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1.
Eur J Med Chem ; 268: 116229, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38430852

RESUMEN

Betel-quid chewing addiction is the leading cause of oral submucous fibrosis and oral cancer, resulting in significant socio-economic burdens. Vaccination may serve as a promising potential remedy to mitigate the abuse and combat accidental overdose of betel nut. Hapten design is the crucial factor to the development of arecoline vaccine that determines the efficacy of a candidate vaccine. Herein, we reported that two kinds of novel arecoline-based haptens were synthesized and conjugated to Bovine Serum Albumin (BSA) to generate immunogens, which generated antibodies with high affinity for arecoline but reduced binding for guvacoline and no affinity for arecaidine or guvacine. Notably, vaccination with Arec-N-BSA, which via the N-position on the tetrahydropyridine ring (tertiary amine group), led to a higher antibody affinity compared to Arec-CONH-BSA, blunted analgesia and attenuated hypothermia for arecoline.


Asunto(s)
Arecolina , Trastornos Relacionados con Sustancias , Arecolina/farmacología , Arecolina/metabolismo , Vacunas Conjugadas , Areca/metabolismo
2.
Int J Nurs Stud ; 153: 104728, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38461798

RESUMEN

BACKGROUND: Colorectal cancer is the leading cause of cancer-related death worldwide. Colonoscopy is widely used as a screening test for detecting colorectal cancer in many countries. However, there is little evidence regarding the uptake and diagnostic yields of colonoscopy in population-based screening programs in countries with limited medical resources. OBJECTIVE: We reported the uptake of colonoscopy and the detection of colorectal lesions and explored related factors based on a colorectal cancer screening program in China. DESIGN: Individuals aged 45-74 years who were asymptomatic for colorectal cancer and had no history of colorectal cancer were recruited. An established risk score system was used to identify individuals at high risk for colorectal cancer, and they were subsequently recommended for colonoscopy. SETTING: A population-based, prospective cohort study was implemented in 169 communities, 14 districts of Chongqing, Southwest China. PARTICIPANTS: A total of 288,150 eligible participants were recruited from November 2013 to June 2021, and 41,315 participants were identified to be at high risk of colorectal cancer. METHODS: Generalized linear mixed model was used to explore the individual and community structural characteristics associated with uptake of colonoscopy. Additionally, the detection rate of colorectal lesions under colonoscopy screening was also reported, and their associated factors were explored. RESULTS: 7859 subjects underwent colonoscopy, with an uptake rate of 19.02 % (95 % CI 18.64 %-19.40 %). Lower uptake rates were associated with older age, lower education, more physical activity, and structural characteristics, including residing in developing areas (OR 0.73, 95 % CI 0.69-0.78), residing more than 5 km from screening hospital (5-10 km: OR 0.85, 95 % CI 0.79-0.91; >10 km: OR 0.85, 95 % CI 0.80-0.91), and not being exposed to social media publicity (OR 0.63, 95 % CI 0.53-0.75). Overall, 8 colorectal cancers (0.10 %), 423 advanced adenomas (5.38 %), 820 nonadvanced adenomas (10.43 %), and 684 hyperplastic polyps (8.70 %) were detected, with an adenoma detection rate of 15.92 %. Several factors, including older age, male, current smoking and a family history of colorectal cancer, were positively related to colorectal neoplasms. CONCLUSIONS: The uptake of colonoscopy for colorectal cancer screening was not optimal among a socioeconomically diverse high-risk population. The screening strategy should attempt to ensure equitable access to screening according to regional characteristics, and enhance the uptake of colonoscopy by recommended multifaceted interventions, which focus on individuals with poor compliance, select a closer screening hospital, and strengthen social media publicity at the structural level.


