The prevention and control of chronic kidney disease(CKD)and end-stage renal disease(ESRD)has become an important public health problem.This article has outlined the status,hazards,and problems in prevention of CKD and ESRD,briefly described the work having been done by the Chinese Society of Nephrology of the Chinese Medical Association,and proposed countermeasures for future prevention and treatment of ESRD,aiming at improving knowledge of the urgency of combating ESRD by the society,government,public,and medical staff in order to improve the prevention and treatment of ESRD in China.

Objective To introduce the current development of nephrology during the period of "Eleventh-Five-Year Plan" in PLA medical circles,to serve as a reference for the further development of nephrology in PLA.Methods Literature concerning nephrology published domestically and abroad in past 5years were retrieved,and the progresses,achieved domestically and abroad,especially in PLA,on new concept,diagnoses and therapy of common nephropathy,and clinical applications of new drugs and techniques were emphatically analyzed.Results Great progresses have been made during the period of "Eleventh-Five-Year Plan" on basic researches,clinical applications and substitution therapy in nephrology,and outstanding achievements have been acquired on basic and clinical researches of chronic nephropathy and acute renal injury,drug treatment of renal diseases and continuous renal replacement therapy.The PLA medical personnel participated in the formulation of "Diagnostic and Therapeutic Standard of Renal Diseases" ,furthered the academic exchanges between the military and civilian circles,both domestically and abroad.The academic level of PLA in nephrology was raised markedly with obvious features and preponderance.Conclusion During the period of "Twelfth-Five-Year Plan" ,the focus of nephropathy researches should be put on the enhancement of the ability of military health service,integrated control and comprehensive remedy of acute renal injury induced by combat wound,trauma and stress injuries.It is important to stably retain the superiority on basic and clinical researches of chronic nephropathy,acquire more achievements,make greater contributions to raising the professional level of diagnosis and treatment of kidney diseases.

Alterations in the balance between synthesis and degradation of extracellular matrix (ECM) and its remodeling may result in an accumulation of ECM molecules and lead to glomerulosclerosis. Recent studies have focused on the role of degradative systems, especially the roles of plasminogen activators/plasminogen activator inhibitors (PA/PAI), matrix metalloproteinases, and their inhibitors[GK2*4/5!2*4/5] (MMP/TIMP) in the initiation and pathogenesis of renal diseases. Previously, attention has been paid to the study of inhibitors of ECM degrading enzymes, such as PAI and TIMP. Recent researchs showed that there existed complex dynamic expressions of enzymes and their inhibitors. Although many studies have tried to elucidate the pathogenesis of renal diseases, the exact underlying mechanisms are still not completely understood. For better understanding of the mechanism of chronic progressive renal diseases, the underlying genetic and molecular regulation of each component of PA/PAI and MMP/TIMP systems should be elucidated in different renal physiological and pathophysiological processes. Future studies are needed to manipulate activity or expression of these proteinases in order to treat and/or prevent glomerular diseases.

Animal model of aged rat nephrotoxicity was induced by i. p. administrationof gentamycin in a dose of 140mg/kg/day. Part of those rats were treated with CordycepsSinensis(CS), Epimedium(Ep) and Astragalus Membranaccus (AM) in form of decoc-tion per Os and others seryed as control. The results were summarized as. 1. The nephro-toxicity of gentamycin was aggrevated with age. CS, Ep and AM are effective drugs inpreventing the tdeular damage caused by gentamycin in rats. The pathological changes ofrenal tuoules of the rat groups which treated with CS, Ep and AM were less severe thanthat of the control. 2. CS, Ep and AM could prevent the decline of renal cortical Na~+-K~+-ATPase activity of aged rat induced by gentamycin.

Chronic kidney disease(CKD)is increasingly recognized as a global public health problem.Uncontrolled complications of CKD,especially cardiovascular diseases,contribute greatly to the premature death and unfavorable prognosis.Recent evidence shows that CKD complications may occur earlier than previously thought.CKD complications deserve early detection and active treatment.Periodical follow-up and regular check should be done to adjust the therapeutic condition.Clinical practice guideline or recommendation based on evidence-based medicine is essential for management of CKD complications.Personalized treatment should be considered to improve survival and quality of life,and to make patient return to society.

