Objective To investigate risk factors of chronic renal failure in IgA nephropathy.Methods A total of 384 cases of patients with IgA nephropathy from the First Affiliated Hospital of Guangxi University in Guangxi during 1997—2006 were divided into renal function normal group(320 cases) as the contrast and renal dysfunction group(64 cases) according to serum creatinine level whether beyond 133 ?mol/L,clinical and pathological materials were contrasted,stepwise multiple variance regression analysis was adopted to find the serum creatinine related factors.Results Significant difference was found between the two groups in rates of maleness,dropsy,hypertension,proteinuria,which were remarkably increased in the renal dysfunction group(P0.05).The scores of glomeruli index,interstitial index,blood vessel index,sclerotic index and so on were remarkably higher in the renal dysfunction group(P

0. 05). but there was a significant difference between the treatment group and the Chinese patent medicine control group (P

Objective To systematically review the efficacy and safety of mycophenolate mofetil versus cyclophosphamide in adults with refractory nephrotic syndrome. Methods The randomized controlled trials of mycophenolate mofetil and cyclophosphamide treatment for refractory nephrotic syndrome were searched from Cochrane library, PubMed, Embase, Wanfang, VIP and CNKI till March 2014. The relevant studies were screened according to inclusion criteria and exclusion criteria. The quality of the included studies was evaluated. Meta-analyses were performed by using RevMan 5.2 software. The indexes were analyzed including the complete remission rate, efficiency, serum albumin, and adverse reaction after completing the treatment for adults with refractory nephrotic syndrome. Results There were 9 RCTs, a total of 467 patients were enrolled. The result of the meta-analysis showed that mycophenolate mofetil could significantly increase complete remission rate (RR=1.45, 95%CI=1.17～1.81, P=0.000 7) and efficiency rate (RR=1.23, 95%CI=1.11～1.36, P＜0.000 1). It can also enhance the level of serum albumin (WMD=2.73, 95%CI=1.42～4.04, P＜0.000 1) and decrease 24-hour urinary protein (SMD=-0.63, 95%CI=-1.16～-0.10, P=0.02) compared with cyclophosphamide in the treatment of refractory nephrotic syndrome. There was no significant difference in the serum level of cholesterol between mycophenolate mofetil group and cyclophosphamide group (SMD=0.31, 95%CI=-0.23～0.84, P=0.26 ). The incidence rates of liver dysfunction (RR=0.13,95%CI=0.06～0.28, P＜0.000 01), leukopenia (RR=0.10, 95%CI=0.04～0.23, P＜0.000 01), gastrointestinal reaction (RR=0.21, 95%CI=0.11～0.39, P＜0.000 01) and alopecia (RR=0.08, 95%CI=0.02～0.29, P＜0.000 01) were significantly lower in mycophenolate mofetil group than those of cyclophosphamide group. There were no significant differences in respiratory tract infection rate (RR=0.68, 95%CI=0.41～1.14, P=0.14) and lung infection rate (RR=0.58, 95%CI=0.31～1.08, P=0.09) between the two groups. Conclusion The safety and efficacy are better in the treatment of refractory nephrotic syndrome using mycophenolate mofetil than that of cyclophosphamide.

Objective To investigate the expressions of Bcl-2 and Bax protein in the renal tissues of patients with lupus nephritis(LN)and their role in the pathology alteration of LN.Methods During 2003-01～2003-04 immunohistochemical staining was used to detect the expressions of Bcl-2 and Bax in renal tissues of 44 cases of LN in the First Affiliated Hospital of Guangxi Medical University.Their relationship with pathology was also observed.Results (1)The expression of Bcl-2 and Bax was significantly increased and both were positively correlated with the grade of intraglomerular cell proliferation and proliferating cell nuclear antigen(PCNA)positive glomerular cells.(2)The expression of Bcl-2 in interstitial cells was significantly increased and positively correlated with the degree of interstitial infiltration of inflammatory cells.(3)The expression of Bax in the tubule of LN was increased and was positively associated with tubulointerstitial lesions.Conclusion There is abnormal expressions of Bcl-2 and Bax in renal tissues of LN.Overexpression of Bcl-2 in renal tissues of LN might play an important role in the process of glomerular hypercellularity and interstitial infiltration of inflammatory cells.Overexpression of Bax in tubular ducts is correlated with tubulointerstitial lesions.

