Clinical Focus

Diagnosis and differential diagnosis of ulcerative colitis

Yang Hong，Zhang Huimin， Jin Meng， Qian Jiaming

2016, 31(8): 813-816. doi:10.3969/j.issn.1004-583X.2016.08.001

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Ulcerative colitis(UC) is a chronic and nonspecific inflammatory bowel disease.The incidence of UC is increasing in recent years. Diverse clinical characteristics and nonspecial diagnostic criteria lead to misdiagnosis and missed diagnosis for UC. The article reviews the key points and the progress of UC.

Differential diagnosis of Crohn disease

Zhang Chunxia1，Wu Xiaoping2

2016, 31(8): 817-819,823. doi:10.3969/j.issn.1004-583X.2016.08.002

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In most cases，it is very difficult for clinician to diagnosis Crohn disease(CD) because the atypical or overlapped colonoscopic manifestations with other diseases. Especially， it is a great challenge to distinguish CD from intestinal tuberculosis(ITB) in clinical practice because the two diseases share the same location，confusingly similar clinical manifestations， and sometimes similar endoscopic features. The differentiation between CD and ITB mainly relies on the comprehensive analysis of pathology and extraintestinal manifestations if the lesion is atypical endoscopically. Another misdiagnosed situation of CD is intestinal lymphoma， because it is quite difficult to make a conclusion to lymphoma via a singe biopsy pathology， which is related to the biopsy specimens and experiences of pathologists. Therefore， multiple sites biopsy and careful pathological examination (if necessary， immunohistochemistry， gene rearrangement or in situ hybridization) serve the key to avoid the misdiagnosis and missed diagnosis of lymphoma. In addition， the atypical lesions of CD should also be ruled out of intestinal Behcet disease，nonsteroidal antiinflammatory drugs(NSAIDs) related enteropathy and other rare causes of enteropathies through a combination of repeated biopsy pathology and specific clinical features.

Reasonable application of 5aminosalicylic acid in inflammatory bowel disease treatment

Guo Jinbo，Zhang Xiaolan

2016, 31(8): 820-823. doi:10.3969/j.issn.1004-583X.2016.08.003

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5-aminosalicylic acid (5-ASA) is the earliest medication widely used for inflammatory bowel disease (IBD) treatment with little side effect. However， improper use of drugs often appear in clinic. The present article mainly introduced the development history， therapeutic mechanism，reasonable application and side effect of 5-ASA in IBD treatment as well as its chemopreventive effect on IBDassociated colonic cancer with the purpose of 5-ASA beneficial use.

Recent advances of immunosuppressive therapy in inflammatory bowel disease

Li Yue， Qian Jiaming

2016, 31(8): 824-827. doi:10.3969/j.issn.1004-583X.2016.08.004

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Inflammatory bowel disease comprises ulcerative colitis and Crohn disease， both of which are characterized by a tendency of chronic or relapsing immune activation and inflammation within the gastrointestinal tract. Immunomodulating drugs， including azathioprine， methotrexate and cyclosporine etc. are most useful in managing steroids resistant or dependent patients to achieve steroidsfree remission.

Rational application of corticosteroids in ulcerative colitis

Li Shengmian

2016, 31(8): 828-830,837. doi:10.3969/j.issn.1004-583X.2016.08.005

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Corticosteroids are efficacious to induce remission in patients with active ulcerative colitis， whilst accompanying by adverse events. Due to the lack of largescale randomized controlled clinical study， standard mode for application of corticosteroids in the treatment of ulcerative colitis is not very clear. To reduce corticosteroids use risk and maximize efficacy need for right patients， appropriate agents should be used at the right time. According to the expert consensus published in recent years， a systematic review has been performed to examine this issue.

How to optimize biological therapy for patients with Crohn disease

Cao Qian

2016, 31(8): 831-833,842. doi:10.3969/j.issn.1004-583X.2016.08.006

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Biologics are effective drugs for Crohn disease. Optimized therapy of biologic can improve the effect and avoid sideeffect. In this review， the author discussed the correct patients， correct time and correct methods of biological therapy for patients with Crohn disease， which will help physicians use biologics more reasonable in the clinic.

