Objective To investigate the risk factors of all-cause mortality in diabetic patients on peritoneal dialysis (PD).Methods As a single-center retrospective cohort study,all incident PD patients who were catheterized at the First Affiliated Hospital of Nanchang University between November 1,2005 and February 28,2017 were included.Patients were divided into diabetes mellitus group (DM group) and non-diabetes mellitus group (NDM group).Outcomes were analyzed by Kaplan-Meier method.Multivariate Cox proportional hazards models were utilized to assess the risk factors of all-cause mortality.Results A total of 977 patients were enrolled.Compared with NDM group,patients in DM group were older (47.5±14.4 vs 59.3±11.3,P ＜ 0.01),had more cardiovascular disease (CVD) (7.5％ vs 20.3％,P ＜ 0.01),higher levels of serum hemoglobin (78.2±17.2 vs 82.3±14.6g/L,P ＜ 0.01),and lower levels of serum albumin (36.1±5.0 vs 32.7±5.6 g/L,P ＜ 0.01).The one-,three-and five-year patient survival rates of DM and NDM group were 89.7％,56.0％,31.9％ and 94.7％,81.3％,67.4％,respectively.Survival rate was significantly lower in DM group than in NDM group (x2=63.51,P ＜ 0.01).Stratified analysis showed that DM group had significant lower survival rate than NDM group in patients younger than 70 years old (x2=73.35,P ＜ 0.01),while survival rate was similar between the two groups patients older than 70 years old (x2=0.003,P=0.96).Multivariate Cox proportional hazards model analysis showed that DM (HR:1.74,95％CI:1.27-2.38,P ＜ 0.01),age (HR:1.05,95％CI:1.04-1.06,P ＜ 0.01),leukocyte (HR:1.06,95％CI:1.00-1.12,P=0.04) and triglyceride (HR:1.19,95％CI:1.07-1.32,P ＜ 0.01) were all independent risk factors for all-cause mortality of PD patients.However,age (HR:1.05,95％CI:1.04-1.07,P＜ 0.01) and alkaline phosphatase (HR:1.01,95％ CI:1.00-1.01,P=0.02) were independent risk factors for all-cause mortality of diabetic patients.Conclusions Long-term survival rate was lower in diabetic PD patients than in non-diabetic PD patients.DM,age,leukocyte and triglyceride were independent risk factors of mortality in PD patients.Age and alkaline phosphatase were independent risk factors of mortality in diabetic patients.

Objective To explore the risk factors and characteristics in patients with peritoneal dialysis who died in different periods.Methods The clinical data of new peritoneal dialysis patients in the Department of Nephrology and Peritoneal Dialysis Center of the First Affiliated Hospital of Nanchang University from November 1,2005 to February 28,2017 was retrospectively analyzed.The patients were divided into two groups according to the time of death:those who died within one year and died after one year.The risk factors of mortality between the two groups were analyzed by Cox regression model.Results A total of 997 patients were enrolled and 244 patients died.There were 69 patients (28.3％) died within one year and 175 patients (71.7％) died after one year.Cardiovascular and cerebrovascular disease was the dominating reason of death in both groups,accounting for 59.4％ (died within one year group) and 51.4％ (died after one year group) respectively.Cox regression analysis showed that for died within one year group,old age (HR=1.035,95％ CI:1.016-1.055,P＜ 0.001),low blood total calcium (HR=0.167,95％ CI:0.053-0.529,P=0.002),low albumin (HR=0.899,95％CI:0.856-0.943,P ＜ 0.001) and low apolipoprotein A1 (HR=0.274,95％CI:0.095-0.789,P=0.016) were risk factors associated with mortality.However,for died after one year group,old age (HR=1.053,95％CI:1.038-1.069,P ＜ 0.001),combined with diabetes (HR=2.181,95％CI:1.445-3.291,P ＜ 0.001) and hypertriglyceride (HR=l.204,95％CI:1.065-1.362,P=0.003) were risk factors associated with mortality.Conclusions The risk factors of mortality for peritoneal dialysis patients of different periods were not exactly the same.For died within one year patients,old age,low blood total calcium,low albumin and low apolipoprotein A1 were independent risk factors for mortality.However,for died after one year patients,old age,combined with diabetes,and high triglycerides were independent risk factors for mortality.

