ABSTRACT
This study was aimed to analyze the pathogen distribution,drug resistance and traditional Chinese medicine (TCM) syndrome of patients with primary nephrotic syndrome complicated with pulmonary infection for the guidance of clinical practice.The clinical data of 180 patients with primary nephrotic syndrome complicated with pulmonary infection were analyzed.The results showed that among 180 patients,117 were male,accounting for 65％;73.33％ of them were over 40 years old.Membranous nephropathy was the most common pathological type,accounting for 40％.Gram-negative bacteria were the main pathogen,accounting for 51.72％.The drug resistance rates of piperacillin/tazobactam,imipenem,amikacin,gentamicin were the lowest.The drug resistance rates of third generation of cephalosporins and quinolone antibiotics were in the middle.In TCM syndrome differentiation,central qi deficiency and phlegm syndrome occupied the highest proportion,accounting for 25.56％;and the phlegm heat in the lung syndrome,accounting for 17.78％;wind evil attacking the lung syndrome,accounting for 13.33％;qi deficiency and phlegm syndrome,accounting for 9.45％;qi deficiency,blood stasis and water stagnation syndrome,accounting for 8.89％;the mixture of deficiency and excess syndrome,accounting for 59.45％,with qi deficiency as the main part.It was concluded that middle-aged and older men,pathologic type of membranous nephropathy had the higher rate of suffering pulmonary infection.Gram-negative bacteria were the main pathogen.The choice of antibiotics should be based on piperacillin/tazobactam,and third generation of cephalosporins.Qi deficiency and phlegm syndrome was the most common TCM syndrome.
ABSTRACT
This paper summarized Professor Huang Chunlin's traditional Chinese medicine (TCM) medication expe-riences for patients with hypoalbuminemia in refractory nephrotic syndrome (RNS). This paper was divided into three parts. The first part was the overview of hypoalbuminemia in RNS. The second part was the TCM medica-tion experiences for patients with hypoalbuminemia in RNS which included the integrated application of tonifying the spleen, nourishing the liver and reinforcing the kidney. The third part was the explanation of the comprehen-sive application of Professor Huang Chunlin's TCM medication experiences for patients with hypoalbuminemia in RNS through the introduction of a typical case. TCM medication experiences for RNS treatment based on experi-ences of famous TCM doctors provided theoretical and practical basis for therapeutic regimen.
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IgA nephropathy is the most common primary glomerular disease in China without any specific treat-ment. Corresponding treatments are usually adopted according to different clinical types. Referred to the clinical classification principles and the experiences of his own, Professor Huang Chunlin presented traditional Chinese medicine (TCM) medication experiences for different clinical types of IgA nephropathy which had some clinical instructive significance .
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This study was aimed to analyze the medication and herbal prescription rules in the treatment of nephrotic syndrome (NS) by Prof. Huang Chunlin with Traditional Chinese Medicine Inheritance Support System ( TCMISS ) . Prescriptions used for NS treatment were collected and the data was entered into the TCMISS . The commonly used herbs and herbal prescription rules in NS treatment by Prof. Huang were summarized through the association rules, revised mutual information, complex system entropy cluster and other unsupervised hierarchical clustering methods. The results showed that based on the analysis of 280 prescriptions from 68 patients, the fre-quency of each herb and association rules among herbs included in the database were identified. And the basic NS treatment prescription by Prof. Huang Chunlin and 8 new prescriptions were mined from the database. It was concluded that data mining is of great practical value to the summarization of clinical experiences of well-known TCM doctors.
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Objective To evaluate the clinical diagnosis and treatment of acute renal infarction.Methods Two cases (3 sides) of acute renal infarction were reported.The patients were 1 male and 1 female,with the age of 62 and 54 years.Case 1 presented acute left flank pain,and enhanced CT showed a non-enhanced area in the upper and mid pole of the left kidney.The diagnosis of focal renal infarction was made and treated with low-molecular heparin (6000 U ).Case 2 presented acute both right abdominal and flank pain,and enhanced CT showed right renal artery embolism and right renal complete infarction.Digital subtraction angiography (DSA) and catheter thrombolytic therapy was applied.4 months later,the patient presented acute left flank pain,and enhanced CT showed a low density area in left kidney without enhanced by contrast,and DSA and catheter thrombolytic therapy was applied again.Results In case 1,contrastenhanced MRI showed a still low signal area like enhanced CT after 2 days of treatment.The renal function remained normal in the follow-up of 36 months.In case 2,the right kidney resorted to moderate blood flow but became atrophy later.In the follow-up of 4 months,a recurrent focal infarction was confirmed in left kidney by enhanced CT.The left kidney also resorted to moderate bloodflow after DSA and catheter thrombolytic therapy.The renal function became normal after follow-up of 10 months and no new infarction was observed.Conclusions The diagnosis of acute renal infraction could be made by enhanced CT or MRI.Early diagnosis and location of the infraction renal artery is critical for recovery of the impaired renal function.Acute renal infraction should be suspected in patients with unexplained persistent and steady flank or abdominal pain in emergence department.
