Objective To investigate the effect and safety of a low-dosed urokinase combined with fosinopri plus leflunomide and prednisone on treatment of moderate and severe IgA nephropathy (IgAN).Methods Fifty-seven patients with IgAN confirmed by biopsy combining with clinical presentations were enrolled,with their ages ranged from 15 to 55,proteinuria excretion ≥ 1.0 g/24 h,serum creatinine (SCr) ≤ 265.20 μmol/L,grade Ⅲ or above in Hass histologic grading systems for renal biopsy.The patients were randomly divided into trial group( n =28 ) and control group( n =29 ) and received treatment for six months.The patients in trial group were treated with a low-dosed urokinase combined with fosinopri plus leflunomide and prednisone,while those in control group were treated with prednisone and fosinopril.Results ( 1 ) After 6 months of treatment,the rates of complete remission (CR) and partial remission (PR) were 52.0％ and 40.0％ respectively in trial group,and 20.8％ and 54.2％ respectively in control group.The total remission rate(TR)and CR in trial group were significantly higher than those in control group ( TR x2 =0.47,P ＜ 0.05 ; CR x2 =5.11,P ＜ 0.05 ).( 2 ) The SCr level was decreased in trial group ( [ 115.83 ± 16.78 ] μmol/L v.s.(93.29 ±12.41 ) μmol/L,P ＜ 0.05 ),while increased in control group ( [ 112.79 ± 12.79 ] μmol/L v.s.( 136.99 ±25.97 )μmol/L,P ＜ 0.05 ).The two groups had significant difference on SCr clearance rate after treatment( P ＜0.05).There was no significant difference between the two groups on the endogenous creatinine clearance rate (Ccr) ( P =0.52 ),and no significant difference within trial group ( [ 79.34 ± 6.09 ] ml/min v.s.[ 85.12 ±12.26] ml/min,P =0.05)and within control group( [80.18 ±6.51 ] mi/min v.s.[84.22 ±8.39] ml/min,P =0.67 ).The levels of 24-hour proteinuria excretion after 6 months were decreased in both groups ( trial group:[1.93 ±0.55]g/24 hv.s.[0.78 ±0.42]g/24 h,P＜0.05;control group:[1.85 ±0.51]g/24 h v.s.[1.30±0.35 ] g/24 h,P ＜ 0.05 ),and the treatment effect was better in trial group ( P =0.04 ).Conclusion Treatment of moderate and severe IgA nephropathy with low-dosed urokinase combined with fosinopri plus leflunomide and prednisone is effective and safe by improving renal function and decreasing proteinuria.

OBJECTIVE:To observe the clinical efficacy and safety of semis glucocorticoid combined with mycophenolate mofetil (MMF) for IgA nephropathy in patients after undergoing tonsillectomy. METHODS:207 patients diagnosed as having IgA nephropathy by renal biopsy were divided into operation group and control group:both groups received semis glucocorticoid combined with MMF. The patients were followed for 1 year to observe the changes of the proteinuria level,red blood cell count,blood pressure and renal function. RESULTS:After 3-month treatment,both group improved in urine red blood cell count and urine protein level,and the operation group had a better improvement than in the control group(P

Objective: To observe the effect of sequential colon dialysis in patients with chronic renal failure(CRF) in early and medium stage.Methods: One hundred and forty-two CRF patients in early and medium stage were treated with sequential colon dialysis and traditional Chinese medicine according to(traditional) Chinese medical syndrome differentiation and typing,and clinical syndromes were observed.(Sixty-three) patients with CRF were selected as controls treated with low protein diet plus essential amino acids.The serum levels of blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),the creatinine(clearance) rate(CCr),electrolyte and medium molecular substance(MMS) were measured before and after treatment.Results: The clinical symptoms of the 142 patients were improved,the serum levels of BUN,Cr,UA and MMS were decreased significantly(BUN:(15.3?4.5)mmol/L vs.(8.6?3.3)mmol/L;Cr:((443.6?73.5)?mol/L) vs.(283.5?38.7) ?mol/L;UA:(512.6?86.5)?mol/L vs.(243.1?33.6)?mol/L;MMS: 0.44?0.06 vs.0.32?0.04),and CCr increased markedly((9.87?3.31)ml/min vs.(15.60?(4.63)ml/min)).The difference between treatment group and control group was significant.The changes in electrolyte levels were not significant before and after treatment in both groups.Conclusion: Sequential colon dialysis has obviously curative effects on CRF patients in early and medium stage,and could ameliorate the(develope) of CRF in early and medium stage.

Objective To study the effects of CUEDC2 on renal interstitial fibrosis and inflammation response in rats with unilateral ureteral obstruction (UUO). Methods 30 Balb/c rats were randomly distributed into sham operation group(sham-vector),uuo operation group(uuo-vector) and CUEDC2 treatment group after uuo (uuo-cuedc2). Hematoxylin-eosin and Masson staining were used to measure renal pathology; Inflammation factors were quantified by ELISA; Immunohistochemistry was performed to measure the expression of CUEDC2;Protein expression of CUEDC2, Fibronectin, E-cadherin, Collagen I were detected by Western Blot. Results At 7 and 14d after operation, the area of interstitial fibrosis and expression of ICAM1,MCP1,IL1,IL8, Fibronectin and Collagen I in uuo-cuedc2 showed a marked decrease when compared to uuo-vector (p?0.05),the level of E-cadherin was significantly increased (P < 0.05). Conclusion CUEDC2 can inhibit renal interstitial fibrosis and decrease the expression of inflammation factors and Collagen deposition.

