Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Glomerulonephritis, IGA ; complications ; diagnosis ; drug therapy ; Humans ; Kidney Failure, Chronic ; drug therapy ; etiology ; Medicine, Chinese Traditional ; Phytotherapy

Glomerulonephritis, IGA ; diagnosis ; therapy ; Humans ; Integrative Medicine ; Risk Assessment

Acute Kidney Injury ; physiopathology ; prevention & control ; therapy ; Humans ; Integrative Medicine ; Kidney ; injuries ; Kidney Function Tests ; Syndrome

Along with the development of clinical and pathological studies, and the wide spreading of the concepts or ideas of chronic kidney disease (CKD) and diabetic kidney disease (DKD), the clinical research of DKD has entered a new stage, which has brought new requirements for Chinese medicine treatment of DKD. It is necessary to carry out good design, have reasonable inclusion and exclusion criteria, select appropriate biomarkers capable of reflecting the pathophysiology of DKD, choose convincible hard endpoints capable of reflecting the prognosis of DKD, and conduct observations of enough long therapeutic course. This is the main trend of conducting clinical trials of DKD and scientifically assessing the efficacy of Chinese medicine treatment of DKD.
Diabetic Nephropathies ; diagnosis ; drug therapy ; pathology ; Humans ; Medicine, Chinese Traditional ; trends

OBJECTIVETo compare the therapeutic effect of Astragalus and Angelica Mixture (AAM) on treating CKD patients according to different CKD primary diseases, staging and TCM syndromes.

METHODSA multicentre, open-label, and self control clinical design was used, and thirty-two patients in line with inclusive criteria were recruited. Based on maintaining their previous basic CKD treatment, patients additionally took AAM (Astragalus and Angelica each 30 g), once a day, three months consisted of one therapeutic course. Serum creatinine (SCr), estimated glomerular filtration rate (eG- FR), 24 h urinary total protein (UTP), plasma albumin (ALB), hemoglobin (Hb), and changes of TCM syndrome factor integrals were compared before treatment, at the end of month 1, 2, and 3. The differences in the aforesaid indices were compared between CKD patients with different CKD primary diseases (chronic glomerulonephritis, chronic renal tubulointerstitial disease, hypertensive renal damage), different CKD stages (CKD 3 and CKD 4), and patients of qi-blood deficiency syndrome (QBDS) and non-QBDS.

RESULTSAAM could improve 78.12% (25/32) patients' renal function. Compared with before treatment, SCr decreased (12.08% +/- 10.11%), eGFR increased (21.14% +/- 18.55%), and ALB increased (2.76% +/- 1.97%) at the end of 3-month treatment (all P < 0.05). As for TCM syndrome factor integrals, compared with before treatment, the integrals for qi deficiency syndrome, blood deficiency syndrome, and yin deficiency syndrome decreased, while the integrals for dampness heat syndrome and turbid-toxin syndrome increased (all P < 0.05). There was no obvious difference in all indices except the integral for hypertensive renal damage patients of yin deficiency syndrome (P > 0.05). The SCr decreasing percent was 19.82% +/- 8.30% for patients of non-QBDS and 5.24% +/- 10.75% for patients of QBDS. The latter was higher with statistical difference (P < 0.05). As for TCM syndrome factor integrals, the integral differences of qi deficiency and blood deficiency were obviously higher in patients of QBDS, when compared with patients of non-QBDS (P < 0.05).

CONCLUSIONAAM could improve the renal function of CKD patients, elevate their ALB levels, and ameliorate associated qi deficiency syndrome, blood deficiency syndrome, and yin deficiency syndrome, especially for CKD patients of QBDS.

