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Objective:To study the glypican 3 (GPC3) fluorescent probe imagings in hepatocellular carcinoma (HCC) tissues and to determine its prognostic value in HCC patients.Methods:The data of 87 patients who were treated at the Affiliated Hospital of Southwest Medical University from January 2019 to August 2020 were retrospectively analyzed. There were 75 males and 12 females, with the age of (56.1±11.9) years. The expressions of GPC3 were measured by immunohistochemistry and by the fluorescent probe. The results obtained by these two tests were compared. Patients were followed up for recurrence after hepatectomy. Univariate and multivariate Cox regression analyses were used to analyze factors influencing recurrence-free survival.Results:Detection of the GPC3 expression by GPC3 fluorescence probe was consistent with the results obtained by immunohistochemical studies ( Kappa=0.84, P<0.001). The positive rates of GPC3 fluorescent probe was 79.3%(69/87), compared with 80.4%(70/87) by immunohistochemistry studies, with no significant difference between the two groups ( P>0.05). The patients were then divided into the low differentiation group ( n=30) and the middle high differentiation group ( n=57) by the degrees of tumor differentiation. The fluorescence intensity in the low differentiation group was 134.4(128.0, 144.7) a. u. which was significantly different from the middle high differentiation group of 84.8(0, 108.5)a.u. ( Z=-7.52, P<0.001). The median fluorescence intensity of 87 patients with HCC was 108.6 a. u.. Multivariate Cox regression analysis showed that patients with a GPC3 fluorescence intensity ≥108.6 a. u. ( HR=2.07, 95% CI: 1.21-3.53, P=0.008) had a significant increased risk of recurrence after hepatectomy. Conclusion:The expressions of GPC3 in HCC were consistent between the studies by using either a GPC3 specific fluorescent probe or immunohistochemistry studies. A GPC3 fluorescence intensity ≥108.6 a. u. was a risk factor of recurrence after hepatectomy in patients with HCC.
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Objective:This meta-analysis was conducted to systematically evaluate the short-term efficacy and safety of indocyanine green fluorescence imaging guided laparoscopic liver tumor resection (FIGLTR).Methods:A systematic search was made for the literature on indocyanine green fluorescence image-guided laparoscopic hepatectomy in randomized, semi-randomized controlled trials and observational studies, and manually search published materials and conference papers in Chinese and English and trace references included in the literature. The retrieval period was up to September 2021. The quality of included studies was evaluated, then the meta-analysis was conducted using Review Manager 5.1 software.Results:Ten studies were included with 803 patients, including 341 in the FIGLTR group and 462 in the non-FIGLTR group. Meta results showed that: Compared to the traditional resection group, indocyanine green fluorescence imaging can significantly shorten the operative time ( MD=-22.61, 95% CI: -34.20--11.03, P<0.001), reduce intraoperative bleeding ( MD=-49.17, 95% CI: -84.99--13.36, P<0.01), shorter hospital stay ( MD=-0.89, 95% CI: -7.72--0.06, P<0.05), Improve the removal rate of R 0 edge ( OR=8.80, 95% CI: 1.96-39.44, P<0.05) and reduce the incidence of postoperative complications ( OR=0.55, 95% CI: 0.34-0.87, P<0.05) of laparoscopic liver tumor resection. There were no differences found in portal block time and transfusion rate. Conclusion:Indocyanine green fluorescence imaging technology provides a new way for safe and accurate laparoscopic resection of liver tumors.
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Objective To investigate the efficacy and safety of enhanced recovery after surgery (ERAS) in the perioperative period of pancreaticoduodenectomy (PD). Methods Chinese and English databases were searched for controlled clinical trials on the application of ERAS in PD published from 2000 to 2021. Screening, quality assessment, and data extraction were performed for the articles, and RevMan5.3 software was used for meta-analysis. This study was registered on PROSPERO with a registration number of CRD42021287931. Results A total of 22 controlled clinical trials were included, with 3531 patients in total. The results showed that the implementation of ERAS in the perioperative period of PD reduced the incidence rates of total complications (odds ratio [ OR ]=0.63, 95% confidence interval [ CI ]: 0.48-0.83, P =0.001), abdominal infection ( OR =0.65, 95% CI : 0.47-0.88, P =0.005), pulmonary complications ( OR =0.57, 95% CI : 0.42-0.78, P =0.000 5), pancreatic leakage ( OR =0.80, 95% CI : 0.67-0.97, P =0.02), and delayed gastric emptying ( OR =0.58, 95% CI : 0.48-0.71, P 0.05). Conclusion ERAS has good efficacy and safety in the perioperative period of PD and can significantly reduce the incidence rates of postoperative complications and shorten the length of postoperative hospital stay. Therefore, it holds promise for clinical application.
