Objective To evaluate the effect of telmisartan on serum adiponectin and urine microalbumin(mAlb) level by administrating it to mice with simple obesity, so as to explore new therapies for obesity-related kidney diseases.Method A total of 24 8-week-old male OB mice and 8 8-week-old male C57 mice were selected for this study.The genetic background of OB mouse was C57 mouse, but the lepin gene was deleted in OB mouse.OB mice were randomly divided into 3 groups by body weight and fed with high-fat diet for 12 weeks: model group (M group), telmisartan group (T1 group) and losartan group (T2 group).C57 mice acted as control and were fed with general diet for 12 weeks.Serum adiponectin and blood glucose levels were measured before and after treatment.24 h urine was collected to measure urine mAlb.Quantitative real-time PCR (qRT-PCR) was used to measure the expression level of peroxisome proliferators-activated receptors gamma mRNA(PPARγ mRNA).HE stain was used to observe the morphological changes of kidney and measure the glomerular diameter.Body weight, serum adiponectin level, blood glucose level, urine mAlb level, expression level of kidney PPARγ mRNA, kidney wet weight and glomerular diameter of 4 groups were compared and a correlation analysis was carried out by Person correlation coefficient.Results Compared with C group, the urine mAlb level in M group increased (P＜0.01), serum adiponectin level and the expression level of kidney PPARγ mRNA in M group decreased (P ＜ 0.01);The urine mAlb level was negatively correlated with serum adiponectin level and expression of kidney PPARγmRNA (r=-0.773,P ＜ 0.01;r=-0.469, P ＜ 0.01).The urine mAlb level in T1 group was lower than M group (P ＜ 0.05),serum adiponectin level and expression of kidney PPARγmRNA in T1 group were higher than M group (P ＜ 0.05).Compared with T2 group, the urine mAlb level in T1 group decreased, serum adiponectin level and expression of kidney PPARγ mRNA in T1 group increased (P ＜ 0.05);Compared with M group, the urine mAlb level in T2 group decreased (P=0.01).The morphological changes of kidney:glomerular volume increase and focal segmental sclerosis were found in some mice in M group and T2 group.No glomerular volume increase and focal segmental sclerosis were observed in T1 group.Conclusions Telmisartan can reduce urine microalbumin, whose mechanism might be that telmisartan can active the PPARγand promote the level of serum adiponectin.

Embryo Transfer ; Endometrium ; Female ; Fertilization in Vitro ; Humans ; Integrative Medicine

Objective To investigate the clinical and epidemiologic features of infection in patients with lupus nephritis (LN). Methods The incidence, sites and pathogen species of infection 1 year after diagnosis in 189 patients with LN were retrospectively analyzed, and the relationships between the clinical, histological types, treatment programs and infection were analyzed. Results Among 189 LN patients (16 males and 173 females), 97 patients had infection (infection group), and 92 patients had not infection (non-infection group). The incidence of infection was 51.3% (97/189), while the incidence of nosocomial infection was 39.7%(75/189). In infection group, the patients had 133 infection episodes, and the principal infection sites were lung and urinary tract system, accounting for 67.7% (90/133); the principal pathogen was bacteria, accounting for 72.9%(97/133), and the second was virus, accounting for 17.3% (23/133). Different clinical or pathological types and treatment options of LN had different infection rates, but there were no statistical differences (P>0.05). The incidence of nosocomial infection in patients with glucocorticoid + cyclophosphamide double impact was significantly higher than that in patients treated with glucocorticoid + mycophenolate mofetil: 52.9% (45/85) vs. 7.7% (2/26), and there was statistical difference (P<0.01). One year after diagnosis, the mortality in infection group was significantly higher than that in non-infection group:8.2%(8/97) vs. 1.1%(1/92), and there was statistical difference (P<0.05). Conclusions The more serious the clinical and pathological types, the higher the incidence of infection. The incidence of infection is associated with the treatment options. Infection is still the most important reason for LN patients′death.

