The Protective Effect of the Asystasia Chelonoides Extracts on Hypertensive Nephropathy Rats

BACKGROUND/AIMS

Hypertensive nephropathy (HN) is one kind of kidney disorder caused by long-term uncontrolled hypertension, usually resulting in severe kidney damage, including inflammation and oxidative stress, no matter in cells or tissues, from patients with nephropathy. In recent years, nephropathy accompanied by hypertension is becoming one of the main causes for kidney replacement therapy, but few effective treatments have been reported for HN treatment. Asystasia chelonoides (AC) is a kind of plant with the effects of anti-inflammation, lowering blood pressure, and anti-oxidative stress. Still, the therapeutic effect of AC in HN rats is not clear.

METHODS

To establish HN model by feeding high sugar and high fat diet spontaneously hypertensive rats. Blood measurement, HE staining, PAS staining and biochemical analysis and were used to assess the therapeutic effects of AC extracts and western blotting analyzed the underlying mechanisms of AC extracts treatment in the HN rat model.

RESULTS

AC extracts could significantly lower systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) in HN rats; and reduce the expression of total protein (TP), blood urea nitrogen (BUN), microalbuminuria (MALB), creatinine (Cr), total cholesterol (TC), triglyceride (TG), and low-density lipoprotein-cholesterol (LDL-C) concentrations, and also could down-regulate expression of IL-6, MDA and AGEs, up-regulate the expression of SOD in HN rats; HE staining and PAS staining demonstrated that AC extracts could alleviate the histopathological changes in HN rats; western blotting demonstrated that AC extracts could up-regulate the expression of PPARγ and down-regulate the expression of TGFβ1 and NF-кB in HN rats.

CONCLUSION

The finding of the article demonstrated that AC extracts had the better therapeutic effect for HN, and provided the pharmacological evidences for AC extracts treatment for HN.

Yishen Huashi granule modulated lipid metabolism in diabetic nephropathy via PI3K/AKT/mTOR signaling pathways

Aim

Diabetic nephropathy (DN) is the primary cause of end-stage renal disease worldwide. Although etiology for DN is complex and still needs to be fully understood, lipid metabolism disorder is found to play a role in it. Previously, we found Yishen Huashi (YSHS) granule could inhibit diabetic damage and reduce level of microalbuminuria (mALB) in DN animals. To explore its role and mechanism in lipid metabolism under DN settings, this study was designed.

Materials and methods

DN rats were induced by streptozotocin (STZ), HepG₂ and CaCO₂ cells were applied for in vitro study. Hematoxylin-Eosin (HE), periodic acid-Schiff (PAS) staining, and Transmission Electron Microscopy (TEM) were applied for histological observation; 16s Sequencing was used for intestinal microbiota composition analysis; western blotting (WB) and immunofluorescence were carried out for molecular biological study, and enzyme-linked immunosorbent assay (ELISA) was used for lipid determination.

Results

YSHS administration significantly reduced levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL-C), while increased level of high-density lipoprotein (HDL-C); meanwhile, histological changes and steatosis of the liver was ameliorated, integrity of the intestinal barrier was enhanced, and dysbacteriosis within intestinal lumen was ameliorated. Mechanism study found that YSHS modulated mitophagy within hepatocytes and inhibited mTOR/AMPK/PI3K/AKT signaling pathway.

Conclusion

In conclusion, we found in the present study that YSHS administration could ameliorate lipid metabolism disorder in DN animals, and its modulation on intestinal-liver axis played a significant role in it.

The protective effect of Bajijiasu on treatment of hypertensive nephropathy in rats

BACKGROUND/AIMS

Hypertensive nephropathy (HN) is a kind of renal diseases caused by essential hypertension, eventually worsens into end-stage renal disease (ESRD). HN could damage the renal tubules, induce kidney damage, renal failure, and increase the risk of stroke, heart disease or death, but there are few ideal drugs for HN treatment.

METHODS

In this study, we explored the therapeutic effect of bajijiasu (a compound from Morinda officinalis how and a common traditional Chinese medicine for tonifying the kidney) on the HN rat model. Biochemical analysis, HE staining, and PAS staining were used to assess the effects of bajijiasu on HN rat model, western blotting was used to analyze the potential mechanisms.

