Risk factors of central vein stenosis in patients with chronic kidney disease and the effects on the function of arteriovenous fistula / 中华肾脏病杂志

Objective:To study the incidence and risk factors of central vein stenosis (CVS) in chronic kidney disease (CKD) patients who received arteriovenous fistula (AVF) creation for the first time, as well as effects of CVS on patency of ipsilateral AVF.Methods:It was a retrospective study. The CKD patients who received AVF creation for the first time in the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2020, with central vein digital subtraction angiography (DSA) results prior to angioplasty were selected as the study subjects. The differences of incidence of CVS in CKD patients with/without a history of cervical catheterization and primary patency rates of AVF between CVS and non-CVS groups were compared. Logistic regression analysis method was applied to analyze the influencing factors of CVS in CKD patients. Kaplan-Meier method was used to analyze the primary patency rate of AVF. Cox regression analysis method was used to analyze the effect of CVS on the primary patency of ipsilateral AVF.Results:A total of 283 CKD patients aged (50.45±14.76) years were enrolled in the study, including 165 males (58.3%). The dialysis age was 0.5 (0, 7.0) months. There were 55 patients (19.4%) diagnosed with CVS before AVF, including 39 patients with stenosis <50% and 16 patients with stenosis ≥50%. The incidence of CVS in patients with history of right internal jugular vein central venous catheter insertion was significantly higher than that in those without this history [60.5% (26/43) vs. 9.9% (15/151), χ2=51.274, P<0.001]. Multivariate logistic regression analysis results showed that hemodialysis catheters indwelling time ≥3 months elevated the risk of CVS ( OR=4.345, 95% CI 1.540-12.263, P=0.006). A subset of 268 patients who had AVF creation ipsilateral to CVS were analyzed to determine the effects of CVS on patency of AVF. The median follow-up time was 34 months. The primary patency rate of AVF in the moderate to severe CVS group was significantly lower than that in the non-CVS group (5/7 vs. 58/228, χ2=7.720, P=0.005). The primary patency rates of AVF in the subclavian vein stenosis group and superior vena cava stenosis group were significantly lower than those in the brachiocephalic vein stenosis group (4/5 vs. 8/27, χ 2=6.974, P=0.008; 6/8 vs. 8/27, χ 2=6.908, P=0.009, respectively). Moderate to severe CVS and combined diabetes were independent influencing factors of primary patency of AVF ( HR=4.362, 95% CI 1.644-11.574, P=0.003; HR=2.682, 95% CI 1.624-4.431, P<0.001, respectively). Conclusions:The incidence of CVS is higher in CKD patients who establish an arteriovenous fistula for the first time. Hemodialysis catheter indwelling time ≥3 months is an independent risk factor of CVS. The moderate to severe CVS is an independent risk factor of primary patency of AVF.

Investigation on soil-transmitted nematode infections in national surveil-lance sites in Jiangsu Province from 2006 to 2015 / 中国血吸虫病防治杂志

Objective To understand the status of soil?transmitted nematode infections in rural residents so as to provide the evidence for formulating the guidance for prevention and control of the diseases. Methods The national surveillance sites of soil?transmitted nematode infections were established in Shuyang County,Suqian City,Jiangsu Province from 2006 to 2015. At least 1 000 fecal samples of residents aged 3 years or above were collected in every autumn,and the intestinal helminth eggs were detected with the Kato?Katz technique and the Enterubius vermicularis eggs were detected by the cellophane tape method for children aged 3-12 years. The soil samples were collected from vegetable fields,lavatories,courtyards and kitchens to exam?ine Ascaris lumbricoides eggs and larvae of hookworm. Results The infection rates of soil?transmitted nematodes in residents and E. vermicularis in children reduced from 1.81%(19/1 049)and 4.72%(5/106)in 2006 to 0.25%(3/1 180)and 0(0/263) in 2015,respectively,in the surveillance sites. The infection intensity was mild in all the infected cases. The soil samples were negative for detecting A. lumbricoides eggs and hookworm larvae. Conclusion The infection rates of soil?transmitted nema?todes in the residents and E. vermicularis in the children show a decreasing trend and keep at a low level of prevalence in Shuy?ang County.

Construction and Standardization Research on Hospital Medical Imaging Data Center Based on Clinical Data Repository / 中国医学影像学杂志

Hospital image information system is evolving from department-oriented to patient-oriented. This paper introduces the implementation of Beijing University People's Hospital image data center. The ideas, approaches and the technological standards for image data center's system integration are proposed. Additionally, the problems in practical application and the outlook for this system are discussed.

