39例IgM肾病临床和病理分析

[目的]探讨IgM肾病的临床病理特点及预后。[方法]对800例原发性肾小球疾病肾活检符合IgM诊断的病例的临床表现、病理及疗效进行分析。[结果]IgM肾病临床表现呈肾病综合征、蛋白尿伴血尿、血尿等多种表现,其组织病理和免疫病理分型也呈多样性,三者之间无明显相关性。所有病例住院治疗,根据临床及病理表现确定相应治疗方案,有效率94.87%。[结论]IgM肾病临床表现及病理分型呈多样性,临床表现以肾病综合征为最常见,免疫荧光沉积物以单纯IgM沉积最为多见。总体来看,IgM肾病短期疗效较佳,远期预后有待进一步观察。     

IL-1和IL-4对肾小球系膜细胞p27和CDK2表达的影响

探讨白细胞介素 1(IL 1)和白细胞介素 4 (IL 4 )对肾小球系膜细胞细胞周期调节蛋白 p2 7和周期素依赖性蛋白激酶CDK2表达的影响。利用体外培养的大鼠肾小球系膜细胞观察IL 1促进系膜细胞增生前后p2 7和CDK2 的表达变化 ,及同时应用IL 4后对上述表达变化的影响。结果发现 ,IL 1可以明显促进系膜细胞增生 ,同时观测到p2 7表达下降而CDK2 表达增高 ;IL 4可以抑制IL 1诱导的系膜细胞增生 ,同时发现p2 7表达增加而CDK2 表达减弱。提示IL 1和IL 4对系膜细胞增生的促进和抑制作用与细胞周期调节蛋白的表达变化密切相关。     

肾毒清冲剂治疗慢性肾功能不全的实验研究

目的：观察肾毒清冲剂对慢性肾功能不全大鼠的保护作用。方法：用含0．75％的腺嘌呤（Adenine,Ade)饲料喂养大鼠造成慢性肾功能不全模型。测定血液生化指标、血清离子浓度并观察大鼠肾脏的病理改变。结果：肾毒清明显增加胸腺指数。肾脏重量也明显低于模型组。肾脏组织形态学表明,肾毒清冲剂显著减轻了肾脏病理改变。药物结晶减少。结论：肾毒清冲剂对慢性肾功能不全大鼠有较强的保护作用。     

Removal of the endothelial surface layer via hyaluronidase does not modulate monocyte and neutrophil interactions with the glomerular endothelium

Objective

The endothelial surface layer (ESL), a layer of macromolecules on the surface of endothelial cells, can both impede and facilitate leukocyte recruitment. However, its role in monocyte and neutrophil recruitment in glomerular capillaries is unknown.

Methods

We used multiphoton intravital microscopy to examine monocyte and neutrophil behavior in the glomerulus following ESL disruption with hyaluronidase.

Results

Constitutive retention and migration of monocytes and neutrophils within the glomerular microvasculature was unaltered by hyaluronidase. Consistent with this, inhibition of the hyaluronan-binding molecule CD44 also failed to modulate glomerular trafficking of these immune cells. To investigate the contribution of the ESL during acute inflammation, we induced glomerulonephritis via in situ immune complex deposition. This resulted in increases in glomerular retention of monocytes and neutrophils but did not induce marked reduction in the glomerular ESL. Furthermore, hyaluronidase treatment did not modify the prolonged retention of monocytes and neutrophils in the acutely inflamed glomerular microvasculature.

Conclusions

These observations indicate that, despite evidence that the ESL has the capacity to inhibit leukocyte-endothelial cell interactions while also containing adhesive ligands for immune cells, neither of these functions modulate trafficking of monocytes and neutrophils in steady-state or acutely-inflamed glomeruli.     

一种简单经济提取小鼠大量肾小球的实验方法

目的 为减轻实验者用磁珠提取肾小球的经济负担，对传统的心脏灌注肾脏提取方法进行改良。方法 结扎远端腹主动脉及下腔静脉，结扎肠系膜上动脉和腹腔动脉，以减少磁珠分流。将磁珠工作液经静脉留置针灌注肾脏。加入相应体积胶原酶A，通过100?μm筛网2次，加入蛋白裂解液，离心裂解吸出含蛋白上清进行肾小球蛋白的纯化、定量。结果 与传统的心脏灌注肾脏提取方法比较，改良胸主动脉灌注肾脏提取肾小球方法磁珠用量仅为原来的1/35～1/40。在获取相同的蛋白情况下，提取肾小球的最佳浓度为4×106磁珠/ml，磁珠用量为20?ml。通过该方法灌注分离的肾小球完整，纯度为（95.7±2.3）%。结论 改良的胸主动脉灌注肾脏是一种简单经济实用磁珠提取肾小球的实验方法，可以快速获取大量完整的肾小球，蛋白质甚至RNA，为肾小球本身的研究提供新的技术支持。     

The role of the mesangium in glomerular function

When discussing glomerular function, one cell type is often left out, the mesangial cell (MC), probably since it is not a part of the filtration barrier per se. The MCs are instead found between the glomerular capillaries, embedded in their mesangial matrix. They are in direct contact with the endothelial cells and in close contact with the podocytes and together they form the glomerulus. The MCs can produce and react to a multitude of growth factors, cytokines, and other signaling molecules and are in the perfect position to be a central hub for crosstalk communication between the cells in the glomerulus. In certain glomerular diseases, for example, in diabetic kidney disease or IgA nephropathy, the MCs become activated resulting in mesangial expansion. The expansion is normally due to matrix expansion in combination with either proliferation or hypertrophy. With time, this expansion can lead to fibrosis and decreased glomerular function. In addition, signs of complement activation are often seen in biopsies from patients with glomerular disease affecting the mesangium. This review aims to give a better understanding of the MCs in health and disease and their role in glomerular crosstalk and inflammation.     

健脾补肾、益气祛浊法治疗糖尿病肾病Ⅲ期的疗效观察及对免疫功能的影响

[目的]观察健脾补肾、益气祛浊法治疗糖尿病肾病Ⅲ期患者的临床疗效及对免疫功能的影响.[方法]选择糖尿病肾病Ⅲ期患者,随机分为对照组和治疗组,两组均接受常规治疗及护理.对照组口服缬沙坦胶囊,80 mg/次,每日1次.治疗组在对照组的基础上加用中药汤剂口服.疗程8周,治疗前后进行疗效性观察指标、肾功能损害相关指标、免疫功能...