Objective To investigate the clinical status of 1242 patients with diabetic kidney diseases (DKD) during their first hospitalization,and to analyze the risk factors of prognosis,so as to provide reference for clinical practice. Methods Retrospective case-control study was performed.Clinical data of 1242 patients diagnosed as DKD in first hospitalizaton from January 2003 to December 2008 were reviewed,and patients were followed up to realize the prognosis.Multiple regression analysis was carried out to screen the risk factors. Results Most of the patients were Mogensen stage Ⅳ or Ⅴ in their first hospitalization,accounting for 77.2％.24.8％ of cases was complicated with cardiocerebrovascular diseases.Scr of 36.6％ patients was higher than 176.8 μmol/L.One way ANOVA indicated that diabetes course,hemoglobin,serum albumin,Scr and Charlson index were significantly different among Mogensen stage Ⅲ, Ⅳ,Ⅴ patients.Logistic regression showed that age,albumin,Scr,cardiocerebrovascular diseases and Chalson index were risk factors for death in DKD patients (OR =1.057,0.908,1.002,2.006,1.371),but sex,diabetes course and hemoglobin were not risk factors,which was in accord with the resuh from 416 non-dialysis patients.Multiple linear regression analysis revealed serum albumin level was positively correlated with survival in non-dialysis DKD patients (P=0.003).The mean survival time was only 1.2145 year in 162 non-dialysis dead patients. Conclusions DKD patients in our hospital refer quite late,usually with poor conditions and complications.Most of DKD patients are Mogensen stage Ⅳ or Ⅴ in the first hospitalization.Age,serum albumin,Scr,cardiocerebrovascular diseases and Charlson index are risk factors of death,while gender,diabetes course and hemoglobin are not significantly correlated with death.In addition,serum albumin is positively correlated with survival time.Early diagnosis and management of risk factors are crucial for improving the prognosis of DKD patients.

Objective To investigate the efficacy and safety of capecitabine in the treatment of colorectal cancer. Methods Totally 160 elderly patients with stageⅣcolorectal cancer were enrolled in this study. After first-line combined chemotherapy,80 patients were treated with capecitabine monotherapy(maintenance group)and another 80 cases were not(control group). The survival rate was analyzed by Kaplan-Meier curve and the efficiency and incidence of adverse events were compared. Results (1) The Kaplan-Meier curve suggested that the difference between two groups was statistically significant(P<0.05).(2)The response rate of maintenance group was significantly higher than that of control group (P < 0.05). (3)The incidence of adverse events during capecitabine monotherapy was lower than that during combined chemotherapy(P < 0.05).(4)The incidence of adverse reactions during capecitabine monotherapy was similar to that of control group(P > 0.05). Conclusion Capecitabine monotherapy in patients with stage Ⅳ colorectal cancer after combined chemotherapy has a longer median PFS than those without maintenance but similar adverse reactions ,which was worthy of clinical promotion.

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on perioperative anxiety and postoperative pain in living kidney donors (LKDs).Methods:Seventy-two American Society of Anesthesiologists physical status Ⅰ or Ⅱ LKDs, aged 18-64 yr, with body mass index of 18-28 kg/m 2, undergoing living kidney transplantation, were selected, and divided into 2 groups ( n=36 each) using a random number table method: TEAS group (group T) and sham stimulation group (group S). In group T, TEAS was performed on the forenoon at 1 day before surgery (T 0), at 30 min before anesthesia induction on the morning of the operation day (T 1) and on the forenoon at 1 day after surgery (T 2) at bilateral Neiguan, Taichong and Yintang with a frequency 2-100 Hz, disperse-dense waves and current intensity 6-15 mA, and each TEAS lasted for 30 min.Only electrode patches were applied at the same acupoint and at the same time point, but no stimulation was applied in group S. In T and S groups, brachial venous blood samples were collected before each stimulation for measurement of the plasma 5-hydroxytryptamine (5-HT) concentration.The Hospital Anxiety Depression Scale-Anxiety subscale (HADS-A) scores at T 0, T 1, T 2, on day 3 after surgery (T 3) and before discharge (T 4) in the 2 groups were recorded.The consumption of anesthetics during operation, laryngeal mask airway removal time, requirement for rescue analgesia within 72 h after surgery and the development of postoperative complications were recorded.The LKDs were followed up by telephone at 3 months after surgery (T 5) to record the scores of HADS-A and Leeds Assessment of Neuropathic Symptoms and Sign (LANSS) scale. Results:Compared to group S, the incidence of anxiety was significantly decreased T 1, T 2 and T 3, the incidence of rescue analgesia within 72 h after surgery was decreased, plasma concentration of 5-HT was increased at T 1 and T 2, the incidence of postoperative nausea and vomiting was decreased, and the time to first flatus was shortened in group T ( P<0.05). There was no significant difference in the consumption of anesthetics during operation, laryngeal mask airway removal time, and the incidence of anxiety and neuropathic pain within 3 months after surgery between the 2 groups ( P>0.05). Conclusion:TEAS can relieve early preoperative and postoperative anxiety and alleviate postoperative pain in LKDs.