Pediatric lupus nephritis(LN),the most severe visceral complication of systemic lupus erythematosus,is characterized by hematuria,proteinuria,and progressive renal dysfunction.It typically presents with an insidious onset,rapid progression,a prolonged disease course,and an unfavorable long-term prognosis.Currently,no consensus exists on the etiology,pathogenesis,or diagnostic-treatment framework for pediatric LN.Based on clinical experience,the proposed core pathogenesis involves"latent pathogens in the triple energizer membrane system with deficiency-induced toxin activation."This mechanism entails the intermingling of heat and blood stasis,forming pathogenic factors that lodge within the triple energizer membrane system.In states of healthy qi deficiency,internal and external factors interact,allowing pathogenic toxins to damage the viscera via the triple energizer membrane network,ultimately targeting the kidneys.The disease progression is classified into three distinct phases.In the latent pathogen phase,internal or external pathogens accumulate in the triple energizer membrane system.Treatment emphasizes pathogen elimination,heat clearance,and healthy qi preservation.In the active renal involvement phase,latent pathogens rapidly disseminate systemically via the membrane network,destabilizing renal essence and causing micro-substance leakage.Treatment focuses on toxin resolution,stasis dispersion,membrane regulation,and renal stabilization.During the triple energizer residual phase,incomplete restoration of healthy qi permits the persistence of dormant pathogens,predisposing to reactivation.Therapeutic focus during this phase includes qi consolidation to restore primordial essence,residual pathogen clearance,and mitigating disease recurrence to delay chronic renal deterioration.This phase-specific differentiation-treatment strategy aims to address disease complexity while optimizing therapeutic outcomes through targeted interventions.

Objective:To investigate the efficacy of Xingnaojing injection combined with Angong Niuhuang pill in the treatment of cerebral hemorrhage and their effects on neuronal injury. Methods:A prospective study was conducted on 117 patients with cerebral hemorrhage admitted to Department of Neurosurgery, Shaoxing Second Hospital, from January 2023 to August 2024. The patients were randomly divided into a control group and an observation group using a random number table method. The control group ( n = 59) was treated with Xingnaojing injection, while the observation group ( n = 58) was treated with Angong Niuhuang pill and Xingnaojing injection for 1 month. Clinical efficacy, neuronal cytokines (S-100B protein, neuron-specific enolase, and brain-derived neurotrophic factor), oxidative stress indicators (superoxide dismutase, malondialdehyde, and glutathione peroxidase), inflammatory factor levels (interleukin-1β, C-reactive protein, and interleukin-6), and adverse reactions (itching, chest tightness, gastrointestinal discomfort, rash, and increased heart rate) were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group [94.83% (55/58) vs. 81.36% (48/59), Z = 2.27, P = 0.023]. After treatment, the levels of S-100B and neuron-specific enolase in the observation group were (0.43 ± 0.16) μg/L and (6.79 ± 1.28) μg/L, respectively, which were significantly lower than those in the control group [(0.62 ± 0.15) μg/L, (8.37 ± 1.15) μg/L, t = -6.62, -7.02, both P < 0.001]. Additionally, the level of brain-derived neurotrophic factor in the observation group was significantly higher than that in the control group [(63.58 ± 4.05) ng/L vs. (57.13 ± 4.39) ng/L, t = 8.26, P < 0.001]. After treatment, the levels of superoxide dismutase and glutathione peroxidase in the observation group were significantly higher than those in the control group ( t = 6.39, 6.94, both P < 0.001). The level of malondialdehyde in the observation group was significantly lower than that in the control group ( t = -5.95, P < 0.001). The levels of interleukin-1β, C-reactive protein and interleukin-6 in the observation group were significantly lower than those in the control group group ( t = -6.64, -8.29, -7.06, all P < 0.05). There was no significant difference in incidence of adverse reactions between the observation and control groups [13.79% (8/58) vs. 22.03% (13/59), χ2 = 1.35, P > 0.05]. Conclusions:The combination of Xingnaojing injection and Angong Niuhuang pill shows good efficacy in the treatment of cerebral hemorrhage, as it can reduce neuronal damage, oxidative stress reactions, and inflammatory responses. This combined treatment is worthy of clinical application.

Pediatric lupus nephritis(LN),the most severe visceral complication of systemic lupus erythematosus,is characterized by hematuria,proteinuria,and progressive renal dysfunction.It typically presents with an insidious onset,rapid progression,a prolonged disease course,and an unfavorable long-term prognosis.Currently,no consensus exists on the etiology,pathogenesis,or diagnostic-treatment framework for pediatric LN.Based on clinical experience,the proposed core pathogenesis involves"latent pathogens in the triple energizer membrane system with deficiency-induced toxin activation."This mechanism entails the intermingling of heat and blood stasis,forming pathogenic factors that lodge within the triple energizer membrane system.In states of healthy qi deficiency,internal and external factors interact,allowing pathogenic toxins to damage the viscera via the triple energizer membrane network,ultimately targeting the kidneys.The disease progression is classified into three distinct phases.In the latent pathogen phase,internal or external pathogens accumulate in the triple energizer membrane system.Treatment emphasizes pathogen elimination,heat clearance,and healthy qi preservation.In the active renal involvement phase,latent pathogens rapidly disseminate systemically via the membrane network,destabilizing renal essence and causing micro-substance leakage.Treatment focuses on toxin resolution,stasis dispersion,membrane regulation,and renal stabilization.During the triple energizer residual phase,incomplete restoration of healthy qi permits the persistence of dormant pathogens,predisposing to reactivation.Therapeutic focus during this phase includes qi consolidation to restore primordial essence,residual pathogen clearance,and mitigating disease recurrence to delay chronic renal deterioration.This phase-specific differentiation-treatment strategy aims to address disease complexity while optimizing therapeutic outcomes through targeted interventions.

