Factors Associated with Mortality in Diabetic Patients with End-Stage Renal Failure Starting Emergency Hemodialysis

Background: Diabetic nephropathy is the leading cause of end-stage chronic kidney disease with poor prognosis in resource-limited settings. This study aimed to determine factors associated with mortality in patients starting dialysis treatment for end-stage chronic renal disease in an emergency context. Patients and Methods: This was a retrospective study from January 2020 to December 2022 at CHU-B. Data from 79 diabetic patients requiring emergency dialysis were compared with those of 79 non-diabetic patients with an end-stage renal disease requiring emergency dialysis. Data were collected from the Nephrology Department registry. We studied their initial clinical and biological profiles and factors related to mortality. Results: Out of 545 compiled records, 79 diabetic chronic kidney disease patients needing dialysis were included (group 1). A control group of 79 non-diabetic chronic kidney disease patients requiring emergency dialysis was also included (group 2). The average age of patients was 53.5 ± 17 years, and the duration of diabetes at dialysis initiation was 14.8 ± 4.3 years. Twenty-three percent were hypertensive. Fifty-two percent of patients experienced intra-dialytic hypotension. Death occurred in 22% of patients. Results show that age (adjusted OR 1.955;CI: 1.025 - 1.086;p-value: Conclusion: Emergency dialysis in diabetics is associated with unfavorable outcomes in terms of mortality. Despite follow-up, renal involvement remains poorly explored, emphasizing the need for physician awareness.

Seroprevalence and Molecular Biodiverisity of Hepatitis C Infection in Congolese Diabetics

Summary: There is no evidence for comorbidity diabetes and hepatitis C virus infection in the Congo. The aim of this work was to determine the seroprevalence and molecular biodiversity of HCV in order to contribute to improving the management of Congolese diabetics. Patients and methods: It was a cross-sectional study that took place from 1 February to 30 September 2018 at the Brazzaville University Hospital, the Diabcare Health Center and the Adolphe Cissé Hospital in Pointe-Noire. It concerned diabetic patients followed in Brazzaville and Pointe-Noire agreeing to the study, after obtaining the opinion of the ethics committee of the research in health science. All samples collected were screened for the presence of anti HCV Ab using a rapid ALERE HCV test and the Monolisa HCV Ag-Ab ultra test for confirmation in Congo. Detection of the viral RNA was done by PCR retrotranscription and genotyping was performed according to the reverse hybridization technique in France. Data analysis was done with EpiInfo 6.0 software (2016);the proportions were compared using the Chi-square test or the Fisher test at the significance level of 5%. Results: Of 447 patients with diabetes mellitus, 49 had HCV positive serology and the sex ratio was 0.63. Seroprevalence of AC anti HCV was 11% (49/447);HCV RNA was detectable in 71.4% (n = 35) patients. The average age of the population was 62 ± 10 years with extremes ranging from 26 to 82 years. The circulating genotypes were 4 (97.1%) and 1 (2.8%). Subtyping was defined in 17.64% (n = 6) of genotype 4 patients;undefined in 82.36% (n = 28) of Genotype 4 patients, and in one of genotype 1 patients. The subtypes identified were subtype 4e (60%), subtype 4e (8.8%), subtype 4a/4c/4d (5.8%), and subtype 4h (2.9%). Conclusion: The prevalence of HCV is high in our study. These are important data for the improvement of the management of diabetics.

碘盐预防碘缺乏病效果的Cochrane系统评价

目的 比较碘盐与其它补碘形式或空白食盐预防碘缺乏病的效果。检索策略 检索了Cochrane Library,Med-line,和中国Cochrane中心RCT文献库;手检了《中国地方病学杂志》、《中国地方病防治杂志》、《中华流行病学杂志》、《中华预防医学杂志》、《微量元素与健康杂志》;检索杂志的最近日期至2001年2月;检索资料库的参考文献目录和正进行的研究至2001年11月。纳入标准 试验组为碘盐、对照组为其它供碘方式或空白食盐的前瞻性对照研究,其观察对象为居住在碘缺乏病区的人群,以地甲肿率、尿碘排量、甲状腺激素和甲状腺球蛋白为测量指标。资料收集和分析 由于收集的资料的相似性和质量低,本系统评价未作Meta-分析,但以叙述形式进行总结。主要结果 找到六个符合目的的前瞻性研究,其中,四个为随机照试验,一个为前瞻性的、但未叙述对照组的分配情况,一个为与不同干预措施对照的前瞻性大样本研究。作对照的干预措施包括无碘食盐、碘化水、碘油,以及碘酸钾与碘化钾。观察对象样本量从35到334,大样本量的前瞻性研究大于20000例。虽然不是所有的研究都得到同样的结果,但总的趋势是由于供应了碘盐,地甲肿的发病率减少;虽然从尿碘排量水平反映出并不总是达到了世界卫生组织制定的标准,但在大多数研究中,碘营养状况获得了?

