Résumé
Diabetic nephropathy (DN) is one of the diabetic microvascular complications characterized by progressive protein uria and renal failure, which may eventually develop into end-stage renal disease (ESRD). Glomerular endothelial cells are one of the important components of glomerular filtration barrier. The structural and functional integrity of these cells are closely related to the maintenance of glomerular filtration function. Dysfunction of glomerular endothelial cells can lead to proteinuria, glomerulosclerosis and interstitial fibrosis, further damaging renal function and accelerating the progression of DN. The mechanisms leading to endothelial dysfunction include glucose metabolism disorder, oxidative stress, abnormal angiogenesis, inflammation and endothelial transdifferentiation. In recent years, it has been proposed that mechanisms such as intercellular communication, epigenetics and exosomes may be involved in the injury of diabetic nephropathy. In present paper, the research progress of related mechanisms was reviewed on the damage of glomerular endothelial cells in DN.
Résumé
<p><b>OBJECTIVE</b>To observe the clinical efficacy of acupuncture combined with massage on infiltrative exophthalmos so as to provide a more effective treatment for infiltrative exophthalmos in hyperthyroidism.</p><p><b>METHODS</b>Forty-five cases of infiltrative exophthalmos were randomly divided into an acupuncture massage group (25 cases) and a western medicine group (20 cases). In acupuncture massage group, acupuncture was applied mainly at Jingming (BL 1), Qiuhou (EX-HN 7), Chengqi (ST 1) and Shangming (Extra); and massage was applied in combination on the back of the neck and the local points around the orbit. In western medicine group, Dexamethasone and Methotrexate were used for intravenous infusion, and Prednisone was for oral administration. The exophthalmos extent and clinical efficacy were compared between two groups.</p><p><b>RESULTS</b>Before and after the treatment, the exophthalmos extents were (20.27 +/- 1.22) mm and (18.11 +/- 0.87) mm in acupuncture massage group and were (20.34 +/- 1.20) mm and (19.47 +/- 1.11) mm in western medicine group separately, indicating remarkable improvement in two groups (both P < 0.01). The improvement in acupuncture massage group was superior remarkably to that in western medicine group (P < 0.01). The total effective rate (83.3%, 40/48) in acupuncture massage group was superior to that (53.8%, 21/39) in western medicine group, and with less adverse reaction.</p><p><b>CONCLUSION</b>Acupuncture combined with acupoint massage is an advanced therapy and has definite efficacy on infiltrative exophthalmos, which is superior to the conventional treatment in western medicine.</p>