Objective To explore the reasons for withdrawal from peritoneal dialysis (PD) in our hospital.Methods This was a single-center,retrospective cohort study.Patients who started PD in the Department of Nephrology,the First Affiliated Hospital of Nanchang University from November 1st,2005 to February 28th,2017,were enrolled,and followed up to May 31,2017.Patients who continued PD after May 31,2017 were as the control group.Patients who withdrew from PD were divided into 4 subgroups:death group,hemodialysis group,kidney transplantation group and loss of follow-up group.The clinical characters of 4 subgroups were compared with the control group.Results A total of 998 patients were enrolled with age of (49.36± 14.94) when PD started and median dialysis duration of 27.13(12.84,42.29) months,in whom 570 patients (57.11％) were male.Five hundred and seventeen dropout events were recorded,and the dropout rate was 51.80％.The main reason for withdrawal from PD was death (258 patients,49.90％),followed by hemodialysis (166patients,32.11％),kidney transplantation (66 patients,12.77％) and loss to follow-up (27 patients,5.22％).The leading cause of death was cardio-cerebro-vascular diseases (136 cases,52.71％),followed by infection (42 cases,16.28％),dyscrasia (20 cases,7.75％) and tumor (5 cases,1.94％).The main reason for transfering to hemodialysis was insufficient dialysis (76 cases,45.78％),followed by peritonitis (55 cases,33.13％) and catheter dysfunction (24 cases,14.46％).Compared with those in the control group,in the death group patients were older at PD commencement,and had higher proportions of hypertension,diabetes and cardio-cerebro-vascular diseases (all P ＜ 0.05).The proportions of male and diabetes mellitus were higher in the hemodialysis group than those in the control group (both P ＜0.05).Biochemical indicators showed that serum albumin and blood phosphorus were lower in the death group than those in the control group (both P ＜ 0.05);blood albumin was significantly lower in the hemodialysis group than that in the control group (P ＜ 0.05).Conclusions The main reasons for withdrawal from PD in our center are death and transfering to hemodialysis.The cardio-cerebro-vascular disease is the leading cause of death,and inadequate dialysis is the main reason for transfering to hemodialysis.

Objective:To study the clinical characteristics of neonatal sepsis caused by raoultella ornithinolytica.Methods:From January 2010 to December 2020, clinical data of seven cases of neonates with raoultella ornithinolytica sepsis in the Department of Neonatology of our hospital were analyzed. Literature published from the establishment of the databases to December 31, 2020 were searched and reviewed on this topic. The databases included PubMed, Web of Science, Embase database, Wanfang Database, CNKI, National Science and Technology Library and Chinese Science Paper Online.Results:Among the 7 cases admitted to our hospital, 6 male and 1 female, 6 premature and 1 full-term small-for-gestational-age (SGA), 6 patients presented with lethargy, 5 patients had fever and 3 showed dyspnea. 4 patients had necrotizing enterocolitis (NEC), 1 congenital intestinal malrotation, 1 congenital jejunal atresia, 1 intestinal adhesion and stricture. 4 patients had history of surgery. Leucocytosis was found in 3 cases and leukopenia in 1 case. Thrombocytopenia and increased inflammatory indicators were found in all cases. All 7 patients recovered and were discharged. 4 articles on 4 newborn cases (3 males, 1 female including two premature infants) were found for literature review. 3 cases had skin flushing, 3 cases showed dyspnea, 2 cases had fever and 1 case presented with lethargy. 1 case received surgery for congenital heart disease. Leucocytosis was found in 2 cases, leukopenia in 1 case, thrombocytopenia in 2 cases and elevated inflammatory indicators in 3 cases. 1 patient died due to septic shock and the other three recovered and were discharged.Conclusions:Raoultella ornithinolytica neonatal sepsis may occur in infants with intestinal comorbidities, history of invasive procedures, premature birth or full-term SGA and congenital malformations. Most anti-infective therapies are effective. However, if the patient had septic shock, the prognosis is poor.

