1.Validation of the Oxford classification for pediatric IgA nephropathy
Huijuan ZHANG ; Qingyin GUO ; Wensheng ZHAI ; Xianqing REN ; Ying DING ; Xiaoqing YANG
International Journal of Pediatrics 2013;40(5):532-534,537
Objective To assess the validity of the Oxford classification for pediatric patients with primary IgA nephropathy (IgAN) and to analyze the correlations between clinical characteristics at time of biopsy and the Oxford classification,which identified four definitive histological features:mesangial hypereellularity,endocapillary proliferation,segmental sclerosis and tubular atrophy/interstitial fibrosis.Methods Clinical and pathological characteristics of 35 children with primary IgAN were analyzed.The scoring sheet was based on the Oxford classification of IgAN,and four pathological variables,namely mesangial hypercellularity (M),endocapillary proliferation (E),segmental sclerosis (S),and tubular atrophy/interstitial fibrosis (T) were assessed.A total of 35 children with IgAN were grouped according to the scores(M,E,S,T):the M0 and M1 group,E0 and E1 group,S0 and S1 group,T0 and T1/T2 group.These groups were compared in terms of estimated glomeralar filtration rate (eGFR),mean artery pressure (MAP) and proteinuria at time of biopsy.Results We found that the Oxford classification was significantly negatively correlated with eGFR (Pearson's correlation coefficient r =-0.48).However,the Oxford classification was shown to be positively associated with initial proteinuria per day(Pearson's correlation coefficient r =0.35).The M,E,S,T scores were strongly associated with proteinuria at biopsy (P < 0.05),and the lesion S was not correlated with eGFR (P > 0.05).The lesion T was significantly associated with eGFR (P =0.001) and MAP (P =0.03) at biopsy.Conclusion We confirmed that the Oxford classification of IgA nephropathy was valid for children.In addition,our study indicated that the four histological lesions M,E,S and T were significantly associated with clinical features.
2.Fifteen Years' Blood Pressure Change in 1079 Workers
Zunzhong ZHAO ; Wanlun GUO ; Shanxiang LIU ; Dexin SHANG ; Qingyin KONG ; Honglian WEI ; Shiyun HUANG ; Mingshan WANG
Chinese Journal of Hypertension 2001;9(1):68-71
Aim To study the change of blood pressure in 1079 workers for fifteen years and the effect of anti-hypertension drugs therapy. Methods We investigated the blood pressure of 1079 workers who were enrolled in six organizations in the year 1983 and 1998 respectively. Results During the 15 years: (1)Mean value of blood pressure: systolic blood pressure increased 22 mmHg in man and 16.9 mmHg in women; diastolic blood pressure increased 9 mmHg in man and 12.7 mmHg in women (P<0.05);(2)The incidence of hypertension increased by 25.03% in man and 28.28% in women;(3)The prevalence rate of hypertension is 27.9 percent in people with initially normal blood pressure (1.86%/y) and 72.6 percent in initially broder line hypertension (4.84%/y);(4)The control rate of hypertension is 2.9 percent;(5)The incidence of stroke is highly related to hypertension (P<0.001);(6)46.6 percent patients had a regular drug therapy, mainly reserpini complex(25.2%);(7)Drug therapy has no obviously effect of the control of hypertension and the incidence of stroke. Conclusion Both the mean value of BP and the incidence of hypertension were increased with age. The control rate of hypertension was low and the drug therapy shows little advantage. We should do mach more works to popularize the knowledge of the prevention of hypertension. Improve people's self-prevention. Regular cheek should be given to the hypertension patients.
3.The clinical and pathological features of capillary proliferative purpura nephritis in 19 children
Chundong SONG ; Ying DING ; Zonggang ZHAI ; Wensheng ZHAI ; Xianqing REN ; Qingyin GUO ; Xia ZHANG ; Meng YANG ; Jian ZHANG
Journal of Clinical Pediatrics 2016;34(6):414-417
Objective To explore the clinical and pathological features, treatment, and prognosis of capillary proliferative purpura nephritis (DEP-HSPN) in children.MethodsThe clinical data of 19 children diagnosed with DEP-HSPN were retrospectively analysis. Fifty-five children diagnosed with HSPN by renal biopsy were randomly selected as control group. ResultsThe average age was 10.6±2.6 years old, and the average course of disease were 19.4±7.4 days before renal biopsy in 19 children with DEP-HSPN (14 males and 5 females) who make up 3.92% of anaphylactic purpura nephritis children conifrmed by renal biopsy in the same period. In these 19 children, there were 10 cases having nephrotic syndrome and 9 case having hematuria and proteinuria type, all of whom were received immunosuppressive therapy. Finally, 14 cases achieved completely remission and 5 cases had partly remission. All of their classiifcations of renal pathology wereⅢb levels, accompanied with 6.38% to 36.36% of crescents. Compared with 55 age and sex matched children with renal pathology classiifcation ofⅢb, the DEP-HSPN children had shorter disease course, higher level of proteinuria, and lower pathological score of chronic renal injury (P all?0.05). There was similar percentage of crescent between two groups.ConclusionsChildren with DEP-HSPN usually have rapid onset, severe clinical manifestations, more active lesions and less chronic lesions. There is no evidence that the capillary proliferative lesion is a risk factor in the prognosis of HSPN so far.
4.Discussion on the Pathogenesis and Treatment of Children Enuresis Based on the Theory "Kidney-Marrow-Brain" Axis and "Yin Heel Channel (阴跷脉)"
Bo ZHANG ; Xianqing REN ; Wen FU ; Yuying SUN ; Xiaoyu LIU ; Chundong SONG ; Xia ZHANG ; Qingyin GUO ; Ying DING
Journal of Traditional Chinese Medicine 2024;65(9):909-914
Guided by the theory of "kidney generates marrow", the study elaborates the viewpoint that the route of Yin Heel Channel (阴跷脉) is consistent with the "kidney-marrow-brain" axis from the perspective of the circulation of the meridians and the relationship between the zang-fu organs. Accordingly, it is believed that disease of Yin Heel Channel and dysfunction of the "kidney-marrow-brain" axis are the core pathogenesis of children enuresis, and it is elaborated from the following three major aspects, firstly, insufficient kidney essence, dysfunction of the "kidney-marrow-brain" axis, secondly, disease of Yin Heel Channel and deficiency and cold in lower jiao, and thirdly, disease of Yin Heel Channel and loss of nourishment of Chong Vessel. It is proposed to use the mode of "firstly needle, secondly moxibustion, and lastly consolidation" to treat children enuresis. Needle is to adjust yin and yang, warm yang and tonify kidney, and wake up the brain and open the orifices. The acupoints in Yin Heel Channel such as Zhaohai (KI 6), Jiaoxin (KI 8) and confluence points of the eight extraordinary vessels such as Waiguan (TE 5), Zulinqi (GB 41) are used, together with Baihui (GV 20), Yintang (EX-HN 3), Guanyuan (CV 4), Qixue (KI 13), Dazhong (KI 4). Moxibustion is to reinforce healthy qi and warm yang, bank up the root and consolidate the original qi by moxibustion at Shenque (CV 8), Mingmen (GV 4), and Xuanshu (GV 5). Consolidation is to use acupoints application to consolidate the therapeutic effect, and Guanyuan (CV 4) & Pangguangshu (BL 28), Qihai (CV 6) & Zhishi (BL 52), and Shenque (CV 8) & Ciliao (BL 32) are commonly used as the three groups of acupoints to warm the kidney and stop collapse, regulate and tonify the qi and blood.