RESULTS

The results of HE staining and PAS staining showed that bajijiasu could alleviate the pathological changes in HN rat models; biochemical analysis found that the concentration of Malondialdehyde (MDA), total protein (TP), albumin (ALB), microalbuminuria (MALB), blood urea nitrogen (BUN), creatinine (Cr), triglyceride (TG), and low-density lipoprotein-cholesterol (LDL-C) were significantly decreased compared with model group after bajijiasu treatment; and bajijiasu could regulate the expression of TNF-α, IL-6, MDA, SOD1 and AGEs in HN rats; the result of western blotting demonstrated that bajijiasu could down-regulate the expression of TGFβ1, NOX4, JNK, p-JNK and up-regulate the expression PPARγ and SOD 1 in HN rats.

CONCLUSION

Those results demonstrated that bajijiasu could alleviate the pathological changes, physiological and biochemical symptoms of HN rat models by regulating the expression of TGFβ1, PPARγ, JNK, p-JNK, NOX4 and SOD1, but could not lower the blood pressure of HN rats. Those evidences may provide a new therapeutic method for HN treatment.

Yishen Huashi Granules Ameliorated the Development of Diabetic Nephropathy by Reducing the Damage of Glomerular Filtration Barrier

Background: Diabetic nephropathy (DN) is one of the most common complications of diabetes and the primary cause of end-stage renal disease. At present, renin–angiotensin–aldosterone system (RAAS) blockers have been applied as first-class drugs to restrain development of DN; however, its long-term effect is limited. Recent evidence has shown definite effects of Chinese medicine on DN. Yishen Huashi (YSHS) granule is a traditional Chinese Medicine prescription that has been used in the clinic to treat DN, but its mechanism is not understood.

Methods: In the present study, both in vitro and in vivo studies were carried out. The DN model was induced by STZ in Wistar rats, and GEnC and HPC cell lines were applied in the in vitro study. Quality of YSHS was evaluated by LC-MS/MS. A metabolomic study of urine was carried out by LC-MS; influence of YSHS on composition of DN was analyzed by network pharmacology. Mechanism of the YSHS on DN was analyzed by Q-PCR, Western Blot, and multi-immunological methods.

Results: We found YSHS administration significantly reduced levels of HbA1c and mALB. Histopathological analysis found that YSHS preserved integrity of glomerular filtration barrier by preserving viability of glomerular endothelial cells and podocytes, inhibiting glomerular fibrosis, reducing oxidative stress damage, and enhancing cross-talk among glomerular endothelial cells and podocytes. Network pharmacology, differential metabolite analysis, as well as intracellular pathway experimental study demonstrated that the PI3K/AKT/mTOR signaling pathway played a pivotal role in it.

Conclusion: Our present findings supplied new understanding toward the mechanism of YSHS on inhibiting DN.

Strategies to work with HLA data in human populations for histocompatibility, clinical transplantation, epidemiology and population genetics: HLA-NET methodological recommendations

HLA-NET (a European COST Action) aims at networking researchers working in bone marrow transplantation, epidemiology and population genetics to improve the molecular characterization of the HLA genetic diversity of human populations, with an expected strong impact on both public health and fundamental research. Such improvements involve finding consensual strategies to characterize human populations and samples and report HLA molecular typings and ambiguities; proposing user-friendly access to databases and computer tools and defining minimal requirements related to ethical aspects. The overall outcome is the provision of population genetic characterizations and comparisons in a standard way by all interested laboratories. This article reports the recommendations of four working groups (WG1-4) of the HLA-NET network at the mid-term of its activities. WG1 (Population definitions and sampling strategies for population genetics’ analyses) recommends avoiding outdated racial classifications and population names (e.g. ‘Caucasian’) and using instead geographic and/or cultural (e.g. linguistic) criteria to describe human populations (e.g. ‘pan-European’). A standard ‘HLA-NET POPULATION DATA QUESTIONNAIRE’ has been finalized and is available for the whole HLA community. WG2 (HLA typing standards for population genetics analyses) recommends retaining maximal information when reporting HLA typing results. Rather than using the National Marrow Donor Program coding system, all ambiguities should be provided by listing all allele pairs required to explain each genotype, according to the formats proposed in ‘HLA-NET GUIDELINES FOR REPORTING HLA TYPINGS’. The group also suggests taking into account a preliminary list of alleles defined by polymorphisms outside the peptide-binding sites that may affect population genetic statistics because of significant frequencies. WG3 (Bioinformatic strategies for HLA population data storage and analysis) recommends the use of programs capable of dealing with ambiguous data, such as the ‘gene[rate]’ computer tools to estimate frequencies, test for Hardy–Weinberg equilibrium and selective neutrality on data containing any number and kind of ambiguities. WG4 (Ethical issues) proposes to adopt thorough general principles for any HLA population study to ensure that it conforms to (inter)national legislation or recommendations/guidelines. All HLA-NET guidelines and tools are available through its website http://hla-net.eu.

