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sPLA2-IB Level Correlates with Hyperlipidemia and the Prognosis of idiopathic membranous nephropathy

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Current Medical Science 2020年第4期40卷 683-690页

作者： Li-yan YANG Yuan-sheng WU Bin-bin DAI Song-hua LIN Hong CHEN Guo-ping LI Xuan TAO Jian-xin WAN Yang-bin PAN Department of Nephrology the First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005China Shanghai Pudong Hospital Fudan University Pudong Medical CenterShanghai 201399China Department of Cardiology the First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005China Department of Pathology the First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005China

Summary:Recent studies suggested that serum secretory phospholipase A2 group IB(sPLA2-IB)was increased in idiopathic membranous nephropathy(IMN).However,the interference of high lipemia on the sPL.A2-IB levels was not taken into account in these *** present study aimed to investigate the correlation between sPLA2-IB and lipemia,and the clinical merit of sPLA2-IB in the prediction of prognosis of IMN patients.A total of 64 IMN patients,39 immunoglobulin A nephropathy(IgAN)patients and 64 healthy controls were included in the *** levels of serum sPLA2-IB,lipemia and proteinuria were *** IMN patients were followed up for 6 *** stages were made for all IgAN and IMN *** results showed that the levels of serum sPLA2-IB,cholesterol and low-density lipoprotein cholesterol(LDL-C)were significantly higher,and the levels of albumin and high-density lipoprotein cholesterol(HDL-C)were significantly lower in IMN patients than in healthy controls and IgAN *** sPLA2-IB levels were also found to be higher in IgAN patients than in heathy controls,but the association of serum sPLA2-IB levels with proteinuria,cholesterol and albumin was only shown in IMN *** against M-type receptor for secretory phospholipase A2(PLA2R1)was positive in 813%IMN *** sPLA2-IB deposition,podocyte fused processes,and density deposition on thickened basement membrane were seen in IMN patients,but not in IgAN *** patients with lower sPLA2-IB and proteinuria levels were found to have better outcome after the 6-month *** IMN patients,sPLA2-IB levels were significantly increased in both serum and renal *** conclusion,serum sPLA2-IB was closely correlated with proteinuria,albumin and cholesterol,and IMN patients with lower sPLA2-IB levels were more likely to achieve a better outcome.

关键词： sPLA2-IB lipemia idiopathic membranous nephropathy prognosis

Effect of Nephritis Rehabilitation Tablets combined with tacrolimus in treatment of idiopathic membranous nephropathy

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World Journal of Clinical Cases 2021年第34期9卷 10464-10471页

作者： Wei Lv Mei-Rong Wang Cheng-Zhen Zhang Xue-Xu Sun Zhen-Zhen Yan Xiao-Min Hu Tao-Tao Wang Department of Nephology China People’s Liberation Army 32298Weifang 261000Shandong ProvinceChina Department of Pharmacy China People’s Liberation Army 32298Weifang 261000Shandong ProvinceChina Department of Blood Purification China People’s Liberation Army 32298Weifang 261000Shandong ProvinceChina

BACKGROUND idiopathic membranous nephropathy(IMN)has a high incidence in the middleaged and elderly population,and poses a great threat to the physical and mental health and quality of life of *** Rehabilitation Tablets have many potential effects,such as clearing residual toxins,tumefying the kidney and spleen,replenishing qi,and nourishing yin,and have played an important role in the treatment of a variety of kidney *** To investigate the efficacy and safety of Nephritis Rehabilitation Tablets combined with tacrolimus in the treatment of *** Eighty-four patients with IMN recruited from January 2017 to September 2020 were randomly divided into a study group(n=42)and a control group(n=42).On the basis of routine symptomatic treatment,both groups were treated with tacrolimus,and the study group was additionally treated with Nephritis Rehabilitation *** groups were treated for 12 *** therapeutic effect,the levels of renal function indexes[serum creatinine(Scr),serum albumin,and 24-h urinary protein],urinary immunoglobulin(IgG4),membrane attack complex(C5b-9),and the incidence of adverse reactions were measured before and after 12 wk of *** The total effective rate in the study group was significantly higher than that of the control *** treatment,there was no significant difference in Scr,serum albumin,or 24 h urinary protein between the two *** 12 wk of treatment,the levels of Scr and 24-h urinary protein in both groups were significantly lower and serum albumin was significantly higher than those before treatment(P<0.05),and the levels of Scr and 24-h urinary protein were significantly lower(P=0.003 and 0.000,respectively),and the level of serum albumin was significantly higher(P=0.00)in the study group than in the control *** treatment,there was no significant difference in urinary IgG4 and C5b-9 levels between the study group and the control group(P=0.336 and 0.438,respectively).Af

