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Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction

World Journal of transplantation 2024年第1期14卷 154-163页

作者： Ameet Kumar Jesrani Syed M Faiq Rahma Rashid Tariq Ali Kalwar Rehan Mohsin Tahir Aziz Nida Amin Khan Muhammed Mubarak department of Radiology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Pathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of transplantation Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan department of Urology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term *** and novel ultrasound-based investigations are being increasingly used for this purpose with variable *** To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological *** This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the departments of transplantation and Radiology,Sindh Institute of Urology and transplantation,Karachi,Pakistan,from August 2022 to February *** consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this *** and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic *** The mean age of all patients was 35.32±11.08 *** these,126(81.8%)were males and 28(18.2%)were *** mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 *** allograft biopsy results showed chronic changes in 55(37.66%)*** sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft *** can be of great help during the routine follow-up of kidney transplant recipients for screening a

关键词： Shear wave Sonoelastography Resistive index Chronic allograft changes Biopsy Histopathology

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BMSC-derived Exosomes Ameliorate Peritoneal Dialysis-associated Peritoneal Fibrosis via the Mir-27a-3p/TP53 Pathway

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Current Medical Science 2024年第2期44卷 333-345页

作者： Jun-li ZHAO Lin ZHAO Qiu-nan ZHAN Miao LIU Ting ZHANG Wen-wen CHU department of nephrology Shanghai University of Medicine&Health Sciences Affiliated Zhoupu HospitalShanghai 201318China Orthopedic department Guangming Traditional Chinese Medicine Hospital of Pudong New AreaShanghai 201399China

Objective:Peritoneal fibrosis(PF)is the main cause of declining efficiency and ultrafiltration failure of the peritoneum,which restricts the long-term application of peritoneal dialysis(PD).This study aimed to investigate the therapeutic effects and mechanisms of bone marrow mesenchymal stem cells-derived exosomes(BMSC-Exos)on PF in response to ***:Small RNA sequencing analysis of BMSC-Exos was performed by second-generation sequencing.C57BL/6J mice were infused with 4.25%glucose-based peritoneal dialysis fluid(PDF)for 6 consecutive weeks to establish a PF model.A total of 36 mice were randomly divided into 6 groups:control group,1.5%PDF group,2.5%PDF group,4.25%PDF group,BMSC-Exos treatment group,and BMSC-Exos+TP53 treatment *** transcription quantitative polymerase chain reaction(RT-qPCR)was performed to measure the expression level of miR-27a-3p in BMSC-Exos and peritoneum of mice treated with different concentrations of *** and Masson staining were performed to evaluate the extent of *** therapeutic potential of BMSC-Exos for PF was examined through pathological examination,RT-qPCR,Western blotting,and peritoneal function ***-mesenchymal transition(EMT)of HMrSV5 was induced with 4.25%*** were divided into control group,4.25%PDF group,BMSC-Exos treatment group,and BMSC-Exos+TP53 treatment *** Counting Kit-8 assay was used to measure cell viability,and transwell migration assay was used to verify the capacity of BMSC-Exos to inhibit EMT in HMrSV5 ***:Small RNA sequencing analysis showed that miR-27a-3p was highly expressed in BMSC-derived exosomes compared to *** RT-qPCR results showed that the expression of miR-27a-3p was upregulated in BMSC-Exos,but decreased in PD *** found that PF was glucose concentration-dependently enhanced in the peritoneum of the PD *** with the control mice,the PD mice showed high solute transport and decreased ultrafiltration volume as well as an obvious f

关键词： peritoneal fibrosis bone marrow mesenchymal stem cell-derived exosomes miR-27a-3p TP53 epithelialmesenchymal transition

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Experimental models for preclinical research in kidney disease

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Zoological Research 2024年第5期45卷 1161-1174页

作者： Jin Miao Huanhuan Zhu Junni Wang Jianghua Chen Fei Han Weiqiang Lin Kidney Disease Center First Affiliated HospitalZhejiang University School of MedicineInstitute of NephrologyZhejiang UniversityKey Laboratory of Kidney Disease Prevention and Control TechnologyZhejiang ProvinceZhejiang Clinical Research Center of Kidney and Urinary System DiseaseHangzhouZhejiang 310003China department of nephrology Center for Regeneration and Aging MedicineFourth Affiliated Hospital of School of Medicineand International School of MedicineInternational Institutes of MedicineZhejiang UniversityYiwuZhejiang 322000China

Acute kidney injury(AKI)and chronic kidney disease(CKD)are significant public health issues associated with a long-term increase in mortality risk,resulting from various etiologies including renal ischemia,sepsis,drug toxicity,and diabetes *** preclinical models have been developed to deepen our understanding of the pathophysiological mechanisms and therapeutic approaches for kidney *** these,rodent models have proven to be powerful tools in the discovery of novel therapeutics,while the development of kidney organoids has emerged as a promising advancement in the *** review provides a comprehensive analysis of the construction methodologies,underlying biological mechanisms,and recent therapeutic developments across different AKI and CKD ***,this review summarizes the advantages,limitations,and challenges inherent in these preclinical models,thereby contributing robust evidence to support the development of effective therapeutic strategies.

