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1.
Locally advanced non-small cell lung cancer (NSCLC), particularly clinical Stage IIIA NSCLC with mediastinal lymph node metastasis, is known to be quite heterogeneous, comprising approximately one-fourth of cases of NSCLC. In this subset, patients with a minor tumor load in the mediastinal lymph nodes, such as microscopically or pathologically proven N2 in the resected specimens, are treated with surgery followed by adjuvant chemotherapy. Meanwhile, the current standard of care for patients with bulky or infiltrative N2 disease is concurrent chemoradiotherapy. The potential role of surgery in multi-modality treatment for clinical N2-Stage IIIA remains controversial. Several prospective clinical trials of this subset have been conducted; however, the heterogeneity of the N2 status and differences in chemotherapy regimens and/or radiation modalities between clinical trials make the results difficult to compare. No optimal chemotherapy regimen has been established to control possible micrometastasis, and radiotherapy is often used to achieve maximum local disease control and minimize post-surgical complications. This review summarizes the findings of prospective clinical trials that assessed the role of surgery in treating clinical N2-Stage IIIA patients within the last two decades and discusses the present status of induction treatment followed by surgery for clinical N2-Stage IIIA NSCLC. 相似文献
2.
The feasibility of applying positive end expiratory pressure within the Bain circuit using an Emerson PEEP valve was studied. It was determined that varying degrees of PEEP may be applied within the Bain circuit using an Emerson PEEP valve during either mechanically or manually controlled ventilation but not during spontaneous breathing. There was some loss of measured tidal volume with increasing PEEP, due primarily to compression gas losses but also from leakage throughout the system. The maximum gas loss was 100 ml per minute at PEEP 15 cm H2O under test conditions. PEEP may be applied between the Bain tubing and the manifold. However, one should then never allow the patient to breathe spontaneously as the PEEP valve presents an obstruction to inspiratory flow. With the PEEP valve relocated between the Bain manifold and the ventilator hose it was found that application of PEEP was possible without this disadvantage, but only during mechanical ventilation. 相似文献
3.
The effects of ethylenediaminetetraacetate (EDTA) were studied in rats. Intravenous infusion of 4.84 mM Na2EDTA increased the urinary excretion of calcium six-fold, phosphorus three-fold and hydroxyproline 55% in 158 g thyroparathyroidectomized (TPTXed) rats. Calcitonin (25 MRC mU/rat/h) abolished the sodium EDTA-induced increase in hydroxyproline excretion, presumptive evidence that sodium EDTA was acting on bone. To determine whether the changes induced by sodium EDTA are due to lowering of plasma calcium, rats were infused with 4.84 mM ethylenebis(oxyethylenenitrilo)tetraacetic acid (EGTA), a more specific calcium chelator. EGTA increased the urinary excretion of calcium and phosphorus (P<0.001) but not hydroxyproline in thyroparathyroidectomized rats. Furthermore, when TPTXed rats were infused with calcium EDTA (4.84 mM Ca2EDTA) in order that ionic calcium concentration would not be altered, hydroxyproline excretion was again markedly increased but phosphorus excretion was decreased by 26%. Since the displacement of the sodium ions in Na2EDTA by calciumin vivo is instantaneous, and since calcium EDTA itself induces collagenolysis, the increase in urinary hydroxyproline excretion due to sodium EDTA cannot be attributed solely to lowering of plasma calcium. From these data two conclusions are drawn. First, sodium EDTA enhances bone breakdown independently of its effect on parathyroid hormone secretion. Second, since bone plays a major role in the maintenance of plasma calcium, interpretation of results should be made with caution in those investigations in which EDTA is used to study calcium homeostasis. 相似文献
4.
