Tuesday, April 29, 2008

Lupus nephritis and prognosis of the factors relevant »

So far, the prognosis of lupus nephritis and ethnic origin, gender and age have not yet found a clear relationship. Most scholars believe that the large number of proteinuria with nephritis syndrome, high blood pressure, treatment has increased serum creatinine poor prognosis. Pathological changes and the prognosis is most closely connected, the type and type Ⅱ generally do not develop end-stage renal disease; Ⅲ of disease activity can have development, but the response to treatment, and 5-year survival rate up to 75.8%; Ⅳ multi-condition Critical, but if timely and correct treatment of 5-year survival rate of 80%, 10-year survival rate 60%; Ⅴ-proliferation is not clear when the prognosis with the same primary membranous nephropathy, but with clear or obvious The proliferative lesions prognosis is poor, and similar type Ⅳ.

Purpura nephritis symptoms

Purpura nephritis symptoms: ① kidney, performance: in half of the patients prior to the onset of one to three weeks with upper respiratory tract infection, almost all cases have characteristics of the symmetry of hemorrhagic rash, urticaria at the beginning of the kind, and then into the skin for high-purple spots Dian, more common in the lower limbs stretch side and buttocks, rash can be repeated within a few months. 60% of the patients have abdominal pain, blood in the stool; about 30% of patients on pain, especially knee and the ankle joint. Some cases of kidney damage in the first rash. Adult gastrointestinal symptoms such as systemic performance may not obvious. ② kidney damage performance: About 40 percent of patients with glomerular damage, more than eight weeks after Purpura there. But may also occur in 2 years later, even before the rash. Henoch-Schonlein purpura kidney damage characterized by hematuria, with mild proteinuria. Clinical performance can be as follows: ① acute nephritis syndrome: accounting for about 30%. ② radical nephritis syndrome: rare. In a few weeks to several months to progress uremia. ③ asymptomatic hematuria and (or) proteinuria syndrome: about 50% of the disease. ④ nephrotic syndrome: about 10% of adults, children see more. ⑤ some patients can develop chronic nephritis syndrome.

Tuesday, April 22, 2008

How is neonatal hepatitis treated?

There is no specific treatment for neonatal hepatitis. Vitamin supplements are usually prescribed and many infants are given medications which improve bile flow. Formulas containing fats more easily digested by the body are also given.
Can neonatal hepatitis be spread to others?
Infants with neonatal hepatitis caused by the cytomegalovirus, rubella or viral hepatitis may transmit the infection to others who come in close contact with them. These infected infants should not come into contact with pregnant women because of the possibility that the woman could transmit the virus to her unborn child.

What complications are associated with neonatal hepatitis?

Infants with neonatal hepatitis caused by rubella or cytomegalovirus are at risk of developing an infection of the brain that could lead to mental retardation or cerebral palsy. Many of these infants will also have permanent liver disease due to the destruction of liver cells and the resulting scarring (cirrhosis).
The majority of infants with giant cell hepatitis will recover with little or no scarring to the liver. Their growth pattern will also normalize as bile flow improves. However, about 20 per cent of affected infants will go on to develop chronic (ongoing) liver disease and cirrhosis. In these children, the liver becomes very hard due to scarring, and the jaundice does not dissipate by six months of age. Infants who reach this point in the disease eventually require a liver transplant.
Infants with chronic neonatal hepatitis will not be able to digest fats and absorb fat soluble vitamins (A, D, E and K) as a result of insufficient bile flow and the damage caused to liver cells. The lack of vitamin D will lead to poor bone and cartilage development (rickets). A deficiency in vitamin A may affect normal growth and vision. Vitamin K deficiency is associated with easy bruising and a tendency to bleed, whereas the lack of vitamin E results in poor coordination. Since bile is responsible for the elimination of many toxins in the body, chronic neonatal hepatitis can also lead to a buildup of toxins in the blood which in turn may result in itching, skin eruptions and irritability.

Sunday, April 20, 2008

The differential diagnosis of acute gastritis

An acute gastritis has served corrosive strong acid (sulfuric acid, hydrochloric acid, nitric acid), alkali (sodium hydroxide, potassium hydroxide), such as history or to Sool. After serving digestive tract caused by burns in the mouth, throat, sternum, and after intense abdominal pain, With swallowing pain, Yanxia difficulties, frequent nausea and vomiting. In serious cases can be hematemesis, Xuchu mucosal blood-Rot, in prostration, shock or cause of esophageal and gastric perforation symptoms, mouth, throat, there will be contact with the inflammation, congestion, edema, erosion, stripping mucosal necrosis, or ulcer see black, white crust. Second, the disease of acute appendicitis early on, there may be abdominal pain, nausea, vomiting, but with the condition progress gradually shift right lower quadrant pain and tenderness and fixed-Tiaotong more with fever, increased leukocyte, neutrophil significantly increased. Third, cholecystitis, cholelithiasis have recurrent abdominal pain, often right upper quadrant mainly radiotherapy to the right shoulder could be back. Check the attention of the sclera, skin jaundice. Right upper quadrant tenderness, Do's levy positive, can be touched or enlarged gallbladder. Quantitative of red blood bile and urine contribute to the diagnosis of biliary 3. Four other Lobar Pneumonia, such as the early stage of myocardial infarction may have varying degrees of abdominal pain, nausea, vomiting. If asked in detail about medical history, physical examination and the necessary support inspection, it is not difficult to identify.

Simple causes of acute gastritis

Acute gastritis can be simple chemicals, physical factors, microbial infection or bacterial endotoxin caused. Gastric mucosal lesions mainly for its congestion, edema, mucus secretion increased, the surface covered with a white or yellow exudate, with a hemorrhage and mild erosion, the incidence of acute gastritis simple more intense, mainly on the performance of abdominal discomfort, pain, loss of appetite, nausea and vomiting. Due to pathogenic infection accompanied with acute enteritis and diarrhea, Qizhou pain, fever can be heavy, water, acid poisoning, or even shock. Shorter duration of the disease is self-limited. Its main principles for medical treatment wipe out the causes and symptomatic treatment, and reasonable use of antibiotics to rectify water, electrolyte imbalance, etc..

Wednesday, April 9, 2008

How early detection of osteonecrosis of the femoral head?

X-ray diagnosis of shares femoral head necrosis convenient, fast, the economy is an important means of the hospital routine. However, as the X-ray imaging of the three-dimensional density changes into two-dimensional images, the density of penetrating ray imaging superimposed on the film, this will result in lesions and normal minor regional differences in the gray, early identification pathological changes not easy delaying treatment. Huangkeqi professors and experts invention of "necrosis of the femoral head image machine", overcome by different X-ray imaging conditions, contrast and brightness changes, caused by the error on bone mineral density distribution. Information through enhanced, high-pass filtering, histogram enhanced, such as cluster segmentation processing, improve detection of the image, made up MRI in the diagnosis of necrosis of the femoral head of the non-specific and not visible in the image texture and morphology of bone deficiencies. And the X-ray films converted into standard eye image identifiable information, the two-dimensional human body in space in the projection of overlapping images can not fully display the information through different image processing techniques show the ultrastructure of the femoral head Pathological changes in bone mineral density and bone morphology and quantitative analysis of the extent of lesions and make early diagnosis.

Osteonecrosis of the femoral head within the duration of symptoms

Also known as aseptic necrosis of the femoral head necrosis of the femoral head and avascular necrosis, which is common Clinical Orthopedics and refractory chronic diseases of the femoral head necrosis due to the hip injury, and long-term use of hormone drugs , alcoholism and other reasons, the blood supply of the femoral head caused obstacles, the femoral head is not normal bone tissue nutrition, in the femoral head to the bone cells, bone marrow hematopoietic cells, fat cells necrosis. As necrosis of the bone tissue fragile, and the need to load the hip, so time will be in the femoral head collapse, all the affected hip.
Early symptoms: low back pain, the affected hip pain, the affected groin pain, limb knee pain, limb chills, activities for a long time weakness, pain, fatigue. These symptoms can not at the same time, it was a 12 symptoms or several symptoms disappear after a short period of time, many times. This is the early symptoms of necrosis of the femoral head should be promptly to the hospital for CT, MRI, or ECT, can be found necrosis of the femoral head. X-ray film is not able to early diagnosis. When the X-ray change, the condition has been achieved in the late, late for some. Early necrosis of the femoral head because the X-ray can see around the femoral head to reduce blood circulation, osteoporosis, a small amount of cystic change. Therefore, X-ray generally can not rely on early detection. Nevertheless, at this moment due to increased pressure within the femoral head, limb pain more obvious each part is often misdiagnosed as diseases such as rheumatism Yaochuibing knee, pain treatment, a number of commonly used analgesics or closed therapy, the symptoms disappeared, or that the illness , resulting in misdiagnosis, the development of advanced illness, which delayed the treatment of patients with the best opportunity. Mid-femoral head necrosis, very obvious symptoms, the main line Quinuclidinyl limp excuses? Function occurred obstacles photographed, X films, will see the majority of the trabecular bone loss, cystic changes, bone sclerosis, femoral cartilage fracture collapse. Advanced femoral head necrosis in patients with more severe limp, was obviously short legs, walking difficulties, pain, X-ray to see the femoral head flat, collapse, joint space narrowing or disappeared, cystic change Obviously, the larger bone sclerosis, Unit bone cartilage completely broken, the articular surface roughness.

Monday, April 7, 2008

Diagnosis of acute hepatitis B how slow

Acute hepatitis B (1) can epidemiological history or blood transfusion, blood products or other drug injection (2) clinical manifestations of acute hepatitis (3) liver function tests, particularly ALT, AST increased, or may be associated with accompanied by increased bilirubin (4) acute phase: HBsAg positive, can be accompanied by a short HBeAg and HBV-DNA or DNAP positive high-titer anti-HBc.IgM positive, positive anti-HBc.IgG low titer; (5) recovery: HBsAg and anti-HBc.IgM low titer (down), and finally negative. Anti-HBc.IgG titer increased, there were anti-HBs.
Chronic Hepatitis B (1) There may be a history of acute hepatitis (often not obvious), (2) clinical performance and abnormal liver function over six months or more (3) HBsAg positive sustained over six months, with the total anti-HBc antibody and the IgG antibody positive activities such as anti-HBc.IgM period can be a medium, and low positive titer (4) HBeAg and HBV-DNA and DNAP positive or negative and the three former anti-HBe positive (5) for liver biopsy further defined chronic persistent hepatitis, chronic active hepatitis or chronic lobular hepatitis. Asymptomatic carriers of HBsAg without any clinical signs and symptoms of hepatitis, liver function was normal, sustained HBsAg positive for more than six months.

