Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler

Background: Preeclampsia (PE) is heterogeneous disorder. The aim of the study was to observe the role of a spot urinary protein - creatinine ratio (UPCR) and uterine artery doppler velocimetry measured between 20-24 weeks of gestation in prediction of preeclampsia.Methods: Prospective observational study conducted on 120 pregnant mothers with singleton pregnancy between 20-24 weeks of gestational age in two tertiary teaching hospitals in eastern India. A spot urinary protein creatinine ratio (UPCR) was determined in a mid- stream urine sample and estimation of protein was done by immunoturbidimetric micro albumin method and creatinine by modified Jaffe’s method. Doppler velocimetry was also determined at 20-24 weeks of gestation. A notch in uterine artery, unilateral or bilateral; or RI > 0.7 and PI of > 1.45 were considered to have an abnormal result. Women were followed-up and relationship between variables was assessed by Chi- square test.Results: Women who subsequently developed preeclampsia had significantly higher UPCR (median 44.8 mg/mmol) when compared with women of unaffected groups (median 26.6 mg/mmol). The optimum spot urinary UPCR to predict preeclampsia was 35.5 mg/mmol and the cut-off value >35.5 mg/mmol had a test sensitivity (80%), specificity (94.06%), PPV (66.76%) and NPV (96.94%).The area under curve (AUC) of spot UPCR in ROC curve was  0.949 (95% CI,0.891 - 1.000). For predicting preeclampsia, the mean uterine artery RI had to be >0.7 having sensitivity (60%), specificity (97.03%), PPV (75%) and NPV (94.23%). The area under curve (AUC) was 0.856 (95% CI, 0.742 - 0.971).Conclusions: Second trimester UA doppler is a useful screening test for prediction of preeclampsia. This test works best when combined with a spot UPCR and accuracy of both the methods for prediction of preeclampsia was 92.24%.

Evaluation of spot urinary albumin - creatinine ratio as a screening tool in the prediction of pre-eclampsia in early pregnancy: a pilot study

Background: Pre-eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in India. Objective of this study was to establish whether a spot urinary albumin/creatinine ratio (ACR) measured between 18-28 weeks of gestation can predict subsequent pre-eclampsia in asymptomatic pregnant women.Methods: A prospective observational study involving 50 registered antenatal cases visiting the obstetrics outpatient department between 18-28 weeks of singleton pregnancy with nil proteinuria upon dipstick measurement were included. ACR was determined from random single midstream urine sample. Statistical analysis was performed using Chi square test and Student’s t-test.Results: Of the study group, 10 patients had high ACR value, with 8(80%) developed pre-eclampsia and 2(20%) remained normotensive. ACR had a sensitivity of 80%, specificity 97.56%, positive predictive value of 88.89%, diagnostic accuracy of the test being 94.12%.Conclusions: The spot urinary protein creatinine ratio is a reliable predictor for pre-eclampsia in pregnancy.

Spot protein/creatinine ratio as a marker for fetomaternal outcome in hypertensive disorder of pregnancy

Background: Gestational hypertension is defined as systolic BP level of > 140 mmHg or a diastolic BP of > 90 mmHg that occur after 20 weeks of gestation. Pre-eclampsia is the hypertensive disorder of pregnancy, associated with adverse fetomaternal complications. It is assosciated with proteinuria. 24 hours urine collection is cumbersome, time consuming and potentially misleading if collected inaccurately. The spot P/C ratio has been considered equivalent to 24-hour urinary protein for predicting proteinuria. Aim of study was to compare spot P/C ratio to 24 hours urinary protein in patients of pre-eclampsia and to determine the fetomaternal outcome in the patients admitted in Dayanand Medical College and Hospital, Ludhiana.Methods: A prospective simple random study. It included 100 hypertensive pregnant women being evaluated for pre-elampsia, regardless of the alerting signs or symptoms. The main measures were the urinalysis of patients which included urinary spot P/C and 24 hours urinary protein excretion and the fetomaternal outcome in these patients. The data was statistically analyzed.Results: A good positive correlation existed between the P/C ratio and 24 hours protein excretion, with a correlation coefficient (r) of 0.912. The sensitivity and specificity of 24 hours urinary protein versus spot P/C ratio ranged between 86.29%-99.51% and 8.35%-99.95% respectively. The positive and negative likelihood ratio of 24 hours urinary protein versus spot P/C ratio was 48 (ranged between 6.89-334) and 0.04 (ranged between 0.01-0.16) respectively. The positive and negative predictive value of 24 hours urinary protein versus spot P/C ratio was 97.96% and 96.08% respectively. Our data showed that urine spot P/C ratio above 3.9/mg strongly predicts significant proteinuria of more than 4 gram/day.Conclusions: Spot urinary P/C ratio with suspected preeclampsia can be used as a rapid alternative test to 24 hours urinary protein.