Adolescent ; Adult ; Aged ; Angelica ; Astragalus Plant ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Renal Insufficiency, Chronic ; drug therapy ; Treatment Outcome ; Yin Deficiency ; drug therapy ; Young Adult

Angioplasty, Balloon ; methods ; Atherosclerosis ; pathology ; therapy ; Humans ; Hypertension ; complications ; drug therapy ; Renal Artery Obstruction ; etiology ; therapy ; Stents

OBJECTIVETo investigate the relationship between degree of TCM blood-stasis syndrome (BSS) with clinic features and renal pathological type of primary glomerular disease (PGD).

METHODSOn-site investigation was adopted, 174 patients with PGD conforming to the inclusive/exclusive criteria were enrolled, and their degree of BSS and deficiency syndrome were scored in 3 days before renal biopsies. The relation of clinical indexes, including age, course of disease, symptoms of deficiency syndrome, 24-h urinary protein excretion (Upro), condition of hypertension and its controlling, glomerular filtrating rate (GFR) based on the predigesting equation of MDRD, and blood levels of uric acid (UA), triglyceride (TG), cholesterol (CHO), hemoglobin (Hb), and albumin (ALB), with the renal pathological type and the BSS score were analyzed.

RESULTS(1) Among the 174 patients, 159 cases (91.38%) were differentiated as BSS, with the degree of moderate in 111 cases and severe in 48 cases; (2) The BSS score was significantly correlated with the level of Upro, CHO, TG, ALB and deficiency syndrome (P < 0.01), but showed insignificant correlation with age, course of disease, grade of the hypertension, and GFR, UA and Hb levels. Multivariate stepwise regression analysis showed that the level of Upro and TG and score of deficiency syndrome had significance for regression equation establishment (P<0.01). (3) Further analysis on renal pathological type in 119 patients of non-nephrotic syndrome showed that the BSS score was insignificantly different among patients with different renal pathological types as the minor/minimal type (3 cases), the focal/segmental glomerular type (72 cases), and the diffuse glomerulonephritis (44 cases, P > 0.05). Further stratified analysis on the 72 cases with focal/segmental lesion showed that BSS score in patients of focal proliferative sclerosing glomerulonephritis were significantly higher than that in those of focal proliferative glomerulonephritis (P < 0.01).

CONCLUSIONBSS is a TCM syndrome most commonly seen in patients with primary glomerular disease, BSS score is significantly correlated with the level of Upro, TG and deficiency syndrome score, and exhibits a higher level in patients with focal proliferative glomerulonephritis accompanying glomerulus sclerosis, indicating that the BSS could give certain clues of the renal chronic changes of primary glomerular disease, being one of risk factors in TCM syndrome in the development of renal diseases.

Adolescent ; Adult ; Aged ; Biopsy, Needle ; Diagnosis, Differential ; Female ; Glomerulonephritis ; diagnosis ; pathology ; Glomerulonephritis, IGA ; diagnosis ; pathology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nephrotic Syndrome ; diagnosis ; pathology ; Regression Analysis ; Syndrome ; Young Adult

OBJECTIVETo observe the effects of AML1-ETO fusion gene on the transcription activity of p21WAF1/CIP1 gene. And to explore the enhancement of leukemia pathogenesis of AML1-ETO.

METHODSThe luciferase reporter plasmids of p21WAF1/CIP1 gene promoter were constructed, and co-transfected into CV-1 cells with AML1-ETO, AML1b and AML1a expression plasmids. The trans-activity of p21WAF1/CIP1 gene promoter was assayed by luminometer.

RESULTSAML1-ETO exhibited a distinct inhibition activity of p21WAF1/CIP1 gene promoter with a sequence-specificity and dosage-dependent manner. The trans-activity of p21WAF1/CIP1 gene promoter decreased to (19 +/- 4)% compared to control group, when 1000 ng pCMV5-AML1-ETO plasmid was used. AML1b and AMLla showed less inhibition activity. The trans-activity of p21WAF1/CIP1 gene promoter decreased to (61 +/- 16)% and (59 +/- 16)% compared to control group, respectively, when 1000 ng plasmid was used.