Report from the killer immunoglobulin-like receptor (KIR) anthropology component of the 15th International Histocompatibility Workshop: worldwide variation in the KIR loci and further evidence for the co-evolution of KIR and HLA

The killer immunoglobulin-like receptor (KIR) anthropology component of the 15th International Histocompatibility Workshop (IHIWS) sought to explore worldwide population variation in the KIR loci, and to examine the relationship between KIR genes and their human leukocyte antigen (HLA) ligands. Fifteen laboratories submitted KIR genotype and HLA ligand data in 27 populations from six broad ethnic groups. Data were analyzed for correlations between the frequencies of KIR and their known HLA ligands. In addition, allelic typing was performed for KIR2DL2 and 3DL1 in a subset of populations. Strong and significant correlations were observed between KIR2DL2, 2DL3 genotype frequencies and the frequency of their ligand, HLA-C1. In contrast, only weak associations were seen for 3DL1, 3DS1 and the HLA-Bw4 ligand. Although some aspects of the correlations observed here differ from those reported in other populations, these data provide additional evidence of linked evolutionary histories for some KIR and HLA loci. Investigation of allele-level variation for the B haplotype locus KIR 2DL2 showed that two alleles, *001 and *003, predominate in all populations in this study. Much more allelic variation was observed for the A haplotype locus 3DL1, with several alleles observed at moderate frequencies and extensive variation observed between populations.

A simulation study on the abatement of CO2 emissions by de-absorption with monoethanolamine

Because of the adverse effect of CO2 from fossil fuel combustion on the earth's ecosystems, the most cost-effective method for CO2 capture is an important area of research. The predominant process for CO2 capture currently employed by industry is chemical absorption in amine solutions. A dynamic model for the de-absorption process was developed with monoethanolamine (MEA) solution. Henry's law was used for modelling the vapour phase equilibrium of the CO2, and fugacity ratios calculated by the Peng-Robinson equation of state (EOS) were used for H2O, MEA, N2 and O2. Chemical reactions between CO2 and MEA were included in the model along with the enhancement factor for chemical absorption. Liquid and vapour energy balances were developed to calculate the liquid and vapour temperature, respectively.

A 3-year follow-up study of psychosocial functioning and general symptoms in settled refugees

OBJECTIVE

Few community studies have addressed the longitudinal course of post-traumatic stress disorder (PTSD) in traumatized refugees in early resettlement. This longitudinal study investigated changes from the first (T1) to the second interview (T2), 3 years later. The relationship between traumatic exposures and psychosocial factors/psychological symptom load were examined.

METHOD

Local health professionals performed the interviews, using rating scales and a structured questionnaire. A total of 240 (52%) refugees attended.

RESULTS

Unchanged Hopkins Symptom Checklist-25 and increase in Harvard Trauma Questionnaire and post-traumatic stress symptoms-16 between T1 and T2 were found, indicating the severity and chronicity of problems. Mean post-traumatic stress score was 15% above cut-off. Severe life-threatening trauma and present life in exile with unemployment and unresolved family reunion were risk factors.

