Abnormal Reactions of Free Radicals and Oxidative Damages in the Bodies of Patients With Chronic Glomerulonephritis

Objective To study the abnormal reactions of a series of free radicals and the oxidative damages induced by free radical abnormal reactions in the bodies of patients with chronic glomerulonephritis. Methods Eighty chronic glomerulonephritis patients (CGNP) and eighty healthy adult volunteers (HAV) were enrolled in a random control study, in which concentrations of nitric oxide (NO) in plasma, lipoperoxides (LPO) in plasma and in erythrocytes, and vitamin C (VC), vitamin E (VE) and beta-carotene (?CAR) in plasma as well as activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) in erythrocytes were determined with spectrophotometric assays. Results Compared with the average values of the above biochemical parameters in the HAV group, the average values of NO in plasma, and LPO in plasma and erythrocytes in the CGNP group were significantly increased (P = 0.0001), while those of VC, VE and -CAR in plasma as well as those of SOD, CAT and GPX in erythrocytes in the CGNP group were significantly decreased (P = 0.0001). Pearson product-moment correlation analysis showed that with increase of the concentration of blood creatinine as well as prolongation of the course of disease in the CGNP, the concentrations of NO in plasma, and LPO in plasma and erythrocytes in the CGNP increased gradually, while the concentrations of VC, VE and ?CAR in plasma as well as the activities of SOD, CAT and GPX in erythrocytes in the CGNP decreased gradually (P = 0.002454 0.000001). The relative risk ratio (RR) of the above biochemical parameters reflecting oxidative damages in the bodies of CGNP ranged from 6.061 to 72.429. The reliability coefficient (alpha) that the above biochemical parameters were used to reflect the oxidative damages of the CGNP was 0.8137, standardized item alpha = 0.9728, Hotelling抯 T-Squared = 1135680.191, F = 53274.6478, P = 0.000001. Conclusions The findings in this study show that in the bodies of CGNP a series of free radical chain reactions result in severe pathological aggravation and induce oxidative damages in their bodies. Therefore, suitable dose of antioxidants should be supplemented to them so as to alleviate oxidative damages in their bodies.

Efficacy and safety of Nephritis rehabilitation tablet combined with Valsartan for chronic glomerulonephritis:A system review and metaanalysis

Objective:To systematically evaluate the efficacy and safety of Nephritis Rehabilitation Tablet(NRT)combined with valsartan in treatment of chronic glomerulonephritis(CGN).Methods:Computer search databases such as CNKI,CBM,VIP,wanfang,Embase,PubMed and Cochrane library,and find all randomized controlled trials(RCTs)comparing NRT combined with valsartan versus valsartan in treatment of chronic glomerulonephritis.The search time limit is to build the database until October 2020.RCTs were screened according to the inclusion and exclusion criteria.After data extraction and quality assessment,the Cochrane risk of bias tool was used to evaluate the methodological quality of these studies.Meta-analysis was performed by Review Manager 5.2,and GRADE system for evidence quality evaluation.Results:We have identified a total of 24 eligible RCTs with 2082 participants and completed a meta-analysis based on these RCTs.The results of the meta-analysis showed that compared with valsartan,NRT combined with valsartan treatment showed effective curative effect in terms of effective treatment rate(OR=4.72;95%CI,3.67,6.08;P<0.00001),24h urine protein quantification(MD=-0.52;95%CI,-0.59,-0.44;P<0.00001),serum creatinine(Scr)(MD=-10.33;95%CI,-14.00,-6.66;P<0.00001),Systolic blood pressure(SBP)(MD=-11.42;95%CI,-17.67,-5.17;P=0.0003),Diastolic blood pressure(DBP)(MD=-6.28;95%CI,-9.14,-3.42;P<0.0001),Blood urine nitrogen(BUN)(MD=-0.02;95%CI,-0.41,0.37;P=0.93),plasma albumin(ALB)(MD=5.05;95%CI,4.27,5.84;P<0.00001),and adverse reactions(OR=0.93,95%CI,0.54,1.60;P=0.78).No serious adverse events were mentioned in these studies.And based on the results of the systematic review,the GRADE system recommended ranking method was used to evaluate the quality of evidence and the recommendation level.The results showed that the level of evidence was moderate and the recommendation intensity was weak recommendation.Conclusions:NRT combined with valsartan has a significant effect on the treatment of CGN,and the treatment effect is better than valsartan alone.There are no obvious adverse reactions during the treatment process.However,due to the generally low quality of the literature included in these studies,and the variability of the evaluation methods of each study,morelarge samples,multi-center,high-quality samples are still needed RCTs are further verified.

