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Objective To investigate the predictive value of nutritional and fluid status measured by bioelectrical impedance methods for the prognosis of acute kidney injury (AKI) patients undergoing continuous renal replacement therapy (CRRT). Methods Patients with severe AKI received CRRT in the First Affiliated Hospital of Nanjing Medical University from September 2016 to September 2018 were enrolled, and divided into death group and survival group according to 28-day survival. Cox regression was used to analyze the association between 28-day survival and lean tissue index (LTI), fat tissue index (FTI), the ratio of extracellular water (ECW) and body cell mass (BCM) (ECW/BCM), and overhydration (OH), respectively. Results A total of 156 patients were included, including 101 males and 55 females. The age was (62.7 ± 15.4) years, with sequential organ failure assessment (SOFA) score of 9.9±3.9. The 28-day mortality rate was 46.2％. The pre-CRRT OH values in the 28-day survival group and death group were 2.95(1.80, 5.50) L and 4.20(2.95, 5.70) L(P=0.016), and ECW/BCM values were 1.00(0.76, 1.18) and 1.07(0.88, 1.25) (P=0.033), respectively. Univariate Cox regression analysis showed that pre-CRRT high OH values (HR=1.08, 95％CI 1.00-1.17, P=0.040) and high ECW/BCM values (HR=3.02, 95％CI 1.46-6.22, P=0.003) were associated with 28-day death. The changes of OH values (HR=0.83, 95％CI 0.72-0.95, P=0.008) and ECW/BCM values (HR=6.79, 95％CI 1.72-26.82, P=0.006) between pre - CRRT and the 7th day after CRRT initiation were significantly associated with 28-day mortality in patients who survived 7 days after CRRT initiation. After adjusting for age, gender, and SOFA scores, multivariate Cox regression analysis showed that the high OH value (HR=1.16, 95％CI 1.06-1.27, P=0.002) and the high ECW/BCM value (HR=2.80, 95％CI 1.30-6.06, P=0.003) before CRRT, the change of OH value (HR=0.82, 95％CI 0.72-0.95, P=0.008) and ECW/BCM value (HR=2.79, 95％CI 1.30-5.98, P=0.009) between the 7th day after CRRT initiation and pre-CRRT, were independently associated with 28-day death, while LTI (HR=0.93, 95％CI 0.86-1.02, P=0.113) and FTI (HR=0.98, 95％ CI 0.92-1.04, P=0.475) before CRRT were uncorrelated with 28-day death. Conclusions In bioelectrical impedance analysis, the high OH value and high ECW/BCM value before CRRT are associated with 28-day mortality in patients with AKI, while the nutritional indicators LTI and FTI before CRRT are not significantly related. The correction of fluid overload by CRRT within 7 days may reduce the risk of 28-day mortality.
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Objective:To analyze the different expressions of miRNAs in peripheral blood of rheumatoid arthritis (RA) patients and the osteoclasts in rats,and to verify the key miRNAs in RA.Methods: The miRNAs expressions in monocyte and the co-cultured osteoclasts,peripheral blood of rheumatoid arthritis (RA) patients and normal were detected by miRCURYTM LNA Array.Real time PCR was applied to verify the reliability of miRNA array.The bioinformatics software and database were applied to predict and analyze target genes.Results: miRNA array results showed that 189 miRNAs changed in RA patients compared with the normal;211 miRNAs were changed in osteoclasts group compared with monocytes group.The expressions of ten miRNAs were all abnormal in RA patients and osteoclasts in rats.The results of Real time PCR were consistent with the array.Results of bioinformatics analysis showed that the target gene of miRNA significantly enriched in signaling pathways such as VEGF,MAPK signaling pathways.Conclusion: Some miRNAs had similar abnormal expressions in different species,and these miRNAs may influence the differentiation of the osteoclasts through regulating the related signal passways.
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Objective:To study the mechanism of Qingluo Tongbi Compound (QLT) treating rheumatoid arthritis(RA)by observing miRNA Network of QLT on collagen-induced arthritis ( CIA) mice.Methods:The model of RA was induced by collagenⅡin DBA/1 mice and randomly divided into control group , CIA group, QLT group.Differently expressed miRNAs were detected by miRCURYTM LNA Array.Real-time PCR was applied to verify the reliability of miRNA array.Results:The bioinformatics software and database were applied to predict and analyze target genes.MiRNA array results showed that 221 miRNAs changed in CIA group compared with the control group ,and 169 miRNAs changed in QLT group compared with CIA group.And the results of real-time PCR were consistent with the array.Compared with the control group ,miR-143 was significantly reduced in CIA group ,intervention of QLT obviously upregulated the expression of miR-143.The target genes of miR-143 were significantly stored in VEGF , T cell receptor, MAPK,signaling pathway.Conclusion: Multiple abnormal expression of miRNAs involved in the pathological process of CIA.QLT affected the expression of various miRNAs ,which might be related to immunity ,inflammation,pain pathological process of RA and miR-143 could be a potential target in the treatment.
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ObjectiveTo evaluate the relationship between waist to stature ratio (WSR) and hypertension,diabetes,dyslipidemia in Qingdao. MethodsData were collected from a 2001 - 2007 Qingdao area diabetes survey,population-based cross-sectional study,and 30 712 Chinese adults aged ＞ 18 years old were enrolled.Correlation analysis of BMI,WSR,hip circumference,waist circumference,waist to hip ratio (WHR) with blood glucose,blood pressure,blood lipid were conducted.ROC curve analysis in diabetes,bypertension,dyslipidemia and multivariate logistic regression analysis were also conducted.ResultsAnthropometric indicators were related with hypertension,diabetes and dyslipidemia in both men and women.Comparing with other anthropometric indicators,WSR was found to have the largest area under the ROC curve and the best cut-off point of WSR was 0.52.Multivariate logistic regression analysis showed that, after controlling age, disease history, physicalactivity, sex, thediabeteshypertension and dyslipidemia risk OR of WSR≥0.52 were largest.ConclusionsAnthropometric indicators intimately related with cardiovascular risk factors in Qingdao region,and may predict and evaluate the risk of cardiovascular disease.WSR may be the best index for predicting cardiovascular risk factors in Qingdao area.The optimal WSR cut off point for identifying cardiovascular risk factors clustering is 0.52.
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The new educational system integrating both medical undergraduate and professional degrees,by integrating the curriculum system rationally,strengthening the clinical practice,innovating the assessment and management mode,establishes and enforces normative resident physician training system to cultivate high-starting point general practitioners led by medical colleges and provide qualified general practitioners,for the purpose of supporting the health reform successfully.
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Objective To investigate the prevalences of metabolic disorders of glucose and lipids in the first degree relatives (FDP) of type 2 diabetic patients in Qingdao,China. Methods 1392 subjects were recruited,including 528 T2DM-FDR(parent and/or siblings have T2DM) and 864 NC-FDR(parent and siblings did not have DM). All subjects received both standard 75g oral glucose tolerance test and measurements of body weight,height,waist and hip circumference,percentage of body fat,blood pressure,blood lipid,and plasma uric acid. Results (1) The prevalence of diabetes was higher in DM-FDR than in NC-FDR (24.24% vs 17.01%,P