Objective: To evaluate the health benefits and intervention efficiency of different strategies of initiating antihypertensive therapy for the primary prevention of cardiovascular diseases in a community-based Chinese population from the Chinese electronic health records research in Yinzhou (CHERRY) study.
Methods: A decision-analytic Markov model was used to simulate and compare different antihypertensive initiation strategies, including: Strategy 1, initiation of antihypertensive therapy for Chinese adults with systolic blood pressure (SBP) ≥140 mmHg (2020 Chinese guideline on the primary prevention of cardiovascular diseases); Strategy 2, initiation of antihypertensive therapy for Chinese adults with SBP ≥130 mmHg; Strategy 3, initiation of antihypertensive therapy for Chinese adults with SBP≥140 mmHg, or with SBP between 130 and 140 mmHg and at high risk of cardiovascular diseases (2017 American College of Cardiology/American Heart Association guideline for the prevention, detection, evaluation, and management of high blood pressure in adults); Strategy 4, initiation of antihypertensive therapy for Chinese adults with SBP≥160 mmHg, or with SBP between 140 and 160 mmHg and at high risk of cardiovascular diseases (2019 United Kingdom National Institute for Health and Care Excellence guideline for the hypertension in adults: Diagnosis and management). The high 10-year cardiovascular risk was defined as the predicted risk over 10% based on the 2019 World Health Organization cardiovascular disease risk charts. Different strategies were simulated by the Markov model for ten years (cycles), with parameters mainly from the CHERRY study or published literature. After ten cycles of simulation, the numbers of quality-adjusted life years (QALY), cardiovascular events and all-cause deaths were calculated to evaluate the health benefits of each strategy, and the numbers needed to treat (NNT) for each cardiovascular event or all-cause death could be prevented were calculated to assess the intervention efficiency. One-way sensitivity analysis on the uncertainty of incidence rates of cardiovascular disease and probabilistic sensitivity analysis on the uncertainty of hazard ratios of interventions were conducted.
Results: A total of 213 987 Chinese adults aged 35-79 years without cardiovascular diseases were included. Compared with strategy 1, the number of cardiovascular events that could be prevented in strategy 2 increased by 666 (95% UI: 334-975), while the NNT per cardiovascular event prevented increased by 10 (95% UI: 7-20). In contrast to strategy 1, the number of cardiovascular events that could be prevented in strategy 3 increased by 388 (95% UI: 194-569), and the NNT per cardiovascular event prevented decreased by 6 (95% UI: 4-12), suggesting that strategy 3 had better health benefits and intervention ef
{"title":"[Comparison of initiation of antihypertensive therapy strategies for primary prevention of cardiovascular diseases in Chinese population: A decision-analytic Markov modelling study].","authors":"Tianjing Zhou, Qiuping Liu, Minglu Zhang, Xiaofei Liu, Jiali Kang, Peng Shen, Hongbo Lin, Xun Tang, Pei Gao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the health benefits and intervention efficiency of different strategies of initiating antihypertensive therapy for the primary prevention of cardiovascular diseases in a community-based Chinese population from the Chinese electronic health records research in Yinzhou (CHERRY) study.</p><p><strong>Methods: </strong>A decision-analytic Markov model was used to simulate and compare different antihypertensive initiation strategies, including: Strategy 1, initiation of antihypertensive therapy for Chinese adults with systolic blood pressure (SBP) ≥140 mmHg (<i>2020 Chinese guideline on the primary prevention of cardiovascular diseases</i>); Strategy 2, initiation of antihypertensive therapy for Chinese adults with SBP ≥130 mmHg; Strategy 3, initiation of antihypertensive therapy for Chinese adults with SBP≥140 mmHg, or with SBP between 130 and 140 mmHg and at high risk of cardiovascular diseases (<i>2017 American College of Cardiology</i>/<i>American Heart Association guideline for the prevention</i>, <i>detection</i>, <i>evaluation</i>, <i>and management of high blood pressure in adults</i>); Strategy 4, initiation of antihypertensive therapy for Chinese adults with SBP≥160 mmHg, or with SBP between 140 and 160 mmHg and at high risk of cardiovascular diseases (<i>2019 United Kingdom National Institute for Health and Care Excellence guideline for the hypertension in adults</i>: <i>Diagnosis and management</i>). The high 10-year cardiovascular risk was defined as the predicted risk over 10% based on the 2019 World Health Organization cardiovascular disease risk charts. Different strategies were simulated by the Markov model for ten years (cycles), with parameters mainly from the CHERRY study or published literature. After ten cycles of simulation, the numbers of quality-adjusted life years (QALY), cardiovascular events and all-cause deaths were calculated to evaluate the health benefits of each strategy, and the numbers needed to treat (NNT) for each cardiovascular event or all-cause death could be prevented were calculated to assess the intervention efficiency. One-way sensitivity analysis on the uncertainty of incidence rates of cardiovascular disease and probabilistic sensitivity analysis on the uncertainty of hazard ratios of interventions were conducted.</p><p><strong>Results: </strong>A total of 213 987 Chinese adults aged 35-79 years without cardiovascular diseases were included. Compared with strategy 1, the number of cardiovascular events that could be prevented in strategy 2 increased by 666 (95% <i>UI</i>: 334-975), while the NNT per cardiovascular event prevented increased by 10 (95% <i>UI</i>: 7-20). In contrast to strategy 1, the number of cardiovascular events that could be prevented in strategy 3 increased by 388 (95% <i>UI</i>: 194-569), and the NNT per cardiovascular event prevented decreased by 6 (95% <i>UI</i>: 4-12), suggesting that strategy 3 had better health benefits and intervention ef","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11167542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To analyze the clinical data of histiocytic necrotizing lymphadenitis(HNL), comparing the similarities and differences between children and adults, to deepen the understanding of the disease by clinical physicians, and to improve diagnostic rate and reduce misdiagnosis and mistreatment.
Methods: The clinical data of hospitalized patients with histiocytic necrotizing lymphadenitis diagnosed by biopsy from January 2010 to August 2023 in Peking University First Hospital were collec-ted, and the clinical features, laboratory examinations, pathological features, treatments with antibiotics and glucocorticoids, and prognosis of histiocytic necrotic lymphadenitis were analyzed. Grouped based on age, the differences of clinical characteristics, laboratory tests, treatment, and prognosis between the children group (< 16 years old) and the adult group (≥16 years old) were compared.
