Background Understanding the characteristics of Chinese dialysis patients and the current practice trends is the first step to evaluate the association between practice pattern and outcome in these populations. In the...Background Understanding the characteristics of Chinese dialysis patients and the current practice trends is the first step to evaluate the association between practice pattern and outcome in these populations. In the present study, we evaluated the status of medical treatment and characteristic features of chronic dialysis patients in China. Methods Through a clustering sampling, we selected 9 centers from the largest dialysis facilities in 6 cities around China. All adult undergoing dialysis in the selected units were screened. A total of 2388 （1775 on hemodialysis （HD） and 613 on peritoneal dialysis （PD）） patients were finally enrolled. All data were collected at enrollment on the bases of review of medical records. Results In this cohort, 1313 （55.0%） were male. The mean age was 54 years old. The median time for dialysis was 26 months （12-51 months）. Seventy-five percent of patients were on HD and 25.0% on PD. Among PD patients, about 21% patients did not receive dialysis adequacy. For HD patients, about 14.0% of them did not achieve dialysis adequacy when the target of kt/V was set as 1.2. Only 44.7% of patients achieved blood pressure target of 140/90 mmHg. About 60% of patients did not reach the hemoglobin target of 110 g/L even though 85.0% of them were treated with erythropoietin. In addition, 48.5% of the patients had uncontrolled mineral metabolism revealed by the high calcium-phosphate product. Compared with HD patients, higher level of serum glucose, triglyceride, and total and low density lipoprotein cholesterol were more common in PD patients. Conclusions This observational study suggests that many Chinese dialysis patients did not achieve the therapeutic target, particularly in blood pressure control, anemia correction, and mineral balance. PD patients were more likely to suffer metabolic disturbance.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
Objective: To evaluate the effect of comprehensive therapy based on Chinese medicine(CM) patterns on self-efficacy and satisfaction with its effectiveness in patients with chronic obstructive pulmonary disease(COPD). ...Objective: To evaluate the effect of comprehensive therapy based on Chinese medicine(CM) patterns on self-efficacy and satisfaction with its effectiveness in patients with chronic obstructive pulmonary disease(COPD). Methods: A total of 216 patients were randomly divided into the trial group(n=108) and the control group(n=108) based on the stratified and block randomization design. Patients in the trial group were treated with conventional Western medicine combined with Bufei Jianpi Granules(补肺健脾颗粒), Bufei Yishen Granules(补肺益肾颗粒), and Yiqi Zishen Granules(益气滋肾颗粒) according to the CM patterns respectively, and patients in the control group were treated with conventional Western medicine. The COPD Self-Efficacy Scale(CSES) and the Effectiveness Satisfaction Questionnaire for COPD(ESQ-COPD) were employed in a 6-month treatment and in further 6 month follow-up visit. Results: Among the 216 patients, 191 patients(97 in the trial group and 94 in the control group) fully completed the study. After 12-month treatment and follow-up, the mean scores of the trial group all continued to increase over time, which were significantly higher than those of the control group(P<0.05), and the improvement in the following trial group domain: negative affect domain(12.13%), intense emotional arousal domain(12.21%), physical exertion domain(11.72%), weather/environmental domain(13.77%), behavioral risk domain(7.67%) and total score(10.65%). The trial group also exhibited significantly higher mean scores in the ESQ-COPD(P<0.05) and the improvement in the following domain: capacity for life and work domain(30.59%), clinical symptoms domain(53.52%), effect of therapy domain(35.95%), convenience of therapy domain(35.54%), and whole effect domain(52.47%). Conclusions: Bufei Jianpi Granules, Bufei Yishen Granules and Yiqi Zishen Granules can improve the self-efficacy and satisfaction of COPD patients.展开更多
