摘要
Objectives To investigate whether the presence of metabolic syndrome (MS) modifies overall survival and cardiovascular (CV) outcomes among patients undergoing long-term peritoneal dialysis (PD) and to explore suitable diagnostic criterion for PD patients.Methods A total of 258 patients on PD in Peking University Third Hospital between October 2008 and March 2009 were enrolled and followed until June 2017.According to the diagnostic criteria of WHO,IDF and ATP Ⅲ,the patients were divided into MS group and non-MS group.The median following time was 51.9 (26.8,97.9) months.Overall survival and cardiovascular death were analyzed by the Kaplan-Meier method.The analyses were also done among non-diabetic PD patients.The influence of MS and its components on outcomes was analyzed by Cox regression models.Results Among 258 PD patients,106(41.1%) fulfilled the WHO criteria,121(46.9%) the IDF criteria,and 167(64.7%) the ATP criteria.139 cases were dead,among which 50(36.0%) cases were caused by CV diseases.The patients with MS had worse outcomes than those without MS by WHO and IDF criteria (cumulative survival rates of WHO criteria:21.3% vs 44.8%,P < 0.01;cumulative surviva rats of IDF criteria:23.3% vs 45.7%,P < 0.01).It was the same even in non-diabetic PD patients.The patients with MS had more CV death than those without MS by WHO and IDF criteria (both P < 0.05).Among non-diabetic PD patients,the results remained the same only by IDF criteria (P < 0.05).By ATP criteria,above analyses showed no difference.By multivariate Cox regression analysis,MS and serum albumin (all P < 0.01) were independently associated with increased risk for overall and cardiovascular survival.Among MS components,waist girth,low-density lipoprotein cholesterol (LDL-C) levels and blood sugar (all P < 0.01) were significant risk factors for adverse survival outcomes.Conclusions In patients undergoing PD,both overall survival and cardiovascular survival were worse in patients with MS than those without MS.Waist girth,blood sugar and serum LDL-C were the main risk factors.For PD patients the IDF criterion for MS was recommended.
摘要
Objective To understand the comparability of the detection results of four items (ALT ,AST , GGT ,ALP) of liver enzymology in 11 clinical laboratories in Xinjiang Production and Construction Corps (XPCC) and offer reference for improving mutual recognition of the results .Methods Eleven clinical labora-tories of XPCC organized the result comparability tests of 4 items of liver enzymology twice in 2017 ,and the samples with 5 batches were completed in each comparability test .One set of detection system in each labora-tory was used as comparability system according to comparability scheme .The detection results were analyzed through Robust Z Score and the evaluation criterion was :|Z|≤2 "satisfied";2< |Z|<3"warning";|Z|≥3 "not satisfied".Results The detection results of all 10 batch samples in 4 clinical laboratories showed |Z|≤2 in 2 comparability tests .In the first comparability test ,the detection results of 5 batch samples for 4 items were |Z|≤2 in 5 laboratories .In the second comparability test ,the detection results of 5 batch samples for 4 i-tems were |Z|≤2 in 8 laboratories ,but the ALT results of 5 batch samples in 1 laboratory showed positive deviation(Z≥3)and the GGT results of 5 batch samples in the other laboratory showed negative deviation (Z≤ -3) .Conclusion The 11 clinical laboratories in XPCC should continuously improve quality management system and make sure that the mutual recognition of the detection results of 4 items of liver enzymology is effective .
摘要
Objective To understand the prevalence rate and related factors of chronic kidney disease (CKD) among elderly people aged more than 65 years old in the 66th regiment of the fourth division of A Crops in Xinjiang .Methods A total of 2 030 elderly people aged more than 65 years old in the 66th regiment of the fourth division of XPCC were distributed in 6 communities . Totally 334 permanent residents aged more than 65 years old were chosen from 2 communities by the stratified random sampling method .The renal injury indicators and related factors were detected .Results Among 329 residents with intact data ,after the age correction ,the prevalence rate of albuminuria ,hematuria and renal function decrease were 22 .2% ,14 .2% ,4 .9% ,respectively .The prevalence rate of CKD in this group was 32 .8% ,CKD stage 1―3 were dominated .The awareness rate was 15 .1% .The multiva‐riate Logistic regression analysis showed that gender and hypertension were independently associated with CKD .Conclusion The prevalence rate of CKD among elderly people aged over 65 years old in the 66th regiment of the fourth division of this Crops is high‐er .The related factors are gender and hypertension .