Asunto(s)
Colonoscopía , Neoplasias Colorrectales , Detección Precoz del Cáncer , Humanos , China/epidemiología , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Persona de Mediana Edad , Colonoscopía/estadística & datos numéricos , Anciano , Estudios Prospectivos , Masculino , Femenino , Detección Precoz del Cáncer/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Tamizaje Masivo/métodos
3.
Artículo en Inglés | MEDLINE | ID: mdl-38100344

RESUMEN

Wireless sensor network (WSN) is an emerging and promising developing area in the intelligent sensing field. Due to various factors like sudden sensors breakdown or saving energy by deliberately shutting down partial nodes, there are always massive missing entries in the collected sensing data from WSNs. Low-rank matrix approximation (LRMA) is a typical and effective approach for pattern analysis and missing data recovery in WSNs. However, existing LRMA-based approaches ignore the adverse effects of outliers inevitably mixed with collected data, which may dramatically degrade their recovery accuracy. To address this issue, this article innovatively proposes a latent feature analysis (LFA) based spatiotemporal signal recovery (STSR) model, named LFA-STSR. Its main idea is twofold: 1) incorporating the spatiotemporal correlation into an LFA model as the regularization constraint to improve its recovery accuracy and 2) aggregating the L1 -norm into the loss part of an LFA model to improve its robustness to outliers. As such, LFA-STSR can accurately recover missing data based on partially observed data mixed with outliers in WSNs. To evaluate the proposed LFA-STSR model, extensive experiments have been conducted on four real-world WSNs datasets. The results demonstrate that LFA-STSR significantly outperforms the related six state-of-the-art models in terms of both recovery accuracy and robustness to outliers.

4.
J Ren Nutr ; 33(5): 639-648, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37302721

RESUMEN

OBJECTIVES: Malnutrition is associated with adverse outcomes in acute or chronic diseases. However, the prediction value of the Geriatric Nutritional Risk Index (GNRI) in critically ill patients with acute kidney injury (AKI) has not been well studied. METHODS: Data was extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) and the electronic intensive care unit database. We used two nutritional indicators, the GNRI and the modified Nutrition Risk in Critically ill (NUTRIC) score, to evaluate the relationship between the nutritional status of patients with AKI and prognosis. The outcome is in-hospital mortality and 90-day mortality. The prediction accuracy of GNRI was compared with the NUTRIC score. RESULTS: A total of 4,575 participants with AKI were enrolled in this study. The median age of 68 (interquartile range, 56-79) years, and 1,142 (25.0%) patients experienced in-hospital mortality, and 1,238 (27.1%) patients experienced 90-day mortality. Kaplan-Meier survival analysis indicated that lower GNRI levels and high NUTRIC score are associated with lower in-hospital and 90-day survival of patients with AKI (P < .001 by log-rank test). After multivariate adjustment, Cox regression analysis demonstrated a 2-fold increased risk of in-hospital (hazard ratio = 2.019, 95% confidence interval: 1.699-2.400, P < .001) and 90-day (hazard ratio = 2.023, 95% confidence interval: 1.715-2.387, P < .001) mortality in the low GNRI group. Moreover, the multivariate-adjusted Cox model containing GNRI had higher prediction accuracy for the prognosis of patients with AKI than that with NUTRIC score (AUCGNRI model vs. AUCNUTRIC model for in-hospital mortality = 0.738 vs. 0.726, AUCGNRI model vs. AUCNUTRIC model for 90-day mortality = 0.748 vs. 0.726). In addition, the prediction value of GNRI was validated by the electronic intensive care unit database (7,881 patients with AKI) with satisfying performance (AUCGNRI model = 0.680). CONCLUSIONS: Our results demonstrated that GNRI is strongly associated with survival in patients in the intensive care unit coexisting with AKI, and the GNRI has a superior predictive value than the NUTRIC score.


Asunto(s)
Lesión Renal Aguda , Desnutrición , Humanos , Anciano , Lactante , Evaluación Nutricional , Enfermedad Crítica , Estado Nutricional , Desnutrición/complicaciones , Factores de Riesgo , Estudios de Cohortes , Lesión Renal Aguda/complicaciones , Evaluación Geriátrica/métodos , Estudios Retrospectivos
5.
Int Urol Nephrol ; 55(11): 2925-2933, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37010735

