ABSTRACT
Objective To assess the efficacy of combined vitamin D with calcium and vitamin D or cal-cium alone in rickets of vitamin D deficiency by meta-analysis method. Methods Searches were made in Cochrance Library , Pubmed, Web of science, Scirus, CNKI, Chinese Biological Medical Literature Database, (CBM),Wangfang from the establishment of the data base till March 2013. All randomized controlled trials about combined with vitamin D and calcium in rickets of vitamin D deficiency were eligible. Serum 25-( OH) ritamin D,phosphate ,ALP,calcium,PTH,phosphate,albumin ,radiographic score were chosen as evaluation in-dex to evaluate the weighted mean diffreence ( WMD) and 95% confidence interval ( CI) for continuous data. RevMan 5. 0. 2 software was used to make meta-analysis. Results 437 literatures were reviewed. Three eligible trials were used for meta-analysis. Meta-analysis showed that:(1)the increase of Serum 25-(OH)vitamin D:Combined therapy group and vitamin D group (MD= -7. 88,95%CI:-12. 24~ -3. 52);Combined therapy group and calcium group (MD= -18. 32,95%CI:-22. 61~ -14. 04). (2)the increase of serum phosphate:Combined therapy group and vitamin D group ( MD= -0. 64 ( 95%CI:-0. 86 ~ -0. 42 );Combined therapy group and calcium group MD= -0. 16 ( 95%CI:-0. 84 ~0. 51 ) . ( 3 ) the decrease of Serum ALP:Combined therapy group and vitamin D group (MD= 109. 99,95%CI:20. 40 ~199. 58);Combined therapy group and calcium group (MD=59. 89,95%CI:10. 09~109. 59 ). (4)the increase of serum calcium :Combined therapy group and vitamin D group (MD= -0. 71,95%CI:-0. 91,-0. 52);the decrease of Radiographic score:Com-bined therapy group and vitamin D group( MD=0. 68,95%CI:0. 42~ 0. 95). Except that the increase of serum phosphate between combined therapy group and calcium group had no significant difference,the rest had signifi-cant difference. Conclusion The long term efficacy in combined therapy group is much effective than vitamin D group or calcium group.
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Objective To evaluate the effects and safety of tarcrolimus on children difficult nephritic syndrome.Methods Databases including the Cochrane Library,Pubmed,Medline,OVID,CNKI,Wan Fang Data and VIP were searched to collect the controlled trials on tacrolimus capsule published from Jan 2003 to Jun 2013.The quality of the included randomized controlled trials was assessed by Jadad,and the complete remission,the fail,the relapsing rate of 12 month and side effects after treatment were extracted,meta-analysis was performed using RevMan 5.0 software.Results Among 179 articles,6 articles were included,4 of them were English and the other 2 were Chinese.The results of meta-analysis based on stratified therapeutic strategies showed that:(1) comparing with cyclophosphamide,tacrolimus could decrease the fail and relapsing rate of 12 month,but could not increase the complete remission (P ＞ 0.05).(2) Comparing with cyclosporine A,tacrolimus had no difference in complete remission and the relapsing rate of 12 month (P ＞ 0.05),but could decrease the fail.(3) Tacrolimus could increase the complete remission and decrease fail,but had no difference in relapsing rate (P ＞ 0.05).(4) There was no significant difference in relapsing rate between tacrolimus and rituximab(P ＞ 0.05).(5) Tacrolimus had less side effects than cyclophosphamide.Conclusion Tacrolimus have advantages to cyclophosphamide,cyclosporine A and prednisolone,but not to rituximab,and have less side effects than cyclophosphamide.
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Objectives To investigate the effect of matrine (MAT) on adriamycin (ADR) induced podocyte injury in vitro and explore the function of the mammalian target of rapamycin (mTOR) protein signaling pathway during the intervention. Methods ADR (1μmol/L) was used to induce the model of podocyte injury and then the podocytes were intervened by 10, 20 and 40μg/ml MAT for 24 hours. The viability and apoptosis rate of podocytes, mRNA and protein expressions of desmin and mTOR were detected. The effect of different concentrations of MAT on ADR-induced podocytes was analyzed. Results Com-pared with the control group, declined viability of podocytes (P<0.001), increased percentage of apoptotic podocytes (P<0.001), and increased expression of damage marker desmin (P=0.002) were observed in ADR group. In ADR group, after intervention with MAT of 10-40μg/ml, increased viability of podocytes (P<0.05), decreased percentage of apoptotic podocytes (P<0.05), and decreased expression of damage marker Desmin were found (P<0.05). The protein expression of mTOR and phosphorylation state of mTOR (p-mTOR) decreased in ADR induced-podocytes (P<0.05), and after intervention with MAT of 10-40μg/ml, the expression of mTOR and p-mTOR increased (P<0.05). The expression of mTOR downstream target protein s6k1 and 4EBP1 mRNA decreased in ADR group (P=0.071), while increased after intervention with MAT of 10-40μg/ml (P<0.05). Conclusions 10-40μg/ml MAT have protective effects on ADR-induced podocytes in vitro. The protection mechanism may be related to mTOR signaling pathway.
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Objective To study the association of vitamin D receptor(VDR) gene BsmI polymorphism and the genetic susceptibility of vitamin D deficiency rickets in infants and to explore a new way of diagnosis and treat-ment. Methods Case-control study was adopted. 56 infants confirmed with rickets (case group) and 76 cases of normal infants (control group) were chosen as the subjects. PCR-RFLP was applied to examine VDR gene BsmI site polymorphism. The frequencies of the VDR genotype and allele were compared between the two groups. Results Frequencies of BB,Bb and bb genotypes were 3.6% (2/56),21.4% (12/56) and 75.0% (42/56) in the rickets group,and 1.3% (1/76),18.4% (14/76) and 80.3% (61/76) in the control group respectively(χ20.521,P> 0.05),frequencies of B,b alleles were 14.3% (16/112),85.7% (96/112) in the rickets group and 10.5% (16/152),89.5% (134/152) in the control group respectively(χ20.783,P>0.05). Multiple logistic regression analysis showed that VDR gene polymorphism Bsml had not higher risk of vitamin D deficiency rickets in Infants. Conclusion VDR gene polymorphism BsmI doesn't appear to pose risk on infants in developing vitamin D deficien-cy rickets.