Guizhou Provincial Peoples Hospital
Guizhou Provincial Peoples Hospital
Zha Y.,Guizhou Provincial Peoples Hospital |
Qian Q.,Rochester College
Nutrients | Year: 2017
Elevated protein catabolism and protein malnutrition are common in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). The underlying etiology includes, but is not limited to, metabolic acidosis intestinal dysbiosis; systemic inflammation with activation of complements, endothelin-1 and renin-angiotensin-aldosterone (RAAS) axis; anabolic hormone resistance; energy expenditure elevation; and uremic toxin accumulation. All of these derangements can further worsen kidney function, leading to poor patient outcomes. Many of these CKD-related derangements can be prevented and substantially reversed, representing an area of great potential to improve CKD and ESRD care. This review integrates known information and recent advances in the area of protein nutrition and malnutrition in CKD and ESRD. Management recommendations are summarized. Thorough understanding the pathogenesis and etiology of protein malnutrition in CKD and ESRD patients will undoubtedly facilitate the design and development of more effective strategies to optimize protein nutrition and improve outcomes. © 2017 by the authors; licensee MDPI, Basel, Switzerland.
Tian J.-L.,Guizhou Provincial Peoples Hospital
Chinese journal of traumatology = Zhonghua chuang shang za zhi | Year: 2014
OBJECTIVE: To study retrospectively 20 hip revison patients treated by cementless total hip arthroplasty with structural allograft.METHODS: Twenty patients suffering from aseptic loosening of an uncemented cup complicated by a large defect underwent cementless total hip arthroplasty with structural allograft and were followed up for at least 5 years. Clinical results were evaluated by Harris score and leg length measurements. Radiographic analysis included implants migration, graft absorbance, osteolysis and liner wear.RESULTS: No cup loosening or graft reabsorption was found at final follow-up. Clinical improvements in pain and functional status were demonstrated during the follow-up period. The mean Harris hip scores improved from 29 preoperatively (range 20-41) to 81 postoperatively (range 73-89).CONCLUSION: Our study shows that cementless total hip arthroplasty with allograft is a good way for massive defect in acetabular bone stock.
Wang X.,Guizhou Provincial Peoples Hospital |
Wang X.,University of Sichuan |
Deng Q.,University of Sichuan |
Deng Q.,Guiyang Maternal and Child Health Care Hospital |
And 2 more authors.
Molecular Neurobiology | Year: 2016
Using sevoflurane for pediatric anesthesia plays a pivotal role in surgeries. Emergence agitation (EA) is a major adverse event accompanied with pediatric anesthesia. Other anesthetic adjuvants can be combined with sevoflurane in clinical practices for different purposes. However, it is uncertain that such a practice may have substantial influence on the risk of EA. We conducted a literature search in online databases, including PubMed, Embase, Cochrane Library, and Clinical Trials. Key data were extracted from eligible randomized control trials (RCTs). Both pairwise and network meta-analysis (NMA) were conducted for synthesizing data from eligible studies. The relative risk of EA was assessed using the odds ratios (ORs) and their corresponding 95 % confidence intervals (CI) or credible intervals (CrI). Ranking scheme based on the surface under the cumulative ranking curve (SUCRA) values was produced. Several key assumptions of NMA such as heterogeneity, degree of consistence, and publication bias were validated by different statistical or graphical approaches. Evidence from 67 randomized control trials was synthesized. The relative risk of EA associated with eight anesthetic adjuvants was analyzed, including ketamine, propofol, dexmedetomidine, clonidine, midazolam, fentanyl, remifentanil, and sufentanil. Patients with the following anesthetic adjuvants appeared to have significantly reduced risk of EA in relation to those with placebo: dexmedetomidine (OR = 0.18, 95 % CrI 0.12–0.25), fentanyl (OR = 0.19, 95 % CrI 0.12–0.30), sufentanil (OR = 0.20, 95 % CrI 0.08–0.50), ketamine (OR = 0.21, 95 % CrI 0.13–0.34), clonidine (OR = 0.25, 95 % CrI 0.14–0.46), propofol (OR = 0.32, 95 % CrI 0.18–0.56), midazolam (OR = 0.46, 95 % CrI 0.27–0.77), and remifentanil (OR = 0.29, 95 % CrI 0.13–0.68). The SUCRA values for each anesthetic adjuvant were: dexmedetomidine (73.65 %), fentanyl (68.04 %), sufentanil (60.81 %), ketamine (59.99 %), clonidine (47.74 %), remifentanil (40.15 %), propofol (33.23 %), midazolam (16.33 %), and placebo (0.06 %). Incorporating anesthetic adjuvants particularly dexmedetomidine into sevoflurane appeared to be significantly associated with a decreased risk of EA in pediatric anesthesia. © 2016 Springer Science+Business Media New York
Li Y.,Chongqing Medical University |
Dai Y.-B.,Guizhou Provincial Peoples Hospital |
Sun J.-Y.,Chongqing Medical University |
Xiang Y.,Chongqing Medical University |
And 3 more authors.