关键词： Nephritis Rehabilitation Tablets Tacrolimus idiopathic membranous nephropathy Renal function IgG4 C5b-9

Successful treatment of patients with refractory idiopathic membranous nephropathy with low-dose Rituximab:A single-center experience

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World Journal of Clinical Cases 2023年第3期11卷 566-575页

作者： Yao-Wei Wang Xin-Hui Wang Hong-Xia Wang Ren-Huan Yu China Department of Nephrology Xiyuan Hospital of China Academy of Chinese Medical SciencesBeijing 100091China

BACKGROUND The recognition of idiopathic membranous nephropathy(IMN)as an autoimmune disease has paved the way for the use of B-cell-depleting agents,such as Rituximab(RTX),which is now a first-line drug for treating IMN with proven safety and ***,the usage of RTX for the treatment of refractory IMN remains controversial and *** To evaluate the efficacy and safety of a new low-dose RTX regimen for the treatment of patients with refractory *** A retrospective study was performed on refractory IMN patients that accepted a low-dose RTX regimen(RTX,200 mg,once a month for five months)in the Xiyuan Hospital of Chinese Academy of Chinese Medical Sciences’Department of Nephrology from October 2019 to December *** assess the clinical and immune remission data,we performed a 24 h urinary protein quantification(UTP)test and measured the serum albumin(ALB)and serum creatinine(SCr)levels,phospholipase A2 receptor(PLA2R)antibody titer,and CD19+B-cell count every three *** A total of nine refractory IMN patients were *** follow-up conducted twelve months later,the results from the 24 h UTP decreased from baseline[8.14±6.05 g/d to 1.24±1.34 g/d(P<0.05)]and the ALB levels increased from baseline[28.06±8.42 g/L to 40.93±5.85 g/L(P<0.01)].Notably,after administering RTX for six months,the SCr decreased from 78.13±16.49μmol/L to 109.67±40.87μmol/L(P<0.05).All of the nine patients were positive for serum anti-PLA2R at the beginning,and four patients had normal anti-PLA2R titer levels at six *** level of CD19+B-cells decreased to 0 at three months,and CD19+B-cell count remained at 0 up until six months of *** Our low-dose RTX regimen appears to be a promising treatment strategy for refractory IMN.

关键词： Refractory nephrotic syndrome idiopathic membranous nephropathy Low-dose rituximab

Non-glomerular Tip Lesion Focal Segmental Glomerulosclerosis as a Negative Predictor in idiopathic membranous nephropathy

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Current Medical Science 2022年第5期42卷 1007-1014页

作者： Hui WANG Cheng WAN Man JIANG Chun ZHANG Department of Nephrology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China Renal Division University of Freiburg Medical CenterFreiburg 79106Germany

Objective To assess the significance of focal segmental glomerulosclerosis(FSGS)variants on clinicopathological characteristics and short-term outcomes in idiopathic membranous nephropathy(IMN)*** The clinicopathological data of 146 IMN patients diagnosed between December 2016 and March 2019 in our center were collected and *** patients were divided into the pure IMN group,IMN with glomerular tip lesion(GTL)group,and IMN with non-GTL FSGS *** The IMN with non-GTL FSGS and IMN with GTL groups both had higher proportions of patients with hypertension,lower serum albumin,and severe proteinuria,while the IMN with non-GTL FSGS group additionally showed higher blood pressure and serum cholesterol,and lower serum IgG than the IMN group(all P<0.05).As for pathology,the IMN with non-GTL FSGS group had higher proportions of patients with acute tubular injury and moderate to severe chronic injuries than the IMN group(all P<0.05).In the IMN,IMN with GTL,and IMN with non-GTL FSGS groups,the overall one-year remission rates were 81.6%,76%,and 58.8%,***,the IMN with non-GTL FSGS group showed the lowest cumulative incidence to reach remission within one *** Cox logistic analysis demonstrated that higher level of serum anti-M-type phospholipase A2 receptor antibody and the existence of non-GTL FSGS lesion were independent predictors for no remission in IMN *** The non-GTL FSGS lesion was a novel negative predictor in IMN and should be taken into account in the management of IMN.

