Analysis on survival time and influencing factors among reported HIV/AIDS in Yunnan Province, 1989-2021 / 中华流行病学杂志

Objective: To analyze the survival time of reported HIV/AIDS and influencing factors of Yunnan Province from 1989 to 2021. Methods: The data were extracted from the Chinese HIV/AIDS comprehensive response information management system. The retrospective cohort study was conducted. The life table method was applied to calculate the survival probability. Kaplan-Meier was used to draw survival curves in different situations. Furthermore, the Cox proportion hazard regression model was constructed to identify the factors related to survival time. Results: Of the 174 510 HIV/AIDS, the all-cause mortality density was 4.23 per 100 person-years, the median survival time was 20.00 (95%CI:19.52-20.48) years, and the cumulative survival rates in 1, 10, 20, and 30 years were 90.75%, 67.50%, 47.93% and 30.85%. Multivariate Cox proportional risk regression model results showed that the risk of death among 0-14 and 15-49 years old groups were 0.44 (95%CI: 0.34-0.56) times and 0.51 (95%CI:0.50-0.52) times of ≥50 years old groups. The risk for death among the first CD4+T lymphocytes counts (CD4) counts levels of 200-349 cells/μl, 350-500 cells/μl and ≥501 cells/μl groups were 0.52 (95%CI: 0.50-0.53) times, 0.41 (95%CI: 0.40-0.42) times and 0.35 (95%CI: 0.34-0.36) times of 0-199 cells/μl groups. The risk of death among the cases that have not received antiretroviral therapy (ART) was 11.56 (95%CI: 11.26-11.87) times. The risk for death among the cases losing to ART, stopping to ART, both losing and stopping ART was 1.66 (95%CI:1.61-1.72) times, 2.49 (95%CI:2.39-2.60) times, and 1.65 (95%CI:1.53-1.78) times of the cases on ART. Conclusions: The influencing factors for the survival time of HIV/AIDS cases were age at diagnosis in Yunnan province from 1989 to 2021. The first CD4 counts levels, antiretroviral therapy, and ART compliance. Early diagnosis, early antiretroviral therapy, and increasing ART compliance could extend the survival time of HIV/AIDS cases.

Incidence and risk factors of ischemic stroke in patients with type 2 diabetes among urban workers in Beijing, China / 北京大学学报(医学版)

OBJECTIVE@#To explore the incidence of ischemic stroke after the onset of type 2 diabetes, and further analyze the risk factors, so as to provide a basis for further research.@*METHODS@#The data were obtained from the database of the Beijing Urban Employee Basic Medical Insurance Database. The study used a prospective design to describe the incidence of ischemic stroke in patients with type 2 diabetes. In our study, these patients were followed up for seven years. Multivariate Logistic regression models were used to analyze the risk factors of ischemic stroke in patients with type 2 diabetes.@*RESULTS@#A total of 185 813 newly diagnosed type 2 diabetes patients were enrolled, with an average age of (58.5±13.2) years, and 49.0% of them were males. A total of 10 393 patients with newly diagnosed ischemic stroke occurred in 7 years, with a cumulative incidence of 5.6% and an incidence density of 8.1/1 000 person-years. Ischemic stroke occurred in all age groups in patients with type 2 diabetes. The cumulative incidence was 1.5% (95%CI: 1.3%-1.6%) in group ≤44 years old, 3.6% (95%CI: 3.4%-3.7%) in group 45-54 years old, 5.4% (95%CI: 5.2%-5.5%) in group 55-64 years old, and 9.2% (95%CI: 9.0%-9.4%) in group ≥65 years old, and the cumulative incidence increased with age (P < 0.05). Cumulative incidence rate of the males (6.8%, 95%CI: 6.7%-7.0%) was higher than the females (4.4%, 95%CI: 4.3%-4.6%). Among the patients < 80 years old, the cumulative incidence rate of the males was higher than that of the females in all the age groups. In the patients ≥80 years of age, the cumulative incidence was higher in the females (9.2%) than in the males (7.9%). Further analysis revealed that complications, such as coronary heart disease (OR=3.18, 95%CI: 2.72-3.72), heart failure (OR=1.53, 95%CI: 1.32-1.79) and kidney failure (OR=1.45, 95%CI: 1.20-1.75) were associated with ischemic stroke in the patients with type 2 diabetes.@*CONCLUSION@#The incidence level of ischemic stroke in patients with type 2 diabetes is high. It is necessary to strengthen the management of risk factors in elderly patients, screen the complications of type 2 diabetes as early as possible, and take active preventive and control measures.

