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Clinical characteristics and outcomes of hospitalized kidney transplant recipients with COVID-19 infection in China during the Omicron wave:a single-center cohort study

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2024年第6期25卷 529-540页

作者： Duo LV xishao xie Qinyun YANG Zhimin CHEN Guangjun LIU Wenhan PENG Rending WANG Hongfeng HUANG Jianghua CHEN Jianyong WU Department of Clinical Pharmacy the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research Hangzhou 310003China Kidney Disease Center the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Key Laboratory of Kidney Disease Prevention and Control Technology Zhejiang ProvinceHangzhou 310003China Institute of Nephrology Zhejiang UniversityHangzhou 310003China Zhejiang Clinical Research Center of Kidney and Urinary System Disease Hangzhou 310003China The Third Grade Laboratory under the National State Administration of Traditional Chinese MedicineHangzhou 310003China Information Center the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Background:Following the short-term outbreak of coronavirus disease 2019(COVID-19)in December 2022 in China,clinical data on kidney transplant recipients(KTRs)with COVID-19 are ***:We conducted a single-center retrospective study to describe the clinical features,complications,and mortality rates of hospitalized KTRs infected with COVID-19 between Dec.16,2022 and Jan.31,*** patients were followed up until Mar.31,***:A total of 324 KTRs with COVID-19 were *** median age was 49 *** median time between the onset of symptoms and admission was 13 ***,azvudine,and nirmatrelvir/ritonavir were administered to 67(20.7%),11(3.4%),and 148(45.7%)patients,***-nine(9.0%)patients were treated with more than one antiviral ***-eight(14.8%)patients were treated with tocilizumab and 53(16.4%)patients received baricitinib *** acute kidney injury(AKI)occurred in 81(25.0%)patients and 39(12.0%)patients were admitted to intensive care *** infections were observed in 55(17.0%)***(15.4%)patients lost their *** 28-d mortality rate of patients was 9.0%and 42(13.0%)patients died by the end of *** Cox regression analysis identified that cerebrovascular disease,AKI incidence,interleukin(IL)-6 level of>6.8 pg/mL,daily dose of corticosteroids of>50 mg,and fungal infection were all associated with an increased risk of death for hospitalized ***:Our findings demonstrate that hospitalized KTRs with COVID-19 are at high risk of *** administration of immunomodulators or the late application of antiviral drugs does not improve patient survival,while higher doses of corticosteroids may increase the death risk.

关键词： Coronavirus disease 2019(COVID-19) Kidney transplant Hospitalization Mortality

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Targeting iron metabolism using gallium nanoparticles to suppress ferroptosis and effectively mitigate acute kidney injury

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Nano Research 2022年第7期15卷 6315-6327页

作者： xishao xie Yunjing Zhang Xinwan Su Junni Wang Xi Yao Dou Lv Qin Zhou Jianhua Mao Jianghua Chen Fei Han Yangyang Li Weiqiang Lin Kidney Disease Center the First Affiliated HospitalZhejiang University College of MedicineHangzhou 310003China International Institutes of Medicine the Fourth Affiliated HospitalZhejiang University School of MedicineJinhua 322000China Institute of Translational Medicine Zhejiang University School of MedicineHangzhou 310029China Department of Clinical Pharmacy the First Affiliated HospitalZhejiang University College of MedicineZhejiang Provincial Key Laboratory for Drug Evaluation and Clinical ResearchHangzhou 310003China Department of Nephrology National Clinical Research Center For Child HealthChildren’s HospitalZhejiang University School of MedicineHangzhou 310003China Key Laboratory of Women’s Reproductive Health Research of Zhejiang Province Women’s HospitalZhejiang University School of MedicineHangzhou 310006China Cancer Center Zhejiang UniversityHangzhou 310058China

