p38MAPK参与高糖刺激大鼠肾小管上皮细胞产生细胞外基质胶原Ⅲ

目的：探讨p38MAPK信号通路在高糖刺激大鼠肾小管上皮细胞产生细胞外基质胶原Ⅲ中的作用。 方法： 采用体外培养和Western blotting等方法，以不同浓度D-葡萄糖、p38MAPK信号通路特异性阻断剂SB203580以及用不同时间刺激正常大鼠肾小管上皮细胞NRK52E，分别检NRK52E细胞p38MAPK磷酸化水平和细胞外基质胶原Ⅲ的表达。 结果： 随D-葡萄糖浓度增加，p38MAPK磷酸化水平、胶原Ⅲ的产生也增加，SB203580可有效阻断高糖引起p38MAPK磷酸化水平的升高和细胞外基质胶原Ⅲ的表达的增高。 结论： 高糖引起p38MAPK磷酸化水平的升高可能在糖尿病肾病的肾间质纤维化中发挥重要作用。SB203580有潜在的糖尿病肾病防治的临床应用价值。     

腹膜透析治疗老年慢性肾功能衰竭的临床分析

目的 分析持续性腹膜透析(PD)治疗老年慢性肾功能衰竭(CRF)患者的临床效果,探讨PD在老年CRF患者中的应用经验.方法 回顾性分析89例老年CRF患者接受PD(简称老年PD组)治疗后的临床表现和生化指标、主要并发症、存活率、死亡原因等,并与53例非老年PD组相比较.结果 老年PD组的原发疾病以糖尿病(37.08%)、原发性高血压(30.34%)为主,而非老年PD组则以肾小球肾炎(54.72%)为主.两组患者的1年与3年存活率差异无统计学意义,腹膜炎仍是两组患者退出PD的主要原因.老年组的病死率明显高于非老年组,感染与心脑血管病是两组患者的主要并发症和死亡原因.低钾血症在老年PD患者中非常普遍.结论 腹膜透析在老年CRF患者的治疗中有效,但长期存活仍受腹膜炎、心脑血管病并发症的影响,老年PD患者的低钾血症应引起足够的重视.     

Effect of hypothermia on renal sodium reabsorption

Summary The relationship between sodium reabsorption and oxygen consumption was studied in an isolated rabbit kidney preparation perfused with blood at 37, 28 and 19° C. When the temperature was lowered from 37° C to 28° C and to 19°C the rate of oxygen consumption and of the maximal P.A.H. excretion (Tm P.A.H.) decreased more than that of sodium reabsorption.TheQ ₁₀ for sodium reabsorption is about 1.8, while that for maximal P.A.H. excretion is 2.5. Some hypothesis on the possible mechanisms of the lowQ ₁₀ of the Na⁺ reabsorption are forwarded.Preliminary reports have been published [Boll. Soc. Ital. Biol. Sper.43, 1019–1023 (1966) and44, 1784–1787 (1967);45, 860–862 (1969) and45, 863–865 (1969)].     

肾阳虚证患者红细胞LPO、SOD和ATP酶活性的变化

目的 :探讨肾阳虚证患者红细胞LPO、SOD和ATP酶活性的特点及其意义。方法 :观察 19例肾阳虚证患者和 2 1例正常人红细胞LPO、SOD和红细胞膜Na+ K+ ATP酶、Mg2 + ATP酶、Ca2 + ATP酶、Ca2 + Mg2 + ATP酶活性的变化。结果 :与对照组比较 ,肾阳虚证患者红细胞LPO含量升高 (P <0 .0 1) ,红细胞SOD活性降低 (P <0 .0 1) ;红细胞膜Na+ K+ ATP酶活性显著升高 (P <0 .0 1) ,而Mg2 + ATP酶活性变化无显著性差异 ,Ca2 + ATP酶活性升高 (P <0 .0 1) ,Ca2 + Mg2 + ATP酶活性也显著升高 (P <0 .0 1)。结论 :肾阳虚证患者红细胞内脂质过氧化反应增强 ,而抗氧化能力降低 ,红细胞膜Na+ K+ ATP酶、Ca2 + ATP酶和Ca2 + Mg2 + ATP酶活性升高 ;本研究为理解肾阳虚证的病理生理基础提供了初步实验依据     

