Chronic kidney disease(CKD)is a high risk factor of cardiovascular disease(CVD).This paper introduces the coronary atherosclerotic heart disease,uremic myocardiopathy,uremic cardiopericarditis,stroke and peripheral arterial disease in patients with CKD.

Active systemic lupus erythematosus(SLE)and lupus nephritis(LN)are often treated with corticosteroids combined with various immunosuppressives.For the critical patients the methylprednisolone plus intensive therapy should be also used on the basis of above-mentioned routine treatment in order to abort the severe activity of SLE/LN rapidly.In this paper the sorts,the routine and intensive therapeutic regimens,the side-effects and the treatment targets of corticosteroids will be reviewed in detail.

Objective To compare primary and secondary focal segmental glomerulosclerosis(FSGS)and the clinical characteristics of different subtypes.Methods The clinical and laboratory manifestations of 116 patients with primary and secondary FSGS in China-Japan Friendship Hospital from January of 2001 to December of 2008 were analyzed and compared.Results Of the 116 patients,88 were with primary FSGS(P-FSGS),13 with IgA nephropathy-associated FSGS(IgAN-FSGS),and 15 with obesity-related FSGS(OB-FSGS).Of the 88 patients with P-FSGS,53 were with not otherwise specified(NOS)type(60.2%),18 with cellular type(20.5%),13 with tip type(14.8%),4 with perihilar type(4.5%),and there was no case of collapsing type.Among the total 116 FSGS cases,the frequency of nephrotic syndrome was 41.3%,hypertension 54.3%,hematuria 59.5%,elevated serum creatinine level 44.8% and reduced creatinine clearance 54.3%.More than a half patients presented abnormal proximal or/and distal tubular function.Compared with P-FSGS and IgAN-FSGS,OB-FSGS patients had less proteinuria,higher serum albumin level,lower prevalence of nephrotic syndome,higher CCr and less decreased CCr cases(P

Over the past decade , with the rapid increase of the incidence of idiopathic membranous nephropathy (IMN) in our country, the diagnosis and treatment of IMN has been paid more and more attention.IMN is an autoimmune disease.Two important podocyte autoantigens , PLA2R and THSD7A, have been indentified sine 2009.Subsequently , serum anti-PLA2R antibody test and anti-THSD7A antibody test have also been used in clinical .Preliminary applications show that these two tests can not only help IMN diagnosis and differential diagnosis , but also help IMN prognosis.

Analgesic nephropathy is a slowly progressive disease caused by the long-term abuse of the non-steroidal anti-inflammatory drugs or their mixtures.Pathologically,the analgesic nephropathy is characterized by chronic tubulointerstitial nephritis and renal papillary necrosis.In the early stage,the clinical characteristics are latent.With further progression of the disease,there are the nonspecific symptoms of end stage renal disease.There is no unified diagnosis standard about the disease.The incidence of analgesic nephropathy has great variation among different country.Based on the current literature,we discussed its pathogenesis,epidemiology,clinical manifestation,diagnosis and therapy.

Objective To investigate the urothelial carcinoma in patients with chronic aristolochic acid nephropathy(CAAN). Methods The clinical data of urothelial carcinoma were analyzed in 4 cases among 102 patients with CAAN. Results (1)Chronic renal insufficiency caused by CAAN was diagnosed in 4 patients after intermittently taking the medicine containing aristolochic acid(AA) for a long time (from 3 years to 24 years). (2) Urinary examination of these 4 cases showed the red cells with uniformed shape. Two of them experienced an episode of macroscopic haematuria. (3) Three of them had papillary transitional cell carcinomas on the bladder wall by the cystoscopy and pathological examination. The other one had carcinoma of the left renal pelvis by the retrograde urography and pathological examination after surgical operation. Conclusion CAAN is associated with the developing urothelial tumours when a patient with CAAN has an episode of macroscopic or obvious microscopic hematuria with red cells of uniformed shape.