BACKGROUND: Apart from anticoagulation property and suppressing platelet congregation capability, tongxinluo preparation has been proved by traditional Chinese medicine to possess certain function for protecting endothelial cells.OBJECTIVE: To observe the influence of Chinese medicinal herb "tongxinluo" compound on adhesion molecule expression in brain ischemia-reperfusion (IR) animal model.DESIGN: Randomized and controlled experiment.SETTING: Department of Neurology, Changzheng Hospital Affiliated to the Second Military Medical University of Chinese PLA.MATERIALS: This experiment was conducted at the laboratory of the Department of Neurology, Shanghai Changzheng Hospital, between October 2002 and January 2003. Totally 25 male SD rats were randomized into sham-operation group of 5 rats, model group of 10 rats and tongxinluo group of 10 rats.METHODS: Middle cerebral artery was occluded using thread-bolt method to induce focal brain IR model in rats. In sham-operation group,nylon thread was placed around the external carotid artery approximating to the branch of internal carotid artery, and the other procedure was the same as that in model group. Rats in tongxinluo group were given tongxininfusion before IR for 1 consecutive week, which was replaced by physiological saline of the same dosage in model group and sham-operation group. Brain tissues were obtained under anesthesia condition and cut into slices; conventional HE staining, immunohistochemical and in situ hybridization staining were conducted.MAIN OUTCOME MEASURES:① The number of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)positive microvessels following IR injury.② The number of ICAM-1 and VCAM-1 mRNA positive microvessels following IR injury.RESULTS:① In sham-operation group,ICAM-1,VCAM-1 protein andICAM-1 mRNA positive microvessels could not be observed in hemispheric cortex and basal ganglion at the operative side.② In model group,the positive expression of ICAM-1, VCAM-1 protein and ICAM-1 mRNA obviously increased at the ischemic side at 6-hour reperfusion following 2-hour ischemia.③ In tongxinluo medication group,the positive protein and mRNA-expressing microvessls were found remarkably reduced in number in ischemic side hemispheric cortex and basal ganglion [(10.42 ±1.98),(12.42±2.14)/HP; (8.54±2.00), (11.12±1.56)/HP] (P ＜ 0.05), but the positive VCAM-1 protein-expressing microvessels did not change remarkably (P ＞ 0.05).CONCLUSION: Tongxinluo can suppress ICAM-1 transcription and translation following rat brain IR, thus attenuating inflammatory injury induced by brain ischemia.

Objective To investigate principle and clinic pathologic characteristics of autoimmune thyroid disease(AITD) associated nephrosis. Methods By introducing 5 cases and related reference to review clinic pathologic characteristics of AITD associated nephrosis. Results AITD associated nephrosis regard proteinuria as principal, and a handful of performance is nephritic syndrome and nephritis syndrome. Pathologic characteristics are diversity. It is usually membranous nephrology, mesangial proliferative glomerulonephritis and focal and sclerosing glomerulonephritis. Conclusion Treatment of AITD associated nephrosis itself and immunosuppressive agent therapy might be useful to get remission of it.

Curcumae Rhizoma comes from Curcuma genus,functional breaking blood stasis,detumescence and acesodyne for treatment of Zhengjia accumulation,amenorrhea,traumatic injury and bruising pain.Modem pharmacological studies have shown that the main monomer composition of zedoary turmeric has a good anti-inflammatory and anti-tumor effects.The main monomer composition of zedoary turmeric copies of curcumol,beta etemene,curcumin anti-inflammatory anti-tumor mechanism of review,provide the basis for the further research progress and clinical application of zedoary turmeric.