衰老大鼠急性肺损伤诱导肾功能受损

目的:观察衰老大鼠的急性肺损伤(ALI)是否可进一步诱导肾功能受损。方法:Wistar雄性大鼠40只, 复制成衰老模型, 然后再随机分成对照组(静脉注射生理盐水), ALI组(静脉注射脂多糖, LPS)及LPS组(左心室内注射LPS), 后两组再分2h及6h组。每组8只。注LPS后2h或6h收集血并取肺、肾。制备肺、肾组织匀浆待测。结果:ALI组在注LPS后仅至6h时血中肌酐(Cr)、尿素氮(BUN)含量才有显著升高(均P＜0.01)。而LPS组Cr、BUN含量均无显著升高。ALI组血中乳酸(LD)、丙二醛(MDA)及一氧化氮(NO)含量在注LPS后2h时均显著升高(P＜0.05, P＜0.01);而肺组织中谷胱甘肽过氧化物酶(GSH-P_X)及Na⁺-K⁺-ATPase活性均显著下降(均P＜0.01);上述变化持续至观察的6h时。ALI组在注LPS后仅至6h时, 肾组织中MDA、NO含量才有显著升高(均P＜0.01)及GSH-P_X、Na⁺-K⁺-ATPase活性显著下降(P＜0.01)。而在LPS组, 除注LPS后2h时的血中和2h、6h的肺组织中NO含量显著升高(均P＜0.05)及2h时的肺组织中Na⁺-K⁺-ATPase活性显著下降(P＜0.05)外, 其它均无显著变化。结论:给衰老大鼠静脉内注射5mg/kg的LPS可致ALI, 并可进一步诱导肾功能受损。     

Apical and basolateral expression of Aquaporin-1 in transfected MDCK and LLC-PK cells and functional evaluation of their transcellular osmotic water permeabilities

 Aquaporin-1 is present in the apical and basolateral membranes in proximal tubules and descending limbs of Henlé’s loop. In order to be able to study the routing of Aquaporin-1 and the regulation of Aquaporin-1-mediated transcellular water flow, we stably transfected LLC-PK₁ and MDCK-HRS cell lines with an Aquaporin-1 expression construct. LLC-PK₁ clone 7 and MDCK clone K integrated two and one copies, respectively, which was reflected in the amount of Aquaporin-1 mRNA expressed in both clones. The Aquaporin-1 protein levels, however, were similar. In both clones, immuno-electronmicroscopy showed extensive labelling of Aquaporin-1 on the basolateral plasma membrane, endosomal vesicles and the apical plasma membrane, including the microvilli. To measure transcellular water permeation, a simple method was applied using phenol-red as a cell-impermeant marker of concentration. In contrast to the native cell lines, both clones revealed a high transcellular osmotic water permeability, which could not be influenced by forskolin add/3-isobutyl-1-methylxanthine (IBMX) or the phorbol ester 12-O-tetradecanoyl 13-acetate (TPA). After glutaraldehyde fixation, it was inhibitable by HgCl₂. These results indicate that targeting of Aquaporin-1 to the apical and basolateral plasma membrane is independent of cell type and show for the first time that water flow through a cultured epithelium can be blocked by mercurial compounds. Received: 9 October 1996 / Received after revision: 3 January 1997 / Accepted: 8 January 1997     

Postnatal expression of transport proteins involved in acid–base transport in mouse kidney

The kidney plays a major role in maintaining and controlling systemic acid–base homeostasis by reabsorbing bicarbonate and secreting protons and acid-equivalents, respectively. During postnatal kidney development and adaptation to changing diets, plasma bicarbonate levels are increasing, the capacity for urinary acidification maturates, and the final morphology and distribution of intercalated cells is achieved. In adult kidney, at least two types of intercalated cells (IC) are found along the collecting duct characterised either by the expression of AE1 (type A IC) or pendrin (non-type A IC) where non-type A IC are found only in the convoluted distal tubule, connecting tubule and cortical collecting duct. Here we investigated in mouse kidney the relative mRNA abundance, protein expression levels and distribution of several proteins involved in renal acid–base transport, namely, the Na⁺/HCO₃ ^– cotransporter NBC1 (SLC4A4), the Na⁺/H⁺-exchanger NHE3 (SLC9A3), two subunits of the vacuolar H⁺-ATPase [ATP6V0A4 (a4), ATP6V1B1 (B1)], the Cl^–/HCO₃ ^– exchangers AE1 (SLC4A1) and pendrin (SLC26A4). Relative mRNA abundance of all transport proteins was lowest at day 3 after birth and increased thereafter in parallel with protein levels. The numbers of type A and non-type A IC in the cortical collecting duct (CCD) increased from day 3 to days 18 and 24, whereas the number of IC in the CCD with apical staining for the vacuolar H⁺-ATPase subunits a4 and B1 decreased from day 3 to days 18 and 24, respectively. In addition, cells with characteristics of non-type A IC (pendrin expression, basolateral expression of vacuolar H⁺-ATPase subunits) were found in the inner and outer medulla 3 days after birth but were absent from the medulla of 24-day-old mice. Taken together, these results demonstrate massive changes in mRNA and protein expression levels of several acid–base transporters during postnatal kidney maturation and also show changes in intercalated cell phenotype in the medulla during these processes.     

