Renal protection should be taken into account when we treat chronic gouty arthritis patients combined with chronic kidney disease.Several drugs should be individualized and adjusted dosage according to renal function parameters such as GFR.At the same time,we should closely monitor the side-effects of drugs.

Objective To study the effect of PPAR-r agonist Troglitazone on the mPGEs expression induced by high glucose in rat mesangial cells. Methods Rat mesangial cells were incubated with high glucose at presence or absence of different concentrations of Troglitanzone, and the mPGEs concentration in supernatant was measured by an enzyme-linked immunosorbent assay (ELISA). Results 5% glucose could obviously induce the mPGEs expression in the rat mesangial cells (P

ObjectiveTostudytheroleof hotshockprotein (HSP)47in tubulointerstitial fibrosis induced by transforming growth factor β1(TGF-β1),and to explore its possible mechanism.Methods Human proximal tubular epithelial cells(HK-2) were divided into threegroups:control,TGF-β1andHSP47siRNA. Theexpressionsof HSP47, collagenⅣ,fibronectin(FN),plasminogen activator inhibitor 1(PAI-1) mRNA and HSP47,collagen Ⅳ,FN protein were detected by RT-PCR and Western blotting respectively.PAl-1 protein was detected by ELISA. ResultsHK-2expressedHSP47innormalmedium. ThemRNAandprotein expressions of HSP47 up-regulated in concentration- and time-dependent manner in HK-2 cells induced with increasing concentrations of TGF-β1(0,2.5,5,10 μg/L) and with prolong times (12,24,48 h),and peaked at 10 μg/L TGF-β1 for 48 h.Similar phenomena was observed in the mRNA andproteinexpressionsof collagenⅣ, FN, PAI-1inHK-2 cellsinducedbyincreasing concentrations of TGF-β1 (0,2.5,5,10 μg/L) at different time points (12,24,48 h),and peaked at 10 μg/L TGF-β1 for 48 h.HSP47 siRNA could significantly reduce the up-regulation of mRNA and protein expressions of HSP47,collagen Ⅳ,FN,PAI-1 in HK-2 cells induced by TGF-β1.Conclusion HSP47 can promote renal tubulointerstitial fibrosis maybe through the regulation of the expressions of collagen Ⅳ,FN,PAI-1.

Objective To investigate the role of oxidative stress in the epithelial-to-mesenchymal transdifferentiation (EMT) of peritoneal mesothelial cells in rat model of peritoneal fibrosis and the effect of probucol on peritoneal fibrosis. Methods The rat model of peritoneal fibrosis was induced by 4.25% high glucose peritoneal dialysis fluid (PDF). The rats were randomly divided into 4 groups:the control group, the saline group, the peritoneal fibrosis group, and the probucol group. A 4 hour peritoneal equilibration test (PET) was performed 4 weeks later. The peritoneal function and net ultrafiltration (UF) volume were determined. The level of malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) in peritoneal tissue were examined. The histology of peritoneal membrane was evaluated by light microscopy. E-cadherin and α-smooth muscle actin (α-SMA) protein expression was evaluated by immunohistochemical method and Western blot.Results The mesothelial cells were detached from peritoneal membrane in peritoneal firbosis rats. Comparing with the control rats, the thickness of visceral peritoneum, the level of MDA, and the-SMA protein expression were increased while the net ultrafiltration volume, the level of GSH-Px and E-cadherin protein expression were decreased in peritoneal firbosis rats. All these changes were reversed in the rats treated with probucol.Conclusion Oxidative stress plays an important role in transdifferentiation of peritoneal mesothelial cell in the peritoneal fibrosis rats. Probucol can improve structure and function of peritoneum, and partially reverse the EMT by reducing the oxidative stress.

