Nrf2 和HO_1 在肾癌组织中的表达及意义

目的：探讨肾癌组织Nrf2 和HO_1 表达水平变化及其临床意义。方法：选择经手术切除肾癌组织标本42 例及正常肾组织42 例作为研究对象,42 例患者均未接受化疗或者放疗,采取免疫组织化SABC法测定Nrf2 和HO_1 表达水平,并进行统计学分析。 结果：Nrf2 及HO_1 于肾癌组织及正常肾组织均有不同程度表达,且主要表达于肿瘤细胞胞浆,肾癌组中Nrf2 阳性35 例 （83.3%）,显著高于正常肾组织14例（33.3%）,差异具有统计学意义,P<0.05。肾癌组HO_1 表达阳性31 例（73.8）,显著高于正常 肾组织组15 例（35.7）,差异具有统计学意义,P<0.05。肾癌组织Nrf2和HO_1 表达水平成正相关,r=0.536。结论：肾癌组织Nrf2 和 HO_1表达水平较正常组织更高,且两者之间呈正相关,表明Nrf2 和HO_1 在肾癌进展中起着重要作用。     

The effect of graded renal nerve stimulation on renal function in the anaesthetized rabbit

The renal nerves of the rabbit were stimulated to cause less than 5, 9 or 22% reduction in renal blood flow. Glomerular filtration rate was reduced by 0, 3 and 11% respectively when the renal nerves were stimulated at these increasing rates. At low and moderate rates of renal nerve stimulation absolute and fractional sodium excretions were reduced by between 17 and 22%, but at the highest rates they were reduced by 55 and 53% respectively. At increasing rates of renal nerve stimulation plasma renin activity was increased by 40, 70 and 180%.     

慢性肾衰竭大鼠模型的建立

目的 建立两种慢性肾衰竭大鼠模型,观察瘦素蛋白在大鼠组织、器官中的表达.方法 建立两种慢性肾衰竭CRF动物模型:(1)大鼠肾大部分切除诱发肾衰(Platt法).(2)腺嘌呤诱发大鼠慢性肾衰竭的动物模型(Yokozawa法).分别测定血清中血尿素氮(BUN),血肌酐(Scr)Ca2+、P5+等含量.取肾脏组织,HE染色,行免疫荧光,检测瘦素蛋白在两种慢性肾衰竭大鼠模型中的表达情况.结果 模型组大鼠血清中血尿素氮(BUN),血肌酐(Scr)等含量明显升高,免疫荧光检测显示两种模型大鼠肾脏组织瘦素蛋白的表达.结论 成功建立两种慢性肾衰竭CRF动物模型,显示不同模型组织部位的瘦素蛋白的表达.为进一步探讨瘦素蛋白在动物体内的生物学作用提供实验基础.     

大鼠左肾静脉狭窄致左肾淤血性损伤模型的建立

目的观察大鼠左肾静脉不同程度狭窄所致左肾病变,为实验研究左肾静脉受压综合征肾组织淤血性损伤提供合适的动物模型。方法采用左肾静脉不全结扎的方法建立大鼠左肾静脉狭窄模型。将大鼠分为4组,假手术组和左肾静脉狭窄1.0mm模型组、0.7mm模型组、0.5mm模型组。术后7周处死动物。肾组织行病理学检查。肾皮质匀浆检测丙二醛（MDA）含量和超氧化物歧化酶（SOD）活性。结果病理学检查见1.0mm模型组未见明显病变,0.7mm和0.5mm模型组肾小球系膜区增生,小管、间质细胞浸润和纤维化形成,0.5mm模型组病变程度较重。各模型组左肾皮质丙二醛含量均显著增高,超氧化物歧化酶活性均显著降低,变化幅度随狭窄程度的增大而增大。结论大鼠左肾静脉狭窄程度为0.7mm时,各项观察指标与胡桃夹综合征（NCS）患者的临床实际情况最接近,而1.0mm和0.5mm相对偏轻和偏重,0.7mm模型组可以作为大鼠左肾静脉狭窄致左肾淤血实验研究的合适模型。     

