益肾清利活血方联合雷公藤多苷片治疗慢性肾小球肾炎的临床研究

目的探讨益肾清利活血方联合雷公藤多苷片治疗慢性肾小球肾炎的临床疗效。方法将本院收治的66例慢性肾小球肾炎患者随机分为三组,每组22例。对照组给予西医常规治疗,A组患者在对照组的基础上加雷公藤多苷片治疗,B组在A组的基础上加益肾清利活血方进行治疗;对三组患者治疗前后的血β-微球蛋白（β-MG）、24 h尿蛋白定量、疗效及A、B组使用雷公藤多苷的不良反应进行比较。结果治疗后A、B组患者的血β-MG、24 h尿蛋白定量较对照组明显降低（P〈0.05）;而A组与B组间比较,差异无统计学意义（P〉0.05）。A组总有效率为81.8%,B组为86.4%,两组间差异无统计学意义（P〉0.05）;对照组的总有效率为63.6%,明显低于A、B组,差异有统计学意义（P〈0.05）。A组雷公藤多苷的不良反应发生率为36.4%,明显高于B组的13.6%,差异有统计学意义（P〈0.05）。结论益肾清利活血方可明显降低雷公藤多苷的不良反应,两者联合疗效显著,具有较好的临床应用价值。     

雷公藤多苷片合益肾活血方对IgA肾病尿IL-6、TNF-α水平的影响

目的 观察雷公藤多苷片合益肾活血方对IgA肾病患者中尿IL-6、TNF-α水平的影响,探讨雷公藤多苷片合益肾活血方治疗IgA肾病的作用机制。方法 将174例IgA肾病患者按随机数字表法分为观察组96例和对照组78例。两组均以氯沙坦钾片50mg/d作为基础治疗,观察组在基础治疗上再予以雷公藤多苷片合益肾活血方治疗,对照组则在基础治疗上予以雷公藤多苷片合益肾活血方的模拟剂治疗,疗程12周。观察治疗前后肝肾功能、尿蛋白定量、尿IL-6和TNF-α水平的变化。观察两组不良反应发生情况。结果两组患者治疗后肾功能稳定、尿蛋白定量均有下降,而观察组肾功能改善及尿蛋白下降更明显（P＜0.05）;观察组尿IL-6和TNF-α水平均有下降,而对照组仅尿IL-6有所下降,两组比较有统计学差异（P＜0.05）。观察组不良反应发生率为15.62％,对照组为6.41％,两组间差异无统计学意义（P＞0.05）。结论雷公藤多苷片合益肾活血方治疗IgA肾病能稳定肾功能、减少蛋白尿、降低尿中炎症因子IL-6和TNF-α的水平。     

益肾活血方加减治疗肾病综合征的临床研究

目的探讨益肾活血方加减治疗肾病综合征（NS）的临床疗效,为中西医结合治疗肾病综合征探索可行途径。方法66例临床及病理确诊的NS患者随机分为治疗组（益肾活血方＋强的松）和对照组（强的松）,观察两组治疗前后的临床疗效、24小时尿蛋白定量、尿α1微球蛋白（α1-MG）、尿β2微球蛋白（β2-MG）,尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）及血肌酐（Scr）、尿素氮（BUN）的水平。结果治疗组总有效率（93.94%）高于对照组（75.75%）;治疗后两组各项生化指标均有改善（P〈0.01或P〈0.05）,治疗组指标改善更明显（P〈0.05）。结论益肾活血方加减治疗NS能提高疗效,改善患者的各项生化指标。     

