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Association of blood transfusion with acute kidney injury after transcatheter aortic valve replacement: A metaanalysis

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World Journal of nephrology 2016年第5期5卷 482-488页

作者： Charat Thongprayoon Wisit Cheungpasitporn Erin A Gillaspie Kevin L Greason Kianoush b Kashani division of nephrology and hypertension Department of Medicine Mayo Clinic division of Cardiovascular surgery Department of Surgery Mayo Clinic division of Pulmonary and Critical Care Medicine Department of Medicine Mayo Clinic

AIM To assess red blood cell(RbC) transfusion effects on acute kidney injury(AKI) after transcatheter aortic valve replacement(TAVR). METHODs A literature search was performed using MEDLINE, EMbAsE, Cochrane Database of systematic Reviews, and *** from the inception of the databases through December 2015. studies that reported relative risk, odds ratio or hazard ratio comparing the risks of AKI following TAVR in patients who received periprocedural RbC transfusion were included. Pooled risk ratio(RR) and 95%CI were calculated using a random-effect, generic inverse variance method. REsULTs sixteen cohort studies with 4690 patients were included in the analyses to assess the risk of AKI after TAVR in patients who received a periprocedural RbC transfusion. The pooled RR of AKI after TAVR in patients who received a periprocedural RbC transfusion was 1.95(95%CI: 1.56-2.43) when compared with the patients who did not receive a RbC transfusion. The meta-analysis wasthen limited to only studies with adjusted analysis for confounders assessing the risk of AKI after TAVR; the pooled RR of AKI in patients who received periprocedural RbC transfusion was 1.85(95%CI: 1.29-2.67). CONCLUsION Our meta-analysis demonstrates an association between periprocedural RbC transfusion and a higher risk of AKI after TAVR. Future studies are required to assess the risks of severe AKI after TAVR requiring renal replacement therapy and mortality in the patients who received periprocedural RbC transfusion.

关键词： Acute kidney injury Transcatheter aortic valve replacement Meta-analysis Mortality blood transfusion

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Pulsatile gonadotropin-releasing hormone therapy is associated with earlier spermatogenesis compared to combined gonadotropin therapy in patients with congenital hypogonadotropic hypogonadism

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Asian Journal of Andrology 2017年第6期19卷 680-685页

作者： Jiang-Feng Mao Zhao-Xiang Liu Min Nie Xi Wang Hong-Li Xu bing-Kun Huang Jun-Jie Zheng Le Min Ursula brigitte Kaiser Xue-Yan Wu Department of Endocrinology Peking Union Medical College Hospital Key Laboratory of Endocrinology Ministry of Health Beijing 100730 China Internal Department Division of Endocrinology Diabetes and Hypertension Brigham and Women's Hospital Harvard Medical School Boston MA 02115 USA.

both pulsatile gonadotropin-releasing hormone （GnRH） infusion and combined gonadotropin therapy （human chorionic gonadotropin and human menopausal gonadotropin [HCG/HMG]） are effective to induce spermatogenesis in male patients with congenital hypogonadotropic hypogonadism （CH H）. However, evidence is lacking as to which treatment strategy is.b.tter. This retrospective cohort study included 202 patients with CHH： twenty had received pulsatile GnRH and 182 had received HCG/HMG. Patients had received therapy for at least 12 months. The total follow-up time was 15.6 ± 5.0 months （range： 12-27 months） for the GnRH group and 28.7 ± 13.0 months （range： 12-66 months） for the HCG/HMG group. The median time to first sperm appearance was 6 months （95% confidence interval [CI]： 1.6-10.4） in the GnRH group versus 18 months （95% Ch 16.4-20.0） in the HCG/HMG group （P〈 0.001）. The median time to achieve sperm concentrations 〉5 x 106 m1-1 was 14 months （95% Ch 5.8-22.2） in the GnRH group versus 27 months （95% Ch 18.9-35.1） in the HCG/HMG group （P 〈 0.001）, and the median time to concentrations 〉10 x 106 m1-1 was 18 months （95% Ch 10.0-26.0） in the GnRH group versus 39 months （95% CI unknown） in the HCG/HMG group. Compared to the GnRH group, the HCG/HMG group required longer treatment periods to achieve testicular sizes of 〉4 ml, 〉8 ml, 〉12 ml, and 〉16 ml. sperm motility （a ＋ b ＋ c percentage） evaluated in semen samples with concentrations 〉1 × 106 ml-1 was 43.7% ± 20.4% （16 samples） in the GnRH group versus 43.2% ± 18.1% （153 samples） in the HCG/HMG group （P= 0.921）. Notably, during follow-up, the GnRH group had lower serum testosterone levels than the HCG/HMG group （8.3 ±4.6 vs 16.2 ± 8.2 nmol 1-1, P 〈 0.001）. Our study found that pulsatile GnRH therapy was associated with earlier spermatogenesis and larger testicular size compared to combined gonadotropin therapy. Additional prospective randomized studies would be required to confirm these findings.

