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1.
Chinese Medical Journal ; (24): 639-647, 2022.
Article in English | WPRIM | ID: wpr-927562

ABSTRACT

BACKGROUND@#Since the diagnostic value of aldosterone to renin ratio (ARR) calculated by plasma renin concentration (PRC) or plasma renin activity (PRA) is still inconclusive, we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA, so as to provide guidance for clinical diagnosis.@*METHODS@#We searched PubMed, Embase, and Cochrane Library from the establishment of the database to March 2021. We included studies that report the true positive, false positive, true negative, and false negative values for the diagnosis of primary aldosteronism, and we excluded duplicate publications, research without full text, incomplete information, or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.@*RESULTS@#The pooled results showed that ARR (plasma aldosterone concentration [PAC]/PRC) had a sensitivity of 0.82 (95% confidence interval [CI]: 0.78-0.86), a specificity of 0.94 (95% CI: 0.92-0.95), a positive-likelihood ratio (LR) of 12.77 (95% CI: 7.04-23.73), a negative LR of 0.11 (95% CI: 0.07-0.17), and symmetric area under the curve (SAUC) of 0.982, respectively. Furthermore, the diagnostic odds ratio (DOR) of ARR (PAC/PRC) was 180.21. Additionally, the pooled results showed that ARR (PAC/PRA) had a sensitivity of 0.91 (95% CI: 0.86-0.95), a specificity of 0.91 (95% CI: 0.90-0.93), a positive LR of 7.30 (95% CI: 2.99-17.99), a negative LR of 0.10 (95% CI: 0.04-0.26), and SAUC of 0.976, respectively. The DOR of ARR (PAC/PRA) was 155.52. Additionally, we conducted a subgroup analysis for the different thresholds (<35 or ≥35) of PAC/PRC. The results showed that the DOR of the cut-off ≥35 groups was higher than the cut-off <35 groups (DOR = 340.15, 95% CI: 38.32-3019.66; DOR = 116.40, 95% CI = 23.28-581.92).@*CONCLUSIONS@#The research results suggest that the determination of ARR (PAC/PRC) and ARR (PAC/PRA) was all effective screening tools for PA. The diagnostic accuracy and diagnostic value of ARR (PAC/PRC) are higher than ARR (PAC/PRA). In addition, within a certain range, the higher the threshold, the better the diagnostic value.


Subject(s)
Aldosterone , Area Under Curve , Humans , Hyperaldosteronism/diagnosis , Hypertension , Renin
2.
International Journal of Surgery ; (12): 427-432, 2021.
Article in Chinese | WPRIM | ID: wpr-907457

ABSTRACT

Varicose great saphenous vein is a common disease of vascular surgery. The treatment needs of a large number of patients and the progress of surgical techniques provide the necessity and feasibility for the active implementation of day surgery. Endovenous thermal closure techniques (laser closure and radiofrequency ablation) and non-thermal, non-tumescent techniques have the advantages of less trauma, faster recovery and fewer complications, and the effective rate and recurrence rate are not inferior to ligation and stripping. Sclerotherapy and phlebectomy are important auxiliary techniques.This paper analyzes and compares the technical characteristics and effectiveness of ambulatory surgeries for varicose great saphenous vein.

