Diabetes mellitus and its complications are becoming one of the most important health problems in the world. Diabetic nephropathy is now the main cause of end-stage renal disease. The mechanisms leading tothe develop... Diabetes mellitus and its complications are becoming one of the most important health problems in the world. Diabetic nephropathy is now the main cause of end-stage renal disease. The mechanisms leading tothe development and progression of renal injury are not well known. Therefore, it is very important to f ind new pathogenic pathways to provide opportunities for early diagnosis and targets for novel treatments. At the present time, we know that activation of innate immunity with development of a chronic low grade inflammatory response is a recognized factor in the pathogenesis of diabetic nephropathy. Numerous experimental and clinical studies have shown the participation of different inflammatory molecules and pathways in the pathophysiology of this complication.展开更多
Background： Chronic kidney disease has become a leading public health concern in China, as it is associated with increased morbidity, mortality, and costs. However, the overall situation regarding common glomerular d...Background： Chronic kidney disease has become a leading public health concern in China, as it is associated with increased morbidity, mortality, and costs. However, the overall situation regarding common glomerular diseases in China remains unclear. Hence, the aim of this study was to assess the national profile of the common types ofglomerulonephritis in China. Methods： We searched Medline, Embase, Cochrane Library, CNKI, SinoMed, VIP, and Wanfang databases for English and Chinese language articles from inception to September 2017. We also collected potentially relevant studies and reviews using a manual search. The fbllowing words in combinations are as keywords： ＂renal biopsy＂, ＂kidney pathological diagnosis＂, and ＂spectrum of pathological types＂. Results： We identified 23 studies involving 176,355 patients from 15 provinces/cities in China. The detection rates of primary glomerulonephritis （PGN） and secondary glomerulonephritis （SGN） were 0.740 and 0.221, respectively. Over the past 30 years, the top five types of PGN were immunoglobulin A nephropathy （IgAN; 24.3%）, mesangial proliferative glomerulonephritis （MsPGN; 10.5%）, membranous nephropathy （MN; 12.6%）, minimal change disease （MCD; 9.8%）, and tbcal segmental glomerulosclerosis （FSGS; 4.6%）, and the top four types of SGN were lupus nephritis （LN; 8.6%）, Henoch-Sch6nlein purpura glomerulonephritis （4.1%）, hepatitis B virus-associated glomerulonephritis （HBV-GN; 2.6%）, and diabetic nephropathy （DN; 1.6%）. The proportion of MN, MCD, HBV-GN, and DN tended to increase, while those of IgAN, MsPGN, FSGS, and LN tended to drop. Conclusions： Although the incidence of SGN is increasing gradually, PGN is still the leading lbrm of kidney disease in patients undergoing renal biopsies in China. IgAN and LN are the most common types of PGN and SGN, respectively. Differences between regions are related to various factors such as nationality, environment, and diet. Furthermore, unified standards and norms 展开更多
Background It remains a challenge to inhibit the local recurrence or distant metastasis of localized or locally advanced renal cell carcinoma （RCC） after surgical resection. We investigated the feasibility, safety a...Background It remains a challenge to inhibit the local recurrence or distant metastasis of localized or locally advanced renal cell carcinoma （RCC） after surgical resection. We investigated the feasibility, safety and efficacy of immunotherapy using autologous tumor lysate （TL）-pulsed dendritic cells （DCs） and cytokine-induced killer （CIK） cells in patients with localized or locally advanced RCC.展开更多
Hantaviruses are comprised of tri-segmented negative sense single-stranded RNA, and are members of the Bunyaviridae family. Hantaviruses are distributed worldwide and are important zoonotic pathogens that can have sev...Hantaviruses are comprised of tri-segmented negative sense single-stranded RNA, and are members of the Bunyaviridae family. Hantaviruses are distributed worldwide and are important zoonotic pathogens that can have severe adverse effects in humans. They are naturally maintained in specific reservoir hosts without inducing symptomatic infection. In humans, however,hantaviruses often cause two acute febrile diseases, hemorrhagic fever with renal syndrome(HFRS) and hantavirus cardiopulmonary syndrome(HCPS). In this paper, we review the epidemiology and epizootiology of hantavirus infections worldwide.展开更多
