2016年 · 第32卷第01期

The results of clinical studies showed that serum cardiac troponin T (cTnT) levels were significantly higher in maintenance hemodialysis (MHD) patients with cardiovascular events than in patients without cardiovascular events^[1]。 C-reactive protein (CRP) is a non-specific marker of inflammatory response and tissue damage. We retrospectively analyzed the correlation between serum cTnT and CRP levels and the short-term prognosis of MHD patients, aiming to provide a reference for predicting the prognosis of MHD patients.

Hypertension, micro-inflammatory response status, diabetes-related factors, uremic toxins and abnormal lipid metabolism are common factors that cause vascular endothelial damage in patients with chronic kidney disease^[1]。 far-infrared (FIR) can reduce the level of oxidative stress and inhibit the inflammatory response of vascular endothelium and intimal hyperplasia. The effect of FIR on vascular endothelial function in uremic states is unknown. We observed the effects of FIR irradiation on the levels of inflammatory response factor, endothelial nitric oxide synthase (eNOS) and asymmetric dimethylarginine (ADMA) in vascular endothelial cells of uremic model rats.

Henoch-Schonlein purpura (HSP), also known as IgA vasculitis in recent years, is a small vasculitis mainly caused by IgA immune complex deposition, which may be accompanied by systemic and multi-system damage, but it is rare for patients with pulmonary hemorrhage. The diagnosis and treatment of two cases of Henoch-Schonlein purpura nephritis (HSPN) with pulmonary hemorrhage in our hospital were retrospectively reported.

Tetramethylene disulfonetramine (tetramine) is a highly toxic rodenticide. After absorption, it often leads to severe clonic convulsions and grand mal seizures caused by brainstem stimulation, which may be accompanied by arrhythmia, respiratory failure, liver failure and other multiple organ dysfunction syndromes. The report of rhabdomyolysis and acute kidney injury caused by tetramine is rare. A case admitted to our hospital is reported as follows.

Catheter ectopia is a rare complication of central venous catheter with internal jugular vein tunnel and polyester sleeve. If it is not diagnosed in time and treated correctly, it will cause serious consequences^[1]。 The department corrected catheter ectopia through endovascular interventional therapy and achieved good results, which are reported below.

Since President Barack Obama proposed the launch of the "Precision Medicine Initiative" in his State of the Union address delivered on January 20, 2015, Precision Medicine has quickly become a global health hot word, attracting widespread concern from political, business, medical and other people in many countries. Relevant departments and experts in China also responded enthusiastically. So, what is precision medicine? What is the purpose of the U.S. launching the Precision Medicine Program? What important implications does the precision medicine plan have for the future development of nephrology in China? This paper makes a preliminary discussion on this.

thrombospondin (TSP) family is an important class of multifunctional extracellular matrix glycoproteins involved in the regulation of angiogenesis, proliferation, apoptosis and protein kinase activation^[1]。 The TSP family consists of five types: TSP-1, TSP-2, TSP-3, TSP-4 and COMP/TSP-5, which are coded and modified by different genes^[2]。 Among them, TSP-1, also known as thrombin sensitive protein 1, is a homotrimeric matrix glycosylated protein with a relative molecular mass of about 480,000. According to the different ligands binding to TSP-1, each peptide chain of TSP-1 can be divided into six functional regions: N-terminal, procollagen homologous fragment, prolysin-like TypeⅠ, epidermal growth factor-like TypeⅡ, calmodulin-like TypeⅢ, and C-terminal, which have different biological effects^[3]。 Under normal physiological conditions, TSP-1 is released by platelet alpha particles and is mainly stored in the platelet pool^[4]It plays an important role in maintaining angiogenesis and homeostasis, participating in the regulation of vascular formation, proliferation and other physiological functions. However, under the induction of pro-inflammatory factors, pathology or stress, TSP-1 can also be secreted by vascular smooth muscle cells, endothelial cells, epithelial cells, fibroblasts and other cells, and binds to CD36, CD47 and other cell surface receptors to regulate the cell-matrix interaction and exert a variety of biological effects^[5]。 In human normal kidney tissue, TSP-1 is only localized in about 1% of the tubular and interstitial regions^[6]While TSP-1 was found to be highly expressed in glomerular mesangial cells, renal vascular smooth muscle cells, proximal tubular epithelial cells, distal tubular epithelial cells, and mesenchymal cells in various animal models of kidney disease and in vitro cell stimulation experiments^[7,8,9]However, its specific mechanism has not been clarified.

ectopic lipid deposition refers to the excessive accumulation of lipids (mainly triacylglycerol, TG) in non-adipose tissue (liver, pancreas, muscle, kidney, etc.). Studies have shown that ectopic fat deposition can cause a series of pathophysiological changes and participate in the occurrence of atherosclerosis, non-alcoholic fatty liver disease, type 2 diabetes, etc. It is worth noting that fat is deposited in the kidney, causing kidney damage through multiple pathways, and plays an important role in the pathogenesis of acute kidney damage, obesity-related nephropathy, chronic kidney disease, especially diabetic kidney disease (DKD). In this paper, the relationship between ectopic fat deposition and DKD and its possible molecular mechanism are reviewed.