3.
Chinese Journal of Nephrology ; (12): 922-928, 2019.
Article in Chinese | WPRIM | ID: wpr-800442

ABSTRACT

Objective@#To investigate the risk factors of clinically diagnosed acute kidney injury (AKI) patients progressing to acute kidney disease (AKD).@*Methods@#The clinical data of AKI patients admitted to the First Affiliated Hospital of Zhengzhou University from January 1, 2018 to December 31, 2018 were retrospectively analyzed. According to the outcome of the patients, AKI patients were divided into non-acute kidney disease (NAKD) group and AKD group. Clinical characteristics and laboratory data of two groups were compared. The risk factors of AKD in patients with AKI were analyzed by logistic regression, and then the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of these risk factors.@*Results@#A total of 254 patients with AKI were enrolled, and 186 patients developed AKD with an incidence of 73.2%. The incidences of AKD in stage 1, stage 2 and stage 3 of AKI were 20.0%, 46.7% and 83.5% respectively. Multivariate logistic regression analysis showed increased peak serum creatinine (within 7 days after AKI diagnosis) (OR=2.561, 95% CI 1.584-4.140, P<0.001), proteinuria (OR=2.952, 95% CI 1.162-7.500, P=0.023) and increased intact parathyroid hormone (OR=1.757, 95%CI 1.104-2.797, P=0.017) were independent risk factors for progression to AKD in patients with AKI. The ROC showed that increased peak serum creatinine (within 7 days after AKI diagnosis) was an important predictor of AKD in patients with AKI (AUC=0.798, P<0.001).@*Conclusion@#Increased peak serum creatinine (within 7 days after AKI diagnosis), proteinuria and increased intact parathyroid hormone are independent risk factors for progression to AKD in patients with AKI, providing new evidences and ideas for clinical preventions and treatments of AKD.

4.
Chinese Journal of Nephrology ; (12): 922-928, 2019.
Article in Chinese | WPRIM | ID: wpr-824785

ABSTRACT

Objective To investigate the risk factors of clinically diagnosed acute kidney injury (AKI) patients progressing to acute kidney disease (AKD). Methods The clinical data of AKI patients admitted to the First Affiliated Hospital of Zhengzhou University from January 1, 2018 to December 31, 2018 were retrospectively analyzed. According to the outcome of the patients, AKI patients were divided into non - acute kidney disease (NAKD) group and AKD group. Clinical characteristics and laboratory data of two groups were compared. The risk factors of AKD in patients with AKI were analyzed by logistic regression, and then the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of these risk factors. Results A total of 254 patients with AKI were enrolled, and 186 patients developed AKD with an incidence of 73.2%. Theincidences of AKD in stage 1, stage 2 and stage 3 of AKI were 20.0%, 46.7%and 83.5%respectively. Multivariate logistic regression analysis showed increased peak serum creatinine (within 7 days after AKI diagnosis) (OR=2.561, 95% CI 1.584-4.140, P<0.001), proteinuria (OR=2.952, 95% CI 1.162-7.500, P=0.023) and increased intact parathyroid hormone (OR=1.757, 95%CI 1.104-2.797, P=0.017) were independent risk factors for progression to AKD in patients with AKI. The ROC showed that increased peak serum creatinine (within 7 days after AKI diagnosis) was an important predictor of AKD in patients with AKI (AUC=0.798, P<0.001). Conclusion Increased peak serum creatinine (within 7 days after AKI diagnosis), proteinuria and increased intact parathyroid hormone are independent risk factors for progression to AKD in patients with AKI, providing new evidences and ideas for clinical preventions and treatments of AKD.

5.
Article in Chinese | WPRIM | ID: wpr-775272

ABSTRACT

OBJECTIVE@#To screening coagulation and anticoagulation genes and mutations in Chinese patients with venous thromboembolism suspected of inhered thrombophilia.@*METHODS@#Patients with venous thromboembolism caused by inherited thrombophilia were collected from the second Affiliated Hospital, Zhejiang University School of Medicine during June 2015 and December 2017. Gene sequencing was conducted to screen the anticoagulant-related genes and coagulation-related genes . The thousands of human genome database, ESP6500 database, Genoma database, HGMD mutation database were used to compare the mutation sites, and the pathogenic mutation sites were predicted according to SIFT, Polyphen, MutationTaster and CADD databases.@*RESULTS@#Among 25 patients screened, eight patients with mutations, two patients with mutations, three patients with mutations; one patient with mutation, one patient with mutation, one patient with mutation, two patient with mutations, and one patient with mutation.@*CONCLUSIONS@#The second generation gene sequencing helps to diagnose inherited thrombophilia and guide the decision of anticoagulation duration.