关键词： Acute kidney injury Chronic kidney disease Mouse models

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Feasibility and outcomes of robotic partial pancreatoduodenectomy

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 669-671页

作者： Antoine Rouault Yasmina Richa Mehdi El Amrani department of Digestive Surgery and transplantation Lille University HospitalLilleFrance School of medicine University College CorkCorkIreland

We read with great interest the randomized controlled trial(RCT)by Klotz et al.(1),which is the first to compare the 90-day postoperative morbidity of minimally invasive robotic partial pancreatoduodenectomy(RPD)to that of the current gold standard,open partial pancreatoduodenectomy(OPD)for all *** study arises in the context of a significant increase in surgical indications for robotic-assisted *** absence of clear recommendations or high-level evidence on RPDs prompted Klotz et *** conduct this phase 2b RCT to directly compare RPD to OPD.

关键词： Robotic minimally invasive pancreatoduodenectomy(PD)

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Impact of Medicaid expansion on kidney transplantation in the State Oklahoma

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World Journal of transplantation 2024年第3期14卷 110-119页

作者： Hyoshin Kwon Zoya Sandhu Zoona Sarwar Oya M Andacoglu department of Surgery Division of TransplantationOu College of MedicineOK 73104United States department of Internal medicine University of OklahomaTulsa School of Community MedicineTulsaOK 74135United States department of Surgery University of Oklahoma College of MedicineOklahomaOK 73104United States department of transplantation and Advanced Hepatobiliary Surgery University of UtahSalt LakeUT 84112United States

BACKGROUND There is no data evaluating the impact of Medicaid expansion on kidney tran-splants(KT)in *** To investigate the impact of Medicaid expansion on KT patients in *** The UNOS database was utilized to evaluate data pertaining to adult KT reci-pients in Oklahoma in the pre-and post-Medicaid *** analysis,Kaplan Meier analysis was used to estimate,and cox proportional models were *** There were 2758 pre-and 141 recipients in the post-Medicaid expansion ***-expansion patients were more often non-United States citizens(2.3%vs 5.7%),American Indian,Alaskan,or Pacific Islander(7.8%vs 9.2%),Hispanic(7.4%vs 12.8%),or Asian(2.5%vs 8.5%)(P<0.0001).Waitlist time was shorter in the post-expansion era(410 vs 253 d)(P=0.0011).Living donor rates,pre-emptive transplants,re-do transplants,delayed graft function rates,kidney donor profile index values,panel reactive antibodies levels,and insurance types were *** with public insurance were more *** increased early(<6 months)rejection rates,1-year patient and graft survival were *** Cox proportional hazards model,male sex,American Indian,Alaskan or Pacific Islander race,public insurance,and frailty category were independent risk factors for death at 1 *** expansion was not associated with graft failure or patient survival(adjusted hazard ratio:1.07;95%CI:0.26-4.41).CONCLUSION Medicaid expansion in Oklahoma is associated with increased KT access for non-White/non-Black and non-United States citizen patients with shorter wait times.1-year graft and patient survival rates were similar before and after *** expansion itself was not independently associated with graft or patient survival *** research is necessary to determine the long-term effects of Medicaid expansion.

关键词： Medicaid expansion Oklahoma Kidney transplant

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Early bifurcation of hepatic artery in right-sided living-donor hepatectomy at Asan Medical Center: rarely a critical issue

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 520-522页

作者： Deok-Bog Moon Gil-Chun Park Sang Hoon Kim Sung-Min Kim Division of Hepatobiliary Surgery and Liver transplantation Department of SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea

In living donor liver transplantation(LDLT),early bifurcation of hepatic artery(HA)relative to the cutting line of bile duct(BD)requires additional skeletonization of the hilar plate,especially around BD,compared to opposite ***,it may preclude higher chances of biliary complications such as bile leak and biliary stenosis in the ***,donor surgeons should be well aware of the anatomical correlations among HA,BD,and portal vein(PV),based on preoperative 3-dimensional(3D)images,and also intraoperatively perform meticulous dissection of HA from the surrounding tissues and minimize the damage of microcirculation to the BD without using energy devices such as electrocautery(1).When extensive dissection around BD&its ischemic damage in the donor is expected to obtain single HA opening of the harvesting graft,we prefer separate two HA openings including right anterior and posterior HAs to single right HA(RHA)opening without skeletonization of donor’s BD.