关键词： combined gonadotropin therapy congenital hypogonadotropic hypogonadism pulsatile GnRH therapy spermatogenesis

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Exploring the role of mononuclear phagocytes in the epididymis

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Asian Journal of Andrology 2015年第4期17卷 591-596页

作者： Nicolas Da silva Tegan b smith Massachusetts General Hospital and Harvard Medical school Division of Nephrology Center for Systems Biology Boston Massachusetts USA.

The onslaught of foreign antigens carried by spermatozoa into the epididymis, an organ that has not demonstrated immune privilege, a decade or more after the establishment of central immune tolerance presents a unique biological challenge. Historically, the physical confinement of spermatozoa to the epididymal tubule enforced by a tightly interwoven wall of epithelial cells was considered sufficient enough to prevent cross talk between gametes and the immune system and, ultimately, autoimmune destruction. The discovery of an intricate arrangement of mononuclear phagocytes （MPs） comprising dendritic cells and macrophages in the murine epididymis suggests that we may have underestimated the existence of a sophisticated mucosal immune system in the posttesticular environment. This review consolidates our current knowledge of the physiology of MPs in the steady state epididymis and speculates on poss.b.e interactions.b.tween auto-antigenic spermatozoa, pathogens and the immune system by drawing on what is known about the immune system in the intestinal mucosa. Ultimately, further investigation will provide valuable information regarding the origins of pathologies arising as a result of autoimmune or inflammatory responses in the epididymis, including epididymitis and infertility.

关键词： antigen-presenting cells autoimmunity dendritic cells epididymis macrophages peripheral tolerance sperm maturation spermatozoa

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Near-fatal infection following an elective ankle-fracture fixation： less risk should not mean less vigilance

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Chinese Medical Journal 2011年第12期124卷 1911-1914页

作者： Giada bianchi Dingxin Qin Joseph A. Dearani Qi Qian Department of Medicine Division of Nephrology and. Hypertension Mayo Clinic College of Medicine Rochester MN USA Department of surgery Mayo Clinic College of Medicine Rochester MN USA

surgical fixation of closed ankle fracture is traditionally viewed as having low risk for post-operative infection. Only a few cases of surgical-site confined infection have been reported. because of the low infection risk, the necessity for perioperative prophylaxis has.b.en questioned. We report a case of fulminant methicillin-resistant staphylococcus aureus endocarditis occurring shortly after an elective ankle fixation surgery in an elderly woman with chronic rheumatoid arthritis. because systemic infection was unexpected, she had been given antipyretics for postoperative fever until just before rapid clinical deterioration. A nearly fatal hematogenous infection occurred after such a procedure, indicating the necessity for being on high alert and considering the poss.b.lity of bloodstream infection.

关键词： ankle fracture-fixation bacteremia methicillin-resistant staphylococcus aureus endocarditis native mitral valve destruction

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Idiopathic cholesterol crystal embolism with atheroembolic renal disease and blue toes syndrome:A case report

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World Journal of Clinical Cases 2022年第25期10卷 9162-9167页

