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1.
Journal of Preventive Medicine ; (12): 380-384, 2022.
Article in Chinese | WPRIM | ID: wpr-923719

ABSTRACT

Objective@#To investigate the origin of infection and risk factors of a case with SARS-CoV-2 infection associated with overseas countries in the Ningbo-Zhoushan Port, Zhejiang Province, so as to provide the evidence for improving the COVID-19 control measures at ports.@*Methods@#Ningbo Center for Disease Control and Prevention ( CDC ) and Beilun CDC conducted case finding and epidemiological surveys immediately after being informed. The general information, history of vaccination and the travel during the latest 14 days were collected from the positive case, and all close contacts were tracked. Saliva samples were collected for SARS-CoV-2 nucleic acid testing and whole-genome sequencing, and the sequencing results were aligned with the GISAID's EpiCoV database. The origin of infection and transmission route of the positive case was investigated.@*Results@#A case was identified positive for SARS-CoV-2 nucleic acid during company M's routine screening in the Ningbo-Zhoushan Port on August 10, 2021, and was confirmed positive for SARS-CoV-2 nucleic acid by Beilun CDC and Ningbo CDC on August 11. Whole-genome sequencing showed SARS-CoV-2 B.1.617.2 ( Delta ) variant, which shared the highest homology with the virus sequence uploaded by Russia on June, 2021 ( Russia/MOW-RII-MH27356S/2021 ). The case was a bundling worker for overseas container ships, and reported communicated with foreign boatmen and contacted materials without protected interventions on the SINOKOR AKITA Container Ship between August 4 and 5, 2021. This ship anchored at Vladivostok, Russia from July 27 to 29, anchored at Ningbo Harbor on August 4, and departed on August 5. Then, 11 boatmen from this ship were tested positive for SARS-CoV-2 nucleic acid on August 8. One asymptomatic case was reported in this epidemic; 254 close contacts and 617 secondary close contacts were identified, and all were tested negative for SARS-CoV-2 nucleic acid. No new cases with SARS-CoV-2 infections were detected until August 25, 2021, and the emergency response was therefore terminated.@*Conclusions@#The infection was a sporadic COVID-19 epidemic associated with overseas countries, which was caused by Delta variant infection through contacts with foreign boatmen or materials by a bundling worker in Ningbo-Zhoushan Port; fortunately, no epidemic spread occurred. Intensified closed-loop management and increased frequency of SARS-CoV-2 nucleic acid test among high-risk populations, and improving the precision and rapid emergency treatment of COVID-19 epidemics are required for the containment of COVID-19 at ports.

2.
Article in Chinese | WPRIM | ID: wpr-796694

ABSTRACT

Objective@#The incidence of complications after skin soft tissue expansion is relatively high. Occurrence of infection often means the expander has to be taken out ahead of schedule. In this retrospective study, we wanted to identify independent risk factors of infection after skin soft tissue expansion, which could be helpful to guide clinical work.@*Methods@#Demographic information of patients who underwent the skin soft tissue expansion at the department of plastic surgery of Xijing Hospital from January 2003 to December 2012 was collected. Univariate associations with infection were measured by logistic regression and represented as odds ratios. The p-value less than 0.1 was identified the potential risk factor. Multivariate logistic regression was used to calculate odds ratios for risk factors of infection. Independent risk factors were identified if the p-value was less than 0.05.@*Results@#A total of 3382 implants were included in the study. The overall infection rate of tissue expansion was 5.2% in 177 implants. The result of multivariate logistic regression showed that preoperative white blood cell count, age, numbers of expander implanted and volume of expander were independent risk factors of infection.@*Conclusions@#Independent risk factors of infection were preoperative white blood cell count, age, numbers of expander implanted and volume of expander. The lower preoperative white blood cell count, age more than 18 years old, more numbers of expander implanted and the bigger volume of the expander, the higher possibility of complications occurred. The result was helpful to guide clinical work and reduce the incidence of infection.

