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Zhao D.,Chinese PLA General Hospital | Sun X.,Chinese PLA General Hospital | Yao L.,Shenyang University | Lin H.,Dalian Medical College | And 12 more authors.
PLoS ONE | Year: 2013

Background:Heparin-induced thrombocytopenia is an immune response mediated by anti-PF4/heparin antibody, which is clinically characterized by thrombocytopenia and thromboembolic events. In this study, a prospective and multi-center clinical investigation 1 determined the positive rate of anti-PF4/heparin antibody in maintenance hemodialysis patients in China, 2 identified the related risk factors, and 3 further explored the effect of the anti-PF4/heparin antibody on bleeding, thromboembolic events, and risk of death in the patients.Methods:The serum anti-PF4/heparin antibody was measured in 661 patients from nine hemodialysis centers, detected by IgG-specific ELISA and followed by confirmation with excess heparin. Risk factors of these patients were analyzed. Based on a two-year follow-up, the association between the anti-PF4/heparin antibody and bleeding, thromboembolic events, and risk of death in the patients was investigated.Results:1 The positivity rate of the anti-PF4/heparin antibody in maintenance hemodialysis patients was 5.6%. With diabetes as an independent risk factor, the positivity rate of the anti-PF4/heparin antibody decreased in the patients undergoing weekly dialyses ≥3 times. 2 The positivity rate of the anti-PF4/heparin antibody was not related to the occurrence of clinical thromboembolic events and was not a risk factor for death within two years in maintenance hemodialysis patients. 3 Negativity for the anti-PF4/heparin antibody combined with a reduction of the platelet count or combined with the administration of antiplatelet drugs yielded a significant increase in bleeding events. However, the composite determination of the anti-PF4/heparin antibody and thrombocytopenia, as well as the administration of antiplatelet drugs, was not predictive for the risk of thromboembolic events in the maintenance hemodialysis patients.Conclusions:A single detection of the anti-PF4/heparin antibody did not predict the occurrence of clinical bleeding, thromboembolic events, or risk of death in the maintenance hemodialysis patients. © 2013 Zhao et al. Source

He P.,General Hospital of the Navy | Zhou C.,Second Military Medical University | Li H.,General Hospital of the Navy | Yu Y.,General Hospital of the Navy | And 5 more authors.
Blood Purification | Year: 2012

Background: Continuous renal replacement therapy plays an important role in emergency rescue. Currently, no continuous renal replacement therapy machine can be used under unstable conditions as the fluid flow of these machines is controlled electronically. A novel machine that can provide emergency continuous renal replacement therapy in disaster rescue is therefore needed. Methods: Based on a volumetric metering method, a prototype portable continuous blood purifier based on a volumetric metering method was developed. Basic performance tests, special environmental tests, animal experiments and clinical use of the novel machine were completed to test and verify its performance under unstable conditions. Results: All tests completed showed that the machine met the requirements of the national industry standards with a size reduced to approximately one half of the Baxter Aquarius machine. The clearance of harmful substances by the machine described here was equal to that of the Baxter Aquarius machine and was adequate for clinical purposes. Conclusions: The novel prototype performed well in all situations tested and can aid rescue work on disaster sites. © 2012 S. Karger AG, Basel. Source

Zhao Y.,General Hospital of the Navy | Liu C.,General Hospital of the Navy | Zhou G.,General Hospital of the Navy | Yu C.,General Hospital of the Navy | And 2 more authors.
Photomedicine and Laser Surgery | Year: 2013

Objective: This article aims to evaluate the safety and efficacy of a new diode laser at a wavelength of 1470 nm, in the surgical treatment of benign prostatic hyperplasia (BPH). Background data: BPH is very common. Laser surgeries, such as photoselective vaporization of the prostate (PVP), have gained interest over the past decade because of their satisfying clinical results and reduced morbidity. Methods: A total of 24 patients who underwent transurethral vaporization of the prostate with a new diode laser prototype at a wavelength of 1470 nm were included in this retrospective study. The baseline characteristics of patients and treatment outcomes were evaluated at 4 weeks after the operation with the International Prostate Symptoms Score (IPSS), duration of catheterization, and maximum urinary flow rate (Qmax). Results: The mean age of patients was 69±8.6 years. The mean time of operation and hospitalization were 97±39 min and 5.3±5.2 days, respectively. The mean duration of catheterization after surgery was 3.1±2.7 days. No recatheterizations or secondary surgeries were required. IPSS and Qmax at 4 weeks postoperatively were significantly changed compared with the baseline (p<0.001). Conclusions: Transurethral vaporization of the prostate using a 1470 nm laser is effective to treat benign prostatic hyperplasia. © Mary Ann Liebert, Inc. Source

Liu C.,General Hospital of the Navy | Chen W.,General Hospital of the Navy | Xie C.,General Hospital of the Navy | Guan W.,General Hospital of the Navy | And 7 more authors.
Photomedicine and Laser Surgery | Year: 2015

Objective: This study aimed to retrospectively evaluate the safety and efficacy of transurethral photoselective Greenlight™ laser vaporization in adult patients with orthotopic ureterocele. Materials and methods: Thirty adult patients diagnosed with orthotopic urecterocele were recruited at our center. Transurethral photoselective Greenlight laser vaporization was used as the exclusive technique for endoscopic management during the study period. Information, including age, gender, mode of presentation, ureterocele size, vesicoureteral reflux, hydronephrosis status, and incidence of reoperation, were collected for evaluation. Results: Our series included 12 men and 18 women. The mean patient age at presentation was 30.5 years (range, 18-62 years). The mean size of ureterocele was 18mm (range, 10-41mm). All patients successfully underwent transurethral photoselective Greenlight laser to vaporize the ureterocele. The operation ranged from 13min to 38min (mean 19.6min). The average blood loss was <10mL. No patient had intraoperative complications. The average postoperative hospital stay was 18.3h. All patients were voided after postoperative catheter removal. None of the patients demonstrated any residual ureterocele and/or hydronephrosis when evaluated with ultrasonography after 3 months. Only one patient with a duplex collecting system presented asymptomatic low-grade reflux at 3 months, which was spontaneously resolved after 6 months of follow-up. All patients were free of any symptoms. No reoperative procedures were required at a mean follow-up of 14.2 months (range, 8-16). Conclusions: Transurethral photoselective Greenlight laser vaporization is safe, effective, and efficient for the management of orthotopic urecteroceles in adults. Therefore, this technique should be considered as the initial treatment in most patients. © Copyright 2015, Mary Ann Liebert, Inc. 2015. Source

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