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Objective To observe the efficacy and side effects of anlotinib combined with paclitaxel and cisplatin as the first-line treatment of advanced esophageal squamous cell carcinoma (ESCC). Methods We retrospectively analyzed 50 cases of advanced esophageal squamous cell carcinoma diagnosed pathologically. Among them, 24 cases were treated with the combination of anlotinib and paclitaxel plus cisplatin (experimental group), and 26 cases were treated with paclitaxel plus cisplatin regimen (control group). The efficacy and adverse reactions were observed and followed up. Results The objective response rates of the experimental and control groups were 83.33% and 53.84% (P < 0.05), the disease control rates were 100% and 96.15% (P > 0.05), mPFS were 10.6 and 9.13 months (P < 0.05), and mOS were 13.4 and 11.8 months (P < 0.05). The common adverse events in the experimental group were hand-foot syndrome (12.5%), hypertension (12.5%), epistaxis (8.33%) and proteinuria (4.16%), all of which were grade Ⅰ-Ⅱ and controllable without affecting the continuity of chemotherapy. Conclusion The combination of anlotinib, paclitaxel and cisplatin as the first-line treatment of advanced esophageal squamous cell carcinoma can improve the curative effect and the adverse effects are endurable.
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ObjectiveTo systematically evaluate the effect of Pringle’s measure (PM) versus hemihepatic vascular occlusion (HVO) in hepatectomy for primary liver cancer. MethodsRelated Chinese and English databases were searched for control studies on HVI versus PM in the treatment of primary liver cancer published up to June 2020. After quality evaluation and data extraction of the included studies, RevMan5.3 software was used for the meta-analysis. ResultsA total of 10 studies were included in the Meta-analysis, with 1272 patients in total. On days 1 and 3 after surgery, the HVO group had a significantly lower level of alanine aminotransferase than the PM group (day 1: mean difference ［MD］=-172.71, 95% confidence interval ［CI］: -289.26 to -56.16, P=0.004; day 3: MD=-130.35, 95%CI: -221.25 to -39.45, P=0.005). On day 3 after surgery, the HVO group had a significantly lower level of aspartate aminotransferase than the PM group (MD=-84.56, 95%CI: -166.47 to -2.65, P=0.04), and on days 1 and 3 after surgery, the HVO group had a significantly higher level of albumin than the PM group (day 1: MD=1.31, 95%CI: 0.06-2.56, P=0.04; day 3: MD=1.81, 95%CI: 027-335, P=0.02). The HVO group had a significantly longer time of operation than the PM group (MD=8.95, 95%CI: 4.30-13.60, P＜0.01). ConclusionHVO is a safe and effective method for vascular occlusion, and compared with PM, it can effectively alleviate liver injury. However, surgeons should select a suitable method for occlusion based on their own personal experience, patients’ conditions, and specific situation during surgery.