Correlation of High Sensitive C-reactive Protein levels with Mean Arterial Pressure and Serum Calcium in Women with Mild and Severe Pre-eclampsia

Aim:To compare the mean results of serum levels of hs-CRP and calcium in mild and severe pre-eclamptic women with healthy pregnant women and to investigate the relationship, if any between levels of serum hs-CRP with mean arterial pressure (MAP) and serum calcium. Material and Methods:A case control study was performed on 50-50 primigravidas with mild and severe PE as cases as per clinical guidelines and 50 healthy pregnant women as controls. They were all age and parity matched primigravidas at the third trimester of pregnancy. Results:By using ANOVA, statistically highly significant mean values of hs-CRP and serum calcium were observed among all groups (healthy pregnant women, mild pre-eclamptic and severe pre-eclamptic women). Significant positive correlation is found between hs-CRP with MAP, while the negative association is detected among hs-CRP and serum calcium.Conclusion:Serum hs-CRP may be feasible to be used as a sensitive biomarker for determining women at risk of PE. There is a significant influence of calcium supplementation during the antenatal period and the occurrence of pregnancy induced hypertension.

Optimization of adriamycin-induced nephropathy rat model / 中草药

Objective To determine the optimal model for the evaluation of pharmacodynamics of Fangji Huangqi Decoction. Methods By changing the doses and times of doxorubicin and the intervention of Fangji Huangqi Decoction and a series of test drugs, the effects of different doses and times of doxorubicin on the model were explored, and body weight, organism index, urine protein quantitation, renal histopathology results, and serum biochemistry can be regarded as evaluation indexes. Results For M1 (5 + 2) mg/kg model, the mortality rate of rats was higher. For M2 (6 mg/kg) model, the mortality rate was up to 20%, and the indicators reflecting renal function did not callback, but instead it showed much higher levels than the model group after receiving the test drug. For M3 (4 + 2) mg/kg model, the callback of part of the indexes, such as lung and kidney organ index, serum total triglyceride, and total protein levels, occurred after receiving the test drug, but the curative effect is not ideal. For M4 or M4’ (4 + 1) mg/kg model, the quantitative level of urinary protein in model rats was significantly different from that in the control at the 14th d, and the sustained and stable growth trend was observed; Moreover, the indicators mentioned above have different degrees of callback with high-, middle-, and low dose of Fangji Huangqi Decoction. Conclusion The final model weight of the rats was determined to be about 300 g, and the cumulative dose of doxorubicin was 5 mg/kg tail intravenous injection of doxorubicin was adopted as follows: on the 1st d of the experiment, 4 mg/kg doxorubicin was injected, and followed another 1 mg/kg at intervals of 1 week, which was the best way to evaluate the pharmacological effect of the related drugs derived from the Fangji Huangqi Decoction and the middle dose was the best.

Study on the Relationship between 24-hour Urinary Protein Quantification and Maternal and Neonatal Complications in Severe Preeclampsia / 医学研究杂志