关键词： Living donor liver transplantation(LDLT) hepatic artery(HA) early bifurcation right-sided living-donor

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Peritoneo-Vaginal Leaks in Peritoneal Dialysis: A Report of 3 Cases

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Open Journal of nephrology 2024年第2期14卷 176-184页

作者： Mariam Jdidou Sara Elmakkoul Nabil Hmaidouch Naima Ouzeddoun Loubna Benamar department of nephrology Dialysis and Renal Transplantation Ibn Sina University Hospital Rabat Morocco

Introduction: Peritoneal dialysis (PD) is an extra-renal purification technique indicated for patients with end-stage kidney disease (ESKD). Although it has many advantages, it also has a number of complications, such as peritoneo-vaginal leakage of dialysate. Cases Reports: Three male patients, aged 70, 50 and 77 respectively, with ESKD were placed on PD. All three patients presented with inadequate drainage and the progressive appearance of bilateral hydrocele, which occurred one year (late leakage), two and four days (early leakage) respectively after the initiation of exchanges. The etiological investigation led to the conclusion of a peritoneo-vaginal leak associated with an inguinal hernia in only one case. The two cases of early leakage were treated by temporary suspension of PD, with a good response in one case and failure in the second, leading to hisdefinitive transfer to hemodialysis (HD);however, the hernia repair enabled immediate resumption of PD in the third patient. Discussion and Conclusion: Peritoneo-vaginal leakage is a rare mechanical complication in PD. The clinical examination plays an essential role in confirming the diagnosis and in the therapeutic decision. If the diagnosis is uncertain, or if there is a clinical need to show the anatomy of the leak, an imaging approach becomes desirable. This complication should not prevent the progression of PD in the management of patients with ESKD.

关键词： Peritoneal Dialysis Peritoneal Leakage Hernia-Peritoneal Scintigraphy

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Analysis of current status of and barriers to exercise participation among patients on maintenance hemodialysis

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Journal of Integrative Nursing 2024年第2期6卷 96-102页

作者： Xin TIAN Xiuli LI Jianhua DENG department of Traditional Chinese medicine Air Force Medical CenterPLABeijingChina department of nephrology Dongfang HospitalBeijing University of Chinese MedicineBeijingChina

Objective:The objective of this study was to analyze the current status of barriers to exercise participation(EP)among patients on maintenance hemodialysis(MHD).Materials and Methods:A cross-sectional study was conducted on 277 outpatients undergoing MHD in 2 tertiary first-class hospitals in Beijing from February 2023 to June 2023 who were selected using convenience sampling *** data of patients on MHD were collected using the general information questionnaire,Physical Activity Rating Scale,Exercise Benefits/Barriers Scale(EBBS),and Exercise Self-Efficacy Scale(ESES).The relationship between EP and barriers to EP was analyzed through univariate and multivariate linear regression ***:Patients on MHD had a low exercise volume score of 13.71±0.68 points and a medium EBBS score of 63.36±0.40 *** logistic analysis showed that exercise volume was significantly related to the following four aspects,including low monthly household income per capita(odds ratio[OR]=86.741,95%confidence interval[CI][1.164-6.465],P=0.042),primary underlying disease of diabetic nephropathy(OR=45.993,95%CI[1.353-1.564],P=0.033),the belief that“fatigue in lower extremities hinders exercise”(OR=4.697,95%CI[1.127-19.585],P=0.034),and the belief that“physical exercise bringing optimistic and positive life attitude”(OR=0.074,95%CI[0.007-0.830],P=0.035).Conclusions:Since patients on MHD had low physical exercise volume,the health-care provider should pay more attention on the controllable factors that affect the EP of patients on ***,feasible and effective intervention measures can be formulated based on ESES in clinical nursing.

关键词： Barrier(s) exercise rehabilitation exercise maintenance hemodialysis physical activity renal dialysis

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Reinforcing the management of type 1 gastric esophageal varices

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World Journal of Gastroenterology 2024年第19期30卷 2615-2617页

作者： Zain Majid Ghazi Abrar department of Gastroenterology Sindh Institute of Urology and TransplantationKarachi 75500Pakistan

Variceal bleed represents an important complication of cirrhosis,with its presence reflecting the severity of liver *** varices,though less frequently seen than esophageal varices,present a distinct clinical challenge due to its higher intensity of bleeding and associated *** upon the Sarin classification,GOV1 is the most common subtype of gastric varices seen in clinical practice.

关键词： Gastric varices Sarin classification Gastroesophageal varices Cyanoacrylate Endoscopic variceal ligation Trans jugular intrahepatic portosystemic shunt

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The burden of depression,anxiety and schizophrenia among the older population in ageing and aged countries:an analysis of the Global Burden of Disease Study 2019

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General Psychiatry 2024年第1期37卷 83-93页

作者： Ying Cheng Yu Fang Jinxin Zheng shiyang Guan Meiti Wang Wu Hong Shanghai Mental Health Center Shanghai Jiao Tong University School of MedicineShanghaiChina department of nephrology Rujin HospitalInstitute of NephrologyInstitute of NephrologyShanghai Jiao Tong University School of MedicineShanghaiChina School of Global Health Chinese Center for Tropical Diseases ResearchShanghai Jiao Tong University School of MedicineShanghaiChina department of Epidemiology and Biostatistics School of Public HealthAnhui Medical UniversityHefeiAnhuiChina

Background Depression,anxiety and schizophrenia among older persons have become global public health ***,the burden of these disorders in ageing and aged countries has not been *** To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged *** Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and *** in incidence and DALYs were analysed by gender and *** In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and *** 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged *** ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and *** ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and ***,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most *** The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged *** awareness about for

关键词： schizophrenia burden ageing

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