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The enhancer of zeste homolog 2 (EZH2) is a histone methyltransferase, which is widely studied in histone methylation modification. It can promote epigenetic gene silencing and mediate the occurrence of tumors through a variety of regulatory mechanisms. The gain-of-function and loss-of-function mutations of EZH2 have been confirmed in many cancers. At present, with the extensive attention paid to the regulatory role of EZH2 in epigenetic mechanism, the exact way in which EZH2 imbalance affects the pathogenesis of hematologic malignancies remains to be clarified. This article reviews the pathogenetic role of EZH2 in hematological tumors, and hope to find new targets for the prevention and treatment of hematological tumors.
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Objective:To investigate the correlation between serum uric acid level and symptomatic intracranial hemorrhage (sICH) and outcomes after endovascular therapy (EVT) in elderly patients with anterior circulation acute ischemic stroke (AIS).Methods:Elderly patients with AIS (aged ≥65 years) received EVT in Beijing Geriatric Hospital and Xuanwu Hospital from December 2017 to December 2020 were retrospectively enrolled. sICH was defined as cerebral parenchymal hemorrhage revealed by CT within 72 h after admission and the Naitonal Institutes of Health Stroke Scale score increased by ≥4 compared with the baseline. At 90 d after onset, the clinical outcome was evaluated by the modified Rankin Scale. 0-2 was a good outcome and 3-6 was a poor outcome. The clinical data of the sICH group and non-sICH group, as well as the good outcome group and poor outcome group were compared. Multivariate logistic regression analysis was used to determine the independent correlation between serum uric acid level and sICH and poor outcomes. Results:A total of 122 patients were enrolled, their age was 73.89±6.24 years, and 73 (59.8%) were male. Fifty-two patients (42.6%) had hemorrhagic transformation, 27 (22.1%) had sICH, and 28 (23.8%) had a good outcome at 90 d after onset. The serum uric acid in the sICH group was significantly lower than that in the non-sICH group ( P=0.002), while the serum uric acid in the good outcome group was similar to that in the poor outcome group ( P=0.510). Multivariate logistic analysis showed that the lower serum uric acid was an independent risk factor for sICH (odds ratio 0.994, 95% confidence interval 0.990-0.998; P=0.011). Conclusion:The lower serum uric acid level was an independent risk factor for sICH after EVT in elderly patients with AIS, but it was not associated with the outcomes.
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Peroneal tendon plays an important role in maintaining the alignment of the hindfoot and stabilizing the arch of the foot. It is also the main tendon against ankle varus injuries, and is of great significance in maintaining lateral ankle stability. As an infrequent disease, peroneal tendon spondylolisthesis can be easily misdiagnosed in clinical diagnosis and treatment which results in pain and instability of the lateral ankle and weakness in eversion of the affected foot. Improper diagnosis or treatment can affect patient quality of life. Peroneal tendon spondylolisthesis is mainly treated by non-surgical and surgical treatments, among which surgical treatments mainly include superior peroneal retinaculum repair, superior peroneal retinaculum augmentation, peroneal bone block procedure, peroneal groove deepening technique, and peroneal rearrangement. Surgical indications for different surgical treatments remain controversial. Moreover, there are no rehabilitation guidelines for peroneal tendon spondylolisthesis at home or abroad, and postoperative rehabilitation is generally based on the experience of clinicians. On the basis of related literature, the authors review the research progress in treating peroneal tendon spondylolisthesis from aspects of anatomical characteristics, injury mechanism, diagnosis, treatment and rehabilitation, so as to provide a reference for accurate and effective diagnosis, treatment and rehabilitation of peroneal tendon spondylolisthesis.