抗病毒治疗对乙型肝炎病毒感染者肾移植术后临床转归的影响

目的 探讨乙型肝炎病毒感染者肾移植术后临床转归及治疗对策.方法 将术前乙肝病毒标志物阳性(HBsAg阳性、HBeAg阳性或HBeAb阳性、HBV DNA阳性或阴性)的32例肾移植术后患者分为抗病毒治疗组和无抗病毒治疗组两组.观察两组(术前1周至术后9年)的肝功能(ALT、AST、TBIL、PT)变化、病毒复制(HBV DNA)及存活情况.结果 抗病毒治疗组23例患者肝功能损害复常率为82.60%,存活率为82.60%,HBV DNA(PCR法)下降(≥2 log10)或保持低复制率为86.95%;未抗病毒组9例患者肝功能损害复常率为22.22%,存活率为11.11%,HBV DNA(PeR法)下降(≥2log10)或保持低复制率为11.11%.抗病毒组肝功能复常率、存活率及HBV DNA下降或保持低复制率高于无抗病毒组,两组比较差异有统计学意义(P<0.05).19例拉米夫定治疗患者6例出现病毒学反弹31.58%,1例加用阿德福韦酯,2例换用恩替卡韦后好转,其余3例肝功能衰竭死亡.结论 持续有效的抗病毒治疗可以有效控制乙肝病毒复制,促进肝功能恢复,减少肝衰竭发生,提高乙肝病毒感染者肾移植术后患者存活率.在治疗过程中出现病毒学反弹应及时换用或加用有效药物减少肝衰竭发生.     

肾混合性上皮间质肿瘤和成人囊性肾瘤的临床病理学观察

Objective To study the clinicopathologie features,immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney ( MEST) and adult cystic nephroma ( CN).Methods Five cases of MEST and 4 cases of CN were retrospectively analyzed.Immunohistochemical study was carried out and the literature was reviewed.Results All of the five patients with MEST were females.Their median age was 45 years.For CN,there were 3 males and 1 female and their median age was 41 years.All patients presented with loin pain and hematuria.On gross examination,MEST was well-circumscribed but non-encapsulated.There was no evidence of haemorrhage or necrosis.Three of the cases were solid in nature.One was composed of a mixture of solid and cystic elements,while the remaining case showed a multicystic cut surface bridged by thick fibrous septa.On the other hand,CN were well-circumscribed and encapsulated.They were multiloculated cystic in nature.The cystic spaces were separated by thin septa and there was no significant solid or necrotic component.Histologically,MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns.Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified.The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium.In contrast,the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical　study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen.The spindle cells in MEST expressed vimentin (5/5 ) ,smooth muscle actin (3/5 ),desmin (4/5 ),CD10 (5/5),estrogen receptor (4/5) and progesterone receptor (4/5).They were negative for HMB45,CD34,CD117 and S-100 protein.On the other hand,the spindle cells in CN were variably positive for vimentin (4/4),smooth muscle actin (4/4),desmin (1/4),estrogen receptor (3/4) and progesterone receptor (1/4).They were negative for CD10,HMB45,CD34,CD117 and S-100 protein.Conclusions Both MEST and CN are uncommon renal neoplasm.Most of them run a benign clinical course.The stromal cells in MEST show smooth muscle or myofibroblastic differentiation.Areas demonstrating Miillerian features also existed in some cases.MEST and CN share overlapping histological and immunohistochemical features,and may represent spectrum of the same group of lesions.     

Ⅲ型胶原肾小球病的形态学观察

目的了解Ⅲ型胶原肾小球病的形态学改变,并对Ⅲ型胶原可能的细胞来源进行初步探讨。方法对3例肾活检组织进行光镜、免疫荧光、电镜和Ⅰ、Ⅲ、Ⅳ型胶原及d平滑肌肌动蛋白(α-SMA)的免疫组织化学染色(SP法)观察。结果2例患者临床表现为肾病综合征,其中1例伴高血压,第3例表现为肾功能不全和肾性高血压。3例均无肾病家族史。光镜检查可见肾小球基膜内和系膜区弥漫性过碘酸-希夫反应阳性物质沉积,系膜细胞无明显增生。电镜检查在基膜内疏松层和系膜区可见大量胶原纤维沉积,系膜细胞胞膜下平行排列的束状微丝明显增加。免疫组织化学显示这些胶原纤维为Ⅲ型胶原,Ⅰ型和Ⅳ型胶原阴性,同时系膜区多数系膜细胞α-SMA阳性。结论Ⅲ型胶原肾小球病光镜、电镜及免疫组织化学上都有其特殊的病理改变。肾小球内激活的系膜细胞可能是Ⅲ型胶原的来源。