The risk prediction value of paraquat poisoning dose, urine protein and myocardial enzymes / 中华劳动卫生职业病杂志

Objective: To explore the value of paraquat (PQ) intake, urine protein and myocardial enzyme indexes in judging the prognosis of patients with acute PQ poisoning. Methods: From September to December 2021, all 201 patients with acute PQ poisoning admitted to Guangzhou Twelfth People's Hospital from January 2010 to December 2019 were selected as the research objects. Based on follow-up results 60 days after poisoning, the research objects were divided into survival group (n=78) and death group (n=123) . The differences in information about poisoning, treatment plan, PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase between the two groups of patients were compared and analyzed. Logistic regression and Cox regression were used to analyze the correlation between poisoning outcome and PQ intake, urine protein and myocardial enzymes. ROC curve and principal component analysis were used to explore high-efficiency indicators for predicting the outcome of acute PQ poisoning. Results: The PQ intake[50 (20, 100) ml], urine protein (total rank 15570.50) , creatine kinase[ (336.36±261.96) U/L], creatine kinase isoenzyme[ (43.91±43.74) U/L], lactate dehydrogenase [ (346.01±196.50) U/L], α-hydroxybutyrate dehydrogenase content[ (271.23±11.92) U/L] of patients in the death group were all higher than the survival group[15 (10, 20) ml, 4730.50, (187.78±178.06) U/L, (18.88±15.50) U/L, (190.92±60.50) U/L, (152.60±48.34) U/L, respectively] (P<0.05) . The outcome of acute PQ poisoning was positively correlated with PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase (P<0.05) . Multivariate logistic regression and multivariate Cox regression analysis showed that creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase and α-hydroxybutyrate dehydrogenase was positively correlated with the prognosis of patients with acute PQ poisoning (P<0.05) . ROC curve analysis and principal component analysis showed that the combined indexes of PQ intake, urine protein and myocardial enzymes had the highest efficacy and weight in judging the prognosis of patients (AUC=0.91, weight coefficient=0.19, sensitivity=0.76, specificity=0.89) . When the combined score was ≥4, the probability of accurately predicting the death of patients was as high as 91% (positive predictive value=0.91) . Conclusion: PQ intake, urine protein combined with creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase has high value in predicting the prognosis of patients with acute PQ poisoning.

Comparison of methods for enriching urine proteins / 生物工程学报

The abundance of proteins in human urine is low and easily to be masked by high-abundance proteins during mass spectrometry analysis. Development of efficient and highly selective enrichment methods is therefore a prerequisite for achieving deep coverage of urine protein markers. Notably, different experimental methods would affect the urine protein enrichment efficacy and the coverage of urine proteome. In this study, ultrafiltration, nitrocellulose membrane enrichment and saturated ammonium sulfate precipitation were used to process 10 mL urine samples from five healthy volunteers and five bladder cancer patients. The urine proteins were enriched and separate by SDS-PAGE to compare the purification efficiency of different methods. Moreover, the peptide identification effects of different purification methods were analyzed by mass spectrometry to determine the best method for enriching urine protein histones. Saturated ammonium sulfate precipitation method outperformed the ultrafiltration and the nitrocellulose membrane enrichment methods in terms of the protein enrichment efficacy and quality. The interference of highly abundant albumin was reduced, whereas the amount of low-abundance protein was increased, and the sensitivity of mass spectrometry identification was increased. The saturated ammonium sulfate precipitation method may be applied for large-scale urine processing for screening clinical diagnostic markers through proteomics.

A prospective post-partum evaluation of renal function in preeclampsia

Background: Hypertensive disorder comprises one of the leading causes of maternal and perinatal morbidity and mortality across the globe. Because women with preeclampsia are at risk of cardiovascular disease and end-stage renal disease, proper follow-up after delivery for resolution of proteinuria and hypertension is required and investigations should be conducted to find out and adequately treat any underlying cardiovascular or renal disease.Methods: This was a prospective study and included as participants pregnant women with preeclampsia who met the inclusion and exclusion criteria and who subsequently delivered at Government Medical College Hospital, Thrissur, Kerala, India. For each eligible participant, clinical and laboratory data were collected from third trimester of antenatal period, and six weeks and three months after delivery.Results: In this study, it is found that 26.2% and 4.23% patients had persistence of systolic blood pressure at 6 weeks and 3 months postpartum where as 19.4% and 3.38% had persistence of diastolic blood pressure at 6 weeks and 3 months post-partum. Serum creatinine was persistently high in 14.4% and 6.77% after 6 weeks and 3 months postpartum respectively. Proteinuria resolved completely in non-severe preeclampsia by 6 weeks postpartum itself. In severe preeclampsia group, 65% and 25% of patients had persisting proteinuria after 6 weeks and 3 months postpartum.Conclusions: Hypertension that persists more than 6 weeks postpartum usually represents a pathology not directly associated with pregnancy such as essential hypertension or underlying endocrine, neurological, or renal disease. Proteinuria that persists beyond 6-12 weeks postpartum may also warrant further investigation, particularly in early onset preeclampsia, the group of women most likely to have underlying renal disease.