Results: Among the 81 enrolled patients, there were 42 males and 39 females. The median age was 21(14, 29) years, the median duration of disease was 20.0(13.0, 30.0) days, and the median length of hospital stay was 13.0 (10.0, 15.0) days. The first symptoms were fever, lymphadenopathy, and both. All the patients had enlarged lymph nodes with different parts and sizes, 96.3% (78 of 81) of the patients had cervical lymphadenopathy, 50.6% (41 of 81) had bilateral cervical lymphadenopathy, 55.6% (45 of 81) had supraclavicular, axillary or inguinal lymphadenopathy, and the median lymph node diameter was 20.0(20.0, 30.0) mm. Only one patient had no fever, the other 80 patients had fever, the median peak body temperature was 39.0(38.0, 39.8) ℃. Accompanying symptoms: rash (8.6%, 7/81), fatigue (34.6%, 28/81), night sweating (8.6%, 7/81), chills (25.3%, 25/81), muscle soreness (13.6%, 11/81), and joint pain (6.2%, 5/81). There were 17 cases (21.0%, 17/81) of hepatosplenomegaly, of which 12 cases (70.6%, 12/17) were splenomegaly. 68.8%(55/80) of patients had a decrease in white blood cell (WBC) count, with 47.5%(38/80)increased in lymphocyte(LY)proportion, 53.4%(39/73) increased in high-sensitivity C-reactive protein(CRP), 79.2%(57/72) increased in erythrocyte sedimentation rate(ESR), 22.2%(18/81) increased in alanine transaminase(ALT), 27.2%(22/81) elevated in aspartate transaminase(AST), and 81.6%(62/76) elevated in lactate dehydrogenase(LDH). All the 81 patients underwent lymph node biopsy, and 77.8%(63/81) of the patients showed that most of the structures in the lymph nodes were destroyed or disappeared, and 16.0%(13/81) of the lymph nodes were still in existence, hyperplasia and normal lymph node were 1.2%(1/81) respectively, and 3.7%(3/81) had normal lymph node structures. Immunohistochemical staining was performed in 67 cases. The percentages of CD3+ and CD68(KP1)+ were respectively 97.0%(65/67), and MPO+ were 94.0%(63/67). In the study, 51 patients (63.0%, 51/81) were tr
{"title":"[Clinical characteristics and treatment in adults and children with histiocytic necroti-zing lymphadenitis].","authors":"Xiuwen Fei, Si Liu, Bo Wang, Aimei Dong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical data of histiocytic necrotizing lymphadenitis(HNL), comparing the similarities and differences between children and adults, to deepen the understanding of the disease by clinical physicians, and to improve diagnostic rate and reduce misdiagnosis and mistreatment.</p><p><strong>Methods: </strong>The clinical data of hospitalized patients with histiocytic necrotizing lymphadenitis diagnosed by biopsy from January 2010 to August 2023 in Peking University First Hospital were collec-ted, and the clinical features, laboratory examinations, pathological features, treatments with antibiotics and glucocorticoids, and prognosis of histiocytic necrotic lymphadenitis were analyzed. Grouped based on age, the differences of clinical characteristics, laboratory tests, treatment, and prognosis between the children group (< 16 years old) and the adult group (≥16 years old) were compared.</p><p><strong>Results: </strong>Among the 81 enrolled patients, there were 42 males and 39 females. The median age was 21(14, 29) years, the median duration of disease was 20.0(13.0, 30.0) days, and the median length of hospital stay was 13.0 (10.0, 15.0) days. The first symptoms were fever, lymphadenopathy, and both. All the patients had enlarged lymph nodes with different parts and sizes, 96.3% (78 of 81) of the patients had cervical lymphadenopathy, 50.6% (41 of 81) had bilateral cervical lymphadenopathy, 55.6% (45 of 81) had supraclavicular, axillary or inguinal lymphadenopathy, and the median lymph node diameter was 20.0(20.0, 30.0) mm. Only one patient had no fever, the other 80 patients had fever, the median peak body temperature was 39.0(38.0, 39.8) ℃. Accompanying symptoms: rash (8.6%, 7/81), fatigue (34.6%, 28/81), night sweating (8.6%, 7/81), chills (25.3%, 25/81), muscle soreness (13.6%, 11/81), and joint pain (6.2%, 5/81). There were 17 cases (21.0%, 17/81) of hepatosplenomegaly, of which 12 cases (70.6%, 12/17) were splenomegaly. 68.8%(55/80) of patients had a decrease in white blood cell (WBC) count, with 47.5%(38/80)increased in lymphocyte(LY)proportion, 53.4%(39/73) increased in high-sensitivity C-reactive protein(CRP), 79.2%(57/72) increased in erythrocyte sedimentation rate(ESR), 22.2%(18/81) increased in alanine transaminase(ALT), 27.2%(22/81) elevated in aspartate transaminase(AST), and 81.6%(62/76) elevated in lactate dehydrogenase(LDH). All the 81 patients underwent lymph node biopsy, and 77.8%(63/81) of the patients showed that most of the structures in the lymph nodes were destroyed or disappeared, and 16.0%(13/81) of the lymph nodes were still in existence, hyperplasia and normal lymph node were 1.2%(1/81) respectively, and 3.7%(3/81) had normal lymph node structures. Immunohistochemical staining was performed in 67 cases. The percentages of CD3<sup>+</sup> and CD68(KP1)<sup>+</sup> were respectively 97.0%(65/67), and MPO<sup>+</sup> were 94.0%(63/67). In the study, 51 patients (63.0%, 51/81) were tr","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11167557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yao Zhang, Jinxin Guo, Shijia Zhan, Enyu Hong, Hui Yang, Anna Jia, Yan Chang, Yongli Guo, Xuan Zhang
Objective: To investigate the function and underlying mechanism of cysteine and glycine-rich protein 2 (CSRP2) in neuroblastoma (NB).
Methods: The correlation between the expression level of CSRP2 mRNA and the prognosis of NB children in NB clinical samples was analyzed in R2 Genomics Analysis and Visualization Platform. The small interfering RNA (siRNA) targeting CSRP2 or CSRP2 plasmid were transfected to NB cell lines SK-N-BE(2) and SH-SY5Y. Cell proliferation was observed by crystal violet staining and real-time cellular analysis. The ability of colony formation of NB cells was observed by colony-forming unit assay. Immunofluorescence assay was used to detect the expression of the proliferation marker Ki-67. Flow cytometry analysis for cell cycle proportion was used with cells stained by propidium iodide (PI). Annexin V/7AAD was used to stain cells and analyze the percentage of cell apoptosis. The ability of cell migration was determined by cell wound-healing assay. The level of protein and mRNA expression of CSRP2 in NB primary tumor and NB cell lines were detected by Western blot and quantitative real-time PCR (RT-qPCR).
Results: By analyzing the NB clinical sample databases, it was found that the expression levels of CSRP2 in high-risk NB with 3/4 stages in international neuroblastoma staging system (INSS) were significantly higher than that in low-risk NB with 1/2 INSS stages. The NB patients with high expression levels of CSRP2 were shown lower overall survival rate than those with low expression levels of CSRP2. We detected the protein levels of CSRP2 in the NB samples by Western blot, and found that the protein level of CSRP2 in 3/4 INSS stages was significantly higher than that in 1/2 INSS stages. Knockdown of CSRP2 inhibited cell viability and proliferation of NB cells. Overexpression of CSRP2 increased the proliferation of NB cells. Flow cytometry showed that the proportion of sub-G1, G0/G1 and S phase cells and Annexin V positive cells were increased after CSRP2 deficiency. In the cell wound-healing assay, the healing rate of NB cells was significantly attenuated after knockdown of CSRP2. Further mechanism studies showed that the proportion of the proliferation marker Ki-67 and the phosphorylation levels of extracellular signal-regulated kinases 1/2 (ERK1/2) were significantly decreased after CSRP2 knockdown.