雷公藤多苷联合厄贝沙坦对IgA肾病疗效及尿足细胞排泄的影响

背景　IgA肾病是全球最常见的原发性肾小球疾病,也是导致终末期肾功能衰竭（ESRD）的常见原因。目前临床上主要采用雷公藤多苷、厄贝沙坦等免疫抑制剂进行治疗,但两者是否具有协同作用从根源上缓解IgA肾病的进展尚未被证实。目的　探讨雷公藤多苷联合厄贝沙坦治疗IgA肾病患者的疗效及其对尿足细胞排泄的影响。方法　根据纳入与排除标准,选取2014年1月-2016年12月河南省人民医院收治的IgA肾病患者128例为研究对象。根据治疗方式,将研究对象分为雷公藤多苷组（42例）、厄贝沙坦组（40例）和联合治疗组（46例）。雷公藤多苷组口服雷公藤多苷片20 mg/次,3次/d;厄贝沙坦组口服厄贝沙坦片150 mg/次,2次/d;联合治疗组同时服用雷公藤多苷片（20 mg/次,3次/d）和厄贝沙坦片（150 mg/次,2次/d）;所有患者治疗12周。收集患者一般资料,治疗前后血压（收缩压、舒张压）、实验室指标〔血肌酐（Scr）、血尿素氮（BUN）、血尿酸（SUA）、血清清蛋白（Alb）、总胆固醇（TC）、估算肾小球滤过率（eGFR）、24 h尿蛋白〕,尿蛋白缓解效果及不良反应,治疗前后尿足细胞。结果　联合治疗组治疗后Alb高于雷公藤多苷组、厄贝沙坦组,治疗后24 h尿蛋白低于雷公藤多苷组、厄贝沙坦组（P<0.05）。雷公藤多苷组、厄贝沙坦组、联合治疗组治疗后Scr、24 h尿蛋白均低于本组治疗前,治疗后Alb、eGFR均高于本组治疗前（P<0.05）;联合治疗组治疗后BUN、SUA低于本组治疗前（P<0.05）。联合治疗组治疗有效率高于雷公藤多苷组、厄贝沙坦组（P<0.05）。3组不良反应发生率比较,差异无统计学意义（P>0.05）。联合治疗组治疗后尿足细胞少于雷公藤多苷组、厄贝沙坦组（P<0.05）。雷公藤多苷组、厄贝沙坦组、联合治疗组治疗后尿足细胞均少于本组治疗前（P<0.05）。结论　雷公藤多苷联合厄贝沙坦治疗IgA肾病患者疗效及减少尿足细胞排泄的效果优于单一雷公藤多苷或厄贝沙坦治疗方案,即二药联用对肾足细胞损伤具有更好的协同保护作用,从而延缓了病情的进展。     

雷公藤多苷治疗糖尿病肾病的随机对照研究

目的探讨雷公藤多苷治疗糖尿病肾病的临床疗效及安全性。方法随机将入选的80例糖尿病肾病患者分为观察组和对照组各40例,两组均采用糖尿病常规综合治疗。观察组在此基础上加用雷公藤多苷,疗程均为6个月。测量比较治疗前后患者24h尿蛋白定量、尿β2-微量蛋白、血尿素氮和血肌酐的变化。结果观察组24h尿蛋白定量、尿β2-MG较治疗前明显降低,差异有统计学意义(P<0.05)。对照组24h尿蛋白定量、尿β2-MG较治疗前明显降低,差异有统计学意义(P<0.05),治疗前后的血尿素氮和血肌酐无明显变化,差异无统计学意义(P>0.05)。观察组降尿蛋白作用较对照组更为明显,两组差异有统计学意义(P<0.05)。公藤多苷治疗未见明显不良反应。结论在常规治疗的基础上,加用雷公藤多苷片降低尿蛋白更有效,且安全可靠。     

不同方法治疗肾病综合征临床疗效分析

目的探讨不同方法治疗肾病综合征临床效果。方法选取该院收治的肾病综合症病人82例,随机分为研究者和对照组,研究组使用甲泼尼松和雷公藤多苷联合治疗,对照组使用单用甲泼尼松进行治疗,比较两组治疗效果。结果研究组患者有28例完全缓解,10例患者病情有缓解,总有效率达到92.7%,4例患者复发,和对照组比较,差异有统计学意义(P<0.05)。在通过24h治疗后尿蛋白含量相比较,两组差异有统计学意义(P<0.05)。结论激素与雷公藤多苷一起用药治疗肾病综合征可以有效增加激素使用效果,减少患者复发率,有临床推广价值。     

贝那普利联合硫唑嘌呤治疗中等量蛋白尿IgA肾病的疗效分析

①目的 探讨贝那普利联合硫唑嘌呤对中等量蛋白尿IgA肾病的治疗疗效.②方法 选择我院经肾穿刺活检术确诊为IgA肾病患者42例作为研究对象,根据就诊先后随机分为联合观察组(贝那普利联合硫唑嘌呤)和对照组(仅贝那普利)各21例.观察组在病理诊断给予贝那普利10mg/d,硫唑嘌呤1.5mg/kg·d治疗.对照组给予贝那普利10mg/d口服治疗.观察比较两组的临床疗效及用药前1天和治疗后12个月患者的血肌酐(SCr)、24小时尿蛋白、尿β2-微球蛋白(β2-MG)的变化情况.③结果 经过12个月的治疗,对照组的尿蛋白治疗后较治疗前下降,尿β2-MG较前下降,血肌酐变化不明显;而联合观察组治疗后12个月的24小时尿蛋白、尿β2-MG分别较治疗前有显著变化,差异有统计学意义(P<0.05),血肌酐无明显升高.联合观察组的有效率为76.2%,对照组的有效率为23.8%,两组疗效比较差异有统计学意义(P<0.05).④结论 对IgA肾病病理Lee分级为Ⅲ~Ⅳ级,24小时尿蛋白定量在1~3.5g之间的患者,贝那普利联合硫唑嘌呤在保护患者肾功能及降低患者的尿蛋白方面优于单用贝那普利的疗效,可以明显降低尿蛋白,改善肾功能,保护肾小管功能.     