A physical model of molten slag granulation by rotary disk was developed based on the mechanism of New-tonian liquid granulation. For geometrical similarity, the radius ratio of model disk to the prototype disk was ch...A physical model of molten slag granulation by rotary disk was developed based on the mechanism of New-tonian liquid granulation. For geometrical similarity, the radius ratio of model disk to the prototype disk was chosen as 1 ： 1. For dynamic similarity, equality of Ohnesorge number between the model and the prototype was achieved firstly by compounding rosin and paraffin wax with mass ratio of 4 ~ 1 as simulation liquid of molten blast furnace （BF） slag, and the simulation material can satisfy the similarity of liquid solid transformation during falling in the medium; then equality of Reynolds number and Weber number was obtained by controlling the volumetric flow rate and the rotary speed, respectively. Model accuracy was verified by comparing the simulation data with the results re ported in literature, which showed good agreement with the calculation results of empirical equation and the actual molten BF slag granulation from the view point of particle size. Furthermore, influences of disk radius, rotary speed and liquid flow rate on granulation were discussed using the developed model, and the Kitamura equation was modi-fied according to the simulation data which can predict particle size more accurately. Using the modified equation, the operation parameters were predicted according to the flow rate of molten industrial BF slag.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
To the editor： Acute pyelonephritis is a common kidney disease in female adult, but an unusual cause of acute renal failure（ARF）. We reported one woman suffered from acute pyelonephritis due to Klehsiella pneumonia...To the editor： Acute pyelonephritis is a common kidney disease in female adult, but an unusual cause of acute renal failure（ARF）. We reported one woman suffered from acute pyelonephritis due to Klehsiella pneumoniae infection presented with ARF and unremarkable abdominal signs, however with a favorable prognosis after appropriate antibiotic treatment.A 23-year-old woman was admitted to the First Affiliated Hospital of Sun Yat-sen University with a 10-day history of abdominal bloating, lower flank pain; 3-day history of fatigue, without fever, urinary urgency, frequency, dysuria or oliguria. She had a history of taking the herbs medicine lbr removing urinary calculi （Wu Lin Hua Shi Dan and other unknown herbs） by herself for one week.展开更多
基金This work was supported by the grants from the National 973 Program （No. 2012CB517703 and No. 2011CB504005）, the National Natural Science Foundation of China （No. U0932002）, and the Public Welfare and Health Sector Research Project （No. 201002010）.
文摘Background Understanding the characteristics of Chinese dialysis patients and the current practice trends is the first step to evaluate the association between practice pattern and outcome in these populations. In the present study, we evaluated the status of medical treatment and characteristic features of chronic dialysis patients in China. Methods Through a clustering sampling, we selected 9 centers from the largest dialysis facilities in 6 cities around China. All adult undergoing dialysis in the selected units were screened. A total of 2388 （1775 on hemodialysis （HD） and 613 on peritoneal dialysis （PD）） patients were finally enrolled. All data were collected at enrollment on the bases of review of medical records. Results In this cohort, 1313 （55.0%） were male. The mean age was 54 years old. The median time for dialysis was 26 months （12-51 months）. Seventy-five percent of patients were on HD and 25.0% on PD. Among PD patients, about 21% patients did not receive dialysis adequacy. For HD patients, about 14.0% of them did not achieve dialysis adequacy when the target of kt/V was set as 1.2. Only 44.7% of patients achieved blood pressure target of 140/90 mmHg. About 60% of patients did not reach the hemoglobin target of 110 g/L even though 85.0% of them were treated with erythropoietin. In addition, 48.5% of the patients had uncontrolled mineral metabolism revealed by the high calcium-phosphate product. Compared with HD patients, higher level of serum glucose, triglyceride, and total and low density lipoprotein cholesterol were more common in PD patients. Conclusions This observational study suggests that many Chinese dialysis patients did not achieve the therapeutic target, particularly in blood pressure control, anemia correction, and mineral balance. PD patients were more likely to suffer metabolic disturbance.