RESUMEN

PURPOSE: The value of monoclonal protein (M-protein) in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients with renal involvement has not been investigated. METHODS: We analyzed AAV patients with renal involvement from 2013 to 2019 in our center. Patients with immunofixation electrophoresis were divided into M-protein positive group and M-protein negative group. The clinicopathological features and outcomes of the two groups were compared. RESULTS: Ninety-one AAV patients with renal involvement were enrolled for analysis, and 16 patients (17.6%) had a positive test for M-protein. Compared with M-protein negative patients, M-protein positive patients had lower hemoglobin (77.6 vs 88.4 g/L, p = 0.016), mean corpuscular hemoglobin concentration (313 vs 323 g/L, p = 0.002),serum albumin (29.4 vs 32.5 g/L, p = 0.026) and complement 3 (C3) (0.66 vs 0.81 g/L, p = 0.047), while higher platelets (252 vs 201 109/L, p = 0.048) and incidence of pulmonary infection (62.5% vs 33.3%, p = 0.029). However, renal pathological features between the two groups had no significant difference. In addition, during a median follow-up of 33 months, Kaplan-Meier survival analysis showed that, compared with M-protein negative patients, M-protein positive patients had a higher risk of all-cause mortality (log-rank test, p = 0.028), especially for patients who were not dialysis-dependent at the time of admission (log-rank test, p = 0.012). CONCLUSION: Our results indicate that M-protein is associated with different clinicopathological features and increased all-cause mortality in AAV patients with renal involvement. Testing M-protein and rigorous diagnosing of the significance of the presence of M-protein may be helpful for assessing the survival of AAV patients with renal involvement.


Asunto(s)
Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos , Fallo Renal Crónico , Humanos , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/complicaciones , Vasculitis Asociada a Anticuerpos Citoplasmáticos Antineutrófilos/diagnóstico , Riñón/patología , Anticuerpos Anticitoplasma de Neutrófilos , Fallo Renal Crónico/diagnóstico , Diálisis Renal/efectos adversos , Anticuerpos Monoclonales , Estudios Retrospectivos
6.
Ren Fail ; 44(1): 994-1003, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35658824

RESUMEN

BACKGROUND: The relationship between arteriolar hyalinosis and renal progression in immunoglobulin A nephropathy (IgAN) is not fully understood. We aimed to investigate the clinicopathological features and outcomes of IgAN with or without arteriolar hyalinosis. METHODS: A total of 762 diagnosed with IgAN patients were retrospectively analyzed. We classified IgAN patients into two groups with or without arteriolar hyalinosis. Then, the clinicopathological characteristics of the two groups were compared. We used Kaplan-Meier survival analysis to compare the composite kidney outcome of the two groups and applied multivariate Cox regression analyses to test the association between arteriolar hyalinosis and composite kidney outcome. RESULTS: Overall, 412 (54.1%) patients had arteriolar hyalinosis, including 173 patients diagnosed with hypertension. IgAN patients with arteriolar hyalinosis were older and had higher proteinuria, urea, uric acid, and blood pressure, while lower eGFR than those without arteriolar hyalinosis. Subgroup analysis showed similar results in IgAN patients with hypertension. Kaplan-Meier survival analysis showed that IgAN patients with arteriolar hyalinosis had worse composite kidney outcome than those without arteriolar hyalinosis. In addition, subgroup analysis revealed that patients with hypertension have worse composite kidney outcome than those without hypertension. Multivariate Cox regression analyses confirm that arteriolar hyalinosis (HR 2.57; 95% CI 1.41-4.69; p = 0.002) is an independent risk factor for renal prognosis in IgAN patients. CONCLUSIONS: Our study demonstrated that arteriolar hyalinosis is a common vascular lesion in IgAN patients. Arteriolar hyalinosis connects closely with hypertension, and arteriolar hyalinosis is an independent risk factor for renal prognosis in patients with IgAN.


