1.The occurrence and influencing factors of vascular calcification in non-dialysis chronic kidney disease patients of stage 3-5
Miaorong XUE ; Wenjiao ZHU ; Zhiman LAI ; Shaozhen FENG ; Yan WANG ; Jianbo LI ; Jianwen YU ; Xi XIA ; Qiong WEN ; Xin WANG ; Xiao YANG ; Haiping MAO ; Xionghui CHEN ; Zhijian LI ; Fengxian HUANG ; Wei CHEN ; Shurong LI ; Qunying GUO
Chinese Journal of Nephrology 2024;40(6):431-441
Objective:To explore the prevalence and independent associated factors of vascular calcification (VC) in non-dialysis chronic kidney disease (CKD) patients of stage 3-5.Methods:It was a single-center cross-sectional observational study. Non-dialysis stage 3-5 CKD patients ≥18 years old who were admitted to the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University from May 1, 2022 to December 31, 2022 with VC evaluation were enrolled. The patients' general information, laboratory examination and imaging data were collected. Coronary artery calcification (CAC), thoracic aorta calcification (TAC), abdominal aorta calcification (AAC), carotid artery calcification and aortic valve calcification (AVC) were evaluated by cardiac-gated electron-beam CT (EBCT) scans, lateral lumbar x-ray, cervical macrovascular ultrasound and echocardiography, respectively. The differences in clinical data and the prevalence of VC at different sites of patients with different CKD stages were compared, and the prevalence of VC at different sites of patients in different age groups [youth group (18-44 years old), middle-aged group (45-64 years old) and elderly group (≥65 years old)] and patients with or without diabetes were compared. Multivariate logistic regression analysis was used to analyse the independent associated factors of VC for different areas.Results:A total of 206 patients aged (51±14) years were included, including 129 (62.6%) males. There were 44 patients with CKD stage 3 (21.4%), 51 patients with CKD stage 4 (24.8%), and 111 patients with CKD stage 5 (53.9%). CKD was caused by chronic glomerulonephritis [104 cases (50.5%)], diabetic kidney damage [35 cases (17.0%)], hypertensive kidney damage [29 cases (14.1%)] and others [38 cases (18.4%)]. Among 206 patients, 131 (63.6%) exhibited cardiovascular calcification, and the prevalence of CAC, TAC, AAC, carotid artery calcification, and AVC was 37.9%, 43.7%, 37.9%, 35.9% and 9.7%, respectively. The overall prevalence of VC in young, middle-aged and elderly patients was 24.6%, 73.6% and 97.4%, respectively. With the increase of age, the prevalence of VC in each site gradually increased, and the increasing trend was statistically significant (all P<0.001). The overall prevalence of VC in CKD patients with diabetes was 92.5% (62/67), and the prevalence of VC at each site in the patients with diabetes was significantly higher than that in the patients without diabetes (all P<0.001). Multivariate logistic regression analysis revealed that age (every 10 years increase, OR=2.51, 95% CI 1.77-3.56, P<0.001), hypertension ( OR=5.88, 95% CI 1.57-22.10, P=0.009), and diabetes ( OR=4.66, 95% CI 2.10-10.35, P<0.001) were independently correlated with CAC; Age (every 10 years increase, OR=6.43, 95% CI 3.64-11.36, P<0.001) and hypertension ( OR=6.09, 95% CI 1.33-27.84, P=0.020) were independently correlated with TAC; Female ( OR=0.23, 95% CI 0.07-0.72, P=0.011), age (every 10 years increase, OR=3.90, 95% CI 2.42-6.29, P<0.001), diabetes ( OR=5.37, 95% CI 2.19-13.19, P<0.001) and serum magnesium ( OR=0.01,95% CI 0-0.35, P=0.014) were independently correlated with AAC. Moreover, age and diabetes were independently correlated with carotid artery calcification, AVC and overall VC Conclusions:The prevalence of VC in non-dialysis CKD patients of stage 3-5 is 63.59%, of which CAC reaches 37.9%, TAC is the most common one (43.7%), while AVC is the least one (9.7%). Age and diabetes are the independent associated factors for VC of all sites except TAC, while hypertension is an independent associated factor for both CAC and TAC.
2. Effect of primary prevention program for stroke in rural areas of Shanghai
Jiping GUO ; Jiuyi HUANG ; Qinghua CHEN ; Haiying CHEN ; Jubo FEI ; Yan WANG ; Yongju YANG ; Yifeng CAO ; Zhenmao GU
Chinese Journal of Health Management 2020;14(1):15-20
Objective:
This study aimed to analyze and summarize the implementation of the primary prevention program for stroke in Shanghai rural community and evaluate its preventive effect.