The phosphatidylinositol 3 kinase （PI3K）/AKT pathway is genetically targeted in more pathway components and in more tumor types than any other growth factor signaling pathway, and thus is frequently activated as a c...The phosphatidylinositol 3 kinase （PI3K）/AKT pathway is genetically targeted in more pathway components and in more tumor types than any other growth factor signaling pathway, and thus is frequently activated as a cancer driver. More importantly, the PI3K/AKT pathway is composed of multiple bifurcating and converging kinase cascades, providing many potential targets for cancer therapy. Renal cell carcinoma （RCC） is a high-risk and high-mortality cancer that is notoriously resistant to traditional chemotherapies or radiotherapies. The PI3K/AKT pathway is modestly mutated but highly activated in RCC, representing a promising drug target. Indeed, PI3K pathway inhibitors of the rapalog family are approved for use in RCC. Recent large-scale integrated analyses of a large number of patients have provided a molecular basis for RCC, reiterating the critical role of the PI3K/AKT pathway in this cancer. In this review, we summarize the genetic alterations of the PI3K/AKT pathway in RCC as indicated in the latest large-scale genome sequencing data, as well as treatments for RCC that target the aberrant activated PI3K/AKT pathway.展开更多
To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases ri...To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade.展开更多
Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glo...Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glomerular filtration rate （GFR） are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages： normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus （DM） patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease （NADKD） or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.展开更多
Background Renal clear cell carcinoma （RCCC） is the most common malignant renal tumor. It is highly malignant, does not cause clinical symptoms in its early stages, and cannot be diagnosed using conventional ultraso...Background Renal clear cell carcinoma （RCCC） is the most common malignant renal tumor. It is highly malignant, does not cause clinical symptoms in its early stages, and cannot be diagnosed using conventional ultrasound. This study was aimed to investigate the contrast-enhanced ultrasound （CEUS） mode and characteristics of the time-intensity curve for RCCC and its pathological basis. Methods Forty-two patients with pathologically diagnosed RCCC underwent CEUS examination before surgery. The patients＇ kidneys were visualized after injection of contrast agents using the Technos MPX DU8. We analyzed the CEUS mode, time-intensity curve, and pathological findings. Results The detection rate of RCCC with conventional ultrasound was about 71%, while the rate using CEUS was 100%. Larger tumors （33 cases） showed non-uniform enhancement with defective filling. CEUS modes were divided into 4 types： type Ⅰ, ＂quick in and out＂ （26.19%, 11/42）; type Ⅱ, ＂quick in and slow out＂ （40.48%, 17/42）; type Ⅲ, ＂Simultaneous in and out＂ （16.67%, 7/42）; and type Ⅳ ＂slow in and out＂ （16.67%, 7/42）. All types had a close correlation to the pathological basis. Time-intensity curve of CEUS consisted of 3 phases, the perfusion phase, regression phase, and lag phase. Cases of types Ⅰ and Ⅲ only had a perfusion and regression phase, those of type Ⅱ and Ⅳ had a perfusion phase, regression phase, and lag phase. Quantitative analysis of the time-intensity curve showed that the time-to-peak （FTP） of the lesions was shorter than that of normal renal parenchyma （P 〈0.0001）, the mean value of the up slope rate of the absolute value of lesions was higher than that of the ipsilateral normal renal parenchyma （P 〈0.0001）, and that the mean value of descent slope rate of the absolute value of lesions was lower than that of the ipsilateral normal renal parenchyma （P 〈0.0001）. Conclusions CEUS is useful in detecting small vessels in tumors. Although there are several differen展开更多
Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation ...Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation of HFRS in China.Data sources Reviews and papers published in Chinese journals, relevant to the objectives, written or collected by the author; and the research work of the author.Study selection An outline was drafted according to the purpose given a bove, and the relevant materials and data were grouped together into different i tems outlined.Data extraction All the materials and data extracted were published or specially assessed.Results HFRS was first recognized in the northeastern China in 1931. It has been found prevalent also in many other parts of China since 1955, and p resently, 28 out of 31 provinces (autonomous regions, or municipalities) have b een proved to be its endemic areas. The total number of cases is 1?256?431 from 1950 to 1997, with 44?304 death (3.53%). 50-100 thousands of cases co uld be registered annually since 1981 when the presence of the Rattus type HFRS wa s first identified serologically in China, with the highest peak in 1986 ( 115 ?985 cases). Three types of endemicity have been differentiated: the Apodemus type, the Rattus type and the mixed type of the two, by their peculiar season al distributions of cases and by methods of serotyping (HI, MAbs serotyping kits ). The epidemiologic features of the Rattus type HFRS are quite different from that of the Apodemus type. 67 species of vertebrates were found to harbor hanta virus antigen or antibodies, but the chief or primary reservoir hosts are A podemus agrarius and Rattus norveg icus only. Besides the commonly recognized enzootic mode of transmission (via co ntact s with the reservoir rodents or their excreta), mite transmission (including cer tain species of gamasid mites, and chigger mites) has been identified as the po tential vectors and reservoir hosts with HFRS. Vertical transmission展开更多
