The Impact Of Damp-heat On The Clinical Condition Of Primary Nephrotic Syndrome And Proteome Research Of Primary Nephrotic Syndrome Damp-heat Syndrome

Objective:To guide clinical treatment of nephrotic syndrome,it was started with primary nephrotic Damp-heat and the first systematic research on the nephrotic syndrome of the impact of clinical conditions which is a comprehensive understanding of heat nephrotic syndrome on the impact of key links.With the purpous of further research in damp-heat syndrome with primary nephrotic syndrome and the possibility of the discovery of that specific protein,we analyzed the specific protein that could reveal the damp-heat syndrome of TCM nephrotic syndrome and the pathogenesis of the connotation.Methods:To explore the molecular mechanism of Primary nephrotic syndrome Damp-heat,and the nature of Damp-heat.It was worked in the methods of cross-section,forward-looking and retrospective survey.To standard in line with the primary nephrotic syndrome,we investgated the patients in general,symptoms,signs,and some indicators of laboratory tests by using SPSS statistical software for statistical analysis to explore the Damp-heat factor in the onset primary nephrotic syndrome and the role in the course of its relevance.Systematically-analyzed the effects of the Damp-heat factors in each course of disease,condition, relapse,laboratory indicators,efficacy,etc.This study use the most cutting-edge proteomics approach,with primary nephrotic syndrome of damp-heat syndrome with non-heat Syndrome and healthy controls for differences in the use of two-dimensional gel electrophoresis protein analysis,and then carried out using mass spectrometry to identify protein differences.Result:(一) The impact of Damp-heat on the clinical condition of Primary nephrotic syndromeIn this study,a total of 120 cases of selected cases,including 60 cases of Damp-heat syndrome group and 60 cases of non Damp-heat syndrome group.Through analyzed and compared between the two groups in general, symptoms,signs,laboratory indicators,effects,this study systematically analysis the effects of the Damp-heat factor in the Drimary nephrotic syndrome patient's course of disease,condition,relapse, laboratory indicators,efficacy,etc.The results are as follows.1.General data analysisThere are 60 cases of Damp-heat syndrome group,Including 47 males and 13 females,and their average age is 28.77±16.13 years old.There are 60 cases of non Damp-heat syndrome group,Including 39 males and 21 females,and their average age is 26.72±15.93 years old.By statistical testing,there is not significant difference between the two groups in gender,age and so on(P＞0.05).2.The impact of Damp-heat on the days staying in hospital of PNS patientsThe average days staying in hospital of Damp-heat syndrome group are 23.90±11.75 days;and the average days staying in hospital of non Damp-heat syndrome group are 16.00±7.47 days.The days staying in hospital of primary nephrotic syndrome Damp-heat syndrome group are significantly longer than the non Damp-heat syndrome group.By statistical testing,there is difference between the two groups(P＜0.05).3.The impact of Damp-heat on the course of PNS patientsThe average duration of Damp-heat syndrome group is 42.13±46.49 months;and the average duration of non Damp-heat syndrome group is 29.18±29.27 months.The duration of PNS Damp-heat syndrome group are significantly longer than the non Damp-heat syndrome group.By statistical testing,there is difference between the two groups(P＜0.05).4.The relationship between Damp-heat and infectionThe percent of infection cases in the Damp-heat group(38.3%)is higher than the non Damp-heat group(16.7%).By statistical testing,there is significant difference between the two groups(P＜0.01).The Damp-heat group includes 11 cases(47.8%) of respiratory infections,5 cases (21.7%)of urinary tract infections,4 cases(17.4%) of gastrointestinal infection and other 3 cases(13.1%);The non Damp-heat group includes 5 cases(50.0%) of respiratory infections,3 cases(30%)of urinary tract infections,1 cases(10.0%) of gastrointestinal infection and other 1 cases(10.0%).By statistical testing,there is not difference between the two groups on the type of infection.5.The impact of Damp-heat on the relapse of PNS patientsThe percent of relapse in the Damp-heat group(65.0%) is higher than the non Damp-heat group(46.7%).By statistical testing,there is difference between the two groups(P＜0.05).6.The impact of Damp-heat on the laboratory indicators of PNS patientsThe total white blood cell of Damp-heat group(11.33±6.51*10e9/L) is significantly higher than the Damp-heat group' s(8.77±4.50*10e9/L).The Total cholesterol of Damp-heat group(10.99±4.00mmol/L) is higher than the Damp-heat group' s(8.19±2.53mmol/L). The 24-hour urinary protein of Damp-heat group(7.74±4.42 g/24h) is higher than the Damp-heat group' s(5.05±3.55 g/24h).By statistical testing,there is difference between the two