Objective: To evaluate the value of high resolution ultrasonography for diagnosis of secondary hyperparathyroism(HPT) in uremia and its relationship with serum parathyroid hormone(PTH). Methods: Ultrasonography was used to examine parathyroid gland and serum PTH, calcium,phosphorus in 55 cases of uremic patients. Results: Totally 64 parathyroid glands in 52 patients(94%) and over 2 glands in 11 cases(20%) were found. The volumes of parathyroid gland was larger and the value of PTH was abviously increased in over 2 glands than in single gland( P

Objective:To establish a rat hyperparathyroidism model secondary to chronic renal failure,so as to lay a foundation for studying the mechanism and treatment of secondary hyperparathyroidism.Methods: Thiry-six male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 6 groups: 5/6 nephrectomy plus high phosphorus food group(STNx + HP),5/6 nephrectomy plus low phosphorus food group(STNx + LP),5/6 nephrectomy plus normal phosphorus food group(STNx + NP),sham operation plus high phosphorus food group(Sham + HP),sham operation plus low phosphorus food group(Sham + LP),and sham operation plus normal phosphorus food group(Sham + NP).Nephrectomy was performed in 2 steps.Serum phosphorus levels(P) and iPTH levels were detected at day 7 pre-operation and day 7,14,and 21 after the second operation.The kidneys,thyroid glands and parathyroid glands complex underwent pathological analysis 4 weeks after operation.Results: Five patients survived in STNx+NP group,4 in STNx+LP group and 4 in STNx+HP group postoperatively.No death occurred in sham operated groups.Serum phosphorus levels of nephrectomy groups at different time points after operation were higher than those before operation and those of sham operation groups(P

Objective:To prepare type Ⅲ sodium-phosphate cotransporter(NaPi-Ⅲ) siRNA-loaded chitosan microspheres and to evaluate their physico-chemical properties and siRNA release in vitro.Methods: NaPi-Ⅲ siRNA was loaded into chitosan microspheres by using the complex coacervation method.The structure of the nanoparticles was observed under scanning electron microscope and their diameter distribution was measured by a laser grain analyzer.RNase assay was used to detect the efficacy of anoparticles in prevention of siRNA from degradation.Ultraviolet spectrophotometry and HPLC technique were used to determine the entrapment efficiency,loading capacity,and siRNA releasing rate in vitro.Results: The chitosan nanoparticles loaded with NaPi-Ⅲ siRNA were successfully prepared.The nanoparticles were spherical in shape and were well distributed,with an average diameter of 173 nm.After RNase treatment,D_(260) rose more slowly in chitosan nanoparticles-based siRNA suspension than in simple NaPi-Ⅲ siRNA solution(P

In order to further explore the protective effect of Cordyceps Sinensis (CS) on Cyclosponne A nephrotoxicity (CsA-Nx) and its possible mechanisms, SD rats were divided into two groups: CsA group and CsA + CS group. The results showed that: in different experiment period, serum BUN. Cr, Na. K and urine EOF excretion in CS group were lower than that in control group. In the third month, serum AT- |J in CS group was also lower than that in control group. Pathological examination showed that CS could protect the kidney from CsA-Nx and ameliorate the glomerular and interstitial injuries. It suggests that CS could protect the kidney from CsA-Nx, especially protect the proximal tubular function and ameliorate renal hemodynamics.

Objective：To study the clinical and pathologic features of patients with lupus nephritis (LN) whose myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) were positive. Methods：The clinical and pathological features were analyzed in 18 patients with LN whose MPO-ANCA were positive. And the data of patients with different clinical outcomes were compared. Results：（1）The hematological abnormalities, hypertension and serositis in these patients were more common than general ones with LN. （2）Proteinuria and hematuria were common, the morbidities of gross hematuria and renal failure in these patients were higher than general ones with LN.（3）Various autoantibodies were positive in these patients.（4）Segmental necrosis crescentic nephritis accompanied by density of immunocomplex in glomeruli and vasculitis in intestitium were common.（5）The morbidity of ESRF and mortality of these patients were similar to general ones with LN. The morbidity of tubular atrophy in those with poor prognosis was significantly higher than those survived. Conclusion：The patients with LN whose MPO-ANCA are positive have some difference from those with negative MPO-ANCA, but positive MPO-ANCA is not directly related to the prognosis.

Objective:To investigate the sensitivities and specificities of high-frequency color doppler ultrasonography, thin layer CT enhancing scan and 99m Tc-MIBI biphasic scintigraphy in diagnosis of secondary hyperparathyroidism(SHPT)in uremia patients.Methods: High-frequency color doppler ultrasonography, thin layer CT enhancing scan and 99m Tc-MIBI biphasic scintigraphy were performed in 35 uric patients to detect the hyperplastic parathyroid glands. Then biopsies with thin needles were conducted with B ultrasound instruction in hyperplastic glands to determine the sensitivities and specificities of the above techniques and free combination of each 2 of them in diagnosis of SHPT. Results: The sensitivities /specificities of high-frequency color doppler ultrasonography, thin layer CT enhancing scan and 99m Tc-MIBI biphasic scintigraphy were 73%/95%, 75%/93% and 89%/98%, respectively; the sensitivity/specificity of 4 combinations: high-frequency color doppler ultrasonography plus CT, high-frequency color doppler ultrasonography plus 99m Tc-MIBI biphasic scintigraphy, CT plus 99m Tc-MIBI biphasic scintigraphy,and high-frequency color doppler ultrasonography plus CT plus 99m Tc-MIBI biphasic scintigraphy were 84%/90%, 93%/93%, 95%/93%, and 100%/90%, respectively. Conclusion: The sensitivity of 99m Tc-MIBI biphasic scintigraphy SHPT is higher than that of high-frequency color doppler ultrasonography and CT, but the specificity is not significantly different 3 photographic techniques. However, combination of high-frequency color doppler ultrasonography and 99m Tc-MIBI biphasic scintigraphy is simple and sensitive and can be regarded as the first choice for diagnosis of SHPT in uremia patients.

