Objective: To explore better therapy and decrease the rate of re-relapse of main nephritic syndrome in children who had been treated with corticosteroids but relapsed. the re-relapse rates of both organizations were observed. The re-relapse rate of the treatment group was 28.2% to 29.3% in the CTX-controlled group. The re-relapse rates between two organizations were almost similar, and with no observed significant difference ( em P /em 0.05). The side effect of tripterysium glucosides was less than that of CTX. Summary: For the treatment of relapsing nephritic syndrome in children, the combination of tripterysium glucosides and prolonged corticosteroid therapy is as effective as the routine of CTX plus prolonged BIX 02189 cell signaling use of prednisone. strong class=”kwd-title” Keywords: Main nephrotic syndrome, Relapse, Tripterysium glucosides, Prednisone Intro Main nephrotic syndrome is the most common renal disease in children. Most children with nephrotic syndrome respond to corticosteroids (Hodson et al., 2000). However, 71.2% of children encounter a relapsing program with recurrent episodes of edema and proteinuria within two years after 6~9 months treatment of corticosteroids (Yang, 2000). The relapse of main nephrotic syndrome in children after treatment and remission is definitely BIX 02189 cell signaling a common phenomenon. In order to reduce the re-relapse, from January 1994 to April 2000 we used different schemes to research treatment. Tripterysium glucosides was produced by abstracting from the wood core part of tripterysium, a Chinese medicine celastraceace plant. It has been proved that tripterysium glucosides possess anti-inflammatory and immunosuppressive effects. Tripterysium glucosides may possess effect by suppressing the production of interleukin-2 and its receptor effect, inducing activated lymphocytes apoptosis, BIX 02189 cell signaling interfering with the lymphocytes cell cycle, decreasing lymphocytes proliferation, and suppressing the activation of nuclear factor-kappa B (Liu et al., 1999; Qiu and Kao, 2003). We compared the effects of tripterysium glucosides plus prolonged use of prednisone with that of CTX plus prolonged use of prednisone. Right now we statement the outcome as follows. PATIENTS AND METHODS Eighty situations in the study met the requirements of the Association Band of Technology and Analysis of the National Childrens Nephropathy in 1981. The therefore known as relapse means: the proteinuria was transformed from detrimental to positive, there have been signals of ++ for 3 x in a single week, or the quantity of protenuria is add up to or higher than 50 mg/kg in 24 h. The regular relapse means: the days of relapse in two a calendar year are add up to or even more than 2, or the days of relapse in BIX 02189 cell signaling a single year are add up to or higher than 3. In scientific practice, we frequently classify principal nephrotic syndrome into scientific basic type and nephritic type. The scientific simple type implies that the sufferers have got four features which includes proteinuria (urinary protein excretion higher than 50 mg/(kgd)), hyperlipidemia, hypoalbuminemia and edema. The nephritic type implies that the sufferers have among the follow circumstances, aside from the above four features: (1) hematuria (a lot more than 10 red blood cellular material per high power field in centrifuged urine 3 x inside a fortnight); (2) hypertention BIX 02189 cell signaling (aside from the impact of prednisone); (3) increased serum degrees of creatinine and urea nitrogen (aside from hypovolemia); (4) hypocomplementemia 3. The sufferers were randomly divided into two organizations. One group is the treatment group. In this group, there were 39 Edn1 cases: male 31 cases, woman 8 cases. The age was from 1 to 13 years old. The mean age was 4.99 years old. There were 35 instances of the medical simple type, 4 instances of the nephritic type; 29 instances of non-frequent relapse type, and 10 instances of frequent relapse type. The additional group was the control group. In this group, there were 41 cases: male 33 cases, woman 8 cases. The age was from 1.5 to 12 years old. The mean age was about 4.37 years old. There were 32 instances of the medical simple type, 9 instances of the nephritic type; 23 instances of non-frequent relapse type, and 18 instances of frequent relapse type (Table ?(Table11). Table 1 Clinical characteristics of the two organizations thead align=”center” GroupsCasesMale/femaleMean age (year)Clinical simple typeNephritic typeNon-frequent relapseFrequent relapseRenal biopsy /thead Tripterysium group3931/84.935429107CTX group4133/84.432923188Total806713522815 Open in a separate window Fifteen cases of frequent relapse were renal biopsied, in which 7 cases were included in the treatment group, 8 cases in the control group. The histopathologic changes showed that there were 6 instances of minimal switch, 4 instances of mesangial proliferative glomerulonephritis from small to medium level, one case of IgA nephropathy, 3 instances of IgM nephropathy, one case of focal segmental glomerulosclerosis. Sufficient dose (1.5C2.0 mg/(kgd), not to exceed 60 mg/d) of prednisone was given to both organizations. When remission occurred within 4 to 8 weeks of therapy, the dose of prednisone was decreased. At the first time, one third of total dose was deducted, and it was given in every morning for 3C4.