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Objective To investigate the expression and distribution of podocin and its role in the development of proteinuria in rats with puromycin aminonucleoside (PAN) nephropathy. Methods The nephropathy model was established by a single injection of PAN. The rats in the Model group were sacrificed on days 1, 3, 10 and 20 after PAN injection. The renal histological changes were observed under light and electron microscopes. The indirect immunofluorescence staining and semiquantitative reverse transcription PCR were used to detect the expression of podocin. Six rats which received normal saline with the same volume as the Model group served as the Control group. Results ① The proteinuria which was gradually increased 3 days after PAN injection reached a peak on day 10 (P< 0.01) and decreased on day 20 but was still greater than that of the Control group (P< 0.05). ② In the process of development of PAN nephropathy, the foot process effacement was seen between 3 and 10 days following PAN injection. ③ The podocin expression began to decrease on day 1, and prominently decreased on day 3 and day 10 compared with those of the Control group (P< 0.01). On day 20, the podocin expression resembled that of day 1, remaining lower than that of the Control group (P< 0.05) although it partly retrieved with the decreased proteinuria. The podocin expression was negatively correlated with proteinuria (r= -0.786, P< 0.05). ④ Podocin staining showed a very fine linear-like pattern along the capillary loop in the Control group. It presented a discontinuous pattern on day 1, a granular pattern on day 3, more coarse granular on day 10 and gradually recovered to a linear-like pattern on day 20. ⑤ Podocin mRNA expression levels were slightly elevated on days 1, 3 and 10 ( 1.2, 1.5, 1.4 folds as the Control group respectively) and recovered to a normal level on day 20 compared with those of the Control group. Conclusions Podocin may be involved in the development of proteinuria and it may be a useful early marker of podocyte injury in nephropathy.

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Objective To investigate the effect of transforming growth factor-β1 (TGF-β1) on the extracellular matrix (ECM) of lungs in premature infants with chronic lung disease (CLD). Methods Sixty premature rats were randomly assigned into a Model group of CLD and a Control group (n=30 each). CLD was induced by hyperoxia exposure. The distribution and expression of TGF-β1 and levels of type I collagen, fibronectin (FN) and hyaluronic acid (HA) from lung specimens were assayed by the immunohistochemical method and enzyme-linked immunoabsorbent technique on days 1, 3, 7, 14 and 21 of the experiment. Results In the Control group there was a slight expression of TGF-β1 in bronchial epithelial cells and vascular endothelial cells. In the Model group, the TGF-β1 expression was similar to that of the Control group on day 1 and day 3, while on day 7, the TGF-β1 expression in alveolar macrophages, alveolar epithelial cells and interstitial cells was found. Expression intensity and range were increased with the time of hyperoxia-inducement and reached a peak on the 21st day. On days 1, 3, and 7, there were no differences in the type I collagen level between the two groups. On day 14, however, it was higher in the Model group than that of the Control group (P< 0.05). This difference was more significant on day 21 (P< 0.01). Levels of FN and HA in the Model group did not differ from those of the Control group at any time point of the experiment. The level of TGF-β1 expression was postitively correlated with the type I collagen level on day 14 (r= 0.709,P< 0.01) and day 21 (r= 0.711, P< 0.01). Conclusions Over-expression of TGF-β1 may play an important role in ECM remodeling in rats with hyperoxia-induced CLD.

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Objective The formation of subepithelial fibrosis and increased deposition of types I and III collagen are important features of airway remodelling in asthma, while transforming growth factor-β1 (TGF-β1) is the major regulative factor of airway remodelling. The study aims at exploring the effect of ligustrazine on the collagen deposition and the expression of TGF-β1 in the airway wall of asthmatic rats. Methods Forty SD rats were randomly assigned into 5 groups (n=8 each): a normal group (A), an asthma model group (B), a dexamethasone group (C), a low-dose ligustrazine group (D) and a high-dose ligustrazine group (E). The asthma model was established by repeated inhalation of oval bulium. Groups C, D and E were treated by injection of 0.5 mg dexamethason and 40 mg or 80 mg ligustraizine respectively before stimulation, while Group A was treated with normal saline instead. The levels of collagen and TGF-β1 expression in airway wall were semi-quantitatively measured by the immunohisto-chemistry technique. Results The levels of collagen type III and TGF-β1 expression were significantly higher in Group B than those in Group A (P< 0.01). In the Group C, Group D and Group E, the levels of collagen type III and TGF-β1 expression in airway wall were lower than those in Group B (P< 0.01), and there was no difference among Groups E, C and A (P> 0.05). The contents of collagen type I had no difference among all five groups. A close correlation between TGF-β1 expression and collagen type III content in various groups was found (r s= 0.7063, P< 0.01). Conclusions Ligustrazine may reduce the deposition of collagen type Ⅲ and inhibit the expression of TGF-β1.