Ferroptosis plays a critical pathophysiological role in several types of acute kidney injury(AKI).The development of nanomaterials targeting iron metabolism and ferroptosis is a promising approach for AKI ***,we synthesized gallic acid-gallium polyvinyl pyrrolidone nanoparticles(GGP NPs)as a potential iron-scavenging agent because of their nearly ionic radius and chemical similarity with *** results indicated that GGP NPs accumulated in tubular epithelial cells and showed good *** NPs significantly inhibited cisplatin(CP)-induced ferroptosis in HK-2 cells by reducing the accumulation of intracellular free iron and mitochondrial dysfunction,and suppressing the perturbations of ferroptosis processes,including lipid peroxidation,nicotinamide adenine dinucleotide phosphate(NADPH)and glutathione(GSH)levels,glutathione peroxidase 4(GPX4)activity,and *** in vivo study demonstrated that treatment with GGP NPs significantly ameliorated the renal tubular injury and mitochondrial damage induced by CP treatment or ischemia-reperfusion *** study suggests that GGP NPs may be an effective and promising candidate for AKI treatment and enable potential clinical translation.

关键词： gallium nanoparticles acute kidney injury ischemia-reperfusion injury iron metabolism ferroptosis

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Renal tubule-targeted dexrazoxane suppresses ferroptosis in acute kidney injury by inhibiting ACMSD

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Nano Research 2023年第7期16卷 9701-9714页

作者： Yunjing Zhang Jicheng Wu Quanlin An Huanhuan Zhu Xinwan Su Ying Wang xishao xie Jian Zhang Xi Yao Chunhua Weng Shi Feng Jianhua Mao Xianghui Fu Fei Han Xin Cao Ben Wang Weiqiang Lin International Institute of Medicine The Fourth Affiliated HospitalZhejiang University School of MedicineJinhua 322000China Institute of Translational Medicine Zhejiang UniversityHangzhou 310029China Cancer Institute(Key Laboratory of Cancer Prevention and Intervention China National Ministry of Education)The Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310009China Zhongshan Hospital Institute of Clinical Science Fudan UniversityShanghai 200032China Kidney Disease Center the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Key Laboratory of Kidney Disease Prevention and Control Technology Zhejiang ProvinceHangzhou 310003China Department of Nephrology The Children's HospitalZhejiang University School of Medicine and National Clinical Research Center for Child HealthHangzhou 310000China Division of Endocrinology and Metabolism National Clinical Research Center for GeriatricsState Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan UniversityChengdu 610041China

Acute kidney injury(AKI)is a heterogeneous clinical complication with no existing definite or particular ***,molecular mechanisms and approaches for treating acute kidney injury are in urgent ***,we demonstrated that dexrazoxane(DXZ),a *** and Drug Administration(FDA)-approved cardioprotective drug,can both functionally and histologically attenuate cisplatin or ischemia-reperfusion injury-induced AKI in vitro and in vivo via inhibiting ferroptosis *** effect is characterized by decreasing lipid peroxidation,shown by the biomarker of oxidative stress 4-hydroxynonenal(HNE)and prostaglandinendoperoxide synthase 2(Ptgs2),while reversing the downregulation of glutathione peroxidase 4(GPX4)and ferritin 1(FTH-1).Mechanistically,the results revealed that DXZ targeted at the renal tubule significantly inhibits ferroptosis by suppressingα-amino-β-carboxymuconate-ε-semialdehyde decarboxylase(ACMSD).Furthermore,the conjugation of dexrazoxane and polysialic acid(DXZ-PSA)is specifically designed and utilized to enhance the therapeutic effect of DXZ by long-term effect in the kidney,especially retention and targeting in the renal *** study provides a novel therapeutic approach and mechanistic insight for AKI by inhibiting ferroptosis through a new type drug DXZPSA with the enhanced renal distribution.