Hepatitis caused by a number of factors which

Hepatitis means inflammation of the liver. Inflammation of the liver caused many reasons, there are common.
(1) virus infection: hepatitis virus caused by a combination. Infectious strong, and to disseminate complex, a wide range of prevalence, incidence rates high. At present the main points of viral hepatitis A, B, C, D and E hepatitis five, and in recent years have found hepatitis and hepatitis G. Including Hepatitis A and E are self-limited, and generally not to chronic, minorities can develop liver cirrhosis. Chronic hepatitis B and closely related to the occurrence of primary hepatocellular carcinoma.
(2) The drug or chemical poisons: Many drugs and toxic chemicals can cause liver damage in hepatitis drugs or toxic hepatitis. Statins such as dual-vinegar phenol, methyl-dopa, tetracycline and arsenic mercury, such as carbon tetrachloride. On the degree of damage depends on the liver drug or toxic chemical exposure dose or taking the time, as well as the quality of individual differences. Long-term use or repeated contact with drugs and toxic chemicals can lead to chronic hepatitis, cirrhosis and even.
(3) Alcohol: Alcohol can cause hepatitis. Mainly due to alcohol (ethanol) and its metabolites in the liver toxicity of acetaldehyde directly damage the cells. According to research, if all day drinking alcohol content of more than 150 g, continuing for more than five years, 90% of liver damage can occur in 10 years or more are about 34% in chronic hepatitis, about 25 per cent of the development of liver cirrhosis . Europe and the United States alcoholics more, all alcoholic cirrhosis of the liver cirrhosis about 50% to 90%. In China the situation is better.
(4) Other: Many infectious diseases are systemic violations of the liver, such as the EB virus, bacterial diseases, such as typhoid fever in, can cause increased serum transaminase or other abnormal liver function. However, these diseases have their own special performance, and inflammation of the liver disease is only a part of performance is not difficult diagnosis of multiple, less misdiagnosed as "hepatitis."
In short, hepatitis is a name, including many different causes of hepatitis. But day-to-day because of the most common viral hepatitis, we are most familiar with it, and the hepatitis usually referred to as "the hepatitis."

Friday, April 4, 2008

Pay attention to what life chronic nephritis

(1) establish and confidence in the fight against the disease: chronic nephritis longer course, easily repeated attacks, patients should be encouraged to strengthen the confidence in the fight against the disease, and closely cooperate with treatment, overcome disease.
(2) rest and work: Once the patients were diagnosed as chronic nephritis, in the beginning stages, regardless of the severity of symptoms, should rest mainly to active treatment, regular follow-up observation of changes of the disease. If conditions improve, edema dissipated, blood pressure returned to normal or near normal urine protein, red blood cells and various micro-management, stable renal function, three months after beginning work in the light, to avoid more manual work, the prevention of respiratory tract and urinary tract infection occurred. Activity should be increased gradually, slowly, in order to promote physical recovery. Where there hematuria, proteinuria, edema, or hypertension, or to patients with renal dysfunction should be bed rest and active treatment.
(3) diet: acute exacerbation of chronic nephritis, edema, or hypertension should be limited to the amount of salt per day for 2 to 4 g suitable. A high degree of edema, should be controlled in the following 2 g daily, salted fish, all kinds of pickles should be Jiyong, to be dissipated after edema of sodium to gradually increase. Apart from a significant edema, water quantity should not be restricted. Plasma protein without azotemia should be low-protein diet, daily protein in 60 ~ 80 g or higher. Azotemia there should be restrictions on the total intake of protein, 40 g following day, supply of essential amino acids rich in high quality protein, the total calories should be 0.146 kJ / kg body weight around, restaurants pay attention to nutritional supplements and vitamins, fruits and vegetables unlimited.

Family Emergency Treatment of Acute Nephritis

Acute nephritis (acute nephritis) refers to a secondary to hemolytic streptococcus B infection caused by glomerular allergic diseases, occurs in children and youth, clinical manifestations of edema, hypertension, hematuria, less urine, or even a few, there may be symptoms of renal failure.
[Causes]
Many secondary to hemolytic streptococcus B infection caused by allergic disease.
[Clinical]
Chen Qi facial swelling, severe cases can affect the body, accompanied oliguria or microscopic hematuria, blood pressure increased, there will be a small number of acute renal failure.
[Diagnosis]
(1) occurs in children and youth.
(2) prior to the onset of 1 to 3 weeks accompanied hemolytic streptococcus infection As of respiratory tract infection, pharyngitis and tonsillitis, scarlet fever and skin diseases such as abscess.
(3) swelling, oliguria, hematuria and elevated blood pressure and other clinical manifestations.
(4) in the urine routine urine was red meat, the higher the proportion of protein-positive, there is much more RBC, WBC and various type.
(5) elevated serum creatinine and urea nitrogen.
(6) ESR and anti-"O" elevated.
(7) in the blood and urine of fibrin degradation products (FDP) increased.
(8) total serum complement, erythrocyte, by the decline of solutions.
[Diagnosis]
(1) chronic nephritis
Past have edema, polyuria and nocturia history, the sustainability of increased blood pressure, often anemia, heart and fundus changes will help identification.
(2) acute pyelonephritis
Onset of intense, accompanied by chills, high fever, low back pain, frequency, urgency and Niaotong symptoms, and urine test can Nongxibao and cultivate bacteria growth can help identification.
[Family Emergency Treatment]
(1) absolute bed rest until hematuria disappeared, edema dissipated, blood pressure returned to normal, normal serum creatinine, gradually increasing the volume of activities.
(2) edema, hypertension should be strictly bogey salt, to be back to normal blood pressure, edema can be dissipated Shaoyan diet.
(3) do not have to strictly limit the quantity of drinking water, but should not be drinking water.
(4) should be a daily protein intake by 1 g / kg body weight given, azotemia, high-quality animal protein daily to 20 grams.
(5) grams of oral dihydrochloride urine thiadiazole, such as a diuretic reserpine, and hypotension.
(6) appear to be serious complications quickly rushed to hospital.

Not married patients with chronic nephritis

More from chronic nephritis transformed from acute nephritis, long course, and the illness was complex and changeable, there are decreased renal function should be active treatment to control disease development. Patients with chronic nephritis more very weak constitution, if the marriage knot, marriage condition will become more complex and will therefore increase the illness. Kidney disease is not a hereditary disease, renal function is not able-bodied persons born children will not be physically healthy, such children physiques poor, the weak resistance, and low immune function, the risk of autoimmune disease, even if growth , in the future may also be a "ears, eyes and renal syndrome," features several organs in this emerging disease, which is obviously not in keeping with the promotion of the "eugenics" requirement.
Patients with chronic nephritis, we must establish the confidence to overcome the disease, even after treatment, the symptoms have seen marked improvement, but also to be alert to prevent repeated illness, said that the disease has not been thoroughly cured before, in any case should not have to be married , or for their own health is extremely detrimental to small, no more happiness to speak.
Seen in this light, chronic nephritis patients in the clinical symptoms disappeared completely, check the data returned to normal, before the effect of the consolidation will not consider the matter of marriage, even if the urine test protein, RBC, WBC, the cells are negative, renal function returned to normal, the body does not have any positive signs, we should not hurry to get married, should be well maintained their own bodies, pay attention to diet to make: the selection of appropriate activities, and moderate physical exercise, enhanced physique, and prevent relapse, the disease "made a comeback", after a number of years to be fully recovered physically, then no later than the establishment of small families, this is undoubtedly the next generation of their own and are beneficial, such marriages can really happy.

Edema in patients with acute nephritis

Acute nephritis patients mainly due to reduced glomerular filtration, and the tubular reabsorption still function normally, and normal renal tubular reabsorption of water amounted to 99% of the sodium, potassium, urea, uric acid, also in varying degrees the re-absorption, thus Shuinazhuliu. In addition, the increased systemic vascular permeability, plasma protein infiltrated organizations gap is a factor. In addition, there are people who think that when acute nephritis edema occurred, the main body is increased capillary permeability, fluid extravasation results. There is also the view that the formation of edema caused by heart failure and hypertension-related.

Variable chronic nephritis acute nephritis?

Acute nephritis patients, if obvious edema, high blood pressure, Niaoshao, red blood cells in urine, bed rest is necessary. If edema dissipated, blood pressure normal, gross hematuria disappeared, it can get out of bed activities, and activities of daily living. Get out of bed activities, if edema not continue to occur, no longer elevated blood pressure, red blood cells in urine is no longer increasing, we can gradually increase the volume of activities, until the means to do something, to not feel that the principle of exhaustion. At this point, needs to be emphasized bed rest.
The general inspection of urine over 90 per cent of acute nephritis are self-healing, a few persistent Fuyu and become chronic. In recent years both at home and abroad large number of scientific data to show that, whether acute nephritis become chronic nephritis, mainly depends on the rest is not good or bad, but by nephritis pathological types calendar decision. So Narita bed rest, some still to chronic nephritis.

Hereditary Nephritis clinical features

Hereditary nephritis, called Alport syndrome, is a single-gene genetic diseases. There are three main characteristics of the disease, chronic kidney disease, eye and ear disorders disorders. However, not all patients at the same time there are three performance.
Kidney damage is the most prominent manifestations of hematuria, almost all patients with hematuria history, a microscope or gross hematuria. Generally not heavy proteinuria, a rare nephrotic syndrome. Chronic renal function was conducted damage.
Ear disease in high-frequency nerve deafness as the main feature, more bilateral deafness, but it can also be unilateral, early, hearing test can be found, and then gradually increase, the majority of deaf patients with renal injury parallel .
Although there may be the eye disease multiple lesions, but now that only the former spherical concave lens and macular centre around the dense yellow or white particulate performance characteristics of the disease. The latter has been seen in chronic renal dysfunction patients.
In addition to the above diseases, individual parents have also found that children with other organ systems (including nerves, muscles, blood, endocrine and metabolism of amino acids) anomaly, some of them unusual (such as the giant platelet disease) may be an integral part of the disease , and some other abnormality may coexist with the disease caused other genetic diseases, gene studies to be clarified.