Radiofrequency ablation (RFA) uses high frequency alternating current to heat a volume of tissue around a needle electrode to induce focal coagulative necrosis with minimal injury to surrounding tissues. RFA can be pe...Radiofrequency ablation (RFA) uses high frequency alternating current to heat a volume of tissue around a needle electrode to induce focal coagulative necrosis with minimal injury to surrounding tissues. RFA can be performed via an open, laparoscopic, or image guided percutaneous approach and be performed under general or local anesthesia. Advances in delivery mechanisms, electrode designs, and higher power generators have increased the maximum volume that can be ablated, while maximizing oncological outcomes. In general, RFA is used to control local tumor growth, prevent recurrence, palliate symptoms, and improve survival in a subset of patients that are not candidates for surgical resection. It's equivalence to surgical resection has yet to be proven in large randomized control trials. Currently, the use of RFA has been well described as a primary or adjuvant treatment modality of limited but unresectable hepatocellular carcinoma, liver metastasis, especially colorectal cancer metastases, primary lung tumors, renal cell carcinoma, boney metastasis and osteoid osteomas. The role of RFA in the primary treatment of early stage breast cancer is still evolving. This review will discuss the general features of RFA and outline its role in commonly encountered solid tumors.展开更多
Total saponins of Panax notoginseng （PNS） have been shown to ameliorate renal interstitial fibrosis. Ginsenoside Rg 1, a panaxatriol saponin, is one of the major active molecules from PNS. The present study was unde...Total saponins of Panax notoginseng （PNS） have been shown to ameliorate renal interstitial fibrosis. Ginsenoside Rg 1, a panaxatriol saponin, is one of the major active molecules from PNS. The present study was undertaken to investigate the effect of ginsenoside Rgl on renal fibrosis in rats with unilateral ureteral obstruction （UUO）. The rats were randomly divided into 3 groups： sham-operation （n=15）, UUO （n=15） and UUO with ginsenoside Rgl treatment （n=15, 50 mg per kg body weight, intraperitoneally （i.p.） injected）. The rats were sacrificed on Days 7 and 14 after the surgery. Histological examination demonstrated that ginsenoside Rgl significantly inhibited interstitial fibrosis including tubular injury as well as collagen deposition, u-smooth muscle actin （α-SMA） and E-cadherin are two markers of tubular epithelial-myofibroblast transition （TEMT）. Interestingly, ginsenoside Rgl notably decreased α-SMA expression and simultaneously enhanced E-cadherin expression. The messenger RNA （mRNA） of transforming growth factor-β1 （TGF-β1）, a key mediator to regulate TEMT, in the obstructed kidney increased dramatically, but was found to decrease significantly after administration of ginsenoside Rg 1. Further study showed that ginsenoside Rgl considerably decreased the levels of both active TGF-β1 and phosphorylated Smad2 （pSmad2）. Moreover, ginsenoside Rgl substantially suppressed the expression of thrombospondin-1 （TSP-1）, a cytokine which can promote the transcription of TGF-β1 mRNA and the activation of latent TGF-β1. These results suggest that ginsenoside Rgl inhibits renal interstitial fibrosis in rats with UUO. The mechanism might be partly related to the blocking of TEMT via suppressing the expression of TSP-1.展开更多
基金Supported by Ministerio de Ciencia e Innovación(Instituto de Salud Carlos Ⅲ-Fondo de Investigación Sanitaria:PI07/0870and PI10/576)Ministerio de Sanidad y Política Social(Dirección General de Terapias Avanzadas y Trasplante:TRA-182)Sociedad Espaola de Nefrología y ACINEF
文摘 Diabetes mellitus and its complications are becoming one of the most important health problems in the world. Diabetic nephropathy is now the main cause of end-stage renal disease. The mechanisms leading tothe development and progression of renal injury are not well known. Therefore, it is very important to f ind new pathogenic pathways to provide opportunities for early diagnosis and targets for novel treatments. At the present time, we know that activation of innate immunity with development of a chronic low grade inflammatory response is a recognized factor in the pathogenesis of diabetic nephropathy. Numerous experimental and clinical studies have shown the participation of different inflammatory molecules and pathways in the pathophysiology of this complication.
