目的探讨供精人工授精(artificial insemination by donor,AID)影响妊娠率的临床因素和AID夫妇的心理特征。方法回顾性分析2015年1月至2018年12月在福建省妇幼保健院生殖中心门诊接受AID治疗的夫妇660对临床资料,共1305个AID周期。对女...目的探讨供精人工授精(artificial insemination by donor,AID)影响妊娠率的临床因素和AID夫妇的心理特征。方法回顾性分析2015年1月至2018年12月在福建省妇幼保健院生殖中心门诊接受AID治疗的夫妇660对临床资料,共1305个AID周期。对女方年龄、不孕年限、体重指数(body mass index,BMI)、不孕类型、治疗方案、子宫内膜厚度、授精方式、同一周期AID次数、治疗周期数与AID妊娠率进行χ2检验和二分类Logistic回归分析,探索各临床因素与AID妊娠率的关系。采用生育压力量表(fertility problem inventory,FPI)和生活质量量表(FertiQoL量表)对2018年1月至2018年12月在福建省妇幼保健院生殖中心门诊接受AID治疗的130对夫妇进行心理创伤调查,比较夫妇双方生育压力和生活压力的差异。结果<25岁[31.7%(51/161)]、25~35岁女性[22.8%(244/1072)]和>35岁[19.4(14/72)]女性周期妊娠率差异有统计学意义(χ2=6.913,P=0.032);不孕年限≤5年和>5年的女性之间妊娠率差异有统计学意义(24.8%比18.6%,χ2=4.248,P=0.039);宫腔内人工授精(intrauterine insemination,IUI)的妊娠率(26.2%)明显高于颈管内人工授精(intracervical insemination,ICI)女性(15.6%),差异有统计学意义(χ2=14.912,P<0.010)。二分类Logistic回归分析显示授精方式是影响AID周期妊娠率的主要因素,IUI周期妊娠率较ICI高(OR=2.028,95%CI 1.458~2.822,P<0.010)。AID女性FPI总分高于配偶[(175.00±8.11)分比(168.68±6.86)分,t=6.295,P<0.010],女性在夫妻关系[(36.08±4.77)分比(34.67±4.74分),t=2.502,P=0.014]、无子女压力[(28.91±3.38)分比(26.91±3.18)分,t=6.530,P<0.010]维度的得分亦高于配偶;AID女性FertiQoL总分低于配偶[(55.96±6.57)分比(62.30±6.84)分,t=-8.582,P<0.010],女性在环境[(50.46±9.51)分比(55.01±9.01),t=-4.149,P<0.010]、耐受性[(51.55±6.17)分比(56.29±6.48)分,t=-5.657,P<0.010]、情感反应[(54.92±5.92)分比(59.85±6.79)分,t=-5.736,P<0.010]、婚姻关系[(58.15±6.71)分比(61.80±7.91)分,t=-4.057,P<0.010]、社会关系[(60.08±8.27)分比(62.79±6.47)分,t=-2.886,P=0.005]、身心关系[(60.93±6.09)分比(64.28±5.68)分,t=-4.595,P<0.010]6个维度得分均低于配偶。结论授精方式是影响AID临床妊娠率的重要因素,采用IUI可提高AID的周期妊娠率。AID女性生育压力高于配偶,生活质量低于配偶,临床诊疗中应注重AID夫妇的心理健康,并给予心理指导。展开更多
Background Data on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease （CKD） patients are limited.The aim of the present study was to investigate the prevalence,awareness,treatment,and co...Background Data on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease （CKD） patients are limited.The aim of the present study was to investigate the prevalence,awareness,treatment,and control of hypertension in the non-dialysis CKD patients through a nationwide,multicenter study in China.Methods The survey was performed in 61 tertiary hospitals in 31 provinces,municipalities,and autonomous regions in China （except Hong Kong,Macao,and Taiwan）.Trained physicians collected demographic and clinical data and measured blood pressure （BP） using a standardized protocol.Hypertension was defned as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg,and/or use of antihypertensive medications.BP 〈140/90 mmHg and 〈130/80 mmHg were used as the 2 thresholds of hypertension control.In multivariate logistic regression with adjustment for sex and age,we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.Results The analysis included 8927 non-dialysis CKD patients.The prevalence,awareness,and treatment of hypertension in non-dialysis CKD patients were 67.3%,85.8%,and 81.0%,respectively.Of hypertensive CKD patients,33.1% and 14.1% had controlled BP to 〈140/90 mmHg and 〈130/80 mmHg,respectively.With successive CKD stages,the prevalence of hypertension in non-dialysis CKD patients increased,but the control of hypertension decreased （P〈0.001）.When the threshold of BP 〈130/80 mmHg was considered,the risk of uncontrolled hypertension in CKD 2,3a,3b,4,and 5 stages increased 1.3,1.4,1.4,2.5,and 4.0 times compared with CKD 1 stage,respectively （P〈0.05）.Using the threshold of 〈140/90 mmHg,the risk of uncontrolled hypertension increased in advanced stages （P〈0.05）.Conclusions The prevalence of hypertension Chinese non-dialysis CKD patients was high,and the hypertension control was suboptimal.With successive CKD stages,the risk of uncontrolled hypertension increased.展开更多
Background Low potassium dextran （LPD） solution can attenuate acute lung injury （ALl）. However, LPD solution for treating acute kidney injury secondary to ALl has not been reported. The present study was performed...Background Low potassium dextran （LPD） solution can attenuate acute lung injury （ALl）. However, LPD solution for treating acute kidney injury secondary to ALl has not been reported. The present study was performed to examine the renoprotective effect of LPD solution in ALl induced by oleic acid （OA） in piglets. Methods Twelve animals that suffered an ALl induced by administration of OA into the right atrium were divided into two groups： the placebo