Analgesic efficacy of ultrasound?guided adductor canal blockade after minor arthroscopic knee surgery / 实用医学杂志

Objective To investigate the analgesic efficacy of ultrasound?guided adductor canal blockade (ACB)after minor arthroscopic knee surgery. Methods Sixty patients undergone minor arthroscopic knee surgery were randomly divided into group ACB(n=20)and group Control(n=20). All patients received spinal anesthesia. The patients in group ACB received ultrasound?gGuided ACB with 20 ml 0.5% ropivacaine,and patients in group Control received 20 ml saline after the surgery. In addition ,all patients have a basic analgesic regimen with etoricoxib. Visual analogue scales(VAS) during rest and passive movement ,additional analgesic dose and side effects were recorded at 4,8,12,24 h Post?operation. At 24 h post?operation,the numbers of patients who can walk for 5 meters were recorded. Results VAS during rest and movement at 4 h,8 h and 12 h post?operation in group ACB were significantly lower than those in group Control. And all patients could walk 5m at 24 h post?operation. No headache,nausea and vomiting,urinary retention and other adverse reactions were observed in group ACB. There were four patients who received additional analgesic and one patient vomitted. Conclusions Significant analgesic effect of the ACB could be detected after minor arthroscopic knee surgery ,with less reduction in requirements for supplemental opioids.

Prevalence of idiopathic membranous nephropathy and clinicopathologic correlation with serum anti-PLA2R antibody in a single center / 中华肾脏病杂志

Objective To conduct a single-center retrospective analysis on the distribution characteristics and prevalence of idiopathic membranous nephropathy (IMN) patients diagnosed with pathology for the past 16 years,to investigate diagnostic and differential diagnostic value of serum antiphospholipase A2 receptor antibodies (PLA2R-Ab),and to evaluate the correlation between PLA2R-Ab and clinical disease activity.Methods (1) 6996 biopsy-proven primary glomerular nephropathy (PGN) patients,including 1567 IMN cases,admitted to the First Affiliated Hospital of Xi'an Jiaotong University from January 2000 to December 2015 were involved.Demographics and pathological type were gathered from all patients.(2) 433 cases receiving renal biopsy and testing PLA2R-Ab from June 2015 to December 2015 were involved,with their clinical and laboratorial data being collected.During the period patients' follow-up time,therapeutic schedule and laboratory results were recorded.Results (1) IMN accounted for 22.4％ of primary glomerular disease,and patients above 40 years old accounted for more than 60％ of the IMN.(2) The sensitivity and specificity of serological PLA2R-Ab were 58.1％(95％CI 47.0％-68.5％) and 98.6％(95％CI 95.6％-99.6％) respectively.PLA2R-Ab positive rate was affected by immunosuppression therapy.(3) The PLA2R-Ab titers wasn't correlated with 24-hour urinary protein (r=-0.017,P=0.887),serum albumin (r=-0.072,P=0.549) and urinary red blood cell count (r=-0.030,P=0.802).There was no difference between PLA2R-Ab positive positive and PLA2R-Ab negative on proportion of IMN pathological stage Ⅰ-Ⅱ (P ＞ 0.05).Thirteen cases of patients with PLA2R-Ab positive were all prescribed glucocorticoid combined with immunosuppressant.After (2.21± 1.09) months,the decrease of PLA2R-Ab titers was in accordance with 24-hour urinary protein quantity descending and serum albumin ascending (P ＜ 0.05).Condusions The incidence of IMN increase year by year,especially in the mid-aged and the elderly.Serum PLA2R-Ab correlates not with IMN pathological stage,but with the development of IMN.Monitoring PLA2R-Ab titers individually may access the efficiency of treatment.

