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Objective:To analyze clinical data related to mineral and bone disorder(MBD)in elderly maintenance hemodialysis patients and provide a basis for the development of precise clinical treatment strategies.Methods:A total of 267 patients receiving regular hemodialysis at Beijing Huairou Hospital and Huairou District Hospital of Traditional Chinese Medicine between April 2022 and June 2022 were selected and divided into an elderly group(age≥60 years)with 129 patients and a younger group(age<60 years)with 138 patients.Patients' general information, medication use, and laboratory data including routine blood work, blood calcium, blood phosphorus, and intact parathyroid hormone were collected, and a survey questionnaire was conducted to collect data on hyperphosphatemia patients' knowledge about diet and medication use.Differences in the rate of meeting calcium and phosphorus target ranges, medication use, and questionnaire scores were compared between patients in the two groups.Results:(1)The rates of controlled Ca(2.3±0.2)mmol/L, P(1.9±0.6)mmol/L and iPTH[213.5(93.5, 359.9)ng/L]levels in the elderly group were 65.1%(84/129), 43.4%(56/129)and 51.2%(66/129), respectively.There were no statistically significant differences compared with the younger group(all P>0.05). The prevalence of hyperphosphatemia in the elderly group(66/129, 51.2%)was lower than that in the younger group(90/138, 65.2%)( χ2=5.422, P=0.020). (2)Compared with the younger group, the elderly group had lower levels of serum creatinine[(796.6±225.2)μmol/L vs.(1025.6±281.4)μmol/L], uric acid[(416.9±97.0)μmol/L vs.(445.0±106.6)μmol/L], albumin[(37.9±2.9)g/L vs.(39.0±3.0)g/L]and serum phosphorus[(1.9±0.6)mmol/L vs.(2.1±0.6)mmol/l]( t=7.289, 2.238, 2.941, 2.820, P<0.05), and a higher blood glucose level[6.9(5.2, 9.8)mmol/L vs.6.1(4.9, 8.2)mmol/l, Z=2.314, P=0.015]. (3)Compared with the younger group, the elderly group had significantly lower utilization rates of calcium-free phosphate binders[12.4%(16/129) vs.23.9%(33/138)]and calcimimetics[2.3%(3/129) vs.10.9%(15/138)]( χ2=5.895, 7.742, P<0.05, respectively). (4)Compared with the younger group, the elderly group had a lower total questionnaire score(36.8±6.6 vs.39.5±6.0), a lower hyperphosphatemia knowledge score(4.7±3.1 vs.6.0±2.8), a lower diet knowledge score(2.8±2.2 vs.4.0±1.9)and a lower medication knowledge score(2.1±1.9 vs.3.1±1.8, t=3.442, 3.694, 4.677, 4.398, respectively, P<0.05 for all), but had a higher compliance score(17.3±1.9 vs.16.4±2.4, t=3.390, P=0.001). (5)Multivariate Logistic regression analysis indicated that pre-dialysis blood urea nitrogen( OR=1.082, 95% CI: 1.011-1.159, P=0.024)and serum creatinine( OR=1.002, 95% CI: 1.001-1.005, P=0.036)were independent predictors of hyperphosphatemia in elderly hemodialysis patients. Conclusions:Compared with the younger group, the serum albumin and phosphorus levels were lower, the utilization rates of calcium-free phosphate binders and calcimimetics were lower, and the total score of the hyperphosphatemia questionnaire was also lower in the elderly group.However, the compliance score was significantly higher in the elderly group.We should focus on the relevant weak links to bolster diet education and medication management for elderly hemodialysis patients.
