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Objective To observe the effects of parathyroidectomy(PTX) on bone metabolism and bone mineral density(BMD) in maintenance hemodialysis patients with secondary hyperparathyroidism (SHPT).Methods A total of 26 dialysis patients with SHPT were treated with PTX.Serum calcium,phosphorus,alkaline phosphatase(ALP) levels were determined by standard methods.The levels of serum intact parathyroid (iPTH),osteocalcin (OC),procollagen type Ⅰ aminoterminal propeptide (PINP),β-crosslaps (β-CTX) were measured by chemiluminescence.BMD was measured by dual energy X ray absorptiometry.iPTH,OC,PINP,β-CTX,serum calcium,phosphorus,ALP were measured before parathyroidectomy and 1,3,6,12,18,24 months after operation.Lumbar spine (LS) and femoral neck (FN) BMD were measured before and 24 months after PTX.Results Compared with that before operation,serum OC[(104.49±25.42) μg/L vs (695.46±355.62) μg/L,P ＜ 0.01] and PINP levels [(248.36 ± 159.38) μg/L vs (809.28 ± 283.50) μg/L,P＜ 0.01] progressively decreased 3 months after PTX,and serum β-CTX levels [(1.60±0.64) μg/L vs (3.37±1.34) μg/L,P ＜ 0.01] decreased 1 month after PTX.Compared with that before operation,BMD levels increased 24months after PTX in LS[(0.88±0.23) g/cm2 vs (0.78±0.23) g/cm2,P ＜ 0.01] andFN[(0.96±0.19) g/cm2 vs (0.84±0.24) g/cm2,P ＜ 0.01],and Z-scores were also increased in both LS[(-1.24±0.55) vs (-1.66± 0.24),P ＜ 0.01] and FN[(-1.51 ±0.72) vs (-1.93 ± 0.40),P ＜ 0.01].Correlation analysis showed that baseline iPTH was positively correlated with ⊿Z-score in FN (r=0.584,P=0.002) and LS (r=0.400,P=0.043),and so did the OC with ⊿Z-score in FN (r=0.651,P ＜ 0.001) and LS (r=0.509,P=0.008).Conclusion The levels of OC,PINP and β-CTX are reduced and BMD is improved in hemodialysis patients with SHPT after PTX.
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Objective To explore aspirin resistance (AR) and its relevant influencing factors in patients on maintenance hemodialysis (MHD).Methods Patients on MHD who visited Beijing Chaoyang Hospital from June 1 to 30,2011 were enrolled in this study.A total of 150 age and gender matched individuals with normal renal function were taken as control group.Anthropometric data,biochemistry parameters,ultrasonography and thromboelastograph (TEG) were inspected in the both groups.AR was defined as inhibiting rate of acetylsalicylic acid drugs [MA (AA)] ＞ 50％ by TEG.Results Among the total 391 patients on MHD,hypercoagulation was found in 18 patients (4.6％),nomal coagulation in 288 patients (73.7％) and hypocoagulation in 85 patients (21.7％).Pearson's correlation analysis revealed that the reaction time (R) and the thrombus maxithrombelastic degree (MA) values were not correlated with the levels of hemoglobin and platelet in MHD patients.A total of 306 patients with hypercoagulation and normal coagulation were chosen as the MHD group.Compared with the control group,higher high sensitivity C reactive protein (hsCRP),homocysteine (Hcy) and R value were observed in the MHD group (P ＜ 0.05),while MA was significantly lower in the MHD group.Statistically higher incidence of AR was shown in the MHD group (48.0％ vs 20.0％,P =0.00).Patients in the MHD group were divided into the AR group and the aspirin sensitive (AS) group by the result of TEG.Compared with the AS group,patients in the AR group were found to be older with a higher female/male ratio,longer dialysis sustained time,higher ratio of diabetes history,higher hsCRP,Hcy and fasting blood glucose (FBG) and MA.They also manifested a higher incidence of cardiovascular and cerebrovascular diseases,peripheral vascular disease and arteriovenous fistulas with thrombosis with more spots of carotid artery and higher intima thickness of carotid artery (IMT) (all P values ＜0.05).Lower R value was shown in the AR group.Binary logistic regressive analysis revealed that the ratio of diabetes history,age and dialysis sustained time.Hcy and hsCRP were the independent risk factors for AR in patients on MHD.A total of 289 patients on MHD with atherosclerosis were followed up for the mean time of 18.0 months with no hemorrhage found in the process.Cox proportional hazards regression modeling demonstrated that AR was associated with the major adverse longterm outcome of the vascular events [HR =0.40,95 ％ CI 0.29-0.72,P =0.00].Conclusions The ratio of platetet activation in patients on MHD is significantly lower than in those with normal renal function.Small dose of aspirin could be prescribed for the patients on MHD with atherosclerosis to prevent vascular events.The incidence of AR is 48.0％ in the MHD group and the independent risk factors for AR in MHD patients are the ratio of diabetes history,age,dialysis sustained time,Hcy and hsCRP.AR is associated with the major adverse long-term outcome of acute vascular events.
