Urinary NAG in model group was markedly higher than that in control group from 7 w after onset (P ＜ 0.01 ) andwas increasingly raised at 12 w and 17 w (P＜0.01). The value of blood BUN and Cr in model group increased at 7 w (P＞0.05) rel-ative to control group. There was significant difference at 12 w and 17.w (P ＜ 0.01 ). Histologically, kidneys in model group, at 7 w,exhibited tubular casts and gently tubular dilation, granuloma in cortex, mononuclear cells infiltration in tubulointerstitial areas, andmild interstitial fibrosis. At 12 w, the degree of tubular injury and tubulointerstitial fibrosis gradually aggravated. Up to 17 w, diffusetubular dilation or atrophy was observed and focal tubules disappear. Diffuse interstitial fibrosis was exhibited. In normal kidneys, im-munohistochemistry suggested that the light expression of BMP-7 was detected in proximal renal tubular epithelial cells and marked ex-pression was identified in distal tubule, collecting duct, and renal tubular epithelial in junction area between cortex and medulla. How-ever, the expression of BMP-7 in kidneys of model group significantly decreased with increasing tubulointerstitial fibrosis and was nega-tive correlation with the expression of TGF-β1(r = -0. 981 P＜0.01) and α-SMA (r= -0.975 P＜0.01). Bailing capsule ad-ministration protected the expression of BMP-7 and reduced TGF-β1 and α-SMA expression before 12 w(P＜ 0.01 ). Conclusions Ourstudy shows an anti-fibrotic reno-protective function of Bailing capsule in rats with tubulointerstitial fibrosis via prevention of epithelial-mesenchymal transition at early stage. However, the beneficial effect lost with increasing tubulointerstitial fibrosis.