Abstract Objective : To evaluate the efficacy and safety of minimally invasive percutaneous nephrolithotomy(MPCNL) standard channel percutaneous nephrolithotomy(SPCNL) in the treatment of kidney stones. Methods: We searched pubmed, Cochrane Liabrary, CNKI, VIP , Wangfang database from January 1, 1992 to April 1, 2015. Screening of the two methods of treatment of kidney stones randomized controlled trials (RCT) and quality assessment, using revman5.2 software for statistical analysis. Results: A total of nine RCT, 1017 patients, 508 cases in MPCNL group, 509 cases in SPCNL group. The results show: the stones clearance , MPCNL group was lower than SPCNL group [ OR= 0.62, 95%CI(0.43, 0.91), P= 0.01]; in terms of operative time, MPCNL group was longer than SPCNL group [MD = 14.23 , 95% CI (6.30, 22.16), P = 0.0004]; hospitalization time, blood loss, total complications, were no significant difference between the two group, the results are [MD = 0.88, 95% CI (-0.69 , 2.44), P = 0.27], [MD =-19.87, 95% CI (-64.36, 24.61), P = 0.38], [ OR= 1.28, 95%CI(0.90, 1.84), P= 0.17]. Conclusion: the stone clearance rate:MPCNL group was lower than SPCNL group, the operative time of MPCNL group was longer which may affect postoperative recovery, the complications, hospital stay, blood loss, the two groups had no significant difference. So , we tend to standard channel percutaneous nephrolithotomy in the treatment of common type of kidney stones.

Abstract Objective: To investigate   the changes of insulin resistance index [Homa-IR (CP)]  in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at different stages of glomerular filtration rate (eGFR), and to analyze the relationship between them. Methods:  From January 2015 to June 2019, 1013 patients with T2DM and CKD were admitted to Mudanjiang Cardiovascular Disease Hospital Diabetes Branch Hospital (grade three grade a hospital). The general conditions of the patients were collected, and the biochemical indexes were measured by the laboratory department of our hospital. After calculating the HOMA IR (CP) and EGFR values according to the obtained data, the patients were divided into five groups according to the CKD grouping criteria: 0 ~ 15 ml·(min·1. 73m 2 ) -1  for group A, 15 ~ 30 ml·(min·1. 73m 2 ) -1  for group B, 30 ~ 45 ml·(min·1. 73m 2 ) -1  for group C, 45 ~ 60 ml·(min·1. 73m 2 ) -1  for group D and 60 ~ 90 mL·(min·1. 73m 2 ) -1  for group E. The relevant data were statistically analyzed by SPSS software.  Results: (1) There   was a negative correlation between EGFR and HOMA IR (CP) in T2DM patients with CKD (r = - 0.25, P = 0.000). (2) The comparison results between HOMA IR (CP) groups showed that there was significant difference between group A and group B and other groups, and there was significant difference between group C and group D and other groups (P0.05). (3) The pairwise comparison between fasting blood glucose groups showed that there was significant difference between group A and group B (LSD-t = -1.74, P = 0.034). There was significant difference in insulin dosage between group A and other groups (P0.05), and there was significant difference between group D and group E (LSD-t = 0.06, P = 0.005). (4) Logistic analysis of EGFR showed that age, serum creatinine and HOMA IR (CP) were the main influencing factors of EGFR (P0.05). Conclusion: there is a significant negative correlation between EGFR and HOMA IR (CP) in T2DM patients with CKD. In the process of aggravating insulin resistance, EGFR increased more significantly in the two stages of 45 ~ 60 ml·(min·1. 73m 2 ) -1  and 15 ~ 30 ml·(min·1. 73m 2 ) -1 .

Abstract Chronic kidney disease(CKD)is now a global public health problem. In chronic kidney disease(CKD)patients，almost all have complications such as calcium and phosphorus metabolism disorders，hyperparathyroidism，cardiovascular disease，anemia，and inflammation，which seriously affect the progress and prognosis of CKD. Fibroblast growth factor 23(FGF23) is a bone-derived hormone that regulates the metabolism of phosphate and vitamin D. In the past，FGF23 was generally considered to play only an important role in the regulation of calcium and phosphorus metabolism. In recent years FGF23has been found to be associated with the occurrence or progression of various CKD complications. This opens up new horizons for studying the role of FGF23 in the course of chronic kidney disease. FGF23 is expected to become a new therapeutic target in the future，improving the prognosis of patients with CKD. This article will review the biological characteristics of FGF23 and its role in the progression of CKD.  And briefly discuss its potential future role in chronic kidney disease.

Abstract Objective:  To   investigate the protective effect of two - myricetin (DMY) on diabetic nephropathy (DN) and its effect on renal fibrosis. Methods: the DN model was established by intraperitoneal injection of high-dose (55 mg · kg -1 ) streptozotocin (STZ). The model was successfully established with blood glucose > 16.7 mmol · L -1 . The rats were randomly divided into normal group, model group and low, medium and high dose DMY group (125, 250 and 500 mg · kg -1 ). DMY group was administered by gavage, and the model group was administered by normal saline for 12 weeks. The contents of 24h urinary protein (24h-Pro), blood urea nitrogen (BUN) and blood creatinine (SCR) were detected by biochemistry. He staining was used to observe the morphological changes of kidney in each group, PAS staining was used to observe the changes of basement membrane thickness of renal tissue in each group, and Masson staining was used to observe the degree of glomerulosclerosis and renal interstitial fibrosis in each group. TGF in renal tissue of rats in each group was detected by Western blot- β1. Expression level of Smad2 and Smad7. Results: compared with the normal group, the contents of 24h pro, bun and SCR in DN model group were significantly increased (P < 0.01). Compared with the model group, the contents of 24h pro, bun and SCR in each dose of DMY group decreased (P < 0.01). The pathological results showed that the renal tissue of the model group showed increased glomerular volume and glue more

Abstract Objective: To explore the feasibility of dynamic monitoring based on renal function indexes to evaluate the efficacy and safety indexes of vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in elderly patients, and to provide reference for the evaluation of the feasibility of vancomycin pharmaceutical care. Methods:  118 elderly patients with MRSA pneumonia treated from March 2017 to February 2020 were divided into routine treatment group ( n =56) and intervention group ( n =62). Patients in the routine treatment group were treated with routine vancomycin, while patients in the intervention group flexibly adjusted the dosage of vancomycin according to the dynamic monitoring of endogenous creatinine clearance (CCR), blood creatinine (SCR) and urea nitrogen (BUN). The changes of CCR, SCR and BUN and the difference of vancomycin serum. Valley concentration were compared between the two groups before and after vancomycin treatment, and the correlation between the changes of CCR, SCR and BUN and vancomycin serum. Valley concentration was analyzed to explore the difference of clinical efficacy and adverse reaction rate between the two groups after treatment.  Results : Two factor analysis of variance showed that the serum trough concentrations of SCR, bun and vancomycin in the intervention group were significantly lower than those in the routine treatment group, but the CCR value was significantly higher than that in the routine treatment group ( P <0.05). Pearson correlation analysis showed that the serum. Valley concentration of vancomycin was negatively correlated with CCR ( r =-0.473), but positively correlated with SCR ( r =0.537) and bun ( r =0.619) ( P  < 0.05) more.