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终末期恶性肿瘤患者及家属对预先指示认知的现况调查 预览
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作者 朱明兰 蒋本利 +1 位作者 崔伟 田晓静 《长治医学院学报》 2019年第1期19-22,共4页
目的:了解终末期恶性肿瘤患者与家属对预先指示(ADs)的认识与态度现状。方法:采用自行设计的“ADs知识及态度问卷”对终末期恶性肿瘤住院患者与家属各90例进行问卷调查,并对调查结果进行分析。结果:终末期恶性肿瘤患者与家属对ADs的知... 目的:了解终末期恶性肿瘤患者与家属对预先指示(ADs)的认识与态度现状。方法:采用自行设计的“ADs知识及态度问卷”对终末期恶性肿瘤住院患者与家属各90例进行问卷调查,并对调查结果进行分析。结果:终末期恶性肿瘤患者与家属对ADs的知晓率分别为1.11%、2.22%;对实施ADs的赞同率分别为54.44%、67.78%,差异均无统计学意义(P>0.05);家属对终末期生命支持技术的赞同率高于患者;文化程度越高的患者和家属,对ADs赞同率越高(P<0.05);有丧亲经历、住院经历的患者对ADs赞同率更高(P>0.05),有丧亲经历的家属对ADs的赞同率更高(P<0.05)。结论:应加强ADs的宣传力度,提高患者及家属对Ads的认知水平。 展开更多
关键词 恶性肿瘤 终末期 预先指示 认知现状
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Contemporary characteristics and outcomes of adults with familial dilated cardiomyopathy listed for heart transplantation 预览
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作者 Mohamed Khayata Sadeer G Al-Kindi Guilherme H Oliveira 《世界心脏病学杂志:英文版(电子版)》 2019年第1期38-46,共9页
BACKGROUND Familial dilated cardiomyopathy(FDCM)account for 20%-30%of non-ischemic cardiomyopathies(NICM).Previous published data showed that some patients with FDCM tend to have rapidly progressive disease;however,fi... BACKGROUND Familial dilated cardiomyopathy(FDCM)account for 20%-30%of non-ischemic cardiomyopathies(NICM).Previous published data showed that some patients with FDCM tend to have rapidly progressive disease;however,five-year mortality was not significantly different in the familial and non-familial forms of NICM with optimal medical therapy.AIM To better define the characteristics and clinical outcomes of FDCM patients listed for heart transplantation(HT).METHODS We queried the United Network for Organ Sharing Registry to identify FDCM patients listed for HT between January 2008 and September 2015 and compared them to NICM and ischemic cardiomyopathy(ICM)patients.We included all patients≥18 years old and we separated patients to three groups:FDCM,NICM and ICM.Chi-square test was used to compare between categorical variables,the t-test was used to compare between continues variables,and Cox-proportional hazards model was used to perform time-dependent survival analyses.RESULTS Of the 24809 adults listed for HT,we identified 677 patients(2.7%)with the diagnosis of FDCM.Compared to patients with NICM and ICM,FDCM patients were younger(FDCM 43.9±13.5 vs NICM 50.9±12.3,P﹤0.001,vs ICM 58.5±8.1,P﹤0.001),more frequently listed as status 2(FDCM 35.2%vs NICM 26.5%,P﹤0.001),with significantly lower left ventricular assist device(LVAD)utilization(FDCM 18.4%vs NICM 25.1%,P﹤0.001;vs ICM 25.6%,P﹤0.001),but higher use of total artificial heart(FDCM 1.3%vs NICM 0.6%,P=0.039;vs ICM 0.4%,P=0.002).Additionally,patients with FDCM were less frequently delisted for clinical deterioration or death and more likely to be transplanted compared to those with NICM[hazard ratio(HR):0.617,95%confidence interval(CI):0.47-0.81;HR:1.25,95%CI:1.14-1.37,respectively],and ICM(HR:0.5,95%CI:0.38-0.66;HR:1.18,95%CI:1.08-1.3,respectively).There was more frequent rejection among patients with FDCM(FDCM 11.4%vs NICM 9.8%,P=0.28;vs ICM 8.4%,P=0.034).One,three,and five post-transplant survival of patients with FDCM(91%,88%and 80%)was similar 展开更多
关键词 FAMILIAL DILATED CARDIOMYOPATHY END-STAGE heart failure Wait list TRANSPLANT OUTCOMES
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Evaluating the risk of adverse events with interventional endoscopic retrograde cholangiopancreatography and endoscopic ultrasound procedures in cirrhotic patients 预览
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作者 Timothy Yoo Raisa Epistola +5 位作者 Jordan Epistola Lawrence Ku Michael W Fleischman Sofiya Reicher Viktor E Eysselein Linda A Hou 《世界胃肠内镜杂志:英文版(电子版)》 2019年第11期523-530,共8页