Asunto(s)
Glomerulonefritis por IGA , Hipertensión , Arteriolas , Presión Sanguínea , Diarrea , Progresión de la Enfermedad , Enfermedades Hereditarias del Ojo , Glomerulonefritis por IGA/complicaciones , Glomerulonefritis por IGA/patología , Humanos , Hipertensión/complicaciones , Enfermedades Intestinales , Riñón/patología , Pronóstico , Estudios Retrospectivos , Anomalías Cutáneas , Enfermedades Vasculares/complicaciones
7.
J Ren Nutr ; 32(6): 710-717, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35134535

RESUMEN

OBJECTIVE: Exercise, like daily walking, may improve overall health and impede progression of chronic kidney disease (CKD); however, no specific walking dose has been recommended for patients with CKD. We aimed to investigate the association between daily walking steps and health-related quality of life (HRQOL) in adults with CKD. DESIGN AND METHODS: The walking steps of patients with CKD were extracted from the We Run mobile application. Their average daily walking steps were calculated and subdivided into the low-, middle-, and high-level groups. HRQOL was assessed using the physical component summary (PCS) and mental component summary (MCS) of the MOS 36 Short Form Health Survey (SF-36). RESULTS: A total of 558 adults (50.5%, men) with an average age of 40.2 (±13.8) years were enrolled. The median daily step count was 7,404 steps. The daily walking step count demonstrated an inverse U-shaped relationship with the SF-36 and subscale scores. Participants with daily walking steps between 7,000 and 12,000 have the highest PCS (68.1 ± 12.2) and MCS scores (70.0 ± 19.5). The multiple linear regression model showed that compared with patients with a daily step count of 7,000 to 12,000, patients with a daily step count >12,000 had a significantly lower MCS score (P < .001), while patients with a daily step count <7,000 had significantly lower PCS (P < .001) and MCS scores (P = .034). Moreover, the multivariable logistic regression model showed that patients with a daily step count >12,000 had significantly lower mental health-related quality (odds ratio [OR], 2.188; 95% confidence interval [CI], 1.079-1.439 for low MCS), while those with a daily step count <7,000 had a significantly lower HRQOL than the 7,000 to 12,000 daily step count group (OR, 2.113; 95% CI, 1.203-3.711 for low PCS; OR, 2.099; 95% CI, 1.210-3.643 for low MCS). CONCLUSIONS: These findings suggest that daily walking steps between 7,000 and 12,000 are associated with high HRQOL in adults with CKD.


Asunto(s)
Calidad de Vida , Insuficiencia Renal Crónica , Adulto , Masculino , Humanos , Femenino , Salud Mental , Caminata , Encuestas Epidemiológicas , Encuestas y Cuestionarios
8.
Front Med (Lausanne) ; 8: 742419, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34568395

RESUMEN

Background: T-lymphocyte subsets reflect patients' immune status and are associated with adverse outcomes in various diseases. However, the association between T-lymphocyte subsets and major infection and renal outcome in chronic kidney disease (CKD) patients has not been well-addressed. Methods: Patients diagnosed with stage 3-5 of non-dialysis CKD were recruited, and healthy subjects were selected as the controls. T-lymphocyte subsets (CD3+, CD4+, CD8+) were detected by flow cytometry, and the CD4+/CD8+ T cell ratio was then calculated. Patients were divided into the normal-level group and the low-level group according to the clinical reference value. The primary outcomes were the major infection and renal outcome. Results: A total of 410 CKD patients were enrolled; the average age was 47.25 years. Compared to the healthy controls, the level of CD3+, CD4+, CD8+ T cells, and the CD4+/CD8+ T cell ratio were significantly decreased in CKD patients (p < 0.05). During the median follow-up of 2.56 (quartile interval 1.24-3.46) years, major infections occurred in 15.10% of the CKD patients. The incidence of infection was significantly higher in the low-level group of CD3+, CD4+ T cells, and CD4+/CD8+ T cell ratio compared with the normal level groups. Kaplan-Meier analysis showed that the lower level of CD3+, CD4+ T cells, and CD4+/CD8+T cell ratio is associated with a greater risk of infection. Cox regression analysis further confirmed that low CD3+, CD4+ T cells, and CD4+/CD8+ T cell ratio were independent risk factors of infection in CKD patients. Moreover, during the follow-up, renal events occurred in 37.50% of patients. Kaplan-Meier analysis indicated that low levels of CD3+, CD4+, and CD8+ T cells are significantly associated with renal outcome in CKD patients. Cox regression analysis showed that low level of CD3+ T cells (HR = 2.407, 95% CI: 1.664-3.482, p < 0.001), CD4+ T cells (HR = 2.397, 95% CI: 1.633-3.518, p < 0.001) and CD8+ T cells (HR = 2.416, 95% CI: 1.476-3.955, p < 0.001) were independent risk factors for renal outcome after multivariable-adjusted. Conclusion: CKD patients had a defect in T-lymphocyte subpopulation. T-lymphocyte subsets were closely associated with infection and renal outcome in CKD patients. Suggesting T-lymphocyte subsets are independent predictors of infection and renal outcome in CKD patients.

