The incidence of chronic kidney disease is increasing worldwide, which greatly increases the risk of end-stage renal disease. It is particularly important to find out the risk factors for the development and progression of chronic kidney disease. Whether gender is a risk factor for the progression of kidney disease remains controversial with inconsistent results in human cohort studies with diabetic or non-diabetic kidney disease. In most of the studies, women seem to exhibit certain gender advantages. Sex hormones, renal hemodynamics and lifestyle differences may play an important role. The underlying mechanism of gender affecting the progression of kidney disease deserves further exploration. This article reviews the gender differences and possible mechanisms in diabetic and non-diabetic chronic kidney disease, in order to provide reference for future research.
The phenomenon of sex differences exists in patients who have abdominal aortic aneurysms (AAA). The occurrence rate of AAA is higher in male, while the rates of rupture and postoperative mortality are higher for female. This phenomenon of sex differences would affect the diagnosis, treatment and postoperative rehabilitation for AAA patients. This article reviewed the recent research status of sex differences on AAA, and explored the phenomenon of sex differences from the aspects of threshold determination, biomechanics and mechanobiology. This review points out that the sex differences on AAA could ascribe to the differences of biomechanical environment and biological properties induced by the vascular size, anatomy structure and structure components of abdominal aortic artery. The comprehensive investigations of the sex differences on AAA could help to optimize the diagnosis, treatment and device design, patient care and rehabilitation strategy of AAA based on sex differences phenomenon.
Objective To explore the impact of gender difference in 90-day outcomes after mechanical thrombectomy for acute cerebral infarction. Methods A prospective registration, observational, and retrospective analysis study was carried out. Patients with acute cerebral infarction who were admitted to the Department of Neurology of the First Affiliated Hospital of Chengdu Medical College and the Department of Neurology of Nanjing First Hospital between June 2015 and June 2019 were collected. Patients were divided into two groups based on gender. The detailed demographic, laboratory examination, imaging examination and clinical data were collected. Then, the data were analyzed using univariate and multivariate logistic regression analyses. Results A total of 298 patients were included. Among them, there were 185 males and 113 females. The differences in age, smoking, atrial fibrillation, using antiplatelet drugs before stroke, TOAST classification, and involved cerebrovascular sites between the two groups were statistically significant (P<0.05), and there was no statistically significant difference in other baseline data between the two groups (P>0.05). The results of univariate logistic regression analysis showed that the rate of 90-day favourable outcome of female patients was lower than that of male patients [odds ratio (OR)=0.462, 95% confidence interval (CI) (0.275, 0.775), P=0.030]. The results of multivariate logistic regression analysis showed that, after adjusting for confounding factors, there was no independent correlation between gender and the 90-day favourable outcome of patients with acute cerebral infarction who underwent mechanical thrombectomy [OR=1.511, 95% CI (0.745, 3.066), P=0.253]. Conclusion The gender has no significant effect on the 90-day favourable outcome of acute cerebral infarction patients treated with mechanical thrombectomy.
ObjectiveTo summarize the research progress of the design and effectiveness of gender-specific prosthesis in total knee arthroplasty (TKA). MethodsThe relevant literature on gender-specific prosthesis in recent years was extensively reviewed and analyzed. ResultsGender-specific prosthesis is designed according to the female knee joint anatomical characteristics. In theory, it should obtain better effectiveness. But a large number of clinical studies have shown that the knee function, pain, and satisfaction has no obvious advantage when compared with conventional prosthesis after TKA for female patient. ConclusionComprehensive evaluation should be considered when gender-specific is selected; and the effectiveness needs further follow-up.
ObjectiveTo investigate the effect of sex on learning and memory ability of newborn mice with hypoxic-ischemic brain injury.MethodsFifty C57BL/6 mice aged 10 days were divided into hypoxia-ischemia group and sham group according to the random number table method, and there were 28 in the hypoxic-ischemic group and 22 in the sham group with half female and half male respectively. In the ischemia-hypoxia group, the left common carotid artery was ligated and then the mice were placed in 34℃ hypoxia chambers with 8% oxygen and 92% nitrogen mixture for 45 minutes. In the sham group, only the skin of the left neck was cut and sutured. After 2 months, Y maze test and Morris water maze test were used to evaluate the learning and memory ability of mice.ResultsThe success rate of the hypoxic-ischemic group was 71.4% (20/28), and that of the sham group was 100.0% (22/22), a total of 42 mice were enrolled in the experiment. In Y maze test, there were differences in entries and total distance of new arms between the two groups (entries: F=16.068, P<0.001; total distance: F=8.532, P=0.007); compared between different groups in the same gender, the entries and total distance of new arms in the hypoxic-ischemic group were lower than those in the sham group with statistically significant differences (entries in males: P=0.001, entries in females: P=0.012; total distance in males: P=0.010, total distance in females: P=0.046). Compared between males and females in the same group, the entries and total distance of new arms of females were higher than those of males in the hypoxic-ischemic group, with statistically significant differences (P=0.039, 0.043). In Morris water maze test, the escape latency of positioning navigation in the hypoxic-ischemic group was higher than that in the sham group, and males showed more obviously poor performance (P<0.001); in the experiment of space exploration, differences were found in the duration of stay and the target quadrant entries between the two groups (duration of stay: F=8.297, P<0.001; entries: F=4.042, P=0.014), and there were statistically significant differences in the same gender males and females in the hypoxic-ischemic group and the sham group (duration of stay in males: P=0.003, duration of stay in females: P=0.038; entries in males: P=0.006, entries in females: P=0.041). Compared between males and females in the same group, the duration of stay and the target quadrant entries of females were higher than those of males in the hypoxic-ischemic group, with statistically significant differences (duration of stay: P=0.018; entries: P=0.032).ConclusionsThe learning and memory ability of newborn mice may be slightly impaired after hypoxic ischemic brain injury. There is significant difference in the effect on learning and memory ability between different genders, and the effect on males is higher than that on females.