BACKGROUND Hepatic cirrhosis is associated with greater adverse event rates following surgical procedures and is thought to have a higher risk of complications with interventional procedures in general.However,these s... BACKGROUND Hepatic cirrhosis is associated with greater adverse event rates following surgical procedures and is thought to have a higher risk of complications with interventional procedures in general.However,these same patients often require interventional gastrointestinal procedures such as endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic ultrasound(EUS).While studies examining this scenario exist,the overall body of evidence for adverse event rates associated with ERCP/EUS procedures is more limited.We sought add to the literature by examining the incidence of adverse events after ERCP/EUS procedures in our safety-net hospital population with the hypothesis that severity of cirrhosis correlates with higher adverse event rates.AIM To examine whether increasing severity of cirrhosis is associated with greater incidence of adverse events after interventional ERCP/EUS procedures.METHODS We performed a retrospective study of patients diagnosed with hepatic cirrhosis who underwent ERCP and/or EUS-guided fine needle aspirations/fine needle biopsies from January 1,2016 to March 14,2019 at our safety net hospital.We recorded Child-Pugh and Model for End-stage Liver Disease(MELD-Na)scores at time of procedure,interventions completed,and 30-day post-procedural adverse events.Statistical analyses were done to assess whether Child-Pugh class and MELD-Na score were associated with greater adverse event rates and whether advanced techniques(single-operator cholangioscopy,electrohydraulic lithotripsy/laser lithotripsy,or needle-knife techniques)were associated with higher complication rates.RESULTS 77 procedures performed on 36 patients were included.The study population consisted primarily of middle-aged Hispanic males.30-d procedure-related adverse events included gastrointestinal bleeding(7.8%),infection(6.5%),and bile leak(2%).The effect of Child-Pugh class C vs class A and B significantly predicted adverse events(β=0.55,P<0.01).MELD-Na scores also significantly predicted adverse events(β=0.037,P<0.01 展开更多
关键词 Endoscopic retrograde cholangiopancreatography Endoscopic ultrasound Fine-needle aspiration Fine-needle biopsy Hepatic cirrhosis Model for End-stage Liver Disease Child-Pugh Class Adverse events
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Anti-hepatitis C virus therapy in chronic kidney disease patients improves long-term renal and patient survivals 预览
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作者 Yi-Chun Chen Chung-Yi Li +1 位作者 Shiang-Jiun Tsai Yen-Chun Chen 《世界临床病例杂志》 2019年第11期1270-1281,共12页
BACKGROUND Hepatitis C virus (HCV) infection is a documented risk factor for chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD). However, to date there are no reports on the long-term hard ... BACKGROUND Hepatitis C virus (HCV) infection is a documented risk factor for chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD). However, to date there are no reports on the long-term hard endpoints (ESRD and death) of anti-HCV therapy [interferon-based therapy (IBT) or new direct-acting antivirals] in CKD patients. Direct-acting antivirals are not available in Taiwan’s singlepayer national health insurance database currently released for research. Therefore, we hypothesized that a retrospective analysis of the long-term outcomes of IBT in CKD patients will serve as a proxy for direct-acting antivirals to increase our understanding of progression to ESRD following HCV infection. AIM To evaluate the long-term outcomes (ESRD and death) of anti-HCV therapy, especially IBT, in HCV-infected patients with stage 1-5 CKD. METHODS We analyzed 93894 Taiwanese adults diagnosed with CKD and without HBV infection. Of these, 4.9% were infected with HCV. Of the 4582 HCV-infected CKD patients, 482 (10.5%) received IBT (treated cohort). They were matched 1:4 with 1928 untreated HCV-infected CKD patients (untreated cohort) by propensity scores and year, which further matched 1:2 by propensity scores with 3856 CKD patients without HCV infection (uninfected cohort). All participants were followed until the occurrence of ESRD, death, or the end of 2012. The association between HCV infection, IBT use, and risks of ESRD and death was analyzed using competing risk analysis. RESULTS Taking the uninfected cohort as a reference, the adjusted hazard ratios for ESRD, after adjusting for competing mortality, were 0.34 (0.14-0.84, P = 0.019) and 1.28 (1.03-1.60, P = 0.029) in the treated and untreated cohorts, respectively. The treated cohort had a 29%(0.54-0.92, P = 0.011) decrease in mortality compared to the untreated cohort, in which the mortality was 31%(1.18-1.45, P < 0.001) higher than in the uninfected cohort. The reduced risks of ESRD (0.14, 0.03–0.58, P = 0.007) and death (0.57, 0.41-0.79, P = 0.001) w 展开更多
关键词 Hepatitis C VIRUS Chronic kidney DISEASE END-STAGE RENAL DISEASE Antihepatitis C VIRUS THERAPY COHORT study
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End-stage liver disease score and future liver remnant volume predict post-hepatectomy liver failure in hepatocellular carcinoma 预览
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作者 Fan-Hua Kong Xiong-Ying Miao +5 位作者 Heng Zou Li Xiong Yu Wen Bo Chen Xi Liu Jiang-Jiao Zhou 《世界临床病例杂志》 2019年第22期3734-3741,共8页
BACKGROUND Hepatocellular carcinoma(HCC)is the world’s sixth most common malignant tumor and the third cause of cancer death.Although great progress has been made in hepatectomy,it is still associated with a certain ... BACKGROUND Hepatocellular carcinoma(HCC)is the world’s sixth most common malignant tumor and the third cause of cancer death.Although great progress has been made in hepatectomy,it is still associated with a certain degree of risk of posthepatectomy liver failure(PHLF),which extends the length of hospital stay and remains the leading cause of postoperative death.Studies have shown that assessment of hepatic functional reserve before hepatectomy is beneficial for reducing the incidence of PHLF.AIM To assess the value of model for end-stage liver disease(MELD)score combined with standardized future liver remnant(sFLR)volume in predicting PHLF in patients undergoing hepatectomy for HCC.METHODS This study was attended by 238 patients with HCC who underwent hepatectomy between January 2015 and January 2018.Discrimination of sFLR volume,MELD score,and sFLR/MELD ratio to predict PHLF was evaluated according to the area under the receiver operating characteristic curve.RESULTS The patients were divided into two groups according to whether PHLF occurred after hepatectomy.The incidence of PHLF was 8.4%in our research.The incidence of PHLF increased with the decrease in sFLR volume and the increase in MELD score.Both sFLR volume and MELD score were considered independent predictive factors for PHLF.Moreover,the cut-off value of the sFLR/MELD score to predict PHLF was 0.078(P<0.001).This suggests that an sFLR/MELD≥0.078 indicates a higher incidence of PHLF than an sFLR/MELD<0.078.CONCLUSION MELD combined with sFLR is a reliable and effective PHLF predictor,which is superior to MELD score or sFLR volume alone. 展开更多
关键词 Post-hepatectomy liver failure Hepatocellular carcinoma HEPATECTOMY Model for end-stage liver disease Standardized future liver remnant Hepatitis B virus
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Recuperation of severe tumoral calcinosis in a dialysis patient:A case report 预览
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作者 Lukas Westermann Lisa K Isbell +4 位作者 Marie K Breitenfeldt Frederic Arnold Elvira Rothele Johanna Schneider Eugen Widmeier 《世界临床病例杂志》 2019年第23期4004-4010,共7页
