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Objective To analyze the causes of 652 hospitalizations in the patients with autosomal dominant polycystic kidney disease (ADPKD).Methods The medical records of all ADPKD inpatients in our hospital from January 1,1990 to December 31,2010 were collected.The differences of hospitalization causes in different age,gender and period were analyzed.Results (1)In 652 hospitalizations,the most common cause was lumbar pain (15.2％),followed by cystic bleeding (14.6％),aggravating renal failure (10.1％),dialysis-related problems (9.4％),renal transplant related issues (8.3％),renal replacement therapy for ESRD (8.0％),urinary tract infection (6.4％),end stage renal failure (5.8％),hypertension (4.1％),renal cyst volume enlargement (3.7％),finding polycystic kidney disease (2.1％),urinary lithiasis (1.8％) and others (10.4％).(2)Younger patients were admitted into hospital because of polycystic kidney bleeding and finding PKD.With the increase of patients age,hospitalization due to dialysis-related problems increased,while many middle-aged patients were hospitalized because of back pain.(3)Male patients were admitted into hospital for aggravating renal failure,ESRD,kidney transplantation-related problems and urinary lithiasis,while female patients mainly for lumbar pain,dialysis-related problems and urinary tract infection.(4)The proportion was significantly reduced with time of finding PKD,renal failure and polycystic kidney bleeding,the proportion of renal cysts increasing and aggravating renal failure increased,there was a significant increase in the proportion of patients with hypertension,while a significant decrease in the proportion of patients with uncontrolled hypertension,and the average SBP was also significantly reduced.Conclusions The highest rate of hospitalization of ADPKD patients is in 40 to 60 age group.Cause of admission varies with age and gender,and changes with the change of time.Over the past decade,the proportion of hospitalization due to renal cysts enlargement and renal failure aggravation increased significantly.The incidence of hypertension is higher than that in the first 10 years,but hypertension control rate increases compared with the previous.Prevention should focus on finding the suppression measures of renal cysts enlargement.
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Objective To summarize the clinical characteristics and outcome of renal cyst infection in patients with autosomal dominant polycystic kidney disease (ADPKD). Methods Clinical data of 40 ADPKD patients with 43 episodes of renal cyst infection admitted in Shanghai Changzheng Hospital from 1st January 1991 to 31st December 2010 were retrospectively analyzed.Differences of microbiological data and treatments between 1st January 1991 to 31st December 2000 and 1st January 2001 to 31st December 2010 were compared. Results Among 473 identified patients with ADPKD and 662 episodes of hospitalization,40 patients had 43 episodes of renal cyst infection,including 8 definite and 35 likely cases.Microbiological documentation was available for 34 episodes (79.0％),Escherichia coli accounting for 82.4％ of all retrieved bacterial strains.Resistant Escherichia coli to quinolone and certain β-lactamine increased in recent decade.Clinical efficacy of initial antibiotic treatment was noted in 69.8％ of episodes. Antibiotic treatment modification was more frequently required for patients receiving initial monotherapy compared with those receiving combination therapy.In the first ten-year group,initial combination therapy and clinical efficacy were noted in 30.0％ and 60.0％ of episodes respectively,and hospital stay was (20.2±6.7) d.In the second ten-year group,initial combination therapy and clinical efficacy were noted in 61.9％ and 78.2％ of episodes respectively,and hospital stay was (16.3±3.2) d.Large infected cysts (diameter ＞5 cm) frequently required drainage. Conclusions In renal cyst infection,the source of the organisms is often a gram negative enteric organism.Empiric therapy is often initiated with two antibiotics.The drainage of large infected cysts remains the main treatment for cyst infection.
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Objective To observe the influence of nocturnal prolonged hemodialysis (INHD) on patients＇ nutrition status. Methods Thirty-two maintenance hemodialysis patients received INHD (3 times per week and 7.5 hours each session) and thirty-five maintenance hemodialysis patients received conventional hemodialysis (3 times per week and 4 hours each session) as control were observed for 6 months.The nutrition status of these patients on various aspects which concluded physical measurements,laboratory tests,and dietary record at baseline(0month) and exit (6 months) were recorded. Results (1)There were no differences in age,sex,body weight,and primary diseases between two groups.(2)The body weight,triceps skinfold thickness (TSF),and hand grip strength increased at exit point,but no statistical difference compared with the control group.Mid-upper arm circumference (MAC) increased signicantly from (27.1±4.2) to (30.5±6.1) cm (P＜0.05).Compared with the control group (26.9±3.4) cm,there was a significant difference (P＜0.05).(3)Serum phosphate decreased significantly from (0.5±0.5) to (0.1±0.6) μ mol/L (P=0.001) in INHD group.(4)The nutrition status were improved in INHD group evaluated by subjective global assessment (SGA)(P=0.03).(5) Dietary intake was recorded by a 3-day food record.Dietary intake of energy,protein,lipid,calcium,potassium,and phosphate increased in INHD group.None of the differences achieved statistical significance between two groups. Conclusion As compared with conventional hemodialysis,INHD can increase the dietary intake,decrease serum phosphate level,and improve patients nutrition status.