Conclusion: CSRP2 is highly expressed in high-risk NB with 3/4 INSS stages, and the expression levels of CSRP2 are negatively correlated with the overall survival of NB patients. CSRP2 significantly increased the proliferation and cell migration of NB cells and inhibited cell apoptosis via the activation of ERK1/2. All these results indicate that CSRP2 promotes the progression of NB by activating ERK1/2, and this study will provide a potential target for high-risk NB ther
目的研究富含半胱氨酸和甘氨酸的蛋白2(CSRP2)在神经母细胞瘤(NB)中的功能及其内在机制:方法:在R2基因组学分析和可视化平台上分析NB临床样本中CSRP2 mRNA的表达水平与NB患儿预后的相关性。将靶向CSRP2的小干扰RNA(siRNA)或CSRP2质粒转染至NB细胞株SK-N-BE(2)和SH-SY5Y。通过水晶紫染色和实时细胞分析观察细胞增殖。通过集落形成单位检测观察 NB 细胞的集落形成能力。免疫荧光试验用于检测增殖标志物 Ki-67 的表达。使用流式细胞仪分析细胞周期比例,细胞用碘化丙啶(PI)染色。Annexin V/7AAD 用于染色细胞并分析细胞凋亡的比例。细胞迁移能力通过细胞伤口愈合试验进行测定。通过 Western 印迹和实时定量 PCR(RT-qPCR)检测 CSRP2 在 NB 原发肿瘤和 NB 细胞系中的蛋白和 mRNA 表达水平:结果:通过分析NB临床样本数据库发现,国际神经母细胞瘤分期系统(INSS)3/4期的高危NB中CSRP2的表达水平明显高于INSS 1/2期的低危NB。CSRP2高表达水平的NB患者的总生存率低于CSRP2低表达水平的患者。我们通过Western印迹检测了NB样本中CSRP2的蛋白水平,发现3/4 INSS期的CSRP2蛋白水平明显高于1/2 INSS期的CSRP2蛋白水平。敲除CSRP2会抑制NB细胞的活力和增殖。过表达CSRP2会增加NB细胞的增殖。流式细胞术显示,缺乏CSRP2后,亚G1期、G0/G1期和S期细胞以及Annexin V阳性细胞的比例增加。在细胞伤口愈合试验中,敲除 CSRP2 后,NB 细胞的愈合率明显下降。进一步的机制研究表明,CSRP2敲除后,增殖标志物Ki-67的比例和细胞外信号调节激酶1/2(ERK1/2)的磷酸化水平明显下降:结论:CSRP2在INSS 3/4期的高危NB中高表达,CSRP2的表达水平与NB患者的总生存率呈负相关。CSRP2能明显增加NB细胞的增殖和迁移,并通过激活ERK1/2抑制细胞凋亡。所有这些结果表明,CSRP2通过激活ERK1/2促进NB的进展,这项研究将为高危NB的治疗提供一个潜在的靶点。
{"title":"[Role and mechanism of cysteine and glycine-rich protein 2 in the malignant progression of neuroblastoma].","authors":"Yao Zhang, Jinxin Guo, Shijia Zhan, Enyu Hong, Hui Yang, Anna Jia, Yan Chang, Yongli Guo, Xuan Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the function and underlying mechanism of cysteine and glycine-rich protein 2 (CSRP2) in neuroblastoma (NB).</p><p><strong>Methods: </strong>The correlation between the expression level of <i>CSRP2</i> mRNA and the prognosis of NB children in NB clinical samples was analyzed in R2 Genomics Analysis and Visualization Platform. The small interfering RNA (siRNA) targeting <i>CSRP2</i> or CSRP2 plasmid were transfected to NB cell lines SK-N-BE(2) and SH-SY5Y. Cell proliferation was observed by crystal violet staining and real-time cellular analysis. The ability of colony formation of NB cells was observed by colony-forming unit assay. Immunofluorescence assay was used to detect the expression of the proliferation marker Ki-67. Flow cytometry analysis for cell cycle proportion was used with cells stained by propidium iodide (PI). Annexin V/7AAD was used to stain cells and analyze the percentage of cell apoptosis. The ability of cell migration was determined by cell wound-healing assay. The level of protein and mRNA expression of <i>CSRP2</i> in NB primary tumor and NB cell lines were detected by Western blot and quantitative real-time PCR (RT-qPCR).</p><p><strong>Results: </strong>By analyzing the NB clinical sample databases, it was found that the expression levels of <i>CSRP2</i> in high-risk NB with 3/4 stages in international neuroblastoma staging system (INSS) were significantly higher than that in low-risk NB with 1/2 INSS stages. The NB patients with high expression levels of <i>CSRP2</i> were shown lower overall survival rate than those with low expression levels of <i>CSRP2</i>. We detected the protein levels of CSRP2 in the NB samples by Western blot, and found that the protein level of CSRP2 in 3/4 INSS stages was significantly higher than that in 1/2 INSS stages. Knockdown of <i>CSRP2</i> inhibited cell viability and proliferation of NB cells. Overexpression of CSRP2 increased the proliferation of NB cells. Flow cytometry showed that the proportion of sub-G1, G0/G1 and S phase cells and Annexin V positive cells were increased after <i>CSRP2</i> deficiency. In the cell wound-healing assay, the healing rate of NB cells was significantly attenuated after knockdown of <i>CSRP2</i>. Further mechanism studies showed that the proportion of the proliferation marker Ki-67 and the phosphorylation levels of extracellular signal-regulated kinases 1/2 (ERK1/2) were significantly decreased after <i>CSRP2</i> knockdown.</p><p><strong>Conclusion: </strong>CSRP2 is highly expressed in high-risk NB with 3/4 INSS stages, and the expression levels of CSRP2 are negatively correlated with the overall survival of NB patients. CSRP2 significantly increased the proliferation and cell migration of NB cells and inhibited cell apoptosis via the activation of ERK1/2. All these results indicate that CSRP2 promotes the progression of NB by activating ERK1/2, and this study will provide a potential target for high-risk NB ther","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11167550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spontaneous renal cyst hemorrhage is one of the clinical emergencies in peritoneal dialysis (PD) patients and is potentially life-threatening. The main complaints are sudden low back pain, paleness, and hypotensive shock with or without vomiting or fever. In contrast to inherited polycystic kidney disease, acquired cystic kidney disease (ACKD) secondary to chronic kidney disease is easily overlooked or delayed in clinical diagnosis and treatment, leading to severe clinical outcomes. We report three patients with spontaneous hemorrhage of ACKD in the peritoneal dialysis center at Peking University First Hospital. The common features are as follows, long history of dialysis, mild to severe low back pain, decrease in hemoglobulin, negative PD solutions, diagnosis established through computed tomography (CT), and continuing PD during treatment of ACKD hemorrhage. Treatments vary from conservative to unilaterally selective renal artery embolization. In this study, ACKD morbidity was investigated in PD patients. A total of 316 patients who had an abdominal ultrasound, CT, or magnetic resonance imaging (MRI) in the past 1 year were enrolled. Among them, 103 cases (32.9%) met the diagnostic criteria of ACKD. The morbidity rates were 27.5%, 37.8%, 43.8%, 59.1%, and 88.6%, when the dialysis history ranged from ≤3, >3 & ≤5, >5 & ≤7, >7 & ≤9, >9 years, respectively, showing a increasing trend. Most ACKD hemorrhages could be healed and got an acceptable prognosis after treatment, including rest, blood transfusion, selective renal artery embolization, or nephrectomy. We summarize the risk factors, including a long history of dialysis, anticoagulation or antiplatelet, and inflammation or stones of the urinary system, but with no difference in initial kidney diseases and gender. ACKD hemorrhage mainly includes intracapsular hemorrhage, cyst rupture, and spontaneous retroperitoneal hemorrhage. In addition, we also recommend an adaptive process for spontaneous kidney hemorrhage of diagnosis and treatment in peritoneal dialysis patients. The significance of these cases lies in the fact that patients with ACKD are potentially associated with complications such as cyst hemorrhage and malignancy. Thus, peritoneal dialysis physicians should place great importance on the surveillance of ACKD.