作者： De-Jin Cheng Lin Li Xiang-Yue Zheng shui-Fu Tang division of nephrology The First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510405Guangdong ProvinceChina division of nephrology Hua Du Hospitals of Traditional Chinese and Western MedicineGuangzhou 510800Guangdong ProvinceChina division of Ophthalmology The First Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510405Guangdong ProvinceChina

bACKGROUND Cholesterol crystal embolization(CCE)is a multisystemic and fatal disease with multiple clinical manifestations;however,there are few cases of idiopathic *** we report a patient with idiopathic CCE accompanied by atheroembolic renal disease and blue toes who had a relatively good prognosis in the short-term due to early treatment with corticosteroids and *** sUMMARY A 76-year-old man complained of coldness,numbness and purple color change in his left foot for 7 *** had a feeling of fatigue,constipation,foamy urine,poor appetite and *** had a lacunar infarction for 5 years and hypertension for 9 *** results showed elevated eosinophils,cholesterol,uric acid,serum creatinine,urea and 24 h urine analysis revealed proteinuria.A renal biopsy revealed atheroembolic renal *** together,these findings strongly supported the diagnosis of idiopathic CCE and atheroembolic renal *** Atheroembolic renal disease and blue toes syndrome can be caused by idiopathic CCE,and early treatment with corticosteroids is effective but requires further investigation.

关键词： Idiopathic cholesterol crystal embolism Atheroembolic renal disease blue toes syndrome Corticosteroids Case report Prognosis

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Effect of early correction of anemia with erythropoietin on left ventricular mass in predialysis patients:a multi-center trial

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Journal of Geriatric Cardiology 2005年第3期2卷 136-139页

作者： Fanfan HOU Jianping JIANG Lizhen GAO Yangbin PAN Niansheng YANG Wei CHEN Guiyang sHU Youming CHEN Jian CHEN Weihua PENG Jianping WU Zhongmin YANG division of nephrology Nanfang HospitalGuanzhou 510515China

Objective To assess the effects of early correction of anemia with recombinant human erythropoietin(rHuEPO)on the development and progression of left ventricular hypertrophy(LVH)in patients with mild-to-moderate chronic renal insufficiency(CRI)who are not on *** A total of 158 patients with serum creatinine from 147μmol/L to 400μmol/L were nrolled in this prospective,multicenter ***-six patients with hemoglobin(Hb)b of≥110g/L(Group A).Forty patients with comparable Hb concentration(but did not receive rHuEPO(Group b)and 32 patients with Hb≥110g/L and without rHuEPO treatment(Group C)were served as *** ventricular mass index(LVMI)was evaluated by echocardiography at baseline and every 3 months for 2 *** There was no difference in age,gender,etiology of renal failure,blood pressure and cardiovascular risk factors among the 3 *** baseline,the prevalence of LVH was 72.1%in group A,72.5%in group b and 59.4%in group *** was inversely correlated with Hb levels(r=0.70,Psed from 142.6±25.7g/m^(2)to 132.4±18.5 g/m^(2)in group A,while increased significantly in both group b and group *** mean Hb concentration increased from 93.8±14.6g/L to 111.2±10.3g/L(Pbut tended to decrease in group b and group *** was no significant change of the mean blood pressure,number of anti-hypertensive drugs and serum creatinine concentrations in all 3 ***,patients'serum creatinine doubled more often in group b and group C than in group *** LVH was common in predialysis CRI patients and was associated with the severity of *** intervention with rHuEPO may reverse LVH in these patients.

关键词： renal failure chronic anemia left ventricular hypertrophy erythropoietin

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Oxidative stress and damage induced by abnormal free radical reactions and IgA nephropathy

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Journal of Zhejiang University-science b(biomedicine & biotechnology) 2005年第1期6卷 61-68页

作者：陈佳兮周君富沈汉超 division of nephrology Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou310009China