Meta-analysis of the efficacy and safety of Shenkang injection combined with Western medicine in the treatment of chronic glomerulonephritis

Objective:The purpose of the research was to systematically evaluate the clinical efficacy and safety of Shenkang injection combined with Western medicine in treating chronic glomerulonephritis.Methods:Randomized controlled trials of Shenkang Injection combined with Western medicine in treating CGN were obtained from 8 Science databases including China National Knowledge Infrastructure(CNKI),China Biomedical Database(SinMed),Weipu Database(VIP),Wanfang Database(Wanfang),PubMed,The Cochrane Library,Embase,Web of Science from establishment to June 2022.Two researchers screened literature and extracted useful data according to inclusion and exclusion criteria,and used RevMan 5.3 and STATA SE 14.0 software to perform meta-analysis.Results:1,214 patients were included in 15 studies,with 607 in treatment group and 607 in control group.The results of meta-analysis showed that the treatment group could improve the clinical effective rate[RR=1.33,95%CI(1.25,1.40),P<0.00001],reduce serum creatinine[MD=-31.28,95%CI(-42.90,-19.66),P<0.00001],blood urea nitrogen[MD=-2.26,95%CI(-3.08,-1.44),P<0.00001],24-hour urine protein quantification[MD=-0.37,95%CI(-0.49,-0.25),P<0.00001],tumor necrosis factor-α[MD=-7.93,95%CI(-10.56,-5.30),P<0.00001],systolic blood pressure[MD=-10.81,95%CI(-13.66,-7.96),P<0.00001]and diastolic blood pressure[MD=-7.36,95%CI(-9.34,-5.38),P<0.00001].Conclusion:Shenkang injection combined with Western medicine can enhance the clinical effective rate of CGN and reduce the levels of serum creatinine,blood urea nitrogen,24-hour urine protein quantification,tumor necrosis factor-α,systolic blood and diastolic blood pressure.However,due to the low quality of literature,the conclusion still needs to be supported by more multi-center,large-sample studies with rigorous design and standardized implementation.

Study on Effect of Yishen Capsule (益肾胶囊) in Preventing Recurrence of Chronic Glomerulonephritis

Objective： To observe the effect of Yishen Capsule （益肾胶囊, YSC） on preventing the recurrence of chronic glomerulonephritis （CGN） and to explore its mechanism preliminarily. Methods： CGN patients were assigned to the treated group （61 cases） and the control group （48 cases） and all of them were orally administered with 4 mg of Perindopril twice a day, but 3 capsules of YSC, thrice a day, were given additionally to patients in the treated group. The therapeutic course for both groups was 18 months. The recurrence rate of CGN at the 6th, 12th, and 18th month in the two groups was observed and compared, and the changes of 24-h urinary protein quantity and T-lymphocyte subsets before and after treatment were observed as well. Results： （1） Comparison of recurrence rate between the two groups showed insignificant difference at the 6th month, but it did show significant difference at the 12th and the 18th month, which was significantly decreased in the treated group than in the control group （P〈0.05, P〈0.01）; （2） The 24-h urinary protein quantity at the 18th month decreased significantly in both groups （P〈0.05, P〈0.01）, but in the treated group was more significant （P〈0.01）; （3） T-lymphocyte subsets showed no obvious change in the control group after treatment （P〉0.05）, while in the treated group, it showed significant increase in CD3, CD4 and CD4/CD8 （P〈0.05 or P〈0.01） and significant decrease in CD8 （P〈0.05）, and also the difference after treatment in T-lymphocyte subsets between the two groups was significant （P〈0.05 or P〈0.01）. Conclusion： YSC has marked effects in reducing the recurrence of CGN and in decreasing urinary protein, and its mechanism might be related with its function in regulating the ratio of T-lymphocyte subsets to enhance the immunity of patients.

Discussion on the medication rule of Professor Ba Yuanming in the treatment of chronic glonerulonephritis based on data mining technology

Objective:To explore the medication rule of Professor Ba Yuanming in the treatment of chronic glonerulonephritis by data mining technology,so as to provide certain reference for clinical and scientific research in the treatment of Chronic glonerulonephritis with traditional Chinese medicine.Methods:collect,sort out and screen the cases of chronic nephritis diagnosed and treated by Professor Ba Yuanming in the outpatient department of Hubei Hospital of traditional Chinese medicine from 2018 to 2019,establish the database on the cloud platform of ancient and modern medical cases(v2.2.1),and use frequency statistics,association rules,hierarchical clustering and other analysis methods to study and analyze the drugs used.Results:1630 cases were included in the prescription,involving 212 traditional Chinese medicines.The high-frequency drugs are Poria cocos,astragalus,dangshen,yam,Chuanshanlong,Cornus,distracted wood,etc;the drugs are mainly warm,cold and calm;the five tastes are sweet and light,spicy and bitter;the meridian tropism is mostly found in the kidney,lung and spleen channels;the effects are calming the mind and the nerves,strengthening the spleen and stomach,promoting water and swelling,etc.The core Chinese medicine combinations of Astragalus and poria were obtained.Conclusion:Professor Ba Yuanming pays attention to comprehensive consideration,attack and supplement in the treatment of CGN,pays attention to the care of the healthy qi of Sanjiao,at the same time clearing away heat and dampness,removing blood stasis and firmness,and is good at using the sweet and gentle products.

