肾小球系膜细胞三维立体培养方法的构建

建立一种肾小球系膜细胞三维立体培养系统，该系统可以模拟肾小球系膜细胞在肾小球系膜区的生长环境，并证实在三维立体培养系统中．肾小球系膜细胞在24、48和72h的增殖作用比传统贴壁培养时明显缓慢。     

Telehealth-based dialysis registration system for the improvement of renal anemia in maintenance hemodialysis: multicenter experiences

Objective To analyze the role of telehealth-based dialysis registration systems in real-time and dynamic reflection of renal anemia in hemodialysis (HD) patients, and discuss the prospect of its application in dialysis registration management. Methods The Red China project was to build up a dialysis registration system based on the WeChat mobile terminal platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, creatinine were recorded in this system. Hemoglobin (Hb) level was monthly recorded. The platform generated Hb statistics report for each HD center monthly, including the detection rate, target rate and the distribution level of Hb, and released it to physicians through the WeChat terminal of mobile phone. After that, physicians could change the treatment of anemia individually on basis of this report. Here the demographic and baseline laboratory parameters, the detection rate, target rate, the average level and the distribution of Hb from June 2015 to October 2017 after the project launched were analyzed. Results From June 2015 to October 2017, 8392 maintenance HD patients from 28 HD centers in Shanghai were enrolled, of whom 5059(60.3%) were male.The average rate age was (60.5±13.7) years old. Baseline average Hb was (108.3±16.0) g/L. Baseline detection rate and target rate were 54.2% and 47.5%, respectively. After 28 months follow-up, the detection rate of Hb increased from 54.2% to 73.6% (P＜0.001), the target rate of Hb increased from 47.5% to 56.1% (P＜0.001), and the level of average Hb rose from (108.3±16.0) g/L to (110.7±16.0) g/L. The difference between average Hb in two consecutive months was less than 1.3 g/L. Conclusions The telehealth-based dialysis registration system can timely report the anemia situation of HD patients, which may improve the awareness rate of anemia, the degree of attention and the compliance of anemia monitoring, so as to improve the detection rate and target rate of Hb and reduce the fluctuation of Hb, which helps to maintain the HD patients to correct anemia in a timely, stable and long-term way. The telehealth-based dialysis registration system, as an improved mode of dialysis registration is a promising way for long-term management of renal anemia in dialysis patients.     

ET—1对系膜细胞增殖和前胶原mRNA表达的影响

目的利用已构建的体外肾小球系膜细胞（MC）三维立体培养系统，研究内皮素（ET－1）是否具有刺激MC增殖和表达Ⅰ、Ⅲ、Ⅳ型前胶原mRNA作用。方法3H－TdR掺入法和斑点杂交方法。结果在0．5％小牛血清存在下，10－7mol／LET－1作用12h后，MC对3H－TdR摄入增加（＜0．01），呈剂量依赖方式，＜10－10mol／LET－1对MC无促增殖作用，ET－1≥10-10mol／L时，随着ET－1浓度增加。MC对3H－TdR摄人也增加；在1％小牛血清存在下，10-7mol／LET－1明显促进MC表达Ⅰ、Ⅲ、Ⅳ型前胶原mRNA，而10-12mol／LET－1无此作用。结论ET－1可通过刺激MC增殖和产生细胞外基质促进慢性肾小球疾病病程进展。     

前庭刺激对心血管自主神经调节及立位耐力的影响

目的观察前庭刺激前后被动直立位耐力试验心率、血压和压力感受器敏感性等指标的变化,了解前庭刺激对心血管自主神经调节功能及直立位耐力的影响。方法对15名男性健康志愿者在转椅刺激前、后进行被动直立位耐力检查。被动直立位耐力实验全程监测心电图和左手中指逐跳血压,在试验的第20,21,23,25,30,35,40,41,45 min测量常规血压、心率和压力感受器反射敏感性指标(BRS)。结果前庭刺激前直立位耐力检查结果均正常,刺激后有两人发生晕厥前症状;常规血压(SBP、DBP)检查在大部分实验时间无统计学差异,心率在检测的大部分时间点有统计学差异;BRS指标仅在直立位25～min段、30～min段有统计学差异,其余检测时间段没有统计学差异。结论前庭刺激可能会削弱机体心血管压力感受器反射调节功能的稳定性,造成部分志愿者直立位耐力的降低。     

内皮素—1对肾小球系膜细胞内游离钙浓度影响

ET－1激发肾小球系膜细胞（glomerularmesangialcell，GMC）内［Ca2 ］i；升高作用分2个时相，即瞬时峰值升高和缓慢持久升高，对峰值升高呈剂量依赖方式，＜10－10mol／L不引起峰值升高，≥10－10mol／L引起峰值升高，且随着剂量增加，幅度增大。维拉帕米对ET－1激发GMC内［Ca2 ］i峰值升高和持久升高均无抑制作用；细胞内储存钙释放抑制剂TMB－8明显抑制峰值升高，但对持久升高无作用；无钙缓含冲液（1mol／LEGTA处理）对峰值升高无作用，但可完全阻止持久升高作用。结果表明ET－1激发GMC内［Ca2 ］i浓度峰值升高是由细胞内储存钙释放介导的，而持久升高是由细胞外钙流入增加引起的。     

