ABSTRACT
OBJECTIVE: To investigate the effect of probiotic on protein energy wasting and micro-inflammation in peritoneal dialysis patients. METHODS: One hundred and twelve patients who underwent peritoneal dialysis at the nephrology department of Guizhou provincial people's hospital in 2017, were randomly divided into intervention group(n=56) and control group(n=56), which were treated probiotic and placebo respectively two months, and collected biochemical, inflammatory, physical measurement and bioelectrical impedance index before and after treatment. RESULTS: The prevalence of protein-energy wasting was 64.29% and 60.71%in intervention group and control group, respectively. Compared with control group, patients in intervention group had lower urea nitrogen, triglyceride, low density lipoprotein, high-sensitivity C-reactive protein and interleukin-6 and higher serum albumin levels, and these differences were statistically significant(P<0.05). Physical measurement results showed that the upper arm muscle circumference of intervention group was increased compared to control group, and the change was statistically significant(P<0.05). Biological resistance testing results showed that the fat percentage of intervention group was significantly higher than that of control group(P<0.05).CONCLUSION: The treatment of probiotic could improve protein energy wasting and micro-inflammation in continuous peritoneal dialysis patients.
ABSTRACT
Objective To investigate the improvement effects of sericin on the retinal oxidative stress and micro-inflammatory state in diabetic rats.Methods A diabetic rat model was established by using high-fat and high-sugar diet and intraperitoneal injection of streptozotocin.Then 24 diabetic rats were randomly divided into sericin treatment group and diabetic model group,with 12 rats for each group,and additional 12 normal rats with the same age were collected as a normal control group.Next,the rats in the sericin treatment group received sericin solution,while the other two groups was given the same amount of normal saline once a day for 35 days.After the agent intervention,the content of malondialdehyde (MDA) and glutathione (GSH) in the retina of all rats were detected by related kits.The expressions of nuclear factor erythroid 2-related factor 2 (Nrf2),heme oxygenase 1 (HO-1),nuclear factor-κB (NF-κB) and tumor necrosis factor-α (TNF-α) protein were detected by Western blot,and finally,the retinal morphology was examined by hematoxylin-eosin staining in the 3 groups.Results The content of MDA,NF-κB and TNF-α protein expression in the sericin treatment group was (4.145 ±0.282) mmol· gprot-1,0.232 ±0.027 and 0.761 ±0.058,respectively,which was significantly lower than that in the diabetic model group [(6.813 ± 0.446) mmol · gprot-1,0.334 ± 0.024 and 0.994 ± 0.084] (all P ＜ 0.05).The content of GSH,Nrf2 and HO-1 protein expression in rat retina in the sericin treatment group was (78.518 ± 4.317) mg · gprot 1,0.591 ± 0.054 and 0.954 ± 0.091,respectively,which was significantly higher than that in the diabetic model group [(59.890 ± 5.932) mg · gprot-1,0.351 ± 0.044 and 0.585 ± 0.054] (all P ＜ 0.05).The diabetic model group presented the disorder arrangement of the neurocyte in different levels in the retina,irregular and swollen inner limiting membrane,vacuoles in the ganglion cells,but in the sericin treatment group,the morphology of retinal layers was more regular and mildly disorderly arranged.The pathological damages in the retina were alleviated significantly.Conclusion Sericin can ameliorate oxidative stress and inflammation in diabetic retina,thereby delaying the development of diabetic retinopathy.
ABSTRACT
Objective To investigate the influence of Enalapril Maleate Tablets on serum micro inflammatory indexes and nutritional indexes in maintenance hemodialysis patients. Methods A total of 90 patients with chronic renal failure treated by maintenance hemodialysis in our hospital from April 2015 to October 2016 were randomly divided into control group and experimental group, with 45casesin each group. The control group was treated with atorvastatin,andthe observation group was treated with atorvastatin combined with enalaprilmaleate tablets. After treatment,the levels of the inflammatory markers of high sensitive C reactive protein (HS-CRP), tumor necrosis factor alpha (TNF-alpha), interleukin-8 (IL-8), interleukin 6 (IL-6) and the nutritional index of plasma albumin(ALB), prealbumin(PA) in two groups were analyzed. Results After treatment, the levels ofHS-CRP, TNF-alpha in the observation group were lower than those in control group, the difference was statistically significant (P<0.05); The levels of IL-6, IL-8 in the observation group were significantly lower than the control group, the difference was statistically significant (P<0.05). The indexes of ALB and PA in the observation group after treatment were higher than those in the control group, the difference was statistically significant (P<0.05). Conclusion For the patients with maintenance hemodialysis treatment, the clinical effect of using conventional atorvastatin treatment combined with Enalapril Maleate Tablets is good, high safety, with further clinical promotion and application significance.