3.
Article in Chinese | WPRIM | ID: wpr-746059

ABSTRACT

Objective To investigate the effects of CD226 knockout ( KO) on obese mice fed with high fat diet and to analyze the composition of immune cells in CD226KO obese mice for further elucidating the immunological mechanism of CD226 involved in high fat diet-induced obesity. Methods Both wild-type ( WT) and CD226KO mice were randomly divided into two groups, high-fat and normal diet groups, and fed for 14 weeks to establish the type 2 diabetes model. Immune cells in mouse spleen and peripheral blood were analyzed by flow cytometry. In in vitro experiments, NK92-MI cells were infected with pshRNA-CD226 lenti-virus to silence CD226 expression, and then qPCR was performed to detect the expression of Foxp3, TNF-αand IFN-γ at mRNA level. Results In the high-fat diet groups, CD226KO mice had lower blood glucose, serum insulin and HOMA-IR than WT mice, but higher HOMA-IS and HOMA-β. CD226KO could reduce compensatory hyperplasia of islet tissue, and significantly down-regulate the proportion of spleen NK cells in mice. The proportion of CD3-CD49b+CD25+Foxp3+regulatory NK cells (NKreg) increased significantly in CD226KO mice. CD226KO could significantly increase Foxp3 expression in NK92-MI cells and decrease the expression of TNF-α and IFN-γ. Conclusions CD226KO can alleviate insulin resistance, increase the number of islet β-cell and improve islet β-cell function in obese mice. The mechanism might be related to the up-regulation of Foxp3+ NKreg ratio.

4.
Article in Chinese | WPRIM | ID: wpr-693853

ABSTRACT

Spinal edema is a very important pathophysiological basis for secondary spinal cord injury,which affects the repair and prognosis of spinal cord injury.Aquaporin-4 is widely distributed in various organs of the body,and is highly expressed in the brain and spinal cord.Inward rectifying potassium channel 4.1 is a protein found in astrocytes of central nervous system.It interacts with aquaporins in function.Aquaporin-4 and inward rectifying potassium channel 4.1 play an important role in the formation and elimination of spinal cord edema,inhibition of glial scar formation and promotion of excitotoxic agents exclusion.The distribution and function of aquaporin-4 and inward rectifying potassium channel 4.1 in the central nervous system and their expression after spinal cord injury have multiple effects on spinal edema.Studies of aquaporin-4 and inward rectifying potassium channel 4.1 in the spinal cord may provide new ideas for the elimination and treatment of spinal edema.

5.
Chongqing Medicine ; (36): 340-345, 2018.
Article in Chinese | WPRIM | ID: wpr-691792

ABSTRACT

Objective The changes of Mg2+ concentration and cell apoptosis were detected by using siRNA to silence MagT1 in rat cardio myocytes.Methods MagT1 siRNA sequences were designed and synthetized,then transfected into primary cultured rat myocardial cell for silencing MagT1.The expression of MagT1 mRNA and protein were detected by RT-PCR and Western blot.The changes of Mg2+ concentration in the cells were detected by fluorescence microscopy.Flow cytometry (FCM) was used to detect the cell apoptosis.Results Compared with negative siRNA group,MagT1 siRNA transfected rat cardiomyocytes after 48 h,MagT1 mRNA silence efficiency was 51.83 % (P<0.05),the silence of MagT1 protein efficiency was 56.75 % (P<0.05),intracellular Mg2+ concentration was reduced by 29.13% (P<0.05),the apoptosis rate was 31.18% (P<0.01);MagT1 siRNA transfected rat cardiomyocytes after 60 h,MagT1 mRNA silence efficiency was 86.91% (P<0.01),the silence of MagT1 protein efficiency was 83.85% (P<0.01),intracellular Mg2+ concentration was reduced by 41.32% (P<0.01),the apoptosis rate was 40.61% (P<0.01).Conclusion After the silencing of MagT1,the concentration of Mg2+ in the cells decreased significantly,the apoptotic rate increased significantly,cell life activities are greatly affected.

6.
Article in Chinese | WPRIM | ID: wpr-923883

ABSTRACT

@#The neuropeptide Y receptors system is a receptor-ligand system composed of neuropeptide Y and its receptors, which is represented by two subtypes, including Y1 receptor (Y1R) and Y2 receptor (Y2R). The system is widely involved in pain modulation in mammals. These receptors are G protein-coupled receptors, participating in neuronal membrane signaling. Neuropeptide Y receptors distribute in the pain-related regions of the central nervous system, play a variety of roles in maintains neuronal activity of pain transmission, relate to the specificity of distribution. At the spinal level, Y1R plays an analgesic role, whereas Y2R is usually related to pain-promoting. The system can also take part in cerebral pain modulation at different nuclei.

