1.Elevated serum uric acid is an independent risk factor for the loss of renal function
Chao XIE ; Shengjian ZHANG ; Jiali TAN ; Jie TIAN ; Wei LI ; Zhihao HUO ; Peiyi YE ; Yaozhong KONG
Chinese Journal of Nephrology 2019;35(2):100-105
Objective To investigate the relationship between serum uric acid level and renal function decline by retrospective cohort study.Methods Through the physical examination system of the First People's Hospital of Foshan,the physical examination data from 2015 to 2018 of a public institution in Foshan city were obtained.The gender,age,blood cell analysis,liver function,serum creatinine,uric acid,fasting blood glucose were obtained.The change of eGFR (△eGFR=eGFR2018-eGFR2015) was analyzed.Results A total of 2505 subjects were followed up for four years.The subjects were divided into △eGFR ≥0 group and △eGFR < 0 group.There were 845 subjects in △eGFR ≥0 group,and 1660 subjects in △eGFR < 0 group.Compared with that in △eGFR < 0 group,the base-level of uric acid in △eGFR ≥ 0 group was higher [(349.48±87.62) μmol/L vs (325.72±82.58) μmol/L,t=6.669,P < 0.001],but the rate of uric acid decline was greater [-15.00(-53.50,17.00) μmol/L vs 15.50(-18.00,49.00) μmol/L,Z=-13.470,P < 0.001].According to the levels of uric acid in 2015 and 2018,then the subjects were divided into four groups,normal to normal group (N-N,1551 cases),normal change into high uric acid group (N-H,299 cases),high uric acid drop to normal group (H-N,238 cases),and high to high uric acid group (H-H,417 cases).The △eGFR was-1.58(-4.17,1.01) ml · min-1 · (1.73 m2) 1 in N-N group,and-3.60(-7.24,-0.98) ml · min-1 · (1.73 m2)-1 in N-H group,-0.20(-3.14,3.27) ml· min-1· (1.73 m2)-1 in H-N group,-0.96(-4.07,1.93) ml· min-1· (1.73 m2)-1 in H-H group,respectively.The △eGFR decreased most significantly in N-H group than the other three groups (x2=103.130,P < 0.001).Multivariate logistic regression analysis showed that elevated uric acid was an independent risk factor for eGFR decline (OR=1.739,95%CI 1.587-1.906,P < 0.001),while elevated indirect bilirubin (OR=0.968,95%CI 0.943-0.993,P=0.013),elevated red blood cells (OR=0.815,95% CI 0.680-0.976,P=0.026) were independent protective factors for eGFR decline.Conclusion Elevated uric acid is an independent risk factor for the decline of renal function.Good control of hyperuricemia is beneficial to the protection of renal function.
2.A multi-center study on effect of low serum albumin levels and duration on first episode of peritonitis in continuous ambulatory peritoneal dialysis
Yanhong TAN ; Jinzhong CHEN ; Shaoxin ZHONG ; Qimei LUO ; Jianyi PAN ; Jun AI ; Yaozhong KONG ; Zhihao HUO ; Xianrui DOU
Chinese Journal of Nephrology 2022;38(7):597-604
Objective:To explore the relationship between low serum albumin levels and its duration on first episode of peritonitis in peritoneal dialysis (PD) patients.Methods:PD patients who were regularly followed up in the Pearl River Delta region from September 1, 2000 to July 6, 2021 in Shunde Hospital of Southern Medical University, Nanfang Hospital of Southern Medical University, and Foshan First People′s Hospital were retrospectively selected. The patients were divided into low serum albumin group (LSA group, mean albumin<35 g/L), moderate serum albumin group (MSA group, 35 g/L≤mean albumin<40 g/L) and high serum albumin group (HSA group, mean albumin≥40 g/L) according to the mean albumin of the patients, and the differences among the three groups were compared. The Kaplan-Meier survival analysis method was used to compare the risk of peritonitis events in different mean albumin groups and different durations of hypoalbuminemia. The multivariate Cox regression model was used to analyze the relationship between serum albumin levels and duration of hypoalbuminemia and new-onset peritonitis.Results:A total of 1 853 PD patients were included in this study, aged (49.72±15.34) years, and 1 036(55.9%) males. There were 551 patients (29.7%) in the LSA group, 920 patients (49.7%) in the MSA group, and 382 patients (20.6%) in the HSA group. The median follow-up was 37 (15, 66) months and there were 508 patients (27.4%) with new-onset peritonitis during the follow-up. Compared with the LSA group, the incidence of new peritonitis in the MSA group and HSA group was lower ( χ2=14.053, P<0.001; χ2=21.857, P<0.001), but there was no significant difference in the incidence of new peritonitis between the HSA group and MSA group. The Kaplan-Meier survival analysis showed that the cumulative incidence of peritonitis in the LSA group was significantly higher than that in the MSA group and HSA group (Log-rank χ2=22.128, P<0.001). Compared with PD patients with normal serum albumin, the patients with longer duration of hypoalbuminemia tended to have a higher incidence of new peritonitis. Multivariate Cox regression analysis showed that the mean albumin<35 g/L (LSA group/MSA group, HR=1.495, 95% CI 1.198-1.866, P<0.001; LSA group/HSA group, HR=1.459, 95% CI 1.104-1.928, P=0.008) was an independent risk factor of new-onset peritonitis in PD patients and the prolongation of duration of hypoalbuminemia had a significantly higher risk of new-onset peritonitis ( HR=1.013, 95% CI 1.003-1.024, P=0.014). Conclusion:The mean albumin<35 g/L and prolong duration of hypoalbuminemia are independent risk factors of PD-related peritonitis in PD patients.