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ObjectiveTo investigate the efficacy and safety of CalliSpheres microsphere-transcatheter arterial chemoembolization (CSM-TACE) versus conventional transcatheter arterial chemoembolization (cTACE) in the treatment of hepatocellular carcinoma (HCC) through a meta-analysis. MethodsPubMed, Web of Science, Cochrane Library, CNKI, Wanfang Data, and VIP were searched for all Chinese and English articles on the application of CSM-TACE and cTACE in HCC published up to the end of October, 2020. After quality assessment was performed for the articles included, RevMan 5.3 software provided by Cochrane Library was used for analysis. ResultsA total of 15 studies were included, with 1535 patients in total. This meta-analysis showed that compared with the patients receiving cTACE, the patients receiving CSM-TACE had significantly higher 1-year overall survival rate (odds ratio ［OR］=2.26, 95% confidence interval ［CI］: 1.63-3.13, P＜0.000 01), 2-year overall survival rate (OR=1.73, 95%CI: 1.20-2.50, P=0.003), and 2-year progression-free survival rate (OR=1.60, 95%CI: 1.05-2.43, P=0.03). In terms of safety, compared with the patients receiving cTACE, the patients receiving CSM-TACE had significantly lower incidence rates of postoperative vomiting (OR=0.65, 95%CI: 0.46-0.92, P=0.01), bone marrow suppression (OR=0.17, 95%CI: 0.05-0.54, P=0.003), and neutropenia (OR=0.18, 95%CI: 0.07-045, P=0.000 3), while there were no significant differences between the two groups of patients in postoperative pyrexia, abdominal pain, and ascites (all P＞0.05). ConclusionCSM-TACE has significant advantages in improving 1- and 2-year overall survival rates and 2-year progression-free survival rates and can significantly reduce the incidence rates of postoperative vomiting, bone marrow suppression, and neutropenia. Therefore, CSM-TACE is a safe and effective treatment method.
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In order to meet the needs of detection of poisoning-inducing pesticides occurring in poisoning emergency events, this article introduces and discusses the characteristics, scope of application, and advantages and disadvantages of two types of detection technologies: laboratory detection and on-site rapid detection. The sample pre-processing technology suitable for on-site detection is also elaborated.
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In order to extract the pulse wave signal of blood volume effectively in the case of uneven light, a light-adaptive heart rate detection method based on webcam was proposed. In this method, adaptive gamma transform is applied to face image sequence to eliminate the influence of illumination. The pulse wave source signal was extracted from the forehead area and the blood volume pulse wave was obtained by wavelet filtering. The heart rate is estimated by Fourier transform analysis. The Bland-Altman analysis indicates that the method used in this paper is in good agreement with the measurement results of the electronic sphygmomanometer, and the adaptive gamma transformation used in this paper eliminates the influence of light interference, and the measurement error of heart rate is significantly reduced, which is completely able to meet the requirements of daily heart rate monitoring.
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Humans , Algorithms , Blood Volume , Face , Heart Rate , Internet , Monitoring, Physiologic , Video RecordingABSTRACT
Objective@#To study the expression level of monoacylglycerol lipase (MAGL) in liver tissues of patients with hepatocellular carcinoma (HCC), and its clinical correlation.@*Methods@#Immunohistochemistry was employed to detect MAGL protein in 353 cases with hepatocellular carcinoma (HCC) and tissue microarray (TMA) for paracancerous liver tissues. The expression levels of MAGL in TMA were quantitatively analyzed using Image-Pro plus 6.0. The difference in MAGL expression between liver cancer tissues and paracancerous liver tissues was compared. Combined with the clinical follow-up data of TMA patients, the correlation between the expression of MAGL in TMA and the degree of HCC tumors differentiation and the survival rate of 1-year and 3-year were analyzed using Logistic regression analysis. The survival curves of patients with different levels of MAGL protein was plotted and analyzed using Kaplan-Meier method. The expression of MAGL protein was analyzed by multiple linear regression analysis. COX regression was used to analyze the correlation between MAGL protein expression level and the risk of HCC death in the included patients.@*Results@#The expression of MAGL in HCC tissues was significantly higher than paracancerous liver tissues. The expression level of MAGL was correlated to the degrees of HCC tumors differentiation (P < 0.001) and 1-year survival rate (P = 0.01), but not with 3-year survival rate (P = 0.91). Survival curve showed that the expression level of MAGL was negatively correlated with prognosis and survival of HCC patients (P = 0.001). Multiple linear regressions showed a negative correlation between MAGL expression level and overall survival time of HCC patients (P=0.010, R2=0.166, Durbin-Watson value: 1.989). COX regression showed that the expression of MAGL was a risk factor for death of patients with HCC [P = 0.004, Exp (B) = 1.000].@*Conclusion@#The expression level of MAGL has positive correlation with the malignant degree in HCC patients, and negative correlation with its prognosis. Therefore, MAGL may serve as a new prognostic indicator for HCC patients.
