Prevalence and risk factors of restless legs syndrome in peritoneal dialysis patients

Objective To investigate the prevalence of restless legs syndrome (RLS) in peritoneal dialysis patients and analyze the related risk factors. Methods This study was a cross-sectional study. The patients receiving maintenance peritoneal dialysis from January 2017 to December 2017 in the Peritoneal Dialysis Center of the Second Hospital Affiliated to Soochow University were selected as the study subjects. RLS was screened for peritoneal dialysis patients by epidemiological field investigation based on the RLS diagnostic criteria of the International Restless Leg Syndrome Research Group in 2014. Clinical data and laboratory examinations of selected patients were collected and the differences of clinical indicators between RLS and non-RLS patients were compared. The risk factors related to RLS were analyzed by logistic regression. Results Seventy-six cases of RLS were screened out from 396 PD patients. The prevalence of RLS was 19.2%. Compared with non-RLS group, RLS group patients had longer dialysis age, less 24 hours urine volume, and elevated blood intact Parathormone (iPTH) and alkaline phosphatase (AKP) (all P﹤0.05). There was no significant difference in primary disease ratio, sex, age, body mass index, blood pressure, hemoglobin, creatinine, urea nitrogen, uric acid, ferritin, serum iron, transferrin saturation, blood calcium, blood phosphorus, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein, eGFR, Kt/V, Ccr between RLS and non-RLS group patients (all P﹥0.05). Multivariate logistic regression analysis showed that long dialysis age (OR=1.010, 95%CI 1.001-1.018, P=0.022) and high blood AKP (OR=1.005, 95%CI 1.001-1.010, P=0.021) were independent risk factors for RLS in peritoneal dialysis patients (both P﹤0.05). Conclusions The prevalence of RLS is high in peritoneal dialysis patients. Long dialysis age and high blood AKP are independent risk factors for RLS.     

互联网远程管理对社区高血压患者治疗依从性影响的研究进展

高血压是严重危害人类健康的慢性病之一，全球范围内有较高的发病率和致死率，且控制率低，尤其在欠发达国家和地区。有效的高血压管理是提高患者治疗依从性和影响血压控制率的关键。随着互联网在全世界的发展，传统基于医生诊室管理高血压患者治疗依从性的模式在发生改变，本文综合探讨了国内外互联网远程管理对高血压患者治疗依从性的影响，分析得出互联网远程管理对高血压患者治疗依从性在健康教育、经济、医患沟通、随访等方面存在优势，但存在使用障碍、数据不准确、研究证据有限、安全性可靠性不能保证等挑战与不足，并提出展望，以期将互联网远程管理更好地应用于社区高血压患者的管理。     

DASH饮食模式治疗高血压的研究进展与挑战

高血压是心血管疾病中导致全球疾病负担及死亡的主要原因，但全球的高血压控制率均较低。终止高血压（DASH）饮食常作为国际高血压联盟及多国高血压防治指南推荐的一线非药物控制血压措施，但因推广性较差、患者依从性低难以有效发挥其作用。改良DASH饮食契合不同的饮食文化和疾病特殊需求，有利于提升饮食外推性、治疗效果及患者依从性。但DASH饮食的改良方法繁多，目前的研究显示其对高血压相关危险因素的防治效果并不统一。本文从改良DASH饮食起源与发展、改良DASH饮食的效果、改良DASH饮食目前的挑战及展望进行阐述，以期为改良DASH饮食降压效果提供依据，为未来改良DASH饮食研究方向提供参考。     