group （n=6） pretreated with normal saline and the LPD group （n=6）, pretreated with LPD solution. LPD solution was injected intravenously at a dose of 12.5 ml/kg via the auricular vein 1 hour before OA injection. Results All animals survived the experiments with mild histopathological injury to the kidney. There were no significant differences in mean arterial pressure （MAP）, creatinin and renal damage scores between the two groups. Compared with the placebo group, the LPD group had better gas exchange parameters at most of the observation points （（347.0±12.6） mmHg vs. （284.3±11.3） mmHg at 6 hours after ALl, P 〈0.01）. After 6 hours of treatment with OA, the plasma concentrations of NGAL and intedeukin （IL）-6 in both groups increased dramatically compared to baseline （（6.0±0.6） and （2.50±0.08） folds in placebo group; and （2.5±0.5） and （1.40±0.05） folds in LPD group）, but the change of both parameters in the LPD group was significantly lower （P 〈0.01） than in the placebo group. And 6 hours after ALl the kidney tissue concentration of IL-6 in the LPD group （（165.7 ± 22.5） pg·m-1·g-1 protein） was significantly lower （P 〈0.01） than that in placebo group （（67.2± 25.3） pg·m-1·g-1 protein）. Conclusion These findings suggest that pretreatment with LPD solution via systemic administration might attenuate acute kidney injury and the cytokine response of IL-6 in the ALl piglet model induced by OA injection.展开更多
Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis （PD） solutions. Some researchers believe that 6 Lid is enough for adequate dialysis, but there...Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis （PD） solutions. Some researchers believe that 6 Lid is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution （Changfu） and its difference between 6 L and 8 L dosage. Methods Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices. Results Changes of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate （Ccr）. Normalized protein catabolic rate （nPCR） from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume （nUF） and estimated glomerular filtration rate （eGFR）. Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L.1.73 m-2.w1. More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that. Conclusions The domestic PD solution （Changfu） was proven to be as effective as Baxter dialysis solution. During 48- week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.展开更多
文摘目的探讨供精人工授精(artificial insemination by donor,AID)影响妊娠率的临床因素和AID夫妇的心理特征。方法回顾性分析2015年1月至2018年12月在福建省妇幼保健院生殖中心门诊接受AID治疗的夫妇660对临床资料,共1305个AID周期。对女方年龄、不孕年限、体重指数(body mass index,BMI)、不孕类型、治疗方案、子宫内膜厚度、授精方式、同一周期AID次数、治疗周期数与AID妊娠率进行χ2检验和二分类Logistic回归分析,探索各临床因素与AID妊娠率的关系。采用生育压力量表(fertility problem inventory,FPI)和生活质量量表(FertiQoL量表)对2018年1月至2018年12月在福建省妇幼保健院生殖中心门诊接受AID治疗的130对夫妇进行心理创伤调查,比较夫妇双方生育压力和生活压力的差异。结果<25岁[31.7%(51/161)]、25~35岁女性[22.8%(244/1072)]和>35岁[19.4(14/72)]女性周期妊娠率差异有统计学意义(χ2=6.913,P=0.032);不孕年限≤5年和>5年的女性之间妊娠率差异有统计学意义(24.8%比18.6%,χ2=4.248,P=0.039);宫腔内人工授精(intrauterine insemination,IUI)的妊娠率(26.2%)明显高于颈管内人工授精(intracervical insemination,ICI)女性(15.6%),差异有统计学意义(χ2=14.912,P<0.010)。二分类Logistic回归分析显示授精方式是影响AID周期妊娠率的主要因素,IUI周期妊娠率较ICI高(OR=2.028,95%CI 1.458~2.822,P<0.010)。AID女性FPI总分高于配偶[(175.00±8.11)分比(168.68±6.86)分,t=6.295,P<0.010],女性在夫妻关系[(36.08±4.77)分比(34.67±4.74分),t=2.502,P=0.014]、无子女压力[(28.91±3.38)分比(26.91±3.18)分,t=6.530,P<0.010]维度的得分亦高于配偶;AID女性FertiQoL总分低于配偶[(55.96±6.57)分比(62.30±6.84)分,t=-8.582,P<0.010],女性在环境[(50.46±9.51)分比(55.01±9.01),t=-4.149,P<0.010]、耐受性[(51.55±6.17)分比(56.29±6.48)分,t=-5.657,P<0.010]、情感反应[(54.92±5.92)分比(59.85±6.79)分,t=-5.736,P<0.010]、婚姻关系[(58.15±6.71)分比(61.80±7.91)分,t=-4.057,P<0.010]、社会关系[(60.08±8.27)分比(62.79±6.47)分,t=-2.886,P=0.005]、身心关系[(60.93±6.09)分比(64.28±5.68)分,t=-4.595,P<0.010]6个维度得分均低于配偶。结论授精方式是影响AID临床妊娠率的重要因素,采用IUI可提高AID的周期妊娠率。AID女性生育压力高于配偶,生活质量低于配偶,临床诊疗中应注重AID夫妇的心理健康,并给予心理指导。
