目的 总结肾移植术后肺部感染的临床表现、病原学及救治措施，以提高其治愈率。 方法 对四川大学华西医院50例次肾移植术后肺部感染住院患者的病历资料进行回顾性分析。 结果 共收集42例（50例）次肾移植肺部感染患者，痰培养检出病原体38例次（76%），未检出12例次，其中细菌感染17例次（44.7%），真菌感染7例次（18.4%），巨细胞病毒感染19例次（38%），支原体感染6例次（12%），混合感染10例次（20%）。肺部感染发生在肾移植术后1个月以内者3例（7%），1～6个月者16例（38%），6个月以后者23例（55%）。50例次感染患者中48例次经积极治疗抢救后好转出院，有2例患者死亡。 结论 肾移植术后肺部感染患者的病原体与肾移植术后时间有一定的规律性。对于肾移植术后肺部感染，救治成功的关键是早期病原体及CT检查，及时给予综合治疗措施，包括经验性抗生素治疗措施，及时调整免疫抑制剂方案，加强全身支持。
【摘要】 目的 探讨生理钙透析液对持续性不卧床腹膜透析（CAPD）患者钙磷代谢的影响。 方法 回顾性分析2008年1月-2009年12月腹膜透析患者的钙磷指标，资料齐全的患者中使用钙浓度为1.25 mmol/L的腹膜透析液（生理钙组）的患者有30例，使用钙浓度为1.75 mmol/L的透析液（标准钙组）患者30例。对两组患者钙磷代谢指标进行比较。 结果 治疗前后两组的血磷、钙磷乘积和全段甲状旁腺素差异均无统计学意义（Pgt;0.05）；治疗后标准钙组血钙较前升高，差异有统计学意义（Plt;0.05），而生理钙组治疗前后血钙差异无统计学意义（Pgt;0.05）。 结论 不同含钙浓度腹膜透析液对机体钙磷代谢的影响是不同的，在高钙、高磷、低转运骨病的腹膜透析患者中使用钙浓度为1.25 mmol/L的生理钙透析液减轻了钙负荷，为临床医生使用含钙磷结合剂提供了治疗空间。【Abstract】 Objective To investigate the effects of physiological calcium dialysate on the calcium and phosphorus metabolism in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods We retrospectively analyzed the clinical data of 60 patients having undergone CAPD in West China Hospital of Sichuan University between January 2008 and December 2009. The patients were divided into two groups with 30 in each by calcium concentration of the dialysate: the physiological calcium dialysate group (1.25 mmol/L) and the standard calcium dialysate group (1.75 mmol/L). The metabolism indexes of calcium and phosphorus for the two group of patients were compared. Results Levels of Serum phosphate, calcium-phosphate product and immoreactive parathyroid hormone (iPTH) of all the patients in both groups before and after treatment showed no significant differences (Pgt;0.05). Serum calcium increased significantly in patients treated with standard calcium dialysate (Plt;0.05), while it did not change significantly in patients treated with physiological calcium dialysate (Pgt;0.05). Conclusions Dialysate with different concentrations of calcium provides different influence on the metabolism of calcium and phosphorus. Changing calcium concentration to 1.25 mmol/L in the dialysate can lower the calcium load for patients with hypercalcium and/or hyperphosphate with low bone turnover, providing treatment space for clinical doctors to use binders containing both calcium and phosphorus.
ObjectiveThrough the analysis on outcome measurements in domestic and overseas randomized controlled trials (RCTs) of smoking cessation, this study aimed to provide references for clinical trial design in the future. MethodsWe searched CNKI, WanFang Data, VIP, PubMed, EMbase, ScienceDirect and SpringLink databases to collect RCTs regarding smoking cessation from January 1998 to December 2013. Two reviewers screened literature according to the inclusive and exclusive criteria, extracted the data, and analyzed the outcome measurements of included RCTs. ResultsA total of 68 RCTs regarding smoking cessation were included. As for the baseline measurements, the frequency from high to low were age, sex, daily cigarette, smoking duration, Fagerstrom Test For Nicotine Dependence (FTND), race and education, etc.; there were significant differences of race, education level, smoking duration, smoking, starting age of smoking, attempts of trying to stop smoking, the presence of other basic disease, FTND and quit date between English and Chinese RCTs (all P<0.05). As for efficacy measurements, the continuous abstinence rate (77.8%) was mainly adopted in Chinese RCTs, while point abstinence rate (95.1%) and continuous abstinence rate (82.9%) was selected in English RCTs. As for the follow-up measurements, 22.1% of the included RCTs did not report it, 70.6% of the RCTs reported abstinence rate, and the follow-up time in Chinese RCTs was shorter than that in the English RCTs (P<0.05). ConclusionThe selection of outcome measurements is significantly different among RCTs regarding smoking cessation, the Chinese RCTs are inferior to English RCTs, and these are needed to be improved in the future clinical trials.
ObjectiveTo summarize the application status of hypoxia mimetic agents in bone tissue engineering.MethodsThe related literature about the hypoxia mimetic agents in bone tissue engineering was reviewed and analyzed. And the application status and progress of hypoxia mimetic agents in bone tissue engineering were retrospectively analyzed.ResultsHypoxia mimetic agents have the same effect as hypoxia in up-regulating the level of hypoxia inducible factor 1α (HIF-1α). The combination of hypoxia mimetic agents and scaffolds can up-regulate the level of HIF-1α in bone tissue engineering, thus promoting early vascularization and bone regeneration of the bone defect area, which provides a new idea for using bone tissue engineering to repair bone defect. At present, the commonly used hypoxia mimetic agents include iron chelating agents, oxoglutarate competitive analogues, proline hydroxylase inhibitors, etc.ConclusionHypoxia mimetic agents have a wide application prospect in bone tissue engineering, but they have been used in bone tissue engineering for a short time, more attention should be paid to their possible side effects. In the future research, the hypoxia mimetic agents should be developed in the direction of higher targeting specificity and safety, and the exact mechanism of hypoxia mimetic agents in promoting bone regeneration should be further explored.
ObjectiveTo explore ways so as to improve smoking cessation rates by studying relevant cases in Hong Kong.MethodsPatients attending the clinical pilot project in Hong Kong from 2010 to 2022 were retrospectively surveyed and analyzed. Information such as patients' general information, reasons for smoking for the first time, situations that enable smoking, barriers to smoking cessation, and withdrawal symptoms were obtained using a pre-designed case report form and analyzed.ResultsA total of 10436 patients, 6936 males and 3500 females, were included. Influenced by friends (67.70%), relieving mental stress (33.12%) and curiosity (30.52%) were the main reasons for smoking for the first time; depression (57.14%), after meals (49.08%) and nervousness (41.26%) were the situations that enable smoking; the main barriers to smoking cessation were physiologic dependence (87.06%) friends or colleagues smoking (37.03%) and compulsiveness to use tobacco (32.45%), top withdrawal symptoms smoking stoppage were craving for cigarettes (50.33%), restlessness (38.33%), and difficulty concentrating (26.63%).ConclusionsThe proportion of patients actively choosing to quit smoking is high in Hong Kong, and smoking cessation methods should be publicized to prompt smokers to take effective measures to quit. A majority of people are influenced by friends to smoke for the first time; thus, adolescent smoking behavior should be supervised to reduce first-time smokers. Moreover, as the most difficult thing to overcome in the process of quitting smoking is psychological addiction, behavioral interventions must be promoted to improve the rate of successful quitting, Steps should be taken to enable the management of withdrawal symptoms to prevent relapse.