Association between mRNA Expression of Aromatase, 17β-HSD2, Level of TGF-β1 and Stage of Endometriosis

Aim: To identify the correlation between mRNA expression of aromatase, 17β-HSD2 level of TGF-β1 and stage of endometriosis. Methods: Case control study was done on 80 patients divided by 40 endometriosis patients and 40 patients as control. mRNA expression of aromatase, mRNA 17β-SD2, was checked using reverse-transcriptase polymerase chain reaction (RT-PCR) and TGF-β1 serum and peritoneal fluid was checked using ELISA. Result: Level of mRNA aromatase from ectopic and eutopic endometrium increased significantly compared to control group (p < 0.001). mRNA 17β-HSD2 expression is significantly lower compared to control (p TGF-β1 on endometriosis group was significantly higher compared to control group (p < 0.05). Level of peritoneal fluid TGF-β1 on endometriosis group was higher than control group (p < 0.001). There are no correlations between mRNA aromatase, type 2 17β-HSD, TGF-β1 serum level to endometriosis stage. There are significant correlations between peritoneal fluid TGF-β1 levels to endometriosis stage.

TRMM/GPM和StageⅣ降水产品在小流域水文模拟效用评估

以地面观测降水作为参照,在美国俄克拉荷马州Little Washita River流域,对比分析了TRMM 3B42 V7,GPM-IMERG卫星降水和StageⅣ雷达降水的精度,并用这3种降水产品驱动CREST分布式水文模型,评估了其水文模拟效用.研究表明:3种降水产品与地面降水的相关系数均大于0.5,通过了0.05置信水平检验;GPM-IMERG和TRMM 3B42 V7卫星降水对无雨和微雨存在低估,对大雨和暴雨存在高估;总体上,StageⅣ降水精度最好,其次GPM降水精度优于TRMM 3B42 V7.在水文模拟效用评估中,设定相同率定期,分别使用3种降水产品率定CREST模型参数,得到率定参数集后,在相同验证期对流域日径流过程进行模拟.对比结果表明:StageⅣ雷达降水在小流域水文模拟中效果最好,GPM-IMERG次之,TRMM 3B42 V7模拟效果不理想.

腹腔镜下侧腹壁悬吊术与阴道后壁修补术联合治疗POP-QⅢ或Ⅳ期盆腔器官脱垂的效果分析

目的:探究腹腔镜下侧腹壁悬吊术联合阴道后壁修补术在盆腔器官脱垂定量分期法(POP-Q)Ⅲ或Ⅳ期盆腔器官脱垂患者中的应用效果。方法:选择2021年2月—2023年6月厦门市第三医院收治的90例POP-QⅢ或Ⅳ期盆腔器官脱垂患者,根据随机数字表法分为对照组和观察组,各45例。对照组进行阴式子宫切除术联合阴道前后壁修补术治疗,观察组则进行腹腔镜下侧腹壁悬吊术联合阴道后壁修补术治疗。比较两组的治疗总有效率、手术指标(手术时间、术中出血量、排气时间、住院时间)、并发症发生率、手术前后的盆底相关参数[阴道总长度(TVL)、阴道前壁中线离处女膜缘3 cm处(Aa)、前穹隆或阴道顶端到Aa点之间阴道前壁上段中距离处女膜的最远点(Ba)及宫颈或子宫切除后阴道顶端所处的最远端(C)]及盆底功能障碍问卷(PFDI-20)评分。结果:观察组治疗总有效率高于对照组,手术指标均优于对照组,并发症发生率显著低于对照组,差异均有统计学意义(P<0.05)。术后6个月,观察组盆底相关参数及PFDI-20各项评分均显著低于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜下侧腹壁悬吊术联合阴道后壁修补术在POP-QⅢ或Ⅳ期盆腔器官脱垂患者中的应用效果更好,可显著改善患者的盆底相关参数及盆底功能,且安全性较高。