缺血预处理通过激活自噬保护肾缺血-再灌注损伤

目的:探讨缺血预处理对缺血-再灌注所致急性肾损伤的保护作用与可能机制。方法:将健康雄性SD大鼠18只随机分为三组:假手术组(Sham组)、肾缺血组(I/R组)、实验组,Sham组大鼠开腹后游离左侧肾蒂血管,不夹闭,观察60 min关闭腹部。I/R组大鼠开腹后切除右肾,左肾蒂血管分离,观察15 min后用无损伤动脉夹持续夹闭左肾蒂血管45 min后,关闭腹部,恢复左肾血流。实验组开腹后切除切除右肾,左肾蒂血管分离,行4个循环夹闭左肾蒂血管1 min/再灌注4 min预处理后,无损伤动脉持续夹闭45 min,关闭腹部,恢复左肾血流。比较各组大鼠术后尿素氮值(Burea nitrogen,BUN)与肌酐值(Serum creatinine,SCR)水平,肾组织病理学评分及微管相关蛋白轻链3(Microtubule-associated protein l light chain 3,LC3)和自噬基因Beclin-1的表达。结果:所有大鼠在实验过程无死亡。I/R组、实验组再灌注后4 h、24 h的BUN与SCr值显著高于Sham组(P0.05),肾脏组织病理学评分显著高于Sham组(P0.05),实验组以上指标均显著低于I/R组(P0.05);I/R组LC3-Ⅱ/LC3-Ⅰ比值、Beclin-1相对表达量显著高于Sham组(P0.05),实验组以上指标均显著低于I/R组(P0.05)。实验组大鼠再灌注后24h LC3-Ⅱ/LC3-Ⅰ比值、Beclin-1相对表达量与肾组织病理学评分、BUN、SCr值呈显著相关性(P0.05)。结论:缺血预处理可能通过激活自噬,减轻缺血-再灌注所致急性肾损伤,并改善肾功能。     

Free tissue transfer in patients with renal disease

Several authors have cited renal disease as a risk factor for free flap failure. The authors performed a retrospective analysis of all patients who underwent free tissue transfer with concomitant renal disease, including acute renal failure, end-stage renal disease, chronic renal insufficiency, and functional kidney transplants, to determine what effect renal disease has on flap survival and overall reconstructive outcome. More than 1053 free flaps were examined. Renal disease was identified in 32 patients who underwent 33 free tissue transfers. Average patient age was 57 years (range, 36 to 80 years). Twelve patients (38 percent) were on chronic dialysis (end-stage renal disease), 18 patients (56 percent) had chronic renal insufficiency, and three patients (9 percent) had the diagnosis of acute renal failure at the time of surgery. Three patients in the chronic renal insufficiency group had a functioning renal transplant. Average follow-up was 16 months. Immediate postoperative complications occurred in 14 patients (42 percent of the 33 flaps). Overall perioperative mortality was 3 percent. Within the first 30 days there were two cases (6 percent) of primary flap failure; an additional four legs were lost as the result of complications related to their bypass grafts. There were no primary flap failures after 30 days; however, within the first year after surgery an additional seven limbs were lost as the result of progressive ischemia or infection, and an additional three patients died. This resulted in a 52 percent incidence of major morbidity or mortality during the first year and a 55 percent reconstructive success rate in survivors at 1 year. No significant difference was seen in postoperative morbidity or mortality when comparing the end-stage renal disease group to the chronic renal insufficiency group; however, patients with renal disease and diabetes tended to have poorer outcomes. Renal disease, especially renal disease associated with diabetes and peripheral vascular disease, can be a strong indicator of possible reconstructive failure. The surgeon and patient should be aware of the medical and surgical complications associated with this procedure at the outset.     

Purification and characterization of renal ferredoxin from bovine renal mitochondria

A renal ferredoxin was purified from bovine renal mitochondria to electrophoretic purity. The molecular weight of the renal ferredoxin was estimated by gel filtration and SDS-polyacrylamide gel electrophoresis to be 12,500 and 13,000, respectively. The optical absorption spectrum of renal ferredoxin in the oxidized form showed two peaks at 416 and 457 nm in the visible region, and the EPR absorption spectrum showed peaks at gx = gy =1.94 and gz = 2.02 in the reduced form at 13K. These spectra were typical of the 2S-2Fe type ferredoxins. Dissimilarities were recognized in the amino acid composition and isoelectric point between bovine renal ferredoxin and bovine adrenodoxin, but not in the optical, magnetic, and immunochemical properties. The reconstitution of 25-hydroxyvitamin D3-1 alpha-hydroxylase system was performed with the three components of NADPH-adrenodoxin reductase from bovine adrenal mitochondria, renal ferredoxin, and cytochrome P-450(1) alpha from bovine renal mitochondria. The results showed that the renal ferredoxin was essential for the 1 alpha-hydroxylase activity of 25-hydroxyvitamin D3.     

