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Research progress of vimentin in lupus nephritis

Systemic lupus erythematosus is an autoimmune disease involving multiple organs of the body. Lupus nephritis is one of the most serious organ manifestations of systemic lupus erythematosus. Vimentin, a member of the intermediate filament protein family, is involved in the pathogenesis of many autoimmune diseases, including lupus nephritis. More and more studies have shown that vimentin plays an important role in the pathogenesis of lupus nephritis, and has an important influence on the disease development, treatment and prognosis of lupus nephritis. This review focuses on the structure, function and post-translational modification of vimentin, the relationship between vimentin and the pathogenesis of lupus nephritis, and the significance of vimentin expression levels in renal tissues, serum and urine, in order to provide theoretical basis for future mechanism research and clinical application.

小管间质性肾炎-葡萄膜炎综合征

小管间质性肾炎-葡萄膜炎综合征是一种新发现的疾病，多发生于青少年女性。其全身表现主要有乏力、体重减轻、发热、恶心呕吐、腹痛或腰痛，眼部一般表现为双眼非肉芽肿性前葡萄膜炎，葡萄膜炎和间质性肾炎发生的时间间隔一般在１年内。实验室检查发现贫血、红细胞沉降率增高、肾功能不全、尿beta;2-微球蛋白升高，肾活检显示肾间质炎症细胞浸润。细胞免疫可能在其发病中起重要作用。治疗以局部和全身应用糖皮质激素为主，预后较好，肾炎一般不复发，而葡萄膜炎易复发。 (中华眼底病杂志, 2002, 18: 325-326)

Mycophenolate Mofetil for Proliferative Lupus Nephritis: A Systematic Review

Objective　To assess the effectiveness and safety of mycophenolate mofetil (MMF) in the treatment of proliferative lupus nephritis. Methods　We searched CBM (November 1979 to February 2006), Chinese Cochrane Centre Database (2005), The Cochrane Library (Issue 4, 2005), MEDLINE (November 1966 to February 2006) and EMBASE (1975 to February 2006) for randomize controlled trials. Data were extracted and analyzed using The Cochrane Collaboration’s RevMan 4.2.7. Results　Nine randomize controlled trials involving 512 patients met the inclusion criteria. The meta-analysis showed that the total clinical effective rate and complete remission rate were not significantly higher for MMF than for cyclophosphamide, azathioprine, or both. Renal survival rate and relapse rate of MMF were not significantly different from those for cyclophosphamide, azathioprine, or both. Patient survival rate and safety of MMF were significantly improved compared with cyclophosphamide, azathioprine, or both. Conclusion　More large-scale multi-center randomized trials are needed to investigate the role of MMF in the treatment of proliferative lupus nephritis.

静脉环磷酰胺冲击治疗狼疮肾炎患者生存质量调查分析

目的:了解和分析静脉环磷酰胺冲击治疗狼疮肾炎患者的生存质量状况及主要影响因素。方法:使用中文版健康状况调查问卷简表－36量表对58例接受冲击治疗的患者进行生存质量调查。结果:狼疮肾炎冲击治疗患者量表各维度得分仍显著低于一般人群(Plt;0.01),但与普通SLE患者人群比较,量表PF、BP、GH、VT、SF等5个维度及综合评分均有显著提高(Plt;0.05);狼疮肾炎患者生存质量,特别是躯体功能,仅与环磷酰胺冲击治疗次数有明显的正相关rp＝0.3593,Plt;0.01),并使患者对自身健康状况评价有明显改善(HT与冲击次数呈负相关,rs ＝-0.318,P＝0.020),而与疾病的活动度及其它因素无明显的相关性。结论:坚持正规环磷酰胺冲击治疗,控制狼疮活动度以防止、减少对肾脏的损伤是提高狼疮肾炎患者生存质量的关键。

血浆置换成功治疗抗基底膜肾炎一例

Research progress on immunoglobulin A nephropathy with positive anti-neutrophil cytoplasmic antibody

In recent years, with the improvement and popularization of anti-neutrophil cytoplasmic antibody (ANCA) detection technology, more and more patients with immunoglobulin A nephropathy (IgAN) have been tested positive for serum ANCA. The clinical value of ANCA is still unclear, and there is a lack of consensus on diagnosis and treatment strategies. This article reviews the clinical and pathological characteristics, diagnosis, and treatment features of IgAN patients with serum ANCA positivity through literature reading and analysis, aiming to provide a reference for standardized diagnosis and individualized management of this type of patient.

