Safety, Effectiveness, and Manipulability of Peritoneal Dialysis Machines Made in China: A Randomized, Crossover, Multicenter Clinical Study / 中华医学杂志(英文版)

Background@#Automated peritoneal dialysis (APD) can cater to individual needs, provide treatment while asleep, take into account the adequacy of dialysis, and improve the quality of life. Currently, independent research and development of APD machines made in China are more conducive to patients. A randomized, multicenter, crossover study was conducted by comparing an APD machine made in China with an imported machine. The safety, effectiveness, and manipulability of the two machines were compared.@*Methods@#Two hundred and sixty patients who underwent peritoneal dialysis (PD) on a regular basis in 18 centers between August 2015 and February 2016 were included. The inclusion criteria include age ≥18 years and PD ≥30 days. The exclusion criteria were as follows: hemodialysis; exit site or tunnel infection; and peritonitis ≤30 days. The patients were randomly divided into Group A, who were first treated with a FM machine made in China, then changed to an imported machine; and Group B, who were treated using the reverse sequence. APD treatment was performed with 10 L/10 h and 5 cycles of exchange. After 72 h, the daily peritoneal Kt/V, the accuracy of the injection rate, accuracy of the injection temperature, safety, and manipulability of the machine were assessed. Noninferiority test was conducted between the two groups.@*Results@#The daily peritoneal Kt/V in the APD machine made in China and the imported APD machine were 0.17 (0.14, 0.25) and 0.16 (0.13, 0.23), respectively. There was no significant difference between the groups (Z = 0.15, P = 0.703). The lower limit of the daily Kt/V difference between the two groups was 0.0069, which was greater than the noninferiority value of -0.07 in this study. The accuracy of the injection rate and injection temperature was 89.7% and 91.5%, respectively, in the domestic APD machine, which were both slightly better than the accuracy rates of 84.0% and 86.8% in the imported APD machine (89.7% vs. 84.0%, P = 0.2466; 91.5% vs. 86.8%, P = 0.0954). Therefore, the APD machine made in China was not inferior to the imported APD machine. The fuselage of the imported APD machine was space-saving, while the APD machine made in China was superior with respect to body mobility, man-machine dialog operation, alarm control, and patient information recognition.@*Conclusions@#The FM machine made in China was not inferior to the imported APD machine. In addition, the FM machine made in China had better operability.@*Trial Registration@#Clinicaltrials.gov, NCT02525497; https://clinicaltrials.gov/ct2/results?cond=&term=NCT02525497&cntry=& state=&city=&dist=.

Efficacy and safety of Flos Abelmoschus manihot (Malvaceae) on type 2 diabetic nephropathy: A systematic review / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Flos Abelmoschus manihot (Malvaceae) on type 2 diabetic nephropathy (DN).</p><p><b>METHODS</b>The Cochrane Library, PubMed/MEDLINE, Excerpta Medical Database, Chinese electronic literature databases, and the references of relevant articles were searched in March 2012 for randomized controlled trials (RCTs) that reported the effects of Flos A. manihot on type 2 DN patients with overt but subnephrotic-range proteinuria (500-3,500 mg/24 h). The quality of trials was evaluated using the Cochrane-recommended method. The results were summarized as risk ratios (RRs) for dichotomous outcomes or mean differences (MDs) for continuous outcomes.</p><p><b>RESULTS</b>Seven trials (531 patients) were included. Flos A. manihot significantly decreased proteinuria [MD -317.32 mg/24 h, 95% confidence interval (CI) [-470.48, -164.17],P<0.01]. After excluding a trial that only included patients with well-preserved renal function, Flos A. manihot was associated with a significant decrease in serum creatinine (MD -11.99 μmol/L, 95% CI [-16.95, -7.04],P<0.01). Serious adverse events were not observed. The most common adverse event was mild to moderate gastrointestinal discomfort; however, patients receiving this herb did not have an increased risk for tolerated gastrointestinal discomfort (RR 1.48, 95% CI [0.39, 5.68],P=0.57).</p><p><b>CONCLUSIONS</b>Flos A. manihot may be considered as an important adjunctive therapy with the first-line and indispensable therapeutic strategies for type 2 DN. High-quality RCTs are urgently needed to confirm the effect of Flos A. manihot on definite endpoints such as end-stage renal disease.</p>

Clinical analysis of 14 patients with thrombotic thrombocytopenic purpura / 中国实验血液学杂志