Objectives To investigate the relationship between the insertion and deletion (I/D) polymorphism of human angiotensin converting enzyme (ACE) gene and the vascular complications in type 2 diabetes. Methods The I/D polymorphism of ACE gene was detected by polymerase chain reaction in 120 type 2 diabetic patients and 100 healthy controls. Results The frequency of DD genotype was significantly higher, while frequency of II genotype was lower in diabetic nephropathy patients (DN) than those in control group. The frequency of ID genotype was significantly higher, while frequency of II genotype was lower in type 2 diabetic patients with coronary heart disease (CHD), when compared to those without CHD. The frequencies of ACE genotypes in patients with diabetic retinopathy (DR) or hypertension (HP) were not different from those in control group and non-DR or non- HP patients. Conclusions ① There were relationships between the I/D polymorphism of ACE gene and DN and CHD in type 2 diabetes. ② The DD genotype and D allele of ACE gene might be as markers in predisposing DN, while II genotype and I allele as protective factors for DN in diabetes. The ID genotype might be as a marker in predisposing CHD, while II genotype as a protective factor for CHD in diabetes.③ There was no relationship between I/D polymorphism of ACE gene and HP or DR in diabetes in Guangxi region.

Objective To investigate the relationship between serum 25-hydroxycholecalciferol [25(OH)D3] deficiency and the risk of peritoneal dialysis associated peritonitis.Methods Baseline clinical data (before the peritoneal dialysis catheter insertion) of peritoneal dialysis patients treated with CAPD in the First Affiliated Hospital of Guangxi Medical University from May 1,2013 to February 1,2016 were retrospective analyzed.All the patients were followed-up until July 31,2016.According to the baseline serum 25(OH)D3 levels,patients were divided into deficiency group (25(OH)D3 ＜ 15 ng/ml) and non deficiency group (25(OH)D3 ≥ 15 ng/ml),the baseline clinical data of the two groups were also analyzed.Kaplan-Meier method was used to compare the time-to-peritonitis of two groups.Cox proportional hazard model was used to analyze the relationship between the 25(OH)D3 deficiency and the risk of peritonitis.ROC curve was used to analyze the predictive value of the baseline serum 25(OH)D3 for the risk of PDAP in peritoneal dialysis patients.Results Compared with the 25(OH)D3 non deficiency group,25(OH)D3 deficiency group had a significant increase incidence of peritonitis,high diastolic blood pressure and mean arterial pressure,but serum albumin,total serum protein decreased significantly (P ＜ 0.05).Kaplan-Meier survival analysis showed that,compared with 25(OH)D3 non deficiency group,the time-to-peritonitis episode of patients with 25(OH)D3 deficiency were shorter (P ＜ 0.05).Cox proportional hazard model showed that after adjusting for age,sex,hemoglobin,serum albumin,C-reactive protein,total Kt/V,eGFR,diabetes or not,25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis (HR 5.247,95％CI 1.180-23.340,P ＜ 0.05).ROC curve showed the area under the curve that baseline serum 25(OH)D3 deficiency predict the occurrence of PDAP was 0.714,and the best cut-off point of baseline serum 25(OH)D3 was 11.35 ng/ml (sensitivity 75％,specificity 63％).Conclusions Peritoneal dialysis associated peritonitis occurred earlier in peritoneal dialysis patients whose baseline serum 25(OH)D3 deficiency.Baseline serum 25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis,which may predict the incidence of peritoneal dialysis associated peritonitis.

Objective To observe biological effect of cardiotrophin-1(Adv-CT1)gene transfection mediated by adnovims on traumatic brain iniuries(TBI)in-vivo and discuss the role and mechanism of Adv-CT1 on TBI. Metheds A rat TBI model was established bv Allen method.After Adv-CT1 was transfefred into the iniured brain by adnovims,the effect of CT-1 on apoptosis and survival of neurons after TBI was determined by means of Nissl staining,TUNEL and flow cytometry apoptosis assay. Resuits Apoptotic cells were increased but the survived cells decreased in the injured cortical brain and hippocampus from 12 hours to 14 days after TBI in the control group.As compared with control group,Adv-CT1 treatment reversed this situation to some degrees. Conclusion CT-1 has neuropmtective effect on neurons after TBI by reducing apoptosis of neurons.

