Risk evaluation for diabetic retinopathy in Chinese renalbiopsied type 2 diabetes mellitus patients

AIM:To investigate diabetic retinopathy(DR)prevalence in Chinese renal-biopsied type 2 diabetes mellitus(T2DM)patients with kidney dysfunction,and to further evaluate its relationship with diabetic nephropathy(DN)incidence and the risk factors for DR development in this population.METHODS:A total of 84 renal-biopsied T2DM patients were included.Fundus and imaging examinations were employed for DR diagnosis.Demographic information and clinical measures along with renal histopathology were analyzed for comparisons between the DR and non-DR groups.Risk factors on DR development were analyzed with multiple logistic regression.RESULTS:DR prevalence was 50%in total.The incidences of DN,non-diabetic renal disease(NDRD)and mixed-type pathology were 47.6%,19.0%and 33.3%in the DR group respectively,while 11.9%,83.3%and 4.8%in the non-DR group.Systolic blood pressure,ratio of urinary albumin to creatine ratio,urinary albumin,24-hours urinary protein,the incidence and severity of DN histopathology were found statistically increased in the DR group.Multiple logistic regression analysis showed histopathological DN incidence significantly increased the risk of DR development[odds ratio(OR)=21.664,95%confidential interval(CI)5.588 to 83.991,P<0.001 for DN,and OR=45.475,95%CI 6.949 to 297.611,P<0.001 for mixed-type,respectively,in reference to (NDRD)],wherein DN severity positively correlated.CONCLUSION:Renal histopathological evidence indicates DN incidence and severity increases the risk of DR development in Chinese T2DM patients inexperienced of regular fundus examinations.

Effect of sodium ferulate in combined with atorvastatin on the renal interstitial fibrosis and inflammatory cytokines in patients with diabetic nephropathy

Objective:To explore the effect of sodium ferulate in combined with atorvastatin on the renal interstitial fibrosis and inflammatory cytokines in patients with diabetic nephropathy (DN). Methods: A total of 111 patients with DN who were admitted in our hospital from January, 2016 to April, 2017 were included in the study and randomized into the observation group and the control 1 and 2 group with 37 cases in each group. The patients in the control group were given routine blood sugar reducing, blood pressure reducing, and high quality low protein diet. On the above basis, the patients in the control 2 group were orally administrated with atorvastatin before sleep (20 mg). On the basis of treatments in the control 1 group, the patients in the observation group were given sodium ferulate (0.3 g) + 0.9% NaCl (250 mL), ivdrip, 1 time/d, and administrated with atorvastatin before sleep (20 mg). The fasting peripheral venous blood before and after treatment in the three groups was collected. The glycse oxidase (GOD) method was used to detect FPG. ELISA was used to detect SCr, TGF-β, AngⅡ, CTGF, hs-CRP, TNF-α, and IL-6. RIA was used to detect BUN and 24hUAER. The strengthened chemiluminescence immunoassay was used to detect CⅣ and PCⅢ. MAP was recorded. Results: FPG, MAP, BUN, 24hUAER, and SCr after treatment in the control 2 group were significantly lower than those in the control 1 group. FPG, MAP, BUN, 24hUAER, and SCr after treatment in the observation group were significantly lower than those in the control 2 group. AngⅡ, TGF-β, CTGF, PCⅢ, and CⅣ after treatment in the control 2 group were significantly lower than those in the control 1 group. AngⅡ, TGF-β, CTGF, PCⅢ, and CⅣ after treatment in the observation group were significantly lower than those in the control 2 group. TNF-α, IL-6, and hs-CRP after treatments in the control 2 group were significantly lower than those in the control 1 group. TNF-α, IL-6, and hs-CRP after treatment in the observation group were significantly lower than those in the control 2 group.Conclusions:The sodium ferulate in combined with atorvastatin can effectively improve the renal function in patients with DN, alleviate the systemic inflammatory reaction, and delay the renal interstitial fibrosis speed.

Non-fluoroscopic percutaneous transcatheter closure of atrial septal defects in children under transesophageal echocardiographic guidance

Background This study sought to investigate the feasibility, safety and effectiveness of transcatheter closure of atrial septal defects (ASDs) under the guidance of transesophageal echocardiography (TEE) in children. Methods We reviewed the medical records of patients who underwent percutaneous ASD closure at our center from August 2016 to December 2017. For a total of 88 patients who were identified as having a single-hole defect and were undergoing percutaneous transcatheter ASD closure, a procedure completely guided by TEE was performed. There were 31 male patients and 57 female patients. The patients' mean age was 60.09 ± 36.42 months (13–182 months), and their mean body weight was 20.16 ± 10.04 kg (9–77 kg). Patients were followed up by performing transthoracic echocardiography and obtaining chest X-rays and electrocardiograms. Results The transcatheter closure of ASDs was successful in all patients. The mean ASD size was 11.58 ± 5.31 mm (3–28 mm), and the mean size of the occlusion device was 16.07 ± 5.29 mm (6–36 mm). The mean procedural times were 13.33 ± 2.82 minutes (6–16 minutes). The mean hospitalization costs were 27,259.66 ± 2507.04 RMB (25,200.00–33,911.45 RMB). The mean postoperative hospital stay was 3.22 ± 0.53 days (3–5 days). Residual shunt, occlusion device shedding or displacement, and pericardial effusion were not observed during or after the operation. Conclusion Percutaneous transcatheter ASD closure completely guided by TEE is a feasible, safe, non-invasive and easy procedure.

Reconstruction of a new pulmonary artery in arterial switch operation

Background:This study was undertaken to evaluate the new method for the reconstruction of the pulmonary artery in arterial switch operation(ASO).Methods:A total of 108 consecutive infants with congenital heart disease were treated with ASO in our department between January 2004 and June 2012.The new pulmonary arterial root was reconstructed with a fresh autologuos pericardium which was clipped pants­like with continuous mattress suture of 6-0 Prolene thread.Patients were reexamined consecutively at 3 and 6 months and 1,2 and 6 years after discharge.The pulmonary arterial blood velocity was measured by continuous Doppler during systole.The pulmonary flow of healthy children of same age was also measured in the control group.Simplified Bernoulli formula was used to calculate the pressure gradient via the pulmonary artery for determining whether there was pulmonary stenosis.Results:In this series,96 infants survived after the surgery and 88 were followed up with a mean peirod of(22±4)months.No pulmonary stenosis was detected with the simplified Bernoulli formula.Conclusion:No pulmonary stenosis was detected with the simplified Bernoulli formula.