Value of abnormal circadian rhythm of heart rate predicting the all-cause mortality in stage 5 chronic kidney disease patients / 中华肾脏病杂志

Objective:To investigate the predictive value of abnormal heart rate circadian rhythm for all-cause mortality in stage 5 chronic kidney disease (CKD 5) patients.Methods:The retrospective study was performed in CKD 5 patients enrolled from the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital) and the Affiliated BenQ Hospital of Nanjing Medical University from February, 2011 to December, 2019. A total of 159 healthy volunteers were enrolled as the healthy control group during the same period. The circadian rhythm of heart rate was monitored by 24-hour Holter. Related indices (including 24-hour, daytime and nighttime mean heart rate, night/day heart rate ratio, 24-hour maximum heart rate, 24-hour minimum heart rate and difference between maximum and minimum of 24-hour heart rate) were calculated. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Cox regression model was used to analyze the risk factors of all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve and Log-rank test were used to compare the differences of cumulative mortality between high ratio group (night/day heart rate ratio>0.91) and low ratio group (night/day heart rate ratio≤0.91). The nonlinear relationship between night/day heart rate ratio and all-cause mortality was analyzed by restricted cubic spline plot. Time-dependent receiver operating characteristic (ROC) curve was used to analyze the predictive value of night/day heart rate ratio for all-cause mortality in CKD 5 patients.Results:A total of 159 healthy volunteers and 221 CKD 5 patients were included in this study. There were 123 males (55.66%) and the age was (52.72±13.13) years old in CKD 5 patients. The total median follow-up time was 50.0 months. Compared with controls, 24-hour, nighttime mean heart rate, 24-hour minimum heart rate in CKD 5 patients were increased (all P<0.05), furthermore, the night/day heart rate ratio was higher [(0.91±0.09) vs (0.81±0.08), P<0.001], showing "non-dipping heart rate". However, the 24-hour maximum heart rate and the difference between maximum and minimum of 24-hour heart rate in CKD 5 patients were lower than controls (both P<0.05). Multivariate Cox regression analysis showed that the increased night/day heart rate ratio (per 0.1 increase, HR=1.557, 95% CI 1.073-2.258, P=0.020) was an independent influencing factor for all-cause mortality in CKD 5 patients. Kaplan-Meier survival curve analysis showed that the cumulative mortality of the high ratio group was significantly increased than that of the low ratio group (Log-rank test χ 2=7.232, P=0.007). From the restricted cubic spline plot, there was a linear effect between night/day heart rate ratio and all-cause mortality ( P=0.141), and when night/day heart rate ratio was above 0.91, the risk of all-cause mortality was significantly increased in CKD 5 patients. According to time-dependent ROC curve, the accuracy of night/day heart rate ratio in predicting all-cause mortality was 70.90% even when the survival time was up to 70.0 months. Conclusions:The circadian rhythm of heart rate in CKD 5 patients displays "non-dipping" state. High night/day heart rate ratio is an independent influencing factor for all-cause mortality in CKD 5 patients.

Effects of parathyroidectomy on heart rate circadian rhythm in patients with stage 5 chronic kidney disease combined with severe secondary hyperparathyroidism / 中华肾脏病杂志

Objective:To observe heart rate circadian rhythm in patients with chronic kidney disease (CKD) stage 5 and to analyze the effects of parathyroidectomy (PTX) on heart rate circadian rhythm in severe secondary hyperparathyroidism (SHPT) patients.Methods:A cross-sectional observation was performed in 213 patients with CKD stage 5 and 96 controls, and the patients were divided into those with severe SHPT (PTX group, n=70) and without severe SHPT (non-PTX group, n=143). Forty-six PTX patients were followed up prospectively. The baseline data were compared among these groups. Holter electrocardiogram was performed for each participant. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Multiple linear regression analysis was used to analyze the related factors of heart rate circadian rhythm in patients with CKD stage 5. Results:The 24-hour, daytime and nighttime mean heart rate in patients with CKD stage 5 were all higher than those in controls, especially in PTX group (all P<0.05). The night/day heart rate ratios of controls and CKD stage 5 patients were (0.81±0.08) and (0.91±0.08) respectively ( P<0.01). Correlation analysis showed 24-hour and daytime or nighttime mean heart rate in patients with CKD stage 5 were positively correlated with serum levels of phosphorus and ln(alkaline phosphatase), while nighttime mean heart rate and night/day heart rate ratio were positively related with serum intact parathyroid hormone level. After adjusting with postoperative follow-up period (median time: 10.9 months), 24-hour and nighttime mean heart rate, and night/day heart rate ratio in PTX patients all decreased significantly (all P<0.01). Conclusions:Heart rate is increased and circadian rhythm is abnormal in patients with CKD stage 5, which are related with mineral and bone disorder. PTX significantly decreases 24-hour and nighttime mean heart rate in severe SHPT patients, and improves the heart rate circadian rhythm.