BACKGROUND One of the common late sequela in patients with end-stage renal disease(ESRD)is the calcium phosphate disorder leading to chronic hypercalcemia and hyperphosphatemia causing the precipitation of calcium sal... BACKGROUND One of the common late sequela in patients with end-stage renal disease(ESRD)is the calcium phosphate disorder leading to chronic hypercalcemia and hyperphosphatemia causing the precipitation of calcium salt in soft tissues.Tumoral calcinosis is an extremely rare clinical manifestation of cyst-like soft tissue deposits in different periarticular regions in patients with ESRD and is characterized by extensive calcium salt containing space-consuming painful lesions.The treatment of ESRD patients with tumoral calcinosis manifestation involves an increase in or switching of renal replacement therapy regimes and the adjustment of oral medication with the goal of improved hypercalcemia and hyperphosphatemia.CASE SUMMARY We describe a 40-year-old woman with ESRD secondary to IgA-nephritis and severe bilateral manifestation of tumoral calcinosis associated with hypercalcemia,hyperphosphatemia and tertiary hyperparathyroidism.The patient was on continuous ambulatory peritoneal dialysis and treatment with vitamin D analogues.After switching her to a daily hemodialysis schedule and adjusting the medical treatment,the patient experienced a significant dissolution of her soft tissue calcifications within a couple of weeks.Complete remission was achieved 11 mo after the initial diagnosis.CONCLUSION Reduced patient compliance and subsequent insufficiency of dialysis regime quality contribute to the aggravation of calcium phosphate disorder in a patient with ESRD leading to the manifestation of tumoral calcinosis.However,the improvement of the treatment strategy and reinforcement of patient compliance enabled complete remission of this rare disease entity. 展开更多
关键词 End-stage renal disease Renal replacement therapy-dialysis HYPERPARATHYROIDISM HYPERCALCEMIA HYPERPHOSPHATEMIA Tumoral calcinosis Case report
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D-dimer level and long-term outcome in patients with end-stage heart failure secondary to idiopathic dilated cardiomyopathy 预览
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作者 Bi HUANG Yuan-Jing LI +3 位作者 Jian SHEN Yuan YANG Gang LIU Su-Xin LUO 《老年心脏病学杂志:英文版》 SCIE CAS CSCD 2019年第8期621-629,共9页
Background Previous studies had demonstrated hemostatic abnormalities in patients with heart failure (HF) and several studies have shown that abnormal coagulation indices, represented by elevated D-dimer, had prognost... Background Previous studies had demonstrated hemostatic abnormalities in patients with heart failure (HF) and several studies have shown that abnormal coagulation indices, represented by elevated D-dimer, had prognostic significance in patients with compatible or acute decompensated HF. However, the impact of D-dimer on the outcome in patients with end-stage HF remains unclear. Methods A total of 244 consecutive patients with end-stage HF due to idiopathic dilated cardiomyopathy (DCM) were prospectively enrolled from February 2011 to September 2014. D-dimer levels were measured and its prognostic value was assessed. Primary endpoint was all-cause mortality during the follow-up period. Secondary endpoints were stroke, bleeding, occurrence of sustained ventricular tachycardia or ventricular fibrillation, and major adverse cardiovascular events (MACE). Results D-dimer was significantly elevated in the non-survivors (median: 0.8 vs. 1.1 mg/L, P < 0.001). Traditional markers including B-type natriuretic peptide, troponin I, left ventricular ejection fraction, and left ventricular end-diastolic dimension provided limited prognostic value;but the addition of D-dimer refined the risk stratification. The optimal cut-off value of D-dimer to predict all-cause mortality was 0.84 mg/L by receiver operator characteristic analysis. Elevated D-dimer level was independently associated with increased risk of long-term all-cause mortality (HR = 2.315, 95% CI: 1.570–3.414, P < 0.001) and MACE (HR = 1.256, 95% CI: 1.058–1.490, P = 0.009), and the predictive value was independent of age, sex, atrial fibrillation and anticoagulation status. Conclusions Elevated D-dimer level was independently associated with poor long-term outcome in patients with end-stage HF secondary to idiopathic DCM, and the predictive value was superior to that of traditional prognostic markers. 展开更多
