The purpose of this study was to investigate the age and gender characteristics of 24-h urinary protein/creatinine ratio (24hUPCR) and urinary microalbumin/creatinine ratio (UMACR) among Chinese children and other related factors, and to establish preliminary reference ranges. A total of 200 healthy children aged 2–15 years were enrolled. We divided the subjects into twelve groups according to age. Kruskal–Wallis one-way ANOVA test and Spearman correlation analysis were used to compare 24hUPCR and UMACR with other variables and 95

Chronic rhinitis and its associated persistent nasal obstruction and mouth breathing are core factors leading to the development of characteristic “rhinitis face” or “adenoid facies” in children and adolescents. This review elucidates the diverse clinical manifestations of “rhinitis face,” including: persistent open-mouth posture; abnormal patterns of facial skeletal growth, such as midface hypoplasia and increased lower anterior facial height resulting in “long face syndrome”; alterations in jaw morphology and position, including maxillary constriction, high-arched palate, and mandibular retrognathia or posterior-inferior rotation; and various dentoalveolar malocclusions, such as proclined maxillary incisors, lip incompetence, narrow dental arches, and open bite. Additionally, these include characteristic periorbital skin changes, such as “allergic shiners” (dark circles under the eyes due to venous stasis or pigmentation), Dennie-Morgan lines (infraorbital folds associated with atopy), and, in some patients, eyelash trichomegaly (increased eyelash growth) potentially due to chronic inflammation. The nose may also exhibit a transverse nasal crease (the “allergic salute” sign) from repetitive rubbing. This paper delves into its pathophysiological mechanisms, emphasizing that mouth breathing patterns triggered by chronic nasal airway obstruction are the initiating factor. This alters the equilibrium of orofacial muscle forces, interferes with normal tongue posture and function, and affects the normal growth trajectory of the maxillofacial skeleton. Combined with local inflammatory responses and mechanical stimuli, these factors collectively contribute to the development of these complex facial characteristics. Clinical assessment requires a comprehensive approach including medical history, detailed physical examination, and various ancillary investigations such as nasal endoscopy, imaging studies (x-ray, CT, CBCT), cephalometric analysis, nasal patency tests, and allergen testing. “Rhinitis face” not only affects aesthetics but can also lead to severe maxillofacial skeletal deformities, dental malocclusions, temporomandibular joint dysfunction, and sleep-disordered breathing. It can also profoundly impact respiratory physiology, exercise tolerance, speech clarity, psychological well-being, and quality of life. Its long-term effects can persist into adulthood, although skeletal adaptive changes diminish after growth cessation. Regarding gender differences in its prevalence, existing data suggest that upstream factors (such as obstructive sleep apnea) may have a higher prevalence in males, and the impact of mouth breathing on facial morphology might exhibit sex-specific differences. However, the overall sex ratio for “rhinitis face” remains inconclusive. Concerning the notion that rhinitis causes enlarged eyes, there is currently no scientific evidence to support an actual increase in eyeball size. The perception of “larger eyes” is more likely a visual contrast effect due to allergic shiners, Dennie-Morgan lines, and possible mild eyelid edema. Regarding public opinions about finding “rhinitis face in girls” attractive, this review emphasizes the lack of scientific basis for such views, which are more likely subjective perceptions or cultural phenomena. Medically, “rhinitis face” is considered a pathological condition requiring active intervention. Management strategies for affected children emphasize a multidisciplinary approach, including early diagnosis and active treatment of the primary nasal pathology (e.g., allergic rhinitis, adenoidal hypertrophy), correction of improper mouth breathing habits through methods like orofacial myofunctional therapy, and, when necessary, intervention by orthodontists or maxillofacial surgeons (e.g., rapid maxillary expansion, fixed orthodontic treatment). This review aims to provide clinicians with a comprehensive understanding of “rhinitis face” to facilitate its early recognition, standardized diagnosis and treatment, and comprehensive management.

