Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD...Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD)on cognitive function.This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition.This cross-sectional study was conducted via the web-based assessment in Chinese mainland.Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment(ICA)and the Number Ordering Test(NOT).Propensity score matching(PSM)was utilized to match the confounding factors between individuals with and without PCSD.Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function.The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression.A total of 8692 individuals with COVID-19 diagnosis were selected for this study.Nearly half(48.80%)of the COVID-19 survivors reported sleep disturbance.After matching by PSM,a total of 3977 pairs(7954 individuals in total)were obtained.Univariate analyses revealed that PCSD was related to worse ICA and NOT performance(P<0.05).Underlying disease,upper respiratory infection,loss of smell or taste,severe pneumonia,and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals(P<0.05).Furthermore,aging,ethnicity(minority),and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals(P<0.05).PCSD was related to impaired neurocognitive performance.Therefore,appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.展开更多
Background Cognitive-behavioural therapy for insomnia(CBTi)is the first-line treatment for those with this sleep disorder.However,depressive and anxiety symptoms often co-occur with acute insomnia,which may affect the...Background Cognitive-behavioural therapy for insomnia(CBTi)is the first-line treatment for those with this sleep disorder.However,depressive and anxiety symptoms often co-occur with acute insomnia,which may affect the effectiveness of CBTitreatment.Aims This study aimed to determine the impact of depressive and anxiety symptoms on the efficacy of CBTi in treating acute insomnia.Methods A single-arm clinical trial was conducted among individuals who have acute insomnia.Participants underwent self-guided CBTi for 1-week.Their insomnia,depressive symptoms and anxiety symptoms were evaluated using the Insomnia Severity Index and the Hospital Anxiety and Depression Scale at baseline,post-treatment and 3-month follow-up.Repeated measures analysis of variance was used to assess the effectiveness of CBTi in treating insomnia,depressive symptoms and anxiety symptoms.A multivariate Cox regression model was used to determine the impact of depressive and anxiety symptoms on insomnia.Results The study found significant reductions in insomnia,depressive symptoms and anxiety symptoms at both post-treatment and 3-month follow-up(F=17.45,p<0.001;F=36.37,p=0.001;and F=81.51,p<0.001,respectively).The duration of CBTi treatment had a positive impact on insomnia recovery(hazard ratio(HR)=0.94,p=0.018).However,baseline depressive symptoms(HR=1.83,p=0.004)and baseline anxiety symptoms(HR=1.99,p=0.001)had significant negative effects on insomnia recovery.Conclusions The study showed that a 1-week self-guided CBTi treatment is effective in treating acute insomnia and comorbid depressive and anxiety symptoms.However,baseline depressive and anxiety symptoms negatively impact treatment effectiveness.Therefore,clinicians should assess for depressive and anxiety symptoms before treating acute insomnia with monotherapy CBTi.展开更多
Background Febuxostat and allopurinol have different pharmacological mechanisms,the efficacy of febuxostat in chronic kidney disease complicated with hyperuricemia remains controversial.A meta-analysis and systemic re...Background Febuxostat and allopurinol have different pharmacological mechanisms,the efficacy of febuxostat in chronic kidney disease complicated with hyperuricemia remains controversial.A meta-analysis and systemic review was conducted to investigate the efficacy and safety of febuxostat in CKD populations complicated with hyperuricemia.Methods A comprehensive search was conducted in multiple electronic databases based on the inclusion and exclusion criteria,before December 2016,searching for the published studies,including Chinese and English,relating to the use of febuxostat in CKD populations complicated with hyperuricemia,and manual retrieval of the inclusion literature.Literature evaluation and data extraction were performed by two reviewers,Rev Man 5.3 was used to perform the meta-analysis.Results Seven studies with 482 CKD patients were included in the meta-analysis.We found that febuxostat can significantly slow the decreasing speed of e GFR[RR=4.90,95%CI(1.95,7.84),P=0.001],and reduce serum uric acid[RR=-99.30,95%CI(-172.24,-26.37),P=0.008]levels in CKD patients complicated with hyperuricemia when compairing with control group.There was no significant difference in the levels of systolic blood pressure[RR=-2.19,95%CI(-9.99,5.61),P=0.58],diastolic blood pressure[RR=-2.30,95%CI(-7.33,2.73),P=0.10],low density lipoprotein[RR=-0.47,95%CI(-7.64,6.69),P=0.90]between the two groups.Compared with the control group,the use of febuxostat increase the incidence of adverse reaction[RR=4.73,95%CI(1.04,21.43),P=0.04]in patients.Conclusions Febuxostat can significantly lower serum uric acid level and effectively delay the process of chronic renal failure in CKD patients complicated with hyperuricemic,increases the incidence of adverse reaction,no significant difference in SBP,DBP,LDL,when compared with control group.展开更多