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Objective@#To investigate the effect of NACHT-LRR-PYD- containing proteins 3 (NLRP3) mediated pyroptosis in myocardial cells undergoing hypoxia/deoxygenation (H/R) injury.@*Methods@#In order to observe whether H/R-treatment could cause pyroptosis, H9c2 cells were divided into 2 groups randomly using the lottery method: control group(without H/R-treatment) and H/R group (in which the H9c2 cells were underwent H/R-treatment). In order to clarify the role of pyroptosis in H/R-injury, H9c2 cells were divided into 4 groups randomly using the lottery method: control group(in which the H9c2 cells were cultivated with normal medium); YVAD group(in which the H9c2 cells were pretreated with z-Val-Ala-Asp(Ome)-fluoromethylketone (Z-YVAD-FMK) 20 μm for 4 hours, then replaced with normal medium); H/R group(H9c2 cells underwent H/R-treatment); YVAD+H/R group (in which the H9c2 cells were pretreated with 20 μm Z-YVAD-FMK for 4 hours before H/R-treatment). To determine whether H/R-induced cell pyroptosis is associated with NLRP3, H9c2 cells were divided into 4 groups randomly using the lottery method: control group (in which cells were transfected with a control nonspecific siRNA); si-NLRP3 group (in which cells were transfected with NLRP3-targeting siRNA); H/R group(in which cells were transfected with a control nonspecific siRNA before H/R-treatment); si-NLRP3+H/R group(in which the H9c2 cells were transfected with NLRP3-targeting siRNA before H/R-treatment). Pore formation on cell membrane was detected by propidium iodide (PI) staining. Cell viability was detected by CCK8 reagent. The protein expression of Caspase-1, interleukin-1β (IL-1β) and NLRP3 was detected by Western blot.@*Results@#(1) The positive rate of PI staining ((26.46±5.15)% vs. (1.69±0.73)%,P<0.01), expression of NLRP3 (0.57±0.16 vs. 0.23±0.06,P<0.01), expression of Caspase-1 (1.07±0.13 vs. 0.37±0.08,P<0.01), and expression of IL-1β (0.38±0.08 vs. 0.16±0.05,P<0.01) were significantly higher in H/R group than in control group. (2)The cell vitality was significantly higher in YVAD+H/R group than in H/R group ((87.31±9.05)% vs. (73.30±7.19)%, P<0.05).The positive rate of PI staining was significantly decreased in YVAD+H/R group than in H/R group ((18.12±4.36)% vs. (26.45±4.60)%, P<0.05). The expression of Caspase-1 (0.72±0.12 vs. 1.07±0.15, P<0.05) and IL-1β(0.29±0.07 vs. 0.39±0.06, P<0.05) were significantly lower in YVAD+H/R group than in H/R group. (3) The cell vitality was significantly increased in si-NLRP3+H/R group than in H/R group ((85.46±7.71)% vs. (72.41±5.53)%, P<0.05). The positive rate of PI staining was significantly lower in si-NLRP3+H/R group than in H/R group ((18.22±4.20)% vs. (26.73±3.26)%, P<0.05). The expression of Caspase-1(0.87±0.07 vs. 1.15±0.15, P<0.05) and IL-1β(0.41±0.07 vs. 0.58±0.10, P<0.05) were significantly decreased in si-NLRP3+H/R group than in H/R group.@*Conclusion@#NLRP3 mediated pyroptosis is involved in H/R injury of myocardial cells.
