1.Influencing factors for unplanned re-hospitalization in adult renal transplant recipients after surgery
Weiwei CAO ; Minghuan ZHONG ; Zhou SUN ; Guofu LIANG ; Fu YAN ; Chao LIU ; Li MA ; Kejing ZHU ; Yanyan XU ; Bei DING ; Yulin NIU
Journal of Clinical Medicine in Practice 2024;28(18):117-122
Objective To investigate the influencing factors of unplanned rehospitalization within one year after surgery among adult renal transplant recipients. Methods The clinical data of 299 recipients who underwent renal transplant surgery in the Department of Organ Transplantation of the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2022 were retrospectively analyzed. The recipients were divided into unplanned rehospitalization group and non-rehospitalization group based on whether they experienced unplanned rehospitalization within one year after surgery. Univariate analysis and binary Logistic regression analysis were performed to explore the influencing factors of unplanned rehospitalization within one year after renal transplantation. Results Among the 299 recipients, 102 experienced unplanned rehospitalization, with an incidence rate of 34.11%. Univariate analysis revealedstatistically significant differences were noted between the two groups in terms of gender, occupational status, preoperative underlying disease, rejection reactions, nosocomial infections, immunosuppressive medication regimens, serum creatinine, cystatin C, serum phosphorus, serum potassium, and initial hospitalization duration (
2.Risk factors of new-onset hypertriglyceridemia in kidney transplant recipients: a single-center analysis
Yuan XU ; Bo YANG ; Chengxin CHEN ; Kejing ZHU ; Yulin NIU ; Haiyang LI
Organ Transplantation 2023;14(5):691-699
Objective To identify the risk factors of new-onset hypertriglyceridemia (HTG) in kidney transplant recipients. Methods Clinical data of 149 kidney transplant recipients were retrospectively analyzed. According to serum triglyceride (TG) level after operation, they were divided into the non-HTG group (TG≤1.7 mmol/L, n=60) and new-onset HTG group (TG>1.7 mmol/L, n=89). Baseline data of all recipients were compared between two groups. The risk factors of HTG in kidney transplant recipients were analyzed by generalized estimating equation (GEE), and validated by multiple regression equations. Results No significant differences were observed in baseline data between two groups (all P>0.05). Multivariate analysis showed that the incidence of HTG in the middle and high tacrolimus (Tac) concentration groups was higher than that in the low Tac concentration group [odds ratio (OR) 3.11, 95% confidence interval (CI) 1.22-7.93, P=0.018 in the middle Tac concentration group; OR 5.11, 95%CI 1.31-19.98, P=0.019 in the high Tac concentration group]. Compared with type-A blood recipients, the risk of new-onset HTG was significantly increased in type-O blood counterparts (OR 2.77, 95%CI 1.14-6.71, P=0.024). The risk of new-onset HTG was decreased along with the increase of preoperative globulin level (OR 0.93, 95%CI 0.87-0.99, P=0.043). At postoperative 3 months, Tac blood concentration in the new-onset HTG group was significantly higher compared with that in the non-HTG group, and significant difference was observed (P<0.05). Multiple regression equations confirmed that the risk of new-onset HTG in type-O blood kidney transplant recipients was higher than that in type-A blood counterparts, and the risk of new-onset HTG in the middle and high Tac concentration groups was higher than that in the low Tac concentration group (all P<0.05). Conclusions Type-O blood kidney transplant recipients are more prone to HTG. It is necessary to strengthen postoperative monitoring and control of blood lipids. The blood concentration of Tac probably affects the new-onset HTG in kidney transplant recipients. Maintaining an appropriate blood concentration of Tac may be beneficial to lowering the risk of HTG.
3.Tissue factors and venous thromboembolism in cancer patients.
Journal of Zhejiang University. Medical sciences 2020;49(6):772-778
Malignant tumor is one of the important acquired risk factors of venous thromboembolism (VTE). As the transmembrane receptor of coagulation factor Ⅶ and activated coagulation factor Ⅶa
Humans
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Neoplasms/complications*
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Risk Factors
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Thromboplastin/metabolism*
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Thrombosis
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Venous Thromboembolism/physiopathology*
4. Comparison of the relative renal function evaluated by 99Tcm-DMSA and 99Tcm-DTPA imaging in children with acute urinary tract infection
Xiaojia PU ; Wei HU ; Kejing SHAO ; Fei WANG ; Bao ZHU
Chinese Journal of Nuclear Medicine and Molecular Imaging 2019;39(12):739-742
Objective:
To compare the relative renal function (RRF) evaluated by 99Tcm-dimercaptosuccinic acid (DMSA) and 99Tcm-diethylene triamine pentaacetic acid (DTPA) imaging in children with acute urinary tract infection (UTI).