Objective Investigate the correlation between serum sclerostinlevel and chronic kidney disease-mineral and bone disorder(CKD-MBD),especially vascular calcification,in maintenance hemodialysis(MHD)patients.Methods This...Objective Investigate the correlation between serum sclerostinlevel and chronic kidney disease-mineral and bone disorder(CKD-MBD),especially vascular calcification,in maintenance hemodialysis(MHD)patients.Methods This is across-sectional study,a total of 72 MHD patients were included from the first affiliated hospital of Jinan university.Measure the biochemical indicators of mineral metabolism,renal function,and serum sclerostin level by ELISA.The abdominal aorta calcification score(AACS)was assessed according to Kauppila method on lateral spine imaging using DEXA.Patients were distributed into two groups according to the level of serum sclerostin:low sclerostingroup(≤125 pg/ml)and high sclerostingroup(>125 pg/ml).Analyze the association of serum sclerostin level with the indicators of CKD-MBD.Results There was significant difference in i PTH level between high sclerost in group and low sclerost in group.Multivariate Logistic regression analysis demonstrated that dialysis duration,male and anuria were independent risk factor of high sclerostin level,and i PTH and Kt/V were protective factors.Conclusion Dialysis duration,man,anuria was independent risk factors and i PTH,Kt/V were protective factors of high serum sclerostin level in MHD patients.There was no correlation between abdominal aorta calcification and serum sclerostin level.展开更多
Calcitonin is a common medicine used in the treatment of osteoporosis,which could restrain the activity of osteoclasts,stop the loss of osteocalcin and reduce the transfer of osteocalcin.Calcitonin can also be used in...Calcitonin is a common medicine used in the treatment of osteoporosis,which could restrain the activity of osteoclasts,stop the loss of osteocalcin and reduce the transfer of osteocalcin.Calcitonin can also be used in the treatment of the pain-caused diseases which usually cause by hypercalcemia and others such like Paget's disease and bone tumors.As is approved by several clinic researches,calcitonin is powerful in adjusting the level of calcium,phosphorus and PTH during the treatment of renal osteodystrophy.In addition,it could improves the life quality of the patients who suffered from chronic kidney disease(CKD)and extending their life period.At present,several studies have shown us Calcitonin could be treated in renal osteodystrophy.However,the treatment experiences of Calcitonin are still lacking.Better understanding of the clinical evaluation for calcitonin in the treatment of renal osteodystrophy will hopefully help us to improve outcomes for these patients.展开更多
Fibroblast growth factor 23(FGF23)is a protein synthesized by bone cell and the osteoblast with endocrine function.The main role of FGF23 is to regulate serum phosphorus and 1,25(OH)2 D3 levels,it also plays an import...Fibroblast growth factor 23(FGF23)is a protein synthesized by bone cell and the osteoblast with endocrine function.The main role of FGF23 is to regulate serum phosphorus and 1,25(OH)2 D3 levels,it also plays an important role in calcium and phosphorus metabolism.The role of FGF23 in renal disease is to inhibit of phosphorus reabsorption,promote urinary phosphorus excretion and maintain a stable blood phosphorus level.Patients with chronic kidney disease(CKD)have more risk to suffer cardiovascular disease(CVD)which is related to the abnormal metabolism of calcium and phosphorus.FGF23,as newly discovered cardiovascular risk marker,several studies have shown that FGF23 level associates with multiple cardiovascular risk factors in CKD patients,especially in CKD patients with vascular calcification.To explore its pathogenesis of vascular calcification in CKD patients is particularly important,and that may help to take appropriate measures to improve the prognosis of CKD patients.展开更多
Female patients,44 years old,due to'regular peritoneal dialysis5 years,stomach ache 1 week'admission.Previous had 2 times for'Peritoneal dialysis related peritonitis'in hospital,after anti-infection tr...Female patients,44 years old,due to'regular peritoneal dialysis5 years,stomach ache 1 week'admission.Previous had 2 times for'Peritoneal dialysis related peritonitis'in hospital,after anti-infection treatment patients symptoms improved and discharged.1 week ago in patients admitted to hospital because of abdominal pain again.Physical:abdominal tenderness,bowel sounds hyperthyroidism.Laboratory inspection index:CRP:172.22 mg/l,WBC:23.26×10~9/L,NEU%:89.23%,D dimer:3 800 ng/ml,PCT:14.86 ng/ml。展开更多
1 Introduction Neuropsychiatric systemic lupus erythematosus(NPSLE)is a serious complication of systemic lupus erythematosus(SLE),with an incidence of about 30%to 40%[1].No matter early or late SLE patients are prone ...1 Introduction Neuropsychiatric systemic lupus erythematosus(NPSLE)is a serious complication of systemic lupus erythematosus(SLE),with an incidence of about 30%to 40%[1].No matter early or late SLE patients are prone to concurrent,so early diagnosis and treatment of NPSLE is extremely important.展开更多
