Yan Zha

Role of the Wnt/β-catenin signaling pathway in inducing apoptosis and renal fibrosis in 5/6-nephrectomized rats

Renal fibrosis is the final common pathway of all progressive renal disease. Excessive and chronic activation of the Wnt/β-catenin signaling pathway results in chronic kidney disease (CKD) progression. To mimic CKD, the present study used 5/6-nephrectomized rats, and alterations in kidney histology, expression of β-catenin and renal cell apoptosis were assessed. In addition, mesangial cells were cultured in vitro and transfected with β-catenin siRNA to evaluate the effect of blocking Wnt/β-catenin signaling on cell apoptosis and the expression of markers of renal fibrosis. The results demonstrated that CKD rat kidney tissues exhibited moderate renal fibrosis and significantly increased expression levels of β-catenin and apoptosis associated proteins compared with sham-operated rats. In vitro, silencing of β-catenin by siRNA attenuated tumor necrosis factor-α-induced apoptosis and decreased mRNA expression levels of various markers of fibrosis, including fibronectin, transforming growth factor-β, and collagen I, III and IV. In conclusion, inhibition of Wnt/β-catenin signaling by β-catenin silencing attenuated apoptosis and expression of fibrosis-associated markers in renal cells. The present study suggested that the Wnt/β-catenin signaling pathway may serve as a potential treatment strategy for renal fibrotic disorders.

Inhibitor of IGF1 receptor alleviates the inflammation process in the diabetic kidney mouse model without activating SOCS2

Objective To explore the anti-inflammatory mechanism of IGF1R inhibitor in diabetic nephropathy. Methods C57/BL6 mice were reared with high-fat diet for 8 weeks, then were injected 30 mg/kg streptozotocin intraperitoneally to induce type 2 diabetes. After 8 weeks, the type 2 diabetes nephropathy model was successfully set up the different drugs were administrated to mice with diabetes (insulin 1–2 U/day, benazepril 10 mg/kg per day intragastrically, IGF-1R inhibitor 30 mg/kg per day intragastrically). After 8 weeks drugs administration, all mice were collected the kidney tissue, measured levels of inflammatory factor (F4/80, TLR4and CD68) and fibrosis markers(αSMA, E-cadherin and SR) using immunohistochemistry and in situ hybridization. Results The type 2 diabetes nephropathy model was built successfully, which along with increased urinary protein excretion rate and increased inflammatory infiltration, and the correlation was characterized by increased CD68+, F4/80+ cells and increased TLR4, αSMA, SR expression. IGF-1R inhibitors reversed this changes, but benazepril and insulin were without significant changes. The insulin decreased the expression level of IGF-1, and increased the levels of suppressor of cytokine signaling 2 (SOCS2). Benazepril and IGF-1R inhibitor were no significant changes like insulin. Conclusion Inhibition of IGF1R was a more effective choice for inflammation treatment than Ben or Ins in diabetic kidney disease (DKD). The IGF1R inhibitor blocked pathological changes induced by the over-expression of IGF1 in DKD without up-regulating SOCS2 protein levels.

Application of mini-clinical evaluation exercise for assessing the integrated-based learning during physical diagnostic course.

Medical education paradigm has been questioned for the requirements of improving the quality and quantity of medical students. This study was to explore the efficiency of integrated‐based learning (IBL) used mini‐clinical evaluation exercise (mini‐CEX) during physical diagnostics course. One hundred and eleven volunteered students were randomly divided into three groups: lecture‐based learning (LBL), case‐based learning (CBL), and IBL. Nephrotic syndrome was the teaching content. In the IBL group, students were provided the guideline and additional interpretation from the instructor about the basic knowledge related to disease as vertical integration curriculum. Their performance was evaluated by mini‐CEX and theoretical examination, respectively. All subjects have completed the study. The difference of five factors (medical interview, physical examination, clinical judgment, organizational effectiveness, and competence) in mini‐CEX between IBL, CBL, and LBL were statistically significant (p <0.05). Sample sizes of below, meets, and above the expectations of mini‐CEX in different instructional groups were statistically significant (X2 =17.842, p =0.001). The final exam scores in IBL group and the CBL group were significantly higher than that of LBL group (F =41.553, p =0.000). And the relationship of final exam score only in the IBL group was positive existed with medical interview (R =0.466, p =0.004), physical examination (R =0.328, p =0.048), professional attitude (R =0.366, p =0.026), and communication skill (R =0.412, p =0.011). Therefore, our study revealed the effect of IBL on the medical students’ skills. It highlights IBL could improve the physical examination, organizational effectiveness, and competence and the application of basic knowledge.