Objective To investigate the relationship between 24-hour urinary protein quantification and maternal and neonatal complications in severe preeclampsia. Methods Totally 2305 cases of pregnant women which were diagnosed as severe preeclampsia more than 28 weeks of single pregnancy in 37 hospitals in mainland China were selected from January 1 to December 31, 2011. According to the results of the highest 24 hours urine protein quantitative after admission, the subjects were divided into 3 groups. The group Ⅰ included 590 cases whose 24h urinary protein were 0-2g. There were 843 cases in group Ⅱ whose 24h urinary protein were 2-5g, 872 cases were in group Ⅲ whose 24h urinary protein were more than 5g. The complications of the maternal and neonatal outcome were analyzed among the three groups. Results The incidence of hypoalbuminemia was 14. 8％, the rate of chest /ascites /pulmonary edema / heart failure was 1. 6％, the incidence of renal dysfuction was 0. 6％ and the incidence of placental abruption and HELLP syndrome was 2. 7％ and 3. 0％. There was significant difference in the incidence of hypoalbuminemia among the three groups of which the incidence of groupⅠwas significantly lower than that of group Ⅱ and group Ⅲ (P ＜ 0. 017). The rate of fetal growth restriction, fetal distress and neonatal asphyxia was 3. 3％, 9. 5％, and 1. 1％. The incidence of neonatal body weight, fetal growth restriction and neonatal asphyxia among the three groups were significantly different (P ＜ 0. 05). The body weight of neonatal group was significantly higher than that of group Ⅱ and group Ⅲ (P ＜ 0. 017). The incidence of FGR in group Ⅱ was significantly higher than that in group Ⅲ (P ＜ 0. 017). The rate of neonatal asphyxia in group Ⅰ was significantly lower than that in group Ⅲ (P ＜ 0. 017). There are no significant difference in the incidence of heart failure /pulmonary edema, placental abruption, HELLP syndrome and cesarean section among the three groups. Conclusion 24-hour urinary protein may increase the risk of hypoalbuminemia in pregnant women with severe preeclampsia, but do not increase the risk of heart failure /pulmonary edema, placental abruption and HELLP syndrome. 24-hour urinary protein was associated with severe preeclampsia neonatal body weight, fetal growth restriction, and neonatal asphyxia.

Regulation effect of Danqi Yishen capsule on laboratory indicators in patients with diabetic nephropathy / 中国基层医药

Objective To observe the efficacy of Danqi Yishen capsule in the treatment of diabetic nephrop-athy(DN),and the effect on laboratory indicators.Methods From March 2016 to December 2016,70 patients with DN in the Traditional Chinese Medicine Hospital of Shanxi Province were selected and divided into control group and observation group according to the different treatment method,with 35 cases in each group.The control group was given basic symptomatic treatment,and the observation group was given Danqi Yishen capsule on the basis of treat-ment in the control group.Both two groups were treated for 8 weeks.The clinical efficacy and changes of laboratory indicators were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group (88.57% vs.62.86%),and the difference was statistically signifi-cant(P＜0.05).After treatment,the levels of fasting plasma glucose(FPG),2h postprandial blood glucose(2hPG),total cholesterol(TC),triglyceride(TG) and low-density lipoprotein cholesterol(LDL-C) in the observation group were (5.81 ±0.75)mmol/L,(7.64 ±2.12) mmol/L,(4.91 ±1.03) mmol/L,(1.71 ±0.46) mmol/L,(2.25 ± 0.69)mmol/L,respectively,which were significantly lower than those in the control group [(6.37 ±0.92)mmol/L,(8.96 ±1.97)mmol/L,(4.91 ±1.03)mmol/L,(2.17 ±0.52)mmol/L,(3.26 ±1.05)mmol/L](t ＝2.791,2.698,3.321,3.920,4.756,all P＜0.05).The levels of 24h urinary protein excretion(UAER),urinary β2-micro-globulin(β2-MG),urinary albumin and creatinine ratio(ACR) in the observation group were (104.12 ±0.61)mg/24h,(256.72 ±96.43)μg/L,(73.86 ±33.12),respectively,which were significantly lower than those in the control group [(139.87 ±38.45 ) mg/24h,( 431.12 ±97.84 ) μg/L,( 125.84 ±38.96 )] ( all P ＜0.05 ). Conclusion Danqi Yishen capsule can significantly relieve the clinical symptoms in patients with DN,and improve the therapeutic effect.Its mechanism may be associated with lowering blood glucose,regulating blood lipids and reducing urinary protein.