文摘Background： Chronic kidney disease has become a leading public health concern in China, as it is associated with increased morbidity, mortality, and costs. However, the overall situation regarding common glomerular diseases in China remains unclear. Hence, the aim of this study was to assess the national profile of the common types ofglomerulonephritis in China. Methods： We searched Medline, Embase, Cochrane Library, CNKI, SinoMed, VIP, and Wanfang databases for English and Chinese language articles from inception to September 2017. We also collected potentially relevant studies and reviews using a manual search. The fbllowing words in combinations are as keywords： ＂renal biopsy＂, ＂kidney pathological diagnosis＂, and ＂spectrum of pathological types＂. Results： We identified 23 studies involving 176,355 patients from 15 provinces/cities in China. The detection rates of primary glomerulonephritis （PGN） and secondary glomerulonephritis （SGN） were 0.740 and 0.221, respectively. Over the past 30 years, the top five types of PGN were immunoglobulin A nephropathy （IgAN; 24.3%）, mesangial proliferative glomerulonephritis （MsPGN; 10.5%）, membranous nephropathy （MN; 12.6%）, minimal change disease （MCD; 9.8%）, and tbcal segmental glomerulosclerosis （FSGS; 4.6%）, and the top four types of SGN were lupus nephritis （LN; 8.6%）, Henoch-Sch6nlein purpura glomerulonephritis （4.1%）, hepatitis B virus-associated glomerulonephritis （HBV-GN; 2.6%）, and diabetic nephropathy （DN; 1.6%）. The proportion of MN, MCD, HBV-GN, and DN tended to increase, while those of IgAN, MsPGN, FSGS, and LN tended to drop. Conclusions： Although the incidence of SGN is increasing gradually, PGN is still the leading lbrm of kidney disease in patients undergoing renal biopsies in China. IgAN and LN are the most common types of PGN and SGN, respectively. Differences between regions are related to various factors such as nationality, environment, and diet. Furthermore, unified standards and norms
基金This study was supported by grants from the National Natural Science Foundation of China （No. 30772178）, Medical Research Fund of Science and Technology of Guangdong （No. B2007062）, Research Fund for the Doctoral Program of Higher Education of China （No. 20060558032）, Natural Science Foundation of Guangdong Province （No. 7117362） and the Program of 5010 of Sun Yat-sen Universitty （No. 2007028）. Conflicts of interest： none.
文摘Background It remains a challenge to inhibit the local recurrence or distant metastasis of localized or locally advanced renal cell carcinoma （RCC） after surgical resection. We investigated the feasibility, safety and efficacy of immunotherapy using autologous tumor lysate （TL）-pulsed dendritic cells （DCs） and cytokine-induced killer （CIK） cells in patients with localized or locally advanced RCC.
基金supported by the National Natural Science Foundation of China (No. 81373118)the National Basic Research Programme of China (973 Programme No. 2012CB518905)
文摘Hantaviruses are comprised of tri-segmented negative sense single-stranded RNA, and are members of the Bunyaviridae family. Hantaviruses are distributed worldwide and are important zoonotic pathogens that can have severe adverse effects in humans. They are naturally maintained in specific reservoir hosts without inducing symptomatic infection. In humans, however,hantaviruses often cause two acute febrile diseases, hemorrhagic fever with renal syndrome(HFRS) and hantavirus cardiopulmonary syndrome(HCPS). In this paper, we review the epidemiology and epizootiology of hantavirus infections worldwide.