关键词 D-DIMER END-STAGE heart failure IDIOPATHIC DILATED CARDIOMYOPATHY Long-term OUTCOME
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家庭医生服务团队护理干预对肾脏病终末期血液透析患者社会回归、心理状态及生活质量的影响 预览
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作者 李杏 谢金娜 +3 位作者 李金娥 倪莹 廖思琴 陈念 《中国社会医学杂志》 2019年第4期368-370,374共4页
目的探讨研究家庭医生服务团队对肾脏病终末期血液透析患者社会回归的影响。方法选取2016年12月-2019年1月某三甲医院收治的肾脏病终末期血液透析患者300例,依据不同干预方式分成两组,对照组应用常规护理干预,研究组联合应用家庭医生服... 目的探讨研究家庭医生服务团队对肾脏病终末期血液透析患者社会回归的影响。方法选取2016年12月-2019年1月某三甲医院收治的肾脏病终末期血液透析患者300例,依据不同干预方式分成两组,对照组应用常规护理干预,研究组联合应用家庭医生服务团队护理干预。结果干预后,研究组社会回归分级情况显著高于对照组(P<0.05);研究组焦虑自评量表及抑郁自评量表评分均显著低于对照组(P<0.05);研究组各项生活质量的评分均显著高于对照组(P<0.05)。结论对肾脏病终末期血液透析患者进行护理干预的过程中,联合应用家庭医生服务团队干预,可有效提高患者的社会回归等级及生活质量,同时还能显著缓解患者的抑郁焦虑情况。 展开更多
关键词 家庭医生 服务团队 肾脏病 终末期 血液透析 社会回归 心理状态
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重组人脑利钠肽治疗终末期心力衰竭临床评价 预览
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作者 王颖 姜世平 《中国药业》 CAS 2019年第2期61-64,共4页
目的观察重组人脑利钠肽治疗终末期心力衰竭(简称心衰)的疗效。方法将医院2017年1月至11月收治的100例终末期心衰患者随机分为对照组和观察组,各50例。对照组患者进行常规抗心衰治疗,观察组患者在此基础上加用注射用重组人脑利钠肽。结... 目的观察重组人脑利钠肽治疗终末期心力衰竭(简称心衰)的疗效。方法将医院2017年1月至11月收治的100例终末期心衰患者随机分为对照组和观察组,各50例。对照组患者进行常规抗心衰治疗,观察组患者在此基础上加用注射用重组人脑利钠肽。结果治疗后,观察组患者收缩压显著高于对照组,24h尿量显著大于对照组,心率,呼吸困难程度评分,血浆NF-κBp65、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、可溶性细胞间黏附分子1(sICAM-1)和可溶性血管细胞黏附分子1(sVCAM-1)等炎性因子水平,血浆血管紧张素Ⅱ、醛固酮、脑利钠肽水平均显著低于对照组(P<0.05);治疗过程中,两组患者出现室性心动过速、恶心、头痛、血肌酐升高例数无显著差异(P>0.05)。结论重组人脑利钠肽可有效提高终末期心衰患者的心功能,降低其血浆炎性因子水平。 展开更多
关键词 重组人脑利钠肽 心力衰竭 终末期 炎性因子
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老年终末期癌症患者生命质量及其与社会支持和心理韧性的关系 预览 被引量:2
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作者 赵欣欣 王玉梅 《现代肿瘤医学》 CAS 2019年第5期852-855,共4页
目的:了解老年终末期癌症患者的生命质量及其与社会支持和心理韧性的关系,探讨社会支持和心理韧性对老年终末期癌症患者的影响机制。方法:以2017年1月到2018年1月在我病房的138例住院患者为研究对象。采用FACT-G中文版问卷对患者的生命... 目的:了解老年终末期癌症患者的生命质量及其与社会支持和心理韧性的关系,探讨社会支持和心理韧性对老年终末期癌症患者的影响机制。方法:以2017年1月到2018年1月在我病房的138例住院患者为研究对象。采用FACT-G中文版问卷对患者的生命质量进行测量;采用MSPSS问卷对患者的社会支持进行测量;采用RS-14问卷对患者的心理韧性进行测量。结果:年龄对老年终末期癌症患者的生命质量有显著影响,其中71岁以上年龄段患者的生命质量显著低于其他组别。社会支持(P<0.01)和心理韧性(P<0.01)与患者生命质量及其四个维度呈显著正相关,FACT-G总分与其四个维度间呈中低度相关,社会支持和心理韧性对生命质量有显著的正向影响。结论:医务工作者可以通过实施特定的社会心理干预,提高患者的外在社会支持和内在心理韧性,进而帮助老年终末期癌症患者保持良好的生存状态,减轻其痛苦,提高生命质量。 展开更多
关键词 终末期 生命质量 社会支持 心理韧性
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血液透析联合血液灌流对慢性肾衰竭终末期患者的应用效果 预览
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作者 李拔敏 《中国当代医药》 2019年第19期87-89,93共4页
目的探讨血液透析联合血液灌流对慢性肾衰竭终末期患者的应用效果。方法选取2016年8月~2018年7月于我院住院治疗的90例慢性肾衰竭终末期患者作为研究对象,随机分为观察组和对照组,每组各45例。对照组患者给予血液透析治疗,观察组患者在... 目的探讨血液透析联合血液灌流对慢性肾衰竭终末期患者的应用效果。方法选取2016年8月~2018年7月于我院住院治疗的90例慢性肾衰竭终末期患者作为研究对象,随机分为观察组和对照组,每组各45例。对照组患者给予血液透析治疗,观察组患者在对照组的基础上给予血液灌流治疗,共治疗3个月。治疗结束后比较两组患者的神经系统并发症发生情况,记录两组患者治疗前后的甲状旁腺激素(PTH)、肌酐(SCr)、尿素氮(BUN)、超敏C反应蛋白(hs-CRP)和降钙素原(PCT)水平及生活质量差异。结果观察组患者治疗后的癫痫、记忆力衰退、定向障碍及睡眠障碍等神经系统并发症发生率均低于对照组,差异有统计学意义(P<0.05);观察组患者治疗后的PTH、SCr、BUN、hs-CRP和PCT水平低于对照组,差异均有统计学意义(P<0.05);观察组患者治疗后的躯体疼痛、生理功能、健康状况及精神状态评分均高于对照组,差异有统计学意义(P<0.05)。结论血液透析联合血液灌流对慢性肾衰竭终末期患者有较好的效果,能明显改善患者的生活质量。 展开更多
关键词 血液透析 血液灌流 慢性肾衰竭 终末期
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Gut microbiota from end-stage renal disease patients disrupt gut barrier function by excessive production of phenol
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作者 Xifan Wang Yanling Hao +5 位作者 Xiaoxue Liu Shoujuan Yu Weibo Zhang Songtao Yang Zhengquan Yu Fazheng Ren 《遗传学报:英文版》 SCIE CAS CSCD 2019年第8期409-412,共4页
End stage renal disease (ESRD), an advanced stage of chronic kidney disease, has received increasing attention as a leading public health problem (Webster et al., 2017). Chronic kidney disease (CKD) and ESRD are invar... End stage renal disease (ESRD), an advanced stage of chronic kidney disease, has received increasing attention as a leading public health problem (Webster et al., 2017). Chronic kidney disease (CKD) and ESRD are invariably accompanied by chronic systemic inflammation which plays central roles in CKD progression (Cachofeiro et al., 2008) and the increased mortality due to cardiovascular disease (Landray et al., 2004). 展开更多