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Objective This study aims to investigate the influences of body weight on bone mineral content (BMC) and bone mineral density (BMD) of lumbar spines and proximal femur in healthy children and adolescents aged 6-15 years and to compare the differences between BMC and BMD. Methods The BMC and BMD of anteroposterior and supine lateral lumbar spines and proximal femur in 547 healthy children and adolescents from Changsha region were measured by DXA QDR-4500A fan beam bone densitiometry. Results The body weight, body mass index (BMI), BMC and BMD of lumbar spines and proximal femur increased with age in both male and female children and adolescent(P< 0.05 or 0.01). The body weight was more correlated with BMC than with BMD. The BMC adjusted by weight of lumbar spines and proximal femur increased,while the BMD adjusted by weight of them decreased with age. Conclusions It is suggested that BMC is more coincident with the property of bone intensity in terms of mechanics so BMC is a better marker than BMD for the assessment of bone intensity in children and adolescents aged 6-15 years.

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Objective To study the influence of the supine or the prone position on the lung function in the neonates with pneumonia in order to find a suitable position for neonates with pneumonia. Methods Respiratory rate, tidal volume, minute ventilation, airway resistance, dynamic pulmonary compliance and work of breathing in the supine or prone position were measured by American Biocore CP-100 Neonatal Pulmonary Apparatus in 30 neonates with pneumonia. Results Respiratory rate ( 44.3± 9.2 bpm/min) and airway resistance [( 153.1± 50.4) cmH 2O/(L.sec)] in neonates with a prone position were significantly lower than those in the supine position [( 48.0± 10.6 bpm/min) and ( 211.9± 63.1) cmH 2O/(L.sec), respectively] (P< 0.01). Tidal volume ( 2.29± 0.46 ml/kg), minute ventilation [( 0.095± 0.024) L/(min.kg)], dynamic pulmonary compliance [( 0.621± 0.214) ml/(cmH 2O.kg)] and work of breathing ( 8.9± 3.5) gm/(cm.kg)] in the prone position were significantly higher than those in the supine position [( 1.65± 0.50 ml/kg), ( 0.075± 0.022) L/(min.kg), ( 0.389± 0.115) ml/(cmH 2O.kg) and ( 5.9± 2.7) gm/(cm.kg), respectively] (P< 0.01). Conclusions A prone position may increase the tidal volume, minute ventilation and dynamic pulmonary compliance and decrease respiratory rate and airway resistance. It suggests that a prone position is the suitable one for neonates with pneumonia.

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Objective In recent years, oversea researchers have found there are “dependent regions” in acute respiratory distress syndrome (ARDS) lung computed tomography (CT). This study aims to explore the changes of lung CT image in rabbits with oleic acid induced ARDS and the effect of body position changes on CT image. Methods The model of rabbit ARDS was induced using oleic acid. The rabbits with ARDS all underwent lung spiral CT scans and were divided into six groups according to the body position of scans. Results Lung CT showed a dependent region and non-dependent region, and the image alteration of two regions was induced by the change of the body position. The gravitational effect was reduced after continuous rotation of body position at an equal speed. Conclusions The continuous rotation of body position can relieve the severity of compressive lung collapse in ARDS.

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Objective To detect serum C-reactive protein (CRP) and procalcitonin (PCT) levels in infants with community-acquired pneumonia (CAP) so as to investigate the significance of the two markers in identification of pathogens of infantile CAP. Methods Serum CRP and PCT levels were measured by enzyme immunoassay and immunoluminometric assay respectively in 64 infants with CAP. Results Among the 64 cases, there were 23 with positive serum CRP and/or PCT, 18 with both positive serum CRP and PCT, 3 with single positive CRP, and 2 with single positive PCT. Positive serum MP-IgM occurred in 11 cases, in which 7 cases had both positive serum CRP and PCT and 1 case had single positive CRP. Among the 30 patients with elevated WBC or neutrophil levels, there were 18 cases with positive serum CRP and/or PCT, while there were only 5 cases in the 34 patients with normal WBC or neutrophil levels. The incidence of positive serum PCT or CRP in the former was significantly higher than that in the latter ( 60.0% vs 14.7%; P< 0.01). Conclusions Detection of serum CRP or PCT levels may be of value in the differential diagnosis of infantile CAP due to bacteria, Mycoplasma or viruses.

