Expression and Significance of Toll-like Receptor 2, 4 of Peripheral Blood Mononuclear Cells in Acute Abdomen Patients Associated with Systemic Inflammatory Response Syndrome

The changes of Toll-like receptor (TLR) 2, 4 of peripheral blood mononuclear cells (PBMCs) in the acute abdomen patients associated with systemic inflammatory response syndrome (SIRS) and their potential significance were explored. A clinical study was performed on 103 acute abdomen patients in whom 65 were associated with SIRS. Forty healthy individuals served as normal controls. The mRNA expression of TLR2, 4 was detected by RT-PCR, and the expression of TNF-αand EL-6 by ELISA. The level of plasma endotoxin, hospital stay and mortality were measured. It was found that the endotoxin level was increased to varying degrees in all the acute abdomen patients, and the endotoxin level was and hospital stay longer in SIRS group than in non-SIRS group (P<0.01). TLR2 mRNA, TLR4 mRNA, IL-6 and TNF-αcould be detected with low value in normal controls, but they were up-regulated markedly on the 1st day after admission. Then TLR4 mRNA, IL-6 and TNF-αwere decreased gradually, but TLR2 mRNA maintained at a high level till the 5th day. These indexes above in SIRS group were higher than those in non-SIRS group (P<0.01). The results of correlation analysis revealed the expression of TLR2, 4 mRNA was positively correlated with the levels of TNF-αand IL-6, and the hospital stay. The results of Logistic regression demonstrated that over-expression of TLR2, 4 mRNA might result in higher risk of multiple organ dysfunction syndrome (MODS). It was concluded that in the acute abdomen patients associated with SIRS, the expression of TLR2, 4 in PBMCs was increased markedly, suggesting that TLR might play an important role in the pathogenesis of acute abdomen associated with SIRS.     

IgA肾病的治疗进展

1968年,Berger等Ⅲ首次提出IgA肾病的概念。目前很多学者认为,它不是一种单一的疾病,而是由于各种损伤机制导致具有共性的组织反应。IgA肾病的发病率很高,每年超过2．5例／10万人群,且有明显的地域差异：东亚（尤其中国和日本）患病率最高,其次为欧洲自种人群,     

Role of Protease Activated Receptor-2 Expression in Renal Interstitial Fibrosis Model in Mice

Summary： The role of protease activated receptor-2 （PAR-2） in the renal tubulointerstitial lesion induced by unilateral ureteral obstruction （UUO） was explored. Mice were sacrificed on the day 1, 3, 5, 7, 10, 14 and 21 after UUO. The expression of PAR-2 mRNA and protein and a-smooth muscle actin （α-SMA） protein in tubuloin,terstitium was detected by RT-PCR and immunohistochemistry at each time point, respedtively. The results showed that the PAR-2 expression in renal tubulointerstitium was increased progressively starting from 24 h to the day 14 post-ligation, and it was significantly associated with the relative volume of interstitium and the positive area of α-SMA. PAR-2 was mainly expressed in renal tubule epithelial cells, especially in proximal tubular cells. It also located in renal capillary ansa, interstitial infiltrate cells and fibroblasts. It was concluded that PAR-2 was active in interstitial and tubular cells in the early phase of fibrotic process and played an important role in mediating the tubulointerstitial lesion after UUO.     

急性弥漫性腹膜炎SIRS患者Toll样受体及炎症介质的表达变化

目的观察急性弥漫性腹膜炎并发全身炎症反应综合征(SIRS)患者外周血单个核细胞(PBMC)Toll样受体(TLR)2,4mRNA及下游炎症介质的表达变化,探讨TLR与SIRS的关系。方法72例急性弥漫性腹膜炎患者分为SIRS组(45例)与非SIRS组(27例),另设40例健康志愿者为对照组。采用鲎试剂法检测血浆LPS水平,RT-PCR法检测PBMC中TLR2,4mRNA的表达,ELISA法检测血清TNF-α和IL-6的表达。结果72例急性弥漫性腹膜炎患者血浆LPS浓度、PBMC中TLR2,4mRNA及血清TNF-α和IL-6表达均显著增高,且SIRS组增高较非SIRS组有显著统计学意义(P<0.01)。结论急性弥漫性腹膜炎SIRS患者PBMC中TLR2,4基因表达显著增加,提示TLR在急性弥漫性腹膜炎SIRS的发生发展过程中发挥了重要的作用。     

泌尿系感染：加替沙星联合万古霉素治疗肠球菌性泌尿系感染24例

48例随机分为对照组和治疗组各24例，对照组给予万古霉素2．0g／d，静滴：治疗组给予加替沙星400mg／d,万古霉素1．0g／,静滴。疗程均14d。结果：对照组和治疗组临床治疗有效率分别为91．7％和87．5％（P〉0．05）。两组分离出48株肠球菌，对万古霉素敏感率为100．0％，粪肠球菌对加替沙星的敏感率为72．7％；     

