Objective Delayed graft function(DGF)and early graft loss of renal grafts are determined by the quality of the kidneys from the deceased donor.As“non-traditional”risk factors,serum biomarkers of donors,such as lipid...Objective Delayed graft function(DGF)and early graft loss of renal grafts are determined by the quality of the kidneys from the deceased donor.As“non-traditional”risk factors,serum biomarkers of donors,such as lipids and electrolytes,have drawn increasing attention due to their effects on the postoperative outcomes of renal grafts.This study aimed to examine the value of these serum biomarkers for prediction of renal graft function.Methods The present study consecutively collected 306 patients who underwent their first single kidney transplantation(KT)from adult deceased donors in our center from January 1,2018 to December 31,2019.The correlation between postoperative outcomes[DGF and abnormal serum creatinine(SCr)after 6 and 12 months]and risk factors of donors,including gender,age,body mass index(BMI),past histories,serum lipid biomarkers[cholesterol,triglyceride,high-density lipoprotein(HDL)and low-density lipoprotein(DL)],and serum electrolytes(calcium and sodium)were analyzed and evaluated.Results(1)Donor age and pre-existing hypertension were significantly correlated with the incidence rate of DGF and high SCr level(≥2 mg/dL)at 6 and 12 months after KT(P<0.05);(2)The donor’s BMI was significantly correlated with the incidence rate of DGF after KT(P<0.05);(3)For serum lipids,merely the low level of serum HDL of the donor was correlated with the reduced incidence rate of high SCr level at 12 months after KT[P<0.05,OR(95%CI):0.425(0.202–0.97)];(4)The serum calcium of the donor was associated with the reduced incidence rate of high SCr level at 6 and 12 months after KT[P<0.05,OR(95%CI):0.184(0.045–0.747)and P<0.05,OR(95%CI):0.114(0.014–0.948),respectively].Conclusion The serum HDL and calcium of the donor may serve as predictive factors for the postoperative outcomes of renal grafts after KT,in addition to the donor’s age,BMI and pre-existing hypertension.展开更多
BACKGROUND We invented Endoscopic Ruler,a new endoscopic device to measure the size of varices in patients with cirrhosis and portal hypertension.AIM To assess the feasibility and safety of Endoscopic Ruler,and evalua...BACKGROUND We invented Endoscopic Ruler,a new endoscopic device to measure the size of varices in patients with cirrhosis and portal hypertension.AIM To assess the feasibility and safety of Endoscopic Ruler,and evaluate the agreement on identifying large oesophageal varices(OV)between Endoscopic Ruler and the endoscopists,as well as the interobserver agreement on diagnosing large OV using Endoscopic Ruler.METHODS We prospectively and consecutively enrolled patients with cirrhosis from 11 hospitals,all of whom got esophagogastroduodenoscopy(EGD)with Endoscopic Ruler.The primary study outcome was a successful measurement of the size of varices using Endoscopic Ruler.The secondary outcomes included adverse events,operation time,the agreement of identifying large OV between the objective measurement of Endoscopic Ruler and the empirical reading of endoscopists,together with the interobserver agreement on diagnosing large OV by Endoscopic Ruler.RESULTS From November 2020 to April 2022,a total of 120 eligible patients with cirrhosis were recruited and all of them underwent EGD examinations with Endoscopic Ruler successfully without any adverse event.The median operation time of Endoscopic Ruler was 3.00 min[interquartile range(IQR):3.00 min].The kappa value between Endoscopic Ruler and the endoscopists while detecting large OV was 0.52,demonstrating a moderate agreement.The kappa value for diagnosing large OV using Endoscopic Ruler among the six independent observers was 0.77,demonstrating a substantial agreement.CONCLUSION The data demonstrates that Endoscopic Ruler is feasible and safe for measuring the size of varices in patients with cirrhosis and portal hypertension.Endoscopic Ruler is potential to promote the clinical practice of the two-grade classification system of OV.展开更多