Background Qingre huazhuo tang (QRHZT) is a traditional Chinese medicine decoction that has been used clinically by traditional Chinese medicine masters for more than 50 years with good results. However, its mechanism is unknown, and further elucidation is necessary. Aim of the study To verify the mechanism by which QRHZT regulates IgA nephropathy through immune checkpoints and ferroptosis by combining network pharmacology, single-cell sequencing and experimental studies. Materials and methods The single-cell sequencing data obtained from podocytes of immunoglobulin A (IgA) nephropathy (IgAN) patients were screened, and the QRHZT target information was obtained from the ETCM database. Moreover, the KEGG, GSEA, immune checkpoint and ferroptosis data were analyzed and plotted using R language. Finally, the relevant immune checkpoint and ferroptosis targets were validated experimentally. Results QRHZT can regulate IgAN through the immune checkpoints FIT, FTH1, AKR1C3, and IL6 and the ferroptosis-related genes PVR and IFNG. Conclusion QRHZT has the potential to regulate IgAN, and omics strategies combined with network pharmacology is a feasible method for exploring the mechanisms of traditional Chinese medicines.

Background Fibrinogen(FIB)is often elevated in children with Henoch Schonlein purpuric nephritis(HSPN),but the correlation between FIB and renal lesions has been less studied.Objective To explore the correlation between FIB in children with HSPN and the International Study Group on Pediatric Kidney Disease(ISKDC)pathology grading and micropathological changes in parts of renal units,and to clarify whether FIB can assess the severity of renal injury in children with HSPN.Methods In total,922 children with HSPN who were hospitalized in the First Affiliated Hospital of Henan University of Chinese Medicine in the pediatric nephrology ward and underwent kidney biopsy at the same time from December 2017 to December 2022 were collected,and the clinical information,FIB and renal pathological information during renal biopsy were summarized,and based on the FIB level,the children were categorized into group A(low)<2.38 g/L,group B(standard)2.38-4.98 g/L,and group C(high)>4.98 g/L.The correlation between FIB and ISKDC pathological grades,glomerular mesangial hyperplasia ratio,the crescentic bodies ratio and the nature of the glomerular lesions from acute to chronic was investigated by Spearman rank correlation analysis,and the prediction of FIB on the micropathological changes of renal units was analyzed by the subject's work characteristic(ROC)curve.Results Among 922 children with HSPN who had undergone renal biopsy,the FIB was(3.48±1.01)g/L.113 cases in group A had a low FIB rate of 12.26%;734 cases in group B had a standardized FIB rate of 79.61%;and 75 cases in group C had a high FIB rate of 8.13%.The ISKDC pathology classification was type Ⅱa in 173 cases(18.76%),type Ⅱb in 29 cases(3.15%),466 cases(50.54%)of type Ⅲa,232 cases(25.16%)of type Ⅲb,and 22 cases(2.39%)of type Ⅳ and above(including 2 cases of type Ⅳa,18 cases of type Ⅳb,and 2 cases of type Ⅴ).The results of the Spearman's rank correlation analysis showed that the FIB and the grouping of the FIB of the children with HSPN were positively related to the renal pathology ISKDC grading(rs=0.146,P<0.001;rs=0.129,P<0.001).911(98.80%)of 922 children with HSPN were mesangial proliferative,and 655(71.04%)had crescentic hyperplasia.Spearman rank correlation analysis showed a weak positive correlation between FIB and FIB subgroups and the rate of mesangial hyperplasia(rs=0.092,P=0.005;rs=0.096,P=0.003),and a positive correlation with the rate of crescentic bodies(rs=0.132,P<0.001;rs=0.830,P=0.012).922 children with HSPN had glomerular acute lesions in 763 cases(82.75%),acute chronic lesions in 97 cases(10.52%),and chronic lesions in 62 cases(6.73%).In addition,FIB gradually increased with the nature of the glomerular lesions from acute to chronic(rs=0.145,P<0.001).At the same time,comparison of some renal biopsy indexes FIB in HSPN children showed statistically significant difference(P<0.05).The ROC curves showed that the FIB had the highest sensitivity for glomerulosclerosis(sensitivity=0.900,specificity=0.303),and the optimal cutoff value for FIB was 2.835 mg/L;the area under the ROC curve(AUC)of FIB for the positive prediction of tubulointerstitial fibrosis=0.623,and that of FIB for the reverse prediction of tubulointerstitial cellular granulomatous degeneration=0.641.Conclusion FIB can be used as a laboratory index reflecting the severity of renal pathological changes in patients with HSPN,can reflect the severity of renal pathological grading,is closely related to irreversible lesions according to renal microscopic indicators such as glomerular sclerosis and balloon adhesion,and can assist clinical diagnosis and treatment.