Objective:To study the protective effect of polygalasaponin F (PGSF) on isoproterenol (ISO)-induced myocardial ischemia (MI) injury in neonatal rats and its possible mechanism.Methods:Fifty newborn Sprague Dawley (SD) rats were randomly divided into control group, model group, low, medium and high dose PGSF groups (5, 10, 50 mg/kg), with 10 rats in each group. The rats in the control group were treated with normal saline; Myocardial ischemia (MI) model was established in model group by subcutaneous injection of isoproterenol (ISO, 85 mg/kg, once a day); The MI model was established in rats of low, medium and high dose PGSF group after intraperitoneal injection of 5, 10 and 50 mg/kg PGSF for 7 days. The cardiac function of rats in each group was evaluated by echocardiography; pathological changes of myocardial tissue of rats in each group were observed by hematoxylin and eosin (HE) staining; The serum activities of troponin I (cTnI), creatine kinase isoenzyme (CK-MB), myoglobin (Mb) and lactate dehydrogenase (LDH) of rats in each group were detected by enzyme linked immunosorbent assay (ELISA); the content of malondialdehyde (MDA) and active oxygen species (ROS) in myocardial tissue were detected ; the expression of nuclear proliferation antigen (Ki67) and caspase-3 protein in myocardial tissue was detected by immunohistochemical staining; The expression of protein kinase B (AKT) and nuclear factor erythroid 2-related factor 2 (Nrf2) protein in myocardium was detected by Western blot.Results:In the model group, the myocardial structure was disordered, the cells were congested and swollen, and there were a lot of inflammatory cells infiltrating and large necrotic foci. The left ventricular wall thickness (LVWT), left ventricular ejection fraction (LVEF), fractional shortening (FS), heart rate (HR) and expression of Ki67 positive protein in the model group were lower than those in the control group (all P<0.05), while the left ventricular end systolic volume (LVESV), activities of cTnI, CK-MB, Mb, LDH in serum, content of ROS and MDA in myocardial tissue and caspase-3 positive protein in the model group were higher than those in the control group (all P<0.05). Compared with the model group, the degree of myocardial pathological changes in neonatal rats of the low, medium and high dose PGSF groups gradually decreased. Compared with model group, the LVWT, LVEF, FS, HR and expression of Ki67 positive protein increased in low, medium and high dose PGSF groups (all P<0.05), while the LVESV, activities of cTnI, CK-MB, Mb and LDH in serum, content of ROS and MDA in myocardial tissue and the expression of caspase-3 positive protein decreased (all P<0.05); Western blot results showed that the relative expression of phosphorylated(p)-AKT/AKT, p-Nrf2/Nrf2 protein in myocardium of model group was lower than that of control group (all P<0.05); The relative expression of p-AKT/AKT, p-Nrf2/Nrf2 protein in myocardium of low, medium and high dose PGSF groups were higher than that in the model group (all P<0.05). Conclusions:PGSF has protective effect on MI injury in neonatal rats, and its mechanism may be related to anti-apoptosis and anti-oxidative stress.

OBJECTIVE: To investigate the changes of iron metabolism index in patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds after ending iron dust exposure for 10 years. METHODS: A total of 22 patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds were selected as study subjects.They were misdiagnosed as electric welder's pneumoconiosis in 2004-2006. After ending exposure to iron dust for 10 years,high k V X-ray photography and computed tomography of chest were conducted. Indicators of serum iron metabolism,blood routine and blood biochemical were examined. Six patients were randomly selected to detect genes of hereditary hemochromatosis. The study subjects were divided into observation group( 13 patients) and control group( 9 patients)according to the lung examination. RESULTS: The median of serum ferritin( SF) was 858. 2 μg/L. The over standard rate of SF was 77. 3%( 17/22),and the iron overload was seen in 40. 9%( 9/22) of patients. The over standard rate of serum total iron binding capacity( TIBC) was 22. 7%( 5/22). The over standard rate of serum iron was 4. 5%( 1/22).The SF level of observation group was higher than that of the control group( P < 0. 05). The SF was positively correlated with alanine aminotransferase( ALT)( P < 0. 05). The serum TIBC was positively correlated with prealbumin( P <0. 05). The serum iron were positively correlated with ALT and aspartate aminotansferase respectively( P < 0. 05). But the above 3 iron metabolism indices were not correlated with the blood routine indices,blood glucose and C-reactive protein( P > 0. 05). The six patients tested for genes of hereditary hemochromatosis were excluded from disease. CONCLUSION: There were iron metabolism abnormalities in patients with occupational pulmonary thesaurosis induced by dust of iron and iron compounds,which is related to the iron deposition in lung.

