Drug-induced nephrotoxicity in children is dependent upon the histological, anatomical and physiological features of their kidneys and the structural and functional characteristics of drugs. The kidney is mainly composed of microvascular network and tubulointerstitial tissue, so drug-induced nephrotoxicity is usually manifested by interstitial nephropathy. The mechanisms of drug-induced nephrotoxicity include cytotoxicity (necrosis or apoptosis), ischemic injury, and immunological injury. Individual drugs cause renal damage by various mechanisms due to differences in chemical structure and pharmacology. This article reviews the main features of nephrotoxicity induced by common antibiotics (cephalosporins, aminoglycosides, vancomycin, carbapenems and amphotericin B), non-steroidal anti-inflammatory drugs, and cyclosporine A.
Anti-Bacterial Agents ; toxicity ; Anti-Inflammatory Agents, Non-Steroidal ; toxicity ; Child ; Cyclosporine ; toxicity ; Humans ; Kidney Diseases ; chemically induced

Objective To investigate the effects of gabapentin(GBP) on plasma β-endorphin(β-EP) level in the patients with painful diabetic neuropathy(PDN). Methods We detected the plasma β-EP level in 24 PDN patients in the treatment with GBP, 18 PDN patients without GBP treatment, 20 diabetic mellitus patients without PDN and 24 healthy control subjects. Results (1)The level of β-EP in diabetic mellitus patients was lower than in the healthy control(P<0.01). (2)The patients who received GBP had a significant change of β-EP level after treatment(P<0. 01).. Conclusions Gabapentin is effective for the treatment of PDN and its adverse effects are mild. It can lower the plasma β-EP level in the patients with PDN.

OBJECTIVETo study the rearrangement of immunoglobulin (Ig) heavy chain variable region (V(H)) genes in human neonates with different gestational ages (GA).

METHODSPeripheral blood from the neonates with GA of 27 weeks (4 cases), 28-32 weeks (9 cases), 33-36 weeks (12 cases), and 37-42 weeks (13 cases) was collected. RT-PCR was used to amplify the Ig V(H) gene, and the PCR products were separated by electrophoresis and analyzed using 6% denaturing PAGE gel.

RESULTSAll Ig V(H) family genes had several rearranged genes in each GA group, and the neonates with different GA showed no significant difference in the median molecular weight for each rearranged Ig V(H) family gene.

CONCLUSIONThe neonates with GA of 27-42 weeks exhibit diversity in Ig V(H) gene rearrangement, and for the same Ig V(H) family, the median length of the arranged Ig V(H) genes is independent of the gestational age.

Gene Rearrangement ; Genes, Immunoglobulin Heavy Chain ; Gestational Age ; Humans ; Immunoglobulin Heavy Chains ; genetics ; Immunoglobulin Variable Region ; genetics ; Infant, Newborn ; Multigene Family ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA

Child ; Female ; Humans ; Lupus Erythematosus, Cutaneous ; Lupus Erythematosus, Systemic ; Lupus Nephritis

OBJECTIVETo investigate the therapeutic effect of baicalin at different doses administered for different periods of time in the treatment of renal interstitial fibrosis in rats with unliateral ureteral obstruction (UUO) and related mechanisms.

METHODSSixty-four Sprague-Dawley rats were randomly divided into sham-operation, model, low-dose baicalin, and high-dose baicalin groups, and each group was further randomly divided into 7-day and 14-day groups (n=8 each). Left ureteral ligation was used to establish the rat model of UUO. Hematoxylin and eosin staining was used to observe the pathological changes in the kidney. ELISA was used to measure the serum levels of transforming growth factor-β1 (TGF-β1), Notch1, and Jagged1. Immunohistochemistry was used to measure the expression of TGF-β1 and Notch1. The Pearson correlation analysis was used for correlation analysis.

