Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 ...Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 % children with IgA nephropathy, but only 10 % in HSPN （P〈0.05）. The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia, compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6 % of HSPN and 29 % of IgA nephropathy （all P〈0.01）. Thin basement membrane nephropathy was only found in 6. 5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, lodse and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2% of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits, moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71. 9 G of HSPN had IgG deposits in glomeruli and only 19.4% of IgA nephropathy showed glomerular IgG deposits （P〈0. 01）. No IgG deposit was observed in 81. 6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn＇t be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16. 1% had active nephritides （P〈0.05）. It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn＇t support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.展开更多
BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing ac...BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.展开更多
Objective: To investigate the effects of tripterygium wilfordii combined with Salvia Miltiorrhiza therapy on renal function, coagulation function and immune response in children with purpura nephritis. Methods: A tota...Objective: To investigate the effects of tripterygium wilfordii combined with Salvia Miltiorrhiza therapy on renal function, coagulation function and immune response in children with purpura nephritis. Methods: A total of 70 children with purpura nephritis who were treated in the hospital between October 2013 and March 2017 were divided into control group (n=35) and Salvia Miltiorrhiza group (n=35) by random number table. Control group received routine + tripterygium wilfordii therapy, Salvia Miltiorrhiza group received routine+ tripterygium wilfordii + Salvia Miltiorrhiza therapy, and the therapies lasted for 3 courses. The differences in renal function, coagulation function and immune response were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in renal function, coagulation function and immune response function between the two groups. After 3 courses of treatment, renal function indexes CysC,β2MG and 24 h UmAlb levels in Salvia Miltiorrhiza group were lower than those in control group;coagulation function indexes FIB and D-D levels in peripheral blood were lower than those of control group;immune response indexes Th1 cytokines IL-2 and IFN-γ contents in peripheral blood were higher than those of control group whereas Th2 cytokines IL-5 and IL-10 contents were lower than those of control group. Conclusion: Tripterygium wilfordii combined with Salvia Miltiorrhiza therapy can effectively optimize the renal function, reduce the hypercoagulation state and reduce the Th1/Th2 immune imbalance in children with purpura nephritis.展开更多
The clinical spectrum of immunoglobulin A vasculitis nephritis(IgAVN)ranges from the relatively common transitory microscopic hematuria and/or low-grade proteinuria to nephritic or nephrotic syndrome,rapidly progressi...The clinical spectrum of immunoglobulin A vasculitis nephritis(IgAVN)ranges from the relatively common transitory microscopic hematuria and/or low-grade proteinuria to nephritic or nephrotic syndrome,rapidly progressive glomerulonephritis,or even renal failure.Clinical and experimental studies have shown a multifactor pathogenesis:Infection triggers,impaired glycosylation of IgA1,complement activation,Toll-like-receptor activation and B cell proliferation.This knowledge can identify IgAVN patients at a greater risk for adverse outcome and increase the evidence for treatment recommendations.展开更多
Recently reported cases of lupus complicated by a thrombotic thrombocytopenic purpura （TTP）-like syndrome suggest a survival beneft to early treatment with plasma exchange. The following is a report of the eighth su...Recently reported cases of lupus complicated by a thrombotic thrombocytopenic purpura （TTP）-like syndrome suggest a survival beneft to early treatment with plasma exchange. The following is a report of the eighth such case in the last ten years. A 44-year-old lady known for lupus presented with the nephrotic syndrome and a renal biopsy was consistent with class 4G lupus nephritis. She was given high-dose steroids and cytotoxic therapy, but her induction therapy was complicated by the classic pentad of TTP. She was subsequently treated with another course of high-dose steroids, a different cytotoxic agent, and plasma exchange, with clinical resolution shortly thereafter. Similar to seven recently reported cases of microangiopathy in lupus, this lady’s TTP-like syndrome improved dramatically after initiation of plasma exchange, despite not having a severely deficient ADAMTS13. This has implications on both current clinical practice and on the pathogenesis of TTP-like syndromes in lupus.展开更多
Objective To compare the difference of therapeutic effects between vessel pricking therapy and Prednisone for treatment of henoch-schonlein purpura nephritis（HSPN）.Methods Seventy cases of acute purpura nephritis sy...Objective To compare the difference of therapeutic effects between vessel pricking therapy and Prednisone for treatment of henoch-schonlein purpura nephritis（HSPN）.Methods Seventy cases of acute purpura nephritis syndrome were randomly divided into an observation group （40 cases） and a control group （30 cases）.Patients in observation group were differentiated into sthenic and asthenic syndromes.Vessel pricking therapy was applied at Hégǔ（合谷 LI 4）,Qūchí（曲池 LI 11）,Xuèhǎi（血海 SP 10） etc.by three-edged needle for sthenic symptom;shallow needling was used at Píshū（脾俞 BL 20）,Shènshū（肾俞 BL 23）,Zúsānlǐ（足三里 ST 36） etc.by filiform needle for asthenic syndromes.The control group was treated with oral administration of Prednisone.The symptom score of TCM,24 h urinary protein,red blood cell count of urinary sediment of both groups were observed before and after treatment and therapeutic effects were compared.Results The total effective rate of 92.5%（37/40） in observation group was superior to that of 80.0%（24/30） in control group,and there was a significant difference between two groups （P0.05）;the symptom score of TCM,24 h urinary protein,red blood cell count of urinary sediment were all improved in both groups after treatment （all P0.05）,and moreover,the improvement in observation group was superior to that of control group （all P0.05）;after treatment,the symptom score of TCM of sthenic syndrome was lower than that of asthenic syndrome in observation group （P0.05）.Conclusion Vessel pricking therapy has a significant therapeutic effect for treatment of HSPN,superior to that of oral administration of Prednisone,and the therapeutic effect is better for treating sthenic syndrome than for asthenic syndrome.展开更多
文摘Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 % children with IgA nephropathy, but only 10 % in HSPN （P〈0.05）. The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia, compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6 % of HSPN and 29 % of IgA nephropathy （all P〈0.01）. Thin basement membrane nephropathy was only found in 6. 5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, lodse and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2% of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits, moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71. 9 G of HSPN had IgG deposits in glomeruli and only 19.4% of IgA nephropathy showed glomerular IgG deposits （P〈0. 01）. No IgG deposit was observed in 81. 6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn＇t be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16. 1% had active nephritides （P〈0.05）. It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn＇t support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.
