The efficacy of hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency

The aim of this study was to explore the efficacy and safety of hemodialysis in interventional therapy for patients with coronary artery disease combined with chronic renal insufficiency. With the aging and social development, the number of coronary artery disease patients with chronic renal insufficiency gradually increased. Total 58 coronary heart disease patients with chronic renal dysfunction were selected. These patients were characterized with typical angina symptoms and typical electrocardiogram (ECG) changes of onset angina. Continuous oral administration of sodium bicarbonate tablets 1?g 3/day?×?3 days and slow intravenous input sodium chloride 1000 ～1500 mL 3–12?h before operation were given. By this way, all patients were treated by hydration and alkalization. After percutaneous coronary intervention (PCI) treatment, patients were immediately transferred to undergo 4?h of dialysis treatment without removing indwelling of femoral artery puncture sheath tube to protect renal function. Changes in renal function including serum creatinine, glomerular filtration rate, and urine were observed and recorded. All patients were successfully underwent PCI treatment. Within one month after PCI, there were no obvious complication and no stent thrombosis occurred. Among of 58 patients, 56 cases showed no significant increase in serum creatinine levels compared with those before operation. However, serum creatinine level of one patient increased to 251?umol/L and one patient still required permanent dialysis. Using hemodialysis in interventional therapy in coronary artery disease patients with chronic renal insufficiency could significantly improve the prognosis of the patients.     

中国人群维生素D受体rs7975232和rs1544410位点基因多态性与骨质疏松症相关性的meta分析

目的本研究采用meta分析的方法,探讨了中国人维生素D受体基因多态性与骨质疏松的关系。 方法检索CNKI、万方、维普、Pubmed、Web of Science、Embase数据库,检索时间从建库至2020年3月,从数据库中检索有关维生素D受体（rs7975232和rs1544410）基因多态性和骨质疏松症之间相关性的文章。采用NOS文献质量评价标准对符合纳入排除标准的文献进行质量评价。采用OR值及其95%可信区间（95% CI）评估关联强度。根据是否存在异质性,采用固定效应模型或随机效应模型合并效应量。采用单因素敏感性分析法进行敏感性分析。 结果本研究最终共纳入20项符合条件的研究,包括4 468例病例和4 988名对照。在等位基因模型中,rs7975232和rs1544410的合并OR估计值分别为1.09（95% CI：0.84,1.39,P=0.524）和0.9（95% CI：0.57,1.43,P=0.659）,尚未发现两个位点与骨质疏松症的关联。在显性模型、隐性模型和共显性模型中,结果均未显示二者的相关性。 结论在中国人群中,维生素D受体（rs7975232和rs1544410）基因多态性与骨质疏松风险之间无关联。     

The effect of intradialytic combined exercise on hemodialysis efficiency in end-stage renal disease patients: a randomized-controlled trial

Purpose

Insufficient dialysis is a difficult problem for patients undergoing hemodialysis, and causes cardiovascular complications and increases mortality. Increasing aerobic exercise and resistance exercise have been shown to be beneficial to physical fitness of patients undergoing hemodialysis, but a few studies have focused on combined exercise (combination of aerobic and resistance exercise training) and the interaction effect of combined exercise and intervention duration on hemodialysis efficiency. This study aimed to investigate the effects of 24-week combined exercise on hemodialysis efficiency, blood pressure, exercise capacity, and quality of life in patients undergoing hemodialysis.

Methods

In total, 47 eligible subjects were randomly allocated to exercise group and control group. The intervention group performed a 24-week, three times weekly, and moderate-intensity intradialytic combined exercise. Patients in the control group received usual care. The primary outcome was hemodialysis efficiency, which recorded every 4 weeks. Secondary outcomes included blood pressure, exercise capacity, and quality of life, measured at baseline and after 24 weeks of intervention.

Results

In intervention group, sp Kt/V significantly improved by 13.2%, and systolic blood pressure and diastolic blood pressure significantly decreased by 8.5 mmHg and 6.5 mmHg, respectively. The 6-min walking distance increased significantly by 43 m (9.8%), but there was no significant change in quality of life.