Clinical Study of Urine Albumin Creatinine Ratio as an Earlier Predictor of Diabetic Nephropathy.

Diabetic nephropathy (DN) is a chronic microvascular complication of diabetes mellitus (DM). Microalbuminuria is an earliest marker of DN. Effective screening measures are required for early diagnosis and management to halt the progression of diabetic nephropathy. We wanted to evaluate urine Albumin Creatinine Ratio (ACR) as an earlier predictor of diabetic nephropathy in comparison to the gold standard test 24-hours urine protein.METHODSThis is a cross sectional study conducted among 210 patients of type-2 DM admitted in the medical ward of a tertiary care hospital, who fulfilled the inclusion and exclusion criteria. Relevant history including duration of DM, and other comorbidities was taken from the patients. Vital parameters such as heart rate, systolic and diastolic blood pressure were recorded. CBC, RFT, FBS, PPBS, HbA1c, Fundoscopy were done in all patients. Urine analysis for ACR from random urine sample and 24-hours urine protein from 24-hour urine sample were done.RESULTSProteinuria was present in 80.95% of patients and that with 24-hour urinary protein, in 59.04% patients. ACR showed sensitivity of 100%, specificity of 46.51% with PPV of 72.94% and NPV of 100%. ACR has strong positive correlation with 24-hours urinary protein. Positive correlation of urine ACR was seen with serum creatinine, blood urea, HbA1c, anaemia, duration of diabetes and the presence of diabetic retinopathy.CONCLUSIONSACR shows high sensitivity in the detection of proteinuria, especially microalbuminuria and hence can be considered as an alternative to 24-hour urine protein in an early screening for DN.

A study of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsia

Background: Preeclampsia is defined as systolic blood pressure level of 140 mmHg or higher or a diastolic blood pressure level of 90 mmHg or higher that occurs after 20 weeks of gestation with proteinuria. Objective of this study was to study the role of spot urine protein: creatinine ratio as an alternative to 24 hours proteinuria for the diagnosis of pre-eclampsiaMethods: This is a prospective observational study conducted in the department of obstetrics and gynaecology, BRD Medical College Gorakhpur, since October 2016 to September 2017 included 120 pregnant women with hypertension of gestational age more than 20 weeks. Ramdom urine sample of all the patient was taken before 12 noon after first voiding. For 24 hours urine sample patient was asked to collect all her urine she voids during 24 hours. The creatinine was estimated by the alkaline picrate method (Jaffe's Reaction) modified by the Bonsnes and Taussky, 1945. Creatinine in a protein free solution reacts with the alkaline picrate and produces red colour complex which is measured colorimeterically. Urinary protein was estimated in all the subjects by the Turbidimetric method. Urinary protein was precipitated by 3% sulphosalicylic acid and turbidity so produced was measured colorimetrically.Results: Protein: creatinine ratio in a random urine sample is better than random urine protein detection by dipstick method in cases of emergency when there is no time for detection of 24 hours urine protein.Conclusions: If cut-off level for urine protein: creatinine ratio in random urine sample is taken as 0.25 or more then sensitivity and specificity become same as 24 hours urine protein.

