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Objective: To explore the short-term efficacy and safety of dapagliflozin in children with hereditary proteinuric kidney disease. Methods: This was a prospective cohort study. From August 2020 to December 2021, 23 children with hereditary kidney disease from Children's Hospital of Fudan University were enrolled. Patients received dapagliflozin 5 mg/d (weight≤30 kg) or initial dose 5 mg/d for 1 week, then 10 mg/d (weight>30 kg) and the dose of angiotensin converting enzyme inhibitors was stable during treatment. Clinical data including demographic parameters, primary diagnosis, estimated glomerular filtration rate (eGFR), 24 h proteinuria and characteristics in the follow-up were collected. The primary outcome was the change in 24 h proteinuria at 12 (±2) weeks, secondary outcomes included changes of 24 h proteinuria at 24 (±2) weeks, eGFR at both 12 (±2) and 24 (±2) weeks. The data were analysed by using mixed linear model. Results: Totally 23 patients were enrolled, including 16 males and 7 females. The age was (10.8±2.9) years. The primary diseases were Alport syndrome (12 cases), Dent disease (5 cases), proteinuria (4 cases), and focal segmental glomerulosclerosis (2 cases) respectively. Primary outcome showed that 24 h proteinuria decreased from baseline at 12 (±2) weeks during treatment (1.75 (1.46, 2.20) vs. 1.84 (1.14, 2.54) g/m2, P<0.05). Secondary outcomes showed that there was no significant difference in 24 h urine protein at 24 (±2) weeks (P>0.05). eGFR decreased slightly at 12 (±2) weeks ((107±21) vs. (112±28) ml/(min·1.73m2), P<0.05), and there was no significant difference at 24 (±2) weeks (P>0.05). Serum albumin increased at 12 (±2) and 24 (±2) weeks following the treatment ((39±8) vs. (37±8) g/L, (38±7) vs. (37±8) g/L, both P<0.05). No hypoglycemia event was reported during the treatment. Conclusion: The dapagliflozin had therapeutic effects on decreasing proteinuria and increasing serum albumin in short-term treatment in children with hereditary proteinuric kidney disease, no hypoglycemia or serious adverse events were observed.
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Female , Male , Humans , Child , Adolescent , Prospective Studies , Nephritis, Hereditary , Proteinuria/drug therapy , Serum AlbuminABSTRACT
Constipation is a common functional gastrointestinal disease with obstructive constipation， prolonged defecation time， or difficulty in defecation as the main symptoms， its prevalence is increasing year by year. Copying the animal model that is highly consistent with the clinical characteristics of traditional Chinese medicine （TCM） and western medicine is the basis for the related research on constipation. Based on the clinical characteristics， etiology and pathogenesis， clinical diagnostic criteria and TCM syndrome differentiation of constipation， a comparative analysis of the anastomosis between common animal models and clinical symptoms was carried out. Existing animal models of constipation were mostly drug induction and non-pharmaceutical intervention methods， and the modeling method was relatively simple， which was different from the multi-factors of constipation in clinical practice， and the evaluation indicators were mainly charcoal-powder propelling rate， defecation function， colon tissue and serum biochemical indicators. TCM syndrome differentiation lacked perfect evaluation system， such as laborious defecation， palpitation， shortness of breath， forgetfulness， cold pain in the abdomen， and other indicators that had not been embodied in the animal models， and the observation indicators were inconsistent with the diagnostic criteria of TCM. The same pathogenic factor could cause different syndromes， such as shortness of breath and fatigue， hot flashes and night sweats in the diagnostic criteria of TCM. Therefore， it is necessary to further explore the animal model of constipation that is highly consistent with the clinical characteristics of TCM and western medicine， in order to promote clinical treatment of constipation.