关键词： idiopathic membranous nephropathy focal segmental glomerulosclerosis glomerular tip lesion

Effect of tacrolimus in idiopathic membranous nephropathy： a meta-analysis

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Chinese Medical Journal 2014年第14期127卷 2693-2699页

作者： Santosh, Thapa Liu Hong Liu Bicheng Southeast Univ Sch Med Zhongda Hosp Inst Nephrol Nanjing 210009 Jiangsu Peoples R China

Background The efficacy and safety of immunosuppression for idiopathic membranous nephropathy （IMN） are still controversial. Recent studies showed tacrolimus is effective in the treatment of IMN. To evaluate the efficacy and safety of tacrolimus （TAC） for IMN, we conducted a meta-analysis of published medical literatures. Methods Studies addressing the effect of tacrolimus in IMN were searched on PUBMED, EMBASE, The Cochrane Library, and *** （March 2013）. Trials comparing tacrolimus with corticosteroid versus control group （cyclophosphamide with corticosteroid） were included. The quality of the studies was assessed using Jadad method. Statistical analyses were performed using Review Manager 5.2 and the results were summarized by calculating the risk ratio （RR） for dichotomous data or the mean difference （MD） for continuous data with 95% confident interval （CI）. Results A total of four studies （259 patients） were included. It was shown that therapy with tacrolimus plus corticosteroid had a higher complete remission rate compared to therapy with cyclophosplamide plus corticosteroid （RR=1.53, 95% CI： 1.05-2.24, P 〈0.05）, but not significant on total remission, partial remission and adverse effects. Also, no significant alterations were observed in proteinuria and serum albumin level between the two groups. During the entire follow-up period, serum creatinine level remained stable in both groups without ±50% increase in its level. Conclusions TAC is more effective than cyclophosphamide （CTX） by achieving complete remission in patients with IMN. Multi-ethnic RCTs are needed to evaluate its long-term efficacy and safety. Chin Med J 2014;127 （14）： 2693-2699

关键词： tacrolimus idiopathic membranous nephropathy meta-analysis

Variants in the Promoter Region of HLA-DQA1 were Associated with idiopathic membranous nephropathy in a Chinese Han Population

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Chinese Medical Journal 2017年第14期130卷 1677-1682页

作者： Xiao-Song Qin Jian-Hua Liu Guan-Ting Lyu Meng-Le Peng Fu-Ning Yang Dong-Chun Qin Yong-Zhe Li Yong Liu Department of Medical Laboratory Shengjing Hospital of China Medical University Shenyang Liaoning 110011 China Department of Blood Transfusion Tangdu Hospital The Fourth Military Medical University Xi&#39 an Shaanxi 710038 China Department of Medical Laboratory The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 450052 China Department of Rheumatology and Clinical immunology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Key Laboratory of Rheumatology and Clinical Immunology Ministry of Education Beijing 100005 China

Background：idiopathic membranous nephropathy （IMN） is an autoimmune disease and the leading cause of adult nephritic ***-DQA1 had been identified to be associated with IMN in Europeans and the result was replicated in Chinese Han *** this study,six single nucleotide polymorphisms （SNPs） in the promoter ofHLA-DQA I and other two SNPs with IgA nephropathy were included for the association ***：The SNPs were genotyped in 509 patients and 601 controls by the MassArray *** quantification ofanti-phospholipase A2 receptor （PLA2R） antibodies in sera of IMN patients was performed by anti-PLA2R ELISA （lgG） ***：After analysis,four SNPs were significantly associated with IMN,with rs2187668 and rs28383345 as the top two signals （P =8.42×10-4 and 2.48× 10-5,respectively）.Even under dominant model,the two SNPs were still significantly associated with IMN （P =3.50×10-3 for rs28383345 and P =6.55×10-5 for rs2187668）.After conditional study with rs2187668,rs28383345 was the only variant significantly correlated with IMN after Bonferroni correction （P =0.016）.The minor alleles of the two SNPs were also mutually exclusive in our *** indicated that the two SNPs were independently associated with IMN in Chinese Han *** of anti-PLA2R autoantibodies were correlated with the genotypes of the two SNPs,but not significantly （P〉0.05）.Conclusions：Our results revealed that a novel independent variant in the promoter of HLA-DQA I was associated with I MN in Chinese Han *** locus possessed regulatory role according to the data of *** exact role of the SNPs on the expression of HLAoDQA1 needs further investigation.

关键词： Autoimmune Disease HLA-DQA1 idiopathic membranous nephropathy Promoter Chinese

Cyclosporine treatment in idiopathic membranous nephropathy nephrotic syndrome in adults： a retrospective study spanning 15 years

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Chinese Medical Journal 2011年第21期124卷 3490-3494页

作者： TAO Jian-ling LIU Li-li WEN Yu-bing GAO Rui-tong LI Hang LI Ming-xi LI Xue-mei LI Xue-wang Division of Nephrology Peking Union Medical College Hospital Peking Union Medical College Chinese Academy of Medical Science Beijing 100730 China

