Randomized urinary and blood samples were obtained from three hundred and ninety-two cases of late pregnancies simultaneously for comparison of the validity in perinatal fetal monitoring. The results of randomized uri...Randomized urinary and blood samples were obtained from three hundred and ninety-two cases of late pregnancies simultaneously for comparison of the validity in perinatal fetal monitoring. The results of randomized urinary estriol/creatinine （RUE<sub>3</sub>/C） and serum free estriol （SFE<sub>3</sub>） tests revealed that Ⅰ. The coefficient of correlation between RUE<sub>3</sub>/C and SFE<sub>3</sub> level were close in either normal or high-risk pregnancies （y=0.1477X+14.2368, r=0.4586, n=170; y=0.1724X+8.6698, r=0.5868, n=222, respectively, P【0.001）; 2.92%cases of the false positive rate of RUE<sub>3</sub>/C were corrected by SFE<sub>3</sub> test. In cases of pregnancy-induced hypertension （PIH） the false positive rate of RUE<sub>3</sub>/C were highest in comparison with those in cuses of other high-risk pregnancies （53.6%）; 3. The correct rate of SFE<sub>3</sub> test in prenatal predication of fetal well-being was significantly higher （95.6%） than that of RUE<sub>3</sub>/C （87.3%） （X<sup>2</sup>=17.77, P【0.001）. This paper suggests that RUE<sub>3</sub>/C can be used as a first line test for perinatal monitoring. When RUE<sub>3</sub>/C value is lower than normal, SFE<sub>3</sub> test should be added to ensure the reliability of perinatal diagnosis, especially in PIH cases. Obviously, to use these two tests for perinatal fetal monitoring simultaneously is better than to use any one test alone.展开更多
Renal function in patients with advanced cirrhosis is an important prognostic factor for survival both prior to and following liver transplantation. The importance of renal function is reflected by the introduction of...Renal function in patients with advanced cirrhosis is an important prognostic factor for survival both prior to and following liver transplantation. The importance of renal function is reflected by the introduction of the model for end stage liver disease(MELD) score, which includes serum creatinine. The MELD score has been shown to predict the short term risk of death for transplant wait listed patients and is currently used by many countries to allocate liver transplants on the basis of severity of underlying illness. Changes in serum creatinine are also used to stage acute kidney injury. However prior to liver transplantation the serum creatinine typically over estimates underlying renal function, particularly when a colorimetric Jaffe based assay is used, and paradoxically then under estimates renal function post liver transplantation, particularly when immunophyllins are started early as part of transplant immunosuppression. As acute kidney injury is defined by changes in serum creatinine, this potentially leads to over estimation of the incidence and severity of acute kidney injury in the immediate post-operative period.展开更多
AIM: To assess the feasibility/accuracy of a commercial handheld device in the context of increased demand for point-of-care serum creatinine (SCr) determination. METHODS: In this institutional review board-approved, ...AIM: To assess the feasibility/accuracy of a commercial handheld device in the context of increased demand for point-of-care serum creatinine (SCr) determination. METHODS: In this institutional review board-approved, prospective study, 401 patients referred for contrastenhanced computed tomography were included at two centres. Capillary (c)SCr was determined using two devices A+B and venous (v)SCr was determined in the centre's laboratory. Method comparison statistics for both centres and for vSCr<>1.2 mg/dL, receiver operating characteristic analysis, negative predictive values (NPV), sensitivity and specificity were calculated pre-/ post-curve offset correction with vSCr. RESULTS: Pearson's coefficients for cSCr vs vSCr were: centre 1-A:0.93/B:0.92; centre 2-A:0.85/B:0.82 (all P < 0.0001). Overall correlation was better for vSCr > 1.2 mg/dL. The area under the receiver operating characteristic curves showed a high accuracy for cSCr, but the device underestimated SCr, which was confirmed by Bland-Altman plot. Addition of the offset correction factor to the original data from centre 1 resulted in an improvement in sensitivity for detecting patients at risk (> 1.2 mg/dL), whilst maintaining acceptable specificity and improving NPV. CONCLUSION: This study showed the feasibility of SCr determination using the evaluated handheld device in a routine clinical setting. The device showed high sensitivity and high NPV, but may significantly underestimate SCr without offset correction to local laboratories.展开更多
