目的:观察抗菌素联合疗法结合BMP红外光治疗宫颈糜烂的疗效和作用机理。方法:用抗菌素职合疗法结合BMP红外光治疗宫颈糜烂92例与83例单用BMP红外光作对比。结果:治疗组痊愈率97.83%,对照组为73.49%,两组比较有显著性差异(Plt;0.005)。治疗组副反应明显低于对照组,创面愈合时间与对照组比较有显著性差异(Plt;0.005)。结论:抗菌素联合治疗法结合BMP红外光治疗宫颈糜烂能提高治愈率,减少副反应,加速创面愈合。
Chronic kidney disease (CKD) has been highlighted as one of the most important public health problems due to sharply climbing incidence and prevalence. To efficiently attenuate the disease burden and improve the disease management, not only active and effective treatment should be administrated, but also comprehensive follow-up nursing management with innovative and evolving spirits should be implemented. Thus dynamic changes of diseases could be acquired in time and patients are under appropriate medical instruction as soon as possible. This editorial is based on quickly developing medical big data resources and advanced internet techniques, from both aspects of patients and health care providers, briefly talking about integrated management strategy of CKD and its future development in China.
Acute kidney injury (AKI) is a common critical illness in clinical practice, with complex etiologies, acute onset, and rapid progression. It not only significantly increases the mortality rate of patients, but also may progress to chronic kidney disease. Currently, its incidence remains high, and improving early diagnosis rate and treatment efficacy is a major clinical challenge. Artificial intelligence (AI), with its powerful data processing and analysis capabilities, is developing rapidly in medical field, providing new ideas for disease diagnosis and treatment, and showing great potential in revolutionizing the early diagnosis, condition assessment, and treatment decision-making models in the AKI field. This article will review the application progress of AI in AKI prediction, condition assessment, and treatment decision-making, so as to provide references for clinicians and promote the further application and development of AI in the AKI field.
The patency of vascular access is of great significance to hemodialysis patients. Combining with guidelines and literature associated with vascular access for dialysis in recent years, the authors interpret the effectiveness and limitations of prophylactic drug strategies, including using fish oil, anticoagulation, anti-platelet, lipid-lowering agents, etc., in order to promote the proper use of these agents in clinical practice, and improve the effect of prophylaxis and treatment of vascular access dysfunction.
Objective To investigate the risk factors of high peritoneal transport characteristics in patients with end-stage renal disease undergoing initial continuous ambulatory peritoneal dialysis. Method The clinical data of continuous ambulatory peritoneal dialysis patients who underwent initial peritoneal dialysis and catheterization in the Department of Nephrology, West China Hospital of Sichuan University from January 2011 to December 2017 and completed the peritoneal equilibration test were collected retrospectively. According to the ratio of dialysate to plasma ratio for creatinine at 4 hour [D/Pcr (4h)] in the standard peritoneal equilibration test, the patients were divided into 4 groups (low transport, low average transport, high average transport and high transport). Spearman correlation analysis was used to analyze the related factors of D/Pcr (4h). The risk factors of high peritoneal transport characteristics were analyzed by ordered multi classification logistic regression. Results A total of 647 patients were included. The average age of the patients was (45.85±14.03) years, and the average D/Pcr (4h) was 0.67±0.12. Among them, there were 89 cases (13.76%) in the high transport group, 280 cases (43.28%) in the high average transport group, 234 cases (36.17%) in the low average transport group and 44 cases (6.80%) in the low transport group. Diabetic patients with D/Pcr (4h) were higher than those without diabetes mellitus (0.72±0.12 vs. 0.66±0.12; t=−4.005, P<0.001). Correlation analysis showed that age and 24-h urine volume were positively correlated with D/Pcr (4h); serum albumin, triglyceride, potassium, calcium, magnesium, phosphorus, hemoglobin, serum uric acid and creatinine were negatively correlated with D/Pcr (4h); body surface area (BSA), high sensitivity C-reactive protein, ferritin, cholesterol, sodium, intact parathyroid hormone and estimated giomerular filtration rate had no correlation with D/Pcr (4h). Regression analysis showed that serum albumin [odds ratio (OR)=0.842, 95% confidence interval (CI) (0.809, 0.877), P<0.001], serum uric acid [OR=0.996, 95%CI (0.994, 0.998), P<0.001], magnesium [OR=0.389, 95%CI (0.156, 0.965), P=0.042], BSA [OR=3.916, 95%CI (1.121, 13.680), P=0.032] were correlated with the incidence of peritoneal high transport characteristics. Conclusion Low serum albumin, high BSA, low magnesium and low serum uric acid were independent risk factors for high transport characteristics in initial PD patients.
In 2017, the Acute Dialysis Quality Initiative (ADQI) Consensus Group released a series of guidelines on the topic of "Precision Continuous Renal Replacement Therapy (CRRT)". The updated content in this guideline included four parts: patient selection and timing of CRRT, precision CRRT and solute control, precision fluid management in CRRT, and role of technology for the management of AKI in critically ill patients. This review will interpret the 2017 ADQI guidelines update in detail.
Sepsis is a common clinical critical illness, which often leads to multiple organ damage including the kidney damage, which is difficult to treat and has a high mortality rate. In recent years, extracorporeal blood purification therapy has made some progress in the field of sepsis. There are a variety of blood purification modes to choose, but there is still no unified standard for the initiation timing of blood purification therapy. Clinicians mainly evaluate the indicators and the initiation timing of blood purification therapy according to the patient’s needs for renal function replacement and/or inflammatory mediator clearance. This article mainly summarizes and discusses the initiation timing of blood purification therapy in sepsis.
Acute kidney injury (AKI) presents as a sharp decline in renal function caused by a variety of reasons. It is a severe clinical challenge affecting multiple organs and multiple systems, with high mortality. Continuous renal replacement therapy (CRRT) plays an important role in the treatment of AKI. Limited by the lack of evidence, the timing of CRRT for AKI remains ambiguous. This article reviews the definition and grading of AKI, the indication and the timing of initiation/termination of CRRT for AKI .
Acute kidney injury (AKI) is characterized by a rapid decrease in renal function caused by different etiologies and can involve multiple organs and systems. AKI is a potentially reversible disease. However, it can also progress to chronic kidney disease (CKD) without proper treatment. The concept of acute kidney disease (AKD) is recently recommended as a derivative between AKI and CKD. At present, AKI still lacks specific drug treatment; therefore prevention and early diagnosis are crucial in AKI management. Due to the heterogeneity of the pathogenesis, the epidemiological features of AKI vary across nations and regions, so the strategies for prevention and control are different. This papers reports new progress of epidemiological features of AKI in different countries, so as to provide reference for assessing the disease burden and formulating public health policies.