Chronic nephritis and the relationship between pregnancy

Generally speaking, the activities of chronic nephritis, chronic nephritis with strict child hypertension, chronic renal insufficiency fertility of women not because of the treatment of chronic nephritis resort is of great significance. Fuyu pregnancy can protracted illness, or even worsening of the illness, the rapid decline of renal function. Chronic nephritis activity period, that is in addition to protein in urine, there is more red blood cells, white blood cell, the type of blood test that reduced complement C3, said that an unstable condition, the immune response are still active, at this time of pregnancy fiery Shangjiao oil, to worsening of the illness.
A large number of chronic nephritis proteinuria not pregnancy, pregnancy may decline to plasma albumin, and lead to serious edema, increased blood volume, high blood pressure can lead to heart failure.
Patients with blood pressure greater than 150/100 mm Hg, not fertility, pregnancy such patients prone pregnancy-induced hypertension, can cause hypertensive encephalopathy, eclampsia, stillbirth, but also can cause heart failure, acute renal failure, postpartum hemorrhage the incidence is also high.
Chronic nephritis with chronic renal insufficiency, not fertility. Renal dysfunction women after pregnancy, and kidney may be overburdened in renal failure, a uremia, life-threatening. However, not all women are not chronic nephritis fertility, depending on the type of nephritis, and the severity of the conditions, circumstances and renal decision.
Some nephritis patients, such as occult chronic nephritis, nephrotic mild type, only a small amount of proteinuria, hypertension, renal dysfunction without, in the strict medical supervision can be allowed to observe the pregnancy. These patients must be regularly checked urine, blood pressure, and examine renal function, especially in the latter part of pregnancy should check 2nd weekly urine routine, daily blood pressure measurement, a check every 1-2 weeks renal function. If there is a substantial increase of urine protein and blood pressure significantly increased trend of decreased renal function should be the timely termination of a pregnancy.
After the pregnancy in patients with chronic glomerulonephritis, it is necessary to pay more attention to life conditioning, Bao Wang adequate rest and sleep. To be reasonable diet, guaranteed nutrition, adequate vitamin supplement to enhance physical fitness, reduce the chances of infection. Cold and warm attention should be paid to prevent upper respiratory tract infection, perineal attention to cleaning, to avoid sexual life, the opportunity to reduce urinary tract infection. Attention should be paid to early treatment of skin clean and dental caries.
Pregnant women with chronic nephritis, if edema, high blood pressure, should be strictly restricted salt intake, rest assured, and added protein and essential amino acids, and correct hypoproteinemia. For high blood pressure, should be selected on renal blood flow had no effect on blood pressure drugs, such as nifedipine, such as captopril. To avoid the use of kidney damage drugs such as gentamycin, streptomycin, kanamycin, sulfonamides medicines, such as aspirin.
Harmonious family life, marital solicitude and care is conducive to the stability and chronic nephritis rehabilitation. Laoyijiege attention, the law of life, sex life should be modest, bogey over exertion. For Concealed nephritis patients, long-term use of some Bushen Gujing Chinese medicine, Ruzuo naturalization pills, Liuweidihuangwan to increase Buzhongyiqi pills, the stabilization benefits.

How treatment Henoch-Schonlein Purpura Nephritis how prognosis?

Henoch-Schonlein Purpura Nephritis majority of the patients are children tend to self-limited, mild symptoms, not special treatment. But in the acute phase should pay attention to warm, bed rest, suspended all suspicious allergy drugs and food, to avoid contact with suspicious allergens. If there can be allergy drug of allergy symptoms (such as chlorpheniramine and diphenhydramine, Astemizole, etc.) symptomatic treatment. Other symptomatic treatment, including anti-infection, lower blood pressure and diuretic therapy. Effect of glucocorticoid on joint pain, abdominal pain and gastrointestinal symptoms have some therapeutic effect, the general use of prednisone 1-2 mg kg_1. D_1, can be used 1-2 weeks. Purpura severe skin can be used hydrocortisone or de-de-hydride succinic acid treatment. Generally believed that the damage to the kidney hormone had no significant effect, can not change Henoch-Schonlein Purpura Nephritis course and prognosis, we can not prevent the recurrence of purpura. But for a rapidly progressive glomerulonephritis syndrome onset of Henoch-Schonlein Purpura nephritis patients, consideration should be given timely use of high-dose methylprednisolone therapy, and to anticoagulant therapy and anti-platelet aggregation, about more than half of the patients effective treatment. Some people think that the performance of the nephrotic syndrome patients with Henoch-Schonlein Purpura Nephritis to use hormone therapy, although not of primary nephrotic syndrome, but the swelling and reduce proteinuria or have a certain effect. Poisons such as cells of the therapeutic effect of cyclophosphamide, and so was not sure. Allergic Purple paralysis nephritis Chinese medicine treatment for the Blood Circulation, mainly Qingrejiedu. Henoch-Schonlein Purpura Nephritis efficacy and clinical performance of the type and extent of the pathological changes are closely related. Minor lesions and better efficacy of acute nephritis, chronic glomerulonephritis type less effective; pathological changes to Ⅱ, Ⅲ type of effect is good. And Ⅳ, Ⅴ of poor treatment. Ⅳ pathological changes in the level and above should pay attention to the protection of renal function. Henoch-Schonlein Purpura Nephritis and the prognosis of patients with kidney closely related to the pathological changes. According to incomplete statistics, about 52% of the patients in the onset can complete remission within a year, 15% of sustainable existence gross hematuria and Victoria proteinuria (1_3 g / day), 18% of the patients with microscopic hematuria sustainable existence and microalbuminuria, no decline in glomerular filtration rate, only 5% of patients in the next few years can progress to chronic renal insufficiency. Some of the patients were children 10 years of follow-up, results showed that 70% -80% of the patients can complete remission, 15% of the patients have sustained renal lesions, 8% of the renal failure patients, and only 1% of patients die . , Henoch-Schonlein Purpura Nephritis affect the prognosis of the main factors: ① age: children with a better prognosis, adult-onset patients with poor prognosis; ② clinical performance: performance for the large number of proteinuria and hypertension associated with a poor prognosis; ③ kidney pathological changes: Some of the statistics Ⅳ more than 40% of patients can progress to chronic renal insufficiency, and the following type Ⅲ only 3 per cent of patients can progress to chronic renal insufficiency; is under the skin and endothelial immune complexes Deposition of patients, more immune complex is confined to the mesangial area, the prognosis is poor.

Lupus nephritis clinical prognosis and what are the factors?

So far, the prognosis of lupus nephritis and ethnic origin, gender and age have not yet found a significant relationship. Most scholars believe that proteinuria with nephritic syndrome, hypertension, treatment has been elevated serum creatinine poor prognosis. Pathological changes in the relationship between the prognosis and the closest, the type and type Ⅱ generally do not develop end-stage renal disease; type Ⅲ have disease activity development, but the response to treatment, and 5-year survival rate up to 75.8%; Ⅳ multi-condition Critical, but if timely and correct treatment of 5-year survival rates of 80%, 10-year survival rate of 60 percent without obvious Ⅴ-proliferation, with the prognosis of primary membranous nephropathy, but without obvious or more obvious hyperplastic lesions of the poor prognosis, and similar type Ⅳ.

How to diagnose lupus nephritis?

The incidence of lupus nephritis forms can be asymptomatic proteinuria / hematuria: acute nephritic syndrome, chronic nephritis syndrome, radical type nephritis, nephrotic syndrome, chronic renal insufficiency, and other performance. Immunological changes include anti-DNA antibodies and increased levels of autoantibodies, decreased serum complement and circulating immune complexes increased. Diagnosis of lupus nephritis now commonly used by American Rheumatism Association (ARA) 1982 revised diagnostic criteria: The following 11 indicators that meet four or more, and consist of seven. (1) of the Department of erythema flat or above the surface of the skin erythema fixed. (2) discoid erythema erythema uplift, and there keratosis Linxie hair follicle suppository, the old scar lesions were shrinking. (3) Light-sensitive sunlight caused skin allergies. (4) Oral Ulcer oral, nasal or throat painless ulcer. (5) arthritis two or more of the peripheral, non-erosive arthritis. (6) serositis pleurisy or pericarditis. (7) renal damage sustained over 0.5 g/24h proteinuria, or urine tube cells. (8) nervous system abnormalities epilepsy or mental disorders. (9) hematologic abnormalities hemolytic anemia, neutropenia, or thrombocytopenia, random checks more than 2 times. (10) immunological abnormalities lupus cells, anti-double-stranded DNA antibodies, anti-Sm antibodies, syphilis or serum test is a more than positive. (11) immunofluorescence test titer or similar abnormal exclude drug lupus syndrome.

Systemic Lupus Erythematosus kidney damage the pathological changes is how to type?

Lupus nephritis histological changes can be divided into activities of the indicators (A1) and chronic Index (CI). Glomerular lesions, activity indicators include: cell proliferation, cellulose necrosis, nuclear fragmentation, the cells of the crescent, transparent kind thrombosis, platinum ears like change and leukocyte infiltration, chronic indicators of glomerular sclerosis and Fibrous crescent. Tubulointerstitial lesions, activity index for mononuclear cell infiltration of indicators including chronic interstitial fibrosis and tubular atrophy. According to the 1982 WHO classification criteria, lupus nephritis by pathological changes differences divided into six types: Ⅰ type: normal glomerular A light microscope, electron microscopy and immunofluorescence no abnormal changes; B, normal light microscope, but immunofluorescence and / or electron microscopy mesangial area immune complex deposition. Type Ⅱ: mesangial lesions A, mesangial matrix widened with mild or mesangial cell proliferation B, in the middle of mesangial cell proliferation Ⅲ type: the focal segmental glomerular nephritis (with light or moderate mesangial lesions) A, including dynamic necrosis lesions B, and activities sclerosis lesions C, sclerosis lesions Ⅳ types: diffuse proliferative glomerulonephritis (mesangial - capillary proliferation / endothelial under extensive sediment) A, no nodular lesions B, including dynamic necrotizing lesions C, activities and hardening of the lesion D, sclerosis lesions Ⅴ type: membranous glomerulonephritis A, simple membranous nephropathy B, lesion with Type Ⅱ C, with Ⅲ lesions. D, with Ⅳ lesions Ⅵ type: sexual sclerosing glomerulonephritis

How lupus nephritis medication

Traditional treatment of lupus nephritis is the hormone drugs, but in recent years the clinical practice shows that use of the poison cell therapy, especially the use of cyclophosphamide for intermittent impact than simply using hormone therapy to better effect. Therefore, the treatment of lupus nephritis mainly cyclophosphamide plus hormone, rather than simply using hormone.
(1) hormone: general use of prednisone, the first stage before treatment, adult 1 mg / kg daily morning Dayton served until eight weeks after the issuance, by 5 mg per week, to small dose (1 mg of yesterday morning / kg) to Dayton next day morning service, according to the specific situation persists for a period of time, continue to better effect reductions until maintain volume (Overnight morning 0.4 mg / kg). Some people think that, lupus nephritis patients should be taking hormone life, the general amount of prednisone every other day morning serving 10 to 20 mg. It is worth noting that before the first dose of hormones must be adequate, inadequate dose (<30 mg / d) is often ineffective, glomerular lesions will continue to progress and become irreversible fibrosis caused by renal failure.
Fulminant or particularly serious illness, high fever up to 40 ℃, extensive rash and Purpura, proteinuria, can also be used large dose hormone therapy. If the unconditional use of methylprednisolone, dexamethasone used 150 mg / d instead, the effect good.
(2) cyclophosphamide: to curb the activities of lupus nephritis, stabilize its course, reducing hormone dosage, and specific antibody inhibited the effect particularly good, the elimination of lupus nephritis non-specific inflammation and T lymphoid cell-mediated immunity also good effect. Research shows that cyclophosphamide pulse therapy more sustainable and better use of fewer side effects. Foreign use of cyclophosphamide 0.75 ~ 1.0 g/m2 each body surface area, intravenous infusion every three months to a shock 1 At the same time, small dose oral prednisone. Improved domestic cyclophosphamide pulse therapy, please refer to the aforementioned related content.