雷公藤是迄今为止免疫抑制作用最可靠的中药之一,被广泛应用于多种儿科疾病的治疗,但其不良反应特别是性腺毒性在很大程度上限制了在临床的使用.作为中医用药法则,"有故无殒"思想体现了"以毒攻毒"和"辨证论治"的中医治则和理念,为正确合理地认识雷公藤治疗作用与性腺毒性提供了思路,雷公藤对儿童性腺的影响既要权衡近期影响,也要考虑远期转归.大量临床研究及实验研究表明,雷公藤的性腺损害大多是"可逆"的,临床上通过采取合理的防治措施,雷公藤对儿童性腺的毒副作用是可以预测和预防的.

目的 了解全日制中医儿科学专业硕士研究生教育情况现状,并提出相应改进措施.方法 采用问卷调查的方式,对某高校中医儿科学2018-2020级硕士研究生的教育情况及培养质量进行调查研究.结果 中医儿科学专业硕士研究生教育质量整体评价良好,在课堂教学方面,68％(89/131)的学生认为教师认真负责,严格按照培养方案规定学时授课;74％(97/131)的学生认为导师对学生的专业和学术指导最重要,37％(49/131)的学生认为导师应加强对学生科研工作方面的指导,85％(111/131)的学生与导师交流每周至少1次;55％(72/131)学生参加各种形式的学术会议,参与学术交流积极性高;30％(39/131)的学生认为学术氛围对研究生质量影响较大,而32％(42/131)的学生则认为学术氛围需要改善,72％(94/131)的学生认为应该在课程学习阶段、科研论文阶段和临床实践阶段加强审核制度.结论 中医儿科学专业研究生教育和培养的质量较高,但在课程内容设置、科研能力培养和临床实践等方面需加以完善.

糖皮质激素性骨质疏松(glucocorticoid-induced osteoporosis,GIOP)是儿童常见的继发性骨质疏松症.因其影响儿童骨骼的正常发育,导致生长发育障碍,降低患儿生活质量,逐渐在世界范围内受到广泛关注.GIOP归属于中医"骨枯""骨痿"范畴,其产生与"肾气热"密切相关.肾为水脏,水不胜火,则热灼精枯,骨失濡养发而为病.糖皮质激素属阳刚燥烈之品,为GIOP发病的源头,过用可出现热盛阴虚的证候,与"肾气热则骨枯髓减"所述病机相吻合.本文基于此理论,结合现代医学研究探讨GIOP的中医发病机制,以期为临床辨证治疗提供思路.

Henoch-Sch?nlein purpura nephritis （HSPN） in children is an immune disorder disease characterized by skin purpura accompanied by hematuria with or without proteinuria. Because of an increasing incidence rate， its treatment and prevention are gradually attracting greater attention. According to its clinical symptoms， the disease is classified as "purpura wind，" "edema，" and "turbid urine，" and it is believed that collaterals are involved in the occurrence of the disease. As a microstructure that cooperates with the collaterals to perform the functions of kidney filtration and circulation of qi， blood， and body fluids， the kidney xuanfu also plays an important role in the pathological process of HSPN. If the opening and closing of the kidney xuanfu are orderly， and the collaterals are circulating smoothly， the kidney function is normal， the renal collaterals are not disturbed by evil factors， and the disease only manifests as skin purpura. If the opening and closing of the kidney xuanfu are not controlled properly， and the collaterals are blocked， the renal collaterals will be damaged， which will lead to the occurrence of HSPN. In view of this， this article proposes that the occurrence and development of HSPN can be divided into three stages: （1） the collaterals are pathogenic， and the kidney xuanfu is open; （2） the collaterals are empty， and the kidney xuanfu is not controlled; and （3） the xuanfu is closed， the collaterals and blood exhibit stasis， and fire generates and phlegm is obstructed. In addition， our team initially explored the treatment principles and methods of HSPN based on the principle of "calming the collaterals and clearing the xuanfu"， "nourishing the collaterals and regulating the xuanfu"， and "opening the collaterals and channels" from the perspective of "the opening and closing of the kidney xuanfu， and the dredging and blocking of collaterals"， with a view to providing new ideas for clinical treatment.

