Background：As a major complication after orthotopic liver transplantation （OLT）,the occurrence of acute kidney injury （AKI） is frequently defined by serum creatinine （Cr）;however,the accuracy of commonly used b...Background：As a major complication after orthotopic liver transplantation （OLT）,the occurrence of acute kidney injury （AKI） is frequently defined by serum creatinine （Cr）;however,the accuracy of commonly used blood urea nitrogen （BUN）,uric acid （UA）,and β2-microglobulin （β2-MG） remains to be explored.This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation.Methods：Patients who underwent OLT in three centers between July 2003 and December 2013 were enrolled.The postoperative AKI group was diagnosed by the Kidney Disease Improving Global Outcomes （KDIGO） criteria and classified by stage.Measurement data were analyzed using the t-test or Wilcoxon rank-sum test;enumerated data were analyzed using the Chi-square test or Fisher＇s exact test.Diagnostic reliability and predictive accuracy were evaluated using receiver operating characteristic （ROC） curve analysis.Results：This study excluded 976 cases and analyzed 697 patients （578 men and 1 1 9 women）;the post-OLT AKI incidence was 0.409.Compared with the no-AKI group,the AKI group showed very significant differences in Model for End-stage Liver Disease score （14.74 ± 9.91 vs.11.07 ± 9.54,Z =5.404;P ＜ 0.001）,hepatic encephalopathy （45 [15.8％] vs.30 [7.3％],x2 =12.699;P ＜ 0.001）,hemofiltration （28 [9.8％] vs.0 [0.0％],x2 =42.171;P ＜ 0.001）,and 28-day mortality （23 [8.1％] vs.9 [2.2％],x2 13.323;P ＜0.001）.Moreover,mean values of Cr,BUN,UA,and β2-MG in the AKI group differed significantly at postoperative days 1,3,and 7 （all P ＜0.001）.ROC curve area was 0.847 of Cr for the detection of AKI Stage 1 （sensitivity 80.1％,specificity 75.7％,cutoffvalue 88.23 μmol/L）,0.916 for Stage 2 （sensitivity 87.6％,specificity 82.6％,cutoff value 99.9 μmol/L）,and 0.972 for Stage 3 （sensitivity 94.1％,specificity 88.2％,cutoff value 122.90 μmol/L）.Conclusion：The sensitivity and specificity of serum Cr might be a high-value indicator for the diagnosis and grading of post-OLT AKI.展开更多
Objective:To examine the effects of hydroalcoholic extract and fractions of Hordeum vulgare Linn.(H.vulgare,Da Mai)on streptozotocin(STZ)-induced diabetic nephropathy in Sprague-Dawley rat models.Methods:The study inv...Objective:To examine the effects of hydroalcoholic extract and fractions of Hordeum vulgare Linn.