Objective: To observe the clinical efficacy of combination of Dahuang Mugong decoction(DMD,大黄牡公汤) and sequential colon dialysis in treatment of chronic renal failure(CRF) and explore its potential mechanism.Methods: Nintyeight patients with CRF were treated with sequential colon dialysis and DMD.Besides the observation on the clinical symptoms and signs,the serum levels of blood urea nitrogen(BUN),serum creatinine(SCr),uric acid(UA),serum phosphorus((SP),inorganic),Ca~(2+) and(albumin)(Alb) were measured with autoanalysis machine and the optical density(A_(450) value) of medium molecule substance(MM) with(nephelometer) between pre treatment and posttreatment.Results: The(accumulated) score of the clinical symptoms and signs were decreased with the combination of DMD and(sequential) colon dialysis(P

Objective To discuss the expression level of CUEDC2 protein and its connection with 24 h urinary albumin and serum creatinine iu db/db mice with diabetic nephropathy.Methods db/db mice were selected as experimental groups (n =10),and db/m mice as control (n =10).All mice were fed in barrier facilities under the same conditions.At week 24,all were sacrificed and the samples were collected for analyses.The histological changes were assessed by Hematoxylin-Eosin(HE) staining,periodic acid-Schiff (PAS) staining and Masson's trichrome (Masson) staining.The location and expression of CUEDC2 were measured by immunohistochemistry assays.24 h urinary albumin and serum creatinine were quantified by clinic lab in our hospital.Results Immunohistochemistry demonstrated that CUEDC2 was mainly located in the medulla tubules plasma cells.The results of HE staining revealed that there appeared glomerular number decreased,atrophy and inflammatory cell infiltration in the mice kidney of diabetic nephropathy group at the 24th week.The mesangial matrix expansion and renal tissue collagen deposition were significantly up-regulated in db/db mice compared with the normal control.As compared with the control group,the CUEDC2 protein expression and mRNA expression in db/db mice were significantly decreased than that in db/m mice (both P ＜ 0.05),and 24 h urinary albumin and serum creatinine were significantly increased.The correlation analysis showed CUEDC2 was negatively correlated with 24 h urinary albumin and serum creatinine (both P ＜ 0.05).Conclusion The expression of CUEDC2 in diabetic nephropathy mice kidney is significantly decreased and negatively correlated with the levels of 24 h urinary albumin and serum creatinine.

Objective To assess the mortality and risk factors for stroke among dialysis patients with different dialysis modality. Methods 590 patients who underwent hemodialysis (HD) or peritoneal dialysis (PD) from January 2008 to December 2012 were recruited in our study, and categorized according to dialysis modality. The prognostic risks of stroke were hazard ratio of risk was calculated by Cox regression analysis in HD and PD patients respectively. by the Kaplan?Meier curves or the Cox proportional hazards model. Results A total of 590 patients is under a median follow?up of 32.5 months. The stroke incidence rate of 49.2/1, 000 patient?years in total patients, and 74.1/1, 000 patient?years in HD patients, which was significantly higher compared with that of 31.8/1,000 patient?years in PD patients. On multivariate analysis, independent predictors of stroke occurrence were age(HR=1.05;95%CI:1.02~1.09;P=0.003)、diabete(HR=1.98;95%CI:1.31~3.46;P=0.001)、CVD(HR=2.06;95%CI:1.62-3.05;P < 0.001)、Total triglycerides(HR = 1.20; 95% CI:1.08-1.58; P = 0.034) and hemodialysis (HR = 2.03; 95% CI:1.46-3.89; P = 0.005). Conclusions Age, diabete, CVD, total triglycerides and hemodialysis are independently associated with increased stroke risks in dialysis patients, which suggest that these patients should pay attention to weight control and glucose control.

OBJECTIVETo prepare the trimeric subunits of recombinant human mannan-binding lectin (MBL) with biological activities.

METHODSA prokaryotic expression vector containing human MBL N-terminal deletant (rhMBLδN) gene we previously constructed was transformed into E. coli for efficient expression of rhMBLδN fusion protein. Based on the principle that the collagen polypeptides tend to self-assembly into the tertiary structure of proteins by forming a triple helix due to the characteristic properties of the collagen proteins, rhMBLδN fusion protein was limitedly hydrolyzed with thrombin. The obtained rhMBLδN polypeptide was repeatedly dialyzed in 50 mmol/L PBS (pH7.2) and ddH(2)O, and the final product was analyzed for its bioactivities using a ligand-binding assay and a C4d deposition assay.

RESULTSrhMBLδN polypeptide with a relative molecular mass of about 20 000 was obtained by limited proteolysis of rhMBLδN fusion protein with thrombin. Repeated dialyses of rhMBLδN polypeptides in 50 mmol/L PBS and ddH(2)O resulted in the isolation of the trimeric subunit trhMBLδN (with a relative molecular mass of about 50 000), which contained a collagen-like helix. The trhMBLδN protein had a higher ligand-binding activity than rhMBLδN polypeptide, and acquired the activity to initiate the lectin pathway of complement activation, but the activities were lower than those of natural MBL.

CONCLUSIONWe have successfully obtained the bioactive trimeric subunit of rhMBL, trhMBLδN, and this structural subunit is also the functional subunit of the MBL molecule.

Complement Activation ; Escherichia coli ; metabolism ; Genetic Vectors ; Humans ; Mannose-Binding Lectin ; biosynthesis ; genetics ; isolation & purification ; Recombinant Proteins ; biosynthesis