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Individualized Traditional Chinese Medicine treatment vs antibiotics for recurrent urinary tract infections: a multicenter, randomized controlled study

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Journal of Traditional Chinese Medicine 2024年第3期44卷 524-529页

作者： GU Xiangchen QIU Meisi XIE Lin CHEN Min DENG Yueyi ZHANG Changming JIAN Guihua WANG Chen WANG Yi department of nephrology Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine department of nephrology Rizhao Hospital of Traditional Chinese Medicine department of nephrology Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine department of nephrology Shanghai Municipal Traditional Chinese Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine department of nephrology the Sixth People's Hospital Affiliated Shanghai Jiaotong University department of nephrology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

OBJECTIVE: To systematically assess the effects of individualized Chinese medicines on recurrent urinary tract infections(rUTIs).METHODS: This study recruited 230 adult female patients in the remission phase of rUTIs from five hospitals in China. The patients were randomly allocated to two groups: an individualized Chinese medicine group(n = 114) and a control group(n = 116). Patients in the Chinese medicine group received individualized Chinese herbs, which were evaluated for syndrome *** in the control group received antibiotic treatment combined with a Chinese medicine placebo. The duration of treatment was three courses of four weeks each, with a three-month subsequent follow-up. UTI recurrence rate,Traditional Chinese Medicine(TCM) syndrome scores,36-item Short Form Survey(SF-36) score, and urine secretory immunoglobulin A(SIgA) were measured and analyzed before and after treatment in each group. RESULTS: Patients from the Chinese medicine group exhibited significant decreases in both short-and longterm UTI recurrence rates compared with the control group(P < 0.05). The changes in TCM syndrome scores between the Chinese medicine and control groups were significant(P < 0.05). The changes in the average SF-36 quality-of-life scores in the Chinese medicine group were also significantly higher than those in the control group after treatment(P < 0.05). The Chinese medicine group also demonstrated a significant increase in urine SIg A expression. CONCLUSION: Taken together, compared to the oftenused long-term antimicrobial prophylaxis during the remission stage of r UTIs, treating patients with an individualized Chinese medicine decoction by syndrome differentiation could effectively reduce the recurrence rate, improve the patients' TCM syndrome scores and quality of life, and enhance immunity, which in turn helps to prevent antibiotic resistance.

关键词： immunoglobulin A, secretory medicine, Chinese traditional quality of life randomized controlled trial syndrome differentiation urinary tract infections

Efficacy of Huangma Ding or autologous platelet-rich gel for the diabetic lower extremity arterial disease patients with foot ulcers

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World Journal of Diabetes 2024年第5期15卷 923-934页

作者： Xue-Qin Wang Dan-Lan Pu Wei-Ling Leng Xiao-Tian Lei Jiang Juan Zou La Ding Yao Jia-Zhuang Xi Li Jian Teng Miao Qi-Nan Wu endocrinology department The People’s Hospital of Yubei District of Chongqing CityChongqing 401120China department of endocrinology Chongqing Yubei District People’s HospitalChongqing 400030China endocrinology department The First Affiliated Hospital of the Army Medical UniversityChongqing 400038China endocrinology and nephrology department Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer HospitalChongqing 400016China department of endocrinology Dazu Hospital of Chongqing Medical UniversityThe People’s Hospital of DazuChongqing 402360China

BACKGROUND Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability,traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment *** To investigate whether Huangma Ding or autologous platelet-rich gel(APG)treatment would benefit diabetic lower extremity arterial disease(LEAD)patients with foot *** A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups:Group A(62 patients;basal treatment),Group B(38 patients;basal treatment and APG),and Group C(55 patients;basal treatment and Huangma Ding).All patients underwent routine follow-up visits for six *** follow-up,we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between *** The infection status of the three groups before treatment was the ***(PCT)improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group *** regression analysis revealed that PCT was positively correlated with total amputation,primary amputation,and minor amputation *** ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group *** major amputation rate,minor amputation rate,and total amputation times in Groups B and C were lower than those in Group *** Our research indicated that diabetic foot ulcers(DFUs)lead to major amputation,minor amputation,and total amputation through local infection and poor microcirculation and *** Ding and APG were effective attreating *** clinical efficacy of Huangma Ding was better than that of autologous platelet gel,which may be related to the better control of local infection by Huangma *** finding suggested that in patients with DFUs combined with coinfection,controll

关键词： Diabetic foot ulcer Huangma Ding Autologous platelet-rich gel Ankle-brachial index Transcutaneous oxygen partial pressure

Effect of Jianpi Shengxue Tablet on Iron Metabolism and Nutritional Status in Patients with Renal Anemia:A Prospective,Randomized,Open,Parallel Controlled and Multicenter Clinical Study

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Current Medical Science 2024年第3期44卷 603-610页