Effects of gross hematuria on the results in laboratory urine examination / 临床儿科杂志

Objectives To explore the effects of gross hematuria on the results of several parmeters in laboratory urine examination. Methods Eighty (80) children with IgA nephropathy and 40 cases with acute post-streptococcal glomerulonephritis hospitalized in our hospital from January 2014 to December 2015 were recruited. The ratio of urinary calcium and protein to creatinine, quantitative test of 24 h urinary calcium and protein, quantitative test of 24 h urinary albumin,α1-microglobulinuria, microalbuminuria and urine protein electrophoresis were tested during and after the gross hematuria, respectively. Results The ratio of urinary calcium and protein to creatinine, quantitative test of 24 h urinary calcium and protein were much higher in the duration of gross hematuria as compared to those after the duration of gross hematuria, while α1-microglobulinuria, microalbuminuria and quantitative test of 24 h urinary albumin showed no difference between the two periods. Conclusions Gross hematuria could increase the level of urinary calcium and protein, while quantitative test of 24 h urinary albremin is not affected.

Effect analysis of Yishenkang capsule on urinary protein in patients with chronic glomerulonephritis / 中国生化药物杂志

Objective To analyze the effect of Yishenkang capsule on urinary protein in patients with chronic glomerulonephritis uraemia. Methods 100 patients with chronic glomerulonephritis uraemia from March 2013 to April 2016 were divided into two groups with lottery method and 50 cases for each group. Two groups were treated with dialysis and routine treatment, the treatment group was added Yishenkang capsule to analyze its effect. Results After treatment, 24 h urinary protein of two groups decreased than before treatment, both Alb and Hb increased than before treatment, and the treatment group was better than that of the control group with statistical significance (P<0.05). SCr, BUN and UA level of two groups decreased than before treatment, the treatment group was lower than that of the control group with statistical significance (P<0.05). The level of inflammation in the control group was significantly higher than that before treatment, the treatment group decreased and lower than that of the control group with statistical significance (P<0.05). There were no significant differences in adverse reactions between two groups. Conclusion Yishenkang capsule could decrease the excretion of urine protein in patients with chronic nephritis uraemia, improve the renal function and has few adverse reactions.

Effect analysis of Yishenkang capsule on urinary protein in patients with chronic glomerulonephritis / 中国生化药物杂志

Objective To analyze the effect of Yishenkang capsule on urinary protein in patients with chronic glomerulonephritis uraemia. Methods 100 patients with chronic glomerulonephritis uraemia from March 2013 to April 2016 were divided into two groups with lottery method and 50 cases for each group. Two groups were treated with dialysis and routine treatment, the treatment group was added Yishenkang capsule to analyze its effect. Results After treatment, 24 h urinary protein of two groups decreased than before treatment, both Alb and Hb increased than before treatment, and the treatment group was better than that of the control group with statistical significance (P<0.05). SCr, BUN and UA level of two groups decreased than before treatment, the treatment group was lower than that of the control group with statistical significance (P<0.05). The level of inflammation in the control group was significantly higher than that before treatment, the treatment group decreased and lower than that of the control group with statistical significance (P<0.05). There were no significant differences in adverse reactions between two groups. Conclusion Yishenkang capsule could decrease the excretion of urine protein in patients with chronic nephritis uraemia, improve the renal function and has few adverse reactions.

Renal injury in female dogs with pyometra / Injúria renal em cadelas com piometra

ABSTRACT: Pyometra is a common disease in intact female dogs and can cause glomerulopathy and tubular injury. This study aimed to evaluate kidney injury in female dogs with pyometra, as well as progression of the injury during treatment and the markers of this condition. This study analyzed 20 intact female dogs with both clinical and sonographic diagnosis of pyometra. Dogs were treated with intravenous fluids and antibiotics, and an ovariohysterectomy was performed. The following parameters were assessed at eight separate time points: blood pressure; serum creatinine, phosphorus, and urea levels; urinalysis and urinary biochemical parameters [urinary gamma-glutamyl transferase (uGGT) and urinary protein-to-creatinine ratio (UPCR)]; glomerular filtration rate (GFR); and urine output. All dogs showed some degree of kidney injury at the time of pyometra diagnosis. This was transient in most animals, resolving with treatment of the pyometra. Measurement of uGGT and UPCR identified renal parenchymal injury, helping to determine the prognosis of the animals analyzed in the present study.