关键词 GUT MICROBIOTA END-STAGE RENAL
终末期肾脏疾病血液透析患者生活质量与人格特征的关系研究 预览
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作者 龙昌顺 《中医临床研究》 2019年第25期125-127,共3页
目的:研究终末期肾脏疾病血液透析患者生活质量(Quality Of Life,QOL)与人格特征的关系。方法:此次研究84例终末期肾脏疾病血液透析患者及同期80例未实施血液透析的慢性肾脏病患者作为研究对象,对比分析两组患者的生活质量和人格特征以... 目的:研究终末期肾脏疾病血液透析患者生活质量(Quality Of Life,QOL)与人格特征的关系。方法:此次研究84例终末期肾脏疾病血液透析患者及同期80例未实施血液透析的慢性肾脏病患者作为研究对象,对比分析两组患者的生活质量和人格特征以及人格特征与生活质量的相关性。结果:研究组的生活质量评分显著低于对照组(P<0.05);终末期肾脏疾病血液透析患者的人格特征中精神质(Psychoticism,P)与生理领域、社会关系领域呈负相关,神经质(Neuroticism,N)和生活质量的心理领域呈显著负相关,内外倾向(Extraversim,E)和生活质量独立性领域呈显著正相关,掩饰(Lie,L)与生理、心理领域呈显著正相关(P<0.05)。结论:终末期肾脏疾病血液透析患者的情绪不稳定性较高,生活质量严重下降,在临床治疗中需要将心理治疗与疾病治疗结合,才能够促进治疗效果和患者生存质量的提升。 展开更多
关键词 终末期 肾脏疾病 血液透析 生活质量 人格特征
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Soluble mannose receptor as a predictor of prognosis of hepatitis B virus-related acute-on-chronic liver failure 预览
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作者 Tai-Ping Li Shi-He Guan +3 位作者 Qin Wang Li-Wen Chen Kai Yang Hao Zhang 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第37期5667-5675,共9页
BACKGROUND Hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)is a syndrome with a high short-term mortality rate,and it is crucial to identify those patients at a high mortality risk clinically.AIM To ... BACKGROUND Hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)is a syndrome with a high short-term mortality rate,and it is crucial to identify those patients at a high mortality risk clinically.AIM To investigate the clinical value of soluble mannose receptor(sMR)in predicting the 90-day mortality of HBV-ACLF patients.METHODS A total of 43 patients were diagnosed with HBV-ACLF between October 2017 and October 2018 at the Second Hospital of Anhui Medical University,and all of them were enrolled in this retrospective study.Their serum sMR levels were determined using an enzyme-linked immunosorbent assay.Demographic and clinical data,including gender,age,albumin level,total bilirubin(TBIL)level,international normalized ratio,HBV-DNA level,HBV serological markers,procalcitonin level,interleukin-6 level,and model for end-stage liver disease(MELD)score were accessed at the time of diagnosis of HBV-ACLF.A multivariate logistic regression analysis was used to analyze the independent risk factors for mortality.RESULTS Serum sMR level was significantly increased in HBV-ACLF patients compared with chronic hepatitis B patients and healthy controls(P<0.01).When compared with surviving patients,it was higher in those patients who succumbed to HBVACLF(P<0.05).Serum sMR level was positively correlated with MELD score(rs=0.533,P=0.001),HBV-DNA level(rs=0.497,P=0.022),and TBIL level(rs=0.894,P<0.001).Serum sMR level(odds ratio=1.007,95%confidence interval:1.004–1.012,P=0.001)was an independent risk factor for the 90-day mortality in the HBV-ACLF cases.The patients with HBV-ACLF were stratified into two groups in accordance with their serum sMR levels at the baseline(low risk:<99.84 pg/mL and high risk:≥99.84 pg/mL).The 90-day mortality rates were 27.3%in the low-risk group and 87.5%in the high-risk group.Furthermore,sMR level apparently improved the performance of MELD score for predicting the prognosis of patients with HBV-ACLF.CONCLUSION Serum sMR level may be a predictor of the prognosis of HBV-ACLF patients 展开更多
关键词 Acute-on-chronic LIVER failure MANNOSE receptor Model for END-STAGE LIVER disease PROGNOSIS Risk factor
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Traditional Chinese medicine nursing protocols for chronic renal failure 预览
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作者 Editorial Board of Nursing of Integrated Traditional Chinese and Western Medicine 《中西医结合护理(中英文)》 2019年第3期263-270,共8页
