Morphogenesis of the renal juxtaglomerular apparatus and peripolar cells in the sheep

Summary The morphogenesis of the juxtaglomerular apparatus and peripolar cells was studied in the metanephros of fetal sheep (from 24 to 147 days of gestation) using light and electron microscopy. The first juxtaglomerular apparatus was detected at 45 days of gestation, following constriction of the edges of Bowman's capsule and formation of the vascular pole of the renal corpuscle. Mesenchymal cells gave rise to lacis cells and to smooth muscle and epithelioid cells of the juxtaglomerular arterioles. Epithelioid cells developed only sparse cytoplasmic granulation, first detectable at 92 days. The macula densa developed from tubular cells at the junction of the middle and upper limbs of the S-shaped body of the developing nephron. Peripolar cells arose from epithelial cells in the lower limb of the S-shaped body, at the constricting edges of Bowman's capsule, and formed a cuff around the origin of the glomerular tuft. Cytoplasmic granules were first detected in peripolar cells at 53 days, and remained more prominent than epithelioid cell granulation throughout gestation.     

Chloride distribution in the proximal convoluted tubule ofNecturus kidney

Summary To assess the mechanism(s) by which intraluminal chloride concentration is raised above equilibrium values, intracellular Cl^– activity ( _i ^Cl ) was studied in the proximal tubule ofNecturus kidney. Paired measurements of cell membrane PD (V _BL) and Cl-selective electrode PD (V _BL ^Cl ) were performed in single tubules, during reversible shifts of peritubular or luminal fluid composition. Steadystate _i ^Cl was estimated at 14.6±0.6 mmol/liter, a figure substantially higher than that predicted for passive distribution. To determine the site of the uphill Cl^– transport into the cell, an inhibitor of anion transport (SITS) was added to the perfusion fluid. Introduction of SITS in peritubular perfusate decreased _i ^Cl , whereas addition of the drug in luminal fluid slightly increased _i ^Cl ; both results are consistent with basolateral membrane uphill Cl^– transport from interstitium to the cell. TMA⁺ for Na⁺ substitutions in either luminal or peritubular perfusate had no effect on _i ^Cl . Removal of bicarbonate from peritubular fluid, at constant pH (a situation increasing HCO ₃ ^– outflux), resulted in an increase of _i ^Cl , presumably related to enhanced Cl^– cell influx: we infer that Cl^– is exchanged against HCO ₃ ^– at the basolateral membrane. The following mechanism is suggested to account for the rise in luminal Cl^– concentration above equilibrium values: intracellular CO₂ hydration gives rise to cell HCO ₃ ^– concentrations above equilibrium. The passive exit of HCO ₃ ^– at the basolateral membrane energizes an uphill entry of Cl^– into the cell. The resulting increase of _i ^Cl , above equilibrium, generates downhill Cl^– diffusion from cell to lumen. As a result, luminal Cl^– concentration also increases.C.N.R.S. Greco 24. Part of this work was presented at the 12^th annual meeting of the American Society of Nephrology, Boston, Mass. (Edelman et al., 1979).     

The mechanism of water-stress-induced embolism in two species of chaparral shrubs

The mechanism of water-stress-induced embolism of xylem was investigated in Malosma laurina and Heteromeles arbutifolia, two chaparral shrub species of southern California. We tested the hypothesis that the primary cause of xylem dysfunction in these species during dehydration was the pulling of air through the pores in the cell walls of vessels (pores in pit membranes) as a result of high tensions on xylem water. First, we constructed vulnerability-to-embolism curves for (i) excised branches that were increasingly dehydrated in the laboratory and (ii) hydrated branches exposed to increasing levels of external air pressure. Branches of M. laurina that were dehydrated became 50% embolized at a xylem pressure potential of -1.6 MPa, which is equal in magnitude but opposite in sign to the +1.6 MPa of external air pressure that caused 50% embolism in hydrated stems. Dehydrated and pressurized branches of H. arbutifolia reached a 50% level of embolism at -6.0 and +6.4 MPa, respectively. Secondly, polystyrene spheres ranging in diameter from 20 to 149 nm were perfused through hydrated stem segments to estimate the pore size in the vessel cell walls (pit membranes) of the two species. A 50% or greater reduction in hydraulic conductivity occurred in M. laurina at perfusions of 30, 42, 64 and 82 nm spheres and in H. arbutifolia at perfusions of 20 and 30 nm spheres. Application of the capillary equation to these pore diameters predicted 50% embolism at xylem tensions of -2.2 MPa for M. laurina and -6.7 MPa for H. arbutifolia, which are within 0.7 MPa of the actual values. Our results suggest that the size of pores in pit membranes may be a factor in determining both xylem efficiency and vulnerability to embolism in some chaparral species. H. arbutifolia, with smaller pores and narrower vessels, withstands lower water potentials but has lower transport efficiency. M. laurina, with wider pores and wider vessels, has a greater transport efficiency but requires a deeper root system to help avoid catastro-phically low water potentials.     

