Prevalence of pulmonary hypertension in patients with chronic kidney disease without dialysis: a meta-analysis

Purpose

Recent epidemiological evidence attempts to demonstrate the risk of pulmonary hypertension (PH) among patients with chronic kidney disease (CKD) without dialysis, but prevalence estimates of PH in CKD without dialysis vary widely in the existing studies. This meta-analysis was to summarize the point prevalence of PH in adults with CKD without dialysis.

Methods

PubMed, EMBASE, the Cochrane Collaboration, and the reference lists of relevant articles were searched to identify eligible studies. We used a random-effect meta-analysis model to estimate the prevalence of PH. Associations were tested in subgroups and meta-regression analyses. We also performed sensitivity analyses and assessments of publishing bias.

Results

Twenty-one observational studies (n?=?8012 participants) were included in this meta-analysis. The result of analysis in random-effect model showed that the pooled prevalence was 32% (95% CI 23–42%), with significant heterogeneity between these studies (I²?=?98%, P?<?0.01). Stratified analyses found that the study design, region, sample size, year of publication, and definition of PH based on PASP?≥?35 mmHg may explain the variation between studies. Sensitivity analysis further demonstrated the results to be robust. There was no evidence of publication bias.

Conclusions

PH is highly prevalent in patients with CKD without dialysis. Owing to the high heterogeneity, future well-designed and large prospective studies are encouraged to confirm the findings and definitively clarify the potential biological mechanisms.

     

血必净、乌司他丁联合治疗对老年重症急性胰腺炎患者动脉血乳酸水平和预后影响的临床研究

目的:观察血必净、乌司他丁联合治疗对老年重症急性胰腺炎患者动脉血乳酸和预后的影响。方法:58例老年重症急性胰腺炎患者随机分为2组,A组(28例)进行常规治疗+静脉滴注血必净100 mL,bid,连用10 d;B组(30例)在A组治疗的基础上加用乌司他丁60万U,静脉滴注,bid,连用10 d,2组患者分别于治疗前及治疗后第3,7,10天行动脉血乳酸检测,并于治疗后第10天进行APACHEⅡ评分、观察10 d内死亡率。结果:2组患者治疗后动脉血乳酸水平与同组治疗前比较显著降低,差异有显著性(P<0.01),治疗7 d后B组动脉血乳酸水平与A组比较下降更加明显,差异有显著性(P<0.05),治疗后第10 d APACHEⅡ评分及10 d内死亡率比较,B组显著优于A组,差异有显著性(P<0.05)。结论:血必净、乌司他丁联合治疗可以显著降低老年重症急性胰腺炎患者动脉血乳酸水平,改善预后。     

复方山茱萸胶囊的成型工艺研究

目的:确定复方山茱萸胶囊的最佳成型工艺.方法:通过对不同辅料对流动性,吸湿性,成型性的考察筛选制备颗粒的辅料,优选最佳制粒成型工艺,并测定临界相对湿度.结果:最佳成型工艺为浸膏粉∶微晶纤维素∶磷酸氢钙=1:0.12:0.03,生产环境的相对湿度宜控制在62%以下.结论:本试验确定的成型工艺能为其实际大生产提供依据.     

复方苍术汤对糖尿病大鼠肾脏非酶糖基化终末产物的影响

目的观察中药复方苍术汤对糖尿病大鼠肾脏非酶糖基化终末产物（AGEs）的影响。方法小剂量链脲佐菌素（STZ）注射加高糖高脂喂养建立糖尿病大鼠模型,给予复方苍术汤喂养8周,观察各组大鼠肾组织AGEs含量、肾重指数和空腹血糖的变化。结果复方苍术汤组大鼠的肾组织AGEs含量、肾重指数、血糖均较模型组降低（P〈0.01）。结论复方苍术汤降低糖尿病大鼠肾脏组织AGEs水平,其作用机制可能与降低血糖有关。     

中药逆转肝癌多药耐药的研究现状

Multi-drug resistance (MDR) is a major obstacle in the chemotherapy of hepatocellular carcinoma. Comparing with western reversal agents, traditional Chinese medicine have advantages of low cost, hypotoxicity, wide safety range, broad-spectrum and multi-targets, etc. Therefore, traditional Chinese medicine may be expected to open up a new path to reverse MDR of liver cancer. Studies about applying traditional Chinese medicine to reverse MDR in hepatocellular carcinoma are outlined below.     

