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Objective:To investigate the relationship between plasma factor VIII (FVIII) level and the clinical indicators and prognosis in IgA nephropathy (IgAN) patients.Methods:The clinical data of IgAN patients diagnosed from the Second Xiangya Hospital of Central South University from January 2016 to December 2016 were collected. Patients were divided into high FVIII group (FVIII>140.50%) and low FVIII group (FVIII≤140.50%) according to the time-dependent receiver operating characteristic curve analysis. The baseline clinical parameters at the time of renal biopsy between two groups of patients were compared. Taking the estimated glomerular filtration rate (eGFR) reduction ≥30% or entering end-stage renal disease (ESRD) as the endpoint event, Kaplan-Meier analysis and Cox proportional hazards models were used to explore the association between plasma FVIII level and prognosis in IgAN patients.Results:A total of 93 patients were ultimately retained for this study, with a median follow-up of 35.15(33.77, 36.76) months. Twelve (12.90%) patients reached the endpoint event. The levels of serum creatinine, urea nitrogen, triglyceride, total cholesterol, plasma fibrinogen, D-dimer, 24-hour urinary protein, protein C, protein S, slope of eGFR and age in the high FVIII group were higher than those in the low FVIII group (all P<0.05). The levels of eGFR, serum albumin and follow-up time in the high FVIII group were lower than those in the low FVIII group (all P<0.05). The renal cumulative survival rate was significantly lower in the high FVIII group than that in the low FVIII group ( χ2=5.635, P=0.018) according to the Kaplan-Meier analysis. After adjusting for variables such as systolic blood pressure, eGFR, urinary protein, and renal tubular atrophy/interstitial fibrosis, multivariate Cox proportional hazards models analysis showed that high level of plasma FVIII was an independent risk factor for poor prognosis in IgAN patients ( HR=4.147, 95% CI 1.055-16.308, P=0.042). Conclusions:The level of plasma FVIII is associated with clinical indicators and prognosis in IgAN patients. The higher level of plasma FVIII can be identified as an independent risk factor for poor prognosis in IgAN patients.
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Objective To investigate the distribution of school students' HBsAg in Xianju county, and the effect of the Hepatitis B vaccine in terms of students' HBV infection after the implementation of planned immunization. Methods HBsAg was tested by ELISA, and then analyze the students' HBsAg carrier rate. Results The positive rate of students' HBsAg in Xianju county was 2.28%. There was no significant difference between boys and girls.The HBsAg-positive rate is highest in high school and secondary in junior school and lowest in primary school, there was significant difference in different grades (P<0.05). The HBsAg-positive rate was increased with increasing age. Conclusion Xianju county achieved remarkable results in the prevention of Hepatitis B in children and adolescents in recently 20 years. Hepatitis B vaccine immunization program is the main effective measures to prevent Hepatitis B infection in children.
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Cirrhotic portal hypertension can lead to serious complications including esophageal variceal bleeding. Hepatic venous pressure gradient (HVPG) and upper gastrointestinal endoscopy can be used to evaluate the severity of portal hypertension and predict the risk of bleeding. However, both methods are invasive, which limits their clinical practice. Therefore, noninvasive techniques for the evaluation of portal hypertension will have certain advantages in clinical practice. This article introduces the noninvasive methods for the measurement of spleen stiffness, including transient elastography, acoustic radiation force impulse, real-time tissue elastography, and magnetic resonance elastography, as well as the value of these methods in evaluation of portal hypertension and influencing factors. It is pointed out that the difference in the diagnostic efficiency of spleen stiffness measured by these methods in portal hypertension needs to be verified by further studies.
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Objective To explore the efficacy and the safety of clinical trials of pemetrexed combined with carboplatin and gemcitabine with carboplatin in treating advanced NSCLC of the elderly patients.Methods A total of one hundred and twenty-eight elderly patients with advanced NSCLC were randomly divided into two groups(n=64).The PC group in which patients were treated with pemetrexed combined with carboplatin,and the GC group in which patients were treated with gemcitabine combined with carboplatin.The effects and the safety were assessed by the following indexes, treatment efficiency,side effects,LCSS. Results The treatment efficiency of the PC group and the GC group were 34.38% and 31.25% after chemotherapy.The difference was no statistically significant between two groups.The difference of LCSS was no statistically significant between two groups.Except hair loss,the incidences of nausea and vomiting,leukopenia,thrombocytopenia and neurotoxicity (grade III-IV )in the PC group (6.25%,3.13%,4.67%,7.81%)were significant lower than those in the GC group(17.18%,20.31%,15.63%,18.75%)(P<0.05).The 1-year and 2-year survival rates of the PC and GC groups were 46.2% VS 46.8% and 13.3% VS 12.5%,respectively,with a median survival of 12.1 VS 1 1.3 months,without a statistically significant difference between two groups.Conclusion PC and GC show similar efficacy for elderly NSCLC patients,however,the toxicities in PC patients are lower than those in GC patients.Thus,pemetrexed combined with carboplatin is an effective therapeutic regimen for advanced NSCLC in elderly patients.
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This study was aimed to investigate the effects of different doses of dexamethasone (Dex) on bone quality in rats. Thirty-one SD rats were randomly divided into 4 groups, Control (7 with saline), Dex-L (8 with 1 mg Dex. / kg), Dex-M (8 with Dex. 2.5 mg/kg), Dex-H (8 with Dex. 5 mg/kg), with tail injection, twice per week for 8 weeks. All the rats were killed then. Their proximal tibia were processed into undecalcified sections and measured for bone histomorphometry. The content of Ca2+ and hydroxyproline in their left ulnars were tested. Bone mineral density (BMD) and biomechanical property of the thigh bone were tested to observe the qualities of bone. Compared to the control group, the bodyweights of the rats in different Dex treatment Groups decreased remarkably. Percent labeled perimeter (%L. Pm), Mineral apposition rate(MAR), Bone formation rate (BFR/BV) and so on reduced significantly. Percent trabecular area (%Tb. Ar) and Trabecular number (Tb. N) were obviously higher while Trabecular separation (Tb. sp) was remarkablely lower than those of the control group. BMD in Dex-L and the content of hydroxyproline in Dex-M reduced notablely. Biomechanical property of Dex groups decreased significantly. Dex suppressed bone formation and reduced bone turnover significantly. As the increase doses of Dex, %Tb. Ar increased, and, on the contrary, BMD and biomechanical property decreased with the reduced matrix in bone at the same time. It suggested that non-mineralized bone formation increased and biomechanical property deceased. The doses of 1 mg/kg Dex had the most obvious effect on bone quality. This dose slightly increased %Tb. Ar, however, bone formation, bone biomechanical property and matrix in bone decreased obviously. Diffferent doses of Dex have different effects on bone qualities. However the dose has no direct influcing ratio to the bone qualities.