Nutritional therapy in inflammatory bowel disease

Wei Tiantong， Wang Huahong

2016, 31(8): 834-837. doi:10.3969/j.issn.1004-583X.2016.08.007

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The patients of inflammatory bowel disease(IBD)，such as ulcerative colitis(UC) and Grohn disease(CD)，are often accompanied by malnutrition and growth retardation. Nutrition support plays an important role in the treatment of IBD. Nutritional risk screening should be performed routinely for patients of IBD and appropriate methods should be used to assess nutritional status. Enteral nutrition is the best dietary intervention for the induction of remission and maintenance of remission in Crohn disease in children，but a replacement for medication in adults. There is a variety of nutritional preparation. As different patients may have different reactions to different supplements， individualization therapy is very essential to maximize the function of nutritional support.

Clinical application of fecal microbiota transplantation on ulcerative colitis

Sun Chengcheng， Jiang Xueliang

2016, 31(8): 838-842. doi:10.3969/j.issn.1004-583X.2016.08.008

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Fecal bacteria transplantation(FMT) originated in the Spring and Autumn Period and Warring-States Period 2700 years ago， however， its treatment on ulcerative colitis is still in infancy. The process of FMT mainly includes the selection of the donor， preparation of the bacterial liquid and introduction of the liquid. The treatment has no serious side effects， and is relatively safe. But， its effect is not as remarkable as in Clostridium difficile infection's treatment. The clinical effect from different studies varied greatly. It may relate to the lack of uniform criteria for the selection of indications， the selection of the donor and the process of transplantation.

Standardized surgical treatment of ulcerative colitis

Liu Gang

2016, 31(8): 843-846. doi:10.3969/j.issn.1004-583X.2016.08.009

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Surgical operation is always an important method for ulcerative colitis， while lack of surgical knowledge and standardization of surgical treatment remains a severe problem in China. It is really a major issue how to more powerfully promote standard surgical concept and practice of ulcerative colitis. This review introduced the surgical indications， operation standard， postoperative complications and longterm outcome of ulcerative colitis and analyzed the real clinical status in China. Summary for current clinical solution and outlook for the future was also given for a better prospect.

Clinical skin manifestations in patients with inflammatory bowel disease

Li Junxia，Tian Yuan，Wang Huahong，Liu Xinguang

2016, 31(8): 847-851. doi:10.3969/j.issn.1004-583X.2016.08.010

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The types of skin manifestations in inflammatory bowel disease(IBD) patients include IBD specific skin manifestations,reactive skin manifestations, the skin manifestations complicated with IBD and secondary skin manifestations of IBD related with other causes.Erythema nodosum and pyoderma gangrenosum associated with IBD are commonly seen in ulcerative colitis，and skin abscesses and fistulas in Crohn disease. Some skin lesions may occur consequently,simultaneously or even before IBD diagnosis. Some skin lesions may indicate the development of IBD. The activity of IBD might have positive correlation with skin manifestations.Treatment of IBD skin lesions should be based on the control of IBD .Special therapy should be given according to the type of skin lesions.

Role of endoscopy in inflammatory bowel disease

Wang Dong，Zhang Xiaolan

2016, 31(8): 852-856. doi:10.3969/j.issn.1004-583X.2016.08.011

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Endoscopy has a crucial role in the diagnosis and management of inflammatory bowel disease(IBD). Endoscopy has also a part in evaluating disease condition， mucosal healing(MH) and the risk for postsurgical recurrence， monitoring or screening colorectal cancer (CRC)， and in providing endoscopic treatment for inflammatory bowel hemorrhage and strictures，fistulas， primarysclerosing cholangitis and cholangiocarcinoma.

Gut microbiota and inflammatory bowel disease

Chi Yan

2016, 31(8): 857-860. doi:10.3969/j.issn.1004-583X.2016.08.012

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Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory condition. Although the etiology of IBD is unknown， the dominant hypothesis suggests the inflammation results from sustained immune response towards altered microbiota within a genetically susceptible host. Gut microbiota plays a significant role in pathogenesis of IBD. In this article， we describe a healthy microbiota，review the important microbiome studies of IBD and talk about the related therapy， such as probiotics and fecal microbiota transplantation.

Helicobacter pylori infection and inflammatory bowel disease

Niu Weiwei， Zhao Dandan， Huo Xiaoxia

2016, 31(8): 861-964. doi:10.3969/j.issn.1004-583X.2016.08.013

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In recent years，with a rising trend in the incidence of inflammatory bowel disease(IBD) the pathogenesis of IBD is still clear. It may associate with heredity， immunity， infection and environmental factors. Helicobacter pylori (H.pylori) is a common gramnegative micro aerobic bacteria in the stomach， which is related to peptic ulcer and gastric malignancies. A correlation between IBD and H.pylori， is uncertain. This article reviews the relationship between IBD and H.pylori in order to have a thorough understanding of the etiology of IBD， and provides a new way of thinking for the clinical treatment of IBD and H.pylori.