Acute nephritis easily confused with the diseases

Early acute nephritis easily confused with the following diseases, should draw attention. (1) fever proteinuria can occur at any febrile illness. During the heat can be detected in urine protein and type, but very few red blood cells, no edema and hypertension. Heat Forward, urine abnormal rapid recovery. (2) any abnormal urinary infection caused by infections such as bacteria, viruses, particularly hepatitis B hemolytic streptococcus infection, about 1 / 3 of patients, there will be mild microscopic hematuria, a small amount of urine protein and the type, but no edema and hypertension, when infection control, urine inspection is back to normal. (3) focal glomerulonephritis generally occurs during infection (acute nephritis occurred in about two weeks after infection); focal nephritis with hematuria and proteinuria very light; cure infection, check urine of patients to return to normal, good prognosis. And the only light acute nephritis urine changes, but no edema and hypertension similar. (4) Movement abnormal urine after strenuous exercise (such as long-distance running, swimming, a quick march……) or over exertion, in the urine within a few hours there can be unusual - hematuria, proteinuria and type urine, but the rest 1-2 days (by less than 7 days) is back to normal. In the event of abnormal urine at the same time without edema and hypertension (individual may have temporarily hypertension). (5) lupus nephritis systemic lupus erythematosus caused kidney damage, and sometimes similar performance acute nephritis, accompanied rashes, hair loss, photosensitivity, joint pain and heart, liver, lung, brain and other organs of lesions, and there are fever, leukopenia, laboratory SM antibodies or anti-DNA antibodies and anti-nuclear antibody positive. (6) toxemia of pregnancy occurs late in pregnancy, patients edema, hypertension, proteinuria and possession of urine, can be serious in hypertensive encephalopathy, especially in the last month of pregnancy when the more obvious symptoms. However, the lack of hematuria is the main feature, and most of normal renal function, fundus that retinal artery spasm, bleeding, leakage and other changes, and after the vast majority of patients to return to normal. (7) primary nephrotic syndrome of acute nephritis with nephrotic syndrome and nephrosis are easily confused. The latter proteinuria (≥ 3.5 g / day) and hypoproteinemia features without hematuria, the former hematuria, no more than hypoproteinemia, differential points for kidney inspection, the former diffuse capillaries proliferative glomerulonephritis, which can be a minor disease or other chronic pathological changes in glomerular damage. (8) acute renal pelvis nephritis acute nephritis occurred if the urethra, bladder mucosa and kidney congestion and edema can cause bladder stimulation symptoms similar acute pyelonephritis. But pyelonephritis fever, hematuria, interleukin are more positive urine culture, effective antibiotic treatment, and no significant edema, hypertension, and other performance, nor red blood cells in urine tube. Shang Yi acute pyelonephritis and chronic nephritis acute confusion.

Caused acute exacerbation of chronic nephritis What are the reasons for the

Caused acute exacerbation of chronic nephritis main reasons: (1) bacterial or viral infections: This is the most common causes, particularly for upper respiratory tract infection (common cold), asymptomatic bacteriuria in, flu, laryngitis, bronchitis, and so can tracheal chronic 'symptoms increase nephritis . (2) over exertion include: over exertion (such as participating in vigorous exercise and heavy manual), Kaiyeche, and even the workers, and so on, may add conditions to chronic nephritis. (3) the use of kidney toxic drugs:--type drugs, gentamicin, and kanamycin such as streptomycin. (4) Stress: The so-called stress is that the body external to the overload of various reasons, such as sudden gastrointestinal bleeding, severe gastroenteritis, nausea, vomiting, diarrhea, low blood pressure, such as anaphylactic shock, more than the body can bear the stress capacity, it refers primarily to cater for the sudden adrenal cortex to stimulate the arrival of emergency to adjust the secretion of adrenal hormones such as. All kinds of stress that can be chronic nephritis acute exacerbation of the condition. (5) Other: water electrolyte imbalance, such as acid-base balance disorders may be caused by acute exacerbation of chronic nephritis. Usually in the role of the above reasons, the same day or a few days a similar clinical manifestations of acute nephritis, such as proteinuria, hematuria increase, edema, hypertension, oliguria, and even renal failure. If timely removal of aggravating factors, and to give the correct treatment, most patients can return to the previous state of acute renal function returned to normal. But may also be due to the above factors lead to heavier condition is deteriorating, and quickly entered the stage renal failure. Therefore, we must attach importance to clinical treatment of acute exacerbation of chronic nephritis various reasons.

The performance of children with acute nephritis

Yan also called acute nephritis acute glomerulonephritis, as a disease of the immune response after infection, and often secondary to the respiratory tract, or skin after streptococcal infection. Of course, most good prognosis of the disease and not leave any after-effects, but if the incidence of early handled properly, or some serious cases, may even chronic nephritis to renal failure, and endanger the lives of babies, we should arouse the attention. The disease often 1-4 weeks prior to the onset of acute tonsillitis, skin diseases such as impetigo pioneer infection. Began to have low-grade fever, dizziness, nausea, vomiting, poor appetite, and other symptoms, these symptoms of fever and general there is no difference between not easy to arouse people's attention, often overlooked. Oliguric swelling and the characteristics of this disease is generally swelling of the eyelid children first, gradually expanded body. Depression does not mean pressure, urine output, swelling decreased significantly, or even urine, about 1-2 weeks, a gradual increase urine output, swelling gradually dissipated. Most children with hematuria is invisible to the naked eye, and only a small number of patients with hematuria visible to the naked eye. Hematuria were some bright red color of meat like washing water, and some may wish tea color, and the pH of the urine, in the hope that the observation of children's urine should be mindful of this point. This generally visible to the naked eye in the hematuria disappear within 1-2 weeks. Hypertension is the performance of children with nausea, vomiting, dizziness, but if a rise in blood pressure too fast, there will be many serious complications. China's current urban medical and health conditions have been greatly improved, and the onset of acute nephritis, will be able to receive timely treatment, in the rare cases of serious city, but in remote rural areas still occur. These serious cases if not early detection and timely treatment, can lead children died. Early onset patients with urine significant decrease in the swelling increased, shortness of breath, heart rate accelerated, irritability, which can be rapidly deteriorating conditions, difficulty in breathing, can not supine and looking grey, cold extremities, and frequent cough, pink bubble-like Kachu sputum that children with heart failure have occurred. If children in the early onset severe dizziness, nausea, vomiting, and the emergence of a blindness, suddenly serious convulsions, coma, compared with the performance of hypertensive encephalopathy. Some serious cases in the early acute renal failure. These conditions, if not promptly addressed, the consequences would be unthinkable. When children have a section of the former suppurative tonsillitis or skin infection history, and in the phenomenon of swelling and oliguria, early diagnosis and treatment.

How to recognize children with acute nephritis

Also known as acute nephritis acute glomerulonephritis, as a disease of the immune response after infection, and often secondary to the respiratory tract, or skin after streptococcal infection. Of course, most good prognosis of the disease and not leave any after-effects, but if the incidence of early handled properly, or some serious cases, may even chronic nephritis to renal failure, and endanger the baby's life. 1-4 weeks prior to the onset of acute tonsillitis often, skin diseases such as impetigo pioneer infection. Began to have low-grade fever, dizziness, nausea, vomiting, poor appetite, and other symptoms. Oliguric swelling and the characteristics of this disease is generally swelling of the eyelid children first, gradually expanding to the whole body. Depression does not mean pressure, urine output, swelling decreased significantly, or even urine, about 1-2 weeks, a gradual increase urine output, swelling gradually dissipated. Most children with hematuria is invisible to the naked eye, and only a small number of patients with hematuria visible to the naked eye. Hematuria were some bright red color of meat like washing water, and some may wish tea color. This generally visible to the naked eye in the hematuria disappear within 1-2 weeks. Hypertension is the performance of children with nausea, vomiting, dizziness, but if a rise in blood pressure too fast, there will be many serious complications. Early onset patients with urine significant decrease in the swelling increased, shortness of breath, heart rate accelerated, irritability, which can be rapidly deteriorating conditions, difficulty in breathing, can not supine and looking grey, cold extremities, and frequent cough, pink bubble-like Kachu sputum that children with heart failure have occurred. If children in the early onset severe dizziness, nausea, vomiting, and a temporary blindness, suddenly serious convulsions, coma, compared with the performance of hypertensive encephalopathy. Some serious cases in the early acute renal failure. These conditions, if not promptly addressed, the consequences would be unthinkable. When your child has a section of the former suppurative tonsillitis or skin infection history, and in the phenomenon of swelling and oliguria, early diagnosis and treatment.

Why should there be acute nephritis hypertension?

80% - 90% of acute nephritis patients with hypertension can be shown, is generally mild to moderate hypertension, adults often 130-160/90-110 mmHg (17-21/12-14kpa). Blood pressure volatile, a one-time, occasionally severe hypertension, and with retinal hemorrhage, bleeding, as papillary edema or hypertensive encephalopathy. Produced hypertension reasons: (1) As the result of renal ischemia increased renin: Renin is a special kind of proteolytic enzymes, it can globulin in plasma activity of hypertension without change for the activity of the protein hypertension, hypertension protein produced by the liver change hypertension protein have a very strong role in vascular contraction, so that high blood pressure. (2) As allergy caused by the reflection of the systemic arteries spasm results. (3) Shuinazhuliu, increased blood volume, thereby enabling high blood pressure.