雷公藤多苷联合替米沙坦对糖尿病肾病患者肾功能和血流变的影响

目的 探讨雷公藤多苷联合替米沙坦对糖尿病肾病患者肾功能和血流变的影响。 方法 以随机数字法将2014年6月—2016年1月温州医科大学附属黄岩医院收治的216例糖尿病肾病患者随机分为2组,每组108例。对照组给予替米沙坦,观察组在对照组的基础上加用雷公藤多苷。治疗前后,检测患者肾功能指标[尿β2微球蛋白(β2-MG)、24 h尿微量白蛋白排泄率(UAER)、24 h尿蛋白定量(UP)、肾小球滤过率(GFR)]、血液生化指标[血白细胞(WBC)、血清肌酐(Scr)、尿素氮(Bun)、糖化血红蛋白(Hb A1c)]、血液流变[血浆黏度(PV)、纤维蛋白原(PF)、全血高切黏度(HBV)、全血低切黏度(LBV)];并统计2组的治疗效果。 结果 治疗后,2组β2-MG、UAER、UP、GFR水平均明显降低(P<0.05),且观察组β2-MG、UAER、UP、GFR水平改善情况优于对照组(P<0.05)。治疗后,2组WBC、Scr、Bun、Hb A1c水平均明显改善(P<0.05),且观察组WBC、Scr、Bun、Hb A1c水平的改善显著优于对照组(P<0.05)。治疗后,2组PV、PF、HBV、LBV水平均明显改善(P<0.05),且观察组PV、PF、HBV、LBV水平的改善显著优于对照组(P<0.05)。治疗后,观察组治疗总有效率为90.7%,显著高于对照组的79.6%(P<0.05)。 结论 雷公藤多苷联合替米沙坦可有效改善糖尿病肾病患者肾功能和血液微循环,治疗效果满意。      

吗替麦考酚酯联合低剂量甲泼尼龙治疗IgA肾病患者的效果

目的：观察吗替麦考酚酯联合低剂量甲泼尼龙治疗IgA肾病患者的效果。方法：选取2020年1月至2023年1月该院收治的202例IgA肾病患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各101例。对照组采用低剂量甲泼尼龙治疗,研究组在对照组基础上联合吗替麦考酚酯治疗,比较两组临床疗效、治疗前后炎性因子[C反应蛋白（CRP）、降钙素原（PCT）、转化生长因子-β1(TGF-β1)]水平、肾功能指标（血尿素氮、24 h尿蛋白总量、尿微量蛋白）水平和不良反应发生率。结果：研究组治疗总有效率为95.05%(96/101),高于对照组的86.14%(87/101),差异有统计学意义（P<0.05）;治疗后,两组CRP、PCT和TGF-β1水平均低于治疗前,且研究组低于对照组,差异有统计学意义（P<0.05）;治疗后,两组血尿素氮、24h尿蛋白总量和尿微量蛋白水平均低于治疗前,且研究组低于对照组,差异有统计学意义（P<0.05）;两组不良反应发生率比较,差异无统计学意义（P>0.05）。结论：吗替麦考酚酯联合低剂量甲泼尼龙治疗IgA肾病患者可提高治疗总有效率,降低炎...     

雷公藤多苷联合吗替麦考酚酯治疗老年IgA肾病的疗效观察

目的探讨雷公藤多苷联合吗替麦考酚酯（mycophendate mofetil,MMF）治疗老年IgA肾病的安全性和有效性。方法将我院收治的42例老年IgA肾病患者随机分为两组,观察组22例,予以雷公藤多苷联合MMF进行治疗;对照组20例,单用MMF进行治疗。结果治疗6个月后,观察组完全缓解率和总有效率均明显高于对照组（P〈0.05）;两组患者的尿蛋白排泄量、血清白蛋白、血肌酐、总胆固醇等均得到了明显改善,且观察组明显高于对照组（P〈0.05）;观察组和对照组不良反应发生率分别为13.6%与15.0%,两者比较差异无统计学意义（P〉0.05）。结论雷公藤多苷与MMF联合应用,副作用小,可以有效降低蛋白尿。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.