GDF-15 Level Correlates with CMKLR1 and VEGF-A in Tumor-free Margin in Colorectal Cancer

Colorectal cancer(CRC)is the third most frequently diagnosed cancer worldwide,responsible for over 880000 deaths each year.Growth/differentiation factor 15(GDF-15)is reported to be a promising diagnostic and prognostic factor in CRC.It induces pleiotropic effects in tumor cells:proliferation,sternness,invasion and metastasis.Some studies indicate that GDF-15 may stimulate angiogenesis in malignant neoplasms.However,it has not been investigated in CRC yet.The aim of our study was to determine the level of GDF-15 and the concentrations of hypoxia-inducible factor-la(HIF-1α),VEGF-A and chemokine-like receptor 1(CMKLR1)in tumor and margin specimens of CRC in relation to histological grade and TNM staging.The study comprised 33 samples of tumor and margin tissues obtained from CRC patients.To assess the concentration of GDF-15,HIF-1α,VEGF-A and CMKLR1,commercially available enzyme-linked immunosorbent assay(ELISA)kits were used.We found significantly increased levels of GDF-15 and CMKLR1 in tumor tissue compared to margin tissue and higher concentrations of HIF-1α and VEGF-A in margin tissue than in tumor tissue.The levels of GDF-15 and HIF-1α were significantly correlated with VEGF-A and CMKLR1 in margin tissue.In CRC,the increased level of GDF-15 might stimulate angiogenesis through upregulation of HIF-1α,VEGF A and CMKLR1 expression.Our study is the first one to reveal the correlation between the levels of GDF-15 and CMKLR1 in CRC.The elevated levels of HIF-1α and VEGF-A in tumor-free margin tissues suggest that noncancer cells in the tumor microenvironment are an important source of proangiogenic factors.

Novel compound heterozygous mutations in the hemojuvelin gene in a juvenile hemochromatosis patient:A case report

BACKGROUND Juvenile hemochromatosis(JH)is an early-onset,rare autosomal recessive disorder of iron overload observed worldwide that leads to damage in multiple organs.Pathogenic mutations in the hemojuvelin(HJV)gene are the major cause of JH.CASE SUMMARY A 34-year-old male Chinese patient presented with liver fibrosis,diabetes,hypogonadotropic hypogonadism,hypophysis hypothyroidism,and skin hyperpigmentation.Biochemical test revealed a markedly elevated serum ferritin level of 4329μg/L and a transferrin saturation rate of 95.4%.Targeted exome sequencing and Sanger sequencing revealed that the proband had a novel mutation c.863G>A(p.R288Q)in the HJV gene which was transmitted from his father,and two known mutations,c.18G>C(p.Q6H)and c.962_963delGCinsAA(p.C321*)in cis,which were inherited from his mother.The p.R288W mutation was previously reported to be pathogenic for hemochromatosis,which strongly supported the pathogenicity of p.R288Q reported for the first time in this case.After 72 wk of intensive phlebotomy therapy,the patient achieved a reduction in serum ferritin to 160.5μg/L.The patient's clinical symptoms demonstrated a notable improvement.CONCLUSION This study highlights the importance of screening for hemochromatosis in patients with diabetes and hypogonadotropic hypogonadism.It also suggests that long-term active phlebotomy could efficiently improve the prognosis in severe JH.

中国人与日本人β3肾上腺素能受体基因Trp64Arg突变的比较

目的 研究 β 3肾上腺素能受体 (β 3AR)基因Trp6 4Arg突变频率及其对体重、血脂、血压、心率及糖尿病发病的影响以及中日民族间的差异。方法 研究了 75 1例中国人该受体基因突变的临床特征 ,并与本文第一作者曾在日本做的研究进行了比较。中国人 :(1 )健康体检者 6 1 4人 ;(2 ) 2型糖尿病患者 1 37人。日本人 :(1 )居民 746人 ;(2 ) 2型糖尿病和 /或高脂血症的内分泌代谢病门诊患者 371人。均测定了身高、体重、血糖、血脂、肝功能。用PCR法扩增含有 β 3AR基因Trp6 4Arg片段 ,限制性内切酶消化 ,判断基因型。结果 (1 )中国人 β 3AR基因Trp6 4Arg平均突变率为 1 7.8% ,日本人为 2 1 .7% ,两国近似。 (2 )中国人的 β 3AR基因突变率随BMI增高而升高 ,女性肥胖组的基因频率与正常偏瘦组相比差异有显著意义 (P <0 .0 2 )。日本人无明显相关性。中国人该基因突变者的平均BMI与正常基因型相比均显著增高 ,(P分别 <0 .0 0 1与 0 .0 0 2 )。日本人则差异无显著意义。 (3)日本人的纯合子及中国人的杂合子及纯合子男性 β 3AR基因突变者的血胆固醇降低 ,差异有显著意义 ,(日本人P <0 .0 3。中国人P分别 <0 .0 0 1与 0 .0 0 5 )。 (4)日本人男性 β 3AR基因纯合子突变者的收缩压有增高的倾向 (P =0 .0 0 2

Growth patterns in children with mucopolysaccharidosis Ⅰ and Ⅱ

Background:Mucopolysaccharidosis(MPS)diseases lead to a profound disruption in normal mechanisms of growth and development.This study was undertaken to determine the general growth of children with MPS I and II.Methods:The anthropometric data of patients with MPS I and II(n=76)were retrospectively analyzed.The growth patterns of these patients were analyzed and then plotted onto Polish reference charts.Longitudinal analyses were performed to estimate age-related changes.Results:At the time of birth,the body length was greater than reference charts for all MPS groups(Hurler syndrome,P=0.006;attenuated MPS II,P=0.011;severe MPS II,P<0.001).The mean z-score values for every MPS group showed that until the 30th month of life,the growth patterns for all patients were similar.Afterwards,these growth patterns start to differ for individual groups.The body height below the 3rd percentile was achieved around the 30th month for boys with Hurler syndrome,between the 4th and 5th year for patients with severe MPS H and between the 7th and 8th year for patients with attenuated MPS H.Conclusions:The growth pattern differs between patients with MPS I and H.It reflects the clinical severity of MPS and may assist in the evaluation of clinical efficacy of available therapies.