What are the acute glomerulonephritis complications?

Acute phase of serious complications mainly the cycle of serious congestive state, hypertensive encephalopathy and acute renal failure. As in recent years to strengthen its work on the prevention of incidence and mortality has decreased significantly. 1. Cycle congestive state: because Shuinazhuliu, blood volume dried up, until pulmonary edema. Each reported incidence of varying severity and treatment related. China 50 to 60 years reported to be hospitalized children with acute nephritis 24% to 27% of such complications seen, in recent years, the report has been lowered to 2.4%. Occurred after the onset of acute nephritis 1 ~ 2 weeks. Clinical manifestations of dyspnea, not supine, chest tightness, cough, lung wet at the end of rales, the liver tenderness, such as law Benma about heart failure symptoms, the result of blood volume expansion due to cardiac pump with real exhaust different. At this time of a stroke more often and are not reduced, the normal cycle time, moving no more blood oxygen difference, and the tonic effect of poor digitalis, diuretics and often to ease the application. Very few can be developed to truly severe heart failure, in a few hours to 1 to 2 days rapidly and life-threatening pulmonary edema. 2. Hypertensive encephalopathy: that blood pressure (DBP in particular) dramatically increased, in terms of a central nervous symptoms. General children than adults. Generally believe that this disease is systemic hypertension on the basis of resistance to the brain caused cerebral vasospasm small hypoxic brain edema caused, but also some people believe that the rapid rise of blood pressure, cerebral vascular original with the automatic control systolic and diastolic function of regulation, a high degree of cerebral vascular congestion, a result of cerebral edema, acute nephritis In addition the Shuinazhuliu also play a role in pathogenesis. Occurred early in the course of acute glomerulonephritis, a general acute onset showed severe headache, frequent nausea and vomiting, followed by visual disturbances, vertigo, diplopia, temporary and Mongolia, and lethargy or irritability, if not promptly Treatment occurred convulsions, coma, a few temporary hemiplegia aphasia, when severe cerebral hernia. Nervous system have no limitations signs, and shallow reflection tendon reflexes can weaken or disappear, sometimes positive ankle clonus, and there will be pathological reflex, can be a serious signs and symptoms of cerebral hernia. Fundus examination common retinal artery spasm, and sometimes that papilledema. CSF Qingliang, pressure and protein in normal or slightly increased. Such as blood pressure more than 18.7/12.0 kPa (140/90mmHg), with a visual impairment, seizures and coma of a three could be diagnosed. 3. Acute renal failure: a significant portion of patients with acute nephritis in the acute phase with varying degrees of azotemia, but progress to acute renal failure, only a very small number. Lack of complications is still effective preventive measures, acute nephritis has become the leading cause of death. Clinical manifestations oliguria or urine, blood urea nitrogen, serum creatinine increased, hyperkalemia, metabolic acidosis. Oliguria or urine for three to five or more than one week, after urine increased, the symptoms disappeared, and the gradual return of renal function. 4, secondary bacterial infection, acute nephritis as lower body resistance and easy to secondary infection, the most common being the lungs and urinary tract infection, in case of a secondary infection, it should actively symptomatic treatment, so as to avoid the original disease heavier.

Chronic nephritis treatment and prognosis

Therapeutic purposes: delay the decline of renal function, to eliminate proteinuria, hematuria as the goal. General adrenal cortex hormones should not be used or cytotoxic drugs can be combined therapy. First, it actively control of hypertension: Hypertension is to accelerate the glomerular sclerosis, and promote the deterioration of renal function important factors, and actively control of hypertension is a very important link. Treatment principles: (1) strive to control blood pressure in the optimal level: target blood pressure of 140/90 mmHg (18.6/12 kPa), proteinuria ≥ 1 g / d, blood pressure should be controlled to below 125/75 mmHg; urinary protein <1g>

Chronic nephritis and differential diagnosis

Typical diagnosis of chronic nephritis It is not difficult, for the young and middle-aged men in general most were slow onset, protracted illness. Abnormal urine checks are often proteinuria, hematuria can be accompanied by edema and hypertension. May have varying degrees of renal impairment. Diagnosis of chronic nephritis with other kidney disease screening method roughly the same, and, in particular to recommend some patients do kidney biopsy, further defined pathological diagnosis, treatment and prognosis of the disease is helpful. There is generally a pathological diagnosis of the following types: mesangial proliferative glomerulonephritis (with IgA nephropathy), mesangial proliferative glomerulonephritis, membranous nephropathy, focal segmental glomerular sclerosis, often at the same time varying degrees of renal small ball sclerosis, renal vascular sclerosis lesions tubular atrophy and fibrosis and inflammatory cell infiltration, and to the development of advanced, we can see that size decreased kidney, renal cortical thinning. Chronic glomerulonephritis symptoms and the incidence of many diseases and have varying degrees of similarity, therefore, in practice should be seriously identification, in order to symptomatic treatment. Chronic nephritis major diseases should be differentiated from the following: 1, chronic nephritis and chronic pyelonephritis Identification Chronic pyelonephritis the clinical manifestations of chronic nephritis may be similar, but have asked in detail about the history of urinary tract infection (particularly women), more leukocytes in urine, can interleukin type, positive urine culture, intravenous pyelography and nuclear Renal examination two kidneys of the degree of damage ranging from the performance. These are beneficial in the diagnosis of chronic pyelonephritis. 2, chronic nephritis with lupus nephritis Identification Lupus nephritis and renal clinical histological changes were similar and chronic nephritis. Systemic lupus erythematosus in women but most were and as a systemic disease, can be accompanied by fever, rash, arthritis and other impaired performance system. Decreased blood cells, immunoglobulin increase can be found lupus cells, anti-nuclear antibody positive, serum complement levels decline. Renal histological examination showed extensive calmly immune complexes in the various parts of the glomeruli. Immunofluorescence inspection "Full-" performance. 3, chronic nephritis and kidney damage identification of essential hypertension Sustained increase in blood pressure with chronic nephritis essential hypertension with renal damage identification, the latter often in the age of onset of 40 years of age, hypertension before a change in the urine, urinary protein often is not serious renal tubular dysfunction and more obvious. Heart, brain and retinal vascular sclerosis vascular changes often more apparent. Some patients with chronic nephritis refractory hypertension, the higher the blood pressure in general, the longer the duration, the more serious condition, the prognosis is poor. And malignant hypertension more common in middle-aged man suffering from hypertension, in the short term often caused renal insufficiency, and chronic nephritis is easy to confuse with hypertension. Malignant hypertension blood pressure is higher than chronic nephritis, often 29/17 kP (200/130mmHg) or higher. However, the early onset of urinary not obvious change more, in less urinary protein, no hypoproteinemia, or edema. Malignant hypertension because of the small atherosclerosis is systemic necrosis, and it a high degree of common retinal arteries narrow, hardened with bleeding and bleeding, as papillary edema, heart expanded cardiac dysfunction than obvious that these can be made Kam basis. 4, the other primary glomerular diseases (1) occult glomerular nephritis: clinical light chronic nephritis with misprision of glomerulonephritis type of identification, the latter mainly for asymptomatic hematuria and proteinuria, no edema, hypertension and renal dysfunction . (2) acute nephritis after infection: a precursor to the infection onset of acute and chronic nephritis be differentiated from the disease. The incubation period of two different serum C3 will help identify the dynamic changes; In addition, the vesting of different diseases, chronic nephritis no tendency to self-healing, a chronic progress can be funded distinction.

Acute Glomerulonephritis diagnosis and differential diagnosis

Often after a streptococcal infection in ~ 3 weeks in hematuria, proteinuria, edema and hypertension, and other clinical features, such as even oliguria azotemia and acute nephritis comprehensive performance, and with decreased serum total C3 complement decline. Positive urine test urine protein, RBC, WBC, and possession of urine. Disease incidence in eight weeks, gradually reduced to return fully to normal, can be clinically diagnosed as acute nephritis. Symptomatic treatment, if the glomerular filtration rate of decline or disease in 1-2 months are not yet fully improved renal biopsy should be timely, clear diagnosis. First, the acute onset of glomerular nephritis disease syndrome 1, other pathogens infection after acute nephritis many bacteria, viruses and parasites infection can cause acute nephritis. At present more than the more common species such as varicella virus - herpes zoster virus flu or a period of 3-5 days after infection, the virus infected the majority of clinical manifestations of acute nephritis less frequently associated with lower serum complement, rarely edema and hypertension, renal function normal, self-limited clinical process. 2, mesangial glomerulonephritis also known as capillary membrane proliferative glomerulonephritis, in addition to clinical manifestations of acute nephritic syndrome, often with nephrotic syndrome, the tendency to self-healing lesions going. 50% - 70% of the patients with persistent hypocomplementemia, not to resume within eight weeks. 3, mesangial proliferative glomerulonephritis (IgA nephropathy and non-IgA mesangial proliferative glomerulonephritis) of the patients showed precursor infection syndrome of acute nephritis, C3 in patients with normal, non-healing illness tendencies. IgA nephropathy patients with the disease incubation period is short, can be infected after a few hours to a few days a gross hematuria, hematuria can be repeated attack, and some patients with IgA increased. Second, rapidly progressive glomerulonephritis with the onset of acute nephritis similar process, except for acute nephritic syndrome, often early in oliguria, anuria rapid deterioration of renal function characterized. Severe acute nephritis showed acute renal failure and the disease difficult to distinguish should promptly make a clear diagnosis of renal biopsy. Third, systemic disease renal involvement in systemic lupus erythematosus nephritis and Henoch-Schonlein Purpura Nephritis and other acute nephritic syndrome may show, but other systems involved with the typical clinical presentation and laboratory tests, which we can identify. When clinical diagnosis difficult, acute nephritic syndrome patients need to be considered for a clear diagnosis of renal biopsy to guide therapy. The indication for renal biopsy: 1, oliguria week or more, or with a reduced volume of renal function deterioration; 2, the course for more than two months without improvement trend; 3, acute nephritis with nephrotic syndrome, syndrome .