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Objective To analyze the relationship between serum uric acid (SUA) level and clinical indicators in maintenance hemodialysis (MHD) patients, and explore its influence on all-cause mortality and cardiovascular mortality. Methods This study was a retrospective cohort study. Patients who received MHD from the blood purification center of the Third Affiliated Hospital of SunYat-sen University from January 1, 2011 to December 30, 2015 were enrolled in the queue. They were divided into 3 groups according to the first and third quantile of the SUA level quartiles, and the baseline data of clinical and laboratory examinations were compared. The correlation between SUA level and clinical indicators was analyzed by Pearson correlation coefficient. Kaplan-Meier method and Cox proportional hazard regression model were used to examine the association between SUA and all-cause mortality and cardiovascular mortality in MHD patients. Results A total of 201 patients were enrolled in the study. The age of the patients was (56.9 ± 16.7) years and the baseline SUA level was (531.1±137.9)μmol/L. Patients were divided into 3 groups with the first quantile (442μmol/L) and the third quantile (620 μmol/L) of the SUA quartiles as the boundary points: group 1 (SUA<442 μmol/L, n=52), group 2 (SUA 442-620 μmol/L, n=101) and group 3 (SUA>620 μmol/L, n=48). The results showed that the patients in group 1 were older and had more proportion of patients with diabetes mellitus and cardiovascular diseases than those in group 3 (all P<0.05). Compared to group 3, the serum albumin, serum phosphorus and serum creatinine were lower in group 1, while the hypersensitive C-reactive protein was higher (all P<0.05). Pearson correlation analysis showed that SUA level was positively correlated with albumin (r=0.135, P=0.047), blood phosphorus (r=0.269, P<0.001) and serum creatinine (r=0.333, P<0.001), and negatively correlated with hypersensitive C-reactive protein (r=-0.216, P=0.002). After a median follow-up of 49.8 months, 66(32.8％) all-cause deaths and 32 (15.9％) cardiovascular deaths were recorded. Kaplan-Meier method showed that with the decrease of SUA, all-cause mortality (Log-rank χ2=18.27, P<0.001) and cardiovascular mortality (Log-rank χ2=15.04, P=0.001) increased. After adjusting for age, gender, comorbidity and other factors using the Cox proportional hazards model, the all-cause mortality and cardiovascular mortality decreased by 20.1％(HR=0.799, 95％CI 0.651-0.980, P=0.031) and 29.6％(HR=0.704, 95％CI 0.524-0.946, P=0.020) for each 100μmol/L increase in baseline SUA. Compared to group 1, all-cause mortality (HR=0.332, 95％CI 0.142-0.774, P=0.011) and cardiovascular mortality (HR=0.140, 95％CI 0.030-0.657, P=0.013) were lower in the group 3. Conclusion Low SUA level increases the risk of all-cause mortality and cardiovascular mortality in MHD patients.
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Objective@#To evaluate the effects of total extraperitonal herniorrhaphy on pain and effusion in patients with surgical area.@*Methods@#The clinical data of 58 cases of inguinal hernia admitted to the First Hospital of Shanxi Medical University from January 2017 to January 2018 were retrospectively analyzed.Complete extraperitoneal inguinal oblique hernia repair was performed under laparoscopy under general anesthesia.The patients were divided into two groups by the single or double of admission date number.The observation group(A group, 32 cases) received post-operative intraoperative pressure homemade ice bags, the control group(B group, 26 patients) was placed in normal temperature saline bag after operation.The degree of pain in patients was evaluated by numerical scoring method.The time of exit, discharge, accumulation rate and recurrence rate of hernia were analyzed.@*Results@#The differences in pain score, pain score during floor movement, and regional efflux rate between A group and B group were statistically significant[(2.11±0.97)points vs.(2.45±1.21)points, (2.63±1.89)points vs.(2.76±1.95)points, 0 case vs.2 cases, t=2.745, 4.189; χ2=1.15, all P<0.05]. The time of discharge from hospital and discharge after surgery in A group and B group were (19.16±9.22)h vs.(19.76±10.52)h, (34.85±7.43)h vs.(37.56±8.91)h, the difference was not statistically significant(t=1.790, 0.834, all P>0.05).@*Conclusion@#After laparoscopic repair of total extraperitonal herniorrhaphy, the area ice pack can achieve the purpose of relieving pain in the surgical area and reducing the accumulation of fluid in the surgical area.