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This study aimed to compare clinical features between membranous nephropathy (MN) and nonmembranous nephropathy (non-MN), to explore the clinically differential diagnosis of these two types, and to establish a diagnostic model of MN. After renal biopsy was obtained, 798 patients were divided into two groups based on their examination results: primary MN group (n = 248) and non-MN group (n = 550). Their data were statistically analyzed. Logistic regression analysis indicated that anti-PLA2R antibodies, IgG, and Cr were independently correlated with MN, and these three parameters were then used to establish the MN diagnostic model. A receiver operating characteristic (ROC) curve confirmed that our diagnostic model could distinguish between patients with and without MN, and their corresponding sensitivity, specificity, and AUC were 79.9%, 89.4%, and 0.917, respectively. The cutoff value for this combination in MN diagnosis was 0.34. The established diagnostic model that combined multiple factors shows a potential for broad clinical applications in differentiating primary MN from other kidney diseases and provides reliable evidence supporting the feasibility of noninvasive diagnosis of kidney diseases.
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Objective To evaluate the clinical efficacy of domestic sulfasalazine (SASP) combined with probiotics on the treatment of inflammatory bowel disease (IBD).Methods According to the search of Chinese periodical full-text database,PubMed and other Chinese databases as well as English databases,the cases of IBD treated with SASP combined with probiotics or metronidazole in China were collected and screened for randomized controlled trials (RCT).The results between combined group and control group were compared using odds ratio (OR) and 95％ Confidence Interval (CI) indicates.The evaluation indicator was the remission rate.According to the inclusion and exclusion criteria,the literature was selected,and data was extracted.Quality assessment of the included methodologies was performed,and RevMan 5.3 software was used for meta-analysis.Results 26 studies including a total of 2 403 patients were adopted in the present study.Among them,13 studies suggested that the remission rate of IBD in SASP combined with probiotics group was significantly improved compared with that in the SASP group alone (x2 =10.29,df =12,I2 =0％,P ＜0.05,the effect model OR =3.70,95％ CI as 2.62-5.21),demonstrating that the combined treatment was superior to monotherapy in IBD.10 studies suggested that the remission rate of ulcerative colitis (UC) in SASP combined with probiotics group was significantly improved compared with that in the SASP group alone (x2 =2.59,df =9,I2 =0％,P ＜ 0.05,the effect model OR =3.84,95％ CI as 2.52 -5.86),demonstrating that the combined treatment was superior in UC.The other 3 studies showed that the remission rate of UC with infection in SASP combined with probiotics group was significantly improved compared with that in SASP combined with metronidazole group (x2 =0.07,df =2,I2 =0％,P ＜ 0.05,the effect model x2 =4.77,95％ CI as 2.27-10.02),demonstrating that treatment of SASP combined with probiotics was superior in UC with infection.Conclusions SASP combined with probiotics can improve the effective response rate in the treatment of IBD.
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Objective To investigate the related factors affecting the efficacy of microvascular decompression (MVD) in the treatment of primary trigeminal neuralgia (TN). Methods MVD was performed in 120 patients with primary TN and single factor χ2 test and Logistic regression analysis were performed on the clinical data to evaluate the independent risk factors influencing the efficacy of MVD in the treatment of primary TN. Results The pain completely disappeared in 101 cases, the pain was relieved in 16 cases and the unhealed in 3 cases. Sixty cases had pure arterial compression,57 cases had venous compression, and 3 cases had no obvious responsibility vessel. Complete elimination of pain in the patients with venous compressionwaslower than that in patients with pure arterial oppression: 73.7% (42/57) vs. 86.7% (52/60), and the difference was statistically significant (P<0.05). The complete pain relief rate in patients with V2 bronchial pain was lower than that in other pain distribution areas: 13/19 vs. 87.1%(88/101), With significant difference (P<0.05). In patients with V2 bronchitis, the responsible vessels were mostly compressed from the ventral surface of the trigeminal nerve, and the difference was statistically significant (P<0.05). Logistic regression analysis showed , Venous compression and V2 pain were the independent risk factors influencing the clinical efficacy of MVD in the treatment of primary TN. Conclusions Patients with venous compression and V2 pain are less likely to havegood postoperative outcomes, and venous compression and V2 painare independent risk factors. In patients with V2 pain, the responsible vasculature tends to ventrally massage the trigeminal nerve, which is a new study direction of refractory V2 pain.