Journal of Molecular Neuroscience | Year: 2016
Excessive accumulation and deposition of amyloid-beta (Aβ) has been considered as a pivotal event in the pathogenesis of Alzheimer’s disease (AD). Neuronal apoptosis is one of the characteristics of AD, which is a possible mechanism underlying Aβ-induced neuronal neurotoxicity. Neuroglobin (Ngb) is a newly discovered vertebrate heme protein that exhibits neuroprotective functions against cell death associated with hypoxic and amyloid insult. However, until now, the exact mechanism of neuroglobin’s protective action has not been determined. To investigate the potential neuroprotective roles and mechanisms of Ngb, transgenic AD mice (APPswe/PSEN1dE9) and SH-SY5Y cells transfected with pAPPswe were enrolled into the study. In vivo, overexpression of Ngb via intracerebroventricular injection with pNgb attenuated memory, cognitive impairment, and plaque generations. In pAPPswe transfected SH-SY5Y cells, Ngb not only decreased the generation of Aβ42, but also attenuated mitochondrial dysfunction and apoptosis through suppressing the activation of caspase-3, caspase-9 by Akt activating phosphorylation, which were restrained by phosphatidylinositol 3-kinase inhibitor (LY294002). Our data indicate the anti-apoptotic property of Ngb may play a neuroprotective role against AD. © 2015, Springer Science+Business Media New York.
Xiao X.,Guizhou Provincial Peoples Hospital |
Ye L.,Guizhou Provincial Peoples Hospital
Aesthetic Plastic Surgery | Year: 2017
Introduction: Scarpa fascia preservation might be a promising approach to reduce seroma and other complications after abdominoplasty. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of scarpa fascia preservation in patients with abdominoplasty. Methods: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials and clinical controlled trials assessing the effect of scarpa fascia preservation versus control (without scarpa fascia) during abdominoplasty were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were seroma and hematoma/bleeding. Meta-analysis was performed using random-effect model. Results: Four studies involving 630 patients were included in the meta-analysis. Overall, compared with the control group, scarpa fascia preservation was associated with a significant reduced seroma (OR 0.16; 95% CI 0.06–0.43; P = 0.0004), time until drain removal (std. mean difference = −0.92; 95% CI −1.31 to −0.54; P<0.00001;), drain output (std. mean difference = −0.92; 95% CI −1.38 to −0.45; P = 0.0001), and hospital stay (std. mean difference = −0.93; 95% CI −1.48 to −0.39; P = 0.0008), but it failed to alter hematoma/bleeding (OR 0.46; 95% CI 0.09–2.38; P = 0.36), infection (OR 0.38; 95% CI 0.11–1.25; P = 0.11), and suture rupture (OR 0.67; 95% CI 0.12–3.73; P = 0.65) in patients with abdominoplasty. Conclusions: Scarpa fascia preservation was associated with a significant decreased seroma, time until drain removal, drain output, and hospital stay, but could not change hematoma/bleeding, infection and suture rupture following abdominoplasty. Scarpa fascia preservation should be recommended during abdominoplasty. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © 2017 Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery
Yang T.Y.,Guizhou Provincial Peoples Hospital
Zhonghua bing li xue za zhi = Chinese journal of pathology | Year: 2017
目的： 探讨缺氧诱导因子1α(HIF-1α)、葡萄糖转运蛋白1(GLUT-1)及乳酸脱氢酶5(LDH-5)在结直肠癌中的表达及其临床病理意义。 方法： 采用免疫组织化学SP法检测142例结直肠癌组织及其癌旁组织中HIF-1α、GLUT-1及LDH-5蛋白的表达。 结果： HIF-1α、GLUT-1及LDH-5在结直肠癌组织的表达率分别为78.2%(111/142)、75.4%(107/142)及68.3%(97/142)，与癌旁组织的表达率(14.8%，21/142；11.3%，16/142；7.0%，10/142)比较，其差异均具有统计学意义(P<0.01)。结直肠癌组织中HIF-1α、GLUT-1及LDH-5的阳性表达率与淋巴结转移、肿瘤分化程度和病理分期有相关性(均P<0.05)；结直肠癌中HIF-1α、GLUT-1和LDH-5的表达两两之间具有关联性，并且表达呈正相关(P<0.05)。 结论： 联合检测HIF-1α、GLUT-1及LDH-5在结直肠癌的表达，可作为评估结直肠癌的发展、转移及预后重要指标。.Objective: To investigate the expression and clinicopathological significance of hypoxia-inducible factor 1 alpha (HIF-1α), glucose transporter 1(GLUT-1) and lactate dehydrogenase(LDH)-5 in colorectal cancer. Methods: The expression levels of HIF-1α, GLUT-1 and LDH-5 were detected by immunohistochemical staining in 142 specimens of human carcinoma in comparison with adjacent normal tissues. Results: The expression levels of HIF-1α(78.2%, 111/142), GLUT-1(75.4%, 107/142) and LDH-5(68.3%, 97/142) were higher in tumor tissues than in adjacent normal tissues(14.8%, 21/142; 11.3%, 16/142; 7.0%, 10/142; P<0.01 for all three proteins), and such over-expression was significantly associated with lymphovascular invasion, tumor grade and pathological stages(all P<0.01). Additional studies showed that HIF-1α, GLUT-1 and LDH-5 were positively associated with each other(r<0.3, P<0.05 for all three proteins). Conclusion: The data suggest that HIF-1α, GLUT-1 and LDH-5 expression may serve as prognostic indicators for colorectal cancer patients.