9.
Clin Interv Aging ; 16: 1303-1313, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34267510

RESUMEN

PURPOSE: Atherosclerosis contributes substantially to cardiovascular mortality in patients with chronic kidney disease (CKD). But precise risk model for subclinical atherosclerosis in the CKD population is still lacking. The study aimed to develop and validate a nomogram for screening subclinical atherosclerosis among CKD patients without dialysis. PATIENTS AND METHODS: A total of 1452 CKD stage 1‒5 has been recruited in this cross-sectional study. Subclinical atherosclerosis was diagnosed with carotid ultrasonography. Patients were divided into the training set and validation set. The risk factors of atherosclerosis were identified by the training set and confirmed by the validation set. The receiver operating characteristic (ROC) curves and decision curve analyses (DCA) were executed to evaluate the accuracy of fitted logistic models in training and validation sets. Finally, a nomogram based on constructed logistic regression model in all participants was plotted. RESULTS: A total of 669 (46.1%) patients were diagnosed with subclinical carotid atherosclerosis. Binary logistic regression analysis showed that males, age, hypertension, diabetes, CKD stages, calcium, platelet, and albumin were risk factors for atherosclerosis. The accuracy of fitted logistic models was evaluated by the area under the ROC curve (AUC), which showed good predictive accuracy in the training set (AUC=0.764 (95% Confidence interval (CI): 0.733-0.794) and validation set (AUC=0.808 (95% CI: 0.765-0.852). A high net benefit was also proven by the DCA. Finally, these predictors were all included to generate the nomogram. CONCLUSION: This proposed nomogram shows excellent predictive ability and might have a significant clinical implication for detecting subclinical atherosclerosis in patients with CKD.


Asunto(s)
Aterosclerosis , Insuficiencia Renal Crónica , Adulto , Anciano , Aterosclerosis/diagnóstico por imagen , Aterosclerosis/etiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nomogramas , Insuficiencia Renal Crónica/complicaciones , Factores de Riesgo
10.
J Nephrol ; 34(6): 1887-1896, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33683672

RESUMEN

BACKGROUND: Hepatitis B virus (HBV) infections are associated with an increased risk of kidney diseases. However, the effects of HBV infection on the prognosis of immunoglobulin A nephropathy (IgAN) are unclear. METHODS: A total of 838 patients with biopsy-confirmed IgAN were enrolled in this retrospective cohort study. The patients were categorized into either affected by IgAN and HBV infection (HBsAg-IgAN) or by primary IgAN with no sign of HBV infection (P-IgAN). A 1:1 propensity-score matching was performed between the two groups, followed by a Kaplan-Meier survival analysis, to compare the prognoses, and a Cox regression analysis, to identify factors influencing the HBsAg-IgAN outcomes. RESULTS: A total of 176 pairs of patients were successfully matched. A significant difference in the systolic blood pressure and urea, serum creatinine, uric acid, and 24-h urine protein levels was observed between the groups. A renal pathological analysis also revealed a significant difference in the mesangial hypercellularity between the groups. During a median follow-up period of 2.4 years, Kaplan-Meier analysis also revealed a significant difference in the renal survival between the groups. Furthermore, multivariate Cox analysis confirmed that HBV infection is an independent risk factor for IgAN progression (hazard ratio [HR] 2.096; 95% confidence interval [CI] 1.091-4.026). Finally, the HBsAg-IgAN patients who received treatment with renin-angiotensin-aldosterone system inhibitors had a better overall prognosis than those who received immunosuppressive therapy and antiviral treatment. CONCLUSION: Our results indicate that the clinicopathological features and outcomes of patients with IgAN differ significantly between those with and without HBV infection, and that HBV is an independent risk factor for IgAN progression.