腹型过敏性紫癜是以腹部疼痛为主要表现的免疫紊乱性小血管炎性疾病,甚者可并发急腹症,严重危害患儿身心健康,目前认为其发病机制与"肠道微生态-免疫炎症"失调有关.糖皮质激素是西医推荐的首选用药.近年来中医药治疗本病疗效日渐显著,但具体机制不明.故本文从中医"阳明"为切入点,阐释肠道"微生态-免疫炎症"失衡与"阳明有余"二者之间的联系与内涵,为中医药靶向"微生态-免疫炎症"治疗和预防腹型过敏性紫癜提供新的研究思路.

目的 基于文献挖掘探讨中药减轻雷公藤雌性生殖毒性的规律分析,为临床合理用药、规避药物不良反应提供参考.方法 以"雷公藤、中草药、生殖"为主题,检索自1981年1月1日-2022年8月31日中国知网、万方、维普、中国生物医学文献数据库及PubMed、Cochrane Library、Embase数据库中相关研究文献,建立数据库,人工筛选文献,用Excel 2021数据透视表统计中药的药味、药性、归经和功效分类,用SPSS Modeler 18.0及SPSS Statistics 26.0软件进行可视化分析.结果 归纳总结符合纳入标准的43篇文献,共涉及84味减轻雷公藤雌性生殖毒性的中药,使用频率≥1％的有熟地黄、菟丝子、当归、枸杞子等28味中药,性味归经以甘、辛、苦3味,温、平、微温3性,肝、肾、脾3经占据前3,补阳药占21.88％,补血药占16.96％,补阴药占12.50％,补气药占10.49％,活血调经药占9.15％.药物关联分析得出21个常用药物组合.对频率≥1％的28味中药进行聚类分析,得出7个新处方.结论 雷公藤雌性生殖毒性的减毒用药规律中,熟地黄-菟丝子是高频药物中最常用的制约雷公藤雌性生殖毒性的药对.

Immunosuppressants are widely used in the treatment of rheumatic immune diseases, but most of them have toxic side effects, causing damage to the immune, digestive, reproductive and other systems, not only reducing patient compliance, but also seriously affecting disease prognosis. At present, Western medicine has no clear solution for the toxic side effects of immunosuppressants. The theory of traditional Chinese medicine（TCM） states that immunosuppressants such as glucocorticoids and cytotoxic drugs are mainly aggressive products. Long-term use of immunosuppressants can damage the lung, spleen and kidney, damage the vital qi of the body, and lead to deficiency symptoms occur. “Treating deficiency with three sources and two systems” is the great method developed by Wang Qishi, a doctor in the late Ming Dynasty, to treat deficiency and fatigue. After continuous enrichment and development in later generations, this has become a classic theory for treating consumption diseases. We studied the toxic side effects of immunosuppressants from the perspective of “treating deficiency with three sources and two systems”. We believe that the symptom of consumption caused by immunosuppressants should be treated from the “three sources” of lung, spleen and kidney, and the two types of syndromes of kidney yin deficiency and kidney yang deficiency should be treated from the “two systems” of lung and spleen. In clinical practice, we can determine the corresponding treatment principles according to different system’s injury syndromes, so as to provide a TCM scheme for safe clinical drug use and expand the theoretical system of toxicity reduction based on TCM.

全球人工智能技术持续发展并迎来巨大变革.ChatGPT已熟知人类所有已知公共知识(包括医学),使用手势、眼球运动及语音进行交互的混合现实(MR)设备Vision Pro也进入普及阶段.在教育智能化的时代基础上,我们有理由推测,基于人工智能及混合现实技术的新型教育模式正逐步成型,且正在挑战传统的教育模式.基于MR与人工智能(AI)的学生与教师、学生与学生、学生与AI、AI与教师沉浸式学习正可直接跨越空间和时间壁垒.虚拟病人模拟接诊、用药、手术全过程的全过程教育医学教育模式可极大缩短医学培训时间,医学教育正逐步走向智能化和高效化.但仍需要注意,医学教育工作者需持续学习以适应新的教学模式.总之,本文阐述了虚拟现实及人工智能对传统医学教育的挑战与变革,并且提出医学教育工作者应直面人工智能的时代潮流,尽快提升专业素质和多学科合作能力,为未来的变革做好充分准备.

