Congestion is an integral component of cardiorenal syn-drome and portends an adverse impact on the outcomes. Recent studies suggest that congestion has the ability ofmodulating the interactions between the kidney and ...Congestion is an integral component of cardiorenal syn-drome and portends an adverse impact on the outcomes. Recent studies suggest that congestion has the ability ofmodulating the interactions between the kidney and the heart in this setting. Peritoneal dialysis （PD） is a home-based therapeutic modality that is not only offered to patients with end-stage renal disease to provide solute clearance and ultrafltration, but it has also been used in patients with refractory heart failure and fuid overload to help optimize volume status. Several uncontrolled studies and case series have so far evaluated the role of PD in management of hypervolemia for patients with heart failure. They have generally reported favorable results in this setting. However, the data on the outcomes of patients with end-stage renal disease and concomitant heart failure is mixed, and the proposed theoretical advantages of PD might not translate into improvedclinical endpoints. Congestion is prevalent in this patient population and has a signifcant effect on their survival. As studies suggest that a significant subset of patients with end-stage renal disease who receive PD therapy are hypervolemic, suboptimal management of congestion could at least in part explain these conficting results. PD is a highly fexible therapeutic modality and the choice oftechniques, regimens, and solutions can affect its ability for optimization of fluid status. This article provides an overview of the currently available data on the role and clinical relevance of congestion in patients with cardiorenal syndrome and reviews potential options to enhance decongestion in these patients.展开更多
Cardiorenal syndrome(CRS) is a new term recently introduced to describe the acute or chronic comorbid state of the heart and kidney that has been long known and frequently managed in very sick individuals. The tight a...Cardiorenal syndrome(CRS) is a new term recently introduced to describe the acute or chronic comorbid state of the heart and kidney that has been long known and frequently managed in very sick individuals. The tight and delicate coordination of physiological functions among organ systems in the human body makes dysfunction in one to lead to malfunction of one or more other organ systems. CRS is a universal very common morbidity in the critically ill, with a high mortality rate that has received very little research attention in children. Simultaneous management of heart and renal failures in CRS is quite challenging; the therapeutic choice made for one organ must not jeopardize the other. This paper reviews the epidemiology, pathophysiology, clinical characteristics and management of acute and chronic CRS in children.展开更多
Several studies have demonstrated that the outcome of chronic hepatitis C (CHC) infection is profoundly influenced by a variety of comorbidities. Many of these comorbidities have a significant influence on the respons...Several studies have demonstrated that the outcome of chronic hepatitis C (CHC) infection is profoundly influenced by a variety of comorbidities. Many of these comorbidities have a significant influence on the response to antiviral therapy. These comorbidities negatively affect the course and outcome of liver disease, often reducing the chance of achieving a sustained virological response with PEGylated interferon and ribavirin treatments. Comorbidities affecting response to antiviral therapy reduce compliance and adherence to inadequate doses of therapy. The most important comorbidities affecting the course of CHC include hepatitis B virus coinfection, metabolic syndrome, and intestinal bacterial overgrowth. Comorbidities affecting the course and response to therapy include schistosomiasis, iron overload, alcohol abuse, and excessive smoking. Comorbidities affecting response to antiviral therapy include depression, anemia, cardiovascular disease, and renal failure.展开更多
Thromboembolic complications have been frequently re- ported in patients with long-lasting nephrotic syndrome （NS）. Although thrombotic complications in the venous system are common in patients with NS, arterial thr...Thromboembolic complications have been frequently re- ported in patients with long-lasting nephrotic syndrome （NS）. Although thrombotic complications in the venous system are common in patients with NS, arterial thromboses associated with NS are much less common. However, coronary thromboses are extremely rarely observed. So, NS is a rare cause of acute coronary syndrome （ACS）. As such, the incidence, pathogenesis, and treatment of these patients have yet to be clearly defined. In the current litera- ture, publications contain less than 15 patients, most of whom are young children.展开更多
Objective:To observe the clinical effect of auricular point sticking therapy for cardiac syndrome X(CSX)in women.Methods:A total of 64 patients were randomized into two groups by the random number table,with 32 cases ...Objective:To observe the clinical effect of auricular point sticking therapy for cardiac syndrome X(CSX)in women.Methods:A total of 64 patients were randomized into two groups by the random number table,with 32 cases in each group.Patients in the control group received conventional treatment for angina,while patients in the treatment group received auricular point sticking therapy on the basis of conventional treatment.After 8 weeks of treatment,the levels of serum estradiol(E2),nitric oxide(NO)and endothelium-1(ET-1)were compared to evaluate the therapeutic effect.Results:After 8 weeks of treatment,the total effective rate and markedly effective rate in the treatment group were significantly higher than those in the control group,and the between-group comparisons showed statistical significance(both P<0.05).After treatment,the scores of chest pain and tightness in the control group dropped significantly,and the intra-group comparisons showed statistical significance(both P<0.05);the scores of chest pain and tightness,palpitations,weakness and shortness of breath in the treatment group dropped significantly,and the intra-group comparisons showed statistical significance(all P<0.05);there were significant inter-group differences in the scores of chest pain and tightness.After treatment,the intra-group comparisons of E2,NO and ET-1 contents in the control group showed no statistical significance(all P>0.05),while the E2,NO and ET-1 contents in the treatment group changed significantly after treatment and were significantly different from those in the control group(all P<0.05).Conclusion:Auricular point sticking on the basis of conventional treatment was effective for CSX in women,and is worth clinical application.展开更多
