Oxidative stress is one of the important pathogenesis of diabetic nephropathy.In recent years,the role of oxidized low-density lipoprotein(Ox-LDL) in the occurrence and progress of diabetic nephropathy has been more and more concerned about,and becomes a hot spot once again.This paper makes a review of the formation and metabolic mechanism of Ox-LDL,the changes of Ox-LDL in the progress of diabetic nephropathy and its clinical significance,and a number of new treatments for Ox-LDL in recent years to further understand the role of Ox-LDL in the occurrence and progress of diabetic nephropathy,then to provide new ideas for effective clinical treatment of diabetic nephropathy. Abstract:Summ ary:Oxidative stress is one of the important pathogenesis of d iabetic nephropathy.In recent years,the role of oxi-d ized low-density lipoprote in(Ox-LDL) in the occurrence and progress of d iabetic nephropathy has been more and more concerned about,and becom es a hot spot once again.Th is paperm akes a review of the form ation and m etabolic m echan ism of Ox-LDL,the changes of Ox-LDL in the progress of d iabetic nephropathy and its c lin ical sign ificance,and a number of new treatm ents forOx-LDL in recent years to further understand the role ofOx-LDL in the occurrence and progress of d ia-betic nephropathy,then to provide new ideas for effective c lin ical treatm ent of d iabetic nephropathy.

AIM: To explore protective and therapeutic effects of the shenfu injection (SF) against renal ischemia reperfusionand and its possible mechanisms by studying the impact of SF on P38 mitogen activated protein kinase (P38MAPK), tumor necrosis factor alpha (TNF-?) and intercellular adhensive molecule-1 (ICAM-1). METHODS: 36 male SD rats were randomly divided into control group, ischemia reperfusion (IR) group and SF group. Rats were subjected to left renal pedicle occlusion followed by reperfusion with contralateral nephrectomy. The expression of P38MAPK and ICAM-1 were evaluated by Imunohistochemistry. The expression of TNF-? in the kidney tissue and plasma were analyzed by enzyme-linked immunoadsordent assay (ELISA). RESULTS: The expression of P38MAPK and ICAM-1, concentration of TNF-? in IR group were higher than that in the control group (P

That sparkplugs and cognizances caution of medical morality base line is a realistic proposition that to spurn mammonism phenomenon filters medical service industry and enhances diathesis of medical affairs personnel.Medical service incited by mammonism phenomenon forms a menace to the medical base line,it is important inducement of medical action of getting out of line,and duties of medical risk and complaints of medical comsumer.Mammonism phenomenon form a nubbin quoted by medical morality base line and duties of medical risk.

0.05).For the cases when discharge,the ratio of curing,improve,inefficiency and death were 67.47%,29.01%,2.00% and 1.52%,respectively;for the cases followed up,the ratio of restoration,improve,aggravation and death were 74.31%,23.84%,1.11% and 0.74,respectively.Conclusions It has been revealed that the main liver diseases affecting the Chinese soldier's health in the past three decades include viral liver diseases,fatty liver diseases and liver injuries induced by drug and environmental factors,and the incidence of non-viral liver diseases has gone up in the last decade.Some epidemiological characteristics have emerged in Chinese soldier with liver disease in age,sex,army service branch,rank and original place.The epidemiological data have shown that the main infectious routs of liver diseases in Chinese soldier include inter-soldiers in group live,family members to soldier,and food and beverage.To make a definite diagnosis,the liver biopsy examination should be a very useful choice to the majority of hardly diagnosed liver diseases on clinic.The serological examinations for several main liver diseases have shown some special features,and most of the soldier with liver diseases has well improved after regular treatments.

Objective To study the disease spectrum,the features of clinical pathology,epidemiology and prognosis of liver diseases in Chinese populations from Jan.1980 to Jun.2008.Methods Twenty-five thousand nine hundred and forty-six patients with liver diseases in a wide spectrum of inhabitants(including 1 448 military patients) from 31 provinces or cities of all over mainland China in recent 28 years were involved in the present study for a retrospective study regarding their clinical,pathological and epidemiological features,including laboratory re-examinations and pathological examination.1 322 patients with liver disease(course lasted from 6 months to 18 years) were followed-up by more than 2 liver biopsies to study the outcome of chronic hepatitis B.Results For all the patients involved,the sex ratio of male to female was 3 to 1,with mean age of 32.3?14.4 years ranging from 41 days to 91 years,and the diseases occurred predominantly between the age of 18 to 37 years.Hebei,Henan,Beijing,Shandong and Shanxi provinces(city) ranked at the fore in the endemic distribution of the diseases.The spectrum of liver disease covered more than 100 kinds of liver diseases,of which 73.05% were infectious liver disease.As a whole,the incidence of both infectious and non-infectious,especially the non-infectious liver diseases became more prevalent since 2000.It was shown that the chronic hepatitis B was the most predominant factor which caused liver failure,liver cirrhosis and liver cancer,and chronic hepatitis C was the second factor.Chronic infection pathological changes were found in the liver tissues in 0.26% patients with hepatitis A and 0.51% patients with hepatitis E.For all the 1 322 followed-up patients with chronic hepatitis B,the incidence of liver cirrhosis and hepatocellular carcinoma was respectively 15.36%(203 cases) and 1.06%(14 cases),and the average progressive period for the changes in pathology was 46.37?16.93 months and 60.29?39.15 months,respectively.Meanwhile,the degree of liver fibrosis increased more than one stage in 188 patients(14.22%),decreased more than one stage in 441 patients(33.36%),and no change in 476 patients(30.01%).Conclusions The liver disease spectrum during recent 28 years in Chinese populations has been essentially identified by a retrospective analysis of a large number of clinical pathological data.The clinical features of predominant liver diseases have been illustrated,and the outcome and transition time of chronic hepatitis B has been elucidated in present study.