Interaction between ischemic stroke risk loci identified by genome-wide association studies and sleep habits / 北京大学学报(医学版)

OBJECTIVE@#To explore the relationship between sleep habits (sleep duration, sleep efficiency, sleep onset timing) and ischemic stroke, and whether there is an interaction between sleep habits and ischemic stroke susceptibility gene loci.@*METHODS@#A questionnaire survey, physical examination, blood biochemical testing and genotyping were conducted among rural residents in Beijing, and the gene loci of ischemic stroke suggested by previous genome-wide association studies (GWAS) were screened. Multivariable generalized linear model was used to analyze the correlation between sleep habits, sleep-gene interaction and ischemic stroke.@*RESULTS@#A total of 4 648 subjects with an average age of (58.5±8.7) years were enrolled, including 1 316 patients with ischemic stroke. Compared with non-stroke patients, stroke patients with sleep duration ≥9 hours, sleep efficiency < 80%, and sleep onset timing earlier than 22:00 accounted for a higher proportion (P < 0.05). There was no significant association between sleep duration and risk of ischemic stroke (OR=1.04, 95%CI: 0.99-1.10, P=0.085). Sleep efficiency was inversely associated with the risk of ischemic stroke (OR=0.18, 95%CI: 0.06-0.53, P=0.002). The risk of ischemic stroke in the subjects with sleep efficiency < 80% was 1.47-fold (95%CI: 1.03-2.10, P=0.033) of that in the subjects with sleep efficiency ≥80%. Falling asleep earlier than 22:00 was associated with 1.26 times greater risk of stroke than falling asleep between 22:00 and 22:59 (95%CI: 1.04-1.52, P=0.017). Multifactorial adjustment model showed that rs579459 on ABO gene had an interaction with sleep time (P for interaction =0.040). When there were two T alleles for rs579459 on the ABO gene, those who fell asleep before 22:00 had 1.56 times (95%CI: 1.20-2.04, P=0.001) the risk of stroke compared with those who fell asleep between 22:00 and 22:59, and there was no significant difference when the number of pathogenic alleles was 0 or 1. In the model adjusted only for gender, age and family structure, sleep duration and the number of T allele rs2634074 on PITX2 gene had an interaction with ischemic stroke (P for interaction=0.033).@*CONCLUSION@#Decreased sleep efficiency is associated with increased risk of ischemic stroke, and falling asleep earlier than 22:00 is associated with higher risk of ischemic stroke. Sleep onset timing interacted with rs579459 in ABO gene and the risk of ischemic stroke. Sleep duration and PITX2 rs2634074 may have a potential interaction with ischemic stroke risk.

Anatomical Location of Cricopharyngeus in Patients with Swallowing Disorder / 中国康复理论与实践

Objective:To further clarify the location of cricopharyngeus in human body. Methods:From September, 2018 to December, 2019, 19 inpatients with swallowing disorders received video fluoroscopic swallowing study (VFSS).The videoes were used to measure the position of cricopharyngeus with Uniweb 4.0 software. Water model simulating the structure of an adult's neck was established to restore the real measurement scene, and obtain the scale ratio between the actual measurement and the computer measurement, then obtain the accurate actual position of the cricopharyngeus. Six adult specimens were dissected. The intersection point of the intended treatment plane and the long axis of cricopharyngeus was taken as the origin, the horizontal axis as X axis, and the sagittal axis as Y axis, to locate the position of cricopharyngeus precisely. Results:Cricopharyngeus was closest to the sixth cervical vertebra. The scaling ratio of the actual measurement obtained from the water model to the computer measurement was about 1∶1.340. The intended treatment plane was closest to the upper edge of the sixth cervical vertebra; on lateral edge of thyroid, cricopharyngeus was (33.47±2.21) mm deep to epidermis, with the angle of (43.37±1.34)° to sagittal axis; and it was (34.59±1.29) mm and (46.32±0.93)° on medial edge of internal jugular vein. Conclusion:The the accurate location of cricopharyngeus in human body has been measured, which can help for the rehabilitation for cricopharyngeal dysfunction.