Histochemical and biochemical examinations of rectal biopsy specimens were performed in 13 patients with Hirschsprung's disease and in seven with idiopathic constipation and no megacolon. Serum and erythrocyte acetylcholinesterase (AchE) activity in these two groups was compared with that in 30 normal controls. AchE staining of rectal biopsy specimens proved to be a reliable and convenient diagnostic approach in patients with Hirschsprung's disease. Biochemical assay of AchE activity in rectal biopsy specimens was also of value in the diagnosis, however, there was an overlap between Hirschsprung's disease and idiopathic constipation. Erythrocyte AchE activity correlated well with AchE activity in rectal biopsy specimens. Therefore, assays of erythrocyte AchE activity provided useful additional information, especially in screening tests for Hirschsprung's disease. 相似文献
5.
Peipei Li Yan Bai Guangfu Yin Ximing Pu Zhongbing Huang Xiaoming Liao Xianchun Chen Yadong Yao 《Journal of bone and mineral metabolism》2014,32(6):627-635
In the present study, the effects of bone morphogenetic protein-2 (BMP-2), vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) on regulation of rat osteoblast (ROB) maturation in vitro were investigated. It was found that the proliferation, differentiation and mineralization of ROBs were all dose-dependently increased at particular times in the case of treatment with only one growth factor. To investigate the effects of combined treatment, ROBs were treated with either a single application of a relatively high dose of each growth factor, or binary/triple combined applications of relatively low doses of the growth factors. Osteogenic differentiation was significantly promoted in the triple combination treatment of BMP-2, VEGF and bFGF compared with the single or binary combination treatments. The optimal timing of the triple combination to enhance osteogenesis was also tested. When bFGF and VEGF were added in the early stage, and BMP-2 and VEGF were added in the late stage, osteogenic differentiation of ROBs could be enhanced more effectively. These results could be used to construct bone tissue engineering scaffolds that release growth factors sequentially. 相似文献
6.
Aslihan Usumez Beyhan Cengiz Serdar Oztuzcu Tuncer Demir Mutan Hamdi Aras Norbert Gutknecht 《Lasers in medical science》2014,29(6):1807-1813
The aim of the present study was to compare the effectiveness of four different laser wavelengths (660, 810, 980, and 1,064 nm) used for low-level laser therapy (LLLT) on the healing of mucositis in an animal model of wound healing by investigating the expression of platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-β), and blood-derived fibroblast growth factor (bFGF). Thirty-five male Wistar albino rats with a weight of 250–300 g body mass and 5 months old were used in the study. All animals were intraperitoneally injected with 100 mg/kg of 5-fluorouracil (5-FU) on the first day and 65 mg/kg of 5-FU on the third day. The tip of an 18-gauge needle was used in order to develop a superficial scratching on the left cheek pouch mucosa by dragging twice in a linear movement on third and fifth days. After ulcerative mucositis were clinically detected on the animals' left cheek pouch mucosa, the laser therapy was started. Four different laser wavelengths (660 nm, HELBO, Bredent; 810 nm, Fotona XD, Fotona; 980 nm, ARC Fox; and 1,064 nm, Fidelis Plus 3, Fotona) used for LLLT at ED 8 J/cm2 daily from the first to the fourth days. Oval excisional biopsy was taken from the site of the wound, and the expression of PDGF, TGF-β, and bFGF was evaluated. The obtained data were analyzed by one2-way ANOVA, and then Tukey HSD tests were used for pairwise comparisons among groups (α?=?0.05). The one-way ANOVA test indicated that expression values of the growth factors, PDGF and bFGF, were significantly affected by irradiation of different wavelengths of lasers (p?0.001). However, expression value of the TGF-β was not affected by irradiation of different wavelengths of lasers (p?>?0.05). The highest PDGF expression was detected in neodymium-doped yttrium aluminum garnet (Nd:YAG) laser group (p?0.05), and there were no statistically significant differences among the other groups (p?>?0.05). The highest bFGF expression was detected in 980-nm diode and Nd:YAG laser groups (p?0.05), and there were no statistically significant differences among the other groups (p?>?0.05). These findings suggest that low-level Nd:YAG and 980-nm diode laser therapy accelerate the wound healing process by changing the expression of PDGF and bFGF genes responsible for the stimulation of the cell proliferation and fibroblast growth. 相似文献
7.