Preparation and characterization of nano-hydroxyapatite/polyurethane composite bio-film / 生物医学工程学杂志

Through Hydroxyl (-OH) reacting with isocyanate group (-NCO), 13 Wt% nano-hydroxyapatite (n-HA)/polyurethane (PU) composite guided bone regeneration membrane was synthesized by use of solvent evaporation method. Its surface character was analyzed by XRD, IR, TG, contact angle, water absorption, elongation and combustion test and SEM. The results indicate that nano-HA/PU has good homogeneity,the interface between the inorganic mineral and organic polymer is optimized to create proper combination; that n-HA crystals are similar to the apatite crystals in natural bone, HA/PU composite membrane has good hydrophilicity mechanical behavior; and that many pores are observed on the membrane which help cells' metabolism. So the HA/PU composite membrane, thus prepared, has the potential for use in guided bone regeneration and tissue engineering.

Preliminary studies on repairing osteochondral defects in the rabbit knee joint by using porous PA66/n-HA combination mesenchymal stem cells / 生物医学工程学杂志

We have investigated the effects of repairing knee osteochondral defects in rabbit by using porous polyamide 66/nano-Hydroxyapatite (PA66/n-HA) combination bone marrow mesenchymal stem cells (MSCs). Eighteen 6-month-old New Zealand rabbits were used to produce the models of 4 mm x 4 mm osteochondral defect in the middle trochlea groove of femur. These models were randomly divided into 3 groups: PA66/n-HA + MSCs Group (Group A), PA66/n-HA group (Group B) and Operation control-group (Group C) in which operation for osteochondral defects was performed but neither material nor cells were implanted. The materials in Group A were seeded with MSCs (5 x 10(5)) in vitro before being implanted in to defects. The materials in groups A and B were 0.5 - 0.8 mm lower than normal cartilage. The animals were killed 1 and 4 months after operation. We assessed the effects by means of macroscopic observation, HE staining, toluidine blue staining, immunohistochemistry assay for type I and type II collagen. Group A displayed a little effect at the 1 month, but at the 4th month, Group A showed better results,compared to Groups B and C. At this time point, the repair tissue of Group A was regular; it presented more metachromatic substance visualized by toluidine blue staining, and it expressed type II collagen(+ +) and type I collagen(+). These results demonstrate that the repair tissue in Group A is nearly hyaline cartilage. So we presume that porous PA66/n-HA provides biomechanical support, and at the same time, MSCs enhance the repair effects.

Preparation and biological safety evaluation of porous n-HA/PA66 composite / 生物医学工程学杂志

Porous nano-hydroxyapatite/polyamide 66 (n-HA/PA66) composite was developed by injection molding method. Uniformly distributed and interconnected pores with an average size of about 500 microm in matrix were obtained. The evaluation of biological safety of the porous composite including cell cytoxicity test, sensitivity test, pyrogen test, haemolysis test was carried out according to GB/T16886 and GB/T16175. The results showed that the porous n-HA/PA66 composite was of no cytotoxicity, no allergen and pyrogen reactions as well as no hemolytic effect.

Study on injectable bioactive bone repairing material of nano-hydroxyapatite and polyamide-66 composite / 生物医学工程学杂志

The aim of this study was to evaluate the injectability, histocompatibility, function and other properties of the injectable bioactive bone repairing material of nano-hydroxyapatite and polyamide-66 (n-HA/PA66) composite. The XRD pattern, the relationship between the injectability and liquid-powder ratio, setting time and liquid-powder ratio, compressive strength and liquid-powder ratio were assessed. The size of the composite was determined to be 70 nm in length and 30 to 50 nm in width, and the molecular weight of polyamides-66 was 18000. The diameter of pores of the composite was about 200 to 400 micrometer. To evaluate the histocompatibility and function, 8 male dogs were studied with the injectable n-HA/PA66 composite implanted in the artificial defected alveolus of mandible on only one side to be compared with the intact alveolus on the other side. The specimens were taken at 4, 8, 12, 16 months after the implantation and the results were evaluated. The XRD pattern of the solidificated n-HA/PA66 composite was the same as the powdered n-HA/PA66 composite. The injectable n-HA/PA66 composite had a good injectability, 25 to 30 minutes setting time and about 37 MPa compressive strength when the liquid-powder ratio was 0.50. The healing of the gingiva was well at the implanted areas in all animals. The height of the repaired alveolar bone was obvious higher than that of the blank control. The earlier sign of ossification was histologically observed at 16 weeks after implantation. The injectable n-HA/PA66 composite has good biocompatibility and osteoconductive property. As an injectable material, with good maneuverability, it is useful for repairing irregular bone defects, especially in oral and maxillofacial surgery.