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Objective To investigate the changes of cerebral volume in end stage renal disease (ESRD) patients with maintaining hemodialysis using voxel based morphometry (VBM),and to observe the correlation of these changes with sleep quality,anxiety and depression.Methods Twenty ESRD patients received maintaining hemodialysis (patient group) and twenty-one normal volunteers (normal control group) underwent MRI and neuropsychological scale evaluations,including the Montreal Cognitive Assessment Scale (MoCA),Pittsburgh Sleep Quality Index Scale (PSQI),Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS).The changes of cerebral volume between the two groups were compared,and the correlation between the changed area of cerebral volume in patient group and the score of neuropsychological scale was analyzed.Results Compared with normal control group,significantly decreased volume in the gray matter of the left middle temporal gyrus,right middle frontal gyrus and left medial frontal gyrus were observed in patient group (all P＜0.001,AlphaSim multiple corrections).The differences of MoCA,PSQI,SAS and SDS between the two groups were statistically significant (all P＜0.05).In patient group,the decreased gray matter volume of the left middle temporal gyrus negativity correlated with PSQI,SDS and SAS (r=-0.588,-0.456,-0.489;P =0.006,0.043,0.029),of the right middle frontal gyrus negativity correlated with SDS and SAS (r=-0.495,-0.466;P=0.026,0.038),of the left medial frontal gyrus positively correlated with MoCA (r=0.462,P=0.040),and negatively correlated with PSQI (r=-0.588,P=0.006).Conclusion Multiple grey matter atrophy and complicated neurocognitive dysfunction were noticed in ESRD patients with maintaining hemodialysis,and the associated poorer sleep quality,anxiety or depression severity might closely related to the decreased volume of corresponding brain gray matter.
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Objective To investiGate the constituent ratio of etioloGy,complications and tumor occurrence of maintenance hemodialysis patients. Methods Obseved the patients with maintenance hemodialysis in ZhonGshan Hospital Affiliated to Dalian University in 20l3. The patientsˊ aGe,Gender, protopathy,and other basic information includinG statistics complication and tumor occurrence rate were surveyed. Results There was same ratio of male and female in 222 cases. The primary disease of diabetic nephropathy accounted for 30. 2%( 67 cases ),hypeertensive nephropathy 2l. 2%( 47 cases ),chronic Glomerulonephritis l8. 0%(40 cases),polycystic kidney 6. 8%(l5 cases),obstructiverenal injury accounted for 5. 4%(l2 cases)and other diseases. HemoGlobin of 73 cases(32. 0%)reached the tarGet value(lll G/L) . There was 55. 2% of patients ( l23 cases ) experienced calcium and phosphorus metabolism disorder. Parathyroid hormone levels of 47. 4% patients( l47 cases ) were hiGher than normal. The tumor incidence was 7. 6%( l7/222 ). Conclusion The major primary disease of the patients with maintenance hemodialysis are diabetic nephropathy,hypertension nephropathy and chronic Glomerulonephritis. The level of hemoGlobin,calcium and phosphorus metabolism disorder and parathyroid hormone are low. There is hiGh incidence of tumor.
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Objective The immune hypofunction of the red blood cell on maintenance hemodialysis patients is one main reason of tumor,and oxidative stress is proved to be involved in decrease of existence quality and the occurrence of various complications of patients with hemodialysis.To investigate the status of erythrocyte immune and high oxidative stress of the hemodialysis patients,as well as the effect of Huangqifuzitang on immune function of red blood cell and oxidative stress in patients with hemodialysis.Methods Twenty healthy people were chosen as control group,and 20 patients were selected as the treatment group.CD58,CD59,superoxide dismutase(SOD),malonaldehyde(MDA) were measured before hemodialysis and after 12 days administration of Huangqifuzitang in the treatment group,and compared with those of the control group.Results There was significant difference between before and after taking Huangqifuzitang in treatment group and control group in terms of CD58 ((38.02 ±8.98) vs.(47.39 ±7.78) vs.(59.10±4.59),F=4.506,P=0.000),CD59 ((62.69 ± 20.84) vs.(80.95 ± 20.42) vs.(193.86 ± 19.87) ; F =239.347,P =0.000),SOD ((68.09 ± 11.86) vs.(78.73±10.58) vs.(111.09±16.61) kU/L;F=21.318,P=0.000),MDA((5.98±2.06) vs.(4.54 ±0.62) vs.(3.03 ± 1.10) μmoL/L;F =55.359,P =0.000) levels.Before taking Huangqifuzitang,the concentration of CD58,CD59 and SOD in treatment group was significant decreased compared with control group,but MDA significant increased,and there was significant difference (P ＜ 0.01).After 12 days administration of Huangqifuzitang in the treatment group,the concentration of CD58,CD59 and SOD was significant increased compared with before taking Huangqifuzitang,but MDA significant significant decreased,and there was significant difference (P ＜ 0.01 or P ＜ 0.05) Conclusion The red blood cell surface receptors CD58,CD59 decreased and oxidative stress index SOD decreased significantly,MDA increased significantly in hemodialysis patients.Huangqifuzitang was proved to be with the ability of enhancing the immune of red bloodCD58,CD59 and decreasing the oxidative stress level in patients with hemodialysis.
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ObjectiveTo investigate the expression levels of the red blood cell surface receptors and oxidative stress of patients with hemodialysis,evaluate the immune function of the red blood cells,and identify the cause of infection and high prevalence of tumor in patients with hemodialysis.MethodsForty-five long-term hemodialysis patients from our blood purification center was chosen as the treatment group.Forty-five healthy individuals conducting physical examination at the same period was chosen as the control group.The flow cytometric method was used to detect CD35 surface receptors numbers of the red blood cell.The red blood cells wreath experiments were used to measure the adhesive function.The ELASA method was used to test the changes of oxidative stress index:SOD,MDA,CAT and GSH-PX.ResultsCompared to the normal control group,the treatment group had significantly lower levels of CD35 [ ( 28.62 ±6.95 ) AU vs.( 19.71 4.89) AU,t =5.441,P ＜0.01 ],impaired adhesive function red blood cells[ (0.63 ±0.07) vs.(0.44 ±0.04),t =0.41,P ＜0.05].For the levels of oxidative stress index,MDA [ ( 6.18 ± 0.16 ) μmol/L vs ( 13.47 ± 0.39 ) μmol/L ] was significantly higher in the treatment group than in the normal control group( t =13.14,P ＜ 0.05 ),and SOD( 34 202.00 ± 1634.00) U/( g · Hb),CAT ( 21.70 ± 0.84 ) U/ml and GSH-PX ( 444.00 ± 10.31 ) U/ml were significantly lower in the treatment group than in the normal control group [ SOD:(24 652.00 ± 2179.00)U/( g · Hb),CAT:( 14.80 ± 1.13 ) U/ml,GSH-PX:( 217.89 ± 13.70 ) U,t =20.246,9.496,27.195,P ＜0.05 ].ConclusionPatients with hemodialysis had lower numbers of red blood cell surface receptors CD35 and impaired immune function of adhesion,and higher oxidative stress levels.This may be the cause of infection and tumor of patients with hemodialvsis.