There are 3 kinds of Renal Replacement Therapy:hemodialysis,peritoneal dialysis and kidney transplantation.Although a kidney transplant would be the best solution,organ donations are limited and the transplanted organ...There are 3 kinds of Renal Replacement Therapy:hemodialysis,peritoneal dialysis and kidney transplantation.Although a kidney transplant would be the best solution,organ donations are limited and the transplanted organs can be rejected by the body.Hemodialysis is a widely recognized and near-universally available treatment method,however,the patient must make at least 3 weekly visits to a hospital to undergo treatment,with each session lasting on average around 4 hours.Consequently this can have an impact on the patients’life,including work and travel.Since the clinical populariza-展开更多
基金supported by the National Key R&D Pro-gram of China(No.2021YFC2501500)the National Natural Science Foundation of China(Nos.82271525 and 82071488)the Nanfang Hospital Clinical Research Project of Southern Medical University(No.2021CR009),China。
文摘Despite that sleep disturbance and poor neurocognitive performance are common complaints among coronavirus disease 2019(COVID-19)survivors,few studies have focused on the effect of post-COVID-19 sleep disturbance(PCSD)on cognitive function.This study aimed to identify the impact of PCSD on neurocognitive function and explore the associated risk factors for the worsening of this condition.This cross-sectional study was conducted via the web-based assessment in Chinese mainland.Neurocognitive function was evaluated by the modified online Integrated Cognitive Assessment(ICA)and the Number Ordering Test(NOT).Propensity score matching(PSM)was utilized to match the confounding factors between individuals with and without PCSD.Univariate analyses were performed to evaluate the effect of PCSD on neurocognitive function.The risk factors associated with worsened neurocognitive performance in PCSD individuals were explored using binary logistic regression.A total of 8692 individuals with COVID-19 diagnosis were selected for this study.Nearly half(48.80%)of the COVID-19 survivors reported sleep disturbance.After matching by PSM,a total of 3977 pairs(7954 individuals in total)were obtained.Univariate analyses revealed that PCSD was related to worse ICA and NOT performance(P<0.05).Underlying disease,upper respiratory infection,loss of smell or taste,severe pneumonia,and self-reported cognitive complaints were associated with worsened neurocognitive performance among PCSD individuals(P<0.05).Furthermore,aging,ethnicity(minority),and lower education level were found to be independent risk factors for worsened neurocognitive performance in PCSD individuals(P<0.05).PCSD was related to impaired neurocognitive performance.Therefore,appropriate prevention and intervention measures should be taken to minimize or prevent PCSD and eliminate its potential adverse effect on neurocognitive function.
基金supported by the National Key R&D Program of China(BZ:grant number 2021YFC2501500)the Basic and Applied Basic Research Project of Guangzhou Basic Research Program(CZ:grant number 202201011502)+2 种基金the National Natural Science Foundation of China(BZ:grant number 82271525)Nanfang Hospital Clinical Research Project of Southern Medical University(BZ:grant number 2021CR009)the Education Research Projects of Nanfang Hospital(BZ:grant number 21NJ-ZDPY01).
文摘Background Cognitive-behavioural therapy for insomnia(CBTi)is the first-line treatment for those with this sleep disorder.However,depressive and anxiety symptoms often co-occur with acute insomnia,which may affect the effectiveness of CBTitreatment.Aims This study aimed to determine the impact of depressive and anxiety symptoms on the efficacy of CBTi in treating acute insomnia.Methods A single-arm clinical trial was conducted among individuals who have acute insomnia.Participants underwent self-guided CBTi for 1-week.Their insomnia,depressive symptoms and anxiety symptoms were evaluated using the Insomnia Severity Index and the Hospital Anxiety and Depression Scale at baseline,post-treatment and 3-month follow-up.Repeated measures analysis of variance was used to assess the effectiveness of CBTi in treating insomnia,depressive symptoms and anxiety symptoms.A multivariate Cox regression model was used to determine the impact of depressive and anxiety symptoms on insomnia.Results The study found significant reductions in insomnia,depressive symptoms and anxiety symptoms at both post-treatment and 3-month follow-up(F=17.45,p<0.001;F=36.37,p=0.001;and F=81.51,p<0.001,respectively).The duration of CBTi treatment had a positive impact on insomnia recovery(hazard ratio(HR)=0.94,p=0.018).However,baseline depressive symptoms(HR=1.83,p=0.004)and baseline anxiety symptoms(HR=1.99,p=0.001)had significant negative effects on insomnia recovery.Conclusions The study showed that a 1-week self-guided CBTi treatment is effective in treating acute insomnia and comorbid depressive and anxiety symptoms.However,baseline depressive and anxiety symptoms negatively impact treatment effectiveness.Therefore,clinicians should assess for depressive and anxiety symptoms before treating acute insomnia with monotherapy CBTi.