Physiologically-based pharmacokinetic modeling for predicting drug-drug interactions induced by acid-reducing agents / 药学学报

Gastric pH is an important factor that affects drug absorption, as gastric pH may lead to lower bioavailability, especially for weak-base drugs. Acid-reducing agents (ARAs) such as antacids, histamine-2 receptor antagonists, and proton pump inhibitors, are susceptible to drug-drug interactions (DDIs), potentially resulting in the loss of efficacy. Physiologically based pharmacokinetic (PBPK) modeling is an important tool for the evaluation of oral drug-drug interactions and the most commonly used models include the advanced comparative absorption and transport (ACAT) model and the advanced dissolution, absorption and metabolism (ADAM) model. These models can be used for adjustment of the dosage regimen and the screening of candidate drugs in drug development by simulating the change of gastric pH to predict the change in drug absorption. This review summarizes the theoretical basis, the most common PBPK models used to predict drug absorption, and the effects of different kinds of ARAs drugs on gastric pH. Some successful applications of PBPK modeling in predicting the effects of gastric pH on drug absorption are also presented.

Prevalence and risk factors of osteoarthritis in patients with type 2 diabetes in Beijing, China from 2015 to 2017 / 北京大学学报(医学版)

OBJECTIVE@#To explore the prevalence and related factors of osteoarthritis in patients with type 2 diabetes mellitus, and provided a scientific basis for the prevention of the comorbidity.@*METHODS@#The data were obtained from the database of all designated medical institutions in Beijing from 2015 to 2017. Data of the adult patients with type 2 diabetes mellitus were collected for descriptive analysis, and a Logistic regression model was used to explore the related factors of osteoarthritis in the patients with type 2 diabetes mellitus.@*RESULTS@#A total of 1 046 264 diagnosed type 2 diabetes mellitus adult patients were included in our study, with an average age of 63.07 years, and 50.78% were males. Among the patients with type 2 diabetes mellitus, there were 341 561 cases with osteoarthritis, and the prevalence of osteoarthritis was 32.65%. The prevalence of females (38.05%) was higher than that of males (27.41%), and the difference was statistically significant (P < 0.05). Osteoarthritis occurred in all age groups among the patients with type 2 diabetes mellitus, with the highest prevalence of osteoarthritis in the age group of 65-69 years (36.76%), and the lowest prevalence in the age group ≤44 years (14.3%). Before the age of 70, the prevalence increased with age. Further analysis of related factors for osteoarthritis in the patients with type 2 diabetes mellitus showed that female (OR=1.62, 95%CI: 1.61-1.63), age (OR=1.01, 95%CI: 1.01-1.01), had other comorbidities (OR=1.19, 95%CI: 1.18-1.21), used hypoglycemic drugs (OR=0.79, 95%CI: 0.78-0.80), having the cardiovascular disease (OR=1.13, 95%CI: 1.11-1.15), having cerebrovascular disease (OR=1.25, 95%CI: 1.23-1.28), and having nephropathy (OR=1.61, 95%CI: 1.51-1.71) were associated with the osteoarthritis in the type 2 diabetic mellitus patients.@*CONCLUSION@#Our study revealed that the prevalence of osteoarthritis in patients with type 2 diabetes mellitus is high in Beijing area. Health education and disease monitoring should be strengthened in middle-aged and elderly patients. Screening for comorbidities should be carried out as soon as possible, with the focus on menopausal women.