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Objective :To study influence of health management mode on poor living habits and incidence rate of relat—ed complications in aged patients with coronary heart disease (CHD).Methods : Medical data of 259 aged CHD pa—tients in our hospital from Jan 2013 to Dec 2016 were collected .Health management mode was performed in our hospital since Jan 2015 ,therefore ,according to treatment time ,patients were divided into CHD control group (n＝114) and health management group (n＝ 140 ) ,both groups were intervened for continuous six months .Scores of self—rated abilities for health practices scale (SRAHP ) and Seattle angina questionnaire (SAQ ) ,levels of fasting blood glucose (FBG) ,blood pressure and blood lipids before and after intervention ,incidence of complications and mortality during follow—up were measured and assessed between two groups .Results :Compared with before interven—tion ,after six—month intervention , there were significant rise in each item score and total scores of SRAHP and SAQ ,and significant reductions in levels of FBG ,SBP ,DBP ,TC and TG in two groups , P＝0. 001 all.Compared with CHD control group after six—month intervention ,there were significant rise in each item score and total score of SRAHP [(82. 95 ± 18.24) scores vs .(91.91 ± 20.23) scores] ,each item score and total score of SAQ [(64. 90 ± 14. 29) scores vs .(72. 15 ± 15.87) scores] ,and significant reductions in levels of FBG [(5.51 ± 1.21) mmol／L vs. (5. 14 ± 1. 13)mmol／L] ,SBP[(121.07 ± 14.52) mmHg vs.(116. 72 ± 14. 01) mmHg] ,DBP [(80. 23 ± 9.63) mmHg vs.(77. 62 ± 9.31)mmHg] ,TC[(4. 31 ± 0.65)mmol／L vs.(4. 11 ± 0. 61) mmol／L] and TG[(1.45 ± 0. 21) mmol／L vs.(1. 39 ± 0.21)mmol／L] in health management group , P＜0. 05 or ＜0. 01. During follow—up ,incidence rates of recurrent angina pectoris (21.4% vs.35.3%) ,heart failure (2. 1% vs.7.6%) and myocardial infarction (3. 6%vs.10. 1%) in health management group were significantly lower than those of CHD control group , P＜0.05 all. Conclusion :Health management mode can enhance health behavior ,correct poor living habits ,stabilize blood glu—cose ,blood lipid and blood pressure ,and reduce incidence rate of related complications in aged CHD patients .
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Objective To investigate the MRI manifestations and analyze the prognostic factors of patients with anterior circulation minor stroke and nonGminor stroke in Qinghai plateau.Methods 41 6 cases of the first admission,including 1 9 2 patients with minor stroke and 224 patients with nonGminor stroke.MRI and MRA examinations of the head were completed in all patients within 72 h of admission.Patients were followed up for one year to observe the recurrence of stroke,and the quality of life was evaluated with the help of modified Rankin Scale (MRS)scores.Results (1)MRA showed that 36.98% of the minor stroke and 58.93% of the nonGminor stroke had the stenosis of the responsible artery at the infarction site.The difference was significant (χ2＝ 1 9.94,P＜ 0.00 1 ).(2 )MRI showed that the initial infarction sites of minor stroke and nonGminor stroke were different (χ2＝4.47 ,P＜0.005 ).(3 )The recurrence rate was 10.42% in minor stroke and 12.05% in nonGminor stroke.There was no significance between the two groups (χ2＝ 0.28,P＞0.05).(4) Among patients with poor prognostic outcomes (whose MRS≥3),there were 1 9 cases of minor stroke and 6 1 cases of nonGminor stroke,and the difference was significant (χ2＝20.00,P＜0.0 1 ).Conclusion LesionGrelated vascular stenosis in patients with minor stroke is mild and the primary infarction is more common in isolated subcortical or deep white matter.The stenosis is severe in patients with nonGminor stroke,and the infarct lesion is often subcortical with or without cortical or deep white matter.There is no difference in recurrence risk between minor stroke and nonGminor stroke.The prognosis of minor stroke is better than that of nonGminor stroke.
