Objective To analyze the effect of arteriovenous impulse system (AVIS) combined with lowmolecular-weight heparins calcium (LMWHC) for prophylaxis of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). Methods From March 2006 to March 2008, 76 cases of osteoarthritis patients (76 knees) accepted TKA, including 25 males and 51 females with an average age of 66.6 years (range, 58-79 years). The affected knees were left side in 41 cases and right side in 35 cases. They were randomly divided into experimental group and control group before surgery. Then LMWHC and rehabil itation training were routinely given in two groups before and after surgery. However, only experimental group was treated with AVIS continually during the first four days and then two times a day for 30 minutes one time during 5-7 days. At 7 daysd after operation, color Doppler ultrasound was used to detect the occurrence condition of DVT. Results Five cases (13.16%) had thrombosis of calf and recovered after treated with urokinase and salvia in the experimental group. Eleven cases had thrombosis of calf and 3 cases had thrombosis of whole low extremities (36.84%), and improved after treated with urokinase and salvia in the control group. There was significant difference in DVT incidencerate between two groups (P lt; 0.05). No pulmonary embol ism or death was found in both groups. Conclusion AVIScan effectively accelerate the venous blood return velocity, a combination of AVIS and LMWHC has a better effect in theprevention of DVT following TKA.
Objective Through investigating and analyzing the training status quo of rural doctors in Liangshan Yi Autonomous Prefecture of Sichuan province, to find out problems existing in the training. Methods In October 2010, the on-site questionnaires were distributed to 300 rural doctors from 13 counties who were studying at medical schools of Liangshan Prefecture. The data of their training status were recorded with Epidata 3.0 software and then analyzed with SPSS 16.0 software. Results Among the total 300 questionnaires distributed, 279 were valid with the response rate of 93%. The results showed that: rural doctors in Liangshan Prefecture were generally low in education background and short of knowledge and skills, and took over the burden of the training tuition; and the training content was not fully correlated with theirs actual demands. Conclusion This paper suggests, the in-service training should be conducted on the following bases: the actual situation of Liangshan Prefecture, the adequate consideration of characters of minority region, the improvement of training quality, and the formulation of supporting policies and implementing methods.
Objective To explore the relationship between 25-hydroxy vitamin D [25(OH)D] and metabolic syndrome (MS) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). Methods Between January 2014 and May 2015, a total of 61 non-dialysis patients with stage 3–5 CKD were included. The patients’ height, weight, blood lipid, levels of 25(OH)D and serum creatinine were conducted. The relationship between 25(OH)D and MS was analyzed. Results The average level of 25(OH)D was (39.99±17.66) nmol/L. Normal level (≥75 mmol/L) of 25(OH)D was observed in 3.3% (2/61) of the patients, insufficiency of 25(OH)D (≥37.5 nmol/L and <75 nmol/L) was observed in 50.8% (31/61), and deficiency (<37.5 nmol/L) was observed in 45.9% (28/61). The prevalence of MS was 67.2% ( 41/61). The body mass index (BMI), proportion of hypertension, proportion of diabetes mellitus, level of triglyceride in the MS group were higher than those in the non-MS group, while the levels of high-density lipoprotein and 25(OH)D were lower in the MS group than those in the non-MS group, and the differences were statistically significant (P<0.05). The patients’ BMI, proportion of hypertension, level of triglyceride and proportion of MS in the 25(OH)D deficiency group were higher than those in the 25(OH)D non-deficiency group, meanwhile, the level of high-density lopoprotein was lower in the 25(OH)D deficiency group than that in the 25(OH)D non-deficiency group, and the differences were statistically significant (P<0.05). Serum 25(OH)D level was correlated negatively with BMI (r=–0.35, P=0.006) and the level of triglyceride (r=–0.16, P=0.039), and correlated positively with the level of high-density lipoprotein (r=0.18, P=0.026). Conclusions Low level of 25(OH)D and MS are both of high incidence rate in non-dialysis patients with stage 3–5 CKD. 25(OH)D is associated with MS.
Scavenger receptor CD36 is a transmembrane protein as well as pattern recognition receptor expressed on the surfaces of multiple types of cells such as monocytes, macrophages, microvascular endothelial cells, smooth muscle cells, and platelets. In recent years, studies have found that the expression of CD36 is increased in some diseases, including type 2 diabetes, atherosclerosis, non-alcoholic fatty liver, and obesity. This paper collates the latest progress in the studies of scavenger receptor CD36, illuminates the role of CD36 receptor in metabolic inflammatory diseases by inflammation control, endoplasmic reticulum stress, macrophage phenotype transformation, and insulin resistance, and briefly introduces that CD36 can be a serum marker of metabolic inflammatory diseases, in order to provide potential therapeutic targets for treatment of metabolic inflammatory diseases.
