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【Objective】 To investigate the correlation of serum exosomal microRNA-301a (miR-301a) with cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. 【Methods】 A total of 211 patients with diabetic nephropathy treated with peritoneal dialysis from June 2019 to June 2020 in the First Hospital Affiliated of Hebei North University were selected as study subjects. Serum exosomal miR-301a was detected by real-time fluorescence quantitative polymerase chain reaction. The patients were divided into high miR-301a group and low miR-301a group based on the median of miR-301a; the clinical data of the two groups were compared. The correlation of miR-301a with high-sensitivity C-reactive protein (hs-CRP) was analyzed by Spearman. Linear regression was applied to analyze the factors associated with the effect of miR-301a. The patients were followed up for two years. Kaplan-Meier and Log-Rank were conducted to compare the cumulative incidence of cardiovascular and cerebrovascular events between the two groups, and COX regression and restricted cubic spline were used to analyze the level-effect relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis. 【Results】 Thirty-seven cases (17.54%) of cardiovascular and cerebrovascular events occurred during follow-up. The hs-CRP level and dialysis duration were lower in low miR-301a group than in high miR-301a group (P<0.05). There was a positive correlation between miR-301a and hs-CRP (rs=0.237, P=0.001). Linear regression analysis showed that hs-CRP was independently associated with miR-301a (P<0.05). The cumulative cardiovascular and cerebrovascular event rate in low miR-301a group was 3.70% (4/108), which was lower than that in high miR-301a group [32.04% (33/103), P<0.001]. COX regression analysis showed that high serum albumin level was an independent protective factor for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy,while high hs-CRP level and miR-301a >1.46 were independent risk factors for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. Restricted cubic spline fitting COX regression analysis showed a non-linear relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy (P<0.05). 【Conclusion】 hs-CRP is independently associated with miR-301a in diabetic nephropathy peritoneal dialysis patients. High miR-301a level suggests a high risk of cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy.
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Objective:To observe the changes of serum micro-inflammatory and nutritional status in elderly peritoneal dialysis patients after treatment with bifidobacterium triple viable bacteria, and the impact of Bifidobacterium triple viable bacteria treatment on the endpoint.Methods:Totally 180 elderly patients receiving peritoneal dialysis were divided into control group and observation group, with 90 cases in each.Both groups were treated on the basis of the routine treatment, the observation group was treated with oral Bifidobacterium triple viable bacteria for twelve months.Before treatment, 6 months and 12 months after treatment, fasting venous blood from the patients in the two groups were collected in the morning.The levels of serum micro-inflammatory indexes[tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-8(IL-8), C-reactive protein(CRP)]were detected by ELISA.The nutritional status and dialysis adequacy indexes[nutritional status: albumin(ALB), hemoglobin(Hb), transferrin(TRF), prealbumin(PA), calcium ion, phosphorus ion; indicators of dialysis adequacy: serum creatinine(Scr), blood uric acid(BUA), blood urea nitrogen(BUN), cystatin C(Cys-c)levels]were detected by automatic blood biochemical analyzer.After 24 months of follow-up, the occurrence of endpoint events(peritonitis, abdominal pain, malnutrition, abdominal infection, cardiovascular and cerebrovascular accidents)in the two groups was recorded.Results:After 24 months of treatment, the levels of TNF-α, IL-6, IL-8 and CRP in the two groups were lower than those before treatment, and the observation group was lower than control group[(25.7±4.0)μg/L vs.(33.6±6.0)μg/L, (2.9±0.7)ng/L vs.(4.9±1.2)ng/L, (17.0±7.2)ng/L vs.(22.8±7.9)ng/L, (4.6±0.7)mg/L vs.