RESUMO: A piometra é afecção frequente em cadelas e pode causar glomerulopatias e lesões tubulares. O presente estudo objetivou avaliar injúria renal em cadelas com piometra, sua progressão ao longo do tratamento e o uso de marcadores dessa alteração. Participaram 20 cadelas com diagnóstico clínico e ultrassonográfico de piometra, submetidas à fluidoterapia, antibioticoterapia e ovariohisterectomia. Foram avaliados pressão arterial, concentração sérica de creatinina, fósforo e ureia; urinálise e bioquímica urinária (gama-glutamiltransferase urinária e razão proteína/creatinina urinárias), taxa de filtração glomerular e débito urinário, em oito tempos. Todas as cadelas apresentaram algum grau de injúria renal no momento do diagnóstico da piometra, sendo transitória na maioria dos animais após o tratamento. O uso de marcadores de injúria renal identificou lesão de parênquima renal, contribuindo com o prognóstico dos animais estudados.

Clinical effect and safety analysis on rosiglitazone applied to patients with early diabetic nephropathy / 中国综合临床

Objective To discuss the clinical effect and safety on rosiglitazone applied to patients with early type 2 diabetic nephropathy.Methods Ninety-six patients with early type 2 diabetic nephropathy were divided into the control group(n=48) and the research group (n =48).The patients of the control group were given mefformin treatment, while of research group were given rosiglitazone, both the courses were three months.The urinary albumin excretion rate (UAER), 24 h urine trace albumin (UAE), serum creatinine clearance (SCr) , fasting plasma glucose (FPG), postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA 1 c), triglycerides (TG), cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) before and after treatment and clinical effect between the two groups were compared.Results The HbA1c, FPG, 2 hPG, UAER, UAE, TC, TG of after treatment of all patients decreased obviously,while the HDL-C level increased remarkably, and compared with control group the differences were significant (HbA1 c: (7.32±0.84)％ vs (7.56±0.98)％, FPG: (8.02± 1.42) mmol/L vs (8.16± 1.54) mmol/L, 2 hPG: (11.54±2.11) mmol/L vs (12.02±1.97) mmol/L,UAER: (67.34±6.45) mg/24 h vs (52.56±5.35) mg/24 h,UAE: (108.64±22.64) mg/d vs (68.84± 11.43) mg/d, TC : (5.44± 0.72) mmol/L vs (4.76± 0.51) mmol/L, TG: (2.04± 0.53) mmol/L) vs (1.73±0.46) mmol/L);t =-4.172,-3.973,-4.026,-4.263,-6.634,-5.737,-5.635, -4.735,-4.633;P＜O.05).While there were no statistical significance about SCr before and after treatment(P ＞0.05).The total clinical effect of the research group was obviously higher than that of the control group (87.5％ (42/48) vs 66.7％ (32/48), x2 =5.363,P =0.035).There were not obvious adverse reaction occurred during treatment for all patients.Conclusion Rosiglitazone can effectively reduce the blood glucose in patients with early type 2 diabetic nephropathy and reduce urinary protein excretion, the effect is more obvious than that of metformin.

Progress in urinary protein tumor markers / 肿瘤研究与临床

The development of proteomic technique has sparked new focus on novel protein markers for many diseases including cancer. Urine is one of the most useful biofluids for routine testing to provide an ideal resource for the discovery of novel biomarkers, with the advantage over tissue biopsy samples due to the ease and the less invasive nature of urinary collection. This review summarizes urinary protein tumor markers found in prostate cancer, bladder cancer, lung cancer and breast cancer that have shown potential for urogenital and non-urogenital cancer, so as to provide reference on high sensitive and high specific urinary protein tumor markers for early prevention, early diagnosis and treatment of cancer.