Conclusion

Combined exercise and intervention duration had an interaction effect on hemodialysis efficiency. Combined exercise improved blood pressure and physical fitness for patients undergoing hemodialysis, but did not affect quality of life. The extensive benefits of combined exercise provide evidence for the exercise development for patients undergoing hemodialysis.

     

Studies on the inhibitory models of pyrazoline derivatives as EGFR kinase inhibitors by 3D-QSAR and molecular docking

The development of EGFR kinase inhibitors attracts much attention of research for treating of cancer in recent years. In this work, based on a dataset composed of 46 EGFR kinase inhibitors, the combination of three-dimensional quantitative structure–activity relationship (3D-QSAR), molecular docking was applied to reveal structural characteristics impacting the inhibitory activity of EGFR, and to provide a better understanding of the binding modes between inhibitors and EGFR kinase. 3D-QSAR models of pyrazoline derivatives were established to reveal how steric, electrostatic, hydrophobic, and H-bond acceptor interactions contribute to inhibitors’ bioactivities, which were unanimous in the docking results. Furthermore, based on the most active compound, several new molecules with high inhibitory activity were obtained.     

全胃多发类癌一例

1 临床资料 患者女,46岁。因进食后腹胀小适1年余,期间无腹痛、恶心、呕吐、反酸、暖气、呕血、黑便等症状,于当地乡镇卫生院就诊,行上消化道钡餐造影检查,诊断为慢性萎缩性胃炎,给予促胃肠动力、抑酸、保护胃黏膜等保守治疗后症状缓解。此后反复发作腹胀不适,为求进一步诊断与治疗患者于2012年8月28日来我院普通外科就诊。患者自述慢性萎缩性胃炎病史10余年、体格检查：胸部和腹部均无阳性体征。     

A comparison of biomechanical changes on femoral head following rotational acetabular osteotomy and eccentric rotational acetabular osteotomy in normal cadaveric hip

Purpose

Both rotational acetabular osteotomy (RAO) and eccentric rotational acetabular osteotomy (ERAO) are effective procedures for young patients with developmental dysplasia of the hip. However, no comparative study of biomechanical changes has been reported following these two procedures. We therefore explored the stress changes on femoral head after RAO and ERAO under different load conditions.

Materials and methods

Twelve female cadaveric hips without deformity were divided into RAO group and ERAO group. Stress value on femoral head was measured preoperatively and postoperatively after the vertical force was loaded on the cadaveric spine from 0 to 500 N. Stress change value was then calculated base on the measurements.

Results

In the RAO group, preoperative stress increased when loading on spine became larger, but postoperative stress changed its increasing trend into decreasing when the load was greater than 200 N (turning point). Same phenomenon was found in the ERAO group (turning point was 300 N). However, the difference between preoperative and postoperative stress was not statistically significant in both RAO and ERAO groups. Stress change value from each procedure showed similar trends. With the load growth, stress change increased firstly and then decreased, but the difference between RAO and ERAO was not statistically significant.

Conclusions

Both RAO and ERAO could correct the abnormal biomechanical effect of dysplastic hip; moreover, they may have similar biomechanical effects on femoral head, obtaining the same clinical outcomes. Non-biomechanical factors (surgical trauma, technical complexity, etc.) also play important roles in procedure selection.     

眼黏膜相关淋巴瘤并骨髓侵犯一例伴文献分析

目的观察眼附属器黏膜相关淋巴瘤的临床特点。方法报告1例双眼同时起病的眼附属器黏膜相关样淋巴组织（MALT）结外边缘区B细胞淋巴瘤（OAML）并骨髓侵犯一例,结合文献对该类型淋巴瘤病因、临床表现、免疫组化、分子生物学改变、治疗进行探讨。结果OAML大部分为局限性病变,单侧多见,晚期播散型少见。结论OAML为惰性过程,相关至死率低,对于IE可给予放疗,加用免疫化学治疗可降低复发,对于IVE期患者需全身化疗,总体预后良好。