Objective To explore adaptive condition of preparation of animal model and afford reliable and stable model animal for further research on clinical diagnosis and treatment of cavernous transformation of portal vein (CTPV) by establishment of animal model by partial portal vein stenosis. Methods According to different straight blunttip needles used, 80 healthy Sprague-Dawley rats were randomly averagely divided into 4 groups: sham operation group, gauge 19 (19G) group, gauge 21 (21G) group and gauge 23 (23G) group. Six weeks after model making, pressure measurement and angiography of portal vein and pathological examination of portal vein and its surrounding tissues were used to evaluate portal hypertension and CTPV. Results Six weeks after model making no rat died in sham operation group, while the numbers of died rats in 19G group, 21G group and 23G group were 2, 4 and 16, respectively. No portal hypertension was displayed in sham operation group and 19G group 6 weeks after model making. Portography showed that the portal vein seemed smooth without variceal and dilatation in sham operation group and 19G group. Pathological examination demonstrated that the portal vein walls were not enlarged, endothelial cells were smooth. The smooth muscles of middle membrane were not thickened and adventitia was intact. Portal pressure increased and CTPV formed in 21G group and 23G group 6 weeks after model making. Portography showed that collateral circulation formed around portal vein in 21G group and 23G group. The vessel lumens with different size and irregular shapes were displayed by pathological examination. Within the narrow fibrous septum between there were the lumens the fat cells, scattered lymphocytes and mast cells, etc. The portal vein walls were enlarged notably, endothelial cells were damaged, the smooth muscle of middle membrane were thickened, thrombosis were formed. Conclusion Establishment of CTPV animal models by partial portal vein stenosis is a reliable method. 21G blund-tip needles fits well in the preparation of CTPV, which is reliable and stable with lower mortality.
【摘要】 目的 探讨瑞舒伐他汀对慢性肾病患者抗炎疗效。 方法 选取2009年11月-2010年12月90例慢性肾病患者，随机分为A、B两组，A组50例，给予瑞舒伐他汀钙10 mg/d；B组40例，给予阿托伐他汀钙10 mg/d，两组患者的年龄和性别相匹配。分别测定其治疗前及治疗后12周时血白细胞、高敏反应蛋白、纤维蛋白原、白介素-6、肿瘤坏死因子-α。 结果 两组治疗前各炎症指标水平差异无统计学意义（Pgt;0.05）。与治疗前相比，两组患者治疗12周后炎症指标水平均较前明显下降（Plt;0.01），瑞舒伐他汀钙组比阿托伐他汀钙组炎症指标下降更为明显。 结论 瑞舒伐他汀可有效改善慢性肾病患者的炎症反应。【Abstract】 Objective To explore the anti-inflammatory effect of rosuvastatin on chronic kidney disease (CKD) patients. Methods Ninety CKD patients treated in our hospital between November 2009 and December 2010 were randomly divided into two groups. One group was given rosuvastatin calcium 10 mg/d, which the other group was given atorvastatin calcium 10 mg/d. The two groups matched in terms of age and gender. We determined blood leukocyte (WBC), high sensitivity reactive protein (hs-CRP), fibrinogen (FIG), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) of the patients before and after treatment for 12 weeks. Results The inflammatory marker levels of both groups before treatment had no significant difference (Pgt;0.05). The inflammatory marker levels of two groups after treatment for 12 weeks were significantly decreased compared with the levels before treatment (Plt;0.01), and rosuvastatin calcium group decreased more apparently than atorvastatin calcium group. Conclusion Rosuvastatin can improve the anti-inflammatory response in CKD patients.
ObjectiveTo explore the characteristics of blood pressure variability (BPV) in maintenance hemodialysis (MHD) patients with and without diabetes mellitus and the effects of BPV on cardiac function based on the research of clinical data. MethodsOne hundred MHD patients treated in the Hemodialysis Center of the People’s Hospital of Taixing City between January 2013 and January 2015 were recruited and divided into diabetes group (n=46) and non-diabetes group (n=54). Interdialytic and intradialytic BPV and cardiac function were monitored and compared between the two groups. Standard deviation (SD) and coefficient of variation (CV) were used for the evaluation of BPV. ResultsTriacylglycerol, cholesterol and plasma albumin were significantly different between the diabetes group and non-diabetes group (P<0.05), while hemoglobin, serum calcium, phosphorus and parathyroid hormone were not significantly different between the two groups (P>0.05). Forty-two patients in the diabetes group and 53 in the non-diabetes group took antihypertensive drugs. The varieties of antihypertensive drugs and the proportion of patients who used antihypertensive drugs were not significantly different between the two groups. The ambulatory blood pressure monitoring displayed 40 patients (86.9%) with reverse dipper or non-dipper blood pressure in the diabetes group and 35 (64.8%) in the non-diabetes group, and the difference was significant (P<0.05). The interdialytic mean systolic blood pressure (SBP), SBP-SD and SBP-CV in the diabetes group were all significantly higher than those in the non-diabetes group (P<0.05), and the mean diastolic blood pressure (DBP), DBP-SD and DBP-CV were also significantly different between the two groups (P<0.05). The intradialytic mean SBP, SBP-SD and SBP-CV in the diabetes group were significantly higher than those in the non-diabetes group (P<0.05), but there were no significant differences in intradialytic mean DBP, DBP-SD and DBP-CV between the two groups. In patients with reverse dipper or non-dipper blood pressure, the interventricular septal thickness, left ventricular end-diastolic diameter and ejection fraction were significantly different between the diabetes group and the non-diabetes group. However, in patients with dipper blood pressure, the cardiac function parameters were not significantly different between the two groups. Conclusion MHD patients with diabetes have higher ratio of reverse dipper or non-dipper blood pressure, more significant blood pressure variability and more severe cardiac function damage.