1.Clinical characteristics and prognosis of Pseudomonas aeruginosa perito-neal dialysis-associated peritonitis
Zhigang WANG ; Yingzhou GENG ; Xiaopei WANG ; Zhao LI ; Changna LIANG ; Wan-hong LU ; Jing LYU
Chinese Journal of Infection Control 2025;24(3):381-387
Objective To analyze the clinical characteristics and prognosis of Pseudomonas aeruginosa peritoneal dialysis-associated peritonitis(PaeP).Methods Peritoneal dialysis-associated peritonitis(PDAP)patients who were followed up in the nephrology outpatient department of a hospital from January 2019 to December 2020 were analyzed retrospectively.According to bacterial culture results,patients were divided into the PaeP group and non-PaeP group.Clinical characteristics of PaeP patients and antimicrobial susceptibility testing results of Pseudomonas aeruginosa were analyzed,clinical manifestations,laboratory test results,and prognosis of two groups of patients were compared.Results A total of 124 peritoneal dialysis patients were included in analysis,164 cases of peritoni-tis occurred,16 cases were in the PaeP group and 148 in the non-PaeP group.11 patients developed 16 episodes of Pseudomonas aeruginosa infection,accounting for 8.9%of PDAP patients.Among them,4 patients had peritoneal dialysis catheter exit-site infection,with 5 recurrence cases,1 case cured,1 case died,and 9 cases were extubated.Among the extubated patients,1 withdrew dialysis,3 were recovered to peritoneal dialysis after hemodialysis,5 changed to permanently hemodialysis,with a technical failure rate of 54.5%.Compared with the non-PaeP group,patients in the PaeP group had a shorter dialysis time(13.83±4.92 vs 38.53±35.77 months).During the infection period,C-reactive protein levels were higher(96.61±6.17 vs 45.87±44.65 mg/L),while albumin levels were lower(25.62±4.42 vs 29.46±8.25 g/L).At the onset of infection,the proportion of polymorphonuclear cells in perito-neal dialysis fluid was relatively higher.On the 5th day of treatment,the negative conversion rate of white blood cell count in peritoneal dialysis fluid was relatively low.Differences were all statistically significant(all P<0.05).The cure rate of patients in the PaeP group was lower than that in the non-PaeP group,the technical failure rate was higher than that in the non-PaeP group,both with statistically significant differences(both P<0.05).There was no statistically significant difference in the mortality between two groups of patients(P>0.05).Conclusion PaeP patients have severe clinical manifestations,poor clinical treatment prognosis,high recurrence and extubation rates.For patients with repeated episodes,resetting and replacing the tunnel after extubation is an effective means to re-duce technical failures.
2.Clinical characteristics and prognosis of Pseudomonas aeruginosa perito-neal dialysis-associated peritonitis
Zhigang WANG ; Yingzhou GENG ; Xiaopei WANG ; Zhao LI ; Changna LIANG ; Wan-hong LU ; Jing LYU
Chinese Journal of Infection Control 2025;24(3):381-387
Objective To analyze the clinical characteristics and prognosis of Pseudomonas aeruginosa peritoneal dialysis-associated peritonitis(PaeP).Methods Peritoneal dialysis-associated peritonitis(PDAP)patients who were followed up in the nephrology outpatient department of a hospital from January 2019 to December 2020 were analyzed retrospectively.According to bacterial culture results,patients were divided into the PaeP group and non-PaeP group.Clinical characteristics of PaeP patients and antimicrobial susceptibility testing results of Pseudomonas aeruginosa were analyzed,clinical manifestations,laboratory test results,and prognosis of two groups of patients were compared.Results A total of 124 peritoneal dialysis patients were included in analysis,164 cases of peritoni-tis occurred,16 cases were in the PaeP group and 148 in the non-PaeP group.11 patients developed 16 episodes of Pseudomonas aeruginosa infection,accounting for 8.9%of PDAP patients.Among them,4 patients had peritoneal dialysis catheter exit-site infection,with 5 recurrence cases,1 case cured,1 case died,and 9 cases were extubated.Among the extubated patients,1 withdrew dialysis,3 were recovered to peritoneal dialysis after hemodialysis,5 changed to permanently hemodialysis,with a technical failure rate of 54.5%.Compared with the non-PaeP group,patients in the PaeP group had a shorter dialysis time(13.83±4.92 vs 38.53±35.77 months).During the infection period,C-reactive protein levels were higher(96.61±6.17 vs 45.87±44.65 mg/L),while albumin levels were lower(25.62±4.42 vs 29.46±8.25 g/L).At the onset of infection,the proportion of polymorphonuclear cells in perito-neal dialysis fluid was relatively higher.On the 5th day of treatment,the negative conversion rate of white blood cell count in peritoneal dialysis fluid was relatively low.Differences were all statistically significant(all P<0.05).The cure rate of patients in the PaeP group was lower than that in the non-PaeP group,the technical failure rate was higher than that in the non-PaeP group,both with statistically significant differences(both P<0.05).There was no statistically significant difference in the mortality between two groups of patients(P>0.05).Conclusion PaeP patients have severe clinical manifestations,poor clinical treatment prognosis,high recurrence and extubation rates.For patients with repeated episodes,resetting and replacing the tunnel after extubation is an effective means to re-duce technical failures.
