The aim of the present study was to compare total parathyroidectomy without autotransplantation (TPTX) versus total parathyroidectomy with autotransplantation (TPTX + AT) for renal hyperparathyroidism (RHPT) with respect to long-term outcomes. A literature search was undertaken using Medline and EMBASE from inception to December 2013. Data were analyzed using Review Manager version 5.0. A total of seven cohort studies comprising 931 patients were identified. Compared with TPTX + AT, patients in the TPTX group have lower "recurrence" (odds ratio (OR) 0.08, confidence interval (CI) 0.03 to 0.21; P < 0.00001), lower "recurrence or persistence"(OR 0.11, 95% CI 0.05 to 0.25; P < 0.00001), lower "requiring reoperation because of recurrence or persistence" (OR 0.17, CI 0.06 to 0.54; P = 0.002), and higher "hypoparathyroidism" (OR 2.97, CI 1.09 to 8.08; P = 0.03). None of the patients in these seven studies were recorded as having severe hypocalcemia or adynamic bone disease. Compared with TPTX + AT, TPTX is associated with lower "requiring reoperation because of recurrence or persistence" and without severe hypocalcemia or adynamic bone disease.
The study revealed that hyperhomocysteinemia increases the risk of decreased eGFR. This suggests that homocysteine could be considered as a useful molecular markers for delaying the development of CKD.
The diverse mechanical properties of nanoscale DNA films on solid substrates have a close correlation with complex detection signals of micro-/nano-devices. This paper is devoted to formulating several multiscale models to study the effect of pH-dependent ionic inhomogeneity on the graded elastic properties of nanoscale DNA films and the resultant bending deflections of microcantilever biosensors. First, a modified inverse Debye length is introduced to improve the classical Poisson-Boltzmann equation for the electrical potential of DNA films to consider the inhomogeneous effect of hydrogen ions. Second, the graded characteristics of the particle distribution are taken into consideration for an improvement in Parsegian's mesoscopic potential for both attraction-dominated and repulsion-dominated films. Third, by the improved interchain interaction potential and the thought experiment about the compression of a macroscopic continuum DNA bar, we investigate the diversity of the elastic properties of single-stranded DNA (ssDNA) films due to pH variations. The relevant theoretical predictions quantitatively or qualitatively agree well with the relevant DNA experiments on the electrical potential, film thickness, condensation force, elastic modulus, and microcantilever deflections. The competition between attraction and repulsion among the fixed charges and the free ions endows the DNA film with mechanical properties such as a remarkable size effect and a non-monotonic behavior, and a negative elastic modulus is first revealed in the attraction-dominated ssDNA film. There exists a transition between the pH-sensitive parameter interval and the pH-insensitive one for the bending signals of microcantilevers, which is predominated by the initial stress effect in the DNA film.
ObjectiveCardiovascular disease (CVD) is the leading cause of mortality and morbidity worldwide. Previous studies have indicated that clustering of major CVD risk factors is common. We aimed to explore the association of clustering of CVD risk factors with arterial stiffness in adults.MethodsA total of 9984 adults were enrolled. We investigated clustering of four major CVD risk factors (defined as two or more of the following: hypertension, diabetes, dyslipidemia, and high body mass index) and their association with arterial stiffness. Arterial stiffness was evaluated using the carotid-femoral pulse wave velocity (cfPWV).ResultsIn the study group (52.2% men, the mean age was 55.4 ± 10.5 years; only 11.9% of participants were free of any pre-defined CVD risk factors and 61.8% of participants had clustering of CVD risk factors. The cfPWV was significantly higher in the clustered risk factors group than in the no risk factor or the single risk factor groups (16.1 ± 3.1, 13.4 ± 2.2, and 14.3 ± 2.6 m/s, respectively; P < 0.001). Multiple linear regression analysis revealed that age, gender, clustering of CVD risk factors, serum uric acid, and decreased renal function positively correlated with cfPWV. For a categorical outcome, the highest cfPWV quartile (cfPWV ≥ 16.9 m/s) was compared with the lower three quartiles. After adjusting for potential confounders, clustering of CVD risk factors significantly correlated with increased cfPWV compared with that in the no risk factor group, with an odds ratio of 5.76 (95% confidence interval: 4.46–7.44).ConclusionsClustering of CVD risk factors significantly correlated with arterial stiffness; this confirms the importance of lifestyle modification to reduce the burden of CVD.
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