Objective To assess the prevalence of metabolic syndrome (MS) and explore the associated risk factors with MS among 35 ～ 80 years elderly people in Changsha.Methods The survey used by cluster random sampling method (from October to December,2008 ) was carried out by the Physical Examination Center of the Second Xiangya Hospital,Changsha.All subjects aged from 35 to 80 years old had the questionnaires,physical examination,and biochemical measurements.MS was defined by IDF 2005.Results The prevalence of MS was 24.3％ among elderly people in Changsha.The prevalence of MS in male and female was 27.9％ and 19.3％,respectively; which in male was significantly higher than in females ( P ＜0.01).According to census of 2000 in Changsha,the age-adjusted rate of MS was 24.4％ among elderly people,27.8％ in male and 21.9％ in female,respectively.The metabolic abnormalities and the prevalence rate of MS were different in gender and age.Except the essential component of the central obesity in the 194 cases of MS patients,there are 80 cases include other two kinds of metabolic abnormalities,accounting for 41.2％,most of them with elevated blood pressure + sugar metabolism disorders; the most common three kinds of metabolic abnormalities of the 78 cases,accounting for 40.2％ of the people with MS,most of them with high TG + elevated blood pressure + sugar metabolism disorders; With 4 kinds of metabolic abnormalities of 36 patients,accounting for 18.6％ of the MS patients.Increasing age,male,overweight and (or) obesity,high LDL-C hematic disease,high uric acid hematic disease,diabetes were all the risk factors of the elderly people in Changsha city.Conclusions Elderly people in Changsha have a relatively high prevalence of MS,especially for male.The prevalence of MS is considerably high in Changsha,which may continue to rising with the social economic development and population aging.There is an urgent need to take actions to reduce the burden of MS.

Objective To systematically review the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS)for post-stroke dysphagia. Methods The clinical trials about rTMS for post-stroke dysphagia were searched on Pubmed,EMbase,MEDLINE,Cochrane library,China National Knowledge Infrastructure (CNKI),Chinese BioMedical Literature Database on disc (CBMdisc),and Wanfang database with computers. Two independent reviewers selected the literatures by the inclusion and exclusion criteria,data extraction and cross-checking,and then conducted the analysis. Results A total of seven trails (228 patients,136 of them in a rTMS group and 92 in a control group)were included. Four randomized controlled trials (RCTs)were used for Meta-analysis (54 patients in the rTMS group,42 in the control group). The other three non-RCTs were only reviewed systematically. (1)Meta-analysis showed that the improvement of swallowing function score after rTMS was better than that of the control group (SMD=1. 73,95%CI 0. 45 to 3. 01;P=0. 008). (2)After high-frequency rTMS (>1 Hz),there was significant difference in the improvement of swallowing function score between the two groups (SMD=1. 60,95%CI 0. 10 to 3. 11;P=0. 04). Compared to the control group,there were also significant differences in the improvement of some swallowing function scores in low-frequency rTMS (1 Hz),suggesting the potential advantages of low-frequency therapy. (3)After rTMS,there was no significant difference in the improvement of Barthel index in patients with stroke compared with the control group (MD= -21. 60,95%CI-36. 21 to-7. 00;P=0. 004). (4)In terms of adverse reactions,seven trials did not report any adverse events, such as headache,tinnitus or epilepsy,etc. Conclusion Using rTMS may significantly promote the recovery of swallowing function for patients with post-stroke dysphagia,and it is both safe and effective.

Objective To investigate the effects of connective tissue growth factor (CTGF) siRNA delivered by pRetro-Super (PRS) retrovirus vector on extracellular matrix and VEGF expression in human peritoneal mesothelial cells (HPMC). Methods Four pairs of oligonucleotides including 64 bp DNA were designed and synthesized in vitro according to siRNA target sequence and PRS retrovirus desire.PRS-CTGF-siRNA1-4 recombinant retrovirus vectors were constructed.The recombinant retrovirus vectors containing CTGF-siRNA were transferred into PT67 packaging cell lines with lipefectamine 2000,then infected HPMC.mRNA expression was determined by semi-quantitative RT-PCR and protein expression was determined by Western blot.Results Both mRNA and protein expressions of CTGF,FN,Col I,laminin (LN) and VEGF were significantly increased in HPMC with 5 μg/L TGF-β1 stimulation (P＜0.01,respectively).CTGF,FN,Col I,LN mRNA and protein and VEGF mRNA expression stimulated by TGF-β1 were significantly decreased in HPMC infected with PRS-CTGF-siRNA1～4 retrovirus vectors (P＜0.01,respectively).The inhibitory rates on CTGF were 69.3%,22.2%,27.4% and 38.8%,respectively (P＜0.01).At the same time,there was also a significant reduction of VEGF protein expression in HPMC infected with PRS-CTGF-siRNA1 vector (P＜0.01).There was no significant difference in HPMC infected with PRS void vector. Conclusion CTGF siRNA delivered by PRS retrovirus vector can effectively inhibit the enhancement of extracellular matrix and VEGF expression stimulated by TGF-β1 in HPMC.