7.
Article in Chinese | WPRIM | ID: wpr-923857

ABSTRACT

@#Objective To explore the expression and the changes of microtubule, aquaporin-4 (AQP4) and potassium ion channel 4.1 (Kir4.1) after spinal cord injury in rats.Methods Ninety female adult Sprague-Dawley rats were randomly divided into sham operation group (n=30) and injury group (n=60). The injury group was divided into six hours, one day, three days, five days and seven days subgroups, with twelve rats in each subgroup. Spinal cord injury at T10 was established with modified Allen's method (20 g×25 mm) in the injury group. The water content of spinal cord was measured at each time point after injury. Then, the pathology was observed with HE staining, the expression of α-Tubulin, AQP4 and Kir4.1 was detected and analyzed with immunohistochemical staining and Western blotting.Results The water content of the spinal cord was higher in the injured group than in the sham operation group (P<0.05), and was highest on the fifth day. HE staining showed that the gray matter hemorrhage at six hours after injury; one day after injury, the gray matter bled seriously, and neuron swelling was aggravated; three days after injury, the area of gray matter necrosis increased, and the edema phenomenon was obvious; five days and seven days after injury, the gray matter necrosis and the edema phenomenon were more serious. Western blotting and immunohistochemistry showed that the expression of AQP4 gradually increased after injury, and raised at peak on the fifth day; the expression of α-Tubulin and Kir4.1 was similar, and the expression gradually decreased after injury, especially on the fifth day.Conclusion The expression of α-Tubulin and Kir4.1 is similar after spinal cord injury, and is contrary to the expression of AQP4. α-Tubulin, AQP4 and Kir4.1 may be related after injury and may participate in the formation of spinal cord edema.

8.
Chinese Journal of Orthopaedics ; (12): 1474-1482, 2017.
Article in Chinese | WPRIM | ID: wpr-664553

ABSTRACT

Objective To determine the effects of gender on distal femoral aspect ratio (DFAR),femoral component fit,and clinical outcomes at 2 years after total knee arthroplasty (TKA).Methods From December 2012 to December 2014,the clinical and radiographic characteristics of 107 consecutive patients (109 knees) were studied prospectively.All patients were divided into two groups according to gender:33 cases (33 knees) were male and 74 cases (76 knees) were female.These subjectives underwent unilateral primary TKAs for end-stage osteoarthritis by using Vanguard high-flex open-box posterior-stabilized fixed-bearing prosthesis.The anterior-posterior size increment of the Vanguard femoral components was 2 mm.The clinical outcomes (Knee Society Score,Western Ontario and McMasters University osteoarthritis index,time-up-to-go test,chair rise test,stair-climbing test,range of flexion,extensor lag,flexion contracture,anterior knee pain score and patient satisfaction) between two groups were compared at 2 years postoperatively.The femoral component fit and two kinds of DFARs were also compared intraoperatively.Results The total overhang value in zone 2 was-5.51±4.46 mm in male and-3.24±3.93 mm in female,respectively.That in zone 3 was-5.99±4.73 mm in male and-3.45±3.98 mm in female.The total underhang value in male was significantly higher than that in female (P<0.05).The rate of significant underhang in zone 3 was significantly higher in male than that in female (60.6%,23.7%,P<O.05).Two kinds of DFARs in male were significantly higher than those in female (1.56±0.12 vs.1.51±0.12,1.28±0.08 vs.1.24±0.11,P<0.05).Compared with intra-operative range of flexion (ROF) in the condition of 90° hip flexion after prosthesis implantation,the loss of ROF against gravity and the loss of passive ROF at 2 years postoperatively were statistically significant higher than those in female (-8.73°±7.71° vs.-4.82°±6.67°,-11.45°±8.78° vs.-7.34°±8.71°,P<0.05).In the male group,the natural ROF after capsule closed (132.85°±6.01°) was significantly larger than that of the female group (128.78°±6.34°),but there was no significant difference in passive flexion.The change of non-weight-bearing passive ROF (1.67°± 14.76°),the Knee Society stairclimbing score (45.15±7.12) and the proportion of being able to squat and rise (97.0%) in male group were greater than those in female group,postoperatively.Conclusion Although DFAR is different within gender;it has little effects on early outcomes after unisex posterior-stabilized TKA.The loss of ROF in male is more prominent than that in female.Increased size offerings of femoral components improve fit in female distal femur.However,distal femur of male still exist obvious underhang.

