Objective： To observe changes in RBC count, changes, RBC morphology, and serum potassium during compressed transfusion of WBC-removal whole blood. Methods： Prepared human WBC-removal whole blood and connected transf...Objective： To observe changes in RBC count, changes, RBC morphology, and serum potassium during compressed transfusion of WBC-removal whole blood. Methods： Prepared human WBC-removal whole blood and connected transfusion apparatus with different sizes of intravenous detaining needles （18G, 20G, 22G and 24G）. Observed RBC count and serum potassium concentration under different pressures （100 mmHg, 200 mmHg, and 300 mmHg） as blood flowed out of the pinhead end of the intravenous detaining needle. Samples obtained with the 20G needle were smeared on glass slides, and RBC morphologic changes were observed under an oil immersion lens. Results： RBC count and serum potassium changed slightly under different pressures with different sizes of intravenous detaining needles as blood flowed through the transfusion apparatus. In addition, the observation of blood samples under a common light microscope revealed that coarse- prick, oblong, and spindle cell counts in the visual fields increased gradually as the pressure increased. Additionally, a portion of cells had undergone splintering. Conclusions： While applying 18G, 20G, 22G and 24G intravenous detaining needles for blood transfusion under less than 300 mmHg of pressure, no significant RBC count change was found in blood samples in the short term. However, there were significant RBC morphologic changes. The results could offer more basis to ensure the clinical safetv of oatients undereoing blood transfilsion.展开更多
The authors conducted a retrospective study over a period of 6 months in a hypertensive population in order to determine the correlation between serum uric acid on glomerular filtration rate (GFR) and estimated serum ...The authors conducted a retrospective study over a period of 6 months in a hypertensive population in order to determine the correlation between serum uric acid on glomerular filtration rate (GFR) and estimated serum potassium with left ventricular hypertrophy (LVH) and obesity. This study enrolled 122 patients including 63 women (51.6%). The mean age was 55.9 ± 10.6 years (range 30 to 74 years). Obesity weight was found in 38 cases (31.1%) of which 20?were men (33.9%) and 18 women (28.6%). Abdominal obesity was found in 104 cases (85.2%). The average serum uric acid in patients with obesity weight was 63.3 ± 18.9 mg/L vs 62.4 ± 14.2 mg/L for no-obese patients (p?= 0.63). The average serum potassium in obese patients was 4.06 ± 0.42 mEq/L vs 4.02 ± 0.46 mEq/L for no-obese (p?= 0.65). The average GFR was 73.4 ± 21.4 ml/L in obese patients vs 66.6 ± 22.6 ml/min in no-obese (p?= 0.03). The LVH was found in 81 cases (66.4%). The LVH was found in 65 (62.5%) obese patients vs?16 (88%) non-obese patients (OR = 4.8, 95% 1.04?-?22?p?= 0.02). Only abdominal?obesity has been correlated with left ventricular hypertrophy after multivariate analysis. Emphasis must be focused on public health actions for effective and appropriate measures against obesity and hypertension, whose prevalence is increasing in our region.展开更多