ABSTRACT
Objective To evaluate the relationship of serum thrombospondin?1(TSP?1)with the micro?inflammation in maintenance hemodialysis(MHD),and to explore its clinical prognosis value in the MHD patients. Methods A total of 84 MHD patients in our hospital were enrolled and prospectively followed for 2 years. The serum levels of TSP?1 and clinical inflammatory markers were detected. Patients were divided into groups according to different serum TSP?1 levels. The clinical inflammatory markers were detected by using ELISA analysis. Pearson simple correlation analysis method was applied to analyze the correlation between TSP?1 levels and inflammation related indicators. At the same time the prognosis and turnover of MHD patients was analyzed by using Kaplan Meier survival curve and survival rate was compared by Deleted:compared log?rank test. Cox regression analysis was used to calculate the hazard ratio (HR) and Deleted:using 95% confidence interval (CI). Results The indexes of blood lipid and inflammatory factors in the TSP?1 high?level groups were higher than that in TSP?1 low?level groups (P<0.05). Correlation analysis showed that the serum TSP?1 level was positively correlated with the serum lipid and inflammatory factors. Survival curve analysis showed that the mortality rate of TSP?1 high?level group was higher than that of TSP?1 low?level groups. Cox hazards analysis revealed that the patients with high?level TSP?1 had a higher risk for mortality than these TSP?1 low?level patients. This predictive value still existed after multivariate adjustment for age,blood lipid,serum albumin and other factors (P < 0.001). Conclusion The serum TSP?1 levels were associated with micro?inflammation and had a significant value in predicating the prognosis of MHD patients.
ABSTRACT
Objective To investigate the effects of Huangkui Capsules on oxidative stress and micro-inflammation state in diabetic nephropathy patients with maintenance hemodialysis. Methods Forty-six patients with diabetic nephropathy who had received maintenance hemodialysis for over six month in Gansu Provincial People's Hospital were randomly divided into observation group (23 cases) and treatment group (23 cases) from January to December in 2014. Twenty healthy subjects who had physical examinations were selected as the control group at the same time. Observation group were given conventional hemodialysis for 4 hours, 3 times a week; treatment group were given conventional hemodialysis combined with Huangkui Capsules, orally, 2.5 g each time, 3 times a day. Both groups were treated for 8 weeks. Blood was collected before and after treatment for detection of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), white blood cell (WBC), malondialdehyde (MDA), cycle of advanced oxidation protein products (AOPP), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels. Results The levels of IL-6, TNF-α, AOPP, WBC, MDA and hs-CRP were significantly higher in the observation group and the treatment group compared with the control group before treatment (P0.05). After treatment, the levels of IL-6, hs-CRP, MDA and AOPP increased in the observation group (P0.05);The levels of AOPP, TNF-α, hs-CRP, WBC, MDA and IL-6 in treatment group significantly decreased (P<0.01), GSH-Px and SOD significantly increased (P<0.01); there was statistical significance between the observation group and the treatment group (P<0.01). Conclusion Micro-inflammation state and oxidative stress exist generally in diabetic nephropathy maintenance hemodialysis patients. Huangkui Capsules can improve oxidative stress and micro-inflammation state in diabetic nephropathy maintenance hemodialysis patients.
ABSTRACT
OBJECTIVE:To compare therapeutic efficacies of Shengxuening tablet and Iron sucrose injection for anemia in maintenance hemodialysis(MHD)patients,and their effects on oxidative stress and micro-inflammation state. METHODS:80 pa-tients who had received MHD over half year were assigned into shengxuening group and iron sucrose group with 40 cases in each group. Both groups received MHD 3 times a week,4 h/time,blood flow of 200~300 ml/min;erythropoietin(EPO)was used at a dose of 10 000 IU/time hypodermically in each group. Shengxuening group was additionally given Shengxuening tablet orally,0.5 g/time,tid. Iron sucrose group was given Iron sucrose injection 100 mg 2 h intravenously via dialyser after the beginning of hemo-dialysis,twice a week,received iron treatment every one week until complete the total dose of 1 000 mg,to maintain ferritin be-tween 100~300 μg/L. The levels of Hb,Hct,SF,TSAT,hs-CRP,IL-6,TNF-α,MDA,SOD and GSH-Px were tested in 2 groups before and 12 weeks after the treatment. RESULTS:After 12 weeks of treatment,the levels of Hb,Hct,SF and TSAT in 2 groups were significantly increased,with statistical significance (P0.05). Compared with before treatment,the levels of hs-CRP,IL-6,TNF-α and MDA increased significantly in iron sucrose group,while SOD and GSH-Px levels declined significantly,with statistical significance (P<0.01). Above indicators of shengxuening group had no significant change,compared with before treatment;there was statistical significance between 2 groups after treatment(P<0.01). No obvious ADR was found in 2 groups. CONCLUSIONS:Therapeutic efficacy of shengxuening is simi-lar to that of iron sucrose in improving the anemia and iron deficiency status of MHD patients,but doesn't aggravate oxidative stress and micro-inflammation state. It is an safe and effective oral iron supplement drugs.
