JNK-c-Jun信号通路下调连接蛋白43的表达引起肾小管上皮细胞转分化

目的 观察c-Jun氨基末端激酶（JNK）-c-Jun通路对连接蛋白43（Cx43）表达的影响及在转化生长因子（TGF）β1诱导的肾小管上皮细胞-肌成纤维细胞转分化（TEMT）中的作用。 方法　大鼠肾小管上皮细胞（NRK-52E）随机分成3组：对照组、TGF-β1（10 μg/L）组和TGF-β1（10 μg/L）+JNK选择性抑制剂SP600125（50 μmol/L）组。用免疫细胞化学、Western印迹检测JNK、c-Jun、连接蛋白43（Cx43）、上皮细胞标志物E-钙黏蛋白（E-cadherin）和肌成纤维细胞标志物α-SMA的表达。用RT-PCR检测Cx43的mRNA水平。用激光共聚焦显微镜荧光漂白恢复（FRAP）技术检测NRK-52E细胞间通讯功能。 结果 TGF-β1引起肾小管上皮细胞α-SMA、JNK、c-Jun表达上调（均P < 0.05）,Cx43、E-cadherin表达下调（均P < 0.05）,Cx43的mRNA水平下降（P < 0.05）,细胞间通迅功能下降 （P < 0.05）。JNK抑制剂处理后,上述改变明显减轻。 结论 TGF-β1引起肾小管上皮细胞内JNK表达上调,增加c-Jun活性,从而抑制Cx43的表达和降低细胞间通迅功能,导致TEMT。     

c-Fos、c-Jun在兔成骨样细胞内的表达

用组织块移植法对兔颅骨细胞进行分离培养。相差显微镜观察，组织化学染色，免疫组织化学染色，mRNA原位杂交及体外钙化检测表明该细胞群符合成骨样细胞的特点。在此基础上用免疫组织化学SP法观察了c-F0s，c-Jun在成骨样细胞内的表达及其与骨钙素合成的关系。结果显示c-Fos、c-Jun从第一代到第十一代成骨样细胞内均有表述，且早期表述较多，可位于胞核、核膜及胞浆内。第六代以后的细胞仅胞浆着色。在c-Fos、c-Jun高表达时骨钙素合成减少c-Fos、c-Jun低表达时骨钙素合成增加，提示c-Fos、c-Jun对骨钙素具有负调控作用。本实验结果为c-Fos、c-Jun参与骨代谢提供了直接证据，同时也为观测成骨细胞生长分化及其影响固素提供了有价值的指标．有助于促进牙周炎牙槽骨骨吸收机理及其它骨代谢相关研究。     

胚胎脊髓移植后大鼠损伤脊髓c-Jun免疫反应的变化及其意义

目的：研究大鼠胚胎脊髓移植后能否影响,c-Hun免疫反应的表达和脊髓损伤后大鼠功能的恢复,方法;将动物分为脊髓半切洞损伤加胚胎脊髓移植组（A组）和单纯脊髓板切洞损伤加明胶海绵填塞组（B组）,每个时相点每组6只动物,术只1,3,7,14和28天,应用行为学和电生理检查观察大鼠功能恢复情况,应用免疫细胞化学方法,c-Jun免疫反应的表达,采用计算机图像分析技术,进行定量分析。结果：大鼠脊髓损伤后c-Jun免疫反应的表达A组明显高于B组,胚胎脊髓抑制后可使损伤脊髓高表达c-Jun 免疫反应持续到术后7天,增加的c-Jun免疫反应阳性细胞数目与神经功能的改善相平行。结论：胚胎脊髓移植后可使损伤脊髓高表达c-Jun,并促进大鼠功能恢复。     