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Objective To investigate aspirin resistance (AR) and its related factors in patients with stage 3-4 chronic kidney disease(CKD).Methods The clinical data of 108 patients with stage 3-4CKD from nephrology department in Beijing Chaoyang Hospital were collected (CKD group) ; and 110 age and sex-matched subjects with normal renal function served as control group.Anthropometric parameters,blood biochemistry index,ultrasonography and thromboelastograph (TEG) were examined in both groups; and inhibition ratio of arachidonic acid ＞ 50％ on TEG was defined as AR.Results The incidence of cardio-cerebral vascular disease,the incidence of peripheral vascular disease,ratio of female,the intimamedia thickness (IMT) of carotid artery,the levels of high-sensitive C-reactive protein (hsCRP),homocysteine(Hcy),evaluated glomerular filtration rate(eGFR) and maximal thrombelastodegree (MA) on TEG in CKD group were significantly higher than those in control group (all P ＜ 0.05),while R value was significantly lower in CKD group.Pearson's correlation analysis revealed that the levels of MA,hsCRP,Hcy,IMT were positively correlated and R value was negatively correlated with eGFR in CKD group.The incidence of AR in CKD group (32.4％) was significantly higher than in control group (20.0％).According to TEG,the patients were divided into AR group (n =35) and aspirin sensitive (AS) group (n =73).The incidence of cardio-cerebral vascular disease,the incidence of peripheral vascular disease,ratio of female,IMT,ratio of diabetes,the levels of hsCRP,Hcy,fasting plasma glucose (FBG),eGFR and MA in AR group were significantly higher than those in AS group (all P ＜ 0.05),while R value was significantly lower in AR group.Binary logistic regressive analysis revealed that the ratio of diabete,FBG,eGFR,hsCRP were independent risk factors for AR in patients with stage 3-4 CKD.Conclusions CKD stage 3-4 is associated with increased ratio of platelet activation and atherosclerosis,and this condition is aggravated while eGFR declining.Incidence of AR is 32.4％ in this group of CKD patients,the independent risk factors of AR in CKD patients are the ratio of diabetes,FBG,eGFR and hsCRP.
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An investigation of differences in gene expression in the longissimus muscle of Meishan and Large White pigs was undertaken, using the mRNA display technique. A fragment of one differentially expressed gene was isolated and sequenced, whereupon the complete cDNA sequence was then obtained by using the rapid amplification of cDNA ends (RACE). The nucleotide sequence of the gene is not related to any known porcine gene. Sequence analysis revealed that the open reading frame of this gene encodes a protein with 322 amino acids, thus displaying high sequence identity with the PDZ binding kinase (PBK) of eleven other animal species - dog, horse, cattle, human, chimpanzee, crab-eating macaque, rhesus monkey, rat, mouse, gray short-tailed opossum and platypus, so it can be defined as the porcine PBK gene. This gene was finally assigned GeneID: 100141310. Phylogenetic tree analysis revealed that the swine PBK gene has a closer genetic relationship with the PBK gene of platypus. Gene expression analysis of eight tissues of a Meishan x Large White cross showed that the porcine PBK gene is differentially expressed in various tissues. Our experiment established the primary foundation for further research on this gene.