ABSTRACT
<p><b>OBJECTIVE</b>To compare the clinical outcomes of open surgical peritoneal dialysis catheter (PDC) insertion with guide wire and the outcomes of PDC insertion without guide wire.</p><p><b>METHODS</b>Data of the patients receiving open surgical Tenkchoff straight catheter insertion in our department from January 2005 to January 2011 were retrospectively analyzed. The 117 patients in whom PDC insertion was conducted with the guidance of guide wire were enrolled into group A, and the 121 cases receiving PDC insertion without guide wire were enrolled into group B. The incidences of post-operative complications (catheter obstruction, catheter displacement, bloody dialysate, and dialysate leakage), catheter survival, and patient survival rates were compared between the 2 groups.</p><p><b>RESULTS</b>The baseline characteristics (gender, age, body mass index, prothrombin time, activated partial thromboplastin time, platelet count, serum creatinine, follow-up time, primary diseases, and outcomes) of the 2 groups were comparable (all P>0.05). In post-operative complications, only the incidence of early bloody dialysate showed significant difference, being 16.2% in group A and 7.4% in group B (P=0.04). Catheter and patient survival rates were not significantly different between the two groups. Overweight patients showed a higher incidence of catheter obstruction compared with normal weight patients [16.0% (4/25) vs.3.3% (7/213), P=0.02], but no differences in post-operative complications were found among overweight patients between the 2 groups.</p><p><b>CONCLUSIONS</b>Open surgical Tenkchoff straight catheter insertion without guide wire does not lead to higher risk of post-operative complications and catheter removal. It may be an alternative option when guide wire is not available.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Catheterization , Methods , Peritoneal Dialysis , Mortality , Postoperative ComplicationsABSTRACT
Objective: To investigate the therapeutic effect of intensive glycemic control on patients with early diabetic nephropathy. Methods: A total of 41 type 2 diabetes patients who developed microalbuminuria were divided into two groups randomly. Patients in Group A received intensive glycemic control and the blood glucose in Group B was regularly controlled. Glycemic monitoring and control were followed for 12 weeks to observe the changes of microalbuminuria in both groups; meanwhile the levels of serum lipids and coagulation indices were also recorded. Results: The urine albumin excretion rate (UAER) in Group A decreased significantly from (47.91±13.86)mg/24 h to (35.31±14.56)mg/24 h after 12 weeks (P0.05]. The decrease of triglyceride (TG) and low-density lipoprotein cholesterol (LDL cholesterol), and the increase of high-density lipoprotein cholesterol (HDL cholesterol) showed no significant differences (P>0.05). And the level of plasma fibrinogen (FIB) showed no significant decrease after 12 weeks, either (P>0.05). Conclusion: Intensive glycemic control reduces the level of microalbuminuria and may ameliorate the progression of early diabetic nephropathy.
ABSTRACT
Objective To evaluate diagnostic value of diffusion tensor imaging(DTI)in ringlike- enhanced lesions.Methods Nine abscesses,12 glioblastomas,10 metastases confirmed clinically or pathologically underwent conventional MRI and DTI.Average diffusion coefficient(ADC)value,fractional anisotropy(FA)value and maps were calculated in the central portion and peripheral edema of the lesions. Results On DTI,the abscesses displayed as hyperintense signal with hypointense or isointense signal of edema;but glioblastomas and metastases all showed as hypointense signal with isointense or hypointense signal of edema.On ADC map,the abscesses showed as hypointense signal,the mean ADC value was (0.66?0.07)x10~(-3)mm~2/s,The mean ADC value were(2.50?0.11)x10~(-3)mm~2/s and(2.37?0.52)x10~(-3)mm~2/s for the glioblastomas and metastases,respectively,all demonstrated as hyperintense signal with slightly hyperintense signal of edema.The difference between abscess and necrotic tumors was statistically significant(F=108.80,P