Asunto(s)
Glomerulonefritis por IGA , Hepatitis B , Glomerulonefritis por IGA/complicaciones , Glomerulonefritis por IGA/diagnóstico , Glomerulonefritis por IGA/tratamiento farmacológico , Hepatitis B/complicaciones , Hepatitis B/diagnóstico , Hepatitis B/tratamiento farmacológico , Virus de la Hepatitis B , Humanos , Pronóstico , Estudios Retrospectivos , Factores de Riesgo
11.
Trials ; 22(1): 37, 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413594

RESUMEN

BACKGROUND: Cardiovascular disease (CVD) is the most common complication and the leading cause of death in patients with chronic kidney disease (CKD). Accelerated atherosclerosis is a pathophysiological process that is vital to the occurrence of cardiovascular complications associated with CKD. Abnormal platelet activation is not only the leading cause of atherosclerosis but also plays a critical role in the occurrence of thrombotic events. Currently, antiplatelet drugs are commonly used as a secondary prevention strategy for high blood pressure, obesity, diabetes, and ischemic heart disease and can reduce the risk of CVD in the susceptible population. However, the benefits and evidence of using antiplatelet agents in patients with CKD remain controversial. This study aimed to determine whether antiplatelet therapy can safely prevent atherosclerosis in patients with CKD in the primary care setting. METHODS/DESIGN: The ALTAS-CKD study is a multicenter, prospective, randomized, double-blind, placebo-controlled trial of 554 adult patients with stage 3-5 non-dialysis-dependent CKD recruited from 10 territory medical centers in China. A secured web-based computer randomization system will be used to administer aspirin 100 mg once daily or a matching inactive placebo for 36 months. The primary endpoint will be the occurrence of atherosclerosis, as measured by carotid ultrasonography. The secondary endpoints will be combined cardiovascular events, all-cause mortality, and 50% decrease in the estimated glomerular filtration rate. TRIAL REGISTRATION {2A}: Current controlled trials number: ChiCTR1900021393 . Registered on 18 February 2019.


Asunto(s)
Aterosclerosis , Insuficiencia Renal Crónica , Adulto , Aterosclerosis/diagnóstico , Aterosclerosis/tratamiento farmacológico , Aterosclerosis/prevención & control , China , Humanos , Estudios Multicéntricos como Asunto , Inhibidores de Agregación Plaquetaria/efectos adversos , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/diagnóstico , Resultado del Tratamiento
12.
Int Urol Nephrol ; 53(5): 961-971, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33387224

RESUMEN

PURPOSE: Previous studies have indicated that platelet indices are related to the pathogenesis of cardiovascular diseases (CVD). However, it is unclear which platelet-related indicators are associated with CVD events in patients with chronic kidney disease (CKD) without dialysis. METHODS: We performed a single-center prospective cohort study involved 1391 CKD patients to explore the relationship between platelet indices and CVD events in CKD patients. A nomogram was generated to predict CVD-free survival after 3 and 5 years of follow-up in terms of the fitted Cox regression model. And the time-dependent receiver-operating characteristic (ROC) curves were applied to evaluate the prediction accuracy of platelet indices on CVD events. RESULTS: During a median follow-up of 3.41 years, 211 (15.2%) patients experienced CVD events. Results showed that platelet counts (PLT), plateletcrit (PCT), platelet-large cell ratio (P-LCR), and platelet distribution width (PDW) among 5 platelet indices were significantly lower in advanced CKD stages. Cox regression model showed that PLT, PDW, and PCT were associated with CVD events. However, after multivariable-adjusted, low level of PLT, hazard ratio (HR) 0.994 and 95% confidence interval (95% CI 0.989-1.000, p = 0.04), and PDW, HR 0.936 (95% CI 0.878-0.998, p = 0.044) predicted CVD events. The area under the ROC curve (AUC) of platelet indices assessed by time-dependent ROC curve analysis showed that only PLT and PDW were significant for predicting CVD events for 5 years. CONCLUSIONS: We demonstrated that PLT and PDW among 5 platelet indices were independently associated with CVD events in patients with CKD.