基金supported by the grant from The University of Texas MD Anderson Cancer Center Kidney Cancer Multidisciplinary Research Program to ZDthe NCI CCSG grant(No. P30 CA016672)the GDAC grant(No.5U24CA143883)
文摘The phosphatidylinositol 3 kinase （PI3K）/AKT pathway is genetically targeted in more pathway components and in more tumor types than any other growth factor signaling pathway, and thus is frequently activated as a cancer driver. More importantly, the PI3K/AKT pathway is composed of multiple bifurcating and converging kinase cascades, providing many potential targets for cancer therapy. Renal cell carcinoma （RCC） is a high-risk and high-mortality cancer that is notoriously resistant to traditional chemotherapies or radiotherapies. The PI3K/AKT pathway is modestly mutated but highly activated in RCC, representing a promising drug target. Indeed, PI3K pathway inhibitors of the rapalog family are approved for use in RCC. Recent large-scale integrated analyses of a large number of patients have provided a molecular basis for RCC, reiterating the critical role of the PI3K/AKT pathway in this cancer. In this review, we summarize the genetic alterations of the PI3K/AKT pathway in RCC as indicated in the latest large-scale genome sequencing data, as well as treatments for RCC that target the aberrant activated PI3K/AKT pathway.
文摘To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade.
文摘Diabetic kidney disease （DKD） is one of the primary causes of end-stage renal disease （ESRD）. Early diagnosis is very important in preventing the development of DKD. Urinary albumin excretion rate （UAER） and glomerular filtration rate （GFR） are widely accepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the first clinical sign of DKD. The natural history of DKD has been divided into three stages： normoalbuminuria, microalbuminuria, and macroalbuminuria. However, this clinical paradigm has been questioned recently, as studies have shown that a portion of diabetes mellitus （DM） patients with normoalbuminuria have progressive renal insufficiency, referred to as normoalbuminuric diabetic kidney disease （NADKD） or nonalbuminuric diabetic nephropathy. Epidemiologic research has demonstrated that normoalbuminuric diabetic kidney disease is common, and the large number of NADKD patients suggests that the traditional paradigm needs to be shifted. Currently, the pathogenesis of NADKD remains unclear, but many clinical studies have identified some clinical and pathological features of NADKD. In addition, the long-term outcomes of NADKD patients remain controversial. In this article, we reviewed the latest studies addressing the pathogenesis, pathology, treatment and prevention of NADKD.
文摘Background Renal clear cell carcinoma （RCCC） is the most common malignant renal tumor. It is highly malignant, does not cause clinical symptoms in its early stages, and cannot be diagnosed using conventional ultrasound. This study was aimed to investigate the contrast-enhanced ultrasound （CEUS） mode and characteristics of the time-intensity curve for RCCC and its pathological basis. Methods Forty-two patients with pathologically diagnosed RCCC underwent CEUS examination before surgery. The patients＇ kidneys were visualized after injection of contrast agents using the Technos MPX DU8. We analyzed the CEUS mode, time-intensity curve, and pathological findings. Results The detection rate of RCCC with conventional ultrasound was about 71%, while the rate using CEUS was 100%. Larger tumors （33 cases） showed non-uniform enhancement with defective filling. CEUS modes were divided into 4 types： type Ⅰ, ＂quick in and out＂ （26.19%, 11/42）; type Ⅱ, ＂quick in and slow out＂ （40.48%, 17/42）; type Ⅲ, ＂Simultaneous in and out＂ （16.67%, 7/42）; and type Ⅳ ＂slow in and out＂ （16.67%, 7/42）. All types had a close correlation to the pathological basis. Time-intensity curve of CEUS consisted of 3 phases, the perfusion phase, regression phase, and lag phase. Cases of types Ⅰ and Ⅲ only had a perfusion and regression phase, those of type Ⅱ and Ⅳ had a perfusion phase, regression phase, and lag phase. Quantitative analysis of the time-intensity curve showed that the time-to-peak （FTP） of the lesions was shorter than that of normal renal parenchyma （P 〈0.0001）, the mean value of the up slope rate of the absolute value of lesions was higher than that of the ipsilateral normal renal parenchyma （P 〈0.0001）, and that the mean value of descent slope rate of the absolute value of lesions was lower than that of the ipsilateral normal renal parenchyma （P 〈0.0001）. Conclusions CEUS is useful in detecting small vessels in tumors. Although there are several differen
