Hou Fanfan provides a new strategy to delay the development of chronic kidney disease through evidence-based medicine research. Once chronic kidney disease has renal insufficiency, it will inevitably develop into end-stage renal failure (uremia). Angiotensin converting enzyme inhibitor (ACEI) and other renin angiotensin system inhibitors (RASI) have been proved to be the main drugs to delay the development of chronic kidney disease in the early and middle stages. Traditionally, these drugs are not only ineffective for advanced chronic kidney disease, but also may increase adverse reactions, so at present, 80% patients with advanced chronic kidney disease have not been effectively treated. Through a five-year large-sample, double-blind, randomized controlled clinical study, the team led by Hou Fanfan confirmed for the first time that ACEI significantly reduced the risk of advanced chronic kidney disease developing into uremia, and delayed the development of kidney disease into uremia by more than 1 times. This achievement, independently completed by Chinese mainland scholars (the author and unit are both in Chinese mainland, and Hou Fanfan is the first correspondent), was published in the most authoritative medical journal N Engl J Med (impact factor 50.05438+07) in the form of original works. In view of the important value of this article, N Engl J Med published an editorial, saying that this study "changed the traditional concept of banning RASI in advanced chronic kidney disease" and "it is time to change our treatment strategy for chronic kidney disease". Since the paper was published in 2006, it has been cited by others in SCI journals 104 times. Ann Intern Med (IF 17.457) listed it as one of the most important papers on doctors' clinical practice and one of the most important papers on kidney diseases in Progress of Internal Medicine published in 2007 and Progress of Kidney Diseases published in 2008 respectively. Conclusion It is included in the classic textbook of internal medicine "Western Medicine (23rd Edition)" and the classic textbook of kidney disease "Kidney (8th Edition)". In 2006, it was rated as "Top Ten Scientific and Technological Progress of Colleges and Universities in China" by the Ministry of Education. It has been used in 49 hospitals across the country.
Hou Fanfan and his team further confirmed through randomized controlled clinical studies that using high-dose RASI to reduce proteinuria is more effective than using conventional drugs to delay the development of chronic kidney disease. Evidence-based medicine is used for the first time to prove that anti-proteinuria therapy can improve the renal prognosis of chronic kidney disease. The results were published in J Am Soc Nephrol (impact factor 7.505), which is the journal with the highest professional impact factor on kidney diseases, and provides a new strategy for clinical intervention on the progress of chronic kidney diseases.
She also discovered new pathogenic molecules that promote the progress of CKD through basic research. It is confirmed for the first time that the oxidative damage protein retained in CKD can be used as endogenous toxin to promote renal inflammation and fibrosis, and it is a new biological pathogenic factor to promote the development of renal diseases. This achievement was published in famous foreign journals such as J Am Soc Nephrol (impact factor 7.505) and Endocrinology (impact factor 4.945), which provided a new target for the prevention and treatment of chronic kidney disease.
The above achievements not only improve the prognosis of patients with chronic kidney disease, reduce the incidence of uremia, save a lot of health resources for the country, but also promote the progress of evidence-based medicine research in China. In 2007, he won the second prize of National Science and Technology Progress Award.
Second, it provides a new strategy for the prevention and treatment of cardiovascular diseases of chronic kidney disease.
The team led by Hou Fanfan provided epidemiological and evidence-based medical evidence for the prevention and treatment of cardiovascular diseases in patients with chronic kidney disease in China. Cardiovascular complications are the first cause of death of chronic kidney disease, and prevention and treatment of cardiovascular diseases is the main measure to reduce the mortality of chronic kidney disease. Hou Fanfan organized and completed an epidemiological survey of cardiovascular diseases in patients with chronic kidney disease in five provinces and autonomous regions of China. The characteristics and risk factors of cardiovascular diseases in people with chronic kidney disease in China were revealed, and the first representative database was established, which provided a basis for prevention and treatment according to the characteristics of patients with China. She also provided clinical evidence for the prevention and treatment of cardiovascular diseases such as chronic kidney disease and left ventricular hypertrophy through multi-center clinical research.
She also put forward a new viewpoint on the mechanism of chronic kidney disease complicated with cardiovascular disease through clinical basic research. It is the first time that the up-regulation of advanced glycation end products-receptor axis and the retention of advanced oxidized protein products in chronic kidney disease promote micro-inflammatory reaction and accelerate the formation of atherosclerosis. This achievement was published in famous foreign journals such as Arterioscler Thromb Vasc Biol (impact factor 6.858) and Antioxid Redox Signal (impact factor 6. 19), which provided a new target for the prevention and treatment of cardiovascular diseases of chronic kidney disease.
Thirdly, it provides a new strategy for preventing and treating fatal and disabling complications related to dialysis.
1. provides a basis for the prevention and treatment of dialysis-related amyloidosis. Dialysis-related amyloidosis is a disabling complication of bones and joints in long-term dialysis patients, and its pathogenesis is still unclear. Hou Fanfan found that circulating β2 microglobulin (β2M) accumulated in dialysis patients was deposited on joints by combining with glycosylated type I collagen in tissues, and locally glycosylated to form a special amyloid protein. This glycosylated β2M interacts with the receptor of glycosylation products expressed by synovial cells of joints, which promotes joint inflammation and injury, thus clarifying the mechanism of "non-toxic" circulating β2M selectively depositing on joints and causing tissue damage. This conclusion was later confirmed by overseas large-scale histological research and included in six foreign textbooks. She also established a non-invasive ultrasonic diagnosis method based on the joint sleeve data of Chinese people, which changed the status quo that the disease could not be diagnosed early by tissue biopsy and was popularized and applied nationwide. She found that hydrazine compounds inhibited the glycosylation of β2M, which laid the foundation for future clinical treatment research. The above research results were published in famous foreign journals such as J Am Soc Nephrol and Kidney Int (impact factor 6.4 18).