基金Guangzhou Development Zone entrepreneurship leading talent project(2017-L153)Guangdong University blood purification technology and Engineering Research Center(GCZX-A1104)+2 种基金Guangzhou entrepreneurial leader talent/LCY201215Guangdong Provincial Center for clinical engineering of blood purification(507204531040)Guangdong Obers Blood Purification Academician Work station(2013B090400004)
文摘Background Febuxostat and allopurinol have different pharmacological mechanisms,the efficacy of febuxostat in chronic kidney disease complicated with hyperuricemia remains controversial.A meta-analysis and systemic review was conducted to investigate the efficacy and safety of febuxostat in CKD populations complicated with hyperuricemia.Methods A comprehensive search was conducted in multiple electronic databases based on the inclusion and exclusion criteria,before December 2016,searching for the published studies,including Chinese and English,relating to the use of febuxostat in CKD populations complicated with hyperuricemia,and manual retrieval of the inclusion literature.Literature evaluation and data extraction were performed by two reviewers,Rev Man 5.3 was used to perform the meta-analysis.Results Seven studies with 482 CKD patients were included in the meta-analysis.We found that febuxostat can significantly slow the decreasing speed of e GFR[RR=4.90,95%CI(1.95,7.84),P=0.001],and reduce serum uric acid[RR=-99.30,95%CI(-172.24,-26.37),P=0.008]levels in CKD patients complicated with hyperuricemia when compairing with control group.There was no significant difference in the levels of systolic blood pressure[RR=-2.19,95%CI(-9.99,5.61),P=0.58],diastolic blood pressure[RR=-2.30,95%CI(-7.33,2.73),P=0.10],low density lipoprotein[RR=-0.47,95%CI(-7.64,6.69),P=0.90]between the two groups.Compared with the control group,the use of febuxostat increase the incidence of adverse reaction[RR=4.73,95%CI(1.04,21.43),P=0.04]in patients.Conclusions Febuxostat can significantly lower serum uric acid level and effectively delay the process of chronic renal failure in CKD patients complicated with hyperuricemic,increases the incidence of adverse reaction,no significant difference in SBP,DBP,LDL,when compared with control group.
文摘Objective Investigate the correlation between serum sclerostinlevel and chronic kidney disease-mineral and bone disorder(CKD-MBD),especially vascular calcification,in maintenance hemodialysis(MHD)patients.Methods This is across-sectional study,a total of 72 MHD patients were included from the first affiliated hospital of Jinan university.Measure the biochemical indicators of mineral metabolism,renal function,and serum sclerostin level by ELISA.The abdominal aorta calcification score(AACS)was assessed according to Kauppila method on lateral spine imaging using DEXA.Patients were distributed into two groups according to the level of serum sclerostin:low sclerostingroup(≤125 pg/ml)and high sclerostingroup(>125 pg/ml).Analyze the association of serum sclerostin level with the indicators of CKD-MBD.Results There was significant difference in i PTH level between high sclerost in group and low sclerost in group.Multivariate Logistic regression analysis demonstrated that dialysis duration,male and anuria were independent risk factor of high sclerostin level,and i PTH and Kt/V were protective factors.Conclusion Dialysis duration,man,anuria was independent risk factors and i PTH,Kt/V were protective factors of high serum sclerostin level in MHD patients.There was no correlation between abdominal aorta calcification and serum sclerostin level.
