Objective To observe the effect of sulodexide and tripterygium glycosides on the idiopathic membranous nephropathy in stage Ⅰ ~Ⅱ.Methods 52 adult patients with idiopathic membranous nephropathy (pathologic stage Ⅰ -Ⅱ stage,24 h urinary protein 4 -8 g/d)were randomly divided into the control group and observation group,with 26 cases in each group.The cases in the control group were treated by conventional treatment and tripterygium glycosides tablet,and the observation group were treated with sulodexide based on the therapy of con-trol group.Six months was a course.24 h urinary protein excretion(24hUpro),serum creatinine(CR),alanine amin-otransferase(ALT),albumin(ALB),activated partial thromboplastin time(APTT),fibrinogen(Fbg)and total choles-terol(TC)were compared before and after treatment.The clinical efficacy and adverse reactions of the two treatments were observed.Results After 6 months of treatment,24hUpro,Fbg and TC of the two groups were significantly decreased than those before treatment(control group:t =3.754,2.096,3.781,observation group:t =5.412,5.043, 6.200,all P <0.05),while serum ALB was significantly higher(control group:t =2.519,observation group:t =4.672,P <0.05).CR and ALT had no significant difference between before and after treatment(all P >0.05).APTT was significantly longer than that before treatment(t =5.115,P <0.05).After treatment,ALB and APTT of the obser-vation group were (30.2 ±3.6)g/L and (36.1 ±2.7)s,which were significantly higher than (27.8 ±4.1))g/L and (33.8 ±3.1)s of the control group(t =2.243,2.853,all P <0.05),while 24hUpro,Fbg and TC were significantly lower than those of the control group(t =2.176,4.072,2.555,all P <0.05).The clinical effect of the observation group was 53.8%,which was significantly higher than the control group's 26.9%(χ2 =5.042,P >0.05 ).Both groups had no serious adverse reactions.Conclusion The clinical efficacy of sulodexide and tripterygium glycosides tablet may be more precise than alone tripterygium for IMN,which is safety.

Objective To explore the clinical efficacy and safety of leflunomide combined with prednisone in the treatment of immunoglobulin A nephropathy.Methods 80 patients with IgA nephropathy were chosen and randomly divided into two groups,40 cases in each group.The control group was orally given prednisone(initial dose 1 mg · kg-1 · d-1),after 2 months of treatment 5mg/2 weeks reduction,and 10mg/d as maintenance therapy,while the observation group was treated with 20mg/d leflunomide treatment based on the treatment of control group.All the two groups had 3 months as a course of treatment.Before treatment and after treatment,the 24h urinary protein,serum albumin,serum creatinine,glomerular filtration rate,cholesterol,triglycerides,cystatin C levels and urinary vascular cell adhesion molecule-1 after treatment (urinary VCAM-1) and interleukin-18 (IL-8) in the two groups were recorded and compared,as well as the clinical efficacy and adverse reactions.Results The total effective rate in the observation group was 92.5％,which was significantly higher than 75.0％ in the control group (x2 =4.501,P ＜ 0.05).After treatment,the serum creatinine,serum albumin,cholesterol,triglycerides,cystatin C,24h urine protein,glomerular filtration rate and urinary VCAM-1,IL-8 in the two groups were all significantly improved (t ≥ 1.945,all P ＜ 0.05).After treatment,the cholesterol and triglycerides in the two groups had no significant differences (t =0.322,1.307,all P ＞ 0.05).After treatment,in the observation group,the serum creatinine,cystatin C,24h urinary protein excretion,VCAM-1 and IL-8 in urine were significantly lower than those in the control group,while serum albumin and glomerular filtration rate were significantly higher (t ≥2.632,all P ＜ 0.05).In the observation group,the total effective rate of Ⅳ,Ⅴ grade by Lee classification were significantly higher (x2 =4.269,4.600,all P ＜ 0.05).And in the two groups,the total effective rate of Ⅰ,Ⅱ grade by Lee classification had no statistically significant differences(x2 =0.000,0.000,all P ＞0.05).In the observation group,the incidence rate of adverse reaction was 10.0％,that in the control group was 8.6％,there was no statistically significant difference between the two groups (x2 =0.157,P ＞ 0.05).Conclusion Leflunomide combined with prednisone in the treatment of IgA nephropathy has better clinical efficacy and higher safety,its mechanism may be associated with decreased urinary VCAM-1 and serum IL-18 levels.

OBJECTIVE:To evaluate the clinical efficacy and safety of letrozole combined with traditional Chinese medicine for ovulation dysfunction induced by polycystic ovarian syndrome(PCOS). METHODS: 300 PCOS outpatients were randomized to 3 groups of 100 each: clomiphene citrate (CC) group (188 cycles);urinary gonadotropin (HMG) group (104 cycles) and letrozole (LE) group (155 cycles). The occurrence rate of mature follicle,ovulation rate,pregnancy rate,abortion rate,superfoetation-terata rate,cancellation rate,incidence of no dominant follicle forming and OHSS etc were compared between the two groups after treatment. RESULTS: 30 babies were born in CC group,34 in HMG group and 43 in LE group were born. The occurrence rate of mature follicles,ovulation rate and pregnancy rate in the LE group were higher than in either CC group or HMG group(P0.05);the superfoetation rate in HMG group was higher than in CC group or LE group(P