2012年全球上市新药

对2012年全球上市新药的基本信息，包括通用名、商品名、结构式、CAS号、研发公司、上市国家和主要适应证进行汇总，为新药研发工作者提供参考。     

乳腺浸润性小叶癌的临床病理特征、诊疗现状及展望

乳腺癌是目前全球范围内发病率最高的恶性肿瘤，且组织学类型多样。乳腺浸润性小叶癌（ILC）是第二大常见浸润性乳腺癌组织学亚型（占5%~15%），近三十年来其发病率有所升高。E-钙黏蛋白表达缺失是乳腺ILC最主要的分子特征，可导致细胞间缺乏黏附性、肿瘤呈特殊弥漫性浸润生长，这给临床查体及影像学检查带来了一定挑战。尽管多数乳腺ILC患者激素受体呈阳性表达、对内分泌治疗反应良好，但也存在内分泌治疗耐药问题。此外，近年研究证实乳腺ILC患者预后并非如既往研究报道的那样良好，仅基于肿瘤分期及分子分型的治疗原则似乎并不完全适用于乳腺ILC，可能有必要将其作为独立的临床实体行进一步研究。本文主要综述了乳腺ILC的流行病学及临床特征、病理学及分子特征、诊断、治疗、预后、未来治疗方向等，以供临床医师更好地了解并优化乳腺ILC的临床诊断和个体化治疗参考。     

以患者为中心 加强医院党建工作

党的先进性建设是党建的重要内容,更是医院建设的核心内容,在医院党的建设过程中贯彻党的先进性,在党的建设实践中体现党的群众路线,以患者为中心,以党的群众路线教育实践为载体,加强党的先进性建设,是本院党建工作的重大创新。     

血清胱抑素C作为肾功能指标预测万古霉素谷浓度效能评估

目的 探讨应用血清胱抑素C（Cys C）作为肾功能指标预测万古霉素血药谷浓度的临床效用。方法收集81例接受万古霉素治疗的住院患者万古霉素血药谷浓度（Cmea）、血清肌酐（Scr）浓度、Cys C浓度，根据Scr或Cys C浓度结合Bayesian反馈法通过NONMEM软件预测万古霉素血药谷浓度（Cpre），比较预测Cpre与实测Cmea的相关性和差别。结果患者基于Scr或Cys C预测的Cpre与实测Cmea间均存在相关性（r=0.678，P<0.01；r=0.727，P<0.01）；基于Scr的平均预测误差（ME）、平均绝对误差（MAE）、均方根误差（RMSE）分别为-5.79，6.86，9.86 μg.mL-1，基于Cys C的ME、MAE、RMSE则分别为-0.82，5.42，7.74 μg.mL-1。结论Cys C 是一项良好的肾功能指标，可用于预测万古霉素血药浓度，指导临床用药。     

Diagnostic value of neutrophil gelatinase-associated lipocalin,cystatin C,and soluble triggering receptor expressed on myeloid cells-1 in critically ill patients with sepsis-associated acute kidney injury

IntroductionNeutrophil gelatinase-associated lipocalin (NGAL), cystatin C (Cys-C), and soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) are novel diagnostic biomarkers of acute kidney injury (AKI). We aimed to determine the diagnostic properties of these biomarkers for detecting AKI in critically ill patients with sepsis.MethodsWe divided 112 patients with sepsis into non-AKI sepsis (n = 57) and AKI sepsis (n = 55) groups. Plasma and urine specimens were collected on admission and every 24 hours until 72 hours and tested for NGAL, Cys-C, and TREM-1 concentrations. Their levels were compared on admission, at diagnosis, and 24 hours before diagnosis.ResultsBoth plasma and urine NGAL, Cys-C, and sTREM-1 were significantly associated with AKI development in patients with sepsis, even after adjustment for confounders by using generalized estimating equations. Compared with the non-AKI sepsis group, the sepsis AKI group exhibited markedly higher levels of these biomarkers at diagnosis and 24 hours before AKI diagnosis (P <0.01). The diagnostic and predictive values of plasma and urine NGAL were good, and those of plasma and urine Cys-C and sTREM-1 were fair.ConclusionPlasma and urine NGAL, Cys-C, and sTREM-1 can be used as diagnostic and predictive biomarkers for AKI in critically ill patients with sepsis.     

Emergence of a virulent porcine reproductive and respiratory syndrome virus in Taiwan in 2018

In March 2018, an abortion storm caused by porcine reproductive and respiratory syndrome virus was confirmed in a farrow‐to‐finish pig herd in Taiwan. Open reading frame 5 and non‐structural protein 2 of the virus confirmed that the virus is closely related to the virulent strains circulating in the United States.