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Lei-shi Li

Publications and source records attributed to Lei-shi Li.

8 recordsLinked to original sources
PubMed2006

[Effects of tacrolimus and cyclosporine on albumin secretion in cultured human hepatocyte].

OBJECTIVE: To investigate the effects of inflammation cytokines, (FK506) and cyclosporine (CSA) on albumin secretion, and the effects of FK506 and CSA on the IL-6 induced suppression of albumin synthesis in cultured human hepatocytes. METHODS: Human hepatoma cell lines (HepG2 cells) were separately cultured with IL-6, IL-2 and IL-10 (0 approximately 10 microg/L) and FK506, CSA (0 approximately 100 microg/L) for 48 h. In another experiment, HepG2 cells were stimulated with different doses of FK506 and CSA (0 approximately 10 microg/L) in the presence of IL-6 (5 microg/L) for 48 h. Albumin levels in the supernatant of all groups were measured by radioimmunoassay (RIA). The concentration of LDH secreted by cells stimulated with FK506 and CSA were detected with spectrophotometry. RESULTS: For cultured HepG2 cells, IL-6 significantly decreased albumin levels in a dose-dependent manner (P <0.01), and the maximal inhibition occurred at 5 microg/L. CSA mildly decreased albumin levels and a significant reduction in albumin production was first visible at 10 microg/ L (P <0.05). In contrast, IL-2, IL-10 and FK506 did not significantly influence albumin pro- duction (P > 0.05). FK506 obviously decreased LDH levels in the supernatant (P < 0.05) and attenuated IL-6 induced suppression of albumin synthesis (P < 0.01). But CSA slightly increased LDH concentration and could not block the IL-6 induced decrease of albumin synthesis (P > 0.05). CONCLUSION: IL-6 but not IL-2 and IL-10 suppressed the production of hepatic albumin in vitro. FK506 protected against the suppression of hepatic albumin synthesis caused by IL-6, suggesting its potential role in improving hypoalbuminaemia in immune glomerulonephritis.

Albumins↗
PubMed2005

Plasma level and genetic variation of apolipoprotein E in patients with lipoprotein glomerulopathy.

BACKGROUND: Lipoprotein glomerulopathy (LPG) is a renal disease characterized by thrombus-like lipoproteins in the glomerular capillaries and its abnormal lipoprotein profiles with marked elevation of apolipoprotein E (apoE). In this study, 15 Chinese patients with LPG were involed in exploring the association of the genetic variation and its plasma level in the pathogenesis of LPG. METHODS: A retrospective analysis of the clinical and pathological features was made in 15 patients with LPG. Plasma concentrations of apoE were measured with radial immunodiffusion assay. Genetic variations of apoE gene were detected using polymerase chain reaction and restriction fragment length polymorphism. Glomerular deposition of apoA, apoB and apoE in these patients were detected by immunofluorescence staining using monoclonal antibodies. RESULTS: Biochemical profiles of lipids and lipoproteins revealed markedly elevated levels of triglyceride, apoB and apoE, but approximately normal levels of total cholesterol, apoA1 and lipoprotein(a) [Lp(a)], which resembled familial hypertriglyceridemia. Genetic analysis demonstrated that the genotype distribution of apoE were 7 cases with epsilon3/epsilon4, 4 cases with epsilon3/epsilon3 and 2 cases with epsilon2/epsilon3. The other 2 cases (a mother and her son) showed a same distinct band. The band pattern of later 2 cases was quite similar to the apoE variant of Tokyo type. The calculated allele frequency of epsilon 4 was relatively high in cases with LPG in comparison with that in the normal controls. We further divided the 13 patients into three groups according to their genotypes of apoE. Patients with the genotype of apoE epsilon2/epsilon3 showed a lower level of plasma apoE as compared to those with apoE epsilon3/epsilon4 (P < 0.05). The serum level of high-density lipoprotein (HDL) was the lowest in patients with the genotype of apoE epsilon3/epsilon4. No difference was found among the patients with different apoE genotype in the other clinical and pathological characteristics. CONCLUSIONS: The genotype of apoE epsilon3/epsilon4 is the predominant one in Chinese patients with LPG. Patients with this genotype tend to have a higher plasma level of apoE and more severe lipid dysmetabolism. No correlation was found between the genotype of apoE and the clinical features in patients with LPG.

Adolescent↗
PubMed2005

Influence of CYP3A5 and MDR1 polymorphisms on tacrolimus concentration in the early stage after renal transplantation.