Kartogenin联合脂肪干细胞对前交叉韧带重建术后腱骨愈合的影响

目的 探讨Kartogenin(KGN)联合脂肪干细胞（adipose-derived stem cells,ADSCs）对兔前交叉韧带（anterior cruciate ligament,ACL）重建术后腱骨愈合的影响。方法 取原代ADSCs传代培养，将第3代细胞与10μmol/L KGN溶液培养72 h后，取KGN-ADSCs上清液与纤维蛋白胶以1∶1比例混合备用；另取第3代ADSCs与纤维蛋白胶混合作为对照。取成年新西兰大白兔80只，随机分为4组，分别为生理盐水组（A组）、ADSCs组（B组）、KGN-ADSCs组（C组）、假手术组（D组）。A～C组制备ACL重建模型后，分别于腱骨界面和肌腱间隙中注射生理盐水、ADSCs与纤维蛋白胶混合液、KGN-ADSCs上清液与纤维蛋白胶混合液；D组仅暴露ACL，不作其他处理。术后观察动物一般情况，于6、12周取腱骨界面组织及ACL标本，通过HE染色、c-Jun氨基末端激酶（c-Jun N-terminal kinase,JNK）免疫组织化学染色、TUNEL细胞凋亡检测观察腱骨愈合情况，计数成纤维细胞，测算JNK蛋白阳性表达率及细胞凋亡指数...     

糖蛋白在胆石形成中的作用及其与自由基的关系（综述）

糖蛋白为胆石的主要成份之一，本文概述了从临床、生化、组织学、细胞生物学、生物物理学等方面对其研究的成果：（一）糖蛋白参与胆石的形成过程；（二）从分子水平上捍，糖蛋白有与胆红素进行疏水结合的能力；（三）胆道系统中有多种来源的自由基反应；（四）胆道系统中的糖蛋白有清除自由基作用；（五）自由基可刺激胆道膜上皮分泌糖蛋白增加；（六）糖蛋白在与自由基反应时，自身裂解，其粘弹性丧失。     

阑尾黏膜防御素5 mRNA的表达及意义

阑尾参与了B淋巴细胞的产生和成熟过程，而且还可能通过分泌免疫球蛋白（immunoglobulin，Ig）参与了炎症防御叭，但对阑尾黏膜是否分泌诸如人防御素5（human defensin 5，HD-5）一类的天然免疫物质以参与抗炎过程尚无文献报道，本研究就此进行了初步探索，现报道如下。     

SUMOylation regulates glutamate-induced and glutamate receptor 6-mediated cell injury via c-Jun activation

Glutamate neurotoxicity, which can result in both neuronal damage via c-Jun N-terminal kinase （JNK）/c-Jun pathway and increased GIuR6 SUMOylation, has been related to hypoxia or ischemia. Here we studied the effects of glutamate on GluR6 SUMOylation status and the impact that these modifications have on c-Jun activity. We showed that SUMOylation of GIuR6 at lysine 886 （K886） could be induced by glutamate treatment and occurred in a rapid manner; however, induced mutation at this site would block SUMOylation in vitro. The activation of c-Jun and PC12 cell death significantly increased after inhibition of SUMO pathways in cells treated with glutamate. We further demonstrated that Ubc9 played a functional role in GluR6 SUMOylation and that the C93S mutant of Ubc9 abrogated SUMO-1 conjugation activity. In conclusion, SUMOylation of GIuR6 has key roles in the regulation of glutamate neuronal excitotoxicity. These data reveal another role of SUMO in protection against cell death.     

骨生长因子对骨形成的协同作用研究进展

骨形成是一个复杂的过程，其中有成骨细胞、破骨细胞及生长因子等参与，而其中主要是局部的骨生长因子环境。目前，已知参与骨形成的生长因子有：骨形态发生蛋白（bone morphogenetic proteins，BMP）、转化生长因子-β（transforming growth factor-β，TGF-β）、类胰岛素生长因子（insulin-like growth factor，IGF）、碱性成纤维细胞生长因子（fibroblast growth factor，FGF）、     

脊髓水平γ-氨基丁酸转运体参与痛觉信息传递的研究进展

γ-氨基丁酸（GABA）是哺乳动物中枢神经系统的重要抑制性神经递质，能快速被γ-氨基丁酸转运体（GAT）摄取，从而终止其抑制作用。GABA作用的程度和持续时间受到GAT的调节。GAT作为GABA能系统重要的组成部分，参与痛觉信息在脊髓水平的传递和慢性疼痛的发生与发展过程。     

