ABSTRACT
Objective To investigate the level of vitamin D in patients with membranous nephropathy and its correlation with proteinuria. Methods Eighty patients with membranous nephropathy were selected from May 2012 to May 2017 in the Department of Nephrology,Shijiazhuang First Hospital. They were divided into two groups with 40 cases in each group. The control group was given prednisolone acetate orally,while the study group was given prednisolone acetate and active vitamin D orally. All patients were followed up for 1 year. Blood urea nitrogen ( BUN), serum creatinine ( Scr), C-reactive protein ( CRP ), cholesterol (TC),triglyceride (TG),calcium (Ca),phosphorus (P),parathyroid hormone (PTH),urinary protein,1,25-dihydroxyvitamin D3 ( 1, 25 ( OH) 2D3) and transforming growth factor-beta ( TG) were measured monthly. F-beta 1 ) and other related biochemical indicators were recorded. Results Before treatment,the level of 1,25(OH) 2D3 in the control group was (3. 67+3. 67) μg／L,while that in the study group was (3. 69+3. 70) μg／L. There was no significant difference ( t＝1. 259,P＞0. 05) . One year after treatment,the level of 1,25(OH) 2D3 in the control group was (4. 87+2. 92) μg／L,while that in the study group was (19. 58+12. 12) μg／L,which was significantly higher in the study group than in the control group (t＝12. 384,P＜0. 05). Serum 1,25 (OH) 2D3 levels were positively correlated with blood calcium,plasma albumin,podocyte and TGF-β1 (r＝0. 301,0. 387,0. 342 and 0. 181,respectively,P＜0. 05); serum 1,25 ( OH) 2D3 levels were negatively correlated with blood phosphorus content,total cholesterol and 24 h urinary protein quantity (r value was －0. 265,－0. 033 and －0. 265,respectively,P＜0. 05) . Serum albumin was an independent factor of serum 1, 25 ( OH ) 2D3 ( P＜0. 05 ) . Conclusion The serum albumin is an independent risk factor for 1, 25 ( OH ) 2D3 in patients with membranous nephropathy. Vitamin D is negatively correlated with proteinuria. Active vitamin D has a better effect on proteinuria in patients with membranous nephropathy.
ABSTRACT
Objective To investigate the effect of emergency nursing pathway in emergency treatment of patients with questionable sources. Methods A clinical nursing pathway for the treatment for patients with questionable sources was formulated. From February to December 2014, 78 patients with questionable sources treated by clinical nursing pathway were selected as the observation group. From January to November 2013, 75 patients with questionable sources treated by routine nursing care methods were selected as the control group. Differences were compared in duration of staying in the emergency department, nursing complication and fees paid rate between the two groups. Results For the average duration of staying in the emergency department, the observation group was lower than that in the control group [19.35%(9.08) vs. 19.90%(25.20), P< 0.05)]. For the nursing complication rate, the observation group was significantly lower than that of the control group [1.28%(1/78) vs.10.67%(8/75), P<0.05]. For the fees paid rate, the observation group was significantly higher than that in the control group [64.10%(50/78) vs. 33.33%(25/75), P<0.01]. Conclusions By the emergency nursing pathway, emergent patients with questionable sources will be treated with satisfactory result in the shortest time.