左卡尼汀联合蔗糖铁对血液透析患者肾性贫血及氧化应激的影响

目的:探讨左卡尼汀联合蔗糖铁对血透患者肾性贫血及氧化应激的影响。方法:抽选我院2010年3月-2013年5月行维持血透治疗的肾性贫血患者79例,采用数字表法分为对照组(39例)和观察组(40例),对照组采用促红细胞生成素(EPO)、单用蔗糖铁及常规对症治疗,观察组在对照组基础上联用左卡尼汀治疗。比较两组患者治疗前、治疗6个月后血红蛋白(Hb)、血细胞比容(Hct)、血浆铁蛋白(SF)、转铁蛋白饱和度(TSAT)、晚期蛋白质氧化产物(AOPP)及血丙二醛(MDA)水平,并对两组治疗开始时、治疗3、6个月时EPO使用剂量进行比较。结果:治疗6个月后,观察组患者Hb、Hct、SF、TSAT明显高于对照组(P0.05),AOPP、MDA明显低于对照组(P0.05);对照组从治疗开始到治疗6个月时一直维持较高的EPO使用剂量,而观察组EPO用量依次递减,至治疗6个月时EPO用量显著低于对照组(P0.05)。结论:左卡尼汀能联合蔗糖铁治疗肾性贫血的疗效显著,能有效缓解氧化应激反应,降低EPO用量,值得临床推广。     

Clinical significance of circulating microRNAs as diagnostic biomarkers for coronary artery disease

Coronary artery disease (CAD) is one of the biggest threats to human life. Circulating microRNAs (miRNAs) have been reported to be linked to the pathogenesis of CAD, indicating the possible role in CAD diagnosis. The present study aimed to explore the expression profile of plasma miRNAs and estimate their value in diagnosis for CAD. 67 Non‐CAD control subjects and 88 CAD patients were enrolled. We conducted careful evaluation by RT‐PCR analysis, Spearman rank correlation coefficients analysis, Receiver Operating Characteristic (ROC) curves analysis and so on. The plasma levels of six miRNAs known to be related to CAD were measured and three of them showed obvious expression change. Circulating miR‐29a‐3p, miR‐574‐3p and miR‐574‐5p were all significantly increased. ROC analysis revealed the probability of the three miRNAs as biomarkers with AUCs (areas under the ROC curve) of 0.830, 0.792 and 0.789, respectively. They were significantly correlated with each other in CAD patients, suggesting the possibility of joint diagnosis. The combined AUC was 0.915, much higher than each single miRNA. Therefore, our study revealed three promising biomarkers for early diagnosis of CAD. The combination of these miRNAs may act more effectively than individual ones for CAD diagnosis.     

An extracellular vesicle epitope profile is associated with acute myocardial infarction

The current standard biomarker for myocardial infarction (MI) is high‐sensitive troponin. Although powerful in clinical setting, search for new markers is warranted as early diagnosis of MI is associated with improved outcomes. Extracellular vesicles (EVs) attracted considerable interest as new blood biomarkers. A training cohort used for diagnostic modelling included 30 patients with STEMI, 38 with stable angina (SA) and 30 matched‐controls. Extracellular vesicle concentration was assessed by nanoparticle tracking analysis. Extracellular vesicle surface‐epitopes were measured by flow cytometry. Diagnostic models were developed using machine learning algorithms and validated on an independent cohort of 80 patients. Serum EV concentration from STEMI patients was increased as compared to controls and SA. EV levels of CD62P, CD42a, CD41b, CD31 and CD40 increased in STEMI, and to a lesser extent in SA patients. An aggregate marker including EV concentration and CD62P/CD42a levels achieved non‐inferiority to troponin, discriminating STEMI from controls (AUC = 0.969). A random forest model based on EV biomarkers discriminated the two groups with 100% accuracy. EV markers and RF model confirmed high diagnostic performance at validation. In conclusion, patients with acute MI or SA exhibit characteristic EV biomarker profiles. EV biomarkers hold great potential as early markers for the management of patients with MI.     