Background: We determined the effects of Cuscutae semen (Cuscuta chinensis Lam. or Cuscuta australis R. Br.)–Radix rehmanniae praeparata (Rehjnannia glutinosa Libosch.) on the protein levels in testicular tissues of rats gavaged with tripterygium wilfordii multiglycosides (GTW) and elucidated the molecular mechanism underlying Cuscutae semen–Radix rehmanniae praeparata for relieving GTW-induced reproductive injury.Methods: A total of 21 male Sprague–Dawley rats were randomly divided into the control group, model group, and Cuscutae semen–Radix rehmanniae praeparata group based on their body weights. The control group was given 10 mLkg−1 of 0.9% normal saline by gavage daily. The model group (GTW group) was administered with 12 mg kg-1 GTW by gavage daily. Cuscutae semen–Radix rehmanniae praeparata group (the TSZSDH group) was administered with 1.56 gkg−1 of Cuscutae semen–Radix rehmanniae praeparata granules daily according to their model group dosing. The serum levels of luteinizing hormone, follicle-stimulating hormone, estradiol, and testosterone were measured after 12 weeks of continuous gavage, and the pathological lesion of testicular tissues was observed. Differentially expressed proteins were evaluated by quantitative proteomics and verified by western blotting (WB) and Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR).Results: Cuscutae semen–Radix rehmanniae praeparata can effectively relieve pathological lesions of GTW-induced testicular tissues. A total of 216 differentially expressed proteins were identified in the TSZSDH group and model group. High-throughput proteomics revealed that differentially expressed proteins are closely associated with the peroxisome proliferator-activated receptor (PPAR) signaling pathway, protein digestion and absorption, and protein glycan pathway in cancer. Cuscutae semen–Radix rehmanniae praeparata can significantly upregulate the protein expressions of Acsl1, Plin1, Dbil5, Plin4, Col12a1, Col1a1, Col5a3, Col1a2, Dcn, so as to play a protective role on testicular tissues. Acsl1, Plin1, and PPARγ on the PPAR signaling pathway were verified by WB and RT-qPCR experiments, which were found to be consistent with the results of proteomics analysis.Conclusion: Cuscutae semen and Radix rehmanniae praeparata may regulate the PPAR signaling pathway mediated Acsl1, Plin1 and PPARγ to reduce the testicular tissue damage of male rats caused by GTW.

丁樱教授认为,儿童肾病综合征属本虚标实,关键病机为禀赋不足,外邪入里,虚实夹杂,正虚以肺脾肾阳虚为主,标实以外感、水湿、湿热、瘀血为要,重视瘀血在本病中的关键作用;辨证论治时需谨记阴中求阳、阳中求阴、血水相依、风激水浊等关键点.治疗的重点应放在温阳化瘀上,提出"激清扬浊,调和阴阳"的治疗原则,在准确辨证的基础上,针对不同兼证,综合运用疏风清热、祛湿通络等法以扬浊,缓解尿浊症状,尽可能减少精微流失,减轻其对机体正气的损害;整个治疗过程关键在于调整阴阳,使阴平阳秘,清源洁流,增强肺脾肾水液代谢功能,减少病情反复.同时创新应用雷公藤多苷.并以现代研究成果为佐证,极大地提高了临床疗效.

Objective We aimed to（i） observe the effects of Shuangbu Pill（a compound prescription of prepared Rehmannia root and dodder seed） on reproductive damage induced by tripterygium glycosides in rats and（ii） explore its regulatory mechanism by metabolomic analysis.Methods Using the random number table method, 21 male 4-week-old Sprague-Dawley rats were randomly divided into the normal group, the tripterygium glycosides group（12.5 mg/kg）, and the Shuangbu Pill group（3.125 g/kg）（7 rats per group） and gavaged continuously for 12 weeks. The serum levels of testosterone（T）, follicle stimulating hormone（FSH）, luteinizing hormone（LH）, and estradiol（E 2 ） were measured by ELISA; sperm density and sperm motility were measured by an automatic sperm quality analyzer; histopathological changes of the testis and epididymis were observed by HE staining; ultrahigh-performance liquid chromatography coupled with tandem time-of-flight mass spectrometry combined with multivariate statistical method was used to detect and identify testicular tissue metabolites; and the Metabo Analyst platform was used for metabolic pathway analysis.Results Compared with the tripterygium glycosides group, the Shuangbu Pill could increase serum T levels（P＜0.01）, improve the sperm density and sperm motility（P＜0.01）, increase the number of spermatogenic cells in testicular tissue, reduce spermatogenic cell cavitation, and increase the number of epididymal sperm. According to our metabonomic analysis, after treatment with Shuangbu Pill, the levels of 19 differential metabolites related to reproductive damage caused by tripterygium glycosides could be significantly restored, which are mainly involved in glutathione metabolism and glycerophospholipid metabolism.Conclusion Shuangbu Pill can significantly reduce the reproductive damage caused by tripterygium glycosides, possibly through regulating glutathione metabolism and glycerophospholipid metabolism.