Simultanenous determination of contents of four nitrogenous compounds in Pinellia peda-tisecta by HPLC / 中国中药杂志

<p><b>OBJECTIVE</b>To develop a HPLC method for the quantitative determination of four nitrogenous compounds in Pinellia peda-tisecta.</p><p><b>METHOD</b>The determination was carried out on Diamonsil-C18 column(4. 6 mm x 250 mm, 5 microm) eluted with acetonitrile-water-triethylamine in gradient elution acetonitrile-water- triethylamine. The mobile phase was a flow rate of 1.0 mL x min(-1) and detection wavelength as 254 nm.</p><p><b>RESULT</b>The linear ranges of trigonelline, thymine, amidopurine and hypoxanthine were 0.2 - 1.0 microg (r = 0.999 6), 2.6-13 microg (r = 0.999 8), 0.55-2.75 microg (r = 0.999 9), 0.65-3.25 microg (r = 0.999 8), respectively. The average recoveries of trigonelline, thymine, amidopurine and hypoxanthine were 100.6%, 99.89%,100.5% and 100.0% respectively, and the RSD of the above four compounds were 2.4%, 0.20%, 1.1%, 1.4%, respectively.</p><p><b>CONCLUSION</b>This method is reliable, accurate and specific. It can be used for quality control of the tube of P. peda-tisecta.</p>

Enhance technique researches on Glycyrrhiza industries, promote three-dimensional rural economic development in three-north areas / 中国中药杂志

<p><b>OBJECTIVE</b>To analyze the current situation about Glycyrrhiza resources, summarize the research achievements on Glycyrrhiza relative industries, and indentify the importance of developing Glycyrrhiza industries to promote the three-dimensional rural economic development in the Three-North areas.</p><p><b>METHOD</b>Literatures and documents were referred to, in combination with overview and analysis of the outcomes and achievements of our group.</p><p><b>RESULT AND CONCLUSION</b>The gap between supply and demand of resources is enlarged continuously. To develop high-quality Glycyrrhiza cultivation is the most powerful and effective measure to protect wild resources and the environment and promote the three-dimensional rural economic development in the Three-North areas.</p>

Review of pharmacological effects of Glycyrrhiza radix and its bioactive compounds / 中国中药杂志

Glycyrrhiza Radix is a commonly used Chinese herbal medicine, derived from the dried roots and rhizomes of Glycyrrhiza uralensis, G. glabra and G. inflata. The main bioactive constituents of licorice are triterpene saponins and flavonoids. There are various types of pharmacological properties of licorice are proved, including antiulcer, antiinflammation, spasmolysis, antioxidative, contravariance, antiviral, anticancer activities, hepatoprotective, eliminating phlegm and reinforcing remembrance effects. Triterpene saponins are the main components of Glycyrrhiza Radix and its pharmacological activities are comparatively thorough and clear. In recent years, licorice flavonoids, proved to have a variety of pharmacological activities, become one of the hot of pharmacological studies. In this review, we summarized the latest five-year progress in pharmacological activities of licorice extract, its triterpenoid saponins and flavonoids, and experimental researches indicated that licorice had both accommodation and protection activity on the digestive system, respiratory system, nervous system, and endocrine system, etc.