【摘要】 目的 制备小鼠肾炎模型并观察双氢青蒿素（dihydroartemisinine，DHA）对模型小鼠细胞因子肿瘤坏死因子-α（tunor necrosis factor，TNF-α）和白细胞介素-6（inter leukin-6，IL-6）的影响以及小鼠肾脏的病理变化。 方法 取雄性昆明种小鼠120只， 随机分为正常对照组、脂多糖（lipopolysaccharides，LPS）组、LPS+肾匀浆组及DHA治疗组；分别于12、24、48 h取血，酶联免疫吸附试验检测血清中TNF-α和IL-6的含量，苏木精-伊红染色法观察小鼠肾脏的病理变化。 结果 造模48 h LPS+肾匀浆组小鼠肾小球出现炎性细胞浸润，而正常对照组未见异常；LPS组及 DHA治疗组仅有轻微的病理改变。LPS刺激使小鼠血清TNF-α和IL-6含量高于正常水平（Plt;0.01），但有随时间不断下降的趋势；LPS+肾匀浆组较正常对照组TNF-α和IL-6含量升高（Plt;0.01）；DHA可显著下调模型小鼠血清TNF-α的水平（Plt;0.01），但对IL-6的影响相对较小（Pgt;0.05）。 结论 运用改良的造模方法LPS+肾匀浆建立肾炎模型效果良好；DHA可以调节模型小鼠炎症因子TNF-α和IL-6的释放，具有一定的改善模型小鼠肾炎症状的作用。【Abstract】 Objective To establish mice nephritis models, detect the serum level changes of cytokines tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) in the model mice treated by Dihydroartemisinin (DHA), and observe the physiological changes of the mice kidneys. Methods One hundred and twenty male Kunming mice were randomly divided into 4 groups: control group, lipopolysaccharides (LPS) group, LPS plus kidney homogenate group, and DHA treated group. The level of cytokines TNF-α and IL-6 in the serum were detected by enzyme-linked immunoabsordent assey at hour 12, 24, and 48, respectively. Pathological changes were observed by hematoxylin: eosin staining. Results At the time hour 48 after the establishment of the model, inflammatory cell infiltration was observed in the glomerulus of the LPS plus kidney homogenate group, but no abnormality was found in the control group. There were only slight pathological changes in mice models of the LPS group and the DHA treated group. The serum level of TNF-α and IL-6 increased remarkably after the treatment of LPS (Plt;0.01), but declined as time went by. The level of TNF-α and IL-6 increased significantly in LPS plus kidney homogenate group compared with the control group (Plt;0.01). DHA could significantly decrease the TNF-α level in the serum (Plt;0.01), but had a low influence on IL-6 (Pgt;0.05). Conclusion The modified LPS plus kidney homogenate has a good result in model establishing. DHA can regulate the release of TNF-α and IL-6 in the model mice, and may have certain good effects on ameliorating the nephritis pathological changes.
摘要:目的:探讨肝素在预防过敏性紫癜性肾炎中的疗效及安全性。方法:采用随机对照的方法,将98例过敏性紫癜患儿分为肝素治疗组(49例)和对照组(49例),肝素组给予肝素钠100～150 Ｕ加入5%葡萄糖100～200 mL中静脉点滴,每日1次,连用5～7天,以后每两周查尿常规1次,至少观察3个月或以上。结果:肝素治疗组发生肾炎3例(6.1%),对照组发生肾炎11例(22.4%),肝素治疗组肾炎发生率低于对照组(0.01lt;P≤0.05)。结论:肝素对预防紫癜性肾炎的发生有效,且不良反应少。Abstract: Objective: To investigate the heparin in the prevention of allergic purpura nephritis in the efficacy and safety. Methods:A randomizedcontrolled method, 98 cases of allergic purpura patients were divided into heparin in the treatment group (49 cases) and control group (49 cases), heparin group received heparin, 100150 u in 5% glucose 100 ~ 200 mL in the intravenous drip, day 1, used in conjunction 57 days, after a routine urine check every two weeks times, at least for 3 months or more.Results: The results of heparin treatment group occurred nephritis in 3 cases (6.1%), glomerulonephritis in 11 cases in control group (22.4%), glomerulonephritis incidence of heparin in the treatment group than the control group (0.01lt;P ≤ 0.05). Conclusion: heparin in preventing the occurrence of HenochSchonlein purpura nephritis and effective, and less adverse reactions.
