BACKGROUND:Diabetes mellitus is one of the risk factors in patients with acute cerebral disease,and always leads to stroke or get it worse.There is often a high level of blood glucose in those patients with diabetes m...BACKGROUND:Diabetes mellitus is one of the risk factors in patients with acute cerebral disease,and always leads to stroke or get it worse.There is often a high level of blood glucose in those patients with diabetes mellitus and cerebral disease,but it is hard to distinguish from both kinds of hyperglycemia.Serum fructosamine is said to be correlated with blood glucose.OBJECTIVE:To explore the relationship between serum fructosamine and blood glucose in patients with acute cerebrovascular disease.DESIGN:A case-controlled study.SETTINGS:Department of Clinical Laboratory,Health Department for Cadres and Department of Neurology of Affiliated Hospital,Qingdao University Medical College.PARTICIPANTS:Forty-eight inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology,Affiliated Hospital of Qingdao University Medical College from December 2004 to April 2005.All the patients were confirmed with CT and MRI.There were 25 patients with diabetes mellitus secondary cerebrovascular diseases,who met the diagnostic standards of diabetes mellitus set by WHO,including 12 males and 13 females with an average of(60±8)years old,the course of diabetes mellitus ranged from 1 to 21 years..The other 23 patients had no diabetes mellitus(without diabetes mellitus group),including 14 males and 9 females with an average of(62±6)years old.Meanwhile,another 50 healthy physical examinees in the hospital were selected as control group,including 26 males and 24 females with the average age of(62±5)years old.Informed content was obtained from all the participants.METHODS:Venous blood was drawn from all the participants,and content of blood glucose was assayed by means of glucose oxidase,and the concentration of serum fructosamine was determined by nitroblue tetrazolium colorimetric method.Comparison between groups was performed by the analysis of variance and q test,and the correlation was tested by linear regression analysis.MAIN OUTCOME MEASURES:①Comparison of blood glucose and serum fructosamine among the groups;②Correlation between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebrovascular diseases and those without diabetes mellitus.RESULTS:All the 48 patients with cerebrovascular disease and 50 healthy subjects were involved in the analysis of results.①Contents of blood glucose and serum fructosamine:There were obvious differences in the contents of blood glucose and serum fructosamine among the diabetes mellitus group,without diabetes mellitus group and control group(F=577.7,115.1,P<0.01).The content of serum fructosamine in the diabetes mellitus group[(4.25±1.35)mmol/L]was obviously higher than those in the control group and without diabetes mellitus group[(1.65±0.27),(1.96±0.25)mmol/L,q=1.47,1.30,P<0.01],whereas there was no significant difference between the without diabetes mellitus group and control group(P>0.05).The content of blood glucose was obviously higher in the patients with and without diabetes mellitus groups[(15.80±2.13),(9.50±1.78)mmol/L]than in the control group[(4.56±0.77)mmol/L,q=1.86,2.46,P<0.01],also markedly higher in the with diabetes mellitus group than in the without diabetes mellitus group(q=1.42,P<0.01).②Results of correlation analysis:The content of serum fructosamine was positively correlated with the level of fasting blood glucose in the patients with diabetes mellitus secondary cerebrovascular diseases(r=0.603,P<0.01).But there was no relationship between serum fructosamine and fasting blood glucose in the patients without diabetes mellitus(r=0.357,P>0.05).CONCLUSION:The contents of blood glucose and serum fructosamine were obviously different among the diabetes mellitus group,without diabetes mellitus group and control group.There are closer relations between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebral disorders,which are not observed in the patients without diabetes mellitus.Fructosamine is significant in differentiating the reasons for the increased blood glucose in patients with acute cerebrovascular disease.展开更多
BACKGROUND Children with acute liver failure(ALF)who meet the criteria are eligible for super-urgent transplantation,whereas children with end-stage chronic liver disease(ESCLD)are usually transplanted electively.Pedi...BACKGROUND Children with acute liver failure(ALF)who meet the criteria are eligible for super-urgent transplantation,whereas children with end-stage chronic liver disease(ESCLD)are usually transplanted electively.Pediatric liver transplantation(PLT)in ALF and ESCLD settings has been well described in the literature,but there are no studies comparing the outcomes in these two groups.AIM To determine if there is a difference in post-operative complications and survival outcomes between ALF and ESCLD in PLT.METHODS This was a retrospective observational study of all primary PLTs performed at a single center between 2000 and 2019.ALF and ESCLD groups were compared for pretransplant recipient,donor and operative parameters,and post-operative outcomes including graft and patient survival.RESULTS Over a 20-year study period,232 primary PLTs were performed at our center;195 were transplanted for ESCLD and 37 were transplanted for ALF.The ALF recipients were significantly older(median 8 years vs 5.4 years;P=0.031)and heavier(31 kg vs 21 kg;P=0.011).Living donor grafts were used more in the ESCLD group(34 vs 0;P=0.006).There was no difference between the two groups concerning vascular complications and rejection,but there were more bile leaks in the ESCLD group.Post-transplant patient survival was significantly higher in the ESCLD group:1-,5-,and 10-year survival rates were 97.9%,93.9%,and 89.4%,respectively,compared to 78.3%,78.3%,and 78.3%in the ALF group(P=0.007).However,there was no difference in 1-,5-,and 10-year graft survival between the ESCLD and ALF groups(90.7%,82.9%,77.3%vs 75.6%,72.4%,and 66.9%;P=0.119).CONCLUSION Patient survival is inferior in ALF compared to ESCLD recipients;the main reason is death in the 1st year post-PLT in ALF group.Once the ALF children overcome the 1st year after transplant,their survival stabilizes,and they have good long-term outcomes.展开更多
