Objective:To analyze and compare clinical characteristics and risk factors of patients with uremic encephalopathy (UE).Methods:A retrospective analysis was performed from January 2014 to January 2019 in our hospital. Seventy patients diagnosed with chronic kidney disease (CKD) at the end stage (according to diagnosis standard of CKD) complicated with UE were classified into the UE group. In principle matching with sex, age and duration of disease, seventy patients with chronic kidney disease at the end stage but without UE were classified into the non-UE group (NUE group). The demographic data, laboratory examination, CT or MRI examination were recorded and analyzed by using t or χ 2 test. In addition, independent risk factors of patients with UE were analyzed by using Logistic model. Results:A total of 70 patients in the UE group and 70 patients in the NUE group were collected. The proportion of patients with a history of alcohol comsumption, chronic obstructive pulmonary disease and polycystic kidney disease were higher in the UE group than in the NUE group ( P<0.05). There were no significant differences in hypertension, diabetes, and coronary artery disease history between the two groups ( P>0.05). The proportion of cerebral focus and lesions for brain white matter revealed by head CT or MRI in the UE group were significantly higher than that in the NUE group ( P<0.05). The serum NLR and UA levels in the UE group were higher than those in the NUE group ( P<0.05), but the serum ALB and FT3 levels in the UE group were lower than those in the NUE group ( P<0.05). Logistic regression analysis showed that serum NLR, ALB and FT3 levels were independent risk factors for UE patients. Conclusions:Cerebral focus and lesions for brain white matter revealed by CT or MRI are typical abnormal in UE patients. The serum NLR, FT3 and ALB levels are independent risk factor for UE patients.

Objective Study on the absorption,distribution,transformation,excretion and toxicity of four forms of arsenic in rats.Methods Four thousand and fifty data were obtained from 28 days animal metabolism experiments of 81 rats exposed to the four As species.Distribution,metabolism,excretion,and subacute toxicity of 4 As species were compared by analyzing the arsenate [As(V)],arsenite [As(Ⅲ)],methyl arsenate (MMAV) and dimethyl arsenate (DMAV) content of rat feces (excrement and urine),blood,seven organs,and liver and kidney pathology.Results After oral administration of each As species,82.9％ of As(Ⅲ),85.1％ of As(V),95.0％ of MMAV and 96.2％ of DMAV were accumulatively secreted via feces and urine,while 16.2％ of As(Ⅲ),14.1％ of As(V),4.65％ of MMAV and 0.120％ of DMAV were detected in blood.The DMAV accumulated in blood and urine after dosing As(Ⅲ),As(V) and MMAV,and the content of DMAV in the blood was 8 times greater than urine.Four kinds of arsenic had effects on rat liver and kidney function,the influence on liver was acute phase effect while that on renal was cumulative effects.The effect of As(Ⅲ) was the most significant,followed by MMAV.Four kinds of arsenic could cause tissue deformation and inflammatory cells infiltration,but showed no difference between groups.Conclusion The distribution,metabolism,excretion,and toxicity of the four kinds of arsenic in rats were different in varying degrees.The research of health risk for arsenic should consider its different forms.