Asunto(s)
Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/etiología , Insuficiencia Renal Crónica/sangre , Insuficiencia Renal Crónica/complicaciones , Adulto , Enfermedades Cardiovasculares/complicaciones , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Estudios Prospectivos , Diálisis Renal
13.
Front Endocrinol (Lausanne) ; 12: 731187, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-35095752

RESUMEN

Aims: To investigate the potential role of renal arterial resistance index (RI) in the differential diagnosis between diabetic kidney disease (DKD) and non-diabetic kidney disease (NDKD) and establish a better-quantified differential diagnostic model. Materials and Methods: We consecutively reviewed 469 type 2 diabetes patients who underwent renal biopsy in our center. According to the renal biopsy results, eligible patients were classified into the DKD group and the NDKD group. The diagnostic significance of RI was evaluated by receiver operating characteristic (ROC) curve analysis. Logistic regression analysis was used to search for independent risk factors associated with DKD. Then a novel diagnostic model was established using multivariate logistic regression analysis. Results: A total of 332 DKD and 137 NDKD patients were enrolled for analysis. RI was significantly higher in the DKD group compared with those in the NDKD group (0.70 vs. 0.63, p< 0.001). The optimum cutoff value of RI for predicting DKD was 0.66 with sensitivity (69.2%) and specificity (80.9%). Diabetic retinopathy, diabetes duration ≥ 60 months, HbA1c ≥ 7.0(%), RI ≥ 0.66, and body mass index showed statistical significance in the multivariate logistic regression analysis. Then, we constructed a new diagnostic model based on these results. And the validation tests indicated that the new model had good sensitivity (81.5%) and specificity (78.6%). Conclusions: RI has a potential role in discriminating DKD from NDKD. The RI-based predicting model can be helpful for differential diagnosis of DKD and NDKD.


Asunto(s)
Diabetes Mellitus Tipo 2/metabolismo , Nefropatías Diabéticas/diagnóstico , Hemoglobina Glucada/metabolismo , Riñón/patología , Arteria Renal/fisiopatología , Insuficiencia Renal Crónica/diagnóstico , Resistencia Vascular , Adulto , Biopsia , Índice de Masa Corporal , Estudios de Casos y Controles , Diabetes Mellitus Tipo 2/complicaciones , Nefropatías Diabéticas/etiología , Nefropatías Diabéticas/patología , Nefropatías Diabéticas/fisiopatología , Retinopatía Diabética/etiología , Diagnóstico Diferencial , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Curva ROC , Insuficiencia Renal Crónica/patología , Insuficiencia Renal Crónica/fisiopatología , Sensibilidad y Especificidad , Factores de Tiempo
14.
Cardiorenal Med ; 10(3): 175-187, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32294646

RESUMEN

BACKGROUND: Experimental studies indicate that Klotho deficiency is a pathogenic factor for CKD-related complications, including cardiovascular disease (CVD). However, the association between serum Klotho and clinical outcomes in nondiabetic CKD patients needs to be further clarified. We aimed to determine whether serum Klotho levels are associated with CVD events and mortality in predialysis CKD patients without diabetes. METHODS: A total of 336 CKD stage 2-5 predialysis patients without diabetes were recruited and followed from the end of 2014 to January 2019 for CVD events and overall mortality. Serum Klotho was detected by ELISA and divided into quartiles (lowest, middle, second highest, and highest quartiles) according to their serum Klotho category. RESULTS: After a median follow-up of 3.52 years (IQR 3.34-3.76), Kaplan-Meier analysis showed that, compared to participants with a Klotho level in the highest quartile (the reference category), those in the lowest Klotho quartile were associated with a higher all-cause mortality risk (HR = 7.05; 95% CI 1.59-31.25) and a higher CVD event risk (HR = 3.02; 95% CI 1.45-6.30). In addition, the middle Klotho quartile was also associated with CVD event risk (HR = 2.56; 95% CI 1.21-5.41). Moreover, in the multivariate-adjusted model, the lowest Klotho quartile remained significantly associated with all-cause mortality (HR = 5.17; 95% CI 1.07-24.96), and the middle Klotho quartile maintained a significant association with CVD event risk (HR = 2.32; 95% CI 1.03-5.21). CONCLUSION: These results suggest that lower serum Klotho levels are independently associated with overall mortality and CVD events in nondiabetic predialysis CKD patients.