{"title":"[Acquired cystic kidney hemorrhage in peritoneal dialysis patients: A report of three cases].","authors":"Wanyin Hou, Jie Dong","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Spontaneous renal cyst hemorrhage is one of the clinical emergencies in peritoneal dialysis (PD) patients and is potentially life-threatening. The main complaints are sudden low back pain, paleness, and hypotensive shock with or without vomiting or fever. In contrast to inherited polycystic kidney disease, acquired cystic kidney disease (ACKD) secondary to chronic kidney disease is easily overlooked or delayed in clinical diagnosis and treatment, leading to severe clinical outcomes. We report three patients with spontaneous hemorrhage of ACKD in the peritoneal dialysis center at Peking University First Hospital. The common features are as follows, long history of dialysis, mild to severe low back pain, decrease in hemoglobulin, negative PD solutions, diagnosis established through computed tomography (CT), and continuing PD during treatment of ACKD hemorrhage. Treatments vary from conservative to unilaterally selective renal artery embolization. In this study, ACKD morbidity was investigated in PD patients. A total of 316 patients who had an abdominal ultrasound, CT, or magnetic resonance imaging (MRI) in the past 1 year were enrolled. Among them, 103 cases (32.9%) met the diagnostic criteria of ACKD. The morbidity rates were 27.5%, 37.8%, 43.8%, 59.1%, and 88.6%, when the dialysis history ranged from ≤3, >3 & ≤5, >5 & ≤7, >7 & ≤9, >9 years, respectively, showing a increasing trend. Most ACKD hemorrhages could be healed and got an acceptable prognosis after treatment, including rest, blood transfusion, selective renal artery embolization, or nephrectomy. We summarize the risk factors, including a long history of dialysis, anticoagulation or antiplatelet, and inflammation or stones of the urinary system, but with no difference in initial kidney diseases and gender. ACKD hemorrhage mainly includes intracapsular hemorrhage, cyst rupture, and spontaneous retroperitoneal hemorrhage. In addition, we also recommend an adaptive process for spontaneous kidney hemorrhage of diagnosis and treatment in peritoneal dialysis patients. The significance of these cases lies in the fact that patients with ACKD are potentially associated with complications such as cyst hemorrhage and malignancy. Thus, peritoneal dialysis physicians should place great importance on the surveillance of ACKD.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11167548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>To investigate the serum lactate level in patients with rheumatoid arthritis (RA) and its relationship with disease activity, and to analyze the effect of sodium lactate on the activation of CD4<sup>+</sup> T cells, the ability of secreting cytokines and CD4<sup>+</sup>T cell subsets in peripheral blood of the RA patients.</p><p><strong>Methods: </strong>The peripheral blood of healthy controls (HC) and RA patients was collected, and the content of lactate in the supernatant was detected by lactate detection kit, the correlation between the content of lactate and the disease score of the RA patients was analyzed; the activation level of CD4<sup>+</sup> T cells, the proportion of CD4<sup>+</sup> T cell subsets and the cytokines secreted by CD4<sup>+</sup> T cells in peripheral blood of all the RA patients were detected by flow cytometry after being stimulated with sodium lactate.</p><p><strong>Results: </strong>The serum lactate level in the RA patients (<i>n</i>=66) was significantly higher than that in the HC (<i>n</i>=60, <i>P</i> < 0.001), and there was a certain correlation with disease activity score in 28 joints (DAS28)-C-reactive protein (CRP) (<i>r</i>=0.273, <i>P</i>=0.029), The levels of rheumatoid factor [RF, 197.50 (26.03, 783.00) IU/mL <i>vs.</i> 29.30 (0.00, 102.60) IU/mL, <i>P</i> < 0.01], CRP [37.40 (11.30, 72.60) mg/L <i>vs.</i> 5.83 (2.36, 12.45) mg/L, <i>P</i> < 0.001], were increased in patients with the lactate concentration greater than 5 mmol/L were significantly higher than those in patients with the lactate concentration less than or equal 5 mmol/L, however, there was no significant difference in the expression of erythrocyte sedimentation rate [ESR, 42.00 (19.00, 77.00) mm/h <i>vs.</i> 25.00 (12.50, 45.50) mm/h, <i>P</i>>0.05] and anti-cyclic citrullinated peptied (CCP) antibody [82.35 (17.70, 137.00) RU/mL <i>vs.</i> 68.60 (25.95, 119.70) RU/mL, <i>P</i>>0.05]. Compared with the control group, the expression of PD-1 (46.15%±8.54% <i>vs.</i> 41.67%±9.98%, <i>P</i> < 0.001), inducible costimulatory molecule (ICOS, 5.77%±8.60% <i>vs.</i> 18.65%±7.94%, <i>P</i> < 0.01) and CD25 (25.89%±5.80% <i>vs.</i> 22.25%±4.59%, <i>P</i> < 0.01) on the surface of CD4<sup>+</sup> T cells in the RA patients treated with sodium lactate was significantly increased. Compared with the control group, the proportion of Th17 (4.62%±1.74% <i>vs.</i> 2.93%±1.92%, <i>P</i> < 0.05) and Tph (28.02%±6.28% <i>vs.</i> 20.32%±5.82%, <i>P</i> < 0.01) cells in CD4<sup>+</sup>T cells of the RA patients in the sodium lactate treatment group increased. Compared with the control group, the expression of IL-21 (5.73%±1.59% <i>vs.</i> 4.75%±1.71%, <i>P</i> < 0.05) in CD4<sup>+</sup>T cells was up-regulated in the RA patients treated with sodium lactate.</p><p><strong>Conclusion: </strong>The level of serum lactate in RA patients is increased, which promotes the activation of CD4<sup>+</sup>T cells and the secretion of IL-21, and up
目的研究类风湿性关节炎(RA)患者血清乳酸水平及其与疾病活动性的关系,分析乳酸钠对RA患者外周血CD4+T细胞活化、细胞因子分泌能力及CD4+T细胞亚群的影响:收集健康对照组(HC)和RA患者的外周血,用乳酸检测试剂盒检测上清液中乳酸的含量,分析乳酸含量与RA患者疾病评分的相关性;用流式细胞术检测所有RA患者外周血中经乳酸钠刺激后的CD4+T细胞的活化水平、CD4+T细胞亚群的比例及CD4+T细胞分泌的细胞因子:结果:RA 患者的血清乳酸水平(n=66)明显高于 HC 患者(n=60,P <0.001),且与 28 个关节的疾病活动度评分(DAS28)-C 反应蛋白(CRP)有一定的相关性(r=0.类风湿因子[RF,197.50(26.03,783.00)IU/mL vs. 29.30(0.00,102.60)IU/mL,P<0.01]、CRP[37.40(11.30,72.60)mg/L vs. 5.83(2.36,12.45)mg/L,P<0.001],乳酸浓度大于5 mmol/L的患者明显高于乳酸浓度小于等于5 mmol/L的患者,但红细胞沉降率[ESR,42.00 (19.00, 77.00) mm/h vs. 25.00 (12.50, 45.50) mm/h,P>0.05]和抗环瓜氨酸肽(CCP)抗体[82.35 (17.70, 137.00) RU/mL vs. 68.60 (25.95, 119.70) RU/mL,P>0.05]的表达无明显差异。与对照组相比,PD-1(46.15%±8.54% vs. 41.67%±9.98%, P < 0.001)、诱导性成本刺激分子(ICOS, 5.77%±8.60% vs. 18.65%±7.94%,P<0.01)和CD25(25.89%±5.80% vs. 22.25%±4.59%,P<0.01)在乳酸钠治疗的RA患者的CD4+T细胞表面明显增加。与对照组相比,乳酸钠治疗组 RA 患者 CD4+T 细胞中 Th17(4.62%±1.74% vs. 2.93%±1.92%,P<0.05)和 Tph(28.02%±6.28% vs. 20.32%±5.82%,P<0.01)细胞比例增加。与对照组相比,乳酸钠治疗组RA患者CD4+T细胞中IL-21(5.73%±1.59% vs. 4.75%±1.71%,P<0.05)表达上调:结论:RA 患者血清乳酸水平升高,可促进 CD4+T 细胞的活化和 IL-21 的分泌,并上调 RA 患者 Th17 和 Tph 细胞的比例。
{"title":"[Regulatory effect of lactate on peripheral blood CD4<sup>+</sup> T cell subsets in patients with rheumatoid arthritis].","authors":"Huina Huang, Jing Zhao, Xiangge Zhao, Ziran Bai, Xia Li, Guan Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the serum lactate level in patients with rheumatoid arthritis (RA) and its relationship with disease activity, and to analyze the effect of sodium lactate on the activation of CD4<sup>+</sup> T cells, the ability of secreting cytokines and CD4<sup>+</sup>T cell subsets in peripheral blood of the RA patients.</p><p><strong>Methods: </strong>The peripheral blood of healthy controls (HC) and RA patients was collected, and the content of lactate in the supernatant was detected by lactate detection kit, the correlation between the content of lactate and the disease score of the RA patients was analyzed; the activation level of CD4<sup>+</sup> T cells, the proportion of CD4<sup>+</sup> T cell subsets and the cytokines secreted by CD4<sup>+</sup> T cells in peripheral blood of all the RA patients were detected by flow cytometry after being stimulated with sodium lactate.</p><p><strong>Results: </strong>The serum lactate level in the RA patients (<i>n</i>=66) was significantly higher than that in the HC (<i>n</i>=60, <i>P</i> < 0.001), and there was a certain correlation with disease activity score in 28 joints (DAS28)-C-reactive protein (CRP) (<i>r</i>=0.273, <i>P</i>=0.029), The levels of rheumatoid factor [RF, 197.50 (26.03, 783.00) IU/mL <i>vs.