Background:The kidneys play a central role in serum potassium(K+)homeostasis,and their dysfunction leads to electrolyte disorders.We aimed to examine the relationship between different levels of K+and mortality among ...Background:The kidneys play a central role in serum potassium(K+)homeostasis,and their dysfunction leads to electrolyte disorders.We aimed to examine the relationship between different levels of K+and mortality among very elderly patients with acute kidney injury(AKI).Methods:We retrospectively enrolled very elderly patients(≥75 years)with AKI from the hospital information system of the Chinese PLA General Hospital from January 1,2007 to December 31,2018.All-cause mortality was examined according to six predefined K+levels:<3.50 mmol/L,3.50-3.79 mmol/L,3.80-4.09 mmol/L,4.10-4.79 mmol/L,4.80-5.49 mmol/L,and≥5.50 mmol/L.We estimated the risk of all-cause mortality using the multivariable adjusted Cox proportional hazard model with the normal K+level at 3.50-3.79 mmol/L as a reference.Results:In total,747 patients were deemed suitable for the final evaluation.The median age of the 747 par-ticipants was 88(84-91)years.After 90 days,the mortality rates in the six strata were 28.3%,21.9%,30.1%,35.4%,45.2%,and 58.3%,respectively.In the multivariable adjusted analysis,patients with K+levels of 4.10-4.79 mmol/L(hazard ratio[HR]:1.638;95%confidence interval[CI]:1.016-2.642),4.80-5.49 mmol/L(HR:2.585;95%CI:1.524-4.384),and≥5.50 mmol/L(HR:2.587;95%CI:1.495-4.479)had an increased risk of all-cause mortality.After 1 year,the mortality rates in the six strata were 44.8%,41.1%,45.1%,51.8%,63.1%,and 76.3%,respectively.In the multivariable adjusted analysis,patients with K+levels of 4.10-4.79 mmol/L(HR:1.452;95%CI:1.014-2.079),4.80-5.49 mmol/L(HR:2.151;95%CI:1.427-3.241),and≥5.50 mmol/L(HR:2.341;95%CI:1.514-3.620)had an increased risk of all-cause mortality.Conclusion:Increased serum K+levels,including levels of 4.10-5.49 mmol/L and≥5.50 mmol/L,were associated with a significantly increased short-and long-term risk of death.Serum K+has the potential to be a marker of disease severity among very elderly patients with AKI.展开更多
目的系统评价服用非奈利酮对糖尿病肾病患者血清钾水平的影响。方法采用计算机从中国知网(CNKI)、中文科技期刊数据库(VIP)、万方数据库、PubMed、Web of Science、Embase、Cochrane Library中检索非奈利酮治疗糖尿病肾病的随机对照试验...目的系统评价服用非奈利酮对糖尿病肾病患者血清钾水平的影响。方法采用计算机从中国知网(CNKI)、中文科技期刊数据库(VIP)、万方数据库、PubMed、Web of Science、Embase、Cochrane Library中检索非奈利酮治疗糖尿病肾病的随机对照试验(RCT),检索时限均从建库至2023年10月12日。采用Cochrane系统评估工具评价文献质量。提取检索资料,包括研究对象基线特征(试验分组、人数、年龄、基线血钾水平等)、干预措施、所关注的结局指标(血清钾较基线水平变化、高钾血症发生率、因高钾血症停止试验等),然后采用RevMan5.4软件进行Meta分析。结果本研究共纳入5项RCT,涉及14182例患者,治疗组干预措施为非奈利酮,对照组干预措施为安慰剂。Meta分析结果显示:与对照组相比,治疗组血清钾水平增长幅度较大[MD=0.14,95%CI(0.05~0.23),P<0.01],高钾血症发生率高[OR=2.21,95%CI(1.96~2.49),P<0.01],中度和重度高钾血症的发生率高[OR=2.43,95%CI(2.17~2.71),P<0.01;OR=2.60,95%CI(2.01~3.35),P<0.01],随访时间>3个月时治疗组高钾血症发生率高[OR=2.21,95%CI(1.96~2.49),P<0.01]。结论服用非奈利酮可使糖尿病肾病患者血清钾水平升高,高钾血症发生率升高。展开更多
Objective:To observe the electrocardiogram (ECG) and heart rate in a rabbit model of hyperkalemia induced by potassium chloride, and provide theoretical and experimental reference for timely diagnosis of hyperkalemia ...Objective:To observe the electrocardiogram (ECG) and heart rate in a rabbit model of hyperkalemia induced by potassium chloride, and provide theoretical and experimental reference for timely diagnosis of hyperkalemia clinically. Methods:Forty rabbits were randomly assigned into four groups. 