Objective To explore the status of immune responses in the lungs and the changes in lymphocyte subgroups in the immune organs in a patient having been suffered from severe acute respiratory syndrome (SARS). Methods The distribution and number of lymphocyte subgroups in the lungs and immune organs from an autopsy case of SARS were analyzed by using immunochemical staining with an array of monoclonal antibodies including CD3, CD4, CD8, CD20, CD57, CD68, S-100 and HLA-DR. Healthy spleen and lymph nodes were used as normal controls. Results CD8 + T lymphocytes constituted the major component of infiltration of inflammatory cells in the pulmonary interstitium. A semi-quantitative analysis of lymphocyte subgroups revealed that the percentage of CD3 +, CD4 +, CD8 + or CD20 + lymphocyte in a total of 31 thoracic lymph nodes of the SARS case were decreased by 74.2%, 67.7%, 74.2%, and 83.9%, respectively, compared with healthy controls. However, the percentages of lymphocyte subgroups in the celiac lymph nodes were less decreased than those in thoracic lymph nodes. The numbers of CD20 + , CD3 +, CD4 + and CD8 + lymphocytes were also decreased. CD20 + lymphocyte were notably decreased in the spleen, while CD57 +, CD68 +, S-100 + and HLA-DR + cells were increased relatively in the lymph nodes and spleen. Conclusions The results suggested that cellular immune responses were predominant in the lung of SARS patient, and it might play an important role in getting rid of coronaviruses in the infected cells and inducing immune mediated injuries to the lungs. There might be a decrease in number and imbalance in various degrees in the proportion of lymphocyte subgroups in the immune organs of the patients with severe SARS, and these changes might have a tendency to be more remarkable in lymphatic tissue situated closer to the lungs.

Objective To explore the significance of cellular apoptosis induced by severe acute respiratory syndrome cronovirus (SARS-CoV) in the pathogenesis of SARS. Methods TdT-mediated biotinylated-dUTP nick end ladelling method (TUNEL), and the double immunochemical staining with cytokeratin and CD3, CD8, CD20 and CD68 monoclonal antibodies were used to study the cellular apoptosis in tissue specimens from six patients who died from SARS. Meanwhile, the expression of Fas, Fas ligand (FasL), P53 and Bcl-2 proteins was detected by immunohistochemical method. Results The number of cellular apoptosis was obviously increased in multiple organs from the six patients died from SARS. The cellular apoptosis occurred predominantly in cytokeratin-positive pneumoncytes, terminal bronchiolar epithelium, CD3 + and CD8 + lymphocytes, as well as a part of CD20 + lymphocytes and CD68 + macrophages. Fas protein was mainly expressed in the infiltrated mononuclear cells, while FasL was chiefly expressed in SARS-CoV target cells, especially in the apoptotic cells. In the lung and immune organs, down-regulation of P53 and Bcl-2 expression was found. Conclusion The occurrence of increased and rapid cell apoptosis induced by SARS-CoV might be the main cause of the injuries to the lung and immune system. That the activated lymphocytes which expressed Fas and FasL attack SARS-CoV target cells might be the underlying mechanism of cell apoptosis in SARS. Down-expression of Bcl-2 and P53 proteins might also participate in cell apoptosis induced by SARS-CoV.