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Objective To study the changes of IFN-γ, IL-4, ECP and IgE levels in children with asthma before and after inactivated bacillus Calmette-Guerin (BCG) inoculation. Methods Forty-five young children with asthma aging from 9 months to 3 years were involved in this study. Serum levels of IgE and ECP were determined with enzyme linked fluoroimmunoassay by Phamacia CAP system. The concentrations of IFN-γ and IL-4 from peripheral blood mononuclear cells (PBMC) were measured using ELISA before and after inactivated BCG inoculation. Forty infants with asthma who received the routine treatment and twenty healthy infants served as the controls. Results After inactivated BCG inoculation for 6 months, the IFN-γ level increased significantly from 16.4± 7.1 pg/L to 241.6± 111.3 pg/L (P< 0.01). The IL-4 and ECP levels decreased significantly from 214.4± 90.9 pg/L and 13.4± 20.2 μg/L to 46.1± 21.5 pg/L and 5.5± 6.5 μg/L respectively (P< 0.05). The IL-4 level was significantly negatively correlated with the IFN-γ level (r= 0.626, P< 0.05). There was no difference in the serum IgE level before and after BCG treatment. In patients who received the routine treatment, only IFN-γ levels differed from that of before treatment ( 32.0± 12.1 pg/L vs 17.6± 7.2 pg/L; P< 0.01). Conclusions Inactivated BCG treatment may increase IFN-γ levels and decrease IL-4 levels, which is favorable to the regulation of T-cell balance. It also can decrease the ECP level and relieve chronic airway inflammation response, but it fails to respond to IgE level.

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Objective This paper aims at studying the effects of alphacalcidol (αD 3) on Wilms' tumor 1 gene (WT 1) expression of renal tissues and on proteinuria in rats with nephrotic syndrome so as to understand the mechanism of proteinuria occurrence. Methods One hundred and twenty SD rats were randomly assigned into five groups: a Control group, a Nephropathy group, a Prednisone-treated nephropathy group (Prednisone group), a αD 3-treated nephropathy group (αD 3 group) and a Prednisone and αD 3-treated group (Combination group). Nephrotic syndrome rat models were established by an injection of adriamycin via the tail vein. The Control group received an injection of 0.1 ml normal saline. After 2 weeks of injections, different treatments were given for the 5 groups daily for 4 weeks. The Prednisone group was administered prednisone daily (12 mg/kg); the αD 3 group was administered αD 3 daily ( 0.03 μg/kg); and the Combination group was administered prednisone (12 mg/kg) and αD 3 ( 0.03 μg/kg) daily. The Control group and the Nephropathy group were given distilled water with the same volume as the 3 treatment groups. Every 2 weeks specimens of the urine of 8 rats in each group were collected for 24 hrs in order to detect the 24-hr urinary protein content, and then the rats were sacrificed for histological study. Immunofluorescence was used to detect the WT 1 expression of renal tissues. Results By the 2nd week, the 24-hr urinary protein contents of the Nephropathy group, the Prednisone group, the αD 3 group and the Combination group were significantly higher than that of the Control group (P< 0.01). By the 4th and 6th weeks, the 24-hr urinary protein contents increased in the Nephropathy group, while those of the Prednisone group, the αD 3 group and the Combination group gradually decreased compared with those of the 2nd week. There were significant differences between the Nephropathy group and the 3 treated-nephropathy groups (P< 0.01). By the 2nd week, the WT 1 expressions of the Nephropathy group, the Prednisone group, the αD 3 group and the Combination group were significantly lower that of the Control group (P< 0.01), while the pathologic scores of the 4 nephropathy groups were significantly higher that of the Control group (P< 0.01). By the 4th and 6th weeks, the WT 1 expression in the Nephropathy group decreased, while those of the 3 treated-nephropathy groups elevated compared with those of the 2nd week. Significant differences were found between the Nephropathy group and the 3 treated- nephropathy groups. The WT 1 expression was negatively correlated to the 24-hr urinary protein content (P< 0.01). By the 4th week, the pathologic scores of the Prednisone group, the αD 3 group and the Combination group rose compared with those of the 2nd week, but they decreased by the 6th week. The pathologic scores of the αD 3 group by the 4th and 6th weeks were lower than that of the Nephropathy group (P< 0.01). Conclusions αD 3 may have protective effects against nephrotic syndrome by increasing the WT 1 expression and decreasing the drainage of proteinuria.