Association of obesity and brachial-ankle pulse wave velocity among type 2 diabetes patients / 中华疾病控制杂志

Objective The aim of this study was to investigate associations of overall obesity (OO) and abdominal obesity (AO) with brachial-ankle pulse wave velocity (baPWV) among type 2 diabetes(T2DM) patients. Methods A community-based study for T2DM patients was conducted in rural communities in Beijing．Every patient completed a questionnaire to collect demography, lifestyle and diseases history, and underwent physical examinations, baPWV assessments and blood biochemical tests. Multivariate linear regression was used to assess the relationship between obesity index and baPWV. Abnormal baPWV was defined as patients with baPWV≥1,700 cm/s. Logistic regression model was performed to explore the risk of abnormal baPWV after adjusting for poetential confounders step by step. Results A total of 2 048 T2DM patients were recruited. The average age was (59.2±8.3) years and total prevalence of abnormal baPWV was 49.7%. After multivariable adjustment, linear regression showed that there was a negative correlation between body mass index(BMI) and baPWV and a positive correlation between waist-to-hip ratio (WHR) and baPWV. Compared to normal weight group, those with BMI≥28 kg/m2 had lower risk of abnormal baPWV (OR=0.59, 95% CI: 0.44-0.78，P<0.001), but there was an increased risk of 46% among patients with obesity in WHR (OR=1.46, 95% CI:1.07-2.00，P=0.018). Compared to those without OO and AO, patients without OO but with AO had a 1.67-fold increasesd risk of abnormal baPWV (OR=1.67, 95% CI: 1.19-2.35，P=0.003). Conclusions Abdominal obesity is related with arterial stiffnening among T2DM patients, and it is critical to evaluate arterial stiffness of T2DM patients with abdmonal obesity and normal BMI in order to reduce future risk of cardiovascular diseases.

Role of cAMP Response Element Binding Protein/Brain-derived Neurotrophic Factor Signaling Pathway in Tiaoxin Formula Improving Learning and Memory of APP/PS1 Mice / 中国康复理论与实践

Objective To observe the changes of cAMP response element binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling pathway in the hippocampus of APP/PS1 double transgenic Alzheimer's disease mice, and in-vestigate the effects of Tiaoxin formula on learning and memory. Methods Totally, 54 three-month-old APP/PS1 transgenic mice were randomly divided into model group (n=18), posi-tive control (donepezil) group (n=18) and Tiaoxin formula group (n=18). Another 18 three-month-old C57/BL6 wild mice were chosen as normal group with same strain and same age. All administration groups received rele-vant medicine. Twelve weeks later, Morris water maze test was used to test the behavior. The real-time quantita-tive polymerase chain reaction (RT-qPCR) was used to detect the expression of CREB mRNA and BDNF mRNA in hippocampus. Western blotting was used to detect the expression of phosphorylated CREB (p- CREB) and BDNF in hippocampus. Results Compared with the model group, the escape latency significantly shortened (P<0.01), the percentage of staying time in the quadrant of original platform significantly increased (P<0.05), the expression of CREB mRNA and BDNF mRNA in hippocampus significantly increased (P<0.05), and the expression of p-CREB and BDNF pro-tein in hippocampus significantly increased (P<0.01) in Tiaoxin formula group. Conclusion Tiaoxin formula could improve the spatial learning and memory of APP/PS1 double transgenic mice with AD, which might be related to the up-regulation of CREB/BDNF signaling pathway.

Research progress in the risk factors and mechanisms of postoperative atrial fibrillation after lung cancer surgery / 上海交通大学学报（医学版）

Postoperative atrial fibrillation (POAF) is a frequent complication occurring in patients after lung cancer surgery.POAF is associated with an increased risk of mortality and morbidity,and increases the costs of the postoperative care.The underlying mechanisms involved in POAF development are multifactorial and for the moment far from being fully elucidated.This review summarized recent clinical researches on the risk factors and mechanisms of POAF,the results of which may lead to a more effective strategy for the prevention of POAF after lung cancer surgery.