Objective To assess the efficacy of extensive esophagogastric devascularization with splenectomy for surgical treatment of portal hypertension complicating cirrhosis of liver, and to explore the pathogenesis of chronic congestive splenomegaly. Methods A retrospective analysis of clinical data of 232 patients of portal hypertension complicating cirrhosis of liver having undergone extensive esophagogastric devascularization with splenectomy was made. Pathological alterations and extracellular matrix productive cells of the congestive splenomegaly were studied both immunohistochemically and histologically. Results The functional markers including the numbers of PLT, WBC, and PTA in the peripheral blood and serum Alb were significantly improved after the operation compared with that of before the operation. Careful pre-operation preparation, replenishment of blood loss during the operation, postoperative drainage of the splenic bed, and prevention of complications were efficiently carried out. The mean volume of CCS spleens was 1 423.67?738.69cm 3. There was an obvious increase in the numbers of vimentin-, ?-SMA-positive cells in the CCS tissues, as well as CD68-positive macrophages. Conclusions The results indicated that extensive esophagogastric devascularization with splenectomy was a reasonably effective alternative therapy for patients with portal hypertension complicated by esophageal varices and congestive splenomegaly. Adequate replacement of blood lost in prevention of operation and postoperative complications were essential for satisfactory recovery of the petient. The activation of macrophagic system, with proliferation of fibroblasts and myofibroblasts, might participate in the pathogenesis of congestive splenomegaly.

Objective To explore the clinical pathological features of Wilson's disease and the pathogenesis of liver fibrosis. Methods The clinical data and liver biopsy specimens obtained from 48 children with Wilson's disease were analysed. The pathological changes were studied with light microscopy, electron microscopy, combined with rhodanine and rubeanic acid for copper staining, Gordon-Sweet's staining for reticular fibers and Masson's staining for collagen fibers. Meanwhile, immunohistochemistry was used to investigate the expression of tissue inhibitors of metalloproteinase (TIMP) -1 and TIMP-2. The apoptosis of activated hepatic stellate cells (HSC) in liver tissues was illustrated with in situ end labeling (ISEL)(TUNEL POD method) and ?-SMA double staining. Results In all the cases, the mean onset age was 10.0?3.8 years, and the positive rates of family history, Kayser-Fleischer’s ring and decreased serum ceruloplasmin level were 29.2%, 68.8% and 93.0%, respectively. The levels of serum ALT, AST, ALP and ?-Glo were 3.6, 3.0, 2.7 and 2.0 fold of normal cutoff values. The major pathological changes in childhood patients with Wilson’s disease presented various chronic inflammatory changes in hepatic acini and portal tracts, interface hepatitis, focal or diffuse vesicular/ microvesicular steatosis, with large and irregular apoptotic bodies, Mallory's bodies, glycogenated nuclei, and eosinophilc granular hepatocytes. Among all the cases, 77.0% of liver specimens were positive for rhodanine and rubeanic acid staining for copper in hepatocyts, especially in the zone I of acinus. Ultrastructural observation showed swollen and unusual giant mitochondria, increased lysosomes and vesicular inclusions in hepatocytes. The incidence of hepatic fibrosis was 100%, presenting expanded portal tracts in the early, fibrotic septa in the moderate and cirrhosis in the late stage. The extent of TIMP-1 and TIMP-2 expression and number of activated HSC were increased in various degrees in all the liver specimens, while apoptotic HSCs were obviously decreased in the majority of cases. Conclusions The clinical and pathological changes of children with Wilson’s disease are varied and relatively obscure, and liver fibrosis appears early and progressive. Excessive activation and proliferation of HSC stimulated by liver injury and inflammation due to copper deposition and the decrease in activity of matrix degradation enzymes might be the important mechanisms underlying the occurrence and progression of hepatic fibrosis in Wilson's disease.

Objective To explore the clinical and pathological features of the autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) overlap syndrome (AIH-PBC overlap syndrome). Methods The clinical data and liver biopsy specimens from 17 cases of the AIH-PBC overlap syndrome were analyzed and compared with 117 cases of AIH and 85 cases of PBC. The pathological features were as analyzed by histological observation and immunohistochemical staining for CK19, CD3, CD4, CD8, CD20, CD25, CD57 and CD68 in the biopsy liver tissues. Results Of the cases of autoimmune liver disease in this study, 8.4% were diagnosed as AIH-PBC overlap syndrome based on clinical, biochemical, serological and pathological examinations. Among the overlap syndrome cases, the females were in predominance (male∶female was 1∶8.5), and the median age of the patients presenting the clinical onset signs was 39.3 years, and the serological double-positive autoantibodies of ANA and AMA-M2 occupied 52.9%(9/17). Serum levels of ALT, ALP, ?-Glo, AST, TBIL, IgG and IgM were higher in patients with overlap syndrome than those in patients with AIH or PBC, respectively. The pathological findings in the biopsy liver tissues from the patients with overlap syndrome included moderate to severe interface hepatitis with plasma cell predominated mixed-inflammatory cells infiltration in hepatic and portal tracts, as well as the damage and obvious reactive proliferation of small bile ducts. Meanwhile, the amounts of CD3, CD4, CD8, CD20, CD25, CD57 and CD68 positive mononuclear cells increased in the overlap syndrome liver tissues compared with those in single PBC or AIH cases. Conclusion AIH-PBC overlap syndrome is not frequent (8.4%) in this study, but exist among autoimmune liver diseases in China. This overlap syndrome presented both clinical and pathological features of AIH and PBC, and cellular immune mediated injuries might be pivotal role in pathogenesis.