Control blood pressure patients with chronic nephritis

Chronic nephritis, and the remaining (or) lesions compensatory renal units in the high hemodynamic status, systemic hypertension undoubtedly add to this condition, resulting in sexual glomerular injury, it should be for patients with chronic nephritis active control of hypertension to prevent the deterioration of renal function.
In recent years, through a series of studies confirmed that the majority of scholars have angiotensin-converting enzyme inhibitors as first-line antihypertensive drugs. In recent years, many clinical studies confirmed the calcium antagonists, such as nifedipine, nicardipine and equal treatment of hypertension and retard deterioration of renal function is more positive effect. Study, calcium antagonists goals despite a slight expansion of the role of small arteries, but it has significantly decreased the role of systemic blood pressure, it could not involved or only partially involved in glomerular hemodynamics high, high metabolic status improved; In addition, calcium antagonists to reduce oxygen consumption, anti-platelet aggregation, through the cell membrane effects of reduced calcium deposition in the mesenchymal cells excessive oxidation and reduction, so as to achieve stability and reduce kidney damage kidney function. Clinical reports, short-term (four weeks) or long (1 to 2 years) with calcium antagonists in treatment of chronic renal failure in patients with glomerulonephritis, and did not find any glomerular injury, but it clearly demonstrated and angiotensin converting enzyme inhibitors are very similar delayed effect of the deterioration of renal function. And angiotensin-converting enzyme inhibitor different, as it generally ratchet urinary protein role. It should be noted that some scholars believe that calcium antagonists have an impact on renal function, there is need for more long-term observation.
Β-blockers, such as the United States and metoprolol, Atenolol, on the renin-dependent hypertension good effect. Β-blockers reduce renin a role, although the drug reduced cardiac output, but did not affect renal blood flow and GFR, it is also used in the treatment of renal hypertension. It should be noted that some of β-blockers, such as Atenolol and naphthalene hydroxyl peace of fat-soluble low, since the renal excretion, so they should pay attention to renal insufficiency and extended medication dose adjustment time.
In addition, the vasodilator drugs such as hydralazine also antihypertensive effect, it can and β-blockers combined to reduce  vasodilating drugs stimulate renin angiotensin system, such as side effects (such as a heartbeat accelerated, Shuinazhuliu ), and improve treatment. Hydralazine 200 mg daily general, but must be vigilant against the drug-induced lupus erythematosus-like syndrome may be.
With edema, if the renal function properly, plus Thiazide diuretics; of poor renal function (serum creatinine> 200 μ mol / L), Thiazide of poor or ineffective drugs, should be replaced myeloid loop diuretic agent. Application diuretics should pay attention to the body electrolyte imbalance, and we should pay attention to a heavier hyperlipidemia, hypercoagulable state trend.

Clinical manifestations IgA nephritis

Often in the typical cases of respiratory tract infection after a few hours to two days, a gross hematuria, usually lasting a few hours to a few days, some up to one week. The total number of such patients accounted for about 40% ~ 50%, slightly higher than in children. Individual can have serious back pain and Futeng may be related to the gastro-intestinal IgA vasculitis. Another common manifestations of the disease is asymptomatic hematuria and / or proteinuria, or about 30% of the total to 40 percent. 20% to 25% of cases may occur in the course of one or several gross hematuria. Nephrotic Syndrome can be found in 5% to 20% of the patients in the cases of children and young people more often is a diffuse proliferative with or without glomerulosclerosis. In addition, sometimes mesangial mainly IgA deposition phenomenon can also occur in the foot process integration to the characteristics of minimal change nephropathy. Some can be less than 10% of the patients with acute renal failure performance, usually self-mitigation. 20% to 25% may need dialysis, because they have more crescentic glomerulonephritis. Activities in the course of a period of retention of nitrogen are not uncommon, accounting for about 25 per cent. At the onset of hypertension that is 10% of the total, ran in the 30-year-old who later onset was significantly increased with the extension of the course, with hypertension, more than 40 per cent.

IgA nephritis treatment

So far, the disease there is no satisfactory treatment. Of the disease with progressive renal dysfunction adrenocorticotropic hormone use with or without immunosuppressants are not consistent. Recent data suggest that more than one of proteinuria g / d, imposed overnight use of adrenocortical hormones useful for the improvement of proteinuria. IgA deposition with minimal change nephropathy, was likely to ease proteinuria. A combination of cyclophosphamide, dipyridamole and Huafulin reduce proteinuria and the glomerular filtration rate is not affected the use of cyclosporine A merger can also reduce proteinuria, Ran has also reduced creatinine clearance rate. Phenytoin, anti-platelet drugs, acid disodium-glycosides, such as diphenyl Hydantoin drug efficacy not sure. Despite reports of urokinase can protect the glomerular filtration rate, but far from conclusion. Recurrent tonsillitis, tonsillectomy may be useful; antibiotics for the prevention and treatment of infection in some acute nephritic syndrome and acute renal failure of performance may be helpful. Observed that a series of smaller agents with the use of fish oil to reduce proteinuria and increased glomerular filtration rate role. Severe IgA nephropathy (glomerular filtration rate monthly decline of 2 to 4 ml / min) using high-dose immunoglobulin intravenous infusion during the cease glomerular filtration rate fell to improve hematuria and proteinuria, but stop After the regular recurrence. To have hypertension and proteinuria severe cases, the use-converting enzyme inhibitors may slow down the rate of decline in glomerular filtration rate and reduce proteinuria, in severe IgA nephropathy, converting enzyme inhibitor is the first choice antihypertensive agents. Conversion of normal blood pressure inhibitors can effectively is unclear. IgA nephropathy to end-stage renal transplantation, kidney transplantation in mesangial area soon IgA deposition; if the donor kidney have subclinical IgA nephropathy, non-implanted uremia, IgA nephropathy, for the mesangial area IgA deposition were often vanish quickly. Recurrent kidney transplantation with IgA nephropathy is not inevitable for renal failure, but by the application after renal transplantation immunosuppressive therapy, including cyclosporine A and also can not prevent its development. Of cadaveric renal transplantation, 1, and three years of renal allograft survival rate up to 87% and 77%, but individual anti-HLA antigen IgA antibody IgA renal transplantation, renal allograft survival 2 years up to 100 percent, reason to believe that these anti-HLA antigen antibody on the increase in renal allograft survival has played a useful role.

How early detection of gout

Gout early detection of the most simple and effective method is to detect serum uric acid concentrations. To carry out large-scale population census of serum uric acid can be found in time hyperuricemia, which early detection and early prevention and treatment of gout is very important significance. In the present conditions there is no large-scale test of serum uric acid circumstances, at least to the following officers of conventional detection of serum uric acid: (1) elderly people over the age of 60, whether male or female and whether it is obesity. (2) obesity in middle-aged men and post-menopausal women. (3) hypertension, arteriosclerosis, coronary heart disease, cerebrovascular disease (such as cerebral infarction and cerebral hemorrhage) patients. (4) diabetes mellitus (type II diabetes is mainly). (5) the reasons for not prescribed arthritis, especially middle-aged and older patients with arthritis, as a single feature. (6) kidney stones, kidney stones and especially the multiple bilateral renal calculi patients. (7) a family history of gout members. (8) Long-term meat, and drinking habits of middle-aged and older people. All the above situation in any one person should take the initiative to go to the hospital to the laboratory examination of gout, as well as early detection hyperuricemia and gout, and will not wait until there has been a typical clinical symptoms (such as subcutaneous Gout stones) to the doctor after. If the initial inspection of serum uric acid normal, and should not be lightly dismissed Gout and Hyperuricemia possibilities. After periodic review should be at least annual health inspections. This will enable early detection rate of gout increased substantially.

How diagnosis of acute gout?

Some people think that the regular joint pain, gout is suspected, a doctor requested single test to see if the blood uric acid (UA) concentration is too high. Gout diagnosis, with joint pain is not in the blood uric acid value of the job. According to the United States in 1980 will develop rheumatoid medical diagnostic element, must be consistent with acute gout: 1. Acute arthritis attack more than once. 2. Attack, the inflammatory response in a day to the most intense level. 3. Attack, only violations of a single joint. 4. Violations of the joint redness. 5. Big feet and the toe joint pain or swelling. 6. Attack, the only side of the great toe and the foot joints 7. Attack, only the side of the feet of joints. 8. Joints in tophi. 9. Hyperuricemia, uric acid in the blood is too high. 10. X-ray and found that the asymmetry of joint swelling 11. X-ray and found that the bone cyst is not being eroded 12. Attack, out of synovial fluid under the microscope found that uric acid crystal. 13. Attack, synovial fluid out of a culture not found microbes. If the acute onset of arthritis cases with the above projects, the possibility of diagnosis of gout higher.

Asthma symptoms status

Asthma status for the type of asthma Phase one. In the paroxysmal or chronic asthma on the basis of infection or because of certain factors can stimulate asthma symptoms were acute and sustained attack more than a few hours or a few hours after another attack mitigation, with the general spasm medication invalid. Serious symptoms, breathing slow, breath profound, inspiratory shorter Wheezing sound obvious, with cyanosis, sweating, cold hands and looking pale, dehydration flustered, pulse breakdown, looked alarmed. Sometimes see cough, sputum smears, white or yellow color, it is not easy Kachu, sometimes bloodshot. Infection with the heat up to 39 ℃. If sustained more than bronchial spasm, or sputum and bronchial obstruction fine Kechu difficult, due to breathing extremely difficult and suffocation, but also of heart failure or physical decline and death. If sputum can during the onset of Kachu, dyspnea, Wheezing, cyanosis, and other symptoms can be gradually to relax and return to normal.

Bronchial asthma symptoms

Bronchial asthma aura of the most common symptoms, cough, or allergic rhinitis, such as common cold. Allergic rhinitis to sneezes, runny nose, itchy nose, itchy eyes, tears, and other common symptoms group. Such as coughing while jets allergic itching, coughing, chest tightness, and other common symptoms group. Threatened period since the beginning of the asthma attack inconsistency can be seen from a few seconds to several minutes, but most of it will attack in a matter of minutes. Women in the pre-menstrual flu fatigue, cough, children in the attack before irritability or less dynamic, spiritual aura symptoms such as poor. When asked in detail about history, sure sign of its symptoms, in a timely attention to the prevention and treatment of Threatened period, the control of asthma is very useful. Once asthma attack has been, for medical treatment to control more difficult. But not every sign of asthma are sometimes inhalation of certain substances can suddenly attack, and more is suddenly awakened during sleep and seizures.