Evaluation of the interference of hemoglobin to the determination of protein in urine by benzethonium chloride / 国际检验医学杂志

Objective To evaluate the interference of occult blood in urine (urinary hemoglobin) and to determine the protein in urine by benzethonium chloride .Methods By reference to EP7‐A2 of CLSI ,urine containing different concentrations of hemoglobin were preparated to produce the dose‐effect curve,while 50 cases of clinical urine with varying degrees of occult blood were col‐lected for clinical sample bias test.Urinary protein was quantified by benzyl chloride in DPP roche comparing with sulfosalicylic acid method .Results When the urinary hemoglobin was 0 .2 g/L or higher ,the determined result of urinary protein of urinary pro‐tein would be significantly interfered by benzethonium chloride method .The clinical sample bias testshowed that clinical urine with different degrees of occult blood caused positive interference to the determination of protein by benzethonium chloride .Conclu‐sion Urine samples with occult blood and /or containing red blood cells should be emphasized and evaluate the accuracy when the urinary protein is quantified by benzyl chloride .If necessary ,it should be confirmed by sulfosalicylic acid .

Brachial-ankle pulse wave velocity correlates to urinaryprotein in patients with type 2 diabetes mellitus / 医学研究生学报

Objective Urinary protein is closely related to the development and progression of major vascular lesionsin diabetic patients.This study was to investigate the correlation between brachial-ankle pulse wave velocity(baPWV) and urinary protein in patients with type 2 diabetes mellitus ( T2DM) . Methods According to the level of 24-hour urinary albumin ( UAL) , 142 T2DM patients were divided into three groups:control (UA<30 mg, n=84), microalbuminuria(UAL<300 mg, n=26), and clinical albuminuria group ( UAL≥300 mg, n=33) .All the patients underwent examination offasting blood glucose, blood lipid, renal function, HbA1c, islet func-tion, C-reactive protein, blood pressure, and BMI.Their baPWV was determined with an Omron atherosclerosis detector and the correla-tion of baPWV with other factors evaluated by Pearson analysis and multivariate linear regression analysis. Results The baPWVwas significantly higher in themicroalbuminuria([1649.19±229.36]cm/s) and clinical albuminuria ([1759.21±291.05]cm/s) than in the control group ([1522.33±248.37]cm/s) (P<0.05).Pearson analysis showed a positive correlation between 24-hour UAL and baPWV ( r=0.347, P<0.01) and multivariate linear regression analysis manifested the same correlation ( P<0.05) . Conclusion The level of urinary protein is closely correlated with baPWV in T2DM patients.

Effect of blood glucose variability on urinary proteins in type 2 diabetes mellitus / 中国综合临床

Objective To investigate the level of urinary protein in type 2 diabetic patients with different glucose excursion and investigation the effect of the glucose excursion on early diabetic nephropathy.Methods Fifty-six type 2 diabetes patients were divided into two groups by the level of glycosylated hemoglobin(HbA1c),good glycemic.Patients in control group with HbA1c ＜ 7.0％ and patients in poor glycemic control group with HbA1c ＜ 7.0％.Microalbuminuria,urine transferring (UTRF),α1-microglobulin (α1-MG) and 32-microglobulin(32-MG) were measured.All the patients were monitored using the continuous glucose monitoring system (CGMS),and mean amplitude of glucose excursions (MAGE) were analyzed.Patients were divided into two groups by MAGE,one group's MAGE was lower than 3.9 mmol/L,and another group's MAGE was higher than 3.9 mmol/L.Urinary proteins were measured and analyzed in the two groups.Results In the poor glycemic control group,the levels of microalbuminuria,UTRF and albunin/ creatinine(A/C) rate were (81.28 ±44.13) mg/L,(4.54 ± 1.54) mg/L and (22.17 ± 14.52) mg/mmol significantly higher than that in the good glycemic control group((21.63 ± 10.16) mg/L,(2.48 ±0.29) mg/L and (2.05 ± 0.76) mg/mmol; t =4.758,5.360,4.805 ; P ＜ 0.05).Fasting C peptide in the poor glycemic control group was (1.01 ± 0.13) ng/ml,significant lower than that in the good glycemic control group ((1.51 ± 0.21) μg/L;t =4.826;P ＜0.05).The levels of A/C rate,α1-MG and β2-MG in the group with MAGE above 3.9 mmol/L significantly higher than those in the group with MAGE below 3.9 mmol/L(t =4.358,8.641,12.702;P ＜ 0.05).Conclusion Both persistent hyperglycemia and blood glucose variability could influent diabetic nephropathy.

