持续性肾脏替代治疗的抗凝方案的确立和存在的问题

持续性肾脏替代治疗（CRRT）以其保持稳定的心血管状态、调整免疫功能、保护内皮细胞以及高效的清除能力，不仅应用于肾脏内科，而且广泛应用于ICU、心脏科、呼吸科、外科等多学科领域。可以说CRRT技术带来了危重患者抢救的新理念，对于提高危重患者救治成功率发挥了不可替代的作用。实施CRRT治疗的患者经常合并各种出血或血栓、栓塞问题，因此合理地确立CRRT抗凝治疗方案非常重要。     

早中期慢性肾脏病进展的防治对策

慢性肾脏病（chronic kidney disease，CKD）是严重危害人类健康和生命的常见病。加强和改善CKD的防治，已经成为不可忽视的公共卫生问题和医疗问题。认识CKD进展的危险因素与机制，改进CKD进展的防治措施，是提高CKD防治水平的客观需要。CKD防治的对策和措施，重点在于针对CKD进展与急剧加重的危险因素，落实早期治疗、基础病治疗和多因素干预治疗。     

Results of statutory rehabilitation measures in Germany

The success of medical rehabilitation measures taken by the LVA Oberfranken and Mittelfranken in 1984 was scrutinized for 12,291 insured people. The criteria for evaluating success were the state of health of the insured persons before rehabilitation and at one month and one year afterwards. Two thirds of the insured persons were at work again one month after discharge from rehabilitation. One year after rehabilitation 14 per cent received a disablement pension. Only every second person insured who was ill before rehabilitation took up work again afterwards. Most of the insured people who were already receiving a pension before rehabilitation continued to receive their pension afterwards (86 per cent). The highest rate of inability to work and also the highest pension rate is found with insured persons suffering from an ischaemic cardiac disease. Only 33 per cent of these persons resume work after rehabilitation.     

低蛋白饮食联合复方α-酮酸治疗在慢性肾脏病中的应用

目前，全球终末期肾脏病（ESRD）进入透析的人群迅速增长。ESRD给患者、家庭和社会带来了巨大的经济负担，这对于全球特别是中国这样一个发展中国家无疑是需要面对的一个巨大的经济问题。据目前的调查研究显示，慢性肾脏病（CKD）患者人数已超过总人口数的10％。为此，我们需要更好的方法来预防和治疗CKD。高蛋白饮食对肾脏结构和功能均存在明显不良影响，这种影响对正常肾脏或许不产生什么严重的后果，但对于已有慢性肾脏病背景，尤其肾功能己遭受损伤的情况下，则可加快病情发展㈦。因此，低蛋白饮食是CKD患者治疗中至关重要的一环，对CKD患者采用限制蛋白饮食的治疗手段已有130多年的历史。     

Systemic edema in kidney diseases

Extracellular fluid expansion states are characterized by increase total body water. These disorders are usually associated with avid renal sodium and water retention. Some examples of such abnormal sodium retention in renal diseases are acute glomerulonephritis and nephrotic syndrome. Edema formation in case of acute glomerulonephritis is primarily responsible for salt retention. On the other hand, the pathogenesis of edema in nephrotic syndrome involves two different mechanisms those are underfill and overfill hypothesis. According to the underfill hypothesis, nephrotic syndrome results in increase of urinary loss of albumin, which subsequently leads to hypoalbuminemia and decreased plasma osmotic pressure. Overfill theory explains that renal salt and water retention is primary phenomenon that leads to plasma volume expansion and subsequent exudation of fluid to the interstitium.