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Objective To investigate the safety and tolerability of darbepoetin alfa.a long-lasting erythmpoietin,single intravenous administration in maintenance hemodialysis(MHD) patients. Methods A single center,open clinical trial was carried out.Forty-three stable MHD patients were divided into 5 groups and received darbepoetin α at dosage of 0.225,0.45,0.9,1.8,3.6 μg/kg respectively.The vital signs,symptoms,ECG and laboratory examinations were monitored and detected before and after administration. Results Of the 43 patients (male 26and female 17),the largest tolerable dosage of darbepoetin alfa was 3.6 μg/kg.During the study,the main side effect associated with darbepoetin was hypertension aggravation(7%).One patient died but that was not associated with darbepoetin alfa. Conclusion Darbepoetin alfa is sale and well tolerated.
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Objective: To explore childhood traumatic experiences of OCD patients who were also diagnosed personality disorders (PDs) and those without PDs. Methods:SCID-I/P was administrated to diagnose OCD patients. PDQ+4 and PDI-IV were then administrated to 44 OCD subjects to determine whether they also suffered from personality disorders. Childhood maltreatment experiences of the sample were measured with Childhood Trauma Questionnaire (CTQ).50 normal control were also collected and subjected to CTQ-SF tests. Results:32 of 44 (72%) OCD patients also met DSM-IV criteria for personality disorders. OCD patients scored significantly higher than normal control in CTQ-SF (Childhood Truma Questionuaire-28 Short Form) and in all domains with the exception of physical abuse. Comparison between OCD subjects with PDs and normal control, the former scored significantly higher in emotional abuse (55.10/32.54), sex abuse (49.63/36.30), physical neglect (52.03/34.76), and emotional neglect domains (55.84/32.32). Whereas OCD subjects without PDs only scored significantly higher in emotional neglect domains compared with normal control (42.50/28.26).Conclusions:Subjects with PDs experienced more severe traumatic events during their early life. "pure OCD" patients, however, might experienced more emotional neglect.
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Objective The efficacies of four cholangiogrphies were compaired with each other in preventing bile duct injury during the procedure of LC. Methods Four cholangiogrphies were used in LC:1. Cold light cholangiography (CLCP); 2. Methylenum coeruleum cholangioguaphy (MCCP); 3. Intraoperative cholangiography (IOCP); 4. Intraoperative endoscopic retrogarde cholangiopancreatography (IERCP). Results The images of CLCP and MCCP were direct and could help operator to identify bile duct structure in LC. The images of IPCP and IERCP were indirect and could not be so helpful. Conclusions CLCP is the only technique that clearly and directly shows the location of the extra hepatic biliary system and may be useful in selected cases with abnormal or uncertain anatomy for the prevention of bile duct injury.
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Objective To investigate the effect of taurine on proliferation and apoptosis of rat mesangial cells cultured in vitro and explore its possible mechanism. Methods Rat mesangial cells were incubated with different concentration of taurine. Cell proliferation was assessed by MTT colorimetric assay. Cell cycle and apoptosis was analyzed by flow cytometry. Form of apoptosis was examined by vital staining of alcidine orange. The expression of c-jun and c-fos was determined by immunocytochemistry and computed video text analysis system. Results Administration of 5 ~ 50 mmol/L taurine into culture medium had no loxicity to mesangial cells, but could significantly inhibit mesangial cells proliferation in dose-dependent manner, subsequently increased the cells in Go/Gi phase and decreased the cells in S phase. In addition, turine could markedly inhibit the expression of c-jun and c-fos( P
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Objective To investigate the antiproliferative effect of HMG CoA reductase inhibitor on ADPKD cyst-lining epithelial cells and its possible mechanism. Methods Cell viability was assayed by MTT. Membrane-bounded p2lras was detected by immunoblotting. The expression of c-jun and c-fos was examined by immunocytochemistry. Results After ADPKD cyst-lining epithelial cells were exposed to HMG CoA reductase inhibitor, proliferation was markedly inhibited( P
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Objective:To observe the effect of eupolyphaga seu steleophaga(ESS) on the proliferation of autosom al dom inant polycystic kidney disease(ADPKD) cyst- lining epithelial cells.Methods:ESS serum and control serum were obtained from SD rats gastrogavaged with ESS water solution and physiological solution.ADPKD cyst- lining epithelial cells were treated with RPMI16 4 0 containing:(1) EGF0 ,2 .5 ,5 ,10 ,2 0 ng/ ml;(2 ) ESS serum and control serum(1% ,2 .5 % , 5 % ) ;(3) EGF10 ng/ ml,ESS serum and control serum(1% ,2 .5 % ,5 % ) .The cell proliferation was determined by Brdu incorporation assay. Results:EGF had a stimulating effect on the ADPKD cyst- lining epithelial cells;the ESS serum significantly inhibited the proliferation of ADPKD cyst- lining epithelial cells compared with control serum;ESS serum also significantly inhibited the proliferation of ADPKD cyst- lining epithelial cells activated by EGF(10 ng/ m l) com pared with control serum.All the effects were dose- dependent.Conclusion:Eupolyphaga seu steleophaga may prolong the progression of ADPKD via the inhibitory effect on the proliferation of cyst- lining epithelial cells. [