</i> 29.30 (0.00, 102.60) IU/mL, <i>P</i> < 0.01], CRP [37.40 (11.30, 72.60) mg/L <i>vs.</i> 5.83 (2.36, 12.45) mg/L, <i>P</i> < 0.001], were increased in patients with the lactate concentration greater than 5 mmol/L were significantly higher than those in patients with the lactate concentration less than or equal 5 mmol/L, however, there was no significant difference in the expression of erythrocyte sedimentation rate [ESR, 42.00 (19.00, 77.00) mm/h <i>vs.</i> 25.00 (12.50, 45.50) mm/h, <i>P</i>>0.05] and anti-cyclic citrullinated peptied (CCP) antibody [82.35 (17.70, 137.00) RU/mL <i>vs.</i> 68.60 (25.95, 119.70) RU/mL, <i>P</i>>0.05]. Compared with the control group, the expression of PD-1 (46.15%±8.54% <i>vs.</i> 41.67%±9.98%, <i>P</i> < 0.001), inducible costimulatory molecule (ICOS, 5.77%±8.60% <i>vs.</i> 18.65%±7.94%, <i>P</i> < 0.01) and CD25 (25.89%±5.80% <i>vs.</i> 22.25%±4.59%, <i>P</i> < 0.01) on the surface of CD4<sup>+</sup> T cells in the RA patients treated with sodium lactate was significantly increased. Compared with the control group, the proportion of Th17 (4.62%±1.74% <i>vs.</i> 2.93%±1.92%, <i>P</i> < 0.05) and Tph (28.02%±6.28% <i>vs.</i> 20.32%±5.82%, <i>P</i> < 0.01) cells in CD4<sup>+</sup>T cells of the RA patients in the sodium lactate treatment group increased. Compared with the control group, the expression of IL-21 (5.73%±1.59% <i>vs.</i> 4.75%±1.71%, <i>P</i> < 0.05) in CD4<sup>+</sup>T cells was up-regulated in the RA patients treated with sodium lactate.</p><p><strong>Conclusion: </strong>The level of serum lactate in RA patients is increased, which promotes the activation of CD4<sup>+</sup>T cells and the secretion of IL-21, and up","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11167554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Herpes zoster of trigeminal nerve was a common skin disease caused by varicella-zoster virus infection. Simple involvement of the third branch of trigeminal nerve was rare, and so were oral complications such as pulpitis, periodontitis, spontaneous tooth loss, bone necrosis, etc. This article presented a case of herpes zoster on the third branch of the left trigeminal nerve complicated with left mandibular osteonecrosis. We reported the case of a 64-year-old man with sudden pain in the left half of the tongue 1 month ago, and then herpes on the left facial skin appeared following with acute pain.The local hospital diagnosed it as herpes zoster and treated it with external medication. A few days later, he developed gum pain in the left mandibular posterior tooth area. He was admitted to Peking University School and Hospital of Stomatology one week ago with loose and dislodged left posterior tooth accompanied by left mandibular bone surface exposure. Clinical examination showed bilateral symmetry and no obvious restriction of mouth opening. Visible herpes zoster pigmentation and scarring on the left side of the face appeared. The left mandibular posterior tooth was missing, the exposed bone surface was about 1.5 cm×0.8 cm, and the surrounding gingiva was red and swollen, painful under pressure, with no discharge of pus. The remaining teeth in the mouth were all Ⅲ degree loosened. Imageological examination showed irregular low-density destruction of the left mandible bone, unclear boundary, and severe resorption of alveolar bone. The patient was diagnosed as left mandibular osteonecrosis. Under general anesthesia, left mandibular lesion exploration and curettage + left mandibular partial resection + adjacent flap transfer repair were performed. The patient was re-exmained 6 months after surgery, there was no redness, swelling or other abnormality in the gums and the herpes pigmentation on the left face was significantly reduced. Unfortunately, the patient had complications of postherpetic neuralgia. This case indicate that clinicians should improve their awareness of jaw necrosis, a serious oral complication of trigeminal zoster, and provide early treatment. After the inflammation was initially controlled, surgical treatment could be considered to remove the necrotic bone, curettage the inflammatory granulation tissue, and extraction of the focal teeth to avoid further deterioration of the disease.
{"title":"[Left mandibular osteonecrosis following herpes zoster of the third branch of left trigeminal nerve: A case report].","authors":"Ying Zhou, Ning Zhao, Hongyuan Huang, Qingxiang Li, Chuanbin Guo, Yuxing Guo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Herpes zoster of trigeminal nerve was a common skin disease caused by varicella-zoster virus infection. Simple involvement of the third branch of trigeminal nerve was rare, and so were oral complications such as pulpitis, periodontitis, spontaneous tooth loss, bone necrosis, etc. This article presented a case of herpes zoster on the third branch of the left trigeminal nerve complicated with left mandibular osteonecrosis. We reported the case of a 64-year-old man with sudden pain in the left half of the tongue 1 month ago, and then herpes on the left facial skin appeared following with acute pain.The local hospital diagnosed it as herpes zoster and treated it with external medication. A few days later, he developed gum pain in the left mandibular posterior tooth area. He was admitted to Peking University School and Hospital of Stomatology one week ago with loose and dislodged left posterior tooth accompanied by left mandibular bone surface exposure. Clinical examination showed bilateral symmetry and no obvious restriction of mouth opening. Visible herpes zoster pigmentation and scarring on the left side of the face appeared. The left mandibular posterior tooth was missing, the exposed bone surface was about 1.5 cm×0.8 cm, and the surrounding gingiva was red and swollen, painful under pressure, with no discharge of pus. The remaining teeth in the mouth were all Ⅲ degree loosened. Imageological examination showed irregular low-density destruction of the left mandible bone, unclear boundary, and severe resorption of alveolar bone. The patient was diagnosed as left mandibular osteonecrosis. Under general anesthesia, left mandibular lesion exploration and curettage + left mandibular partial resection + adjacent flap transfer repair were performed. The patient was re-exmained 6 months after surgery, there was no redness, swelling or other abnormality in the gums and the herpes pigmentation on the left face was significantly reduced. Unfortunately, the patient had complications of postherpetic neuralgia. This case indicate that clinicians should improve their awareness of jaw necrosis, a serious oral complication of trigeminal zoster, and provide early treatment. After the inflammation was initially controlled, surgical treatment could be considered to remove the necrotic bone, curettage the inflammatory granulation tissue, and extraction of the focal teeth to avoid further deterioration of the disease.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To analyze the concentration of formic acid, propionic acid and butyric acid in gingival crevicular fluid (GCF) of patients with stages Ⅲ and Ⅳ periodontitis, and their relationship with periodontitis.
Methods: The study enrolled 37 systemically healthy patients with periodontitis and 19 healthy controls who visited Department of Periodontology, Peking University School and Hospital of Stomatology from February 2008 to May 2011. Their GCFs were collected from the mesial-buccal site of one molar or incisor in each quadrant. Periodontal clinical parameters, including plaque index(PLI), probing depth(PD), bleeding index(BI), and attachment loss(AL). Concentrations of formic acid, propionic acid and butyric acid in the supernatant of the GCFs were analyzed by high-performance capillary electrophoresis (HPCE). The prediction ability of formic acid, propionic acid and butyric acid with the risk of periodontitis and the differences between grade B and grade C periodontitis were analyzed.