摘要
Objective To explore the changes of appendicular skeletal muscle (ASM) in peritoneal dialysis (PD) patients, and to analyze the relationship between ASM changes and dietary intake.Methods One hundred and fourteen PD patients were enrolled in Department of Nephrology, Peking University Third Hospital using convenience sampling.At baseline, and 6 and 12 months after PD, bioelectrical impedance analysis was used to assess the body weight, total muscle mass, and ASM of these patients, and three-day food record was used to assess the dietary intake.Demographics and clinical data were also collected at baseline.Results Compared with baseline, the patients' ASM at 12 months after PD decreased significantly [(19.27 ± 5.59) kg vs.(25.65 ±6.09) kg, P =0.000], the dietary protein intake and energy intake decreased significantly [(0.85 ± 0.21) g/(kg · d) vs.(0.90 ± 0.27) g/(kg · d), P =0.038;(128.37 ± 26.67) kJ/(kg· d)vs.(137.27 ±29.23) kJ/(kg· d), P=0.001].The patients were divided into three groups based on ASM loss, the mean dietary protein intake of the top-loss 1/3 group was statistically lower than that of the bottom-loss 1/3 group [(0.82 ± 0.18) g/(kg · d) vs.(0.91 ± 0.20) g/(kg · d), P =0.021].Conclusions With the continuation of PD, ASM of patients may decrease, which is likely to be mainly related to deficiency in protein and energy intakes.Dietary management should be strengthened in PD patients to alleviate the loss of ASM.
摘要
Objective To verify the clinical applicability of the published standard intervals of routine clinical chemistry (WS/T404 .1‐2012 ,WS/T404 .2‐2012) based on the health examination results of Han and Uygur populations in Urumqi .Methods This was a retrospective study .The results of serum TP ,ALB ,ALT ,AST ,ALP ,GGT from healthy examination individuals of Han and Uygur populations (from 2013 August to 2015 January) were collected and the healthy cases (age range:20 -79 years old) were chosen to calculate the 2 .5% and 97 .5% percentiles ,excluding the significant abnormal results according to the Medical Deciding Level 2 recommended by Staland .The percents of health cases not falling in the published standard interval were calculated to meet the judgment criterion of verification (<10% ) .Results The test of normality revealed that the Han and Uygur's results of all veri‐fied items were skewed distributions .The 2 .5% and 97 .5% percentiles of the results of two populations were as follows ,TP(Han 65 -81 g/L ;Uygur 64-81 g/L) ,ALB(Han 41-53 g/L ;Uygur 40-52 g/L) ,ALT(Han:male 9-51 U/L and female 7-42 U/L ;Uygur:male 9-53 U/L and female 6-43 U/L) ,AST(Han:male 14-42 U/L and female 12-37 U/L ,Uygur:male 12-42 U/L and female 12-38 U/L) ,ALP(Han:male 45-119 U/L ;Uygur:male 47-122 U/L) ,ALP(female 20-49 years old:Han 35-95 U/L and Uygur 40-104 U/L) ,ALP(female 50-79 years old:Han 43-131 U/L and Uygur 51-132 U/L) ,GGT(Han:male 11-71 U/L and female 8-54 U/L ;Uygur :male 11 -73 U/L and female 7 -55 U/L ) .The percents of AST results for Han's male , Uygur's male and Uygur's female not falling in the published standard reference interval were slightly over 10% ,but AST results o‐ver 10% were mainly under the lower limit of the published standard reference interval .The health case percents for the other veri‐fied items of Han and Uygur populations not falling in the published standard reference interval were under 10% .Conclusion The published standard reference intervals of routine clinical chemistry (WS/T404 .1‐2012 ,WS/T404 .2‐2012) are applicable in our la‐boratory for the detection of Han and Uygur population .