Renal tubular cell necrosis and apoptosis in transplanted kidneys

Renal wedge biopsies were taken from donors' kidneys immediately at the end of cold ischaemia and 30 min after transplantation in 11 cases. Five renal grafts showed immediate and six showed delayed renal function clinically. The ratio of apoptotic and necrotic renal tubular cells and Ki67 activity was determined in both biopsies. Necrotic and apoptotic as well as proliferating renal tubular cells were seen in all samples. Both apoptotic and proliferative activity was decreased in samples taken 30 min after transplantation in cases of immediate renal function compared to the samples taken before transplantation. This phenomenon was not observed in cases of delayed renal function.     

Systemic vasodilatation and renal sodium excretion: Effects of hydralazine and diazoxide

The effects on renal sodium excretion of two systemic vasodilators, hydralazine and diazoxide, were investigated in volume expanded, anesthetized rats with unilaterally denervated kidneys. Urinary sodium excretion and fractional excretion of filtered sodium increased following hydralazine but decreased following diazoxide. Changes in renal hemodynamics were dissimilar as well: renal plasma flow was increased following hydralazine, but unchanged with diazoxide. All changes in renal sodium excretion and renal hemodynamics following hydralazine were prevented by pretreatment with indomethacin. Renal denervation accentuated the increases in fractional sodium excretion and renal blood flow that occured following hydralazine.Hydralazine and diazoxide differ substantially in their effects on renal sodium excretion, apparently due to the stimulation of renal prostaglandins by the former agent. Although renal innervation attenuates the natriuretic effect of hydralazine, stimulation of the sympathetic nervous system does not account for differences in the renal effects of these two drugs.     

Viability of the kidney following autovenoplasty of its artery]

A segment of one of the renal arteries of the dog was substituted for a piece of the femoral vein of the same dog. Along the site of vascular anastomoses the kidney was excluded from general blood circulation. The results of the vessel plastics were not always favourable. Inspite of the independence of anastomoses in the course of operation, the lumen of the substituted piece of the renal artery underwent deformity in a number of experiments, the circulation of the kidney was disturbed, the parenchyma of the organ was injured, a part of renal bodies and tubules were atrophied, intraorganic vessels, especially glomeruli were reconstructed. The alterations were of focal character. In general the structure of the kidney was preserved. In most experiments the substitution of the renal artery for the own vein did not cause any disorders. The wall of the transplanted vein was soon reconstructed--artealized, the renal parenchyma kept normal structure. The success of vascular plastics and the full value of blood circulation was controlled by removing the twin organ. Animals with one kidney lived practically unlimited time without obvious disorders, the content of nitrogen in the blood was normal, no alterations were found in intraorganic vessels and the renal parenchyma.     

Differential sympathetic and angiotensinergic responses in rats submitted to low- or high-salt diet

The present study was designed to evaluate, in Wistar rats, the effect of high- or low-salt diet on the hemodynamic parameters and on the renal and lumbar sympathetic nerve activity. The renal gene expression of the renin angiotensin system components was also evaluated, aiming to find some correlation between salt intake, sodium homeostasis and blood pressure increase. Male Wistar rats received low (0.06% Na, TD 92141-Harlan Teklad), a normal (0.5% Na, TD 92140), or a high-salt diet (3.12% Na, TD 92142) from weaning to adulthood. Hemodynamic parameters such as cardiac output and total peripheral resistance, and the renal and lumbar sympathetic nerve activity were determined (n=45). Plasma renin activity, plasma and renal content of angiotensin (ANG) I and II, and the renal mRNA expression of angiotensinogen, renin, AT1 and AT2 receptors were also measured (n=24). Compared to normal- and low-salt diet-, high-salt-treated rats were hypertensive and developed an increase (P<0.05) in total peripheral resistance and lumbar sympathetic nerve activity. A decrease in renal renin and angiotensinogen-mRNAs and in plasma ANG II and plasma renin activity was also found in salt overloaded animals. The renal sympathetic nerve activity was higher (P<0.05) in low- compared to high-salt-treated rats, and was associated with an increase (P<0.05) in renal ANG I and II and with a decrease (P<0.05) in AT2 renal mRNA. Plasma ANG I and II and plasma renin activity were higher in low- than in normal-salt rats. Our results show that increased blood pressure is associated with increases in lumbar sympathetic nerve activity and total peripheral resistance in high-salt-treated rats. However, in low-salt-treated rats an increase in the renal sympathetic nerve was correlated with an increase in the renal content of ANG I and II and with a decrease in AT2 renal mRNA. These changes are probably in favor of the antinatriuretic response and the sodium homeostasis in the low-salt group.     

