Objective To investigate the relationship between fetuin A and left ventricular function and their influences on residual renal function(RRF) in peritoneal dialysis patients.Method Eighty patients recently initiating peritoneal dialysis were enrolled into this study and were divided into high fetuin A group and low fetuin A group accordin to the value of serum fetuin A concentration.Hemoglobin,high sensitive C reactive protein(hsCRP),calcium,phosphorus,albumin,lipoproteins and left ventricular myocardial performance index(LV-MPI) were examined.All these patients were followed up for 12 months,to discover the parameters' differences between two groups and to investigate the association between fetuin A and left ventricular function and RRF.Results At the beginning of the study,there was no difference of hsCRP,calcium,phosphorus,albumin,lipoproteins and LV-MPI,estimated glomerular filtration rate (eGFR) between two groups;After 12 months follow-up,MPI was obviously shorter (P ＜ 0.05) and RRF was obviously higher (P ＜ 0.05) in high fetuin A group than thosein low fetuin A group.Compared with the beginning of the study,LV-MPI was significantly increased and eGFR was significantly decreased after 12 months follow-up (both P ＜ 0.05) in low fetuin A group,but no obviously change of LV-MPI or eGFR was found in high fetuin A group after followup.Pearson correlation analysis discovered an obvious negative correlation between fetuin A and MPI (r=-0.680,P ＜ 0.01).Multiple regression analysis indicated that eGFR had positive correlation with fetuin A (B=0.058,t=3.679,P＜ 0.01) and negative correlations with MPI (B=-0.511,t=-2.903,P=0.007),age(B=-0.144,t=-4.013,P＜0.01).Diabetes was risk factor to loss of RRF (B=-2.031,t=-2.759,P ＜ 0.05).Conclusion Fetuin A has very close relationship with left ventricular function.Decreased serum fetuin A level and decreased left ventricular function are risk factors to the loss of the RRF in ERSD patients.

Objective To investigate the association of vascular calcification,fetuin A and Creaction protein (CRP),and explore the influence on cardiovascular events.Methods Sixty peritoneal dialysis (PD) patients were enrolled in this study.Carotid intima-media thickness (cIMT),fetuin A and CRP,along with the other serum related parameters were detected to find out their influence on vascular calcification in PD patients.The relationship between cIMT,fetuin A,CPR and cardiovascular events was analyzed in PD patients with 18 months followed-up.Results Of the 60 PD patients,carotid intima-media thickness (cIMT) was increased in 38 patients(63.3％).Compared with the non-increased cIMT patients,serum fetuin A concentration was significantly decreased(P ＜ 0.05),CRP(P＜0.01) and calcium × phosphate products(P＜0.05) were significantly increased in the highincreased cIMT group.Compared with the low-increased cIMT patients,fetuin A concentration was obviously lower(P ＜ 0.05) and calcium×phosphate products were obviously higher(P ＜ 0.05) in the highincreased cIMT group.Linear regression analysis discovered an obvious negative correlation between CRP and fetuin A(R2 =0.629,F=47.522,P ＜ 0.01),as well as fetuin A and calcium×phosphate products (R2=0.299,F=11.948,P=0.002).Multiple regression analysis indicated that fetuin A was independently negatively correlated with cIMT(B=-0.019,t =-6.042,P ＜ 0.01).At 18 months,there were 36 newly-happened cardiovascular events and among which 6 cases died.Logistic regression analysis found that increased cIMT was risk factor to cardiovascular events in PD patients(OR=3.691,95％CI 1.467-9.258,P=0.006).Conclusion Decreased fetuin A and increased calcium×phosphate products deteriorate carotid calcification in PD patients.Micro-inflammation of PD patients represented by high CRP levels may increase calcium×phosphate products by depressing the fetuin A level,and in the end will stimulate carotid calcification.Increased cIMT is a risk factor for cardiovascular events.

OBJECTIVETo investigate the association of fetuin-A with residual renal function and carotid artery calcification in patients with chronic kidney disease (CKD).

METHODSBlood examples were collected form 60 CKD patients in stages CKD3 to CKD5 (20 patients per stage) for measurement of serum fetuin-A, albumin, calcium, phosphorus and parathyroid hormone, cholesterol, triglycercide, low-density lipoprotein, and high-density lipoprotein. MDRD equation was used to calculate the estimated glomerular filtration rate (eGFR), and ELISA was used to detect serum fetuin-A. Color Doppler ultrasound was performed to measure carotid intima-media thickness (CIMT).

RESULTSAs the eGFR decreased, serum fetuin-A significantly decreased in CKD5 stage compared with that in CKD4 stage (P<0.05); compared with that in CKD3 stage, serum fetuin-A level was significantly lowered in CKD4 stage (P<0.05). Linear regression analysis suggested a significant positive correlation between fetuin-A and eGFR. The rate of carotid artery calcification was the highest in CKD5 stage. Rank correlation analysis showed a negative correlation between fetuin-A and cIMT, and logistic regression analysis identified decreased serum Fetuin-A as a risk factor of carotid artery calcification.

CONCLUSIONSerum fetuin-A decreases following the decrease in eGFR, and decreased serum Fetuin-A level is a risk factor of carotid artery calcification in CKD patients.

