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Objective:To compare the effects of rosuvastatin and atorvastatin on coronary artery bypass grafting (CABG) on the incidence of acute kidney injury (AKI), and assess the independent risk factors of AKI.Methods:We retrospectively collected 550 patients aged 18 years or older who underwent CABG from May 2014 to May 2020. They were divided into the rosuvastatin group ( n=322), atorvastatin group ( n=125) and non statins group ( n=103) according to whether rosuvastatin or atorvastatin was routinely used before operation. Demographic data, clinical data before and after CABG and laboratory results were collected. Blood urea nitrogen (BUN), serum creatinine (Scr), creatinine clearance rate (Ccr) and incidence of postoperative AKI were compared among the three groups. Univariate analysis and binary logistic regression analysis were used to investigate the effect of statins on AKI in patients undergoing CABG. Results:Compared with preoperation, BUN showed no significant change ( P>0.05), while Scr was increased and Ccr was decreased significantly (both P<0.01); BUN in the rosuvastatin group was decreased significantly ( P<0.01), whereas Scr and Ccr had no significant change ( P>0.05); Scr in the atorvastatin group was increased significantly ( P<0.01), but there was no significant difference in BUN and Ccr ( P>0.05). BUN and Scr in the non statins group were increased significantly (both P<0.01), while Ccr was decreased significantly ( P<0.01). After operation, BUN and Scr in the rosuvastatin group and atorvastatin group were significantly lower than those in the non statins group (all P<0.01); Ccr was significantly higher than that in the non statins group ( P<0.01). BUN and Scr were not significantly different between the rosuvastatin and atorvastatin groups ( P>0.05), but Ccr was significantly higher than that in the atorvastatin group ( P< 0.05). There were significant differences in BUN, Scr and Ccr among the three groups ( χ2=48.925, 22.677 and 34.426, all P<0.01). The incidence of AKI among 550 patients was 15.1% (83/550), of which 9.6% (31/322) in the rosuvastatin group, 16.0% (20/125) in the atorvastatin group and 31.1% (32/103) in the non statins group. The incidence of AKI in the rosuvastatin and atorvastatin groups was significantly lower than that in the non statins group ( χ2=28.412, 7.282, P<0.01). Multivariate regression analysis showed that hypertension ( OR=3.555, 95% CI: 1.959-6.451, P<0.01), NHYAⅢ/Ⅳ ( OR=2.438, 95% CI: 1.187-5.008, P=0.015), and increased serum creatinine level ( OR=1.018, 95% CI: 1.003-1.032, P=0.016), and intraoperative cardiopulmonary bypass ( OR=2.936, 95% CI: 1.454-5.927, P=0.003) were independent risk factors for AKI after CABG, while preoperative conventional statin therapy ( OR=0.490, 95% CI: 0.247-0.974, P=0.042) and increased serum albumin level ( OR=0.920, 95% CI: 0.856-0.990, P=0.026) were protective factors for AKI after CABG. Conclusions:The incidence of AKI after CABG is common. Rosuvastatin or atorvastatin and increased preoperative serum albumin level can protect renal function and reduce the incidence of AKI, which are the protective factors of AKI after CABG. The hypertension, NHYAⅢ/Ⅳ, increased preoperative serum creatinine level and cardiopulmonary bypass are the independent risk factors of AKI after CABG.
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Objective To investigate the prevention of acute kidney injury (AKI) by earlier application of rosuvastatin in patients after coronary artery bypass grafting (CABG).Methods A total of 200 patients with CABG were enrolled from May 2013 to April 2017.According to whether rosuvastatin were used routinely before operation or not,all patients were divided into the trial group (n =136) and the control group (n =64).Demographics,and clinical data were collected before and after CABG.The renal function markers including blood urea nitrogen (BUN),serum creatinine (sCr),endogenous creatinine clearance rate (GFR),emergence of AKI of two groups were documented and compared.Enumeration data were analyzed with x2 test,measurement data were analyzed with t test,and P ＜ 0.05 was considered to be significant.Results There were no differences in sCr (t =-1.156,P ＞ 0.05) but differences in BUN and eGFR (t =-2.915,3.690,respectively,P ＜ 0.05) before operation between two groups.After operation,the BUN was decreased (t =2.486,P ＜ 0.05) compared with that of pre-operation in the trial group,but there were no significant difference in sCr and eGFR (t =-1.877,-0.752,respectively,P ＞0.05).The BUN and sCr were increased (t =-3.792,-5.027,respectively,P ＜ 0.05) after operation compared with that of pre-operation in the control group,while the eGFR was decreased (t =5.540,P ＜0.05).Compared with the control group,BUN,sCr and the incidence of AKI were significantly decreased in the trial group (t/x2 =5.759,4.196,15.506,respectively,P ＜0.05),while the eGFR was increased (t =-6.215,P ＜ 0.05).Conclusions Earlier application of rosuvastatin before CABG can effectively protect renal function and reduce the incidence of AKI.