有丝分裂蛋白激酶及其上游调节信号在人肝癌组织中的表达

目的探讨有丝分裂原蛋白激酶(MAPK)通路在调控细胞的增殖和凋亡过程中所起到的作用.方法手术切除16份肝癌及癌旁组织标本,Western印迹检测ERK1、ERK2、JNK1、p38和MEK1、MEK2的蛋白含量.结果在本组的16例患者中,每例患者肝癌组织中的ERK1、ERK2、JNK1、p38蛋白表达显著高于癌旁组织,ERK1积分光密度值(Integral optic density IOD)在肝癌和癌旁组织中分别为300±98和98±48,差异有显著意义(P＜0.01).ERK2的IOD值在肝癌和癌旁组织中分别为587±83和232±96,差异有显著意义(P＜0.01);p38的IOD值在肝癌和癌旁组织中分别为270±85和107±88,差异有显著意义(P＜0.01);肝癌组织中的JNK1蛋白表达显著低于癌旁组织;JNK1的IOD值在肝癌和癌旁组织中分别为111±93和292±109,差异有显著意义(P＜0.01);MEK1、MEK2蛋白表达显著高于癌旁组织,MEK1的IOD值在肝癌和癌旁组织中分别为1418±244和806±90,差异有显著意义(P＜0.01),MEK2的IOD值在肝癌和癌旁组织中分别为1041±122和468±40,差异有显著意义(P＜0.05).结论在肝癌组织中细胞分裂增殖的信号传导通路ERK1、ERK2、MEK1、MEK2激酶处于高表达,JNK1激酶在肝癌组织中处于低表达,它们的失衡导致肝癌细胞生长失控和无限增殖的重要原因之一.JNK1和p38在肝癌组织中可能存在不同的激活途径.     

Surgical Complications and Long-Term Outcome of Different Biliary Reconstructions in Liver Transplantation for Primary Sclerosing Cholangitis—Choledochoduodenostomy versus Choledochojejunostomy

Choledochojejunostomy (CJS) is commonly used for biliary reconstruction in liver transplantation for primary sclerosing cholangitis (PSC). We alternatively performed choledochoduodenostomy (CDS) and side-to-side choledochodocholedochstomy in a large cohort of patients. Fifty-one patients with PSC, transplanted between 1988 and 2000, were analyzed retrospectively. Biliary reconstruction was CDS in 25 (49%), CJS in 20 (39%) and CC in 6 transplantations (12%). Biliary leaks occurred in the early follow-up (< or =41 days) only in CDS patients (20%). However, in the late follow-up (>4 months), stricturing of anastomosis was found once in CDS (4%) and CJS (5%). Later (>9 months), intrahepatic bile duct strictures were diagnosed in four CDS (16%), one CJS (5%) and one CC (17%) patient(s). In 48% of CDS (12/25), 60% of CJS (12/20) and 17% of CC (1/6) at least one incidence of cholangitis was observed. Overall, biliary complication rates were significantly higher in CDS (40%) than CJS (10%) and CC (17%); of those none in CC and 12% in CDS were anastomosis-related. Graft/patient survival showed no significant differences among groups. Based on our results we consider CJS the standard method for biliary reconstruction in PSC; however, in selected cases where CJS is difficult to accomplish because of previous surgery or for retransplantation, CDS may present an alternative technique.     

The effect of two different protocols of potassium haemodiafiltration on QT dispersion.