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Objective@#To analyze the relationship between serum uric acid (SUA) level and clinical indicators in maintenance hemodialysis (MHD) patients, and explore its influence on all-cause mortality and cardiovascular mortality.@*Methods@#This study was a retrospective cohort study. Patients who received MHD from the blood purification center of the Third Affiliated Hospital of Sun Yat-sen University from January 1, 2011 to December 30, 2015 were enrolled in the queue. They were divided into 3 groups according to the first and third quantile of the SUA level quartiles, and the baseline data of clinical and laboratory examinations were compared. The correlation between SUA level and clinical indicators was analyzed by Pearson correlation coefficient. Kaplan-Meier method and Cox proportional hazard regression model were used to examine the association between SUA and all-cause mortality and cardiovascular mortality in MHD patients.@*Results@#A total of 201 patients were enrolled in the study. The age of the patients was (56.9±16.7) years and the baseline SUA level was (531.1±137.9) μmol/L. Patients were divided into 3 groups with the first quantile (442 μmol/L) and the third quantile (620 μmol/L) of the SUA quartiles as the boundary points: group 1 (SUA<442 μmol/L, n=52), group 2 (SUA 442-620 μmol/L, n=101) and group 3 (SUA>620 μmol/L, n=48). The results showed that the patients in group 1 were older and had more proportion of patients with diabetes mellitus and cardiovascular diseases than those in group 3 (all P<0.05). Compared to group 3, the serum albumin, serum phosphorus and serum creatinine were lower in group 1, while the hypersensitive C-reactive protein was higher (all P<0.05). Pearson correlation analysis showed that SUA level was positively correlated with albumin (r=0.135, P=0.047), blood phosphorus (r=0.269, P<0.001) and serum creatinine (r=0.333, P<0.001), and negatively correlated with hypersensitive C-reactive protein (r=-0.216, P=0.002). After a median follow-up of 49.8 months, 66(32.8%) all-cause deaths and 32(15.9%) cardiovascular deaths were recorded. Kaplan-Meier method showed that with the decrease of SUA, all-cause mortality (Log-rank χ2=18.27, P<0.001) and cardiovascular mortality (Log-rank χ2=15.04, P=0.001) increased. After adjusting for age, gender, comorbidity and other factors using the Cox proportional hazards model, the all-cause mortality and cardiovascular mortality decreased by 20.1% (HR=0.799, 95% CI 0.651-0.980, P=0.031) and 29.6% (HR=0.704, 95% CI 0.524-0.946, P=0.020) for each 100 μmol/L increase in baseline SUA. Compared to group 1, all-cause mortality (HR=0.332, 95%CI 0.142-0.774, P=0.011) and cardiovascular mortality (HR=0.140, 95%CI 0.030-0.657, P=0.013) were lower in the group 3.@*Conclusion@#Low SUA level increases the risk of all-cause mortality and cardiovascular mortality in MHD patients.
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Objective To analyze the predictive value of apolipoprotein B (ApoB) in the risk of progression to renal replacement therapy (RRT) in diabetic kidney disease (DKD) patients with chronic kidney disease (CKD) stage 3-5. Methods The data of DKD patients with CKD stage 3-5 who were hospitalized and followed up with detailed clinical data from January 2011 to November 2014 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively collected. Estimated glomerular filtration rate (eGFR) was calculated according to the CKD-EPI formula. After 2 years of follow-up, the patients were divided into RRT group and non-RRT group according to whether they had entered renal replacement therapy. Cox regression analysis was used to analyze the influencing factors of DKD progression to RRT. The predicted value of ApoB in the risk of progression to renal replacement therapy (RRT) of DKD patients within 2 years of follow-up was analyzed by plotting the receiver operating characteristic curve (ROC). By establishing multiple Cox models, the effect of ApoB elevation on the progression of DKD patients to RRT was analyzed after adjusting for the influencing factors gradually. Results A total of 258 cases were included in this study, including 156 males and 102 females. They were (66.13±11.88) years old (27-91 years old). CKD 3-5 patients were 181 cases, 50 cases and 27 cases respectively. There were 165 cases in the non-RRT group and 93 cases in the RRT group. There were statistically significant difference in hemoglobin, hematocrit, blood phosphorus, ApoB, serum creatinine, urea nitrogen, serum cystatin C, eGFR and in the proportion of using angiotensin converting enzyme inhibitor, diuretic, β blockers between the two groups (all P＜0.05). Multivariate Cox regression analysis showed that ApoB was an independent predictor of progression to RRT in patients with DKD within 2 years (HR=2.203, 95% CI 1.352-3.589, P=0.002). The area under the ROC curve of ApoB for DKD progression to RRT within 2 years of follow-up was 0.641 (C-index=0.749, P＜0.01). After adjusting for confounding factors, Cox regression analysis showed that for every 1 mmol/L increase in ApoB, the risk of RRT increased by 1.038 times in DKD patients with CKD stage 3-5 (HR=2.038, 95% CI 1.312-3.168, P=0.002). Conclusions ApoB is an independent predictor of progression to RRT with CKD stage 3-5 diabetic kidney disease (DKD). For every 1 mmol/L increase in ApoB, the risk of progression to RRT in patients with CKD 3-5 DKD increases by 1.038 times.