Objective To investigate the impact of continued ambulatory peritoneal dialysis (CAPD)for 1 month,thus to provide effective therapy to control the symptoms of uremia in early stage. Methods A total of 129 nephrotic patients in final stage were treated with CAPD ,dialysis adequacy were assessed after 1 month of CAPD. Complications and biochemical indicators were compared between before and after 1 month of CAPD. Results The dialysis adequacy was good at the end of 1 month of CAPD. Compared to before CAPD,The prevalence of edema after 1 month of CAPD significantly decreased compared to before CAPD (7.8%vs. 24.8% ,χ2 = 13.765, P ＜ 0.05 ). After CAPD gastrointestinal, symptom, such as nausea and vomit significantly decreased from 66.7% to 6. 2% ( χ2 = 101. 821, P ＜ 0. 05 ). Itch of skin significantly decreased from 22. 5% before CAPD to 6. 2% after CAPD(χ2 = 13.914,P ＜0. 05) . Hemoglobin increased significantly from (79. 10 ± 17.13 ) g/L to (96. 50 ± 18. 69 ) g/L after CAPD ( t = - 6. 333, P ＜ 0. 01 ), serum calcium was sisilar, ( 1.99 ± 0.30) mmol/L and (2.07 ± 0. 20) mmol/L at before and after CAPD respectively ( t = -1. 920,P ＞0. 05). Albumin was (30. 62 ±5.24) g/L before CAPD and after CAPD(31.84 ±5.64) g/L ,with no significant difference ( t= - 0.333, P ＞ 0. 05 ) . Serum inorganic phosphorus, kalemia, urea nitrogen and creatinine concentration significantly decreased from ( 2. 06 ± 0. 54 ) mmol/L, ( 4.30 ±: 0. 68 ) mmol/L, 22. 00( 15.87,30.03 ) mmol/L and 864. 00 ( 733.00,1046. 25 ) μmol/L to ( 1.72 ± 0. 52) mmol/L, ( 3.84 ± 0.47 )mmol/L , 17.00 ( 13.91,20. 91 ) mmol/L and 777. 50 ( 627.00, 1047.75 ) μnol/L, respectively ( t = 3.284,4. 669, Z = - 3.717 and - 2. 408, respectively,Ps ＜ 0. 01 or 0. 05 ).. The level of serum PTH increased slightly from [ 184. 80 ( 114. 21,369. 77) ng/L to 226. 26 ( 124. 22,335.92 ) ng/L, but the difference was not significant ( Z = - 0. 597, P ＞ 0. 05 ). Conclusion CAPD had significant effect in early stage of dialysis with good dialysis adequacy. Hypocalcemia and hyperphosphatemia can be improved. The levels of serum kalemia decreased. The iatients's quality of life significantly improved.

Objective To investigate the clinical features and risk factors of adult nephrotic syndrome with pulmonary thromboembolism (PTE). Methods Sixty patients diagnosed with nephrotic syndrome and clinically suspected with PTE were enrolled in this retrospective study. Patients were divided into PTE group (n=32) and no-PTE group (n=28) according to the results of computed tomographic pulmonary angiography (CTPA). The single factor analysis and Logistic repres?sion analysis were used to analyse risk factors including age, gender, onset time, clinical symptoms, laboratory examination and pathological types. According to the independent risk factors, the receiver-operating characteristic curve (ROC curve) was used to determine PTE threshold value based on the evaluation index in nephrotic syndrome. Results Single factor analysis showed that there were significant differences in disease duration, hemoglobin, serum albumin, total cholesterol, low-density lipoprotein cholesterol, D-dimer and physical examination in P2 hyperthyroidism between two groups (P <0.05). Logistic regression analysis showed that D-dimer was independent risk factor of PTE. The analysis of ROC curve indi?cated that D-dimer optimal threshold was 1 015.50μg/L. Conclusion D-dimer is an independent risk factor of PTE in pa?tients with nephrotic syndrome. When D-dimer is greater than 1 015.50μg/L, should pay attention to the occurrence of PTE.

Objective To investigate the serum concentration of vascular endothelial growth factor (VEGF) and its soluble receptor 1 (sFlt-1) in patients with systemic lupus erythematosus (SLE) and its correlation with clinic and pathologic parameters.Methods serum levels of VEGF and sFlt-1 in a group of 60 patients with SLE and 30 healthy controls were assessed by ELISA.Results The VEGF and sFlt-1 serum levels were higher in active SLE group than the control group (P＜0.01).The VEGF/sFlt-1 ratio in the control group was lower than that in the active SLE group.inactive SLE group and LN group (P＜0.01).Particularly the ratio increased in WHO class Ⅴ LN group compared to WHO classⅡ,Ⅲ,Ⅳ LN group (P＜0.05).The semm level of sFlt-1 was correlated to proteinuria (rs=0.6244,P＜0.01) and ESR (rs=0.4235,P＜0.01) and the serum levels of VEGF and sFlt-1 were correlated to the systemic lupus erythematosus disease activation index (SLEDAI) (rs=0.5046,P＜0.01 and rs=0.5152,P＜0.01,respectively).The serum level of VEGF was correlated with renal tissue activation index (RAI) (rs=0.3386.P＜0.05) and the serum levels of VEGF and sFlt-1 were not correlated to blood pressure,serum creatine,blood ureanitmgen,C3,C4,C-reative protein.The muhi-factors stepwise regression analysis indicated that serum VEGF was positively correlated with SLEDAI (R2=0.1 75,P＜0.05),serum sFlt-1 was positively correlated with ESR and proteinurine (R2=0.497,P＜0.05).Conclusion Serum VEGF and sFlt-1 are elevated in patients with active SLE and they can reflect the activity of the disease.The overcxpression of serum VEGF might be correlated to the proliferated glomerulonephritis and the overexpression of sFlt-1 contribhtes to proteinurla.The imbalance between these two factors may act an important role in SLE pathogenesis.