【摘要】 目的 探讨男性和女性糖尿病肾病患者危险因素之间的差异。方法 收集2004年1月—2008年12月以糖尿病肾病为诊断的住院患者1 300例,根据入院日期以系统的方法随机纳入650例患者,排除20例尿常规正常和血肌酐值正常的患者,共630例,其中男342例,女288例,平均年龄65岁。288例女性患者中有271例为绝经后妇女,平均年龄48岁。比较女性和男性糖尿病肾病患者危险因素的差别。结果 ①绝经后糖尿病肾病患者占女性患者的94.1%；②女性糖尿病肾病患者组收缩压、脉压及糖化血红蛋白水平高于男性糖尿病肾病患者组,两者有统计学意义(Plt;0.05)；③两组患者在发病年龄,病程,糖尿病家族史,空腹血糖水平,低密度脂蛋白,高密度脂蛋白,血肌酐,24 h尿蛋白定量、是否使用血管紧张素转换酶抑制剂,血管紧张素受体拮抗剂,胰岛素,是否透析,死亡率均无统计学意义(Pgt;0.05)。结论 在女性糖尿病肾病患者中绝经后妇女所占比例较高,女性糖尿病肾病患者收缩压、脉压及糖化血红蛋白水平均高于男性糖尿病肾病患者,雌激素的水平可能导致差异的产生。
ObjectiveTo explore the influence factors of gallstone. MethodsClinical data of 511 patients who were admitted to our hospital from Apr. 2015 to Apr. 2016 were retrospectively analyzed. ResultsOf 511 patients, there were 274 patients with gallstone (gallstone group) and 237 patients without gallstone (control group). Univariate analysis results showed that, no significant difference of age, gender, and diabetes was found between gallstone group and control group (P > 0.050), but the levels of serum total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), and fasting blood glucose (FBG) were significantly higher in patients of gallstone group (P < 0.050), but the level of serum high density lipoprotein (HDL-C) was significantly lower in patients of gallstone group (P=0.001). Logistic regression results showed that four factors including diabetes〔OR=4.491; 95% CI is (2.021, 9.976); P < 0.001〕, the serum TC〔OR=2.548; 95% CI is (1.944, 3.338); P < 0.001〕, HDL-C〔OR=0.115; 95% CI is (0.056, 0.237); P < 0.001〕, and FBG〔OR=1.277; 95% CI is (1.086, 1.502); P=0.003〕 entered the final regression model after controlling confounding factors. The results showed that patients who combined with diabetes, high levels of serum TC and FBG, and low level of serum HDL-C, had higher ratio of galls-tone. ConclusionDiabetes, high-level of serum TC and FBG, low-level of serum HDL-C were risk factors of gallstone.