Blood pressure variability is independent of systolic pressure in adolescent and young adult patients undergoing hemodialysis

BackgroundPre-dialysis blood pressure variability (BPV) in adolescent and young-adult maintenance hemodialysis (MHD) patients remains unknown. This study aimed to show the degree of 44-h BPV and to explore its related risk factors in adolescent and young-adult MHD patients.MethodsOne hundred and fifty-three hemodialysis patients aged from 14 to 29 were selected from 11 medical facilities in Guizhou, China. Variability independent of the mean BP (VIM) obtained by 44-h ambulatory BP monitoring was used to calculate BPV. Baseline characteristics, physical measurement, and laboratory parameters were compared between different groups categorized by quartiles of VIM of systolic BP (VIMSBP).ResultsVIMSBP levels were found to be positively related to interdialytic weigh growth rate (IDWG), serum phosphorus, and serum intact parathyroid hormone (iPTH; Spearman correlation coefficients 0.474, 0.229, and 0.437, respectively; P<0.05 for all) and negatively related to hemoglobin (Hb) and albumin (−0.317, P<0.001, and −0.166, P=0.04, respectively) in all adolescent and young-adult MHD patients. In multiple linear regression analysis, IDWG, Hb, serum phosphorus, and serum iPTH had an independent association with VIMSBP.ConclusionOur analysis revealed an independent association of BPV with IDWG, Hb, serum phosphorus, and serum iPTH among adolescent and young-adult patients undergoing dialysis. This observation warrants further study.

Omega-3 Fatty Acids Supplementation on Systemic Inflammatory Biomarkers and Albumin in Dialysis Patients: Meta-analysis of Randomized Clinical Trials

of peritoneal dialysis catheter insertion were advocate complete bed rest for 1e3 days in the past years. But most patients suffered from poor dialysate drainage, drifting tube and voiding difficulty after complete bed rest. The aim of this study was to explore whether early ambulation could reduce the incidence of drift tube in peritoneal dialysis patients after peritoneal dialysis catheter insertion. Methods: We included 134 patients with end-stage renal disease (ESRD) who are undergoing peritoneal dialysis in peritoneal dialysis center of Guizhou Province. Patients were divided into 2 groups randomly. Patients with six hour ambulation after the operation of peritoneal dialysis catheter insertion were allocated to the study group, and patients who got the traditional postoperative care were assigned to the control group. No obvious difference was found between the two groups in age, gender, dialysis tube type, catheter way, and dialysis prescriptions. The incidence of drift tube in thease patiets was recorded and catheter patency rate was compared. Results: The catheter patency rate in the study group was 97.01%, and 91.04% in the control group. The incidence of drift tube was 1.49% in the study group and 5.97% in the control group. Differences between the two groups were statistically significant, P < 0.05. Conclusion: Six hour ambulation after the operation of peritoneal dialysis catheter insertion could induce the incidence of drifting tube.

Early Ambulation and Incidence of Drift Tube After Peritoneal Dialysis Catheter Insertion

coculture system using Transwell. After the coculture is done, the gene and protein expression level of PMCs in up wells are tested by RT-PCR, Immunofluorescence and Western blotting respectively. Results: The IL-10 mRNA expression level all decrease in 6e24 h while increase 24 h later, and is lower in M1 than other groups (M0, M2a, and M2c). M1 shows high expression of IL-6, IL-12, while the M2a and M2c relatively lower. The mRNA expression level of CCL17 is higher in M2a while CCL17 higher in M2c. Compared to the control group, fluorescence intensity of E-cadherin in coculture groups is decreased, and the M2c group is the most obvious with statistical difference (P < 0.05). The fluorescence intensity of a-SMA in PMCs cocultured with macrophage is higher than the control group. The gene expression of E-cadherin in PMCs is down-regulated when cocultured with M2c (P < 0.05). a-SMA expression level is up-regulated after cocultured with M2a or M2c (P < 0.05). Compared with the control group, the protein expression of E-cadherin is down-regulated and a-SMA is upregulated when cocultured with M2c. Conclusion: We successfully inducemacrophage subsets (M1, M2a, M2c) differentiation using THP-1 with TPA and LPS+IFN-g, IL-4, IL-10. 2. Macrophage subtypes up-regulate a-SMA expression and down-regulate E-cadherin, promoting EMT of PMCs in some degree. And the effect of M2c is the most significant.

Analysis of Pathogens and Drug Resistance in Peritonitis in Elderly Patients Treated with Continuous Ambulatory Peritoneal Dialysis

December 2014. For comparison purposes, patients were divided into 2 groups: control group used the practical course of PD programs eight step operation, five steps to take over (n Z 20), experimental group used modified PD in fluid technology training (n Z 20), the method of five step over simplified into three steps: a pull, right hand holding dual system pipeline, left a TAB. Second, twist, left hand picked up the short tube, right index finger and thumb and iodine caps unscrewed to abandon. Three, will be a short tube end both connect tighten with double systems. Two groups of patients adopt the Baxter duplex system, observed in the qualified rate of liquid in operation, completed the training time and the incidence of peritonitis have statistically significant. Results: There was no statistical significance in liquid operation qualification rate. Compared with the control group (7.2 1.3 days), experimental group (3.6 1.5 days) completed the training time significantly shortened (p< 0.05) and less the incidence of peritonitis dropped significantly (p< 0.05). Conclusion: The proportion of the aged with PD is rapidly progressive growth worldwide, elderly patients with metabolic disorders, disorders of thinking, memory loss, slow, insensitive, decreased vision physiological functions such as degenerative changes. Modified of PD in fluid technology will take over the five step method to three steps, can effectively avoid the connection cause “around” action caused in the process of exposure to pollution, and can solve some insufficient efforts in elderly patients because of the little finger and ring finger to grip the dual system. Not only reduced PD training time, but also to reduce the incidence of peritonitis significantly.