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0bjective To investigate the occurrence of frequent intradialytic hypotension in hemodialysis patients and Analyzed influencing factors. Methods The 1 933 hemodialysis sections of 156 maintenance hemodialysis patients in the Huashan hospital affiliated to Fudan University in Shanghai were selected, and divided into frequent intradialytic hypotension and non- frequent intradialytic hypotension depending on whether the incidence of intradialytic hypotension is greater than 20%, and the patients' dialysis data and biochemical examination data are collected for the analysis of influencing factors. Results The incidence of frequent IDH in maintenance hemodialysis patients was 62.18%(97/156), and the pre-dialysis blood pressure of frequent IDH patients were higher than non-frequent IDH patients, frequent IDH patients: (134.02±21.01)/(73.85±10.73) mmHg(1 mmHg=0.133 kPa), non-frequent IDH patients: (124.66 ± 17.89)/(69.32 ± 10.65) mmHg, (t=-2.851,-2.558, P＜0.05), but lower in post-dialysis, frequent IDH patients:(114.91±19.21)/(68.38±11.41) mmHg, non-frequent IDH patients: (127.90± 20.58)/(74.46±11.79) mmHg, (t=3.989, 3.189, P＜0.01). Binary Logistic regression analysis showed that hemoglobin ( OR=0.354, P=0.015) and high-density lipoprotein ( OR=0.155, P=0.003) were protective factors for the occurrence of frequent IDH, and ultrafiltration volume/weight ( OR=6.021, P=0.002) and N-terminal pro-brain natriuretic peptide ( OR=2.687, P=0.020) were risk factors. Conclusions The incidence of frequent IDH in hemodialysis patients is high, and patients with high filtration rate, high N-terminal pro-brain natriuretic peptide, low hemoglobin and high density lipoprotein should be paid close attention to. It is recommended to regularly monitor patients' biochemical indicators, strengthen blood pressure monitoring for high-risk groups, and timely deal with the symptoms of low blood pressure.
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Objective@#To translate the English version of Fatigue, Resistance, Ambulation, Illness, and Loss (FRAIL) for elder patients into Chinese, and to test the reliability and validity of the Chinese version of FRAIL.@*Methods@#After obtaining authorization from the developer, the FRAIL was translated and culturally adapted into Chinese version. The reliability and validity of the Chinese version of FRAIL were tested in 179 patients.@*Results@#The Cronbach α coefficient was 0.826. The test-retest reliability was 0.828. Two nurses used the scale to evaluate the consistency of the results and the Kappa coefficient was 0.892. The content validity index of the I-CVI ranged from 0.93 to 1.00, and the S-CVI/Ave index was 0.98. The correlations coefficients between each dimension score and the total score ranged from 0.637 to 0.865(P<0.01). and the correlations coefficients between each dimension score ranged from 0.277 to 0.817(P<0.01, P<0.05), The KMO index of factor analysis was 0.766. Five factors were extracted from exploratory factor analysis, and the cumulative variance contribution rate was 77.572%. The load value of each item on the corresponding factor was 0.560 to 0.889.@*Conclusions@#The Chinese version of FRAIL has been proved to have good reliability and validity. It can be used to assess elderly patients risk of frailty in the Chinese settings.