Yusuke Suzuki Keiichi Matsuzaki Hitoshi Suzuki Keiko Okazaki Hiroyuki Yanagawa Norio Ieiri Mitsuhiro Sato Toshinobu Sato Yoshio Taguma Joe Matsuoka Satoshi Horikoshi Jan Novak Osamu Hotta Yasuhiko Tomino 《Clinical and experimental nephrology》2014,18(5):770-777
Background
The primary abnormal manifestation in immunoglobulin A nephropathy (IgAN) is recurring bouts of hematuria with or without proteinuria. Although immunohistochemical analysis of renal biopsy tissue remains the gold standard not only for diagnosis but also for evaluating the activity of IgAN, new sensitive and reasonably specific noninvasive tests are emerging to guide therapeutic strategy applicable to all stages of IgAN. The present study examined serum levels of galactose-deficient IgA1 (Gd-IgA1) and its immune complex (IgA/IgG-IC) as noninvasive markers for the disease activity.Methods
We enrolled 50 IgAN patients (male 40 %, median age 37 years) showing complete or partial clinical remission after steroid pulse therapy with tonsillectomy (TSP) whose clinical data and serum could be followed up for 3–5 years.Results
Cross-sectional analysis revealed that the degree of hematuria and proteinuria were significantly associated with levels of Gd-IgA1 and levels of IgA/IgG-IC. Longitudinal analysis further showed that from the group of 44 patients with heavy hematuria before TSP, 31 patients showed complete disappearance of hematuria (group A), but the remaining patients did not (group B). Although the levels of Gd-IgA1 and IgA/IgG-IC in the two groups before TSP were similar, percentage decrease of Gd-IgA1 and IgA/IgG-IC levels in group A was significantly higher than in group B.Conclusion
Disease activity of IgAN assessed by hematuria and proteinuria correlated with serum levels and changes of Gd-IgA1 and IgA/IgG-IC. These new noninvasive disease activity markers can be useful for future activity scoring system and guiding therapeutic approaches. 相似文献8.
Pamela M. Choi Raphael C. Sun Josh Sommovilla Jose Diaz-Miron Jun Guo Christopher R. Erwin Brad W. Warner 《Journal of gastrointestinal surgery》2014,18(11):1887-1893
Previously, we have demonstrated that genetically disrupting retinoblastoma protein (Rb) expression in enterocytes results in taller villi, mimicking resection-induced adaption responses. Rb deficiency also results in elevated insulin-like growth factor-2 (IGF-2) expression in villus enterocytes. We propose that postoperative disruption of Rb results in enhanced adaptation which is driven by IGF-2. Inducible, intestine-specific Rb-null mice (iRbIKO) and wild-type (WT) littermates underwent a 50 % proximal small-bowel resection (SBR) at 7–9 weeks of age. They were then given tamoxifen on postoperative days (PODs) 4–6 and harvested on POD 28. The experiment was then repeated on double knockouts of both IGF-2 and Rb (IGF-2 null/iRbIKO). iRbIKO mice demonstrated enhanced resection-induced adaptive villus growth after SBR and increased IGF-2 messenger RNA (mRNA) in ileal villus enterocytes compared to their WT littermates. In the IGF-2 null/iRbIKO double-knockout mice, there was no additional villus growth beyond what was expected of normal resection-induced adaptation. Adult mice in which Rb is inducibly deleted from the intestinal epithelium following SBR have augmented adaptive growth. IGF-2 expression is necessary for enhanced adaptation associated with acute intestinal Rb deficiency. 相似文献
9.