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Objective To discuss the imaging diagnostic features of adrenal injury. Methods The imaging features of the 29 patients of adrenal bruise and hernatoma (20 male and 9 females, average age 37) were retrospectively analyzed. The clinical appearances were all flank and hack pain, local sensitive to percus-sion and associated injury appearance. Among the 29 cases, 25 cases(86%) had adrenal injuries on right side, 2 cases(7%) on left side, and 2 cases(7%) on both sides, and no apparent abnormality was found in the relevant endocrine examination after injury. CT (n=29), MRI (n=5) and ultrasonography (n=6) were checked. CT follow-up were taken in 23 eases. MRI (n=1) and ultrasonography (n=l) were followed as well. Results The first-time exam coincidences of CT, MRI and sonography were 28/29 (97%), 5/5 (100%) and 3/6 (50%) respectively. One case of simple right-side adrenal hematoma 3 weeks after injury wasn't clearly diagnosed by CT, which was later diagnosed by MRI. The CT features of adrenal bruise were local or diffuse intumescence and focus high-density hemorrhage shadow. The CT appearances of acute stage adrenal hematoma were round-like high-density shadow without enhancement and the diameters were 1-3 cm. MRI appearances of 5 cases of subacute and chronic phase hematoma were typical high signal of T1WI, T2WI and DWI and toroid low signal around T2WI. Hematorna was not be enhanced when CT or MRI en-hancement scanning, and formed characteristic "nut-like" image feature with toroid high-density or high sig-nal enhanced shadow forming around. Uhrasonography appearances of 3 cases of hematoma were abnormal shadow of the adrenal gland. Conclusions CT is the prior imaging method for adrenal bruise and hemato-ma. MRI has the characteristic appearance for the few cases which are difficult to be identified by CT and ul-trasonography. Characteristic "nut-like" image feature is helpful for the diagnosis and differential diagnosis.
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Objective To investigate the best dose of treating diabetic renal insufficiency (DRI) with Tangduqing granules. Methods To establish model rats of DRI by the method of 5/6 nephrectomy and abdominal cavity injection with streptozotocin. The successful model rats with DRI were divided into four groups randomly:model group, high dose group, medium dose group, low dose group. Ten age-matched healthy male SD rats were served as controls (administered with NS 2 mL/d). Ten weeks later, contents of the BUN, SCr and urine protein excretion in 24 hours were determined. And to detect the best dose of treating DRI with Tangduqing granules by evaluating the effect of Tangduqing. Results Tangduqing had the function of reducing contents of BUN, SCr and urine protein excretion in 24 hours of rats with renal insufficiency. Conclusions Tangduqing may effectively delay the development of renal failure. The therapeutic effects of medium dose group were the best.
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Neferine, an alkaloid, isolated form Nelumbo nucifera Gaertn,has antiarrhytbmic effect. The present report deals with its action on the ECG in rat & the surface potential of toad sciatic nerve.Neferine could prolong ECG, P-R & Q-T intervals, and widen QRS in a dose-dependent manner, The effects are similar to quini-dine, and dissimilar to tetrandrine. The inhibitory effects of neferine & quinidine on the surface potential of toad sciatic nerve are similar in potency.
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Tetrandrine, a bis-benzy 1-i soqui noline alkaloid isolated from Radix Stephania tetrandra S. Moor, was proved to be a calcium antagonist. Its effects upon the heart conduction system were investigated in anesthetized rabbits.Tetrandrine 8 mg/kg iv could prolong the sino-atrial conduction time & the sinus node recovery time from 50 ? 13 ms & 286? 36 ms to 75?19 ms ( n= 8 , P