输尿管镜钬激光治疗输尿管纤维上皮息肉14例报告

目的：探讨输尿管镜钬激光治疗输尿管纤维上皮息肉的有效性和安全性。方法：应用输尿管镜钬激光技术治疗输尿管纤维上皮息肉患者14例，其中上段息肉10例，中、下段息肉各2例，并发输尿管结石9例。结果：术后随访3个月，12例疗效满意，肾积水明显改善．保护了肾功能；1例发生输尿管狭窄．1例残留结石。结论：输尿管镜钬激光技术是治疗输尿管纤维上皮息肉安全、有效的方法，但远期疗效尚需进一步研究。     

Relaxin inhibits renal fibrosis and the epithelial-to-mesenchymal transition via the Wnt/β-catenin signaling pathway

Renal fibrosis is a common characteristic and the final pathological mechanism of chronic kidney disease (CKD). Although CKD remains incurable, inhibition of renal fibrosis is beneficial to inhibit the CKD process. Relaxin alleviates renal fibrosis in some experimental models, but its mechanism remains unclear. In the following, we studied the regulatory effect of relaxin on epithelial-mesenchymal transition (EMT) after unilateral ureteral obstruction (UUO). Our results demonstrate that relaxin could downregulate Wnt/β-catenin signaling and decrease EMT, thus protecting against loss of transporters in tubular epithelial cells (TECs) and abrogate renal interstitial fibrosis following UUO. We confirmed that relaxin can downregulate Wnt/β-catenin signaling and decrease EMT in NRK52E, thus abrogating G2 cell cycle arrest in vitro experiments. Therefore, a novel mechanism by which relaxin is antifibrotic is that relaxin regulates the EMT program of TECs via Wnt/β-catenin signaling pathway. The inhibition of EMT contributes to protecting the functional capabilities of TECs and promoting the regeneration of TECs.     

改良构建大鼠单侧输尿管梗阻肾间质纤维化模型

文题释义：肾盂积液：输尿管完全或不完全梗阻时,由于尿液无法正常排出体外而导致肾盂积液。慢性肾盂积液引起的肾脏损伤是不可逆的,可由多种上尿路梗阻性疾病诱发,导致肾盂肾盏扩大,肾小管与肾小球结构与功能丧失,进而肾组织萎缩。 肾间质纤维化：是各种慢性肾病发展至终末期的共同病理特征,以肾小管间质瘢痕硬化为特征,最终导致肾脏组织功能完全丧失。该过程受到转化生长因子β、成纤维细胞生长因子、内分泌等信号通路的调控,肾间质纤维化动物模型是研究相关药物药理机制的重要模型。 背景：传统的大鼠单侧输尿管梗阻手术方法,可以在较短的时间内(一两周)导致动物梗阻侧肾脏发生肾间质纤维化,但具有术后并发症较多、死亡率较高的缺点。 目的：优化并改良大鼠单侧输尿管梗阻手术操作,降低动物术后的并发症发生率,提高存活率,检测改良单侧输尿管梗阻方法建模大鼠的病理生理指标,为功能药理学基础研究提供背景数据支持。 方法：①取20只雄性SD大鼠,随机分为4组,分别进行传统单侧输尿管梗阻方法结扎、改良单侧输尿管梗阻方法结扎、不游离输尿管结扎、开腹腔但不结扎输尿管(假手术组)操作,术后14 d时比较组间大鼠肾间质纤维化成模率、死亡率、术后并发症发生率的差异;②另取28只SD大鼠,雌雄各半,随机分为改良组与假手术组,采用尿液分析、血细胞分析、血液生化分析方法,检测两组大鼠的生理指标,并通过苏木精-伊红染色与Masson染色法,观察改良组大鼠术后14,21 d时的肾脏组织病理学结果。 结果与结论：①与不游离输尿管结扎组大鼠相比,传统单侧输尿管梗阻组和改良单侧输尿管梗阻组大鼠的成模率高;②在单侧输尿管梗阻手术操作过程中,采用输尿管中段双结扎、中间不剪断的改良方法与传统方法相比,操作更简便易行,手术开创更小,肾间质纤维化成模快、成模率较高,动物术后死亡率与并发症发生率均低;③改良组与假手术组相比,术后14 d时的尿素氮、谷草转氨酶、白蛋白等血液生化指标差异有显著性意义(P < 0.05),其梗阻侧肾脏的组织病理切片苏木精-伊红染色与Masson染色结果均可见典型的肾间质纤维化病理特征。 ORCID: 0000-0001-7823-2897(孙杰) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