Relationship between B-tupe natriuretic peptide and preeclampsia of hypertensive disorder complicating pregnancy as well as its significance / 中国综合临床

Objective To investigate and evaluate the correlation between brain natriuretic peptide (BNP) and gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy (HDCP).Methods Fifty cases with HDCP and 46 cases with mild and 83 cases with sever stage preeclampsia were selected as our subjects.And 33 cases with regular pregnancy and 31 with irregular pregnancy were served as control group.Plasma brain natriuretic peptide,urinary protein quantity(UBQ),24-hour urinary protein assay (UPA) were measured.The correlations of brain natriuretic peptide and UBQ,UPA,systolic pressure (SP),diastolic pressure (DP) were analyzed.Results The levels of brain natriuretic peptide in the group with gestational hypertension and mild,severe preeclampsia groups were (48.54± 18.27),(79.46± 32.18) and (292.24±213.08) ng/L,higher than that in normal pregnancy and non pregnant group ((27.84± 14.58) and (20.63± 8.28) n/L;F =49.583,P＜0.05).While no significant difference exists between normal pregnancy group and non pregnant group.Grouped on the median values (199) of brain natriuretic peptide of the severe preeclampsia group,the levels of 24-hour UPA,systolic pressure and diastolic pressure were (5.46±2.68) g,(174.55± 13.58) mmHg,(113.74±9.91) mmHg in patients with brain natriuretic peptide ≥ 199 ng/L(n=42),significant higher than those in patients with brain natriuretic peptide ＜ 199 ng/L(n =41;(4.34± 1.95)g,(165.31±11.12) mmHg,(106.05±8.02) mmHg;t=2.603,3.396,2.308;P=＞0.010,0.001,0.024).The levels of 24-hour UPA,systolic pressure and diastolic pressure of patients with brain natriuretic peptide ≥ 86ng/L(n=20) in mild preeclampsia were (1.68±0.27) g,(163.69±8.29) mmHg,(105.45±6.71) mmHg,significant higher than those in patients with brain natriuretic peptide ＜ 86 ng/L (n =26;(1.16 ± 0.31) g,(152.90±7.32) mmHg,(99.19 ± 5.25) mmHg;t =3.180,2.508,2.32;P =0.010,0.016,0.025).Brain natriuretic peptide was closely correlated with UPA,systolic pressure and diastolic pressure in hypertensive disorder complicating pregnancy (HDCP) (r =0.29,0.30;P ＜ 0.01).Brain natriuretic peptide was closely correlated with UPA systolic pressure and diastolic pressure in mild preeclampsia (r =0.39,0.37,0.40;P ＜0.01).And correlation efficacy of brain natriuretic peptide with UPA,systolic pressure and diastolic pressure were 0.44,0.42 and 0.53 (P＜0.01).Conclusion The level of brain natriuretic peptide is closely associated with the severity of gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy.Correlation of brain natriuretic peptide to the severity of gestational hypertension and preeclampsia is independent of urinary protein and hypertension.Brain natriuretic peptide is an important indicator for the severity of gestational hypertension and preeclampsia of hypertensive disorder complicating pregnancy.

A clinical analysis of 36 cases of systemic lupus erythematosus with lupus mesenteric vasculitis / 中华风湿病学杂志

Objective To analyze the clinical profiles of lupus mesenteric vasculitis (LMV).Methods Thirty-six SLE patients diagnosed with LMV and 72 SLE patients (1:2) without LMV at West China Hospital between October 2009 and January 2012 were enrolled.The imaging,clinical manifestation,laboratory examinations data were analyzed retrospectively.Quantitative differences were analyzed by the Student's t and Z tests and qualitative data were compared with Chi-square.P value less than 0.05 was considered as statistically significant.Results ① The prevalence of LMV in patients with SLE was 1.2％(36/3 051),while 47％(17/36) as the initial symptom of SLE.Thirty-six LMV patients were all female.The prevalence of abdominal pain was 78％(28/36),nausea or vomitting was 58％(21/36),abdominal distension was 50％(18/36),diarrhea was 47.2％ (17/36),intestinal perforation was 3％ (1/36) and incomplete obstruction was 8％ (3/36).Enhanced CT scan showed 81％(25/31) patients suffered from intestinal dilation and (or) mesenteric edema;SLEDAI (17±5),C3 (0.44±0.25) g/L,C4 (0.10±0.09) g/L,Z value on above items were 4.30,-3.85 and-2.94 respectively compared to SLE patients without LMV,and all P＜0.05,the differemces were significant.In addition,Also,the proportion of ANA and anti-ENA antibody showed no significant difference.68.6％(13/36) patients were also diagnosed with lupus nephritis;61％(22/36) patients were treated with methylprednisolone more than 200 mg/d resulting in relief of symptom.Conclusion Female patients with SLE may be more likely to suffer from LMV;Enhanced abdominal CT scan is still essential to the diagnosis of LMV.LMV is correlated with urinary system malfunction.LMV always occurs in active lupus with low C3 and C4 level.More than half patients should be treated with corticosteroid and cyclophosphamide pulse therapy.