老年终末期肾病患者的透析方式选择

随着人口老龄化加剧,在全球范围内需要接受肾脏替代治疗的老年终末期肾脏病(ESRD)患者人数日益增加。老年ESRD患者由于年龄老化、生理机能下降、合并症多、自我维护能力差、预期生存时间短等特点给透析治疗亦带来了诸多困难。老年ESRD患者在透析的治疗时机、透析方式的选择上均具有其特殊性,需要根据患者原发病因、评估透析治疗可能带来的并发症、所在地医疗卫生条件等制定个体化的治疗方案。除了医疗技术因素外,还需综合考虑如患者预期寿命、对生活质量的期望以及对患者家庭的影响等其他非医疗因素。     

Leflunomide versus cyclophosphamide in the induction treatment of proliferative lupus nephritis in Chinese patients: a randomized trial

Clinical Rheumatology - A prospective, multi-center, randomized controlled study was conducted to evaluate the efficacy and safety of a 24-week course low-dose leflunomide combined with prednisone...     

EFFECTS OF DIFFERENT AMOUNTS OF PROTEIN DIETS ON KIDNEY IN DIABETIC RATS

Sixty-three streptozotocin-induced diabetic rats were divided into 3 groups fed with different amounts of protein diets 7%, 20% and 40% protein in Group 1, 2 and 3 respectively for 2 months. The ratio of right kidney weight/body weight (RKW/BW), 24h urinary protein excretion (UPE), creatinine clearance (Ccr), mean glomerular diameter (MGD), and colloidal iron staining (CTS) on surface of processes of glomerular podocyte were obsrerved by the end of the experiment. The results showed that RKW/BW and UPE in Group Ⅰreduced as compared with those in Group 2 and 3. The MGD in Group 3 in creased as compared with those in Group 2 and 1. But Ccr in diabetic rats fed with different diets showed no significant difference. Finally, it was found that fusion of the glomerular epithelial cell foot processes and decreased CIS were intensified by increased dietary protein content. The present findings suggest that restriction of protein intake may be able to retard the progression of diabetic nephropathy.     

Higher activation of the interferon-gamma signaling pathway in systemic lupus erythematosus patients with a high type I IFN score: relation to disease activity

Increased IFN-γ levels have been associated with systemic lupus erythematosus (SLE). However, the relationships among IFN-γ, type I interferons (IFNs) and clinical features have not been extensively studied. Peripheral blood samples from 44 SLE patients and 36 healthy donors (HDs) were collected. Quantitative real-time PCR was used to assess the mRNA expression of IFNG, type II IFN-inducible genes (IRF1, GBP1, CXCL9, CXCL10, and SERPING1, which are used for the type II IFN score), type I IFN-inducible genes (IRF7, MX1, ISG15, and ISG20, which are used for the type I IFN score), TBX21, and EOMES in peripheral blood mononuclear cells. Flow cytometry was used to measure the IFN-γ levels in lymphocytes. The mRNA levels of type II IFN-inducible genes, IFNG, TBX21, and EOMES were significantly higher in SLE patients than those in HDs. Similarly, the percentages of IFN-γ-producing cells in lymphocytes and their subsets in SLE patients were significantly increased. Linear regression indicated that IFNG expression levels and type II IFN scores were positively correlated with anti-double-stranded DNA autoantibody levels and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores. Compared with patients with low type I IFN scores, patients with high type I IFN scores showed increased type II IFN scores and SLEDAI scores. Type II IFN scores were positively associated with type I IFN scores. The IFN-γ signaling pathway is activated in SLE patients and may be considered an index of disease activity. IFN-γ, together with type I IFNs, promotes the pathogenesis of SLE.     

血管紧张素Ⅱ和血小板衍生生长因子BB:引起系膜细胞内游离钙浓度变化的异同

目的：研究血管紧张素Ⅱ(AngⅡ)和血小板衍生生长因子BB(platelet-derived growth factor-BB，PDGF-BB)引起的肾小球系膜细胞(MC)内游离钙浓度变化的异同。方法：以体外培养的MC为研究对象，激光共聚焦显微术结合Fura-3染色法动态测定细胞内游离钙浓度。结果：AngⅡ和PDGF-BB均可浓度依赖性地引起MC内游离钙浓度的升高，但二者的动态变化曲线存在显著不同。无钙缓冲液和钙通道阻滞剂均可抑制AngⅡ和PDGF-BB引起的细胞内钙浓度变化，但其抑制的方式和程度均有所不同。结论：AngⅡ和PDGF-BB通过不同的激发途径引起MC内游离钙浓度的升高。