Zhang Y.C.,Guizhou Provincial Peoples Hospital
Zhonghua wai ke za zhi [Chinese journal of surgery] | Year: 2016
Objective: To evaluate the effects of traditional monitoring and self-monitoring in patients who take the oral anticoagulation medicine after mechanical valve replacement surgical operations. Methods: A great number of Chinese and English literatures about this subject were investigated in detail, and these literatures were selected from the Cochrane Central Register of Controlled Trials, EMBase, MEDLINE, Web of Knowledge, CNKI, CBM, VIP, and WanFang Data. It should be noted that all of the literatures were published before October, 2015. Based on the results of the literature investigation, several studies were selected as the candidates. Moreover, many aspects about these candidates such as the experimental designs, characteristics of the objects of the studies and the results of the studies were filtered and recorded by two researchers independently. Furthermore, RevMan 5.3 were employed to analyze the data of the candidates. Results: Eight randomized controlled trials were studied, which included 1 262 cases in self-monitoring group and 1 198 cases in traditional monitoring group. The results of meta-analysis indicated that compared with the traditional monitoring group, lower incidence of thromboembolism (Z=3.50, P=0.000) and lower mortality (Z=4.64, P=0.000) were observed, and the bleeding difference (Z=0.07, P=0.940) had no significant statistical meaning. Moreover, compared with the traditional monitoring, the international normalized ratio (INR) of the patients who were controlled in the range of treatment of the self-monitoring increased from 6% to 20.9%, and the total number of the INR tests was increased by 2.1 to 4.98 times. Conclusions: Self-monitoring could obviously reduce the possibilities of the thromboembolism and death of the patients who took the oral anticoagulation medicine after mechanical valve replacement surgical operations. Furthermore, self-monitoring could not only control the INR in the range of treatment but also increase the total number of the INR tests. In short, self-monitoring has practical value of clinical application.
Du F.-W.,Guizhou Provincial Peoples Hospital
Journal of Interventional Radiology (China) | Year: 2016
Objective: To analyze the risk factors and prognosis of patients with coronary stent thrombosis (ST) after receiving percutaneous coronary drug - eluting stent implantation. Methods: Clinical data of 39 patients with ST, who were encountered at author's hospital during the period from July 2006 to March 2012, were retrospectively analyzed. With 1:2 pairing selection, 78 patients with no stent restenosis on coronary angiography encountered during the same period were collected and used as the control group. The risk factors of postoperative stent thrombosis were analyzed. Results: Acute myocardial infarction (AMI) as the initial onset, the smaller stent diameter (≤2.94 mm), the longer length (>29.5 mm) and the lower (>50%) preoperative left ventricular ejection fraction (EF) were related to the occurrence of stent thrombosis. Emergency coronary intervention was carried out once more in 33 patients, of whom one patient died during hospitalization period and the remaining 32 patients recovered at the time of discharge. Conclusion AMI as initial onset, smaller stent diameter, longer stent length and lower preoperative EF (>50%) are independent predictors of coronary stent thrombosis. Stent length ≥29.5 mm and stent diameter ≤2.94 mm are associated with higher occurrence of coronary stent thrombosis. Clinically, most patients with coronary stent thrombosis after receiving percutaneous coronary drug-eluting stent implantation are manifested as AMI. The mortality is higher when stent thrombosis occurs. For such patients emergency coronary intervention is safe and effective.