Methods:
A total of 69 children (29 males, 40 females, age: (45±38) months; duration of disease: <6 months) with acute UTI diagnosed clinically in Wuxi People′s Hospital from January 2017 to June 2019 were enrolled retrospectively. All children underwent 99Tcm-DMSA renal static imaging and 99Tcm-DTPA renal dynamic imaging, and the regions of interest (ROI) were drawn manually to calculate the RRF of the right and left kidneys. The consistency of RRF evaluated by the two imaging methods was analyzed by Bland-Altman analysis, the correlation was analyzed by Pearson correlation analysis, and the difference was compared by the independent-sample
5.Application of infectious disease index to prediction of infectious diseases
Xiling YIN ; Wencan DAI ; Song WANG ; Yong ZHOU ; Kejing ZHU ; Xiaodong LIANG ; Deyun LI ; Aijun TAN
Journal of Preventive Medicine 2019;31(9):897-900
Objective:
To establish a prediction model for infectious disease index(IDI)by autoregressive integrated moving average(ARIMA),and to provide forcast of infectious diseases to the public.
Methods:
The data of the percentage of influenza-like illness(ILI),the incidence rates of hand-foot-mouth disease(HFMD)and other infectious diarrhea(OID)from the 1st week of 2014 to the 14th week of 2018,and Breteau index(BI)from the 1st week of 2016 to the 14th week of 2018 were collected. ARIMA models were built to predict the risk indicators of ILI,HFMD,OID and BI. The weights of the four indicators were evaluated seasonally by the entropy weight method. Then the IDI was calculated and the data of ILI,HFMD, OID and BI from 15th to 19th week in 2018 was used for verification.
Results:
The forecast was in summer,so IDI=ROUND(0.33×risk index of ILI percentage +0.47×risk index of HFMD incidence +0.10×risk index of OID incidence+0.10×risk index of BI). The predicted IDI would be 2(less safe)in the whole city and Xiangzhou District,and 1(safe)in Doumen District and Jinwan District. The consistency rates of IDI prediction was 97.50%,95.00%,97.50%,85.00% and 77.50% from 15th to 19th week in 2018,respectively.
Conclusion
It was feasible to use IDI for short-term risk prediction of infectious diseases.
6.Application value of contrast-enhanced transrectal ultrasound in differential diagnosis of benign and malignant prostate nodules
Lianhua ZHU ; Yanli GUO ; Ping CHEN ; Chunlin TANG ; Kaixuan CHEN ; Ying TAN ; Kejing FANG
Chinese Journal of Medical Ultrasound (Electronic Edition) 2018;15(3):233-238
Objective To investigate the application value of contrast-enhanced transrectal ultrasound (CE-TRUS) in differential diagnosis of prostate benign and malignant lesions. Methods A retrospective analysis of patients with prostate lesions detected by CE-TRUS from January 2014 to December 2016 in Southwest Hospital of Third Military Medical University was performed. Seventy-two cases of prostate disease with 88 lesions were confirmed by transrectal prostate biopsy under ultrasound guidance. The age of patients with benign and malignant lesions, serum prostate specific antigen (PSA), and the size of prostate and prostate inner gland were compared by independent sample t test. Pathologic results of transrectal prostate biopsy under ultrasound guidance were used as diagnostic gold standard, and the sensitivity, specificity and accuracy of CE-TRUS in diagnosis of benign and malignant prostate lesions were calculated. Results Sixty- seven lesions in 52 patients were benign prostatic diseases, and 21 lesions in 20 patients were prostate cancer in this study. The size of prostate and prostate inner gland were not different between patients with prostate cancer and benign prostatic diseases [(58.33±34.99) cm3vs (57.14±24.42) cm3, t=0.185, P=0.854; (34.98±19.96) cm3vs (33.89±17.65) cm3, t=0.213, P=0.832]. Most of prostate cancer lesions were in prostate outer gland area (15/21), and contrast-enhanced ultrasound imaging showed contrast enhancement increased mostly in arterial phase and faded faster than the surrounding tissues (16/21). However, most of prostate benign lesions were in prostate inner gland (47/67), and contrast-enhanced ultrasound imaging showed contrast enhancement was mostly equal with the surrounding tissue in arterial phase and faded the same as the surrounding tissues in venous phase (47/67). Pathologic results of transrectal prostate biopsy under ultrasound guidance were used as diagnostic gold standard, the sensitivity of CE-TRUS in diagnosis of benign and malignant prostate lesions was 85.71%, the specificity was 91.04%, and the accuracy was 89.77%. Two lesions were in prostate inner and outer gland border areas in the three missed prostate cancer lesions, and Gleason scores were all medium and high differentiated group. Six prostate benign lesions were diagnosed as malignant lesions, five lesions were confirmed prostate hyperplasia with chronic prostatitis and one was confirmed granulomatous inflammation with coagulation necrosis by transrectal prostate biopsy under ultrasound guidance. Conclusion CE-TRUS can effectively identify prostate benign and malignant lesions, and provides reliable information for accurate diagnosis of prostate cancer.