SUMMARY A 15-year-old boy was admitted with nephritic and nephrotic syndrome,renal dysfunction and decreased serum C3,who suffered from varicella for two months.His renal histopathology revealed endocapillary proliferative glomerulonephritis with podocytes proliferation and severe tubular injury by light microscopy.Direct immunofluorescence showed global granular deposition of IgG,IgA,IgM,C3,Clq and fibrinogen in mesangium and along glomerular capillary wall.Electron microscopic examination showed electron-dense deposits in multiple sites of glomeruli.Furthermore,specific serum IgM antibodies against varicella-zoster virus (VZV) were detected.VZV antigen and mRNA were demonstrated in glomerular and tubular epithelial cells by immunohistochemical staining and in-situ hybridization.Virus particles and virus inclusions were identified by electron microscopy and special staining ( Methylene Blue and Eosion staining or Mann staining).The patient also experienced epileptic episodes and his brain MRI and electroenephalogram indicated herpes encephalitis with secondary epilepsy.Therefore,the diagnosis of VZV-associated glomerulonephritis and encephalitis was established.This is the first case of VZV-associated glomerulonephritis with renal histooathological evidence using in situ hybridization technique.

Objective This study was to observe the effects of different test conditions on the qualitative and quantitative detection of cryoglobulin .Methods We prepared 5 blood samples of different types of cryoglobulinemia . We detect the cryoglobulin qualitatively and quantitatively at different temperatures (37 ℃and room temperature of 20-25 ℃), and with different observation time (3 days and 7 days) and with different amount of blood (5 ml and 20 ml) .Further we will categorize the type of cryoglobulin and detect the components of cryoglobulin by immunofixation electrophoresis ( IFE) and other laboratory tests.Results (1) Blood samples from two groups were clotting and the serums were separated at 37 ℃ and room temperature respectively , and cryoglobulins of two groups were all qualitatively positive . Quantitative detection of cryoglobulins showed that the concentrations of cryoglobulins of room temperature group are lower than that of 37℃group;(2) Compared with 7 days, observing for only 3 days may lead to false-negative results in qualitative detection of cryoglobulin , and concentrations of cryoglobulin are also decreased;(3) Compared with 20 ml blood sample,5 ml blood sample is not enough for qualitative and quantitative detection of cryoglobulins .It may lead to false-negative results;(4) After purification, IFE and other laboratory tests can be used to categorize the types and find the components of cryoglobulins .Such examinations are helpful for finding the potential causes of cryoglobulinemia .Conclusions The positive of serum cryoglobulin is a key indicator of cryoglobulinemia .Detection of cryoglobulin can be affected by temperature, observed time and the blood volume for measurement .In addition, IFE and other laboratory tests are helpful for finding the type and the components of cryoglobulin .

This study was designed to investigate whether there is an antagonistic effect of MsC—derived IL—1 and PGE2 on MsC proliferation. Experimental results showed that: (1)MsC stimulated by LPS could produce IL—1; (2) MsC stimulated by MsC—derived IL—1 could release PGE2; (3) exogenous PGE2(100ug/ml) inhibited the MsC proliferation induced by MsC—derived IL—1; (4) indomethacin(2ug/ml) which inhibited the production of endogenous PGE2, enhanced the MsC proliferation induced by MsC—derived IL—1. The results suggest that there is a self—regulation effect on MsC proliferation by MsC—derived IL—1 and PGE2. Clinically, the beneficial effect of PGE2 should be protected, so that the abuse of indomethacin in the treatment of glomerulonephritis should be avoided.

Objective To study the expression of intercellular adhesion molecule-1 ( ICAM-1 ) and vascular cell adhesion molecule-l(VCAM-L) on human mesangial cells (HMC) after stimulation by endothelin-1 (ET-1). Methods The ex-pression of ICAM-1 and VCAM-1 was detected at mRNA and protein levels by using Northern bolt and cell ELISA respectively. Results There was basic mRNA and protein expression of ICAM-1 and VCAM-1 on HMC in the control groups without ET-1. ET-l(10-7mol)augmented the mRNA expression of ICAM-1 and VCAM-1 with the maximum at 4 -8 hr. Increased protein expression of ICAM-1 and VCAM-1 was followed thereafter in a time-depended manner. Conclusion The upregulated expression of ICAM-1 and VCAM-1 by ET-1 may have an important role in the development of glomerulonephritis.