ABSTRACT
Objective:To explore the effects of Bailing capsules combined with breviscapine injections on the micro-inflammation in the patients with peritoneal dialysis. Methods:Sixty-five patients with peritoneal dialysis for more than 6 months were randomly di-vided into the treatment group (33 patients) and the control group (32 patients). The two groups were still given peritoneal dialysis and treated with the conventional symptomatic treatment combined with breviscapine, while in the treatment group, Bailing capsules were given additionally. Before and after the 2-week treatment, serum creatinine, urea, plasma albumin, hs-CRP and IL-6 were exam-ined and compared in the two groups. Results:After the treatment, serum creatinine and urea in the two groups were significantly de-creased(P<0. 05), and plasma albumin was increased significantly(P<0. 05), and the changes in the treatment group were more no-table than those in the control group (P<0. 05). After the treatment, the average levels of hs-CRP and IL-6 were decreased signifi-cantly in the two groups (P<0. 05 or P<0. 01), and those in the treatment group were lower than those in the control group (P<0. 01). Conclusion:The combined therapy of Bailing capsules and breviscapine injections shows better clinical effects on the micro-inflammation in the patients with peritoneal dialysis than breviscapine injections alone.
ABSTRACT
Objective To evaluate the effects of blood perfusion(HP)combined with hemodialysis(HD)on micro inflammation and malnutrition status in patients with maintenance of hemodialysis(MHD). Methods Eighty MHD patients admitted to blood purification center of Wuhan Puai Hospital in Hubei Province were enrolled and randomly divided into two groups. Pure HD group underwent conventional HD for 4 hours,3 times a week,and based on the weekly HD series,the HD+HP group took additionally HP once a week,the therapeutic course in both groups being consecutive 12 weeks. Blood was collected before and after treatment for detection of interleukin-6. (IL-6) and tumor necrosis factor-α(TNF-α) levels by enzyme-linked immunosorbent assay (ELISA), and the serum high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) levels were determined with electrochemiluminescence immunoassay,and the changes in nutritional indexes of hemoglobin(Hb),total protein(TP), albumin(Alb),transferrin(TRF)were observed. Results Compared with the indexes before treatment,in HD+HP group,hs-CRP(ng/L:5.65±2.21 vs. 13.91±2.10),IL-6(ng/L:50.10±6.65 vs. 101.22±21.32),TNF-α(ng/L:80.21±9.41 vs. 197.64±25.47),Hcy(μmol/L:13.31±2.21 vs. 40.96±9.42)were significantly decreased (all P0.05). There were statistical significant differences in above indexes after treatment between HD+HP group and HD group〔hs-CRP (ng/L):5.65±2.21 vs. 13.22±1.10,IL-6(ng/L):50.10±6.65 vs. 100.32±25.24,TNF-α(ng/L):80.21±9.41 vs. 196.87±24.54,Hcy(μmol/L):13.31±2.21 vs. 37.23±8.33,Hb(g/L):106.65±22.21 vs. 94.22±13.10,TP (g/L):62.10±22.65 vs. 51.32±12.32,Alb(g/L):38.21±6.41 vs. 32.87±4.54,TRF(μg/L):196.31±22.21 vs. 162.23±15.33,all P<0.05〕. Conclusion HP combined with HD in the treatment of MHD can improve the micro inflammation and malnutrition state in patients with MHD.
