Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol

Kidney transplantation is the treatment of choice for patients suffering from end-stage renal disease. It offers better life expectancy and higher quality of life when compared to dialysis. Although the last few decades have seen major improvements in patient outcomes following kidney transplantation, the increasing shortage of available organs represents a severe problem worldwide. To expand the donor pool, marginal kidney grafts recovered from extended criteria donors (ECD) or donated after circulatory death (DCD) are now accepted for transplantation. To further improve the postoperative outcome of these marginal grafts, research must focus on new therapeutic approaches such as alternative preservation techniques, immunomodulation, gene transfer, and stem cell administration.Experimental studies in animal models are the final step before newly developed techniques can be translated into clinical practice. Porcine kidney transplantation is an excellent model of human transplantation and allows investigation of novel approaches. The major advantage of the porcine model is its anatomical and physiological similarity to the human body, which facilitates the rapid translation of new findings to clinical trials. This article offers a surgical step-by-step protocol for an autotransplantation model and highlights key factors to ensure experimental success. Adequate pre- and postoperative housing, attentive anesthesia, and consistent surgical techniques result in favorable postoperative outcomes. Resection of the contralateral native kidney provides the opportunity to assess post-transplant graft function. The placement of venous and urinary catheters and the use of metabolic cages allow further detailed evaluation. For long-term follow-up studies and investigation of alternative graft preservation techniques, autotransplantation models are superior to allotransplantation models, as they avoid the confounding bias posed by rejection and immunosuppressive medication.     

Long-term survival of haptophyte and prasinophyte resting stages in marine sediment

Resting stages of marine phytoplankton have been shown to have potential for long-term survival and to remain viable in marine sediments for up to about a century. This study documents for the first time long-term survival in haptophytes and prasinophytes, by germination of resting stages of Isochrysis galbana and Mantoniella squamata from up to 40-year-old sediment layers. Germination was induced by setting up sediment slurries in L1 medium at 15°C. Cyst formation was induced in culture strains acquired from the germinations by keeping mixtures of strains in the light or dark at salinities of 20 or 30. The identity of the two species was confirmed by light and electron microscopy as well as LSU and SSU rDNA-based phylogenetic analyses.     

过敏性紫癜性肾炎肾组织中KIM-1的表达与临床意义

目的:探讨过敏性紫癜性肾炎肾组织中肾损伤分子1(kidney injury molecule 1,KIM-1)的表达与临床意义。方法:选择2015年4月到2018年1月在我院诊治的过敏性紫癜性肾炎患者150例作为研究对象,采用免疫组化法检测患者肾组织中KIM-1表达,采用半定量评分系统进行肾脏病理损害评分,并对二者进行相关性分析。结果:肾炎组织与肾旁组织的KIM-1相对表达量分别为(9.28±1.38)和(2.74±1.30),肾炎组织中KIM-1的表达显著高于肾旁组织(P=0.000);肾炎组织的毛细血管外肾小球活动、系膜增殖、内皮增殖、肾间质炎症、肾小球慢性化、肾小管间质慢性化指数评分均显著高于肾旁组织(P0.05);肾组织KIM-1表达量与肾小球慢性化指数、肾间质炎症指数、肾小管间质慢性化指数均呈显著正相关性(P0.05)。结论:过敏性紫癜性肾炎组织中KIM-1呈高表达,可能作为评估肾脏病理病变程度的参考指标。     

后腹腔镜下肾部分切除术对肾癌患者肾功能和预后的影响

目的:探讨后腹腔镜下肾部分切除术对肾癌患者肾功能以及近远期预后的影响。方法:回顾性分析2012年1月～2017年8月在我院接受手术治疗的肾癌患者92例,根据不同手术治疗方法分为观察组(n=48)和对照组(n=44)。对照组行传统开放手术治疗,观察组行后腹腔镜下肾部分切除术。对比两组患者术前、术后血清肌酐(Cr)、血尿素氮(BUN)、β2-微球蛋白(β2-MG)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平的变化,术后1年、3年、5年生存率及切口感染、肺部感染、腹部疼痛、肾周血肿等并发症的发生情况。结果:观组患者手术时间、术后胃肠功能恢复时间、住院时间均明显短于对照组(P0.05),术中出血量、术后引流管引流量均显著低于对照组(P0.05)。术后1个月、术后2个月,两组患者血清Cr、BUN、β2-MG表达水平均较治疗前上升,且观察组以上指标显著低于对照组(P0.05)。术后,两组患者血清CRP、IL-6水平虽有升高,但观察组以上指标明显低于对照组(P0.05)。两组患者术后3年、5年的生存率均较术前下降,但观察组均分别高于对照组(P0.05)。术后,两组患者均有出现切口感染、肺部感染、腹部疼痛、肾周血肿等并发症,观察组总发生率(10.42%)明显低于对照组(29.54%,P0.05)。结论:后腹腔镜下肾部分切除术治疗肾癌患者可缩短患者的住院时间,对肾功能影响小,明显提高患者术后3年、5年生存率,且安全性更高。     

