Clinical efficacy of levamisole in the treatment of primary nephrosis in children

The purpose of the study was to evaluate the efficacy and the toxicity of levamisole given for 1 year to 16 children suffering from minimal change primary nephrosis who were relapsing frequently. The overall results showed that under levamisole the relapse rate decreased by 55% and the steroid requirements by 50%. After cessation of levamisole administration, most children (11/16) relapsed again. A second course of levamisole treatment reduced the relapse rate significantly once again. At the dosage of 2.5 mg/kg given every other day for 1 year or more, no side effects of levamisole were observed. It is concluded that levamisole does not cure nephrosis but reduces the incidence of relapses for the period it is administered. It also reduces the steroid requirements without any important side effects.     

Congenital nephrosis: Ultrasonographic features

The striking ultrasonographic features in a case of Congenital Nephrosis are described. The kidneys are enlarged and markedly echogenic. There is loss of distinction between the cortex, medulla and renal sinus. The differential diagnosis and histological findings are discussed.     

CONGENITAL NEPHROTIC SYNDROME DETECTED BY HYPOTHYROID SCREENING

Abstract. Finnegan, J., Slosberg, E., Postellon, D. and Primack, W. (Borgess Medical Center, Kalamazoo, Michigan and Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, USA). Congenital nephrotic syndrome detected by hypothyroid screening. Acta Pediatr Scand, 69: 705, 1980.—An infant was evaluated for a low thyroxine value, detected on routine neonatal screening for congenital hypothyroidism. She was found to have the congenital nephrotic syndrome, and to be euthyroid with low thyroid binding globulin. Congenital nephrosis can be detected by neonatal screening programs which use thyroxine as the primary screening test, but not by those which use TSH. This may be important in those countries in which the incidence of congenital nephrosis approaches that of congenital hypothyroidism.     

高血压高血糖对2型糖尿病肾病尿蛋白排泄量的影响（附68例临床分析）

目的探讨高血压高血糖对2型糖尿病肾病尿蛋白排泄量的影响。方法从2004年1月~2008年3月住院的糖尿病人中,按照ADA1999年标准筛选出2型糖尿病患者,把具有糖尿病视网膜病变、持续尿蛋白排泄量超过500mg/24小时,并排除糖尿病以外的肾脏或泌尿系疾病,具有糖尿病肾病共有135例,其中,男性78例,女性57例,年龄平均为58岁,病程平均10年,伴有或不伴有高血压的糖尿病肾病分别有68例和67例。按血压、血糖控制理想和良好分A、B、C、D 4组。结果严格控制高血压可减少尿蛋白的排泄量,严格控制高血糖亦有助于蛋白尿排泄量减少。结论高血糖和高血压共同作用于肾脏,引发肾血流动力学异常,加速糖尿病肾病的发生和发展,及时有效的控制血糖的同时,理想的控制血压至关重要。     

临床疑似IgAN患者应及早行肾活检

目的:IgA肾病患者的临床表现及其病理类型、损害程度。方法:分析经肾活检证实为原发性IgA肾病的44例患者的资料。结果:临床表现以尿检异常型最常见,其次是高血压型及大量蛋白尿型的结果。结论:IgA肾病的临床表现和病理类型多样,要综合临床表现并早期行肾活检以明确肾脏病理诊断的。     

姜黄素对阿霉素肾病大鼠NADPH氧化酶和nephrin表达的影响

目的通过观察姜黄素对阿霉素肾病大鼠肾组织中尼克酰胺腺嘌呤二核苷酸磷酸（NADPH）．氧化酶与肾小球裂隙膜分子nephrin表达的影响,探讨姜黄素治疗肾病综合征的作用机制。方法将Sprague．Dawley大鼠50只随机分为5组（正常对照组、模型组、姜黄素低剂量干预组、姜黄素高剂量干预组和波尼松干预组）。除正常组大鼠外,各组大鼠尾静脉一次性注射阿霉素（5mg／kg）造模。分别在建模后第28天收集24h尿液,第29天处死所有大鼠,取肾脏组织,应用化学比色法检测肾组织氧化应激指标丙二醛（MDA）和超氧化物歧化酶（SOD）,实时荧光定量聚合酶链式反应法和蛋白质印迹法检测肾组织NADPH氧化酶活性的关键亚基p47phox和neprhinmRNA与蛋白的表达变化。结果与正常对照组相比,模型组大鼠24h尿蛋白量、肾组织MDA含量明显增加,肾组织p47phoxmRNA和蛋白表达明显增加,SOD活性明显下降;肾组织中nephrinmRNA和蛋白表达均明显减少。与模型组比较,姜黄素干预组尿蛋白、肾组织MDA明显减少,SOD活性明显增加。姜黄素干预组可显著下调p47phoxmRNA和蛋白表达;姜黄素干预组nephrinmRNA和蛋白表达均明显增加。结论姜黄素能减轻肾小球滤过屏障损伤,降低尿蛋白,抑制肾组织p47ph“表达和增加nephrin表达可能是其作用机制之一。     