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Objective Some research has shown that the inflammatory reaction induced by the intercellular adhesion molecule may be involed in ischemic renal injury. Intercellular adhesion molecule-1 (ICAM-1) plays an important role in renal injury by up-regulating and inducing the adhesion between white blood cells and endothelium. This paper aims to study the effect of ICAM-1 on the inflammatory reaction in the fetal rat kidneys after acute ischemia. Methods The models of intrauterine ischemia and reperfusion in various time points were established by clamping one side of the vessels supplying blood to uterus in 21-gestational day-old Wister rats. The dynamic changes of ICAM-1 in the fetal kidneys were detected by immunohistochemical technique. Meanwhile, renal histopathological changes were observed. Another group of rats, the Sham-operation group, were given a normal blood supplement in the other side of the uterus. Results There was a small quantity expression of ICAM-1 in the cortical tubuli, especially in the proximal tubuli, in the Sham-operation group. The ICAM-1 expression began to increase 35 and 45 minutes after ischemia (P< 0.05). Compared with that of the Sham-opereation group, after a 15-minute ischemia and then a 2-hr repefusion, it began to rise (P< 0.01), reached a peak at 15 hrs of reperfusion (P< 0.01) and remained a higher level till 30 hrs of reperfusion (P< 0.05). Histological changes were most prominent after a 15-minute ischemia and then a 15-hr reperfusion, including vascular congestion, tubular vacuolar degeneration or necrosis and neutrophil accumulation. Conclusions There may be an inflammatory reaction in renal injury induced by intrauterine ischemia and reperfusion. Ischemia and reperfusion can induce the elevation of ICAM-1 expression. This suggests that ICAM-1 may play an important role in the development of inflammatory reaction in renal injury induced by acute ischemia and hypoxia.

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Objective In the brain, three isoforms of nitric oxide synthase (NOS), namely neuronal NOS (nNOS), inducible NOS (iNOS), and endothelial NOS (eNOS), have been implicated in biological roles, each isoform exhibiting different roles. This study aims to investigate the effects of lipopolysaccharide (LPS) and dexamethasone on the three isoforms expressions in neonatal rats by using a model of endotoxemia induced by LPS. Methods LPS (5 mg/kg) or LPS (5 mg/kg) plus dexamethasone (10 mg/kg) or sterile saline (controls) was injected intraperitoneally into 68 7-day-old Wistar rats. The rats were sacrificed 2, 4, 6 or 24 hrs after injection respectively. The expressions of NOS isoforms were examined by the immunohistochemical technique. Results nNOS was detected, but in contrast iNOS was not detectable, and eNOS was only faintly expressed in the brain of the controls. The nNOS expression was increased 4 hrs after LPS injection and the iNOS and eNOS expressions were increased 6 hrs after LPS injection. The expressions of the three isoforms reached a peak 24 hrs after LPS injection. Positive immunoreactivity was detected in the cerebral cortex, hippocampus, hypothalamus, paraventricular nucleus and striatum. In addition, nNOS was also detected in the limbic cortex. eNOS or iNOS was faintly expressed in the endothelial cells of cerebral blood vessels. The expressions of three NOS isoforms were remarkably inhibited between 2 and 6 hrs after dexamethasone administration and the inhibition effect continued until 24 hrs after administration. Conclusions nNOS and eNOS may be identified and iNOS is not detectable in the brain of normal neonatal rats. LPS can induce the expressions of three NOS isoforms, and the distribution and intensity of the expressions of three NOS isoforms varies, suggesting that NOS may play roles in the central nervous system development and brain damage in LPS-induced endotoxemia. Dexamethasone has a neuroprotective effect against brain damage induced by endotoxemia.

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Objective This study aims to investigate the influence of cerebral hemodynamic changes during headache-free periods on the efficacy of migraine prophylaxis. Methods Fifty-two children with migraine were given a TCD test during headache-free periods and then Normal TCD and Abnormal TCD groups were selected according to the TCD findings. Each group was randomly given either flunarizine or cyproheptadine treatment. The efficacy was evaluated with Bussone scores after 4 months of treatment. Results Bussone scores of patients treated with flunarizine were significantly lower than those of patients treated with cyproheptadine in the Abnormal TCD group ( 5.69± 4.15 vs 15.92± 10.52; P< 0.05). In the Normal TCD group, the patients treated with cyproheptadine had lower Bussone scores than those treated with flunarizine ( 6.43± 6.62 vs 17.46± 11.62; P< 0.01). Conclusions The efficacy of migraine prophylaxis may be improved by selecting rational drugs based on cerebral hemodynamics changes during headache-free periods.

