| ObjectiveTo explore the feasibility and effectiveness of BOLD-MRI and DTI-MRI in evaluating the effect of traditional Chinese medicine Tangshen Formula on rats with early diabetic nephropathy.So as to provide noninvasive imaging methods for diagnosis of preclinical diabetic nephropathy and evaluation of the efficacy of traditional Chinese medicine(TCM),to provide new ideas and methods for the evaluation of the efficacy of compound Chinese medicine.Materials and Methods35 male Sprague-Dawley rats were randomly divided into a normal control group(NC group)of 5 rats and a model group of 30 rats.The model group was induced by high-sugar and high-fat diet combined with low-dose streptozotocin(STZ)(40 mg/kg)to induce diabetic nephropathy.Then,24 rats which modeled successfully were randomly divided into test group(T group)and model control group(MC group),with 12 rats in each group.The T group was given Chinese medicine Tangshen Formula(3.6g/kg/d)for 6 weeks,the NC group and the MC group were given an equal volume of distilled water.The body weight,fasting blood glucose(FBG),urine volume and 24-hour urine protein quantitative of rats were monitored every 2 weeks.Six weeks later,BOLD-MRI and DTI-MRI examinations were performed on 27 surviving rats(5 NC rats,8 MC rats,9 T rats).After the MRI examination,we killed all the rats and collected the inferior vena cava blood for serum creatinine and blood urea nitrogen.Then we collected right kidney tissues and fixed them with 4% paraformaldehyde for HE and PAS examination to determine the stage of diabetic nephropathy.Under the guidance and training of the senior imaging physician,two postgraduate students of the imaging medicine analyzed BOLD-MRI and DTI-MRI imaging data to obtain the R2* value,ADC value and FA value of the renal cortex and medulla.The consistency of the data measured by the two physicians was analyzed by ICC test.LSD test or Kruskal-Wallis H test was used to compare the body weight,FBG,urine volume,serum creatinine,urea nitrogen,24 h urine protein quantitation and kidney MR scan data(include R2* value,ADC value and FA value)among the three groups.Nonparametric paired test(Wilcoxon signed rank test)was used to compare the R2* value,ADC value and FA value of each kidney cortex and medulla.Results1.Growth,biochemical indicators,pathological examination: Before modeling,all the rats were in good spirits,and there was no obvious abnormality in weight,FBG and urine volume.After modeling for 2 weeks,the rats which modeled successfully showed obvious symptoms of diabetes such as polydipsia,polyphagia,polyuria and weight loss,and their FBG was above 16.7 mmol/L.In the whole process of the experiment,the general condition and biochemical indexes of the NC rats had no abnormal change.Compared with the NC group,the body weight of the MC group and the T group gradually decreased,and the FBG,urine volume,and 24 h urine protein gradually increased during the treatment of Tangshen Formula.The difference was the highest at the end of the experiment,which was statistically significant(P<0.05).At the end of treatment,the FBG of T group was significantly lower than that of MC group(P<0.05),and other indicators showed a certain improvement trend but no statistical significance(P>0.05).Renal pathological examination results of NC rats showed no obvious abnormalities.Pathological examination of T group and MC group showed tubular dilatation,interstitial inflammatory cell infiltration,and mild thickening of glomerular basement membrane.According to the Mogensen staging criteria,6 right kidneys(75%)MC group were accordance with the DN diagnostic criteria of stage ? and 2 kidneys(25%)of stage ?;5 kidneys(55.6%)of T group were accordance with the DN diagnostic criteria of stage ? and 4 kidneys(45.4%)of stage ?.2.The consistency of R2* values,ADC values and FA values were good between the two postgraduate students according to ICC test.3.MRI examination:There were no significant differences in MRI images of 3 groups.BOLD-MRI: The renal medulla R2* value of the MC group was higher than that of the NC group(P<0.05).The medulla R2* value of the T group was lower than that of the MC group,and their difference was not statistically significant(P>0.05).There was no significant difference in renal cortex R2* values of 3 groups(P>0.05).DTI-MRI: The cortex FA values of 3 groups were lower than the medulla FA values(P<0.05).The cortex ADC value of the MC group was higher than that of the NC group,and the difference between them was statistically significant(P<0.05).Compared with the MC group,there was upward trend in the renal medulla FA value of T group,and decreased trend in the renal cortex ADC value.However their difference was not statistically significant(P>0.05).Conclusions1.Traditional Chinese medicine Tangshen Formula can reduce the FBG level of diabetic nephropathy model rats,and its specific mechanism needs further study.2.BOLD-MRI and DTI-MRI evaluation of the efficacy of traditional Chinese medicine Tangshen Formula has certain feasibility,but it is still necessary to expand the sample size for further research.3.BOLD-MRI and DTI-MRI can assess renal renal function changes in the early diabetic nephropathy earlier than the biochemical indicators such as urine protein,serum creatinine,blood urea nitrogen and other abnormalities. |
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