Search

Ling-Cang Xu,1,2 Fang-Fang Zhou,1,2 Meng Li,1,2 Zhi-Wei Dai,1,2 Ke-Dan Cai,1,2 Bei-Xia Zhu,1,2 Qun Luo1,2 1Department of Nephrology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang Province, 315010, People’s Republic of China; 2Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang Province, 315010, People’s Republic of ChinaCorrespondence: Qun LuoDepartment of Nephrology, Hwa Mei Hospital, University of Chinese Academy of Sciences, No. 41, Northwest Street, Ningbo, Zhejiang Province, 315010, People’s Republic of ChinaTel/Fax +86-574-83870217Email nbeyluoqun@126.com; luoqun@ucas.ac.cnObjective: This study is to investigate the correlation between serum triiodothyronine (T3) levels and all-cause and cardiovascular mortality in PD patients.Methods: A total of 376 end-stage renal disease (ESRD) patients who started maintenance PD treatment in the Department of Nephrology in our hospital and stable treatment for ≥ 3 months were selected, and the total T3 (TT3) and free T3 (FT3) levels were determined. Among them, 168 cases with FT3 < 3.5 pmol/L and/or TT3 < 0.92 nmol/L were divided into the low serum T3 level group, and the remaining 208 cases were divided into normal serum T3 level group. The Cox survival analysis method was used to analyze the correlation between low serum T3 levels and all-cause and cardiovascular mortality in PD patient.Results: Compared with the normal serum T3 level group, patients with low serum T3 levels had higher systolic blood pressure and a higher proportion of heart disease, and lower levels of total T4, free T4, hemoglobin, serum albumin, blood calcium, serum total bilirubin, alanine aminotransferase, and 24-h urine volume (all P < 0.05). Binary Logistic regression analysis showed that heart disease (P = 0.003, OR: 2.628, 95% CI: 1.382– 4.997) and high TT4 level (P < 0.001, OR: 0.968, 95% CI: 0.956– 0.979) were related to low serum T3 levels in PD patients. Multivariate Cox regression analysis showed that low serum FT3 level was an independent risk factor for all-cause death in PD patients (HR = 0.633, 95% CI = 0.431– 0.930; P < 0.020).Conclusion: Low serum T3 levels in PD patients were associated with heart disease and TT4 levels. Low serum FT3 levels were associated with the risk of all-cause death in PD patients.Keywords: serum T3 level, peritoneal dialysis, all-cause death, cardiovascular death, correlation

Ying Wang,1,2,* Xin-Hong He,1,2,* Li-Chao Xu,1,2 Hao-Zhe Huang,1,2 Guo-Dong Li,1,2 Yao-Hui Wang,1,2 Wen-Tao Li,1,2 Guang-Zhi Wang3 1Department of Interventional Radiology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People’s Republic of China; 2Department of Medical Oncology, Fudan University Shanghai Cancer Center, Xuhui, Shanghai 200032, People’s Republic of China; 3Department of Medical Imaging Center, Affiliated Hospital, Weifang Medical University, Weifang 261053, People’s Republic of China *These authors contributed equally to this work Objective: The study aimed to investigate the efficacy of computed tomography (CT)-guided cryoablation debulking of unresectable pelvic recurrent colorectal cancer (CRC). Patients and methods: From January 2013 to April 2016, 30 patients (18 males and 12 females; aged 57.8±10.5 years) with unresectable pelvic recurrent CRC who had previously received radiotherapy or chemotherapy were included. A total of 35 tumors ranging from 1.2 to 6.3 cm underwent cryoablation. Tumor response was evaluated 1 month after cryoablation according to the Modified Response Evaluation Criteria in Solid Tumors. Logistic regression was used to analyze the risk factors for tumor response. Degree of pain palliation was also determined using the Numerical Rating Scale. Cox proportional hazard models were used to identify predictors of outcomes. Results: Cryoablation was successfully performed in all patients. Complete response (CR) was achieved for 27 tumors in 23 patients and partial response was achieved for eight tumors in seven patients 1 month after cryoablation. The rate of CR was 77.14%, and tumor size was an independent risk factor for CR. Pain relief was satisfactory in 21 symptomatic patients (P

Ling-Ling Zhu,1 Ling-Cheng Xu,2 Hui-Qin Wang,3 Jing-Fen Jin,3 Hua-Fen Wang,3 Quan Zhou21Cadre Department, 2Department of Pharmacy, 3Division of Nursing, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaAbstract: A utilization study was performed in a 2200-bed tertiary care teaching hospital. Data mining was performed on all nasogastric medication prescriptions for patients hospitalized in 2011. Nurses were interviewed by questionnaire. A PDCA (Plan-Do-Check-Act) cycle was used for continuous quality improvement. The proportion of patients with nasogastric tubes (NGT) was 3.2%. A large number of medical orders (n  6261) involved nasogastric medications with a package insert particularly noting that they should not be crushed or opened (group 1) or medications without a specific formulation recommendation in the package insert but having evidence discouraging NGT dosing (group 2). Of the nasogastrically administered sustained-release or controlled-release formulations, a sustained-release sodium valproate tablet formulation was the most prescribed drug and a sustained-release 2.5 mg felodipine tablet was prescribed with the highest proportion of NGT dosing [NGT/(NGT  oral)  12.3%]. Among the nasogastrically administered enteric-coated formulations, a myrtol-standardized enteric-coated capsule formulation was the most prescribed drug and a pantoprazole tablet formulation was prescribed with the highest proportion of NGT dosing [NGT/(NGT  oral)  19.3%]. Proportions of NGT dosing for amiodarone and carbamazepine (group 2) were 4.8% and 6.3%, respectively. The percentage of nurses with adequate knowledge about pharmaceutical dosage formulations was 60%. The rate of answering correctly as to whether medications in group 1 could be crushed or opened was only 30%. Awareness of evidence discouraging NGT dosing of medications in group 2 was zero. Most nurses (90%) left physicians and pharmacists with the entire responsibility for knowledge and decision-making concerning route of drug administration. After a 3-month preliminary intervention, irrational medical orders involving nasogastric administration of medications in group 1 were successfully abolished. The rate of answering correctly as to whether medications in group 1 could be crushed or opened increased to 100%. This utilization study indicates poor awareness concerning nasogastric administration of medication on the part of physicians and nurses, and preliminary intervention measures were efficient in improving knowledge through team cooperation and effort.Keywords: nasogastric tube, rational drug use, drug administration routes, drug absorption, pharmaceutical preparations, nursing