摘要
This paper was to explore the relationship between plasma omentin and obesity and insulin resistance in patients of polycystic ovary syndrome(PCOS).The results showed that there were statistically significant differences in serum omentin levels among control group,PCOS-normal weight group,and PCOS-overweight group [(115.29 ± 33.92),(111.12 ± 34.50),and (42.85 ± 19.39) pg/ml,P< 0.05].Omentin were negatively correlated with homeostasis model assessment for insulin resistance(HOMA-IR) and body mass index(BMI).In the multiple stepwise regression analysis,only omentin was negatively correlated with BMI.Omentin may be involved in the development of PCOS by affecting obesity.
摘要
Objective To investigate the energy intakes and energy consumption in continuous ambulatory peritoneal dialysis (CAPD) patients,and to identify the possible influence factors for overweight and obesity of CAPD patients.Methods A total of 115 CAPD patients were enrolled from May to December 2011 in Peking University Third Hospital.Based on body mass index (BMI),they were divided into normal group (18.5 kg/m2 ≤ BMI < 24 kg/m2,n =61) and obese group (BMI ≥ 24 kg/m2,n =54).Three-day dietary intakes including dietary energy,protein,fat,and carbohydrates intakes were collected.Glucose absorption from dialysate was measured.Three-day activities were recorded for the calculation of resting energy expenditure (REE) and total energy expenditure (TEE).Body composition of the patients was analyzed.Results There were no significant differences in age,height,dietary energy intake,protein intake,carbohydrate intakes,lean tissue mass,and hydration status between the two groups.Glucose absorption from dialysate and dietary fat intake were significantly higher in the obese group than in the normal group [(1 920.5 ± 506.3) kJ/d vs.(1 673.6 ±535.6) kJ/d,x2 =2.536,P=0.013; (62.5 ±19.8) g/dvs.(53.1 ±18.7) g/d,x2=2.575,P =0.011].Although REE was higher in the obese group as compared with the normal group [(5 066.8 ±1 029.3) kJ/d vs.(4 556.4 ± 799.1) kJ/d,x2 =2.979,P =0.004],there was no significant difference in TEE between the two groups [(7 819.9 ±728.0) kJ/d vs.(7 803.2 ± 1 092.0) kJ/d,x2 =0.770,P =0.939].Logistic regression showed that glucose absorption from dialysate and dietary fat intakes were risk factors for obesity in the study population (OR =1.003,95% CI =1.000-1.007,P =0.029 ; OR =1.024,95% CI =1.003-1.046,P =0.027).Conclusions Obese CAPD patients may absorb more glucose from peritoneal dialysate and consume more fat than non-obese CAPD patients,but TEE is not significantly different.It indicates that obese CAPD patients are at positive energy balance.Less use of high glucose dialysate and more physical exercises are recommended for these patients.
摘要
Objective To provide the objective evidence for reducing stat test turnaround time (TAT) reasonably through the comparative analysis of different intervals of stat test TAT between emergency department (ED) and intensive care unit (ICU ) . Methods Laboratory information system was used to collect data about blood cell analysis and biochemical profiles of department of emergency and ICU from 1st January to 31th March ,2014 ,then comparatively analyzing different intervals of stat test TAT be‐tween two departments .Results TAT outlier rates of stat CBC tests ordered by ED and ICU were 2 .4% and 15 .1% ,and that of stat biochemical profiles ordered by ED and ICU were 12 .3% and 24 .5% ,respectively .there were no significant differences in mean times between order‐to‐receipt of stat CBC tests and biochemical profiles ordered by ED and collection‐to‐receipt of stat CBC tests and biochemical profiles ordered by ICU [(11 .2 ± 4 .0) min vs .(11 .2 ± 4 .5) min ,P>0 .05 ;(13 .2 ± 14 .1)min vs .(13 .8 ± 9 .8) min ,P>0 .05] .ED had significantly shorter mean time of receipt‐to‐report than ICU for stat CBC tests and biochemical profile [(5 .8 ± 4 .4) min vs .(19 .3 ± 12 .5) min ,P0 .01] .The TAT mean times of stat CBC tests and biochemical profiles ordered by ED were shorter than those ordered by ICU [(17 .0 ± 6 .2) min vs .(30 .5 ± 14 .9) min ,P<0 .01 ;(46 .9 ± 17 .2) min vs .(49 .3 ± 16 .5) min ,P<0 .01] .Conclusion The ED TATs for CBC tests and biochemical pro‐files are reasonably set ,and each interval of the ED TATs is well controlled .The ICU TATs for CBCs and biochemical profiles should be reset ,and the process of stat test for ICU should be optimized .
