Objective To determine whether plasma Leptin level is associated with atherosclerosis in maintenance hemodialysis(MHD)patients.Methods During 1997-01~2003-06,plasma Leptin levels in MHD patients and healthy volunteers were measured and intima-media thickness(IMT)and prevalence of atherosclerotic plaques of the extracranial common carotid artery were also measured.Results Plasma Leptin levels in the MHD patients were higher than those in the healthy volunteers(P

Objective To assess the effect of continuous renal-replacement therapy (CRRT) dose on the outcome of acute renal failure (ARF) patients with meta-analysis of randomized controlled trials (RCTs). Methods Studies were identified by systematic search of peer-reviewed publications in Medline, EMBASE and Cochrane library database through June 2010. All the RCTs that compared the incidence of clinical outcome such as mortality, need for chronic dialysis between standard and low dose CRRT were eligible. The pooled relative risk (RR) for clinical outcome was compiled using a random-effects model. Heterogeneity was evaluated by means of subgroup and sensitivity analysis. Results Six eligible studies were identified. By meta-analysis, standard dose CRRT was associated with non-significant 13% mortality risk reduction (RR 0.87, 95%CI 0.70-1.07, P=0.19)and 13% composite outcome risk reduction of chronic dialysis dependence and mortality (RR 0.87, 95%CI 0.69-1.09, P=0.21), but the trend toward increased chronic dialysis dependence risk among survivors (RR 1.43, 95%CI 0.94-2.18, P=0.09). The overall test for heterogeneity among cohort studies was significant (P=0.001, I2=76.2%). The risk of mortality was modality was significantly lower in some studies of which delivered dose was moer than 35 ml·kg-1·min-1,modality was continuous venous-venous hemofiltration (CVVH) and major cause was non-sepsis treated with standard dose CRRT. Conclusions Standard dose CRRT in patients with ARF does not improve survival, renal recovery and composite outcome, but decreases mortality in important subgroups including those with higher delivered dose, CVVH and non-sepsis.

Objective To summarize the experience of the trans-unilateral nasal and sphenoidal approach to pituitary denomas.Methods 20 cases of pituitary adenomas were removed by the trans-unilateral nasal and sphenoid approach under operating microscope,of which there were 2 microadenoma patients,16 macroadenoma patients;2 giant pituitary adenoma patients.Results Of all the 20 patients,12 had total resection of tumor;4 had subtotal resection of tumor and 4 had part resection of tumor.All cases showed improvement.After the operation,3 had diabetes insipidus and 2 had CSF rhinorrhea,which had been cured by the time they left the hospital.Conclusion this method is minimally invasive with short operative distance,time and fewer complications.

0.05). In RAC group, the Na +,K + ATPase activity of the left kidney decreased compared with that of the right kidney (1.96?0.42 vs 5.33?0.77, P

To explore the relationship between serum 1,25(OH)2D3 and oxidative stress in patients with diabetic nephropathy (DN).The serum levels of 1,25(OH)2D3 in DN patients were significantly lower than those in DM and healthy controls.And the 1,25(OH)2D3 level was negatively correlated with advanced oxidation protein products ( AOPP ) , reactive oxygen species ( ROS ) and positively correlated with superoxide dismutase (SOD) in DN patients.1,25(OH)2D3, low density lipoprotein-cholesterol (LDL-C), body mass index ( BMI) , serum creatinine and age were associated with the level of oxidative stress in DN patients.With the progression of CKD , the serum levels of AOPP and ROS increased significantly while those of SOD and 1,25(OH)2D3 decreased markedly.