Subject(s)
Blood Proteins , Genetics , China , Genome, Human , Genetics , Humans , Mutation , Thrombophilia , Diagnosis , Genetics
6.
Article in Chinese | WPRIM | ID: wpr-611088

ABSTRACT

Objective To screen out some Chinese medicines with obvious inhibitory actions on triple-negative breast cancer based on data mining. Methods Literatures of breast cancer effectively treated by Chinese medicine issued in recent 15 years were collected, and then the frequency analysis and cluster analysis were used to screen the frequently-used herbs. According to the above results, the serum containing the obtained drugs were prepared respectively. And then the proliferation, migration and invasion abilities of breast cancer cells MDB-MB-231 treated with the serum containing various Chinese medicines for 12, 24 h were observed by methyl thiazolyl tetrazolium(MTT) assay and transwell cell invasion and migration experiments, respectively. Results The frequently-used herbs were screened out as Rhizoma Chuanxiong, Herba Taraxaci, Herba Hedyotis Diffusae, Radix Trichosanthis, Radix Achyranthis Bidentatae. The proliferation of MDB-MB-231 cells was significantly inhibited by serum seperately containing Rhizoma Chuanxiong, Herba Taraxaci, Herba Hedyotis Diffusae, Radix Trichosanthis, and Radix Achyranthis Bidentatae to different degrees, and the migration abilities of MDB-MB-231 cells were obviously inhibited by serum containing Herba Taraxaci, Herba Hedyotis Diffusae, Radix Achyranthis Bidentatae, respectively. And the invasion abilities of MDB-MB-231 cells were obviously inhibited by serum containing Herba Taraxaci, Rhizoma Chuanxiong, Herba Hedyotis Diffusae, respectively. Conclusion Chinese medicines such as Rhizoma Chuanxiong, Herba Taraxaci, Herba Hedyotis Diffusae, Radix richosanthis, Radix Achyranthis Bidentatae obtained by data mining technology have obviously inhibitory effects on triple-negative breast cancer.

7.
International Journal of Surgery ; (12): 847-851, 2016.
Article in Chinese | WPRIM | ID: wpr-515471

ABSTRACT

Heparin-induced thrombocytopenia is a profoundly dangerous,potentially lethal,immunologically mediated adverse drug reaction to unfractionated heparin or low-molecular weight heparin.Clinical vigilance of this disease process is important to ensure its recognition,diagnosis,and treatment.Misdiagnosis of the syndrome,as well as misunderstanding of the disease process,continues to contribute to its morbidity and mortality.In this comprehensive review,the authors highlight heparin-induced thrombocytopenia's clinical presentation,diagnostic principles,and treatment.

8.
Article in Chinese | WPRIM | ID: wpr-494871

ABSTRACT

Objective To study the relationship among hepatitis B viral genome (HBV‐DNA) ,hepatitis Be antigen(HBeAg) and liver function in chronic hepatitis B patients ,and to provide the reference for clinical treatment .Methods The quantitative levels of HBV‐DNA ,HBeAg ,alanine aminotransferase (ALT) and aspartate aminotransferase(AST) in 401 patients were analyzed and the correlation analysis between HBV‐DNA and HBeAg was performed .The grouping was performed according to the HBV‐DNA and HBeAg quantitative levels and the differences of ALT and AST levels were compared among the groups .Results (1) The correla‐tion existed between HBV‐DNA and HBeAg positive rate ,r=0 .671(P<0 .01);(2)when HBV‐DNA load reaching 105 copies/mL , serum ALT and AST levels showed significantly increased compared with the HBV‐DNA negative group and low load group ,the difference was statistically significant (P<0 .05);(3)when HBV‐DNA load was equivalent ,the difference of ALT and AST activity had no statistically significant difference between the HBeAg‐positive and HBeAg‐negative groups .Conclusion (1)HBeAg has a correlation with HBV‐DNA ;(2)the patients with higher HBV‐DNA load are easy to develop the liver function abnormality ;(3)the HbeAg existence situation has no obvious relation with the liver function .

