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OBJECTIVE@#To investigate the effect of dexmedetomidine (DEX) on renal function after laparoscopic radical nephrectomy.@*METHODS@#We reviewed the clinical data of 282 patients with renal cell carcinoma (RCC), who underwent laparoscopic radical nephrectomy (LRN) in the Department of Urology, Third Medical Center of PLA General Hospital from November, 2020 and June, 2022.According to whether DEX was used during the operation, the patients were divided into DEX group and control group, and after propensity score matching, 99 patients were finally enrolled in each group.The incidence of acute kidney injuries were compared between the two groups.Serum creatinine (sCr) data within 3 months to 1 year after the operation were available in 51 patients, including 26 in DEX group and 25 in the control group, and the incidence of chronic kidney disease (CKD) was compared between the two groups.@*RESULTS@#After propensity score matching and adjustment for significant covariates, there were no significant differences in postoperative levels of sCr, cystatin C (CysC), β2-microglobulin (β2-MG), hemoglobin (Hb), or C-reactive protein (CRP), extubation time, incidence of AKI, or length of hospital stay between the two groups (P>0.05).The intraoperative urine volume was significantly higher in DEX group than in the control group (P < 0.05).A significant correlation between AKI and CKD was noted in the patients (P < 0.05).The incidence of CKD did not differ significantly between the two groups (P>0.05).@*CONCLUSION@#DEX can not reduce the incidence of AKI or CKD after LRN.
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Humanos , Dexmedetomidina , Incidência , Pontuação de Propensão , Insuficiência Renal Crônica/epidemiologia , Neoplasias Renais/cirurgia , Nefrectomia/efeitos adversos , Laparoscopia/efeitos adversos , Injúria Renal Aguda/prevenção & controle , Estudos RetrospectivosRESUMO
Objective To investigate the clinical characteristics and the pathogens of recurrent urinary tract infection (RUTI) after renal transplantation.Methods The data of adult recipients with UTI from November 2011 to December 2016 were retrospectively analyzed.The recipients were divided into single UTI (SUTI) group and RUTI group.The clinical characteristics and pathogens were analyzed,and the independent risk factors of RUTI were analyzed using logistic regressionmodel.Results Fifty-three cases were selected,including 29 cases of SUTI and 24 cases of RUTI.The positive rate of blood culture (55％ vs.25％,P =0.042) and the concentration of FK506 in the peri-infection period (11.0 + 3.4 ng/mL vs.8.6 + 3.2 ng/mL,P =0.024) in the RUTI group were significantly higher than that those in the SUTI group at the first UTI.The increased concentration of FK506 in the peri-infection period at the first UTI was an independent risk factor for RUTI (β:0.282,95％ CI:1.026-1.713,P＜0.05).There were 86 infection events in 53 patients,and pathogenic microorganisms were cultured in blood culture and urine culture for 86 times.The positive frequency of culture in the RUTI group was higher than that in the SUTI group,but not significantly.The most common pathogenic microorganisms included Escherichia coli (17 times),pseudomonas aeruginosa (16 times),and Enterococcus (16 times).Conclusion Reduction of the FK506 concentration during the peri-infection period at the first UTI is the key to prevent RUTI after renal transplantation.The empirical antibiotics for RUTI should be sensitive for Escherichia coli (ESBL +)and pseudomonas aeruginosa.
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Four patients with coexistence of sarcoidosis and primary Sj(o)gren syndrome (pSS) were retrospectively analyzed.All patients were female,who were referred to our department mainly because of respiratory symptoms.Positive antinuclear antibody (ANA) was detected in 2 patients and anti-Sj(o)grens syndrome A (SSA) antibody positive in 1 patient.All patients presented specific histologic patterns of both sarcoidosis and pSS.Publications related to coexistence of these two diseases were reviewed.Forty-one patients were finally included in the analysis,among whom 37 confirmed patients were from literature search.There were 37 women and 4 men.The main clinical features presentation were xerophthalmia in 40,xerostomia in 38,hilaradenopathies in 28,interstitial lung disease in 15,respiratory symptoms in 13.The main immunologic data were positive ANA in 23,SSA antibody in 19,anti-Sj(o)grens syndrome B antibody in 10 and rheumatoid factor in 12.All patients presented specific histologic patterns of both diseases.Patients with both sarcoidosis and pSS of ten represent multisystemic involvement and positive immunologic parameters,as well as the dual expression of specific histologic characteristics.
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0.05).The apoptotic percentage was increased significantly after X-rays irradiation with the dose of 6 Gy(P
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Objective To study the effects of whole-body irradiation(WBI)with different doses of X-rays on apoptosis in mouse splenocytes and peritoneal macrophages.Methods The apoptosis percentages of mouse splenocytes and peritoneal macrophages were detected with flow cytometry(FCM)at different time after the whole-body X-irradiation using the staining of Annexin-V and PI.Results As compared with the control,the percentage of apoptosis in mouse splenocytes began to increase gradually 24 h after WBI with 2 Gy X-rays(P
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Objective To determine the optimal dose range of naloxone to enhance the analgesic effect of morphine.Methods One half of a total of 84 adult male Sprague-Dawley rats were randomly assigned into seven groups(6 rats for each group).Rats in group NS received normal saline,and in group M received 6mg/kg of morphine.Different doses of naloxone(1?g/kg,100ng/kg,10ng/kg,1ng/kg and 0.1ng/kg)with 6mg/kg of morphine were given to the rats in group MN1,group MN2,group MN3,group MN4 and group MN5.Pain thresholds were determined at different time points before and after subcutaneous injection of normal saline or morphine or mixture of the drugs(morphine and naloxone).Another 42 rats were randomly assigned into seven groups similar to the above grouping,but the morphine doses for group M and groups MN were changed to 2mg/kg.Acute pain was prodused by an in cision on the hind paw.Then they were given subcutaneous injection of the drugs in different doses as categorized above.Cumulative pain scores were observed within an hour.Results Compared with group NS,the pain thresholds of all the other groups were significantly increased at the time points from 5 minutes to 120 minutes after subcutaneous injection(P0.05).Conclusions Low-dose of naloxone can enhance the analgesic effect of morphine,and the dose range 1ng/kg~100ng/kg may be acceptable.Dose of 1?g/kg naloxone may antagonize the analgesic effect of morphine,while dose of 0.1ng/kg naloxone,perhaps,is too low to show an effect.
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0.5 mV and change in color of myocardium. Blood samples were taken from right atrium for determination of plasma SOD activity and plasma MDA level and from coronary sinus and artery for determination of blood lactate level before occlusion of LAD ( T0 ) , before reperfusion (T1),1,2,3,4,5,6 h after reperfusion (T2-7 ) . Myocardial lactate production was calculated from the difference between coronary sinus and arterial blood lactate concentrations. Results ( 1) In HTEA group HR, MAP and CVP decreased by 22% , 25% and 28% after epidural blockade, while in control group there was no significant change after epidural saline. (2) In HTEA group plasma SOD activity started increasing at T6 and blood MDA level decreased at T4 and T5, whereas in control group blood SOD activity started decreasing and blood MDA level started increasing at T3 . (3) Myocardium released no lactate before ischemia. Myocardial lactate release greatly increased during ischemia and started decreasing after reperfusion in both groups. But myocardial lactate production was significantly less in HTEA group than that in control group. (4) One animal died from ventricular fibrillation at the beginning of reperfusion in HTEA group while in control group four animals died. Conclusion HTEA can alleviate the myocardial ischemia-reperfusion injyry by blocking sympathetic nervous activity.