Objective To estimate dry weight (DW) and prevent dialysis-related hypotension and hypertension with the on-line monitoring of relative blood volume (RBV) and other judgments.Methods One hundred and eight maintenance hemodialysis patients were assigned to three groups according to their blood pressure:normal blood pressure group (A group,n=43),hypotension group (B group,n=35) and hypertension group (C group,n=35).The level of hemoglobin,serum albumin,dialysis adequacy were determined.Systolic blood pressure,diastolic blood pressure,mean arterial pressure,heart rate,ultrafiltration volume,relative blood volume changes and the corresponding clinical symptoms were monitored during hemodialysis in all patients.Each of the patients was continuously monitored of the indicators above for 10-12 times.At the observing period,the inferior vena cava diameter (IVCD),brain natriuretic peptide (BNP) and cardiothoracic ratio(CTR) were measured.Then according to the monitoring results,appropriate clinical interventions were given under on-line blood volume monitoring guidance.Results (1)The shape of RBV curve in group A showed doubleexponential curve early,then down to the final linear decling ended during hemodialysis.(2)The RBV curve in group B was stable in the former two hours,then rapidly linear declined.RBV changes were significantly higher in group B than group A (P ＜ 0.05),but when changes in RBV were plotted against ultrafiltration volume,there was no significant difference in the two groups.The level of RBV reduction at which symptomatic hypotension occurred showed considerable inter-individual variability (P ＜ 0.05,coefficient of variation=0.28).(3)The RBV curve in group C slowly linear declined.At the end of dialysis,RBV changes were significantly lower in group C than group A (P ＜ 0.05).(4)The IVCD values in three groups of patients before dialysis were greater than normal,significantly decreased after the dialysis (P ＜ 0.05),but that in group B and group C were still greater than that in group A (P ＜ 0.05).The BNP values were significantly greater in three groups before and after dialysis (P ＜ 0.05),but after dialysis,the values decreased significantly than that before dialysis (P ＜ 0.05).(5)After appropriate clinical intervention were given under on-line blood volume monitoring in hemodialysis,the patients of group B controlled weight gain,and even cut dry weight,the RBV change significantly decreased at the end of dialysis and significantly reduced the incidence of hypotension events (P ＜ 0.05); When the patients of group C cut dry weight,increased ultrafiltration,the RBV change increased,the mean arterial pressure decreased significantly than before (P＜ 0.05).Conclusions (1)Hemodialysis patients with symptomatic hypotension show larger RBV decline rate in the forth hour and lager total RBV changes,which provides important information for forecasting the symptomatic hypotension in hemodialysis.(2)IVCD and CTR have certain significance to the adjustment of dry weight,but the BNP has guiding significance to volume change.(3)On-line monitoring of RBV can effectively guide the adjustment of dry weight,reduction of symptomatic hypotension occruence,and controlling of refractory hypertension in hemodialysis.

Objective To summary the experience of microsurgery of meningioma in skull base treatment. Methods To study the clinical data of 10 cases patients of meningioma in skull base who were subjected to microsurgery by using retrospective analysis. Among the 10 patients, there were 3 cases of meningioma of the olfactory groove. There were 2 cases of sphenoid ridge meningioma, meningioma in the middle cranial fossa, meningioma in the cerebellopontine angle respectively.There was 1 case of meningioma of velarium in temporal lobe. Results In 7 cases, the meningioma was completely removed. And in another 3 cases, the meningioma got subtotal resection. During and after the operation, there were no severe complications observed or death occurrence in all the 10 cases of meningioma patients. Two months post of operation,all patients got a significant amelioration in their symptoms. A total of 9 cases were followed up. There was 1 case of IIa type meningioma recurred. Conclusion To elevate the whole shearing rate of meningioma in skull base and reduce the mortality of it,it is most important for appropriate operative route selection and well mircosugical technique application.

Objective To modify the purified water analysis methods in the Chinese Pharmacopoeia (Vol .Ⅱ ,Edition 2010) ,and mainly focus on the pH value determination ,analysis of nitrate and nitrite ,and the inspection of microorganism . Methods The usage of regents and colorimetric tubes in the analysis of nitrate and nitrite were inquired ,the feasibility of plat-ing culture used in the inspection of microorganism were proposed ,and the suggestion of using more instrumental analysis in-stead of titrimetric analysis in the purified water inspection wasraised .Results The choice of colormetric apparatus and the precision of the regents were explicit .The plating method was better in convenience and reliability than membrane-filter proce-dure during the microorganism inspection .Instrumental analysis is the trend of purified water inspection and deserved to be rec-ommended .Conclusion Based on our own and others′studies ,the methods of impurity analysis are improved ,which might be accepted in the revision of Chinese Pharmacopoeia in future .

The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. Methods: This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. Results: Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = –0.356, p < 0.001 and r = –0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73–1.81), 1.69 (1.07–2.70), and 2.87 (1.69–4.88) (p for trend = 0.005). Conclusion: Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.

Objective To analyze the epidemiological characteristics of viral hepatitis in Minhang District, Shanghai from 2010 to 2020, to predict the number of cases in 2021, and to provide a scientific basis for the prevention and control of viral hepatitis. Methods A descriptive epidemiological method was used to analyze the epidemic data of viral hepatitis in Minhang District of Shanghai from 2010 to 2020. The Holt-Winters additive model was used to predict the incidence of viral hepatitis in the future. Results A total of 10 769 cases of viral hepatitis were reported in Minhang District, Shanghai from 2010 to 2020, with an average annual incidence rate of 38.81/100 000. The reported cases were mainly concentrated in the central urban areas with dense population and large flow of people. The reported population was mainly concentrated in the 20-60 years old (78.2%). The ratio of male to female was 1.92:1. Retirees accounted for the largest proportion of all types of hepatitis. The Holt-Winters additive model predicted 958 cases in 2021. Conclusion The overall prevention and control of viral hepatitis in Minhang District have achieved great success, but still face challenges. It is necessary to further strengthen the publicity and intervention to the floating population, especially the young, middle-aged and retired people, and to strengthen the surveillance to reduce the infection rate.