Objective Delayed graft function(DGF)and early graft loss of renal grafts are determined by the quality of the kidneys from the deceased donor.As“non-traditional”risk factors,serum biomarkers of donors,such as lipid...Objective Delayed graft function(DGF)and early graft loss of renal grafts are determined by the quality of the kidneys from the deceased donor.As“non-traditional”risk factors,serum biomarkers of donors,such as lipids and electrolytes,have drawn increasing attention due to their effects on the postoperative outcomes of renal grafts.This study aimed to examine the value of these serum biomarkers for prediction of renal graft function.Methods The present study consecutively collected 306 patients who underwent their first single kidney transplantation(KT)from adult deceased donors in our center from January 1,2018 to December 31,2019.The correlation between postoperative outcomes[DGF and abnormal serum creatinine(SCr)after 6 and 12 months]and risk factors of donors,including gender,age,body mass index(BMI),past histories,serum lipid biomarkers[cholesterol,triglyceride,high-density lipoprotein(HDL)and low-density lipoprotein(DL)],and serum electrolytes(calcium and sodium)were analyzed and evaluated.Results(1)Donor age and pre-existing hypertension were significantly correlated with the incidence rate of DGF and high SCr level(≥2 mg/dL)at 6 and 12 months after KT(P<0.05);(2)The donor’s BMI was significantly correlated with the incidence rate of DGF after KT(P<0.05);(3)For serum lipids,merely the low level of serum HDL of the donor was correlated with the reduced incidence rate of high SCr level at 12 months after KT[P<0.05,OR(95%CI):0.425(0.202–0.97)];(4)The serum calcium of the donor was associated with the reduced incidence rate of high SCr level at 6 and 12 months after KT[P<0.05,OR(95%CI):0.184(0.045–0.747)and P<0.05,OR(95%CI):0.114(0.014–0.948),respectively].Conclusion The serum HDL and calcium of the donor may serve as predictive factors for the postoperative outcomes of renal grafts after KT,in addition to the donor’s age,BMI and pre-existing hypertension.展开更多
目的探讨达格列净联合维格列汀治疗老年糖尿病肾病(DN)患者的效果及对尿蛋白与肌酐比值(uPCR)、肾小球滤过率(eGFR)和血清内皮素-1(ET-1)水平的影响。方法选取98例老年DN患者,随机分为对照组和观察组,各49例,对照组接受维格列汀治疗,观...目的探讨达格列净联合维格列汀治疗老年糖尿病肾病(DN)患者的效果及对尿蛋白与肌酐比值(uPCR)、肾小球滤过率(eGFR)和血清内皮素-1(ET-1)水平的影响。方法选取98例老年DN患者,随机分为对照组和观察组,各49例,对照组接受维格列汀治疗,观察组接受达格列净联合维格列汀治疗,观察两组治疗前及治疗12周的血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、肾功能(uPCR、eGFR)、血清血管内皮功能指标[血管内皮生长因子(VEGF)、血管生成素1(Ang1)、ET-1]及其他血清生化指标[转化生长因子β1(TGF-β1)、基质金属蛋白酶-9(MMP-9)、组织金属蛋白酶抑制剂-1(TIMP-1)]水平变化。结果治疗12周后,两组FBG、2 h PG、HbA1c、HOMA-IR、uPCR水平低于治疗前(P<0.05),eGFR水平高于治疗前(P<0.05),两组血清VEGF、Ang1、ET-l、TGF-β1及TIMP-1水平低于治疗前(P<0.05),血清MMP-9水平高于治疗前(P<0.05),以上指标观察组的变化幅度大于对照组(P<0.05)。结论达格列净联合维格列汀能有效控制老年DN患者的血糖水平,改善胰岛β细胞功能和肾功能,抑制血清ET-1等血管内皮功能指标和TGF-β1、TIMP-1水平,并可上调MMP-9水平。展开更多
文摘Randomized urinary and blood samples were obtained from three hundred and ninety-two cases of late pregnancies simultaneously for comparison of the validity in perinatal fetal monitoring. The results of randomized urinary estriol/creatinine （RUE<sub>3</sub>/C） and serum free estriol （SFE<sub>3</sub>） tests revealed that Ⅰ. The coefficient of correlation between RUE<sub>3</sub>/C and SFE<sub>3</sub> level were close in either normal or high-risk pregnancies （y=0.1477X+14.2368, r=0.4586, n=170; y=0.1724X+8.6698, r=0.5868, n=222, respectively, P【0.001）; 2.92%cases of the false positive rate of RUE<sub>3</sub>/C were corrected by SFE<sub>3</sub> test. In cases of pregnancy-induced hypertension （PIH） the false positive rate of RUE<sub>3</sub>/C were highest in comparison with those in cuses of other high-risk pregnancies （53.6%）; 3. The correct rate of SFE<sub>3</sub> test in prenatal predication of fetal well-being was significantly higher （95.6%） than that of RUE<sub>3</sub>/C （87.3%） （X<sup>2</sup>=17.77, P【0.001）. This paper suggests that RUE<sub>3</sub>/C can be used as a first line test for perinatal monitoring. When RUE<sub>3</sub>/C value is lower than normal, SFE<sub>3</sub> test should be added to ensure the reliability of perinatal diagnosis, especially in PIH cases. Obviously, to use these two tests for perinatal fetal monitoring simultaneously is better than to use any one test alone.
文摘Renal function in patients with advanced cirrhosis is an important prognostic factor for survival both prior to and following liver transplantation. The importance of renal function is reflected by the introduction of the model for end stage liver disease(MELD) score, which includes serum creatinine. The MELD score has been shown to predict the short term risk of death for transplant wait listed patients and is currently used by many countries to allocate liver transplants on the basis of severity of underlying illness. Changes in serum creatinine are also used to stage acute kidney injury. However prior to liver transplantation the serum creatinine typically over estimates underlying renal function, particularly when a colorimetric Jaffe based assay is used, and paradoxically then under estimates renal function post liver transplantation, particularly when immunophyllins are started early as part of transplant immunosuppression. As acute kidney injury is defined by changes in serum creatinine, this potentially leads to over estimation of the incidence and severity of acute kidney injury in the immediate post-operative period.