Prophylactic lateral pelvic lymph node dissection in stage Ⅳ low rectal cancer

AIM To assess the clinical significance of prophylactic lateral pelvic lymph node dissection (LPLND) in stage Ⅳ low rectal cancer.METHODS We selected 71 consecutive stage Ⅳ low rectal cancer patients who underwent primary tumor resection,and enrolled 50 of these 71 patients without clinical LPLN metastasis.The patients had distant metastasis such as liver,lung,peritoneum,and paraaortic LN.Clinical LPLN metastasis was defined as LN with a maximum diameter of 10 mm or more on preoperative pelvic computed tomography scan.All patients underwent primary tumor resection,27 patients underwent total mesorectal excision(TME) with LPLND(LPLND group),and 23 patients underwent only TME(TME group).Bilateral LPLND was performed simultaneously with primary tumor resection in LPLND group.R0 resection of both primary and metastatic sites was achieved in 20 of 50 patients.We evaluated possible prognostic factors for 5-year overall survival (OS),and compared 5-year cumulative local recurrence between the LPLND and TME groups.RESULTS For OS,univariate analyses revealed no significant benefit in the LPLND compared with the TME group (28.7% vs 17.0%,P = 0.523); multivariate analysis revealed that R0 resection was an independent prognostic factor.Regarding cumulative local recurrence,the LPLND group showed no significant benefit compared with TME group (21.4% vs 14.8%,P = 0.833).CONCLUSION Prophylactic LPLND shows no oncological benefits in patients with Stage Ⅳ low rectal cancer without clinical LPLN metastasis.

Radical treatment of stage Ⅳ pancreatic cancer by the combination of cryosurgery and iodine-125 seed implantation

AIM:To investigate the therapeutic effect of radical treatment and palliative treatment in stage Ⅳ pancreatic cancer patients.METHODS:81 patients were enrolled in the study.Radical treatment was performed on 51 patients,while 30 patients were put under palliative treatment.The procedural safety and interval survival for stage Ⅳ pancreatic cancer(IS-Ⅳ) was assessed by almost 2.5 years of follow-ups.The IS-Ⅳ of patients under the two kinds of treatment,and the effects of treatment timing and frequency on IS-Ⅳ,were compared.RESULTS:The IS-Ⅳ of patients who received radical treatment was significantly longer than those who received palliative treatment(P < 0.001).The IS-Ⅳ of patients who received delayed radical or palliative treatment was longer than those who received accordingly timely treatment(P = 0.0034 and 0.0415,respectively).Multiple treatments can play an important role in improving the IS-Ⅳ of patients who received radical treatment(P = 0.0389),but not for those who received palliative treatment(P = 0.99).CONCLUSION:The effect of radical treatment was significantly more obvious than that of palliative treatment,and multiple radical treatments may contribute more to patients than a single radical treatment.

Macroscopic appearance of TypeⅣand giant Type Ⅲ is a high risk for a poor prognosis in pathological stage Ⅱ/Ⅲ advanced gastric cancer with postoperative adjuvant chemotherapy

AIM To evaluate whether a high risk macroscopic appearance(Type Ⅳ and giant Type Ⅲ) is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage Ⅱ/Ⅲ(p Stage Ⅱ/Ⅲ) gastric cancer.METHODS One hundred and seventy-two advanced gastric cancer(defined as pT2 or beyond) patients with p Stage Ⅱ/Ⅲ who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival(RFS)(35.7%) and overall survival(OS)(34%) than an average risk appearance(P = 0.0003 and P < 0.0001, respectively). A high-risk macroscopic appearance was significantly associated with the 13^(th) Japanese Gastric Cancer Association(JGCA) pT(P = 0.01), but not with the 13^(th) JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13^(th) JGCA p Stage(P < 0.0001)and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified highrisk macroscopic appearance(P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS) as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13^(th) JGCA stage in p Stage Ⅱ/Ⅲ advanced gastric cancer.

Resection of the primary tumor in stage Ⅳ breast cancer

Stage Ⅳ breast cancer refers to breast cancer that has already metastasized to distant regions when initially diagnosed. Treatment for stage Ⅳ is intended to "prolong survival and palliate symptoms". Resection of a primary tumor is considered to be "effective only at alleviating chest symptoms and providing local control" in spite of the advances of imaging examination and medication for breast cancer. Molecular target and endocrine drugs are very effective and useful to tailor-make a treatment strategy according to breast cancer subtypes. Positron emission tomography-computed tomography can detect and diagnose the very small metastases and recurrences which can potentially be cured even if they are distant metastases. Recently, many retrospective studies have reported the survival benefit of surgery for breast cancer patients with metastases and some clinical trials which confirm the surgical prognostic benefit for them have started to enrol patients. The goal of treatment has to be clearly identified:increase the patient's survival time, provide local control or perform histology to determine the cancer's properties. The best evidence is absolutely essential to treat patients who need surgery at the right time. We need to evaluate the treatment strategy, including primary resection for stage Ⅳ breastcancer particularly, and find new evidence by prospective analysis.