Evaluation of critical quality attributes of an anti-HER2 humanized monoclonal antibody drug / 中国药学杂志

OBJECTIVE: To perform a multidimensional study on the critical quality attributes of a therapeutic anti-HER2 humanized monoclonal antibody targeting HER2-positive breast cancer. METHODS: The critical quality attributes such as purity, impurities, structure, and function were evaluated using multidimensional analytical techniques including HPLC, CE-SDS, dynamic light scattering, circular dichroism, differential scanning calorimeter, LC-MS/MS, in vitro bioactivity assay and SPR binding kinetics. RESULTS: The monomer content of the antibody was more than 98% while the polymer impurities were less than 2%. The sum of heavy chain and light chain peak area was over 97% while the non-glycosylated heavy chain impurities area was less than 1% on the CE-SDS electrophoretogram. The antibody drug demonstrated comparable CD spectrum, predicted secondary structure and unfolding temperatures to the reference product. It had highly similar N-glycan profile involving glycosylation site and N-glycan types to the reference product. The analysis showed no significant difference in the functional CQAs like BT474 proliferation inhibiting bioactivity, ADCC efficacy, the binding affinity to HER2 and Fc receptors between the evaluated drug product and the reference. CONCLUSION: The characteristics of the monoclonal antibody drug such as high purity and few impurities indicate homogeneity and low-risk of safety issues. High similarity to the reference has been verified in multiple aspects like higher structure, glycosylation and function. The positive quality evaluation result is a prerequisite for clinical research. Moreover, to some extent, there can be potential correlation between CQAs and clinical safety and efficacy.

Pharmacokinetic effect of Sappan Lignum on hydroxysafflor yellow A in Carthami Flos / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the pharmacokinetic effect of Sappan Lignum on hydroxysafflor yellow A (HSYA) in Carthami Flos.</p><p><b>METHOD</b>Concentration of HSYA in rat plasma was detected by RP-HPLC after rats were orally administered with extracts of Carthami Flos or Carthami Flos combined with Sappan Lignum. Pharmacokinetic parameters were calculated by DAS 2.0 pharmacokinetic software.</p><p><b>RESULT</b>In vivo pharmacokinetic models of HSYA were two-compartment open models in both of the Carthami Flos group and the Carthami Flos combined with Sappan Lignum group. After compatibility, HSYA showed a significant lower in apparent volumes of distribution of t(1/2Ka), t(1/2alpha) and V1/F, with slight advance in T(max).</p><p><b>CONCLUSION</b>Sappan Lignum can accelerate absorption, distribution and metabolic process of HSYA in vivo and reduce its accumulation in vivo.</p>

Formation and identification of virus-like particles of poliovirus type I / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To establish a method to produce virus-like particles (VLP) of poliovirus type I in Saccharomy cescerevisiae to develop potential novel recombinant vaccine against poliovirus type 1.</p><p><b>METHODS</b>The genes of P1 and 3CD of poliovirus type I were optimized, synthesized and inserted into expression vector, which was further transfected into Saccharomy cescerevisiae. The extracts of yeast cells were purified by CsCl density gradient centrifugation after induction and cell lysis.</p><p><b>RESULTS</b>Electrophoresis and sequencing analyses showed that the genes P1 and 3CD of poliovirus type I were successfully inserted into expression vector and encode a protein whose amino acid sequences were identical with wide-type genes of poliovirus type I. Electronic microscopy analysis showed that the VLPs of poliovirus type I could be efficiently formed in Saccharomy cescerevisiae.</p><p><b>CONCLUSION</b>The VLPs of poliovirus type I could be efficiently produced by co-expression of P1 and 3CD genes in Saccharomy cescerevisiae.</p>

