曲尼司特对环孢素A诱导的人肾小管上皮细胞向间充质转变的抑制作用

目的 研究曲尼司特(Tran)对环孢素A(CsA)诱导的人肾小管上皮细胞(HK-2)向间充质转变的影响,并探讨该药抗纤维化的机制.方法 所有用于实验的HK-2细胞株均为8～12代细胞,分为4组:(1)空白对照组,收获细胞,不做任何处理;(2)CsA组,加入4.2μmol/LCsA;(3)CsA+Tran组,预先加入100μmol/L Tran,作用2 h后再加入4.2 μmol/L CsA;(4)Tran组,仅加入100μmol/L Tran.72 h后于共聚焦显微镜下观察各组细胞形态学变化;用免疫荧光法以及免疫印迹法检测各组钙黏蛋白(E-cadherin)、平滑肌肌动蛋白α(α-SMA)和骨桥蛋白(OPN)的表达.结果 HK-2细胞在正常情况下表现为典型的"鹅卵石"样形态,细胞圆钝,且与邻近的细胞连接较为紧密;空白对照组和Tran组细胞表现为典型的HK-2细胞形态;CsA组细胞变狭长,甚至向周边伸出"伪足"样改变,细胞间连接较为稀疏;CsA+Tran组的细胞形态学改变有明显改善.CsA组细胞E-cadherin荧光表达强度明显弱于对照组,α-SMA、OPN荧光表达强于对照组;CsA+Tran组细胞E-cadherin荧光表达强于CsA组,α-SMA、OPN荧光表达弱于CsA组.免疫印迹检查中,CsA组细胞E-cadherin 的表达明显低于对照组,而α-SMA、OPN的表达明显高于对照组,CsA+Tran组细胞E-cadherin的表达高于CsA组,而α-SMA、OPN的表达低于CsA组.结论 曲尼司特能抑制CsA诱导的HK-2细胞由肾小管上皮向间充质细胞转化的过程,其机制可能与抑制OPN的表达有关.

Abstract：

Objective To study the effect of tranilast on cyclosporine A (CsA)-induced epithelial-to-mesenchymal transition in human renal tubular epithelial cells, and investigate the mechanism of its antifibrotic effect. Methods Cultured HK-2 cells were divided into four groups: (1)In the control group, cells were treated without any medicine; (2) The cell were treated with CsA (4. 2μmol/L) for 72 h; (3) The cells were treated with a combination of CsA (4. 2 μmol/L) and tranilast (100μmol/L); (4) The cells were treated with tranilast (100 μmol/L) alone for 72 h.Morphological changes of the cells were assessed by phase-contrast microscopy. The immunofluorescence and Western blotting were adopted to detect the expression of E-cadherin, α-SMA and OPN mRNA and proteins respectively. Results Tranilast could markedly ameliorate the morphological changes of HK-2 cells stimulated by CsA. The irmmunofluorescence staining revealed the expression of E-cadherin was markedly decreased in HK-2 cells stimulated with CsA for 72 as compared with the control group, while the expression of α-SMA and OPN was significantly higher in CsA group than the control group. The expression of E-cadherin in the CsA + Tranilast group was higher than the CsA group, while the expression of α-SMA and OPN in the CsA + Tranilast group was lower than the CsA group. Western blotting showed that protein expression level of E-cadherin in CsA group was dramatically lower than that in the control group (P＜0. 05), while that of α-SMA and OPN in CsA group was significantly higher than in the control group (P＜0.05). The protein expression level of E-cadherin in HK-2 cells in the CsA + Tranilast group was markedly higher than in the CsA group (P＜0.05), and that of α-SMA and OPN in CsA + Tranilast group was significantly lower than in the CsA group (P＜0. 05). Conclusion Tranilast can block the CsA-induced epithelialto-mesenchymal transition in HK-2 cells probably by suppressing the expression of OPN.     

亲属肾移植供体随访进展

活体亲属肾移植中供肾切除术对供者的影响一直是广大终末期肾病患者家属和医务工作者关心的问题 ,如何解除人们对活体供肾的担心就显得尤为重要 ,近年来国外提出死亡率、患病率、长期肾功能和生活质量等方面的预后评估 ,本文对此作一综述     

周期性麻痹治验一则

王××,男,61岁,干部,住院号040167。四肢痿软不用5天,于1985年3月29日在我院门诊观察治疗。体查:心率85次/分,第一心音减弱,双膝腱反射消失,化验血清钾11毫克%,心电图:ST段下移,T波低平、u波增高,Tu波融合,提示:呈低钾表现。追问病史,病者述自本年元月以来曾有类似发作病史3次。住院后诊为周期性麻痹,因病者要求中药     

肾移植患者不同免疫抑制方案对sCD30水平的影响

目的 观察肾移植患者术后不同免疫抑制方案对血清可溶性CD30(sCD30)水平的影响,并探讨其临床意义.方法 根据免疫抑制方案将肾移植患者分为环孢素(CsA)治疗组(79例)和他克莫司(FKS06)治疗组(33例),对患者临床资料、sCD30水平、肌酐值及血药浓度进行相关分析.结果 比较两组患者的临床资料、sCD30水平及第24月时肌酐值差异均无统计学意义(P>0.05);两组患者sCD30水平在手术后均逐渐下降,术后第7天开始较术前差异有统计学意义(P<0.05);线性回归分析提示,两组患者第24个月时肌酐值、血药浓度均与术前sCD30水平相关(P<0.05).结论 以CsA或FKS06为主的免疫抑制方案均能降低肾移植患者术后sCD30水平;并且sCD30水平与远期肾功能、血药浓度明显相关.     