A study to find the correlation between 24-hour urinary protein and spot urinary albumin to creatinine ratio and to determine the accuracy of spot urinary albumin to creatinine ratio as an indicator to detect proteinuria and its use as a rapid alternative test over 24-hour urinary protein in preeclamptic women

Background: Preeclampsia is a multisystem endothelial disease leading to glomeruloendotheliosis with endothelial leak causing significant proteinuria. It is associated with high maternal and fetal risks and fetomaternal morbidity and mortality. Spot urinary albumin to creatinine ratio (ACR) leads to earlier detection of glomerular damage leading to prompt management of preeclamptic patients. To determine the accuracy of Spot Urinary ACR as an indicator to detect proteinuria and its use as a rapid alternative test over 24-hour urinary protein in women with Preeclampsia and to find the correlation between the two.Methods: Spot urinary ACR was measured in 70 consecutive patients with preeclampsia in Assam Medical College, Dibrugarh. The best cut-off value to differentiate between significant and insignificant proteinuria was calculated. The mean, standard deviation and range of various parameters were computed and various statistical tests were used. The Area under the curve and ROC curve were plotted.Results: The best cut-off value to differentiate significant and insignificant proteinuria was calculated as 291.9 mg/g beyond which adverse fetomaternal outcomes and complications were seen. The correlation coefficient between 24-hour urinary protein and spot urinary albumin to creatinine ratio was 0.922 highly significant. The area under the curve was found to be 0.98 with a standard error of 0.0155 which implied that the discriminant ability of spot urinary ACR to differentiate significant proteinuria from insignificant proteinuria in patients with preeclampsia was found to be 98%. Similar studies mentioned in the table below showed a good correlation between 24-hour urinary protein estimation and spot urinary ACR.Conclusions: Compared with 24-hour urinary protein excretion, spot urinary ACR is a simple and accurate indicator of significant proteinuria and helps to detect fetomaternal outcomes in preeclamptic women which may lead to prompt management to reduce fetomaternal complications.

Analysis of Mechanism of Phytolaccae Radix and Its Processed Products on Doxorubicin-induced Nephropathy in Rats / 中国实验方剂学杂志

Objective: To compare the protective effect of Phytolaccae Radix and its processed products on nephropathy induced by doxorubicin (DOX) in rats, and explore its mechanism. Method: A rat model of nephropathy was established by a single tail intravenous injection of DOX hydrochloride. Content of esculentoside A (EsA) in Phytolaccae Radix and its processed products was determined by HPLC-ELSD. Contents of serum total protein (TP), albumin (Alb), urea nitrogen (BUN), serum creatinine (SCr), total cholesterol (TC) and urine protein (UP) were determined by enzyme-linked immunosorbent assay (ELISA). The mRNA and protein expression of transforming growth factor-β (TGF-β) in renal tissue of rats was examined by real-time quantitative polymerase chain reaction (Real-time PCR) and immunohistochemistry. Result: A single intravenous injection of DOX could induce a severe nephrotic syndrome associated with decreased serum TP, Alb and elevated serum BUN, SCr, TC, and a high urinary excretion of protein (Pβ in renal tissue of model group rats was significantly higher than that of blank group (PPPConclusion: Phytolaccae Radix and its processed products can improve the symptoms of DOX nephropathy model rats in different degrees, among which the vinegar prepared products have the strongest effect, and this effect may be related to the reduction of TGF-β expression in renal tissue.

Study on clinical value of urinary synaptopodin in diabetic nephropathy / 中国实用内科杂志

OBJECTIVE: To investigate the relationship between urinary synaptopodin levels and clinical pathology in patients with diabetic nephropathy, in order to provide new biomarkers for diabetic nephropathy. METHODS: Seventy-five patients with diabetic nephropathy confirmed by renal biopsy were enrolled in this study. Those patientsin was in the First Affiliated Hospital of Zhengzhou University and the Second Hospital of Lanzhou University from September 2016 to December 2017. The level of urinary synaptopodin was measured and the relationship between urinary synaptopodin and clinical and pathological changes was analyzed. RESULTS: The levels of urinary synaptopodin/β-Actin in patients with nodular diabetic nephropathy and diffuse sclerosing diabetic nephropathy were significantly higher than those in the early diabetic nephropathy group(P<0.05). Correlation analysis indicated urinary synaptopodin/β-Actin had a positive correlation with 24-hour urine protein(r=0.408, P=0.014), urinary albumin(r=0.0.341, P=0.043) and serum creatinine(r=0.386, P=0.021) CONCLUSION: The level of urinary synaptopodin in patients with diabetic nephropathy is significantly increased and is associated with clinical and pathological conditions, which may become a potential new biomarker for diabetic nephropathy.