Immunological changes in the serum of elderly patients with primary nephrotic syndrome / 西安交通大学学报(医学版)

Objective To investigate immunological changes in the serum of elderly patients with primary nephrotic syndrome (PNS).Methods We made a retrospective analysis of clinically relevant immunological parameters and pathological data of PNS patients 60 years old and above (elderly group)in our hospital for kidney biopsy between September 2010 and November 2013.The data of similar patients but younger than 60 years old (control group)were collected for comparison.Results ① The average levels of IgG in serum of the two groups were both lower than the normal level.And the patients with a decreased level accounted for 59.3% in the elderly group and 78.2% in the control group.The results exhibited a significant difference (P 0.05).③ IgG had a negative correlation with urinary protein and cholesterol in serum (the values of r were-0.107,-0.238,respectively,P <0.05).However,there was a positive correlation between IgG and albumin (r=0.252,P <0.05).The results in both groups were consistent.④ Membranous nephropathy was the most common pathological type in aged patients while in control group IgA nephropathy was the most common.Conclusion ① The level of IgG in the serum decreases in most aged patients with PNC.The serum IgA and IgG/IgM ratio are elevated while concentrations of C3 and C4 change little.②The change of IgG is correlated with urinary protein, serum albumin and cholesterol in aged patients with PNS.

Analysis of clinical and pathological relationship of idiopathic membranous nephropathy in elderly patients / 中华老年医学杂志

Objective To understand the clinical and pathological characteristics of idiopathic membranous nephropathy,and to investigate their relationships in the elderly patients.Methods The clinical and pathological data of idiopathic membranous nephropathy diagnosed by renal biopsy in the recently 10 years in our hospital were retrospectively analyzed and compared.Results Sex composition variable was not significant between elderly and non-elderly groups,with male accounting for 57.4％ and 59.2％ respectively (P＞0.05).The ratio of idiopathic membranous nephropathy in primary glomerular disease was higher in the elderly than in non-elderly group (42.8％ vs.17.4％,x2 =119.058,P＜0.01).The course of the disease,the occurrence of edema,hypertension,levels of blood urea nitrogen,serum creatinine,blood IgG,IgA and IgG/IgM ratio were higher,while glomerular filtration rate and blood IgM level were lower in elderly group than in non-elderly group (all P＜0.05).The risk for membranous nephropathy was higher in elderly than in non-elderly group (Z=-5.853,P＜0.01).Nephrotic syndrome was common in the clinical diagnosis in the two groups,but it was more common in elderly group than in non-elderly group (x2 =6.825,P=0.033).Membranous nephropathy stage Ⅱ was common in the two groups,and there were no significant differences in the pathological stages,clinical manifestations and their relationships between the two groups (all P＞0.05).Conclusions The risk for idiopathic membranous nephropathy is higher in elderly group than in non-elderly group.Edema,hypertension and renal dysfunction occur more commonly in elderly patients with idiopathic membranous nephropathy.

Inhibitory effect of MG132 on proliferation, migration and epithelial-mesenchymal transition of human lens epithelial cells / 中华实验眼科杂志

Background The primary pathologic mechanism of posterior capsular opacification (PCO) is proliferation,migration and epithelial-mesenchymal transition (EMT) of residuary lens epithelial cells (LECs) after cataract extract surgery.Researches showed that MG132,a proteasome inhibitor,can attenuate the proliferation of bovine LECs,but its effect on human LECs remains unclear.Objective This study was to investigate the inhibitory effect of MG132 on proliferation,migration and differentiation of human LECs in vitro.Methods Human lens capsule were collected during the surgery.Human LECs were primarily cultured by explant method and passaged.The second or third generation of cells were incubated to 96-well plates at the density of 5×105/ml (200 μl/well) for 24 hours.Fibroblast growth factor-2 (FGF-2,10 mg/L),MG132 (10 μmol/L) or MG132+FGF-2 was added into the culture medium for 24 hours separately,and regular cultured cells served as the control group.The proliferation value (absorbance,A490) of the cells was assayed by MTT colorimetric method.A bare area was made by a sterile cotton swab in the cell layer,and migrated cell number in the blank zone was counted to evaluate the migration ability of the cells after 24 hours.Transforming growth factor-32(TGF-β2),MG132 or MG132+TGF-β2 was added into the culture medium for 24 hours separately,and the expression of fibronectin (FN) in the cells was detected using immunochemistry.Results The proliferation values (A490) of the cells were 0.582±0.020,0.723±0.010,0.434± 0.011 and 0.465±0.008 in the control group,FGF-2 group,MG132 group and MG132 + FGF-2 group,respectively,showing a significant difference among the groups (F =110.482,P＜0.01).The A value was significantly higher in the FGF-2 group and lower in the MG132 group and MG132+FGF-2 group than that of the control group (all at P＜ 0.05).The migrated cell number was 8.67 ± 1.08,11.58 ± 1.59,2.67 ± 0.09 and 2.75 ± 0.09 in the control group,FGF-2 group,MG132 group and MG132+FGF-2 group,respectively,with a significant difference among the groups (F=34.301,P＜0.01),and more cells in the blank zone were seen in the FGF-2 group and less cells were in the MG132 group and MG132+FGF-2 group in comparison with the control group (all at P＜0.05).Compared with the control group,the proliferative rate and migrating rate of the cells declined by 25.4％ and 75.0％ in the MG132 group as well as 20.1％ and 68.3％ in the MG132+FGF-2 group,but in the FGF-2 group,they increased by 24.2％ and 33.6％.The expressing levels (A value) of FN in the LECs were 1.242±0.023,2.329±0.113,1.043 ±0.021 and 1.163±0.018 in the control group,TGF-β2 group,MG132 group and MG132 +TGF-β2 group,respectively,with a significant difference among the groups (F =113.752,P＜0.01),a considerably increased expressing value was seen in the TGF-β2 group and decreased value was in the MG132 group and MG132+TGF-β2 group when compared with the control group (all at P＜0.05).Conclusions MG132 can effectively inhibit the proliferation,migration and differentiation of human LECs in vitro.