Results: In this study, 32 patients with stage Ⅲ and 5 patients with stage Ⅳ were enrolled, including 9 patients with grade B and 28 patients with grade C. Clinical periodontal variables in the patients with periodontitis were significantly higher than those in the control group (P<0.001). Formic acid was significantly lower in periodontitis than that in the control group [5.37 (3.39, 8.49) mmol/L vs. 12.29 (8.35, 16.57) mmol/L, P<0.001]. Propionic acid and butyric acid in periodontitis were significantly higher than those in the control group: Propionic acid, 10.23 (4.28, 14.90) mmol/L vs. 2.71 (0.00, 4.25) mmol/L, P < 0.001; butyric acid, 2.63 (0.47, 3.81) mmol/L vs. 0.00 (0.00, 0.24) mmol/L, P<0.001. There was no significant difference in formic acid, propionic acid and butyric acid concentrations between grade B and grade C periodontitis (P>0.05). Propionic acid and butyric acid in the deep pocket were significantly higher than in the shallow pocket, while the concentration of formic acid decreased with the increase of PD. Propionic acid (OR=1.51, 95%CI: 1.29-1.75) and butyric acid (OR=3.72, 95%CI: 1.93-7.17) were risk factors for periodontitis, while formic acid (OR=0.87, 95%CI: 0.81-0.93) might be a protective factor for periodontitis. Propionic acid (AUC=0.852, 95%CI: 0.805-0.900), butyric acid (AUC=0.889, 95%CI: 0.841-0.937), f (formic acid, AUC=0.844, 95%CI: 0.793-0.895) demonstrated a good predictive capacity for the risk of periodontitis.
Conclusion: The concentration of formic acid decrease in the GCF of periodontitis patients, which is a protective factor for periodontitis, its reciprocal have good predictive capacity. However, propionic acid and butyric acid increase, which are risk factors for periodontitis and have good predictive capacity
目的分析Ⅲ期和Ⅳ期牙周炎患者牙龈细缝液(GCF)中甲酸、丙酸和丁酸的浓度及其与牙周炎的关系:研究对象为2008年2月至2011年5月在北京大学口腔医学院附属北京大学口腔医院牙周科就诊的37名全身健康的牙周炎患者和19名健康对照者。他们的 GCF 都是从每个象限的一颗磨牙或切牙的颊面部位采集的。牙周临床参数包括牙菌斑指数(PLI)、探诊深度(PD)、出血指数(BI)和附着丧失指数(AL)。采用高性能毛细管电泳(HPCE)分析了GCF上清液中甲酸、丙酸和丁酸的浓度。分析了甲酸、丙酸和丁酸对牙周炎风险的预测能力以及B级和C级牙周炎之间的差异:本研究共纳入 32 例Ⅲ期患者和 5 例Ⅳ期患者,其中 B 级患者 9 例,C 级患者 28 例。牙周炎患者的临床牙周变量明显高于对照组(Pvs.12.29(8.35,16.57)mmol/L,Pvs.2.71(0.00,4.25)mmol/L,P<0.001;丁酸,2.63(0.47,3.81)mmol/L vs. 0.00(0.00,0.24)mmol/L,PP>0.05)。深袋中的丙酸和丁酸明显高于浅袋,而甲酸的浓度随着 PD 的增加而降低。丙酸(OR=1.51,95%CI:1.29-1.75)和丁酸(OR=3.72,95%CI:1.93-7.17)是牙周炎的危险因素,而甲酸(OR=0.87,95%CI:0.81-0.93)可能是牙周炎的保护因素。丙酸(AUC=0.852,95%CI:0.805-0.900)、丁酸(AUC=0.889,95%CI:0.841-0.937)、甲酸(AUC=0.844,95%CI:0.793-0.895)对牙周炎的风险具有良好的预测能力:结论:牙周炎患者 GCF 中甲酸浓度的下降是牙周炎的保护因素,其倒数具有良好的预测能力。然而,丙酸和丁酸浓度升高,这是牙周炎的危险因素,具有良好的预测能力。甲酸、丙酸和丁酸的浓度随探诊深度的变化而变化,但在 B 级和 C 级牙周炎之间没有显著差异。
{"title":"[Relationship between short-chain fatty acids in the gingival crevicular fluid and periodontitis of stage Ⅲ or Ⅳ].","authors":"Yuru Hu, Juan Liu, Wenjing Li, Yibing Zhao, Qiqiang Li, Ruifang Lu, Huanxin Meng","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the concentration of formic acid, propionic acid and butyric acid in gingival crevicular fluid (GCF) of patients with stages Ⅲ and Ⅳ periodontitis, and their relationship with periodontitis.</p><p><strong>Methods: </strong>The study enrolled 37 systemically healthy patients with periodontitis and 19 healthy controls who visited Department of Periodontology, Peking University School and Hospital of Stomatology from February 2008 to May 2011. Their GCFs were collected from the mesial-buccal site of one molar or incisor in each quadrant. Periodontal clinical parameters, including plaque index(PLI), probing depth(PD), bleeding index(BI), and attachment loss(AL). Concentrations of formic acid, propionic acid and butyric acid in the supernatant of the GCFs were analyzed by high-performance capillary electrophoresis (HPCE). The prediction ability of formic acid, propionic acid and butyric acid with the risk of periodontitis and the differences between grade B and grade C periodontitis were analyzed.</p><p><strong>Results: </strong>In this study, 32 patients with stage Ⅲ and 5 patients with stage Ⅳ were enrolled, including 9 patients with grade B and 28 patients with grade C. Clinical periodontal variables in the patients with periodontitis were significantly higher than those in the control group (<i>P</i><0.001). Formic acid was significantly lower in periodontitis than that in the control group [5.37 (3.39, 8.49) mmol/L <i>vs.</i> 12.29 (8.35, 16.57) mmol/L, <i>P</i><0.001]. Propionic acid and butyric acid in periodontitis were significantly higher than those in the control group: Propionic acid, 10.23 (4.28, 14.90) mmol/L <i>vs.</i> 2.71 (0.00, 4.25) mmol/L, <i>P</i> < 0.001; butyric acid, 2.63 (0.47, 3.81) mmol/L <i>vs.</i> 0.00 (0.00, 0.24) mmol/L, <i>P</i><0.001. There was no significant difference in formic acid, propionic acid and butyric acid concentrations between grade B and grade C periodontitis (<i>P</i>>0.05). Propionic acid and butyric acid in the deep pocket were significantly higher than in the shallow pocket, while the concentration of formic acid decreased with the increase of PD. Propionic acid (<i>OR</i>=1.51, 95%<i>CI</i>: 1.29-1.75) and butyric acid (<i>OR</i>=3.72, 95%<i>CI</i>: 1.93-7.17) were risk factors for periodontitis, while formic acid (<i>OR</i>=0.87, 95%<i>CI</i>: 0.81-0.93) might be a protective factor for periodontitis. Propionic acid (AUC=0.852, 95%<i>CI</i>: 0.805-0.900), butyric acid (AUC=0.889, 95%<i>CI</i>: 0.841-0.937), f (formic acid, AUC=0.844, 95%<i>CI</i>: 0.793-0.895) demonstrated a good predictive capacity for the risk of periodontitis.</p><p><strong>Conclusion: </strong>The concentration of formic acid decrease in the GCF of periodontitis patients, which is a protective factor for periodontitis, its reciprocal have good predictive capacity. However, propionic acid and butyric acid increase, which are risk factors for periodontitis and have good predictive capacity","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Afferent baroreflex failure (ABF) is a rare disease. It refers to the clinical syndrome caused by the impairment of the afferent limb of the baroreflex or its central connections at the level of the medulla. The recognized causes include trauma, surgery in related areas (radical neck tumor surgery, carotid endarterectomy), neck radiotherapy, brain stem stroke, tumor growth paraganglioma and hereditary diseases, among which the most common cause is extensive neck surgery or radiotherapy for neck cancer. The main manifestations are fluctuating hypertension, orthostatic hypotension, paroxysmal tachycardia and bradycardia. This case is a young man, whose main feature is blood pressure fluctuation, accom-panied by neurogenic orthostatic hypotension (nOH). After examination, the common causes of hypertension and nOH were ruled out. Combined with the previous neck radiotherapy and neck lymph node dissection, it was considered that the blood pressure regulation was abnormal due to the damage of carotid sinus baroreceptor after radiotherapy for nasopharyngeal carcinoma and neck lymph node dissection, which was called ABF. At the same time, the patient was complicated with chronic hyponatremia. Combined with clinical and laboratory examination, the final consideration was caused by syndrome of in- appropriate antidiuretic hormone (SIADH). Baroreceptors controlled the secretion of heart rate, blood pressure and antidiuretic hormone through the mandatory "inhibition" signal. We speculate that the carotid sinus baroreceptor was damaged after neck radiotherapy and surgery, which leads to abnormal blood pressure regulation and nOH, while the function of inhibiting ADH secretion was weakened, resulting in higher ADH than normal level and mild hyponatremia. The goal of treating ABF patients was to reduce the frequency and amplitude of sudden changes in blood pressure and heart rate, and to alleviate the onset of symptomatic hypotension. At present, drug treatment is still controversial, and non-drug treatment may alleviate some patients' symptoms, but long-term effective treatment still needs further study. The incidence of ABF is not high, but it may lead to serious cardiovascular and cerebrovascular events, and the mechanism involved is extremely complicated, and there are few related studies. The reports of relevant medical records warn that patients undergoing neck radiotherapy or surgery should minimize the da-mage to the baroreceptor in the carotid sinus in order to reduce the adverse prognosis caused by complications.