Opportunistic infections and inflammatory bowel disease

Lei Lei1，2， Zhang Xiaolan1， Yin Fengrong1

2016, 31(8): 865-868. doi:10.3969/j.issn.1004-583X.2016.08.014

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Application of immunosuppression opens a door for the treatment of inflammatory bowel disease (IBD)， while the opportunistic infections (OI) have emerged in it. Opportunistic infections in patients with IBD include viral infections， bacterial infections， fungal infections and parasite infections and so on. The OI increase the mortality and morbidity of IBD patients， so early detection and identification of IBD with OI and early treatment or preventive treatment were extremely important.

Epidemiological characteristics and risk factors on dyslipidemia of people in Dongxiang nationality of Gansu province

Su Peng1a，Chen Junhui1b，Liu Shurao2，Gao Xia1b，Ouyang Xiaolei2，Ma Liya1a，Wang Nan1a

2016, 31(8): 869-874. doi:10.3969/j.issn.1004-583X.2016.08.015

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ObjectiveTo investigate the abnormal incidence of serum cholesterol (TC)， triglyceride (TG)， highdensity lipoprotein cholesterol (HDLC)， lowdensity lipoprotein cholesterol (LDLC) among the midaged and elderly people of Dongxiang minority area in Gansu province and provide the basis for the prevention and treatment of cardiovascular disease such as hypertension and diabetes mellitus. MethodsQuestionnaire investigation and physical examination among 1 000 people over 45 years of Dongxiang minority area in Gansu province were carried out by stratified random sampling method. The serum levels of TC， TG， HDLC and LDLC were detected.ResultsTC and LDLC of Dongxiang were significantly higher than those of Han. Meanwhile， TC， TG and LDLC of 60 years old or older were significantly higher than 45 to 59 years old and middleaged people.The dyslipidemia rate of Dongxiang was significantly higher than that of Han and the rate of abnormal TG and LDLC had significant differences (P<0.05).And the dyslipidemia rate of old people over 60yearold was higher than that of 45 to 59 years old and middleaged people. At the same time， the rate of abnormal TG and LDLC had significant difference (P<0.05). The dyslipidemia rate of over 60yearold in Dongxiang and Han among the different ethnic groups were significantly higher than those of 45 to 59 years old and middleaged people. TG， HDLC and LDLC abnormal rate of elder people in Dongxiang were significantly higher than those of middle age and TG and HDLC abnormal rate of elder people in Han were significantly higher than those of middleaged people.In different age groups， dyslipidemia rate of the elder people over 60 year old in Dongxiang was significantly higher than that of Han， especially TC， TG and LDLC. And dyslipidemia rate of 45 to 59 years old and middleaged in Dongxiang were significantly higher than those of Han， especially TG and LDLC. Fifteen factors of dyslipidemia factors were analyzed， statistically significant factors were analyzed again. The final results showed that age and nationality were the risk factors of dyslipidemia.ConclusionDyslipidemia rate of middleaged and elder people in Dongxiang county of Gansu is higher， the dyslipidemia rate of elder people in Dongxiang is significantly higher than that of Han and the elder people over 60 years old are significantly higher than those of 45 to 59 years old and middleaged people.Dyslipidemia of residents in Dongxiang county of Gansu has the relation with the age， nationality， smoking， high blood pressure and BMI， of which the ethnic and age factor are great impact factors.

Screening of chronic kidney diseases and followup in migrant children in Lanzhou Xigu district