Background Cyclosporine is effective in treating nephrotic syndrome （NS） with idiopathic membranous nephropathy （IMN） in adults. But high relapse rate remains a major concern. The way to manipulate cyclosporine is inconclusive. The aim of this study was to introduce the way how to titrate the cyclosporine to maintain complete remission without relapse. Methods Patients with biopsy-proven IMN with NS treated with cyclosporine for at least 1 month from 1996 to 2011 at Peking Union Medical College Hospital were reviewed. Results Mean age of the 51 eligible patients was 52 years, with 39 men. Mean proteinuria was （7.47±3.14） g/d, serum albumin （24.50±6.29） g/L, and serum creatinine （82.62±21.18） μmol/L. Cyclosporine was commenced at a mean dose of （3.46±0.63） mg·kg^-1·d^-1. Oral prednisone （0.40±0.29） mg·kg^-1·d^-1 was given concomitantly in 38 patients. Cyclosporine was administered for a median of 16 months （range 1-93 months） and stopped in non-responders by month six. By month 3 （n=47）, the number in complete remission （CR） and partial remission （PR） was 3 and 24, which shifted to 12 and 17 by month 6 （n=41）. Male gender, heavy proteinuria, low serum albumin level, and high serum creatinine level were significant determinants in poor response by month six （P 〈0.05 in all variables compared with responders）. There was a significant reversible serum creatinine increase within 25% during month 3 to 12 （P 〈0.05 in all variables compared with baseline value）. Eleven patients maintained cyclosporine for more than 24 months with a cyclosporine dose of （1.04±1.06） mg·kg^-1·d^-1. Nine patients were in CR. Renal function, systolic and diastolic blood pressure remained stable. Renal impairment （〉30% rise of serum creatinine）, secondary infection, hypertension, gingival hyperplasia and liver impairment occurred in 6, 4, 10, 4, and 1 patients, respectively. Conclusions The observation time for cyclosporine to effectively induce CR of NS in IMN adults should be at least six month

关键词： cyclosporine idiopathic membranous nephropathy nephrotic syndrome treatment

Efficacy and Safety of Tacrolimus vs. Cyclophosphamide for idiopathic membranous nephropathy:A Meta-analysis of Chinese Adults

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2015年第5期35卷 623-628页

作者：李贞琼胡曼丽张春王玉梅 Department of Nephrology Union HospitalTongji Medical CollegeHuazhong University of Science and Technology

The efficacy and safety of tacrolimus （TAC） and cyclophosphamide （CTX） in the treatment of idiopathic membranous nephropathy （IMN） were compared in Chinese adult patients using a meta-analysis of the available literatures. Randomized controlled clinical trials （RCTs） of the treatment of primary IMN with TAC or CTX combined with corticosteroids in the English databases PubMed, Embase and Cochrane, as well as Chinese databases, were searched. Qualified studies were subjected to quality assessment and meta-analysis. A total of 8 RCTs, including 359 Chinese patients, were included in the meta-analysis. The complete remission rate and overall remission rate in the TAC treatment group after 6 months of treatment were higher than those in the CTX treatment group. No significant difference in remission rate was found after 12 months of treatment. There was no significant difference in the adverse reaction between the two groups at the 6th or 12th months. TAC-based treatment was associated with a faster response than CTX at the 6th month, but there was no significant difference between the two groups at 12th month in Chinese adults. Further study is needed to evaluate the long-term efficacy and safety of this treatment regimen.

关键词： idiopathic membranous nephropathy tacrolimus eyclophosphamide

CiteSpace-based Knowledge Graph Analysis of the Current Status and Trends of Chinese Medicine Research in idiopathic membranous nephropathy

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TMR Theory and Hypothesis 2021年第4期4卷 533-543页

作者： Fu-ru Hu Fa-rong Zhang Shandong University of Traditional Chinese Medicine JinanChina250000 Affiliated Hospital of Shandong University of Traditional Chinese Medicine JinanChina250000

Objective:To analyze the current status and development trend of Chinese medicine research in the field of idiopathic membranous nephropathy since ***:The literature related to Chinese medicine for idiopathic membranous nephropathy published in China Knowledge Network(CNKI)since 2000 was searched,and CiteSpacewas applied to visualize the publication time,authors,and keywords of the literature and to draw a visual knowledge ***:372 relevant literatures were *** analysis showed that there were 343 authors included,and the authors with the highest number of publications published 13 articles,and the core authors accounted for 10.2%of the total number;keyword analysis showed that 15 clusters were formed after burst analysis,and 10 emergent words were formed after keyword emergence ***:Chinese medicine recognizes and intervenes in idiopathic membranous nephropathy in terms of evidence type,treatment method,common prescriptions and single herbs,auxiliary examination,treatment modality,and clinical *** development trend lies in the combination of macroscopic and microscopic,the synergy between Chinese and Western,multidisciplinary collision diagnosis and treatment,as well as the use of Chinese medicine to intervene in the disease process at an early stage,and the integration of a worldwide standardized diagnosis and treatment guideline of Chinese medicine for idiopathic membranous nephropathy.

关键词： idiopathic membranous nephropathy traditional chinese medicine CiteSpace status and trends