Aortic stiffness and its influencing factors in patients with chronic kidney disease / 浙江大学学报·医学版

To investigate the changes of aortic stiffness and its influencing factors in patients with chronic kidney diseases (CKD).Eightyfour patients with CKD from Department of Nephrology, Zhejiang Provincial People's Hospital were divided into the dialysis group (CKD stage 5,=48) and non-dialysis group (CKD stage 3-5,=36). Clinical data, biochemical parameters and echocardiography findings were collected. SphygmoCor pulse wave analysis system was used to obtain pulse wave analysis (PWA) parameters including central aortic systolic blood pressure (CSP), central pulse pressure (CPP), augmented pressure (AP), augmentation index (AIX), and heart rate 75-adjusted augmentation index (HR75AIX). The influencing factors of aortic stiffness were analyzed by spearman correlation analysis and multiple regression analysis.CSP, CPP, AP, AIX and HR75AIX in dialysis patients had no significant differences compared with those in non-dialysis group (all>0.05). Spearman correlation analysis showed that CSP was positively correlated with systolic blood pressure, diastolic blood pressure, cholesterol, low-density lipoprotein cholesterol, left atrial diameter (LA),left ventricular systolic diameter (LVDs), left ventricular diastolic diameter (LVDd), and negatively correlated with calcium and hemoglobin levels. CPP was positively correlated with systolic blood pressure, age, LA, LVDd, and negatively correlated with diastolic blood pressure and hemoglobin levels. AP was positively correlated with systolic blood pressure, age, LA, LVDd, and negatively correlated with hemoglobin levels. AIX was positively correlated with systolic blood pressure, age, sodium, and negatively correlated with phosphorus levels. HR75AIX was positively correlated with systolic blood pressure, sodium, cholesterol, and negatively correlated with hemoglobin and albumin levels. Multiple regression analysis showed that higher systolic blood pressure was the independent risk factor for CSP (β=0.944,<0.01); lower diastolic blood pressure (β=0.939,<0.01) and higher systolic blood pressure (β=-1.010,<0.01) were the independent risk factors for CPP; older age (β=0.237,<0.01) and higher systolic blood pressure (β=0.200,<0.01) were the independent risk factors for AP; higher systolic blood pressure (β=0.163 and 0.115,<0.05 and<0.01) and higher sodium (β=0.646 and 0.625, all<0.05) were independent risk factors for both AIX and HR75AIX.No significant correlation is observed between aortic stiffness and CKD of different stages. Control blood pressure and restrict sodium intake may be effective means of delaying arterial stiffness in patients with CKD.

Surveillance and drug resistance analysis of pathogenic microorganism of urinary tract infection in a hospital of Hangzhou city during 2005 to 2007 / 中华临床感染病杂志

Objective To identify the spectrum of pathogenic microorganisms of urinary tract infection and the drug resistance in a hospital setting. Methods The pathogenic microorganisms isolated from 3117 mid-stream urine samples of patients admitted in Hangzhou First People's Hospital from 2005 to 2007 and their drug resistance results were retrospectively analyzed. Results Bacteria were the most prevalent microorganisms in the urinary tract infection, and followed by fungus, mycoplasma and chlamydia. Escherichia eoli accounted for the largest proportion of gram-negative bacteria, in which the ESBLs positive strains accounted for 51.2%, and their drug resistance rate was much higher than that of ESBLs negative strains. Main gram-positive coccobacteria was all sensitive to vancomycin, and relatively sensitive to nitrofurantnin and ampicillin. Conclusions Escherichia coli continue to prevail upon the spectrum of pathogenic microorganism of the urinary tract infection, and the fungus, mycoplasma and chlamydia infections are rising. Antibacterial agents should be used under the guidance of drug sensitivity test, and the combined use should be avoidd.