1.Predictive Role of the Systemic Immune Inflammation Index in the Progression of Non-Dialysis Chronic Kidney Disease
Leile TANG ; Jianhao KANG ; Shaomin LI ; Ying DENG ; Xun LIU
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(6):1041-1049
ObjectiveOur study seeks to investigate the connection between systemic immune inflammatory index and renal function, as well as to assess its predictive capacity for the deterioration of renal function in chronic kidney disease patients with non-dialysis. MethodsAdult non-dialyzing patients diagnosed with CKD were included. The computation of SII was calculated as the product of the peripheral blood neutrophil count (×10⁹/L) and platelet count (×10⁹/L), divided by the lymphocyte count (×10⁹/L). The logistic and Cox regression models were employed to scrutinize the linkage between SII levels and CKD. ResultsOut of the cohort, a significant portion of patients, numbering 244, which constitutes 17.2%, experienced progression of CKD. A notable upsurge in SII corresponded with an increased prevalence of advanced CKD and its progression, with significant difference. This trend was mirrored by a decline in the estimated glomerular filtration rate and hemoglobin levels, while serum creatinine, C-reactive protein, and lipoprotein(a) levels were on the rise. After adjusting for multiple variables, the natural logarithm of SII exhibited an independent association with advanced CKD [OR=1.85 95% CI(1.46,2.35),P<0.01]. Furthermore, Cox proportional hazards model analysis revealed that SII acted as an independent predictor for CKD progression [adjusted HR= 1.35, 95% CI(1.09,1.67), P< 0.01]. Subgroup analysis indicated a significant interaction among SII, gender, and hypertension concerning CKD progression. ConclusionOur findings underscore the robust relationship between SII and renal function, positioning SII as a potential forecaster for the progression of CKD.
2.Analysis of the causes of revision total knee arthroplasty
Jian JIN ; Liyi ZHANG ; Wulin KANG ; Xuan GAO ; Jianhao LIN ; Zhichang LI
Chinese Journal of Orthopaedics 2024;44(4):217-225
Objective:To assess causes for revision total knee arthroplasty (TKA) in China using the data of revision TKA in the past 15 years in our single center andcompare the differences in survival time, operation time and blood loss among different revision reasons.Methods:Data of 337 patients (345 knees) with revision TKAs at our institution from January 2007 to December 2021 (15 years) were retrospectively analyzed. The included population consists of 57 males and 288 females. The causes for first revision TKA were identified and compared according to the time of revision surgery as early (up to 2 years) and late revision (more than 2 years). The reason for revision before 2012 and after 2012 was also compared. Furthermore, the differences of survival time, operation time and blood loss among different revision reasons were compared.Results:The most common reasons for revision of knee joints in 345 cases were periprosthetic infection (133 knees, 38.6%), followed by aseptic loosening (97 knees, 28.1%) and joint instability (35 knees, 10.1%). Early revisions were performed in 171 knees (49.6%), while late revisions were performed in 174 knees (50.4%). Periprosthetic infection (96 knees, 56.1%) and aseptic loosening (86 knees, 49.4%) were the most common reasons for early and late revisions, respectively. There were 59 revisions performed before 2012 and 286 revisions performed after 2012, with periprosthetic infection being the main reason for revision in both groups. The percentage of revisions due to infection decreased from 64.4% before 2012 to 33.2% after 2012, and this difference was statistically significant (χ 2=18.790, P<0.001). The proportion of revisions due to aseptic loosening was 15.3% before 2012, which was significantly lower than the proportion of 30.8% after 2012 (χ 2=5.083, P=0.024). The median survival time of the prostheses in the included patients was 30 months, with shorter survival time observed in patients with stiffness, patellar complications, and periprosthetic infection, and longer survival time observed in patients with polyethylene wear and aseptic loosening. There were significant differences in operation time and blood loss among different reasons for revision ( P<0.001). Conclusion:In our specialized arthroplasty center periprosthesis infection was the most common reason for revision. Periprosthesis infection and aseptic loosening needed to be considered for early or late-stage revision. With the development of technique of total knee arthroplasty, the proportion of periprosthesis infection is decreasing, while the incidence of aseptic loosening is increasing.
3.Epidemiology study on the incidence and distribution of the patellofemoral arthritis in 50-year-old people in Wuchuan region of Inner Mongolia of China
Jianhao LIN ; Yi YANG ; Xiaozheng KANG ; Hu LI
Chinese Journal of Rheumatology 2010;14(3):161-164
Objective To identify the diagnostic criteria and investigate the incidence and distribution of the patellofemoral arthritis in aged people in Wuchuan region of the Inner Mongolia of China. Methods A population-based cross-sectional survey was conducted among 1030 residents aged 50 years and over of Wuehuan County, Inner Mongolia. Survey participants, mostly farmers, reported heavy physical activity, completed an interview-based questionnaire and Skyline View weight-bearing films were evaluated for KeU-gren and Lawrence (K/L) grade. Radiological patellofemoral arthritis (RPFA) and symptomatic patellofemoral arthritis (SPFA) were defined. Statistical package SPSS 14.0, crosstabs chi-squae test and Excel were adopted for statistical analysis. Results One thousanod and twenty-five participants were included in this study and 2050 knee joint Skyline View weight-bearing films were analyzed. The incidence of RPFA was 8.72%(6.8% in men, and 10.5% inwomen). The incidence of SPFA was 6.33% (4.8% in men, and 8.0% in women).The RPFA incidence of age groups 50~, 60~,≥70 was 3.8%, 10.6%, 22.9% respectively, while the incidence of SPFA was 2.7%, 7.7%, 17.3% respectively. The Three age groups' SPFA/RPFA was 71.7%, 72.0%, 75.6% respectively. The incidence of RPFA was 6.00/0, 7.3%, 11.0%, 11.3%, and the incidence of SPFA was 4.2%,5.2%, 7.3%, 9.6% and the four SPFA/RPFA was 70.0%, 71.3%, 66.7%, 84.8% in people whose BMI was less than 18.5, 18.5~, 23.0~ and higher than ≥25.0 kg/m~2 respectively, 73.6% people had joint pain among RPFA.Conclusion The prevalence of symptomatic patellofemoral arthritis in the rural areas of China is 6.8%, the incidence of that in women is higher than in men, and elder people suffer a high incidence. And the heavier the people are, the higher the incidence of patellofemoral arthritis.

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