急性肾小球肾炎继发双眼渗出性视网膜脱离一例

Characteristics and diagnostic value of temporal retinal thinning in young patients with Alport syndrome

ObjectiveTo observe the features of temporal macular thinning and its value for the diagnosis of Alport syndrome (AS) in young patients.MethodsEighty-one young patients with AS (81 eyes) from Peking University First Hospital during January 2016 and July 2017 were included in this study. There were 67 males (67 eyes) and 14 females (14 eyes),the aged from 3 to 17 years, with the mean age of 9.6 years. Among 81 patients (81 eyes), there were 64 patients with X-linked AS (XLAS, including 53 males and 11 females), 17 patients with autosomal recessive AS (ARAS, including 14 males and 3 females). One hundred healthy subjects aged 4 to 17 years were included as controls. Clinical data were retrospectively evaluated, including visual acuity, slit-lamp microscopy, dilated fundus photography, and OCT. Retinal thickness was measured with an OCT scan and the temporal thinning index (TTI) was calculated as stated in a previous study. The TTI values of each group was compared by One-way ANOVA or independent sample t test. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic effectiveness for AS.ResultsThe TTI of the control group, XLAS and ARAS patients were 6.46±1.58, 10.93±3.77, 12.14±4.05, respectively. Compared with the control group, the TTI value of males were larger in the XLAS and ARAS group (F=45.056, P＜0.001), the TTI value of females were larger in the ARAS group (F=26.541, P＜0.001). The difference of TTI value in females was significant between the XLAS and ARAS groups (F=26.541, P＜0.001). In males, the area under the ROC curve was 0.896 (95%CI 0.837−0.955, P＜0.001). The optimal cutoff value of the TTI was determined as 9.47, with a sensitivity of 73.1% and a specificity of 100%.ConclusionsTTI is a common ocular finding in young patients with AS. In males, a TTI ＞ 9.47 may differentiate AS from normal males.

Severe Acute Nephritis after Streptococcal Infection in children with Blood Pressure Changes and Related Factors

摘要:目的: 观察急性链球菌感染后肾炎(APSGN)患儿血压变化规律。 方法 :观察15例重型APSGN(重型组)和20例普通型APSGN(普通组)患儿病程中各时期血压及尿量变化,并进行免疫和生化指标对比。 结果 :APSGN患儿高血压总共26例(7429%),其中重症组高血压14例(933%),普通组高血压12例(60%),高血压发生率重症组高于普通组〖WTBX〗P lt;005。重症APSGN患儿入院时舒张压、少尿期收缩压舒张压、多尿期舒张压与普通组比较均有显著性差异,〖WTBX〗P lt;005;而且重症APSGN与普通组在少尿期持续时间、尿量、多尿期持续时间、尿量的指标比较也均有显著性差异,〖WTBX〗P lt;005。重症APSGN患儿血IgG、BUN、Cr明显高于普通APSGN,Plt;005。 结论 :高血压是APSGN主要临床表现之一,血压增高多发生于少尿期,但重症APSGN患儿于多尿期出现血压增高的第二次高峰,临床上应注意监测,及时治疗。Abstract: Objective: To observe the law of the changes of children’s blood pressure after the infection of steptococcus with acute nephritis(APSGN).〖WTHZ〗Methods :Watching 15 cases of serious APSGN and 20 cases of ordinary APSGN for their changes in blood pressure and their urine amounts in various periods; contrasting their indexes in immunity and biochemistry.〖WTHZ〗Results :Among 26cases(7429%)of patients’high blood pressure with APSGN,of which 14cases (933%)are serious ones and 12cases (60%)are ordinary ones,the occurrence rate of the serious group is higher than that of the ordinary group, Plt;005At the initial stage, either the diastolic presssure or the diastolic pressure and the systolic pressure of the serious group with a small amount of unine, the diastolic pressure with a large amount of urine are evidently different from those of the ordinary group, Plt;005Furthermore,there are evident differences in the durations and amounts of urine with either a small or a large amount of urine, Plt;005The IgG,BUN and Cr of the serious group are evidently higher than those of the ordinary group,Plt;005 Conclusion :High blood pressure is one of the main clinical manifestations of APSGN.The increase of blood pressure mostly occurs during the period of a small amount of urine, but a second summit of high blood pressure with APSGN mostly appears in the period of a large amount of urine.It must be closely observed and therefore given the timely treatment.

Evidence-Based Treatment Practice for A Hepatitis B Related Nephritis Patient with Renal Failure

Objective　By means of evidence-based clinical practice, to find more effective treatment for a hepatitis B related nephritis patient with renal failure. Methods　The following databases as Up to Date (May 2011), The Cochrane Library (Issue 5, 2011), PubMed (1978 to 2011) and CNKI (1978 to 2011) were searched to identify systematic reviews and randomized controlled trials (RCTs) of treating hepatitis B related nephritis with glucocorticoid, immunosuppressor or antiviral therapies, and the quality of collected clinical evidence was evaluated by using GRADEpro software. Results　The glucocorticoid or combined immunosuppressors was not recommended for existing adverse effects and not acting on the remission of hepatitis B related nephritis and reduction of proteinuria. However, the antiviral therapy used alone was recommended for acting on the remission of hepatitis B related nephritis and the reduction of proteinuria. In view of adverse effects and expensive price of interferon, the nucleoside analogue antiviral agent was suggested. Considering the renal toxicity of adefovir and tenofovir, and possible drug-resistance of lamivudine, the entecavir (0.5 mg qd) was finally selected with patient’s agreement, and the supporting therapies such as lowering blood pressure, and protecting the kidney and liver were adopted continually. After one month treatment, 24-hour urinary protein got reduced, serum albumin got increased, kidney function got stable, and hepatitis B virus DNA quantity got reduced. Conclusion　For treating hepatitis B related nephritis with kidney failure, entacavir can reduce 24-hour urinary protein, raise serum albumin, stabilize kidney function and reduce hepatitis B virus DNA in a short term, but its long-term efficacy still requires further studies.