Relationship between peritoneal transport type and serum C-reactive protein in maintenance peritoneal dialysis patients / 中国医师进修杂志

Objective To evaluate the relationship between peritoneal transport type and serum C-reactive protein (CRP) in maintenance peritoneal dialysis (MPD) patients.Methods Standard peritoneal equilibration test (PET) was performed in 56 MPD patients (MPD group) with regular follow-up.According to D/P values,56 patients were divided into high permeability group (D/P ＞ 0.65,18 cases) and low permeability group (D/P ≤ 0.65,38 cases).In parallel at the date of PET examination,serum creatinine,blood urea nitrogen,uric acid,CRP and dialysate creatinine,blood urea nitrogen,uric acid was tested with an automatic biochemical analyzer,and urea clearance index and creatinine clearance rate was calculated.Dialysis prescription was formulated according to PET results to reach the criteria urea clearance index ≥ 1.7 and creatinine clearance rate ≥ 50 L/(week· 1.73 m2).Six months after MPD treatment,these indexes were detected again.And 20 cases of healthy person (control group) and 30 cases of uremic non-dialysis patients (uremic non-dialysis group) were selected randomly.Results The serum CRP level in high permeability group,low permeability group,uremic non-dialysis group was higher than that in control group [(54.41 ± 17.77),(43.34 ± 18.07),(39.10 ± 17.86) mg/L vs.(2.00 ±0.36) mg/L,P＜ 0.05].The serum CRP level in high permeability group was higher than that in low permeability group (P ＜ 0.05).There was no significant difference in the serum CRP level between MPD group and uremic non-dialysis group (P ＞0.05).There was no significant difference in the serum CRP level between 6 months after MPD and the date of the PET examination in high permeability group,low permeability group (P ＞ 0.05).Six patients with low permeability peritoneal transport changed into the high permeability at 6 months after MPD.The serum CRP level in these 6 patients at 1 month after catheter were significantly higher than the other patients of the low permeability [(64.45 ± 13.05) mg/L vs.(39.38 ± 16.12) mg/L,P ＜ 0.05].Conclusions Uremic patients in vivo exist micro-inflammatory state.The peritoneal transport characteristics of MPD patients are mainly in low permeability.Peritoneal transport characteristics of high permeability in vivo in patients with existing micro-inflammatory status are more severe than those in patients with low permeability.MPD treatment can not change the serum CRP levels in uremic patients.The original micro-inflammatory state in uremic patients may affect their peritoneal transport type.

Response and Intervention of Adolescence Mental Crisis from Public Crisis Events / 中国医学伦理学

The adolescence group is a unique group that deserves being paid close attention to.In terms of public crisis events,they are lack of essential sense of crisis and proper evaluation of crisis information,thus unable to protect and adjust their mental status.Correct responses to public crisis events for adolescence include a re-recognition of the real world,a positive adjustment of mental emotions,effective solutions to problems,and exploration for social support.In terms of intervention of adolescence mental crisis,it is important to implement early stage evaluation and intensification therapy,crisis counseling and treatment,crisis evaluation and intervention,and the usage of crisis intervention hotline.