9.
Chinese Journal of Orthopaedics ; (12): 611-619, 2017.
Article in Chinese | WPRIM | ID: wpr-614488

ABSTRACT

Objective To compare the effect of preservation or complete excision of infrapatellar fat pad (IPFP) on clinical outcomes after total knee arthroplasty (TKA) at one year follow-up.Methods We randomized 100 patients (100 knees) undergoing TKA into two groups from June 2014 to August 2015,16 male and 78 female,with the average of 62.37 years old (range from 48 to 75).In excision group,50 patients underwent TKA with complete IPFP excision and in preservation group,50 patients received TKA without IPFP excision.We compared the outcome at postoperative 1 year between the two groups.Wound complication rate and patellar tendon injury rate were also evaluated.Results Complete follow-up data were available on 94 patients (46in preservation group and 48 in excision group).There were no intraoperative patellar tendon injury and postoperative wound complication cases.The patellar tendon length of excision group and preservation group at 1 week was (40.35±6.05) mm and (40.56±6.17) mm,and at 1 year were (36.18±7.09) mm and (38.75±6.23) mm,there were no statistical differences between the two groups.The patellar tendon shortening at postoperative 1 year in excision group was (-4.18±3.52) mm,more than preservation group which was (-1.81±2.08) mm,and there was statistically significant difference between the two groups.One year postoperatively,the anterior knee pain score in preservation group 2.42±2.19 was lower than excision group excision group 0.93± 1.40,and anterior knee pain rate was 2.2% and 18.8% in each group,the difference were all statistically significant.The Knee Society (KS) scores,knee flexion,flexion contracture,patient satisfaction score,and patient satisfaction rate had no statistical differences between the two groups.Conclusion Complete resection of IPFP results in a significant patellar tendon shortening and a higher probability of occurrence of knee pain after 1 year of TKA.Retention of IPFP did not increase the risk of patellar tendon injury and should therefore be kept as much as possible for complete IPFP.

10.
Article in Chinese | WPRIM | ID: wpr-808178

ABSTRACT

Objective@#To investigate the feasibility of one-stage thinning of latissimus dorsi muscle, rectus abdominis muscle and gracilis flap in reconstruction of the hand and foot defects.@*Methods@#From June 2009 to April 2015, 24 free muscle flaps were thinned during transfer operation by removing their superficial muscle layers on the basis of their vessel pedicles running in the deep surface of flaps. The surface of the muscle flaps were covered by split-thickness skin grafts. There were 16 latissimus dorsi muscle flaps, 4 gracilis flaps and 4 rectus abdominis muscle flaps. Flap size ranged from 6 cm×4 cm to 20 cm×12 cm. Thinned muscle flaps were used to resurface 7 hand defects and 17 foot defects.@*Results@#All muscle flaps survived the thinning procedures without any circulation problems except for one case which suffered total flap necrosis due to venous thrombosis. Skins grafts on muscle flaps also took well. One patient experienced partial skin loss. Two patients underwent secondary debridement and thinning procedure for infection and bulkiness. During the 0.3-20 months follow-up, the contour of thinned muscle flaps matched well with the recipient areas. Reconstructed feet are able to wear regular shoes.@*Conclusions@#Intraoperative immediate thinning of free muscle flaps can be safely accomplished during the primary reconstruction procedure. This procedure prevents the limitations of muscle flap bulkiness and may provide an alternative for surface coverage.