文摘AIM: To assess the feasibility/accuracy of a commercial handheld device in the context of increased demand for point-of-care serum creatinine (SCr) determination. METHODS: In this institutional review board-approved, prospective study, 401 patients referred for contrastenhanced computed tomography were included at two centres. Capillary (c)SCr was determined using two devices A+B and venous (v)SCr was determined in the centre's laboratory. Method comparison statistics for both centres and for vSCr<>1.2 mg/dL, receiver operating characteristic analysis, negative predictive values (NPV), sensitivity and specificity were calculated pre-/ post-curve offset correction with vSCr. RESULTS: Pearson's coefficients for cSCr vs vSCr were: centre 1-A:0.93/B:0.92; centre 2-A:0.85/B:0.82 (all P < 0.0001). Overall correlation was better for vSCr > 1.2 mg/dL. The area under the receiver operating characteristic curves showed a high accuracy for cSCr, but the device underestimated SCr, which was confirmed by Bland-Altman plot. Addition of the offset correction factor to the original data from centre 1 resulted in an improvement in sensitivity for detecting patients at risk (> 1.2 mg/dL), whilst maintaining acceptable specificity and improving NPV. CONCLUSION: This study showed the feasibility of SCr determination using the evaluated handheld device in a routine clinical setting. The device showed high sensitivity and high NPV, but may significantly underestimate SCr without offset correction to local laboratories.
基金The study was supported by the Innovation Team Fund Project of Hubei Province(No.WJ2021C001)the Key Research and Development Plan of Hubei Province(No.2022BCA015).
文摘Objective Delayed graft function(DGF)and early graft loss of renal grafts are determined by the quality of the kidneys from the deceased donor.As“non-traditional”risk factors,serum biomarkers of donors,such as lipids and electrolytes,have drawn increasing attention due to their effects on the postoperative outcomes of renal grafts.This study aimed to examine the value of these serum biomarkers for prediction of renal graft function.Methods The present study consecutively collected 306 patients who underwent their first single kidney transplantation(KT)from adult deceased donors in our center from January 1,2018 to December 31,2019.The correlation between postoperative outcomes[DGF and abnormal serum creatinine(SCr)after 6 and 12 months]and risk factors of donors,including gender,age,body mass index(BMI),past histories,serum lipid biomarkers[cholesterol,triglyceride,high-density lipoprotein(HDL)and low-density lipoprotein(DL)],and serum electrolytes(calcium and sodium)were analyzed and evaluated.Results(1)Donor age and pre-existing hypertension were significantly correlated with the incidence rate of DGF and high SCr level(≥2 mg/dL)at 6 and 12 months after KT(P<0.05);(2)The donor’s BMI was significantly correlated with the incidence rate of DGF after KT(P<0.05);(3)For serum lipids,merely the low level of serum HDL of the donor was correlated with the reduced incidence rate of high SCr level at 12 months after KT[P<0.05,OR(95%CI):0.425(0.202–0.97)];(4)The serum calcium of the donor was associated with the reduced incidence rate of high SCr level at 6 and 12 months after KT[P<0.05,OR(95%CI):0.184(0.045–0.747)and P<0.05,OR(95%CI):0.114(0.014–0.948),respectively].Conclusion The serum HDL and calcium of the donor may serve as predictive factors for the postoperative outcomes of renal grafts after KT,in addition to the donor’s age,BMI and pre-existing hypertension.
文摘目的探讨达格列净联合维格列汀治疗老年糖尿病肾病(DN)患者的效果及对尿蛋白与肌酐比值(uPCR)、肾小球滤过率(eGFR)和血清内皮素-1(ET-1)水平的影响。方法选取98例老年DN患者,随机分为对照组和观察组,各49例,对照组接受维格列汀治疗,观察组接受达格列净联合维格列汀治疗,观察两组治疗前及治疗12周的血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、肾功能(uPCR、eGFR)、血清血管内皮功能指标[血管内皮生长因子(VEGF)、血管生成素1(Ang1)、ET-1]及其他血清生化指标[转化生长因子β1(TGF-β1)、基质金属蛋白酶-9(MMP-9)、组织金属蛋白酶抑制剂-1(TIMP-1)]水平变化。结果治疗12周后,两组FBG、2 h PG、HbA1c、HOMA-IR、uPCR水平低于治疗前(P<0.05),eGFR水平高于治疗前(P<0.05),两组血清VEGF、Ang1、ET-l、TGF-β1及TIMP-1水平低于治疗前(P<0.05),血清MMP-9水平高于治疗前(P<0.05),以上指标观察组的变化幅度大于对照组(P<0.05)。结论达格列净联合维格列汀能有效控制老年DN患者的血糖水平,改善胰岛β细胞功能和肾功能,抑制血清ET-1等血管内皮功能指标和TGF-β1、TIMP-1水平,并可上调MMP-9水平。