Early versus late percutaneous dilational tracheostomy in critically ill patients anticipated requiring prolonged mechanical ventilation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Tracheostomy should be considered to replace endotracheal intubation in patients requiring prolonged mechanical ventilation (MV). However, the optimal timing for tracheostomy is still a topic of debate. The present study aimed to investigate whether early percutaneous dilational tracheostomy (PDT) can reduce duration of MV, and to further verify whether early PDT can reduce sedative use, shorten intensive care unit (ICU) stay, decrease the incidence of ventilator associated pneumonia (VAP), and increase successful weaning and ICU discharge rate.</p><p><b>METHODS</b>A prospective, randomized controlled trial was carried out in a surgical ICU from July 2008 to June 2011 in adult patients anticipated requiring prolonged MV via endotracheal intubation. Patients meeting the inclusion criteria were randomly assigned to the early PDT group or the late PDT group on day 3 of MV. The patients in the early PDT group were tracheostomized with PDT on day 3 of MV. The patients in the late PDT group were tracheostomized with PDT on day 15 of MV if they still needed MV. The primary endpoint was ventilator-free days at day 28 after randomization. The secondary endpoints were sedation-free days, ICU-free days, successful weaning and ICU discharge rate, and incidence of VAP at day 28 after randomization. The cumulative 60-day incidence of death after randomization was also analyzed.</p><p><b>RESULTS</b>Total 119 patients were randomized to either the early PDT group (n = 58) or the late PDT group (n = 61). The ventilator-free days was significantly increased in the early PDT group than in the late PDT group ((9.57 ± 5.64) vs. (7.38 ± 6.17) days, P < 0.05). The sedation-free days and ICU-free days were also significantly increased in the early PDT group than in the late PDT group (20.84 ± 2.35 vs. 17.05 ± 2.30 days, P < 0.05; and 8.0 (interquartile range (IQR): 5.0 - 12.0) vs. 3.0 (IQR: 0 - 12.0) days, P < 0.001 respectively). The successful weaning and ICU discharge rate was significantly higher in early PDT group than in late PDT group (74.1% vs. 55.7%, P < 0.05; and 67.2% vs. 47.5%, P < 0.05 respectively). VAP was observed in 17 patients (29.3%) in early PDT group and in 30 patients (49.2%) in late PDT group (P < 0.05). There was no significant difference between the two groups in the cumulative 60-day incidence of death after randomization (P = 0.949).</p><p><b>CONCLUSIONS</b>The early PDT resulted in more ventilator-free, sedation-free, and ICU-free days, higher successful weaning and ICU discharge rate, and lower incidence of VAP, but did not change the cumulative 60-day incidence of death in the patients' anticipated requiring prolonged mechanical ventilation.</p>

Prenatal screening and diagnosis of genetic deafness by microarray / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate a microarray-based mutation screening method for genetic deafness and its application in prenatal diagnosis.</p><p><b>METHODS</b>Mutation screening of common deafness genes was performed in pregnant women and volunteers spouses. Nine common mutations in four major deafness genes, GJB2, GJB3, SLC26A4 and mitochondrial 12S rRNA, were detected simultaneously by a microarray-based method. Genetic counseling was given based on their testing results.</p><p><b>RESULTS</b>5.11% of pregnant women carried at least one mutation. Among them, seven carried mutation in the mitochondria 12S rRNA gene and were offered aminoglycoside-induced ototoxicity warning. For other mutation carriers of GJB2 or SLC26A4 genes, additional mutation screening was performed in their husbands by direct sequencing. A total of 20 couples were at risk of giving birth to children with genetic deafness. Of five couples who selected to undergo prenatal diagnostic testing of the fetus, four were diagnosed as wild type or heterozygous for the tested genes and one as p.V37I/c.235delC compound heterozygous for GJB2.</p><p><b>CONCLUSIONS</b>DNA microarray is a quick, easy and reliable method to screen mutations in genetic deafness genes. Application of this method in prenatal screening and diagnosis might effectively reduce the occurrence of genetic deafness.</p>