11.
Chinese Journal of Orthopaedics ; (12): 964-973, 2016.
Article in Chinese | WPRIM | ID: wpr-496914

ABSTRACT

Objective To determine the accuracy of femoral components sizing predicted by standardized digital templating in total knee arthroplasty (TKA).Methods Fifty consecutive patients (50 knees),who underwent primary TKAs for endstage osteoarthritis,were prospectively studied.The intra-operative and radiographic data were collected.All operations were performed by the same surgical techniques with PS type,open box Vanguard Complete Knee System.All patients underwent lateral and AP radiography of the involved knee under fluoroscopy before and after surgery.The distal femoral anteroposterior dimension (DFAP) were measured and the femoral components size were predicted on preoperative radiographs by two different methods:measurement of DFAP did not include (group A) the cartilage thickness of the medial posterior condyle or included that (group B).Cutting errors were corrected gradually,and DFAP was measured consequently.The most appropriate size was chose after each step respectively based on postoperative radiographs.The accuracy of femoral size predicted under different conditions was compared within two groups.Results During correction of cutting errors,the correct rate ranged from 18% to 44% in group A and from 26% to 34% in group B,the accuracy within one size ranged from 54% to 84% in group A and from 58% to 84% in group B.The cartilage thickness of medial posterior condylar,external rotation of femoral component,under-resected of anterior condylar,flexion of femoral component,and over-resected of posterior condylar can change the DFAP by 1.97±0.85 mm,1.56±2.06 mm,1.15±1.31 mm,-2.86±1.52 mm,and-0.87±0.77 mm,respectively.Conclusion Variation of intraoperative cutting errors and the cartilage thickness of medial posterior condyles can influence the accuracy of templating to some extent.Standardized digital radiography templating cannot predict femoral sizes accurately.

12.
Chinese Journal of Orthopaedics ; (12): 553-561, 2016.
Article in Chinese | WPRIM | ID: wpr-489175

ABSTRACT

Objective To explore the effect of the posterior condylar offset (PCO) on clinical results after total knee arthroplasty (TKA) using a high-flex posterior-stabilized (PS) fixed-bearing prosthesis.Methods Clinical and radiographic materials of 107 consecutive female patients (107 knees),who had undergone primary TKAs for end-stage osteoarthritis was prospectively analyzed.All operations were performed by using the same operative technique.Based on the corrected PCO change,all cases were divided into two groups:66 knees in which the corrected PCO change ≥0 mm (aged 48-73 years,with an average of 61.4 years) and 41 knees in which the corrected PCO change < 0 mm (aged 52-75 years,with an average of 62.2 years).One-year postoperatively,clinical and radiographic variables from the two groups were compared by independent t-test.The associations between the corrected PCO changes and the improvements of clinical variables in all patients were analyzed by Pearson linear correlation.Results The corrected PCO change was 2.49±1.71 mm in the PCO change ≥0 mm group and-1.28±1.41 mm in the PCO change < 0 mm group.One-year postoperatively,the Knee Society scores,the Western Ontario and McMaster Universities Osteoarthritis Index,non-weight-bearing active and passive range of knee flexion,flexion contracture,and their improvements had no statistical differences between the two groups.The corrected PCO change was not significantly correlated with the improvement of any clinical variable.While the PCO change ≥0 mm group (130.40°± 11.63°) demonstrated greater flexion than the PCO change < 0 mm group (123.80°±13.12°) during active weight-bearing one year after TKA,which was significantly different between the two groups (t=2.11,P=0.0401).Conclusion Restoration of PCO plays an important role in the optimization of active knee flexion during weight-bearing conditions after posterior-stabilized TKA,while it had no benefit to non-weight-bearing knee flexion and any other clinical result.

13.
Article in Chinese | WPRIM | ID: wpr-485249

ABSTRACT

Objective To compare the X-ray cephalometric results of teeth and skeleton relationship between individual lingual orthodontic and labial straight wire orthodontics,and to provide reliable theoretical foundation for selecting orthodontic system in clinic. Methods The general conditions of the patients, classification of malocclusion,severity of denture crowding and orthodontic design were used as the selection criteria. Thirty familiar adult patients with malocclusion in clinic were divided into two groups randomly:individual lingual orthodontics group (A group)and labial straight wire orthodontics group (B group),15 cases in each group.X-ray cephalometrics were taken using Steiner and Tweed cephalometrics analysis,the results of analysis were compared between pre-treatment and post-treatment in two groups respectively, and the course of treatment in two groups was compared,too.The difference of treatment effect and course of treatment between two different orthodontic systems was evaluated.Results The relationship of first molar and canine of the patients in two groups was neutral relationship,overbite and overjet of anterior teeth was shallow,the teeth arrangement was orderly and no space was left after treatment.There was no statistically significant difference (P>0.05)between two groups in each measured values detected by Steiner Analysis after orthodontic treatment;there was no statistically significant difference (P>0.05)between two groups in each measured value detected by Tweed Analysis after orthodontic treatment;and there was no statistical significance (P>0.05 )in the D-values of Steiner Analysis and Tweed Analysis between two groups before and after treatment.The duration of treatment of the patients in two groups had no significant difference (P>0.05).Conclusion Both individual lingual orthodontics and labial straight wire orthodontics could obtain well teeth arrangement and occluding relationship and achieve satisfying clinical orthodontic outcome.