BACKGROUND: The risk of developing cardiovascular diseases is higher in patients on haemodialysis than in the general population. These patients may develop arrhythmias that depend on the extra- and intracellular concentrations of potassium. ECG findings, particularly the QT interval and its dispersion (QT(d)) and the QT(c) (QT interval corrected for heart rate according to Bazett's formula) and its dispersion (QT(cd)), may be direct indicators of the risk of developing arrhythmia. METHODS: Our cohort comprised 28 patients who were dialysed for 3.5-4 h three times per week, first with haemodiafiltration with a constant potassium concentration (HDF) in the dialysis bath then with haemodiafiltration with variable concentrations of potassium (HDF(k)). ECGs were done at different time intervals: at the start of dialysis (T(0)), at 15 (T(15)), 45 (T(45)), 90 (T(90)) and 120 min (T(120)) after the beginning of the session, and at the end of treatment (T(end)). ECG-derived data (QT, QT(d), QT(c) and QT(cd)) were measured. At the same time points, plasma electrolytes, intra-erythrocytic potassium and the electrical membrane potential at rest (REMP) of the erythrocytic membrane were measured. RESULTS: Plasma potassium concentration diminished more gradually in HDF(k) than in HDF, the difference being statistically significant at T(15) and T(45) (P<0.05), and T(90) (P<0.01). The intra-erythrocytic potassium concentration remained constant throughout the observation period. In both HDF and HDF(k), REMP was lower at all points after T(0) (P<0.05), but the reduction was greater and more significant in HDF than in HDF(k) at T(15) and T(120) (P<0.05). ECG revealed a statistically significant diminution in HDF(k) vs HDF in the measures of dispersion of QT and QT(c) at T(15), T(90), T(120) and T(end) (P<0.01) and of QT(cd) at T(45) (P<0.05). The mean of QT(d), adjusted for plasma potassium, increased over time in HDF with large alternate mean increase and decrease peaks and error intervals. In HDF(k), instead, there was a progressive and constant diminution with minor error intervals. QT(cd) adjusted for plasma potassium had the same trend. A marked difference was found between the final values in standard HDF and those in HDF(k). CONCLUSIONS: HDF and HDF(k) have significantly different effects on QT(c). ECG data demonstrate that the risk of arrhythmia could be lower, with a variable removal of potassium during haemodialysis. With HDF but not HDF(k), hyperpolarization of the cell membrane is detected, and this could have a destabilizing effect on different types of cardiac cell, giving rise to retrograde circuits.     

部分创面外用抗菌药物与成纤维细胞生长因子2、表皮生长因子、重组人生长激素对成纤维细胞生物学特性影响的实验研究

目的观察部分创面外用抗菌药物与成纤维细胞生长因子(FGF)2、表皮生长因子 (EGF)、重组人生长激素(rhGH)对成纤维细胞生物学特性的影响。方法体外培养成纤维细胞, 按所加药物不同分为对照组(常规培养)、丁胺卡那霉素(0．021、0．210、2．100 mg/L)组、庆大霉素(5、 50、500 mg/L)组、氯霉素(0．01、0．10、1．00 mg/L)组、磺胺米隆(5、10 g/L)组、FGF2(2 400 U/ml)组、 EGF(2 000 U/ml)组及rhGH(0．016、0．160、1．600 g/L)组。用噻唑蓝(MTT)法测定各组成纤维细胞增殖活性[吸光度(A)值],用流式细胞仪检测细胞周期,并于显微镜下观察细胞形态的变化。结果 (1)MTT法检测:与对照组A值0．455 3±0．021 7比较,各种剂量丁胺卡那霉素组、庆大霉素组、氯霉素组、磺胺米隆组成纤维细胞A值均明显降低(P<0．05或0．01),其中磺胺米隆(5、10 g/L)组降低最明显,分别为0．101 3±0．001 1、0．095 0±0．004 1(P<0．01)。FGF2组及0．016 g/L rhGH 组细胞A值明显高于对照组(P<0．05),而EGF组及0.160、1．600 g/L rhGH组A值与对照组接近 (P>0．05)。(2)细胞周期检测:对照组细胞增殖指数(PI)为(9．63±0．45)％,与之比较,0．210 mg/L丁胺卡那霉素组细胞PI值无明显变化(P>0．05),FGF2组、EGF组及0．016 g/L rhGH组PI值均明显升高,分别为(46．76±2．33)％、(42．30±1．41)％、(13．29±0．47)％(P<0．05或0．01)。 (3)形态学观察:对照组、EGF组及0．160、1．600 g/L rhGH组成纤维细胞数目较多,呈长条形或梭形, 轮廓不清,透明度高;丁胺卡那霉素组、庆大霉素组、氯霉素组、磺胺米隆组细胞数目较少,形态不规则,轮廓清晰,透明度低,细胞内多有颗粒样物质及空泡;FGF2组、0．016 g/L rhGH组细胞分布均匀、密集,呈长条形或梭形,核分裂相多见,轮廓不清,透明度高。结论不同创面外用药物对成纤维细胞生物学特性的影响各异,在创面修复过程中应选择合适的创面外用药物,以促进愈合并抑制瘢痕增生。     

