The incidence of chronic kidney disease is on the rise and has become an important factor affecting global public health issues. The intake of sweet beverage remains high worldwide, which has been proved to be related to chronic health problems such as obesity, type 2 diabetes, some cancers and cardiovascular diseases. In recent years, some studies have found that a higher intake of sweet beverage is associated with chronic kidney disease and its risk factors. This article mainly reviews the current research status and potential mechanisms of the correlation between different types of sweet beverages and risk of chronic kidney disease.
Continuous renal replacement therapy (CRRT) is the treatment of choice for critically ill patients with hemodynamic instability who require renal replacement therapy. This review summarizes the impact of CRRT treatment on nutritional support in critically ill patients, including: energy increase caused by citrate-based anticoagulants, energy loss caused by glucose-free replacement fluid and dialysate, a large amount of amino acids loss in the effluent, and the influences on the way of lipid emulsion administration, capacity, electrolyte, vitamins, and trace elements. It is hoped that the intensive care unit doctors, nephrologists, and nutritionists can fully cooperate to determine the CRRT prescription and the nutritional support prescription.
Renal cancer is a common malignant tumor and the deadliest cancer of the urinary and reproductive system. Given the increasing incidence rate of kidney cancer, timely intervention of its controllable risk factors is crucial. Antimicrobial agent is widely used worldwide, and in recent years, some studies have found that long-term use of antimicrobial agent is associated with an increased risk of kidney cancer. The mechanism may involve multiple factors such as nephrotoxicity of antimicrobial agent and intestinal flora imbalance. This article reviews the relationship between long-term use of antimicrobial agent and risk of kidney cancer, and explores possible mechanisms, to understand the impact of long-term use of antimicrobial agent on the risk of kidney cancer, and to provide more references for early prevention of kidney cancer and rational use of antimicrobial agent.
In recent years, the incidence of hyperlipidemia acute pancreatitis (HLAP) has been increasing year by year, but its pathogenesis has not been completely clear. There are many clinical treatment methods for HLAP, such as lipid-lowering drugs, low molecular weight heparin, insulin, and plasma exchange. Actively reducing serum triglyceride is the core of treatment. Plasma exchange can quickly and effectively reduce the level of triglyceride, and its application in the treatment of HLAP is gradually increasing. This article reviews the recent advances in the pathogenesis, clinical characteristics, diagnosis, and treatment of HLAP, focusing on the mechanism, indications, timing, and disadvantages of plasma exchange therapy for HLAP.
目的：糖尿病周圍神經病變是糖尿病最常見的并發癥，我們對治療2型糖尿病周圍神經病變的有效方法進行了償試。方法:將66例2型糖尿病周圍神經病變患者隨機分為兩組。在常規應用口服降糖藥或胰島素治療的基礎上，治療組加用彌可保500 μg肌注每周3次，前列腺素E1100 μg加入生理鹽水250 mL中靜脈滴注，每日1次；對照組加用維生素B12500 μg肌注每周3次，復方丹參注射液20 mL加入生理鹽水250 mL中靜脈滴注，每日1次，療程均為4周。結果:治療組總有效率82.3%，與對照組比較差異有顯著性（Plt;0.05）。臨床癥狀改善方面，治療組肢體麻木、肢體疼痛改善率分別達72%和75%，明顯高于對照組的37%和44%，感覺減退、多汗、口干、腹瀉、便秘、排尿障礙改善也優于對照組（分別為53%比26%、51%比16%、53%比19%、57%比26%、51%比28%、61%比26%）。結論:彌可保與前列腺素E1合用治療糖尿病周圍神經病變是一種有效的方法。
Type 1 diabetes mellitus (T1DM) is an autoimmune disease in which pancreatic β cells are destroyed, resulting in an absolute lack of insulin. Intestinal microbiota and its metabolites can promote the progression of T1DM by destroying pancreatic β cells, increasing insulin resistance, increasing intestinal permeability, interfering with immune response. Therefore, fecal microbiota transplantation is expected to become a new method for preventing and treating T1DM in the future. This article mainly explores possible pathways for the application of fecal microbiota transplantation in T1DM, including protection of pancreatic β cells, improving insulin resistance, reducing intestinal permeability, and regulating immune responses.
ObjectiveTo summarize the injury characteristics and therapeutic strategy of patients injured in " 8·8” Jiuzhaigou earthquake.MethodsThe clinical data of 48 patients injured in " 8·8” Jiuzhaigou earthquake who were admitted to Mianyang Central Hospital were analyzed retrospectively. There were 25 males and 23 females with an average age of 36 years (range, 5-87 years). The average interval from injury to admission was 30 hours (range, 3-53 hours). The patients from Sichuan province accounted for 45.8% (22 cases), from other province for 52.1% (25 cases), and from abroad for 2.1% (1 case). Patients were primarily hurted by collapsing houses and flying stones. Thirty-seven patients (77.1%) had single injury, mainly involving 36 patients (75.0%) in limbs, and the other 11 patients (22.9%) had multiple injuries. Ten patients (20.8%) had open fractures, including 1 case rated as typeⅠ, 2 as typeⅡ, 3 as type Ⅲa, 2 as type Ⅲb, and 2 as type Ⅲc according to Gustilo classification criteria. The abbreviated injury scale (AIS) score was 2-3 in 37 patients of single injury, and the injury severity score (ISS) was 8-22 (mean, 13.2) in 11 patients of multiple injuries. Sixteen patients (33.3%) were diagnosed as mental disorders by Hamilton rating scale for anxiety (HAMA), including 8 cases had their anxiety scores≥29, 4 cases of 21-28, 3 cases of 14-20, and 1 case of 7-13. Of the 16 patients, 2 showed suicidal tendency.ResultsExcept 2 referrals, 30 patients received operation［28 patients (93.3%) for orthopaedic surgeries］and 16 patients received conservative treatment. The procedures included internal fixation, soft tissue debridement, external fixation, bipolar femoral head replacement, embolization of carotid cavernous sinus arteriovenous fistula, and amputation. Among the 46 patients treated in this hospital, 21 discharged from hospital at 2-12 days (mean, 6.7 days) after admission, the others received further rehabilitation in this hospital or local hospital. No undesirable consequence occurred in 16 patients with mental disorders. Five cases of infection occurred out of hospital were cured after debridement. No dead and nosocomial infection case reported.ConclusionIntensive treatment, specialist management, multidisciplinary team, and early intervention of nosocomial infection and deep venous thrombosis are the key to improve the general level of successful earthquake medical rescue.