AIM: To perform sequencing analysis in patients with very early-onset inflammatory bowel disease(VEO-IBD) to determine the genetic basis for VEO-IBD in Chinese pediatric patients.METHODS: A total of 13 Chinese pediatr...AIM: To perform sequencing analysis in patients with very early-onset inflammatory bowel disease(VEO-IBD) to determine the genetic basis for VEO-IBD in Chinese pediatric patients.METHODS: A total of 13 Chinese pediatric patients with VEO-IBD were diagnosed from May 2012 and August 2014. The relevant clinical characteristics of these patients were analyzed. Then DNA in the peripheral blood from patients was extracted. Next generation sequencing(NGS) based on an IlluminaMiseq platform was used to analyze the exons in the coding regions of 10 candidate genes: IL-10, IL-10 RA, IL-10 RB, NOD2, FUT2, IL23 R, GPR35, GPR65, TNFSF15, and ADAM30. The Sanger sequencing was used to verify the variations detected in NGS.RESULTS: Out of the 13 pediatric patients, ten were diagnosed with Crohn's disease, and three diagnosed with ulcerative colitis. Mutations in IL-10 RA and IL-10 RB were detected in five patients. There were four patients who had single nucleotide polymorphisms associated with IBD. Two patients had IL-10 RA andFUT2 polymorphisms, and two patients had IL-10 RB and FUT2 polymorphisms. Gene variations were not found in the rest four patients. Children with mutations had lower percentile body weight(1.0% vs 27.5%, P = 0.002) and hemoglobin(87.4 g/L vs 108.5 g/L, P = 0.040) when compared with children without mutations. Although the age of onset was earlier, height was shorter, and the response to treatment was poorer in the mutation group, there was no significant difference in these factors between groups.CONCLUSION: IL-10 RA and IL-10 RB mutations are common in Chinese children with VEO-IBD. Patients with mutations have an earlier disease onset, lower body weight and hemoglobin, and poorer prognosis.展开更多
Background Good quality of care for inflammatory bowel disease(IBD)depends on high-standard management and facility in the IBD center.Yet,there are no clear measures or criteria for evaluating pediatric IBD(PIBD)cente...Background Good quality of care for inflammatory bowel disease(IBD)depends on high-standard management and facility in the IBD center.Yet,there are no clear measures or criteria for evaluating pediatric IBD(PIBD)center in China.The aim of this study was to develop a comprehensive set of quality indicators(QIs)for evaluating PIBD center in China.Methods A modified Delphi consensus-based approach was used to identify a set of QIs of structure,process,and outcomes for defining the criteria.The process included an exhaustive search using complementary approaches to identify potential QIs,and two web-based voting rounds to select the QIs defining the criteria for PIBD center.Results A total of 101 QIs(35 structures,48 processes and 18 outcomes)were included in this consensus.Structure QIs focused on the composition of multidisciplinary team,facilities and services that PIBD center should provide.Process QIs highlight core requirements in diagnosing,evaluating,treating PIBD,and disease follow-up.Outcome QIs mainly included criteria evaluating effectiveness of various interventions in PIBD centers.Conclusion The present Delphi consensus developed a set of main QIs that may be useful for managing a PIBD center.展开更多
An experimental study to investigate various features of subsurface vortices and their evolutions inside a closed pump intake under different pressure conditions at free surface,and to analyze the influence of a pipe ...An experimental study to investigate various features of subsurface vortices and their evolutions inside a closed pump intake under different pressure conditions at free surface,and to analyze the influence of a pipe bell with different mean axial velocities at the same water level on flow patterns is presented.For all cases,three different flow regimes are closely observed:various side-wall attached,back-wall attached and submerged vortices structures,and their evolutions are subject to the free-surface pressure for a critical flow rate,the number and strength of all these vortex rise as the absolute value of the pressure increases for a higher flow rate,for a lower flow rate,whether the side-wall vortices occur or not is related closely to the pressure magnitude,and there are no vortices for lower absolute pressure values,the number and the strength of the side-wall vortices increase as the absolute pressure values increase.Besides,based on statistical analyses,the side-wall vortex probability on the right side along the stream-wise direction is much higher than that on the opposite side for all operation cases,particularly single vortex probability,and the back-wall vortex probabilities are quite higher with values of more than 90%,meanwhile,the multi-vortices probability is much higher than that of the single-vortex.The captured vortices have been qualitatively classified into different“vortex zones”:no vortex zones and vortex zones including transition,single-and multi-vortex.The Reynolds number and the absolute value pressure are the most important parameters which influence the existence and the number of these vortices,and the increase of the two parameters reduces the no vortex transition zone and causes bigger difference in the back-wall and side-wall vortex zones.展开更多
基金The study was supported by the Innovation Team Fund Project of Hubei Province(No.WJ2021C001)the Key Research and Development Plan of Hubei Province(No.2022BCA015).