Objective We searched for evidence on mycophenolate mofetil(MMF) as a treatment for patients with diffuse proliferative lupus nephritis. Methods We attempted to find the current best evidence by searching The Cochrane Library(Issue 4, 2005), MEDLINE(1990 to June 2007), CMB(1980 to December 2006), CNKI(1979 to October 2007). We critically appraised the available evidence. Results Four systematic reviews and 6 randomized controlled trials of high quality were available. MMF and prednisolone were found to be an effective continuous induction-maintenance treatment for diffuse proliferative lupus nephritis. MMF was associated with less drug toxicity. Conclusion Given the current evidence and our clinical experience, and considering the patient and the values and preferences of his family,MMF was given at 1 g daily in combination with steroids at the beginning. No obvious adverse effects occurred during 3 months of follow-up.
Objective By means of evidence-based clinical practice, to find more effective treatment for a hepatitis B related nephritis patient with renal failure. Methods The following databases as Up to Date (May 2011), The Cochrane Library (Issue 5, 2011), PubMed (1978 to 2011) and CNKI (1978 to 2011) were searched to identify systematic reviews and randomized controlled trials (RCTs) of treating hepatitis B related nephritis with glucocorticoid, immunosuppressor or antiviral therapies, and the quality of collected clinical evidence was evaluated by using GRADEpro software. Results The glucocorticoid or combined immunosuppressors was not recommended for existing adverse effects and not acting on the remission of hepatitis B related nephritis and reduction of proteinuria. However, the antiviral therapy used alone was recommended for acting on the remission of hepatitis B related nephritis and the reduction of proteinuria. In view of adverse effects and expensive price of interferon, the nucleoside analogue antiviral agent was suggested. Considering the renal toxicity of adefovir and tenofovir, and possible drug-resistance of lamivudine, the entecavir (0.5 mg qd) was finally selected with patient’s agreement, and the supporting therapies such as lowering blood pressure, and protecting the kidney and liver were adopted continually. After one month treatment, 24-hour urinary protein got reduced, serum albumin got increased, kidney function got stable, and hepatitis B virus DNA quantity got reduced. Conclusion For treating hepatitis B related nephritis with kidney failure, entacavir can reduce 24-hour urinary protein, raise serum albumin, stabilize kidney function and reduce hepatitis B virus DNA in a short term, but its long-term efficacy still requires further studies.
ObjectiveTo observe the features of temporal macular thinning and its value for the diagnosis of Alport syndrome (AS) in young patients.MethodsEighty-one young patients with AS (81 eyes) from Peking University First Hospital during January 2016 and July 2017 were included in this study. There were 67 males (67 eyes) and 14 females (14 eyes),the aged from 3 to 17 years, with the mean age of 9.6 years. Among 81 patients (81 eyes), there were 64 patients with X-linked AS (XLAS, including 53 males and 11 females), 17 patients with autosomal recessive AS (ARAS, including 14 males and 3 females). One hundred healthy subjects aged 4 to 17 years were included as controls. Clinical data were retrospectively evaluated, including visual acuity, slit-lamp microscopy, dilated fundus photography, and OCT. Retinal thickness was measured with an OCT scan and the temporal thinning index (TTI) was calculated as stated in a previous study. The TTI values of each group was compared by One-way ANOVA or independent sample t test. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic effectiveness for AS.ResultsThe TTI of the control group, XLAS and ARAS patients were 6.46±1.58, 10.93±3.77, 12.14±4.05, respectively. Compared with the control group, the TTI value of males were larger in the XLAS and ARAS group (F=45.056, P＜0.001), the TTI value of females were larger in the ARAS group (F=26.541, P＜0.001). The difference of TTI value in females was significant between the XLAS and ARAS groups (F=26.541, P＜0.001). In males, the area under the ROC curve was 0.896 (95%CI 0.837−0.955, P＜0.001). The optimal cutoff value of the TTI was determined as 9.47, with a sensitivity of 73.1% and a specificity of 100%.ConclusionsTTI is a common ocular finding in young patients with AS. In males, a TTI ＞ 9.47 may differentiate AS from normal males.
目的 探讨抗核抗体（ANA）在IgA肾病中的阳性率及其对临床的意义。 方法 回顾性分析2007年1月－2009年12月间进行ANA检测的115例IgA肾病患者及59例非IgA肾病慢性肾炎患者的临床资料。统计分析ANA阳性与阴性的临床指标。 结果 IgA肾病患者中有12例（10.4%）存在ANA阳性，与非IgA肾病慢性肾炎中的阳性率比较差异无统计学意义（P＞0.05），ANA阳性的IgA肾病血浆IgG水平较高，病理改变较轻。 结论 IgA肾病ANA阳性的机体免疫有增强，肾功、尿蛋白及病理损害较轻，其对IgA肾病预后的影响仍需进一步研究。