Observations on the Therapeutic Effect of Herbal Cake Moxibustion on Chronic Renal Failure / 上海针灸杂志

Objective To investigate the clinical efficacy of herbal cake moxibustion in treating chronic renal failure. Methods Sixty CRF patients were randomly allocated to treatment and control groups, 30 cases each. The control group received medication and diet control and the treatment group, herbal cake moxibustion on Shenshu, Pishu or Ganshu in addition. Pre-/post-treatment differences in serum creatinine (Scr), blood urea nitrogen (BUN), endogenous creatinine clearance rate (Ccr) and 24-h urinary protein quantity were observed in the two groups and the clinical therapeutic effects were compared between the two groups after 3 months of treatment.Results The marked efficacy rate and the total efficacy rate were 46.7% and 86.7%, respectively, in the treatment group and 20.0% and 46.6%, respectively, in the control group, and there were statistically significant differences in both between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in Scr, BUN, Ccr and 24-h urinary protein quantity in the two groups (P<0.05). There were statistically significant post-treatment differences in Scr, BUN and 24-h urinary protein quantity between the treatment and control groups (P<0.05).Conclusion Herbal cake moxibustion is an effective way to treat chronic renal failure.

Urinary protein markers predict the severity of renal histological lesions in children with IgA nephropathy and IgM nephropathy / 中华实用儿科临床杂志

Objective To compare the clinical manifestations,renal histological lesions,and the levels of urinary protein markers between the children with IgA nephropathy (IgAN) and those with IgM nephropathy (IgMN), and to determine whether urinary protein markers could predict the severity of renal histological lesions in children with IgAN and IgMN.Methods Seventy-four children with renal biopsy-proven IgAN and IgMN from January 2002 to October 2014 were enrolled in the study.The levels of IgG, albumin (Alb), transferrin (TRF), α1-microglobulin (α1-MG) ,β2-microglobulin (β2-MG) and N-acetyl-β-glucosaminidase (NAG) in morning urine samples before biopsy were measured.The semi-quantitative scores of mesangial hypercellularity (MC), glomerulosclerosis (GS), and tubule-interstitial damage (TID) were used to assess renal histological lesions.Multivariate Logistic regression analysis was used to determine whether urinary protein levels were independently associated with renal histological lesions.The area under the receiver-operating-characteristic curve (AUC) was calculated to assess the predictive ability of urinary protein markers.Results Seventy-four children (44 cases with IgAN,30 cases with IgMN) were included.The urinary levels of α1-MG and Alb were significantly higher in children with IgAN as compared to those with IgMN.The differences, however, did not remain significant after adjustment for age.The urine protein, as an independent factor associated with severe MC(＞ 5 mesangial cells per mesangial area) was TRF(B =0.010), and severe GS (≥ 10％ glomeruli showing segmental adhesion or sclerosis) was significantly correlated with Alb(B =0.001) ,and severe TID (focal or diffuse tubular and interstitial lesions) was significantly correlated with NAG(B =0.038).Urinary β2-MG was not significantly associated with severe MC, GS and TID.Urinary TRF, Alb and NAG achieved the best AUC of 0.85 (P ＜ 0.001) ,0.78 (P =0.002), and 0.78 (P =0.003), respectively, for predicting severe MC, GS, and TID.Conclusions Urinary proteins are useful to predict the severity of renal histological lesions in children with IgAN and IgMN.Urinary TRF, Alb and NAG have better predictive value.