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.
Ni M.,Guizhou Provincial Peoples Hospital |
Yang X.,Guizhou Provincial Peoples Hospital
Experimental and Therapeutic Medicine | Year: 2017
Langerhansmporal histiocytosis (LCH) refers to a group of diseases that are characterized by the primary pathogenesis of an abnormal polyclonal proliferation of Langerhans cells that affect different structures of the human body, including the temporal bone. Thus far, the etiology of LCH remains unclear. Diagnosis of LCH is based on a synthetic analysis of the clinical presentations, as well as on features of imaging and histopathology. The clinical features, diagnosis, treatment and prognosis of LCH remain obscure, and temporal LCH is often confused with ear inflammatory lesions and malignant tumors. There are several therapeutic modalities for temporal bone LCH that include surgery, chemotherapy, radiotherapy and steroidal injections. The present study reports the case of an infant presenting a 1-month history of worsening left facial paralysis and a slowly enlarging post auricular mass followed by a 1-month history of postauricular swelling in the left ear. Computed tomography demonstrated a large mass of organized tissue. Moreover, the diagnosis of LCH was confirmed by histopathological and immunohistochemical examinations. The patient also suffered from multiple organ failure, including the liver, kidney, lymphatic system, skin, hematopoietic system and lungs. Following surgical intervention with mastoidotympanectomy, the parents of the patient refused further chemotherapy, and the patient succumbed to the disease ~6 months later. © 2017, Spandidos Publications. All rights reserved.
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.
Xiong Y.,Guizhou Provincial Peoples Hospital
Zhonghua yi xue za zhi | Year: 2014
OBJECTIVE: To explore the surgical efficacy of lesions in mesencephalic aqueduct and around it with neuroendoscope.METHODS: A total of 14 cases with lesion underwent neuroendoscope. Endoscopic third ventriculostomy (ETV), excision or biopsy and mesencephalic aqueduct plasty were performed.RESULTS: There were primary obstruction (n = 4), glioma (n = 4), intraventricular cysticercosis (n = 2), pineal cell tumor (n = 1), lymphoma (n = 1), brain abscess (n = 1) and germinoma (n = 1). Postoperative cranial computed tomography (CT) and/or magnetic resonance imaging (MRI) showed narrowed ventricle. The outcomes were symptomatic improvement (n = 5), no change (n = 5), worsening (n = 4) and mortality (n = 0).CONCLUSION: ETV, lesion biopsy or partial lesion resection and aqueductal plasty are efficacious for the patients with lesions in mesencephalic aqueduct and around it.
Ding J.,Guizhou Provincial Peoples Hospital
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery | Year: 2011
To evaluate the necessity of splenectomy in radical resection of gastric cancer. Twelve studies comparing outcomes after radical resection of gastric cancer with or without splenectomy were identified. Both fixed effect model and random effect model were used. There were 2628 patients in total. There were significant differences in complications between splenectomy group and spleen-preserving group(OR=1.91, 95% CI:1.28-2.87, P<0.05), while no significant difference in 5-year survival rate was noticed(HR=0.90, 95% CI:0.73-1.11, P>0.05). Radical resection of gastric cancer combined with splenectomy is not associated with improved survival but increased postoperative complications.
Ding J.,Guizhou Provincial Peoples Hospital |
Ding J.,Central South University |
Zhang Z.-M.,Guizhou Provincial Peoples Hospital |
Xia Y.,Guizhou Provincial Peoples Hospital |
And 5 more authors.
British Journal of Cancer | Year: 2013
Background: Emerging evidence has demonstrated that lysine-specific demethylase 1 (LSD1) has an important role in many pathological processes of cancer cells, such as carcinogenesis, proliferation and metastasis. In this study, we characterised the role and molecular mechanisms of LSD1 in proliferation and metastasis of colon cancer. Methods: We evaluated the correlation of LSD1, CDH-1 and CDH-2 with invasiveness of colon cancer cells, and investigated the roles of LSD1 in proliferation, invasion and apoptosis of colon cancer cells. We further investigated the mechanisms of LSD1-mediated metastasis of colon cancer. Results: Lysine-specific demethylase 1 was upregulated in colon cancer tissues, and the high LSD1 expression was significantly associated with tumour-node-metastasis (TNM) stages and distant metastasis. Functionally, inhibition of LSD1 impaired proliferation and invasiveness, and induced apoptosis of colon cancer cells in vitro. The LSD1 physically interacted with the promoter of CDH-1 and decreased dimethyl histone H3 lysine 4 (H3K4) at this region, downregulated CDH-1 expression, and consequently contributed to colon cancer metastasis. Conclusion: Lysine-specific demethylase 1 downregulates the expression of CDH-1 by epigenetic modification, and consequently promotes metastasis of colon cancer cells. The LSD1 antagonists might be a useful strategy to suppress metastasis of colon cancer. © 2013 Cancer Research UK. All rights reserved.
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.
Deng Y.K.,Guizhou Provincial Peoples Hospital
Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine / Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban | Year: 2010
To investigate the erythrocyte protective effects of Ginaton, a ginkgo biloba extract, in patients undergoing hypothermic cardiopulmonary bypass (CPB). Sixty patients, who suffered from rheumatic heart disease of ASA grade II-III and scheduled for mitral valve replacement with intravenous anesthesia, were randomly assigned to two groups equally, the Ginaton group and the control group. They were administered with Ginaton 1 mg/kg and saline respectively via intravenous dripping before open heart surgery before beginning CPB. Blood samples were taken from radial artery at different time points, i.e., before CPB (T1), nasopharyngeal temperature (30-31 degrees C) stabilized stage (T2), nasopharyngeal temperature restoration (36 degrees C) stage (T3), 30 min after CPB (T4) and 3 h after CPB (T5), for determination of malondialdehyde (MDA) and superoxide dismutase (SOD) levels in plasma and erythrocyte (P-MDA, E-MDA, P-SOD and E-SOD), as well as the Na+ -K+ -ATPase and Ca+ -Mg2+ -ATPase activities in erythrocytes. As compared with those at T1, in the control group, P-MDA, E-MDA, and E-SOD at T2-T5 and E-SOD at T2 were higher, but E-SOD at T3-T5 were lower (P < 0.01); while in the Ginaton group P-MDA, E-MDA, and E-SOD at T3-T4 were higher (P < 0.05 or P < 0.01). As compared with those in the control group, the levels of P-MDA and E-MDA at T2-T5 were significantly lower, and E-SOD at T3-T5 were higher (P < 0.05 or P < 0.01). Activities of Na+ -K+ -ATPase and Ca+ -Mg2+ -ATPase significantly increased at T2 and gradually decreased after then in both groups (P < 0.05 or P < 0.01), but those at T2-T5 were significantly higher in Ginaton group than in control group (P < 0.05 or P < 0.01). Ginaton displays an erythrocyte protecting effect by way of alleviating the lipid peroxidation in erythrocytes' membrane.