Objective: To estimate the oxidative stress and oxidative damage induced by abnormal free radical reactions in IgA nephropathy (IgAN) patients' bodies. Methods: seventy-two IgA N patients (IgANP) and 72 healthy adult volunteers (HAV) were enrolled in a random control study design, in which the levels of nitric oxide (NO) in plasma, lipoperoxide (LPO) in plasma and in erythrocytes, and vitamin C (VC), vitamin E (VE) and β-carotene (β-CAR) in plasma as well as the activities of superoxide dismutase (sOD), catalase (CAT) and glutathione peroxidase (GPX) in erythrocytes were determined with spectrophotometric mothods. Results: Compared with the HAV group, the averages of NO in plasma, and LPO in plasma and in erythrocytes in the IgANP group were significantly increased (P＜0.0001), while those ofVC, VE and β-CAR in plasma as well as those of sOD, CAT and GPX in erythrocytes in the IgANP group were significantly decreased (P＜0.0001). Linear correlation analysis showed that with the increase of the values of NO, and LPO in plasma and in erythrocytes, and with the decrease of those ofVC, VE, β-CAR,sOD, CAT and GPX in the IgAN patients, the degree of histological damage of tubulointerstitial regions was increased gradually (P＜0.0001); and that with the prolongation of the duration of disease the values of NO, and LPO in plasma and erythrocytes were increased gradually, while those of VC, VE, β-CAR, sOD, CAT and GPX were decreased gradually (P＜0.005). The discriminatory correct rates of the above biochemical parameters reflecting oxidative damage of the IgAN patients were 73.8%-92.5%, and the correct rates for the HAV were 70.0%-91.3% when independent discriminant analysis was used; and the correct rate for the IgAN patients was increased to 98.8%, the correct rate for the HAV was increased to 100% when stepwise discriminant analysis was used. The above biochemical parameters' reliability coefficient (alpha) were used to estimate the oxidative damage of the IgAN patients as 0

关键词： Chronic glomerulonephritis Free radicals Oxidation Lipoperoxidation Nitric oxide Lipoperoxide Antioxidant Antioxidase Oxidative stress Oxidative damage

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Clinical progress of nanomedicine-based RNA therapies

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bioactive Materials 2022年第6期7卷 203-213页

作者： siyoung A.Lim Alysia Cox Madelynn Tung Eun Ji Chung Department of biomedical Engineering University of Southern CaliforniaLos AngelesCAUSA Mork Family Department of Chemical Engineering and Materials science University of Southern CaliforniaLos AngelesCAUSA Department of Medicine Division of Nephrology and HypertensionUniversity of Southern CaliforniaLos AngelesCAUSA Department of surgery Division of Vascular Surgery and Endovascular TherapyUniversity of Southern CaliforniaLos AngelesCAUSA

The clinical application of nanoparticles(NPs)to deliver RNA for therapy has progressed rapidly since the FDA approval of Onpattro®in 2018 for the treatment of polyneuropathy associated with hereditary transthyretin *** emergency use authorization or approval and widespread global use of two mRNA-NP based vaccines developed by Moderna Therapeutics *** Pfizer-bioNTech in 2021 has highlighted the translatability of NP technology for RNA ***,in clinical trials,a wide variety of NP formulations have been found to extend the half-life of RNA molecules such as microRNA,small interfering RNA,and messenger RNA,with limited safety *** this review,we discuss the NP formulations that are already used in the clinic to deliver therapeutic RNA and highlight examples of RNA-NPs which are currently under evaluation for human *** also detail NP formulations that failed to progress through clinical trials,in hopes of guiding future successful translation of nanomedicine-based RNA therapeutics into the clinic.

关键词： Nanoparticles RNA therapy Drug delivery Nanomedicine Clinical trials COVID-19

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Long-term antifibrotic action of interferon-γ treatment in patients with chronic hepatitis.b.virus infection

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Hepatobiliary & Pancreatic Diseases International 2011年第2期10卷 151-157页

作者： Peter R Mertens steven Dooley Department of nephrology and hypertension Otto-von-Guericke-University First Affiliated Hospital Zhejiang University School of Medicine Molecular Hepatology-Alcohol Dependent Diseases II. Medical Clinic Faculty of Medicine at MannheimUniversity of Heidelberg