OBJECTIVE: Tacrolimus is an immunosuppressive drug with a narrow therapeutic range and wide interindividual variation in its pharmacokinetics. Cytochrome P450 (CYP) 3A and P-glycoprotein (P-gp, encoded by MDR1) play an important role in the absorption and metabolism of tacrolimus. The objective of this study was to evaluate whether or not CYP3A5*1/*3 or MDR1 C3435T polymorphisms are associated with the tacrolimus concentration per dose. METHODS: CYP3A5 and MDR1 genotypes were determined by polymerase chain reaction followed by restriction fragment length polymorphism analysis in 118 Chinese renal transplant patients receiving tacrolimus. Whole blood trough tacrolimus concentration was measured by enzyme-linked immunosorbent assay and dose-adjusted concentration (ng/mL per mg/kg/d) was calculated at 1 wk, 1 month, and 3 months after transplantation. RESULTS: The dose-adjusted concentration of CYP3A5*1/*1 and *1/*3 patients was significantly lower than *3/*3 patients (32.8 +/- 17.7 and 41.6 +/- 15.8 vs. 102.3 +/- 51.2 at 1 wk; 33.1 +/- 7.5 and 46.4 +/- 12.9 vs. 103 +/- 47.5 at 1 month; 35.3 +/- 20.9 and 59.0 +/- 20.6 vs. 150 +/- 85.3 at 3 months after transplantation respectively). At 1 wk, 46% of the CYP3A5*1 allele carriers had a tacrolimus concentration lower than 5 ng/mL and 77% lower than 8 ng/mL, whereas 20% of the *3/*3 patients had a concentration higher than 20 ng/mL. There was a mild difference between *1/*1 homozygotes and *1/*3 heterozygotes at 1 and 3 months after transplantation. No difference was found among the MDR1 genotypes. CONCLUSION: CYP3A5*1/*3 polymorphisms are associated with tacrolimus pharmacokinetics and dose requirements in renal transplant recipients. Pharmacogenetic methods could be employed prospectively to help initial dose selection and to individualize immunosuppressive therapy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2004

Lipoprotein glomerulopathy: clinical features and pathological characteristics in Chinese.

BACKGROUND: Lipoprotein glomerulopathy (LPG), once recognized as a rare glomerular disease, has been reported around the world in recent years. In this study, we reported 8 patients of LPG and aimed to explore the clinical features and pathological characteristics of LPG under light microscope, immunofluorescence staining, and electron microscope. METHODS: Clinical manifestations were recorded on the day of renal biopsy. Biochemical patterns of lipids and lipoproteins were detected by routine examination. Plasma concentrations of apo B and apo E were determined by radial immunodiffusion assays. Biopsy specimens were then processed for light microscopy, immunohistochemical staining for immunoglobulins and complement components, and electron microscopy. Glomerular deposition of apo A, B, and E were detected using monoclonal antibodies on cryostatic sections. RESULTS: All of the eight patients presented with edema, microscopic hematuria, severe proteinuria, anemia, and enlarged kidney size. Biochemical profiles revealed high levels of triglycerides, apo B, and apo E. We noted increments of glomerular size and lipoprotein thrombi occupying capillary lumina in the glomeruli of all patients. Immunofluorescence staining showed that the thrombi were strongly positive for apo A, B, and E. Granules and various sizes of vacuoles were observed in the thrombi under electron microscope. CONCLUSION: Compared with previous reports on LPG in other countries, unique clinical and pathological features were found in this group of Chinese LPG patients.

Adolescent↗
PubMed2003

[Continuous veno-venous hemofiltration in treatment of acute severe hyponatremia: a report of 6 cases].

