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To evaluate the efficacy of heparin combined with low molecular heparin against early thrombosis in chronic patients after native arteriovenous fistula ( AVF) . Methods: A total of 299 patients were enrolled in the study from January 2012 to December 2014 and randomly divided into two groups. The control group received 5000IU low molecular heparin after the operation for 7 days and the trial group received 3 000u heparin additionally through free arterial end and venous terminal during the operation. The thrombosis formation rate and adverse drug reactions ( ADR ) of one week and 4 weeks after the operation were observed in the two groups. Results:One week after the operation, the thrombosis formation rate in the control group and the trial group was 3. 4% and 0, respectively, and four week after the operation, that was 4. 8% and 0. 67%, respectively. The incidence of ADR showed no statistical-ly difference between the two groups (P>0. 05), and no severe ADR appeared in both groups. Conclusion:Heparin combined with low molecular heparin may be more effective and safer in the prevention of primary thrombosis in the patients after AVF.
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Objective To investigate the effects and underlying mechanism of the scavenger receptor CD36 in high glucose-induced rat glomerular mesangial cells apoptosis.Methods The mesangial cells of rats were divided into 4 groups:control group (5.6 mmol/L glucose),mannitol group (24.2 mmol/L mannitol+5.6 mmo]/L glucose),high glucose group (30 mmol/L glucose),CD36 monoantibody group (30 mmol/L glucose+CD36 mono-antibody).The intracellular ROS level was detected by confocal microscopy with fluorescent probe CM-H2DCFDA.MDA,GSH-PX,8-OHDGA in cell supernatant were detected.Apoptosis was determined by flow cytometry followed by Annexin V-FITC/PI double stains.The expression of CD36,Bax and Bcl-2 were detected by RT-PCR and Western blotting.Results The expression of CD36 was detected in glomerular mesangial cells.The highest level was found in high glucose group in 24 hours.There was no significant difference found between control group and mannitol group with respect to intracellular ROS generation,MDA,8-OHDG,GSH-PX level,apoptosis rate,expression of CD36,Bax and Bcl-2 (all P ＞ 0.05).There was no significant difference in the expression of CD36 between CD36 mono-antibody group and high glucose group (P ＞ 0.05).Compared to control group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of CD36 and Bax were significantly increased,the GSH-PX level and the expression of Bcl-2 were significantly lower in high glucose group (all P ＜ 0.05).Compared to the high glucose group,the intracellular ROS generation,MDA and 8-OHDG levels,apoptosis rate,the expression of Bax were suppressed but the GSH-PX level and the expression of Bcl-2 increased in CD36 mono-antibody group (all P ＜ 0.05).The intracellular ROS level was positively correlated with apoptosis rate,protein expression of CD36 and Bax gene,was negatively correlated with Bcl-2 protein expression.Conclusions CD36 was involved in the high glucose induced apoptosis of mesangial cells which was potentially mediated by an increased level of oxidative stress.
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Objective To investigate the HBV reactivation status and clinic outcomes in the renal allograft recipients with inactive HBsAg carriers,and explore the preventive measures.Methods A retrospective analysis of clinical manifestation was processed in 88 cases of inactive HBsAg carriers before and after renal transplantation.Preoperative liver function in all cases was normal and serum HBsAg positive,HBV DNA＜106 copies/L.Tacrolimus (or cyclosporine A) + mycophenolate mofetil (MMF) + prednisone were given in prevention of rejection after transplantation.In 88 cases,56 cases were given nucleoside analogues (acid) for prophylactic antiviral therapy,in which 31 cases were given lamivudine (LAM) (LAM group),25 cases were given entecavir (ETV) (ETV group) ; The rest 32 cases were not given prophylactic antiviral therapy,only receiving routine liver-protecting therapy (inosine,glucurolactone) (control group).Incidence of HBV re-activation,liver function,response to treatment and the pathological changes of hepatic tissue were observed.Results During the follow-up period,the incidence of HBV reactivation in LAM group and ETV group was 45.2％ and 28.0％ respectively,significantly lower than in control group (84.4％,P＜ 0.05).In prophylactic treatment groups,HBV reactivation occurred later,liver function damage was milder,and HBV DNA load peak was lower (P＜0.05).In LAM group,HBV reactivation occurred in 14 cases,including 10 cases occurred during administration of LAM,and ETV treatment was given for about 2 months,serum HBV DNA levels in 7 cases were under detection line;in the rest 4 cases,HBV reactivation occurred in patients with treatment less than 1 year and noncompliance,who withdrew medicine blindly.After the original scheme of antiviral therapy was done,serum HBV DNA levels in 3 cases were under detection line,and the effect was not obvious in one case.In control group,HBV reactivation occurred in 27 cases.Fourteen cases therefore accepted nucleoside (acid) analogs antiviral therapy,and HBV DNA levels in 10 cases were under detection line.Histological examination revealed the liver with fibrotic cholestatic hepatitis changes in 9 patients,including 8 cases in control group,and 1 case in LAM group due to blind withdrawal of medicine.Conclus(i)on LAM and ETV prophylactic use may decrease the HBV reactivation rate in inactive HBsAg carriers after renal transplantation,reduce the severity of liver damage and the occurrence of fibrotic cholestatic hepatitis.
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Objective:To evaluate the clinical efficacy of shenxiong glucose injection in the treatment of chronic re- nal failure(CRF).Method:78 patients with CRF were divided into a treatment group(n=40)and a controlled gronp(n= 38).The treatment group received shenxiong glucose injection 200ml daily,14 days for one course of treatment.The con- trolled group received ligustrazine injection 80mg with 5% glucose.The changes of serum BUN and SCr were observed.Re- sult:The serum BUN and SCr were significantly decreased in the two groups after the treatment(P
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Objective:To evaluate the clinical efficacy of benazepril in combination with valsartan in treating chronic kidney patients with proteinuria and hypertension.Method:75 chronic kidney patients were divided into benazepril group(n=28)and valsartan group(n=26)and combination treatment group(n=21).The changes of 24 hours urinary protein excretion and blood pressure and serum BUN and SCr were observed before the treatment and 4 and 8 weeks after it. Result:The 24 hours urinary protein excretion and blood pressure in all the groups showed significant decreases after the treatment(P0.05),but the levels of SUA were significantly lower in the valsartan group and combination treatment group than those in the benazepril group(P
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OBJECTIVE To detect the trace glutaraldehyde in the fluid from venous circuit tube of hemodialysis,a HPLC assay was developed.METHODS 20 mL fluid taken from the venous circuit tube were derived with DNPH for 3 h,then filtered and injected. Chromatography was conducted on C18 column at 29℃.The mobile phase was consisted of 60% CH3N and 40% H3PO4 with the flow rate at 1 mL*min-1, and the detetion wavelength was at 365 nm.RESULTS The concentrations of glutaraldehyde in the fluid ranged from 14.99 to 37.40 μg.mL-1.CONCLUSION This HPLC method is simple and accurate to detect the trace glutaraldehyde remained in the fluid from venous circuit tube.