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End-stage renal disease (ESRD) patients undergoing outpatient hemodialysis (HD) and home peritoneal dialysis (PD) are high risk population of severe and critical types caused by SARS-CoV-2 infection. In order to improve the quality of diagnosis and treatment in dialysis patients with SARS-CoV-2 infection, we wrote this recommendation for primary care clinicians. During the epidemic period of SARS-CoV-2 infection, all patients should be instructed to strengthen self-management. Once the SARS-CoV-2 infection was found in dialysis patients, early stratified management should be carried out within 72 hours after the first positive nucleic acid or antigen test results, which includes early antiviral therapy, early recognition, and transferring severe patients from community or primary hospital to a referral hospital promptly. Guidance for dietary and sports rehabilitation after SARS-CoV-2 infection should also be started as soon as possible.
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【Objective】 To explore the role and mechanism of TRPC6 in apoptosis of glomerular mesangial cells (HBZY-1) induced by endoplasmic reticulum stress (ERS). 【Methods】 The experiment groups were classified as follows: normal control (NC), thapsigargin (TG), TG+SKF96365, and TG+TRPC6 siRNA groups. Transcription and protein expressions of TRPC6 and ERS related proteins (GRP78 and Caspase12) were detected by qRT-PCR and Western blotting. Additionally, cell apoptosis was measured by flow cytometry and Hoechst33258. Finally, Fluo-4 AM Ca2+ imaging technique was used to determine changes of intracellular calcium ( [Ca2+] i) by laser scanning confocal microscope. 【Results】 Morphological changes of apoptotic cells were characterized by nuclear enrichment or nuclear fragmentation, and the apoptosis rate was increased after TG stimulation. The expressions of TRPC6 and ERS related proteins (GRP78 and Caspase12) were elevated in TG group compared with NC group (P<0.05). Pre-incubation of HBZY-1 cells with SKF96365 and TRPC6 siRNA decreased cell apoptosis (P<0.05). The entry of [Ca2+] i also increased after TG stimulation (P<0.05). The expressions of TRPC6, GRP78 and Caspase12 were downregulated compared with TG group after treatment with SKF96365 and TRPC6 siRNA accompanied by decreased [Ca2+] i (P<0.05). 【Conclusion】 Taken together, this study suggests that inhibition of TRPC6 can alleviate TG-induced HBZY-1 cell apoptosis.
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Objective:To investigate the effect of hemoglobin (Hb) volatility on cardiovascular prognosis in peritoneal dialysis (PD) patients.Methods:Retrospective cohort study was designed. Patients undergoing stable PD for more than 3 months and followed up regularly for at least 1 year were enrolled from May 1, 2013 to October 31, 2014 in the General Hospital of Ningxia Medical University. According to the Hb variation based on the mean changes in Hb standard deviation at 1 month, 3 months, 6 months, 12 months over baseline Hb, all patients were divided into low volatility group (≤10 g/L), moderate volatility group (>10-20 g/L) and high volatility group (>20 g/L), and baseline information were compared among these groups. Kaplan-Meier survival analysis and Cox regression equation were used to analyze the relationship between Hb variation and cardiovascular mortality and all-cause mortality. Besides, the patients were divided into qualified group (Hb≥110 g/L) and substandard group (Hb<110 g/L) by the Hb level at the study endpoint (cardiovascular death and all-cause death) according to KDIGO guidelines and relevant literature. Cox regression analysis was used to analyze the relationship between Hb variation and cardiovascular death in qualified group or substandard group. Multivariate linear regression analysis was used to analyze the related factors of Hb fluctuation in PD patients.Results:A total of 267 patients were enrolled. There were 160 males (59.93%) in this study. The age was (52.66±13.72) years old, and the median dialysis age was 37(21, 61) months. The patients' baseline Hb (before