Objective To synthesize 18F labeled N-(2-18 F-fluoropropionyl)-L-glutamine (18 F-FPGLN) for tumor PET imaging,and to perform its biodistribution study on normal mice and PC-3 tumorbearing nude mice.Methods 4-nitrophenyl-2-18F-fluoropropionate (18F-NFP) was synthesized on the MF2V-IT-I synthesizer and was purified by semi-preparative HPLC.Anhydrous 18F-NFP was added to a solution of L-glutanine t-butyl ester to synthesize 18F-FPGLN t-butyl ester,which was hydrolyzed by HCl (3 mol/L) and neutralized with NaOH (2 mol/L) solution.18F-FPGLN product was collected for further study.Biodistribution study was performed on normal Kunming mice and PC-3 prostate cancer tumor-bearing nude mice,respectively.Results 18F-FPGLN was synthesized with 10％-15％ (decay uncorrected) overall radiochemical yield after 130 min of radiosynthesis.The radiochemical purity was higher than 96％.Rapid and high uptake of radiotracer was observed within the kidneys,and was quickly excreted through the urinary bladder.The uptake in kidney reached (35.0±1.2) ％ID/g at 5 min post-injection,and descended to (1.5±0.3) ％ID/g at 120 min.The liver,lung,heart and small intestine showed relatively moderate uptake of radioactivity.The uptake in the pancreas,muscle,spleen,stomach and brain was low,and the lowest uptake of (1.5±0.3) ％ID/g was found in the brain at 30 min post injection.High accumulation of 18F-FPGLN in PC-3 xenograft was observed,and the tumor/muscle ratio reached 2.07 at 60 min post injection.Conclusion A novel N-position 18F-labeled glutamine analogs 18F-FPGLN,with favorable pharmacokinetic characteristics,is synthesized successfully,which makes it possible to perform tumor PET imaging using 18F-FPGLN subsequently.

Objective: The study aims to explore the associations of family functioning with sleep disturbance and depressive symptoms among primary and secondary school students, to provide scientific reference for preventing depression in primary and middle school students. Methods: A convenience sampling method was used to recruit 124 357 primary and secondary school students in Baoan District, Shenzhen. A self administered general information questionnaire, the Youth Self Rating Insomnia Scale, and the Patient Heath Questionnaire-9 were used to assess the students demographic characteristics, family functioning, sleep disturbance, and depressive symptoms. Results: About 34.6% of students reported moderate family dysfunction, and 8.7% reported severe family dysfunction. The prevalence rates of sleep disturbance and depressive symptoms were 13.0% and 13.1% in elementary and secondary school students, respectively. The prevalence rates of sleep disturbance and depressive symptoms were statistically significantly higher in girls(14.6%, 16.8%) than boys(11.6%, 9.9%) ( χ 2=255.25, 1 269.50, P <0.01). Depressive symptoms were positively correlated with sleep disturbance ( r =0.61) and negatively correlated with family functioning ( r =-0.31)( P <0.01). Family functioning moderated the relationship between sleep disturbance and depressive symptoms, and the positive predictive effect of sleep disturbance on depressive symptoms decreases as the level of family functioning increases. Conclusion Family functioning buffers the effects of sleep disturbance on depressive symptoms among primary and secondary school students. Attention should be paid to sleep quality among primary and secondary school students, to improve their family functioning, and thus decrease and prevent the occurrence of depression in adolescents.

OBJECTIVETo investigate long-term efficacy and safety of ambrisentan monotherapy in patients with pulmonary arterial hypertension (PAH).

METHODSPatients with PAH who received 2.5 mg or 5 mg of ambrisentan once daily between July 10, 2011 and August 30, 2012 for at least 6 months were enrolled. The efficacy endpoints were change in exercise capacity, World Health Organization (WHO) functional class and N-terminal pro-brain natriuretic peptide (NT-proBNP) level, echocardiographic parameters. The safety endpoint was the safety of long-term ambrisentan administration, as defined by the incidence and severity of adverse events.

RESULTSA total of 18 patients with PAH were enrolled. Mean age was (39 ± 17) years, 8 (55.6%) were female, and 11 (61.1%) patients were in WHO functional class III. The median duration of treatment was 17 months (range: 6-26 months). After treatment, the 6MWD was significantly increased[ (495 ± 97) m vs. (400 ± 91) m, P < 0.001], NT-proBNP was significantly reduced [308 (53-1 645) ng/L vs. 80(22-454) ng/L, P = 0.005], the systolic pulmonary artery was significantly decreased [(62 ± 30) mmHg vs. (82 ± 41) mmHg, P = 0.001] and left ventricular end diastolic diameter was significantly increased [(44 ± 6) mm vs. (40 ± 6) mm, P < 0.004] compared to pre-treatment. WHO functional class was improved compared with baseline in 11(61.1%) patients, stable in 7(38.9%) patients. No patient died during the treatment period. No patient was withdrawn from this study for safety reasons.