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Objective To investigate the prevention of acute kidney injury (AKI) by earlier application of rosuvastatin in patients after coronary artery bypass grafting (CABG).Methods A total of 200 patients with CABG were enrolled from May 2013 to April 2017.According to whether rosuvastatin were used routinely before operation or not,all patients were divided into the trial group (n =136) and the control group (n =64).Demographics,and clinical data were collected before and after CABG.The renal function markers including blood urea nitrogen (BUN),serum creatinine (sCr),endogenous creatinine clearance rate (GFR),emergence of AKI of two groups were documented and compared.Enumeration data were analyzed with x2 test,measurement data were analyzed with t test,and P ＜ 0.05 was considered to be significant.Results There were no differences in sCr (t =-1.156,P ＞ 0.05) but differences in BUN and eGFR (t =-2.915,3.690,respectively,P ＜ 0.05) before operation between two groups.After operation,the BUN was decreased (t =2.486,P ＜ 0.05) compared with that of pre-operation in the trial group,but there were no significant difference in sCr and eGFR (t =-1.877,-0.752,respectively,P ＞0.05).The BUN and sCr were increased (t =-3.792,-5.027,respectively,P ＜ 0.05) after operation compared with that of pre-operation in the control group,while the eGFR was decreased (t =5.540,P ＜0.05).Compared with the control group,BUN,sCr and the incidence of AKI were significantly decreased in the trial group (t/x2 =5.759,4.196,15.506,respectively,P ＜0.05),while the eGFR was increased (t =-6.215,P ＜ 0.05).Conclusions Earlier application of rosuvastatin before CABG can effectively protect renal function and reduce the incidence of AKI.
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Karyotype analysis has been considered as the key tool for prenatal diagnosis .Although it is cost-effective, it has great challenge to meet the growing demand of efficiency and quality in clinical settings.To improve the effeiciency and detection quality , cytogenomic microarray analysis ( CMA ) is developed, with high detection rate.However, traditional karyotype analysis at different resolution should also be used as the reference for CMA .
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<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype, histological diagnosis and prognosis of hepatic epithelioid angiomyolipoma.</p><p><b>METHODS</b>Clinical data of 25 cases of hepatic epithelioid angiomyolipoma were collected along with follow-up study of the patients. The pathological features were documented and immunohistochemical study of various markers was performed with an emphasis on diagnosis and differential diagnosis.</p><p><b>RESULTS</b>Hepatic epithelioid angiomyolipoma was more commonly found in young women without characteristic clinical symptoms. Its morphological features were characterized by marked cytological atypia, relatively rare mitotic figures; radial distribution of tumor cells around the thin-walled blood vessels or muscular vessels; and the presence of common multinucleated giant cells and large ganglion-like tumor cells. The tumor cells expressed both melanoma cell markers (HMB45, MART-1) and smooth muscle cell markers (SMA). Tumor cells expressed various other markers including ER 16% (4/25), PR 32% (8/25), TFE3 24% (6/25) and p53 60% (15/25).</p><p><b>CONCLUSIONS</b>Hepatic epithelioid angiomyolipoma has variable morphological features and characteristic immunohistochemical phenotype. The differential diagnoses include a variety of tumors. The biological behavior of the tumor tends to be benign.</p>
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Female , Humans , Age Factors , Angiomyolipoma , Genetics , Allergy and Immunology , Metabolism , Pathology , Biomarkers, Tumor , Metabolism , Diagnosis, Differential , Follow-Up Studies , Gastrointestinal Neoplasms , Giant Cells , Pathology , Immunohistochemistry , Immunophenotyping , Liver Neoplasms , Genetics , Allergy and Immunology , Metabolism , Pathology , MART-1 Antigen , Metabolism , Melanoma-Specific Antigens , Metabolism , Muscle, Smooth , Metabolism , PrognosisABSTRACT
Objective To explore the characteristics and drug resistance of pulmonary tuberculosis combined with Stenotrophomonas maltophilia infection.Methods The clinical data of 65 patients with Stenotrophomonas maltophilia infection were analyzed retrospectively.Results It showed that 65 strains of Stenotrophomonas maltophilia mainly came from sputum sample [75.4％(49/65)] and were highly resistant to many kinds of antimicrobial agents,of which the resistance rate to carbapenems,β-lactames was above 60％ and the sensitive rate to moxifloxacin,ethoprin-sulfamethoxazole and ticarcillin/clavulanic was above 70％.Conclusion Clinical practices should pay more attention to the high resistance of Stenotrophomonas maltophilia infection,which might result in pulmonary tuberculosis,and prescribe antibiotics rationally according to the drug sensitive test.