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Objective To evaluate the effects of total extraperitonal herniorrhaphy on pain and effusion in patients with surgical area.Methods The clinical data of 58 cases of inguinal hernia admitted to the First Hospital of Shanxi Medical University from January 2017 to January 2018 were retrospectively analyzed.Complete extraperitoneal inguinal oblique hernia repair was performed under laparoscopy under general anesthesia .The patients were divided into two groups by the single or double of admission date number.The observation group(A group,32 cases) received post－operative intraoperative pressure homemade ice bags ,the control group ( B group,26 patients) was placed in normal temperature saline bag after operation.The degree of pain in patients was evaluated by numerical scoring method. The time of exit,discharge,accumulation rate and recurrence rate of hernia were analyzed.Results The differences in pain score,pain score during floor movement ,and regional efflux rate between A group and B group were statistically significant[(2.11 ±0.97)points vs.(2.45 ±1.21) points,(2.63 ±1.89) points vs.(2.76 ±1.95) points,0 case vs.2 cases,t ＝2.745,4.189;χ2 ＝1.15,all P＜0.05].The time of discharge from hospital and discharge after surgery in A group and B group were (19.16 ±9.22) h vs.(19.76 ±10.52) h,(34.85 ±7.43) h vs.(37.56 ± 8.91) h, the difference was not statistically significant ( t ＝1.790, 0.834, all P ＞0.05 ).Conclusion After laparoscopic repair of total extraperitonal herniorrhaphy ,the area ice pack can achieve the purpose of relieving pain in the surgical area and reducing the accumulation of fluid in the surgical area .
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Objectives To analyze the links of the in-hospital delay by investigating the status of in-hospital delay in patients with acute ischemic stroke in a tertiary hospital in Beijing and to shorten the in-hospital delay by intervention. Methods From August 2016 to July 2017,98 patients with ischemic stroke treated by endovascular therapy and met the inclusion criteria in the Xuanwu Hospital, Capital Medical University were collected prospectively. According to before and after intervention,the patients were divided into before intervention (from August 2016 to January 2017,n=44) and after intervention (from February to July 2017,n=54). The questionnaire was designed by the authors. The survey included the basic information of patients,clinical features,and key time point of hospital treatment process. The delay links were analyzed through the value flow diagram,and the targeted interventions were given to shorten the time of in-hospital delay. Results (1) The main links of the presence of in-hospital delay are physician evaluation,disease notification, signing of the informed consent, and preoperative preparation. ( 2 ) The intervention effect was significant. The median total nosocomial process time before and after intervention were 138. 0 (118. 5,188. 8) min and 93. 5 (80. 0,114. 0) min respectively. There was significant difference(Z=5. 929,P<0. 01). Compared with before intervention,the time of examination,imaging examination, preoperative preparation and femoral artery puncture were shorter ( 16. 5 [ 10. 0, 27. 2 ] min vs. 35. 0 [18. 2,51. 8] min;10. 0 [9. 0,11. 0] min vs. 12. 5 [10. 0,23. 8] min;48. 0 [30. 0,67. 5] min vs. 60. 5 [45. 5,90. 8] min;15. 0 [12. 0,18. 2] min vs. 21. 0 [13. 0,33. 0] min,Z=4. 150,3. 685,2. 801,and 2. 852,respectively;all P<0. 05). Conclusions The nosocomial process of endovascular treatment in patients with ischemic stroke is seriously delayed. Through continuous improvement of the nosocomial process,setting up a parallel treatment modality,strengthening the stroke team training,and improving the docking measures of the information system platform can significantly shorten the in-hospital time.
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Objective To analyze the related factors of micro-albuminuria and macroalbuminuria in type 1 diabetes mellitus (DM) in the classification tree model,and to screen the high risk population of diabetic kidney disease.Methods 394 patients with type 1 diabetes were enrolled in the hospital from 2008 to 2015.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 1 diabetes group (299 cases),micro-albuminuria group (73 cases) and macro-albuminuria group (22 cases).The classification tree model was utilized to analyze related factors of the different stages of proteinuria,and the high-risk population was screened by node gain analysis.Results Four important explanatory variables were screened out by the classification tree model from the 27 candidate variables related to primary renal damage,including retinopathy,fibrinogen,waist-hip ratio (WHR),red blood cell distribution width (RDW).Retinopathy was an major factor of DKD.The probability of macro-albuminuria in retinopathy and WHR ＞ 0.82 group was 43.8％,and if at the same time RDW ＞ 0.14,the probability of macro-albuminuria was 88.9％.Conclusions The classification tree model can analyze factors of the separate stages of proteinuria in type 1 diabetic patients effectively.Retinopathy is the major influential factors of type 1 diabetic patients with proteinuria.