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Objective@#To set up a chyle (n-hexane) testing method based on n-hexane extraction system.@*Methods@#The hydrothorax specimen which was positive in chyle testing was selected and the feasibility was evaluated by replace Diethyl ether with n-hexane. The optimal extraction volume ratio for the new chyle testing was confirmed and sultan Ⅲ dye process was improved. Then, the new chyle testing method and its standard operation process was established.A total of 120 specimens with triglyceride(TG)in different levels were collected and divided into three groups with 40 specimens for each group (group A. TG≤1.7 mmol/L; B. 5.6<TG<12.8 mmol/L; C. TG≥12.8 mmol/L). Then, 50 body fluid specimens were collected and used to confirm the above test results. A total of 134 real body fluid specimens were used to assessment the clinical using by review and calculating the clinical coincidence rate.@*Results@#N-hexane can replace Diethyl ether in the Chyle test. The extraction volume ratio of 1 ml sample plus 400 μl N-hexane is the best one and the sultan Ⅲ tube dying method is better than former direct smear. Compared with the old Chyle test using Diethyl ether, the new Chyle test using N-hexane is in good consistency with the Kappa value 0.95. The clinical coincidence rate of the above Chyle test reaches 94.8%(127/134) after the verification of 134 specimens.@*Conclusions@#A new N-hexane test is established successfully. It was convenient to operate with high security and little contamination and thus has a wide clinical application value.(Chin J Lab Med, 2018, 41: 527-530)
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Objective The aim of the study was to investigate the early failure of newly created arteriovenous fistula(AVF) in patients on maintenance hemodialysis and the factors responsible for the failure. Methods The clinical data were retrospectively reviewed, preoperative examination and laboratory biochemical indicators of 88 patients with newly created AVF for maintenance hemodialysis in our hospital through Hospital Management Information System and telephone follow-ups. Binary Logistic regression was used to analyze the protective factors for early failure. Results In 88 patients, early failure of the AVF was found in 15 patients. Twenty-three factors, including gender, were involved in statistical analysis. There were statistical differences between the two groups in hypertension (χ2=7.689, P=0.006) and whether they had early referral to nephrologists (χ2=5.334, P=0.021). Further regression analysis showed hypertension ( OR=0.192, 95% CI=0.0538-0.692, P=0.012) was protective factor and without early referral ( OR=3.651, 95% CI=1.068-18.302, P=0.039) was the risk factor of early failure. Conclusion This study shows that no early referral and combined hypertension is an important factor affecting the early failure, emphasizing the clinical work, for the diagnosis of patients with chronic kidney disease, early nephrological referral should be established, and blood pressure monitoring should be done to help reduce the incidence of complications.
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Objective To clarify the role of nuclear factor κB(NF-κB) signaling pathway in pathogenesis of Kashin-Beck disease(KBD) by observing the expression of NF-κB p65 in the whole blood samples of patients with KBD and controls,and the expression of NF-κB p65 in C28/I2 chondrocyte, and to analyze the role of NF-κB p65 molecule in chondrocyte apoptosis. Methods Through a case-control study, 161 patients with KBD (KBD group) were selected from Xunyi, Yongshou, Changwu, Linyou, Qianyang and Long counties in KBD endemic areas and 312 healthy people(control group) were matched by age and sex in Shaanxi Province. Venous blood samples were collected from patients and healthy controls, which were anticoagulated and used for determination of NF-κB p65 protein.According to the group design,the model of C28/I2 chondrocyte oxidative damage was established.The experiments were divided into 4 groups including control group(C), tBHP injury group (O, tBHP 300.00 μmol/L), low selenium pre-protection group (OS1, 0.05 mg/L Na2SeO3+ 300.00 μmol/L tBHP), and middle selenium pre-protection group(OS2, 0.10 mg/L Na2SeO3+ 300.00 μmol/L tBHP). Then, cell apoptosis was detected by Hoechst 33342 and reactive oxygen species (ROS) was detected by dichlorfluorescein(DCF) method. The protein was extracted by Trizol method, then protein expression level of NF-κB p65 molecule was detected by Western blotting in whole blood samples and C28/I2 chondrocyte. Results The differences in age and sex were not statistically significant between KBD group and control group (t = 0.336, P > 0.05; χ2= 0.407, P > 0.05). The protein expression level of NF-κB p65 in KBD group was 1.835 times as high as that of control group (KBD:0.167 ± 0.026, control: 0.091 ± 0.014, t = 5.147, P < 0.01). Under the fluorescence microscope, chondrocyte showed strong blue fluorescence in tBHP group and the level of ROS(1.219 ± 0.104) was higher than those of low and middle selenium pre-protection groups(0.832 ± 0.077, 0.635 ± 0.070, P < 0.05).The protein expression level of NF-κB p65 in tBHP group (1.563 ± 0.351) was higher than that of control group (0.451 ± 0.069, P < 0.05), and protein levels of NF-κB p65 had a decreasing tendency in low and middle selenium pre-protection groups compared to tBHP group. Conclusion The NF-κB signaling pathway is up-regulated in KBD patients, moreover, chondrocyte experiments show that cell apoptosis is mediated via upregulation of NF-κB p65,which suggests NF-κB signaling pathway may play an important role in pathogenesis of KBD.