In order to enhance the understanding of thrombotic thrombocytopenic purpura (TTP), the clinical features, laboratory characteristics, treatment and outcome of 14 patients with TTP were retrospectively analyzed and investigated. The results showed that 7 out of 14 patients with TTP had predisposing factors, such as pregnancy in 4 cases, infection in 3 cases, systemic lupus erythematosus (SLE) in 1 case and hematopoietic stem cell transplantation (HSCT) in 1 case. Fourteen patients all had neuropsychological symptoms, hemolytic anemia with negative-Coombs test, and decreased platelet counts. Eight patients had irregular fever with different degree. There were 8 patients with kidney damage including proteinuria in 8 cases and renal function abnormalities in 4 cases. The von Willebrand factor-cleaving protease (VWF-CP, ADAMTS13) activity of 13 cases out of 14 patients significantly decreased (less than 10%). At same time, plasma ADAMTS13 inhibitors were detected in 12 cases out of these 13 patients with decreased ADAMTS13 activity. After treatment with plasma exchange, glucocorticoid and rituximab so on, 12 cases achieved complete remission, in which 8 cases relapsed in two years. Two patients died at last, in which one case was secondary to HSCT. It is concluded that TTP is a kind of thrombotic microangiopathy due to platelet microthrombosis involved in multiple systems and multiple organs dysfunction with dangerous clinical process. The mortality of TTP patients is very high. Early diagnosis and early treatment with plasma exchange as the main means can greatly improve the prognosis of patients with TTP.

Effects of DNA methylation on expression of TIG1 gene in acute leukemia / 中国实验血液学杂志

This study was purposed to investigate the expression and methylation status of TIG1 in acute leukemia (AL). The TIG1 expression of 53 cases of AL and 20 cases of normal control (NC) were measured by using real-time quantitative PCR (RT-QT-PCR) and methylation-specific PCR(MS-PCR). The leukemia KG-1a, U937 and K562 cells were treated with 5-Aza-CdR. The results indicated that TIG1 gene expressed at a high level in cases of NC, but expressed at a low level in patients with AL. TIG1 gene was unmethylated in NC, but frequently methylated in AL. Aberrant methylation rate of TIG1 in AL was 75% (40/53). The expression of TIG1 in unmethylated patients was higher than that in methylated patients. Hypermethylation of TIG1 promoter CpG islands was detected in all the cell lines. 5-Aza-CdR treatment led to the hypomethylation of TIG1 promoter CpG islands. After the treatment with 5-Aza-CdR of different concentration, the expression of TIG1 was restored, and the effect of 5-Aza-CdR displayed dose-dependency. It is concluded that the reduced expression of TIG1 may play an important role in the pathogenesis of AL, and methylation may be responsible for the decreased transcription of TIG1 gene.

Efficacy and safety of Changfu peritoneal dialysis solution: a multi-center prospective randomized controlled trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A multi-center large scale study is needed to confirm the efficacy and safety of domestic peritoneal dialysis (PD) solutions. Some researchers believe that 6 L/d is enough for adequate dialysis, but there is no multi-center prospective study on Chinese population to confirm this. In this study, we evaluated the efficacy and safety of domestic PD solution (Changfu) and its difference between 6 L and 8 L dosage.</p><p><b>METHODS</b>Adult PD patients who had taken PD therapy for at least one month were selected and divided into four groups according to two dialysis solution brands and two dialysis dosages, i.e., 6 L dose with Changfu dialysis solution, 6 L dose with Baxter dialysis solution, 8 L dose with Changfu dialysis solution, and 8 L dose with Baxter dialysis solution. After 48 weeks, the changes of primary and secondary efficacy indices were compared between different types and different dosages. We also analyzed the changes of safety indices.</p><p><b>RESULTS</b>Changes of Kt/V from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of creatinine clearance rate (Ccr). Normalized protein catabolic rate (nPCR) from baseline to 48 weeks between Changfu and Baxter showed no statistical differences; so did those of net ultrafiltration volume (nUF) and estimated glomerular filtration rate (eGFR). Changes of nPCR from baseline to 48 weeks between 6 L and 8 L showed no statistical differences; so did those of nUF and eGFR. The decline of Kt/V from baseline to 48 weeks in 6 L group was more than that in 8 L group. Change of Ccr was similar. During the 48-week period, the mean Kt/V was above 1.7/w, and mean Ccr was above 50 L×1.73 m(-2)×w(-1). More adverse events were found in Changfu group before Changfu Corporation commenced technology optimization, and the statistical differences disappeared after that.</p><p><b>CONCLUSIONS</b>The domestic PD solution (Changfu) was proven to be as effective as Baxter dialysis solution. During 48-week period, a dosage of 6 L/d was enough for these patients to reach adequate PD. Clinical study promotes technological optimization, further helps to improve the safety indices of the medical products.</p>

Multiple viral transmission chains of enterovirus 71 co-circulated in Jilin Province during 2009-2010 / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyze the genetic characterization of enterovirus type71 (EV71) associated with hand foot and mouth disease (HFMD) epidemics in Jilin province, during 2009-2010.</p><p><b>METHODS</b>Randomly selected 31 representative EV71 strains from the cases of 8 prefectures to amplify and sequences of VP1 genes of EV71 strains, and analyzed with Bioedit and Mega4.0 program.</p><p><b>RESULTS</b>All representative 31 EV71 strains belong to C4a subgenotype, the homology of nucleotide in VP1 region among the 31 EV71 strains were 94. 5%-100. 0%, and were clustered into 5 transmission chains respectively. 25 strains out of 31 strains were associated with a predominant transmission chain, and circulating in 8 prefectures, while other 6 strains clustered into 4 lineages.</p><p><b>CONCLUSION</b>Multiple transmission chains of EV71 C4a subgenotype were co-circulating in Jilin province during 2009-2010, and a predominant transmission chain was circulating in 8 prefectures, associated with HFMD outbreaks of Jilin province.</p>