7.Establishment of biotin-streptavidin time-resolved fluoroimmunoassay method for the measurement of heparanase
Bao ZHU ; Guoqiang XIE ; Hualong XIAO ; Biao HUANG ; Kejing SHAO ; Yafeng XU ; Yi ZHANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2014;34(4):308-311
Objective To establish a novel TRFIA for the measurement of heparanase (HPA) in serum samples,and investigate its clinical application.Methods The micro-pore plate wells were first coated with partially recombinant murine anti-human HPA monoclonal antibody.Biotin-labeled recombinant HPA protein was then used to compete with HPA in serum samples,and the prepared europium (III)-labeled streptavidin (Eu3+-SA) was used as signal readout for establishing the BSA-TRFIA assay.Using this assay,the serum HPA levels in healthy subjects (n=32) and tumor patients (n=54) were measured.The results of BSA-TRFIA were compared with those of ELISA.Two-sample t test (or t' test),and linear correlation analysis were used to analyze the data.Results The sensitivity of BSA-TRFIA for measuring HPA was 0.33 ug/L.The CV values for intra-batch and inter-batch were 5.29% and 7.54%,respectively.The average recovery rate was 105.5%.The standard curve range was 0-1 000 ug/L.The serum HPA level measured by the BSA-TRFIA method in healthy subjects was (2.03_+ 1.47) Iug/L.In tumor patients,the HPA level was significantly higher:(22.13_+7.38) ug/L (t'=19.388,P
8.Effect of anti-syphilis treatment on perinatal outcomes and neonatal prognosis in pregnant women complicated with syphilis
Min ZHOU ; Zhu CHEN ; Yilan ZENG ; Kejing HE ; Zhaohui ZHU ; Haixia HUANG
Chinese Journal of Clinical Infectious Diseases 2013;6(4):226-229
Objective To investigate the effect of anti-syphilis treatment on the perinatal outcomes and neonatal prognosis in pregnant women complicated with syphilis.Methods One hundred and ninety eight pregnant women complicated with syphilis were collected from Chengdu Hospital of Infectious Diseases during January 2010 and January 2012,including 98 cases received standard treatment,59 cases received nonstandard treatment and 41 cases did not receive treatment.Pearson x2 and partition of chi-square were used for the comparison of pregnant outcomes,neonatal prognosis and negative rates of rapid plasma circle card test (RPR) among 3 groups.Results The incidence of adverse pregnancy outcomes,including miscarriage,prematurity,still birth and congenital malformation were 4.08%,27.12% and 63.41% in three groups,respectively.The incidence of congenital syphilis,low birth weight,asphyxia in infants and neonatal death raised in from standard-treatment group,nonstandard-treatment group to untreated group.Congenital syphilis rates were 2.04%,18.75% and 35.29% in three groups,respectively.RPR titers in newborns from mothers with high RPR titer (≥ 1 ∶ 8) in standard-treatment group were significantly lower than those in nonstandard-treatment group and untreated group (x2 =37.122,P < 0.01).RPR negative rates were 100.00%,59.26% and 25.00% in three groups,respectively (x2 =18.839,P < 0.01).Conclusion Standard anti-syphilis treatment can improve pregnant outcome,neonatal prognosis and reduce the incidence of congenital syphilis.