The effect of lidocain on the renal function

The evidence supporting a role for direct neurogenic control of renal function was investigated in twenty anaesthetized dogs. Unilateral renal sympathectomy was induced by 0.5 mg/kg/min of lidocain infusion into the left renal artery and the kidney function changes were compared to those observed in the right non infused kidney. The renal parameters were similar in the kidneys during the control periods. 0.5 mg/kg/min of lidocain infusion into the left renal artery resulted in significant reductions of the RBF, GFR, urine and sodium excretion in the left kidney. The intrarenal lidocain infusion induced a small decrease of the arterial blood pressure but this can not explain the changes observed in the left kidney. The modifications of the right kidney function during lidocain infusion were significantly less than those observed in the left kidney. Comparing the measured RBF and the renal blood flow calculated by the CPAH in the left kidney during the lidocain infusion, we have found a marked difference, when the decrease of the calculated RBF was greater. We believe that effects of pharmacological denervation can be best explained by the intrarenal hemodinamically mediated changes. The sympathectomy produces a considerable vasoconstriction in the renal cortical vascular bed, subsequently it decreases the RBF, GFR renal sodium and water excretion. But the lidocain blocks the sympathetic nerves influencing the renal medullary vessels and the renal medullary blood flow increases. These observations are not consistent with the notion that renal nerves are at least partially responsible for the natriuresis accompanying salt loading.     

Ultrasound studies in varicocele

Renal function, the anatomic and functional status of the vena cava inferior, renal arteries and veins, and spermatic veins were evaluated in healthy individuals and patients with varicocele before and 12 months after laparoscopic ligation of the left spermatic vein. The renal vessels were assessed by color Doppler ultrasonography and renal function was examined by complex radionuclide study with 99mTc-pentatech. There were no significant changes in the diameter of renal arteries and vena cava inferior and the right arterial blood flow velocities in healthy individuals and patients. No difference were found in the diameter of renal veins and in the blood flow velocity in renal arteries and veins. The enlarged renal veins and decreased mean blood flow velocity in the left renal vein in healthy persons and patients with varicocele and lower blood flow in the left renal artery than in the right one indicate left-sided renal hypertension that is attributable to left renal vein overload due to a great variety of collaterals and to compression at the site of "a forcepts". At the same time 12-month postoperative ultrasonic, Doppler and complex radionuclide studies revealed no significant changes in the diameter and blood flow velocity in the left renal vein.     

大鼠单根近端肾小管Na+-K+-ATPase活性测定方法的改进

本研究旨在对Doucet等报道的定量检测大鼠单根近端肾小管Na^＋-K^＋-ATPase活性方法进行改进。取经过Ⅱ型胶原酶消化的大鼠肾脏皮质组织,在体视显微镜下手工分离单根近端肾小管,并测量其长度,经低渗和冻融处理后与[γ-^32P]ATP共同孵育,液闪法检测从[γ-^32P]ATP解离出的^32Pi,采用修正后的公式计算Na^＋-K^＋-ATPase活性。改良法与Doucet等的方法比较,测定单根近端肾小管Na^＋-K^＋-ATPase活性无显著性差异（P〉0．05）。改进后的方法节省试剂,操作简便、省时。     

Microvascular disease precedes the decline in renal function in the streptozotocin-induced diabetic rat