Thioredoxin-interacting protein promotes activation and inflammation of monocytes with DNA demethylation in coronary artery disease

Numerous studies have demonstrated that thioredoxin-interacting protein (TXNIP) expression of peripheral blood leucocytes is increased in coronary artery disease (CAD). However, the molecular mechanism of this phenomenon remained unclear. DNA methylation plays important roles in the regulation of gene expression. Therefore, we speculated there might be a close association between the expression of TXNIP and methylation. In this study, we found that compared with controls, DNA methylation at cg19693031 was decreased in CAD, while mRNA expressions of TXNIP and inflammatory factors, NLRP3, IL-1β, IL-18, were increased. Methylation at cg19693031 was negatively associated with TXNIP expression in the cohort, THP-1 and macrophages/foam cells. Furthermore, Transwell assay and co-cultured adhesion assay were performed to investigate functions of TXNIP on the migration of THP-1 or the adhesion of THP-1 on the surface of endothelial cells, respectively. Notably, overexpressed TXNIP promoted the migration and adhesion of THP-1 cells and expressions of NLRP3, IL-18 and IL-1β. Oppositely, knock-down TXNIP inhibited the migration and adhesion of THP-1 and expressions of NLRP3, IL-18. In conclusion, increased TXNIP expression, related to cg19693031 demethylation orientates monocytes towards an inflammatory status through the NLRP3 inflammasome pathway involved in the development of CAD.     

Interlock可解脱弹簧圈在脾动脉瘤腔内治疗中的应用

目的:探究Interlock可解脱弹簧圈在脾动脉瘤的腔内治疗中的应用价值。方法:回顾性分析2016年2月至2019年2月于本中心使用Interlock可解脱弹簧圈治疗的36例脾动脉瘤患者的临床资料,包括10例男性,26例女性,31例真性动脉瘤,5例假性脾动脉瘤,术前均行超声或CTA明确诊断。术中栓塞后,立即血管造影以明确技术成功率。围手术期及术后2周、3个月和6个月监测血常规、胰淀粉酶和主动脉CTA,观察并发症的发生情况。结果:6例患者弹簧圈栓塞动脉瘤远近端及瘤腔,其余仅栓塞脾动脉瘤瘤腔。术中DSA血管造影提示即刻脾动脉瘤栓塞闭塞率为97%以上,术中共使用128枚Interlock弹簧圈,其中104枚为钻石型,24枚为普通2D型。弹簧圈平均直径为6.3±4.2(2-12)mm,平均长度为16±13.5(3-32)mm,瘤体平均尺寸为40.6±12.5(15-70) mm。围手术期无并发症发生。平均随访10.0±3.2(6-15)个月,1月后2例出现脾梗死,7例发生轻微腹痛及低热等症状,所有病例均未见瘤腔再通和瘤体增大。结论:Interlock可解脱弹簧圈可以安全有效地治疗脾动脉瘤,但其远期疗效需长期随访观察。     

乌司他丁对非停跳冠脉搭桥术患者的心肺保护作用研究

目的:探讨乌司他丁对非停跳冠脉搭桥术患者的心肺保护作用。方法:选取2017年12月-2019年4月我院收治的非停跳冠脉搭桥术患者76例,根据使用的药物不同分为两组,对照组应用常规方法,研究组应用乌司他丁,在麻醉之后切皮之前为T1,旁路血管开放时时间点为T2,手术结束为T3,手术之后的8 h为T4。比较两组治疗前后的心肺功能指标、动脉血气分析及血浆炎症因子、氧合指数术后恢复。结果:和T1进行对比时,两组T3、T4中的气道阻力(Air way Resistance,Raw)、呼吸指数(Respiratory Index,RI)、肺泡-动脉血氧分压差P(A-a)DO2均有所升高,在T2、T4中(PVR)有所升高,在T2、T3、T4中肺顺应性(Compliance of Lung,CL)有所降低。和对照组进行对比时,研究组在T3、T4中肺循环阻力(pulmonary vascular resistance, PVR)、RI、P(A-a)DO2有所降低,在T2、T3、T4中通气死腔百分比(VD/VT)有所降低(P0.05),在T2中CL有所升高(P0.05);治疗前,两组BNP、TNF-α、IL-6、IL-8无统计学意义(P0.05),治疗后BNP、肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白细胞介素-6 (Interleukin-6,IL-6)、白细胞介素-8 (Interleukin-8,IL-8)在T1、T2、T3、T4中低于对照组(P0.05),肌钙蛋白(cardiac troponin,cTnI)在T1中和对照组没有明显差异(P0.05),T2、T3、T4中研究组明显低于对照组(P0.05),研究组氧合指数高于对照组(P0.05);研究组T1、T2、T3、T4时平均动脉压(mean artery pressure,MBP)均高于对照组(P0.05),T1、T2、T3、T4时心率均低于对照组(P0.05);研究组ICU停留时间、ICU带气管插管时间、ICU机械通气时间、肺部并发症均低于对照组(P0.05)。结论:乌司他丁用于非停跳冠脉搭桥术的效果较好,可以保护患者的心肺功能。