2. It provides a basis for the prevention and treatment of peritoneal sclerosis caused by peritoneal dialysis. It was found that the high concentration of glucose as osmotic active substance in the formula of peritoneal dialysate currently used in clinic increased the synthesis of extracellular matrix of peritoneal mesothelium and promoted peritoneal fibrosis, which provided a basis for improving the formula of peritoneal dialysate, and won the "Outstanding Scientific Report Award" at 1995 European Kidney Disease Dialysis Transplantation Conference. According to this discovery and similar reports by other scholars, other osmotically active substances have been used to prepare peritoneal dialysis solution instead of glucose.
3. A new method to prevent and treat the complications of dialysis infection was established. 1) established a serological diagnosis method for chronic kidney disease complicated with tuberculosis, which solved the problem of early diagnosis of tuberculosis in this special population. After 10 years of clinical application, it is confirmed that the positive rate of this method is obviously higher than that of the traditional method. The indications for the prevention and treatment of tuberculosis in patients with chronic kidney disease were formulated. Through 4-year follow-up of 2382 cases, it was confirmed that prevention and treatment reduced the incidence of active pulmonary tuberculosis by 57%. 2) It is confirmed that the chronic carrying status of Staphylococcus aureus in the nasal cavity of dialysis patients in China is the reason for the high incidence of bacteremia. On this basis, preventive treatment for carriers reduced the incidence of bacteremia in dialysis by 67%. 3) The liver histological screening criteria for patients with hepatitis virus infection before renal transplantation were established, which reduced the incidence of postoperative liver failure by 86%. The above treatment methods were applied in 104 hospitals in 26 provinces and 4 municipalities directly under the central government. Won the second prize of national scientific and technological progress.
Around the above work, Hou Fanfan published 44 papers 144 as the first author or correspondent, and 42 papers were included in SCI, including 20 international journals with impact factors ranging from 4.2 to 47.05, such as N Engl J Med, J Am Soc Nephrol, Arterioscler Thromb Vasc Biol, etc. The paper was cited by others *** 15 13 times, among which the works of the first author or correspondent author were cited by others in 8 foreign textbooks 15 times, including 2 classic textbooks of internal medicine (West's internal medicine) 1 book and 2 classic textbooks of kidney diseases (kidney and kidney diseases).
Edited and published Critical Kidney Disease 1. Since 200 1, 19 times has been invited to give special lectures at international academic conferences. The thesis won four awards in major international professional societies ("Outstanding Scientific Report Award of European Society of Nephrology"; American Society of Nephrology "Blue Ribbon Award"; International Society of Nephrology "First Prize for Best Paper" and "Excellent Paper Award"). The International Society of Nephrology once made a special report on her in its organ publication ISN NEWS, entitled "A voyage from China", which won honor for the country.
The first finisher won two second prizes for national scientific and technological progress, three first prizes for ministerial and provincial scientific and technological progress and three second prizes. Won 2 national invention patents. As the person in charge, he presided over 3 key projects of the National Natural Science Foundation and 7 national-level projects such as sub-projects of 973 projects.
He is the editor-in-chief or editor-in-chief of SCI journals such as Kidney Disease, Chinese Medical Journal English Edition and China Science (Life Science) Series C, and is also a visiting professor at institutions and universities such as the Hong Kong Kidney Education Research Foundation. He was awarded the "Science and Technology Progress Award" in ho leung ho lee foundation and the seventh "Ding Ying Science and Technology Award" in Guangdong. Won the titles of "Science and Technology Venus" of the General Logistics Department of the People's Liberation Army and "March 8th Red Flag Bearer" of Guangdong Province.
Hou Fanfan has good scientific ethics. There are some risks in the clinical research of prevention and treatment of advanced nephropathy. Hou Fanfan encourages participating doctors by "taking risks for patients". Clinical research needs to follow up a large number of patients for many years. In order to get a reliable conclusion, she and her team resisted some current impetuous thoughts and insisted on "grinding a sword for ten years". In order to get information in time and ensure the safety of patients, they announced their home phone number, mobile phone number and QQ number to patients to ensure that they can respond to patients' questions and needs 24 hours a day. Hou Fanfan has a strict scientific style. Before publication, all the research results completed by her team have to be reviewed by at least three experts in different fields to ensure the reliability and accuracy of the research conclusions. The discipline she led was rated as the key discipline and key laboratory of Guangdong Province by the Ministry of Education, and was awarded the title of "Advanced Grass-roots Unit" and "Excellent Scientific Research Team" by the General Logistics Department.
Hou Fanfan is also an excellent clinician with superb medical skills and noble medical ethics. In order to meet the patients seeking medical treatment, she often works continuously for more than 7 hours in the outpatient department. In order to rescue the sudden death patient, she sucked the vomit out of the patient's mouth without equipment, saving the patient's life. For two years in a row, she served as a health consultant of the Central Health Bureau, and successfully completed many important rescue tasks organized by the central government, provinces and cities, and won second-class merit 1 time and third-class merit twice. He was awarded the second China Physician Award of China Medical College, Baiyun Gongde Public Welfare Star and other awards to commend outstanding clinicians. Won the title of "party member" produced by the PLA General Logistics Department.