Clinical observation on efficacy of Bushen Huoxue formula for treatment of stage G3a diabetic nephropathy / 中国中西医结合急救杂志

Objective To observe the clinical therapeutic effect of Bushen Huoxue formula for treatment of diabetic nephropathy at G3a stage. Methods Sixty patients with stage G3a diabetic nephropathy were admitted to the Department of Nephrology of Affiliated Hospital of Tianjin Institute of Traditional Chinese Medicine from June 2017 to June 2018, and according to difference in treatment, they were divided into an integrated traditional Chinese and western medicine treatment group and a western medicine treatment group with 30 cases in each group. The two groups were treated with Huangkui capsule 2.5 g/time, 3 times a day; the integrated traditional Chinese and western medicine treatment group was additionally given Bushen Huoxue formula, one dose daily, twice a day taken orally; 2 months for 1 course. The changes of 24-hour urinary protein, serum creatinine (SCr) and urea nitrogen (BUN) were observed after 3 courses of treatment. Results After 3 courses of treatment, the levels of 24-hour urinary protein, SCr and BUN of the integrated traditional Chinese and western medicine treatment group were lower than those of the western medicine treatment group [24-hour urinary protein quantification (g): 1.45±0.26 vs. 2.11±0.35, SCr (μmol/L): 105.15±12.31 vs. 158.32±17.26, BUN (mmol/L): 7.26±2.41 vs. 12.87±3.24], the differences being statistically significant (all P < 0.05). The total effective rate of integrated traditional Chinese and western medicine treatment group was significantly higher than that of western medicine treatment group [86.67% (26/30) vs. 53.33% (16/30), P < 0.05]. Conclusion Bushen Huoxue formula in the treatment of patients with diabetic nephropathy at stage G3a can decrease their urinary protein and SCr, BUN significantly.

The clinical significance of detecting renal urinary proteins through nephrostomy tube in children with extremely severe hydronephrosis / 中华泌尿外科杂志

Objective To explore the change of urine proteins from nephrostomy tube and renal function in patients with very severe hydronephrosis after nephrostomy in order to determine the treatment strategy of either renal preservation or resection.Methods Retrospective analysis of clinical data from March 2015 to March 2017 of 28 cases with congenital unilateral severe hydronephrosis in children's hospital affiliated to Zhejiang University,including 19 boys and 9 girls,with 20 cases on the left and 8 on the right,an average age of 26.6 (0.3 to 122.0) months at the first consultation and 2 cases of urinary biochemical abnormalities.Front to rear diameter for puncture were between 5.7 and 7.6 cm,with an average of 6.7 cm,and the differential renal function (DRF) for the affected kidneys were 6.98 ％-9.89 ％ (average 8.65 ％) before puncture.The children underwent percutaneous renal perforation fistula.According to the recovery of renal function after perforation fistula,those who underwent nephrectomy were recruited as a nephrectomy group and the children whose kidney were preserved as kidney preservation group.Comparison 24 hours before and 3 months after puncture was made beteween groups regarding the proportion of urine,pH of the renal pelvis urine,oαl microglobulin (α1-MG),albumin (Alb),β2 microglobulin (β2-MG),immunoglobulin G (IgG),transferrin (TRF),and the recovery of the damaged renal function (direnal function DRF).Results Twenty-eight cases of percutaneous nephrolithotomy were successful without puncture complications,with 10 cases in the nephrectomy group and 18 cases in the renal preservation group.The difference of renal pelvis urine from the affected kidney of the nephrectomy group showed no statistical significance 24 hours before and 3 months after the procedure when comparing the following parameters,including urinary specific gravity (1.006 ± 0.007 vs.1.009 ± 0.005),pH value (7.74 ± 0.41 vs.7.70 ± 0.32),urine creatinine value [(462.20 ± 158.01) μmol/L and (449.20 ± 143.41) μmol/L],αl microglobulin [(14.03 ± 4.360) mg/L vs.(13.84 ± 2.55) mg/L],β2 microglobulin [(0.76 ± 0.28) mg/L vs.(0.65 ±0.14) mg/L],immunoglobulin G [(1 292.20 ± 303.50) mg/L vs.(1 175.33 ± 376.67) mg/L],and kidney function (DRF) [(8.86 ±0.67) ％ vs.(9.90 ± 1.26)％].While microalbumin [(8 644.40 ± 829.54) mg/L vs.(3 145.10 ± 1 445.02) mg/L] and transferrin [(445.70 ± 46.71) mg/L vs.(214.30 ± 40.13) mg/L,P ＜ 0.05] were significantly increased 3 months after than 24 h before the procedure in nephrostomy group.There were no significant differences of the urine specific gravity 24h before and 3 months after the procedure in the kidney preserved group (1.003 ± 0.003 vs.1.005 ± 0.003,P ＞ 0.05).The creatinine value of 3 months after the procedure was significantly increased than that 24 hours within the procedure [(654.50 ± 154.52tμmol/L) vs.(423.94 ± 172.74) μmol/L],and the urine pH (7.28 ± 0.32 vs.7.91 ± 0.56),α1 microglobulin [(5.85 ± 0.38) mg/L vs.(12.58 ± 3.40) mg/L],microalbumin [(571.50 ± 167.14) mg/L vs.(2 343.28 ± 576.22) mg/L],β2 microglobulin [(0.14 ±0.05)mg/L vs.(0.53 ±0.13) mg/L],immunoglobulin G [(247.38 ±75.29) mg/L vs.(1 026.44 ±245.42)mg/L],and transferrin [(67.64 ± 16.34) mg/L vs.(249.17 ±78.62) mg/L] were significantly decreased 3 months after than 24 hours before the procedure.The renal function was higher 3 months after than 24 hours within the procedure [(8.53 ± 0.80) ％ vs.(20.50 ± 7.87) ％,P ＜ 0.05].Conclusions The increase of creatinine value and the decrease of urine pH,α1 microglobulin,microalbumin,β 2 microglobulin,immunoglobulin G and transferrin in renal pelvis urine suggested that renal function recovered after renal puncture,which is important for next-step plan of treatment strategy.