(H.vulgare,Da Mai)on streptozotocin(STZ)-induced diabetic nephropathy in Sprague-Dawley rat models.Methods:The study involved preliminary phytochemical screening of extract and fractions,estimation of secondary metabolites,chromatographic studies using high performance liquid chromatography(HPLC),antioxidant potential using 1,1-diphenyl-2-picrylhydrazyl(DPPH),nitric oxide radical scavenging and reducing power methods along with the determination of potential against diabetic nephropathy in STZ-induced rat models.Results:The phytochemical evaluation of the hydroalcoholic extract of H.vulgare and fractions revealed the presence of various phytoconstituents such as alkaloids,saponins,tannins,flavonoids,and glycosides.The chromatographic analysis indicated the peak complementing marker compound epicatechin and significant antioxidant activity in the extract and aqueous fraction.STZ-induced rats showed abnormal levels of serum albumin,creatinine,total cholesterol,blood urea nitrogen(BUN),and triglycerides,and urine albumin and creatinine,which returned to normal after 8 weeks of treatment with hydroalcoholic extract(400 mg/kg)and aqueous fraction(50 mg/kg)of H.vulgare.Conclusion:Hydroalcoholic extract(400 mg/kg)and aqueous fraction(50 mg/kg)of H.vulgare have significant antioxidant potential and positive effects on diabetic nephropathy.The fractionation and optimization increase the concentration of polyphenols in aqueous extract,causing a decrease in the dose required for effects against diabetic nephropathy.展开更多
目的:探究尿素氮与白蛋白比值(blood urea nitrogen to serum albumin ratio,B/A)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肾功能不全患者,无创机械通气(non-invasi...目的:探究尿素氮与白蛋白比值(blood urea nitrogen to serum albumin ratio,B/A)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肾功能不全患者,无创机械通气(non-invasive mechanical ventilation,NIV)预后的预测价值。方法:选择2021年1月至2023年1月,在连云港市第二人民医院肾内科,收治的老年AECOPD合并肾功能不全患者接受NIV患者220例,依据患者住院NIV治疗后28 d的生存情况分为:生存组(180例)和死亡组(40例),比较两组患者的B/A,运用Logistic回归性分析和受试者工作特征曲线ROC评价入院初24 h的B/A预测AECOPD合并肾功能不全患者NIV治疗后28 d预后的价值。结果:生存组白蛋白、血红蛋白和血小板显著高于死亡组患者(P <0.05),生存组尿素氮、B/A、急性生理和慢性健康评分(acutephysiology and chronic health evaluationⅡ,APACHEⅡ)显著低于死亡组患者(P <0.05)。Logistic回归分析结果显示B/A和APACHEⅡ评分是导致患者死亡的危险因素(P <0.05)。ROC分析显示,B/A的曲线下面积、敏感度、特异度均较APACHEⅡ评分增高,B/A与APACHEⅡ评分的AUC差异无统计学意义(t=1.686,P=0.093)。结论:B/A和APACHEⅡ评分均可用于评估老年AECOPD合并肾功能不全患者NIV预后,与APACHEⅡ评分比,B/A在评估老年AECOPD患者NIV预后的效能更高。展开更多
【目的】系统评价益气养阴法联合西药治疗肾病综合征的有效性及安全性。【方法】检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方(Wangfang)、维普(VIP)、PubMed、Web of Science、Cochrane Library、Embase等国内外主要文献数...【目的】系统评价益气养阴法联合西药治疗肾病综合征的有效性及安全性。【方法】检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方(Wangfang)、维普(VIP)、PubMed、Web of Science、Cochrane Library、Embase等国内外主要文献数据库,筛选其中有关益气养阴法联合西药(试验组)对比单纯西药(对照组)治疗肾病综合征的临床随机对照试验(RCTs),采用Cochrane手册中的偏倚风险工具进行文献的质量评价,运用RevMan 5.3软件进行Meta分析。【结果】共纳入18个RCTs,包含1334例患者。Meta分析结果显示,益气养阴法联合西药在提高临床有效率(RR=1.24,95%CI[1.16,1.32],P<0.00001),改善24 h尿蛋白定量(24hUPRO)(MD=-0.92,95%CI[-1.09,-0.75],P<0.00001)、血清白蛋白(ALB)(MD=7.06,95%CI[4.73,9.39],P<0.00001)、尿素氮(BUN)(MD=-1.57,95%CI[-2.01,-1.13],P<0.00001)、血肌酐(SCr)(MD=-12.23,95%CI[-16.58,-7.88],P<0.00001)、总胆固醇(TC)(MD=-1.06,95%CI[-1.69,-0.43],P=0.0009)、甘油三酯(TG)(MD=-0.58,95%CI[-0.94,-0.21],P=0.002)水平,以及降低不良反应发生率(RR=0.50,95%CI[0.40,0.64],P<0.00001)方面优于单纯西药治疗。【结论】益气养阴法联合西药治疗肾病综合征在提高临床疗效及改善24hUPRO、ALB、BUN、SCr、TC、TG方面优于单纯西药治疗,且能降低激素产生的不良反应。因纳入文献较少,文献质量较低,潜在疗效需更多的高质量研究进行验证。展开更多