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OBJECTIVE To intensify the management of the acupuncture department and prevent and control nosocomial infection.METHODS During the course of the management of the acupuncture department,the causes of nosocomial infection were found through analyzing the possible reasons of nosocomial infection and a series of relevant measures were taken to improve the control of nosocomial infection.RESULTS In order to control nosocomial infection in acupuncture department we needed to strength the disinfection management in the following aspects:air in the room,medical procedures and implement,medical staff hands and medical disposals.CONCLUSIONS Strict management is the important measures to reduce the nosocomial infection.
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OBJECTIVE To investigate the drug resistance and distribution of nosocomial infection (NI) pathogens. METHODS A total of 519 strains of NI pathogens during from Jan 2006 to Dec 2007 were completely surveyed. RESULTS Among all pathogens,Gram-positive cocci were 209 strains (40.27%),the main pathogen was Staphylococcus aureus. Gram-negative bacilli were 256 strains (49.33%). Fungi were 54 strains (8.28%). resistance the rate in nosocomial infectionis was increased year by year. CONCLUSIONS The Gram-negatives of NI pathogens are markedly increased year by year. The drug resistance rate of pathogens is higher and the clinically selected anti-bacterial drugs should be based on the bacterial culture and drug susceptibility test.
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OBJECTIVE To explore the ward-round by hospital director to control nosocomial infection.METHODS To investigate prevalence rate of the nosocomial infection the day before the ward-round by hospital director.At the ward-round day to check the situation of disinfection,isolation,monitoring and control of the nosocomial infection,the hands-washing of the medical workers and the medical waste management.RESULTS To intensity the management of nosocomial infection of the clinical departments,to intensify the ideas of the prevention and control of the nosocomial infection among the medical workers,and to raise their compliance,in order to effectively control the nosocomial infection.CONCLUSIONS Strict and all-round management especially in participation of hospital director is the important measures to control the nosocomial infection.
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Objective To investigate the relationship between tumor suppressor gene DPC4 and the development and prognosis of pancreatic carcinoma. Methods Relevant literatures of recent years were reviewed. Results DPC4 was located on chromosome 18. Its product was Smad 4 protein. Smad 4 protein was the central component of the transforming growth factor-beta signaling pathway, and all the biological effect was the results of interaction of Smad 4 and different Smads. The gene was deleted or inactive in about 50% of pancreatic carcinomas. The deletion of DPC4 had a great relation to the development and prognosis of pancreatic carcinoma. Conclusion The alteration of tumor suppressor gene DPC4 is connected with the development and prognosis of pancreatic carcinoma. However, this research should be further studied.
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Objective To investigate the relationship between PSMA expression and histologic grading of prostatic carcinoma. Methods Different prostatic tissues and non-prostatic tumors (PCa 70,prostate intraepithelial tumor 21,BPH 20,nonprostatic malignancies 30) were analysed for the expression of PSMA by using PSMA mono-clonal antibody and ABC immunohistochemical staining. Results All prostatic tissues but 2 cases of prostatic carcinoma and 4 cases of benign prostate hyperplasia were stained positively,while all of the non-prostatic tumors were stained negatively.There was a negative correlation between PSMA expression and histologic grading of prostatic adenocarcinoma. Conclusions PSMA was prostatic organic specific and could be a prognostic marker of prostate adenocarcinoma.
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OBJECTIVE To investigate the bacteriologic feature and the spectrum of drug resistance in lung cancer patients who got nosocomial nonfermenters bacteria infection,and to conclude the experience and how to prevent and control the nosocomial infection.METHODS A rectrospective analysis of the composition of the pathogens,the feature of drug resistance and the prognosis of 109 lung cancer inpatients with nosocomial infection was made.RESULTS Nosocomial nonfermenters bacteria infections were most happened in hospital lung cancer patients.Main strains included Pseudomonas aeruginosa 55(49.5%),Acinetobacter baumannii 23(20.7%),and Stenotrophomonas maltophilia 8(7.2%).The sensitive rate of P.aeruginosa to imipenem was 100%,but to Cotrimoxazole,the resistant rate was 100%.The sensitive rate was relatively high to ticarcillin,piperacillin and their compounds.The antimicrobial resistance rate of A.baumannii was higher than P.aeruginosa.Stenotrophomonas were resistant to most antibiotics,and the resistance rate to imipenem was 100.0%.CONCLUSIONS The resistance rate of nosocomial nonfermenters bacteria infection is high.The treatment is difficult and the prognosis is bad.The mortality of multiple infection is high.
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Objective To study the effect of temperature and content of residual chlorine on bacteriological indexes of drinking water. Methods In 2003-2004, the drinking water quality was monitored and the relationship between temperature, content of residual chlorine and the bacteriological indexes of drinking water was investigated in two water plants in Binzhou, Shandong province. Results As for the water source, the bacteriological indexes presented a positive correlation with the temperature , the total amount of bacteria presented a negative correlation with the content of residual chlorine in the tap water. Conclusion Temperature and content of residual chlorine in drinking water are important factors in prevention and control of drinking water contamination.