Physiologic effects of pneumoperitoneum in adults with sickle cell disease undergoing laparoscopic cholecystectomy (A case control study)

BACKGROUND: Many studies have demonstrated the adverse consequences of pneumoperitoneum. However, few studies have examined the physiologic effects of pneumoperitoneum in adults with sickle cell disease (SCD) during laparoscopic cholecystectomy (LC). METHODS: 60 ASA 1-capital PE, Cyrillic capital PE, Cyrillic patients, with cholelithiasis, scheduled for elective LC were allocated into two equal groups: group 1, normal patients without SCD (control group), and group 2, patients with SCD. The perioperative parameters of 30 SCD patients matched by age and sex to the 30 members of the non-sickler control group who underwent cholecystectomy were assessed. Study parameters (in the two groups) included heart rate (HR) per minute, mean blood pressure (MAP, mmHg), PETCO(2), and O(2) saturation (SpO(2)) at the following intervals: before induction of anesthesia in the supine position (all except PETCO(2)), after anesthesia and before CO(2) insufflations in the supine position, 15, 30, 45, 60 min after CO(2) insufflations in the anti-Trendelenburg position, at the end of CO(2) exsufflation in the supine position and 5 min after the end of CO(2) exsufflation in the supine position. Arterial blood gases, to measure pH, PaCO(2), and PaO(2), were determined after induction of anesthesia and before CO(2) insufflation in the supine position, then 30 min after CO(2) insufflations in the anti-Trendelenburg position, and 5 min after the end of CO(2) exsufflation in the supine position. Statistical significance was established at the p < 0.05 level. RESULTS: Induction of anesthesia produced a significant increase in HR in both groups. CO(2) insufflations led to an additional increase in HR and persisted till abdominal deflation. After CO(2) insufflations, MAP significantly increased from the baseline at 15, 30, 45, and 60 min, and just before deflation in the anti-Trendelenburg position. CO(2) insufflations led to a significant increase in end-tidal CO(2) (ETCO(2)) in the study groups, reaching a maximum level just before abdominal deflation in the anti-Trendelenburg position. Regarding SpO(2) and PaO(2), there were insignificant changes in the two study groups throughout the procedure. In group 2, none of the patients experienced vaso-occlusive crises or other SCD- related complications. CONCLUSION: This study proved the safety of LC in patients with SCD and cholelithiasis, and that they can tolerate the physiological effects of pneumoperitoneum as non-SCD adults.     