Effects of leflunomide on serum vascular endothelial growth factor and endothelin in patients with IgA nephropathy / 重庆医学

Objective To observe the efficacy and safety of prednisone combined with leflunomide in the treatment of immu-noglobulin A(IgA)nephropathy.Methods Eighty patients with IgA nephropathy were selected and divided into the treatment group and control group.The patients in the control group were given prednisone and the treatment group received prednisone plus leflunomide.The treatment course lasted for 12 months.Total effective rate,serum creatinine(Scr),urinary protease inhibitor C(Cys C),blood urea nitrogen(BUN)and 24 h proteinuria(U-prot)were measured at 6-month and 12-month treatment.Serum levels of vascular endothelial growth factor(VEGF)and endothelin-1(ET-1)were measured by enzyme-linked immunosorbent assay (ELISA).Results The effective rates at 6-month and 12-month treatment in the treatment group were 85% and 90% respective-ly,which in the control group were 65% and 70% respectively,the difference between the two groups was statistically significant (P<0.05).The BUN and U-prot levels after 6-moth and 12-month treatment were significantly reduced,moreover the effect in the treatment group was better than that in the control group(P<0.05).The levels of plasma VEGF and ET-1 after 6-moth and 12-month treatment in the two groups were decreased,moreover the decrease range in the treatment group was greater than that in the control group(P<0.05).Conclusion Prednisone combined with leflunomide can significantly improve the renal function in the pa-tients with IgA nephropathy,and it is safe and effective.

Design and application of 24-hour urine collecting device / 医疗卫生装备

Objective To develop a 24-hour urine collecting device to ensure the accuracy of 24-hour quantitative examination of urinary protein. Methods The device was composed of a barrel, a slot, a sealing bar, a thermometer, a top cover,a sample point,a handle,a holding slot,scale and stirring rod.24-hour urine was put into the barrel,and temperature was considered to determine whether the preservatives was added in to urine.Sampling was executed at the sample point,and the urine amount could be read out and recorded through the scale. Results The device facilitated to read out the urine amount and to ensure the effectiveness of the urine.Conclusion The device has easy operation,simple structure,low cost and high accuracy,and thus is worthy promoting practically.

Clinical Observation of Sitagliptin Combined with Benazepril in the Treatment of Diabetic Nephropathy / 中国药房