Jonathan B. Yuval Abed Khalaileh Mahmoud Abu-Gazala Yair Shachar Andrei Keidar Yoav Mintz Aviram Nissan Ram Elazary 《Obesity surgery》2014,24(12):2134-2137
Background
Gastrointestinal stromal tumor (GIST) is a rare neoplasm of the alimentary tract. Previous reports described an incidence of 1 per 100,000. Laparoscopic sleeve gastrectomy (LSG) provides pathological specimens of the majority of the stomach. We examined the pathology from LSG and the incidence and location of GIST. The aim of this study was to study the incidence of asymptomatic GISTs found during LSG at our institution.Methods
A search was conducted in a prospectively maintained bariatric registry. Data collected included the following: gender, age, body mass index (BMI), and concomitant hypertension or diabetes mellitus. Histopathology reports were reviewed for incidental GIST. We compared the patients with incidental GIST to the rest of the cohort.Results
Pathology reports of 827 patients that underwent LSG between 2007 and 2014 were reviewed. Five patients had GIST in the resected stomach, an incidence of 0.6 %. The group of patients with GIST had lower BMI and older age compared to the remaining 822 patients. All tumors were located close to the lesser curvature.Conclusions
The incidence of GIST found in this cohort is significantly higher than previously reported. This may be due to an association between these tumors and obesity or because asymptomatic GISTs are underdiagnosed in the general population. These tumors are particularly common in older patients and special attention must be given when performing LSG on this subpopulation. The stomach should be inspected thoroughly before resection. A tumor on the lesser curvature may necessitate changing the surgical plan or aborting the procedure. 相似文献10.
Dimitrios Panousis P. Ntasiou D. Grosomanidis K. Chatzopoulos E. Lagoudianakis E. Charitidou G. Xepapadakis 《Hellēnikē cheirourgikē. Acta chirurgica Hellenica》2014,86(5):280-286
Aim
The aim of this study is to describe the characteristics of triple-negative breast cancer (TNBC) among patients of a Greek population and investigate the extent to which international TNBC patterns apply to the particular ethnic group.Material and methods
In this single-centre, retrospective study, medical records of 1455 female patients undergoing breast cancer surgery from 1999 to 2013 were examined in order to identify TNBC patients and evaluate their clinicopathologic characteristics.Results
In total, 91 TNBC patients (6.3%) were identified, with a median age of 50 years, 91.2% of whom had high-grade tumours. Only nine relapses and four deaths occurred during the study period. Overexpression of Ki-67 and p53 was observed in 95.5% and 76.8% of cases, respectively. Significant correlation was found between relapse and age at first breast surgery (p-value = 0.007) and also between Ki-67 and lymph vessel metastasis (p-value = 0.02).Conclusions
Our study revealed that in this specific population of Greek patients with breast cancer, TNBCs are characterized by aggressive prognostic factors such as increased expression of Ki-67, EGFR, mutations of p53, high grade and presence of metastatic disease to the regional lymph nodes with concomitant lymph vessel dissemination. The relationship between young age and TNBC reported in other international studies was not observed here. On the other hand, it seems that there is a strong correlation between age at first diagnosis and age at the time of relapse. 相似文献11.
Katsuhiko Okada Atsuo Yagi Tetsuya Tamio Kunio Sakuramoto Tatsuaki Saigusa Kunio Okajima Akira Yonemitsu Masataka Siraki 《Surgery today》1981,11(4):277-282
A retrospective analysis was performed in order to evaluate diagnostic accuracies by computed tomography (CT) and by endoscopic retrograde cholangiopancreatography (ERCP). Materials studied were 67 lesions out of 56 cases with hepato-biliary and pancreatic diseases confirmed mainly at surgery. Diagnostic accuracy of the CT & ERCP for the hepatobiliary lesions was 59.5% & 86.5% and that of CT & ERCP for the pancreatic lesions was 60% & 80% respectively. CT scan is useful for diagnosing abscess, cyst or tumors. On the contrary, lesions which invade the hepatobiliary tract or pancreatic duct can be readily diagnosed by ERCP examination. ERCP is less useful for the diagnosis of parenchymatous lesions or infiltration of lesions into the surrounding organs. Therefore, the combined use of both CT and ERCP is important for the diagnosis of hepato-biliary or pancreatic disease. 相似文献
12.