(6.9±1.2)mg/L]( t=10.272, 13.134, 5.040, 15.575, respectively, P<0.05 for all). After 24 months of treatment, the levels of ALB, Hb, TRF, PA and calcium ion of the two groups were higher than before treatment, and the levels of phosphorus ion were lower than before treatment, and the changes of the above indicators in observation group were more obvious than those in the control group[(45.7±5.2)g/L vs.(39.8±4.9)g/L, (72.7±8.0)g/L vs.(68.6±9.0)g/L, (4.3±1.0)g/L vs.(3.0±0.6)g/L, (321.5±29.0)mg/L vs.(297.6±25.1)mg/L, (4.9±1.3)mmol/L vs.(2.9±0.9)mmol/L, (1.3±0.9)/L vs.(1.8±0.3 mmol/L)]( t=7.737, 3.213, 9.880, 5.9 00, 11.937, 4.415, P<0.05 for all). There was no significant difference in intestinal flora between the two groups before treatment( P>0.05). After 24 months, an increase was observed in Lactobacilli and Bifidobacteria in both groups, while Enterobacteria and Enterococcus in both groups were decreased, and the changes of the above indicators in the observation group were also more obvious than those in the control group[(8.4±0.9)IgCFU/g ratio(6.4±0.9)IgCFU/g, (8.8±1.3)IgCFU/g ratio(7.9±1.3)IgCFU/g, (7.1±0.9)IgCFU/g ratio(8.0±1.1)IgCFU/g, (5.4±0.7)IgCFU/g ratio(6.9±0.9)IgCFU/g]( t=14.248, 4.339, 5.825, 12.753, P<0.05 for all). There was no significant difference in dialysis adequacy index between the two groups before treatment( P>0.05 for all). After 24 months of treatment, the levels of Scr, BUA, BUN and Cys-C in both groups decreased, and those of the observation group were lower than those of the control group[(471.5±50.5)μmol/L vs.(623.3±62.6)μmol/L, (17.5±0.5)mmol/L vs.(20.6±1.8)mmol/L, (16.4 ± 3.0)mmol/L vs.(22.5±2.0)mmol/L, (1.9±0.5)mg/L vs.(3.0±0.7)mg/L]( t=17.877, 14.976, 15.842, 11.749, P<0.05 for all). The incidence of endpoint events in the observation group was significantly lower than that in the control group(12.2% vs.2.2%, t=6.574, P<0.05 for all). Conclusions:After the treatment of Bifidobacterium triple viable bacteria in elderly peritoneal dialysis patients, the micro-inflammatory state of the patients was reduced, the nutritional status was improved, and the incidence of endpoint events was low, and has high clinical promotion and application value.
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Bone defects caused by trauma, infection, tumor and other factors is a thorny problem in orthopedic clinic, and promoting bone repair and regeneration is the key and difficult point of treatment. In addition to autologous bone grafting, artificial bone materials are often used for large bone defects. β-tricalcium phosphate has good biocompatibility, bone conduction and bone induction properties, and has been studied deeply because of its excellent drug delivery performance and has shown broad application prospects. In this paper, the author will summarize the research progress of β-tricalcium phosphate composites loaded with different drugs in the treatment of bone defects caused by trauma, infection and tumor.
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Objective · To design and synthesize five new tropane compounds, and test their antagonistic activity against M3 receptor and inhibition activity to neutrophil elastase (NE), of which the structure-activity relationship were preliminarily investigated. Methods · The five compounds, A1-A3,B1 and C1, were prepared with 3α-hydroxy-tropane (A0) as the starting material by modifying the structure in C-3α position and N atom on the tropane skeleton. The antagonistic activity of the compounds to muscarinic M3 receptors on tracheal rings of guinea pigs was evaluated by functional assays in vitro. The hydrolysis of PGlu-Pro-Val-PNA as substrate was catalyzed by NE to get colorful nitroaniline (PNA). The NE inhibition activity of the tropane compounds was obtained by determining the absorbance [(D(405 nm)] of PNA. Results · The five new tropane compounds generated strong antagonistic activity against M3 receptors. Among them, A2 had the greatest activity [antagonistic parameter pA2(M3)=9.004], and elicited obvious inhibitory effect to NE (inhibition ratio YA2=20.29%). Conclusion · Introducing strong electron-attraction group, such as sulfuryl and hydrophobic group with large volume into C-3α position on the tropane skeleton can improve the M3 receptor antagonistic activity as well as the NE inhibition activity.
