1.Diagnostic experience on familial Gitelman syndrome
Wen JI ; Wei HE ; Qiqi YIN ; Luyao ZHANG ; Zhihong LIAO
Chinese Journal of Endocrinology and Metabolism 2015;31(12):1051-1054
Objective To report two cases of familial Gitelman syndrome and literature review regarding the updates of relevant genes,classification,treatment,and prognosis.Methods The clinical data of two sisters with Gitelman syndrome were retrospectively analyzed.Results Their blood pressures were within normal range.Hypokalaemic alkalosis,hypomagnesemia,and hypocalciuria were corrected almost completely after three days of intravenous magnesium and potassium infusion,spirolactone and indometacin.However,the maintenance of normal potassium was unsuccessful over one year.Conclusion Hypokalaemic alkalosis,hypomagnesemia,and hypocalciuria were normalized in Gitelman syndrome.There was some debate in regard to using PGE2 synthetase inhibitors.Tolerance of long-term medication will be the big challenge for curative effect.
2.The detection rate of the arc of Buhler by CTA and DSA:a meta-analysis
Luyao JI ; Gaowu YAN ; Hongwei LI ; Yong LI ; Linwei ZHAO ; Xiaoping FAN ; Jiantao DENG ; Jing YAN
Journal of Interventional Radiology 2024;33(6):604-609
Objective To discuss the detection rate of the arc of Bühler(AOB)in CTA and DSA examinations and its clinical significance.Methods A computerized retrieval of academic papers concerning AOB from the databases of PubMed,Web of Science,Scopus,Embase,Google Scholar,CBM,CNKI,WanFang,VIP and Baidu Scholar was conducted.Stata 17.0 software was used to make meta-analysis.Results A total of 11 articles including 3 837 subjects and 65 AOB cases were included in this analysis.The pooled prevalence of AOB was 1.9%(0.8%-3.2%).CTA showed a pooled prevalence of AOB of 2.0%(0.5%-4.3%)and DSA showed a pooled prevalence of AOB of 1.8%(0.5%-3.9%).Conclusion Clinically,AOB is a rarely-seen anatomical variation.The possibility of the presence of an AOB should be considered when performing the relevant abdominal surgery so as to avoid causing operation difficulties and complications such as abdominal visceral organ ischemia or bleeding.(J Intervent Radiol,2024,33:604-609)
3.Risk factors and nomogram prediction model establishment of perioperative blood transfusion in pa-tients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic surgery
Luyao HE ; Shuhua WANG ; Xiaomei SU ; Qianhui QIU ; Wenjin JI
The Journal of Clinical Anesthesiology 2024;40(6):587-591
Objective To explore the risk factors of perioperative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic surgery,and construct a nomogram predic-tion model.Methods A retrospective analysis was conducted on the clinical data of 262 patients who un-derwent the nasal endoscopic surgery from January 2021 to May 2023.The patients were divided into two groups according to perioperative blood transfusion or not:non-transfusion group and transfusion group.Uni-variate and multivariate logistic regression were conducted to identify independentrisk factors of perioperative blood transfusion,and a nomogram prediction model was developed.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated.Results The incidence of blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic surgery was 46(17.6%).Multivariate logistic regression analysis revealed that preoperative hemoglobin level 70 to<100 g/L(OR=6.178,95%CI 2.271-16.805,P<0.001),preoperative albumin level 25 to<35 g/L(OR=2.126,95%CI 1.021-4.424,P=0.044),and classification of surgery grade Ⅲ or Ⅳ (OR=4.725,95%CI 1.634-13.584,P=0.004)were independent risk factors for predicting perioper-ative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic sur-gery.The AUC of the nomogram model was 0.769(95%CI 0.701-0.838),the sensitivity was 67.6%,and the specificity was 76.1%.Conclusion Preoperative hemoglobin level 70 to<100 g/L,preoperative albumin level 25 to<35 g/L,and classification of surgery grade Ⅲ or Ⅳ are independent risk factors of perioperative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endo-scopic surgery.The nomogram model established based on the above risk factors has good predictive ability for perioperative blood transfusion.
4.Analyse the risk factors for producing anti-HLA antibodies in patients with hematological diseases
Kai JI ; Lan WANG ; Luyao CHEN ; Xiaojing BAO ; Xiaoni YUAN ; Xiaojin WU ; Jun HE
Chinese Journal of Blood Transfusion 2024;37(2):165-173
【Objective】 To explore the risk factors for the production of anti-HLA antibodies in patients with hematological diseases before hematopoietic stemcell transplantation. 【Methods】 The results and clinical data of 1 008 patients with hematological diseases in our hospital who underwent anti-HLA antibody testing were collected by using Luminex technology platform before transplantation from 2016 to 2018 for statistical analysis. 【Results】 The total positive rate of anti-HLA antibodies in 1 008 patients was 24.08%. Multivariate analysis showed that independent risk factors associated with the production of anti-HLA antibodies included age≥30 years old(P=0.046, OR1.467, 95%CI1.007-2.136), time from disease diagnosis to antibody testing≥41 days(P=0.000, OR1.830, 95%CI1.306-2.565), initial platelet count<20×109/L(P=0.020, OR1.543, 95%CI1.072-2.220), prior pregnancy(P=0.000, OR5.187, 95%CI3.689-7.293), transfusions before admission(P=0.001, OR1.762, 95%CI1.257-2.470)and total platelet transfusion volumes after admission≥30 U(P=0.000, OR2.352, 95%CI1.638-3.376). Age ≥30 years old(P=0.023, OR=1.839, 95%CI1.088-3.108)and prior pregnancy(P=0.042, OR=5.258, 95%CI1.062-26.038)are associated with the production of anti-HLA class Ⅰ and class Ⅱ antibodies, respectively. The time from disease diagnosis to antibody testing≥41 days(P=0.000, OR=2.873, 95%CI1.612-5.119), initial platelet count<20×109/L(P=0.008, OR=2.164, 95%CI1.225-3.822), prior pregnancy(P=0.002, OR=6.734, 95%CI1.993-22.751), transfusions before admission(P=0.001, OR=2.746, 95%CI1.531-4.925)and total platelet transfusion volumes after admission>30 U(P=0.006, OR=3.459, 95%CI1.416-8.451)are associated with the production of anti-HLA class Ⅰ and Ⅱ antibodies. 【Conclusion】 Older age, longer course of disease, lower PLT count, history of pregnancy and blood transfusion, and higher total amount of PLT transfusion are risk factors which affect the production of anti-HLA antibodies.Therefore, it is advisable to test for anti-HLA antibodies according to the situation before transplantation, which is of great value in guiding donor selection, monitoring antibody changes and improving transplant prognosis.