钬激光治疗输尿管结石患者的护理

目的探讨钬激光治疗输尿管结石的护理。方法总结钬激光治疗87例输尿管结石患者的临床资料,分析患者在治疗过程中所采用的护理措施。结果87例患者单次碎石率为96.6%(84/87),平均结石排尽时间为19.5日,平均住院2.5日。除1例输尿管穿孔外,无其他并发症。结论针对患者特点,术前加强心理护理,术后严密观察各引流管情况和并发症的发生,是手术成功的重要环节。     

Comparison of PGE2, 6-keto PGF1α and renin release from dog kidneys

Several renal cell types synthesize prostaglandin E₂ (PGE₂) and prostacyclin (PGI₂). To examine whether the release of these prostaglandins varies in proportion, prostaglandin synthesis was stimulated in anaesthetized dogs by renal arterial constriction, ureteral occlusion, intrarenal angiotensin II infusion and infusion of arachidonic acid, the precursor of PG synthesis. PGI₂ was measured as its stable hydrolysed product, 6-keto PGF_1α. The two former procedures raised PGE₂ release to 13 ± 2 pmol min^-1, 6-keto PGF_1α release to 5 ± 2 pmol min^-1 and renin release to 23 ± 5 μg AI min^-1, Angiotensin II infusion, reducing the renal blood flow by 30%, increased PGE₂ and 6-keto PGF_1α release only half as much as ureteral and renal arterial constriction, and exerted no significant effect on renin release. By increasing the infusion rate of angiotensin II up to 10 times, the renal blood flow remained unaltered in four dogs and fell to 50% of control in two dogs, but PGE₂ and 6-keto PGF_1α release did not increase further in any of the experiments. Arachidonic acid, infused at 40 and 160 μg kg^-1 min^-1, increased prostaglandin release in proportion to the infusion rate. At the highest infusion rate, PGE₂ release averaged 166± 37 pmol min^-1 and 6-keto PGF_1α release 98 ± 28 pmol min^-1. All procedures increased PGE₂ and 6-keto PGF_1α release in a fixed proportion of about 2.5:1, whereas renin release increased only during autoregulatory vasodilation.     

FTY720对单侧输尿管梗阻大鼠肾小管周围毛细血管的保护作用

目的 观察单侧输尿管梗阻大鼠模型中肾小管周围毛细血管(PTC)病变情况及FTY720对其干预作用.方法 采用单侧输尿管结扎术建立肾间质纤维化模型,将45只SD大鼠随机分为假手术组、模型组和FTY720治疗组.FTY720治疗组术前3d予0.2g·L-1FTY7200.5 mg·kg-1 ·d-1灌胃,假手术组和模型组予等量9 g·L-1盐水.每组分别于术后7、14、21 d各处死5只大鼠,处死前收集血清和24h尿液,观察肾功能和24h尿蛋白变化.取梗阻侧肾行组织学检查,观察肾间质纤维化程度和炎性细胞浸润情况.免疫组织化学方法检测其肾组织CD141、α-平滑肌肌动蛋白(α-SMA)、Ⅲ型胶原(COLⅢ)的表达水平.结果 与假手术组比较,模型组大鼠肾功能下降、肾间质纤维化明显,肾间质大量炎性细胞浸润,α-SMA、COLⅢ表达明显增加,肾间质微血管病变严重,术后7、14、21 d PTC密度分别为(116.80±8.92) mm-2、(98.80±3.96) mm-2、(62.20±7.01) mm-2(Pa＜0.05).与模型组比较,FTY720治疗组大鼠肾功能下降程度轻,肾间质浸润细胞数明显减少,肾间质纤维化程度、α-SMA、COLⅢ表达明显减少,且术后7、14、21 d PTC密度均高于模型组,分别为(132.50±8.32) mm-2、(119.40±12.21)mm-2、(85.00±2.59) mm-2 (Pa＜0.05).PTC密度与肾小管间质纤维化程度、肾间质炎性细胞浸润数、血清肌酐、BUN、24h尿蛋白量均呈负相关(r=-0.75、-0.72、-0.64、-0.65、-0.67,Pa＜0.01).结论 FTY720能明显减少单侧输尿管梗阻大鼠肾间质炎性细胞浸润及肾间质毛细血管丢失,保护肾功能,减轻肾间质纤维化程度.