Methods:
A cluster sampling method was used to select approximately 50 000 community natural population from a town in Fengxian District of Shanghai. A primary stroke prevention program was established and implemented in the community from 2008 to 2010 and from 2012 to 2015. The prevention program inclueded stroke
3.Clinical medication response under new major infectious disease: off-label use and compassionate use
Zhuman LI ; Zhijun GUO ; Feng XU
Journal of Pharmaceutical Practice 2020;38(3):207-210
At present, there are no specific targeted drugs for the treatment of pneumonia (COVID-19) caused by the novel coronavirus (SARS-CoV-2). Interferon, lopinavir/ritonavir, ribavirin, chloroquine phosphate were chosen as off-label use, and remdesivir was chosen as compassionate use. This paper reviewed the behavior of the two medication response to the new major infectious disease.
4.Fallopian tube perfusion with ozone water for recanalization of obstructed fallopian tube in pluripara:observation of curative effect
Fengxian GUO ; Lequn WEI ; Chao HE ; Hongjiang BAI ; Hongwei QU
Journal of Interventional Radiology 2017;26(5):455-458
Objective To evaluate the curative effect of fallopian tube perfusion with ozone water in treating obstructed fallopian tube in pluripara.Methods A total of 116 patients with distal fallopian tube obstruction were included in this study.The diagnosis was confirmed by clinical and laboratory materials.The patients were randomly divided into the study group and the control group with 58 patients in each group.During hospitalization period all patients received interventional recanalization therapy for obstructed fallopian tube.For the patients of the study group,ozone water perfusion of fallopian tube was employed,while for the patients of the control group,fallopian tube perfusion with conventional anti-inflammatory drug and antiadhesion solution was adopted.All the patients were followed up for 6 months,the pregnancy rate and the fallopian tube re-occlusion rate of both groups were calculated,and 2 weeks after the treatment the patients'discomfort symptoms were evaluated.Results The success rate of fallopian tube recanalization,the pregnancy rate and the re-obstruction rate in the study group were 93.1% (54/58),79.3% (46/58) and 5.2%(3/58) respectively,which in the control group were 91.4% (53/58),60.3% (35/58) and 172% (10/58) respectively.Statistical analysis indicated that no significant difference in the success rate of fallopian tube recanalization existed between the two groups (P>0.05).The pregnancy rate of the study group was higher than that of the control group,while the re-obstruction rate in the study group was lower than that in the control group;the differences between the two groups were statistically significant (P<0.05).No significant differences in discomfort symptom scores existed between the two groups (P>0.05).Conclusion Fallopian tube perfusion with ozone water can be adopted for tubal recanalization,this technique can effectively improve the postoperative pregnancy rate and reduce the tubal re-obstruction rate.
5.Analysis of fast comprehensive rehabilitation care for single hole thoracoscopic pulmonary lobectomy in patients in perioperation
Yi XU ; Fengxian CUI ; Shaofen ZHANG ; Jun GUO ; Jun PENG
Journal of Clinical Medicine in Practice 2017;21(14):75-77
Objective To study the perioperative comprehensive rapid rehabilitation care for single hole thoracoscopic lobectomypatients.Methods Clinical data of 68 cases with single-hole thoracoscopic lung resection were retrospectively analyzed, and were randomly divided into observation group(n=34) and control group(n=34), given perioperative rapid rehabilitation comprehensive nursing and routine nursing, respectively.Results Observation group had lower incidence rate and higher nursing satisfaction, and there were no died patients and all 68 patients were recovered after actively symptomatic treatment and careful nursing.Conclusion Single hole thoracoscopic pulmonary lobectomy is featured by relieving pain, shorten treatment courses, rapid recovery and shorter hospitalization time.
6.Analysis of fast comprehensive rehabilitation care for single hole thoracoscopic pulmonary lobectomy in patients in perioperation
Yi XU ; Fengxian CUI ; Shaofen ZHANG ; Jun GUO ; Jun PENG
Journal of Clinical Medicine in Practice 2017;21(14):75-77
Objective To study the perioperative comprehensive rapid rehabilitation care for single hole thoracoscopic lobectomypatients.Methods Clinical data of 68 cases with single-hole thoracoscopic lung resection were retrospectively analyzed, and were randomly divided into observation group(n=34) and control group(n=34), given perioperative rapid rehabilitation comprehensive nursing and routine nursing, respectively.Results Observation group had lower incidence rate and higher nursing satisfaction, and there were no died patients and all 68 patients were recovered after actively symptomatic treatment and careful nursing.Conclusion Single hole thoracoscopic pulmonary lobectomy is featured by relieving pain, shorten treatment courses, rapid recovery and shorter hospitalization time.
7.Advance in research on causative genes of xeroderma pigmentosum and related diseases.