CONCLUSIONAML1-ETO exhibits more inhibition activity of p21WAF1/CIP1 gene promoter than AML1b and AMLla, results from recruiting transcription co-repression complex efficiently by ETO. Based on previous researches, the effects of exogenous AML1-ETO on p21WAF1/CIP1 gene promote may be dependent on the type of cell lines.

Animals ; Cell Line ; Core Binding Factor Alpha 2 Subunit ; genetics ; Cyclin-Dependent Kinase Inhibitor p21 ; genetics ; Haplorhini ; Oncogene Proteins, Fusion ; genetics ; Plasmids ; genetics ; Promoter Regions, Genetic ; genetics ; RUNX1 Translocation Partner 1 Protein ; Transcription, Genetic ; Transfection

OBJECTIVETo explore the effect of 17-allylamide-17-demethoxygeldanamycin (17AAG), a heat shock protein 90 (HSP90) inhibitor, on the growth, differentiation and apoptosis of leukemic Kasumi-1 cells.

METHODSKasumi-1 cells were treated with 17AAG at different concentrations in suspension culture. Cell proliferation was analysed by MTT assay, expression of myeloid-specific differentiation antigen and cell cycle by flow cytometry, cell apoptosis by annexin V staining, agarose gel electrophoresis and flow cytometry. KIT protein was analysed by Western blot and c-kit mRNA by RT-PCR.

RESULTS17AAG treatment caused a dose-dependent inhibition of the cell proliferation with the IC(50) of 0.62 micromol/L. A dose-dependent increase in early apoptosis occurred at 24 hours treatment and in late apoptosis at 48 hours treatment. 17AAG induced a time- and dose-dependent increase in expression of myeloid cell surface protein CD11b and CD15, a progressive decline in S-phase cell fraction and an increase in G(0)/G(1) cells. When Kasumi-1 cells were incubated with 1 micromol/L of 17AAG, KIT protein began to decrease at 2 hours and KIT protein could hardly be detected at 20 hours, but c-kit mRNA was not decreased.

CONCLUSION17AAG treatment of Kasumi-1 cells could lower KIT protein expression, inhibit cell proliferation, induce cell partial differentiation, apoptosis and accumulation in G(0)/G(1) phase.

Apoptosis ; drug effects ; Benzoquinones ; pharmacology ; Cell Cycle ; drug effects ; Cell Differentiation ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; HSP90 Heat-Shock Proteins ; antagonists & inhibitors ; Humans ; Lactams, Macrocyclic ; pharmacology ; Proto-Oncogene Proteins c-kit ; genetics ; metabolism ; RNA, Messenger ; genetics

Chronic kidney disease is a kind of disease with the condition always worsening over time passing through a sequence of stages, and the evaluation on its clinical treatment is mainly by observing the speed of renal function deteriorating and the time of terminal renal failure occurrence. In order to conduct the trial go on wheels, the authors proposed that the "surrogate end points (SEP)" should be introduced. It is the biologic mark for substitute the clinical terminal point (event), formed depending upon the scientific evidences of epidemiology, pathophysiology, drug-therapy and other scientific evidence, which could be used for predicting the efficacy or damage of a certain measure, present or absent. This article aimed to explain the definition of SEP and to discuss the usable SEP for clinical trial on chronic kidney disease, such as proteinuria, declination of glomerular filtration rate and its slope coefficient as well as the time of terminal occurrence. Moreover, through analyzing the existent problems in clinical researches concerning TCM treatment of chronic kidney disease, the authors suggested that some improvements, chiefly the utilization of SEP for efficacy evaluation, are necessary in the clinical observation methodologies for chronic kidney disease.
Animals ; Biomedical Research ; Clinical Trials as Topic ; Drug Evaluation ; standards ; Drugs, Chinese Herbal ; therapeutic use ; Glomerular Filtration Rate ; Humans ; Kidney Failure, Chronic ; drug therapy ; physiopathology ; Kidney Function Tests ; Medicine, Chinese Traditional