【Objective】 To develop and implement a precise and efficient telephone recruitment strategy for apheresis platelet donors based on the information management of blood collection and supply process. 【Methods】 A telephone recruitment strategy based on the whole process information management of apheresis platelet donors (hereinafter referred to as telephone recruitment) was formulated From January 1, 2019, apheresis platelet donors in Hangzhou, registered in the intelligent blood donor recruitment system(hereinafter referred to as the recruitment system), were recruited by telephone calls or (and) SMS reminders to inform re-donation interval, key points of recruitment consultation, blood donation appointment time and other precautions. Response rate, pass rate and blood donation rate of donors before(in 2018) and after( in 2019) the implementation of telephone recruitment, as well as the above three rates during the COVID-19 epidemic in 2020 in Hangzhou were collected and analyzed by χ² test. 【Results】 The response rate, pass rate, and blood donation rate of apheresis platelet donors in Hangzhou before /after the implementation of telephone recruitment and during the COVID-19 epidemic were 28.52%(3 901/13 678)vs 30.52%(4 429/14 511)vs 39.36%(4 064/10 326), 73.80%(2 879/3 901)vs 77.83%(3 447/4 429)vs 78.20%(3 178/4 064)and 6.77%(2 879/42 553)vs 7.77%(3 447/44 366)vs 8.13%(3 178/39 077, respectively(P<0.05). In 2020, 85.94%(3 178/3 698) of apheresis donors were recruited by telephone(P<0.05). The proportion of apheresis donations successfully recruited by telephone in 2018 and 2019 accounted for 11.74% (2 879/24 519) and 12.48% (3 447/27 628), respectively(P<0.05), contributing 10.59% (4 030 U/38 040 U) and 11.38% (4 875 U/42 853 U) of units(P<0.05) that issued to the clinical. Due to the COVID-19 epidemic, the number of blood donors recruited by telephone and its proportion in 2020 decreased significantly as compared with those before the implementation of telephone recruitment (2019). 【Conclusion】 The telephone recruitment strategy based on the whole-process information management (system) of blood collection and supply can effectively improve the targeted recruitment of apheresis platelet donors and enhance its proportion of apheresis collection that issued to the clinical.

Objective To investigate the prevalence of iron deficiency(ID)and iron deficiency anemia (IDA) in pregnant women in urban areas of China. Methods The study was a national cross-sectional survey conducted from September 19th, 2016 to November 20th, 2016. According to the classification of the National Bureau of Statistics, all survey sites were set up in 6 regions of the country. Pregnant women were continuously selected using multistage stratified sampling. A total of 12 403 pregnant women were collected and examined for serum ferritin and hemoglobin levels. Results The median serum ferritin level during pregnancy was 20.60 μg/L(11.78-36.98 μg/L), the hemoglobin level was(118±12)g/L. With the progress of pregnancy, the levels of serum ferritin and hemoglobin decreased gradually. The median serum ferritin levels in the first, second trimester and third trimester were 54.30 μg/L(34.48-94.01 μg/L), 28.60 μg/L(16.40-50.52 μg/L), and 16.70 μg/L(10.20-27.00 μg/L)respectively(P<0.01). The mean hemoglobin levels were(127 ± 10)g/L,(119 ± 11)g/L and(117 ± 11)g/L respectively(P<0.01). The prevalence of ID in urban pregnant women was 48.16%(5 973/12 403), and IDA prevalence was 13.87% (1 720/12 403). The prevalence of IDA in the first, second trimester and third trimester were 1.96% (20/1 019), 8.40%(293/3 487)and 17.82%(1 407/7 897), respectively(P<0.01). The prevalence of standardized ID and IDA were significantly different in various regions of China(P<0.01). The standardized prevalence of ID were relatively higher in East China and Northeast China, 57.37% and 53.41% respectively, while it was the lowest in Southwest China, 30.51%. The standardized prevalence of IDA in South Central, Northwest, and East China were relatively high, 21.30%, 16.97% and 17.53% respectively, and the standardized prevalence of IDA in Southwest China was the lowest, 5.44%,the differents in various regions were significant(all P<0.01). Conclusion The current phenomenon of ID and IDA in pregnant women is still very common,and nutrition and health care during pregnancy should be strengthened.

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults and is poorly controlled. Previous studies have shown that both macrophages and angiogenesis play significant roles in GBM progression, and co-targeting of CSF1R and VEGFR is likely to be an effective strategy for GBM treatment. Therefore, this study developed a novel and selective inhibitor of CSF1R and VEGFR, SYHA1813, possessing potent antitumor activity against GBM. SYHA1813 inhibited VEGFR and CSF1R kinase activities with high potency and selectivity and thus blocked the cell viability of HUVECs and macrophages and exhibited anti-angiogenetic effects both in vitro and in vivo. SYHA1813 also displayed potent in vivo antitumor activity against GBM in immune-competent and immune-deficient mouse models, including temozolomide (TMZ) insensitive tumors. Notably, SYHA1813 could penetrate the blood-brain barrier (BBB) and prolong the survival time of mice bearing intracranial GBM xenografts. Moreover, SYHA1813 treatment resulted in a synergistic antitumor efficacy in combination with the PD-1 antibody. As a clinical proof of concept, SYHA1813 achieved confirmed responses in patients with recurrent GBM in an ongoing first-in-human phase I trial. The data of this study support the rationale for an ongoing phase I clinical study (ChiCTR2100045380).