Adult ; Calcinosis ; etiology ; Carotid Artery Diseases ; etiology ; Carotid Intima-Media Thickness ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Middle Aged ; Renal Insufficiency, Chronic ; blood ; complications ; physiopathology ; Risk Factors ; alpha-2-HS-Glycoprotein ; metabolism

Objective:To explore a solution for the construction of the CCI index with an example of cerebral infarction to provide a guide for adjusting the policy of Diagnosis-Intervention Packet.Methods:Lasso regression was used to screen for comorbidities to construct the model,K-means clustering was used for case severity categorization.CCI indices were calculated as one plus the sum of standardized regression coefficients.Results:According to the analysis,five key variables were found,including other disorders of the lungs,non-insulin-dependent diabetes mellitus with ketoacidosis,systemic inflammatory response syndrome of non-infectious etiology with organ failure,acute duodenal ulcer with bleeding,and chronic obstructive pulmonary disease with acute lower respiratory tract in-fection,with CCI indices of 1,1,1.026,1.034,and 1.101.Simulated calculation's result showed a decrease in medical insurance pay-ment losses after applying CCI indices.Conclusion:The CCI index construction scheme based on Lasso regression and K-means clus-tering is reasonable and effective.

The community-friendly program " Online mobile payment of medical insurance" , launched by Guangzhou Municipal Medical Insurance Bureau, poses new challenges to hospital medical insurance management and information intelligence. To this end, the Second Affiliated Hospital of Guangzhou Medical University staged from January 2017 to March 2019 kept upgrading its IT system and built an intelligent monitoring system for medical insurance. These efforts prepared adequately for the medical insurance mobile payment, and explored a mode of medical insurance management, evolving from extensive management to standard and fine management.

Objective To utilize sophisticated CT-driven radiomics to prognosticate the mutation situation of KRAS in patients with colorectal cancer(CRC).Methods A total of 393 patients who underwent KRAS mutation testing and preoperative triphasic enhanced CT were analyzed retrospectively.All patients were divided into training group(n=276)and validation group(n=117)with a ratio of 7∶3.The characteristics tightly associated with KRAS mutation were extracted and screened to construct three models,include clinical,radiomics,and clinical-radiomics fusion models for prediction of KRAS mutation.The performance and clinical utility of these three models were assessed via receiver operating characteristic(ROC)curve and decision curve analysis(DCA).Results The study identified significant correlations between KRAS mutation and CEA,CA199,and a set of 13 radiomics features,respective-ly.Based on these clinical indicators and radiomics features,clinical,radiomics,and clinical-radiomics fusion models were constructed to prognosticate KRAS mutation.The radiomics model construc-ted in this study had good performance for the prediction of KRAS mutation status in CRC patients.Most notably,a clinical-radiomics nomogram that amalgamated both clinical risk factors and radiomics parameters emerged as the most effective predictor of KRAS mutation,with an area under the curve(AUC)of 0.782 and 0.744 in the training group and validation group,respectively.Conclusion The refined CT radiomics model serves as a robust,non-invasive,quantitative tool for the assessment of KRAS mutation status in CRC patients.

Internal injury of seven emotions is an important proposition in etiology of traditional Chinese medicine.In view of the urgent social problem of brain aging,our research group put forward the hypothesis that"Liver failing to facilitate the coursing of Qi caused by long-term accumulation of negative emotions accelerates the process of brain aging".Firstly,establish the rat model of long-term negative emotional stress by indirect electric shock,and create films that induce anger.Secondly,through the perspective of animal experiments,case-control and normal population,it is revealed that the long-term accumulation of either single negative emotion(anger)or compound negative emotion can accelerate the process of brain aging and its mechanism.It also found the possibility biological basis of excessive and insufficient of liver catharsis in traditional Chinese medicine,and deepened the understanding of the individual differences of liver Zang Xiang syndrome and physiological function.Finally,with the help of event-related potentials(ERPs)and functional magnetic resonance imaging(fMRI),it is found that the potential objective diagnostic indexes of mild cognitive impairment(MCI)patients with long-term liver qi stagnation,and Liver Soothing method can improve their cognitive function,and reveal its therapeutic mechanism.The above research is helpful to make up for the defects of target emotion induction,improve the TCM etiology and pathogenesis theory of brain aging,provide possible biological indexes for early warning of diseases induced by abnormal of liver facilitate the coursing of Qi,and provide reference for early screening,diagnosis and treatment of MCI.

Objective Using event-related potentials(ERPs),to study the effect and mechanism of negative emotion accumulation hepatic insufficiency on working memory in normal people.Methods Fifty subjects in each of the emotionally stable group and emotionally unstable group were given two load tasks(0-back and 1-back)in the N-back paradigm,the reaction time and correct rate were recorded,and the ERPs components N200 and P300 were detected.The latency and amplitude of P300 were analyzed statistically.Results ①Compared with the emotionally stable group,the emotionally unstable group had a longer reaction time(P<0.05).②Compared with the emotionally stable group,the subjects in the emotionally unstable group had prolonged N200 latency,decreased P300 amplitude significantly(P<0.05),and P300 latency had a tendency to extend(P<0.1).Conclusion Long-term accumulation of negative emotions and liver failure in normal people have the performance of decreased working memory,which may be related to the reduction of attention resource allocation and the impairment of cognitive processing function.