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2.
Zhonghua Gan Zang Bing Za Zhi ; 28(9): 742-746, 2020 Sep 20.
Artigo em Chinês | MEDLINE | ID: mdl-33053973

RESUMO

Objective: To investigate the efficacy of shunt after transjugular intrahepatic portosystemic shunt (TIPS) in liver cirrhosis accompanied with portal vein thrombosis (PVT). Methods: Forty-four cases with liver cirrhosis accompanied with PVT who underwent TIPS treatment from January 2015 to May 2018 were retrospectively analyzed. Clinical baseline data of the patients were collected. Portal vein pressure gradient (PVPG) before and after the surgery was recorded. Shunt patency was observed at 3, 6, 12, 18 and 24 months after the surgery. The influencing factors were determined by univariate and multivariate analysis. Results: Transjugular intrahepatic portosystemic shunt was successfully established in all 44 cases. The postoperative PVPG was lower than preoperative (P < 0.01). The shunt patency rate after TIPS in PVT was 18.2% (n = 8). The cumulative shunt patency rates at 3, 6, 12, 18, and 24 months after surgery were 95.5%, 90.7%, 90.7%, 86.8% and 74.4%, respectively. Univariate analysis showed that diabetes history, platelet level and prothrombin time-international normalized ratio were associated with postoperative shunt dysfunction. Multivariate analysis showed that diabetes history (P = 0.007, OR = 28.606) was an independent risk factor for postoperative shunt dysfunction. Conclusion: TIPS is a safe and feasible procedure, which can effectively reduce the portal pressure in liver cirrhosis accompanied with PVT. Diabetic patients have a higher risk of postoperative shunt dysfunction. Therefore, clinical intervention should be strengthened for high-risk patients.


Assuntos
Derivação Portossistêmica Transjugular Intra-Hepática , Humanos , Cirrose Hepática/complicações , Veia Porta/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
3.
Zhonghua Yi Xue Za Zhi ; 97(2): 85-91, 2017 Jan 10.
Artigo em Chinês | MEDLINE | ID: mdl-28088950

RESUMO

Objective: To evaluate pre-and early post-transplantation risk factors for acute rejection(AR) in kidney recipients. Methods: This subgroup analysis of a multi-center registry study was conducted on living-donor kidney transplant recipients in China with 10 years of follow-up. This study analyzed 1 255 recipients including 921 males(73.4%) and with a mean age of (33±10)years. Data from patients were first analyzed with univariate analysis and then multivariate analysis was used for finding out the potential risk factors of AR. Results: A total of 106(8.4%) patients were suspected with AR after kidney transplantation, while 1 149 patients were considered as non-AR. Multivariable analysis demonstrated a significant influence of recipient age and cold ischemia time(CIT) on the occurrence of AR(OR: 0.956, 95% CI: 0.923-0.990; OR: 1.006, 95% CI: 1.002-1.011, respectively). The frequency of severe infection was significantly higher in the AR group than non-AR group(38.7% vs 10.8%; P<0.000 1). The occurrence of new-onset diabetes mellitus and tumors was similar in the two groups. Conclusions: Recipient age and CIT are risk factors for AR after living-donor kidney transplantation. Reducing CIT and intensive management of younger recipient could benefit kidney transplant patients.


Assuntos
Rejeição de Enxerto , Transplante de Rim , Doença Aguda , Adulto , China , Diabetes Mellitus , Feminino , Sobrevivência de Enxerto , Humanos , Doadores Vivos , Masculino , Análise Multivariada , Sistema de Registros , Fatores de Risco , Adulto Jovem
4.
Osteoporos Int ; 26(1): 261-72, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25160570

RESUMO

UNLABELLED: We investigated the densitometric and microstructural features of the distal radius in psoriatic arthritis (PsA) patients using high-resolution peripheral quantitative computed tomography. PsA patients have unique bone microstructural deficits, manifested as lower cortical bone density and higher cortical porosity, which are associated with a propensity to bone fragility. INTRODUCTION: The aim of this study was to investigate the densitometric, geometric, microstructural, and biomechanical features of the distal radius in psoriatic arthritis (PsA) patients. METHODS: This study cohort consisted of 53 PsA patients (24 males and 29 females), with an average age of 53.1 years and 53 gender- and age-matched controls. Areal bone mineral density (aBMD) of the hip, lumbar spine, and ultradistal radius was measured by dual-energy X-ray absorptiometry. High-resolution peripheral quantitative computed tomography (HR-pQCT) was performed at the distal radius to obtain measures of volumetric BMD (vBMD), microstructure, and derived biomechanical indices. RESULTS: There were no significant between-group differences in aBMD at the femoral neck, total hip, and ultradistal radius, while aBMD at the lumbar spine was significantly higher in patients. The only indices indicating compromised bone quality in PsA patients were related to cortical bone quality. Cortical vBMD were -3.8% significantly lower, while cortical pore volume, porosity index, and pore diameter were 108, 79.5, and 8.6%, respectively, significantly higher in patients. Cortical stress was marginally lower (-1.3%, p = 0.077) in patients with stress significantly more unevenly distributed (4.9%, p = 0.035). Endocortical perimeter and cortical pore volume were significantly higher in patients with vertebral fracture. Deficits in cortical bone quality were associated with indices of disease activity/severity and were more prominent in patients with type 2 diabetes mellitus or hypertension. CONCLUSIONS: There is an intertwined relationship between chronic inflammation, cardiovascular risk factors, and bone loss in PsA. PsA patients seem to have unique bone microstructural deficits which are associated with a propensity to bone fragility.