Chronic renal failure (CRF) is defined as the loss of renal function over a period of several years,finally progressing into the end-stage renal disease (ESRD).Nowadays,there are no effective methods to alleviate the ... Chronic renal failure (CRF) is defined as the loss of renal function over a period of several years,finally progressing into the end-stage renal disease (ESRD).Nowadays,there are no effective methods to alleviate the process from the initial CRF to ESRD.In clinic,the integrated therapy of traditional Chinese and western medicine is frequently adopted for CRF in combination with hemodialysis,but in the process of treatment,traditional Chinese medicine (TCM) nursing plays a key role.This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of CRF in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior. 展开更多
关键词 chronic RENAL failure END-STAGE RENAL disease EDEMA CUTANEOUS PRURITUS traditional Chinese medicine NURSING syndrome differentiation
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Hemorrhagic blisters in fulminant Aeromonas hydrophila bacteremia: Case report and literature review
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作者 Yao-Tien Chang Sung-Yuan Hu Che-An Tsai 《亚太热带医药杂志:英文版》 SCIE CAS 2019年第2期91-94,共4页
The Aeromonas species, belonging to the family Aeromonadaceae, are opportunistic pathogens found in humans with an incidence rate of 76 cases per million inhabitants in Southern Taiwan.The incidence of Aeromonas septi... The Aeromonas species, belonging to the family Aeromonadaceae, are opportunistic pathogens found in humans with an incidence rate of 76 cases per million inhabitants in Southern Taiwan.The incidence of Aeromonas septicemia is relatively low, accounting for less than 15% of cases.Patients diagnosed with Aeromonas hydrophila bacteremia who were presented with skin blisters and septic shock have been reported to have a mortality rate of 100%.Aeromonas infection must be considered in the differential diagnosis of gangrene-like tissue damage or skin lesions in patients with end-stage renal disease, due to the potential sources of infections.A 49-year-old Taiwanese diabetic woman with end-stage renal disease had underwent regular hemodialysis.She was referred to our hospital due to a one-day course of fever, dyspnea, hypotension, and fulminant hemorrhagic blisters covering her whole body.A physical examination uncovered multiple hemorrhagic blisters, along with a ruptured blister over the lower left leg.Laboratory tests revealed an elevation of liver enzymes, impaired renal function, lactatemia, and high anion-gap metabolic acidosis.Cultures of both blood and hemorrhagic blister fluid grew Aeromonas hydrophila.However, she experienced persistent shock despite aggressive intravenous fluid, empiric antibiotics, and inotropic agents with norepinephrine and dopamine.Early diagnosis and prompt management using intravenous fluids, antibiotics and surgical debridement is recommended in order to improve a patient’s survival rate. 展开更多
关键词 Aeromonas HYDROPHILA BACTEREMIA End-stage renal disease HEMORRHAGIC BLISTER
Clinical factors associated with hepatitis B screening and vaccination in high-risk adults 预览
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作者 Rotimi Ayoola Sebastian Larion +1 位作者 David M Poppers Renee Williams 《世界肝病学杂志:英文版(电子版)》 2019年第1期86-98,共13页
BACKGROUND Hepatitis B virus is a viral infection that can lead to acute and/or chronic liver disease, and hepatocellular carcinoma (HCC). Hepatitis B vaccination is 95% effective in preventing infection and the devel... BACKGROUND Hepatitis B virus is a viral infection that can lead to acute and/or chronic liver disease, and hepatocellular carcinoma (HCC). Hepatitis B vaccination is 95% effective in preventing infection and the development of chronic liver disease and HCC due to hepatitis B. In 2011, the Centers for Disease Control updated their guidelines recommending that adults at high-risk for hepatitis B infection be vaccinated against hepatitis B including those with diabetes mellitus (DM). We hypothesize that adults at high-risk for hepatitis B infection are not