作者： Juan YANG Meng-yuan LIANG Yu LI Hao ZHANG Wei LI Jing LV Li-ping DONG Jing-song JIN Cheng YANG Qing-hong ZHANG Li LONG Rong ZOU Yi GAO Dan SONG Chun-qin PAN Ying YAO Xiao-lin ZHAN Xiao-hui WANG department of nephrology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China department of nephrology The First People’s Hospital of GuiyangGuiyang550000China department of nephrology The Third Xiangya HospitalCentral South UniversityChangsha410000China department of nephrology The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an710061China department of nephrology Wuhan No. 4 HospitalWuhan430033China department of nephrology Hubei Provincial Hospital of Traditional Chinese MedicineWuhan430060China department of nephrology Central Theater General Hospital of PLAWuhan430064China department of nephrology Taihe HospitalShiyan442000China department of nephrology Third People’s Hospital of Hubei ProvinceWuhan430033China department of nephrology Hubei Province Integrated Traditional Chinese and Western Medicine Hospital of Hubei provinceWuhan430024China department of nephrology Xi’an No.3 HospitalAffiliated Hospital of Northwest UniversityXi’an710000China department of nephrology Shenzhen Guangming District People’s HospitalShenzhen518000China department of nephrology Xiantao First People’s HospitalXiantao433000China department of Nutrition Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China department of nephrology Huangshi Central HospitalHuangshi435000China department of nephrology The Fifth Hospital of WuhanWuhan430050China

Objective This study aimed to analyze the clinical efficacy of the Jianpi Shengxue tablet for treating renal *** A total of 200 patients with renal anemia from December 2020 to December 2022 were enrolled and randomly divided into two *** in the control group were treated with polysaccharide-iron complex,and those in the experimental group were administered Jianpi Shengxue *** 8 weeks of continuous treatment,the therapeutic outcomes regarding anemia were compared between the two *** After treatment,the red blood cell(RBC)count,hematocrit(HCT),reticulocyte percentage(RET),ferritin(SF),serum iron(SI),transferrin saturation(TSAT),and serum albumin(ALB)all increased(P<0.01),and the clinical symptom score and total iron binding capacity decreased(P<0.01)in the experimental ***,the improvements in RBC,HCT,RET,SF,SI,TAST,ALB,and clinical symptoms(fatigue,anorexia,dull skin complexion,numbness of hands and feet)in the experimental group were significantly greater than those in the control group(P<0.05).The total effective rate for treating renal anemia was significantly higher in the experimental group than in the control group(P<0.01).Conclusion The Jianpi Shengxue tablet demonstrates efficacy in treating renal anemia,leading to significant improvements in the laboratory examination results and clinical symptoms of patients with renal anemia.

关键词： Jianpi Shengxue tablet renal anemia randomized open parallel control multicenter clinical study

Anti-vascular endothelial growth factor drugs combined with laser photocoagulation maintain retinal ganglion cell integrity in patients with diabetic macular edema: study protocol for a prospective, non-randomized, controlled clinical trial

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Neural Regeneration Research 2024年第4期19卷 923-928页

作者： Xiangjun Li Chunyan Li Hai Huang Dan Bai Jingyi Wang Anqi Chen Yu Gong Ying Leng department of Ophthalmology Affiliated Hospital of Beihua University department of endocrinology Affiliated Hospital of Beihua University

The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting *** major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser ***,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many *** might result from the incomplete recovery of retinal ganglion cell ***,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision *** this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their *** patients will be followed up for 12 *** primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after *** secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after *** measure is the incidence of adverse events at 1,3,6,9,and 12 months after *** study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up *** trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal

关键词： choroidal thickness diabetic macular edema laser photocoagulation retinal ganglion cell-inner plexiform layer thickness retinal ganglion cells retinal nerve fiber layer thickness thickness of the macular area vascular endothelial growth factor visual acuity

Targeted therapies for lupus nephritis:Current perspectives and future directions

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Chinese Medical Journal 2024年第1期137卷 34-43页

作者： Xiuzhi Jia Yuewen Lu Xunhua Zheng Ruihan Tang Wei Chen department of nephrology The First Affiliated HospitalSun Yat-Sen UniversityGuangzhouGuangdong 510080China NHC Key Laboratory of Clinical nephrology(Sun Yat-Sen University) and Guangdong Provincial Key Laboratory of NephrologyGuangzhouGuangdong 510080China

Lupus nephritis(LN),a severe manifestation of systemic lupus erythematosus,poses a substantial risk of progression to end-stage renal disease,with increased *** therapy for LN relies on broad-spectrum immunosuppressants such as glucocorticoids,mycophenolate mofetil,and calcineurin *** therapeutic regimens have evolved over the years,they have inherent limitations,including non-specific targeting,substantial adverse effects,high relapse rates,and prolonged maintenance and remission *** drawbacks underscore the need for targeted therapeutic strategies for *** advancements in our understanding of LN pathogenesis have led to the identification of novel therapeutic targets and the emergence of biological agents and small-molecule inhibitors with improved specificity and reduced *** review provides an overview of the current evidence on targeted therapies for LN,elucidates the biological mechanisms of responses and failure,highlights the challenges ahead,and outlines strategies for subsequent clinical trials and integrated immunomodulatory approaches.