RESULTSHematoxylin and eosin staining showed inflammatory cell infiltration and edema in renal interstitium, tubular dilation and structure disorder, degeneration and necrosis of renal tubular epithelial cells, and a basically normal structure of the glomeruli on days 7 and 14 in the model group, and these lesions were alleviated in the low- and high-dose baicalin groups. Compared with the sham-operation group, the model group had a significantly higher serum level of TGF-β1 and a significantly higher number of TGF-β1-positive cells in renal tissues on days 7 and 14 (P<0.05). Compared with the model group at the same time points, the high- and low-dose baicalin groups had a significantly lower serum level of TGF-β1 and a significantly lower number of TGF-β1-positive cells in renal tissues on days 7 and 14 (P<0.05). The serum level of Jagged1 showed no significant differences between any two groups on days 7 and 14 (P>0.05). The serum level of TGF-β1 was positively correlated with that of Notch1 (r=0.650, P<0.01), and the serum level of Notch1 was positively correlated with that of Jagged1 (r=0.727, P<0.01). TGF-β1 level in renal tissues was also positively correlated with the number of Notch1-positive cells (r=0.743, P<0.01).

CONCLUSIONSBaicalin can alleviate renal interstitial fibrosis in UUO rats, probably by inhibiting Notch1 signaling pathway and the expression of TGF-β1.

Animals ; Fibrosis ; Flavonoids ; therapeutic use ; Immunohistochemistry ; Kidney ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Receptor, Notch1 ; analysis ; Transforming Growth Factor beta1 ; analysis ; Ureteral Obstruction ; pathology

Alanine Transaminase ; blood ; DNA, Viral ; blood ; Female ; Hepatitis B Antibodies ; blood ; Hepatitis B Surface Antigens ; blood ; Hepatitis B, Chronic ; virology ; Humans ; Male

OBJECTIVETo investigate the efficacy of hemoperfusion treatment in children with acute tetramine poisoning.

METHODSThirty-two children aged from 1 to 8 years ( mean 4.6+/-2.4 years) with acute tetramine poisoning received hemoperfusion treatment. Serum tetramine concentrations were measured by gas chromatography before hemoperfusion, 1 and 2 hrs after hemoperfusion initiation and 12 and 24 hrs by the end of hemoperfusion. The median time for full recovery of consciousness and the time to seizure control were observed.

RESULTSSeventeen children received hemoperfusion treatment for one time, 12 for twice, 2 for 4 times and 1 for 3 times. Twenty- seven (84%) cases recovered, 2 (7%) cases improved and 3 (9%) cases died of multi-organ failure. The serum tetramine concentrations 1 and 2 hrs after hrmoperfusion initiation were significantly lower than those before hemoperfusion (P<0.01). The serum tetramine concentrations 12 and 24 hrs by the end of hemoperfusion were also significantly lower than those before hemoperfusion (P<0.01). The median time for full recovery of consciousness and the time to seizure control were 5.4+/-4.2 and 10.1+/-7.3 hrs, respectively.

CONCLUSIONSHemoperfusion treatment is effective for acute tetramine poisoning in children.

Acute Disease ; Bridged-Ring Compounds ; blood ; poisoning ; Child ; Child, Preschool ; Female ; Hemoperfusion ; Humans ; Infant ; Male ; Time Factors

Objective To investigate the value of endoscopy combined with laparoscopy in the treatment of colorectal polyps and polyp canceration.Methods Different combinations of endoscopic and laparoscopic procedures were employed and the clinical efficacies were compared.Results From January 2004 to September 2006,46 cases with colorectal polyp were treated with endoscopy combined with laparoscopy.Among them,5 cases(10.87%)underwent laparoscopic-assisted endoscopic polypectomy,30(65.22%)endoscopic-assisted laparoscopic resection,6(13.04%)synchronously endoscopic and laparoscopic resection.Five cases were performed further operation after endoscopic polypectomy.According to the pathological findings,21(45.7%)were proved to be polyp canceration,among which 6 were advanced carcinoma,and 3 were found metastasis to the lymph nodes.Among the 41 cases of laparoscopic resection,there was no conversion to an open surgery.Anastomotic leakage was found in 2 cases and anastomotic bleeding in 1.In the 5 cases of laparoscopic-assisted endoscopic polypectomy,no complication was observed.During the period of follow-up(1 to 21 months),no recurrence was detected.Conclusion Endoscopy combined with laparoscopy extends the safety and indications of endoscopic polypectomy,and is minimally invasive to the patients.It is an ideal procedure in the treatment of colorectal polyps and poly carceration.