14.
Article in Chinese | WPRIM | ID: wpr-343481

ABSTRACT

<p><b>OBJECTIVE</b>To reconstruct a simpler and reliable composite tissue transplantation model-the femur osteomyocutaneous flap for the replacement of hindlimb transplantation.</p><p><b>METHODS</b>Ten femur osteomyocutaneous flaps from 5 Lewis rats were transplanted into 10 syngeneic recipients' inguinal region. Their nutrient vessels were anastomosed with recipients vessels. The graft of this model was consisted of the groin flap and partial femur. To verify the feasibility of this model, gross and histological appearance were studied after transplantation to evaluate the viability of grafts.</p><p><b>RESULTS</b>The operative time was (159.0 +/- 8.3) min with the harvesting time of (68.0 +/- 4.8) min and the ischemia time of (55. 8 +/- 6.8) min. The methylene blue injection showed rich blood supply of transplanted femur osteomyocutaneous flap. All the 10 flaps survived completely with pink skin color and hair regrowth. The histologic examination of the flaps also revealed the normal appearance of the viable skin and bone marrow.</p><p><b>CONCLUSIONS</b>The femur osteomyocutaneous flap is a simple and reliable model for composite tissue transplantation, and its establishment will provide a new tool for the study of composite tissue allografts.</p>


Subject(s)
Animals , Bone Transplantation , Femur , Transplantation , Male , Models, Animal , Muscle, Skeletal , Transplantation , Rats , Rats, Inbred Lew , Skin Transplantation , Surgical Flaps , Tissue Transplantation
15.
Article in Chinese | WPRIM | ID: wpr-438074

ABSTRACT

Objective To study the risk factors of aortic arch calcification (AoAC) in maintenance hemodialysis (MHD) patients.Methods Retrospective analysis was performed in patients who accepted MHD ≥ 5 years.The clinical data were collected.The images of plan chest radiograph detected during followup period were reviewed by certain imaging physicians,and the AoAC score was calculated.Logistic regression model analysis was proceeded to study the risk factors of AoAC.The patients were divided into AoAC positive group (29 cases) and AoAC negative group (37 cases) respectively.The clinical parameters were compared between the 2 groups.Results Sixty-six patients (21 male,45 female) were selected.The year AoAC scores from the zeroth to fifth year were (0.013 40 ± 0.074 96),(0.018 90 ± 0.078 55),(0.118 50 ± 0.170 06),(0.157 00 ± 0.207 55),(0.166 00 ± 0.205 37),(0.175 50 ± 0.222 29) scores,progressively.There were significant differences in AoAC score from the third year compared with that of the zeroth year (Z =-3.984,-4.021,-4.017;P < 0.01).Logistic regression model analysis result showed that only the age of dialysis beginning was the risk factor for AoAC (relative risk 1.177,regression coefficient 0.163,P =0.002).The age of dialysis beginning,rate of diabetic nephropathy,serum calcium-phosphate product were significantly higher in AoAC positive group than that in AoAC negative group [(59.5 ± 12.6) years vs.(52.9 ± 13.2) years,27.6%(8/29) vs.2.7%(1/37),(5.81 ± 1.63) mmol2/L2 vs.(4.13 ± 0.86) mmol2/L2].Conclusions The AoAC will aggravate with the increased duration of dialysis in MHD patients.The age of dialysis beginning is the risk factor of AoAC.