文摘Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation of HFRS in China.Data sources Reviews and papers published in Chinese journals, relevant to the objectives, written or collected by the author; and the research work of the author.Study selection An outline was drafted according to the purpose given a bove, and the relevant materials and data were grouped together into different i tems outlined.Data extraction All the materials and data extracted were published or specially assessed.Results HFRS was first recognized in the northeastern China in 1931. It has been found prevalent also in many other parts of China since 1955, and p resently, 28 out of 31 provinces (autonomous regions, or municipalities) have b een proved to be its endemic areas. The total number of cases is 1?256?431 from 1950 to 1997, with 44?304 death (3.53%). 50-100 thousands of cases co uld be registered annually since 1981 when the presence of the Rattus type HFRS wa s first identified serologically in China, with the highest peak in 1986 ( 115 ?985 cases). Three types of endemicity have been differentiated: the Apodemus type, the Rattus type and the mixed type of the two, by their peculiar season al distributions of cases and by methods of serotyping (HI, MAbs serotyping kits ). The epidemiologic features of the Rattus type HFRS are quite different from that of the Apodemus type. 67 species of vertebrates were found to harbor hanta virus antigen or antibodies, but the chief or primary reservoir hosts are A podemus agrarius and Rattus norveg icus only. Besides the commonly recognized enzootic mode of transmission (via co ntact s with the reservoir rodents or their excreta), mite transmission (including cer tain species of gamasid mites, and chigger mites) has been identified as the po tential vectors and reservoir hosts with HFRS. Vertical transmission
文摘Radiofrequency ablation (RFA) uses high frequency alternating current to heat a volume of tissue around a needle electrode to induce focal coagulative necrosis with minimal injury to surrounding tissues. RFA can be performed via an open, laparoscopic, or image guided percutaneous approach and be performed under general or local anesthesia. Advances in delivery mechanisms, electrode designs, and higher power generators have increased the maximum volume that can be ablated, while maximizing oncological outcomes. In general, RFA is used to control local tumor growth, prevent recurrence, palliate symptoms, and improve survival in a subset of patients that are not candidates for surgical resection. It's equivalence to surgical resection has yet to be proven in large randomized control trials. Currently, the use of RFA has been well described as a primary or adjuvant treatment modality of limited but unresectable hepatocellular carcinoma, liver metastasis, especially colorectal cancer metastases, primary lung tumors, renal cell carcinoma, boney metastasis and osteoid osteomas. The role of RFA in the primary treatment of early stage breast cancer is still evolving. This review will discuss the general features of RFA and outline its role in commonly encountered solid tumors.
基金Project (No. 30170437) supported by the National Natural Science Foundation of China
文摘Total saponins of Panax notoginseng （PNS） have been shown to ameliorate renal interstitial fibrosis. Ginsenoside Rg 1, a panaxatriol saponin, is one of the major active molecules from PNS. The present study was undertaken to investigate the effect of ginsenoside Rgl on renal fibrosis in rats with unilateral ureteral obstruction （UUO）. The rats were randomly divided into 3 groups： sham-operation （n=15）, UUO （n=15） and UUO with ginsenoside Rgl treatment （n=15, 50 mg per kg body weight, intraperitoneally （i.p.） injected）. The rats were sacrificed on Days 7 and 14 after the surgery. Histological examination demonstrated that ginsenoside Rgl significantly inhibited interstitial fibrosis including tubular injury as well as collagen deposition, u-smooth muscle actin （α-SMA） and E-cadherin are two markers of tubular epithelial-myofibroblast transition （TEMT）. Interestingly, ginsenoside Rgl notably decreased α-SMA expression and simultaneously enhanced E-cadherin expression. The messenger RNA （mRNA） of transforming growth factor-β1 （TGF-β1）, a key mediator to regulate TEMT, in the obstructed kidney increased dramatically, but was found to decrease significantly after administration of ginsenoside Rg 1. Further study showed that ginsenoside Rgl considerably decreased the levels of both active TGF-β1 and phosphorylated Smad2 （pSmad2）. Moreover, ginsenoside Rgl substantially suppressed the expression of thrombospondin-1 （TSP-1）, a cytokine which can promote the transcription of TGF-β1 mRNA and the activation of latent TGF-β1. These results suggest that ginsenoside Rgl inhibits renal interstitial fibrosis in rats with UUO. The mechanism might be partly related to the blocking of TEMT via suppressing the expression of TSP-1.