9.
Article in Chinese | WPRIM | ID: wpr-491833

ABSTRACT

Objective To systematically evaluate the performance of the Sysmex CS2000i Automatic Blood Coagulation Analysis System .Methods According to the standards of the Clinical and Laboratory Standards Institute (CLSI) ,the precision ,accuracy ,lin‐earity ,biological reference interval and carry‐over rates of the Sysmex CS2000i Automatic Blood Coagulation Analysis System were detected ,meanwhile the detections of 5 clinical specimens were compared between this system and the Sysmex CA 1500 Automatic Blood Coagulation Analysis System .Results The intra‐assay precision coefficient of variation (CV) ,inter‐day precisions CV carry‐over rate ,accuracy and linearity of plasma prothrombin time ,activated partial thromboplastin time ,fibrinogen and D‐dimmer detec‐ted by the Sysmex CS2000i Automatic Blood Coagulation Analysis System were all consistent with the quality target requirements of our laboratory .Conclusion The Sysmex CS2000i Automatic Blood Coagulation Analysis System has better performance in vari‐ous aspects ,the detection results could be used for the clinical diagnosis and treatment of related diseases .

10.
Article in Chinese | WPRIM | ID: wpr-482638

ABSTRACT

Objective To evaluate combined effect on different population through 2 459 data of SAA,hs-CRP and PCT from 8 three-level hospitals in Guangdong region.Methods Subjects were divided into five groups by ages,and every group had bacterial and virus type.In order to confirm diagnostic effect on infection,methods were performed including in tendency of SAA and hs-CRP,Paired t test between bacterial and virus group,efficiency of 3 indexes in judging infection depending on ROC and parameters,multiple logistic regression,consistency between positive bacterial infection and bacterial culture.Re-sults There were statistically significant differences in SAA and hs-CRP between bacterial and virus in infants and children (P <0.001).SAA had the biggest AUC area 0.824 with sensibility 71.8% and specificity 82.6% in younger group.Corre-sponding,hs-CRP had the biggest area 0.806 with sensibility 84%.There was the accuracy of 78.8% for differential diagno-sis in younger group,while 65.1% in elder group.AUC of SAA was 0.883 for positive bacterial culture with sensibility 71.2% and specificity 90.7%,accuracy of 95.2% for differential diagnosis.Conclusion There was obvious trend of age in SAA and hs-CRP,3 indexes could be used for differential diagnosis alone or combined,especially in younger group.SAA is the best index as a separated index.There is less value at ratio of SAA and hs-CRP.

11.
Article in Chinese | WPRIM | ID: wpr-287965

ABSTRACT

Peripheral arterial disease (PAD) shows increasing morbidity and mortality. Clinical manifestations of PAD, such as intermittent claudication, rest pain and nonhealing ulcer, contribute to impaired quality of life, and ischemic stroke caused by PAD can be life-threatening. Unfortunately, PAD patients often receive suboptimal treatment, and pathogenesis of the disease is still unclear. Over the past decade, the evolving technology and interdisciplinary collaboration have enabled improvement of diagnosis and treatment for PAD. This review makes a brief summary of the current status and progress in genetics research on PAD, which included candidate gene studies, linkage analyses, genome-wide association studies, and applications and development prospects of epigenetics, mitochondrial DNA and other new technologies.


Subject(s)
Animals , DNA, Mitochondrial , Genetics , Genetic Predisposition to Disease , Genetics , Genome-Wide Association Study , Methods , Genotype , Humans , MicroRNAs , Genetics , Peripheral Arterial Disease , Genetics , Therapeutics , Polymorphism, Single Nucleotide , Risk Factors
12.
Article in Chinese | WPRIM | ID: wpr-686489

ABSTRACT

Objective To evaluate the relevance and accuracy of fibrinogen (Fib) detection by using PT-der assay and Von-Clauss assay on Sysmex CA-1500 Automated Coagulation Analyzer .Methods PT-der assay and Von-Clauss assay on Sysmex CA-1500 Automated Coagulation Analyzer were employed to detect the plasma Fib concentrations of 755 blood samples .The dilution ratios of samples with high Fib concentration were 1∶8 ,2∶7 ,3∶6 ,4∶5 ,5∶4 ,6∶3 ,respectively .The dilution ratios were served as the abscissa ,and the Fib concentrations measured by two methods as the ordinate ,a simple linear regression analysis was per-formed .Results When Fib concentration was in 2 .0- <6 .0 g/L ,the Fib value obtained by Von-Clauss assay was higher than that by PT-der assay(P<0 .01) .When Fib concentration was below 2 .0 g/L or above 6 .0 g/L ,the Fib value obtained by PT-der assay was higher than that by Von-Clauss assay(P<0 .01) .The linear regression equations of PT-der assay and Von-Clauss assay were Y=4 .537 7X+1 .551 3(R2 =0 .897 3) ,Y = 7 .792 2X+ 0 .290 0(R2 =0 .980 5) ,respectively .Conclusion Von-Clauss assay can better reflect the Fib level of human body which has a blood clotting function .