关键词： dexrazoxane dexrazoxane-polysialic acid acute kidney injury ischemia-reperfusion injury ferroptosis α-amino-β-carboxymuconate-ε-semialdehyde decarboxylase(ACMSD)

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The Mammalian Target of Rapamycin Inhibitors(mTOR-I) Versus Mycophenolic Acid(MPA) as the Primary Immunosuppression Combined with Calcineurin Inhibitor(CNI) for Kidney Transplant Recipients:A Meta-analysis

The Mammalian Target of Rapamycin Inhibitors(mTOR-I) Versus ...

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2014浙江省肾脏病学术年会

作者： xishao xie yan jiang xiuxiu lai shilong xiang zhangfei shou jianghua chen 浙江大学附属第一医院

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The Mammalian Target of Rapamycin Inhibitors(mTOR-I) Versus ...

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2014年浙江省内科学学术年会青年医师论坛暨内科常见病规范化诊疗国家级学习班

作者： xishao xie yan Jiang xiuxiu lai shilong xiang zhangfei shou jianghua chen 浙江大学医学院附属第一医院肾脏病中心

Objective The mammalian target of rapamycin inhibitors(mTOR-I)have been used for more than ten years as effective immunosuppressive agents in kidney transplantation.A number of recent studies have provided longterm information regarding the risks and benefits of mTOR-I combined with calcineurin inhibitors(CNI)when compared to mycophenolic acid(MPA).Methods We performed a systematic literature search using the Cochrane Central Registerof Controlled Trials,Medline and *** controlled trials comparing mTOR-I to MPA as primary immunosuppressive regimen in combination with CNI were *** studies were assessed for methodological *** were pooled by using meta-analysis to provide summary effects(relative risk[RR]or weighted mean difference[WMD])with 95%confidence intervals(CI).Stratified and subgroup analysis were used to explore possible sources of *** Ten RCTs including 4808 patients met the inclusion *** significant difference was observed in the risk of BPAR and patient death when mTOR-I was compared with MPA,but an increased risk of graft loss(RR,1.20;95%CI,1.02-1.40;P=0.03)and inferior graft function(creatinine clearance,WMD,-2.41μmol/L;95%CI,-4.55 to-0.26;P=0.03)were demonstrated in mTOR-I-treated *** the adverse outcomes,patient treated with mTOR-I had a higher risk of NODM(RR,1.30;95%CI,1.05-1.60;P=0.01),dyslipidemia,proteinuria(RR,1.80;95%CI,1.38-2.35;P<0.0001),peripheral edema(RR1.24;95%CI,1.03-1.49;P=0.02),thrombocytopenia(RR,1.97;95%CI,1.19-3.35;P=0.008)and lymphocoele(RR,1.76;95%CI,1.34-2.30;P<0.0001),but a lower risk of CMV infection(RR,0.43;95%CI,0.29-0.63;P<0.0001),malignancy(RR,0.64;95%CI,0.45-0.91;P=0.01)and leucopenia(RR,0.43;95%CI,0.28-0.65;P<0.0001).There was no difference in diarrhea,anemia,urinary tract infection,BK virus infection and impaired wound healing when mTOR-I was compared with *** According to the current evidence,we suggest that mTOR-I used in de novo kidney r

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腹膜透析患者平均动脉压水平与死亡的关系

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浙江大学学报（医学版） 2019年第2期48卷 180-185页

作者：吕朵谢锡绍张晓辉陈江华浙江大学医学院附属第一医院肾脏病中心浙江杭州310003 浙江大学医学院附属第一医院临床药学研究中心浙江杭州310003

目的:探讨腹膜透析患者平均动脉压(MAP)水平与患者预后之间的关系。方法:回顾性分析2008至2016年在浙江大学医学院附属第一医院开始腹膜透析的1737例终末期肾病患者的平均MAP水平,随访33.0(19.3,52.4)个月。取腹膜透析开始3个月内的MAP... 详细信息

