Influence of renal compensatory hypertrophy on mitochondrial energetics and redox status

A reduction in functional renal mass is common in numerous renal diseases and aging. The remaining functional renal tissue undergoes compensatory growth primarily due to hypertrophy. This is associated with a series of physiological, morphological and biochemical changes similar to those observed after uninephrectomy. Previous work showed that compensatory renal cellular hypertrophy resulted in an increase in susceptibility to several drugs and environmental chemicals and appeared to be associated with oxidative stress. Compensatory renal cellular hypertrophy was also associated with increases in mitochondrial metabolic activity, uptake of glutathione (GSH) across renal plasma and mitochondrial inner membranes, and intracellular GSH concentrations. Based on these observations, we hypothesize that the morphological, physiological and biochemical changes in the hypertrophied kidney are associated with marked alterations in renal cellular energetics, redox status and renal function in vivo. In this study, we used a uninephrectomized (NPX) rat model to induce compensatory renal growth. Our results show alterations in renal physiological parameters consistent with modest renal injury, altered renal cellular energetics, upregulation of certain renal plasma membrane transporters, including some that have been observed to transport GSH, and evidence of increased oxidative stress in mitochondria from the remnant kidney of NPX rats. These studies provide additional insight into the molecular changes that occur in compensatory renal hypertrophy and should help in the development of novel therapeutic approaches for patients with reduced renal mass.     

全身炎症反应综合征患儿凝血功能变化的临床意义

目的探讨全身炎症反应综合征(SIRS)的危重病患儿凝血功能的变化及临床意义。方法随机选择合并SIRS的危重病患儿50例,及同期住院的非SIRS患儿60例,分别检测各组患儿的血浆D-二聚体(DD)、凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(APTT)及血小板(PLT)计数。结果SIRS组与非SIRS组相比:D-二聚体含量明显升高(P<0.05);PT、TT、APTT均延长(P<0.05);PLT计数降低(P<0.05)。SIRS组中多器官功能障碍综合征(MODS)及单器官功能不全组患儿与非SIRS组相比DD含量升高更明显,PLT计数降低更明显,PT、TT、APTT延长更明显,差异有显著性意义(P<0.01)。结论SIRS患儿存在凝血纤溶系统的功能紊乱,检测D-二聚体、PT、TT、APTT、PLT等指标,可了解SIRS患儿体内凝血纤溶系统的变化,是早期发现弥漫性血管内凝血(DIC)的敏感指标。     

D-二聚体检测在肝病中的应用价值

目的探讨肝脏疾病患者血浆D-二聚体(D-dimer,DD)水平及其临床应用价值。方法采用免疫散射比浊法,分别测定30例正常人和104例肝病患者血浆D-二聚体水平。结果肝病患者各组血浆D-二聚体水平与正常对照组相比均有显著性差异(其中急性肝炎组P<0.05,其他组P<0.001)。结论不同类型肝病患者血浆D-二聚体水平均有不同程度的升高,且与病情的严重程度呈正相关,因此动态观察血浆D-二聚体定量水平对肝脏疾病患者肝功能的评价、病情的预后及治疗具有重要的临床应用价值。     

急性早幼粒细胞白血病治疗体会

急性白血病(AL)系造血系统恶性克隆性疾病。按FAB分类,AL分为急性淋巴细胞白血病(ALL)和急性髓性白血病(AML)。急性早幼粒细胞白血病(APL)属FAB分类中M3型AML。APL是一种独特类型的AML,以特殊的形态学、超微结构、细胞遗传学和临床表现为特征。该型白血病出血倾向严重,易并发弥     

Identification of in-vivo induced genes of Streptococcus suis serotype 2 specially expressed in infected human