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Objective@#To evaluate the efficacy of systemic glucocorticoid (steroid) combined with high dose inhaled steroid in the treatment of children with acute laryngitis.@*Methods@#A total of 78 children with acute laryngitis were randomly divided into study group(n=40) and control group(n=38) between November 2016 and April 2017. In addition to routine treatment of anti infection and symptomatic treatment, Dexamethasone injection(0.3-0.5 mg/kg, 1-3 d, according to the patient′s condition) was provided to each group. In addition to the treatment mentioned above, the study group were assigned to receive 1.0 mg Budesonide suspension for inhalation, oxygen-driven atomizing inhalation, every/30 minutes, 2 times in a row, after that every 12 hours. The improvement of inspiratory dyspnea, hoarseness, barking cough and wheezing of both groups was evaluated at 30 min, 1 h, 2 h, 6 h, 12 h, 24 h and 72 h after treatment.Sigmaplot 11.5 software was used to analyze the data.@*Results@#No significant difference was detected in terms of inspiratory dyspnea, hoarseness, barking cough or stridor score before treatment between the two groups(P>0.05). Compared with those before treatment, symptoms of inspiratory dyspnea, hoarseness, barking cough and stridor score of both groups improved markedly at 12 h and 24 h after treatment(P<0.05). While there was no significant difference regarding inspiratory dyspnea, hoarseness, barking cough or stridor score at each time point after treatment between the two groups(P>0.05). The effective rate was 92.50% and 92.11% in study group and control group, respectively, and no significant difference was noted (P>0.05).@*Conclusion@#Compared with single systemic glucocorticoid, systemic glucocorticoids combined with inhaled steroid possessed similar efficacy in treating acute laryngitis and relieving laryngeal obstruction of children.
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Objective To explore the expression and clinical significance of CD 8 +CD28 -T lymphocytes in the patients with endometriosis ( EMT) complicating with pelvic fluid .Methods Eighty patients with endometriosis complicating with pelvic fluid ( ca-ses of ⅠtoⅣwere 15, 12, 22, and 31, respectively) were enrolled.The peripheral blood as well as the pelvic fluid were collected and flow cytometry was applied to detect the frequencies of CD 8 +CD28 -T lymphocytes and their intracellular cytokines , including transforming growth factor β1 (TGF-β1) and interleukin 10 (IL-10).Twenty health women with the same range of age were enrolled as the control group .Results Compared with the control ones , the frequencies of peripheral blood CD 8 +CD28 -T lymphocytes , TGF-β1, and IL-10 of the EMT subjects were increased significantly (all P Ⅲ>Ⅱ>Ⅰand the difference between every two of the Ⅰ~Ⅳgroups was significant (all P Ⅲ>Ⅱ>Ⅰ.Moreover, the difference of pelvic fluid TGF-β1 between any two groups was more apparent compared with CD 8 +CD28 -T lymphocytes and IL-10 ( P <0.05 ) .Spearman correlation analysis showed that any one of CD8 +CD28 -T lymphocytes, TGF-β1, and IL-10 positively correlated with any stage of ⅠtoⅣ( rs =0.791, 0.753,0.726 and all P <0.05).Conclusions CD8 +CD28 -T lymphocytes, TGF-β1, and IL-10 were closely related to the stages and could be the negative roles in the pathogenesis of EMT .TGF-β1 played a vital role in the formation of pelvic fluid .
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Objective To investigate the clinical value of interventional ultrasound treatment for non-ruptured ectopic pregnancy. Methods Seventeen cases of ectopic pregnancy with masses 20~50 mm(mean,35 mm) in diameter and embryo sacs 15~42 mm(mean,26 mm) in diameter were included.Under the guidance of ultrasonography,needle puncture and aspiration of lesions of ectopic pregnancy was conducted through the posterior fornix.Then the methotrexate(MTX) 20~40 mg was injected into.Results All the 17 cases were punctured and MTX-injected on one session.The embryo sac disappeared within 4 weeks after the treatment in 16 cases,while there was no improvement in 1 case and a further surgery was given.Of the 16 successfully treated cases,salpingography showed the oviduct as "patent" in 14 cases and as "unobstructed" in 2.Conclusions Interventional ultrasound treatment of non-ruptured ectopic pregnancy has advantages of simplicity of performance,good safety and efficiency,minimal invasion,and few adverse effects.This procedure is worthy of being recommended.