Objective To investigate the expressions of aldehyde dehydrogenase 1 (ALDH1) and sex determining region Y-box protein 2 (SOX2) in breast cancer tissues and their clinical significance. Methods Immunohistochemistry was used to detect the expressions of ALDH1 and SOX2 protein in cancerous and its paracancer tissues of 80 patients with breast cancer treated in our hospital from 2017 to 2019, and to analyze the correlation between the expressions of ALDH1 and SOX2 protein, as well as the relationship between their expression and clinicopathological characteristics and prognosis of breast cancer patients. Results The positive expression rates of ALDH1 and SOX2 protein in breast cancer tissues were 75.0% and 62.5%, respectively. The positive expression rates of ALDH1 and SOX2 protein in paracancer tissues were 30.0% and 21.3%, respectively. The positive rates of ALDH1 and SOX2 protein expressions in breast cancer tissues were higher than those in paracancer tissues, and the difference was statistically significant (P<0.05). The expressions of ALDH1 and SOX2 proteins in breast cancer tissues were correlated with histological grade, TNM stage and axillary lymph node status of breast cancer (P<0.05). By Spearman correlation analysis, ALDH1 was positively correlated with SOX2 expression (rs=0.507, P<0.001). The univariate analysis of statistically significant indicators and the combination of clinical characteristics of the logistic regression multivariate analysis found that, breast cancer tumor size, histological grade, TNM stage, axillary lymph node status and ALDH1 protein and SOX2 protein expressions were not significantly correlated with those reaching disease-free survival (DFS) after follow-up (P>0.05, which may be affected by small sample size and small number of endpoint events). The Kaplan-Meier method was used to plot survival curves, and log-rank test results showed that the cumulative DFS rates of patients with positive ALDH1 and SOX2 protein expression were lower than those of with negative expression (P<0.05). Conclusions ALDH1 and SOX2 proteins are highly expressed in breast cancer tissues, and they are positively correlated. Survival curves show that positive ALDH1 and SOX2 proteins in breast cancer tissues tend to have a poorer prognosis.
ObjectiveTo analyze the glycated hemoglobin A1c (HbA1c) level among healthy adults in Quanzhou area and explore distribution of HbA1c concentration by age and gender, and establish relevant reference range. MethodsUnder the standardized test of HbA1c, HbA1c concentrations of 1 931 healthy adults were determined by HLC-723 G8 HbA1c analyzer (TOSOH corp, Japan) and its agents. HbA1c levels of different age (18-30, 31-40, 41-50, 51-60, >60) and gender groups were compared, percentile was adopted to establish the corresponding HbA1c reference range of healthy adults in Quanzhou area according to "WS/T402-12-2012. Define and Determine the Reference Interval in Clinical Laboratory" and CLSI C28-A3. ResultsThe total HbA1c levels among healthy adults in Quanzhou area were 3.8%-6.4% (5.31%±0.40%), and the total HbA1c levels among male and female healthy adults in Quanzhou area were 5.55%±0.36% and 5.47%±0.43%, respectively, HbA1c concentration between different gender were statistically significant (P≤0.01). Compared in HbA1c levels of different age (18-30, 31-40, 41-50, 51-60, >60) and gender groups: the difference of HbA1c concentration between different gender in 18-30 years and 31-40 years group was statistically significant (P<0.05) and on the contrary the remaining three age groups were no statistically significant. Compared in HbA1c levels of different age groups in male: the difference of HbA1c concentration between different age groups in 31-40 years and 41-50 years group were no statistically significant (P>0.05), but statistically significant (P<0.05) in the remaining three age groups. The difference of HbA1c concentration between different age groups in female were statistically significant (all P values ≤0.01). The reference intervals of HbA1c for males and females were 4.8%-6.2% and 4.6%-6.3%, respectively, with statistically significant (P=0.000); the reference intervals of HbA1c according to age and gender were: for 18-30 years in males and females were 4.6%-6.0% and 4.4%-6.0%, respectively, with statistically significant (P≤0.01); for 31-40 years in males and females were 4.7%-6.0% and 4.7%-6.2%, respectively, with statistically significant (P≤0.01); for 41-50 years, 51-60 years, >60 years in males and females were no statistically significant (P>0.05), the reference intervals were 4.8%-6.2%, 4.8%-6.4%, and 5.1%-6.4%, respectively. Compared in HbA1c reference intervals in this paper with ADA and Chinese Clinical Operating Program, the difference were statistically significant (P=0.000). ConclusionUnder the standardized test of HbA1c, HbA1c concentrations of age and gender groups of 1 931 healthy adults in Quanzhou area are partial different, the reference interval of HbA1c of age and gender groups for healthy adults in Quanzhou area are established.
Objective To explore the correlation between gender and long-term prognosis of patients with type-B acute aortic dissection (AAD) after endovascular therapy (EVT). Methods From January to December 2012, all patients with type-B AAD undergoing EVT were enrolled by retrospective and observational study. They were divided into male and female groups. Kaplan-Meier analysis was used to analyze the correlation between gender and the cumulative survival rate. Results A total of 131 tyep-B AAD patients who had undergone EVT were selected, including 97 males (74.0%), and 34 females (26.0%). The medium follow-up duration was 2.1 years. Smoking history, cholesterol, white blood cell count, hemoglobin, creatinine and uric acid of the patients in males were higher than those in females (P<0.05); while the difference in other indexes were not significant (P>0.05). The inhospital mortality of male patients was 10 (10.3%), and was 3 (8.8%) in female patients; there was no significant difference between the two groups (P=0.803). Kaplan-Meier analysis showed that there was no significant difference in cumulative survival rate between the two groups (84.5% vs. 82.4%; Logrank test χ2=0.023, P=0.880). Conclusion No correlation between gender and long-term prognosis in patients with type-B AAD after EVT is found.