Analysis of clinical and pathological features of primary nephrotic syndrome in elderly patients / 中华老年医学杂志

Objective To study the clinical and pathological features of primary nephrotic syndrome in elderly patients.Methods Clinical data of patients with primary nephrotic syndrome aged ≥ 60 years underwent renal biopsy were retrospectively analyzed and patients with primary nephrotic syndrome aged ＜60 years were selected as control group.Results Male patients with primary nephrotic syndrome were common in the elderly group and control group,and there was no significant difference in gender composition between the two groups (62.0％ vs.61.5 ％,P＞0.05).The degree of edema and hypertension,levels of blood urea nitrogen,serum albumin,blood IgG and ratio of IgG /IgM were higher while levels of urinary protein and blood cholesterol were lower in elderly group than in control group (all P ＜ 0.05).No significant differences in the incidence of hematuria,serum levels of creatinine,IgA,and complement were found between the two groups (all P＞0.05).The risk of primary nephrotic syndrome was higher in elderly group than in control group (P＜0.01).The level change of blood IgG was positively associated with plasma albumin,while negatively associated with urinary protein and blood cholesterol in both groups (r=0.327,-0.147,-2.860,respectively,all P＜0.05).Membranous nephropathy was the most common type in elderly patients,accounting for 49.77％,while only accounting for 23.6％ in control group,which had a significant difference between the 2 groups (x2 =62.390,P ＜ 0.01).Mesangial proliferative glomerulonephritis was common in both groups,but no significant difference(x2 =62.390,P＞0.05).Conclusions Male patients are more common than female patients in primary nephrotic syndrome.The clinical manifestations including urinary protein and serum albumin are milder but the risk is much greater in elderly patients than in the non-elderly patients.The change of blood IgG level is associated with urine albumin,plasma albumin and plasma cholesterol.Membranous nephropathy is the most common type followed by mesangial proliferative glomerulonephritis in elderly patients with nephrotic syndrome.

Clinical and pathological analysis on renal biopsy of elderly patients / 中华老年医学杂志