Effect of TCM Combined with Chemotherapy on Immune Function and Quality of Life of Patients with Non-small Cell Lung Cancer inStage Ⅲ-Ⅳ

Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in stage Ⅲ-Ⅳ. Methods: One hundred cases with stage Ⅲ-Ⅳ NSCLC were randomly divided into two groups. The treated group (n=50) received CT combined with TCM, and the control group received CT alone. The percentage of T lymphocyte subset in peripheral blood and the change of natural killer (NK) cell count were observed after treatment. The QOL and tolerance of CT were also compared between the two groups after treatment. Results: In the treated group, CD3 cell count, CD4 cell count, CD4/ CDg ratio and NK cell activity were higher than those in control group, while CD8 cell count in the treated group was lower than that in the control group (P<0.05), and QOL and tolerance of CT in the treated group were also better (P<0.05). Conclusion: TCM combined with CT could raise the patients' ability in tolerating CT in stage Ⅲ-ⅣNSCLC.

Ⅳ期非小细胞肺癌患者营养风险及营养相关血液学指标分析

目的:探讨Ⅳ期非小细胞肺癌患者营养风险发生情况及营养相关血液学指标的变化,并通过指标分析为营养支持提供一定的依据。方法:采用回顾性研究方法,收集安徽医科大学第二附属医院肿瘤科2020年1月—2023年1月收治的92例首次确诊Ⅳ期非小细胞肺癌患者的临床资料,包括年龄、性别、体重指数(BMI)、营养风险筛查2002(NRS 2002)评分、血液学指标。根据年龄将患者分为老年组(66~89岁)和中青年组(18~65岁),并分析两组营养不足发生情况和血液学指标异常情况。结果:92例Ⅳ期非小细胞肺癌患者营养风险发生率为22.83%,66~89岁患者营养风险发生率明显高于18~65岁患者,差异有统计学意义(χ^(2)=8.573,P=0.003)。Ⅳ期非小细胞肺癌患者营养不足发生率为13.04%(12/92),老年组营养不足发生率(21.57%)显著高于中青年组(2.44%),差异有统计学意义(P=0.007)。Ⅳ期非小细胞肺癌患者血液指标异常率较高,超过25%的患者存在白蛋白(ALB)、血红蛋白(Hb)、白细胞(WBC)计数、淋巴细胞绝对值(LYM)。老年组白蛋白(ALB)、钾(K)、镁(Mg)异常率均明显高于中青年组,WBC异常率低于中青年组,差异均有统计学意义(P<0.05)。结论:Ⅳ期非小细胞肺癌患者存在较高的营养风险,其营养相关血液学指标显著异常。

血清TAP、proGRP、cyfra21-1与Ⅲ~Ⅳ期NSCLC新辅助化疗疗效及预后的关系

目的探讨血清肿瘤异常蛋白(TAP)、胃泌素释放肽前体(proGRP)、细胞角蛋白19片段(cyfra21-1)与Ⅲ~Ⅳ期非小细胞肺癌(NSCLC)新辅助化疗(NCT)疗效及预后的关系。方法选取100例Ⅲ~Ⅳ期NSCLC患者为研究对象,所有患者均采用NCT治疗,根据疗效将患者分为有效组和无效组,比较不同疗效患者化疗前后TAP、proGRP、cyfra21-1水平,分析化疗后TAP、proGRP、cyfra21-1水平对NSCLC患者NCT疗效的评估价值。所有患者均随访1年,分析化疗后TAP、proGRP、cyfra21-1表达水平与预后的关系。结果化疗后,有效组TAP、proGRP、cyfra21-1水平低于无效组(P<0.05)。ROC曲线结果显示,TAP评估NSCLC患者NCT疗效的AUC和截点值分别为0.739、178.18μm 2,proGRP评估NSCLC患者NCT疗效的AUC和截点值分别为0.810、52.21 ng/L,cyfra21-1评估NSCLC患者NCT疗效的AUC和截点值分别为0.775、7.70μmol/L,联合评估NSCLC患者NCT疗效的AUC为0.913,高于单项诊断(P<0.05)。TAP、proGRP、cyfra21-1高表达患者的1年生存率均低于低表达患者(P<0.05)。结论TAP、proGRP、cyfra21-1联合评估Ⅲ~Ⅳ期NSCLC患者NCT疗效具有较高价值,且其均与NSCLC患者预后密切相关。

