2016年 · 第32卷第08期

Idiopathic membranous nephropathy (IMN) with crescent by Moorthy et al.^[1]It is reported for the first time and has attracted the attention of many scholars because of its poor clinical prognosis. Domestic studies have reported that cases with large numbers of crescents are less than 1% of patients with IMN^[2]。 In recent years, we have observed that it is not uncommon for patients with IMN to suggest a small amount of crescent. Whether a small amount of crescent has an impact on the prognosis of IMN remains to be further explored. In this study, we compared the cases of IMN with a small number of crescents with those without crescents in the same period in recent 5 years, in order to understand the correlation between this pathological phenomenon and the clinical and short-term prognosis of IMN to some extent.

Renal tubular epithelial-mesenchymal transdifferentiation (EMT) is a complex process, including the destruction of tight junctions and adhesive junctions, the reorganization of actin cytoskeleton, the loss of apical-basal polarity and the induction of mesenchymal gene expression^[1]。 Transforming growth factor β 1 (TGF-β 1) is the main trigger of EMT, and the Smad signaling pathway plays a major role in regulating TGF-β 1-dependent EMT^[2], the classical Smad signaling pathway has been studied more, and the non-SMAD pathway has been studied less. Par6 is an important polar protein discovered in recent years. Some scholars have found that TGF-β 1 promotes the phosphorylation of Par6 Ser345, binds to Smurf1 protein, degrades RhoA protein, destroys the tight junction of epithelial cells, and promotes the occurrence of EMT. Mutation of Par6 Ser345 site or siRNA-Smurf1 knockout of Smurf1 gene can reverse TGF-β 1-induced EMT^[3]。 The effect of Par6 on TGF-β 1-induced EMT was studied in renal tubular epithelial cell NRK-52E.

Renal tubulo-interstitial fibrosis (TIF) is a common pathological feature of various chronic kidney diseases (CKD) progressing to end-stage kidney disease. Its severity is closely related to renal dysfunction and prognosis of CKD. At present, there is still a lack of effective clinical intervention and prevention measures. adiponectin, a cytokine secreted by adipose tissue, can inhibit inflammatory response and oxidative stress, improve vascular endothelial cell function and anti-fibrosis in kidney, and may be an intervention target for prevention and treatment of CKD^[1]。 peroxisome proliferator activated receptor (PPAR γ) is related to glycolipid energy metabolism and various cell differentiation, and is involved in regulating many physiological and pathological processes of the body. Animal experiments showed that PPAR γ agonists can up-regulate the expression of adiponectin and increase the serum adiponectin level, thus exerting pharmacological effects^[2]。 This paper aims to observe the effect of PPAR γ agonist rosiglitazone (RGZ) on the rat TIF model and its mechanism, so as to provide theoretical and experimental basis for a new approach to clinical prevention and treatment of CKD.

dialysis associated steal syndrome (DASS) is one of the complications of arteriovenous access surgery. Due to the individual complexity of dialysis access, there is currently no "gold standard" for managing this complication. There are few reports on the management of DASS in China. Our center used proximalization of the arterial inflow (PAI) to treat 4 cases of this disease, of which 2 cases were modified PAI, which are reported as follows.