Assuntos
Artrite Psoriásica/fisiopatologia , Densidade Óssea/fisiologia , Inflamação/fisiopatologia , Osteoporose/etiologia , Rádio (Anatomia)/fisiopatologia , Absorciometria de Fóton/métodos , Adulto , Artrite Psoriásica/complicações , Estudos de Casos e Controles , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Humanos , Inflamação/complicações , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoporose/fisiopatologia , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/fisiopatologia , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos
5.
Lupus ; 17(7): 638-44, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18625636

RESUMO

To evaluate the efficacy and safety of leflunomide in the treatment of proliferative lupus nephritis, a prospective multi-centre observational study was conducted. Patients with biopsy proven proliferative lupus nephritis were assigned to receive either leflunomide or cyclophosphamide with concomitant prednisone. Leflunomide was given orally with a loading dose of 1 mg/kg/day for 3 days followed by 30 mg/day. Intravenous cyclophosphamide was administered monthly at a dose of 0.5 g/m2 of body-surface area. A total of 110 patients were enrolled, 70 in the leflunomide group and 40 in the cyclophosphamide group. The complete remission rate in the leflunomide group was 21% and partial remission rate 52%, as compared with 18% and 55%, respectively, in the cyclophosphamide group. Renal parameters and systemic lupus erythematosus disease activity index improved significantly and similarly in both groups. Serum creatinine decreased or stabilized in both treatment groups. No significant difference was noted with respect to clinical outcome between groups. Repeat biopsy also showed a significant reduction of active lesions in kidney pathology after 6 months of leflunomide treatment. Major adverse events, similar in both treatment groups, included infection, alopecia and hypertension. Leflunomide, compared with cyclophosphamide, in combination with prednisone was effective in the induction therapy of proliferative lupus nephritis and was generally well-tolerated.


Assuntos
Imunossupressores/uso terapêutico , Isoxazóis/uso terapêutico , Nefrite Lúpica/tratamento farmacológico , Adolescente , Adulto , Idoso , Biópsia , Progressão da Doença , Feminino , Humanos , Rim/patologia , Rim/cirurgia , Leflunomida , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
6.
J Cancer Res Clin Oncol ; 123(5): 296-9, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9201254

RESUMO

The activities of N-acetylglucosaminyltransferase (GnT) III, IV and V were determined in 10 cases of renal cell carcinoma (RCC) and compared with the normal kidney cortex (NKC) regions of the same kidney resected from RCC patients. It was found that the GnT III and GnT IV activities decreased consistently in all samples of RCC, while GnT V activity increased, decreased or did not change in different samples. The mean levels of GnT III and GnT IV activities in RCC were found to be very significantly lower than those of NKC on statistical analysis, but the mean value of GnT V activity was almost identical in RCC and NKC. The decrease in GnT activities in RCC were compatible with the decrease in bisecting N-acetylglucosamine (GlcNAc) and antennary number of complex-type N-glycans in gamma-glutamyltranspeptidase (gamma-GT) partially purified from RCCs as studied with concanavalin A (ConA) affinity column chromatography, which showed a decrease of unbound fraction and increase of bound fractions.


Assuntos
Carcinoma de Células Renais/enzimologia , Neoplasias Renais/enzimologia , N-Acetilglucosaminiltransferases/metabolismo , Adulto , Idoso , Feminino , Humanos , Rim/enzimologia , Masculino , Pessoa de Meia-Idade
7.
Zhonghua Wai Ke Za Zhi ; 28(11): 672-5, 703, 1990 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-2086074

RESUMO

41 non-cement total hip arthroplasties with the Mecring cup are reported in this paper. The follow-up results in an average of 14 months showed that this operation relieved the hip pain and improved the functional capacity and the motion of the hip. 80.5% of the reported hips gained excellent or good results. Because the cup was firm on the acetabulum with the thread, the defect of bone was smaller and the cup revision was easier than others, it is applicable not only for the elderly but also for younger patients. The relationship between the hip function and cup position was observed and it suggested that the correct abduction angle of the cup should be 40-50 degrees and the anteversion angle 5-20 degrees. The postoperative complications were dislocation and ectopic ossification.


Assuntos
Articulação do Quadril/fisiopatologia , Prótese de Quadril/métodos , Osteoartrite do Quadril/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/fisiopatologia , Período Pós-Operatório
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