文摘Congestion is an integral component of cardiorenal syn-drome and portends an adverse impact on the outcomes. Recent studies suggest that congestion has the ability ofmodulating the interactions between the kidney and the heart in this setting. Peritoneal dialysis （PD） is a home-based therapeutic modality that is not only offered to patients with end-stage renal disease to provide solute clearance and ultrafltration, but it has also been used in patients with refractory heart failure and fuid overload to help optimize volume status. Several uncontrolled studies and case series have so far evaluated the role of PD in management of hypervolemia for patients with heart failure. They have generally reported favorable results in this setting. However, the data on the outcomes of patients with end-stage renal disease and concomitant heart failure is mixed, and the proposed theoretical advantages of PD might not translate into improvedclinical endpoints. Congestion is prevalent in this patient population and has a signifcant effect on their survival. As studies suggest that a significant subset of patients with end-stage renal disease who receive PD therapy are hypervolemic, suboptimal management of congestion could at least in part explain these conficting results. PD is a highly fexible therapeutic modality and the choice oftechniques, regimens, and solutions can affect its ability for optimization of fluid status. This article provides an overview of the currently available data on the role and clinical relevance of congestion in patients with cardiorenal syndrome and reviews potential options to enhance decongestion in these patients.
文摘Cardiorenal syndrome(CRS) is a new term recently introduced to describe the acute or chronic comorbid state of the heart and kidney that has been long known and frequently managed in very sick individuals. The tight and delicate coordination of physiological functions among organ systems in the human body makes dysfunction in one to lead to malfunction of one or more other organ systems. CRS is a universal very common morbidity in the critically ill, with a high mortality rate that has received very little research attention in children. Simultaneous management of heart and renal failures in CRS is quite challenging; the therapeutic choice made for one organ must not jeopardize the other. This paper reviews the epidemiology, pathophysiology, clinical characteristics and management of acute and chronic CRS in children.
文摘Several studies have demonstrated that the outcome of chronic hepatitis C (CHC) infection is profoundly influenced by a variety of comorbidities. Many of these comorbidities have a significant influence on the response to antiviral therapy. These comorbidities negatively affect the course and outcome of liver disease, often reducing the chance of achieving a sustained virological response with PEGylated interferon and ribavirin treatments. Comorbidities affecting response to antiviral therapy reduce compliance and adherence to inadequate doses of therapy. The most important comorbidities affecting the course of CHC include hepatitis B virus coinfection, metabolic syndrome, and intestinal bacterial overgrowth. Comorbidities affecting the course and response to therapy include schistosomiasis, iron overload, alcohol abuse, and excessive smoking. Comorbidities affecting response to antiviral therapy include depression, anemia, cardiovascular disease, and renal failure.
基金The program is supported by grants from the National Na tural Science Foundation of China （No.81400238）.
文摘Thromboembolic complications have been frequently re- ported in patients with long-lasting nephrotic syndrome （NS）. Although thrombotic complications in the venous system are common in patients with NS, arterial thromboses associated with NS are much less common. However, coronary thromboses are extremely rarely observed. So, NS is a rare cause of acute coronary syndrome （ACS）. As such, the incidence, pathogenesis, and treatment of these patients have yet to be clearly defined. In the current litera- ture, publications contain less than 15 patients, most of whom are young children.
文摘Objective:To observe the clinical effect of auricular point sticking therapy for cardiac syndrome X(CSX)in women.Methods:A total of 64 patients were randomized into two groups by the random number table,with 32 cases in each group.Patients in the control group received conventional treatment for angina,while patients in the treatment group received auricular point sticking therapy on the basis of conventional treatment.After 8 weeks of treatment,the levels of serum estradiol(E2),nitric oxide(NO)and endothelium-1(ET-1)were compared to evaluate the therapeutic effect.Results:After 8 weeks of treatment,the total effective rate and markedly effective rate in the treatment group were significantly higher than those in the control group,and the between-group comparisons showed statistical significance(both P<0.05).After treatment,the scores of chest pain and tightness in the control group dropped significantly,and the intra-group comparisons showed statistical significance(both P<0.05);the scores of chest pain and tightness,palpitations,weakness and shortness of breath in the treatment group dropped significantly,and the intra-group comparisons showed statistical significance(all P<0.05);there were significant inter-group differences in the scores of chest pain and tightness.After treatment,the intra-group comparisons of E2,NO and ET-1 contents in the control group showed no statistical significance(all P>0.05),while the E2,NO and ET-1 contents in the treatment group changed significantly after treatment and were significantly different from those in the control group(all P<0.05).Conclusion:Auricular point sticking on the basis of conventional treatment was effective for CSX in women,and is worth clinical application.