Asunto(s)
Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/mortalidad , Glucuronidasa/sangre , Insuficiencia Renal Crónica/complicaciones , Insuficiencia Renal Crónica/mortalidad , Adulto , Animales , Enfermedades Cardiovasculares/epidemiología , China/epidemiología , Diabetes Mellitus/diagnóstico , Femenino , Estudios de Seguimiento , Glucuronidasa/deficiencia , Humanos , Estimación de Kaplan-Meier , Proteínas Klotho , Masculino , Ratones , Ratones Transgénicos , Persona de Mediana Edad , Modelos Animales , Evaluación de Resultado en la Atención de Salud , Pronóstico , Estudios Prospectivos , Insuficiencia Renal Crónica/clasificación , Insuficiencia Renal Crónica/metabolismo , Factores de Riesgo
15.
J Colloid Interface Sci ; 506: 1-9, 2017 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-28709016

RESUMEN

Significant research has been focused on the synthesis of metal-organic frameworks (MOFs) with controllable compositions and structures, while much fewer works have been devoted to the construction of large micro-sized MOFs with uniform sizes and morphologies, which could be beneficial for practical applications. In this paper, a unique microfluidic jet spray drying technology has been adopted to reassemble nano-sized MIL-101 building blocks into hierarchical microparticles with uniform and large particle sizes. Specifically, suspension precursors of nano-sized MIL-101 building blocks are atomized into uniform droplets and then converted to microparticles on a one-to-one basis through a fast and scalable spray drying process. The particle size and morphology can be controlled by adjusting the solid concentration of the suspension and the drying temperature. The particle formation process with evolution of different morphologies are discussed. The resultant uniform MIL-101 microparticles possess hierarchical porosities and maintain the intrinsic crystal structure, microporosity and thermal stability of the nano-sized building blocks. They demonstrate a high efficiency toward benzene adsorption from n-octane solutions with high adsorption rates and very high adsorption capacities under batch conditions. Moreover, the large particle size and hierarchical structure make them applicable as filler of a fixed bed for dynamic flow separation of benzene from n-octane solutions with promising performance. The microfluidic jet spray drying technology can also be extended for the reassembly of other uniform MOF microparticles.

16.
ACS Appl Mater Interfaces ; 8(14): 9254-61, 2016 Apr 13.
Artículo en Inglés | MEDLINE | ID: mdl-27015527

RESUMEN

Solution-processed 8-hydroxyquinolinatolithium (s-Liq) was successfully applied as an efficient cathode interlayer in bulk heterojunction polymer solar cells (PSCs), giving rise to enhancement in device performance. The ultraviolet photoelectron spectra results revealed that the presence of s-Liq could lower work function of Al cathode, allowing for the ohmic contacts with the fullerene acceptor for better electron extraction and also a larger work function difference between the two electrodes, which leads to an increase in open-circuit voltage (V(oc)). Scanning Kelvin probe microscopy study on the surface potential of active layers suggested that an interfacial dipole was formed in the s-Liq interlayer between the active layer and the Al cathode, which enhanced the intrinsic built-in potential in the device for better charge transportation and extraction. Consequently, the V(oc), fill factor, and current density of the device can be improved by the introduction of s-Liq interlayer, leading to a power conversion efficiency (PCE) improvement. With PTB7 (or PTB7-Th) as the donor and PC71BM as the acceptor, the s-Liq-based PSC devices exhibited a PCE of 8.37% (or 9.04%), much higher than those of devices with the evaporated Liq (7.62%) or commonly used PFN (8.14%) as the cathode interlayer. Moreover, the s-Liq-based devices showed good stability, maintaining 75% (in N2) and 45% (in air) of the initial PCE after 7 days, respectively. These results suggest the great potential of s-Liq as cathode interlayer material for high-performance solar cells application.

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