16.
Chinese Journal of Nephrology ; (12): 98-102, 2013.
Article in Chinese | WPRIM | ID: wpr-431366

ABSTRACT

Objective To clarify the clinical significance of visit-to-visit variability in blood pressure (BP) of stage 3-4 chronic kidney disease (CKD) patients with hypertension.Methods One hundred and fifty-two cases of stage 3-4 CKD patients with hypertension were enrolled in the study.Variability in BP was defined as the standard deviation (SD) in BP.For each patient,SD and mean BP from BP measurements were calculated at all the visits.Correlations between the decline in estimated glomerular filtration rate (eGFR) and SD in BP were analyzed by multivariable regression.Results Visit-to-visit variability in BP was significantly associated with renal function decline (P < 0.05),in addition,baseline eGFR,baseline albuminuria and mean SBP during follow-up were significantly associated with renal function decline as well (all P < 0.05).The percentage of CCBs used in low SD of the SBP group was higher than that in high SD of the SBP (76.1% vs 58.2%,P < 0.05).Conclusion Visit-to-visit variability in BP is significantly associated with renal function decline.Drugs which can decrease the variability of blood pressure should be the first choice in the treatment of hypertension.

17.
Tianjin Medical Journal ; (12): 863-866, 2013.
Article in Chinese | WPRIM | ID: wpr-475541

ABSTRACT

Objective To evaluate the femur biomechanical changes of finite analysis with different femoral stem ex-tension implants in total knee arthroplasty (TKA). Methods The full-length femoral CT scan was performed in selected healthy volunteers. The femoral digital model was established with Mimics 10.0 and Geomagic Studio 10.0 software. The models of femoral prosthesis and stem extension implant were created by laser scanner. According to the common three hip loading modes (1 586 N, 1 690 N and 2 132 N), the maximum principal stress (MPS), the maximum principal elastic deforma-tion (MPES) and MPES distribution changes were recorded and analyzed by three-dimensional finite element analysis with ANSYS Workbench13.0 software. Results The MPS values before TKA were 98.54, 147.36 and 143.51 MPa respectively when values of femoral head loading were 1 586 N, 1 690 N and 2 132 N. With the increase in the length of the femoral pros-thesis extension rod, the MPS and MPES showed a decreasing trend. There was a positive correlation between free femur ra-tio (FFR) and MPES (P<0.05). The MPES distribution was gradually concentrated at the top point of femur stem extension implant with the increase in the length of the femoral prosthesis extension rod. Conclusion The values of MPS and MPES were gradually decreased with the increase in the length of the femoral stem extension implant. There was a positive linear correlation between FFR and MPES. The stress concentration was focused obviously at the top end of femoral stem extension implant with its length more than 120 mm.

18.
Article in Chinese | WPRIM | ID: wpr-420587

ABSTRACT

Objective To evaluate the effects of continuous quality improvement (CQI) management on nutritional status,renal function progression,and compliance of low protein diet in patients with chronic kidney disease (CKD).Methods Totally 115 CKD patients who were regularly followed up in CKD clinic services were recruited in this study.Plan,Do,Check,and Act (PDCA) method was adopted to manage the dietary of these patients for 12 months.The clinical indicators and diet compliance before and after receiving CQI management were compared.Results After receiving the CQI management,the nutritional status of patients was well maintained;meanwhile,the average hand strength and the hemoglobin,serum albumin,total cholesterol,and triglyceride levels showed no significant changes (all P > 0.05).Subjective feelings of patients were improved.The modified Subjective Global Assessment of Nutrition (mSGA) score was decreased from 7.0 (7.0,8.0) to 7.0 (7.0,7.0) (P =0.000).The estimated glomerular filtration rate (eGFR) calculated by formula of modified MDRD was decreased from (40.74 ± 14.49) to (37.94 ± 16.86) ml/(min · 1.73 m2) (P =0.000),and the average descended speed was (2.81 ±7.42) ml/(min · 1.73 m2) per year.The creatinine clearance rate had no statistical difference between pre-and post management (P =0.910),and the average descended speed was (0.19 ± 17.01) ml/min per year.The daily protein intake (DPI) and protein equivalent of nitrogen appearance rate (PNA) were both significandy descended:DPI/kg decreased from (0.79 ± 0.27) to (0.64 ± 0.15) g/ (24 h · kg) (P =0.000),and PNA/kg dropped from (1.02 ± 0.32) to (0.82 ± 0.24) g/ (24 h · kg) (P =0.000).The scores of awareness and compliance of patients on low protein diet were significantly increased after CQI management (P =0.000).Conculsion Applying CQI on dietary and nutrition management in CKD patients can maintain the good nutritional status and improve the compliance of low protein diet.