Objective To investigate the safety and efficacy of a traditional Chinese medicine（TCM） treatment of pediatric Henoch-Sch9nlein purpura nephritis（HSPN）（proteinuria below the nephrotic level）.Methods This study was a prospective multicenter stratified randomized controlled trial. In total, 316 children diagnosed with HSPN were divided into the Chinese medicine group（mild: n=132; severe: n=83） and the Western medicine group（mild: n=60; severe: n=41）. Patients in the Chinese medicine group were treated with tripterygium wilfordii multiglucoside + sulfotanshinone sodium injection+Qingre Zhixue Formula, the starting dose of tripterygium wilfordii multiglucoside for the Chinese medicine mild group was 1.5 mg/（kg·d）, while that for the Chinese medicine severe group was 2 mg/（kg·d）. Patients in the Western medicine mild group were treated with low-molecular-weight heparin calcium + benazepril + dipyridamole + a TCM simulator. In addition, patients in the Western medicine severe group received prednisone. The patients were treated for 12 weeks and followed up for 36 weeks. The urinary protein levels and urinary red blood cell（RBC） count were investigated in the 4th week and the 12th week. In addition, the recurrence rate at the end of 48 weeks of follow-up was calculated, and the incidence of adverse events at the end of 12 weeks of treatment was calculated.Results The urinary protein levels in the Chinese medicine group, the Chinese medicine mild group and the Chinese medicine severe group at the 4th week and the 12th week were significantly lower than in the Western medicine group, the Western medicine mild group and the Western medicine severe group（P＜0.01）. The urinary RBC counts in the Chinese medicine group, the Chinese medicine mild group and the Chinese medicine severe group at the 4th week and the 12th week were significantly lower than in the Western medicine group, the Western medicine mild group and the Western medicine severe group（P＜0.01）. No significant difference in recurrence rate was found between the Chinese medicine group and the Western medicine group, between the Chinese medicine mild group and the Western medicine mild group, or between the Chinese medicine severe group and the Western medicine severe group. The incidence of adverse events was lower in the Chinese medicine group than in the Western medicine group, and it was lower in the Chinese medicine severe group than in the Western medicine severe group（P＜0.01）, but there was no significant difference between the Chinese and Western medicine mild groups.Conclusion Chinese medicine alone can be used to reduce urinary protein levels and urinary RBC counts in both mild and severe HSPN. The effect of Chinese medicine on proteinuria was quicker than that of Western medicine, and the incidence of adverse events was significantly lower in the Chinese medicine group than in the Western medicine group. The stepwise Chinese medicine scheme, which is mainly based on tripterygium wilfordii multiglucoside combined with Qingre Zhixue Formula, shows an excellent curative effect and fewer adverse events, indicating it is worthy of clinical promotion.

Immunoglobulin A (IgA) vasculitis (IgAV), also known as Henoch-Schönlein purpura, is the most common form of childhood vasculitis. It is characterized by cutaneous hemorrhage, resulting from red blood cell leakage into the skin or mucosae, possibly caused by damage to small blood vessels. These acute symptoms usually disappear without treatment. Endothelial cells are distributed on the inner surfaces of blood vessels and lymphatic vessels, and have important functions in metabolism and endocrine function, as well as being the primary targets of external stimuli and endogenous immune activity. Injury to endothelial cells is a feature of IgA vasculitis. Endothelial cell damage may be related to the deposition of immune complexes, the activation of complement, inflammatory factors, and chemokines, oxidative stress, hemodynamics, and coagulation factors. Both epigenetic mechanisms and genetic diversity provide a genetic background for endothelial cell injury. Here, research on the role of endothelial cells in allergic IgA vasculitis is reviewed.