OBJECTIVE:To observe the clinical efficacy of sitagliptin combined with benazepril in the treatment of diabetic nephropathy(DN). METHODS:Sixty DN patients admitted to our hospital during Sept. 2014-Jun. 2015 were divided into sitagliptin group,benazepril group,drug combination group according to random number table,with 20 cases in each group. Based on routine treatment,sitagliptin group was given sitagliptin 100 mg orally,qd;benazepril group was given Benazepril 10 mg orally,qd;drug combination group was given sitagliptin 100 mg+benazepril 10 mg orally,qd. The drug dosage would be doubled if the blood pressure of patients in 3 groups had not yet reached the standard. Treatment course of 3 groups lasted for 12 weeks. The levels of 24 h urine protein,IL-6 and Cys-C were measured in 3 groups before and after treatment. Clinical efficacies and the occurrence of ADR were observed. RESULTS:Total response rate of drug combination group(90.00%)was significantly higher than those of sitagliptin group (65.00%)and benazepril group(70.00%);there was statistically significance(P0.05). No obvious ADR was found in 3 groups during treatment. CONCLUSIONS:Both sitagliptin and benazepril can decrease the levels of 24 h urine protein,IL-6 and Cys-C,while drug combination shows better effect and clinical response rate,and does not influence the safety of drug use.

Methodology establishment and application of therapeutic treatment on rats with anti-glomerular basement membrane nephritis / 中草药

Objective To establish a suitable model for therapeutic treatment on rats of anti-glomerular basement membrane nephritis. Methods Rabbit with rat glomerular basement membrane and freund’s adjuvant were immuned by multi-point subcutaneous injection biweekly, five times totally, and the antiserum was prepared. Experimental model for therapeutic treatment was established. Serum level of immune complex (CIC), intensity of immunofluorescence of glomerular basement membrane, lesion of kidney and glomerular basement membrane was measured by multiple intravenous injection of antiserum to rats to determine suitable experiment conditions including titer of antiserum, dose of antiserum, method and time of antiserum injection. The model was observed the efficacy using Gushen 2 as therapeutic drug. Results Rats with 4 mL antiserum (titer 1:4) by intravenous injection were immuned 4 times 3 d. Rat anti-glomerular basement membrane nephritis form on day 6, 8, and 10 since immunization; Pathogenic condition were relatively mild on day 6 since immunization and basically stable on day 8 and 10 since immunization. Verification tests showed that, Gushen 2 significantly reduced the 24 h urine protein excretion, relieved kidney lesion for 30 consecutive days, which had obvious therapeutic effect on rats with anti-glomerular basement membrane of nephritis. Conclusion Rats immuned with 4 mL antiserum (titer 1:4) by intravenous, immune points up to 4 times 3 d, rat anti-glomerular basement membrane nephritis model form which are suitable for therapeutic treatment of drug on day 8 since immunization.

A Brief Review on Free Light Chain Assays: From Conventional to Current

Free light chains (FLCs) are tumour markers of monoclonal gammopathies. Detection of urinary FLC or also known as Bence-Jones protein through urinary protein and its immunofixation electrophoreses (UPE and uIFE, respectively) have been considered the gold standard for its biochemical diagnosis. This is mainly due to their superior detection limits compared to their counterpart investigations in serum. However, urinalysis is limited in many ways. The emergence of serum FLC assay with markedly improved detection limit circumvents many of these problems and has gained much importance in biochemical investigations of monoclonal gammopathies. Nevertheless, they are not without limitations. This review discusses the advantages and limitations of serum and urinary FLC assays.

Clinical Study of Sanqi Granules in Treating Chronic Glomerulonephritis / 广州中医药大学学报

Objective To evaluate the efficacy and safety of Sanqi Granules (SG) for the treatment of chronic glomerulonephritis(CGN).Methods A prospective randomized controlled trial was carried out in 60 CGN patients with qi deficiency and blood stasis syndrome.The included patients were assigned into SG group,losartan group,and SG plus losartan group,20 cases in each group.The course of intervention was 24 weeks.Before and after treatment,24-hour urine protein quantity,serum creatinine (SCr),estimated glomerular filtration rate (eGFR) and the scores of traditional Chinese medical syndromes were observed.The clinical efficacy of Chinese medicine and western medicine,and the safety was evaluated after treatment.Results (1) After treatment for 12 and 24 weeks,the scores of traditional Chinese medical syndromes in the three groups were markedly improved (P ＜ 0.05),and the improvement in SG group and SG plus losartan group was superior to that in losartan group (P ＜ 0.05).(2) After treatment for 24 weeks,24-hour urine protein quantity in losartan group was significantly decreased (P ＜0.05),while SG group and SG plus losartan group only showed a decreasing trend(P ＞ 0.05).(3) After treatment for 24 weeks,renal function indexes of SCr and eGFR in SG group and SG plus losartan group were improved to some degrees,and the difference of eGFR in SG group was significant (P ＜ 0.05 compared with that before treatment),while the renal function injury in losartan group showed a deteriorative trend.SG group and SG plus losartan group had better effect on improving SCr and eGFR than losartan group (P ＜ 0.05).(4) After treatment for 24 weeks,the total effective rate of Chinese medicine in losartan group,SG group,SG plus losartan group was 50.00％,90.00％,84.21％,and the total effective rate of western medicine was 88.89％,75.00％,63.16％,respectively.SG group and SG plus losartan group had better clinical efficacy of Chinese medicine than losartan group (P ＜ 0.05),while the difference of clinical efficacy of western medicine among the three groups was insignificant (P ＞ 0.05).(5) During the follow-up,no severe adverse events were shown in the three groups.Conclusion SG exert certain therapeutic effect on improving the scores of traditional Chinese medical syndromes and protecting renal function,while have no obvious effect on decreasing urine protein.

