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Objective:Acute kidney injury (AKI) is one of the common complications in critically ill septic patients, which is associated with increased risks of death, cardiovascular events, and chronic renal dysfunction. The duration of AKI and the renal function recovery status after AKI onset can affect the patient prognosis. Nevertheless, it remains controversial whether early recovery status after AKI is closely related to the prognosis in patients with sepsis-associated AKI (SA-AKI). In addition, early prediction of renal function recovery after AKI is beneficial to individualized treatment decision-making and prevention of severe complications, thus improving the prognosis. At present, there is limited clinical information on how to identify SA-AKI patients at high risk of unrecovered renal function at an early stage. The study aims to investigate the association between early recovery status after SA-AKI, identify risk factors for unrecovered renal function, and to improve patients ' quality of life.Methods:We retrospectively analyzed clinical data of septic patients who were admitted to the intensive care unit (ICU) and developed AKI within the first 48 hours after ICU admission in the Second Xiangya Hospital and the Third Xiangya Hospital of Central South University from January 2015 to March 2017. Sepsis was defined based on the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). AKI was diagnosed and staged according to the 2012 Kidney Disease:Improving Global Outcomes (KDIGO) guideline. SA-AKI patients were assigned into 3 groups including a complete recovery group, a partial recovery group, and an unrecovered group based on recovery status at Day 7 after the diagnosis of AKI. Patients ' baseline characteristics were collected, including demographics, comorbidities, clinical and laboratory examination information at ICU admission, and treatment within the first 24 hours. The primary outcome of the study was the composite of death and chronic dialysis at 90 days, and secondary outcomes included length of stay in the ICU, length of stay in the hospital, and persistent renal dysfunction. Multivariate regression analysis was performed to evaluate the prognostic value of early recovery status after AKI and to determine the risk factors for unrecovered renal function after AKI. Sensitivity analysis was conducted in patients who still stayed in hospital on Day 7 after AKI diagnosis, patients without premorbid chronic kidney disease, and patients with AKI Stage 2 to 3.Results:A total of 553 SA-AKI patients were enrolled, of whom 251 (45.4％), 73 (13.2％), and 229 (41.4％) were categorized as the complete recovery group, the partial recovery group, and the unrecovered group, respectively. Compared with the complete or partial recovery group, the unrecovered group had a higher incidence of 90-day mortality (unrecovered vs partial recovery or complete recovery: 64.2％ vs 26.0％ or 22.7％; P<0.001) and 90-day composite outcome (unrecovered vs partial recovery or complete recovery:65.1％vs 27.4％or 22.7％;P<0.001). The unrecovered group also had a shorter length of stay in the hospital and a larger proportion of progression into persistent renal dysfunction than the other 2 groups. After adjustment for potential confounders, patients in the unrecovered group were at an increased risk of 90-day mortality (HR=3.50, 95％ CI 2.47 to 4.96, P<0.001) and 90-day composite outcome (OR=5.55, 95％CI 3.43 to 8.98, P<0.001) when compared with patients in the complete recovery group, but patients in the partial recovery group had no significant difference (P>0.05). Male sex, congestive heart failure, pneumonia, respiratory rate>20 beats per minute, anemia, hyperbilirubinemia, need for mechanical ventilation, and AKI Stage 3 were identified as independent risk factors for unrecovered renal function after AKI. The sensitivity analysis further supported that unrecovered renal function after AKI remained an independent predictor for 90-day mortality and composite outcome in the subgroups. Conclusion:The early recovery status after AKI is closely associated with poor prognosis in critically ill patients with SA-AKI. Unrecovered renal function within the first 7 days after AKI diagnosis is an independent predictor for 90-day mortality and composite outcome. Male sex, congestive heart failure, pneumonia, tachypnea, anemia, hyperbilirubinemia, respiratory failure, and severe AKI are risk factors for unrecovered renal function after AKI. Therefore, timely assessment for the renal function in the early phase after AKI diagnosis is essential for SA-AKI patients. Furthermore, patients with unrecovered renal function after AKI need additional management in the hospital, including rigorous monitoring, avoidance of nephrotoxin, and continuous assessment for the renal function, and after discharge, including more frequent follow-up, regular outpatient consultation, and prevention of long-term adverse events.
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Objective To explore the effect of SIRT1 gene silencing on the radiosensitivity of diffuse large B-cell lymphoma (DLBCL) cells.Methods Immunohistochemistry was used to measure the protein expression of SIRT1 in DLBCL tissues.Western blot was used to measure the expression of SIRT1 in DLBCL cell lines (OCI-Ly3,SU-DHL-2,and SU-DHL-4) and the immortalized B cell line HMy2.CIR.After SU-DHL-4 cells were transfected with si-SIRT1 and si-NC using Lipofectamine 2000,the expression of SIRT1 was determined by Western blot.MTT assay and colony-forming assay were used to assess the cell growth and colony formation ability of SU-DHL-4 cells treated with radiation.The group t-test or univariate analysis of variance was used for comparison between groups.Results The expression rate of SIRT1 in DLBCL tissues was 72.6%(103/140),which was significantly higher than that in reactive lymphoid hyperplasia (RLH) tissues (26.5%,8/25)(P=0.001).The SIRT1 expression was significantly higher in DLBCL cells than in HMy2.CIR cells (P=0.020).After SIRT1 gene silencing by si-SIRT1,the expression of SIRT1 was significantly reduced in SU-DHL-4 cells (P=0.008).Besides,SIRT1 gene silencing significantly reduced the growth rate and colony formation ability of SU-DHL-4 cells treated with radiation (P=0.030).Conclusions SIRT1 gene silencing enhances the radiosensitivity of DLBCL cells,providing a novel target for the radiotherapy of DLBCL.