ABSTRACT
Objective To investigate the effect of tannic acid on glomerular mesangial cells (GMC),and to clarify the mechanism of tannic acid in improving the pathological changes of diabetic nephropathy (DN)from the aspect of oxidative stress and micro-inflammation. Methods The glomerular mesangial cells were treated with glucose (30 mmol·L-1 )or advanced glycosylation end-products (AGEs)bovine serum albumin(BSA)(250 mg·L-1 )and then different concentrations of tannic acid (10,20,40 and 80μmol·L-1 )were added into the GMC.The cells cultured by normal glucose or treated with BSA were used as control groups and then the level of malonic dialdehyde (MDA), glutathione peroxidase (GSH-Px ), superoxide Dismutase (SOD ), CAT (Catalase ) activities and 8-hydroxy-2′-deoxyguanosine(8-OHdG)levels in the culture supernatant 48 h after culture were determined by colorimetry and ELISA method. The expressions of intercellular cell adhesion molecule-1 (ICAM-1 ) protein, monocyte chemotactic protein 1 (MCP-1 ) and ICAM-1 mRNA in GMC were detected by immunohistochemical staining and RT-PCR method.Results Compared with high glucose and AGEs groups,the MDA levels in tannic acid groups were reduced significantly(P<0.05);the activities of GSH-Px,SOD and CAT were increased significantly(P<0.05 or P<0.01);the 8-OHdG levels in annic acid groups were significantly reduced (P<0.05). Compared with high glucose and AGEs groups,the expressions levels of ICAM-1 protein in 40 and 80μmol· L-1 tannic acid groups were decreased (P<0.05 ). The mRNA expressions levels of MCP-1 and ICAM-1 were significantly lower than those in high glucose group (P<0.01 ).Conclusion Tannic acid could protect GMC against the damage of oxidative and inflammatory mediators,thereby delaying and improving the glomerular lesions of DN.
ABSTRACT
Objective To investigate the influence and the possible mechanism of tea polyphenols on maintenance hemodialysis (MHD)patients’ oxidative stress and micro inflammatory condition.Methods 60 cases of MHD patients were randomly divided into routine group and tea polyphenols group.30 healthy subjects were chosen as normal control group.After 3 months,MDA,AOPP,SOD,TNF-α,CRP,IL-6 and NF-κB of routine group and tea polyphenols group were detected.Results Before treatment,compared with normal control group,MDA and AOPP of routine group and tea polyphenols group increased (P <0.01 ),SOD decreased (P <0.01 );after treatment,compared with routine group,MDA and AOPP of tea polyphenols group decreased (P<0.01),SOD increased (P<0.01).After treatment,compared with normal control group,NF-κB,TNF-α,CRP, IL-6 and oxidative index of routine group and tea polyphenols group increased,and the difference was statistically significant (P<0.01);compared with routine group,oxidative index of tea polyphenols group decreased,and the difference was statistically significant (P <0.01 ).Conclusion Tea polyphenol can improve MHD patients’oxidative stress and micro inflammatory state.
ABSTRACT
This article was aimed to discuss the mechanism of lactulose enema therapy to improve efficiency among maintenance hemodialysis (MHD) patients with uremic pruritus (UP) from the intervention of parathyroid hormone (PTH) and micro-inflammation state. A total of 60 cases of chronic kidney disease (CKD) stage 5, MHD patients with UP were randomly divided into 3 groups according to different intervention methods, which were the control group, loratadine and lactulose group. The integration of kidney disease treatment was adopted in the control group. In the loratadine group, on the basis of the control group medication, oral administration of loratadine, 10 mg/time, once a day, was combined. In the lactulose group, on the basis of the control group medication, lactulose enema, 30 mg/time, twice a day, was combined for 30 days. The pretreatment and posttreatment clinical curative effects were e-valuated among patients from 3 groups. Observation was also made on their itchy visual analogue scale (VAS) and serum PTH, high-sensitivity c-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) lev-el, respectively. The results showed that there were significant improvements on VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) before and after treatment (P< 0.05 or P< 0.01). Compared to the control group, the posttreatment clinical total curative effects were significantly increased in both the loratadine group and lactulose group (P< 0.05); VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) were significantly decreased (P< 0.05). There was no statistical difference of indexes mentioned above in the loratadine group and lactulose group. It was concluded that lactulose enema therapy improve PTH and micro-inflammation state among MHD patients with UP. It is one of the mechanisms to relieve skin itching.