dialysis) was (80.16±14.89) g/L and at the end of the study Hb was (105.34±22.08) g/L. Body mass index and baseline Hb levels in the high volatility group were lower than those in low volatility group and moderate volatility group (all P<0.05). Both moderate and high volatility groups had lower estimated glomerular filtration rate than that in low volatility group, and high volatility group had higher urea nitrogen level than that in low volatility group (all P<0.05). The amount of erythropoietin usage in the high volatility group was higher than that in moderate volatility group ( P<0.05). The Kaplan-Meier survival analysis results showed that there was no significant difference in survival rate for all-cause death (Log-rank χ2=0.735, P=0.693) and cardiovascular death (Log-rank χ2=2.961, P=0.228) in different Hb volatility groups. Cox regression analysis showed that after adjusting for age, sex, serum creatinine, and blood albumin, higher Hb volatility was associated with a lower risk of cardiovascular death ( HR=0.972, 95% CI 0.947-0.999, P=0.040). After adjusting for related confounding factors, higher Hb volatility was still a protective factor for cardiovascular death in the substandard group ( HR=0.946, 95% CI 0.903-0.992, P=0.022), but there was no significant correlation between Hb fluctuation and all-cause death. Multivariate linear regression analysis results showed that the fluctuation level of Hb was positively correlated with Kt/V ( B=4.682, 95% CI 2.480-6.884, P<0.001) and erythropoietin dosages ( B=0.001, 95% CI 0-0.001, P=0.003), and negatively correlated with baseline Hb ( B=-0.554, 95% CI -0.651--0.457, P<0.001). Conclusions:High Hb variability is a protective factor for cardiovascular death in PD patients with lower Hb level (substandard Hb). Adopting a reasonable program to correct anemia timely to reach the standard level has a greater impact on reducing risk of cardiovascular death in PD patients than Hb variation in anemia treatment.
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Objective:To explore the status of volume management behavior in patients with peritoneal dialysis, and to explore the relationship between health belief and volume management behavior.Methods:Convenient sampling was used to select 129 patients who underwent regular dialysis in the peritoneal dialysis center of the General Hospital of Ningxia Medical University from January to December 2019. The general condition questionnaire, Health Belief Scale, and Capacity Management Behavior Scale for patients with peritoneal dialysis were used.Results:The total score of the Capacity Management Behavior Scale of peritoneal dialysis patients was 20.23±3.54. Among all the entries: "Weigh and record the infusion volume and drainage volume" and "Regular monitoring of renal function and electrolytes and other related examinations as directed by the doctor" scored higher; while the item "Eat less high-salt and high-sodium food and adjust fluid intake according to the amount of ultrafiltration, edema and urine output" item scored lower; single factor analysis found that different educational levels, different employment conditions, whether had diabetes mellius and different over hydration had statistical significance ( F value was 3.911, t values were 2.409, 4.990, 6.070, P<0.05). The dimension of the perception maintenance capacity balance disorder was negatively correlated with the total score and each dimension of the capacity management behavior( r values were -0.243, -0.260, -0.299, P<0.05) , and the liquid intake self-efficacy dimension is positively correlated with the total score and each dimension of the capacity management behavior ( r values were 0.329, 0.397, 0.393, P<0.05). Conclusions:The level of capacity management behavior of peritoneal dialysis patients needs to be improved; employment status, and whether he has diabetes or not are the influencing factors of the patients' capacity management behavior; in health beliefs, perception of maintenance of volume balance disorders and self-efficacy and peritoneal dialysis are correlated with patients' capacity management behaviors.
