Objective To investigate the renoprotective effect of irbesartan on tubulointerstitial fibrosis in rats with adriamycin-induced nephropathy and its possible mechanism. Methods Rats received twice-intravenous injections of adriamycin(ADR) after the right kidney was removed. Those rats were randomly assigned to irbesartan treatment group and nephropathy group. Treatment group received 50 mg? kg-1 ? d-1 irbesartan for 4 weeks. Rats with sham operation served as normal control. Proteinuria and serum creatinine of were measured after 4 weeks. Renal histopathological changes were evaluated as well. Immunohistochemistry was used to examine the protein expression of TGF-?1, MMP-9 and TIMP-1. The mRNA levels of MMP-9 and TIMP-1 were detected by in situ hybridization. Results Proteinuria of treatment group decreased significantly as compared to nephropathy group. TGF-?1, TIMP-1 and MMP-9 were significantly lower than that of nephropathy group in tubulointerstitium and consistently associated with tubular degeneration and interstitial fibrosis progressed. Conclusion Irbesartan has a renoprotective effect on tubulointerstitial fibrosis by modulating the ECM degradation.

Objective To investigate whether the signaling pathway of PI3K-AKT is involved in Ang II-induced apoptosis in rat renal tubular epithelial cells (NRK-52E).Methods Cultured cells were incubated in media containing either buffer (control) or different concentrations of Ang II (10-9 to 10-6 mol/L) for 24 h. Cells were stained by Annexin V-F1TC/PI Kit and apoptosis was evaluated by flow cytometer. Western blotting was performed to assess the levels of PI3K, total- and phosphor-AKT. Results Ang II induced tubular epithelial cell apoplosis in a dose dependent manner. Ang II significantly inhibited the phosphorylation of AKT. The level of AKT phosphorylation was negatively correlated with apoptosis in Ang II-stimulated cells(r=-0.90 ,P

Objective To prepare sustained-release tablet contained paeoniflorin and evaluate its drug release mechanism.Methods Orthogonal design was used to obtain the best formula.Hydroxypropykmethyl cellulose(HPMC K4M)and ethylcellulose(EC 20CPS)were used as hydrophilic matrix material,and PVP which dissolved in ethanol was used as adhesive material,then the sustained-release tablet was prepared by the wet granule compression technique.The best formula was determined by powder technology,including compression ratio,angle of repose,flow rate,and angle of contact as indexes.The optimum formula was obtained by comprehensive scoring method.The drug release in vitro was determined,and the release formula was made to investigate the release mechanism.Results The optimized prescription was with HPMC 20%,EC 20%,PVP 0%,and ethanol concentration 80%.The dissolution curves in vitro showed that the drug release could be best described by the Higuchi equation(Q=0.367 5 t1/2-0.165 8,r=0.993 2)and Peppas equation(lnQ=0.72 lnt-1.608 6,r=0.991 8).It showed that the release mechanism was Fick diffusion and backbone corrosion.The release rate could meet the requirement of quality control on sustained-release tablet in Chinese Pharmacopoeia(2005).Conclusion The method of content determination is simple and sustained-releasing rate is significant.The release mechanism follows the kinetic model of sustained-release tablet.It is worth doing further research for the clinical use.

AIM: To measure and compare the content of glycyrrhizic polysaccharides in Glycyrrhiza in three different growth time. METHODS: The contents of polysaccharides were determined by phenol-sulfuric acid method and by reference to glucose, and wavelenth in spectrophotometer was set at 490 nm. RESULTS: There was difference of the content of the extracted polysaccharides among Glycyrrhiza for 1, 2 and 3 year, amounted to 11.75%, 11.07%, 7.88%, respectively. CONCLUSION: Annual glycyrrhiza appeared to be the appropriat crude drug for polysacchrides content. 1.Colle