Predictive value of RIFLE classification on prognosis of critically ill patients with acute kidney injury treated with continuous renal replacement therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The optimal timing to start continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) patients has not been accurately established. The recently proposed risk, injury, failure, loss, end-stage kidney disease (RIFLE) criteria for diagnosis and classification of AKI may provide a method for clinicians to decide the "optimal timing" for starting CRRT under uniform guidelines. The present study aimed: (1) to analyze the correlation between RIFLE stage at the start of CRRT and 90-day survival rate after CRRT start, (2) to further investigate the correlation of RIFLE stage with the malignant kidney outcome in the 90-day survivors, and (3) to determine the influence of the timing of CRRT defined by RIFLE classification on the 90-day survival and malignant kidney outcome in 90-day survivors.</p><p><b>METHODS</b>A retrospective cohort analysis was performed on the data of 106 critically ill patients with AKI, treated with CRRT during a 6-year period in a university affiliated surgical intensive care unit (SICU). Information such as sex, age, RIFLE stage, sepsis, sepsis-related organ failure assessment (SOFA) score, number of organ failures before CRRT, CRRT time during SICU, survival, and kidney outcome conditions at 90 days after CRRT start was collected. According to their baseline severity of AKI at the start of CRRT, the patients were assigned to three groups according to the increasing severity of RIFLE stages: RIFLE-R (risk of renal dysfunction, R), RIFLE-I (injury to the kidney, I) and RIFLE-F (failure of kidney function, F) using RIFLE criteria. The malignant kidney outcome was classified as RIFLE-L (loss of kidney function, L) or RIFLE-E (end-stage kidney disease, E) using RIFLE criteria. The correlation between RIFLE stage and 90-day survival rate was analyzed among these three RIFLE-categorized groups. Additionally, the association between RIFLE stage and the malignant kidney outcome (RIFLE-L + RIFLF-E) in the 90-day survivors was analyzed.</p><p><b>RESULTS</b>Fifty-three of the overall 106 patients survived to 90 days after the start of CRRT. There were 16, 22 and 68 patients in RIFLE-R, RIFLE-I and RIFLE-F groups respectively with corresponding 90-day survival rate of 75.0% (12/16), 63.6% (14/22) and 39.7% (27/68) (P < 0.01, compared among groups). The percentage of the malignant kidney outcome of 90-day survivors in the RIFLE-R, RIFLE-I, and RIFLE-F groups was 16.7% (2/12), 21.4% (3/14) and 55.6% (15/27), respectively (P for trend < 0.01). After adjustment for other baseline risk factors, the relative risk (RR) for the 90-day mortality significantly increased with baseline RIFLE stage. Patients in RIFLE-F had a higher RR of 1.96 (95% confidence interval (CI): 1.06 - 3.62) than patients in RIFLE-I (RR: 1.09, 95% CI: 0.55 - 2.15) compared with patients in RIFLE-R (P for trend < 0.01). Similarly, baseline RIFLE stage also significantly correlated with the odds ratio (OR) for the malignant kidney outcome in 90-day survivors (P for trend < 0.05). Ninety-day survivors in the RIFLE-F group had a borderline significantly highest OR of 6.88 (95% CI: 0.85 - 55.67).</p><p><b>CONCLUSIONS</b>The RIFLE classification may be used to predict 90-day survival after starting CRRT and the malignant kidney outcome of 90-day survivors in the critically ill patients with AKI treated with CRRT. Starting CRRT prior to RIFLE-F stage may be the optimal timing. Prospective, multi-center, randomized controlled trials are needed to confirm its predictive value in these patients.</p>

Contrast Research on Decreasing Rate of Serum ?_2-Microglobulin before and after Children′s Hemodialysis and Hemodiafiltation / 实用儿科临床杂志

Objective To explore the influence of hemodialysis(HD) and henodiafiltation on serum ?_2-microglobulin(?_2-MG) of children with acute renal failure and contrast research on declining rate of serum ?_2-MG before and after(children′s) HD and HDF.(Met-)hods By Branc Dialog HD machine of double-pump,HDF for 18 times and HD for 20 times were given to children with acute renal(fai-)lure.The serum ?_2-MG were observed before and after HD and HDF.Results A great difference was observed in level of serum ?_2-MG between before and after HD and HDF.In HDF group,there was significant difference in level of serum ?_2-MG before and after HDF(P

Application of Hemodialysis and Filtration in Children with Acute Renal Failure / 实用儿科临床杂志

Objective To discuss the application of the hemodialysis and filtration(HDF) in children with acute renal failure(ARF).Methods By Branc Dialog hemodialysis machine of double-pump,HDF for 19 times and hemodialysis(HD) for 21 times were given to the children with ARF.The serum blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA),?_2 microglobulin(?_2-MG) and the rate of the heart,blood pressure,temperature were observed before and after HD and HDF.Results The clearance rates of BUN,Cr,UA,(?_2-)MG of HDF were markedly higher than those of HD(P