Objective To study the epidemiology,pathologies and clinical manifestations of renal diseases in elderly patients of different genders in China northwest region.Methods Retrospective analysis was used to evaluate the clinical and pathological informations of patients above 60 years old who underwent renal biopsy and had the integrated data in the past 20 years.Results (1)Among the 559 patients,there were 347 men accounting for 62.1％,and there were 212 women accounting for 37.9％ ； the average age was (66.7±5.3)years,the median course of disease was 5.0months when receiving renal biopsy,and 50％ cases was (1.3 ～ 12.0)months.(2) Primary glomerulopathy accounted for 69.59％(389/559),secondary glomerulopathy,tubulointerstitial disease and the others accounted for 25.4％ (142/559),3.8％ (21/559) and 1.3％ (7/559),respectively.(3)According to clinical manifestation,nephrotic syndrome was the most common disease(accounting for 60.7％),and then chronic glomerulonephritis accounted for 31.6％.In pathology,membranous nephropathy was the most frequently category accounting for 34.5％,then mesangial proliferative glomerulonephritis accounted for 32.4％.(4) Among secondary glomerulopathy,the frequent diseases were primary polyangitis,diabetic nephropathy,amyloidosis of kidney and lupus nephritis,accounting for 24.7％,19.7 ％,13.4 ％ and 10.6 ％,respectively,and the number of women was more than men in lupus nephritis(P＜0.05).(5) The common diseases of primary glomerulopathy that would result in renal insufficiency were nephrotic syndrome and chronic glomerulonephritis,accounting for 76.5 ％ (26/34)and 76.2 ％ (48/63),respectively,and the common pathological type was both mesangial proliferative glomerulonephritis.The common diseases of secondary glomerulopathy that would result in renal insufficiency were primary small vessel vasculitis and diabetic nephropathy,accounting for 46.3％(19/41)and 34.4％(11/32),respectively.Conclusions (1)the number of men was more than women in this group,and was opposite in lupus nephritis.(2) The most common disease was primary glomerulopathy,as for clinical manifestation,nephrotic syndrome and chronic glomerulonephritis were most common； the most common pathological type were membranous nephropathy and mesangial proliferative glomerulonephritis.(3) The common disease resulting in secondary kidney damage were primary small-vessel vasculitis and diabetic nephropathy.(4)The pathological type of disease resulting in renal insufficiency was mesangial proliferative glomerulonephritis,the common diseases resulting in acute renal insufficiency were nephrotic syndrome,primary small vessel vasculitis,and those resulting in chronic renal insufficiency were chronic glomerulonephritis and diabetic nephropathy.

Clinical and pathological analysis of patients with primary mesangial proliferative glomerulonephritis in different genders / 中国综合临床

Objective To understand the differences between sexes in the clinical and pathological features of patients with mesangial proliferative glomerulonephritis(MPGS).MethodsOne hundred and five patients with MPGS admitted to our hospital were retrospectively studied in clinical and pathological aspects.Results( 1 ) The proportion of male patients were 75 of 105 ( 71.43 ％ ) and that of females were 30 of 105 ( 28.57％ ) ; ( 2 ) The average age of the male patients was ( 40.25 ± 15.50 ) and that of the females was (36.23 ± 15.26) in year.There was no significant difference between the two groups( t =1.206,P =0.231 ) ;(3) There was no significant difference in duration of disease,hematuria,edema,hypertension prevalence and mean blood pressure( P ＞ 0.05 ).The proportion of patients with hematuria was 56.19％ (59/105).The males accounted for 69.33％ ( 52/75 ) and the females were 63.33％ ( 19/30 ) in the main clinical manifestations of nephrotic syndrome.There was no significant difference( x2 =0.352,P ＞ 0.05 ) between the proportion of males and females; (4)Males and females groups had no significant difference( P ＞ 0.05 )on levels of urinary protein,serum albumin,immunoglobulin,complement,urea nitrogen and serum creatinine.Complement decreased in 53 cases,accounting for 53％ of all the participants.The proportion of male patients with renal insufficiency was 24.00％ (18/75),and the proportion of females with renal insufficiency was 13.33％ (4/30).There was no significant difference ( x2 =1.472,P ＞ 0.05 )on the percentage of males and females with renal insufficiency.The mean value of urea nitrogen was higher than the normal levels ; (5) The proportion of male cases with different deposition of immune complexes was 93.06％ (67/72),and the proportion in females were 92.86％ (26/28) in the exception of 5 cases ( male 3 and female 2 ) with no glomeruli in immunofluorescence examination.No significant difference was found between the two groups( x2 =0.001,P ＞ 0.05 ) ; ( 6 ) There was no significant gender differences( x2 =1.696,P ＞ 0.05 ) found in risk assessment.ConclusionThe prevalence of MPGS is higher in male patients than in females,the main clinical manifestations of which were nephrotic syndrome.Patients were found to have a higher rate of hematuria,decreased complement C3,and renal dysfunction than the normal levels.There was no significant difference in gender on the clinical and pathological aspects of MPGS.