Objective To explore the effects of hyperbaric oxygen (HBO) treatment on expression of extra-cellular signal regulated kinase 1/2 (ERK 1/2) and neurological function in acute traumatic brain injury (TBI) rats so as to offer trial support for clinical application of HBO in TBI.Methods Twenty-four adult Sprague-Dawley rats were randomly divided into sham-operation group,TBI group and HBO treatment group,with eight rats per group.The sham-operation group was free from TBI but skull was opened only but the TBI group was subjected to TBI according to Alice method.TheHBO treatment group was treated with HBO for 10 days ( one time per day) after TBI operation.On day 14,NSS rating was performed in all rats.Then,the rats were sacrificed and cortex of which was obtained to measure the expression of ERK1/2 by using reverse transcription-polymerase chain reaction (RT-PCR).The localization of the expression of ERK was detected by immunohistochemical staining and the changes in ERK protein was analyzed by optical density.Results The NSS score in the HBO group was significantly decreased at day 14 after HBO treatment ( P ＜ 0.01 ) and the expression of ERK1/2 in HBO group was also significantly decreased (P ＜ 0.05 ) in comparison with the TBI group.Conclusions HBO treatment can significantly decrease NSS score and expression of ERK1/2 in acute TBI rats,indicating that HBO may improve neurological function through down-regulating expression of ERK1/2.

Objective Benign childhood epilepsy with centrotemporal spikes (BECT) is the most common partial epilepsy syndrome in children, and responds well to carbamazepine (CBZ), oxcarbazepine (OXC), and valproic acid (VPA). The aim of this study is to investigate the therapeutic effect of OXC on BECT. Methods We retrospectively discussed a case of partial epilepsy in a 6-year-old boy with no abnormality on neuroradiologic examination. Results The patient′s seizures were easily controlled by administration of OXC, but electroencephalography (EEG) identified deterioration of the EEG features following the introduction of OXC monotherapy. Then OXC was gradually decreased in dose and substituted with VPA. When VPA was increased to the dose of 0.5g/d, the boy had no more seizures and exhibited normal EEG in the conscious state. Conclusion OXC may induce new types of seizure and aggravate EEG features although it is considered to be the first-line anti-epileptic drug (AED) and much better tolerated than either phenytoin or CBZ.

Objective To investigate the role of mitochondrial respiratory chain in the hyperpermeability of human peritoneal mesothelial cells (HPMCs) induced by high glucose peritoneal glucose PDS was also added. Transmesothelial electrical resistance (TER) measurement was examined for detection of permeability damage in HPMCs. Immunostaining and Western blotting analysis were used to detect claudin-1 expression. Mitochondrial superoxide (MitoSOX) Red staining and respiratory chain complexes activities were determined for detection of mitochondrial reactive oxygen species (ROS) production and mitochondrial complexes activities. Results TER was decreased in a time- and concentration-dependent manner after culture with high glucose PDS for was also down-regulated significantly by high glucose PDS (P＜0.01). Complex Ⅲ activity was inhibited (10.8% of control, P＜0.01) accompanied with increased mitochondrial ROS generation.These changes were partially prevented by glutathione. Conclusion Mitochondrial respiratory complex Ⅲ pathway has crucial importance in maintaining TER of HPMCs, which may reveal a valuable target for novel therapies to fight hyperpermeability of peritoneum during the prolonged PD treatment.