[Objective]To investigate the correlation between proteinuria and anglopoietin-2(Ang-2)in patients with diabetes nephropathy.[Methods] The clinical data of 104 patients with diabetes nephropathy were analyzed retrospectively.All the patients were divided into non-pmteinuria group with 45 cases and proteinuria group with 59 cases according to the urinary albumin excretion rate(UAER).UAER was detected by radioimmunoassay.The level of serum Ang-2 was detected by double antibody enzyme linked immunosorbent assay.Blood pressure,glycosylated hemoglobin(HbA:c),fasting blood glucose(FBG),treacylglycerol(TG),total cholesterol(TC),creatinine(Cr),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)were also detected.[Results]There was no significant difference in diastolic blood pressure,FBG,HbA1c,TG,TC,LDL-C,HDL-C between two groups(P＞0.05).Systolic blood pressure and Cr in proteinuria group[(140.1±17.4)mm Hg(1 mm Hg=0.133 kPa),(126.7±23.8)μmol/L]had statistical significance compared with those in non-proteinuria group[(126.3 ± 15.2)mm Hg,(70.3 ± 22.1)μ mol/L](P ＜ 0.05).The level of serum Ang-2 in proteinuria group was significantly higher than that in non-proteinuria group[(24.86±4.31)ng/L vs.(18.83±7.28)ng/L](P＜0.01).Partial correlation analysis showed that UAER was positively correlated with Ang-2(r=0.615,P＜0.01).[Conclusions] The level of serum Ang-2 increases significantly when there is renal damage in patients with diabetes nephropathy.

Objective To observe the effect and safety of tripterygium combined with huangkui capsule in the treatment of diabetic nephropathy.Methods 128 diabetic nephropathy patients were classified into two groups,observation group of 64 cases were treated with tripterygium combined with huangkui capsule and control group of 64 cases were treated with huangkui capsule.The clinical effect,urinary protein between the two groups were compared.Results The total effective rate in observation group ( 82.8％ ) was significantly higher than that in control group (65.6％) ( x2 =4.940,P ＜ 0.05 ).After treatment,the levels of 24h urinary microalbumin and α1-microglobulin were significantly decreased in both groups( t =4.131,3.912,7.253,6.517,all P ＜ 0.05 ).Moreover,the levels of 24h urinary microalbumin and α1-microglobulin in observation group were significantly lower than those in control group( t =5.114,4.526,all P ＜ 0.05 ).Conclusion Tripterygium combined with huangkui capsule in the treatment of diabetic nephropathy could enhance the clinical effects,degrade urinary protein lelves,and had less adverse effect.

ObjectiveTo investigate the effects of thyroid hormone tablets on the outcome of patients with primary nephritic syndrome.MethodsRadioimmunoassay(RIA) was used to determine the level of serum FT3,FT4 and TSH before and after the routine treatment in 36 healthy patients and 72 patients with primary nephritic syndrome and hypothyroidism.The curative effect of thyroid hormone tablets was observed.ResultsThe levels of FT3 and FT4 [ (1.67 ± 0.39)pmol/L,(8.3 ± 2.2 )pmol/L] in patients group were significantly lower than that in control group (t =12.635,16.304,P =0.041,0.032 ).But the level of TSH was not different before and after treatment( t =2.245,P ＞0.05).The levels of FT3 and FT4 after treatment were higher than before treateat (P ＜0.01 ).At the corresponding period,the levels of FT3 and FT4 in the observation group with thyroid hormone tablets were significantly higher than that in the group with routine treatment.At the same time,the treatment time for complete remission was also shorter,and after 12 months the catabatic rate (72.2％) was higher than routine treatment( x2 =21.04,P ＜0.05 ).ConclusionTreatment with,thyroid hormone tablets could shorten the course of the disease and increase the catabatic rate.

Objective To investigate the effect of transforming growth factor-β1 (TGF-β1)and Smad anchor for receptor activation(SARA) in high glucose induced epithelium to mensenchymal transition(EMT) in proximal tubule HKC cells.Methods The model of EMT in HKC cells by high glucose treatment was developed.After stimulation by 25 mmol/L glucose for 0,12,24,and 48 h,the cells were collected and total protein was extracted.Vimentin,E-cadherin,TGF-β1,SARA and Smad2 expression were detected by western blot analysis.Results At 0,12,24,and 48 h after treated with 25 mmol/L glucose the expression of E-cadherin was 1.13 ±0.31,0.74 ±0.14,0.63 ±0.18 and 0.32 ±0.12 respectively,with significantly difference between each group ( Ps ＜ 0.05 ) ; the expression of vimentin in HKC cells increased from 0.23 ± 0.09,0.34 ± 0.04,0.83 ±0.15 to 1.02 ±0.22 signifiantly(Ps ＜0.05).High glucose treatment also upregulated the protein expression of TGF-β1,with expression of 0.25 ± 0.08,0.44 ± 0.12,0.72 ± 0.21,and 0.92 ± 0.28 after treated with 25 mmol/L glucose for 0,12,24,and 48 h ( Ps ＜ 0.05 ).The protein expression of SARA significanlty decreased from 0.83 ±0.21,0.54 ±0.13,0.42 ±0.09 to 0.35 ±0.12(Ps ＜0.05),and the protein expression of Smad2 also significantly decreased from 1.14 ± 0.22,0.82 ± 0.15,0.61 ± 0.17 to 0.30 ± 0.13 ( Ps ＜ 0.05 ).Conclusion The upregulation of TGF-β1 might play a key role in high glucose induced EMT in proximal tubule HKC cells.The downregulation of SARA and Smad2 protein might contribute to TGF-β1 mediated renal fibrosis.