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Objective:To explore the effect of aerobic exercise combined with diet management on volume overload and cardiac function in patients with peritoneal dialysis.Methods:A total of 100 patients who received peritoneal dialysis in the Second Affiliated Hospital of Xi ′an Jiaotong University from August 2017 to March 2019 were recruited in the present study. Patients were randomly divided into intervention group and control group according to the random number table (50 cases in each group). The control group received routine nursing, while the intervention group carried out aerobic exercise combined with diet management on the basis of routine nursing. Before and after 6 months of intervention, the volume status, edema degree and cardiac function were compared between the two groups. Results:After 6 months of intervention, the levels of body weight, 24 h urine volume, 24 h ultrafiltration volume, systolic pressure, extracellular water, and extracellular water/total body water were (58.99 ± 7.30) kg, (366.41 ± 66.92) ml, (565.08 ± 102.24) ml, (142.64 ± 11.70) mmHg (1 mmHg=0.133 kPa), (12.30 ± 2.01) L, 0.39 ± 0.08 in the intervention group, significantly lower than in the control group (63.46 ± 12.90) kg, (431.90 ± 78.92) ml, (625.35 ± 91.31) ml, (150.11 ± 11.44) mmHg, (14.37 ± 4.12) L, 0.43 ± 0.07, the differences were statistically significant ( t values were 2.026-4.208, all P<0.05); the left ventricular ejection fractions, E/A were (61.38 ± 9.42)%, 1.15 ± 0.35 in the intervention group, significantly higher than in the control group (57.04 ± 7.83)% and 1.00 ± 0.29, the differences were statistically significant ( t values were 2.358, 2.113, all P<0.05). After 6 months of intervention, the normal ratio increased and Ⅲ grade ratio decreased in the intervention group, the difference of edema degree between the two groups was statistically significant ( Z value was 3.153, P<0.01). Conclusions:Aerobic exercise combined with diet management can effectively control the volume overload status and improve the cardiac function of patients with peritoneal dialysis.
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Objective To investigate health beliefs and fluid status in diabetic peritoneal dialysis patients, to explore the relation between fluid status and health beliefs in diabetic peritoneal dialysis patients. Methods The data were collected from the peritoneal dialysis center in Ningxia Medical University General Hospital from January 2014 through January 2015. A total of 64 diabetic peritoneal dialysis patients were recruited and investigated with health beliefs scale, fluid status and laboratory index, the influencing factors were analyzed with Logistic regression. Results Levels of perceived barriers in diabetic peritoneal dialysis patients was the lowest. The score of perceived barriers, levels of albumin and daily water intake in pedal edema diabetic peritoneal dialysis patients were 35.34±10.31, (29.90±4.51) g/L,(860.34±516.71) ml/d, and the results in the non-pedal edema patients were 31.67±12.47, (32.72±6.87) g/L, (872.22±271.85) ml/d, the difference was significant (t=-1.99,2.09,-3.07, P<0.05 or 0.01). Perceived barriers in diabetic peritoneal dialysis patients was positively correlated with edematous level (r=0.16,P<0.05) and perceived capacity balancing was negatively correlated with edematous level (r=-0.25,P<0.05). Regression analysis showed that marital status,dialysis age,daily water intake and perceived barriers were the main factors influencing fluid control in diabetic peritoneal dialysis patients. Conclusions Fluid control in diabetic peritoneal dialysis patients is affected by their health beliefs, this indicates that diabetic peritoneal dialysis patients must have insufficient awareness of fluid status and fluid adherence. It is suggested that they should establish comprehensive health beliefs.
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Objective To analyze reasons for the generation of unqualified blood specimens in coagulation test in tumor patients and to develop countermeasures ,so as to ensure the quality of samples prior to analysis .Methods Blood specimens received from outpatients in Tumor Hospital of Yunnan Province in 2012(40 253 specimens) ,2013(46 756 specimens) and first quarter of 2014 (14 566 specimens)were retrospectively analysed .Unqualified rate was used to describe situation of unqualified specimens ,and the distribution and changes of unqualified specimens were compared among the three years .Results The unqualified rate of blood specimens in coagulation test in 2012 and 2013 was 0 .57% and 0 .96% ,respectively .Reasons for unqualified blood specimens in 2012 was ,in order ,specimens agglutination ,insufficient amount of specimen ,excessive amount of specimen ,wrong container ,no specimen .Reasons for unqualified blood specimens in 2013 was ,in order ,specimens agglutination ,insufficient amount of specimen , excessive amount of specimen ,bar code error ,contaminated specimen ,wrong container ,no specimen ,hematocrit≥55% ,repeated in‐spection .Conclusion Coagulation test requires high quality specimen and quality assurance prior to analysis is particularly impor‐tant .The clinical laboratories should strengthen the links between the nursing and clinical departments ,timely communicate and feedback situation of unqualified specimens ,find the cause together and develop and implement effective improvement measures ,in order to ensure the quality of specimens on the steps before analysis .