曲尼司特对环孢素A诱导的人肾小管上皮细胞向间充质转变的抑制作用

Objective To study the effect of tranilast on cyclosporine A (CsA)-induced epithelial-to-mesenchymal transition in human renal tubular epithelial cells, and investigate the mechanism of its antifibrotic effect. Methods Cultured HK-2 cells were divided into four groups: (1)In the control group, cells were treated without any medicine; (2) The cell were treated with CsA (4. 2μmol/L) for 72 h; (3) The cells were treated with a combination of CsA (4. 2 μmol/L) and tranilast (100μmol/L); (4) The cells were treated with tranilast (100 μmol/L) alone for 72 h.Morphological changes of the cells were assessed by phase-contrast microscopy. The immunofluorescence and Western blotting were adopted to detect the expression of E-cadherin, α-SMA and OPN mRNA and proteins respectively. Results Tranilast could markedly ameliorate the morphological changes of HK-2 cells stimulated by CsA. The irmmunofluorescence staining revealed the expression of E-cadherin was markedly decreased in HK-2 cells stimulated with CsA for 72 as compared with the control group, while the expression of α-SMA and OPN was significantly higher in CsA group than the control group. The expression of E-cadherin in the CsA + Tranilast group was higher than the CsA group, while the expression of α-SMA and OPN in the CsA + Tranilast group was lower than the CsA group. Western blotting showed that protein expression level of E-cadherin in CsA group was dramatically lower than that in the control group (P＜0. 05), while that of α-SMA and OPN in CsA group was significantly higher than in the control group (P＜0.05). The protein expression level of E-cadherin in HK-2 cells in the CsA + Tranilast group was markedly higher than in the CsA group (P＜0.05), and that of α-SMA and OPN in CsA + Tranilast group was significantly lower than in the CsA group (P＜0. 05). Conclusion Tranilast can block the CsA-induced epithelialto-mesenchymal transition in HK-2 cells probably by suppressing the expression of OPN.     

补中益气汤临证举隅

李东垣《脾胃论》之补中益气汤具调补脾胃,升阳益气之功,主治由脾胃气虚所致之诸证。临床上各种疾病凡具脾胃亏虚、中气下陷证型者,笔者在本方辨证加减,均获满意效果,现介绍如下: 一、转胞仲某,女,26岁,已婚,住怀化市花桥乡。于1984年12月15日就诊。 3天来,小腹急胀,小溲艰涩难出,曾服西药利尿罔效而靠插管排尿,并伴精神不爽,四肢乏力,而色不华。查:脉细滑,舌淡红,苔薄白。妇查见阴道壁轻度膨出,宫     

益气活血补肾法治疗脑血栓形成38例

益气活血补肾法治疗脑血栓形成３８例①韩志坚（湖南省祁阳县人民医院，永州，４２１７００）１９９２年１０月至１９９６年１２月，我们以益气活血补肾法治疗脑血栓形成３８例，并与西药治疗的３２例进行对比，结果显示中药有较好疗效，现报道如下：１资料和方法１．１一...     

归脾汤加味治疗产后失音

<正> 龙某,女,38岁。因产后失音10天于1985年12月15日初诊。患者12天前因产时过度劳累,产后流血过多,产后第2天出现声音嘶哑,随后失音。某医予感冒清及抗炎药物治疗,症状无好转;随后又内服宣肺解表之品,失音仍无改善。诊见失音,神疲体倦,纳谷欠馨,心悸而慌,阴道仍有少量流血,血色淡红,大便干结,面色萎黄少华,舌质淡胖,苔白,脉细无力。辨证为脾虚血亏,声道失其濡养所致,治以健脾益气养血,佐以开音之品。方投归脾汤加味:     

低龄儿童 DCD 单侧供肾用于成人肾移植的单中心经验

目的：分析低龄儿童单侧供肾在成人肾移植中的临床效果。方法：回顾性分析南京医科大学第一附属医院2013年11月—2016年9月期间6例低龄儿童公民逝世后器官捐献（donation after citizen’s deceased,DCD）单侧供肾肾移植的临床资料。结果：6例成人受体接受了来自5例低龄儿童DCD单侧供肾。供体中位月龄50个月（20~60个月）,中位体重15.5 kg（12.0~17.0 kg）。受体中位年龄25岁（18~31岁）,中位体重43.5 kg（34.0~55.0 kg）,中位体重指数（body mass index,BMI）18.3 kg/m2（14.7~22.0 kg/m2）。随访期间,术后受体的血肌酐水平逐渐下降,估算的肾小球滤过率（estimated glomerular filtration rate,eGFR）水平稳步升高,术后半年至3年内肾功能稳定在正常范围。移植肾长径在术后2周内迅速增长（P=0.042）,术后1年内进一步生长。移植肾及人6 个月及1年存活率均为100%。结论：低龄儿童单侧供肾用于成人肾移植是可行、有效的,这将为扩大供肾来源带来希望。     

输尿管软镜联合钬激光碎石治疗肾结石146例临床分析

目的 评价输尿管软镜联合钬激光碎石治疗肾结石的疗效及安全性.方法 回顾性分析输尿管软镜联合钬激光治疗肾结石146例资料.结果 单次输尿管软镜进镜成功率为93.1％,结石寻及率为96.6％.手术时间15-240 min.术后1个月复查腹部平片,碎石成功率76.7％(112/146).无严重手术并发症发生.结论 输尿管软镜联合钬激光治疗肾结石,微创、安全、有效.