Pregnant women with asthma how to deal with

Bronchial Asthma is a lung of allergic disease, characterized by repeated attacks of breathing difficulties, self-improvement, or a lifting of drugs. Attack short in just a few minutes, a few hours or a few days the elderly (medically known as "Asthma Status "). Bronchial asthma pregnant women should avoid exposure during pregnancy can induce seizures of certain allergens, such as spices, pollen, dust, tobacco, such as cold air to ensure adequate rest, avoid over exertion and mental stress and less to public places to prevent respiratory tract infections, sudden changes when the temperature changes injection of appropriate clothing. Drug therapy should be conducted under the guidance of a doctor, according to the severity of the correct medication. In the first three months of pregnancy, embryonic differentiation and organ development stage, is extremely sensitive factors outside influence, it should avoid unnecessary period of fetal teratogenic drugs, such as tetracycline family, sulfonamides, such as iodine agents. Mild asthma patients may be taking drugs, commonly used are: isoproterenol, salbutamol aerosol Ling, aminophylline, salbutamol Ling tablet. At the same time use of antibiotics to control and the prevention of respiratory tract inflammation (penicillin, erythromycin is safer antibiotics during pregnancy drug), and supplemented by sedative, expectorant cough medicine. Asthma status, due to serious lack of oxygen, can cause premature or stillbirth should be hospitalized. Reflect on the long-term chronic asthma attacks were serious low cardiorespiratory function, or the treatment of asthma status null and void, should consider abortion or artificial induction of. In short, asthma, pregnant women as long as confidence in conquering disease, in close coordination with the doctor, to adjust their diets, daily life and prevent and reduce the number of asthma attacks, the general is through the pregnancy.

Systemic hormone treatment of asthma should pay attention to what

Adrenal hormones can be quickly contained because of allergic inflammation, relieve symptoms and reduce the suffering of patients, has been widely used for clinical. However, there are also a certain amount of abuse, and even conventional hormone as a treatment of asthma medication, and have neglected their cause adverse reactions and side-effects of the consequences. Therefore, use should be noted: 1. Strict application of the hormone indications. The general mild cases, without the use of hormones; of chronic, intractable, recurrent cases, the hormones should also be a variety of treatment methods ineffective as the second-line drugs. 2. Systemic hormone therapy can relieve symptoms should use the smallest effective dose, and the need to use larger doses to demands complete control of all symptoms. 3. In order to reduce adverse reactions and complications, treatment should be as short as possible, usually in symptom control, particularly in emergency mitigation, it should be in two to three days, reductions or disable. 4. Long-term use of the volume control symptoms cases, and often can cause drug dependency, drug resistance and the occurrence of withdrawal syndrome, attention should be paid to disable hormones, so as to avoid accidents. 5. If secondary pulmonary infection, we must increase the effective use of antibiotics. Such as infection control, the hormone to be ineffective. 6. Systemic application of hormones, growth and development of children have some effect, the use of hormones in children in particular should be strictly controlled indications, the general should not use large doses, and should not, the use of long-term systemic.

Acute bronchial asthma performance

(1) difficulty in breathing: Threatened symptoms often followed after chest tightness, chest sense of urgency and even suffocation, chest pressure may be witherite by 10 ~ 15 minutes after the main difficulty to breath breathing difficulties, and with Asthma Singing. Patients were forced to sit, not 15 minutes, the first to Jianfu, shoulders Songqi, thus shoring knee forced pant. Attack sustainable dozens minutes to a few hours, on their own or remission after treatment. (2) cough, expectoration: because of the aura of allergic bronchial mucosa caused coughing. Generally dry cough with phlegm, varying degrees. Stage to reduce cough, breathing oriented. Attack be drawing to a close, bronchospasm and reducing mucosal edema, a large number secretions to be discarded, and cough, expectoration symptoms heavier, more rarefied Gechu sputum or phlegm and mucus suppository. If the merger infection, Kachu purulent sputum. A small number of patients can cough is the only performance. (3) Other: more severe bronchial asthma attack, a long time, may have chest pain. Some patients may also have vomiting and even incontinence. When a sustained severe attack, headache, dizziness, anxiety and pathological behaviour, and he was vague, lethargy and coma spirit of neurological symptoms. If the infection may be fever. After the attack there are fatigue, weakness systemic symptoms.

Bronchial asthma and chronic stage performance

Chronic asthma attack can be a period of the year, from the environment, climate, or the ease of control after a relatively shorter period was often repeated attack, but the severity is not too serious, it is most acute bronchial control bad results. Due to long-term repeated attack, mostly associated with pulmonary emphysema, lung function decreased, the body was caused by hypoxia. Even in peacetime no acute, flu symptoms dyspnea, asthmatic breathing, and often awakened in the middle of the night, coughing or dyspnea with Wheezing tone. Chang and onset of influenza, cough, 1,10 white foam or thick sputum. Usually poor health, low resistance, and if respiratory infection, often accompanied by fever attack.

Asthma can be divided into several Which?

Often can be seen living men, women and children will be suffering from asthma, dyspnea, though similar, but asthma is a wide variety of reasons. Common asthma as follows: Bronchial asthma, allergic disease is a majority in the incidence of young or young, and in spring or autumn when the attack Yuhan. Asthma attack when travel faster, and difficult to breath for the characteristics of asthma after the cessation of the same as normal. But if repeated attack, not ease, the development of pulmonary emphysema, pulmonary heart disease. Wheezy bronchitis, chronic bronchitis patients addition to the symptoms: chronic cough, expectoration, and also with significant breathing and respiratory infections in more than aggravating. Onset usually in the cold seasons, in the majority of the elderly. If not control this disease, often late for the development of emphysema, pulmonary heart disease. Another is bronchogenic carcinoma, when a bronchial carcinoid tumor plug, it can cause breathing. Patients breath, both the inspiratory difficulties. Several more are bronchial asthma or lung diseases caused by, called pulmonary asthma. There is a type of asthma is caused by heart disease, asthma Heart derived. Patients usually have coronary heart disease, rheumatic heart disease, cardiac disease or hypertension, a left ventricular failure, causing pulmonary bleeding, gas exchange impairment, asthma. This respite often attack at night, after more than 2 hours in Shuishu sudden difficulty in breathing. Gas hold patients chest tightness and suddenly woke up and forced to sit up pant, cough, 1,10 pink bubble-like sputum. After sitting up most of the patients, to alleviate breathing space, this process called paroxysmal breathing difficulties at night. In addition, there is an occupational asthma, asthma and certain occupations, that is to say, for example, the work of exposure to certain chemical or metal compounds, cause asthma. Their main features are: contact with a particular material or, in certain specific circumstances, the disease can cause seizures, once the disengagement, the symptoms disappeared.

Early cardiac asthma

"Cardiac asthma," namely "paroxysmal night breathing difficulties." Due to hypertensive heart disease, coronary heart disease caused by chronic heart failure caused by more common in the elderly. Patients with heart disease often sleeping 1-2 hours after suddenly feel chest tightness, dyspnea and wakened, often require rapid Zuoqi, and a frequent cough, big mouth breathing, vomit bubble-like sputum. After several minutes to light gradually, and will re-appear the risk of acute pulmonary edema symptoms, there are obvious Wheezing Music "heartbeat accelerated, lips cyanosis, 1,10-bubble-like powder cylinder sputum The incidence of cardiac asthma, sleep, mainly because of some blood from the lower half transfer to the lungs, thereby increasing the original left ventricular failure caused by chronic lung Yu blood; the supine position, FVC reduced to a ventilation obstacles, and cause hypoxia. Carbon dioxide retention, resulting in pulmonary hypertension, an increase of the reflection on the respiratory center stimulation. In addition, the intensity of human activities, with the changes in circadian rhythm shows that changes in sympathetic nerve activity during the day strong, vagus nerve activity at night dominant, rendering coronary artery contraction, myocardial blood supply reduction. This is the heart of the direct cause of asthma in the -. Joinet emergency handling this disease: first sitting of patients admitted with severe illness in the legs will be sitting down and use a soft cloth band ligation rotation of the three limbs in the limbs, and every five minutes for a physical扎, the aim is to reduce output Rhodobryum roseum, reduce heart burden, to gain time to do further Jisong hospital diagnosis and treatment.

Which bronchial asthma several clinical types

According to bronchial asthma severity, extent and causes seizures were divided into different types. 1. Induced asthma under the etiology, clinical asthma will be divided into allergic asthma (or exogenous asthma), infection-induced asthma (or endogenous asthma), exercise-induced asthma, asthma drugs and mixed asthma. 2. According to the severity of asthma is divided into mild, moderate asthma, and severe asthma. 3. Under attack extent divided into small attack: Although the attack but did not affect sleep, or oral application, spray in the drug within two hours mitigated in the attack: Attack even drama, not between lying and affect sleep two hours or more, or a similar degree of attack; big attack: Attack keen sick child can not tolerate, and often can be alleviated injection administration. Chinese asthma how Category: Pediatric acute asthma attack can be divided into real and imaginary Surge Surge two. Surge there is the cold and heat of the general surge more than Hanchuan heat, cold and hot breath ratio is about 2:1 dyspnea. In addition to real end, the disease long as there are imaginary, and is often of the same view, the inclusion of a strength, generally speaking, there are physical Yang, a sustained attack Hanchuan; known as dark virtual physical, more attacks Surge was hot. Asthma can be divided into Bifei kidney deficiency and deficiency, kidney deficiency in children than adults rare, for the most Bifei deficiency.

The clinical manifestations of chronic bronchiectasis

Refers to chronic bronchial inflammation and damage to the surrounding tissue wall, cause bronchial lumen expansion and deformation. Is a common chronic purulent bronchial diseases, the majority of secondary to upper respiratory tract infection and bronchial obstruction, especially children and youth measles, whooping cough after bronchial pneumonia. After a chronic clinical, measles, pertussis, influenza, inhaled foreign bodies, chronic rhinitis and sinusitis nasal side, such as history. Many childhood suffering from pneumonia, whooping cough and other serious lung infection history. Youth accompanied recurrent respiratory tract infection, and then a chronic cough with purulent sputum, Chen Qi or bed at night, postural changes in sputum volume increased. Acute respiratory tract infection with a high fever, chest pain, cough intensified, suffering from weight loss, anemia and other symptoms of systemic poisoning. Sputum collected in glass observation, can be found four characteristics for the upper bubble, the next hanging purulent composition, mixed in the mucus, the bottom sediments of necrotic tissue. Hemoptysis is another typical example of bronchiectasis. Some patients cough, expectoration not obvious, mainly hemoptysis repeatedly practiced "dry bronchiectasis." Expectoration not obvious. Mild patients can no abnormal signs, a typical local lesion can be heard and in the continued existence of moist rales, long-term infection can occur repeatedly clubbed fingers (toe) and emphysema levy.