A Summary of Lei Genping's Experience in the Treatment of Chronic Nephritis

Chronic glomerulonephritis involves multiple organs.It has a variety of clinical manifestations and is the major cause of progression to end-stage renal disease in patients with kidney disease.Professor Lei Genping believes that the treatment of this disease in Chinese medicine should be based on the deficiency and reality characteristics of the disease mechanism,distinguishing the priorities and identifying the strengths and weaknesses of the internal organs,as well as advocating the integration of Chinese and western medicine at the right time and in the right manner,in order to achieve fundamental results.

Oxidative stress and damage induced by abnormal free radical reactions and IgA nephropathy

Objective: To estimate the oxidative stress and oxidative damage induced by abnormal free radical reactions in IgA nephropathy (IgAN) patients' bodies. Methods: Seventy-two IgA N patients (IgANP) and 72 healthy adult volunteers (HAV) were enrolled in a random control study design, in which the levels of nitric oxide (NO) in plasma, lipoperoxide (LPO) in plasma and in erythrocytes, and vitamin C (VC), vitamin E (VE) and β-carotene (β-CAR) in plasma as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) in erythrocytes were determined with spectrophotometric mothods. Results: Compared with the HAV group, the averages of NO in plasma, and LPO in plasma and in erythrocytes in the IgANP group were significantly increased (P＜0.0001), while those ofVC, VE and β-CAR in plasma as well as those of SOD, CAT and GPX in erythrocytes in the IgANP group were significantly decreased (P＜0.0001). Linear correlation analysis showed that with the increase of the values of NO, and LPO in plasma and in erythrocytes, and with the decrease of those ofVC, VE, β-CAR,SOD, CAT and GPX in the IgAN patients, the degree of histological damage of tubulointerstitial regions was increased gradually (P＜0.0001); and that with the prolongation of the duration of disease the values of NO, and LPO in plasma and erythrocytes were increased gradually, while those of VC, VE, β-CAR, SOD, CAT and GPX were decreased gradually (P＜0.005). The discriminatory correct rates of the above biochemical parameters reflecting oxidative damage of the IgAN patients were 73.8%-92.5%, and the correct rates for the HAV were 70.0%-91.3% when independent discriminant analysis was used; and the correct rate for the IgAN patients was increased to 98.8%, the correct rate for the HAV was increased to 100% when stepwise discriminant analysis was used. The above biochemical parameters' reliability coefficient (alpha) were used to estimate the oxidative damage of the IgAN patients as 0.8145, the standardized item alpha=0.9730, F=53273.5681, P＜0.0001. Conclusions: A series of free radical chain reactions caused serious pathological aggravation in the IgANP' bodies, thus resulting in oxidative damage in their bodies. In treating IgANP, therefore, it is necessary that suitable dose antioxidants should be supplemented to them so as to alleviate the oxidative damage in their bodies.

糖尿病肾病与慢性肾小球肾炎血液透析患者贫血治疗比较

目的通过比较糖尿病肾病与慢性肾小球肾炎导致的CKD5期维持血液透析患者肾性贫血治疗效果,来分析不同病因对肾性贫血治疗的影响。方法我院肾内科CKD5期维持血液透析的原发病为糖尿病肾病和慢性肾小球肾炎的病人,依原发病分为两组:糖尿病肾病组52例和慢性肾小球肾炎组36例,两组均在血液透析后静脉推注重组人促红细胞生成素,每周120 U/kg,治疗1年,对比两组贫血及临床相关指标并分析影响贫血治疗的相关因素。结果糖尿病肾病组较慢性肾小球肾炎组贫血治疗效果差,差异有统计学意义(P<0.05)。空腹血糖、C反应蛋白与血红蛋白呈负相关,尿素清除指数与血红蛋白呈正相关。结论与原发病为慢性肾小球肾炎的血透患者相比,原发病为糖尿病肾病的血透患者对重组人促红细胞生成素的疗效较差,导致疗效差异的原因可能与血糖、炎症、透析充分性等因素有关。