The correlation analysis of urinary protein electrophoresis and pathologic in children with glomerular diseases / 重庆医学

Objective To understand the significance of urinary protein components in children with different pathological types of glomerular diseases ,to explore the significance to diagnosis and treatment of disease .Methods Totally 120 children with glomerular diseases ,from November 2010 to July 2012 in the First Affiliated Hospital of Zhengzhou University were collected ,in which 6 children with acute glomerulo nephritis(AGN) ,35 children with minimal change disease(MCD) ,9 children with focal seg‐mental glomerulosclerosis(FSGS) ,44 children with Nephritis of Schonlein‐Henoch Purpura(HSPN) ,17 children with IgA nephrop‐athy(IgAN) and 9 children with hemolytic uremic syndrome(HUS) .Urine protein electrophoresis and urineβ2‐microglobulin(β2‐MG)levels were investigated in different glomerular diseases .Results Significant difference was detected inβ2‐microglobulin ,lyso‐zyme ,retinol‐binding protein ,free light chain ,α1‐microglobulin ,light chain dimmer ,albumin and transferring levels in different glo‐merular diseases(P=0 .016 ,P=0 .017 ,P=0 .017 ,P=0 .023 ,P=0 .004 ,P=0 .025 ,P=0 .049 ,P<0 .01) .A significant correlation was detected between low molecular weight protein and urineβ2‐microglobulin levels(r=0 .243 ,P=0 .025) .Conclusion It is sig‐nificant for diagnosis and treatment of glomerular diseases to the combination of urine protein electrophoresis and renal pathology .Urinary protein profiles are different in different pathological types .Proteomics may be significant for the mechanism of glomerular diseases .

Analysis on application of urine protein electrophoresis in renal diseases / 国际检验医学杂志

Objective To explore the application value of non‐concentrated urine protein electrophoresis in renal diseases in order to guide to adjust the treatment scheme and judge the prognosis .Methods The clinical data in 152 cases of renal biopsy in the Xuzhou Municipal First People′s Hospital from December 2010 to January 2016 were retrospectively collected ,mainly including the pathological report and the results of urine protein electrophoresis .The classification was performed according to the WHO renal pathology classification standard(Ⅰ ,Ⅱ ,Ⅲ ,Ⅳ) .The relationship between the renal pathological classification with the classification of urine protein electrophoresis and the proportions of various compositions in electrophoresis spectrum was comparatively ana‐lyzed .Results The glomerular lesion rate was higher than the renal tubules‐interstitial lesion rate ,the majority of renal tubules‐in‐terstitial lesion had combining glomerular lesions .The glomerular urine protein level reflected by the urine protein electrophoresis was associated with glomerular damage degree ,with WHO pathological grade (Ⅰ - Ⅳ ) increase ,the proportion of haptoglobin (HAP)and IgG/A in urine protein electrophoresis showed an increasing trend ,the differences were statistically significant (F=2 .237 ,P<0 .05 ;F=7 .269 ,P<0 .05) .Conclusion Detecting the proportion of HAP and IgG/A in urine protein electrophoresis has an important clinical value in reflecting the glomerular damage severity .