Diabetic nephropathy is a progressive and generalized vasculopathic condition associated with abnormal angiogenesis. We aim to determine whether changes in renal microvascular (MV) density correlate with and play a role in the progressive deterioration of renal function in diabetes. We hypothesize that MV changes represent the early steps of renal injury that worsen as diabetes progresses, initiating a vicious circle that leads to irreversible renal injury. Male nondiabetic (ND) or streptozotocin-induced diabetic (D) Sprague-Dawley rats were followed for 4 or 12 wk. Renal blood flow and glomerular filtration rate (GFR) were measured by PAH and (125)I-[iothalamate], respectively. Renal MV density was quantified ex vivo using three-dimensional micro computed tomography and JG-12 immunoreactivity. Vascular endothelial growth factor (VEGF) levels (ELISA) and expression of VEGF receptors and factors involved in MV remodeling were quantified in renal tissue by Western blotting. Finally, renal morphology was investigated by histology. Four weeks of diabetes was associated with increased GFR, accompanied by a 34% reduction in renal MV density and augmented renal VEGF levels. However, at 12 wk, while GFR remained similarly elevated, reduction of MV density was more pronounced (75%) and associated with increased MV remodeling, renal fibrosis, but unchanged renal VEGF compared with ND at 12 wk. The damage, loss, and subsequent remodeling of the renal MV architecture in the diabetic kidney may represent the initiating events of progressive renal injury. This study suggests a novel concept of MV disease as an early instigator of diabetic kidney disease that may precede and likely promote the decline in renal function.     

肾移植术后患者同型半胱氨酸、肾功能和血脂水平的变化及其相关性分析

目的:分析肾移植术后患者血清的同型半胱氨酸(Hcy)、肾功能和血脂水平的变化和相关性,探讨其在肾移植术后评价肾功能的应用价值。方法:将2013年10月~2016年9月就诊于我院确诊慢性肾衰并进行肾移植手术的300例术后随访患者作为观察组,选择同期健康志愿者100例作为对照组。检测并比较两组Hcy、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平。根据观察组患者Hcy水平的不同将其分成Hcy正常组与Hcy异常组,并对比两组患者的血脂指标水平;测定半胱氨酸蛋白抑制剂C(CysC)的水平并计算肾小球滤过率(eGFR);对观察组血清Hcy与eGFR值、血脂指标水平进行相关性分析,并采用Logistic回归分析分析观察组肾移植术后eGFR下降的影响因素。结果:观察组患者的血清Hcy、TC、TG、HDL-C、LDL-C水平均明显高于对照组(P0.05)。Hcy异常组血清LDL-C水平明显高于Hcy正常组,而HDL-C水平明显低于Hcy正常组(P0.05)。观察组患者血清Hcy与eGFR、HDL-C水平呈负相关关系(r=-0.573、-0.414,P0.05);与TG水平呈正相关(r=0.432,P0.05),与TC、LDL-C无相关(P0.05)。多元Logistic回归分析显示,Hcy、TG、LDL-C水平均与患者eGFR下降有关(P0.05)。结论:在肾移植术后,慢性肾衰患者的TG、LDL-C、Hcy水平均升高,且伴有eGFR水平的降低;肾移植术后肾功能的改变与血清TG、LDL-C、Hcy水平相关;检测肾移植患者血脂指标、Hcy的水平可以评估移植肾功能受损情况。     

Properties of guanylate cyclase from rat kidney cortex and transplantable kidney tumors.

The subcellular distribution and properties of guanylate cyclase was examined in preparations of normal rat renal cortex and Morris renal tumors MK2 and MK3. In normal kidney cortex about two-thirds of guanylate cyclase activity of homogenates was found in soluble fractions. With renal tumors the homogenate activity was less and the enzyme was equally divided between particulate and soluble fractions. The particulate enzyme in kidney cortex and tumors was associated with all particulate fractions. Triton X-100 increased the activity of all preparations. All preparations preferred Mn2+ as the sole cation. The stimulatory effects of Ca2+ on soluble enzyme and inhibitory effects on particulate activity were similar with preparations of renal cortex and tumors. ATP inhibited all preparations. Soluble and particulate guanylate cyclases from renal cortex were activated several-fold with 1 mM NaN3. Preparations of tumor enzymes did not respond to NaN3. Thus, compared to normal renal cortex the subcellular distribution of guanylate cyclase and some of its properties are altered in preparations of renal tumors.     

