1.Perioperative risk factors for chronic kidney disease after acute type A aortic dissection repair: A retrospective cohort study
Pianpian YAN ; Xijie WU ; Shengwen GUO ; Yiting HUANG ; Meili LU ; Lulu JIANG ; Yanqing ZHOU ; Jiarong MA
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(11):1588-1596
Objective To investigate the renal function recovery and perioperative risk factors for chronic kidney disease in patients after acute Stanford type A aortic dissection (ATAAD) repair. Methods A retrospective study was conducted on patients who underwent ATAAD repair at the Xiamen Cardiovascular Hospital, Xiamen University from 2020 to 2021, and their clinical data were analyzed. Results A total of 255 patients were included, with 200 males and 55 females, and an average age of (52.80±12.46) years. The incidence of acute kidney injury (AKI) after ATAAD repair was 43.9%. Dissection involving the renal artery [OR=2.144, 95%CI (1.234, 3.765), P=0.007], intraoperative urine output [OR=0.761, 95%CI (0.625, 0.911), P=0.004], and intraoperative red blood cell transfusion [OR=1.288, 95%CI (1.088, 1.543), P=0.004] were significantly associated with early AKI after ATAAD repair. Long-term renal function follow-up data were available for 232 patients, among whom 40 (17.2%) patients developed chronic kidney disease (CKD). Independent predictors for CKD included lower body mass index [OR=0.827, 95%CI (0.723, 0.931), P=0.003], preoperative cardiac tamponade [OR=5.344, 95%CI (1.65, 17.958), P=0.005], preoperative renal hypoperfusion syndrome [OR=12.629, 95%CI (5.003, 35.373), P<0.001], postoperative peak serum creatinine time>3 d [OR=7.566, 95%CI (2.799, 22.731), P<0.001], and AKI grade [grade 1: OR=4.418, 95%CI (1.339, 15.361), P=0.016; grade 2: OR=8.345, 95%CI (1.762, 40.499), P=0.007; grade 3: OR=9.463, 95%CI (2.602, 37.693), P<0.001]. Conclusion AKI related to ATAAD repair can recover in the early postoperative period, but both the duration and severity of AKI will affect long-term renal function. In addition, patients' nutritional status, preoperative cardiac tamponade, and renal hypoperfusion syndrome are also independent risk factors for long-term renal dysfunction.
2.Improvement mechanism of proanthocyanidins on gentamicin-induced acute kidney injury of rats through SIRT1/AMPK signaling pathway
Meili FU ; Qiang JIANG ; Shengliang FU ; Shushan FU ; Taomei XIE ; Shanshan LI
China Pharmacy 2024;35(7):807-812
OBJECTIVE To explore the improvement mechanism of proanthocyanidins on acute kidney injury (AKI) induced by gentamicin in rats. METHODS Gentamicin sulfate was injected intraperitoneally to construct the AKI rat model; the model rats were randomly divided into model control group, benazepril hydrochloride 5 mg/kg group (positive control), proanthocyanidins 50 mg/kg group, proanthocyanidins 100 mg/kg group, and proanthocyanidins 200 mg/kg group, with 10 rats in each group; in addition, 10 normal rats were selected to be treated as the normal control group. The rats in each administration group were given corresponding liquid intragastrically, and the normal control group and model control group were given equal volumes of normal saline intragastrically, once a day, for 28 consecutive days. After the last administration, the levels of serum creatinine (SCr), blood urea nitrogen (BUN), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and 24 h urinary protein (UP) were detected; the renal index was calculated; the pathological changes of renal tissue were observed and the pathological score was calculated; the apoptotic rate of cells in renal tissue and the expression levels of Caspase-3 and Bcl-2 associated X protein (Bax), as well as the phosphorylation levels of silent information regulator of transcription 1 (SIRT1) and AMP-activated protein kinase (AMPK) were detected. RESULTS Compared with the model control group, the levels of SCr, BUN, UP and MDA, the renal index, the pathological score of renal tissue, the apoptotic rate of cells in renal tissue, the protein expression levels of Caspase-3 and Bax in renal tissue of rats in each administration group were decreased significantly; SOD and GSH-Px levels, phosphorylation levels of SIRT1 and AMPK protein were increased significantly (P<0.05), and the effect of proanthocyanidins was in a dose-dependent manner (P<0.05). There were no significant differences in the above indexes between proanthocyanidins 200 mg/kg group and benazepril hydrochloride 5 mg/kg group (P>0.05). CONCLUSIONS The improvement effect of proanthocyanidins on AKI rats may be related to the activation of SIRT1/AMPK signaling pathway to inhibit oxidative stress.