文摘Objective Delayed graft function(DGF)and early graft loss of renal grafts are determined by the quality of the kidneys from the deceased donor.As“non-traditional”risk factors,serum biomarkers of donors,such as lipids and electrolytes,have drawn increasing attention due to their effects on the postoperative outcomes of renal grafts.This study aimed to examine the value of these serum biomarkers for prediction of renal graft function.Methods The present study consecutively collected 306 patients who underwent their first single kidney transplantation(KT)from adult deceased donors in our center from January 1,2018 to December 31,2019.The correlation between postoperative outcomes[DGF and abnormal serum creatinine(SCr)after 6 and 12 months]and risk factors of donors,including gender,age,body mass index(BMI),past histories,serum lipid biomarkers[cholesterol,triglyceride,high-density lipoprotein(HDL)and low-density lipoprotein(DL)],and serum electrolytes(calcium and sodium)were analyzed and evaluated.Results(1)Donor age and pre-existing hypertension were significantly correlated with the incidence rate of DGF and high SCr level(≥2 mg/dL)at 6 and 12 months after KT(P<0.05);(2)The donor’s BMI was significantly correlated with the incidence rate of DGF after KT(P<0.05);(3)For serum lipids,merely the low level of serum HDL of the donor was correlated with the reduced incidence rate of high SCr level at 12 months after KT[P<0.05,OR(95%CI):0.425(0.202–0.97)];(4)The serum calcium of the donor was associated with the reduced incidence rate of high SCr level at 6 and 12 months after KT[P<0.05,OR(95%CI):0.184(0.045–0.747)and P<0.05,OR(95%CI):0.114(0.014–0.948),respectively].Conclusion The serum HDL and calcium of the donor may serve as predictive factors for the postoperative outcomes of renal grafts after KT,in addition to the donor’s age,BMI and pre-existing hypertension.
基金This study is registered at https://www.clinicaltrials.gov/.The registration identification number is NCT04639323.
文摘BACKGROUND We invented Endoscopic Ruler,a new endoscopic device to measure the size of varices in patients with cirrhosis and portal hypertension.AIM To assess the feasibility and safety of Endoscopic Ruler,and evaluate the agreement on identifying large oesophageal varices(OV)between Endoscopic Ruler and the endoscopists,as well as the interobserver agreement on diagnosing large OV using Endoscopic Ruler.METHODS We prospectively and consecutively enrolled patients with cirrhosis from 11 hospitals,all of whom got esophagogastroduodenoscopy(EGD)with Endoscopic Ruler.The primary study outcome was a successful measurement of the size of varices using Endoscopic Ruler.The secondary outcomes included adverse events,operation time,the agreement of identifying large OV between the objective measurement of Endoscopic Ruler and the empirical reading of endoscopists,together with the interobserver agreement on diagnosing large OV by Endoscopic Ruler.RESULTS From November 2020 to April 2022,a total of 120 eligible patients with cirrhosis were recruited and all of them underwent EGD examinations with Endoscopic Ruler successfully without any adverse event.The median operation time of Endoscopic Ruler was 3.00 min[interquartile range(IQR):3.00 min].The kappa value between Endoscopic Ruler and the endoscopists while detecting large OV was 0.52,demonstrating a moderate agreement.The kappa value for diagnosing large OV using Endoscopic Ruler among the six independent observers was 0.77,demonstrating a substantial agreement.CONCLUSION The data demonstrates that Endoscopic Ruler is feasible and safe for measuring the size of varices in patients with cirrhosis and portal hypertension.Endoscopic Ruler is potential to promote the clinical practice of the two-grade classification system of OV.