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Objective To analyze the related factors of micro-albuminuria and macroalbuminuria in type 1 diabetes mellitus (DM) in the classification tree model,and to screen the high risk population of diabetic kidney disease.Methods 394 patients with type 1 diabetes were enrolled in the hospital from 2008 to 2015.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 1 diabetes group (299 cases),micro-albuminuria group (73 cases) and macro-albuminuria group (22 cases).The classification tree model was utilized to analyze related factors of the different stages of proteinuria,and the high-risk population was screened by node gain analysis.Results Four important explanatory variables were screened out by the classification tree model from the 27 candidate variables related to primary renal damage,including retinopathy,fibrinogen,waist-hip ratio (WHR),red blood cell distribution width (RDW).Retinopathy was an major factor of DKD.The probability of macro-albuminuria in retinopathy and WHR ＞ 0.82 group was 43.8％,and if at the same time RDW ＞ 0.14,the probability of macro-albuminuria was 88.9％.Conclusions The classification tree model can analyze factors of the separate stages of proteinuria in type 1 diabetic patients effectively.Retinopathy is the major influential factors of type 1 diabetic patients with proteinuria.
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[Objective]To investigate the expression change of miR-134 in methamphetamine(MA)-induced neuronal injury in PC12 cells and its effect on neuronal excitability and understand the pathogenesis of methamphetamine-induced neuronal injury.[Methods]PC12 cells in the logarithmic phase were divided into control group and MA group. The MA group was treated with 800μmol/L MA to establish the model of neuronal injury. The cellular injury was observed under microscope. The neuronal apoptosis was detected by Hoechst3342/PI double staining,and miR-134 expression was measured by using real-time quantitative PCR (Real time-PCR). Furthermore,we constructed miR-134 interference vector and observed its effect on evoked action potential.[Results]The cultured PC12 cells were damaged under the 800 μmol/LMA treatment ,and neurites became shorter ,the apoptotic cells were evidence. Real time-PCR showed that miR-134 expression was increased after MA treatment. Electrophysiological data showed that the evoked action potential increased after miR-134 interference.[Conclusions]High concentration of MA can induce neuronal damage and apoptosis and also increase miR-134 expression. While silence miR-134 expression can increase neuronal excitability.Our study provides an experimental basis for elucidating the possible mechanism of MA-induced neuronal injury and the role of miR-134 in neurotoxicity and neuronal excitability.
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<p><b>OBJECTIVE</b>To compare the effects and security between internal fixation and total hip arthroplasty for the patients in elderly with femoral neck fracture of displacement type through a meta analysis.</p><p><b>METHODS</b>Studies on comparison between internal fixation and total hip arthroplasty for the patients in the elderly with femoral neck fracture of displacement type were identified from PubMed database,EMBase database, COCHRANE library, CMB database, CNKI database and MEDLINE database. Data analysis were performed using Revman 5.2.6(the Cochrane Collaboration).</p><p><b>RESULTS</b>Six published randomized controlled trials including 627 patients were suitable for the review, 286 cases in internal fixation group and 341 cases in total hip arthroplasty group. The results of meta analysis indicated that statistically significant difference were observed between the two groups in the quality of life which was reflected by the Harris scale (RR = 0.82, 95%CI:0.72-0.93, P < 0.05) , the reoperation rate (RR = 5.81, 95%CI:3.09-10.95, P < 0.05) and the major complications rate (RR = 3.60, 95%CI:2.29-5.67, P < 0.05) postoperatively. There were no difference in the mortality at 1 year and 5 years postoperatively(P > 0.05).</p><p><b>CONCLUSIONS</b>For the patients with femoral neck fracture of displacement type in the elderly, there is no statistical difference between two groups in the mortality postoperatively. The quality of life and the security of operation in internal fixation group is worse than the total hip arthroplasty group.</p>
