1.Correlation between protein-bound uremic toxins and renal function in patients with chronic kidney disease stage 3-5
Zhenzhen REN ; Lide LUN ; Xinlun LI ; Jian LI ; Guifang DOU
Military Medical Sciences 2015;(7):532-536,549
Objective To investigate the serum concentrations of protein-bound uremic toxins of hippuric acid ( HA) , indoxyl sulfate ( IS ) , p-cresyl sulfate ( PCS ) and 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid ( CMPF ) in patients with chronic kidney disease(CKD) 3-5 stages(CKD3-5) and to assess the correlation between renal function and pro-tein-bound uremic toxin concentrations in CKD3-5 patients.Methods Serum concentrations of HA, IS, PCS, and CMPF from 60 healthy volunteers and 112 CKD3 -5 patients were measured by liquid chromatography mass spectrometry/mass spectrometry ( HPLC-MS/MS ) .Correlation analysis was conducted between the levels of HA, IS, PCS, CMPF and the estimated glomerular filtration rate( eGFR) .Results Compared with healthy subjects, serum concentrations of these four solutes were significantly increased in CKD3-5 patients (all P<0.01).The serum levels of HA,IS and PCS in CKD3-5 patients were significantly increased (all P<0.05),while those of CMPF did not significantly change (P>0.05).Linear correlation analysis showed that HA, IS, PCS and CMPF were in significantly negative correlation with eGFR.The curve regression analysis showed that the curvilinear regression fitting equation was Y=-46.171lnX+209.464(R2 =0.601,P<0.01)for HA and eGFR, Y=-62.570 lnX+279.537(R2 =0.633,P<0.01)for IS and eGFR, Y=-84.297 lnX+383.172(R2 =0.529,P<0.01)for PCS and eGFR, and was Y=-7.648 lnX+53.546(R2 =0.172,P<0.01)for CMPF and eGFR .Conclusion The levels of the four types of protein-bound toxins in CKD3-5 patients increase significantly compared to healthy subjects.The serum levels of HA,IS and PCS are increased when the renal function decreases, but the level of CMPF changes little.Renal dysfunction can lead to significantly elevated levels of HA,IS and PCS in CKD3-5 patients, but has little effect on CMPF.
2.Adherence management to health belief model based-antiretroviral therapy
Xuezheng JIN ; Weihua CAO ; Xinlun WANG ; Yubo LI
Chinese Journal of Health Management 2013;(3):171-173
Objective To describe the status of adherence to antiretroviral therapy (ART) in low endemic area,and to explore the factors affecting ART adherence so as to provide evidence for behavior management program.Methods A cross-sectional study was conducted in 53 patients receiving free ART in Chuanying and Yongji of Jilin Province.Structured face-to-face interview was carried out to determine sociodemographic characteristics,medical treatment information,medication adherence behaviors,health belief and self-efficacy,doctor-patient relationships and health service information.Results Among 53 patients,3 reported drug discontinuance.Of the other 50 patients,41 (82.0%) obeyed the request of the doctors (to be defined as adherence).All the participants had high levels of perceived benefits of adherence,perceived severity of non-adherence and self-efficacy.94.3% of them reported using medication reminders,88.7% reported receiving directly observed therapy (DOT),and 73.6% reported falling into the habit of drug administration.Conclusions HIV/AIDS patients show relatively good adherence to medical treatment.Local comprehensive education and supportive programs may contribute to patients' good adherence to ART.
3.Construction of the Intelligent Service Platform for the Patient -oriented Blood Purification Center
Xinlun LI ; Hongxia LI ; Dejun QIU ; Lina SUI ; Lide LUN ; Yanli WU ; Qiang KUANG
Journal of Medical Informatics 2015;(9):31-34
〔Abstract〕 In a response to problems and needs in the current daily work of the blood purification center , the intelligent service plat-form for the patient -oriented blood purification centers should be constructed .The design philosophy , composition and basic functions of the platform are introduced in the paper .This platform can meet the needs of the patient -oriented service , improve work productivity , standardize the medical process and save social resources .