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Objective:To observe the clinical effect of mild moxibustion for knee osteoarthritis (KOA) and to explore the role of mild moxibustion in relieving pain,reducing stiffness and improving joint dysfunction in patients with KOA.Methods:Eighty patients with KOA were randomly allocated into either a moxibustion group or a medication group by the random number table,with 40 cases in each group.The moxibustion group used mild moxibustion at Neixiyan (EX-LE 5),Dubi (ST 35),Xuehai (SP 10) and Liangqiu (ST 34),30 min each time,3 times a week;the medication group was given celecoxib capsule (celebrex),0.2 g each time,once a day.Both groups were treated for 4 weeks.The visual analog scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC)scores were evaluated before and after treatment.The efficacy of the two groups was compared after treatment.Results:After treatment,the overall efficacy of the moxibustion group was significantly different from that of the medication group (P＜0.05).The VAS and WOMAC scores of the two groups were lower than those before treatment (both P＜0.01).The changes in the VAS and WOMAC scores after treatment in the moxibustion group were significantly different from those in the medication group (both P＜0.05).After treatment,in single item of WOMAC,the changes in pain and joint dysfunction in the moxibustion group were more statistically significant than those in the medication group (both P＜0.05).Conclusion:Mild moxibustion and oral celebrex can reduce the VAS and WOMAC scores of patients with KOA.Mild moxibustion is superior to oral celebrex in relieving pain and improving joint function.
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With the implementation of the national "The Belt and Road" strategy,the international exchange of Chinese medicine is increasing day by day,and foreign drug resources provide a vast space for the development of traditional Chinese medicine(TCM).The introduction of foreign high-quality resources to promote the development of TCM has become the mission of the times to TCM practitioners.In this paper,the successful cases of herbalization of foreign drugs were analyzed.From the three aspects of the image thinking,the original application,the clinical and experimental validation,TCM was recognized and the preliminary research method of herbalization of the foreign medicines was put forward.Through the repeated exploration mode of "theoretical discussion(literature research+field investigation)→experimental verification→clinical practice",the performance of foreign drugs was investigated,providing reference for the research method of herbalization of foreign drugs.
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With a clear efficacy in external treatment of diseases, traditional Chinese medicine(TCM) has been widely applied in surgery, in acute, pediatric, gynecological, internal medicine and other departments. Its advantages include easy use, direct access to lesions, and prevent of the first-pass effect of the liver. However, its mechanism of action is still unclear, which impacts its clinical promotion. This article makes analysis and summary on the clinical application of TCM in external treatment of diseases, the characteristics of commonly used TCM in treatment of diseases, and the relationship of the common externally treated diseases and the "neurological-endocrine-immune network". The findings showed that TCM for external treatment were widely used, with exact curative effects; the pathogenesis of commonly used TCM for externally treating diseases is closely related to the "neuro-endocrine-immune network". Moreover, the modern pharmacological effects of TCM for externally treating diseases were found to be 100%related to the "neuro-endocrine-immune network". According to the analysis of the relationship between the common diseases externally treated with TCM and the "neuro-endocrine-immune network", the pathogenesis of the treatment with TCM is closely related to the "neuro-endocrine-immune network". Therefore, we believe that the "neuro-endocrine-immune network" system is probably one of the main mechanisms of action of TCMs for externally treating diseases. The verification of this mechanism requires the joint efforts of various departments in conducting clinical or experimental verification in the future, so as to provide a reference for clarifying the mechanism of TCM for external use, and basis for the promotion and application of TCM for external use.
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Based on the clinical symptom characteristics of transient ischemic attack in Chinese and Western medicines, the existing models of transient ischemic attack were summarized and analyzed. Then the advantages and disadvantages of each model, the diagnostic criteria of traditional Chinese and Western medicine and clinical symptoms compliance were analyzed to put forward the evaluation method and improvement method of the corresponding animal models. It was found that there were many modeling methods of transient ischemic attack, but they can not reflect the transience, reversibility, recurrence and other typical characteristics of the disease, with significant differences with clinical symptoms. Moreover, there is lack of reasonable quantitative criteria for the success of the animal model. By combining the existing single factor animal models, a composite animal model that was more closely related to the clinical symptoms of transient ischemic attack was established to replicate an animal model that was more compatible with the characteristics of clinical symptoms. It is the future development directions of the transient ischemic attack animal models to establish reasonable quantitative standards, reflect the causes of Chinese and Western medicine symptoms and improving a series of systematic and complete model evaluation methods.