OBJECTIVETo investigate whether there are different stromal compositions in the prostate tissue of patients with benign prostatic hyperplasia (BPH) and evaluate their significance in the course of the disease.

METHODSForty-three surgical or bioptic prostatic specimens of BPH and 5 autoptic normal prostatic specimens were stained by the Masson method to display the elements of the muscle fiber and collagen. The relationship of the changes in the prostatic stromal composition was analyzed with the degree of bladder outlet obstruction (BOO) , IPSS and medication results.

RESULTSThe mean ratio of muscle fiber to collagen in the normal prostate tissue was (3.2 +/- 0.2):1, significantly higher than that of the BPH patients (1: [4.7 +/- 3.1] ) (P < 0.01); that in the BPH patients with BOO was 1: (5.4 +/- 3.7) markedly lower than in those without BOO (1: [2.5 +/- 1.1] ) (P = 0.02); that in the BPH patients with severe prostatic symptoms was 1: (9.1 +/- 2.9), remarkably lower than in those with moderate (1: [5.3 +/- 3.4]) and mild prostatic symptoms (1: [2.8 +/- 1.7]) (P < 0.01); and that in the BPH patients with satisfactory medicinal therapeutic results was 1:(2.3 +/- 1.9), significantly higher than in those with poor therapeutic results (1: [7.6 +/- 4.3]) (P < 0.01).

CONCLUSIONThe stromal composition in the prostatic tissue of BPH patients undergoes different degrees of changes. More obvious BPH symptoms and poorer therapeutic results are associated with a bigger proportion of collagens and a smaller proportion of muscle fibers in the prostatic tissue. These changes may play an important role in the development and progression of BPH.

Aged ; Aged, 80 and over ; Case-Control Studies ; Fibrosis ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostatic Hyperplasia ; pathology ; Urinary Bladder Neck Obstruction ; pathology

OBJECTIVETo investigate fibronectin synthesis in SD rat mesangial cells after transforming growth factor-beta1 (TGF-beta1) is silenced by the short interfering RNA (siRNA) expressed by reconstructed pGEFP-C1 vectors.

METHODSDepending upon the 538th - 556th (A) and 895th - 913th (B) nucleotides of rat TGF-beta1 gene, a nucleotide (A or B) was constructed into a small hairpin nucleotide which was separately (A or B) or together (A plus B) inserted into a pGEFP-C1 vector with three reconstructed pGEFP-C1 vectors separately expressing the siRNAs for A or/and B. TGF-beta1 and fibronectin were dynamically investigated for their interrelationship by ELISA in the supernatant and RT-PCR in their extracted total RNA.

RESULTSThe siRNA hairpin-like molecules were constructed according to the 538th - 556th nucleotides of rat TGF-beta1 gene were able to markedly silence the expression of TGF-beta1 mRNA (P < 0.01) and protein (P < 0.01) at 48 h. Lipfectamin 2000 transfection stimulated the peak secretion of fibronectin at 24 h in the control and the experimental group whose TGF-beta1 was not silenced, but the silence of TGF-beta1 in both experimental groups delayed the top values of fibronectin to 48 h (P < 0.01).

CONCLUSIONThe silence of TGF-beta1 by siRNA decreased the fibronectin expression, but the latter was possibly not completely TGF-dependent.

Animals ; Cells ; Cells, Cultured ; Fibronectins ; metabolism ; Mesangial Cells ; drug effects ; metabolism ; RNA Interference ; drug effects ; physiology ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; chemistry ; genetics