目的:探讨腹膜透析患者平均动脉压(MAP)水平与患者预后之间的关系。方法:回顾性分析2008至2016年在浙江大学医学院附属第一医院开始腹膜透析的1737例终末期肾病患者的平均MAP水平,随访33.0(19.3,52.4)个月。取腹膜透析开始3个月内的MAP平均值作为基线MAP值。通过Cox比例风险模型和分数多项式回归模型分析MAP水平与腹膜透析患者全因死亡和心脑血管死亡之间的关系。结果:随访过程中共有208例患者死亡,其中因心脑血管原因死亡95例,占45.7%。相比于MAP>95~<120 mmHg的腹膜透析患者,MAP≤95 mmHg的腹膜透析患者全因死亡风险增高(HR=1.40,95%CI:1.01~1.93,P<0.05),MAP≥120 mmHg的患者全因死亡(HR=2.12,95%CI:1.32~3.40,P<0.01)和心脑血管死亡风险均明显增高(HR=2.55,95%CI:1.38~4.70,P<0.01)。腹膜透析患者MAP水平与患者全因死亡呈"U"型关系,与心脑血管死亡呈"J"型关系。结论:高MAP和低MAP水平均会增加患者死亡的风险。

关键词：肾功能衰竭,慢性/治疗腹膜透析动脉压死亡心血管疾病回顾性研究

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居家血压水平与腹膜透析患者死亡的相关性

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中华肾脏病杂志 2019年第10期35卷 721-727页

作者：汪丽谢锡绍张晓辉陈江华浙江大学医学院附属第一医院肾脏病中心杭州310003 衢州市人民医院肾内科浙江省衢州市324300

目的分析探讨腹膜透析(peritoneal dialysis,PD)患者不同血压水平对预后的影响。方法回顾性分析2008年1月1日至2017年6月30日在浙江大学附属第一医院肾脏病中心开始PD的终末期肾病患者6个月内居家血压水平,收集患者临床和预后资料,通过... 详细信息

目的分析探讨腹膜透析(peritoneal dialysis,PD)患者不同血压水平对预后的影响。方法回顾性分析2008年1月1日至2017年6月30日在浙江大学附属第一医院肾脏病中心开始PD的终末期肾病患者6个月内居家血压水平,收集患者临床和预后资料,通过Cox比例风险模型和限制性立方样条图(restricted cubic spline)回归模型分析不同血压水平与PD患者全因死亡及心脑血管事件死亡之间的关系。结果共1663例PD患者被纳入本研究,其中女性737例(44.3%),中位随访时间29.9个月,收缩压(SBP)和舒张压(DBP)分别为(135.2±15.8)mmHg和(83.1±10.5)mmHg。至随访终点,共221例(13.3%)患者死亡,其中心脑血管原因死亡102例,占46.2%。以130≤SBP<140mmHg或80≤DBP<90mmHg作为参照,SBP<120mmHg(HR=2.05,95%CI1.29~3.27,P=0.001)、SBP≥150mmHg(HR=1.83,95%CI1.19~2.82,P=0.005)、DBP≥90mmHg(HR=1.80,95%CI1.21~2.68,P=0.005)的PD患者全因死亡风险增高。PD患者SBP水平与患者全因死亡呈“U”形关系,DBP水平与患者全因死亡呈“J”形关系。结论SBP水平过高、过低均会增加PD患者全因死亡风险,DBP过高亦会增加PD患者全因死亡风险,但无论SBP还是DBP都未观察到与心脑血管事件死亡风险有统计学意义上的关系,这个结果还有待多中心和前瞻性研究进一步证实。

关键词：腹膜透析血压预后终末期肾病

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Mass extinctions, their causes and consequences: an interview with Douglas *** and Shuzhong Shen

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National Science Review 2024年第1期11卷 66-70页

作者： Shucheng xie State Key Laboratory of Biogeology and Environmental Geology China University of Geosciences at Wuhan

‘Mass extinctions’ have been a hot topic for several decades. What triggers a mass extinction? How does a mass extinction impact the evolution of life? How does our ecosystem recover after a mass extinction? These questions attracted the interest of both scientists and the public *** spoke to two renowned researchers in the field of mass extinctions: Prof. Douglas H. Erwin from the National Museum of Natural History of the USA, and Prof. Shuzhong Shen from Nanjing University, China.