3.Evolutionary Game Analysis of the Implementation of the Annual Salary System for Principal Officials in Public Hospi-tals
Mian XIA ; Shengjie YIN ; Shuai JIANG ; Meili ZHANG
Chinese Health Economics 2024;43(5):5-8
Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.
4.Evolutionary Game Analysis of the Implementation of the Annual Salary System for Principal Officials in Public Hospi-tals
Mian XIA ; Shengjie YIN ; Shuai JIANG ; Meili ZHANG
Chinese Health Economics 2024;43(5):5-8
Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.
5.Evolutionary Game Analysis of the Implementation of the Annual Salary System for Principal Officials in Public Hospi-tals
Mian XIA ; Shengjie YIN ; Shuai JIANG ; Meili ZHANG
Chinese Health Economics 2024;43(5):5-8
Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.
6.Current status of tuberculosis burden in China
Xinyao WANG ; Meili JIANG ; Yuanjie PANG ; Dianjianyi SUN ; Canqing YU ; Lan WANG ; Jun LYU ; Liming LI
Chinese Journal of Epidemiology 2024;45(6):857-864
Tuberculosis, caused by Mycobacterium tuberculosis, is an infectious disease that most often affects the lungs. China is still among the high-burden tuberculosis countries in the world. Although the estimated incidence of tuberculosis in China has declined in recent years, the declining rate is slow. It still faces major issues such as a slower rate of decline, a widening gap between estimated and notified incidence, higher risk among middle-aged and older adults, a high number of cases among agriculture and related workers, and a heavier disease burden in the country's western regions. In addition, latent tuberculosis infection, drug-resistant tuberculosis, tuberculosis coinfection with HIV, and extrapulmonary tuberculosis have also exacerbated the disease burden of tuberculosis to some extent. This paper reviewed the epidemic characteristics of tuberculosis, the epidemiological triad, three links and two factors in the transmission process, the disease burden, and other aspects to provide a reference for formulating prevention and control strategies on tuberculosis.
7.Evolutionary Game Analysis of the Implementation of the Annual Salary System for Principal Officials in Public Hospi-tals
Mian XIA ; Shengjie YIN ; Shuai JIANG ; Meili ZHANG
Chinese Health Economics 2024;43(5):5-8
Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.
8.Evolutionary Game Analysis of the Implementation of the Annual Salary System for Principal Officials in Public Hospi-tals
Mian XIA ; Shengjie YIN ; Shuai JIANG ; Meili ZHANG
Chinese Health Economics 2024;43(5):5-8
Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.
9.Evolutionary Game Analysis of the Implementation of the Annual Salary System for Principal Officials in Public Hospi-tals
Mian XIA ; Shengjie YIN ; Shuai JIANG ; Meili ZHANG
Chinese Health Economics 2024;43(5):5-8
Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.
10.Evolutionary Game Analysis of the Implementation of the Annual Salary System for Principal Officials in Public Hospi-tals
Mian XIA ; Shengjie YIN ; Shuai JIANG ; Meili ZHANG
Chinese Health Economics 2024;43(5):5-8
Objective:It explores how to promote the effective implementation of the annual salary system in public hospital.Methods:On the basis of the existing annual salary system reform,through evolutionary game model,it analyzes the key factors that affect strategy selection of government and principal person in charge of hospitals during the implementation of the annual salary sys-tem.Results:In addition to the interaction between behavioral agents,the cost of government supervision,the internal and external pressure of social and administrative systems affect the strategic choice of government.The level and structure of annual salary,the difficulty degree of achieving performance goals and intensity of punishment affect the strategic choice of the main person in charge of hospital.Conclusion:In order to improve the implementation of the annual salary system,government should make a reasonable sala-ry scheme,improve the reward and punishment mechanism and reduce transaction costs.

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