0.9% isotonic saline solution was perfused in the groupⅠ, while l.0%, 4.0% and 10.0% potassium chloride solutions were perfused in the other groups, respectively, to induce hyperkalemia. Results:The changes of serum potassium, ECG and heart rate before perfusion were significantly (P<0.05) different from those after perfusion in the other groups compared with groupⅠ. The effect of ECG variability rates was well consistent (Kappa=0.724, P<0.01) with that of serum potassium on diagnostic tests in the other groups. The area under ROC curve in diagnosis effect of ECG variability rates and serum potassium on hyperkalaemia was much significantly larger (P<0.01 and P<0.05) compared with 0.5. There was asignificantly positive correlation between ECG variability rates and serum potassium (r=0.865, P<0.05 for bilateral Pearson test). There was certain positive correlation between heart rate and serum potassium, but the correlation was poor (r= 0.526, R 2 =0.277). Conclusion:A combination of serum potassium, ECG variability rates and heart rate should be considered and analyzed by synthesis to establish an accurate and timely diagnosis for hyperkalemia.展开更多
目的评价黄疸、溶血、脂血、尿毒症等异常标本中内源性干扰物质对酶法测定血清中钾钠氯结果的影响。方法依据美国国家临床实验室标准化委员会(NCCLS)的EP 7-P文件,分别用间接离子选择性电极(ISE)和酶法测定正常对照组(非黄疸、溶血、脂...目的评价黄疸、溶血、脂血、尿毒症等异常标本中内源性干扰物质对酶法测定血清中钾钠氯结果的影响。方法依据美国国家临床实验室标准化委员会(NCCLS)的EP 7-P文件,分别用间接离子选择性电极(ISE)和酶法测定正常对照组(非黄疸、溶血、脂血)、黄疸组、溶血组、脂血组、尿毒症组标本中钾钠氯,对结果进行统计学分析。结果正常对照组,酶法钠氯均高于ISE(P<0.05),钾在两种方法间无差异;溶血、黄疸对酶法测定钾钠氯均无干扰(P>0.05);脂血(TG<15mm o l/L)对酶法测定钾氯无干扰,钠呈负偏差,但酶法不能测定严重脂血标本(TG>15 mm o l/L)中钾钠氯,脂血标本中钠偏倚与甘油三酯、胆固醇浓度不相关(r=0.06,r=0.10);尿毒症组样品中钾与对照组呈负偏差(P<0.05),与CREA、BUN的浓度间弱相关(r=0.31,r=0.26),而尿毒症组标本中钠氯较正常对照组呈正偏差(P<0.05),与CREA、BUN浓度间无相关性(r=0.07,r=0.05)。结论溶血、黄疸、轻中度脂血对酶法测定钾钠氯无干扰,但不能用于分析严重脂血标本、尿毒症标本的钾钠氯测定。展开更多
基金supported by the Shanxi Science and Technology Development Fund(No.200233)
文摘Objective： To observe changes in RBC count, changes, RBC morphology, and serum potassium during compressed transfusion of WBC-removal whole blood. Methods： Prepared human WBC-removal whole blood and connected transfusion apparatus with different sizes of intravenous detaining needles （18G, 20G, 22G and 24G）. Observed RBC count and serum potassium concentration under different pressures （100 mmHg, 200 mmHg, and 300 mmHg） as blood flowed out of the pinhead end of the intravenous detaining needle. Samples obtained with the 20G needle were smeared on glass slides, and RBC morphologic changes were observed under an oil immersion lens. Results： RBC count and serum potassium changed slightly under different pressures with different sizes of intravenous detaining needles as blood flowed through the transfusion apparatus. In addition, the observation of blood samples under a common light microscope revealed that coarse- prick, oblong, and spindle cell counts in the visual fields increased gradually as the pressure increased. Additionally, a portion of cells had undergone splintering. Conclusions： While applying 18G, 20G, 22G and 24G intravenous detaining needles for blood transfusion under less than 300 mmHg of pressure, no significant RBC count change was found in blood samples in the short term. However, there were significant RBC morphologic changes. The results could offer more basis to ensure the clinical safetv of oatients undereoing blood transfilsion.
