ABSTRACT
Objective To assess the efficacy of mycophenolate mofetil (MMF) combined with low dose of hormone and lamivudine in the treatment of hepatitis B virus associated glomerulonephritis (HBV-GN).Methods The clinical data of 49 HBV-GN patients diagnosed by renal pathology was reviewed.They were treated with MMF( ≥ 12 years old,0.75 g,two times a day; ＜ 12 years old,0.4 g/m2,two times a day),low dose of hormone [0.5 mg/(kg·d) ],lamivudine( ≥ 12 years old,100 mg/d; ＜ 12 years old,3 mg/kg,two times a day).Results Among of 49 HBV-GN patients,clinical cure rate was 71.4％(35/49),the total effective rate was 81.6％(40/49),85.7％(42/49) patients' HBV DNA level decreased from 5.43 ×104 copies/ml to ＜ 1000 copies/ml.The complete remission rate was 88.0％ (22/25),the partial remission rate was 8.0％ (2/25),the inefficiency was 4.0％ (1/25) in membranous nephropathy (MN);the complete remission rate was 44.4％ (4/9),the inefficiency was 55.6％ (5/9) in mesangial proliferative glomerulone phritis (MsPGN) ; the complete remission rate was 70.0％(7/10); the partial remission rate was 30.0％(3/10)in membrane proliferative glomerulone phritis (MPGN) ;the complete remission rate was 40.0％ (2/5),the inefficiency was 60.0％(3/5) in focal segmental glomerulosclerosts (FSGS).There was significant difference among the different pathological type (P＜0.05).There were less adverse reactions.Conclusions MMF combined with low dose hormone and lamivudine is safe and effective in treating HBV-GN.The efficacy and pathological type has some relationship,MN has the best response,MPGN and MsPGN are second,FSGS is poor.
ABSTRACT
Objective To discuss the value of diffusion weighted imaging (DWI) in severity assessment and prognosis prediction of diffuse axonal injury (DAI). Methods A retrospective study was performed on the clinical imaging data and the follow-up results at six months after injury in 29 patients with DAI. The detection rate of DAI lesion by DWI and conventional MRI was compared by means of one-way ANOVA. The correlation between the number of lesion in different areas with GCS and GOS was analyzed with Spearman rank correlation test. Results (1)The average detected DAI lesions were 19.24±5.72 on DWI, 14.41 ±4.50 on FLAIR, 10.58±3.79 on T2WI and 4.83 ±2. 11 on TIWI, with the highest detection number of DAI lesion on DWI (P < 0, 05). (2) There was a significant correlation of the number of central lesions (in corpus callosum, basal ganglia and brain stem) with GCS and COS (P < 0. 05), but there was no correlation of total lesion number or periphery lesion with GCS and COS (P > 0.05). Conclusions DWI is a potentially useful imaging modality in detecting DAI lesion, when the number of central lesion on DWI can be served as an objective marker in severity assessment and prognosis prediction of DAI.
ABSTRACT
Objective To observe the changes of diffusion weighted imaging (DWI) after diffuse axonal injury (DAI) in rats. Methods Models of various degrees of DAI (mild, moderate and severe) were established in 135 SD rats by Marmarou method, and MRI examinations were performed 4, 8 and 24 h after injury. Another 8 rats were served as control group. The findings of MRI were analysed, and the apparent diffusion coefficient (ADC) values were compared among each group. Results No clear traumatic lesion was found from MRI in rats after injury. Four hours after injury, ADC values decreased in each DAI group, and there were significant differences between moderate DAI group and control group, and between severe DAI group and control group (P<0.05). Eight hours after injury, ADC values increased in each DAI group, and there was no significant difference between DAI groups and control group (P>0.05). There were significant differences in ADC values between 8 h after injury and 4 h after injury in severe DAI group (P<0.05), while there was no significant difference in moderate and mild DAI groups (P>0.05). Twenty-four hours after injury, ADC values continuously increased, especially in severe trauma group. Conclusion ADC values may reveal traumatic changes that can not be demonstrated by MRI. ADC values decrease in acute phase of DAI in rats, then increased, and the degree of variation may be related to the severity of DAI.