13.
A case report of a patient known to have long Q-T syndrome (LQTS) undergoing elective oral surgery is presented. While nitrous oxide-narcotic, nitrous oxide-enflurane, or nitrous oxide-halothane techniques for anaesthetic management of LQTS have been previously reported, we report the use of nitrous oxide-isoflurane for the maintenance of anaesthesia. The authors feel that isoflurane is a safe anaesthetic agent for use in LQTS. 相似文献
14.
Ningning Hou Na Huang Fang Han Jiangang Zhao Xue Liu Xiaodong Sun 《International urology and nephrology》2014,46(10):2045-2051
Purpose
To determine whether adiponectin could reduce microalbuminuria and provide renal protective effects by improving endothelial dysfunction and uncoupling of the glomerular vascular endothelial growth factor (VEGF)–nitric oxide (NO) axis in streptozotocin-induced type 2 diabetic rats.Methods
Wistar rats were randomly divided into normal control group, diabetic nephropathy (DN) group induced by high-fat feeding and streptozotocin, diabetic rats injected with adenovirus-expressed adiponectin (AD-AdipoQ), and diabetic rats injected with AD-IRES-EGFP as control. Blood and urine samples were collected. Endothelium-dependent vasodilatation (EDV) of the aorta was measured. Renal tissues were collected for CD34 immunohistochemistry. Glomerular NO and VEGF levels were measured by the Griess reaction and Western blot testing, respectively.Results
Injections of AD-AdipoQ significantly increased serum adiponectin levels and reduced the urinary albumin-to-creatinine ratio in diabetic rats (P < 0.05). The levels of plasma glucose, serum insulin, high-sensitivity C-reactive protein, and malondialdehyde were significantly reduced in diabetic rats after injections of AD-AdipoQ (P < 0.05). Severe EDV impairment was observed in the DN group, which was improved by AD-AdipoQ. CD34 expression in the glomeruli was also higher in diabetic rats, indicating increased proliferation of glomerular endothelial cells. However, AD-AdipoQ improved the increased proliferation of endothelial cells in the glomeruli. Diabetic rats showed increased glomerular VEGF levels and reduced NO levels. This uncoupling of the VEGF–NO axis was partially improved by AD-AdipoQ.Conclusion
Adiponectin reduces the degree of microalbuminuria and has renal protective effects by improving endothelial dysfunction and uncoupling of the glomerular VEGF–NO axis in early diabetic nephropathy. 相似文献15.
Gabriel Cara-Fuentes Clive H. Wasserfall Heiman Wang Richard J. Johnson Eduardo H. Garin 《Pediatric nephrology (Berlin, Germany)》2014,29(12):2333-2340
Background
Minimal Change Disease (MCD) is associated with CD80 expression in podocytes and elevated urinary CD80 excretion during active renal disease. We have evaluated the urinary excretion of CTLA-4 and CD80 during different stages of the nephrotic syndrome in patients with MCD to test the hypothesis that persistent increased urinary CD80 excretion in patients with MCD in relapse is due to an ineffectual CTLA-4 response of the host to curtail the activation of CD80.Methods
Thirty-two children with biopsy-proven MCD were studied during relapse and/or remission. Eleven healthy subjects served as controls.Results
Urinary CD80 excretion was significantly increased in MCD patients in relapse relative to that in MCD patients in remission (p?0.001) and controls (p?0.001). Although urinary CTLA-4 excretion was higher in MCD patients in relapse than in MCD patients in remission (p?=?0.01) and controls (p?=?0.03), no significant correlation was observed between urinary CD80 excretion and urinary CTLA-4 level in MCD patients at the time of relapse (p?=?0.06). At the time of remission, CD80 had decreased significantly in all patients, but CTLA-4 levels either decreased or remained unchanged in all but five patients, and no correlation was observed between urinary CD80 excretion and CTLA-4 level (p?=?0.7).Conclusions
Urinary CTLA-4 levels do not correlate with urinary CD80 excretion, suggesting the possibility that the CTLA4 response may be suboptimal in this disease during relapse. 相似文献16.