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Objective Juvenile polyposis syndrome (JPS) may present epithelial dysplasia, while the molecular mechanism of dysplasia has not been explained. This paper aims to study its pathologic mechanisms by detecting the expressions of proliferating cell muclear antigen (PCNA), P53 protein (DO-7), P21 wafl and P53 mRNA in JPS cases with dysplasia. Methods Thirty-five specimens from 5 cases with JPS (24 specimens with dysplasia and 11 without dysplasia), 5 normal specimens from colonic mucosa, 32 specimens from simple JP and 10 specimens from colorectal cancer were collected. The expressions of PCNA, P53 protein (DO-7) and P21 waf1 were detected by immunohistochemistry. The expression of P53 mRNA was detected using in situ hybridization techniques. Results The average PCNA labelling index, the positive expressions of P53 protein and P53 mRNA, and the positive expression areas of P53 in JPS cases with dysplasia were significantly higher than those in JPS cases without dysplasia. There was no significant difference in the positive expression rate of P21 waf1 between them. The expressions of P53 protein and P53 mRNA were positively correlated with PCNA expression in JPS cases with dysplasia. Conclusions PCNA and the variation of P53 gene may be involved in the formation of dysplasia. The genetic changes of P53 might play an important role in the induction of cell proliferation.

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The aim of this article is to improve the clinician's cognition to the cryptococcosis through a case of analysis of disseminated cryptococcosis. Cryptococcosis is a kind of deep mycosis caused by cryptococcus neoformans. Because the clinical manifestion of this disease has no specificity and it is easy to be misdiagnosed. The disease starts insidiously and often occurrs in patients who are in low resistance or have been treated with either broad spectrum antibiotics, hormone, antimetabolites, immuno-suppressive agents and anti-tumor drugs for a long time and have been on venous cannulation or indwelling urinary catheter for a long time. The clinical manifestions of the disorder include fever, swelling of liver, spleen and lymph nodes, lesions of liver function, skin, lung, skeleton and central nervous system. The final diagnosis depends on the finding of cryptococcus in lesion tissues or fluid by Chinese ink staining or biopsy. The differential diagnosis should be made with tubercular meningitis, sepsis and lymphoma. The disease should be treated with at least two to three antifungal medicines.

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目的　近年来神经肽在成人心脑血管疾病中的作用日益受到重视 ,但在新生儿窒息中的作用报道较少。该文探讨新生儿窒息血浆神经肽Y(NPY)和神经元特异性烯醇化酶 (NSE)的变化及临床意义。方法　选择窒息新生儿 34例 ,其中轻度窒息 18例 ,重度窒息 16例及正常对照组 14例 ,采用放射免疫法测定血浆NPY ,采用酶联免疫法测定血清NSE。结果　窒息新生儿NPY ,NSE水平均高于正常对照组 ,差异有显著性 (P <0 .0 1)。轻度窒息组与重度窒息组NPY为 16 6 .6 2± 15 .71ng L ,182 .4 1± 17.5 8ng L ;NSE为 16 .0 2± 1.93μg L,18.39±1.4 2 μg L。两组比较差异亦有显著性 (P <0 .0 1,P <0 .0 5 )。并且NPY与NSE呈正相关 (r =0 .6 5 5 ,P <0 .0 1)。结论　窒息新生儿NPY和NSE水平均显著升高 ,其水平高低与窒息程度密切相关 ,可作为判断新生儿窒息的参考指标之一。

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目的　进展中的肾脏疾病是以间质中炎症细胞的浸润及纤维化为主要特征 ,而作为炎症细胞中重要成员的肥大细胞目前国内研究较少。该研究旨在探讨肥大细胞在大鼠慢性肾功能不全模型肾脏中的分布及意义。方法　复制阿霉素肾病大鼠的慢性肾功能不全模型 ,采用甲苯胺蓝染色和类胰蛋白酶抗体免疫组化的方法 ,观察肥大细胞及类胰蛋白酶在肾脏中的分布。结果　①肥大细胞在皮质、髓质均可见到 ,以间质纤维化区域最为多见 ,肾小球内基本未见。类胰蛋白酶可在胞浆内发现 ,部分被释放在细胞外。②随间质纤维化程度的加重 ,肥大细胞数目明显增加 ,差异有显著性 (P <0 .0 5 )。结论　肥大细胞在慢性肾功能不全中参与间质纤维化 ,对肾小球的病理进展可能影响不大。

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