文摘The authors conducted a retrospective study over a period of 6 months in a hypertensive population in order to determine the correlation between serum uric acid on glomerular filtration rate (GFR) and estimated serum potassium with left ventricular hypertrophy (LVH) and obesity. This study enrolled 122 patients including 63 women (51.6%). The mean age was 55.9 ± 10.6 years (range 30 to 74 years). Obesity weight was found in 38 cases (31.1%) of which 20?were men (33.9%) and 18 women (28.6%). Abdominal obesity was found in 104 cases (85.2%). The average serum uric acid in patients with obesity weight was 63.3 ± 18.9 mg/L vs 62.4 ± 14.2 mg/L for no-obese patients (p?= 0.63). The average serum potassium in obese patients was 4.06 ± 0.42 mEq/L vs 4.02 ± 0.46 mEq/L for no-obese (p?= 0.65). The average GFR was 73.4 ± 21.4 ml/L in obese patients vs 66.6 ± 22.6 ml/min in no-obese (p?= 0.03). The LVH was found in 81 cases (66.4%). The LVH was found in 65 (62.5%) obese patients vs?16 (88%) non-obese patients (OR = 4.8, 95% 1.04?-?22?p?= 0.02). Only abdominal?obesity has been correlated with left ventricular hypertrophy after multivariate analysis. Emphasis must be focused on public health actions for effective and appropriate measures against obesity and hypertension, whose prevalence is increasing in our region.
基金the Special Scien-tific Research Project of Military Health Care(grant 20BJZ27 to FHZ),and the Military Medical。
文摘Background:The kidneys play a central role in serum potassium(K+)homeostasis,and their dysfunction leads to electrolyte disorders.We aimed to examine the relationship between different levels of K+and mortality among very elderly patients with acute kidney injury(AKI).Methods:We retrospectively enrolled very elderly patients(≥75 years)with AKI from the hospital information system of the Chinese PLA General Hospital from January 1,2007 to December 31,2018.All-cause mortality was examined according to six predefined K+levels:<3.50 mmol/L,3.50-3.79 mmol/L,3.80-4.09 mmol/L,4.10-4.79 mmol/L,4.80-5.49 mmol/L,and≥5.50 mmol/L.We estimated the risk of all-cause mortality using the multivariable adjusted Cox proportional hazard model with the normal K+level at 3.50-3.79 mmol/L as a reference.Results:In total,747 patients were deemed suitable for the final evaluation.The median age of the 747 par-ticipants was 88(84-91)years.After 90 days,the mortality rates in the six strata were 28.3%,21.9%,30.1%,35.4%,45.2%,and 58.3%,respectively.In the multivariable adjusted analysis,patients with K+levels of 4.10-4.79 mmol/L(hazard ratio[HR]:1.638;95%confidence interval[CI]:1.016-2.642),4.80-5.49 mmol/L(HR:2.585;95%CI:1.524-4.384),and≥5.50 mmol/L(HR:2.587;95%CI:1.495-4.479)had an increased risk of all-cause mortality.After 1 year,the mortality rates in the six strata were 44.8%,41.1%,45.1%,51.8%,63.1%,and 76.3%,respectively.In the multivariable adjusted analysis,patients with K+levels of 4.10-4.79 mmol/L(HR:1.452;95%CI:1.014-2.079),4.80-5.49 mmol/L(HR:2.151;95%CI:1.427-3.241),and≥5.50 mmol/L(HR:2.341;95%CI:1.514-3.620)had an increased risk of all-cause mortality.Conclusion:Increased serum K+levels,including levels of 4.10-5.49 mmol/L and≥5.50 mmol/L,were associated with a significantly increased short-and long-term risk of death.Serum K+has the potential to be a marker of disease severity among very elderly patients with AKI.