3.Effect of whey protein on hypoproteinemia in patients with peritoneal dialysis
Yaozhong SHAO ; Changna LIANG ; Yingzhou GENG ; Yinhong JIN ; Luyuan CHANG ; Jing LÜ
Journal of China Medical University 2024;53(2):166-171
Objective To compare the therapeutic efficacy of whey protein powder in peritoneal dialysis hypoproteinemia patients.Methods From August 2019 to August 2020,100 patients with peritoneal dialysis hypoproteinemia from the Peritoneal Dialysis Center of the First Affiliated Hospital of Xi'an Jiaotong University were investigated.The patients were separated into 2 groups randomly;the study group were administered whey protein powder and the control group with high protein food.After 32 weeks of treatment,biochemical and biometric indices including hemoglobin(Hb),albumin(ALB),prealbumin(PA),triglyceride(TG),total cholesterol(TC),phosphorus(P),low density lipoprotein(LDL),high density lipoprotein(HDL),serum creatinine(Scr),blood urea nitrogen(BUN),estimated glo-merular filtration rate(eGFR),total spKt/Vurea(TKt/V),total creatinine clearance rate(TCcr),hand grip strength(HG),triceps skinfold(TSF),arm circumference(AMC),mid-arm muscle circumference(MAMC)were compared between groups.Results Compared with 0 week,at 16 and 32 weeks,ALB,PA,and HG were significantly increased in the study group(P<0.05).Compared with the control group,ALB,PA,and HG increased significantly at 16 and 32 weeks in the study group(P<0.05).There were no significant differences in TG,TC,HDL,LDL,eGFR,TKt/V,and TCcr at 0,8,16,and 32 weeks between the control and study groups(P>0.05).Conclusion For patients with peritoneal dialysis hypoproteinemia caused by insufficient protein intake or excessive protein loss,the addition of whey protein during peritoneal dialysis can significantly improve the nutritional status of patients,with greater efficacy than a high protein diet alone.
4.EFFECTS OF ADENOSINE IN SIMULATED ISCHEMIA AND REPERFUSION ON ISOLATED GUINEA-PIG VENTRICULAR MYOCYTES
Zhenghang ZHAO ; Weijin ZANG ; Xiaojiang YU ; Yingzhou GENG
Journal of Pharmaceutical Analysis 2001;13(1):20-24
Objective To investigate the effects of adenosine (Ado) on myocardiac electrophysiology in simulated ischemia and reperfusion in guinea-pig ventricular myocytes. Methods Electrical activity was recorded using standard intracellular microelectrode technique. Right ventricle was superfused with simulated ischemic Tyrode's solution for 15 min, and reperfued with normal Tyrode's solution for 30 min. Results The results showed Ado had no measurable effects on guinea-pig ventricular myocytes in normal Tyrode's solution. In the presence of Ado, maximal diastolic potential tended to be more depolarized during ischemia, and action potential (AP) parameters were abbreviated greatly in a concentration-dependent manner. Especially, the concentration of Ado 100 μmol·L-1 had significant effects on AP parameters in ischemic phase [APD30, APD50, and APD90 reduced by (86 ± 8) % versus (65± 6) %, (70± 7)%versus (50±6)%, and (60±6)%versus (42±4)% for control after 15 min, P<0.05]. During reperfusion, AP parameters did not completely return to initial values in presence of Ado. This study illustrated that Ado significantly decreased incidence of arrhythmias induced by ischemia and reperfusion (in presence of Ado 100 μmol·L-1, the incidence of DAD decreased by 17% versus 82% for control during reperfusion). Conclusion Ado has no significant effects on guinea-pig ventricle in normal conditions, abbreviates greatly AP parameters during ischemia with a concentration-dependent manner, and has marked antiarrhythmic effects in ischemia and reperfusion.

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