基金Supported by National Nature Science Foundation of China,No.81400588
文摘AIM: To perform sequencing analysis in patients with very early-onset inflammatory bowel disease(VEO-IBD) to determine the genetic basis for VEO-IBD in Chinese pediatric patients.METHODS: A total of 13 Chinese pediatric patients with VEO-IBD were diagnosed from May 2012 and August 2014. The relevant clinical characteristics of these patients were analyzed. Then DNA in the peripheral blood from patients was extracted. Next generation sequencing(NGS) based on an IlluminaMiseq platform was used to analyze the exons in the coding regions of 10 candidate genes: IL-10, IL-10 RA, IL-10 RB, NOD2, FUT2, IL23 R, GPR35, GPR65, TNFSF15, and ADAM30. The Sanger sequencing was used to verify the variations detected in NGS.RESULTS: Out of the 13 pediatric patients, ten were diagnosed with Crohn's disease, and three diagnosed with ulcerative colitis. Mutations in IL-10 RA and IL-10 RB were detected in five patients. There were four patients who had single nucleotide polymorphisms associated with IBD. Two patients had IL-10 RA andFUT2 polymorphisms, and two patients had IL-10 RB and FUT2 polymorphisms. Gene variations were not found in the rest four patients. Children with mutations had lower percentile body weight(1.0% vs 27.5%, P = 0.002) and hemoglobin(87.4 g/L vs 108.5 g/L, P = 0.040) when compared with children without mutations. Although the age of onset was earlier, height was shorter, and the response to treatment was poorer in the mutation group, there was no significant difference in these factors between groups.CONCLUSION: IL-10 RA and IL-10 RB mutations are common in Chinese children with VEO-IBD. Patients with mutations have an earlier disease onset, lower body weight and hemoglobin, and poorer prognosis.
基金supported by a grant from the Key Program of the Independent Design Project of National Clinical Research Center for Child Health.
文摘Background Good quality of care for inflammatory bowel disease(IBD)depends on high-standard management and facility in the IBD center.Yet,there are no clear measures or criteria for evaluating pediatric IBD(PIBD)center in China.The aim of this study was to develop a comprehensive set of quality indicators(QIs)for evaluating PIBD center in China.Methods A modified Delphi consensus-based approach was used to identify a set of QIs of structure,process,and outcomes for defining the criteria.The process included an exhaustive search using complementary approaches to identify potential QIs,and two web-based voting rounds to select the QIs defining the criteria for PIBD center.Results A total of 101 QIs(35 structures,48 processes and 18 outcomes)were included in this consensus.Structure QIs focused on the composition of multidisciplinary team,facilities and services that PIBD center should provide.Process QIs highlight core requirements in diagnosing,evaluating,treating PIBD,and disease follow-up.Outcome QIs mainly included criteria evaluating effectiveness of various interventions in PIBD centers.Conclusion The present Delphi consensus developed a set of main QIs that may be useful for managing a PIBD center.
基金supported by the National Natural Science Foundation of China(Grant Nos.51479196,51779257)the National Natural Science Foundation for the Youth of China(Grant No.51909132).
文摘An experimental study to investigate various features of subsurface vortices and their evolutions inside a closed pump intake under different pressure conditions at free surface,and to analyze the influence of a pipe bell with different mean axial velocities at the same water level on flow patterns is presented.For all cases,three different flow regimes are closely observed:various side-wall attached,back-wall attached and submerged vortices structures,and their evolutions are subject to the free-surface pressure for a critical flow rate,the number and strength of all these vortex rise as the absolute value of the pressure increases for a higher flow rate,for a lower flow rate,whether the side-wall vortices occur or not is related closely to the pressure magnitude,and there are no vortices for lower absolute pressure values,the number and the strength of the side-wall vortices increase as the absolute pressure values increase.Besides,based on statistical analyses,the side-wall vortex probability on the right side along the stream-wise direction is much higher than that on the opposite side for all operation cases,particularly single vortex probability,and the back-wall vortex probabilities are quite higher with values of more than 90%,meanwhile,the multi-vortices probability is much higher than that of the single-vortex.The captured vortices have been qualitatively classified into different“vortex zones”:no vortex zones and vortex zones including transition,single-and multi-vortex.The Reynolds number and the absolute value pressure are the most important parameters which influence the existence and the number of these vortices,and the increase of the two parameters reduces the no vortex transition zone and causes bigger difference in the back-wall and side-wall vortex zones.
