原发性肾病综合征湿热证与炎症因子相关性的探讨

湿热证是原发性肾病综合征的主要证候之一,在肾病综合征的辨证治疗中是一个不容忽视的重要因素.主要探讨原发性肾病综合征湿热证与炎症因子的相关性,希望从细胞因子水平客观揭示原发性肾综湿热证与炎症细胞因子的相关性,进而从现代化角度进一步揭示中医湿热因素的实质及部分病理机制.     

肾复康胶囊治疗慢性肾炎的临床观察

慢性肾小球肾炎(慢性肾炎)是一种病因病机较为复杂的疾病,它是一种多发病、常见病,是进入终末期肾功能衰竭的一个阶段,故而需要早期治疗.我院研制的纯中药制剂肾复康胶囊及肾炎康胶囊治疗慢性肾炎收到了良好效果.为了进一步评价肾复康胶囊的疗效及其安全性,参照"中药新药治疗慢性肾炎临床研究指导原则”,对慢性肾炎的气阴两虚、瘀血内阻证进行临床观察.中医认为慢性肾炎的根本原因在于机体脏腑功能的虚损,以致气血运行失常,形成血瘀、湿热、水湿等标实之证.所以认为采取益气养阴、活血化瘀,治疗慢性肾炎的气阴两虚、瘀血内阻之证,可以取得较好疗效.     

慢性肾炎从咽论治84例

慢性肾炎从咽论治８４例许陵冬王钢（南京中医药大学附属医院２１００２９）关键词慢性肾炎从咽论治中医药疗法慢性肾炎是一种常见的肾脏疾患。我们在临证中发现上感、扁桃体炎、咽炎是其常见的兼证。而且肾炎的发病与复发，以及病情的加重和外感、咽部炎症密切相关。在辨...     

慢性肾炎中医辨证与免疫指标相关性研究概况

慢性肾炎中医辨证的微观指标的研究是近年来中西医结合临床与科研的热门课题 ,许多学者对此做了大量有益的工作 ,在一定程度上揭示了中医证与客观指标的内在联系。自 80年代开始 ,从临床分证、实验室检查、病理活检、免疫指标、血液流变学、内分泌、微量元素等不同角度研究慢性肾炎有关中医辨证的微观指标变化 ,为临床宏观辨证提供了客观的参考依据 ,将宏观辨证与微观辨证有机结合起来 ,对推动慢性肾炎的中西医结合诊疗水平有着重要意义。随着免疫学的发展 ,肾小球肾炎的产生与免疫反应的密切相关性日益受到人们的重视 ,在中西医结合领域 ,…     

非IgA系膜增生性肾小球肾炎中医辨证与临床疗效分析

目的了解慢性肾小球疾病在常规西医治疗下不同中医辨证分型之间疗效的差异性。方法调查随访住院接受肾活检的129例非IgA系膜增生性肾小球肾炎病人的中医辨证分型与疗效。结果肺肾气虚证组患者与脾肾气虚证组患者比较,其发病年龄较轻,病程较短;湿热证组患者血白细胞水平较非湿热证组患者高;瘀血证组患者与非瘀血证组患者比较,其发病年龄较大,病程较长,血肌酐水平较高;非湿热证组患者临床疗效优于湿热证组;非瘀血证组患者疗效优于瘀血证组。结论非IgA系膜增生性肾炎病理类型的慢性肾脏病患者,其中医辨证类型不同,接受同样治疗方案后疗效也不同,对于有湿热证侯的患者应加强抗炎除湿热治疗,对于有瘀血证侯的患者,应加强活血化瘀治疗。     

肾复良胶囊治疗慢性肾炎的临床观察

慢性肾小球肾炎 (慢性肾炎 )是一种病因病机较为复杂的疾病 ,它是一种多发病、常见病 ,是进入终末期肾功能衰竭的一个阶段 ,故而需要早期治疗。我院研制的纯中药制剂肾复康胶囊及肾炎康胶囊治疗慢性肾炎收到了良好效果。为了进一步评价肾复康胶囊的疗效及其安全性 ,参照“中药新药治疗慢性肾炎临床研究指导原则” ,对慢性肾炎的气阴两虚、瘀血内阻证进行临床观察。中医认为慢性肾炎的根本原因在于机体脏腑功能的虚损 ,以致气血运行失常 ,形成血瘀、湿热、水湿等标实之证。所以认为采取益气养阴、活血化瘀 ,治疗慢性肾炎的气阴两虚、瘀血内阻…     

慢性肾炎的辨证施护

现代医学认为,肾炎是变态反应性疾病,与机体免疫功能密切相关,近年来,对肾炎患者采用中西医辨证施治,结合调整免疫功能药物进行治疗,同时加强辨证施护,也是提高治愈慢性肾炎的一大举措,现就其谨作介绍.     

银屑病关节炎中医辨证分型与免疫炎症指标、细胞因子相关性研究

[目的]观察银屑病关节炎(Ps A)不同中医证型与免疫炎症指标、细胞因子相关性。[方法]将62例确诊为Ps A的患者按照中医辨证分型分为湿热内蕴证、寒湿阻络证、阴虚血燥证,检测各组患者的红细胞沉降率(ESR)、C-反应蛋白(CRP)、免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)、肿瘤坏死因子-α(TNF-α)、白介素(IL)-17、IL-23等指标,研究其中医证型与各项指标之间的相关性。[结果]3组患者Ig A、Ig G、Ig M水平均高于正常范围,但各组间差异无统计学意义(P0.05),湿热内蕴证患者ESR、CRP、TNF-α、IL-17、IL-23水平显著高于寒湿阻络证及阴虚血燥证患者,差异有统计学意义(P0.01)。[结论]银屑病关节炎患者的病情活动程度、免疫功能状态与中医证型存在关联,炎症指标和细胞因子可能作为中医辨证分型的微观指标。     

中医辩证施治加肾炎合剂治疗慢性肾炎90例临床分析

我们在应用中医辨证施治加肾炎合剂治疗慢性肾炎取得疗效的基础上(《中医杂志》(4):34,1981),进一步探索了中医辨证加肾炎合剂治疗慢性肾炎安全而有效的方法,并观察了见效时间以及与免疫的关系,现将1980—1983年初90例慢性肾炎住院患者进行临床分析如下:     

大肠癌中医辨证文献研究

目的:寻求大肠癌中医辨证施治规律、便于规范大肠癌的中医治疗;方法:本文就近30年来国内公开发表的中医药治疗大肠癌的相关文献进行筛选、整理、统计和分析;结果:病因中正虚是以脾虚、肾虚为主,邪实以热毒、瘀血、湿热为主;辨证分型主要为脾肾阳虚证、气血两虚证、肝肾阴虚证、湿热证、瘀毒证;结论:大肠癌的中医辨证施治是有规律可循,但目前的文献报道难以反应中医辨证治疗的演变规律。     

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.