文摘BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.
文摘Objective: To investigate the effects of tripterygium wilfordii combined with Salvia Miltiorrhiza therapy on renal function, coagulation function and immune response in children with purpura nephritis. Methods: A total of 70 children with purpura nephritis who were treated in the hospital between October 2013 and March 2017 were divided into control group (n=35) and Salvia Miltiorrhiza group (n=35) by random number table. Control group received routine + tripterygium wilfordii therapy, Salvia Miltiorrhiza group received routine+ tripterygium wilfordii + Salvia Miltiorrhiza therapy, and the therapies lasted for 3 courses. The differences in renal function, coagulation function and immune response were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in renal function, coagulation function and immune response function between the two groups. After 3 courses of treatment, renal function indexes CysC,β2MG and 24 h UmAlb levels in Salvia Miltiorrhiza group were lower than those in control group;coagulation function indexes FIB and D-D levels in peripheral blood were lower than those of control group;immune response indexes Th1 cytokines IL-2 and IFN-γ contents in peripheral blood were higher than those of control group whereas Th2 cytokines IL-5 and IL-10 contents were lower than those of control group. Conclusion: Tripterygium wilfordii combined with Salvia Miltiorrhiza therapy can effectively optimize the renal function, reduce the hypercoagulation state and reduce the Th1/Th2 immune imbalance in children with purpura nephritis.
文摘The clinical spectrum of immunoglobulin A vasculitis nephritis(IgAVN)ranges from the relatively common transitory microscopic hematuria and/or low-grade proteinuria to nephritic or nephrotic syndrome,rapidly progressive glomerulonephritis,or even renal failure.Clinical and experimental studies have shown a multifactor pathogenesis:Infection triggers,impaired glycosylation of IgA1,complement activation,Toll-like-receptor activation and B cell proliferation.This knowledge can identify IgAVN patients at a greater risk for adverse outcome and increase the evidence for treatment recommendations.
文摘Recently reported cases of lupus complicated by a thrombotic thrombocytopenic purpura （TTP）-like syndrome suggest a survival beneft to early treatment with plasma exchange. The following is a report of the eighth such case in the last ten years. A 44-year-old lady known for lupus presented with the nephrotic syndrome and a renal biopsy was consistent with class 4G lupus nephritis. She was given high-dose steroids and cytotoxic therapy, but her induction therapy was complicated by the classic pentad of TTP. She was subsequently treated with another course of high-dose steroids, a different cytotoxic agent, and plasma exchange, with clinical resolution shortly thereafter. Similar to seven recently reported cases of microangiopathy in lupus, this lady’s TTP-like syndrome improved dramatically after initiation of plasma exchange, despite not having a severely deficient ADAMTS13. This has implications on both current clinical practice and on the pathogenesis of TTP-like syndromes in lupus.
基金Supported by Research Project of Administration of Traditional Chinese Medicine of Hebei Province:2009128
文摘Objective To compare the difference of therapeutic effects between vessel pricking therapy and Prednisone for treatment of henoch-schonlein purpura nephritis（HSPN）.Methods Seventy cases of acute purpura nephritis syndrome were randomly divided into an observation group （40 cases） and a control group （30 cases）.Patients in observation group were differentiated into sthenic and asthenic syndromes.Vessel pricking therapy was applied at Hégǔ（合谷 LI 4）,Qūchí（曲池 LI 11）,Xuèhǎi（血海 SP 10） etc.by three-edged needle for sthenic symptom;shallow needling was used at Píshū（脾俞 BL 20）,Shènshū（肾俞 BL 23）,Zúsānlǐ（足三里 ST 36） etc.by filiform needle for asthenic syndromes.The control group was treated with oral administration of Prednisone.The symptom score of TCM,24 h urinary protein,red blood cell count of urinary sediment of both groups were observed before and after treatment and therapeutic effects were compared.Results The total effective rate of 92.5%（37/40） in observation group was superior to that of 80.0%（24/30） in control group,and there was a significant difference between two groups （P0.05）;the symptom score of TCM,24 h urinary protein,red blood cell count of urinary sediment were all improved in both groups after treatment （all P0.05）,and moreover,the improvement in observation group was superior to that of control group （all P0.05）;after treatment,the symptom score of TCM of sthenic syndrome was lower than that of asthenic syndrome in observation group （P0.05）.Conclusion Vessel pricking therapy has a significant therapeutic effect for treatment of HSPN,superior to that of oral administration of Prednisone,and the therapeutic effect is better for treating sthenic syndrome than for asthenic syndrome.