{"title":"[Afferent baroreflex failure with hyponatremia: A case report].","authors":"Shengjia Peng, Yu Qi, Lijie Sun, Dan Li, Xinyu Wang, Jiangli Han, Baoxia Chen, Yuan Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Afferent baroreflex failure (ABF) is a rare disease. It refers to the clinical syndrome caused by the impairment of the afferent limb of the baroreflex or its central connections at the level of the medulla. The recognized causes include trauma, surgery in related areas (radical neck tumor surgery, carotid endarterectomy), neck radiotherapy, brain stem stroke, tumor growth paraganglioma and hereditary diseases, among which the most common cause is extensive neck surgery or radiotherapy for neck cancer. The main manifestations are fluctuating hypertension, orthostatic hypotension, paroxysmal tachycardia and bradycardia. This case is a young man, whose main feature is blood pressure fluctuation, accom-panied by neurogenic orthostatic hypotension (nOH). After examination, the common causes of hypertension and nOH were ruled out. Combined with the previous neck radiotherapy and neck lymph node dissection, it was considered that the blood pressure regulation was abnormal due to the damage of carotid sinus baroreceptor after radiotherapy for nasopharyngeal carcinoma and neck lymph node dissection, which was called ABF. At the same time, the patient was complicated with chronic hyponatremia. Combined with clinical and laboratory examination, the final consideration was caused by syndrome of in- appropriate antidiuretic hormone (SIADH). Baroreceptors controlled the secretion of heart rate, blood pressure and antidiuretic hormone through the mandatory \"inhibition\" signal. We speculate that the carotid sinus baroreceptor was damaged after neck radiotherapy and surgery, which leads to abnormal blood pressure regulation and nOH, while the function of inhibiting ADH secretion was weakened, resulting in higher ADH than normal level and mild hyponatremia. The goal of treating ABF patients was to reduce the frequency and amplitude of sudden changes in blood pressure and heart rate, and to alleviate the onset of symptomatic hypotension. At present, drug treatment is still controversial, and non-drug treatment may alleviate some patients' symptoms, but long-term effective treatment still needs further study. The incidence of ABF is not high, but it may lead to serious cardiovascular and cerebrovascular events, and the mechanism involved is extremely complicated, and there are few related studies. The reports of relevant medical records warn that patients undergoing neck radiotherapy or surgery should minimize the da-mage to the baroreceptor in the carotid sinus in order to reduce the adverse prognosis caused by complications.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiangjing Wang, Shunyi Wei, Yingfang Ao, Yuping Yang
Objective: The pain-relieving effect and safety of compound aminopyrine phenacetin tablets, tramcontin (tramadol hydrochloride sustained-release tablets) and dolantin in the early stage of autologous tendon reconstruction of the anterior cruciate ligament (ACL) of the knee joint were compared.
Methods: Retrospective analysis of postoperative pain and drug analgesia in 45 patients performed by the same group from November 2018 to February 2019. The random area group design was divided into two groups according to whether ACL rupture was combined with meniscal injury, group A was 24 patients with ACL reconstruction of knee joint and group B was 21 patients with ACL fracture combined with meniscus injury. The two groups were divided into three subgroups respectively according to the actual treatment of postoperative analgesic drugs received by the patients, including 4 cases of compound aminopyrine phenacetin tablets, 11 cases of oral tramcontin, 9 cases of intramuscular dolantin combined with phenergan in group A; 3 cases of compound aminopyrine phenacetin tablets, 10 cases of oral tramcontin, and 8 cases of intramuscular dolantin combined with phenergan in group B. When the early postoperative patients complain about pain and actively ask for analgesia. When the patients complained about pain after the operation and actively asked for analgesia, they were randomly given painkillers, tramcontin or dolantin combined with phenergan to relieve pain. Pain visual analogue scale (VAS) was used to evaluate pain relief and observe the occurrence of adverse reactions.
Results: There were no significant dif-ferences in gender, age, body mass index, and time of hospital stay between the two groups of patients (P > 0.05). In the patients who used tramcontin and dolantin combined with phenergan to relieve pain judging by VAS score before and 1 h after taking the drug, it was found that the pain situation of the patient was significantly relieved, and the difference before and after taking the drug had statistical significance (P < 0.05). Pairwise comparisons of the three drugs applied in the two groups showed significantly greater pain relief in the dolantin combined with phenergan group than in the remaining two drugs. There was no significant difference (P > 0.05). Dolantin was prone to nausea and vomiting, but the application of phenergan was also used to reduce side effects. In terms of adverse reactions, only 1 case of nausea occurred in the tramcontin group for simple ACL reconstruction, and none of the patients in the other groups showed serious complications and allergic reactions.
Conclusion: Whether in cruciate ligament reconstruction alone or combined with meniscus molding or suture, compound aminopyrine phenacetin tablets, tramcontin, dolantin combined with phenergan can effectively relieve pain. Among the three drugs, dolantin caused the la
目的:比较复方氨酚黄那敏片、曲康定(盐酸曲马多缓释片)和多兰婷在膝关节前交叉韧带(ACL)自体肌腱重建术早期的镇痛效果和安全性:回顾性分析2018年11月-2019年2月同组45例患者术后疼痛及药物镇痛情况。随机区组设计,根据前交叉韧带断裂是否合并半月板损伤分为两组,A组为膝关节前交叉韧带重建患者24例,B组为前交叉韧带断裂合并半月板损伤患者21例。根据患者实际接受的术后镇痛药物治疗情况,将两组患者分别分为三个亚组,其中 A 组患者使用复方氨基比林苯乙双胍片 4 例,口服曲安奈德 11 例,肌肉注射多兰丁联合苯乙双胍 9 例;B 组患者使用复方氨基比林苯乙双胍片 3 例,口服曲安奈德 10 例,肌肉注射多兰丁联合苯乙双胍 8 例。术后早期患者主诉疼痛并主动要求镇痛时。当患者在术后主诉疼痛并主动要求镇痛时,随机给予他们止痛药、曲康定或多兰婷联合苯乙双胍以缓解疼痛。采用疼痛视觉模拟量表(VAS)评估疼痛缓解情况,并观察不良反应的发生情况:两组患者在性别、年龄、体重指数和住院时间上无明显差异(P>0.05)。在使用曲安奈德和多兰婷联合苯乙双胍缓解疼痛的患者中,通过服药前和服药后 1 h 的 VAS 评分,发现患者的疼痛情况明显缓解,服药前后的差异有统计学意义(P < 0.05)。对两组应用的三种药物进行配对比较发现,多兰婷联合苯乙双胍组的疼痛缓解程度明显高于其余两种药物。没有明显差异(P>0.05)。多兰婷容易引起恶心和呕吐,但应用 phenergan 也可减少副作用。在不良反应方面,仅有1例恶心发生在前交叉韧带简单重建的曲康定组,其他组患者均未出现严重并发症和过敏反应:结论:无论是单纯的十字韧带重建,还是结合半月板成型或缝合,复方氨基比林苯乙双胍片、曲康定、多兰婷联合苯乙双胍都能有效缓解疼痛。在这三种药物中,多兰婷的止痛效果最好。同时,联合使用 phenergan 有效减少了呕吐、恶心等不良反应,提高了用药安全性。
