Objective: To detect anti tubular basement membrane antibodies in sera from patients with tubulointerstitial nephritis (TIN) and investigate its clinical significance. Methods: The sera were studied from 46 patients with renal biopsy proven TIN. The normal human renal cortex was obtained from patients with nephroectomy, far from carcinoma. Tubules were isolated by a differential sieving technique. The fragments of renal epithelia were removed from tubular basement membrane enriched materials by sonication and centrifugation. Tubular basement membrane antigens were solubilized with 6 mol/L guanidine HCl. The soluble proteins were used as antigens in Western blot analysis to detect autoantibodies in sera from patients with TIN. The clinical characteristics of positive and negative patients were statistically analyzed. Results: Eleven patients with tubulointerstitial nephritis had anti tubular basement membrane antibodies by Western blot analysis, and seven protein bands could be blotted by the TIN sera. The positive prevalence of anti 55?10 3 antibody (63.8%) was higher than that of other antibodies. Eight of 27 (29.6%) patients with acute tubulointerstitial nephritis and four of 19 (21.1%) patients with chronic tubulointerstitial nephritis had anti tubular basement membrane antibodies. ESR,serum IgG and IgM in patients with acute TIN with positive anti tubular basement membrane antibodies were higher than those of the negative group There was no significant difference in the other clinical variables such as gender,age,hemoglobin,complement C 3,serum IgA,serum creatinine,blood urea nitrogen and creatinine clearance in patients with acute TIN between the positive and negative groups .There was no significant difference in clinical variables mentioned above in patients with chronic TIN between the positive and negative groups. Conclusion: Circulating anti tubular basement membrane antibodies could be detected in sera from some patients with TIN, and autoimmunity may play a role in the pathogenesis of TIN.

ObjectiveTo investigate the value of serum creatinine(SCr) to monitor the renal function of patients with spinal cord injury(SCI).Methods1298 SCI patients were investigated in Beijing Charity Hospital from January 2004 to May 2009. 249 healthy people were involved as control. The data of SCr were analysed.ResultsThe level of SCr for the SCI patients was (56.81±14.33) μmol/L with normal distribution, 95% CI was 28.73～84.89 μmol/L; The level of SCr for the healthy people was (75.98±11.34) μmol/L, 95% CI was 57.36～101.80 μmol/L. The level of SCr was significantly lower in the SCI patients comparing to the healthy people (P<0.01). Among the SCI patients, the level of SCr was (59.59±13.76) μmol/L for male while (46.41±11.31) μmol/L for female(P<0.05). There was no difference in level of SCr among different ages of the SCI patients(P>0.05). The characteristics were likely in the two groups. There was no difference in level of SCr between paraplegic (55.54±14.96) μmol/L and quadriplegic (57.67±13.83) μmol/L (P>0.05).ConclusionThe characteristics of level of SCr were likely in SCI patients and healthy people with normal distribution. The level of SCr was lower in SCI patients comparing to healthy people, which was higher for male SCI patients comparing to female SCI patients.

Objective To view and compare the clinical characteristics of renal tubular acidosis in adults and children.Methods Clinical data of patients with renal tubular acidosis diagnosed by Shandong Provincial Hospital affiliated to Shandong University from Jan 1991 to Sep 2017 were reviewed.The difference and consistency in clinical characteristics of renal tubular acidosis between adults and children were analyzed.Results Data from 206 adults and 60 children were analyzed.89.81％ cases in adults were secondary to other diseases,mainly primary Sjogren's syndrome.Most children patients (81.67％) were idiopathic,others largely originated from inherited metabolic diseases.The most common subtype of both was distal renal tubular acidosis.Proximal renal tubular acidosis was easier to be found in idiopathic renal tubular diseases of children.Chief complaints or starting symptoms were mainly composed of polydipsia with polyuria (41.4％) and fatigue (35.3％).Children were typical of growth retardation,rickets and digestive symptoms.The rate of missed diagnosis and misdiagnosis was 41.4 percent.Routine therapy consisted of healing metabolic acidosis and electrolyte disorders,treating underlying diseases and preventing complications.The majority of patients (95.5％) improved after treatments.Conclusions Renal tubular acidosis possesses various underlying diseases,diverse clinical manifestation and high rate of misdiagnosis.Given the high incident of secondary types,investigation of underlying disease,especially autoimmune diseases such as Sjogren's syndrome,is of great importance in adults.Most children patients suffer from primary renal tubular acidosis.Attention should be paid to them in order to reduce the rate of misdiagnosis and teratogenicity.