关键词： Stratigraphy

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Turbulence Statistics of Thermo-Buoyancy Supercritical Fuel Flow in a Regenerative Cooling Channel

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Journal of Thermal Science 2024年第1期33卷 126-137页

作者： SUN Feng xie Gongnan School of Marine Science and Technology Northwestern Polytechnical UniversityXi'an 710072China Department of Thermal Engineering Tsinghua UniversityBeijing 100084China

Active regenerative cooling with supercritical hydrocarbon fuel is considered as the most promising thermal protection *** existence of buoyancy force would lead to strongly anisotropic flow and thermal transport *** is closely related to the cooling performance of the *** elucidate the mechanisms of turbulent transport,the large eddy simulation(LES) was performed to assess turbulence statistics within different turbulence *** results indicated that the buoyancy and inertial force together dominated the change of turbulent ***,the spatial thermal buoyancy effect significantly suppressed the vertical velocity *** is due to the laminar motion caused by the buoyancy force,thereby weakening the thermal *** the statistics of velocity fluctuation,it was found that the buoyancy force and inertial force greatly weaken the vertical and streamwise velocity fluctuation,*** the statistics of thermal transport,the results pointed out that the near-wall heat transport characteristics need to be paid more *** thickness of the temperature mixing boundary layer led to the attenuation of vertical heat flux,which inhibited vertical temperature diffusion and predisposed to extreme conditions of heat transfer *** results can enhance the academic understanding of the heat transfer mechanism of supercritical fluids,and give guidance for further applications of thermal protection.

关键词： active regenerative cooling large eddy simulation(LES) buoyancy force turbulence statistics

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临时血液透析对维持性腹膜透析患者生存预后的影响

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浙江大学学报（医学版） 2016年第2期45卷 195-200页

作者：边薇官继超谢锡绍童金张晓辉寿张飞浙江省诸暨市人民医院肾内科浙江绍兴311800 浙江省绍兴市人民医院肾内科浙江绍兴312000 浙江大学医学院附属第一医院肾脏病中心浙江杭州310003

目的：探讨临时血液透析对维持性腹膜透析患者生存预后的影响及相关因素。方法：回顾性分析2010年1月1日至2014年12月31日植入腹膜透析管并维持腹膜透析患者的临床资料，患者至少规律随访3个月。数据来自浙江省透析质量控制中心的透析... 详细信息

目的：探讨临时血液透析对维持性腹膜透析患者生存预后的影响及相关因素。方法：回顾性分析2010年1月1日至2014年12月31日植入腹膜透析管并维持腹膜透析患者的临床资料，患者至少规律随访3个月。数据来自浙江省透析质量控制中心的透析登记系统。患者根据腹膜透析前有或无血液透析史分为两组：未血液透析组和临时血液透析组（血液透析时间少于3个月）。采用***生存曲线、Cox回归模型分析比较两组存活率及影响生存的相关因素。结果：纳入腹膜透析患者共908例，其中未血液透析组732例、临时血液透析组176例。1年、2年、3年、4年患者存活率未血液透析组分别为96．2％、91．4％、88．0％、85．0％，临时血液透析组分别为92．8％、88．8％、78．2％、78．2％，差异均具有统计学意义（均P〈0．05）；两组患者技术存活率差异无统计学意义（P〉0．05）。Cox回归模型分析结果提示患者临时血液透析史、高龄、血清白蛋白水平以及查尔森合并症指数评分是影响生存的独立危险因素。结论：有血液透析史的腹膜透析患者长期存活率低于无血液透析史患者，临时血液透析是影响腹膜透析患者生存的独立危险因素之一，需重视患者的透析前计划与宣教。

关键词：肾功能衰竭慢性腹膜透析存活率肾透析预后回顾性研究

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