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Objective To explore the correlation between non-Hodgkin lymphoma (NHL) and hepatitis C virus (HCV) infection.Methods HCV infection of 208 NHL patients was investigated from the Affiliated Tumor Hospital of Zhengzhou University.Patients with leukemia or other tumors,and healthy people were used as the control and were pair matched on age and gender.ELISA method was used to detect the HCV-antibody in serum.Results HCV-antibody positive rate in NHL patients [11.5 ％ (24/208)] was significantly higher than those in leukemia patients [3.8 ％ (8/208)] (x2 =8.667,P =0.003),patients with other tumors (6/208,2.9 ％) (x2 =11.639,P =0.001) and healthy people [1.0 ％ (2/208)] (x2 =19.856,P =0.000).Conclusion HCV infection is related to NHL in Henan area.
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Based on the kidney controlling bones of traditional Chinese medicine theory,this article researched the effects of treating osteoporosis with the method of kidney-tonifying and bone-strengthening massage therapy.Commonly used method of modeling included ovariectomized rat model of osteoporosis (OVX),senile rat model of osteoporosis and glucocorticoid induced rat model of osteoporosis (GIOP),kidney-tonifying and bone-strengthening massage therapy were applied on these models,and the rat bone mineral density (BMD) and biochemical marker of bone metabolism changes were observed.Confirmed by animals experiment,it was effective to repair a bone in all rat osteoporosis models with kidney-tonifying and bone-strengthening massage,which provided theoretical basis and methodological guidance for the use of kidney-tonifying and bone-strengthening massage therapy in the clinical treatment of osteoporosis.
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In recent years, pharmacological researches of Chinese medicine found that single Chinese medicines of tonifying kidney, such as epimedium, psoralen, eucommia, dipsacus, cistanche, velvet, curculigo and cynomorium had very good effects of resisting osteoporosis, significantly improving the bone mineral density (BMD) and bone mineral content (BMC) , promoting hone formation, and preventing bone absorption. Based on the documentations from home and abroad, the overview had analyzed the current situation for providing new ideas and methods of osteoporosis prevention and treatment.
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In recent years, pharmacological researches of Chinese medicine have found that single Chinese exterior-relieving medicines such as Pueraria, Semen Sojae Praeparatum and Cimicifuga had very good anti-osteoporosis effect. They can significantly improve the bone mineral density (BMD) and bone mineral content(BMC), promote bone formation, and prevent bone absorption. Based on relative documents from home and abroad, this paper analyzed the current situation and provided new ideas and methods for prevention and treatment of osteoporosis.
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In recent years,pharmacological researches of Chinese medicine found that the single Chinese medicines of activating blood and dissolving stasis,such as Drynaria and Bidentata and Salvia and Panax notoginseng had very good effects of resisting osteoporosis,significantly improving bone mineral density(BMD)and bone mineral content(BMC),promoting bone formation,and preventing bone absorption.Based on the documentations from home and abroad,the overview had analyzed the current situation for providing new ideas and methods of osteoporosis prevention and treatment.
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Massage therapy is commonly used in the treatment of infantile muscular torticollis clinically.The massage therapy can reduce the therapeutic course effectively and prevent the occurrence of sequel due to long-term un-heating of the disease.This research provided many manipulative methods of massage in treating infantile muscular torticollis for clinical uses.
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Objective To observe the clinical effects of treating infantile muscular torticollis with the primary massage therapy of twining manipulation with one finger and by the traditional massage therapy. Methods 300 cases were randomly recruited into a control group (141 cases) and a treatment group (159 cases). The treatment group was treated with primary massage of twining manipulation with one finger, while the control group was treated with conventional massage. Both groups were treated once daily. 20 min for each time, and 15 days constituted one therapeutic course. After 4 therapeutic courses, the changes of the shape and the size of the sternocleidomastoid muscle were detected by two-dimensional supersonic examination, the changes of the stream of blood of the sternocleidomastoid muscle was observed by the colored doppler supersonic observation, and assessed the overall curative effect combined with neck deflection degree and the activity. Results In the treatment group, 33 cases were healed, excellent therapeutic effects were seen in 72 cases, effectiveness were seen in 45 cases, 9 cases were inefficacy, and the total effective rate was 94.34%; In the control group, 9 cases were healed, excellent therapeutic effects were seen in 36 cases, effectiveness were seen in 75 cases, 21 cases were inefficacy, and the total effective rate was 85.11%. The result of the two groups showed a significant difference (P<0.05) .Conclusion Infants muscular torticollis mainly treated by twining manipulation with one finger showed a better result than conventional massage. It can effectively shorten the therapeutic time and avoid the Sequela due to the protraction of disease.