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Anciano , Anciano de 80 o más Años , Humanos , Artroplastia de Reemplazo de Cadera , Métodos , Fracturas del Cuello Femoral , Cirugía General , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To discuss the curative effect of the dynamic hip system blade (DHS-blade) on the treatment of femoral neck fractures in elderly patients with osteoporosis.</p><p><b>METHODS</b>A retrospective study was conducted to analyse the clinical data of 60 elderly patients with osteoporosis who had been treated for femoral neck fractures with DHS-blade in our department between September 2012 and February 2014. There were 22 males and 38 females with a mean age of (66.8±3.2) years. According to the Singh Index Classification, all the patients'Singh index was below level 3. The Harris criterion and function recovery after operation were analysed.</p><p><b>RESULTS</b>All patients were followed up for 12-17 months (mean 14 months). No femoral head necrosis, femoral neck shortening, internal fixation loosening or backing out of the nails occurred. Bone nonunion was found in one case and he had a good recovery after total hip arthroplasty. The time for fracture healing ranged from 3-6 months (average 3.5 months). According to Harris criterion, 35 cases were rated as excellent, 22 good, 2 fair and 1 poor. The Harris scale was significantly improved from 28.46±2.35 preoperatively to 91.98±3.26 at 6 months postoperatively (P<0.05).</p><p><b>CONCLUSION</b>DHS-blade, being minimally invasive, allowing earlier postoperative exercise and avoiding the complications elicited by traditional internal fixation, is advisable for treatment of femoral neck fractured patients with osteoporosis.</p>
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Anciano , Femenino , Humanos , Masculino , Fracturas del Cuello Femoral , Cirugía General , Fijación Interna de Fracturas , Métodos , Curación de Fractura , Procedimientos Quirúrgicos Mínimamente Invasivos , Fracturas Osteoporóticas , Cirugía General , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
Objective To analyze the prevalence,risk factors of kidney disease in type 2 diabetic patients with KDIGO classification of chronic kidney disease,also to study cardiovascular and cerebrovascular diseases and death in these patients,so as to investigate the significance of the KDIGO classification system.Methods One thousand six hundred and forty-five type 2 diabetic patients who were in hospitalization from June 2008 to December 2012 were grouped according to the KDIGO classification of chronic kidney disease and the incidence of vascular disease was analyzed based on the classification.Clinical features were compared between patients with or without kidney disease.The risk factors of kidney disease and the death of diabetic patients were also investigated.Results There were 915 male and 730 female,aged a median (57.86±12.54) years with (6.35±6.30) years duration of diabetes mellitus among the 1645 cases,and 37.2％ of patients had concomitant kidney disease.According to the classi fi cation of CKD,patients in CKD group 3a,group 3b and CKD group 4-5 accounted for 5.7％,3.5％ and 7.6％,while 33.4％ of patients had proteinuria,among which 19.5％ with microalbuminuria,13.5％ with macroalbuminuria.On complications,patients with hypertension accounted for 49.5％,hyperlipidemia 67.7％,diabetic retinopathy 27.4％,cardiovascular and cerebrovascular diseases 18.5％ (coronary artery disease 16.5％,cerebrovascular diseases 8.8％).Statistical difference was detected in the incidence of diabetic retinopathy,coronary artery disease and cerebrovascular diseases between CKD group 3a and 3b (P ＜ 0.05).The duration of diabetes,concomitant hypertention especially with elevated systolic blood pressure,diabetic retinopathy and hyperuricemia were the independent risk factors for type 2 diabetic patients with kidney disease.Age,Scr,complicating cardiovascular and cerebrovascular diseases and advanced CKD stage were the independent risk factors for the death of type 2 diabetic patients with kidney disease.Conclusion KDIGO classification of chronic kidney disease enables better staging of kidney diseases in diabetic patients for management and prognosis.Diabetic patients have a higher prevalence of renal diseases and cardiovascular and cerebrovascular events than the general population.Early control of factors such as blood pressure and serum uric acid can delay the progression of kidney disease,and the predictive role of diabetic retinopathy should be emphasized.
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Objective To analyze the impact factors for early renal damage in type 2 diabetic patients by the classification tree model.Methods A total of 601 patients with type 2 diabetes were enrolled.According to glomerular filtration rates and urine albumin quantification,the patients were divided into type 2 diabetes group (418 cases) and early diabetic renal damage group (183 cases).The clinical data of the patients were recorded to analyze the main influential factors for the microalbuminuria of type 2 diabetic patients using the Exhaustive CHAID classification tree algorithm.Results Six important explanatory variables were screened out by the classification tree model from the 34 candidate variables related to early renal damage,including fibrinogen,history of hypertension,retinopathy,Cys C levels,SBP and peripheral neuropathy.Elevated fibrinogen was the main factor.Conclusion The classification tree model can analyze the major influential factors of early renal damage in type 2 diabetic patients effectively,and it can help develop the prevention and treatment methods.