ABSTRACT
Objective To study the influence of hemodiafiltration on high-sensitivity C-reactive protein (hs-CRP),serum parathyroid hormone (iPTH) and cardiac function in uremic patients undergoing maintenance hemodialysis (MHD).Methods Forty patients with uremia were divided into hemodiafiltration (HDF) group (n =20) and hemodialysis(HD) group(n =20) by random numbers.Serum hs-CRP and iPTH were measured before treatment and at 6 months after treatment.Their left ventricular diastolic diameter (LVEDD),left ventricular end-systolic dimension (LVESD),interventricular septal thickness (IVST) and left ventricular ejection fraction(LVEF) were measured by echocardiogram.Ten healthy volunteers were recruited as the normal controls.Results After treatment,serum hs-CRP and iPTH decreased significantly in the HDF group (hs-CRP:(3.32±1.t4) mg/L vs.(7.84 ±2.21) mg/L,t =2.072,P =0.046;iPTH:(155.36 ±81.33) ng/L vs.(190.25 ±82.31) ng/L,t =2.121,P =0.023).No significant difference of serum hs-CRP and iPTH was observed in the HD group before and after treatment (hs-CRP:(7.91 ±2.11) mg/L vs.(7.68 ± 1.86) mg/L,t =1.731,P =0.111 ; iPTH:(177.43 ± 85.43) ng/L vs.(184.35 ± 87.21) ng/L,t =1.331,P =0.210).Color Doppler indices of cardiac structure of the HDF group significantly improved after treatment compared with before treatment (LVEDd:(55.3 ±3.7) mm vs.(58.8 ±4.3) mm,t =2.345,P =0.015 ;LVESd:(33.5 ±2.6) mm vs.(36.4±4.3) mm,t=2.178,P=0.046;IVST:(10.2±1.7) mmvs.(13.1 ±1.8) mm,t=2.630,P=0.012;LVEF:(55.3 ±2.6)％ vs.(42.5 ±3.3)％,t =2.860,P =0.010;LVMI:(132.5 ±9.1)g/m2 vs.(137.4 ± 8.7) g/m2,t =2.871,P =0.009).After treatment,cardiac structure of the HDF group was significantly better than that of the HD group (LVEDd:(55.3 ± 3.7) mm vs.(59.1 ± 4.2) mm,LVESd:(33.5 ±2.6) mm vs.(36.1 ±3.4) mm,IVST:(10.2±1.7) vs.(12.4 ±1.3) mm,LVEF:(55.3 ±2.6)％vs.(43.4±2.7)％,LVMI:(132.5 ±9.1) g/m2 vs.(139.4 ±8.9) g/m2;P ＜0.05).During the six month treatment,the incidence rate of cardiovascular events of the HDF group was significantly less than the HD group (36.39％(524/1440) vs.(72.08(1038/1440),x2 =21.583,P＜0.01).Conclusion HDF may efficiently remove iPTH,improve cardiac function of uremic patients,and help them recover from micro-inflammatory state.
ABSTRACT
Objective To observe the effect of hemoperfusion on micro-inflammation in patients with maintenance hemodialysis (MHD).Methods Fifty MHD patients (MHD group) and 25 healthy volunteers (control group) were involved in this study.The MHD patients were divided into two groups by random digits table:hemoperfusion combined with hemodialysis group (HP + HD group,25 cases) and hemodialyais group (HD group,25 cases).The plasma levels of micro-inflammatory cytokines including high-sensitive C-reactive protein (hs-CRP),interleukin-6 (IL-6) and tumor necrosis faetor-α (TNF-α ) were measured before and after treatment.Results The plasma levels of hs-CRP,IL-6 and TNF-α in MHD group were significantly higher than those in control group [(6.72 ± 2.63) mg/L vs.(1.35 ± 0.92) mg/L,(348.83 ± 64.41) ng/L vs.(54.49 ±22.47) ng/L,(7.52 ± 3.17) ng/L vs.(2.53 ±0.88) ng/L](P＜0.05).There was no significant difference in the plasma levels of hs-CRP,IL-6,TNF-α before treatment between HD group and HP+HD group (P＞0.05),Compared with those in HD group,the plasma levels of hs-CRP,IL-6 and TNF-α after treatment in HP+HD group were significantly decreased [(4.78 ±2.49) mg/L vs.(6.89 ±2.69) mg/L,(260.54 ±56.72) ng/L vs.(357.14 ±56.37) ng/L,(5.36 ±2.41) ng/L vs.(7.49 ±2.87) ng/L] (P <0.05).Conclusion Hemoperfusion improves micro-inflammation in patients with MHD.
ABSTRACT
0.05).(3) IL-17 was positively correlated to CRP(r=0.460,P 0.05).Conclusion:(1) IL-17 in patients is much higher than that in normal people,and is positively correlated to CRP,the acknowledged marker of inflammation status,but not correlated to dialysis duration,suggesting that IL-17 plays a role in pathogenesis of immune anomaly and micro-inflammation in patients with ESRD and HD;(2) There is no correlation between IL-6 and IL-17,and the mechanism of IL-17 elevation in ESRD patients needs to be further investigated.