Association between prognostic nutritional index and cognitive impairment in maintenance hemodialysis patients / 中华肾脏病杂志

Objective:To explore the relationship between prognostic nutritional index (PNI) and cognitive impairment (CI) in maintenance hemodialysis (MHD) patients.Methods:It was a multicenter cross-sectional study that included adult patients who received MHD treatment at 18 hemodialysis centers in Guizhou province from June to October 2020 as the study subjects. Cognitive function was assessed with the mini-mental state examination score. According to the scale score, the patients were divided into CI group (≤27 scores) and non-CI group (>27 scores), and the differences between the two groups were compared. The patients were divided into Q1 (PNI<38.0), Q2 (38.0≤PNI<40.4), Q3 (40.4≤PNI<43.0), and Q4 (PNI≥43.0) groups based on the PNI quartiles. The PNI was estimated based on the serum albumin and lymphocyte count. Multivariate logistic regression analysis was used to analyze the correlation between PNI and CI, and subgroup analysis was conducted.Results:A total of 1 740 MHD patients were enrolled in the study, with 1 021 males (62.9%) and 719 females (37.1%). The age was (55±15) years old. There were 411 patients (23.6%) with CI. The age, C-reactive protein, and the proportions of females, current smoking/drinking and diabetes in the CI group were significantly higher than those in the non-CI group, and the education level, blood lymphocyte count, blood prealbumin, serum albumin, serum creatinine, blood uric acid and PNI were significantly lower than those in the non-CI group (all P<0.05). The risk of CI in Q1 group was 1.88 times higher than that of Q4 group after adjusting for confounding factors such as sex, age, body mass index, education level, comorbidities, current smoking/drinking, dialysis age and C-reactive protein ( OR=1.88, 95% CI 1.17-2.30, P=0.008). Subgroup analysis showed that there was an interaction between age and PNI on CI ( P=0.040 for interaction). Q1 group in the patients aged 18 to 45 years old had a higher risk of CI compared to Q4 group ( OR=3.30, 95% CI 1.19-9.10). Conclusions:Low PNI significantly increases the risk of CI in MHD patients, in particularly in the patients aged <45 years old.

Detection of serum food specific antibodies of 6 common foods in patients with IgA nephropathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the relationship between the major allergens of 6 common allergic foods and IgA nephropathy.</p><p><b>METHODS</b>A sensitive sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of food-specific IgA1, IgG and IgE in 31 patients with IgA nephropathy and 80 healthy volunteers. All the patients were examined for a history of food allergy using a questionnaire.</p><p><b>RESULTS</b>Serum levels of IgA1 and IgG against the major allergens of the 6 common allergic foods were significantly higher in patients with IgA nephropathy than in healthy volunteers (P<0.05). There was no detectable food-specific IgE antibodies in the two groups. No patients had a clear history of food allergy. All the patients with increased IgG levels specific to 4 or more foods simultaneously had proteinuria.</p><p><b>CONCLUSIONS</b>Some foods especially the highly allergic ones may participate in the pathogenesis and progression of IgA nephropathy.</p>

Intraarterial Chemotherapy Followed by Radical Hysterectomy for Locally Advanced Cervical Cancer / 复旦学报（医学版）

PurposeTo evaluate the curative effect and possibility of the intraarterial chemotherapy followed by radical hysterectomy for locally advanced cervical cancer. Methods59 patients with FIGO stage lb-IV cervical cancer were enrolled and the tumor size with stage lb and Ua must be more than 4 cm. Treatment consisted of bilateral internal iliac artery infusion of cisplatin 80 rog, 5-Fu 1 500 rog, and AT1258 60 mg for 1 - 3 courses separated by 3 weeks. The tumor size was measured by vagina ultrasonic and CT before and after chemotherapy to calculate the shrunk size percent. All patients underwent radical hysterectomy. Patients with disease in the vagina, parametrium, pelvic lymphnodes or microscopic tumor emboli were followed postoperative pelvic irradiation. Results59 patients underwent 122 courses of intraarterial chemotherapy for 1 - 3 courses each. The total response rate was 95 %. Complete response (CR) was achieved in 18 of 59 patients (31%) ,while a partial response (PR) was noted in 38 (64%) and stable disease (SD) in 3 (5% ). No patient had progressive disease. 14 patients with pelvic lymphnode metastasis were all found to have PR and SD. No patient had lymphnode metastasis in CR. Of 18 patients with CR, 17 patients had not recurrence. Only one patient with stage lla recurred 20 months after operation. But he also cured. All 18 patients with CR were living free of disease. But 3 in 38 patients with PR died and 3 patients with SD were all died. There were no severe complications related to intraarterial chemotherapy and radical hysterectomy. Conclusionslntraarterial chemotherapy before operation can shrink tumor size, decrease the lymphnode metastasis. It is feasible in helping elevating cure rate of patients with locally advanced cervical cancer who are at high risk for failure with conventional treatment.