3.Study based on the impact of the timeliness of the first elective operation start time on the operating room costs
Zhihao TAN ; Yiliang CAI ; Jinhuan FENG ; Qin LI ; Xiaozhen XU ; Shishen XU ; Yanfu HUANG ; Jiachen CHEN
Modern Hospital 2024;24(9):1407-1410
Objective To analyze the timeliness of the start time of the first elective operation in a hospital and observe its impact on the operating room cost.Methods Make statistics and analysis on the opening of the first operation in a hospital,record the on-time opening rate of the first operation,analyze the reasons for the delay in the opening time of the first operation,formulate corresponding intervention measures and set up a"management team to improve the efficiency of operating room use".The on-time rate of the first operation,operation,cost control and the satisfaction of surgeons and patients were compared before and after the operation.Results The overall punctuality rate of the first operation was 53.74%,among which the colorectal sur-gery department had the highest punctuality rate of 63.16%,while the minimally invasive surgery department had the lowest punctuality rate of 45.45%.The main reasons for the delay of first operation(35.29%),failed anesthesia(30.88%),and the termination of the operation(17.65%);compared with before implementation,higher overtime time of nurses,shorter opening time and expected time,decreased interval between operation(P<0.05),lower frequency of centralized delivery and unnecessa-ry consumables cost within 1 month after implementation(P<0.05),and higher satisfaction of patients and physicians after im-plementation(P<0.05).Conclusion By improving the first elective operation on time,can effectively reduce the cost of the operating room,shorten the nurse overtime time,at the same time improve the satisfaction of doctors and patients,and improve the management efficiency of the operating room,the first operation on time improved,interval time and unnecessary consumables costs are significantly reduced,optimize the use efficiency of the operating room resources.
4.Chemical Constituents, Pharmacological Activities, and Identification of Amomi Fructus: A Review
Yuancong GU ; Zhihao TAN ; Bangyu LYU ; Huifang ZHANG ; Xinhe YANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(22):270-278
Amomi Fructus (AF) refers to the dried mature fruit of Amomum villosum A. villosum. var. xanthiondes, and A. longiligulare, all belonging to the Zingiberaceae family. As one of the renowned "Four Southern Medicines", AF is also classified as an ingredient featured by "medicinal and food homology". It is mainly produced in Guangdong, Yunnan, and Hainan provinces in China. In recent years, with the in-depth implementation of the "Healthy China" strategy, AF has gained increasing popularity among the public due to its significant medicinal value. At the same time, research on its chemical composition, pharmacological effects, and identification methods has garnered widespread attention from scholars. The chemical composition of AF is highly complex. Its primary constituents include volatile components such as borneol acetate, camphor, and borneol, as well as non-volatile components such as polysaccharides, polyphenols, and mineral elements. AF possesses a wide range of pharmacological effects, including gastrointestinal protection, lipid-lowering and weight loss, glucose-lowering, uric acid-lowering, antioxidant, anti-inflammatory, antibacterial, and analgesic activities. The identification techniques for AF, including microscopic identification, molecular biological identification, and electrochemical fingerprinting, are crucial for its quality control, safety, and efficacy. However, in recent years, there have been few comprehensive summaries of research on AF, which limits further in-depth research and high-value development and utilization of AF. This article systematically reviewed the research progress on the chemical composition, pharmacological activity, and identification methods of AF, and is expected to provide prospects for future research.
5.Dihydroartemisinin attenuates ischemia/reperfusion-induced renal tubular senescence by activating autophagy.
Huiling LIU ; Zhou HUANG ; Hong JIANG ; Ke SU ; Zilin SI ; Wenhui WU ; Hanyu WANG ; Dongxue LI ; Ninghua TAN ; Zhihao ZHANG
Chinese Journal of Natural Medicines (English Ed.) 2023;21(9):682-693
Acute kidney injury (AKI) is an important factor for the occurrence and development of CKD. The protective effect of dihydroartemisinin on AKI and and reported mechanism have not been reported. In this study, we used two animal models including ischemia-reperfusion and UUO, as well as a high-glucose-stimulated HK-2 cell model, to evaluate the protective effect of dihydroartemisinin on premature senescence of renal tubular epithelial cells in vitro and in vivo. We demonstrated that dihydroartemisinin improved renal aging and renal injury by activating autophagy. In addition, we found that co-treatment with chloroquine, an autophagy inhibitor, abolished the anti-renal aging effect of dihydroartemisinin in vitro. These findings suggested that activation of autophagy/elimination of senescent cell might be a useful strategy to prevent AKI/UUO induced renal tubular senescence and fibrosis.
Animals
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Kidney
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Acute Kidney Injury/chemically induced*
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Ischemia
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Reperfusion Injury/drug therapy*
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Autophagy
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Reperfusion