9.Application of left femoral neck radioactive uptake ratio in 99Tcm-MDP bone scan for evaluation of osteoporosis
Bao ZHU ; Kejing SHAO ; Dan YANG ; Hang YUAN ; Hui ZHU ; Xiaojia PU ; Fei WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2013;33(6):440-443
Objective To evaluate the value of 99Tcm-MDP uptake by left femoral neck for diagnosing osteopomsis.Methods A total of 58 cases (23 males,35 females,mean age:(66.15±8.45) years) with spondyloarthmpathies from May to December of 2012 were selected.Serum concentrations of type Ⅰ collagen telopeptide (sCTX-1) and bone ALP (BALP) were determined.All patients underwent dual-energy X-ray absorptiometry (DXA) to detect bone mineral density (BMD).According to the T scores,patients were divided into 2 groups:normal group (NG) (T>-1.0) and osteoporosis group (OG) (T≤-2.5).99TcmMDP bone scan was further performed.The average radioactive ratio of the left femoral neck to the medial soft tissue of left femur (T/N) was measured.Data differences between the 2 groups were compared by twosample t test and Pearson correlation analysis.Results According to BMD,13 patients (7 males,6 females) were included in NG and 28 patients (10 males,18 females) were included in OG.The mean ages of OG and NG were significantly different ((68.82± 10.41) years vs (62.46± 11.77) years; t =3.560,P<0.05).The BMD of left femoral neck in OG was significantly lower than that in NG ((0.67±0.08) g/cm2 vs (0.91±0.10) g/cm2 ; t=9.917,P<0.01).Although BALP level of OG was significantly higher than that of NG ((35.92±11.58) U/L vs (22.38±6.34) U/L; t=-3.397,P<0.05),no significant difference was observed on sCTX-1 between the 2 groups (t=-0.463,P>0.05).T/N ratio of OG (11.63±6.22) was higher than that of NG (9.74±4.44) (t =-3.027,P< 0.05).There were significant correlations between the T/N ratio of the left femoral neck and the sCTX-1 and BALP concentrations (r=0.376,0.483,both P<0.01).No correlations between the T/N ratio of the left femoral neck and age,BMI and BMD were observed (r=-2.031,-0.017,0.134,all P>0.05).Conclusion The uptake ratio of the left femoral neck in 99Tcm-MDP bone scan could evaluate the metabolism of bone,and it is useful for the early diagnosis of osteoporosis.
10.Perioperative intervention to prevent lower extremity deep venous thrombosis after gynecologic surgery
Zhijun ZHU ; Suhua FANG ; Minzhen WANG ; Hongying LOU ; Jing SHU ; Kejing YING
Chinese Journal of Obstetrics and Gynecology 2009;44(9):669-672
Objective To investigate the preventative effect of perioperative intervention to lower extremity deep venous thrombosis (DVT) after gynecologic surgery. Methods The 1062 patients, who received gynecologic surgery during 2007 June to 2008 June, were derided into intervention and nonintervention groups randomizely. According to the risk factors of DVT, the patients in intervention group were divided into 4 subgroups: low, mid, high and extremely high rise Each group had its own preventive measures. If patients had spontaneous pain, tenderness and swelling, positivity of Neuhof or Homan syndrome, and extension of one low extremity superficial vein, the low extremity color Doppler ultrasound would be carried out immediately. The ultrasound would also be routinely carried out in the high and extremely high risk groups in intervention group after 2 and 7 days after surgery. A prospective study was carried out investigating incidence of DVT and coagulation function perioperation. The vein blood samples were taken at in a week before surgery and 48 hours post-operation. Results The incidence of DVT of intervention group was 1.10% (6/546), and in nonintervention group, the incidence was 3.29% (17/ 516). There was significant difference between two groups (P<0.05). The incidence of DVT in extremely high risk subgroup was 21.05% (4/19), which was significantly higher than that of low(0), mid(0) and high risk groups[2.13% (2/94), P<0.05]. D-dimer, antithrombin-Ⅲ(AT-Ⅲ) post-operation were all higher than that pre-operation in the two groups, but there was no significant difference (P>0.05). The indexes of coagulation system, such as blood platelet count, prothrombin time (PT), active partial throraboplastin time (APTT), fibrinogen (Fbg), thrombin time (TT), tissue-plasminogen activator (t-PA), plasminogen activator inhibitor(PAI), were not significantly changed perioperation (P>0.05 in all pre-or post-operation indexes). Conclusions Perioperative intervention measurement according to different risk of DVT could cut down the incidence of DVT. DVT preventive intervention is suggested to high and extremely high risk people.


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