Objective To study the mechanism of diabetic nephropathy(DN) in type 2 diabetes mellitus of blood glucose fluctuation and oxidative stress.Methods 90 patients with type 2 DN were selected,included 30 cases of the normal albuminuria (DM group),30 cases of microalbuminuria (NA group),30 cases of the mass albuminuria (MA group),and during the same period,30 healthy persons in our hospital for medical examination were selected as the control group(NC group).The blood glucose,blood lipid,blood glucose fluctuation and oxidative stress were compared among the 4 groups.Results The blood glucose(FBG),postprandial 2h blood glucose(2hPG),glycosylated hemoglobin(HbA1c) levels had statistically significantly differences among the 4 groups(F=23.088,24.356,43.553,all P<0.05),which in the NC group[(4.03±1.12)mmol/L,(7.11±1.41)mmol/L,(4.11±0.83)%]were lower than the other 3 groups[DM group:(6.34±1.48)mmol/L,(9.13±1.52)mmol/L,(6.67±1.24)%;NA group:(6.58±1.53)mmol/L,(9.78±1.79)mmol/L,(7.53±1.51)%;MA group:(6.84±1.71)mmol/L,(10.23±1.36)mmol/L,(8.11±2.02)%](F=23.088,24.356,43.553,all P<0.05).There were no statistically significant differences in total cholesterol(TC),three acyl glycerin(TG),high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C) among the 4 groups(F=1.079,1.732,0.358,1.428,all P>0.05).The mean amplitude of glycemic excursions(MAGE),mean absolute value of blood glucose(MODD),superoxide dismutase(SOD) and malondialdehyde(MDA) levels in the 4 groups had statistically significant differences(F=37.350,216.899,21.003,93.211,all P<0.05).Correlation analysis showed that in patients with type 2 DN,negative correlation was observed between SOD and MAGE and MODD(r=-0.430,-0.523,all P<0.05),MDA and MAGE,MODD was positively correlated(r=0.534,0.624,all P<0.05).Conclusion Blood glucose fluctuation is involved in the occurrence and development of DN,the mechanism may be correlated with oxidative stress.

Objective:To observe the clinical effect of Banxia Xiexin decoction combined with clarithromycin and tinidazole in the treatment of pediatric gastritis.Methods:From March 2017 to November 2018, 100 children with gastritis admitted to the First People's Hospital of Wenling were selected.They were divided into control group (50 cases) and observation group (50 cases) by random number table method.The control group was treated with conventional western medicine.The observation group was treated with Banxia Xiexin decoction combined with clarithromycin and tinidazole.Both two groups had the same course of treatment for two weeks.The symptom score, quality of life score, epigastric fullness, epigastric pain and acid reflux disappearance time were observed before and after treatment.The clinical efficacy and adverse reactions were compared between the two groups.Results:Before treatment, there were no statistically significant differences in the scores of gastritis symptoms and quality of life between the two groups (all P>0.05). After treatment, the scores of gastritis symptoms and quality of life in the control group were (1.27±0.22)points and (80.22±4.45)points, respectively, which in the observation group were (0.56±0.11)points and (90.53±4.11)points, respectively, the differences between the two groups were statistically significant( t=5.824, 7.825, all P<0.05). The disappearance time of upper abdominal fullness, pain and acid reflux in the control group were (5.42±2.51)d, (4.47±2.24)d, (4.68±1.51)d, respectively, which in the observation group were (4.11±1.12)d, (3.25±1.21)d, (3.21±0.24)d, respectively, the differences were statistically significant between the two groups( t=5.221, 5.167, 5.121, all P<0.05). The total effective rate of the observation group was 98.00% (49/50), which was higher than 80.00% (40/50) of the control group (χ 2=8.201, P<0.01). The incidence of adverse reactions in the observation group was 6.00%(3/50), which was lower than that in the control group [18.00% (9/50)] (χ 2=6.278, P<0.05). Conclusion:Banxia Xiexin decoction combined with clarithromycin and tinidazole can effectively improve the clinical symptoms, gastric function and quality of life of children with gastritis, with fewer adverse reactions, and the effect is better than conventional western medicine.