关键词： Lupus nephritis Molecular targeted therapies Adaptive immunity Immunity,Innate Cytokines

Experience of humanistic nursing in hemodialysis nursing for patients with diabetic kidney disease

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World Journal of Diabetes 2024年第2期15卷 186-195页

作者： Xiao-Ying Chai Xiao-Yan Bao Ying Dai Xing-Xing Dai Yu Zhang Yu-Ling Yang department of nephrology The Affiliated Hospital of Jiangnan UniversityWuxi 214000Jiangsu ProvinceChina department of Hemodialysis The Affiliated Hospital of Jiangnan UniversityWuxi 214000Jiangsu ProvinceChina department of endocrinology The Affiliated Hospital of Jiangnan UniversityWuxi 214000Jiangsu ProvinceChina

BACKGROUND Diabetic kidney disease(DKD)is a prevalent complication of diabetes that often requires hemodialysis for *** the field of nursing,there is a growing recognition of the importance of humanistic care,which focuses on the holistic needs of patients,including their emotional,psychological,and social ***,the application of humanistic nursing in the context of hemodialysis for DKD patients remains relatively *** To explore the experience of humanistic nursing in hemodialysis nursing for DKD *** Ninety-six DKD patients treated with hemodialysis from March 2020 to June 2022 were included in the study and divided into the control cluster(48 cases)and the study cluster(48 cases)according to different nursing methods;the control cluster was given routine nursing and the study cluster was given humanized *** variances of negative emotion mark,blood glucose,renal function,the incidence of complications,life mark and nursing satisfaction before and after nur-sing were contrasted between the two *** No significant difference in negative emotion markers between the two clusters were observed before nursing(P>0.05),and the negative emotion markers of the two clusters decreased after *** Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale markers were lower in the study cluster than the control *** healing rate of patients in the study cluster was significantly higher than the control cluster(97.92%vs 85.42%,P0.05).However,after nursing,blood urea nitrogen and serum creatinine(SCr)levels in the study cluster were lower than those in the control cluster(P<0.05).The incidence rate of complications was significantly lower in the study group compared to the control cluster(6.25%vs 20.83%,P<0.05).There was no significant difference in the life markers between the two clusters be

关键词： Diabetic kidney disease Hemodialysis Humanistic nursing Incidence of complication Effect

Effect and Safety of Herbal Medicine Foot Baths in Patients with Diabetic Peripheral Neuropathy:A Multicenter Double-Blind Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2024年第3期30卷 195-202页

作者： HUANG Hao-yue LIN Yu-ping WEI Hua FU Yu ZHOU Yue-hong FANG Zhao-hui QIU Xiao-tang WANG Mei LI Qing-bo LI Shan-shan WANG Shi-dong DAI Fang LIU Zhen-jie ZHAO Ling WEN Jian-xuan WU Li-yan ZENG Hui-yan ZHANG Jin-ming LU Qi-yun HE Liu SONG Wei SUN Lu LUO Lu-lu HE Jia-li XIE Wen-wen LIANG Qing-shun HUANG Yuan ZHU Sheng-ling LONG Jie-er GAO Zhi-juan WEN Ze-huai LI Chun-ji OUYANG Wen-wei LI Geng WU Ming-hui LI An-xiang HUANG Jin-zhu Sanjoy K Paul TANG Xian-yu FAN Guan-jie department of endocrinology Guangdong Provincial Hospital of Chinese MedicineGuangzhou510120China The Second Clinical College of Guangzhou University of Chinese Medicine Guangzhou510120China department of endocrinology The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou510120China Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou510120China department of endocrinology The First Affiliated Hospital of Henan University of Chinese MedicineZhengzhou450000China department of endocrinology Liuyang Hospital of Chinese MedicineChangsha410000China department of endocrinology The First Affiliated Hospital of Anhui University of Chinese MedicineHefei230000China department of endocrinology Hainan Provincial Hospital of Traditional Chinese MedicineHaikou570100China department of endocrinology The Affiliated Hospital of Liaoning University of Traditional Chinese MedicineShenyang110000China department of Geriatric Luoyang No.1 Hospital of Traditional Chinese MedicineLuoyangHenan Province471000China department of endocrinology The Second Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuiyang550000China department of endocrinology Beijing University of Chinese Medicine Affiliated Dongzhimen HospitalBeijing100000China department of endocrinology The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuiyang550000China Melbourne EpiCentre The University of Melbourne and Melbourne HealthMelbourne3013Australia