Objective To explore the effects of alanyl-glutamine (Ala-Gln) dipeptide supplemented parenteral nutrition (PN) on the short-term outcomes in critically ill adult patients.Methods In this retrospective study,we reviewed the clinical data of critically ill adult patients who were treated by standard PN from January 2006 to December 2011.The length of stay in intensive care unit (ICU-LOS),incidences of infections and multiple organ dysfunction syndrome (MODS),and mortality were compared between the group of Ala-Gln dipeptide supplemented PN (intervention group) and the group of PN without Ala-Gln dipeptide (control group).Results Finially,617 cases were enrolled in the study,including 312 cases in the control group and 305 cases in the intervention group.The ICU-LOS was significantly shorter in the intervention group than that in the control group [(17.2 ± 6.5) d vs.(16.1 ± 5.3) d,P =0.011).Compared with the control group,the incidences of infection (42.9％ vs.33.1％,P =0.011) and MODS (46.5％ vs.38.0％,P =0.030) and the mortality (34.9％vs.25.9％,P =0.014) in the intervention group patients were significantly lower.Conclusion Ala-Gln dipeptide supplemented PN can improve the short-term outcomes of critically ill adult patients.

OBJECTIVETo establish a HPLC fingerprint for quality evaluation of fructus Euodiae rutaecarpa, and to perform qualitative and quantitative analysis of its main constituents.

METHODThe 10 batches of samples were analyzed by HPLC linear gradient elution method and evaluated by similarity evaluation and system cluster analysis. The common peaks in chromatographic fingerprint were identified by LC-DAD-MS.

RESULTThe HPLC fingerprint of Euodiae Fructus showed 32 characteristic peaks, among them 13 peaks were identified, and 2 constituents were quantified.

CONCLUSIONThe HPLC fingerprint established could reflect the main constituents of Euodiae Fructus, and could combine with content determination to take an overall control of Euodiae Fructus.

Objective:To observe the association between serum cystatin C(CysC)and bone turnover markers levels in elderly chronic kidney disease(CKD)patients with different estimated glomerular filtration rate(eGFR).Methods:A total of 74 elderly patients aged 61-97(79.5±8.7)years with 40 males, receiving serum CysC and bone turnover markers tests, were recruited in the Department of Geriatrics, Peking University Third Hospital from June 2019 to June 2020.They were divided into normal eGFR group(G1 and G2 stage)(eGFR≥60 ml·min -1·1.73 m -2, n=42)and decreased eGFR group(G3-G5 stage)(eGFR<60 ml·min -1·1.73 m -2, n=32). Serum levels of CysC and bone turnover markers[β-isomerized C-terminal telopeptides(β-CTX)and procollagen type I N-terminal propeptide(P1NP)]were tested.The association between CysC and bone turnover markers was analyzed. Results:The levels of β-CTX, P1NP and parathyroid hormone(PTH)were higher in decreased eGFR group(G3-G5 stage)than in normal eGFR group(G1 and G2 stage), and 25(OH)D3 was lower in decreased eGFR group(G3-G5 stage)than in normal eGFR group(G1 and G2 stage), but the differences were not statistically significant(all P>0.05). In decreased eGFR group(G3-G5 stage), CysC had significant association with β-CTX( r=0.598, P<0.01)and P1NP( r=0.519, P<0.01), respectively.In normal eGFR group(G1 and G2 stage), CysC was significantly related with P1NP( r=0.342, P<0.05), and CysC had no correlation with β-CTX( r=-0.030, P> 0.05). Multiple regression analysis showed that CysC was independently positively associated with P1NP in total 74 subjects( β=19.19, P<0.01), and in 21 osteoporosis patients( β=28.78, P<0.05). Conclusions:In elderly patients with moderate and severe renal dysfunction, a higher CysC level indicates higher bone turnovers.CysC is independently positively associated with the bone formation marker P1NP, suggesting CysC may reflect a bone protective effect in elderly patients with different renal function.