羊踯躅根对免疫复合物型肾小球肾炎核因子κB表达的影响

目的探讨核因子κB（NF-κB）在免疫复合物型肾小球肾炎发病机制中的作用；观察羊踯躅根对其表达的影响。方法采用牛血清白蛋白（BSA）方法复制免疫复合物型肾小球肾炎大鼠模型，设对照组、模型组和羊踯躅根治疗组。分别进行24h尿蛋白定量、血清肌酐检测和肾组织学检查；采用实时荧光PCR方法检测NF-κB抑制剂IκBmRNA的表达；Western blot方法检测NF-κB蛋白的表达。结果与对照组相比，治疗组和模型组的24h尿蛋白定量、血肌酐明显增加，出现异常肾组织学改变；治疗组与模型组比较，肾脏病理改变减轻，IκBmRNA降解减少，NF-κB蛋白表达下降，具有统计学意义（P〈0．01）。结论NF-κB在免疫复合物型肾小球肾炎的发病机制中扮演了重要角色，羊踯躅根制剂可能通过抑制NF-κB的激活和表达对免疫复合物型肾小球肾炎的治疗发挥作用。     

肾炎康复片联合西药治疗慢性肾小球肾炎的Meta分析及系统评价

目的使用Meta分析及系统评价的方法评估肾炎康复片治疗慢性肾小球肾炎的临床效果。方法选取的关键词为"慢性肾小球肾炎"、"肾炎康复片"、"蛋白尿"、"肌酐",从国内主要的几个期刊数据库中搜索相关文献,主要围绕单纯西药治疗和同时联合肾炎康复片治疗方面进行,搜索在慢性肾小球肾炎患者中采用这两种治疗方法疗效对比研究,筛选随机对照研究的文献,利用筛选出的实验数据进行Meta分析及系统评价。结果检索出31篇研究,一共纳入2519名患者,随访时间的中位数为12周(6～48周)。在对蛋白尿的Meta分析中,加权化均数差(WMD)为-0.63,95%CI[-0.67,-0.59],P0.05。同时,我们对患者治疗前后血肌酐水平也进行了分析, WMD为-7.96,95%CI[-9.06,-6.85],P0.05。结论肾炎康复片能同时降低慢性肾炎患者蛋白尿和血肌酐水平。肾炎康复片联合西药治疗慢性肾小球肾炎效果显著,且优于单纯使用西药治疗,同时安全性有所保障,未见不良反应增加。     

抗核小体抗体与狼疮肾炎活动性关系的研究

目的探讨抗核小体抗体与狼疮肾炎活动性的关系。方法对2007年4月至2009年12月在我院住院的75例经肾活检确诊为狼疮肾炎患者的临床资料进行回顾性研究。结果抗核小体抗体在活动性增殖性狼疮肾炎中的阳性率（59．3％）较非活动性增殖性狼疮肾炎（27．3％）和非增殖性狼疮肾炎（20．0％）高（P〈0．05）。活动性狼疮肾炎组的抗核小体抗体阳性率（53．8％）较非活动性狼疮‘肾炎组阳性率（23．8％）高（P〈0．05）。抗核小体抗体阳性组的病理活动性指数（active index,AI）较阴性组高（P〈0．05）,两组慢性指数（chronic index.CI）和狼疮肾炎的临床活动性评分（renalactivity score,RAS）无显著差异（P〉0．05）。结论抗核小体抗体与狼疮肾炎的病理活动性相关,在活动性增殖性狼疮肾炎中出现较为普遍,是提示活动性增殖性狼疮肾炎的一项重要的指标。     

NG2蛋白多糖在糖尿病大鼠肾脏组织中表达的改变

糖尿病肾病（DN）的发病率在全世界范围内正在显著增加，已成为诱导终末期肾衰竭需要肾替代治疗的最常见的原因。早期DN的主要特征为肾小球肥大和进行性细胞外基质（ECM）积聚，其分子机制涉及到多种因素和途径，是目前研究的热点。本实验的目的为观察NG2蛋白多糖在正常大鼠和糖尿病大鼠肾脏中的表达，探讨NG2在DN中的作用机制。     

致康胶囊对急性创伤患者血液流变学的影响

目的：观察致康胶囊治疗急性创伤患者过程中血液流变学指标的变化。方法：急性创伤患者40例，随机分成治疗组和对照组各20例。两组常规治疗相同。治疗组加服致康胶囊每次2～4粒，tid，于治疗前及治疗后第7天检测血液流变学指标。结果：与对照组相比，治疗组全血低切粘度、全血高切粘度、血浆粘度、红细胞聚集指数、血沉、红细胞变形指数于治疗后均有显著改善(P＜0.05或＜0.01)。结论：致康胶囊可降低急性创伤患者的血液粘度，对预防创伤后血栓形成有重要作用。