加减猪苓汤治疗糖尿病肾病Ⅳ期的临床观察及对尿AQP2的影响

目的探讨加减猪苓汤治疗糖尿病肾病(diabetic kidney disease,DKD)Ⅳ期的临床疗效及对尿水通道蛋白2(Aquaporin2,AQP2)的影响。方法临床采用辨证属阴虚水肿型DKDⅣ期样本50例,随机分为治疗组25例和对照组25例,所有病例均进行常规降糖药控制血糖、低盐、优质低蛋白、低脂饮食、控制血压和运动指导等一般治疗。对照组口服厄贝沙坦片150 mg/d,治疗组在上述治疗基础上,加用加减猪苓汤,6周后比较治疗前后两组24尿蛋白定量、肝肾功能、糖化血红蛋白、血糖、中医症候积分情况等,同时分别在第1、3、6周末检测两组尿AQP2表达。结果治疗6周后,两组中医症候积分、24 h尿蛋白定量、血浆白蛋白、血肌酐及均较治疗前有所改善,差异有统计学意义(P<0.05),且治疗组优于对照组(P<0.05),治疗组尿AQP2在第3周及第6周均表达高于第1周(P<0.05),且高于对照组(P<0.05)。结论猪苓汤猪苓汤治疗DKDⅣ期的患者可减少尿蛋白、改善肾功能及减少中医症候积分,同时提高尿中AQP2表达,延缓DKD的进展。

儿童Ⅳ期神经母细胞瘤远期随访报告

目的总结分析儿童Ⅳ期神经母细胞瘤(NB)诊断治疗方案的远期疗效及影响预后的因素,为方案的改进提供依据。方法研究对象为1996年4月1日至2005年12月31日新诊断的Ⅳ期NB患儿,年龄1个月至15岁,共69例。其中Ⅳ期67例,Ⅳs期2例。根据年龄将患儿分为中危组和高危组,综合治疗方案包括根据分组采用不同强度化疗、完成化疗后全顺式维甲酸诱导分化治疗及适时肿瘤根治性切除术,起病年龄>1岁的患儿在停药前造血干细胞支持下超剂量化疗(ASCT),部分术后有残留者接受局部放疗。结果16/69例在接受44疗程后好转中放弃治疗。53例按计划治疗>4个疗程,22例接受了ASCT(中危组3例,高危组19例)。获得非常好的部分缓解(very good partial remission,VGPR)49例(92.45%),获得部分缓解(PR)4例(7.55%)。中位随访期28个月(7个月至79个月)。末次随访时在VGPR中13例(24.53%),中位VGPR时间为38个月。带病生存病情稳定5例。疾病进展、复发或已死亡35例(66.04%)。2年总体生存率(OS)和VGPR生存率(VGPRS)分别为64.4%和60.4%,3年OS和VGPRS分别为43.9%和41.2%,4年OS和VGPRS分别为19.8%和14.4%。肿瘤原发于后腹膜、骨髓转移对预后的影响达统计学有效水平,P值均<0.05。结论Ⅳ期NB在强烈化疗等综合治疗下远期预后仍然极差,原发于后腹膜并有骨髓转移者预后更差,需进一步探索研究新的治疗手段,以改善其预后。