Chen Junhui1， Lei Xiaoyan1， Liu Shurao2， Suo Yanhong3， Gao Xia1

2016, 31(8): 875-878. doi:10.3969/j.issn.1004-583X.2016.08.016

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ObjectiveTo explore the abnormal detection rates in sceening of chronic kidney disease (CKD) in migrant children in Lanzhou Xigu district and to analyze the reason. MethodsA total of 1 233 migrant children ranging 68 years old were collected and another 1 129 resident children were collected as control group. Urine test was performed in all children by urine test paper method. Among 2 332 children， repeat urine test was done in 147 children who had abnormal result in the first test. Children with abnormal urine result were divided into three groups: hematuria， proteinuria， hematuria and proteinuria， and bacteriuria. ResultsOur data showed that total detection rate was 13.6%， including hematuria 9.3%，proteinuria 0.4%，hematuria and proteinuria 0.3% and bacteriuria 4.1%. The detection rate of hematuria (10.8%) in migrant childrenwas significantly higher than that of the resident children， but in proteinuria， bacteriuria， hematuria and proteinuria， there were no significant difference between them. The detection rates of hematuria， hematuria and proteinuria and proteinuria were significantly higher in the male migrant children than in the male resident children. There were no significant difference in hematuria， proteinuria， hematuria and proteinuria， and bacteriuria between female migrant children and female resident children. In 147 cases of followup， 21 cases with simple hematuria were found， one case with henochschonlein purpura nephritis was found， two cases with urinary tract infection were found. ConclusionUrine screening is a convenient way for early detection of renal disorders in children. More attention should be paid to the positive screening results in the migrant children.

Case management model's effect on hyperlipidemia in diabetic outpatients

Liu Yueqin， Zhao Qin，Hou Lin， Li Yongyong， Hou Xiaojuan， Dong Yuxia， Wang Fujun

2016, 31(8): 879-881,885. doi:10.3969/j.issn.1004-583X.2016.08.017

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ObjectiveTo explore the effect of case management model on hyperlipidemia in diabetic outpatients. MethodsPatients with diabetes mellitus from Mar 2014 to Jun 2014 were enrolled and randomly divided into two groups. The patients in experimental group were treated with a health plan that was made personally for six months. Those of control group were treated with normal health education at the same time. The changes of fasting blood glucose， postprandial 2 hour blood glucose， HbA1c， total cholesterol and triglyceride were compared between experimental group and control group. ResultsAfter one month of health management， the five biochemical indexes above in each patient were all up to standard， the difference between two groups was not statistically significant (P>0.05). But， six months later， the indexes of patients in experimental group were still in control standard， while the control group showed different degrees of increase (P<0.05). ConclusionDiabetes health case management model can be an effective implementation of continuous care for discharged patients to help on a strict diet management， correcting bad habits， prevention of risk factors， improving clinical biochemical indexes， so as to achieve the purpose of effective control of diabetes mellitus.

Endobronchial ultrasound transbronchial lung biopsy with guidesheath for diagnosis of benign peripheral pulmonary lesions

Pan Wensen，Yu Jing，Yuan Yadong

2016, 31(8): 882-885. doi:10.3969/j.issn.1004-583X.2016.08.018

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ObjectiveTo evaluate the diagnostic value of endobronchial ultrasound transbronchial lung biopsy with guidesheath (EBUSGS) in benign peripheral pulmonary lesions（PPL）．MethodsRetrospective analysis was performed in 49 patients with PPL inaccessible by conventional bronchoscopy．The diagnostic yield，safety and associated factors were analyzed．ResultsFortynine patients with PPL (35 males and 14 females，age 35 to 88 years，mean ［63.1±11.1］ years) were confirmed by CT but not detected by conventional bronchoscopy．PPL were examined in 49 patients，and 37 cases with PPL were detected by EBUSGS，and the diagnostic rate was 75.5%．The diagnosis rate of malignant PPL was 87.5% (14/16)， while that of benign disease was 69.7％(23/33)．All patients tolerated the procedure very well．Mild bleeding was observed in the biopsies of some patients．No pneumothorax or other serious complications were observed.ConclusionThe technique of EBUSGS was safe，and its diagnostic rate was higher to either malignant or benign PPL.

Shortterm efficacy of tiotropium bromide combined with budesonide and formoterol fumarate dihydrate in bronchial asthmaCOPD overlap syndrome