摘要
OBJECTIVE@#Three genes including the OTOF, the DFNB59 and the DIAPH3 have been implicated previously in human non-syndromic auditory neuropathy. In this study, we aim to investigate whether DIAPH3 gene or the known deafness loci of 25 cloned autosomal dominant deafness (DFNA) genes contribute to the nonsyndromic hearing loss of a Chinese pedigree with dominantly inherited auditory neuropathy (AN).@*METHOD@#Nine members of the kernal pedigree in this family were selected. Genomic DNA was isolated from the peripheral leukocytes of the subjects using the Puregene DNA Isolation Kits. Firstly, the 5'UTR of DIAPH3 gene was PCR amplified in all subjects. Then, the DNA fragments spanning the entire coding regions of DIAPH3, GJB2 and GJB3 genes, and 50 exons in other 23 cloned DFNA genes were amplified using specific primers. Each fragment was purified and analyzed by direct sequencing. The resultant sequence data were compared with the standard sequence to identify deafness-associated mutations.@*RESULT@#PCR amplifications were successfully conducted. We failed to detect the presence either of c. --172G > A mutation in the 5'UTR that have been reported, or any other deafness-associated mutations in the whole DIAPH3 gene, by sequence analysis. We also did not find any known deafness-causing mutations among the 25 cloned DFNA genes.@*CONCLUSION@#The DIAPH3 gene, and the known deafness loci of 25 cloned DFNA genes seem not contribute to the pathogenesis of this Chinese AN family in this study, which suggesting new gene(s) involvement.
Subject(s)
Humans , Adaptor Proteins, Signal Transducing , Genetics , Asian People , China , Connexins , DNA Mutational Analysis , Deafness , Exons , Hearing Loss , Hearing Loss, Central , Genetics , Hearing Loss, Sensorineural , Genetics , Mutation , Pedigree , Polymerase Chain Reaction摘要
Objective To clarify the association of onset and maintenance of metabolic syndrome (MS) with energy metabolism imbalance,especially with dialysate glucose load in peritoneal dialysis (PD) patients.Methods Using retrospective self-controlled study,the changes of MS,dialysate glucose load and dietary energy intake (DEI) in 126 PD patients in about 1 year were collected and analyzed to define the effect of energy intake on MS.Resting energy expenditure (REE) was measured and physical activity level (PAL) was evaluated based on the activity records in PD patients with unchanged MS state and their impacts on MS were analyzed.Results The incidence of changing from non-MS to MS was higher in glucose load increasing group than that of glucose load unchanged or decreasing group.When glucose load increased,patients developing MS had significantly increased serum triglyceride (TG) level (P<0.01) and significantly decreased serum high density lipoprotein cholesterol (HDL-C) level (P<0.05),while the waist circumference and blood glucose level did not alter significantly.In patients changing from MS to non-MS,their serum C reactive protein (CRP) levels significantly decreased during the follow-up (P<0.05).No significant difference was found in DEI in patients changing from MS to non-MS.However,in patients changing from non-MS to MS,their DEI decreased during the follow up (P<0.05).In a subgroup analysis in 36 PD patients who maintained their metabolic status and did not change their glucose load,there was no difference in REE per body surface per day between the MS group and the nonMS group (t=0.840,P>0.05).However,the PAL was lower in the MS group than that of the nonMS group (t=2.358,P<0.05).Conclusions The increase of dialysate glucose load may be an important factor leading to the onset of MS,by altering serum TG and HDL-C level.Inflammation and the sedentary life also contribute to the MS state.
摘要
With high incidence and prevalence,high costs and poor outcome.Optimal dietary and nutrition management is an essential part in managing chronic kidney disease (CKD) and is associated with better patient outcome.An appropriate dietary and nutrition management should be based on chronic disease management model,provided by a multidisciplinary team,and implemented continuously with patient education,evaluation and goal-setting,and finally improve patients' clinical outcomes.