CONCLUSION

Early diagnostic interview should be followed by targeted approach. Pinpointing those in need of specialist services is essential. An interdisciplinary approach is necessary in this work.

[Phlegmasia cerulea dolens as the initial symptom of abdominal aortic aneurysm]

Phlegmasia cerulea dolens is a serious condition and a result of central venous obstruction which can lead to venous gangrena and amputation of the affected limb. Multiple underlying conditions are described: malignant disease, trauma and hypercoagulable states such as heparin-induced thrombocytopenia, deficiency of protein C and antithrombin III. Phlegmasia cerulea dolens is also described as complication to insertion of a vena caval filter. We present a patient who developed phlegmasia cerulea dolens in his left lower limb as a result of an undiagnosed lumbal aortic aneurysm. To our knowledge this is the first report of phlegmasia cerulea dolens as the initial symptom of an abdominal aneurysm.

[Ruptured splenic artery aneurysm in pregnancy--a case report]

Ruptured splenic artery aneurysm in pregnancy is a serious condition with high mortality rates for both mother and child. Early diagnosis and surgical intervention without delay is essential to avoid a fatal outcome. The diagnosis should be considered in pregnant women with upper abdominal pain. We describe a patient with ruptured splenic artery aneurysm in pregnancy. Both mother and child survived.

[Torture-related injuries--a medical challenge. Diagnosis and treatment of Falanga victims]

Torture victims are generally reluctant to present complaints linked to the torture. Many patients from refugee populations have experienced traumatic events such as war, violence and torture. Health professionals need to know more about the nature of these traumas, and how to diagnose the sequelae of torture. If they are to give torture victims adequate treatment they need to be familiar with the relevant diagnostic procedures, and how to treat health problems caused by systematic violence. A clinical case history is used to present the method of torture called Falanga, the beating of the soles of the feet. The case shows how the diagnosis and treatment of the physical injuries have a marked effect on the rehabilitation process. After receiving treatment for his foot injuries, patient's physical and mental health both improved dramatically, as did his psychosocial rehabilitation.

[Rhabdomyolysis in self-induced poisoning. A prospective study]

In a prospective study of 103 patients hospitalized for self-poisoning the incidence of rhabdomyolysis (creatine kinase > 1000 U/l) was nearly 7%. A further 9.7% had elevated creatine kinase activity, but lower than 1000 U/l. Two patients showed clinical symptoms of rhabdomyolysis at time of admission; one after heroin and the other after salicylate intoxication. Both developed renal failure, and one of them underwent peritoneal dialysis. The high incidence of rhabdomyolysis found in the study suggests that creatine kinase activity should be considered in all cases of intoxication admitted to hospital. Rhabdomyolysis may often present no symptoms even in conscious patients, and serious complications can be limited by preventive measures if rhabdomyolysis is recognized early.

[Spontaneous gastrocolic fistula in stomach ulcer]

Spontaneous development of a gastrocolic fistula following a benign unoperated gastric ulcer is a rare complication. This complication seems to occur more frequently, however, as a side-effect of increased use of anti-inflammatory medication. A 61-year-old woman developed abdominal pain and diarrhoea, and lost weight, after several years of treatment with indomethacin. During diagnostic endoscopy the gastroscope unexpectedly passed to the transverse colon through a relatively large ulcerous gastrocolic fistula. The patient was successfully treated by en bloc resection of the stomach and transverse colon.

