Using the IL—6 dependent hybridoma cell line KD83, we investigated the relationship between KNA—anti—DNA immune complexes(DNA—anti—DNAICs)from the sera of lupus nephritis patients and interleukin 6 (IL—6) production by mouse glomerular mesangial cells cultured in vitro. The results show that DNA—anti—DNA IgM and DNA—anti—DNA IgG and DNA—anti—DNA IgM all enhance IL—6 production by mesangial cells; of those DNA—anti—DNA IC, the effect of DNA—anti—DNA IgM on IL—6 production by mesangial cells was significant. This enhanced production of IL—6 by mesangial cells was dependent on concentration of DAN—anti—DNA ICs.

Objective To study the role of fibroblasts in the pathomechanisms of renal interstitial fibrosis(RIF). Methods Growth behavior and apoptos, of renal interstitial fibroblasts in cultures, established using renal biopsies of casts with and without RIF, were studied. Results There were significant alterations in the growth behavior, the differentiation pattern of potentially mitotic fibroblast populations and programmed cell death in cultures derived from kidneys with RIF, as compared with cultures of normal origin. Conclusion The abnormal growth and apoptosis of fibroblasts may play an im-portant role in RIF. Inhibiting the proliferation and promoting the programmed death of fibroblasts may be benificial to patients with RIF.

To investigate the best intennittence and reasonable dosage of CDC pulse therapy on different activity degree of lupus nephritis (LN). Methods 96 severe LN cases were divided into three groups. Croup A; CTX pusle treatment (IV-CTX), once 2 weeks, 8- 12 mg'kg'Vd for two days; Group B: IV-CTX once a month, 0.5 - 1.0/m2; Group C: IV-CTX once 3 months, 0.5 - 1.0/m2. Prednisone was given to three groups simultaneously. Results The time taking effect was shorter significantly in Group A than that in Group B and C. Remission rate was higher significantly in Group A than that in Group B and C ( P 0. 05). Intermittence of 15 cases (23.8%) from Group Ek C was changed to once 2 weeks and then the disease activity had been controlled since these patients became worse during the treatment. Intennittence of 3 patients (9% ) from Group A was delayed a week because of the decreasing of WBC counting. There was no significantly difference between three groups in side effect and its incidence. Conclusion A reasonable IV-CTX should be choosen according to the disease activity. IV-CTX 8 - 12 mg'kg'Vd for two days, once 2 weeks should be used for acute and severe LN. When disease becomes mild, IV-CTX can be changed to 0.5 - 1.0/m2, once a month. After LN activity is controlled basically, 0.5- 1.0/m2, once a month is recommended.

Objective In order to investigate the reversibility of uremia in patients with lupus nephritis(LN). Methods 37 uremic patients with IN who underwent dialysis were treated with a progressive protocol of combined glucocorticoid and cyclophosphamide (CTX) during the last 15 years. Results 83.8% of patients withdrawed from dialysis, with an average withdrawal period of 40.6 ?21.5 months, and with serum creatinine of 179.36 ?88.24 fjiaoVL at least half year after the withdrawal. Conclusion Uremic patients with LN who should be dialysed are not necessarily in end stage of their renal diseases, and those who are indicated for immunosuppressants and probable to be reversed should be treated properly and promptly.

Objective To investigate the role of NF-?B in the pathogenesis of lupus nephritis (LN). Methods A microwave-based immunohistochemistry (APAAP) was used to detect the expression of NF-?B p65 and C-myc protein in renal tissue of LN and normal control. At the same time, the correlation between expression of NF-?B and renal injuries in LN was examined. Results The expression of NF-?B in LN was higher than that of normal control, the highest one was type Ⅳ LN. The number of positive cells expressing NF-?B in renal tissue of LN showed a strong correlation with C-myc protein expression, kidney activity of LN, histological changes and functional lesion in LN, respectively. Conclusions NF-?B may play an important role in the pathogenesis of LN, and the number of positive cells expressing NF-?B may be considered as a predictor for the kidney activity and progressive renal injury in LN.