Objective To analyze the relationship between the morphological characteristics and rotator cuff tear (RCT) by MR.Methods The data of clinic and shoulder MRI of 37 patients with RCT (patients group) were analyzed retrospectively,and 19 healthy volunteers were collected in control group.The acromial shapes were classified into type Ⅰ (flat),type Ⅱ (curved),type Ⅲ (hooked) and type Ⅳ (convex).Additional measurements about pathogenesis of RCT including acromio-humeral distance (AHD),acromial index (AI),lateral acromial angle (LAA) and acromial thickness were performed for further assessment.Results Type Ⅱ was the most commonly encountered acromial shape in patients group (16/37,43.24 ％) and control group (11/19,57.89 ％).There was no statistically significant difference in the incidence of each acromial shape between two groups (P＞0.05).However,the AHD,AI,LAA and acromial thickness showed statistically significant difference between the patients group and control group (all P＜0.05).The type Ⅲ acromion was signifi candy different from the other types in patients group (P＜0.05).Conclusion MRI can clearly display RCT.The AHD and LAA are smaller,the AI and acromial thickness are bigger in RCT patients.Type Ⅲ acromion may increase risks for RCT.

Objective To investigate the effect of cinacalcet combined with low －dose calcitriol in the treatment of patients with secondary hyperparathyroidism of end －stage renal disease.Methods A prospective analysis was conducted in 129 patients with end－stage renal disease and secondary hyperparathyroidism from April 2015 to August 2017 in the Department of Nephrology of Integrative Medicine Hospital of Wenzhou City,Zhejiang Province.The patients were randomly divided into 3 groups:group A received cinacalcet,group B received calcitriol, group C received cinacalcet and low－dose calcitriol for 3 months,respectively.Before and after treatment,the levels of serum phosphorus and serum calcium in the three groups were measured.The levels of parathyroid hormone and the parathyroid hormone clearance rate were measured to find out the therapeutic effect.Results The levels of serum calcium,phosphorus and total parathyroid hormone in group A were significantly lower than those before treatment(t＝3.269,2.263,4.233,all P＜0.05).PTH was significantly decreased,blood calcium and phosphorus significantly in-creased compared with those before treatment,the differences were statistically significant(t＝2.827,2.386,3.342, all P＜0.05).The phosphorus,total parathyroid hormone levels of group C were significantly decreased(t＝3.085, 5.142,all P＜0.05),and no significant change in serum calcium level(t＝0.258,P＞0.05).The total parathyroid hormone level:group B＞group A ＞group C,the whole parathyroid hormone clearance rate:group C ＞group A ＞group B,the differences were statistically significant(t ＝3.642,3.263,all P＜0.05).After treatment,the serum calcium level among the three groups had statistically significant difference,group B＞group C＞group A,the serum phosphorus level among the three groups after treatment had statistically significant difference,group B＞group A ＞group C (t＝3.265,3.332,all P＜0.05).Conclusion The combined use of cinacalcet and low－dose calcitriol in the treatment of secondary hyperparathyroidism in patients with end－stage renal disease can significantly reduce the level of parathyroid hormone and serum phosphorus,and without affecting serum calcium concentration.

Objective To investigate the relationship between serum progesterone level at the day with human chorionic gonadotrophin (hCG) administration and pregnant outcome from in in-vitro fertilization-embryo transfer(IVF-ET). Methods From Mar. 2002 to Apr. 2007, 786 cycles with serum progesterone measurement on the day of hCG administration for final oocyte maturation in IVF were analyzed retrospectively in Reproductive Medicine Center in First Affiliated Hospital of Nanjing Medical University.All stimulations were down-regulated with gronadotrophin release hormone agonist (GnRH-a) in both long protocols and short protocols before gonadotrophin stimulation. When the thresholds of serum progesterone were set at 5.5, 6.0,6.5,7.0,7.5,8.0,8.5 and 9.0 nmol/L, respectively. If the level of progesterone was less than the thresholds, those patients were in lower progesterone group, on the contrary, more than the threshold value, those patients were in higher progesterone group. The laboratory results and the clinical outcomes between all patients at lower and higher progesterone group at different thresholds value were analyzed. Results The rate of normal fertilization, quality embryos, successful implantation, chemical pregnancy, clinical pregnancy and live birth did not exhibit remarkable difference between patients with higher and lower serum progesterone level at multiple thresholds on the day of hCG administration in the 786 cycles (P >0.05). However, when the thresholds of serum progesterone were at 8.5 and 9.0 nmol/L, early abortion rates of 27.3% (3/11) and 3/7 in higher progesterone group were significantly higher than 8.8% (26/297) and 8.6% (26/301) in lower progesterone group (P<0.05). And the total abortion rates of 3/7 in higher progesterone group were significantly higher than 11.0% (34/301) in lower progesterone group when the thresholds of serum progesterone were 9.0 nmol/L (P<0.05). Conclusions This study did not prove the correlationship between progesterone level at the clay with hCG administration and the probability of clinical pregnancy or live birth. However, early abortion rates or the total abortion rates were associated with higher progesterone level when the thresholds of serum progesterone were at 8.5 nmol/L or 9.0 nmoL/L.

A temporary demand pacemaker with electrocardiosignal display is introduced in this paper. Double way low-noise electrocardiosignal preamplifier, amplitude limiter, high and low pass filter, 50 Hz notch filter, TTL level generator and stimulating pulse formation circuit are components of the hardware electrocircuit. The demand pacing and the electrocardiosignal display are separately controlled by the software in which the double microcontrollers communications technique is used. In this study, liquid crystal display is firstly used in body surface electrocardiosignal display or intracardial electrophysiologic signal display when the temporary demand pacemaker is installed and put into use. The machine has proven clinically useful and can be of wide appliation.
Electrocardiography ; Humans ; Pacemaker, Artificial