being adequately screened and/or vaccinated for hepatitis B in a large urban healthcare system. AIM To investigate clinical factors associated with Hepatitis B screening and vaccination in patients at high-risk for Hepatitis B infection. METHODS We conducted a retrospective review of 999 patients presenting at a large urban healthcare system from 2012-2017 at high-risk for hepatitis B infection. Patients were considered high-risk for hepatitis B infection based on hepatitis B practice recommendations from the Center for Disease Control. Medical history including hepatitis B serology, concomitant medical diagnoses, demographics, insurance status and social history were extracted from electronic health records. Multivariate logistic regression was used to identify clinical risk factors independently associated with hepatitis B screening and vaccination. RESULTS Among the 999 patients, 556 (55.7%) patients were screened for hepatitis B. Of those who were screened, only 242 (43.5%) patients were vaccinated against hepatitis B. Multivariate regression analysis revealed end-stage renal disease [odds ratio (OR): 5.122; 2.766-9.483], alcoholic hepatitis (OR: 3.064; 1.020-9.206), and cirrhosis or end-stage liver disease (OR: 1.909; 1.095-3.329); all P < 0.05 were associated with hepatitis B screening, while age (OR: 0.785; 0.680-0.906), insurance status (0.690; 0.558-0.854), history of DM (OR: 0.518; 0.364-0.737), and human immunodeficiency virus (OR: 0.443; 0.273-0.718); 展开更多
关键词 Health prevention VACCINATION Hepatitis B VIRUS SCREENING Diabetes mellitus Cirrhosis END-STAGE renal disease Human IMMUNODEFICIENCY VIRUS Intravenous drug users
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腹膜透析治疗终末期糖尿病肾病的效果分析 预览
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作者 王喜凤 程锦 《内蒙古医学杂志》 2019年第5期518-520,共3页
目的 探讨终末期糖尿病肾病患者采用腹膜透析治疗的效果。方法 选取2011年9月至2018年1月我院收治的终末期糖尿病肾病患者70例,参照随机数表法分为观察组35例和对照组35例。对照组采用血液透析治疗,观察组采用腹膜透析治疗,对比两组血... 目的 探讨终末期糖尿病肾病患者采用腹膜透析治疗的效果。方法 选取2011年9月至2018年1月我院收治的终末期糖尿病肾病患者70例,参照随机数表法分为观察组35例和对照组35例。对照组采用血液透析治疗,观察组采用腹膜透析治疗,对比两组血清甲状旁腺素(PTH)、β2微球蛋白(β2-MG)水平及不良事件和死亡情况。结果 观察组治疗后血清PTH、β2-MG水平低于对照组,差异有统计学意义(P<0.05);两组感染、脑梗死及死亡发生率比较,差异无统计学意义(P>0.05);观察组心功能不全及出血发生率均低于对照组,差异有统计学意义(P<0.05)。结论 腹膜透析治疗可有效降低终末期糖尿病肾病患者血清PTH、β2-MG水平,减少心功能不全及出血发生。 展开更多
关键词 糖尿病肾病 终末期 腹膜透析
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糖尿病肾病患者血清1,25-二羟基维生素D_3水平及其临床意义 预览
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作者 李剑 闫双通 +2 位作者 卢彦慧 成小玲 邵迎红 《广西医学》 CAS 2018年第4期399-401,共3页
目的探讨糖尿病肾病(DN)患者的1,25-二羟基维生素D_3[1,25-(OH)_2D_3]的水平及其临床意义。方法根据尿白蛋白排泄率(UAER)水平,将200例2型糖尿病患者分为单纯糖尿病(DM)组56例、早期DN组55例、临床DN组45例、DN终末期组44例,并... 目的探讨糖尿病肾病(DN)患者的1,25-二羟基维生素D_3[1,25-(OH)_2D_3]的水平及其临床意义。方法根据尿白蛋白排泄率(UAER)水平,将200例2型糖尿病患者分为单纯糖尿病(DM)组56例、早期DN组55例、临床DN组45例、DN终末期组44例,并选取50例健康者作为对照组。采用酶联免疫吸附法测定受试者的1,25-(OH)_2D_3水平,并分析DN患者的1,25-(OH)_2D_3水平与UAER、肾小球滤过率的相关性。结果对照组、单纯DM组、早期DN组、临床DN组、DN终末期组的血清1,25-(OH)_2D_3水平依次降低(P〈0.05)。DN患者的血清1,25-(OH)_2D_3与UAER呈负相关(P〈0.05),与肾小球滤过率呈正相关(P〈0.05)。结论DN患者的1,25-(OH)_2D_3水平均低于正常健康人群,其水平可能与DN的发生发展有关。 展开更多
关键词 糖尿病肾病 1 25-二羟维生素D_3 2型糖尿病 早期 终末期 尿蛋白排泄率 肾小球滤过率
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托拉塞米对终末期肥厚型非梗阻性心肌病心力衰竭患者心脏功能及生化指标的影响 预览
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作者 潘丽 《中国医学创新》 CAS 2018年第19期57-61,共5页
目的:探讨托拉塞米对终末期肥厚型非梗阻性心肌病心力衰竭患者心脏功能及生化指标的影响。方法:收集2014年10月-2017年11月本院收治的60例终末期肥厚型非梗阻性心肌病心力衰竭患者作为观察对象,按数字奇偶法分为观察组与对照组,各30例... 目的:探讨托拉塞米对终末期肥厚型非梗阻性心肌病心力衰竭患者心脏功能及生化指标的影响。方法:收集2014年10月-2017年11月本院收治的60例终末期肥厚型非梗阻性心肌病心力衰竭患者作为观察对象,按数字奇偶法分为观察组与对照组,各30例。两组均给予常规抗心衰治疗,观察组在此基础上采取托拉塞米治疗,对照组采取呋塞米治疗。观察比较两组治疗效果情况。结果:治疗后,两组体重均明显减轻、腹围均明显减少、尿量均明显增加,与治疗前比较差异均有统计学意义(P<0.05),且观察组改善效果明显优于对照组(P<0.05)。治疗后,观察组水肿消失率为86.67%、双肺淤血改善率为83.33%均分别明显高于对照组46.67%、43.33%(P<0.05)。治疗后,两组6 min步行距离均明显增加,且观察组增加幅度明显大于对照组(P<0.05)。治疗后,观察组B型利尿肽、血浆肾素、血管紧张素Ⅱ水平均较治疗前明显降低,且均明显低于对照组(P<0.05)。观察组不良反应发生率为10.00%,明显低于对照组的33.33%(P<0.05)。结论:托拉塞米治疗终末期肥厚型非梗阻性心肌病心力衰竭效果确切,利尿效果理想,可有效改善心脏功能及生化指标,具有较高的推广价值。 展开更多
关键词 托拉塞米 终末期 肥厚型非梗阻性心肌病心力衰竭 心脏功能 生化指标
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