TB in children how to use drug therapy

Children are suffering from TB is of primary pulmonary tuberculosis. Since the disease after 3 to 6 months the majority of lesions or tend sclerosis began absorption, absorption calcification in 2 years and recovered. More than 95 percent of its general clinical course is benign. If conditions deteriorate to the development of more than seen in the first six months after infection, so protracted illness refractory up to 2 to 3 years or longer. Therefore treatment of TB, it is necessary to early treatment and use in the treatment of drug-sensitive and adhere to the completion of adequate treatment. In a high state of the children with allergies to row with the TB bacteria, strict isolation and take strict disinfection measures to avoid duplication of Mycobacterium tuberculosis infection. Desensitization and timely use of calcium and vitamin C to make a lot of adjuvant therapy. If large tracts of real change or pulmonary atelectasis existence or serious poisoning symptoms can be adrenal cortex hormones. Generally believed that no primary infectious tuberculosis, solely on the basis of positive tuberculin tests and X-ray examination was not discovered, children can be life as usual, nursery or school. Only a few symptoms of the conduct of primary tuberculosis, or severe acute tuberculosis patients, the light of the specific situation should be given proper rest and treatment in isolation. Quality anti-TB drugs by the order is divided into A, B, C three categories: A drugs: isoniazid and rifampicin. B drug streptomycin, pyrazinamide, and ethambutol, kanamycin, B sulfur Isonicotinic amines, Cycloserine, purple adriamycin and tendril adriamycin. Class C drugs: sodium p-aminobenzoic acid and ammonia thiourea. By clinical experience has shown that children with tuberculosis chemotherapy good results. According to drug efficacy and toxicity size, the evaluation of the anti-TB drugs are as follows: ① first-class level, isoniazid and rifampicin, two for first-class streptomycin, pyrazinamide, B amine and sulfur Isonicotinic ethambutol. ② second: the amino acid sodium, kanamycin, tendril adriamycin, purple adriamycin and Cycloserine. ③ third class for ammonia thiourea.

How elderly tuberculosis treatment?

(1) general treatment: elderly patients with pulmonary tuberculosis in active lesions, bed rest should be adequate intake of nutrients. Condition improves, gradually participate in a number of activities to enhance physical fitness, increase resistance to disease. (2) anti-tuberculosis drug treatment: Practice has proved that reasonable antituberculosis drug therapy is completely cured of the disease of the most important ways. Early treatment principle is to pay close attention governance, rule-balanced, focused on the treatment of sputum-positive patients, and do a good job the whole course of management, and continuously improve the cure rate. Early treatment is followed, appropriate, the use of Cross and the whole approach. ① early Governance: senile initial discovery tuberculosis, or TB drugs has been found that without treatment, are the beginning of the jurisdiction. Minor lesions, non-empty, not carriers of the sputum may be oral isoniazid 0.4 g / day, rifampicin 0.45 g / day, a morning Dayton suits, taking consecutive year. Lesions significantly activities, accompanied by destruction of lung tissue and sputum positive, can be oral isoniazid 0.4 g / day, rifampicin 0.45 g / day, ethambutol 0.75 g / streptomycin, or 0.75 g / , intramuscular injection, in February after two times a week instead of the use of isoniazid and rifampicin, with a total course of treatment for nine months. ② complex governance: the past have received anti-tuberculosis drug treatment, rehabilitation once again called for governance. Elderly complex governance contained in the cases of tuberculosis resistant bacteria increased use of bacteria must be sensitive drug treatment. TB drug sensitivity tests can help select drugs, but the time is too long, the general results only a few weeks. Therefore, in accordance with regular clinical treatment of patients in detail the past, elected by the previous unused or less, or has been used by the Joint Rules of drugs, alternative treatment programmes, joint two kinds or more drug treatment, in accordance with drugs after The results of chemotherapy sensitivity adjustment programme. Early treatment of tuberculosis elderly can often be achieved satisfactory results, which we must seize the opportunity of early treatment of tuberculosis lesions often elderly fiber lesions and cheese stoves, as these lesions poor blood supply, tuberculosis in a low metabolic state, the role of hard drugs , the anti-TB drugs should be used in UEFA, the course should be long enough to completely heal; the elderly speaking, streptomycin easily cause deafness, dizziness, so to rifampin, isoniazid, triethylamine D Alcohol or pyrazinamide "triple" better. Isoniazid, rifampicin, pyrazinamide can cause liver damage, Ethambutol can cause visual impairment, medication should be highly vigilant.

Asthma will develop emphysema?

Children or adolescents with allergic asthma generally unpopular with chronic bronchitis, and most have longer attack intermittent, or each attack is not a long time, so in the short term will not develop emphysema. But if lower resistance, often irritating substances or repeated contact with the upper respiratory tract viral infection, can be associated with chronic bronchitis, persistent refractory disease. So simple chronic bronchitis asthma not as easy to develop into pulmonary emphysema or heart disease. However, very frequent seizures, or status with asthma, particularly with chronic bronchitis, emphysema and thus occurred develop into cor pulmonale on the possibility of a larger. Bronchial asthma due to cramps, mucosal edema and increased secretion, airway obstruction, when the strong contraction inspiratory diaphragm, rib muscle on the question, thorax expansion, chest negative pressure increased alveolar expansion, the expansion of the lungs, the whole thorax as emphysema state. In asthma, there may not Qi tumor clinical manifestation, but if regular asthma attacks, repeated inflammation of bronchial mucosal edema, respiratory tract, the narrow and will be long-lasting. Inspiratory bronchiectasis, able to enter alveolar gas, breath when bronchial narrowing collapse of the lung is not easy drained residues within the alveolar gas increased flexibility diminishes, thus creating the so-called obstructive pulmonary emphysema. In chronic obstructive pulmonary emphysema on the basis of, as her illness became more serious, alveolar pressure rising, oppression around the alveolar capillary wall, which luminal stenosis or semi-Cypriots, which alveolar rupture, pulmonary capillary bed greatly feed pulmonary vascular resistance increases in pulmonary hypertension. Chronic obstructive ventilatory dysfunction of transmission lines and the lack of oxygen, to the pulmonary artery spasm, thereby increasing the pulmonary vascular resistance and pulmonary hypertension, forming a vicious circle, and ultimately to the development of right ventricular hypertrophy and dilated right heart failure characterized by cor pulmonale.

Can cor pulmonale with emphysema

Bronchial asthma than simply easier to develop into chronic bronchitis and emphysema cor pulmonale. But often attacks, the continued state of asthma, especially with chronic bronchitis, emphysema and develop into a pulmonary heart disease situation is not uncommon. Bronchial asthma due to cramps, mucosal edema and increased secretion, airway obstruction, when inspiratory, strong contraction diaphragm, rib muscle on the question, thorax expansion, increasing negative pressure within the chest, alveolar expansion, lung expansion , on the whole thorax showed pulmonary emphysema state. In asthma, emphysema no clinical manifestations. But if regular asthma attack, bronchial mucosal edema recurrent respiratory formed lasting narrow. Bronchodilator inspiratory gas alveolar able to enter, when bronchial narrowing breath, depression, patent, not gas from the lungs, alveolar residual volume increased flexibility damaged, thus creating obstructive pulmonary emphysema. In chronic obstructive pulmonary emphysema on the basis of the increase with emphysema, pulmonary pressure increased, oppression alveolar capillary wall, which luminal stenosis or occlusion, and alveolar rupture, pulmonary capillary bed much less pulmonary circulation resistance increased, in pulmonary hypertension. Followed, chronic obstructive ventilatory dysfunction and hypoxic pulmonary artery spasm, thereby increasing the pulmonary vascular resistance and pulmonary hypertension, resulting in a vicious cycle, to right ventricular hypertrophy and dilated right heart failure.

Why repeated asthma attack will cause emphysema

Bronchial asthma attack, due to bronchial smooth muscle spasm, mucosal edema, and increased secretion lead to the formation of the trachea complete obstruction, suction, inspiratory muscle contraction, thorax expansion, gas may still enter the alveolar; breath, closed tracheal depression , and further increased airway resistance, alveolar gas can not be fully discharged而使whole lung gradually expanded. But alveolar bronchial smooth muscle and elastic fibers no pathological damage, this can be alleviated if bronchial spasm, pulmonary gas can be discharged, sick child can be fully restored, therefore, emphysema is reversible. If long-term repeated attack, which would have led: ① bronchi and bronchioles between Waterloo proliferation of muscle hypertrophy, bronchiolo-forming organic stenosis; ② bronchial gland hyperplasia hypertrophy, viscous substances secreted large, thin bronchial obstruction; ③ thin bronchial wall cartilage damage, loss of normal stent, suction, bronchiectasis, gas may still enter the alveolar but breath, bronchial closure subsidence, gas can not be discharged within the alveolar gas accumulation and expansion; ④ long-term accumulation of gas, the pressure increased pulmonary alveolar bloated flexibility diminish, and finally break down, forming emphysema.

Chronic obstructive pulmonary disease how drug treatment

As chronic obstructive pulmonary disease COPD, including chronic bronchitis and chronic obstructive pulmonary emphysema, is a serious and endanger people's health common diseases, multiple, and the need for long-term treatment of standardization. In addition to its smoking cessation therapy, rehabilitation exercises to enhance physical, but also the attention of rational drug use. (1) anti-infective treatment. Diffuse pulmonary resistance acute exacerbation is the most common cause of respiratory tract infection, the causative organism is Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis-card bacteria, virus. If it is suddenly impossible sensitivity test, according to clinical experience from 7 to 14 days of antibiotic treatment, such as amoxicillin, quinolones (such as ciprofloxacin, fluoride Zhen acid, etc.), the new cephalosporin (eg, first of Proton). Macrolides (such as erythromycin ethylsuccinate, ether Spiramycin, etc.), aminoglycoside (such as Rickettsia bacteria Star, etc.). In recent years due to Staphylococcus aureus, Haemophilus influenzae and resistant Streptococcus such an increase, if the initial empirical treatment of poor, as soon as possible in accordance with appropriate antimicrobial susceptibility test results replacement of antibiotics. (2) spasmolysis asthma. At present there are mainly three types of anti-asthmatic drug spasm: ① β2 receptor agonists such as salbutamol, such as asthma aerosol Kang speed. ② anticholinergic drugs such as such as ipratropium bromide. ③ methyl purine such as gifted Yanchuanping, tea Surge equality. Should be based on individual patients choose to use, although not all patients after treatment will be improved lung function, but may relieve symptoms and improve patient mobility. (3) Glucocorticoids, such as prednisone, each weighing 0.4 kg to 0.6 mg daily use, for 2 to 3 weeks. If can significantly improve lung function, can consider long-term use, but it should be timely reductions to the lowest effective level, the prevention of the occurrence of complications. In addition agent may also be used phlegm, mucus dissolved agent with drug treatment, so as to improve the curative effect.