论药品不良反应信息通报制度的目的与作用

目的:利用《药品不良反应(ADR)信息通报》,进一步发挥药物警戒与干预的作用,有效避免或减少ADR。方法:收集国家ADR监测中心自2001年11月～2009年5月发布的共22期《ADR信息通报》,运用Excel软件进行数据分类统计,探讨《ADR信息通报》制度的目的与作用。结果:《ADR信息通报》的定期公布,使ADR病例报告数量显著提高,但同时也存在政府监管部门与临床用药单位信息反馈滞缓,部分药品反复通报但ADR仍重复发生与蔓延等现象。被通报药品中,中药ADR居多,占25%以上;重复通报的14个药品中,中药高达50%。结论:需进一步采取多种形式加强ADR的宣传与培训,使医务人员有效利用《ADR信息通报》,确保公众用药安全。     

某生物制品所工作人员体检结果分析

目的探讨某生物制品所职工不同年龄组常见疾病（脂肪肝、肝囊肿、胆结石、胆息肉及肾结石）分布状况。方法用超声诊断仪及生化分析仪对862名受检人员进行健康检查。结果40岁以上组工作人员脂肪肝、肝囊肿、胆结石、胆息肉及肾结石的发病率明显高于30岁以下组和30～40岁组,其血脂和肝功能不良也明显增加。结论该生物制品所工作人员的脂肪肝、肝囊肿、胆结石、胆息肉及肾结石发病率以及血脂异常和肝功能不良随年龄增加而增高。     

Role of Micro RNAs in the Pathogenesis of Rheumatoid Arthritis: Novel Perspectives Based on Review of the Literature

The contributions of micro RNAs (miRNAs) to rheumatoid arthritis (RA) are beginning to be uncovered during the last decade. Many studies in efforts to use miRNAs as biomarkers in disease diagnosis, prognosis, and treatment are ongoing.We conducted a systematic literature review to reveal the role of miRNAs in the pathogenesis of RA in order to inform future research.We analyzed all the literature which is searched by keywords “microRNA” and “arthritis” in PubMed from December 2007 to June 2015, and the references cited by the articles searched were also considered.Relevant literature focusing on the field of miRNAs and RA was identified. The searching process was conducted by 5 independent investigators. The experts in the field of miRNAs and Rheumatology were involved in the process of analyzing.Relevant literature was analyzed according to the objective of this review and the availability of full text.The crucial role of miRNAs in maintaining immune and inflammatory responses is revealed. In addition, it is now clear that miRNAs are implicated in the development of RA synovial phenotype including synovial hyperplasia and joint destruction. Intriguingly, the biomedical application of several miRNAs may result in the effects of “double-edged sword.” Moreover, there appears to have a feedback loop for expression of some miRNAs related to disease activity in inflammatory milieu of rheumatoid joint.This review underscores the potential importance of miRNAs to diagnosis, prognosis, and treatment of RA. Further investigations are required to identify the unique miRNAs signatures in RA and characterize the mechanisms mediated by miRNAs in the pathology of RA.     

吸烟诱导的慢性支气管炎大鼠模型巨噬细胞炎性蛋白-2及髓过氧化物酶研究

目的制备吸烟诱导的慢性支气管炎大鼠模型,研究大鼠血清髓过氧化物酶(MPO)的变化与巨噬细胞炎性蛋白-2(MIP-2)之间的关系,探讨慢性支气管炎气道炎症形成的可能机制。方法雄性Wistar大鼠随机分为二组:正常对照组、吸烟模型组。采用单纯吸烟的方法建立慢性支气管炎大鼠模型。光镜下观察支气管肺组织病理形态学改变。分析支气管肺泡灌洗液(BALF)细胞计数和分类;用ELISA法测定肺组织匀浆MIP-2质量浓度;用生化比色法测定大鼠血清MPO含量。结果模型组病理形态学改变符合人类慢性支气管炎的特点。与正常组比较,模型组血清MPO及肺组织匀浆MIP-2含量明显升高(P<0.01),模型组血清MPO与BALF中性粒细胞数,肺组织匀浆MIP-2质量浓度成显著正相关(分别为r=0.876及r=0.739;均P<0.01)。结论吸烟诱导的慢性支气管炎大鼠可能通过MIP-2介导中性粒细胞聚集,活化参与气道炎症反应。     

老年糖尿病合并脑卒中的临床分析

目的：探讨老年糖尿病合并脑卒中的临床特点。方法：回顾性对老年2型糖尿病合并脑卒中组、非糖尿病脑卒中组及糖尿病无卒中组的临床病历资料进行分析比较。结果：老年2型糖尿病并脑卒中患者中高血压的发生率（58．0％）高于非糖尿病脑卒中组及糖尿病无卒中组（P〈0．05）。老年糖尿病合并脑卒中组以腔隙性脑梗死及多发脑梗死多见（94．0％）,更容易出现肢体偏瘫（50．0％）、构音障碍（10．0％）和失语（24．0％）。血脂、血糖、尿酸、纤维蛋白原的水平高于糖尿病无卒中组和非糖尿病脑卒中组（P〈0．05）。结论：老年糖尿病合并脑卒中时有特征性临床表现模式,血糖控制不佳,高血压、高血脂、高尿酸、高纤维蛋白原是老年2型糖尿病并发脑卒中主要危险因素．影响预后。