基金Guangzhou Development Zone entrepreneurship leading talent project(2017-L153)Guangdong University blood purification technology and Engineering Research Center(GCZX-A1104)+2 种基金Guangzhou entrepreneurial leader talent/LCY201215Guangdong Provincial Center for clinical engineering of blood purification(507204531040)Guangdong Obers Blood Purification A cademician Work station(2013B090400004)
文摘Calcitonin is a common medicine used in the treatment of osteoporosis,which could restrain the activity of osteoclasts,stop the loss of osteocalcin and reduce the transfer of osteocalcin.Calcitonin can also be used in the treatment of the pain-caused diseases which usually cause by hypercalcemia and others such like Paget's disease and bone tumors.As is approved by several clinic researches,calcitonin is powerful in adjusting the level of calcium,phosphorus and PTH during the treatment of renal osteodystrophy.In addition,it could improves the life quality of the patients who suffered from chronic kidney disease(CKD)and extending their life period.At present,several studies have shown us Calcitonin could be treated in renal osteodystrophy.However,the treatment experiences of Calcitonin are still lacking.Better understanding of the clinical evaluation for calcitonin in the treatment of renal osteodystrophy will hopefully help us to improve outcomes for these patients.
基金Construction of collaborative platform for clin ical re search and clinical research of blood purification(201604020175)Guang dong University blood purification tech nology and Engineering Research Center(GCZX-A1104)+2 种基金Guangdong Obers Blood Purification A ca demi cian Work station(2013B090400004)Guangdong Provincial Center for clinical en gineering of blood purification(507204531040)Guangzhou entrepreneurial leader talent/LCY201215
文摘Fibroblast growth factor 23(FGF23)is a protein synthesized by bone cell and the osteoblast with endocrine function.The main role of FGF23 is to regulate serum phosphorus and 1,25(OH)2 D3 levels,it also plays an important role in calcium and phosphorus metabolism.The role of FGF23 in renal disease is to inhibit of phosphorus reabsorption,promote urinary phosphorus excretion and maintain a stable blood phosphorus level.Patients with chronic kidney disease(CKD)have more risk to suffer cardiovascular disease(CVD)which is related to the abnormal metabolism of calcium and phosphorus.FGF23,as newly discovered cardiovascular risk marker,several studies have shown that FGF23 level associates with multiple cardiovascular risk factors in CKD patients,especially in CKD patients with vascular calcification.To explore its pathogenesis of vascular calcification in CKD patients is particularly important,and that may help to take appropriate measures to improve the prognosis of CKD patients.
基金Guangzhou Development Zone entrepreneurship leading talent project(2017-L153)Guangdong University blood purification technology and Engineering Research Center(GCZX-A1104)+2 种基金Guangzhou entrepreneurial leader talent/LCY201215Guangdong Provincial Center for clinical engineering of blood purification(507204531040)Guangdong Obers Blood Purification Academician Work station(2013B090400004)
文摘Female patients,44 years old,due to'regular peritoneal dialysis5 years,stomach ache 1 week'admission.Previous had 2 times for'Peritoneal dialysis related peritonitis'in hospital,after anti-infection treatment patients symptoms improved and discharged.1 week ago in patients admitted to hospital because of abdominal pain again.Physical:abdominal tenderness,bowel sounds hyperthyroidism.Laboratory inspection index:CRP:172.22 mg/l,WBC:23.26×10~9/L,NEU%:89.23%,D dimer:3 800 ng/ml,PCT:14.86 ng/ml。
基金Guangdong Obers Blood Purification Academician Work station(2013B090400004)Construction of collaborative platform for clinical research and clinical research of blood purifica tion(201604020175)+2 种基金Guangzhou entrepreneurial leader talent/LCY201215Guangdong University blood purification technology and Engineering Re search Center(GCZX-A1104)Guangdong Provincial Center for clinical engineering of blood purification(507204531040)
文摘1 Introduction Neuropsychiatric systemic lupus erythematosus(NPSLE)is a serious complication of systemic lupus erythematosus(SLE),with an incidence of about 30%to 40%[1].No matter early or late SLE patients are prone to concurrent,so early diagnosis and treatment of NPSLE is extremely important.
基金Guangdong Obers Blood Purification Aca demician Work station(2013B090400004)Guangzhou entrepreneurial leader talent/LCY201215+3 种基金Science and technology plan project of Guangdong in dustri al high and new technology field(2013B010203019)Construc tion of col laborative platform for clinical research and clinical research of blood purification(201604020175)Guangdong University blood purifi cation tech nology and Engineering Re search Center(GCZX-A1104)Guangdong Innovation Fund Project(2014A010101123)
文摘There are 3 kinds of Renal Replacement Therapy:hemodialysis,peritoneal dialysis and kidney transplantation.Although a kidney transplant would be the best solution,organ donations are limited and the transplanted organs can be rejected by the body.Hemodialysis is a widely recognized and near-universally available treatment method,however,the patient must make at least 3 weekly visits to a hospital to undergo treatment,with each session lasting on average around 4 hours.Consequently this can have an impact on the patients’life,including work and travel.Since the clinical populariza-
