银杏叶制剂和丹参对急性肾功能衰竭家兔rRBF的影响

目的探讨急性肾功能衰竭 (ARF)兔肾皮质局部血流量(rRBF)与血液流变学的关系 ,以及银杏叶制剂 (GbE)、丹参对其的影响。方法用50 %的甘油10ml/kg 行兔后肢肌肉加压注射 ,建立ARF动物模型 ,观察血液流变学、rRBF的变化 ,并给予GbE、丹参注射液对比观察。结果ARF组血液流变学指标明显异常 ,rRBF明显下降。ηb、ηp、EAI、HCT等与rRBF呈明显负相关(P均<0.05)。GbE组、丹参组动物血液流变学、rRBF等指标明显改善。结论ARF时血液流变特性恶化和肾局部微循环障碍可能是造成rRBF下降的直接原因之一。GbE、丹参对甘油所致ARF家兔的血液流变特性及肾组织缺血性损害有明显的保护作用     

银杏叶制剂、丹参对急性肾功能衰竭家兔血液流变学的影响

目的 :探讨银杏叶制剂 (GbE)、丹参对实验性急性肾功能衰竭(ARF)兔血液流变学、肾功能的影响。方法 :用 5 0 %的甘油 10ml/kg行兔后肢肌肉加压注射 ,建立ARF动物模型 ,观察不同时相血液流变学、肾功能 (血Cr、BUN)的改变 ,并给予GbE、丹参注射液处理。结果 :ARF组肾功能明显下降 ,血液流变学指标明显异常。GbE组、丹参组动物血液流变学指标明显改善 ;肾功能得到保护。结论 :GbE、丹参对甘油所致ARF家兔的血液流变性、肾功能有明显的保护作用     

急性肾功能衰竭家兔肾皮质局部血流量与球结膜微循环变化的研究

目的探讨急性肾功能衰竭(ARF)兔球结膜微循环(BCM)与肾皮质局部血流量(rRBF)变化的关系.方法用50%的甘油10ml/kg行兔后肢肌肉加压注射,建立ARF模型,观察不同时相BCM、rRBF、肾功能(血Cr、BUN)以及肾组织形态学的改变.结果ARF组肾组织出现严重损害,肾功能明显下降,BCM功能障碍,rRBF明显下降.BCM总积分与rRBF呈明显负相关(P均<0.05）。结论1、甘油所致ARF家兔BCM形态、流态、管周状态积分及总积分明显升高；rRBF降低；肾组织出现严重损害。2、肾局部微循环障碍可能是造成rRBF下降和肾组织形态学损害的直接原因之一。     

实验性急性肾功能衰竭家兔肾组织学损伤与血液流变学的关系

目的 探讨实验性急性肾功能衰竭（ARF）兔肾组织形态学改变与血液流变学的关系。方法 用50%的甘油10ml/kg行兔后肢肌肉加压注射，建立ARF动物模型，观察不同时相血液流变学，肾组织形态学以及肾功能改变，结果 ARF组肾组织出现严重损害，主要为：肾小球轻度出血；肾小管广泛颗粒变性，部分肾小管上皮细胞坏死，管腔闭塞；大量管型形成；肾小管轻度出血；肾间质水肿，炎性细胞浸润；肾血管瘀血，肾功能明显下降，血液流变学指标明显异常。结论 1、甘油所致ARF兔血液流变特性明显异常；肾组织出现严重损害，2、ARF时血液流变特性恶化可能是造成肾组织形态学损害的直接原因之一。     

兔脑局部冷冻对血液流变性的影响

目的 :探讨脑局部冷冻兔血液流变学变化及蝮蛇抗栓酶对其的保护作用。方法 :日本白色兔 2 4只 ,分为三组 :单纯冷冻组 (Ⅰ组 )、生理盐水对照组 (Ⅱ组 )、药物治疗组 (Ⅲ组 ) ,分别检测脑局部冷冻前后不同时相血液流变学指标的变化。结果 :Ⅰ组、Ⅱ组脑局部冷冻后血液流变学指标明显改变 ,与冷冻前比较 :ηb、ηp、ESR、K值、EAI明显升高 (P <0 .0 5或 0 .0 1)。Ⅲ组脑局部冷冻前后比较 ,差别无显著性意义 (P >0 .0 5 )。Ⅲ组冷冻后不同时相血液流变学指标明显低于Ⅰ组和Ⅱ组 (P <0 .0 5 )。结论 :兔脑局部冷冻能引起血液流变性改变 ,蝮蛇抗栓酶对兔脑局部冷冻造成的血液流变性损害有保护作用。目的 :探讨脑局部冷冻兔血液流变学变化及蝮蛇抗栓酶对其的保护作用。方法 :日本白色兔 2 4只 ,分为三组 :单纯冷冻组 (Ⅰ组 )、生理盐水对照组 (Ⅱ组 )、药物治疗组 (Ⅲ组 ) ,分别检测脑局部冷冻前后不同时相血液流变学指标的变化。结果 :Ⅰ组、Ⅱ组脑局部冷冻后血液流变学指标明显改变 ,与冷冻前比较 :ηb、ηp、ESR、K值、EAI明显升高 (P <0 .0 5或 0 .0 1)。Ⅲ组脑局部冷冻前后比较 ,差别无显著性意义 (P >0 .0 5 )。Ⅲ组冷冻后不同时相血液流变学指标明显低于Ⅰ组和Ⅱ组 (P <0 .0 5 )。结论 :兔脑局部冷冻?     