文摘BACKGROUND:Diabetes mellitus is one of the risk factors in patients with acute cerebral disease,and always leads to stroke or get it worse.There is often a high level of blood glucose in those patients with diabetes mellitus and cerebral disease,but it is hard to distinguish from both kinds of hyperglycemia.Serum fructosamine is said to be correlated with blood glucose.OBJECTIVE:To explore the relationship between serum fructosamine and blood glucose in patients with acute cerebrovascular disease.DESIGN:A case-controlled study.SETTINGS:Department of Clinical Laboratory,Health Department for Cadres and Department of Neurology of Affiliated Hospital,Qingdao University Medical College.PARTICIPANTS:Forty-eight inpatients and outpatients with cerebrovascular diseases were selected from the Department of Neurology,Affiliated Hospital of Qingdao University Medical College from December 2004 to April 2005.All the patients were confirmed with CT and MRI.There were 25 patients with diabetes mellitus secondary cerebrovascular diseases,who met the diagnostic standards of diabetes mellitus set by WHO,including 12 males and 13 females with an average of(60±8)years old,the course of diabetes mellitus ranged from 1 to 21 years..The other 23 patients had no diabetes mellitus(without diabetes mellitus group),including 14 males and 9 females with an average of(62±6)years old.Meanwhile,another 50 healthy physical examinees in the hospital were selected as control group,including 26 males and 24 females with the average age of(62±5)years old.Informed content was obtained from all the participants.METHODS:Venous blood was drawn from all the participants,and content of blood glucose was assayed by means of glucose oxidase,and the concentration of serum fructosamine was determined by nitroblue tetrazolium colorimetric method.Comparison between groups was performed by the analysis of variance and q test,and the correlation was tested by linear regression analysis.MAIN OUTCOME MEASURES:①Comparison of blood glucose and serum fructosamine among the groups;②Correlation between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebrovascular diseases and those without diabetes mellitus.RESULTS:All the 48 patients with cerebrovascular disease and 50 healthy subjects were involved in the analysis of results.①Contents of blood glucose and serum fructosamine:There were obvious differences in the contents of blood glucose and serum fructosamine among the diabetes mellitus group,without diabetes mellitus group and control group(F=577.7,115.1,P<0.01).The content of serum fructosamine in the diabetes mellitus group[(4.25±1.35)mmol/L]was obviously higher than those in the control group and without diabetes mellitus group[(1.65±0.27),(1.96±0.25)mmol/L,q=1.47,1.30,P<0.01],whereas there was no significant difference between the without diabetes mellitus group and control group(P>0.05).The content of blood glucose was obviously higher in the patients with and without diabetes mellitus groups[(15.80±2.13),(9.50±1.78)mmol/L]than in the control group[(4.56±0.77)mmol/L,q=1.86,2.46,P<0.01],also markedly higher in the with diabetes mellitus group than in the without diabetes mellitus group(q=1.42,P<0.01).②Results of correlation analysis:The content of serum fructosamine was positively correlated with the level of fasting blood glucose in the patients with diabetes mellitus secondary cerebrovascular diseases(r=0.603,P<0.01).But there was no relationship between serum fructosamine and fasting blood glucose in the patients without diabetes mellitus(r=0.357,P>0.05).CONCLUSION:The contents of blood glucose and serum fructosamine were obviously different among the diabetes mellitus group,without diabetes mellitus group and control group.There are closer relations between serum fructosamine and blood glucose in patients with diabetes mellitus secondary cerebral disorders,which are not observed in the patients without diabetes mellitus.Fructosamine is significant in differentiating the reasons for the increased blood glucose in patients with acute cerebrovascular disease.
文摘BACKGROUND Children with acute liver failure(ALF)who meet the criteria are eligible for super-urgent transplantation,whereas children with end-stage chronic liver disease(ESCLD)are usually transplanted electively.Pediatric liver transplantation(PLT)in ALF and ESCLD settings has been well described in the literature,but there are no studies comparing the outcomes in these two groups.AIM To determine if there is a difference in post-operative complications and survival outcomes between ALF and ESCLD in PLT.METHODS This was a retrospective observational study of all primary PLTs performed at a single center between 2000 and 2019.ALF and ESCLD groups were compared for pretransplant recipient,donor and operative parameters,and post-operative outcomes including graft and patient survival.RESULTS Over a 20-year study period,232 primary PLTs were performed at our center;195 were transplanted for ESCLD and 37 were transplanted for ALF.The ALF recipients were significantly older(median 8 years vs 5.4 years;P=0.031)and heavier(31 kg vs 21 kg;P=0.011).Living donor grafts were used more in the ESCLD group(34 vs 0;P=0.006).There was no difference between the two groups concerning vascular complications and rejection,but there were more bile leaks in the ESCLD group.Post-transplant patient survival was significantly higher in the ESCLD group:1-,5-,and 10-year survival rates were 97.9%,93.9%,and 89.4%,respectively,compared to 78.3%,78.3%,and 78.3%in the ALF group(P=0.007).However,there was no difference in 1-,5-,and 10-year graft survival between the ESCLD and ALF groups(90.7%,82.9%,77.3%vs 75.6%,72.4%,and 66.9%;P=0.119).CONCLUSION Patient survival is inferior in ALF compared to ESCLD recipients;the main reason is death in the 1st year post-PLT in ALF group.Once the ALF children overcome the 1st year after transplant,their survival stabilizes,and they have good long-term outcomes.