17例Ⅳ期高危神经母细胞瘤肿瘤包绕大血管放疗介入诊治分析

目的:探讨对Ⅳ期高危神经母细胞瘤肿瘤包绕大血管放疗介入时机。方法:2010年1月至2011年12月上海交通大学医学院附属新华医院肿瘤放化疗科收治17例Ⅳ期高危神经母细胞瘤肿瘤包绕大血管患儿,其中男性11例,女性6例,对12例行术前化疗、手术、术后化疗、造血干细胞移植后大剂量化疗,然后接受局部放疗;5例因术前化疗效果不明显而行术前放疗。结果:12例中有7例复发:2例脑转移及骨转移、2例局部复发、3例骨转移中2例为腹腔广泛转移,平均复发时间在放疗结束后2个月。5例行术前放疗的患儿中4例放疗后3～4周完成手术,1例出现全身广泛转移死亡。结论:Ⅳ期高危神经母细胞瘤肿瘤包绕大血管者预后较差,复发率高,治疗包括术前化疗、手术、术后化疗、造血干细胞移植的大剂量化疗治疗,对原发肿瘤部位的进一步放疗通常认为是必需的,在造血干细胞移植的巩固化疗前用放疗来提高局控率可减少转移。当术前化疗不敏感时可采用术前放疗,从而获得手术治疗机会。

国Ⅳ城市公交车NO_x排放特性的试验研究

利用车载排放测试系统对两辆国Ⅳ城市公交车在实际运行时的排放特性进行了试验研究。结果表明,车辆的NOx排放受车辆行驶状况影响较大,当行驶道路畅通,车速较高且输出功率较大时,车辆的NOx排放率较低,反之,NOx排放率较高;当车速由15km/h提高到55km/h以上时,NOx的平均排放率可以降低70%,而尿素喷射时间占比可提高25个百分点。因此,提高车速是充分发挥国Ⅳ车辆排放优势,改善交通的有效手段之一。

超声内镜和多层螺旋CT对BorrmannⅣ型胃癌术前分期的比较研究

目的对超声内镜(EUS)和多层螺旋CT(MSCT)检查在BorrmannⅣ型胃癌术前分期中的作用进行比较。方法回顾性分析48例BorrmannⅣ型胃癌患者的影像学术前TNM分期,并与术后病理分期进行比较。结果 EUS和MSCT检查对T分期的准确率分别为54.2%和79.2%(P=0.009),分层分析表明MSCT对T3、T4分期的准确率高于EUS(T3:84.6%vs 57.7%,P=0.032;T4:82.4%vs 41.2%,P=0.032)。两者对N分期的准确率,均为56.3%(P=1.000),无明显差异,EUS和MSCT对淋巴转移检查的特异度和灵敏度分别为83.3%/72.2%和66.7%/91.7%。结论 EUS更适合对早期胃癌分期,而已浸润至浆膜层及有远处转移的BorrmannⅣ型胃癌患者,应优先选择MSCT检查进行分期。

188例Ⅳ期非小细胞肺癌化疗过程中原发灶区放疗与否的预后分析

目的:回顾性分析Ⅳ期非小细胞肺癌(NSCLC)全身化疗过程中,原发灶放疗与否与生存期的关系。方法:188例Ⅳ期NSCLC患者(1999年12月至2004年1月)接受含铂方案为主的一线方案化疗,疗效达PR或SD者。其中63例择期予以原发灶区放疗,简称放疗组;125例未行原发灶放疗,简称非放疗组。比较两组生存期、安全性。结果:全组188例患者1年生存率(SR)48.9%,中数生存期(MS)12个月。放疗组1年SR77.8%,MS15个月;未放疗组1年SR41.6%,MS10个月。两组SR差别明显(P=0.025)。全组疗效达PR者(74例),放疗组(37例)与未放疗组(37例)MS分别为17和13个月,1年SR分别为84.2%和66.7%,但生存趋势无差别(P=0.454)。疗效SD者,两组MS分别为12和8个月,1年SR分别为45.0%和24.6%,生存率差别明显(P=0.0027)。放疗组中无WHOⅢ～Ⅳ度血液学毒性,WHOⅢ度的放射性肺炎7例(11.1%),需静脉营养支持的WHOⅢ度食管炎1例(1.5%)。结论:Ⅳ期NSCLC在全身化疗基础上择期行原发灶放疗,有延长生存期作用,对化疗达SD者似更有意义。