Tan Jingfu，Ye Yongqing，Yang Longfeng，Chen Yong，Liao Zhenhui

2016, 31(8): 886-888,892. doi:10.3969/j.issn.1004-583X.2016.08.019

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ObjectiveTo analyze the shortterm efficacy of tiotropium bromide (Spiriva) combined with budesonide and formoterol fumarate dihydrate (Symbicort) in bronchial asthmaCOPD overlap syndrome. MethodsA total of 152 patients with bronchial asthmaCOPD overlap syndrome were selected and divided into test group (80 cases) and control group (72 cases). Test group patients took treatment of Spiriva combined with Symbicort based on regular treatment， control group patients adopted mucosolvan sheet and seretide treatment for four weeks. Treatment effect of patients was compared between two groups. ResultsAfter treatment，the lung function was improved in both groups of patients. The indexes of forced expiratory volume in one second (FEV1) and forced expiratory volume in one second occupation force vital capacity (FEV1/FVC) in test group were significantly higher than in control group (P<0.05); the index of residual volume/total lung capacity (RV/TLC) in test group was significantly lower than that in control group (P<0.05). The COPD score (CAT score) was decreased in both groups， and was significantly lower in test group than in control group (P<0.05). The asthma control test scores (CAT score) was increased in both groups and was significantly higher in test group than in control group (23±4 vs 15±2，P<0.05). The number of exacerbation was decreased in both groups and was significantly lower in test group than in control group. No severe adverse reaction occurred in both groups. There was no significant difference in the average cost between test group and control group (P>0.05). ConclusionIn patients with bronchial asthmaCOPD overlap syndrome， Spiriva combined with Symbicort inhalation can improve the efficacy and cost of treatment did not significantly increase.

Change and significance of serum amyloid A and interleukin6 in neonatal critical illness

Wu Jingzhi， Li Fangjun， Chen Bo， Liu Aixia

2016, 31(8): 889-892. doi:10.3969/j.issn.1004-583X.2016.08.020

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ObjectiveTo explore the change of newborn umbilical arterial blood serum amyloid A (SAA) and interleukin6 (IL6). MethodsA total of 86 cases of newborn umbilical arterial blood were collected between April 2015 and March 2016， including 13 cases of extremely critical group， 23 cases of critical group， 20 cases of noncritical group and 30 cases of normal group. The levels of serum SAA and IL6 were determined by ELISA and compared between four groups. The receiveroperating characteristic curve(ROC) was adopted to define SAA and IL6 in the diagnosis of the critical point of tangency of a newborn. The judgement of sensitivity and specificity were calculated in the critically ill newborns. ResultsThe levels of serum SAA and IL6 in disease groups were significantly higher than those in normal group (P<0.05). The levels of SAA and IL6 were positively correlated with the degree of critically illness(P<0.05). The areas of SAA and IL6 in the diagnosis of neonatal critical illness under ROC curve were 0.925(95%CI) and 0.945(95%CI)， respectively. The sensitivity and specificity of SAA were 83.9% and 96.7%， respectively; the sensitivity and specificity of IL6 76.8% and 96.7%， respectively.ConclusionThe levels of SAA and IL6 can reflect the severity of illness and better identify the critical neonates in a timely manner. Meanwhile， the SAA and IL6 have higher sensitivity and specificity and can be used in neonatal critical illness assessment.

Clinical significance of early detection of highlysensitivity C-reactive protein and immune function in children with handfoot and mouth disease

Zhou Qinghua1， Chen Juan2

2016, 31(8): 893-896. doi:10.3969/j.issn.1004-583X.2016.08.021

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ObjectiveTo explore the clinical significance of highlysensitivity Creactive protein (hsCRP) and immune function in children with handfoot and mouth disease (HFMD). MethodsA total of 60 children with severe HFMD were selected as research group， and as control group， 100 cases of healthy children were enrolled. Using the immune turbidimetry， hsCRP， immunoglobulin (IgA， IgG， IgM， C3 and C4) and T lymphocyte subsets (CD3+， CD4+ and CD8+) were detected. ResultshsCRP and WBC in acute phase and recovery phase in research group were significantly higher than those in control group (P<0.01). hsCRP and WBC in recovery phase were significantly lower than those in acute phase， however，and they were significantly higher than those in control group (P<0.01). IgA in acute phase and recovery phase in observation group was significantly lower than that in control group (P<0.05). IgG， C3 and C4 in acute phase and recovery phase in observation group were significantly higher than those in control group (P<0.05). CD3+， CD4+ and CD4+/CD8+ ratio in acute phase and recovery phase in observation group were significantly lower than those in control group (P<0.05). CD3+ in recovery phase was significantly higher than that in the acute phase of observation group (P<0.05). ConclusionInflammation and myocardial injury can be detected in children with HFMD by hsCRP monitor， obviously lower function in cellular immunity and humoral immunity can be observed in acute phase of severe children with HFMD and in the recovery phase， the humoral immunity， cellular immunity and inflammation become gradually normal.