Objective To determine whether peritoneal mesothelial cells express CD40 and to investigate potential mechanism by which CD40-CD40 ligand(CD40L) interaction may be involved in the inflammation of peritoneal membrane. Methods Rat peritoneal mesothelial cells (MC) were harvested from peritoneal cavity and maintained under defined in vitro conditions. Expression of CD40 on MC under normal culture or stimulation with interferon-?(IFN-?), tumor necrosis factor-?(TNF-?), interleukin(IL)-1 was examined by RT-PCR and FACS analysis. After activation with CD40 mAb, the expression of intercellular adhesion molecule-1 (ICAM-1) on MC was analyzed by FCAS. Results MC cultured in vitro expressed CD40 constitutively. The expression of CD40mRNA and CD40 protein up-regulated markedly following the stimulations with IFN-?, but not with IL-1, TNF-?. The expression of ICAM-1 on MC was significantly increased after activation of CD40 with IFN-? and CD40mAb. Conclusions MC functionally expresses CD40. The interaction of CD40 on MC and CD40L+ cells in peritoneal cavity may play an important role in peritoneal local defense and may be involved in the inflammation process of peritoneum.

Objective To define which hyaluronan synthase (HAS), of three hyaluronan synthesizing enzymes HAS-1, HAS-2, and HAS-3, is primarily responsible for hyaluronan synthesis and extracellular matrix/extracellular coat formation in human peritoneal mesothelial cells (HPMCs) . Methods As a prerequisite study, the expression of each HAS mRNA in cultured HPMCs was measured by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). Only the expression of HAS-2 and HAS-3 mRNA could be detected. The level of HAS-2 mRNA expression was about 10 fold higher than that of HAS-3. HAS-2 specific antisense oligonucleotide was then transfected into cultured HPMCs by lipofectamine. After 0, 8, 24, and 48 hours, the expression of HAS-2 mRNA was detected by RT-PCR and the extracellular coat was measured by particle exclusion test. Results 8 hours and 24 hours after transfection, the expression of HAS-2 mRNA in HPMCs decreased by 58% and 89% respectively; 48 hours after transfection, the expression of HAS-2 mRNA in HPMCs partially restored to 25% of the normal level. Correspondingly, 24 hours after transfection, the extracellular matrix/extracellular coat in HPMCs almost completely disappeared. However, as control, sense and reverse oligonucleotides showed no effect. Conclusion HAS-2 plays a leading role in HPMCs hyaluronan synthesis and the formation of extracellualr matrix/extracellular coat.

Objective To study clinical feature,pathology,treatment and outcome of acute renal failure(ARF) in idiopathic nephrotic syndrome(IDNS).Methods History-taking of 38 cases were carried out all detailly 24-hour urine protein,biochemistry markers,hemorheology,renal histopathology were detected.Results The study fandings that 82 percent of patients were less than 40 years old,76 3 percent were male,74 percent(28 patients) were non-oliguria and 52 6 percent were minimal change glomerulonephritis through the renipuncture,most of the cases had edema of interstitium, by give prednisone of standard dosage,symptomatic treatment or dialysis the satisfying efficacy was got.Conclusions The main features of IDNS complicated with ARF are usual,it is non-oliguria type in clinic minimal glomerulonephritis in pathology,and deficient blood volume leads to occurrence of ARF,but the renal function could be recovered by give prednisone of routine dosage,symptomatic treatment and hemodialysis therapy.

ObjectiveTo investigate the clinical features of acute myocardial infarction in CAPD patients.MethodsCompare the clinical and laboratory data of 39 patients with CAPD and AMI for the first time (PD group),including clinical symptoms,signs,electrocardiogram changes,myocardial enzyme changes and in hospital mortality,with those of 50 patients without renal insufficient but with AMI for the first time (C group).Diagnosis of AMI was made in hospital.ResultsCompared to C group, the symptoms presented at first in PD group were more atypical and the patients went to see doctor more lately after AMI.Atypical electrocardiogram changes were more in PD group than in C group (61.5% vs 26.0%,P

Complications in CRF-CAPD were treated by TCM during the past 17 years. Loss of appetite and hypoproteinemia were treated with modified Renshen Yangrong Decoction, for abdominal pain and distention, modified Xiangsha Liujunzi Decoction; for peritonitis, modified Dacaihu Decoction; for diarrhea due to hypofunction of spleen with exuberant dampness, modified Shenling Baizhu Powder; for Yang-deficiency of the Spleen and Kidney, modified Lizhong Decoction plus Sishen Pill; for skin pruritus, Siwu Decoction with additives; for renal -ortheopathy, treated by principles of tonifying the liver - kidney, strengthening the bones and tendons and blood - activating and stasis - relieving; for hyperlipidemia, by principles of tonifying the liver -kidney, phlegm and turbidity - eliminating and blood - activating stasis - relieving; for renalanemia, Guishao Sijunzi Decoction with additives. To improve patient'sliving quality and nutrition, self- formulated Shentekang capsule was given to improve renal function, decrease the frequencies and duration of dialysis, self - formulated Shenshuai Recipe was administered.