Tian M.-L.,Guizhou Provincial Peoples Hospital |
Shen Y.,Guizhou Provincial Peoples Hospital |
Sun Z.-L.,Guizhou Provincial Peoples Hospital |
Zha Y.,Guizhou Provincial Peoples Hospital
International Urology and Nephrology | Year: 2015
Objective: Pentoxifylline (PTF) has anti-inflammatory properties, which may be beneficial for diabetic nephropathy (DN). A meta-analysis was conducted to assess the additive effect of pentoxifylline and its safety among patients with type 2 DN under blockade of angiotensin system. Data sources: Relevant studies were searched from PubMed, CBM, EMBASE, CENTRAL and Cochrane renal group specialized register. Selection criteria: All RCTs that compared the benefits and harms of pentoxifylline and ACEI/ARB with ACEI/ARB alone for DN were included. Data extraction and analysis: Pertinent data were extracted independently by two authors. Meta-analyses were performed when more than one study provided data on a comparable outcome. Standard mean differences (SMDs) for proteinuria and albuminuria, mean differences (MDs) for systolic blood pressure (SBP), diastolic blood pressure (DBP), HbA1c, serum creatinine (Scr), creatinine clearance (CrCl) and urine tumor necrosis factor-alpha (UTNF-α), 95 % confidence intervals (CIs) were calculated, and heterogeneity was assessed with the I2 test. Adverse effects were assessed using descriptive techniques. Results: Eight studies including 587 patients with a median duration of 5 months were identified. Compared with ACEI/ARB alone, the combination of PTF and ACEI/ARB significantly reduced proteinuria (SMD 0.76, 95 % CI 0.52–0.99), albuminuria (SMD 0.36, 95 % CI 0.12–0.59) and UTNF-α (MD 1.56 ng/g, 95 % CI 0.09–3.03). However, no statistically significant changes were observed for SBP, DBP, HbA1c, Scr and CrCl. The most frequent adverse effects in patients treated with PTF were gastrointestinal symptoms (28/298) and dizziness (7/298), but in most cases, these symptoms were mild, only six participants withdrew due to intractable nausea and vomiting. Conclusions: Pentoxifylline can significantly provide additive antiproteinuric effect independent from the decrease in BP or improvement in glycemic control in DN patients under blockade of angiotensin system. Further large, multicenter, high-quality studies with long duration are necessary to prove whether it really has renoprotective effects in this patient population. © 2015, Springer Science+Business Media Dordrecht.
Zha Y.,Guizhou Provincial Peoples Hospital
Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases | Year: 2013
To investigate the effect of continuous renal replacement therapy (CRRT) on the outcome of severe pneumonia in patients receiving long-term immunosuppressants. Thirty-four patients, who had been treated with long-term immunosuppressants, were admitted for severe pneumonia. After admission, the dose of immunosuppressants including glucocorticoids was decreased, and the patients were divided into 2 groups: antibiotic treatment group (n = 16) and antibiotic + CRRT treatment group (n = 18). Before and after treatment, the changes of the patients' condition, chest CT and blood gas analysis were monitored. Biomarkers including C-reactive protein (CRP), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8(IL-8), white blood cell and neutrophil counts were determined. After treatment, the levels of CRP[(109 ± 24) vs (40 ± 13) mg/L], IFN-γ [(151 ± 28) vs (42 ± 12) ng/L], TNF-α [(301 ± 45) vs (118 ± 28) pg/L], IL-6 [(214 ± 45) vs (76 ± 23) pg/L], IL-8[(590 ± 121) vs (159 ± 60) pg/L], white blood cell count [(14.3 ± 5.7)×109/L vs (8.5 ± 2.7)×109/L], and neutrophil percentage [(91.3 ± 3.1)% vs (75.3 ± 2.6)%] decreased significantly in the antibiotic + CRRT group (P < 0.05) as compared to the antibiotic treatment group. In the antibiotic + CRRT group, blood gas showed significant improvement in pH [(7.30 ± 0.12) to (7.37 ± 0.18)], SaO2 [(80.6 ± 7.6)% to (91.9 ± 7.3)%] and PaO2 (41 ± 6) mm Hg (1 mm Hg = 0.133 kPa) to (71 ± 9) mm Hg. The patients' condition and chest CT abnormalities also improved more rapidly in the antibiotic + CRRT group. The 6-month survival was increased by 12.9% in the antibiotic + CRRT group as compared to the antibiotic group (P < 0.05). CRRT is effective in clearance of inflammatory mediators and may increase survival of severe pneumonia patients receiving long-term treatment of immunosuppressants.