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ABSTRACT: Hemodialysis (HD) patients are at high risk of infection by hepatitis B virus (HBV) or hepatitis C virus (HCV). The present study was designed to determine the impact of quality control measures on the prevention of transmission of blood-borne viruses.
A total of 6182 adult maintenance HD patients from all HD units in Zhejiang Province were recruited on January 1, 2007. The baseline demographic and clinical characteristics were recorded and all patients were followed up until death or survival at 4 years later. The Quality Control Standards of Hemodialysis were gradually implemented in HD units. The HBV or HCV seroconversion rates of the recruited patients were calculated and compared every year during the observation period.
The prevalence of HBV was 8.3% at the beginning of the study, and 6.6% for HCV. With the implementation of the HD quality control measures, the HBV seroconversion rate tended to decrease year by year (X2=6.620, P=0.085), and the HCV seroconversion rate decreased significantly (X2=10.41, P=0.015). Compared with the data in 2007, the HBV seroconversion rate (X2=4.204, P=0.040, relative risk ratio 0.393, 95% CI 0.156-0.991) and the HCV seroconversion rate (X2=7.373, P=0.007, relative risk ratio 0.386, 95% CI 0.189-0.787) decreased significantly in 2010.
Quality control measures for HD decreased the seroconversion rates of HBV or HCV in HD patients, showing that updated quality control measures reduce the risk for transmission of blood-borne viruses in the HD population.
Hepatobiliary & pancreatic diseases international: HBPD INT 06/2012; 11(3):302-6. · 1.08 Impact Factor
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You-ying Mao,
Hao yang,
Minmin Wang,
Wenhan Peng,
Qiang He,
Zhang-fei Shou, Hua Jiang,
Jianyong Wu,
Yong-qi Fang,
Hai-tao Dong,
Jiang-hua Chen
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ABSTRACT: Effective non-invasive monitoring method to tell histopathology is a big challenge in renal transplantation.
We used 70-mer long oligonucleotide array with 449 immune related genes to determine gene expression profiles of peripheral blood mononuclear cells (PBMCs) under different immune status including stable renal function (TX), acute tubular necrosis (ATN), biopsy conformed acute rejection (AR), clinical rejection with pathology of borderline changes (BL), clinical rejection without biopsy proven/presumed rejection (PR) and renal dysfunction without rejection (NR).
Distinct molecular expression signatures in each group were found to correlate with histopathology. And we concluded that B cell chemokine CXCL13 and mast cell may play a role in renal allograft rejection through significant difference analysis and functional pathway analysis.
It provides a potential non-invasive method for monitoring renal allograft function and immune status of renal transplant recipients.
Transplant Immunology 04/2011; 24(3):172-80. · 1.46 Impact Factor
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ABSTRACT: OBJECTIVE. To evaluate the efficacy of continuous high-volume hemofiltration for the treatment of severe acute pancreatitis patients and the impact of acute physiology and chronic health evaluation (APACHE) II score on the efficacy of high-volume hemofiltration. MATERIAL AND METHODS. A total of 63 patients diagnosed with severe acute pancreatitis between January 2005 and July 2007 were retrospectively analyzed: 34 accepted adjunctive continuous high-volume hemofiltration (HVHF group); and 29 only accepted conventional recommended treatments (control group). RESULTS. There were no differences in physiological characteristics between the two groups when entering the intensive care unit. After treatment, the percentages of patients successfully weaned from mechanical ventilation (p = 0.004) and who experienced renal function recovery (p = 0.046) were significantly higher in the HVHF group than in the control group. The 28-day survival rate was 91.2% in the HVHF group, compared with 65.5% in the control group (p = 0.014). For patients with APACHE II scores > 15, survival was significant higher in the HVHF group than in the control group (87.5% vs 50%; p = 0.044). No difference in survival was found in patients with APACHE II scores < or = 15 between the two groups (94.4% vs 76.5%; p = 0.177). After HVHF therapy, APACHE II score, body temperature, urine volume and laboratory indices, including serum creatinine, base excess and blood calcium, were significantly improved. CONCLUSIONS. Adjunctive continuous HVHF was beneficial for the survival of severe acute pancreatitis patients. Survival improvement was significant in patients with APACHE II score > 15.
Scandinavian journal of gastroenterology 01/2009; 44(11):1363-9. · 2.08 Impact Factor
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ABSTRACT: Several studies have identified FcgammaRIIIb (Fcgr3b) polymorphisms that determine susceptibility to autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. The objective of the study was to clarify whether FcgammaRIIIb allele polymorphism influence susceptibility to end stage renal disease (ESRD) patients with renal transplantation.
DNA fragments were amplified by PCR-SSP using genomic DNA from 172 unrelated, healthy blood donors and 171 renal recipients in our Kidney Disease Centre. We performed direct sequencing using 20 PCR products of renal recipients carrying different FcgammaRIIIb forms according to the allele-specific PCR.
FcgammaRIIIb NA1/NA2 genotype frequency showed significant difference between renal recipients and healthy controls (chi(2)=19.3, P<0.005). In addition, the allele frequency also showed significant difference between the two groups. Lower frequency of genotype FcgammaRIIIb NA1/NA1 was observed in renal recipients than in healthy controls (chi(2)=5.06, P=0.024). In comparison with nonrejectors, rejectors displayed no significant defference of FcgammaRIIIb NA1/NA2 genotype frequency, as well as allele frequency.
FcgammaRIIIb NA1/NA2 heterozygote genotype frequency was increased in ESRD patients in Chinese. The present findings showed that FcgammaRIIIb genotype related to the disease susceptibility, although FcgammaRIIIb polymorphisms did not affect the acute rejection.
Transplant Immunology 08/2007; 18(1):28-31. · 1.46 Impact Factor
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ABSTRACT: To observe the incidence of long-term venous indwelling catheter related complications in hemodialysis patients and to report our clinical approach to the complications.
A hundred eleven hemodialysis patients was prospectively studied from Jan. 2001 to Mar. 2003, in whom the venous indwelling catheter had been in place for more than 6 months. Catheter related complications were observed over a total period of 1090 patients months, with a mean period of 9.8 months (6 - 27 months).
The incidence of hematoma was 8.1% (9/111), and that of catheter malposition was 4.5%. There was no hemothorax, pneumothorax, air embolism or veinous laceration. Six episodes of catheter related infection were observed during the observation, with an incidence of 5.4%; two cases with bacterial infection were successfully treated; while among the 4 cases with fungal infection, one was successfully treated and catheters were removed in other 3 cases for uncontrolled infection. The incidence of catheter thrombosis was 18.9% (21/111) and the catheter had been used for a mean period of 36 days (6 - 725 days) from placement to thrombosis. Catheter patency was restored in 95.2% (20/21) by urokinase infusion. Recurrent thrombosis occurred in 18 of 20 catheters (90.0%), of which 5 worked functionally following anti-platelet therapy and 13 had recurrent thrombosis. Following anticoagulation by warfarin, 9 became functional (69.2%), but the other 4 cases turned to other vascular access. Urokinase infusion followed by anticoagulation had prolonged the mean catheter life-time for 6 months (3 - 18 months).
Cuffed dual lumen catheter as permanent access is safe and effective. Catheter thrombosis is the most common complication. Urokinase infusion followed by anticoagulation can significantly prolong the catheter life-time.
Zhonghua nei ke za zhi [Chinese journal of internal medicine] 04/2004; 43(3):198-200.