ObjectiveTo observe the clinical effect ofbenazepril combined with alprostadil in the treatment of diabetic nephropathy.MethodsNinety-four cases with diabetic nephropathy were divided by random digits table method into two groups with 47 cases in each:observation group (treated with benazepril combined with alprostadil) and control group(treated with benazepril).The clinical effect,24 h urinary microalbumin,serum urea nitrogen and serum creatinine of the two groups were observed and compared.ResultsThe total effective rate of observation group was 80.9％(38/47),and significantly higher than that in control group[68.1％(32/47)](P＜0.05).The levels of 24 h urinary microalbumin,serum urea nitrogen and serum creatinine of the two groups before treatment had no significant difference (P＞0.05).The levels of 24 h urinary microalbumin,serum urea nitrogen and serum creatinine in observation group after treatment were (212.15 ± 25.59 ) mg,(7.52 ± 1.81 ) mmol/L and ( 105.62 ± 8.51 ) μmol/L,while the levels in control group were(332.46 ±38.71) mg,(9.06 ±2.43) mmol/L and(122.29 ± 11.98) μmol/L.The levels all improved after treatment compared with those before treatment,and the levels of observation group were obviously lower than those of control group respectively (P＜ 0.05).ConclusionsBenazepril combined with alprostadil in the treatment of diabetic nephropathy can improve the clinical effect significantly as well as the kidney function.Therefore,it deserves the application in clinic.

The author excludes many social factors , focuse on building a harmonious relationship between doctors and patients from the perspective of hospital manager .Medical staff must pay attention to the doctor -patient communication skills and methods from their own , play an important role in good doctor -patient communication by understanding, respecting and caring.

Objective To investigate risk factors for postoperative complications after percutaneous nephrolithotomy (PCNL) according to the modified Clavien scoring system. Methods The clinical data of 523 patients who underwent PCNL from 2008 to 2015 were retrospectively analyzed, and the risk factors of the complications of PCNL were analyzed. Results There were 417 patients without postoperative complications and 106 patients with postoperative complications, among whom 25 patients had major complications. After multivariate Logistic regression analysis, elder (P = 0.002), previous PCNL (P=0.035), two or more comorbidities (P=0.001), staghorn calculi (P=0.031), longer operative time (P = 0.000) had association with the postoperative complications. Two or more comorbidities (P =0.013), multiple tracts (P=0.008), and longer operative time (P=0.003) had association with the major postoperative complications. Conclusions Elder, previous PCNL, two or more comorbidities, staghorn calculi, multiple tracts, longer operative time have association with the major postoperative complications.

OBJECTIVE:To compare the contents of triterpenoids,polysaccharides and heavy metals in Ganoderma lucidum sporule powder and Ganoderma lucidum.METHODS:The triterpenoid compounds in Ganoderma lucidum sporule powder and Ganoderma lucidum samples were analyzed by HPLC;five heavy metals in the samples were determined by ICP-MS and the polysaccharides were quantified by anthrone-sulfuric acid method.RESULTS:There were significant differences beween Ganoderma lucidum sporule powder and Ganoderma lucidum in the HPLC characteristic chromatogram of triterpenoid compunds.The total content of polysaccharide in Ganoderma lucidum sporule powder was higher than in Ganoderma lucidum sample.However,the five heavy metals in the two materials showed no marked differences.CONCLUSION:This study provides theoretical basis for the pharmacological difference between Ganoderma lucidum sporule powder and Ganoderma lucidum.

Objective To investigate the deep ulcer infection of anaerobic bacteria in patients with diabetic foot ,while make clini-cal value analysis .Methods 87 specimens collected from the patients with deep ulcers of diabetic foot were performed by bacterio-logical smear and bacterial culture respectively .Results The bacteriological smear positive cases were 81 ,the aerobic culture posi-tive cases were 67 and the anaerobic culture positive cases were 17 .Conclusion The deep ulcers of diabetic foot often are infected by anaerobic bacteria .Aerobic culture and anaerobic culture are both necessary to define the pathogen .It must be noted that the an-aerobic culture positive rate would be interfered by incorrect sampling ,no timely examination ,using antibiotics and incorrect culture conditions .

Doctors and nurses from general outpatient and emergency department usually lack the treatment experience of hemophilia,therefore,emergency system and diagnostic criteria for hemophilia is es-sential.Physicians of emergency department should be trained on identifying the undiagosed patients with inherited bleeding disorders and assessing the condition of bleeding.Prompt clotting factors replacement therapy should be given to the patients with hemophilia once bleeding is suspected.Physicians should be aware that inhibitors make the emergency treatment more complicated.