阿霉素肾病大鼠nephrin及podocalyxin蛋白表达及泼尼松干预作用的探讨

目的 探讨阿霉素肾病（ADN）大鼠肾组织nephrin及podocalyxin蛋白表达及泼尼松的干预作用。方法 24只雄性Wistar大鼠随机分成ADN组、泼尼松组、对照组,于0、4、8周测定大鼠24h尿蛋白（24hUP）、血清胆固醇（Cho）及白蛋白（Alb）。实验8周取肾组织观察病理形态改变,计算肾小球细胞外基质面积与肾小球面积之比（ECM/GA）,评估肾脏病理积分。用免疫组织化学法观察肾小球nephrin、podocalyxin表达。结果 实验4周时,ADN组较之对照组24hUP、Cho升高（P〈0.05）,Alb下降（P〈0.01）。实验8周时,泼尼松组较ADN组24hUP、Cho下降,ECM/GA及肾脏病理积分降低,nephrin、podoralyxin表达增多,Alb升高（P〈0.01）。ADN组nephrin、podlocalyxin表达与24hUP、Cho、ECM/GA及肾小球病理积分均呈负相关,与Alb呈正相关;nephrin与podocalyxin呈正相关。结论 nephrin、podocalyxin与蛋白尿的发生及发展密切相关。泼尼松能减轻ADN大鼠的蛋白尿及肾脏病理损害,其机制可能通过上调nephrin、podoralyxin表达来发挥肾保护作用。     

阿霉素肾病小鼠病理机制中白细胞介素-18水平分析

目的探讨白细胞介素-18(IL-18)在阿霉素肾病模型(微小病变型肾病,MCN)小鼠病程中的免疫失调作用。方法采用阿霉素单次尾静脉注射昆明种小鼠,诱导形成微小病变型肾病模型,设置模型组、生理盐水对照组和IL-18mAb抗体中和实验组(mAb)。测定3组小鼠第1、2、4、6周24h尿蛋白(24hUPQ)水平;于第42天时心脏采血法留取血清,检测模型组与对照组血清总蛋白(TP)、清蛋白(ALB)、尿素氮(BUN)、肌酐(Cr)、三酰甘油(TG)、总胆固醇(Tch)的水平;取单侧肾做病理检测,同时制备脾淋巴细胞悬液、肾组织匀浆液检测3组IL-18、γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)及IL-4水平。结果模型组小鼠从注射阿霉素第2周起,24hUPQ值均高于对照组,差异均有统计学意义(P0.01);血清TP、ALB、BUN、Cr、Tch、TG结果和病理诊断结果显示,模型小鼠出现低蛋白血症、高脂血症等类肾病综合征症状。检测显示模型组小鼠血清、肾组织匀浆上清液、脾淋巴细胞培养上清液IL-18、INF-γ、TNF-α水平均高于对照组,而IL-4水平均低于对照组,组间比较差异均有统计学意义(P0.01)。mAb组小鼠24hUPQ及IL-18、IFN-γ、TNF-α水平均低于模型组,组间比较差异有统计学意义(P0.01)。结论模型小鼠病程中,Th1类细胞因子分泌增强,Th2类因子受抑制,且IL-18mAb起到部分中和内源性IL-18的作用,表明IL-18是小鼠MCN病程中重要的免疫失调因子。     

中性粒细胞/淋巴细胞比值对微小病变型肾病发生激素性骨坏死的预测价值

目的　探讨中性粒细胞与淋巴细胞的比值（NLR）预测微小病变型肾病（MCD）患者发生激素性骨坏死的价值。方法　回顾性分析经皮肾穿刺活检术诊断的329例MCD患者的临床资料。根据受检者工作特征（ROC）曲线确定NLR诊断MCD发生激素性骨坏死的最佳截断值,以截断值为界将研究对象分为低NLR组（NLR≤3.321）262例和高NLR组（NLR＞3.321）67例,比较2组患者的基线临床指标、激素用量及时间、合用钙剂及活性维生素D3情况,分析NLR与MCD患者发生激素性骨坏死的相关性,以Kaplan-Meier生存曲线比较2组患者的关节生存率;以多因素Cox回归模型分析MCD患者发生激素性骨坏死的危险因素。结果　全部患者的总中位随访时间为38个月。高NLR组的年龄、白细胞计数、单核细胞计数、C反应蛋白、红细胞沉降率、纤维蛋白原、骨钙素、β胶原特殊序列、血尿素氮、血肌酐及发生激素性骨坏死的比例均较低NLR组高,估算肾小球滤过率较低NLR组降低（P＜0.05）。Kaplan-Meier生存曲线显示,低NLR组患者的关节累积生存率明显高于高NLR组（c2=10.130,P＜0.01）,高NLR组与低NLR组的1年、3年、5年生存率分别为82.9% 和93.5%、76.3%和88.9%、65.2%和85.6%。多因素Cox回归分析结果显示,高NLR水平是MCD患者发生激素性骨坏死的独立危险因素（HR=2.155,95%CI：1.136～4.089,P＜0.05）。结论　血NLR水平与MCD患者发生激素性骨坏死的风险相关,可作为评估MCD患者发生激素性骨坏死风险的有价值指标。     

The inhibitory effects of ginsenoside and quercetin on oxidative damage by puromycin aminonucleoside in rat

This study examined the protective effect of two natural antioxidants, ginsenoside Rb-1 and quercetin, on acute nephrosis induced by puromycin aminonucleoside (PA). The protective action of Rb-1 and quercetin were evidenced by their ability to suppress the formation of phosphatidylcholine hydroperoxide in the plasma, liver and kidney. Another beneficial effect noted from these natural antioxidants was increased glutathione peroxidase activity in the blood. Our results suggest that the severity of PA-induced acute nephrosis can be ameliorated by the antioxidative action of these two flavonoids. © 1998 John Wiley & Sons, Ltd.