Objective:To investigate the efficacy of Xingnaojing injection combined with Angong Niuhuang pill in the treatment of cerebral hemorrhage and their effects on neuronal injury. Methods:A prospective study was conducted on 117 patients with cerebral hemorrhage admitted to Department of Neurosurgery, Shaoxing Second Hospital, from January 2023 to August 2024. The patients were randomly divided into a control group and an observation group using a random number table method. The control group ( n = 59) was treated with Xingnaojing injection, while the observation group ( n = 58) was treated with Angong Niuhuang pill and Xingnaojing injection for 1 month. Clinical efficacy, neuronal cytokines (S-100B protein, neuron-specific enolase, and brain-derived neurotrophic factor), oxidative stress indicators (superoxide dismutase, malondialdehyde, and glutathione peroxidase), inflammatory factor levels (interleukin-1β, C-reactive protein, and interleukin-6), and adverse reactions (itching, chest tightness, gastrointestinal discomfort, rash, and increased heart rate) were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group [94.83% (55/58) vs. 81.36% (48/59), Z = 2.27, P = 0.023]. After treatment, the levels of S-100B and neuron-specific enolase in the observation group were (0.43 ± 0.16) μg/L and (6.79 ± 1.28) μg/L, respectively, which were significantly lower than those in the control group [(0.62 ± 0.15) μg/L, (8.37 ± 1.15) μg/L, t = -6.62, -7.02, both P < 0.001]. Additionally, the level of brain-derived neurotrophic factor in the observation group was significantly higher than that in the control group [(63.58 ± 4.05) ng/L vs. (57.13 ± 4.39) ng/L, t = 8.26, P < 0.001]. After treatment, the levels of superoxide dismutase and glutathione peroxidase in the observation group were significantly higher than those in the control group ( t = 6.39, 6.94, both P < 0.001). The level of malondialdehyde in the observation group was significantly lower than that in the control group ( t = -5.95, P < 0.001). The levels of interleukin-1β, C-reactive protein and interleukin-6 in the observation group were significantly lower than those in the control group group ( t = -6.64, -8.29, -7.06, all P < 0.05). There was no significant difference in incidence of adverse reactions between the observation and control groups [13.79% (8/58) vs. 22.03% (13/59), χ2 = 1.35, P > 0.05]. Conclusions:The combination of Xingnaojing injection and Angong Niuhuang pill shows good efficacy in the treatment of cerebral hemorrhage, as it can reduce neuronal damage, oxidative stress reactions, and inflammatory responses. This combined treatment is worthy of clinical application.

Objective:To correlate acute ischemic stroke with leukoaraiosis with intracranial and extracranial artery stenosis.Methods:A total of 300 patients with acute ischemic stroke admitted to Shaoxing Second Hospital from January to December 2017 were included in this study. All patients underwent magnetic resonance (MRI) examination. According to the examination results, these patients were divided into control (acute ischemic stroke, n = 100) and acute ischemic stroke with leukoaraiosis, n = 200). Carotid artery plaque size and blood sugar level were recorded in each group. Intracranial and extracranial large artery stenosis rates were compared between the two groups. Severity of leukoaraiosis was correlated with intracranial and extracranial artery stenosis. Results:The percentage of patients developing hypertension in the observation group was significantly higher than that in the control group [66.0% (132/200) vs. 44.0% (44/100), χ2 = 13.31, P < 0.01]. The incidence of coronary heart disease in the observation group was significantly higher than that in the control group [49.0% (98/200) vs. 31.0% (31/100), χ2 = 8.81, P < 0.01]. The incidence of carotid artery plaque in the observation group was significantly higher than that in the control group [49.5% (99/200) vs. 34.0% (34/100), χ2 = 6.49, P = 0.01]. The incidence of carotid artery stenosis in the observation group was significantly higher than that in the control group [23.5% (47/200) vs. 12.0% (12/100), χ2 = 5.58, P = 0.01]. There was no significant difference in the incidence of anterior cerebral artery stenosis between observation and control groups [5.5% (11/200) vs. 4.0% (4/100), χ2 = 0.32, P = 0.57]. The size of carotid artery plaque in the observation group was significantly larger than that in the control group [(1.86 ± 0.42) cm vs. (1.39 ± 0.27) cm, t = 10.18, P < 0.01]. The incidence of intracranial and extracranial artery stenosis in the observation group was significantly higher than that in the control group [41.0% (82/200) vs. 24.0% (24/100), χ2 = 8.43, P < 0.01]. The severity of leukoaraiosis was positively correlated with the degree of intracranial and extracranial artery stenosis ( r = 0.79, P < 0.01). Conclusion:Patients with acute ischemic stroke with leukoaraiosis have a high intracranial and extracranial artery stenosis and the severity of leukoaraiosis is positively correlated with intracranial and extracranial artery stenosis.