不育男性精浆总抗氧化能力与精子运动功能的关系

目的:研究不育男性精浆总抗氧化能力(TAC)与精子运动能力和方式之间的关系,探讨精浆TAC水平在男性生育中的临床意义。方法:113例精子密度正常的不育男性,28例正常生育男性作为对照组。精液于37℃液化后采用计算机辅助精液分析(CASA)系统进行精液常规分析,采用比色法进行精浆TAC分析。结果:正常生育组精浆TAC为(19.82±6.33)U,不育男性精子密度正常组精浆TAC为(14.37±8.45)U,不育男性精子密度正常组与正常生育组比较存在显著性差异(P<0.01)。精浆TAC与a级精子百分率(r=0.208,P<0.05)和(a+b)级精子百分率(r=0.231,P<0.05)呈显著正相关,精浆TAC与精子运动参数中的前向性(r=0.200,P<0.05)、直线性(r=0.208,P<0.05)、曲线速度(r=0.189,P<0.05)、直线速度(r=0.210,P<0.05)、平均移动速度(r=0.215,P<0.05)及鞭打频率(r=-0.248,P<0.01)之间有显著的相关性,其中前向性、直线性、直线速度、曲线速度、平均移动速度与TAC呈正相关(P<0.05),而鞭打频率与TAC呈负相关(P<0.01)。精浆TAC与摆动性、侧摆幅度、平均移动角度之间无显著相关。结论:精浆中TAC水平与精子运动能力和运动方式密切相关,适宜的精浆TAC为精子运动提供了良好的外部环境,精浆中过低的TAC水平与精子运动能力下降和运动方式改变有关,可能是引起男性不育的病因之一。精浆中TAC分析可为探讨男性不育的发病机制以及临床用药提供依据。     

硫化氢在肠缺血-再灌注损伤大鼠肠黏膜屏障功能障碍中的作用

目的 观察硫化氢(H_2S)在肠缺血.再灌注损伤大鼠肠黏膜屏障功能障碍中的作用.方法 雄性Wistar大鼠24只,分为S(假手术)组、Ⅰ(缺血-再灌注)组,N(缺血-再灌注+NaHS)组(n=8),N组在再灌注前10 min静脉注射100 μmol/kg NaHs后按每小时1 mg/kg持续静脉注射直到再灌注2 h,S和Ⅰ组静脉注射相同体积的生理盐水.采用改良的酶学分光光度法测定血浆D-乳酸水平,采用分光光度法检测小肠黏膜超氧化物歧化酶(SOD)和髓过氧化物酶(MPO)、丙二醛(MDA)、黄嘌呤氧化酶(XO)水平,敏感硫电极法检测硫化氢(H_2S)浓度.电镜下观察肠黏膜形态学改变,TUNEL染色观察小肠上皮细胞凋亡指数(AI),逆转录.聚合酶链反应(RT-PCR)法检测小肠黏膜组织胱硫醚-γ-裂解酶(CSE)、胱硫醚-β-合酶(CBS)、多聚ADP核糖合成酶(PARP)和细胞凋亡蛋白酶(Caspase)-3 mRNA的表达,蛋白质印迹法检测小肠黏膜PARP和Caspase-3蛋白水平.结果 N组D-乳酸含量、AI分别为(2.35±0.26)mg/L、(24.41±2.76)%,低于Ⅰ组、高于S组(P<0.01),两者正相关(r=0.892,P<0.01);N组MDA、XO分别为(9.17±0.35)nmol/mg、(9.94±0.41)U/g,低于Ⅰ组、高于S组(P<0.01),两者正相关(r=0.995,P<0.01);N组CSE mRNA、H_2S、SOD、MPO分别为(0.33±0.02)μmol/L、(35.27±3.14)μmol/L、(8.83±0.29)U/mg、(5.95±0.49)U/mg;N组CSE mRNA、H_2S、SOD水平均低于S组(P<0.01),N组H2S、SOD水平均高于Ⅰ组(P<0.01),N组MPO水平高于S组、低于Ⅰ组(P<0.01);N组活化的Caspase-3、PARP蛋白表达量分别为11.50±1.25、9.37±1.18,高于s组、低于Ⅰ组(P<0.01),两者正相关(r=0.785,P<0.01).结论 H_2S对肠缺血再灌注损伤大鼠肠黏膜屏障功能障碍有保护作用,其机制之一是减少中性粒细胞浸润和激活、肠上皮细胞氧化损伤水平,增加SOD清除氧自由基的活性,下调活化的Caspase-3和PARP蛋白表达.     

The Czech registry of renal biopsies. Occurrence of renal diseases in the years 1994-2000.