E. Klineberg D. R. Haudenschild K. D. Snow S. Garitty B. A. Christiansen C. Acharya S. Maitra M. C. Gupta 《European spine journal》2014,23(11):2385-2392
Study design
Noggin protein levels and spinal fusion rates were compared in a rabbit model after application of siRNA against BMP antagonist noggin in paraspinal muscle.Objective
To test whether endogenous BMPs are sufficient to form bone in the absence of their antagonists, using noggin siRNA to interrupt the negative feedback loop on endogenous BMP within the paraspinal muscles in rabbits.Summary of background data
Unused Posterolateral lumbar fusion is a standard surgical treatment for many spinal disorders, yet even under ideal conditions the rate of non-fusion approaches 25 %. BMPs are effective in promoting bone formation, and are inhibited by antagonists such as noggin. We have previously shown that in this model, endogenous BMPs are present and endogenous BMP antagonist noggin is strongly increased during spinal fusion. Previous studies have found that noggin siRNA enhanced spinal fusion in combination with supra-physiological amounts of exogenous BMP; however, the effect of the siRNA alone remains unknown.Methods
A posterolateral intertransverse rabbit lumbar fusion was utilized, as established by Boden et al. SiRNA against noggin was electroporated into paraspinal muscle to determine its effect on fusion. Outcome measures included noggin protein expression, and assessment of spinal fusion at 6 weeks.Results
SiRNAs were effective in reducing overexpressed noggin in vitro. Noggin protein was successfully knocked down in vivo for the initial 7 days in our rabbit model and returned to detectable levels by 4 weeks and to normal levels by 6 weeks. The overall fusion rate was not significantly enhanced compared to established controls from our earlier work (Tang et al.).Conclusions
Early noggin suppression does not appear to enhance the BMP activity sufficiently to significantly affect final fusion rates in our model. 相似文献17.
Min-Sheng Piao Jung-Kil Lee Jae-Won Jang Hyuk Hur Shin-Seok Lee LuWei Xiao Hyung-Seok Kim 《Acta neurochirurgica》2014,156(11):2173-2182
Background
Matrix metalloproteinases (MMPs), especially MMP-2 and MMP-9 play an important role in secondary inflammatory reaction and blood–central nervous system (CNS) barrier disruption after spinal cord injury (SCI). Theoretically, it is expected that early blockade of activation of MMPs can provide neuro-protective effects from secondary tissue damage and improve functional neurological outcomes. The aim of this study was to investigate the expression and the activity of MMP-2 and MMP-9, and to determine the regulatory effect of melatonin on MMP expression and activity after photochemically induced SCI in rats.Methods
Female Sprague–Dawley rats weighing between 250 and 300 g (age 8 weeks) received focal ischemia by photothrombosis using Rose Bengal (RB). The injured animals were divided into two groups; one group received 50 mg/kg of melatonin intraperitoneally, starting 1 h after injury and at 12 h intervals for 7 days, while animals in the control group received weight-adjusted doses of a saline vehicle. In each group, the expressions and activities of MMP-2 and MMP-9 were assessed by Western blot and gelatin zymography at various times from 6 h to 3 days. The locomotor function was assessed using the Basso-Beattie-Bresnahan (BBB) scale at 3 days after SCI and then once per week for 4 weeks. The animals were killed at 28 days after the injury, and the histopathology of the lesions was assessed.Findings
The expressions and activities of MMP-9 were increased at 6, 24, 48, and 72 h after SCI in the control group. In the melatonin-treated group, the expression of MMP-9 was significantly decreased at 24, 48, and 72 h after SCI compared with the control group, and the activity of MMP-9 was significantly reduced at 72 h after SCI. In contrast, there were no significant changes in the MMP-2 level in both groups during the experimental period. Melatonin treatment following photochemically induced SCI in rats significantly ameliorated the functional deficits. On histopathologic examination, the lesion size in the spinal cord after photothrombotic insult was significantly reduced by melatonin administration.Conclusions
This study showed that the up-regulation of MMP-9 correlated with the secondary damage after SCI in rats. The results of this study suggest that the ability of melatonin to reduce secondary tissue damage is intimately related to the reduction of MMP-9 expression, resulting in functional improvement. 相似文献18.
