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Objective:To explore the early predictive value of urinary nephrin in acute kidney injury (AKI) for critically ill neonates.Methods:A prospective study was conducted to neonates who were admitted to Neonatal Intensive Care Unit (NICU) Children′s Hospital of Soochow University, from July to October 2016.According to whether AKI occurred during the NICU′s hospitalization, neonates were divided into AKI group and non-AKI group.Urinary nephrin levels were detected at the first 24 h of NICU, and the score for neonatal acute physiology (SNAP) was assessed within 24 hours of NICU.Multivariate linear analyses were applied to analyze potential variables that were asso-ciated with urinary nephrin level.Multivariate Logistic regression analysis was adopted to evaluate the relationship between urinary nephrin and AKI after adjusting for confounding factors.A receiver operating characteristic(ROC) curve and the area under the ROC curve (AUC) were calculated to assess the early predictive value of urinary nephrin for neonatal AKI. Results:Among the 156 neonates enrolled in the study, 16 cases(10.2%) developed AKI.The median of urinary nephrin, urinary albumin and SNAP scores were 0.27 μg/mg uCr, 0.48 g/g uCr and 9 scores with AKI group, while the median of urinary nephrin, urinary albumin and SNAP scores were 0.16 μg/mg uCr, 0.16 g/g uCr and 7 scores with non-AKI group.When compared with non-AKI neonates, urinary nephrin ( Z=-3.201, P=0.001), urinary albumin ( Z=-2.652, P=0.008) and SNAP score ( Z=-2.611, P=0.009) were significantly higher in AKI neonates.Multiple linear regression analysis proved that urinary nephrin levels were significantly correlated with urinary albumin ( B=0.488, SE=0.117, P<0.001). Multivariate Logistic regression analysis revealed that urinary nephrin remained significantly associated with AKI ( P=0.018) after adjusting for confounding factors, including gestational age, birth weight, gender, SNAP score, mechanical ventilation and apnea.Urinary nephrin achieved AUC of 0.746 (95% CI: 0.606-0.886, P=0.001). Conclusions:As a biomarker of glomerular injury, urinary nephrin is significantly related to the occurrence of AKI and has early predictive value for AKI in critically ill neonates.
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Objective To analyze the relationship betWeen serum fibroblast groWth factor 23( sFGF23)and glomerular filtration function in critically ill children,and to investigate the predictive value of sFGF23 in glomerular fil﹣tration rate in critically ill children. Methods This prospective study included the children from the Pediatric Intensive Care Unit(PICU)of Children＇s Hospital of SoochoW University from May to August in 2012. A total of 143 critically ill children aged 1 to 156 months and Weighing 2. 5 to 46. 0 kg Were included. The levels of sFGF23 Were measured on the first day of admission. The pediatric risk of mortality Ⅲ score( PRISM Ⅲ)Was calculated based on 16 items Which Were collected during the first 24 hours of admission. Multivariable linear regression analysis Was used to assess the rela﹣tionship betWeen sFGF23 and estimated glomerular filtration rate( eGFR). A receiver operating characteristic( ROC) curve and the area under the ROC curve(AUC)Were calculated to assess the predictive strength. Results Of the total 143 children,8 cases(5. 4%)died during the first Week of admission to PICU. Regression analysis shoWed that sFGF23 levels Were significantly associated With eGFR,even after adjusted for age and body Weight,and sFGF23 achieved AUC of 0. 741 for predicting eGFR,Which Was statistically significant(95%CI:0. 624－0. 858,P﹦0. 002). Conclusions sFGF23 has a good correlation With glomerular filtration function in critically ill children. The sFGF23 has certain clinical application value in evaluating glomerular filtration function in the critically ill children.
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Objective To evaluate the curative effects of modified minimally invasive double eyelid operation and traditional embedding double eyelid operation.Methods Chinese and English databases including Wanfang Science and Technology Periodical Full-text Database,VIP Chinese Science and Technology Periodical Full-text Database (VIP) and CNKI,PubMed,Web of Science,Science Drirect Online and Cochrane Library were searched by computer.Some randomized controlled clinical trials that compared the effects of modified mini-eyelid operation and traditional embedding double eyelid operation were collected for this Meta analysis.Results The postoperative satisfaction of modified minimally invasive double eyelid surgery was higher than that of the traditional embedding double eyelid surgery (Z =6.16,P＜0.00001).The success rate of modified minimally invasive blepharoplasty surgery was higher than that of the traditional embedding double eyelid surgery (Z =4.84,P＜0.00001).Conclusions The clinical effect of modified minimally invasive double eyelid surgery is better than that of the traditional embedding double eyelid surgery.