19.
Chinese Journal of Nephrology ; (12): 747-751, 2012.
Article in Chinese | WPRIM | ID: wpr-429279

ABSTRACT

Objective To study the effect of long session hemodialysis (LSHD) on the quality of life in maintenance hemodialysis (MHD) patients.Methods A total of 40 MHD patients in our dialysis center were enrolled in the study.Quality of life was investigated by SF-36 table.Sleep questionnaire survey concluded the Athens insomnia scale (AIS),Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS).Clinical data were collected.Forty MHD patients were equally divided into HD and LSHD groups according to clinical data and sleep quality score for prospective study.Hemodialysis dose of HD group was 4 h thrice weekly,and of LSHD group was 8 h thrice weekly.The trial lasted for 6 months.Changes of life quality were compared between two groups.Results As compared to HD group,LSHD group had significant higher Kt/V (1.73±0.36 vs 1.41±0.23,P<0.05),higher levels of serum hemoglobin [(124.67±9.08) vs (110.55±9.01) g/L,P<0.01] and albumin [(45.01±2.66) vs (39.28±2.63) g/L,P<0.01].better sleep quality score (16/20 vs 5/20,P=0.001) and higher blood pressure control proportion (14/20 vs 5/20,P=0.010),higher score of SF-36 (P<0.05).Conclusion LSHD can improve the life quality of MHD patients by increasing sleep quality and nutrition level.

20.
Chinese Journal of Nephrology ; (12): 587-591, 2012.
Article in Chinese | WPRIM | ID: wpr-429226

ABSTRACT

Objective To evaluate the effect of cardiovascular disease (CVD) on the healthcare costs associated with chronic kidney disease (CKD).Methods A total of 96 patients with stage 3-4 CKD treated at CKD clinic of Beijing Friendship Hospital,Capital Medical University were enrolled in the study.Their mean age was (61.6±9.5) years including 65 male and 31 female patients.A retrospective analysis of clinical material and health claims between January 2010 and October 2010 was conducted.Firstly,patients were grouped according to median CKD-associated healthcare cost and clinical characteristics were compared between two groups.Secondly,patients were stratified into three categories based on CVD prevalence (with acute cardiovascular events,with CVD but no acute events,and without CVD),and CKD-associated healthcare costs were assessed among the groups.Finally,the potential factors influencing CKD-associated healthcare costs were evaluated by optimal scaling regression analysis.Results During January to October in 2010,median CKD-associated healthcare costs was 13960.5 yuan (interquartile range 10226.5,19667.2 yuan).In the group with higher healthcare costs,more females,greater urine albumin-creatinine ratio,more emergency observations and/or hospitalizations caused by acute cardiovascular events,higher diabetes mellitus prevalence and calcium-phosphorus products,and lower eGFR and hemoglobin levels were found (P<0.05,respectively).In contrast,the total prevalence of CVD was not significantly different between the groups (P=0.386).When grouping by CVD prevalence,significant differences of CKD-associated healthcare costs were observed only between patients with acute cardiovascular events and the other two groups (P<0.01,respectively).The median healthcare cost of the former was approximately twice as higher as that of the other two groups,and the maximal cost was also found in the acute-cardiovascular-event group.For the optimal scaling regression analysis,both emergency observations and/or hospitalizations caused by acute cardiovascular events and diabetes mellitus entered the equation,and standardized coefficients were -0.538 and -0.217 respectively (P<0.01 and P<0.05).Conclusions Emergency observations and/or hospitalizations caused by acute cardiovascular events are important factors inducing high CKD-associated healthcare costs in patients with stage 3-4 CKD.Therefore,the prevention of acute cardiovascular events may be favorable to reduce CKD-associated healthcare costs.Larger and longer-time perspective studies are required to confirm it.In addition,diabetes mellitus also influences CKD-associated healthcare costs.

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