Objective:To evaluate the effect and safety of foot baths with Tangbi Waixi Decoction(TW)in treating patients with diabetic peripheral neuropathy(DPN).Methods:It is a multicenter double-blinded randomized controlled *** with DPN were recruited between November 18,2016 and May 30,2018 from 8 hospitals in *** patients received basic treatments for glycemic *** received foot baths with TW herbal granules either 66.9 g(intervention group)or 6.69 g(control group)for 30 min once a day for 2 weeks and followed by a 2-week rest,as a therapeutic *** the Toronto Clinical Scoring System total score(TCSS-TS)6 points,the patients received a total of 3 therapeutic courses(for 12 weeks)and were followed up for 12 *** primary outcome was change in TCSS-TS score at 12 and 24 *** outcomes included changes in bilateral motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the median and common peroneal *** was also ***:Totally 632 patients were enrolled,and 317 and 315 were randomized to the intervention and control groups,*** the 12-week intervention,patients in both groups showed significant declines in TCSSTS scores,and significant increases in MNCV and SNCV of the median and common peroneal nerves compared with pre-treatment(P0.05),and no serious adverse event was related with ***:Treatment of TW foot baths was safe and significantly benefitted patients with DPN.A low dose of TW appeared to be more effective than a high dose.(Registry *** CTR-IOR-16009331)

关键词： diabetic peripheral neuropathy herbal medicine foot baths Chinese medicine randomized controlled trial Tangbi Waixi Decoction

Chinese expert consensus on the clinical application of sodium-glucose cotransporter 2 inhibitors in patients with chronic kidney disease

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Chinese Medical Journal 2024年第11期137卷 1264-1266页

作者： The Expert Group of Chinese Expert Consensus on the Clinical Application of Sodium-glucose Cotransporter 2 Inhibitors in Patients with Chronic Kidney Disease Fan Fan Hou Chuanming Hao Min Zhang Chuanming Hao 不详 department of nephrology Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510515China Division of nephrology Huashan HospitalFudan UniversityShanghai 200040China

The prevalence of chronic kidney disease(CKD)in China was 8.2%in 2018-2019.[1]CKD may progress to end-stage kidney disease(ESKD),necessitating kidney replacement treatment such as dialysis or kidney transplantation,[2]which imposes a substantial burden on both family and ***,patients with CKD have a high risk of comorbidities including cardiovascular diseases.[3]The risk of death rises as the estimated glomerularltration rate(eGFR)declines.[3]A substantial portion of CKD patients die,primarily from cardiovascular events,before reaching the stage requiring dialysis.[3]As such,delaying the progression of CKD and reducing cardiovascular events are key elements in patient *** recent years,important progress has been made in the cardiorenal protection of patients with ***cally,the advent of sodium-glucose cotransporter 2(SGLT2)inhibitors has provided a new and important approach for the treatment of CKD.

关键词： kidney patients dialysis

Application and management of continuous glucose monitoring in diabetic kidney disease

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World Journal of Diabetes 2024年第4期15卷 591-597页

作者： Xin-Miao Zhang Quan-Quan Shen Geriatric Medicine Center Department of EndocrinologyZhejiang Provincial People's Hospital(Affiliated People's HospitalHangzhou Medical College)Hangzhou 310014Zhejiang ProvinceChina Urology and nephrology Center Department of NephrologyZhejiang Provincial People’s Hospital(Affiliated People’s HospitalHangzhou Medical College)Hangzhou 310014Zhejiang ProvinceChina

Diabetic kidney disease(DKD)is a common complication of diabetes mellitus that contributes to the risk of end-stage kidney disease(ESKD).Wide glycemic var-iations,such as hypoglycemia and hyperglycemia,are broadly found in diabetic patients with DKD and especially ESKD,as a result of impaired renal *** is essential to monitor glycemia for effective management of *** A1c(HbA1c)has long been considered as the gold standard for monitoring glycemia for>3 ***,assessment of HbA1c has some bias as it is susceptible to factors such as anemia and liver or kidney *** glucose monitoring(CGM)has provided new insights on glycemic assessment and *** directly measures glucose level in interstitial fluid,reports real-time or retrospective glucose concentration,and provides multiple glycemic *** avoids the pitfalls of HbA1c in some contexts,and may serve as a precise alternative to estimation of mean glucose and glycemic *** studies have demonstrated the merits of CGM for precise monitoring,which allows fine-tuning of glycemic management in diabetic ***,CGM technology has the potential for better glycemic monitoring in DKD *** research is needed to explore its application and management in different stages of DKD,including hemodialysis,peritoneal dialysis and kidney transplantation.

关键词： Diabetic kidney disease Continuous glucose monitoring Glycemic monitoring Hemodialysis Peritoneal dialysis Kidney transplantation