13.
Article in Chinese | WPRIM | ID: wpr-446571

ABSTRACT

Objective To investigate the distribution characteristics of serum hepatitis B virus (HBV) markers of population in hospital and to provide the basis for prevention and control of virus B hepatitis .Methods 11 210 people in hospital who had accepted HBV serological testing were enrolled ,and were divided into >0 -25-year old group(n=3 553) and >25 -50-year old group(n=7 651) according to their ages .Enzyme-linked Immunosorbent Assay(ELISA) and Roche Cobas E601 Automatic Electro-chemiluminescence immunoassay analyzer were employed to detect serum HBV surface antigen (HBsAg ) ,anti-HBV surface anti-body(HBsAb) ,HBV e antigen(HBeAg) ,anti-HBV e antibody(HBeAb) and anti-HBV core antibody(HBcAb) .Results HBsAg positive rates of subjects in > 0 -25-year old group and > 25 -50-year old group were 16 .16% and 21 .19% ,respectively .The overall positive rates of HBsAg and HBsAb and full-negative rate were 19 .59% (2 195/11 204) ,37 .02% (4 148/11 204) and 11 .84% (1 327/11 204) ,respectively .Conclusion Distribution characteristics of HBV markers of population in hospital may pro-vide a reliable basis for taking effective protective and control measures against virus B hepatitis .

14.
Article in Chinese | WPRIM | ID: wpr-454670

ABSTRACT

Warfarin is a well-accepted drug used for preventing thromboembolic diseases. It is important to monitor the dosage of warfarin. Prothrombin time is one of the screening tests of extrinsic coagulation path,which is the first choice to monitor the oral use of warfarin. Standardized prothrombin time, namely international normalized ratio ( INR ) is used to adjust warfarin dosage in clinical practice. Many herbal medicines and foods may enhance the effect of warfarin therapy,and some of them may weaken this effect,which can result in severe clinical complications.

15.
Article in Chinese | WPRIM | ID: wpr-430908

ABSTRACT

Objective To investigate the feasibility and safety of laparoscopic aortobifemoral bypass (LABF) for diffuse aortoiliac occlusive diseases.Methods Clinical data of 18 cases who underwent LABF were retrospectively analyzed.The intraoperative procedures and postoperative outcome were evaluated.Results LABF was performed successfully in 17 of 18 patients.The mean operation time was (280 ±57) minutes,with a mean aortic cross-clamp time of (117 ±32) minutes.Estimated blood loss was(524 ±45) ml.Mean ICU stay was ( 1.0 ± 1.2) days.The mean postoperative hospital stay was ( 10 ±5) days.Mean time to resume diet was (3 ± 3 ) days.Postoperative myocardial infarction developed in 1 case,lung infection in 2 cases.There was no perioperative mortality.Graft thrombosis developed in 1 case and embolectomy surgery was successfully performed.All patients were followed up from 3 to 27 months,with mean follow-up of (18 ± 8) months,grafts were all patent.Conclusions Laparoscopic aortic bypass is feasible and miniinvasive in patients with diffuse aortoiliac occlusive disease.Short-term outcomes are comparable to those with open conventional aortic bypass.