bACKGROUND:The first priority in treating fibrosis is to eliminate the causes that result in liver injury,e.g.,hepatitis.b.and C ***,in many liver diseases the cause is either unknown or *** present study was designed to investigate the long-term antifibrotic effect of interferon-gamma(IFN-γ)treatment in patients chronically infected with hepatitis.b.virus. METHODs:A total of 42 patients,30 treated with IFN-γand 12 controls,were enrolled from an original clinical trial(Clin Gastroenterol Hepatol 2005;3:819.).Three serial liver biopsies that were obtained at the initiation and end of IFN-γtreatment as well as 4 to 6 years after treatment discontinuation were assessed according to the modified Chevallier scoring system. REsULTs:Twenty-five out of 30 IFN-γ-treated patients were followed up until 4 to 6 years after the treatment was stopped. However,all controls were excluded from follow-up due to death,loss and elevated virus level within 2 ***-five IFN-γ-treated patients had stable serum liver function and liver fibrosis indices without any further antiviral or anti-fibrotic *** inflammatory and fibrotic scores were found after nine months of IFN-γtreatment according to the modified Chevallier scoring system(inflammation:11.8±6.5 at the beginning of IFN-γtreatment vs.9.2±4.1 after 9 months, Pbrosis:15.0±7.3 at baseline vs.12.6±6.8 after 9 months, Ps accepted a third serial liver biopsy 4 to 6 years after treatment discontinuation,and the fibrotic score was increased(14.2±8.3 vs.11.9±7.6 after 9 months, PsIONs:Nine-month IFN-γtreatment significantly improves the fibrosis score in patients with chronic HbV *** majority of patients demonstrate stable serum biochemical indices and quality of ***,they do not show a long-term benefit according to histological criteria. Given the limited sample size,long-term IFN-γtreatment regimens should be assessed in further

关键词： hepatic stellate cells hepatitis.b.virus liver fibrosis inflammation interferon-gamma

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Prevalence and associated factors of hospitalization for dysglycemia among elderly type 2 diabetes patients: A nationwide study

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World Journal of Diabetes 2019年第3期10卷 212-223页

作者： Wisit Kaewput Charat Thongprayoon Narittaya Varothai Anupong sirirungreung Ram Rangsin Tarun bathini Michael A Mao Wisit Cheungpasitporn Department of Military and Community Medicine Phramongkutklao College of Medicine Bangkok 10400 Thailand division of nephrology and hypertension Department of Medicine Mayo Clinic Rochester MN 55905 United States division of Geriatrics Department of Medicine Phramongkutklao Hospital and College of Medicine Bangkok 10400 Thailand Department of Epidemiology Fielding School of Public Health University of California Los Angeles CA 90095 United States Department of Internal Medicine University of Arizona Tucson AZ 85721 United States division of nephrology Department of Medicine University of Mississippi Medical Center Jackson MS 39216 United States

bACKGROUND The prevalence of older individuals with type 2 diabetes mellitus (T2DM) is increasing due to the aging population and improved medical care. These patients are very susceptible to disease and treatment-related hospitalizations, resulting in higher health care costs, morbidity, and decreased quality of life. However, data of treatment-related complications, especially dysglycemiarelated hospitalizations, are lacking. AIM To assess the prevalence and associated factors for dysglycemia-related hospitalizations among elderly diabetic patients in Thailand using nationwide patient sample. METHODs T2DM patients aged ≥ 65 years who received medical care at public hospitals in Thailand in the year 2014 were included. The prevalence of hospitalization due to dysglycemia within one year was examined. Multivariable logistic regression was performed to assess the independent factors associated with hospitalization due to hypoglycemia and hyperglycemia REsULTs A total of 11404 elderly T2DM patients were enrolled in this study. The mean age was 72.9 ± 5.5 years. The prevalence of hospital admissions due to diabetic ketoacidosis, hyperosmolar hyperglycemic state, hyperglycemic dehydration syndrome, and hypoglycemia among elderly T2DM patients in the year 2014 was 0.1%, 0.1%, 1.7% and 3.1%, respectively. Increased hospitalization due to hypoglycemia was associated with older age, female sex, had hypertension, dementia, lower body mass index, elevated hemoglobin A1C (HbA1C), decreased kidney function, insulin use. Increased hospitalization due to hyperglycemia was associated with dementia, depression, lower body mass index, elevated HbA1C, and insulin use. CONCLUsION The prevalence of dysglycemia-related hospitalization in elderly T2DM patients in Thailand was 4.9%. Close monitoring of blood glucose should be provided in high-risk patients for prevention and early detection for these complications.

关键词： Type 2 diabetes mellitus Hospitalization Diabetes in elderly Dysglycemia Hypoglycemia Hyperglycemia

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