生脉注射液联合曲美他嗪治疗缺血性心肌病合并肾功能不全的临床疗效分析

目的:研究生脉注射液联合曲美他嗪治疗缺血性心肌病合并肾功能不全的临床疗效。方法:选取2015年3月至2017年3月我院收治的100例缺血性心肌病合并肾功能不全患者,按照随机数表法分为观察组(n=50)和对照组(n=50)。对照组采用曲美他嗪治疗,观察组采用生脉注射液联合曲美他嗪治疗。观察和比较两组的治疗疗效、治疗前后心功能指标(左心室射血分数(LVEF)、左室收缩末径(LVESD)、左室舒张末期内径(LVEDD))、肾功能指标(血肌酐(Scr),尿素氮(BUN))、心肌损伤标志物(血清胱抑素(Cys C)、同型半胱氨酸(HCY)、脑钠肽(BNP))水平的变化。结果:治疗后,观察组总有效率显著高于对照组[92.30%(48/52) vs.70.83%(34/48)](P0.05),LVEDD、LVESD水平均显著低于对照组[(51.21±8.54)mm vs.(56.63±10.83)mm,(42.91±6.30)mm vs.(45.86±7.32)mm](P0.05),LVEF水平均显著高于对照组[(46.02±7.85)%vs.(41.20±8.84)%](P0.05),Scr、BUN水平均显著低于对照组[(164.30±17.95)μmol/L vs.(211.75±19.31)μmol/L;(8.12±0.76)mmol/L vs.(11.74±1.72)mmol/L](P0.05)。血清Cys C、HCY、NT-Pro BNP水平均显著低于对照组[(0.90±0.21)mg/L vs 1.52±0.34)mg/L (12.34±3.89)μmol/L vs.(20.86±5.28)μmol/L,(298.47±78.41)ng/L vs.(402.35±92.76)ng/L](P0.05)。结论:生脉注射液联合曲美他嗪治疗缺血性心肌病合并肾功能不全的的临床疗效显著优于单用曲美他嗪治疗,其可有效改善患者心、肾功能,减轻心肌细胞损伤。     

敲低PFKP联合肉碱棕榈酰基转移酶抑制剂etomoxir协同对肾透明细胞癌细胞Caki-1的抗肿瘤作用

目的:研究敲低P型磷酸果糖激酶(phosphofructokinase,PFKP)联合肉碱棕榈酰基转移酶抑制剂etomoxir对肾透明细胞癌Caki-1细胞的影响,并进一步探究其作用机制。方法:利用Western blot验证对照及PFKP shRNA敲低肾透明细胞癌细胞中PFKP的敲低效率,分别检测对照组(shCtrl)、PFKP敲低组、etomoxir组(shCtrl+etomoxir)、PFKP敲低联合etomoxir组的增殖曲线。使用Annexin-V/PI染色并用流式细胞检测对照组、PFKP敲低组、etomoxir组、PFKP敲低联合etomoxir组的细胞死亡,研究PFKP敲低联合etomoxir对细胞存活的影响。分别检测对照组、PFKP敲低组、etomoxir组、PFKP敲低联合etomoxir组的ATP水平与脂肪酸变化。结果:Western blot结果验证了PFKP的敲低效率。流式细胞检测显示,对照组、PFKP敲低组、etomoxir组、PFKP敲低联合etomoxir组的平均细胞死亡率分别为1.1、1.9、13.9、31.3%。PFKP敲低联合etomoxir组Caki-1细胞的死亡率显著高于单纯PFKP敲低与etomoxir组(P0.05)。PFKP敲低联合etomoxir组Caki-1细胞的ATP水平显著低于单纯PFKP敲低与etomoxir组(P0.05)。Etomoxir的加入抑制了PFKP敲低引起的游离脂肪酸下降(P0.05)。结论:PFKP敲低联合etomoxir对Caki-1细胞呈现协同的细胞毒抗肿瘤作用。     

肾衰宁胶囊联合血液透析对慢性肾功能衰竭患者肾功能及血液流变学的影响

目的:探讨肾衰宁胶囊联合血液透析对慢性肾功能衰竭患者肾功能及血液流变学的影响。方法:选取中国医科大学本溪中心医院于2015年1月-2017年9月期间收治的慢性肾功能衰竭患者80例为研究对象。根据随机数字表法将患者分为对照组(n=40)与研究组(n=40),两组患者均给予血液透析治疗,研究组在此基础上联合使用肾衰宁胶囊治疗,疗程均为3个月。观察并比较两组患者治疗3个月后临床疗效及不良反应发生情况,比较两组患者治疗前、治疗3个月后血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(eGFR)水平及全血高切黏度、全血低切黏度、血浆黏度、红细胞比容。结果:研究组患者总有效率为92.50%(37/40),高于对照组的67.50%(27/40),差异有统计学意义(P0.05)。两组患者治疗3个月后Scr、BUN水平较治疗前降低,且研究组低于对照组(P0.05);而两组患者治疗3个月后eGFR水平较治疗前升高,且研究组高于对照组(P0.05)。研究组患者治疗3个月后的全血高切黏度、全血低切黏度、血浆黏度以及红细胞比容均低于对照组(P0.05)。对照组不良反应发生率为7.50%,与研究组的10.00%比较差异无统计学意义(P0.05)。结论:肾衰宁胶囊联合血液透析对慢性肾功能衰竭患者有较好的治疗效果,能够改善患者肾功能状况,同时稳定患者血液流变学,并且安全性较好。     