Transmission and prevalence patterns of C4a evolutionary lineage of human enterovirus 71 circulating in mainland China, 2008-2010 / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To understand the evolutionary relationship between the C4a evolutionary lineage of human enterovirus 71 (HEV71) strains circulating in mainland of China during 2008-2010 and 2008 Fuyang strains and study the prevalence and transmission patterns of 2008 Fuyang strains.</p><p><b>METHODS</b>Download all the complete VP1 ( > or = 891 bp) or approximate complete VP1 (> or = 876 bp) gene nucleotide sequences from GenBank of HEV71 strains circulating in Mainland of China during 2008-2010. And analyze the phylogenetic relationship between Fuyang strains and other provinces' strains using the MEGA software, version 5.0.</p><p><b>RESULTS</b>All of the HEV71 isolates circulating in Mainland of China during 2008-2010 were clustered into evolutionary lineage C4a except for eight strains grouped in the genotype A and one isolate belongs to evolutionary lineage C4b; the homology analysis showed there were 96.5%-100% identity between C4a viruses circulating in mainland China during 2008-2010 and 2008 Fuyang strains, and they were evolved from C4b viruses of 1998. The transmission chains of Fuyang strains were mainly transmitted in Guangdong, Jiangsu, Shanghai, Hunan, Shandong provinces.</p><p><b>CONCLUSION</b>The predominant viruses circulating in Mainland of China during 2008-2010 were evolutionary lineage C4a of human Enterovirus 71; Fuyang transmission chains mainly distributed in southern of China and the Central China around Anhui provinces.</p>

Application of a simple method for the detection of measles virus genome by loop-mediated isothermal amplification (LAMP) / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>A new simple RT-LAMP method was applied to detect measles virus nucleic acid and compared with nest-RT-PCR.</p><p><b>METHODS</b>Compare the detection rate of the RT-LAMP method with that of nest-RT-PCR by detecting measles virus nucleic acid from measles virus and clinical samples.</p><p><b>RESULTS</b>The nucleic acid positive rates of all 23 strains of measles virus are all 100% by the two methods. But to the detection of 18 clinical samples which are negative in measles isolation, the nest-RT-LAMP showed 56.52% positive rate of nucleic acid of measles virus and nest-RT-PCR showed 47.83%.</p><p><b>CONCLUSION</b>RT-LAMP is more sensitive than nest-RT-PCR.</p>

Genotype and gene charactrization of wild-type measles viruses circulated in Jilin Province / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the genotype and gene characterization of measles wild viruses circulated in Jilin provinces, and to provide scientific evidences for setting down controlling and preventing strategy and measures.</p><p><b>METHODS</b>38 strains of measles virus isolated in 2001-2006 were genotyped by RT-PCR-RFLP, some strains of measles virus in Jilin province were chosen for the phylogenetic analysis and for the homology analysis of nucleotide and amino acid sequences.</p><p><b>RESULTS</b>All the 38 strains of measles virus were identified as H1 genotype by RT-PCR-RFLP, and 29 strains of them were identified further as H1 a by sequence analysis. The homology of nucleotide was 88.0%-89.4% and the homology of amino acid was 91.8%-92.7% .The average diversity was less than 1.4%.</p><p><b>CONCLUSION</b>The measles virus of H1a genotype was the circulating virus within recent years in Jilin province. There were the same measles virus strains circulating and transmitting at different years and also the different H1a measles virus strains co-circulating at the same year. There were the same transmission chain caused by the same measles virus with other provinces.</p>

Expressions of c-IAP2 and Smac gene in leukemia and their clinical significance / 中国实验血液学杂志

To investigate the expressions of c-IAP2 and Smac in leukemia and their prognostic significance in adult patients with acute leukemia (AL), the mRNA expressions of c-IAP2 and Smac in 103 AL adult patients were measured by semi-quantity reverse transcription polymers chain reaction (RT-PCR). Other 20 adults were selected as normal controls (NC), K562 and Kg-1alpha cell lines were employed as positive control. The results showed that the expressions of c-IAP2 and Smac in de novo AL patients were higher than those in NC, while they decreased in patients at complete remission (CR). In relapsed patients, the expressions of c-IAP2 and Smac increased again. The mRNA expression of c-IAP2 and Smac in CML-CP were higher than that of NC, but no statistical significance was found (P > 0.05). In AL patients, the CR rate of c-IAP2+ and Smac+ cases were lower than those of c-IAP2- and Smac- cases. It is concluded that overexpression of c-IAP1 and Smac may play a synergic role in the pathogenesis of AL, and there is a positive correlation beween them. The c-IAP2 and Smac expressions are associated with remission rate in AL, while the patients with high level of c-IAP2 or Smac have low remission rates. It seems that c-IAP2 and Smac serve as markers of poor prognosis in AL.