Fig. 4.

Histopathological finding of the renal cortex and medulla at the end of 24 h reperfusion: sham group (A and D) showed normal appearance. Obvious tissue injuries were observed in the BIR group (B and E); a higher degree of Bowman space enlargement (blue arrow), loss of brush border in the proximal tubules (black arrow), cast formation (yellow arrow), and tubular necrosis (white arrow). Remote ischemic per-conditioning improved structural changes in the BIR+RIPerC group (C and F). The level of each manifestation was graded according to the changes involved, scoring 0 with no changes, 1 with less than 20%, 2 with 20–40%, 3 with 40–60%, 4 with 60–80%, and 5 with greater than 80%. The sum of all numerical scores in each group was stated as the total histopathological score (G). H & E staining (magnification ×400) and data are expressed as mean ± SEM, ^***P<0.01 vs. the sham group and ^###P<0.001 vs. the BIR group. BIR, bilateral ischemic reperfusion; RIPerC, remote ischemic per-conditioning