Zhonghui SUN ; Yunyi GUO ; Jia ZHANG ; Yin ZHUANG ; Ming LI ; Zhirong YAO
Chinese Journal of Medical Genetics 2016;33(5):708-712
Ultraviolet light(UV)-sensitive disorders refer to a group of diseases due to damages to the nucleotide excision repair mechanism which cannot effectively repair DNA damage caused by ultraviolet radiation. The inheritance pattern of such diseases, mainly including xeroderma pigmentosum, Cockayne syndrome and trichothiodystrophy, is autosomal recessive and known to involve 13 genes. As proteins encoded by such genes are involved in DNA repair and transcription pathways. There is overlap between the symptoms of such diseases, and their genotype - phenotype correlations are quite complex. To facilitate genetic and prenatal diagnosis for such diseases, a summary of the research progress is provided, which mainly focused on mutation research and genotype - phenotype correlation studies. We also propose a strategy for their genetic diagnosis based on recent findings of our group.
Biomedical Research
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methods
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trends
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Cockayne Syndrome
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genetics
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DNA Damage
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DNA Repair
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genetics
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Genetic Predisposition to Disease
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genetics
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Humans
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Skin
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metabolism
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pathology
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radiation effects
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Trichothiodystrophy Syndromes
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genetics
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Ultraviolet Rays
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Xeroderma Pigmentosum
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genetics
8.Effects of gastric bypass versus medicine administration in obese patients with type 2 diabetes
Zhengang WEI ; Xiaohu GUO ; Fengxian WEI ; Mancai WANG ; Youcheng ZHANG
Chinese Journal of Endocrinology and Metabolism 2015;(6):486-491
Objective To assess the effects of gastric bypass versus medical therapy in patients with obesity and type 2 diabetes. Methods The Cochrane library, Embase, PubMed, Chinese biomedical literature database and Wanfang database up to April 2014 were searched. Randomized controlled trails(RCTs) of frequently-used bariatric surgery for obese patients with type 2 diabetes were included. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results Four RCTs involving 157 patients in the gastric bypass groups and 152 patients in the medical therapy group were enrolled. Compared with medical therapy, gastric bypass for type 2 diabetes significantly decreased the levels of HbA1C(mean difference = -1. 85% , 95% CI -2. 15 ~ -1. 56, P< 0. 01), fasting blood glucose( standard mean difference = - 0. 90 mmol/ L, 95% CI-1. 24 ~ -0. 57, P<0. 01), body weight(mean difference=-23. 39 kg, 95% CI -29. 17 ~ -17. 61, P<0. 01), waist circumference(mean difference= -15. 36 cm, 95% CI -17. 51 ~ -13. 22, P<0. 01) and the dose of hypoglycemic medicine; while it increased the number of patients with HbA1C<6% (RR=5. 49, 95% CI 2. 22 ~ 13. 56, P<0. 01), the rate of adverse events(RR=1. 96, 95% CI 1. 42 ~ 2. 70, P<0. 01), and the level of high-density lipoprotein-cholesterol(mean difference=1. 24 mmol/ L, 95% CI 0. 64 ~ 1. 84, P<0. 01). Conclusions Gastric bypass surgery is more effective compared with medical therapy alone for obese patients with type 2 diabetes. Further intensive RCTs of high-quality in multiple centers with long-term follow-up should be carried out to provide more reliable evidences.
9.Curative effect of 308nm excimer laser on child vitiligo and nursing measures
Haiyan CHEN ; Suping GUO ; Fengxian OU ; Sulian YANG ; Chun LU ; Wei LAI
Modern Clinical Nursing 2014;(8):37-39
Objective To explore the curative effect of 308 nm excimer laser on child vitiligo and nursing measures. Method Fourty-eight children with vitiligo were treated with 308 nm excimer laser and nursed with targeted psychological treatment, skin and diet nursing.Result After treatment,6 of them got recovered(12.5%),24 remarkably improved(50%),15 slightly improved(31.2%)and 3 ineffectively treated(6.2%).Conclusions 308 nm excimer laser is effective for the treatment of child vitiligo.High quality nursing can ensure and improve the efficiency of the 308 nm excimer laser.
10.Nursing care of patients with cosmetic dermatitis receiving patch test
Haiyan CHEN ; Suping GUO ; Yue ZHENG ; Sulian YANG ; Fengxian OU
Modern Clinical Nursing 2013;(11):39-41,42
Objective To summarize key points of nursing patients with cosmetic dermatitis during patch test.Method One hundred and forty one patients with contact dermatitis induced by cosmetics underwent patch test and the nursing care was performed. Results The top five allergens based on the positive rate ranked in descending order were potassium dichromate(43?97%),nickel sulfate (43?26%),cobalt chloride(36?17%),mixture of hydroxy benzoic acid(23?40%)and fragrance mix(20?57%).The positive suspicious cosmetics ranked in ascending order included body spray(80?00%),freckle cream(56?00%),liquid products(38?89%),cleaning supplies (31?58%)and skin care cream(25?62%).Conclusion During the cosmetic patch test for the patients with contact dermatitis,the nurses should conduct mental care,carefully observe the patients and make instructions to them on cosmetic health knowledge.

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