Objective To analyze the clinic-pathological data and peritubular capillary (PTC) injuries of malignant nephrosclerosis (MN) patients and their correlations with the long term renal survival.Methods This was a retrospective cohort study of 52 MN patients in Peking Union Medical College Hospital from January 2003 to March 2012.Their clinical data and renal biopsy samples were carefully studied.CD34 staining was performed to evaluate the PTC area,using Benign nephrosclerosis (BN,n=17) patients and glomerular minimal lesions (GML,n=19) patients as controls.Multivariate Cox proportional hazard model was used to identify the potential independent risk factors for long term renal survival.Results Fifty-two MN patients were enrolled.The sex ratio of male to female was 12:1 and the average age was (34.0±8.2) years.The maximum blood pressure (SBP/DBP) was (230.4 ± 25.0)/(156.4 ± 20.6) mmHg,companied with significant loss of eGFR and proteinuria.Glomerular sclerosis index,tubular atrophy and interstitial fibrosis correlated with eGFR and proteinuria (P ＜ 0.05).After aggressive treatment,BP control rate improved significantly (76.9％ vs 3.7％,P ＜0.01),Scr [(376.4±263.8) μmol/L vs (486.8±375.7) μmol/L,Wilcoxon test,P＜ 0.01] and proteinuria [(1.10±0.70) g/24 h vs (2.04± 1.26) g/24 h,P ＜ 0.01,n=21] also improved.PTC area in MN patients was significantly lower than those in BN patients and GML patients,and it correlated well with Scr (r=-0.553,P=0.001) and eGFR (r=0.476,P=0.004).The median follow-up time was 74 months,the cumulative renal survival rate at 1 year,5 year and 10 year was 90％,64％ and 23％,respectively.Kaplan-Meier analysis showed that the patients with higher PTC area had longer renal survival time [(114.8± 12.4) months vs (63.0±8.3) months, x2=5.312,P ＜ 0.05].Univariate Cox proportional hazard model found that unsatisfied BP control,eGFR ＜ 30 ml · min-1 · (1.73 m2)-1 upon discharge,lower PTC area,severer tubular-interstitial damage and anemia were associated with poor renal outcome.Multivariate Cox model showed that unsatisfied BP control (RR=3.89,95％ CI 1.75-8.65,P=0.001),eGFR ＜ 30 ml · min-1 · (1.73 m2)-1 upon discharge (RR=4.27,95％ CI 1.40-13.09,P=0.011) were independent risk factors for long-term renal survival.Conclusions The correlation between PTC area and renal functions in MN patients are much better than that of classic vascular changes.Unsatisfied BP control and eGFR ＜ 30 ml · min-1 · (1.73 m2)-1 upon discharge are independent risk factors for long-term renal survival.

Objective To explore the effect of Mongolian medicine Naru-3 pills on the treatment of neuropathic pain(NP)with pregabalin combined with nerve block.Methods Forty-one hospitalized pa-tients in the department of pain medicine diagnosed with NP from October 2022 to September 2023 were se-lected,including 20 males and 21 females,aged 40-80 years,BMI≥18.5 kg/m2.The patients were di-vided into two groups by random number table method:Mongolian medicine Naru-3 pills group(observation group,n=20)and conventional treatment group(control group,n=21).The control group received conventional treatment:oral pregabalin capsule combined with ultrasound-guided nerve block in pain area.The observation group was added oral administration of Mongolian medicine Naru-3 pills(2 g/10 capsules)on the basis of conventional treatment,taking 3-5 capsules orally before going to bed every night for 2 weeks.The numerical rating scale(NRS)pain score,short-form McGill pain questionnaire(SF-MPQ)score,and Pittsburgh sleep quality index(PSQI)were recorded before treatment and 2 weeks,1 month,and 2 months after the treatment.The serum concentrations of IL-6,IL-8,IL-1β,and TNF-α were detected by enzyme-linked immunosorbent assay(ELISA)1 day before treatment and 2 weeks after treatment.Occur-rence of adverse reactions during treatment such as nausea,vomiting,bloating,palpitations,drowsiness,and dizziness were recorded.Results Compared with 1 day before treatment,NRS pain score,SF-MPQ score,and PSQI were lower in both groups 2 weeks,1 month,and 2 months after the treatment(P＜0.05),the serum concentrations of IL-6,IL-1β,and TNF-α were reduced in both groups 2 weeks after the treatment(P＜0.05).Compared with the control group,NRS pain score,SF-MPQ score,and PSQI were lower in the observation group 2 weeks,1 month,and 2 months after the treatment(P＜0.05);the serum concentrations of IL-6,IL-1 β,and TNF-α were reduced in the observation group 2 weeks after the treatment(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Mongolian Naru-3 pills combined with conventional therapy can effectively reduce the pain of NP patients,improve the quality of sleep of patients,and may have the effect of regulating neuroinflammation.