急性肾功能衰竭兔血液流变性改变致心肌缺血性损伤的研究

目的 :探讨甘油所致急性肾功能衰竭 (Acuterenalfailure ,ARF)家兔心肌缺血性损害与血液流变性的关系。方法 :用 50 %的甘油 10ml/kg行兔后肢肌肉内加压注射 ,建立ARF动物模型 ,观察动物心肌组织形态学以及血液流变学指标的变化。结果 :ARF组兔出现高粘滞血症 ,表现为全血粘度、血浆粘度、红细胞聚集指数、红细胞刚性指数、血沉等明显升高。心肌组织出现严重的缺血性损害 ,主要表现为心肌细胞弥漫性变性、心肌纤维间质水肿、血管周围水肿等。结论 :ARF时血液流变特性恶化可能是造成心肌组织缺血性损害的直接原因之一。     

丹参对脊髓损伤后伤区血流量及血液流变学指标的影响

目的 :比较应用丹参对兔脊髓损伤 (SCI)后伤区血流量及血液流变学指标的影响 ,探讨丹参对脊髓损伤的保护机制。方法 :5 8只成年日本大耳白兔 ,随机分成四组 ,A组 10只 ,作为正常组 ;B、C、D组各 16只 ,分别作对照组、地塞米松 (Dex)治疗组和丹参治疗组。比较脊髓损伤前后及应用Dex、丹参治疗后伤区血流量 (SCBF)及血液流变学指标的变化。结果 :脊髓损伤后 ,SCBF下降 ,血液粘度(ηb)、纤维蛋白原 (Fib)、细胞聚集指数 (RAI)增高。Dex对脊髓SCBF和血液流变学指标异常的改善不明显 ,而使用丹参治疗后 ,脊髓SCBF增高 ,血液流变学指标明显改善。结论 :丹参对脊髓损伤具有保护作用 ,且疗效较Dex明显 ,为临床治疗提供依据。     

血栓通对急性肾衰兔血液流变性影响的研究

目的:探讨血栓通对甘油所致急性肾功能衰竭(Acuterenalfailure,ARF)家兔血液粘度及血小板聚集功能的影响。方法:将实验动物随机分为对照组、ARF组、血栓通组。检测各组不同时相血液流变学指标以及血小板聚集功能的变化。结果:ARF组兔出现高粘滞血症,表现为全血粘度、血浆粘度、红细胞聚集指数、红细胞刚性指数明显升高,血沉明显增快(P<0.01);血小板聚集功能明显增强(P<0.01)。血栓通组与ARF组比较,血液流变性指标明显改善,血小板聚集功能明显下降(P<0.01)。结论:血栓通能明显降低ARF兔血液粘度和血小板聚集功能,从而改善血液流变性和微循环功能。     

芪蛭颗粒治疗下肢深静脉血栓形成患者血液流变学和血流动力学变化

目的:观察芪蛭颗粒治疗下肢深静脉血栓形成(DVT)对血液流变学和血液动力学指标的影响。方法:选择100例住院病人,随机分为芪蛀颗粒治疗组和对照治疗组,观察两组病人用药前后血液流变学和血液动力学指标的变化。结果:(1)治疗组全血表观粘度(ηb)、血浆粘度(ηp)、红细胞压积(Hct)、血沉(ESR)、纤维蛋白原(Fg)等血液流变学指标较对照治疗组均明显下降(P<0.05);(2)芪蛭颗粒治疗组节段性静脉容积(SVC)、静脉最大回流量(MVO)、静脉回流速率(Ratio)、静脉压恢复时间(VRT)等血液动力学指标较对照治疗组均明显增加(P<0.05);(3)两组均未见明显出血性并发症。结论:芪蛭颗粒可通过改善血液流变学和血液动力学指标有效治疗DVT。     