Haluk Çabuk Arzu Avci Hüseyin Durmaz Fatmagül Kuşku Çabuk Fatih Ertem İ. Muhittin Şener 《Archives of orthopaedic and trauma surgery》2014,134(12):1739-1744
Introduction
Matrix metalloproteinases (MMPs) are involved in physiological events such as restructuring of the tissue, morphogenesis, wound healing and normal developmental process. Use of diclofenac sodium following rotator cuff repair can disrupt healing of tendon through acting on MMPs.Materials and methods
Supraspinatus tendons of rats (n = 84) were detached from their insertion on humerus, and repaired to anatomic footprint. Rats were divided into study group (n = 42) and control group (n = 42). Study group received a dose of 1 mg/kg daily diclofenac sodium subcutaneously. The rats were killed at weeks 1, 3 and 6, and seven rats from each groups were included in biomechanical and immunohistological examinations. Immunohistological staining of MMP-2, MMP-3 and MMP13 were used.Results
Maximum load was reduced in the study group at the end of week 1 (8.76 vs. 5.28 N) (p = 0.01). MMP-3 level was statistically significantly lower in the study group at the end of week 1. MMP-13 level and stiffness decreased towards week 6 in the study group while in the control group the level of MMP-2 decreased towards week 6.Conclusion
Diclofenac has an impact on the levels of MMP-2, MMP-3 and MMP-13, which are needed for normal healing process, and it can also lead to disruption of tendon healing. 相似文献19.
Xiurong Li Xianlin Xu Jinfeng Liu Junwei Yang Li Fang Liying Miao Jia Di Xiaozhou He 《International urology and nephrology》2014,46(11):2207-2214
Background
Previous observational studies using differing methodologies have yielded inconsistent results regarding the association between glycemic control and outcomes in diabetic patients receiving maintenance hemodialysis (MHD). The aim of this study was to investigate the association between HbA1c and survival in diabetic MHD patients in Han Chinese population.Methods
A 5-year cohort (October 2007–December 2013) of 236 diabetic MHD patients with HbA1c data was examined for associations between HbA1c and mortality. Death hazard ratios (HR) were estimated using Cox regressions.Results
Two hundred and thirty-six diabetes patients undergoing MHD in clinics over 5 years were included in our study. Unadjusted survival analyses indicated paradoxically lower death HRs with higher HbA1c values. However, after adjusting for potential confounders (demographics, dialysis vintage, comorbidity, anemia, and inflammation), higher HbA1c values were incrementally associated with higher death risks.Conclusions
Poor glycemic control (HbA1c ≥ 8 %) appears to be associated with decreased survival in the general population of diabetic MHD patients. Our study suggests that moderate hyperglycemia increases the risk for all-cause mortality of diabetic MHD patients in Han Chinese population. 相似文献20.
Danielle A. Bischof Yuhree Kim Ramy Behman Paul J. Karanicolas Fayez A. Quereshy Dan G. Blazer III Shishir K. Maithel T. Clark Gamblin Todd W. Bauer Timothy M. Pawlik 《Journal of gastrointestinal surgery》2014,18(12):2123-2129