目的探讨血尿素氮与白蛋白比值(blood urea nitrogen and albumin ratio,B/A)在妇科肿瘤及女性乳腺癌重症患者预后评估中的临床价值。方法收集重症监护医学信息数据库(Medical Information Mart for Intensive Care,MIMIC)中在重症监护...目的探讨血尿素氮与白蛋白比值(blood urea nitrogen and albumin ratio,B/A)在妇科肿瘤及女性乳腺癌重症患者预后评估中的临床价值。方法收集重症监护医学信息数据库(Medical Information Mart for Intensive Care,MIMIC)中在重症监护病房(intensive care unit,ICU)住院的妇科肿瘤和女性乳腺癌患者的一般临床资料。根据患者360d的预后情况将其分为存活组(n=472)和死亡组(n=388),比较两组患者的一般情况。根据B/A水平将患者分为低B/A组(B/A<0.075,n=435)和高B/A组(B/A≥0.075,n=425)。采用Kaplan-Meier法绘制生存曲线,并建立Cox风险比例模型,比较B/A与患者360d全因死亡风险的相关性。结果死亡组患者的B/A显著高于生存组(P<0.05)。B/A与患者360d全因死亡风险整体呈非线性趋势关系(χ^(2)=18.790,P<0.001)。生存分析显示,无论是总体人群还是妇科肿瘤或乳腺癌患者中,高B/A患者的累积生存率均显著低于低B/A患者(P<0.001)。Cox回归分析提示B/A≥0.075是妇科肿瘤及女性乳腺癌重症患者360d全因死亡的独立危险因素(HR=1.529,95%CI:1.197~1.952,P=0.001)。结论入住ICU时高B/A是妇科肿瘤及女性乳腺癌重症患者长期死亡风险增加的独立危险因素,有助于临床医生及护理人员早期识别高危患者。展开更多
目的分析尿素氮与肌酐比值(UCR)与血乳酸清除率(LCR)预测老年重症肺炎患者死亡风险的价值。方法选择南京鼓楼医院来安分院2018年5月至2022年3月呼吸重症监护室(RICU)收治的老年重症肺炎患者83例,收集患者临床资料,根据患者入院28 d的预...目的分析尿素氮与肌酐比值(UCR)与血乳酸清除率(LCR)预测老年重症肺炎患者死亡风险的价值。方法选择南京鼓楼医院来安分院2018年5月至2022年3月呼吸重症监护室(RICU)收治的老年重症肺炎患者83例,收集患者临床资料,根据患者入院28 d的预后情况分为生存组(n=22)与死亡组(n=61)。分析老年重症肺炎患者死亡的危险因素,以及入院6 h UCR、LCR和二者联合对老年重症肺炎患者死亡风险的预测价值。结果死亡组入院时急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、年龄、入院时肺炎严重指数(PSI)分级>3级病例数占比、入院6 h超敏C反应蛋白(hs-CRP)、中性粒细胞与淋巴细胞比值(NLR)、红细胞分布宽度(RDW)、白细胞(WBC)计数和UCR高于生存组(P<0.05),入院6 h LCR低于生存组(P<0.05)。入院时PSI分级>3级、入院6 h UCR升高、LCR降低为老年重症肺炎患者死亡的危险因素(P<0.05)。入院后6 h UCR与LCR及二者联合预测老年重症肺炎患者死亡风险的曲线下面积(AUC)分别为0.715、0.701和0.805(P<0.05)。结论入院时PSI分级>3级、入院6 h UCR升高、LCR降低是老年重症肺炎患者死亡的影响因素;入院6 h UCR与LCR可用于预测老年重症肺炎患者的死亡风险,二者联合对于老年重症肺炎患者的死亡风险预测价值更高。展开更多
文摘Background：As a major complication after orthotopic liver transplantation （OLT）,the occurrence of acute kidney injury （AKI） is frequently defined by serum creatinine （Cr）;however,the accuracy of commonly used blood urea nitrogen （BUN）,uric acid （UA）,and β2-microglobulin （β2-MG） remains to be explored.This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation.Methods：Patients who underwent OLT in three centers between July 2003 and December 2013 were enrolled.The postoperative AKI group was diagnosed by the Kidney Disease Improving Global Outcomes （KDIGO） criteria and classified by stage.Measurement data were analyzed using the t-test or Wilcoxon rank-sum test;enumerated data were analyzed using the Chi-square test or Fisher＇s exact test.Diagnostic reliability and predictive accuracy were evaluated using receiver operating characteristic （ROC） curve analysis.Results：This