文摘目的系统评价服用非奈利酮对糖尿病肾病患者血清钾水平的影响。方法采用计算机从中国知网(CNKI)、中文科技期刊数据库(VIP)、万方数据库、PubMed、Web of Science、Embase、Cochrane Library中检索非奈利酮治疗糖尿病肾病的随机对照试验(RCT),检索时限均从建库至2023年10月12日。采用Cochrane系统评估工具评价文献质量。提取检索资料,包括研究对象基线特征(试验分组、人数、年龄、基线血钾水平等)、干预措施、所关注的结局指标(血清钾较基线水平变化、高钾血症发生率、因高钾血症停止试验等),然后采用RevMan5.4软件进行Meta分析。结果本研究共纳入5项RCT,涉及14182例患者,治疗组干预措施为非奈利酮,对照组干预措施为安慰剂。Meta分析结果显示:与对照组相比,治疗组血清钾水平增长幅度较大[MD=0.14,95%CI(0.05~0.23),P<0.01],高钾血症发生率高[OR=2.21,95%CI(1.96~2.49),P<0.01],中度和重度高钾血症的发生率高[OR=2.43,95%CI(2.17~2.71),P<0.01;OR=2.60,95%CI(2.01~3.35),P<0.01],随访时间>3个月时治疗组高钾血症发生率高[OR=2.21,95%CI(1.96~2.49),P<0.01]。结论服用非奈利酮可使糖尿病肾病患者血清钾水平升高,高钾血症发生率升高。
基金supported by the Guangdong Provincial Medical Science and Technology Research Fund Project(B2023011)the Guangzhou Science and Technology Plan Project(202102080292)。
基金Supported by Natural Science Foundation of Chengdu Medical College(CYZ09-004)The "Challenge Cup" Sichuan Undergraduate Curricular Academic Science and Technology Works(CT11D-1006)
文摘Objective:To observe the electrocardiogram (ECG) and heart rate in a rabbit model of hyperkalemia induced by potassium chloride, and provide theoretical and experimental reference for timely diagnosis of hyperkalemia clinically. Methods:Forty rabbits were randomly assigned into four groups. 0.9% isotonic saline solution was perfused in the groupⅠ, while l.0%, 4.0% and 10.0% potassium chloride solutions were perfused in the other groups, respectively, to induce hyperkalemia. Results:The changes of serum potassium, ECG and heart rate before perfusion were significantly (P<0.05) different from those after perfusion in the other groups compared with groupⅠ. The effect of ECG variability rates was well consistent (Kappa=0.724, P<0.01) with that of serum potassium on diagnostic tests in the other groups. The area under ROC curve in diagnosis effect of ECG variability rates and serum potassium on hyperkalaemia was much significantly larger (P<0.01 and P<0.05) compared with 0.5. There was asignificantly positive correlation between ECG variability rates and serum potassium (r=0.865, P<0.05 for bilateral Pearson test). There was certain positive correlation between heart rate and serum potassium, but the correlation was poor (r= 0.526, R 2 =0.277). Conclusion:A combination of serum potassium, ECG variability rates and heart rate should be considered and analyzed by synthesis to establish an accurate and timely diagnosis for hyperkalemia.
文摘目的评价黄疸、溶血、脂血、尿毒症等异常标本中内源性干扰物质对酶法测定血清中钾钠氯结果的影响。方法依据美国国家临床实验室标准化委员会(NCCLS)的EP 7-P文件,分别用间接离子选择性电极(ISE)和酶法测定正常对照组(非黄疸、溶血、脂血)、黄疸组、溶血组、脂血组、尿毒症组标本中钾钠氯,对结果进行统计学分析。结果正常对照组,酶法钠氯均高于ISE(P<0.05),钾在两种方法间无差异;溶血、黄疸对酶法测定钾钠氯均无干扰(P>0.05);脂血(TG<15mm o l/L)对酶法测定钾氯无干扰,钠呈负偏差,但酶法不能测定严重脂血标本(TG>15 mm o l/L)中钾钠氯,脂血标本中钠偏倚与甘油三酯、胆固醇浓度不相关(r=0.06,r=0.10);尿毒症组样品中钾与对照组呈负偏差(P<0.05),与CREA、BUN的浓度间弱相关(r=0.31,r=0.26),而尿毒症组标本中钠氯较正常对照组呈正偏差(P<0.05),与CREA、BUN浓度间无相关性(r=0.07,r=0.05)。结论溶血、黄疸、轻中度脂血对酶法测定钾钠氯无干扰,但不能用于分析严重脂血标本、尿毒症标本的钾钠氯测定。