CONCLUSIONSLong-term treatment of ambrisentan can effectively improve the exercise capacity, reduce systolic pulmonary artery pressure and NT-proBNP in PAH patients. Ambrisentan is safe and well tolerated in Chinese PAH patients.

Adult ; Blood Pressure ; Female ; Humans ; Hypertension, Pulmonary ; drug therapy ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; metabolism ; Peptide Fragments ; metabolism ; Phenylpropionates ; therapeutic use ; Pyridazines ; therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the clinical characteristics and survival on Chinese patients with idiopathic pulmonary arterial hypertension (IPAH) and familiar pulmonary arterial hypertension (FPAH) during conventional therapy era and targeted therapy era.

METHODSIPAH and FPAH patients who were referred between Jan 1999 and Oct 2004 in Fuwai Hospital were defined as conventional therapy era group (before 2005 no PAH-specific drug was available in China). All patients in this group were followed up till Jun 2005. IPAH and FPAH patients who were referred between Sep 2006 and Aug 2011 were defined as targeted therapy era group (new PAH-specific drugs were available in China since 2006) were analyzed. All patients in this group were followed up till Dec 2013. The primary endpoints were death and therapy medicine.

RESULTSSeventy-two patients were enrolled in conventional therapy era group, 375 were enrolled in targeted therapy era group. The mean age was (35.9 ± 12.2) years and (34.5 ± 17.4) years respectively (P = 0.67), and women was predominant in both groups. There was no difference in WHO functional class and hemodynamic data between the two groups. About 90.3% patients were treated by calcium-channel blockers (CCB) in conventional therapy era group. In targeted therapy era group, almost all patients were treated by at least one PAH-specific drug, only 3.2% patients who had a positive response to acute pulmonary vasodilator testing were treated by CCB. The median survival time was 30.4 months in conventional therapy era group and 66.2 months in targeted therapy era group. The 1-, 2-, 3- and 5- year survival rates of IPAH and FPAH patients were 68.0%, 56.9%, 38.9% and 20.8% in conventional therapy era group, and 89.3%, 78.1%, 68.2% and 53.7% in targeted therapy era group respectively (P < 0.000 1).

CONCLUSIONCompared with conventional therapy era, the survival rate of Chinese IPAH and FPAH patients is significantly improved in targeted therapy era.

Adult ; Aged ; China ; epidemiology ; Familial Primary Pulmonary Hypertension ; epidemiology ; therapy ; Female ; Follow-Up Studies ; Humans ; Hypertension, Pulmonary ; epidemiology ; therapy ; Male ; Middle Aged ; Survival Rate ; Young Adult

Objective    To analyze the cause of death in low-risk cardiac surgery patients during postoperative period and discuss the prevention and treatment methods to increase the survival rate. Methods    We retrospectively analyzed the clinical data of 132 patients dead after cardiac surgery from January 2014 to December 2018, among whom 35 patients had a EuroSCORE Ⅱ score <4% (low-risk cardiac surgery patients), including 20 males and 15 females aged 62.7±13.4 years. The cause of death in these low-risk patients was analyzed. Results    The main causes of death were cardiogenic and brain-derived causes (60.0%), and infections and ogran failure (45.7%). Pulmonary infection and low cardiac output after surgery were the main causes of death. Cerebral infarction, malignant arrhythmia and multiple organ failure were the common causes of death. There were 4 deaths (11.4%) caused by accidents, including gastrointestinal bleeding caused by esophageal ultrasound probe, cough and asphyxia caused by drinking water, postoperative paralytic ileus and multiple perioperative allergic reactions caused by allergic constitution. Conclusion    Postoperative treatment and prevention for low-risk cardiac surgery patients should be focused on postoperative infection, and cardiac and brain function protection. Changes in various organ functions need to be closely monitored for preventing organ failure, accidents should be strictly controlled, and more details of intraoperative and postoperative treatment still need to be further improved.