BACKGROUND: Nucleus raphe magnus(NRM) is an important nucleus located in the median raphe of ventral medulla. Many studies have been focused on the crucial role which plays in acupuncture analgesia, cardiovascular regulation, respiratory regulation and other aspects of health. However,little attention has been paid to its role in the regulation of digestive system heretofore.OBJECTIVE: To investigate the effect of NRM on gastric movement and gastric electric activity in rabbits.DESIGN: Comparative study based on the experimental animals.SETTING: A laboratory of functional medicine in a traditional Chinese medical university. PARTICIPANTS: From September 2002 to April 2004, the study was conducted in the functional medicine laboratory of Heilongjiang University of Chinese Medicine(Provincial Key Laboratory). Seventy healthy New Zealand white rabbits were used including male and female, which weighed 2 - 2. 5 kg on average, supplied by the Laboratory Animal Center of Heilongjiang University of Chinese Medicine(Class I) . The rabbits were randomly divided into 7 groups: saline group, 5-hydroxytryptamine(5-HT)group, cyproheptadine group, substance P group, substance pantagonist group, morphine group and noradrenaline group.METHODS: Through cannula, microinjection of 5-HT, cyproheptadine, substance P, substance P antagonist, morphine and noradrenaline were given into NRM. Synchronously, gastric movement and changes in the amplitude and frequency of gastric electric slow wave in rabbits were recorded.MAIN OUTCOME MEASUREMENTS: Gastric movement and gastric electric activity were observed after microinjection of 5-HT, cyproheptadine,substance P, substance P antagonist, morphine and noradrenaline into NRM.RESULTS: After microinjection of 5-HT and substance P into NRM,gastric movement and gastric electric slow waves in rabbits were inhibited ( P ＜ 0. 05, P ＜ 0. 01 ). After microinjection of cyproheptadine, substance P antagonist, gastric movement and gastric electric slow waves in rabbits were increased( P ＜ 0.05, P ＜ 0.01) . Meanwhile, it turned out that microinjection of morphine and noradrenaline into NRM had no effect on gastric movement and gastric electric slow waves in rabbits ( P ＞ 0.05).CONCLUSION: 5-HT and substance P in NRM contribute to the regulation of gastric movement and gastric electric slow wave in rabbits by NRM, while morphine and noradrenaline presumably have no relation with the regulation.

Background Glucocorticoid drugs have been used increasingly in ophthalmology.It has been established that glucocorticoid are associated with a rise in intraocular pressure (IOP) and the development of glaucoma.Selective laser trabeculoplasty (SLT) is thought to be effective in treating patients with glucocorticoidinduced elevated IOP.Objective This study was to assess the efficacy of SLT in lowering IOP in patients with glucocorticoid-induced ocular hypertension.Methods A retrospective case series study was adopted.SLT around 360° chamber angle was performed in 9 eyes of 9 patients with glucocorticoid-induced glaucoma in Eye & ENT Hospital of Fudan University,including 5 eyes of 5 patients owing to use of glucocorticoid eye drops for long-term after laser in situ keratomileusis (LASIK) and 4 eyes of 4 patients who received intravitreal injection of 0.1 ml triamcinolone acetonide (TA) (4.0 mg) for macular edema induced by central retinal vein occlusion(CRVO).All of the patients were lack of preexisting glaucoma or ocular hypertension and underwent unsuccessful maximum tolerated medical therapy before SLT treatment.The base IOP was 35-44 mmHg and glucocorticoid drugs were ceased for 2-12 months prior to the SLT.The patients were followed-up for 6 months.IOP was measured and recorded before and 1 hour,1 week,1 month and 3 months,6 months after SLT.The difference of IOP was compared by repeated measures analysis of variance and multiple comparison analysis.Results All the patients received single SLT operation.The mean IOP was (40.0±2.9) mmHg before operation,but the IOP was (37.9±8.1),(34.9±5.9),(27.6±6.7),(21.6±6.9) and (17.9±2.9)mmHg 1 hour,1 week,1 month,3 months and 6 months after SLT.The IOP at 1 month,3 months and 6 months after SLT were significantly lower than that before operation (all at P＜0.05).Two patients received a filtration surgery for uncontrolled IOP at 1 month and 3 months after SLT respectively,and another patient still used 2 kinds of lowing-IOP eye drops until the end of following-up duration.Conclusions SLT reduce IOP in 6 eyes of 9 patients with glucocorticoid-induced increased IOP from the initial 1 month through 6 months after SLT.