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<p><b>OBJECTIVE</b>To deeply understand prognosis of pediatric cases with lupus nephritis (LN) treated in our hospital and analyze the prognostic factors.</p><p><b>METHOD</b>One hundred and one patients were enrolled, who were diagnosed as lupus nephritis in our hospital during the period from Jan. 1996 to Dec. 2007. Clinical data were retrospectively analyzed; the observation was ended on 31(st) Dec. 2009. Patients were divided into renal biopsy group and non renal biopsy group; group A (type I + II LN), group B (type III + IV LN) and group C (type V LN); CTX group (cyclophosphamide) and MMF group (mycophenolate mofetil); remission group (complete remission and partial remission) and ineffective group (treatment failure and death). Medication non-compliance means (1) the interval of CTX pulse was more than 45 days or treatment course less than 6 times; (2) patients discontinued MMF or other immunosuppressant on themselves more than a week ago. SPSS 11.0 software Life-Tables method was used to analyze cumulative survival rates.</p><p><b>RESULT</b>(1) Three and five years' patient survival rates were 93.59% and 87.80% respectively. Three and five years' kidney survival rates were 100% and 91.12% respectively. (2) Univariate analysis showed that induction remission were related to five factors, including whether received renal biopsy (χ(2) = 9.023, P = 0.003), different pathological types (χ(2) = 9.437, P = 0.009), different induction drug (χ(2) = 4.610, P = 0.032), treatment compliance (χ(2) = 18.716, P = 0.000) and proteinuria amount (χ(2) = 8.013, P = 0.046), and maintenance remission were related to the former four factors (χ(2) = 10.209, P = 0.001;χ(2) = 7.757, P = 0.021;χ(2) = 4.206, P = 0.04;χ(2) = 24.571, P = 0.000). (3) Multivariate analysis showed that maintenance remission was mainly related to medication-compliance (χ(2) = 9.818, P = 0.002). Poor medication compliance mainly occurred in non renal biopsy group (χ(2) = 9.569, P = 0.002). (4) In renal biopsy group, 15 cases showed a small amount proteinuria, 4 of them were proved as severe pathological type LN (2 cases type III, 1 case type IV and 1 case type V). (5) In group B, no medication non-compliance occurred, and the efficacy of MMF and CTX had no significant difference (P = 0.405).</p><p><b>CONCLUSION</b>The main affecting factor of remission rate was medication compliance. In type III and IV lupus nephritis, the efficacy of MMF and CTX were no significant difference. The poor outcome of non-renal biopsy group may be due to unclear pathological classification and poor medication compliance. We strongly recommend that SLE patients with mild abnormal results of urinalysis should receive renal biopsy.</p>
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Biopsy , China , Follow-Up Studies , Kidney , Pathology , Lupus Nephritis , Diagnosis , Therapeutics , Medication Adherence , Prognosis , Remission Induction , Survival AnalysisABSTRACT
<p><b>OBJECTIVE</b>To observe the effect of Phragmites communis polysaccharide on aging mice induced by injections of D-gulactose.</p><p><b>METHOD</b>Aging mice were used as experimental objective.</p><p><b>RESULT</b>Phragmizes communis polysaccharide could obviously increase the activity of CAT, SOD, GSH-PX in blood, lower the levels of LPO in plasma and the thick liquid made of grinding the tissues of brain and liver, and markedly resist the atrophy of the thymus, spleen and brain tissues of aging mice.</p><p><b>CONCLUSION</b>Phragmites communis polysaccharide has good anti-aging actions.</p>