Risk Evaluation of Selective Renal Arterial Embolization in the Treatment of Delayed Hemorrhage from Renal Artery Pseudoaneurysm After Partial Nephrectomy

Renal-artery pseudoaneurysm (RAP) is a well-described complication of partial nephrectomy. We aimed to evaluate the occurrence rate of delayed hemorrhage from RAP after partial nephrectomy, and to investigate the efficacy and safety of selective renal arterial embolization. Between January 2000 and December 2010, 426 partial nephrectomies were performed at our institution for treatment of small renal mass (SRMs). A retrospective review of these cases revealed that 14 patients developed a postoperative RAP (3.29 % incidence). We compared the clinical characteristics between the 14 patients with delayed renal hemorrhage and other 412 patients. RAP was diagnosed by renal angiography in 12 patients with delayed renal hemorrhage. Of the 12 patients, 10 patients were successfully treated with selective renal arterial embolization after presenting with symptoms postoperatively, 1 patient was treated with open surgery, and 1 patient was treated with nephrectomy. The other two patients showed no abnormalities in renal angiography, and the symptoms relieved by transfusion and hemostasis treatment. We found that tumor type, tumor size, tumor location, and surgical approach were significantly different between the 14 patients and other 412 patients. RAP showed a low incidence. The risk factors of RAP included renal cell carcinoma, tumor with large size, and tumor location. Most patients with delayed renal hemorrhage from RAP were successfully cured by selective renal arterial embolization. Therefore, selective renal arterial embolization can be used as the preferential therapy for RAP.     

Effects of inhibition of cystathionase activity on glutathione and metallothionein levels in the adult rat

The effects of alterations in sulfur metabolism on hepatic and renal metallothionein and glutathione metabolism were studied in the adult rat using inhibition of two enzymes of these pathways, hepatic cystathionase and renal gamma-glutamyl transpeptidase. Rats were fed a diet containing both methionine (0.66%) and cystine (0.20%) for 1 week before receiving three consecutive daily intraperitoneal injections of propargylglycine, a selective cystathionase inhibitor, at various doses (2.5–375 μmol/kg). When hepatic cystathionase was inhibited greater than 90% (≥50 μmol propargylglycine/kg), renal and hepatic metallothionein and hepatic glutathione were unaltered except at the highest dose. On the other hand, renal glutathione was increased twofold with a concomitant decrease in renal gamma-glutamyl transpeptidase activity (50% of control). In another experiment, when renal gamma-glutamyl transpeptidase was inhibited greater than 90% with three consecutive daily injections of acivicin, a selective gamma-glutamyl transpeptidase inhibitor (10 mg/kg IP), renal glutathione content was unaltered while hepatic glutathione was decreased. Renal and hepatic metallothionein were not changed. Thus, the cysteine pools for metallothionein and glutathione appear unrelated under the present experimental conditions. In addition, following either propargylglycine or acivicin injections, renal and hepatic glutathione pools appear to be altered differently. These results suggest that renal glutathione may be preferentially maintained even when hepatic glutathione is decreased.     

超微血流成像术用于肾移植患者术后评估的临床价值分析

目的:探讨超微血流成像术用于肾移植患者术后评估的临床价值。方法:选取我院2019年2月-2019年8月收治的60例肾移植患者的临床资料,根据术后恢复情况分为A、B、C三组,A组(27例,术后肾功能恢复良好)、B组(20例,术后发生过敏肾功能异常病变但治疗后肾功恢复正常)、C组(13例,术后血肌酐水平持续增高肾功能异常者),三组均采用超微血管流成像术检测血管指数,比较不同组患者的血管指数并分析其与血肌酐水平的关系。结果:三组患者的肾移植长径、前后径、左右径、皮质厚度、叶间动脉阻力指数比较无显著差异(P0.05)。C组患者的肾皮质血管指数(23.34±6.03%)明显低于A组(33.23±3.45%)、B组(31.23±4.23%)(P0.05)。肾功能异常患者肾皮质的血管指数较低,且随着血肌酐水平的升高而下降,两者呈显著负相关(r=-0.23,P0.05)。结论:超声微血流成像术用于肾移植患者术后评估可较好地反映肾皮质血供及术后肾功能的变化。