study excluded 976 cases and analyzed 697 patients （578 men and 1 1 9 women）;the post-OLT AKI incidence was 0.409.Compared with the no-AKI group,the AKI group showed very significant differences in Model for End-stage Liver Disease score （14.74 ± 9.91 vs.11.07 ± 9.54,Z =5.404;P ＜ 0.001）,hepatic encephalopathy （45 [15.8％] vs.30 [7.3％],x2 =12.699;P ＜ 0.001）,hemofiltration （28 [9.8％] vs.0 [0.0％],x2 =42.171;P ＜ 0.001）,and 28-day mortality （23 [8.1％] vs.9 [2.2％],x2 13.323;P ＜0.001）.Moreover,mean values of Cr,BUN,UA,and β2-MG in the AKI group differed significantly at postoperative days 1,3,and 7 （all P ＜0.001）.ROC curve area was 0.847 of Cr for the detection of AKI Stage 1 （sensitivity 80.1％,specificity 75.7％,cutoffvalue 88.23 μmol/L）,0.916 for Stage 2 （sensitivity 87.6％,specificity 82.6％,cutoff value 99.9 μmol/L）,and 0.972 for Stage 3 （sensitivity 94.1％,specificity 88.2％,cutoff value 122.90 μmol/L）.Conclusion：The sensitivity and specificity of serum Cr might be a high-value indicator for the diagnosis and grading of post-OLT AKI.
基金supported by Rashtrsant Tukadoji Maharaj Memorial Fellowship from Rashtrasant Tukadoji Maharaj Nagpur University。
文摘Objective:To examine the effects of hydroalcoholic extract and fractions of Hordeum vulgare Linn.(H.vulgare,Da Mai)on streptozotocin(STZ)-induced diabetic nephropathy in Sprague-Dawley rat models.Methods:The study involved preliminary phytochemical screening of extract and fractions,estimation of secondary metabolites,chromatographic studies using high performance liquid chromatography(HPLC),antioxidant potential using 1,1-diphenyl-2-picrylhydrazyl(DPPH),nitric oxide radical scavenging and reducing power methods along with the determination of potential against diabetic nephropathy in STZ-induced rat models.Results:The phytochemical evaluation of the hydroalcoholic extract of H.vulgare and fractions revealed the presence of various phytoconstituents such as alkaloids,saponins,tannins,flavonoids,and glycosides.The chromatographic analysis indicated the peak complementing marker compound epicatechin and significant antioxidant activity in the extract and aqueous fraction.STZ-induced rats showed abnormal levels of serum albumin,creatinine,total cholesterol,blood urea nitrogen(BUN),and triglycerides,and urine albumin and creatinine,which returned to normal after 8 weeks of treatment with hydroalcoholic extract(400 mg/kg)and aqueous fraction(50 mg/kg)of H.vulgare.Conclusion:Hydroalcoholic extract(400 mg/kg)and aqueous fraction(50 mg/kg)of H.vulgare have significant antioxidant potential and positive effects on diabetic nephropathy.The fractionation and optimization increase the concentration of polyphenols in aqueous extract,causing a decrease in the dose required for effects against diabetic nephropathy.
