OBJECTIVE:To observe the clinical efficacy and safety of ezetimibe combined with simvastatin in the treatment of membranous nephropathy complicated with hyperlipidemia. METHODS:90 patients with membranous nephropathy complicated with hyperlipidemia were randomly divided into observation group and control group,45 cases in each group. All patients received health guidance,low-fat diet,and the drugs without interfere with regulating lipid,hepatoprotective and lipid metabolism were for-bid. Control group was orally given 20 mg Simvastatin tablet,qd;observation group was additionally given 10 mg Ezetimibe tab-let,qd. They were treated for 8 weeks. Clinical efficacy was observed,lipid levels [total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C)],aspartate aminotransferase (AST),ala-nine aminotransferase(ALT),urinary protein quatitation,creatine kinase(CK)before and 2,4,8 weeks after treatment,and the incidence of adverse reactions were compared. RESULTS:Total effective rates of membranous nephropathy and hyperlipidemia were 95.56% and 93.30% in observation group,which were significantly higher than 73.33% and 75.56% in control graup,with statistical significance (P<0.05) .There were no significant differences in TG,HDL-C and LDL-C levels before and 2,4,8 weeks after treatment,and TC level before and 2,4 weeks after treatment between 2 groups (P>0.05);after 8 weeks of treat-ment,TC level in observation group was significantly lower than control group,the differences were statistically significant (P<0.05). Compared with control group,there were no significant differences in AST,ALT,urinary protein quatitation and CK level between 2 groups before and 2,4,8 weeks after treatment(P>0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:Ezetimibe shows similar clinical efficacy with simvastatin in the treatment of membranous nephropathy complicated with hyperlipidemia,it can effectively reduce TC level,with good safety.

Objective To establish CT image-based, three-dimensional finite element models of healthy tibiae and plateau-fracture tibiae, and to calculate the displacement and stress distribution of the tibial models .Methods Continuous-time tomographic images of knee joints of a healthy adult and a patient with tibial plateau fractures were obtained using multi-slice spiral CT scan , and inputed to Mimics to establish three-dimensional surface mesh models of tibiae .The models underwent global meshing procedures and material properties assignment to construct finite element models of normal and plateau-fracture tibiae in ANSYS , and the newly established models were analyzed and calculated .Results In case of applied load on the tibial plateau , the peak strains of the load-contact sites in the healthy subject and the patient presented divergent directions , with peak strains on the medial tibia in the healthy subject and lateral tibia in the patient , respectively . Equivalent stress decreased gradually down the tibiae and concentrated in the one -third of the upper and middle regions in both types of tibiae .Moreover, concentration of stress was also present in the locus of the fractured tibia .The deformation displacement gradients were more evident in the healthy tibia than in the fractured tibiae .There was significant difference in overall stress distribution between the two types of tibiae .Conclusion Three-dimensional finite element models of tibiae have been established that can demonstrate the differences in biomechanical properties between healthy and plateau -fracture tibiae, which might provide reference and guidance for orthopedic regimens .