BACKGROUND: This report describes data collected by the Czech Registry of Renal Biopsies (CRRB). METHODS: Twenty-eight centres provided data on all biopsies of native kidneys performed in the Czech Republic (population 10.3 million) over the period 1994-2000. Data on serum creatinine concentration (sCr), 24 h proteinuria, haematuria, serum albumin level, arterial hypertension, diabetes mellitus, histological diagnosis and complications after renal biopsy were collected. RESULTS: Altogether 4004 biopsies in 3874 patients were performed (males 57.9%, children < or = 15 years 17.7%, elderly >60 years 14.3%). Microhaematuria was present in 65.9%, macrohaematuria in 9.2%, nephrotic proteinuria (> or = 3.5 g/24 h) in 39.3%, and low-grade proteinuria (<3.5 g/24 h) in 41.4%. Among adults, hypertension was present in 45.2%, mild renal insufficiency in 23% (sCr 111-200 micromol/l) and advanced renal insufficiency in 13.7% (sCr 201-400), while 11.5% of patients had sCr >400 micromol/l. The most frequent renal diseases were primary (59.8%) and secondary (25.4%) glomerulonephritis (GN). Tubulointerstitial nephritis (TIN) was observed in 4.4% and hypertensive nephroangiosclerosis in 3.4%. The samples were non-diagnostic in 4.6%. Among primary GNs, the most frequent diagnoses were: IgA nephropathy (IgAN) 34.5%, minimal change disease (MCD) 12.4%, non-IgA mesangioproliferative GN (MesGN) 11.3%, focal segmental glomerulosclerosis (FSGS) 10.8% and membranous GN (MGN) 9.3%. Among secondary GNs, systemic lupus erythematosus (SLE) represented 23.0%, necrotizing vasculitis (NV) 15.5%, Henoch-Schonlein purpura 5.7%, thin basement membrane glomerulopathy (TBN) 19.3%, Alport syndrome 6.9%, renal amyloidosis 9.9% and myeloma kidney 2.9%. Among children, the most common were IgAN (19.2%), MCD (17.6%) and TBM glomerulopathy (12.3%), while among the elderly the most common were MGN (11.0%), NV (10.7%) and amyloidosis (9.6%). The most common in patients with nephrotic proteinuria were MCD (50.5%) among children, but IgAN (24.6%) in adults aged 16-60 years and MGN (16.8%) among the elderly. IgAN (21.3%) and FSGS (8.3%) were the most common diagnoses among patients with mild renal insufficiency, but TIN (11.6%) and NV (11.3%) were the most common in more advanced renal insufficiency. Since 1999, diabetic patients represented 12.2% of adults, with mean proteinuria 8.9 g/24 h; diabetic glomerulosclerosis was found in 42.4% (with microhaematuria present in 66%) and non-diabetic renal diseases in 47.5% (IgAN in 17.5%, MGN and NAS in 11.1% and NV in 9.5%). The mean annual incidence (per million population) was: primary GN 32.4, secondary GN 13.8, IgAN 11.2, MCD 4.0, MesGN 3.7, FSGS 3.5, SLE 3.2, MGN 3.0, TBM 2.7, TIN 2.4 and NV 2.1. Ultrasound needle guidance was used in 56%, preferably in children (79%). The frequency of serious complications (gross haematuria, symptomatic haematoma, blood transfusion) remained at 3%. CONCLUSION: The CRRB provides important data on the epidemiology of GN based on a whole country population.     

Comparison of anthropometric equations for estimation of total body water in peritoneal dialysis patients.