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Objective:To optimize the preparation technology of compound sodium lactate injections for the improvement of clari-ty. Methods:The orthogonal test was adopted to screen the best preparation conditions using four influencing factors including the de-carburization temperature of the concentrated solution (A), pH value of the concentrated solution (B), decarburization time of the concentrated solution ( C) and the filling temperature of the injections ( D) with 3 levels for each, and the clarity of the injections as the index. Results:The best preparation conditions were as follows:the decarburization temperature was 60℃, pH value of the con-centrated solution was 6. 5, the decarburization time was 20minute and the filling temperature was 50℃. Conclusion: The optimal process can improve the clarity of compound sodium lactate injections.
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Objective] To discuss the inner experiences of occupational injury of laboratory animal workers, and provide basis for conducting targeted occupational protective education and health management. [Methods] The phenomenological methodology was used in the study. 12 laboratory animal workers were participated in non-structured interview regarding the experiences of occupational injury. [Results] 3 themes were found including:category of occupational injury(physical injury, chemical injury, biological injury); emotional experiences of occupational injury(fears and concerns, helplessness and self-abasement); help most needed(more attention, knowledge supports, advanced and convenient protective equipment and hardware facilities). [Conclusion] Management of experimental animal industry should lay great emphasis on occupational health and protection of laboratory animal workers, increase both financial and material resources, and enhance occupational protection education, in order to maximize bad physical and psychological effects from occupational injury.
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Objective: To establish an HPLC method for the simultaneous determination of chloromycetin and metronidazole in chlortalidone and metronidazole spirits. Method:The HPLC method was performed on an NOV-pak C18 (150 mm × 4. 6 mm, 5 μm) column and the mobile phase consisted of methanol and water (75∶25). The flow rate was 1. 0 ml·ml-1, the detection wavelength was 297nm, the temperature of column was 30℃ and the sample size was 20 μl. Result: The calibration curve of metronidazole was linear within the range of 5-80μg·ml-1(r=0. 999 7), and the average recovery was 100. 83% with RSD of 1. 82%(n=6). The cal-ibration curve of chlortalidone was linear within the range of 50-800μg·ml-1(r=0.999 7), and the average recovery was 100.2%with RSD of 0. 55%(n=6). Conclusion: The method is simple, rapid, accurate and reproducible, and can be used in the quality control of chlortalidone and metronidazole spirits.
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Objective To investigate the influence of self-management and education on behaviors of medical compliance of patients undergoing vitrectomy combined with tamponade.Methods Sixty-four patients undergoing vitrectomy combined with tamponade were randomized equally into the control group and observation group in the order of admission.The control group received routine care and health education,while the observation group received self-management education follow-ups besides the routine nursing.The two groups were compared in terms of the cumulative time of the correct position,compliance behavior and the incidence of postoperative complications.Results The cumulative time of the correct position of observation group was longer than that of the control group after operation.The observation group did better in compliance behavior than the control group and the incidence of postoperative complications in the former group was lower than the latter(P<0.05).Conclusion Self-management and education can enhance patients’behaviors in medical compliance and decrease postoperative complications and promote the success of the surgery.
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[Purpose] To discuss about the graduation internship quality control system for undergraduate students majoring in nursing. [Method] First, de-velop a graduation internship quality control system; Second, monitor during the graduation internship process; Third, assess the comprehensive skil s after graduation internship. [Conclusion] Developing and implementing the graduation internship quality control system leads to better process and better quality of the graduation internship.