文摘目的:探究尿素氮与白蛋白比值(blood urea nitrogen to serum albumin ratio,B/A)对老年慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肾功能不全患者,无创机械通气(non-invasive mechanical ventilation,NIV)预后的预测价值。方法:选择2021年1月至2023年1月,在连云港市第二人民医院肾内科,收治的老年AECOPD合并肾功能不全患者接受NIV患者220例,依据患者住院NIV治疗后28 d的生存情况分为:生存组(180例)和死亡组(40例),比较两组患者的B/A,运用Logistic回归性分析和受试者工作特征曲线ROC评价入院初24 h的B/A预测AECOPD合并肾功能不全患者NIV治疗后28 d预后的价值。结果:生存组白蛋白、血红蛋白和血小板显著高于死亡组患者(P <0.05),生存组尿素氮、B/A、急性生理和慢性健康评分(acutephysiology and chronic health evaluationⅡ,APACHEⅡ)显著低于死亡组患者(P <0.05)。Logistic回归分析结果显示B/A和APACHEⅡ评分是导致患者死亡的危险因素(P <0.05)。ROC分析显示,B/A的曲线下面积、敏感度、特异度均较APACHEⅡ评分增高,B/A与APACHEⅡ评分的AUC差异无统计学意义(t=1.686,P=0.093)。结论:B/A和APACHEⅡ评分均可用于评估老年AECOPD合并肾功能不全患者NIV预后,与APACHEⅡ评分比,B/A在评估老年AECOPD患者NIV预后的效能更高。
文摘目的探讨血尿素氮与白蛋白比值(blood urea nitrogen and albumin ratio,B/A)在妇科肿瘤及女性乳腺癌重症患者预后评估中的临床价值。方法收集重症监护医学信息数据库(Medical Information Mart for Intensive Care,MIMIC)中在重症监护病房(intensive care unit,ICU)住院的妇科肿瘤和女性乳腺癌患者的一般临床资料。根据患者360d的预后情况将其分为存活组(n=472)和死亡组(n=388),比较两组患者的一般情况。根据B/A水平将患者分为低B/A组(B/A<0.075,n=435)和高B/A组(B/A≥0.075,n=425)。采用Kaplan-Meier法绘制生存曲线,并建立Cox风险比例模型,比较B/A与患者360d全因死亡风险的相关性。结果死亡组患者的B/A显著高于生存组(P<0.05)。B/A与患者360d全因死亡风险整体呈非线性趋势关系(χ^(2)=18.790,P<0.001)。生存分析显示,无论是总体人群还是妇科肿瘤或乳腺癌患者中,高B/A患者的累积生存率均显著低于低B/A患者(P<0.001)。Cox回归分析提示B/A≥0.075是妇科肿瘤及女性乳腺癌重症患者360d全因死亡的独立危险因素(HR=1.529,95%CI:1.197~1.952,P=0.001)。结论入住ICU时高B/A是妇科肿瘤及女性乳腺癌重症患者长期死亡风险增加的独立危险因素,有助于临床医生及护理人员早期识别高危患者。
文摘目的分析尿素氮与肌酐比值(UCR)与血乳酸清除率(LCR)预测老年重症肺炎患者死亡风险的价值。方法选择南京鼓楼医院来安分院2018年5月至2022年3月呼吸重症监护室(RICU)收治的老年重症肺炎患者83例,收集患者临床资料,根据患者入院28 d的预后情况分为生存组(n=22)与死亡组(n=61)。分析老年重症肺炎患者死亡的危险因素,以及入院6 h UCR、LCR和二者联合对老年重症肺炎患者死亡风险的预测价值。结果死亡组入院时急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、年龄、入院时肺炎严重指数(PSI)分级>3级病例数占比、入院6 h超敏C反应蛋白(hs-CRP)、中性粒细胞与淋巴细胞比值(NLR)、红细胞分布宽度(RDW)、白细胞(WBC)计数和UCR高于生存组(P<0.05),入院6 h LCR低于生存组(P<0.05)。入院时PSI分级>3级、入院6 h UCR升高、LCR降低为老年重症肺炎患者死亡的危险因素(P<0.05)。入院后6 h UCR与LCR及二者联合预测老年重症肺炎患者死亡风险的曲线下面积(AUC)分别为0.715、0.701和0.805(P<0.05)。结论入院时PSI分级>3级、入院6 h UCR升高、LCR降低是老年重症肺炎患者死亡的影响因素;入院6 h UCR与LCR可用于预测老年重症肺炎患者的死亡风险,二者联合对于老年重症肺炎患者的死亡风险预测价值更高。