Objective: To determine the clinical application value of percutaneous lung biopsy guided by ultrasound in the diagnosis of peripheral lung lesions of silicosis. Methods: Experimental silicosis was produced in rabbits by the intratracheal administration of silica with non-exposure method. Imaging changes were observed in 36 rabbits on 60 days after intratracheal instillation of silica. To contrast with CT results, percutaneous lung biopsy of peripheral lesions was guided by ultrasound. The success rate of sufficient material, the diagnosis rate of coincidence between biopsy and pathology, and the incidence of complications were calculated. The biopsy with sufficient material, biopsy findings coincided with pathological results and no complications were defined as strictly success of the puncture. The baseline data and monitoring index were compared between successful biopsy group and unsuccessful biopsy group. Each rabbit was intravenously administrated by 10 000 U of heparin for the antiocoagulation and sacrificed by fast injection of 10% KCl through jugular vein catheterization. Specimens from lung tissue were collected and stained with hematoxylin-eosin. Pathological changes of lung tissue were observed through an optical microscope. Results: Of 36 silicosis rabbits, peripheral lung lesions of silicosis were observed in 30 rabbits. Biopsy procedures were performed with ultrasound guidance in 30 rabbits. The total success rate of biopsy was 70% (21/30). The success rate of sufficient material was 93% (28/30), the diagnosis rate of coincidence between biopsy and pathology 86%(24/28), and the incidence of complications was 10% (3/30) respectively. Compared with failure group, peripheral lesions in successful biopsy group were bigger in size, closer to the chest wall, and lower respiratory rate, the difference was statistically significant (P<0.05). There was no significant difference in weight, heart rate, temperature and stages of silicosis (P>0.05). The pathological results showed typical silicosis nodules. Silica-exposed rabbit also showed signs of vascular remodeling with pulmonary artery muscularization, vascular occlusion, and medial thickening. Conclusions Ultrasound-guided percutaneous lung biopsy is an effective and safe method in peripheral lung lesions of silicosis. It can serve as an important technical means to monitor the evolution of silicosis lesions and provide reference for the diagnosis of silicosis. Observation of small vascular changes in silicosis nodules by lung biopsy is helpful for clinical intervention treatment.

Objective To explore the feasibility and clinical outcome of lateral cervical incision via sternocleidomastoid intermuscular approach(SMIA)in the treatment of primary hyperparathyroidism.Methods The clinical data of 64 patients with primary hyperparathyroidism who underwent unilateral parathyroid surgery in the First Affiliated Hospital,School of Medicine of Zhejiang University from January 2019 to June 2022 were retrospectively analyzed.They were divided into lateral cervical incision via sternocleidomastoid intermuscular approach group(SMIA group)and linea alba cervicalis approach group(LACA group)based on the surgical incision and access route.The differences in clinical features,surgery-related outcomes and postoperative functions of the anterior cervical region were compared between the two groups.The EQ-5D-5L scale was used to assess the subjective feeling of postoperative neck discomfort,while the Hollander Wound Assessment Scale was used to assess the clinical outcome of incision healing.Results There were no statistical differences between the two groups of patients in terms of age,gender,intraoperative bleeding,parathyroid hormone or blood calcium levels before and after surgery(P＞0.05).The duration of surgery was significantly shorter in the SMIA group than in the LACA group[(39.77±5.69)min vs.(54.41±4.66)min].There was a statistical difference between the two groups in functional protection of the anterior cervical region at 1 month and 12 months after surgery(1 month,84.67±3.74 vs.79.47±5.38,P＜0.001;12 months,93.80±2.52 vs.89.94±2.39,P＜0.001),and the SMIA group was better than the LACA group.The Hollander Incision Assessment Scale scores of the SMIA group were better than those of the LACA group at 6 months and 12 months after surgery,and the difference was statistically significant(6 months,1.93±0.58 vs.2.41±0.66,P=0.003;12 months,1.03±0.67 vs.1.74±0.62,P＜0.001).Conclusion Parathyroidectomy via sternocleidomastoid intermuscular approach through lateral cervical incision is a simple,safe and effective surgical procedure,which makes it easier to search for parathyroid lesions and shortens the surgical time compared with the traditional incision,and has obvious advantages in the protection of anterior cervical region function.