脑梗塞病人胰岛素、血糖与血液流变性关系的研究

目的探讨脑梗塞(CI)病人血浆胰岛素(INS)、血糖(BS)、血浆内皮素(ET)水平与血液流变学指标的相关性.方法对49例非急性期的脑梗塞患者和29例健康人分别测定INS、BS、ET以及血液流变学等指标.结果CI组与对照组比较INS、BS、ET明显升高(P＜0.01);血液流变学指标明显异常.ηb低切值、ESR、K值、EAI与INS呈明显正相关;ηb低切值、ESR、EAI与BS呈明显正相关;INS与ET、BS水平呈明显正相关(相关系数分别为r=0.48、0.4,P＜0.01).结论CI患者INS与ET、BS关系密切,互相作用,引起血液流变学的改变,导致脑缺血,促进脑梗塞的发生.     

Renal replacement therapy in the intensive care unit

Acute renal failure is a frequent complication in critically ill patients that carries with it considerable morbidity and mortality. The management of renal failure in patients with multi-organ failure is different from that of renal failure that presents as a single organ failure. Intermittent haemodialysis, done in the conventional manner may not be tolerated by most critically ill patients. Continuous renal replacement therapy is physiologically superior; however, there is lack of strong evidence to prove a clinical benefit. Hybrid therapies that combine the benefits of intermittent haemodialysis and continuous therapies have emerged in the past few years. These are simpler to carry out, provide more flexibility and may be cost effective and need to be studied in a systematic manner.     

Mitochondria with Tubulovesicular Cristae in Renal Oncocytomas

Renal oncocytoma and chromophobe renal cell carcinoma (CRCC) are closely related tumors. They are considered the extremes of a spectrum with several variants. Ultrastructural examination of the mitochondria is a helpful procedure in the diagnosis of these neoplasms. Renal oncocytomas show mitochondria with piled lamellar cristae, and CRCC exhibited mitochondria with tubulovesicular cristae. In a series of 23 histologically diagnosed renal oncocytomas examined by electron microscopy, the authors found 5 tumors exhibiting more cells with mitochondria showing tubulovesicular cristae. The authors believe these 5 cases present a submicroscopic appearance intermediate between renal oncocytoma and CRCC, although with benign clinical behavior.     

Renal findings in 40 individuals with Williams syndrome

We tabulated the frequency of renal abnormalities in 40 Williams syndrome individuals presenting for medical and/or developmental assessment to a multi-disciplinary Williams syndrome program. The average age at time of assessment was 7²/12 years. Seven individuals (7/40 = 18%) had abnormalities detected, including nephrocalcinosis = 2; marked asymmetry in kidney size = 2; small kidneys = 1; solitary kidney = 1; and pelvic kidney = 1. Renal function was also assessed. Two individuals had evidence of renal dysfunction, one secondary to nephrocalcinosis and the second due to hypercalcemia and interstitial nephritis of unclear pathogenesis. We examined the frequency of renal artery stenosis in 9 individuals who underwent abdominal angiography during cardiac catheterization. We found unilateral or bilateral mild renal artery narrowing in 4 individuals and normal renal arteries in the remaining 5. Persistent hypertension occurred in only 2 individuals and did not correlate with renal artery status. We conclude that intrinsic renal anomalies, as well as problems secondary to hypercalcemia, occur with sufficient frequency to warrant baseline renal screening in all individuals with Williams syndrome. © 1993 Wiley-Liss, Inc.     

Renal parameter estimates in unrestrained dogs

A mathematical formulation has been developed to describe the haemodynamic parameters of a conceptualised kidney model. The model was developed by considering regional pressure drops and regional storage capacities within the renal vasculature. Estimation of renal artery compliance; pre- and postglomerular resistance and glomerular filtration pressure is feasible by considering mean levels and time derivatives of abdominal aortic pressure and renal artery flow. If the level of flow is not greatly altered during an experimental sequence, it may also be feasible to estimate changes in glomerular filtration rate. Changes in the smooth muscle tone of the renal vessels induced by exogenous angiotensin amide, acetylcholine and by the anaesthetic agent halothane were estimated by use of the model. By employing totally implanted telemetry, the technique was applied on unrestrained dogs to measure renal resistive and compliant parameters while the dogs were being subjected to obedience training, to avoidance reaction and to unrestrained caging. An increase in vasoconstrictor tone in the renal artery and in the afferent arterioles in response to an increasing level of stimulation was demonstrated using this model.     