目的:探讨清热止血方联合雷公藤多苷治疗紫癜性肾炎患儿的临床疗效,为临床应用提供依据.方法:收集紫癜性肾炎患儿45例,使用中央随机系统按1:2分为对照组15例,观察组30例,对照组给予贝那普利联合双嘧达莫治疗,观察组给予清热止血方联合雷公藤多苷治疗,疗程12周,观察2组患儿治疗4、8、12周的临床疗效及不良事件发生率,Elisa法检测血清可溶性血管内皮生长因子受体(soluble vascular endothelial growth factor receptor,sFlt)-1、血管性血友病因子(von Willebrand factor,vWF)的变化.结果:治疗4周观察组降低蛋白尿疗效高于对照组,差异有统计学意义(P<0.05);2组治疗8、12周降低尿蛋白疗效比较差异无统计学意义(P>0.05).观察组与对照组在治疗12周时血清sFlt-1、vWF水平均较治疗前显著下降(P<0.05);观察组在治疗4周时,血清sFlt-1表达水平较对照组明显下降(P<0.05),2组患儿治疗期间均有轻度不良事件发生,组间比较差异无统计学意义(P>0.05).结论:清热止血方联合雷公藤多苷能有效降低紫癜性肾炎患儿尿蛋白量,下调血清sFlt-1、vWF水平,与对照组比较起效更快且无明显不良反应.

This study systematically searched CNKI and Web of Science(WoS) for the research papers on the toxicity of Tripterygium wilfordii included from database inception to August 31, 2021, and visually displayed the authors, research institutions, keywords, and other contents using bibliometrics and CiteSpace 5.8.3. Furthermore, the current situation and research progress on T. wilfordii safety were also analyzed based on information extraction to find the research hotspot, evolution path, and development trend, and to provide references for future research. A total of 1 876 Chinese papers and 243 English papers were included in the study. The analysis of authors showed that WANG Qi and ZHANG Luyong had the most publications in Chinese and English papers, respectively. According to the analysis of research institutions, National Institutes for Food and Drug Control and China Pharmaceutical University possessed the largest number of Chinese and English papers, respectively, but there was less cooperation between them. The analysis of keywords in Chinese and English papers showed that the research contents of the safety of T. wilfordii mainly focused on clinical monitoring, mechanism, dosage form improvement, quality standard, component analysis, monomer research, efficiency and toxicity reduction, etc. Metabonomics, tripterine, and the underlying mechanism of toxicity were the research hotspots in the future. At present, the research on the toxicity of T. wilfordii is still under development. It is necessary to highlight the in-depth research and strengthen the inter-group and inter-region cooperation of authors or institutions to provide references for the research on the toxicity of T. wilfordii.

目的:搜集整理多年来中医药治疗紫癜性肾炎的中英文文献,以了解演变过程及研究热点,为研究本病提供参考.方法:检索中国知网及Web of Science自建库至2021年9月28日已发表的中医药治疗紫癜性肾炎的国内外相关文献,运用CiteSpace 5.8.R3软件对研究作者、机构及关键词等内容进行可视化图谱显示,并结合文献查阅对中医药治疗紫癜性肾炎的研究热点及发展趋势进行分析.结果:经过筛选,最终纳入中文文献1263篇,英文文献448篇.张君、SUZUKI分别是中英文发文量最多的研究作者;辽宁中医药大学、福岛县立医科大学分别是中英文发文量最多的研究机构;研究显示机构之间缺少良好的交流合作;对中医药治疗紫癜性肾炎的中、英文文献里的关键词分析,主要表现在发病人群、临床表现、肾脏病理分型、治疗方案、结局及预后,中文文献更加强调中医药的应用,例如儿童发病,症见皮肤紫癜、血尿,治则为活血化瘀、清热解毒,用药为雷公藤等,英文文献更注重实验室检查,例如凝血功能、牛津分型、结局及预后等.结论:图谱直观展示了自1976年至2021年9月28日中医药治疗紫癜性肾炎近45年的研究情况,明确了当前中医药治疗紫癜性肾炎领域的研究现状及趋势,但是仍存在一些研究不足,需更进一步深入研究并且加强作者及机构间的合作,为今后研究紫癜性肾炎提供可靠依据.