groups on total white blood cell,Total cholesterol and 24-hour urinary protein(P＜0.05).But,by statistical testing,there is not difference between the two groups on Other laboratory indicator(P＞0.05).7.The relationship between Damp-heat and Pathological typesIn the collection of 120cases of PNS,there are 39 cases of patients having pathology report,accounted for 32.5 percent of total cases, including 20 cases of Damp-heat syndrome group and 19 cases of non Damp-heat syndrome group.The Damp-heat group includes 6 cases(30%) of Minimal change nephropathy,5 cases(25.0%) of Mesangial proliferative glomerulonephritis,8 cases(40.0%) of Membranous nephropathy and 1 case(5.0%)of Mesangial capillary glomerulonephritis.And the non Damp-heat group includes 4 cases(21.1%) of Minimal change nephropathy, 10 cases(52.6%) of Mesangial proliferative glomerulonephritis,3 case(15.8%) of Focal segmental glomerulosclerosis and 2 cases(10.5%) of Membranous nephropathy.The results showed that the membranous nephropathy patients of PNS Damp-heat Syndrome group are more than the non Damp-heat syndrome group' s.By statistical testing,there is difference between the two groups on membranous nephropathy(P＜0.05). But,by statistical testing,there is not difference between the two groups on other pathological types(P＞0.05).8.The impact of Damp-heat on curative effectThe Damp-heat group includes 19 cases(31.7%) of complete remission, 12 cases(20.0%) of significant remission,10 cases(16.7%) of partial remission and 19 cases(31.7%) of invalid.The total effective rate of the Damp-heat group is 68.3 percent.The non Damp-heat group includes 24 cases(40.0%) of complete remission,17 cases(28.3%) of significant remission,9 cases(15.0%) of partial remission and 10 cases(16.7%) of invalid.The total effective rate of the non Damp-heat group is 83.3 percent.This shows the effective rate of Damp-heat syndrome group was lower than the non Damp-heat syndrome group.By statistical testing,there is difference between the two groups on effective rate(P＜0.05).(二) Proteome research of Primary nephrotic syndrome Damp-heat syndromeIn proteomics research,That select 5 cases of normal control group, 10 cases of PNS Damp-heat syndrome group and 10 cases of non Damp-heat syndrome group to do serum Two-dimensional gel electrophoresis and mass spectrometry analysis.The experimental results show:The pictures are clear;There is no background interference stripes;The protein spots are completely separated;Under the same conditions and repeated 3 times,the experimental results similar to Figure;Through analysising the three sets of maps,there are finded out 1108 protein spots.Select the normal map as a reference gel,the other two groups with reference to glue rubber match,so that the gel of protein spots with reference to the corresponding glue together with the reference gel protein spots in the same match with the point of a protein.The results showed that the percentage of protein spots matched on the three sets of gel is about 80.12%.The study use PDQuest software to analysis the differentially expressed protein in the two-dimensional gel images ofthe normal control group,PNS Damp-heat syndrome group and non Damp-heat group.Combined with the naked eye to distinguish,we found 19 protein spots in the gel three groups were significantly different in expression.By software analysis and manual selection,we selected six protein spots that are clear and obvious changes in expression levels from the differentially expressed protein to do mass spectrometry.The results of identified show that the No.2 protein is Apolipoprotein C-Ⅲ,the No.5 protein is Alpha-2-HS-glycoprotein,the No.8 protein is Immunoglobulin kappa 1-5, the No.10 protein is Inter-alpha-trypsin inhibitor heavy chain H2,the No.15 protein is Isoform 1 of Alpha-1-antitrypsin and the No.5 protein is Serotransferrin.Combined clinical and protein function,that the Apolipoprotein C-Ⅲandα2-HS-glycoprotein protein can be used as the specific expressed protein of PNS Damp-heat Syndrome.Conclusion:1.Form the data of the relationship between PNS Damp-heat and infection and recurrence,the study came to the conclusion that Damp-heat is an an important factor that Leads to recurrence of PNS patients.2.Form the data of the relationship among PNS Damp-heat,course of disease,the days staying in hospital,blood lipids and urinary protein, efficacy,etc,;The study came to the conclusion that Damp-heat is an important factor that Leads to the condition of PNS patients exacerbate, procrastinate and Refractory.3.Through analysising Serum protein silver staining 2-DE map of Normal control group,PNS Damp-heat syndrome group and non Damp-heat Syndrome, we found the differentially expressed proteins.4.Through the identification of differences in protein,the study reached a preliminary view that Apolipoprotein C-Ⅲandα2-HS-glycoprotein protein can be used as evidence of the specific expressed protein of PNS Damp-heat.