Streptococcus suis (S. suis) serotype 2 usually cause infection in swine. Recently, two large-scale outbreaks in China with severe streptococcal toxic shock syndrome (STSS) and high mortality raised worldwide concern to human S. suis infection. To reveal the molecular pathogenesis of S. suis 2 during human infection, in-vivo induced antigen technology (IVIAT) was applied to identify the in-vivo induced genes (ivi genes) of S. suis 05ZYH33. The ivi genes are specifically expressed or up-regulated in-vivo and always associated with the in-vivo survival and pathogenicity of pathogens. In present study, convalescent sera from S. suis 05ZYH33 infected patients were pooled and fully adsorbed with in-vitro grown S. suis 05ZYH33 and Escherichia coli BL21 (DE3). Genomic expression library of 05ZYH33 was repeatedly screened with colony immunoblot assay using adsorbed sera. Finally, 19 genes were assessed as ivi genes of 05ZYH33. Fifteen of 19 genes encode proteins with biological functions in substance transport and metabolism, cell structure biogenesis, cell cycle control, replication, translation and other functions. The 4 remaining genes encode proteins with unknown functions. Of the 19 ivi genes, five (SSU05_0247, 0437, 1577, 1664 and 2144) encode proteins with no immunoreactivity to control sera from healthy individuals never exposed to 05ZYH33. The successful identification of ivi genes not only sheds light on understanding the pathogenesis of S. suis 05ZYH33 during its human infection, but also provides potential targets for the developments of new vaccines, therapeutic drugs and diagnostic reagents against human S. suis infection.     

重型胎盘早剥合并DIC1例

1 病历摘要 患者27岁.主因妊娠8个月第一胎,劳动后腹痛12小时,阴道出血2小时,于2000年10月12日22时急诊入院.妊娠期检查无高血压,B超提示无前置胎盘.查体:T36.5℃,P90/分,R18/分,BP11/8kPa.     

抢救M_3合并DIC的护理体会

收治颗粒增多型早幼粒细胞性白血病(M_3)9例,并发DIC3例。1例于入院后3d因大出血,呼吸、循环功能衰竭死亡;2例经积极抢救,平稳渡过DIC期,经治疗完全缓解出院。细心观察发现DIC征象并及早处理极为重要,并要加强抗凝药物的监测,做好心理护理,预防感染及观察化疗后的反应。     

FDP D-二聚体测定的临床应用

目的通过对不同疾病进行FDP D-二聚体(D-Dimer)的检测,探讨FDP D-Dimer在临床治疗和观察中的应用.方法以抗FDPD-Dimer特异性单克隆抗体标记乳胶颗粒,后者与待测血浆混合.当血浆中FDP含量≥5μg/ml,D-Dimer含量≥0.5μg/ml时,标记的乳胶颗粒则发生凝集呈现阳性反应.结果 DIC时,血浆FDP D-Dimer明显增高,呈阳性反应,要结合临床表现警惕DIC前状态的存在.D-Dimer在原发性纤溶时正常,继发性纤溶亢进时显著增高,是两者鉴别的重要指标.此外,急性粒细胞白血病,急性心梗,急性脑梗,肺栓塞,病毒性肝炎等均可见血浆FDP D-Dimer水平增高.深静脉血栓病人FDP D-Dimer 100%阳性,可作为溶栓治疗用药的指导及疗效观察.结论 FDP D-Dimer对高凝状态和血栓性疾病的诊断有重要意义,可作为血管内凝血,纤溶和血栓形成的标志物.     

孕产妇弥散性血管内凝血的成分输血疗效观察

目的探讨成分输血抢救孕产妇弥散性血管内凝血(DIC)的疗效。方法参照DIC诊断标准、治疗原则及成分输血方案制订详细的孕产妇DIC治疗方案,分析在去除病因前、后输注成分血,特别是新鲜冰冻血浆(FFP)对血常规及出凝血相关指标的影响及临床出血情况。结果符合条件的25名病人在去除病因前,成分输血(如FFP)对临床出血症状、血小板计数、凝血酶原时间、活化的部分凝血活酶时间、纤维蛋白原、3P试验等指标的纠正不明显(P>0.10),但在病因去除后得到明显改善(P<0.001)。在输注浓缩血小板前静脉注射微量肝素10mg是比较安全的。羊水栓塞孕产妇在密切观察下及时静脉注射小剂量肝素(25～50mg)可阻止DIC的进展。结论成分输血抢救孕产妇DIC出血有一定疗效,在去除病因后疗效更好,早期输注成分血对去除产科病因,赢得抢救时间有积极作用。     

产科弥漫性血管内凝血的护理30例

肾盂输尿管连接部狭窄、梗阻是造成先天性小儿肾积水最常见的原因，约占90％。常见的治疗方法是离断式肾盂输尿管成型术。我院1998年12月-2004年11月行介入治疗，经皮肾穿刺输尿管球囊成型扩张术治疗因肾盂输尿管连接部狭窄所致肾积水患儿32例，取得良好疗效，现将护理报道如下。