Ultrastructural Evaluation of Renal Cell Oncocytomas

The utility of ultrastructural evaluation of eosinophilic renal cell neoplasms is illustrated by two case studies. The differential diagnosis between granular renal cell carcinoma and renal cell oncocytoma may be difficult. Ultrastructural demonstration of the presence of abundant mitochondria is useful in the definitive diagnosis of fine-needle aspiration specimens, those neoplasms with nuclear pleomorphism, or in patients requiring renal parenchymal sparing surgery.     

Ultrastructural Evaluation of Renal Cell Oncocytomas

The utility of ultrastructural evaluation of eosinophilic renal cell neoplasms is illustrated by two case studies. The differential diagnosis between granular renal cell carcinoma and renal cell oncocytoma may be difficult. Ultrastructural demonstration of the presence of abundant mitochondria is useful in the definitive diagnosis of fine-needle aspiration specimens, those neoplasms with nuclear pleomorphism, or in patients requiring renal parenchymal sparing surgery.     

尸体肾移植肾血管变异与临床应用

本文在尸体肾移植中取尸肾53具,发现供肾血管变异25例,占47.2%,其中多枝肾动脉15例,占28.3%,多枝静脉10例,占18.9%,经对异常血管进行成形术,肾移植术后吻合口无狭窄及出血,肾功能良好,与供肾正常血管比较无明显的差别。     

Renal oncocytosis

Renal oncocytosis is a rare disorder in which numerous oncocytic nodules develop in the kidney. An additional case is reported here. The patient was a 51-year-old woman who had received hemodialysis for 27 years. Nineteen years previously she had developed a tumorous lesion in the right kidney, which had been diagnosed as oncocytoma with laparotomic biopsy. Recently the kidney was removed because of enlargement of the tumor. The renal parenchyma was entirely replaced with numerous brownish nodules. Histologically, the nodules were composed of nests of uniform oncocytic cells. Ultrastructurally, the oncocytic cells contained numerous mitochondria. Immunohistochemical features of the nodules were identical to those of sporadic oncocytomas, that is, immunophenotypes similar to the distal nephron and reactivity with antimitochondrial antigen. Based on these findings, the lesion was diagnosed as renal oncocytosis. It was not possible to determine whether the larger nodules should be diagnosed as oncocytoma or a part of oncocytosis. Additionally, the germ line mutation of the Birt-Hogg-Dubé (BHD) syndrome gene was examined using the genomic DNA obtained from the peripheral lymphocytes, which failed to show any gene alteration. Despite the rare occurrence pathologists and urologists should be aware of renal oncocytosis, as a precursor lesion of renal oncocytoma and chromophobe renal cell carcinoma.     

Renal autoregulation in medical therapy of renovascular hypertension

Introduction

Renovascular hypertension (RVH) is caused by renal ischaemia associated with haemodynamically significant renal artery stenosis (RAS). The choice of optimal treatment of atherosclerotic RAS is still controversial. Increase in the renal resistive index (RI) value after captopril administration is considered to indicate preserved renal autoregulation. The objective of the study was to assess the effect of medical therapy of RVH on renal autoregulation efficiency in patients with atherosclerotic RAS.

Material and methods

19 persons (38 kidneys) in 2 groups: 1) study: with RVH and stenosis of 1 renal artery – 8 patients; 2) control: – 11 healthy volunteers. Doppler captopril test with RI measurements and estimation of creatinine clearance (CCr) were performed in both groups at baseline, and after a period of controlled medical therapy (CMT) only in the study group. ABPM was evaluated in controls at baseline, and in the study group at the end of CMT.

Results

In the study group the mean period of CMT was 8.3 ±2.7 months, the number of antihypertensive drugs was 4.1 ±1.0, and mean 24-hour blood pressure was 138/74 mmHg. Mean CCr was stable during the study. Significant increase of RI after captopril was found only in controls. At baseline, in the group of kidneys with a non-stenotic renal artery, significant lowering of RI was observed, and ΔRI differed significantly from controls. After CMT, ΔRI increased in non-stenotic kidneys in comparison to the baseline, and did not differ from controls.

Conclusions

Adequate medical therapy of RVH preserved renal function and improved renal autoregulation efficiency in non-stenotic kidneys.     

Ultrastructural and Biosynthetic Changes in Epitheliocytes of Renal Tubules during the Development of Chronic Renal Failure

Structural and functional studies of changes in the tubular compartment during progressive renal dysfunction showed that the major types of damage to tubular cells include dystrophy, degeneration, and atrophy. These changes were associated with inhibition of biosynthetic processes in the tubular epithelium, progressive interstitial fibrosis, and disturbances in the structure and function of peritubular microvessels.__________Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 139, No. 3, pp. 352–356, March, 2005