Two sensitivity levels of cattle oocytes to puromycin

Germinal vesicle breakdown (GVBD) in cumulus-enclosed and denuded cattle oocytes was sensitive to puromycin at concentrations at or above 50 micrograms/ml. Media supplemented with 5-25 micrograms/ml of puromycin did not significantly reduce either rate or sequence of GVBD after 8 h of culture (82-96% GVBD). In concentrations of 50, 75, and 100 micrograms/ml, GVBD occurred in 15, 4, and 2% of oocytes, respectively. However, 50 micrograms puromycin/ml did postpone the time sequence of GVBD, since all treated oocytes underwent GVBD after 20 h of culture. Oocytes arrested in the germinal vesicle (GV) stage possessed GV filled with highly condensed bivalents. The puromycin block (100 micrograms/ml) was fully reversible, and the time sequence of GVBD was two times faster than in control medium. Proteins important for GVBD were synthesized during the first 4 h of culture, and 81% of oocytes underwent GVBD when puromycin (100 micrograms/ml) was added after 4 h of preincubation in control medium. The first polar body (I PB) expulsion was more sensitive to inhibition of protein synthesis, as shown by the observation that 2.5 and 5 micrograms puromycin/ml significantly (69 and 61%) reduced the incidence of Metaphase II, and 10 micrograms/ml highly significantly (31%) reduced it. The I PB expulsion in concentrations of 25 and 37 micrograms puromycin/ml was less than 5%. The subsequent culture in puromycin (8 h) and 6-dimethylaminopurine (8 h) proved that nuclear membrane breakdown is less sensitive to inhibition of protein phosphorylation than the process of chromatin condensation.

[Correction of severe hyponatremia]

Profound hyponatremia is a life-threatening emergency which can result in permanent neurological damage. The rate at which severe hyponatremia should be corrected is the focus of clinical debate. It is important, however, to differentiate chronic from acute hyponatremia and to develop a plan for correcting hyponatremia. A treatment regime is suggested.

[Severe, symptomatic hyponatremia]

Severe hyponatremia (serum sodium levels less than 120 mmol/l) is associated with increased morbidity and mortality. We report three cases where patients developed hyponatremia and severe neurological manifestations after medical treatment. The first two patients experienced episodes of general seizures and coma, but recovered in 24 hours without neurologic sequelae after correction of the electrolyte disturbance. The third patient developed the syndrome central pontine myelinolysis with pseudobulbar palsy and quadriparesis. Marked improvement occurred, however, and in three months the patient was almost completely recovered. The development of hyponatremia deserves special attention in connection with the use of diuretics, infusion of sodium-free carbohydrates and immediately after operation.

[Organophosphate poisoning]

Three cases of poisoning by organophosphate dimethoate are described and the importance of correct diagnosis and adequate treatment emphasized. Therapy consists of large doses of atropine, to counteract the muscarinic and other effects on the central nervous system, followed by a reactivator (e.g. toxogonin) to reverse muscle weakness (nicotinic effects).

Epidural analgesia vs. general anesthesia for cesarean section

A prospective study based upon interviews included 92 women who had undergone cesarean section, 38% with epidural analgesia and 62% under general anesthesia. The two groups were compared with respect to anesthesiological complications, postoperative morbidity and birth experience. The puerperal period was less complicated after epidural analgesia than after general anesthesia. There was a quicker re-establishment of the gastrointestinal function after epidural analgesia and the patients were more quickly mobilized and less tired. The overall morbidity after cesarean section, 16%, was lower than in other studies. Nearly half of the patients in the epidural experienced slight peroperative pain. In the case of repeated cesarean section, 86% of women who had epidural analgesia wanted the same anesthesia again. On the basis of this study, epidural analgesia is recommended for cesarean section.

Effect of epidural vs. general anesthesia on breastfeeding

In a prospective interview study, two groups each consisting of 28 sectio caesarea patients were compared concerning the course of breastfeeding. The women in the two groups were delivered under either epidural analgesia or general anesthesia. The two groups were identical with respect to age, parity, participation in antenatal preparatory courses and former breastfeeding. A significantly higher breastfeeding frequency and longer breastfeeding periods were were found after epidural analgesia than after general anesthesia.

[Acquired renal cysts in maintenance dialysis patients]

Ultrasonographic examination of the kidneys of 111 patients on long term maintenance hemodialysis was performed. None of the patients had genuine polycystic kidney disease. In many patients acquired cysts were found. Frequency and volume of these cysts were the same on the right and left side. There was no correlation between the age of the patients and the number of cysts. There were no differences concerning sex and type of primary renal disease. There was a significant positive correlation between time on maintenance hemodialysis and number of cysts but no correlation between number of cysts and hemoglobin concentration. This is in contrast to data in the literature. Clinical relevance of acquired kidney cysts in dialysis patients concerns hematuria, retroperitoneal bleeding, kidney stone formation, septicemia and malignancy.