BACKGROUND: Several formulae exist for estimating total body water (TBW). We aimed to assess their validity in peritoneal dialysis patients by comparison with TBW estimated by deuterium oxide dilution (TBW(D)). METHODS: We compared the equations of Chertow (TBW(Cher)), Chumlea (TBW(Chum)), Hume and Weyers (TBW(HW)), Johansson (TBW(J)), Lee (TBW(L)), Watson (TBW(W)) and TBW as 58% of body weight (TBW(0.58Wt)) with TBW(D) in 31 peritoneal dialysis (PD) patients and 32 controls. Estimates were compared with TBW(D) using Bland and Altman comparison. Extracellular water (ECW) was also estimated by sodium bromide dilution. RESULTS: In PD patients, mean TBW(D) was 35.04 (SD 7.84) l. Estimates were greater for TBW(Cher), TBW(Chum), TBW(HW), TBW(J) and TBW(0.58Wt). Mean TBW(L) and TBW(W) did not differ from TBW(D). Ninety-five percent limits of agreement (LOA) compared with TBW(D) (as a percentage of the mean) were similar for all of the different equations in PD patients (between +/-15.4 and +/-17.3%) except TBW(0.58Wt), which was far greater (+/-26.4%). In controls, mean TBW(D) was 37.03 (SD 6.63) l. Estimates were greater for TBW(Cher), TBW(Chum), TBW(HW), TBW(J) and TBW(0.58Wt). Mean TBW(L) and TBW(W) did not differ from TBW(D). Ninety-five percent LOA compared with TBW(D) (as a percentage of the mean) were similar for all equations in the controls, and closer than in PD patients (between +/-9.1 and +/-11.5%) except TBW(0.58Wt), which was again far greater than the other equations (+/-28.1%). TBW(HW) - TBW(D) correlated with mean TBW (r=-0.412, P<0.05 in PD and r=-0.383, P<0.05 in controls). TBW(W) - TBW(D) (r=-0.539, P<0.005) correlated with mean TBW in PD. TBW(0.58Wt) - TBW(D) correlated with body mass index (BMI) (r=0.624, P<0.0001 in PD and r=0.829, P<0.0001 in controls) and ECW/TBW (r=0.406, P<0.05 in PD and r=0.411, P<0.02 in controls). CONCLUSIONS: Predictive equations were less accurate in PD than controls. TBW(0.58Wt) was most inaccurate, with systematic overestimation of TBW with increasing BMI and ECW/TBW. There were no differences in LOA with TBW(D) for the other equations within each group.     

TEP与改良Kugel术治疗双侧腹股沟疝的临床效果

目的分析比较TEP与改良Kugel术治疗双侧腹股沟疝的临床效果及患者生活质量。 方法选取2012年1月至2017年1月在上海交通大学医学院附属第九人民医院接受手术治疗双侧腹股沟疝患者157例。按照手术方式分为腹腔镜组（TEP组）和开放组（改良Kugel）组。其中，TEP组71例，改良Kugel组86例。分析比较包括2组患者的手术时间、术中出血量、住院时间、术后并发症、术后早期疼痛、慢性疼痛、复发情况和生活质量。采用SPSS 20.0统计学软件进行数据分析。 结果TEP组手术时间（93.5±10.9）min，改良Kugel组（102.6±9.8）min，差异有统计学意义（P<0.05）。TEP组住院时间（1.05±0.21）d，改良Kugel组（1.52±0.69）d，差异有统计学意义（P<0.05）。TEP组术中出血量（22.1±7.1）ml，改良Kugel组（23.4±6.8）ml，差异无统计学意义（P>0.05）。TEP组术后恢复正常活动时间（8.67±2.32）d，改良Kugel组（9.14±2.40）d，差异无统计学意义（P>0.05）。TEP组术后并发症5（7%），改良Kugel组10例（11.6%），差异无统计学意义（P>0.05）。并发症患者中身体质量指数>27 kg/m²，TEP组1例（20%），改良Kugel组6例（60%），差异无统计学意义（P>0.05）。TEP组慢性疼痛3例（4.2%），改良Kugel组14例（16%），差异有统计学意义（P<0.05）。截止至随访结束，TEP组术后复发0例，改良Kugel组术后复发1例，占约1%；2组无明显差异（P>0.05）。术后1及7 d，2组疼痛视觉模拟评分比较，差异有统计学意义（P<0.05）；术前、术后及12个月比较，差异无统计学意义（P>0.05）。术前、术后1、2、6及12个月2组生活质量量表评分比较，差异均无统计学意义（P>0.05）。 结论通过TEP治疗双侧腹股沟疝能有效地减少患者的手术时间、住院时间、术后疼痛。