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Supported by the National Natural Science Foundation of China(No.81473799)the Outstanding Youth Science and Technology Innovation Leader Program of Henan Province(No.144100510010)the National Key Technology R&D Program during the 12th Five-Year Plan Period(No.2014BAI10B06)
文摘Objective: To evaluate the effect of comprehensive therapy based on Chinese medicine(CM) patterns on self-efficacy and satisfaction with its effectiveness in patients with chronic obstructive pulmonary disease(COPD). Methods: A total of 216 patients were randomly divided into the trial group(n=108) and the control group(n=108) based on the stratified and block randomization design. Patients in the trial group were treated with conventional Western medicine combined with Bufei Jianpi Granules(补肺健脾颗粒), Bufei Yishen Granules(补肺益肾颗粒), and Yiqi Zishen Granules(益气滋肾颗粒) according to the CM patterns respectively, and patients in the control group were treated with conventional Western medicine. The COPD Self-Efficacy Scale(CSES) and the Effectiveness Satisfaction Questionnaire for COPD(ESQ-COPD) were employed in a 6-month treatment and in further 6 month follow-up visit. Results: Among the 216 patients, 191 patients(97 in the trial group and 94 in the control group) fully completed the study. After 12-month treatment and follow-up, the mean scores of the trial group all continued to increase over time, which were significantly higher than those of the control group(P<0.05), and the improvement in the following trial group domain: negative affect domain(12.13%), intense emotional arousal domain(12.21%), physical exertion domain(11.72%), weather/environmental domain(13.77%), behavioral risk domain(7.67%) and total score(10.65%). The trial group also exhibited significantly higher mean scores in the ESQ-COPD(P<0.05) and the improvement in the following domain: capacity for life and work domain(30.59%), clinical symptoms domain(53.52%), effect of therapy domain(35.95%), convenience of therapy domain(35.54%), and whole effect domain(52.47%). Conclusions: Bufei Jianpi Granules, Bufei Yishen Granules and Yiqi Zishen Granules can improve the self-efficacy and satisfaction of COPD patients.
基金Sponsored by China Postdoctoral Science Foundation(20110491517)Fundamental Research Funds for Central Universities of China(N100402012)Doctor Start-Up Fund of Natural Science Foundation of Liaoning Province of China(201120004)
文摘A physical model of molten slag granulation by rotary disk was developed based on the mechanism of New-tonian liquid granulation. For geometrical similarity, the radius ratio of model disk to the prototype disk was chosen as 1 ： 1. For dynamic similarity, equality of Ohnesorge number between the model and the prototype was achieved firstly by compounding rosin and paraffin wax with mass ratio of 4 ~ 1 as simulation liquid of molten blast furnace （BF） slag, and the simulation material can satisfy the similarity of liquid solid transformation during falling in the medium; then equality of Reynolds number and Weber number was obtained by controlling the volumetric flow rate and the rotary speed, respectively. Model accuracy was verified by comparing the simulation data with the results re ported in literature, which showed good agreement with the calculation results of empirical equation and the actual molten BF slag granulation from the view point of particle size. Furthermore, influences of disk radius, rotary speed and liquid flow rate on granulation were discussed using the developed model, and the Kitamura equation was modi-fied according to the simulation data which can predict particle size more accurately. Using the modified equation, the operation parameters were predicted according to the flow rate of molten industrial BF slag.
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.
文摘To the editor： Acute pyelonephritis is a common kidney disease in female adult, but an unusual cause of acute renal failure（ARF）. We reported one woman suffered from acute pyelonephritis due to Klehsiella pneumoniae infection presented with ARF and unremarkable abdominal signs, however with a favorable prognosis after appropriate antibiotic treatment.A 23-year-old woman was admitted to the First Affiliated Hospital of Sun Yat-sen University with a 10-day history of abdominal bloating, lower flank pain; 3-day history of fatigue, without fever, urinary urgency, frequency, dysuria or oliguria. She had a history of taking the herbs medicine lbr removing urinary calculi （Wu Lin Hua Shi Dan and other unknown herbs） by herself for one week.