Objective To investigate the clinico-pathological characters of acute and chronic Aristolochic acid nephropathy, and analysis the pathological mechanism of chronic Aristolochic acid nephropathy.Methods 26 cases of aristolochic acid nephropathy diagnosed in our department were examined. They were divided into acute and chronic group by their pathological characters. Immunohistochemical staining for the expression of collagen III, PAI-1, TIMP-1 and PCNA was done in renal biopsy specimens.Results There were 11 acute cases and 15 chronic cases. Compared with acute cases, there were more female, longer duration of the medicine intake[ (142.3?52.7 months of chronic cases and 4.5 ? 2.7 months of acute cases), higher degree of hypertension[(156.7?32.4) mm Hg of chronic cases and 127.3?24.2 mm Hg of acute cases], 24 hour urinary protein,anemia, glomerulosclerosis, tubular atrophy, interstitial fibrosis and artery lesions in chronic patients(Pall

Objective To investigate the effects of the expression of integerin-linked kinase (ILK) on connexin 43 (Cx 43) in rat mesangial cells (RMCs). Methods RMCs were divided into three different groups (6 for each group): RMC group, ILK-con siRNA group and ILK-siRNA group. ILK siRNA was synthesized, and then transfected into RMCs by LipofectAMIN 2000. RMCs were transiently transfected with ILK-con siRNA, ILK-siRNA and lysed 24h later, and mRNA was then extracted and detected by reverse transcription-polymerase chain reaction (RT-PCR) analysis using ILK and Cx43-specific primers, and an aliquot of protein from each sample was subjected to western blot analysis using ILK and Cx43 antibodies. Cells were seeded into 96-well plates (2?103 cells/well) and then transfected with ILK-con siRNA and ILK-siRNA. After incubation for 24, 48 and 72 hours, respectively, 20?l of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) (5mg/ml) was added into each well and incubated for 4 hours. Subsequently, 150?l of dimethyl sulfoxide (DMSO) was added to each well to dissolve the formazan crystals, and the absorption at 492nm was measured. Results ILK mRNA and protein levels decreased by 30%-50% after being transiently transfected with ILK-siRNA, while Cx 43 mRNA and protein levels increased by 30%-40% and 60%-70%, respectively. The viabilities in ILK-siRNA infected RMCs at 24, 48 and 72 hours were significantly higher than that in ILK-con siRNA infected RMCs. Conclusion Inhibition of ILK pathway will up-regulate the expression of Cx 43 and the viability of RMCs, implying that the regulation of connexin 43 might possibly be achieved via ILK pathway.

Objective To determine the changes in expressions of thrombin receptor and fibrin deposit in glomeruli during the process of senility. Method Rats were divided into 3 groups (8 rats in each group): 3-month-old group (3m), 12-month-old group (12m) and 24-month-old group (24m). Fibrin deposition was detected by Martius-Scarlet-Blue staining and direct immunofluorecence method. Immunohistochemical studies were performed to detect the expression of thrombin receptor (PAR-1) and transforming growth factor-? (TGF-?). Semi-quantitative PCR was performed to detect the changes in PAR-1 mRNA expression. A quantitative analysis of the expressions was performed by image analysis system. Result Significant pathological changes were found in glomeruli during the process of senility. Fibrin deposition was not observed in glomeruli in different groups. Significant expression of PAR-1 was found in glomerular endothelial cells, mesangial cells and epithelial cells in 3m rats. On the contrary, in 24m rats, PAR-1 expression in glomeruli was significantly decreased. Expression of TGF-? was increased with senility in glomeruli. PAR-1 gene expression, barely detectable in control tissue, was strikingly increased in 24m rats. Conclusion Thrombin receptor activation could be found in glomeruli of senile rat, and it is independent of fibrin deposition. Activation of PAR-1 may play an important role in the process of renal senility.