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Objective To investigate the expression and significance of CCR9/CCL25 pathway in acute rejection of mouse skin transplantation.Method BALB/c mice and C57BL/6 mice were selected as allogeneic and syngeneic skin graft donors and C57BL/6 as recipients,then established a murine skin transplantation model of acute rejection.Allogeneic transplant recipient mice were injected with an AntiCCL25(2 g,as experimental group) mAb or IgG(2 g,as control group) every other day via tail vein,a total of 10 injections.The transplanted graft was scored visually daily,and then we collected skin graft and spleen from recipient mice of each group at 3,5,7 days after transplantation.HE staining was done to analyze necrosis of skin tissue Confocal and immunohistochemistry were also used to measure CCR9 and CCL25 expression in recipient skin grafts.Result HE staining indicated that there was a widespread inflammatory cell infiltration in the skin from allo-transplantation mice,and CCR9 expression measured by immunohistochemistry and confocal was significantly elevated in the surface of the infiltrated CD3 + T cells from skin grafts tissue and spleen.Neutralization of CCL25 with Anti-CCL25 mAb significantly prolonged allogra,ft survival and markedly reduced inflammation.Conclusion CCR9 was highly expressed in the spleen and skin grafts tissue of allogeneic transplanted mice Neutralization of CCL25 by intravenous injection of Anti-CCL25 monoclonal antibody significantly prolonged skin allograft survival.Our study indicates that CCR9/CCL25 pathway is involved in acute rejection process of skin transplantation model in mice were used as syngeneic and skin grit skin graft donor mice.
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Objective To observe the association between therapeutic effect of speech disorder and the age on treatment of children with cerebral palsy,and to explore the best treatment period of speech disorder children with cerebral palsy.Methods One hundred and twenty-one cases of speech disorder children with cerebral palsy aged 1 to 6 years in Maternal and Child Health Center of Hebei Province,Hebei Children's Hospital,were selected as subjects,and the patients were randomly divided into training group,which included 64 cases who received scalp acupuncture combined with language and 57 cases treated with speech training group.After 6 courses of treatment,the therapeutic effect for speech disorder of children between 1 to 3 years old and ＞ 3 to 6 years old were compared,the association between children's age for treatment and treatment effects was explored.Results The total treatment efficiency of 1 to 3 years and ＞ 3 to 6 years old children in scalp acupuncture group combined with language training group were 95.45％ and 83.33％ respectively,the difference was significant (x2 =6.859 8,P ＜ 0.05) ; while in 1 to 3 years and ＞ 3 to 6 year-old children in speech training group the total treatment efficiency were 84.62％ and 77.42％,and the difference was significant(x2 =6.625 7,P ＜ 0.05).In both groups,total efficiency of 1 to 3 years and ＞ 3 to 6 years old children were 89.58％ and 80.82％,respectively,and the difference was statistically significant (x2 =9.617 5,P ＜ 0.01).Conclusions The best treatment period of speech disorder children with cerebral palsy is less than 3 years old,as age grows,the effect is gradually decreasing.
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Objective To investigate safety and efficiency of anti-coagulation therapy in patients with high-risk of bleeding and multiple organ dysfunction syndrome (MODS) during continuous veno-venous hemofiltration (CVVH). Meth-ods Forty patients with high-risk bleeding MODS during CVVH in our hospital were divided into heparin-free group (A group) and low-dose heparin group (B group). Blood coagulation function, platelets counts, blood urea nitrogen, serum creati-nine, PaO2/FIO2 and Apache Ⅱ scores in two groups were tracked before treatment and 24 h, 48 h after treatment. Filter lifespan, median ventilation time, ICU admission time and bleeding complications were observed. Results (1)There was significant difference in levels of blood urea nitrogen, serum creatinine, PaO2/FIO2 and ApacheⅡscores at 24 h, 48 h after treatment between in low-dose heparin group and those in heparin-free group (P＜0.05). (2)Levels of activated partial thromboplastin time(APTT), thrombin time (TT) were prolonged. Platelets count were significantly lower at 24 h after treat-ment than that before treatment in low-dose heparin group. Levels of APTT, TT and platelets count had no changes with pro-longed time of CVVH therapy.(3)Average ventilation time, ICU admission time were obviously shorter in low-dose heparin group than that in heparin-free group. Filter lifespan was significant longer in low-dose heparin group than that in heparin-free group, (P＜0.05).(4)Bleeding in skin and mucosa was observed in 1 case in low-dose heparin group without other se-vere bleeding complications. Conclusion The results of monocentric study show that low dose of heparin ensure smooth op-eration of CVVH in patients with MODS and high-risk bleeding. The clinical application is safe and efficient.