{"title":"[Comparison of the early analgesic efficacy of three different drugs after anterior cruciate ligament reconstruction].","authors":"Jiangjing Wang, Shunyi Wei, Yingfang Ao, Yuping Yang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The pain-relieving effect and safety of compound aminopyrine phenacetin tablets, tramcontin (tramadol hydrochloride sustained-release tablets) and dolantin in the early stage of autologous tendon reconstruction of the anterior cruciate ligament (ACL) of the knee joint were compared.</p><p><strong>Methods: </strong>Retrospective analysis of postoperative pain and drug analgesia in 45 patients performed by the same group from November 2018 to February 2019. The random area group design was divided into two groups according to whether ACL rupture was combined with meniscal injury, group A was 24 patients with ACL reconstruction of knee joint and group B was 21 patients with ACL fracture combined with meniscus injury. The two groups were divided into three subgroups respectively according to the actual treatment of postoperative analgesic drugs received by the patients, including 4 cases of compound aminopyrine phenacetin tablets, 11 cases of oral tramcontin, 9 cases of intramuscular dolantin combined with phenergan in group A; 3 cases of compound aminopyrine phenacetin tablets, 10 cases of oral tramcontin, and 8 cases of intramuscular dolantin combined with phenergan in group B. When the early postoperative patients complain about pain and actively ask for analgesia. When the patients complained about pain after the operation and actively asked for analgesia, they were randomly given painkillers, tramcontin or dolantin combined with phenergan to relieve pain. Pain visual analogue scale (VAS) was used to evaluate pain relief and observe the occurrence of adverse reactions.</p><p><strong>Results: </strong>There were no significant dif-ferences in gender, age, body mass index, and time of hospital stay between the two groups of patients (<i>P</i> > 0.05). In the patients who used tramcontin and dolantin combined with phenergan to relieve pain judging by VAS score before and 1 h after taking the drug, it was found that the pain situation of the patient was significantly relieved, and the difference before and after taking the drug had statistical significance (<i>P</i> < 0.05). Pairwise comparisons of the three drugs applied in the two groups showed significantly greater pain relief in the dolantin combined with phenergan group than in the remaining two drugs. There was no significant difference (<i>P</i> > 0.05). Dolantin was prone to nausea and vomiting, but the application of phenergan was also used to reduce side effects. In terms of adverse reactions, only 1 case of nausea occurred in the tramcontin group for simple ACL reconstruction, and none of the patients in the other groups showed serious complications and allergic reactions.</p><p><strong>Conclusion: </strong>Whether in cruciate ligament reconstruction alone or combined with meniscus molding or suture, compound aminopyrine phenacetin tablets, tramcontin, dolantin combined with phenergan can effectively relieve pain. Among the three drugs, dolantin caused the la","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jinrong Zhu, Yana Zhao, Wei Huang, Weiwei Zhao, Yue Wang, Song Wang, Chunyan Su
Objective: To analyze the clinical characteristics of hemodialysis patients with corona virus disease 2019 (COVID-19) in a single-center from Beijing.
Methods: Patients with COVID-19 who received regular hemodialysis at Peking University Third Hospital from November 30, 2022 to January 4, 2023 were selected as the study objects. Clinical symptoms, severity and duration of symptoms during the period of virus positive were investigated in the form of questionnaires, and the basic information of the patients, as well as the results of blood tests (routine blood and blood biochemistry, etc.) before and after infection, dialysis treatment and the outcome of the disease were collected by consulting medical records.
Results: A total of 203 subjects were included in this study, including 148 mild cases (72.91%), 23 medium cases (11.33%), 32 severe and critical cases (15.76%), and 16 (7.88%) deaths occured during the follow-up. Clinical symptoms mainly included respiratory symptoms (among which 81.77% had cough, 68.97% had expectoration), fever (81.28%) and fatigue (65.52%), and fatigue and weakness had the longest duration [9 (5, 15) days] among all symptoms. Twenty-six patients (12.8%) reduced the dialysis sessions [1 (1, 2) times], 25 patients (12.32%) had the behavior of early finishing dialysis (27 times), reducing the dialysis time by 30.0 (20.0, 30.5) minutes. Univa-riate analysis showed that the hemoglobin, creatinine, urea nitrogen and ultrafiltration decreased signi-ficantly after infection (P < 0.05). There were significant differences in age, albumin, hemoglobin, creatinine levels and vascular access types among the patients with different clinical subtypes, and the changes of dialysis sessions, fever, expectoration and fatigue degree were also different among the patients with different clinical subtypes (P < 0.05). Multivariate Logistic regression analysis showed that age (OR=1.051, 95%CI: 1.017-1.086, P=0.003) and albumin levels (OR=0.905, 95%CI: 0.803-1.019, P=0.098) corrected by fever, expectoration and fatigue levels were still associated with the occurrence of pneumonia.
Conclusion: The morbidity of pneumonia and the proportion of deaths in hemodialysis patients with COVID-19 were higher, and some clinical symptoms lasted for a longer time than the general population. During the infection period, the incidence of dialysis-related complications increased, hemoglobin and nutritional status decreased. Elderly patients and patients with low albumin level had a higher risk of developing pneumonia after infection.
{"title":"[Clinical characteristics of COVID-19 infection in patients undergoing hemodialysis].","authors":"Jinrong Zhu, Yana Zhao, Wei Huang, Weiwei Zhao, Yue Wang, Song Wang, Chunyan Su","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical characteristics of hemodialysis patients with corona virus disease 2019 (COVID-19) in a single-center from Beijing.</p><p><strong>Methods: </strong>Patients with COVID-19 who received regular hemodialysis at Peking University Third Hospital from November 30, 2022 to January 4, 2023 were selected as the study objects. Clinical symptoms, severity and duration of symptoms during the period of virus positive were investigated in the form of questionnaires, and the basic information of the patients, as well as the results of blood tests (routine blood and blood biochemistry, <i>etc</i>.) before and after infection, dialysis treatment and the outcome of the disease were collected by consulting medical records.</p><p><strong>Results: </strong>A total of 203 subjects were included in this study, including 148 mild cases (72.91%), 23 medium cases (11.33%), 32 severe and critical cases (15.76%), and 16 (7.88%) deaths occured during the follow-up. Clinical symptoms mainly included respiratory symptoms (among which 81.77% had cough, 68.97% had expectoration), fever (81.28%) and fatigue (65.52%), and fatigue and weakness had the longest duration [9 (5, 15) days] among all symptoms. Twenty-six patients (12.8%) reduced the dialysis sessions [1 (1, 2) times], 25 patients (12.32%) had the behavior of early finishing dialysis (27 times), reducing the dialysis time by 30.0 (20.0, 30.5) minutes. Univa-riate analysis showed that the hemoglobin, creatinine, urea nitrogen and ultrafiltration decreased signi-ficantly after infection (<i>P</i> < 0.05). There were significant differences in age, albumin, hemoglobin, creatinine levels and vascular access types among the patients with different clinical subtypes, and the changes of dialysis sessions, fever, expectoration and fatigue degree were also different among the patients with different clinical subtypes (<i>P</i> < 0.05). Multivariate Logistic regression analysis showed that age (<i>OR</i>=1.051, 95%<i>CI</i>: 1.017-1.086, <i>P</i>=0.003) and albumin levels (<i>OR</i>=0.905, 95%<i>CI</i>: 0.803-1.019, <i>P</i>=0.098) corrected by fever, expectoration and fatigue levels were still associated with the occurrence of pneumonia.</p><p><strong>Conclusion: </strong>The morbidity of pneumonia and the proportion of deaths in hemodialysis patients with COVID-19 were higher, and some clinical symptoms lasted for a longer time than the general population. During the infection period, the incidence of dialysis-related complications increased, hemoglobin and nutritional status decreased. Elderly patients and patients with low albumin level had a higher risk of developing pneumonia after infection.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}