超声对早期糖尿病肾病的诊断价值及肾动脉血流阻力指数与血清hs-CRP、VEGF的关系分析

目的:研究彩色多普勒超声对早期糖尿病肾病的诊断价值及肾动脉血流阻力指数与血清超敏C反应蛋白(hs-CRP)、血管内皮生长因子(VEGF)的关系。方法:选取从2017年2月～2018年2月兰州大学第二医院收治的早期糖尿病肾病患者50例记为病变组,另取同期于该院进行体检的健康人员50例记为对照组。分别对两组人员进行彩色多普勒超声检查,比较肾血流参数。采用酶联免疫吸附法检测两组人员血清hs-CRP、VEGF水平,并作指标间的相关性分析。结果:病变组肾主动脉、肾锥体两侧叶间动脉、肾段动脉的收缩期峰值速度、舒张期最低速度较对照组降低,病变组肾主动脉、肾锥体两侧叶间动脉、肾段动脉的阻力指数较对照组升高(均P0.05)。病变组血清hs-CRP、VEGF水平较对照组升高(均P0.05)。经Pearson相关性分析显示:早期糖尿病肾病患者肾主动脉、肾锥体两侧叶间动脉、肾段动脉的血流阻力指数与血清hs-CRP、VEGF均呈正相关关系(均P0.05)。结论:彩色多普勒超声应用于早期糖尿病肾病的诊断价值较高,且肾动脉血流阻力指数与血清hs-CRP、VEGF密切相关,临床工作中通过联合检测血清hs-CRP、VEGF,从而有助于早期糖尿病肾病的诊断。     

Chromosome‐level reference genome of X12, a highly virulent race of the soybean cyst nematode Heterodera glycines

Soybean cyst nematode (SCN, Heterodera glycines) is a major pest of soybean that is spreading across major soybean production regions worldwide. Increased SCN virulence has recently been observed in both the United States and China. However, no study has reported a genome assembly for H. glycines at the chromosome scale. Herein, the first chromosome‐level reference genome of X12, an unusual SCN race with high infection ability, is presented. Using whole‐genome shotgun (WGS) sequencing, Pacific Biosciences (PacBio) sequencing, Illumina paired‐end sequencing, 10X Genomics linked reads and high‐throughput chromatin conformation capture (Hi‐C) genome scaffolding techniques, a 141.01‐megabase (Mb) assembled genome was obtained with scaffold and contig N50 sizes of 16.27 Mb and 330.54 kilobases (kb), respectively. The assembly showed high integrity and quality, with over 90% of Illumina reads mapped to the genome. The assembly quality was evaluated using Core Eukaryotic Genes Mapping Approach and Benchmarking Universal Single‐Copy Orthologs. A total of 11,882 genes were predicted using de novo, homolog and RNAseq data generated from eggs, second‐stage juveniles (J2), third‐stage juveniles (J3) and fourth‐stage juveniles (J4) of X12, and 79.0% of homologous sequences were annotated in the genome. These high‐quality X12 genome data will provide valuable resources for research in a broad range of areas, including fundamental nematode biology, SCN–plant interactions and co‐evolution, and also contribute to the development of technology for overall SCN management.     

Urinary D-serine level as a predictive biomarker for deterioration of renal function in patients with atherosclerotic risk factors

Background: D-serine, the enantiomer of L-serine, was identified in mammals 20?years ago. Although a close relationship between D-serine and renal dysfunction has been shown, the clinical implications of urinary D- and L-serine in humans are poorly understood. The aim of this study was to evaluate the relationship between urinary D- and L-serine with well-known renal biomarkers, and clarify the prognostic value of D- and L-serine for renal events.

Methods: This cross-sectional, prospective study included 65 patients with atherosclerotic risk factors, who were followed up for a median of 16?months. The primary endpoint was a composite of end-stage renal disease and a decline in estimated glomerular filtration rate (eGFR)?≥?25% from baseline.

Results: Urinary D-serine concentrations showed a better correlation with eGFR than did urinary L-serine, whereas neither urinary D- nor L-serine correlated with tubular markers such as urinary liver-type fatty acid-binding protein and N-acetyl-beta-D-glucosaminidase. A Cox regression analysis revealed that low urinary D-serine levels were significantly associated with the primary endpoint after adjusting for confounding factors (hazard ratio 12.60; 95% confidence interval, 3.49–45.51).

Conclusions: Urinary D-serine is associated with glomerular filtration and can be a prognostic biomarker of renal dysfunction in patients with atherosclerotic risk factors.