文摘Background Data on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease （CKD） patients are limited.The aim of the present study was to investigate the prevalence,awareness,treatment,and control of hypertension in the non-dialysis CKD patients through a nationwide,multicenter study in China.Methods The survey was performed in 61 tertiary hospitals in 31 provinces,municipalities,and autonomous regions in China （except Hong Kong,Macao,and Taiwan）.Trained physicians collected demographic and clinical data and measured blood pressure （BP） using a standardized protocol.Hypertension was defned as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg,and/or use of antihypertensive medications.BP 〈140/90 mmHg and 〈130/80 mmHg were used as the 2 thresholds of hypertension control.In multivariate logistic regression with adjustment for sex and age,we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.Results The analysis included 8927 non-dialysis CKD patients.The prevalence,awareness,and treatment of hypertension in non-dialysis CKD patients were 67.3%,85.8%,and 81.0%,respectively.Of hypertensive CKD patients,33.1% and 14.1% had controlled BP to 〈140/90 mmHg and 〈130/80 mmHg,respectively.With successive CKD stages,the prevalence of hypertension in non-dialysis CKD patients increased,but the control of hypertension decreased （P〈0.001）.When the threshold of BP 〈130/80 mmHg was considered,the risk of uncontrolled hypertension in CKD 2,3a,3b,4,and 5 stages increased 1.3,1.4,1.4,2.5,and 4.0 times compared with CKD 1 stage,respectively （P〈0.05）.Using the threshold of 〈140/90 mmHg,the risk of uncontrolled hypertension increased in advanced stages （P〈0.05）.Conclusions The prevalence of hypertension Chinese non-dialysis CKD patients was high,and the hypertension control was suboptimal.With successive CKD stages,the risk of uncontrolled hypertension increased.
基金This work was supported by grants from the National Natural Science Foundation of China （No. 30971380 and No. 31071026） and by the National Excellent Doctoral Dissertation of China.
文摘Background Low potassium dextran （LPD） solution can attenuate acute lung injury （ALl）. However, LPD solution for treating acute kidney injury secondary to ALl has not been reported. The present study was performed to examine the renoprotective effect of LPD solution in ALl induced by oleic acid （OA） in piglets. Methods Twelve animals that suffered an ALl induced by administration of OA into the right atrium were divided into two groups： the placebo group （n=6） pretreated with normal saline and the LPD group （n=6）, pretreated with LPD solution. LPD solution was injected intravenously at a dose of 12.5 ml/kg via the auricular vein 1 hour before OA injection. Results All animals survived the experiments with mild histopathological injury to the kidney. There were no significant differences in mean arterial pressure （MAP）, creatinin and renal damage scores between the two groups. Compared with the placebo group, the LPD group had better gas exchange parameters at most of the observation points （（347.0±12.6） mmHg vs. （284.3±11.3） mmHg at 6 hours after ALl, P 〈0.01）. After 6 hours of treatment with OA, the plasma concentrations of NGAL and intedeukin （IL）-6 in both groups increased dramatically compared to baseline （（6.0±0.6） and （2.50±0.08） folds in placebo group; and （2.5±0.5） and （1.40±0.05） folds in LPD group）, but the change of both parameters in the LPD group was significantly lower （P 〈0.01） than in the placebo group. And 6 hours after ALl the kidney tissue concentration of IL-6 in the LPD group （（165.7 ± 22.5） pg·m-1·g-1 protein） was significantly lower （P 〈0.01） than that in placebo group （（67.2± 25.3） pg·m-1·g-1 protein）. Conclusion These findings suggest that pretreatment with LPD solution via systemic administration might attenuate acute kidney injury and the cytokine response of IL-6 in the ALl piglet model induced by OA injection.
文摘Background A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis （PD） solutions. Some researchers believe that 6 Lid is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution （Changfu） and its difference between 6 L and 8 L dosage. Methods Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices. Results Changes of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate （Ccr）. Normalized protein catabolic rate （nPCR） from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume （nUF） and estimated glomerular filtration rate （eGFR）. Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L.1.73 m-2.w1. More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that. Conclusions The domestic PD solution （Changfu） was proven to be as effective as Baxter dialysis solution. During 48- week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.