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Objective To explore the effects of rhubarb navel therapy on fecal continence in rectal cancer patients with colostomy.Methods 60 patients with colostomy were randomly divided into the experimental group and the control group with 30 patients in each group.Patients in the control group received routine therapy and health education whereas the experimental group received 30-day extra rhubarb navel therapy started on the 15th day after the operation.The two groups were compared in postoperative 3 months with the following factors:the functions of colostomy and the formation of bowel regularity.Results The scores of the scale about the functions of permanent abdominal colostomy were improved in both groups.However,the score in the experimental group was much higher than that in the control group.The number of patients forming bowel regularity in the experimental group was more than that in the control group (19 and 4 cases respectively).Conclusions Rhubarb navel therapy is beneficial to rectal cancer patients with colostomy to improve the functions of colostomy and form the bowel regularity.
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BACKGROUND: Directly percutaneous injection of protein-denaturant hydrochloric acid (PDHA) into tumors can lead to fast killing of tumor, sustained drug release and prevention of in situ recurrence of tumor. However, whether implants can be used combined with denaturant still remains unknown. OBJECTIVE: To investigate the compatibility of fluorouracil implants and PDHA (6 mol/L). DESIGN, TIME AND SETTING: Observational study was performed in the Hefei Industry University between October 2006 and March 2007. MATERIALS: A total of 78 Wistar rats, weighing (200i20) g, half males and half females, were used for testing drug release in vivo. Drugs fluorouracil implants (H20030345; columniform particle, diameter 0.8 mm, length 4 mm; specifications: Fluorouracil 2 mg/particle; batch number: 20060922; meeting the National Drug Quality Standards [WS1-(X-103)-2005Z]) were provided by Wuhu Zhongren Pharmaceutical Company,Ltd. Hydrochloric acid (37%) was analytical reagent. METHODS: 96 tubes of the implants and PDHA were kept at (37.0± 0.5) ℃. Each time, six samples were collected at 1, 8, 16, 24, 96, 120, 168, 240, 360, 432, 480, 528, 600, 720, and 960 hours after incubation. Appearance of the implants was observed by microscope. Stability of fluorouracil in PDHA was determined by HPLC and ultraviolet absorb method. Based on the entering quantity and residual quantity of fluorouracil, the release rates were calculated. MAIN OUTCOME MEASURES: The approximate solubility, stability and morphological change of fluorouracil in denaturant and the corresponding drug release character in both denaturant and rats in vivo. RESULTS: At (37.0±0,5) ℃, the fluorouracil was stable for 960 hours in PDHA, the saturated concentration of fluorouracil was (22.72±0.04) g/L. The appearance of implants was intact. The surface was porous. Compared with the speed of releasing drug in rats, the speed of releasing drug was faster in the early stage of release process and slower in the later stage. The drug release was incomplete. At 1, 24, 96, 360 and 960 hours, the implants' release rates were (11.9±6.7)%, (37.9±5.3)%, (52.6±4.5)%, (75.3±3.8)%, and (85.5±2.1)%, respectively. CONCLUSION: The fluorouracil implants and hydrochloric acid (6 mol/L) are compatible and no influence is detected during the observation.
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AIM To establish mice hyperuricemia model METHOD Yeast extract paste 7 5～30 g?kg -1 was given to mice by ig once daily for 7,14,21,28 consecutive days, and detected the level of uric acid in serum RESULT The serum uric acid level in mice were (271 8?53 2),(215 4?31 5),(195 9?56 0),(142 1?30 7) ?mol?L -1 in 30 g?kg -1 group after administration 1,2,3,4 weeks;and (226 8?40 7),(148 67?30 4),(176 9?27 0),(119 3?27 4) ?mol?L -1 in 15 g?kg -1 group after administration 1,2,3,4 weeks;In 7 5 g?kg -1 group the serum uric acid level was (117 0?29 0) ?mol?L -1 after 1 week, respectively CONCLUSION Yeast extract paste (15～30) g?kg -1 given by ig could form mice hyperuricemia model, and the hyperuricemia could last 1～2 weeks