64排螺旋CT对Ⅳ期胃癌术前分期的价值

目的评价64排螺旋CT对Ⅳ期胃癌术前分期的准确性。方法收集2007年7月至2008年4月期间我院胃肠外科收治的49例Ⅳ期胃癌患者的临床资料,对其中术前行64排螺旋CT(64MDCT)检查的29例患者进行回顾性分析并按日本胃癌规约对肿瘤进行分期。将CT术前分期结果与临床-手术-病理分期结果进行对照分析。结果本组病例经64MDCT术前分期,其中65.2%(15/23)T分期准确,47.8%(11/23)N分期准确,70.8%(17/24)M分期准确,58.6%TNM分期准确(17/29)。而腹膜转移患者中6/9未能经术前64MDCT检出。结论64MDCT可以对Ⅳ期胃癌进行较准确的分期,其分期准确率降低的主要原因为腹膜转移的漏诊,但64MDCT分期降低并不增加剖腹探查率。

AHSG和IL-6基因多态性与Ⅳ期卵巢子宫内膜异位囊肿的相关性研究

目的：探讨α2-HS-糖蛋白（AHSG）基因和白细胞介素-6（IL-6）基因调控区-174位点多态性与中国河北省育龄妇女Ⅳ期卵巢子宫内膜异位囊肿遗传易感性的关系。方法：采用病例对照研究的方法，以50例Ⅳ期卵巢子宫内膜异位囊肿患者（评分〉40）及62例非子宫内膜异位症对照者的外周血白细胞为样本，利用聚合酶链反应（PCR）技术分析AHSG基因和IL-6基因调控区-174位点基因的多态性。结果：Ⅳ期卵巢子宫内膜异位囊肿组中AHSG基因的3种基因型AHSG1＊1、AHSG1＊2、AHSG2＊2各占44％、46％、10％，对照组则分别为71％、25．8％、3．2％。将突变型与杂合型合并与野生型比较，两组间差异有统计学意义（χ=8．317，P=0．004），其OR为3．111（95％CI为1．422～6．805），携带变异基因的患病风险率高。AHSG1、AHSG2等位基因频率总体分布差异有统计学意义（χ^2=8．723，P=0．003），携带AHSG2等位基因的患病危险度高，OR为2．561，（95％CI为1．358-4．831）。在50例试验组与62例对照组中均未发现IL-6突变基因。结论：AHSG2基因可使患Ⅳ期卵巢子宫内膜异位囊肿的遗传易感性升高，未发现Ⅳ期卵巢子宫内膜异位囊肿与IL-6基因调控区-174位点突变有相关性。

化疗放射综合治疗Ⅳ期肺癌对生存期的影响

本文对44例接受化疗和60Co放疗综合治疗的Ⅳ期肺癌患者和25例单纯接受化疗的Ⅳ期肺癌这两组病人的疗效进行观察，放化组有效率34．1％，中位生存期11月，单化组有效率12％，中位生存期4.5月。本文显示应用适当有效的化疗和放疗综合治疗Ⅳ期肺癌能够缓解病情，延长生存期。

糖尿病肾病患者Ⅲ、Ⅳ、Ⅴ期中医证候及分布规律

目的探讨280例糖尿病肾病(DN)患者Ⅲ、Ⅳ、Ⅴ期中医证候规律及证候分布规律,以期为DN的规范化诊治提供新的思路及理论支持。方法采用回顾性方法研究分析280例符合中西医诊断标准的Ⅲ、Ⅳ、Ⅴ期DN患者,针对各期患者主要及次要临床表现及问卷调查结果,采用德尔菲法总结DNⅢ、Ⅳ、Ⅴ期中医证候规律,采用聚类分析法探讨DNⅢ、Ⅳ、Ⅴ期中医证候分布规律,并进行描述性统计分析中医证候规律及其证候分布规律的特点。结果Ⅲ期和大量蛋白尿期DN患者中医症候特点为本虚标实,气阴两虚夹瘀型,Ⅴ期逐渐发展至气血阴阳俱虚,兼见湿浊、瘀血夹杂重症。结论随着DN的不断进展,中医症状出现相应频次的变化,其中医证候规律及其分布规律各有特点,对本病的临床诊治研究意义重大。