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Objective:To explore the relationship between metabolic acidosis and cardiac valve calcification in maintenance hemodialysis (MHD) patients in the Pearl River Delta Region.Methods:Patients on MHD greater than 3 months who were treated in 10 blood purification centers in the Pearl River Delta Region from July 1 to September 30, 2019 were selected for this multicenter cross-sectional study. Based on a Doppler ultrasound, MHD patients were further divided into non-valve calcification group and valve calcification group. The demographics data, frequency of dialysis, blood pressure, single pool Kt/V(spKt/V), dialysis medications and laboratory data were collected and compared. Spearman correlation analysis was used to analyze the correlation between serum carbon dioxide combining power (CO 2CP) and cardiac valve calcification. Multivariate logistic regression model was used to analyze the influencing factors of cardiac valve calcification. Results:A total of 664 MHD patients were included in this study, with age of (57.0±14.2) years old and dialysis age of 43.0 (22.3, 71.7) months, including 395 males (59.5%) and 269 females (40.5%). Among them, there were 119 patients (17.9%) with diabetes and 186 patients (28.0%) with dialysis 2 times per week. There were 329 patients (49.5%) in the valve calcification group, and 335 patients (50.5%) in the non-valve calcification group. Compared to those in non-valve calcification group, valve calcification group had longer duration of dialysis, higher proportion of patients with dialysis 2 times per week, higher levels of diastolic blood pressure, fasting blood glucose, intact parathyroid hormone and ferritin, higher proportion of patients with blood CO 2CP<19 mmol/L (median CO 2CP), higher proportion of patients on usage of calcium channel blocker, angiotensin converting enzyme inhibitor/angiotensin receptor blocker, α-receptor blocker, β-receptor blocker, calcitriol and lanthanum carbonate (all P<0.05), while the levels of spKt/V, hemoglobin, serum CO 2CP, corrected calcium, blood phosphorus, blood alkaline phosphatase, albumin, total cholesterol, triacylglycerol, low-density lipoprotein, high-density lipoprotein, transferrin saturation, and the proportion of patients on usage of sevelamer and cinacalcet were lower (all P<0.05). Spearman analysis showed significant negative correlation between serum CO 2CP and valve calcification ( rs=-0.697, P<0.001). Multivariate logistic regression analysis showed that dialysis performed twice a week ( OR=2.789, 95% CI 1.232-6.305, P=0.014), blood total cholesterol ( OR=1.449, 95% CI 1.014-2.071, P=0.042), CO 2CP<19 mmol/L ( OR=22.412, 95% CI 10.640-47.210, P<0.001) were the influencing factor of valve calcification in MHD patients. Conclusions:MHD patients with cardiac valve calcification have significant acid loading. Metabolic acidosis is an independent influencing factor for cardiac valve calcification in MHD patients.
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Objective To explore the influence of early intervention on physical and intelligent development of premature infants with very low birth weight. Methods Selected 32 premature infants of very lowbirth weight treated in neonatal intensive care unit during November 2011 to October 2012 as the intervention group. To avoid the violation of medical ethics, we select another 32 premature infants with very low birth weight who were born before November 2011and aged between 9 to 15 months as the control group. The intervention group was treated with early intervention, including regular physical development evaluation, neuromotor examination and test of intelligence. The intervention group was followed-up until correction age of 1 year and the control group was only at the year of correction age of 1 year. Results The physical development in the intervention group was better than the control group at the age of 1, the mental development index (MDI) and psychomotor development index (PDI) significantly higher than those of the control group as well. The incidences of low intelligence and cerebral palsy were lower than those of the control group. The differences were statistically significant. Conclusion Early intervention is obviously effective in promoting the physical and intelligent development of very low birth weight premature infants, reducing the incidence of low intelligence and cerebral palsy, and improving the long-term living quality of the survivors. Still, the method centers on family, and therefore, is feasible and effective. So the doctors for children′s care from basic hospitals should vigorously promote the method.
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Objective To explore the association of-11377 site single nucleotide polymorphism in promoter region of adiponectin gene and carotid intima-media thickness(CIMT)in patients with type 2 diabetes mellitus.Methods The adiponectin gene-11377C→G polymorphism was identified by PCR-restriction fragment length polymorphism(RFLP)in 504 patients with type 2 diabetes mellitus(250 patients with increased CIMT and254 Datients with normal CIMT). Serum lipid and fasting plasma glucose were detected by full automatic biochemical analysor.fasting serum insulin(FINS) was measured by radioimmunoassay,and serum adiponectin level was assessed by ELISA.Results The frequencies of adiponectin gene-11377C→G genotype and allele were different between type 2 diabetic patients with normal and increased CIMT(P<O.01).In type 2 diabetic patients, the values of CIMT,diastolic blood pressure,low-density lipoprotein cholesterol (LDL-C)and homeostasis model assessment of insulin resistance (HOMA-IR) in-11377CC group were significantly lower than those in-11377CG +GG group(P<0.05 or P<O.01),but serum adiponectin level was higher in-11377CC group than that in -11377CG+GG group [(5.70 ±3.58 vs 4.72±2.34)mr/L,P<O.01].Variation at adiponectin gene-11377C→G was associated with increased CIMT in type 2 diabetic patients independent of serum adiponectin level(P= 0.037).Conclusion In type 2 diabetic patients of Fujian,the-11377C→G polymorphism of the adiponectin gene is associated with CIMT.
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A total of 123 type 2 diabetics was randomised into 3 groups to receive gliclazide-MR, gliclazide or glibenclamide treatments for 16 weeks.All the subjects took self-monitoring of blood glucose (SMBG) during the trial.The effect of therapy was similar in 3 groups.The subtraction value between maximum and minimum blood glucose, mean postprandial maximum blood glucose, postprandial 2 h blood glucose, postprandial 2 h serum insulin and hypoglycaemia events were lower in gliclazide-MR group than those in glibenclamide group (all P＜0.01).The data suggest that SMBG is an useful method to evaluate blood glucose excursion.
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Objective To explore the effects of subclinical hyperthyroidism (SH) on heart and bone and the optionof treatment. Methods Forty-three patients with endogenous SH were divided into two groups by the TSH level: group A (21 cases,TSH 0.03-0.60 mIU/L) and group B (22 cases, TSH