Role of PTEN and desmin in patients with diabetic nephropathy

Xing Lingling1， Song Hongwang2， Zhang Chunxia1， LI Shaomei1， Yang Lin1

2016, 31(8): 897-900. doi:10.3969/j.issn.1004-583X.2016.08.022

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ObjectiveTo investigate the role of PTEN and desmin in glomeruli in patients with diabetic nephropathy (DN). MethodsThirty patients diagnosed as diabetic nephropathy by clinical data and renal biopsy were divided into three groups (grade Ⅰ， Ⅱ， Ⅲ) by glomerular lesion， 10 cases of renal tissues without evident renal disease were obtained from distant portion of renal tumors as control group. The expression of PTEN and desmin in glomeruli were detected by immunocytochemistry. ResultsImmunocytochemical staining showed that the expression of desmin strengthened with the severity of the lesions of glomeruli in DN，but the expression of PTEN was less remarkable. There were obviously negative correlation between the expression of PTEN in glomeruli and 24 h urine protein excretion and the expression of desmin in glomeruli (r=-0.675 and -0.642，respectively，P＜0.01) . ConclusionThe downregulation of PTEN expression may lead to podocyte lesion and aggravate progress of diabetic nephropathy.

Analysis of quality control situation of diagnosis and treatment on cancer pain in Mentougou District Hospital

Cao Ying1，Luan Haibo1，Liang Chunhui2

2016, 31(8): 901-904. doi:10.3969/j.issn.1004-583X.2016.08.023

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ObjectiveTo investigate the implementation of 'Standardized Diagnosis and Treatment of Cancer Pain' in our hospital and analysis our current problems. And to provide the basis for quality control of diagnosis and treatment on cancer pain in our hospital. MethodsThe methods of terminal medical case reviews and medical cases field investigation were applied to analyze the application of narcotic drugs in our hospital cancer patients in the third quarter of 2015. The reviews and investigations method based on ‘Expert Consensus on Standardization of Cancer Pain Treatment and Quality Control in Beijing (2014 edition)’. The contents of analysis were divided into nursing and clinical parts. ResultsNursing procedures were accomplished in accordance with the requirements for the hospital. However， the completing the preciseness of the data needed improvement. The clinical part lacked too much contents， the starting point was too low， which did not achieve the basic standard of quality control in Beijing. ConclusionTaining for diagnosis and treatment on cancer pain should be strengthened. Moreover，the quality control standards should be set up and strictly implemented.

Tonsillectomy combined with medication therapy in patients with immunoglobulin A nephropathy: a metaanalysis

Ma Xuxianga， Xin Lingb， Li Yinga， Zong Xiaoyinga， Qian Pinga

2016, 31(8): 905-908. doi:10.3969/j.issn.1004-583X.2016.08.024

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ObjectiveTo evaluate the efficacy of tonsillectomy combined with medication therapy (TCMT) on immunoglobulin A nephropathy nephropathy (IgAN). MethodsWe identified eligible studies in either English or Chinese published up to March 31， 2015 by searching Embase， Pubmed， China Biology Medicine disc(CBM)， Chinese National Knowledge Infrastructure(CNKI)，etc. The quality of selected randomized controlled trails or prospective controlled trails that treated IgA nephropathy with TCMT was assessed and metaanalyses were conducted by using Stata statistical software (version 13.0). ResultsSix studies were ultimately enrolled in this metaanalysis， including 3 prospective controlled trails and 3 randomized controlled trails. ①The overall efficacy of TCMT in patients with IgAN: three studies witha total of 224 patients were included， involving 134 patients in TCMT group and 90 patients in medication therapy group.Pooling results of meta-analysis indicated that TCMT was statistically significantly superior to medication therapy alone (OR=2.68，95%CI=1.474.90，P=0.001). ②The proteinuria remission rate of TCMT in patients with IgAN: 5 studies with a total of 326 patients were included，involving 167 patients in TCMT group and 159 patients in medication therapy group.Meta-analysis showed significant difference between the two groups (OR=4.38，95%CI=2.677.20，P<0.001). ③The remission rate of erythrocyte of TCMT with IgAN: five studies with a total of 326 patients were included，involving 167 patients in TCMT group and 159 patients in medication therapy group. Metaanalysis also indicated that the difference was statistically significant between the two groups (OR=3.90，95%CI=1.3811.07，P=0.01). ConclusionCompared with the single medication therapy， our study indicated that the TCMTcan improve the complete remission of IgAN， proteinuria remission rate and the remission rate of erythrocyte.

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