16.
Article in Chinese | WPRIM | ID: wpr-326691

ABSTRACT

<p><b>OBJECTIVE</b>To study the effect of integrative Chinese and Western medicine (ICWM) on improvement of the islet beta cell function in treating patients with latent autoimmune diabetes mellitus in adults (LADA).</p><p><b>METHODS</b>Eighty-four patients of LADA were randomly divided into 3 groups (20 in A, 33 in B and 31 in C), they were treated respectively with sulfonylurea, insulin and combination of insulin and Chinese medicine. The changes before and after treatment in blood glucose, glycohemoglobin and islet beta cell function were observed.</p><p><b>RESULTS</b>After treatment, the damaged islet beta cell function in Group A was not improved, the secrete peak value of C-peptide was still low and delayed in Group A, but in Group B and C, it shifted earlier, suggesting that a certain degree of improvement and recovery of islet beta cell function. The improving effect in Group C was better.</p><p><b>CONCLUSION</b>Chinese herbal medicine had effect in lowering blood glucose and improving islet beta cell function in patients with diabetes mellitus, and showed a synergistic and enhancing action when combined use with insulin. Early treatment of insulin or combination of insulin and Chinese medicine should be applied to patients with LADA.</p>


Subject(s)
Adult , Autoimmune Diseases , Drug Therapy , Blood Glucose , Metabolism , C-Peptide , Metabolism , Diabetes Mellitus , Classification , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Female , Glycated Hemoglobin A , Metabolism , Humans , Insulin , Therapeutic Uses , Islets of Langerhans , Male , Middle Aged , Phytotherapy
17.
Article in Chinese | WPRIM | ID: wpr-560381

ABSTRACT

Research of cell cycle is the bas is of investigating the organism growth,development,heredity and other medical associated events. The molecular basis of cell cycle control is the regulator control system with CDK-Cyclin-CKI as the core.Protein kinase CK2 is one of the most conservative protein kinase during evolution and more and more researches have proved that protein kinase CK2 plays an important role in cell cycle control.

18.
Article in Chinese | WPRIM | ID: wpr-577596

ABSTRACT

Objective To observe the therapeutic effect of liver-soothing and spleen-strengthening herbal medicine for metabolic syndrome(MS).Methods Ninety-three MS patients were randomized into group A(N=51)and group B(N=42).The two groups received the basic treatment including dietary control and exercises.Group A received liver-soothing and spleen-strengthening herbal medicine(such as Radix Bupleuri,Rhizoma Atractylodis Macrocephalae,Radix Paeoniae Alba,Radix Angelicae Sinensis,Poria,Radix Rehmanniae,Radix Astragali,Rhizoma Alismatis,Semen Coicis,Cortex Moutan,Rhizoma Dioscoreae,Radix Glycyrrhizae,etc.)additionally.The treatment course lasted 3 months.After treatment,the therapeutic effect was evaluated,and the changes of blood pressure,body weight index(BWI),blood glucose(BG)and insulin levels,insulin sensitivity index(ISI),and the blood lipid levels were observed.Results After treatment,23 patients were cured,26 effective,2 ineffective,and the total effective rate was 96.08% in group A;in group B,12 were cured,21 effective,9 ineffective,and the total effective rate was 78.57%.The therapeutic effect in group A was better than that in group B(P0.05).Fasting BG,2-hour BG and BWI were decreased in the two groups(P0.05).Total cholesterol(TC)and triglyceride levels decreased,and high density lipoprotein cholesterol(HDLC)increased in the two groups(P0.05).Conclusion Liver-soothing and spleen-strengthening herbal medicine exerts an effect for metabolic syndrome,not only decreasing blood pressure,blood lipid levels and body weight,but also improving insulin resistance and increasing ISI.

19.
Article in Chinese | WPRIM | ID: wpr-579590

ABSTRACT

AIM: To study the chemical constituents from the leaves of Phyllanthus emblica L. METHODS: The constituents were extracted by percolation with 95% ethanol.Then the extract was separated by systemic solvent separation methods.The ethyl acetate portion from the leaves were separated and purified by silica gel column chromatography and polyamide column chromatography with gradient elution,liquid preparation and recrystal methods.The structures of crystals were identified by physiochemical properties,spectrum analysis and literatures ontrast. RESULTS: Five compounds were isolated and identified.They were ?-sitosterol(Ⅰ);?-carotene(Ⅱ);kaemferol(Ⅲ);quercetin(Ⅳ);avicularin(Ⅴ). CONCLUSION: Chemical compound Ⅴ is isolated from this plant for the first time.

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