Objective　To observe about curative effect of MMF on type Ⅳ lupus nephritis and to review the literature about MMF used to treat LN.Method　Ten patients with type Ⅳ LN were treated with MMF 1～2 g/d plus prednisone at middle or little dose.Curative duration of these patients was between 6 and 12 months.After 3,6 and 12 months curative effect was observed.Results　After treatment proteinurie and systemic lupus activity measurement were decreased gradually.Before and after treatment ANA positive rates were 80% and 30%,anti dsDNA antibody positive rates were 50% and 10%,respectively,and low C3 and C4 was rectified.After treatment renal failure in 3 patients was recovered.During treatment major adverse reactions included gastrointestinal symptoms and herpes zoster.Conclusion　MMF has exacttly effect on type Ⅳ LN and low side effect.

Objective:To study the clinical and pathologic features of patients with lupus nephritis (LN) whose myeloperoxidase anti neutrophil cytoplasmic antibody (MPO ANCA) were positive. Methods:The clinical and pathological features were analyzed in 18 patients with LN whose MPO ANCA were positive. And the data of patients with different clinical outcomes were compared. Results:(1)The hematological abnormalities, hypertension and serositis in these patients were more common than general ones with LN. (2)Proteinuria and hematuria were common, the morbidities of gross hematuria and renal failure in these patients were higher than general ones with LN.(3)Various autoantibodies were positive in these patients.(4)Segmental necrosis crescentic nephritis accompanied by density of immunocomplex in glomeruli and vasculitis in intestitium were common.(5)The morbidity of ESRF and mortality of these patients were similar to general ones with LN. The morbidity of tubular atrophy in those with poor prognosis was significantly higher than those survived. Conclusion:The patients with LN whose MPO ANCA are positive have some difference from those with negative MPO ANCA, but positive MPO ANCA is not directly related to the prognosis. [

Objective To observe the efficacy of ealcitonin and bisphosphonates on renal osteopathy of maintenance hemodialysis (MHD)patients. Methods Forty-three MHD patients were raindomly divided into two groups: A group and B group. All the patients were routinely received oral calcium carbonate 1.0 g tid and calcitriol 0.25 μg qd. Calcitonin (20U) hypodermic injection was given three times a week additionally during hemodialysis in A group. Patients in B group received bisphosphonates 70 mg once a week based on the therapy of A group. Serum levels of intact parathyroid hormone (iPTH), calcium, phosphorus, alkaline phosphatase (AKP), bone mass density (BMD) of lumbar spine and femoral neck, and the degree of bone ache (visual analogue scale, VAS) were assessed before the therapy and 3, 6 and 12 months after treatment. The adverse reactions were recorded during treatment. Results The levels of AKP and iPTH in both two groups decreased significantly after treatment. The above values of pre-treatment and 12 months after treatment were as follows: AKP(U/L)of A group 244.05±41.99 and 148.35±27.71,of B group 245.60±40.86 and 143.40±28.03;PTH(ng/L) of A group 697.5±119.7 and 267.4±45.9,of B group 708.2±120.3 and 277.6±41.9 (all P<0.05). While the levels of calcium and phosphorus did not change obviously during treatment (P>0.05). BMD was not improved at 3, 6 mouths and became better at 12 mouths after treatment. As compared to pre-treatment, BMD of lumbar spine(g/cm2) in A group was 1.062±0.223 vs 1.202±0.251 ,in B group 1.033±0.152 vs 1.189±0.225; BMD of femoral neck (g/cm2)in A group was 0.993±0.108 vs 1.067±0.095,in B group 0.947±0.083 vs 1.018 ±0.217 (all P<0.05). The scores of VAS also decreased significantly at 3, 6, 12 months after treatment(P<0.05). No severe adverse reaction was found during the treatment. Conclusions Utilization of calcitonin and combination with bisphosphonates during bemodialysis can effectively preserve the BMD and prevent bone loss in MHD patients and is well tolerated. No significant difference of therapeutic effect is observed between using ealcitonin or combination with bisphosphonates.

Objective To investigate the protective effect and mechanism of pamidronate disodium on calcification in rat vascular smooth muscle cells (RVSMCs) induced by hyperphosphate.Methods RVSMCs were placed in various culture mediam, including normal phosphate medium (Pi 1.4 mmol/L), high phosphate medium (Pi 4.5 mmol/L), different pamidronate disodium concentrations medium (Pi 4.5 mmol/L+pamidronate disodium 10-5, 10-6, 10-7 mmol/L). Calcium content and cell protein content were quantified by the O-cresolphthalein complexone method and BCA protein assay respectively. Calcification was visualized by yon Kossa staining, and cbfα-1,osteocalcin were quantified by Western blotting. Results After culture for 3 days, calcium content in high phosphate group were much higher than that in control group, and pamidronate disodium groups had a lower calcium content compared with high phosphate group (all P＜0.05).Calcium deposit in RVSMCs was greater in high phosphate group, while pamidronate disodium groups revealed obviously decreased deposit (all P＜0.05). Protein expression of cbfα-1 and osteocalcin in pamidronate disodium groups was much lower than that in high phosphate group.Conclusion Pamidronate disodium can protect RVSMCs from phosphate-induced calcification in vitro, which may be associated with the blockage of transformation of RVSMCs into osteoblast.