Objective To investigate the influence of renal function on serum BNP in the diagnosis of CRF with heart failure by observing the relationship between eGFR and BNP in serum and comparing cut-off values of BNP in different eGFR levels. Methods The elderly participants were enrolled in the study, including 52 patients with heart failure, and 29 patients without heart failure and 30 healthy controls. Serum BNP level was measured by ELISA.Results The level of serum BNP increased significantly in subjects with heart failure compared with those with renal dysfunction for no-heart failure patients (P ＜ 0.05) and healthy controls. BNP level was significantly higher in CRF no-heart failure patients than in control subjects. eGFR showed negative correlation with BNP in ESRD no-heart failure patients (γ= -0. 581, P ＜ 0.01). There was no correlation between eGFR and ESRD with heart failure patients (γ= - 0.081, P ＞ 0.05). The AUC of BNP in patients (eGFR 30 ～ 60 ml) was 0. 951, when cut-off value was 1 500 ng/L,the sensitivity and specificity of BNP were 96.4% and 86. 7% respectively. The AUC of BNP in patients(eGFR ＜30 ml)was 0. 860, when cut-off value was 1 850 ng/L,the sensitivity and specificity of B NP were 66.7% and 92.9%respectively. Conclusions Heart failure was major factor result in higher levels of BNP in chronic renal failure with heart failure patients. BNP could be used as a diagnostic marker for CRF with heart failure patients.

Objective To explore the clinical effect of combination of vascularized fibular head epiphysis and peroneal neurovascular reverse flap repair defects of bone and skin in lateral malleolus in children.Methods Eight children with defects of bone and skin in lateral malleolus were recruited from May,2009 to September,2014.The age of children was ranging from 4 to 12 years old.Four children were injured by wheel twist,2 children were injured by traffic accident,1 was injured by machinery,and 1 was crashed with heavy object.The size of soft-tissue defect was ranging from 3 cm × 5 cm to 7 cm × 9 cm.The flap and bone healing along with ankle joint function scoring were evaluated.Patients were reviewed every 4 to 6 weeks during one year after their surgery,and they were reviewed every 6 months one year later.Results Secondary repair were conducted in all children.The curative effect got well after follow up for 6 months to 2 years(mean,12 months).The flap and fibular head epiphysis were well developed.The ossification of fibular head epiphysis did not found.According to American Orthopaedic Foot and Ankle Society (AOFAS) ankle function evaluation criteria,the results were excellent in 5 cases,good in 2 cases and poor in 1 at 10 months after operation.The shape and function of ankle joint were good,with one exception.The average motion degree of ankle joint was (68±5.12)°.Conclusion Combination of vascularized fibular head epiphysis and peroneal neurovascular reverse flap repair defects of bone and skin in lateral malleolus in children is effective.

A complete explanation of the new idea,grounds,spirit,inner-contradiction of the 3 major documents in the new framework of epileptic knowledge re-defined by International League Against Epilepsy was made in accordance with the International League Against Epilepsy original articles.And the different recognition about them nowadays existed among our nerologists was also deeply explored.

Objective To study the clinical and radiographic characteristics of complicated axis fractures combined with adjacent segment instability and explore reasonable surgical treatment strategy. Methods A retrospective study was performed on 21 patients with axis fractures treated from August 2003 to June 2009. There were 14 males and 7 females at mean age of 34 years. The treatment strategy was based on the fracture type and the stabilities of adjacent atlantoaxial joint and intervertebral C2/3.Treatment strategies included anterior C2/3 interbody discectomy and fusion, anterior cervical plate internal fixation, odontoid screw fixation, posterior C1-2 pedicle screw fixation, cervical lateral mass screw fixation or combined anteroposterior approach. Results All patients were immobilized in a hard collar for thee months and followed up for 6-36 months (average 12 months), which showed bony fusion and cervical stability, with no intraoperative surgery-related complications such as loosening, extrusion or breakage of fixation, vertebral artery injury, nerve damage, cerebrospinal fluid leakage or wound infection. Neurological recovery was observed in five patients. Conclusions For complicated atlas fractures, correct identification of fracture type and instability disturbance of adjacent atlantoaxial joint and C2/3 as well as active treatment can conduce to better effect.