ABSTRACT
OBJECTIVE：To study the diff erences in the overall chemical constituents of Angelicae dahuricae with and without sulphur-fumigation，and to select chemical markers that can be used for identification. METHODS ：Each 16 batches of A. dahuricae with and without sulphur-fumigation were selected as samples. Deuterated methanol-deuterium oxide （1 ∶ 0.2，V/V）was used as extraction solvent ，and 1H-NMR metabolomics was used to detect the primary and secondary metabolites in A. dahuricae . In addition ，visual analysis ，principal component analysis （PCA）and t-test were used to compare the component differences of A. dahuricae by two kinds of pretreatment methods. RESULTS ：A total of 19 chemical constituents such as coumarins ，amino acids and sugars were simultaneously detected and identified from two kinds of A. dahuricae . Visual analysis showed that the chemical profiles of the two kinds of A. dahuricae were similar ，but their coumarins and carbohydrates were quite different in 1H-NMR signal intensity. PCA analysis showed that all samples could be divided into two categories according to different treatment methods. The results of t-test showed that the contents of oxypeucedanin ，imperatorin，glucose and sucrose of A. dahuricae were decreased significantly after sulphur fumigation （P＜0.01 or P＜0.001），while the contents of alanine and leucine were significantly increased （P＜0.01 or P＜0.001）. There was no statistical significance in the contents of other 13 kinds of components （P＞0.05）. CONCLUSIONS：There are obvious differences in the 6 chemical compounds of oxypeucedanin ，imperatorin，glucose，sucrose， alanine and leucine in A. dahuricae with and without sulphur-fumigation ，which can be used as chemical markers for the identification of sulphur-fumigated A. dahuricae in the market.
ABSTRACT
Objective To investigate the clinical features and risk factors of adult nephrotic syndrome with pulmonary thromboembolism (PTE). Methods Sixty patients diagnosed with nephrotic syndrome and clinically suspected with PTE were enrolled in this retrospective study. Patients were divided into PTE group (n=32) and no-PTE group (n=28) according to the results of computed tomographic pulmonary angiography (CTPA). The single factor analysis and Logistic repres?sion analysis were used to analyse risk factors including age, gender, onset time, clinical symptoms, laboratory examination and pathological types. According to the independent risk factors, the receiver-operating characteristic curve (ROC curve) was used to determine PTE threshold value based on the evaluation index in nephrotic syndrome. Results Single factor analysis showed that there were significant differences in disease duration, hemoglobin, serum albumin, total cholesterol, low-density lipoprotein cholesterol, D-dimer and physical examination in P2 hyperthyroidism between two groups (P <0.05). Logistic regression analysis showed that D-dimer was independent risk factor of PTE. The analysis of ROC curve indi?cated that D-dimer optimal threshold was 1 015.50μg/L. Conclusion D-dimer is an independent risk factor of PTE in pa?tients with nephrotic syndrome. When D-dimer is greater than 1 015.50μg/L, should pay attention to the occurrence of PTE.
ABSTRACT
Objective To systematically review the efficacy and safety of mycophenolate mofetil versus cyclophosphamide in adults with refractory nephrotic syndrome. Methods The randomized controlled trials of mycophenolate mofetil and cyclophosphamide treatment for refractory nephrotic syndrome were searched from Cochrane library, PubMed, Embase, Wanfang, VIP and CNKI till March 2014. The relevant studies were screened according to inclusion criteria and exclusion criteria. The quality of the included studies was evaluated. Meta-analyses were performed by using RevMan 5.2 software. The indexes were analyzed including the complete remission rate, efficiency, serum albumin, and adverse reaction after completing the treatment for adults with refractory nephrotic syndrome. Results There were 9 RCTs, a total of 467 patients were enrolled. The result of the meta-analysis showed that mycophenolate mofetil could significantly increase complete remission rate (RR=1.45, 95%CI=1.17～1.81, P=0.000 7) and efficiency rate (RR=1.23, 95%CI=1.11～1.36, P＜0.000 1). It can also enhance the level of serum albumin (WMD=2.73, 95%CI=1.42～4.04, P＜0.000 1) and decrease 24-hour urinary protein (SMD=-0.63, 95%CI=-1.16～-0.10, P=0.02) compared with cyclophosphamide in the treatment of refractory nephrotic syndrome. There was no significant difference in the serum level of cholesterol between mycophenolate mofetil group and cyclophosphamide group (SMD=0.31, 95%CI=-0.23～0.84, P=0.26 ). The incidence rates of liver dysfunction (RR=0.13,95%CI=0.06～0.28, P＜0.000 01), leukopenia (RR=0.10, 95%CI=0.04～0.23, P＜0.000 01), gastrointestinal reaction (RR=0.21, 95%CI=0.11～0.39, P＜0.000 01) and alopecia (RR=0.08, 95%CI=0.02～0.29, P＜0.000 01) were significantly lower in mycophenolate mofetil group than those of cyclophosphamide group. There were no significant differences in respiratory tract infection rate (RR=0.68, 95%CI=0.41～1.14, P=0.14) and lung infection rate (RR=0.58, 95%CI=0.31～1.08, P=0.09) between the two groups. Conclusion The safety and efficacy are better in the treatment of refractory nephrotic syndrome using mycophenolate mofetil than that of cyclophosphamide.