The effect of blood purification on removing plasma inflammatory mediators in HFRS patients / 西安交通大学学报(医学版)

Objective To observe the removal of tumor necrosis factor-? (TNF-? ), interleukin-6 (IL-6) and endothelin-1 (ET-1) in continuous renal replacement therapy (CRRT) on hemorrhagic fever with renal syndrome (HFRS) patients, and investigate the effect of inflammatory mediators on HFRS. Methods A total of 40 patients with moderate or more severe HFRS were divided into two groups randomly. Continuous venous-venous hemofiltration (CVVH) was applied to the 20 cases in CVVH group, and hemodialysis (HD) was applied to the 20 cases in HD group. The levels of TNF-? and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA), and ET-1 level was measured by radioimmunoassays (RIA). Results ① In comparing CVVH and HD groups, the days of oliguria (3.0?2.1, 6.0?3.4), incidence of complications (25%, 40%), and mortality (15%, 25%) had significant differences (P0.05). ④ In CVVH group, IL-6 and ET-1 could be detected constantly in filtrate, but TNF-? was not detectable. TNF-?, IL-6 and ET-1 were not detectable in dialysate. Conclusion Continuous blood purification can remove plasma inflammatory mediators. Therefore, it is helpful in recovering renal function, improving the prognosis of HFRS, and decreasing complications and mortality. CVVH is one of the best methods to treat HFRS.

CLINICAL SIGNIFICANCE OF MEASUREMENT OF SERUM PROLACTIN IN PATIENTS WITH RENAL FAILURE / 西安交通大学学报(医学版)

In this article, we observed the serum level of Prolactin and the intensity of renal insufficiency in 40 patients with renal failure and compared their relationship. Our study showed that the serum level of Prolactin in patients with renal failure was much higher than that of normal controls (P

HEPARIN PROPHYLAXIS AND TREATMENT OF ACUTE RENAL FAILURE (OLIGURIA PHASE) DUE TO OBSTETRICAL DISEASE / 西安交通大学学报(医学版)

This paper reports the clinical course in the treatment of 5 cases of acute renal failure due to obstetrical diseases by using heparin. The mechanism of acute renal failure easily occurring in pregnacny and the use of heparin are discussed.

Alteration and significance of vascular endothelial growth factor in the serum of patients with glomerular diseases / 西安交通大学学报(医学版)

Objective To study the concentration alteration of serum vascular endothelial growth factor (VEGF) in patients with primary and secondary glomerular diseases (GD), the effect of immune inhibitors on the concentration, and analyze the relationship between VEGF concentration and some clinical indexes. Methods Serum VEGF concentration of GD patients was determined by sandwich ABC-ELISA. Results All of the GD patients had higher level of serum VEGF than the control group. Of the 5 groups divided according to the clinical classification, patients of chronic glomerulonephritis(CGN) group, latent glomerulonephritis(LGN) group, Henoch-Schonlein purpura nephritis(HSPN) group and lupus nephritis(LN) group had higher serum VEGF level than the control group, respectively, with no difference among the above groups. The patients without taking immune inhibitors had higher serum VEGF level than the control group,while no difference was observed between the patients taking immune inhibitors and the control group.Patients with glomerulonephritis had a significantly lower serum VEGF level after receiving immunosuppression aggressive therapy than before. The serum VEGF level of nephrotic syndrome in nephrotic phase was higher than in remission stage. In membranous glomerulonephritis serum VEGF correlated positively with 24-hour proteinuria excretion. The serum VEGF level correlated positively with anti-dsDNA Ab titer and the concentration of ? globulins in LN. Conclusion Cytokine VEGF is involved in the pathogenesis of glomerulonephritis, and in the occurrence and progression of proteinuria. Immunosuppression therapy can inhibit the expression of VEGF. In LN patients, the serum VEGF level is related to LN activity.

THE CHANGES OF SERUM PROTEIN IN ELECTROPHORESIS IN UREMIA AND NEPHROTIC SYNDROME PATIENTS / 西安交通大学学报(医学版)

It is reported in this article that ?-lipoprotein and partial ?_1-and X_2-globulin in scrum are apparently lower, but haptoglobin and ?-lipoprotein are apparently higher by polyacryamide gel clectrophoresis in 50 cases of uremi(?) patients, and that albumin and partial ?_1-and ?_2-globulin in scrum are apparently lower, but partial ?_2-globulin and ?-lipoproteinare apparently higher by polyacryamide gel clectrophoresis in 50 cases of nephrotic syndrome patients. The mechanism and clinical significance of these changes are discussed.