Effect of mailuoning injection on calcitonin gene-related peptide expression in facial nerve of rabbits with facial spasm / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the mechanism of Mailuoning injection (MLN) in protecting facial nerve from injury.</p><p><b>METHODS</b>The New Zealand white rabbit model with facial spasm was established by compressing superficial temporal artery to make artificial demyelinated lesion of the main peripheral facial nerve trunk. The successful establishment was confirmed by using electrophysiological technique to determine abnormal muscle response (AMR) which is a characteristic for facial spasm. MLN was injected continuously through ear marginal vein for 2 weeks. The change of CGRP expression in facial nerve was detected by immunohistochemical technique.</p><p><b>RESULTS</b>As compared with the model group, CGRP expression in facial nerve was significantly increased in the MLN group (P <0.01), and CGRP immunoreactive positive fibers were not seen in the shamoperation group. In the model group, the facial nerve fibers degenerated obviously, myelin sheath loosened and dissociated, the turgent axons with vacuole or even completely disappeared. But the facial nerve lesion was lessened in the MLN group.</p><p><b>CONCLUSION</b>MLN has a significant protective effect on facial nerve demyelination in rabbits with facial spasm, which is closely related with its effect in improving CGRP expression in the facial nerve.</p>

Microanatomical study on the nutrient artery of facial nerve in cerebellopontine angle / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the arterial origin of the facial nerve and the site of the arteries joining it in cerebellopontine angle (CPA), in order to provide anatomical data for clinical application.</p><p><b>METHODS</b>The nutrient arteries were observed on 22 fresh adult head specimens fixed and perfused with formalin and gelatin under operation microscope.</p><p><b>RESULTS</b>Of all the nutrient arteries of facial nerve motor root,31 were derived from the artery loops in CPA space (50.82%) and 17 from the branch of anterior inferior cerebellar artery (27.88%). Eight of them originated from the labyrinthine artery (13.1%), 3 from posterior inferior cerebellar artery (4.92%) and 2 from basilar artery (3.28%) respectively. Forty-seven nutrient arteries (77.05%) entered the proximal 1/3 segment of facial nerve motor root. Thirty-six nutrient arteries of nervus intermedius raised from the artery loops in CPA space (73.47%), 7 from the branch of anterior inferior cerebellar artery (14.29%) and 6 from labyrinthine artery (12.24%) respectively.</p><p><b>CONCLUSIONS</b>The observation of the arterial origin of the facial nerve and the site of the arteries joining it in cerebellopontine angle provided an anatomic basis for the etiology of hemifacial spasm and the microsurgical operation in CPA.</p>

Experimental study of mailuoning injection on therapy of hemifacial spasm / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the protective effect of Mailuoning on the facial nerve demyelination of Hemifacial spasm and provide the data for therapy of Hemifacial spasm.</p><p><b>METHOD</b>24 New Zealand white rabbits were divided into control group, Saline group and Mailuoning group, on the latter two groups the models of Hemifacial spasm were made by the temporal superficial artery closely contacting the main trunk of facial nerve at stylomastoid foramen. From the 5th week, the Saline and Mailuoning were injected intravenously into ear margin for 2 weeks on Saline and Mailuoning group respectively. At the 7th week, the MDA and SOD in serum were measured, mean while the microstructure and ultrastructure of facial nerve were observed on 3 animal groups.</p><p><b>RESULT</b>The MDA decreased obviously (P < 0.05) and SOD increased significantly (P < 0.01) in Mailuoning group comparing with that of Saline group, while the MDA and SOD showed insignificant changes of Mailuoning group and control group. The facial nerve severely demyelinated and axons retrogressively changed in Saline group but mild in Mailuoning group.</p><p><b>CONCLUSION</b>Mailuoning injection has a significant protective effect on the facial nerve demyelination of Hemifacial spasm and the very important applied value for therapy of Hemifacial spasm.</p>