Correlación entre el cociente proteinuria/creatininuria en una orina al azar y la proteinuria de 24 horas

Introducción: la cuantificación de proteínas en orina es un estudio que evalúa la afectación renal por ciertas enfermedades. Su medición puede realizarse también a través del cociente proteinuria/creatininuria. Objetivo: determinar la correlación entre el cociente proteinuria/creatininuria y la proteinuria de 24 horas. Metodología: se realizó un estudio descriptivo observacional, prospectivo con componente analítico de corte transverso, de muestreo no probabilístico. Se incluyó a 60 pacientes con factores de riesgo de padecer enfermedad renal crónica, que acudieron al Hospital Nacional (Itauguá) en el año 2014. Todos se realizaron análisis de orina de 24 horas y de una muestra de orina al azar para estimar el cociente proteinuria/creatininuria. Resultados: se observó que existe una correlación muy significativa (r= 0,9 p < 0,001) entre los valores del cociente de proteinuria/creatininuria en una orina al azar y la proteinuria de 24 horas, con una sensibilidad 94,1% (IC95% 79-100), especificidad 100% (IC95% 98-100%), valor predictivo positivo 100% (IC95% 96-100) y valor predictivo negativo 97,7% (IC95% 92-100). Conclusiones: el cociente proteinuria/creatininuria es útil para detectar proteinuria en rango no nefrótico.

Introduction: The quantification of proteins in urine is a study that evaluates kidney involvement in some diseases. The measurement can be made through the urine protein-creatinine ratio. Objective: To determine the correlation between the urine protein-creatinine ratio and 24-hour urine protein. Methodology: A cross-sectional prospective observational descriptive study with analytical component and non-probabilistic sampling was performed. Sixty patients who had risk factors of chronic renal disease and attended the National Hospital (Itauguá) in 2014 were included. Twenty four-hour urine and a random urine sample were analyzed to estimate the protein-creatinine ratio. Results: A very significant correlation (r= 0.9 p < 0.001) was observed between the values of the protein-creatinine ratio in a random urine and 24-hour urine protein with a sensitivity of 94.1% (IC95% 79-100), specificity of 100% (IC95% 98-100%), positive predictive value of 100% (IC95% 96-100) and negative predictive value of 97.7% (IC95% 92-100). Conclusion: The protein-creatinine ratio is useful to detect proteinuria in a non-nephrotic range.

Effect of Euryale ferox seeds ethanol extract on renal function of diabetic nephropathy rats and determination of its antioxidant ability in vitro / 国际药学研究杂志

Objective To investigate the effect of Euryale ferox seeds ethanol extract on renal funtion of diabetic nephropathy (DN) induced by strepotozotocin (STZ) in rats and the antioxidant ability of ethanol extract,water extract supernatant and precipitation. Methods Ethanol extract of Euryale ferox seeds were prepared by ethanol extraction and followed by evaporation and freeze-dry. The seeds residue was further extracted with water and precipitated with ethanol to obtain water extract supernatant and precipitation. Sprague Dawley male rats were given intraperitoneal injection of STZ at a dose of 60 mg/kg to induce DN. STZ-induced DN rats were administrated by gavage with different dose of Euryale ferox seeds ethanol extract(75, 150, 300 and 600 mg/kg body weight) once daily for 12 weeks. 24 h urine was collected for examining urinary protein and microalbumin every four weeks. Blood serum was also collected for examining of serum creatinine (Cr) and blood urea nitrogen (BUN) level after rats sacrificed at the end of 12 weeks after administration, and the pathological changes of kidney were observed. Antioxidant capacity of the three extracts were determined by Fe3+ reduction, and radical scavenging rate to 1,1-diphenyl-2-picrylhydrazyl radical 2,2-diphenyl-1-(2,4,6-trinitrophenyl)hydrazl(DPPH), O2-and OH-free radicals. Results Compared with model group, the content of 24 h urine protein and urine microalbumin of DN rats were reduced in all Euryale ferox seeds ethanol extract administration groups, and 24 h proteinuria were significantly reduced in the group of 150 and 600 mg/kg administration(P<0.05);BUN level was also reduced in all dose of Euayale ferox seeds ethanol extract administration, and more remarkably reduced in the group of 300mg/kg (P<0.01). 12 weeks after administration, kidney damage amelioration was observed in pathological sections of rats in Euryale ferox seeds ethanol extracts 300 and 600 mg/kg groups. Meanwhile, Euryale ferox seeds ethanol extract showed a certain antioxidant abilities in reducing of Fe3+ and scavenging DPPH, O2- and OH- at the concentrations of 0.6, 0.8 and 1.0 mg/ml. Conclusion Euryale ferox seeds ethanol extract could decrease proteinuria of STZ-induced DN rats,this may be associated with its antioxidant capacity.