OBJECTIVE: To investigate the effect of continuous veno-venous hemofiltration (CVVH) in the treatment of acute severe hyponatremia. METHODS: Six patients with acute severe hyponatremia were studied, including 5 males and 1 female, aged 48.5 (25 - 61) years. Clinical manifestations of hyponatremia included confusion (6/6), drowsiness (3/6), and delirium (3/6). The course of hyponatremia before the initiation of CVVH was 45 - 48 hours. AN69, AV600, FH66 and HF1200 hemofilters were applied and changed every 24 hours. The ultrafiltration rate was 2 000 ml/h, with a blood flow rate of 200 - 250 ml/min, and the substitute fluid was infused by a pre-dilution route. Low molecular weight heparin was used for anticoagulation. RESULTS: The average treatment duration of CVVH was 59.7 (45.6 - 86) hours. All the patients survived and tolerated CVVH well. During CVVH, the serum sodium increased significantly from (101.2 +/- 4.2) mmol/L before CVVH, to (115.0 +/- 2.7) mmol/L at the 6th hour of CVVH, (129.2 +/- 4.1) mmol/L at the 24th hour, and (140.3 +/- 1.6) mmol/L at the 48th hour of CVVH; with the correction rate of serum sodium controlled at (2.5 +/- 0.4) mmol.L(-1).h(-1) over the first 24 hours, (1.2 +/- 0.1) mmol.L(-1).h(-1) for the first 48th hour, and the correction rate of (0.82 +/- 0.10) mmol.L(-1).h(-1). The sodium concentrations in the replacement solution were (16.0 +/- 6.0) mmol/L higher than the serum sodium concentration at 0 hour, (11.6 +/- 4.3) mmol/L higher at 4th hour, (5.5 +/- 5.1) mmol/L higher at 24th hour, and (0.75 +/- 0.96) mmol/L higher at 48th hour of CVVH. After CVVH, the serum osmolarity increased significantly, from (216.7 +/- 7.4) mOsm/kgH(2)O pre-CVVH, to (245.0 +/- 5.5) mOsm/kgH(2)O at 6th hour, with a correction rate of (5.16 +/- 0.81) mOsm.kgH(2)O(-1).h(-1); (272.7 +/- 7.1) mOsm/kgH(2)O at 24th hour, with a correction rate of (2.33 +/- 0.28) mOsm.kgH(2)O(-1).h(-1); and (295.0 +/- 4.2) mOsm/kgH(2)O at 48th hour, with a correction rate of (1.63 +/- 0.20) mOsm.kgH(2)O(-1).h(-1). The Glasgow scores and APACHEII scores improved significantly as compared to pretreatment. CONCLUSION: CVVH is effective in the treatment of acute severe hyponatremia, and could be considered as a treatment option because of its slow and continuous nature. A low-sodium replacement solution should be prepared to minimize its sodium concentration difference from the serum concentration. We recommend that the serum sodium concentration be corrected at an average rate of (2.50 +/- 0.14) mmol.L(-1).h(-1) at 6 h, (1.2 +/- 0.1) mmol.L(-1).h(-1) at 24 h and (0.82 +/- 0.10) mmol.L(-1).h(-1) at 48 h.

Acute Disease↗
PubMedDate not supplied

Idiopathic IgA nephropathy with diffuse crescent formation.

OBJECTIVE: To investigate the clinicopathological features and outcome of idiopathic IgA nephropathy with diffuse crescent formation in Chinese patients. METHODS: Twenty-five patients with diffuse crescentic IgA nephropathy (DCIgAN), 15 males and 10 females with median age of 28.5, and median disease duration of 5.1 months, were studied. Their clinical, laboratory and pathological features and outcome were investigated. Twenty-one were administered pulse immunosuppressive therapy, and 15 were followed up for more than 6 months. RESULTS: 1.14% had total IgA nephropathy, and 16.4% total diffuse crescentic glomerulonephritis. Clinically, most of patients (88%) showed rapidly progressive glomerulonephritis associated with a high level of serum creatinine (418 +/- 264 micromol/l). Gross hematuria was noted in 72%, hypertension in 64%, and nephrotic syndrome in 48%. Pathologically, except for diffuse crescent formation (a median 65% and range 50-95%), we observed segmental necrosis of glomerular capillaries in 60%, glomerular infiltrating cells in 48%, endothelial cells proliferation in 32%, and rupture of Bowmans' capsule in 24%. Severe tubular interstitial damage was also found, tubular atrophy in 64%, interstitial fibrosis in 60%, diffuse interstitial infiltrating cells in 74%, and interstitial vasculitis in 40%. Immunopathologically, four phenotypes were observed; however, IgA associated with IgM deposition was higher than that in patients with general IgA nephropathy (IgAN). In addition, the infiltrating CD4+, CD8+, CD68+ and PCNA+ cells in renal tissue were significantly high compared with that in controls. In a follow-up study, 66.7% of patients had life-sustaining renal function, 4 of them had normal range of serum creatinine (<124 micromol/l), and only 5 were dialysis-dependent. CONCLUSIONS: The patients with crescentic IgA nephropathy mostly show rapidly progressive nephritis associated with more severe pathological changes including glomerular, tubular interstitial and vascular lesions than in patients with general IgAN. The infiltrates in glomeruli may contribute to the crescentic formation, and the intensive immune suppressing treatment is useful to improve renal damage in patients with DCIgAN.

Adult↗