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Objective:To explore the risk factors of hypocalcemia and the correlation between calcium supplementation and clinical parameters after parathyroidectomy (PTX) in maintenance hemodialysis patients with secondary hyperparathyroidism (SHPT), and to analyze the effect of calcium supplementation after PTX on the long-term prognosis of patients.Methods:This study was a single-center retrospective study. The patients who underwent PTX in maintenance hemodialysis patients with SHPT in the Huashan Hospital affiliated to Fudan University from October 2014 to March 2021 were retrospectively enrolled. Total PTX with auto transplantation or total PTX alone were the surgical procedures. According to the postoperative requirement of calcium in the first week, the patients were divided into two groups: high calcium supplement (>16.05 g/week) group and low calcium supplement group (≤16.05 g/week). According to the average serum calcium level in the first week after operation, the patients were divided into hypocalcemia group (≤2.1 mmol/L) and non-hypocalcemia group (>2.1 mmol/L) and the differences of clinical parameters between the two groups were compared. The correlation between clinical parameters and the postoperative calcium requirement was examined through Pearson or Spearman correlation analysis. The influencing factors for hypocalcemia after PTX were examined through logistic regression analysis. The survival curve was made by Kaplan-Meier method, and the difference of cumulative survival rate between the two groups was compared by log-rank test.Results:A total of 98 maintenance hemodialysis patients with SHPT were enrolled. The levels of serum calcium, phosphorus, and intact parathyroid hormone (iPTH) after the operation decreased significantly than those of preoperation (all P<0.05). Multiple linear regression analysis showed age ( β=-0.160, P=0.030), iPTH ( β=0.004, P=0.025) and C-reactive protein ( β=0.186, P=0.011) were correlated with postoperative calcium requirement. Preoperative alkaline phosphatase ( OR=1.002, 95% CI 1.000-1.004, P=0.018) and hemoglobin ( OR=0.977, 95% CI 0.954-1.000, P=0.048) independently predicted the occurrence risk of postoperative hypocalcemia through multivariate logistic regression analysis. The recurrence rate of high calcium supplement group was higher than that of low calcium supplement group (10.26% vs 0, P=0.023) and there was no significant difference in all-cause mortality between the two groups (17.95% vs 5.08%, P=0.086). The recurrence rate between the hypocalcemia group and non-hypocalcemia group was no significantly different (8.3% vs 1.8%, P=0.451) and there was no significant difference in all cause mortality between the two groups (12.5% vs 12.7%, P=1.000). Kaplan-Meier survival curve showed that the cumulative survival rate between the two groups was no significantly different (log-rank test χ2=0.147, P=0.702). Conclusions:PTX is a safe and effective therapeutic method to reduce the level of iPTH and improve the metabolism of calcium and phosphorus in SHPT patients. Age, iPTH and C-reactive protein are correlated with the postoperative requirement of calcium in the first week. Preoperative alkaline phosphatase and hemoglobin are independent risk factors for postoperative hypocalcemia. Correcting preoperative electrolyte disorder, improving infection and anemia can reduce the incidence of hypocalcemia after PTX.
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Objective:To explore the effects of dietary phosphate restriction education on serum phosphorus level, dietary phosphate intake and the knowledge of hyperphosphatemia in maintenance hemodialysis (MHD) patients.Methods:This study was a retrospective cohort study. A total of 116 hemodialysis patients in Huashan Hospital, Huadong Hospital and Tongji Hospital from October 2019 to December 2020 were enrolled in this study. They were divided into short-term group (84 cases) and long-term group (32 cases). The short-term group did not receive education or received education≤60 minutes. Meanwhile, the long-term group received education>60 minutes. Serum phosphorus level, dietary phosphate intake and knowledge of hyperphosphatemia were compared between the two groups after 4 weeks.Results:At baseline, age [64(56, 69) years old vs 65(60, 73) years old, Z=-1.493, P=0.136], the proportion of males [58.3%(49/84) vs 56.3%(18/32), χ2=0.041, P=0.839], dialysis age [55(26, 130) months vs 53(20, 132) months, Z=-0.062, P=0.951], body mass index, diabetes history, single-pool Kt/V, proportion of calctriol used, blood calcium, blood phosphorus, intact parathyroid hormone and dietary protein, dietary phosphorus and dietary phosphorus protein ratio had no statistical significance between short-term group and long-term group (all P>0.05). Adequate dietary phosphate restriction education reduced dietary phosphate intake [777.98(653.81, 943.16) mg/d vs 896.56(801.51, 1 015.51) mg/d, Z=-2.903, P=0.004], phosphate/protein ratio [13.16(11.52, 14.21) mg/g vs 15.27(13.31, 17.48) mg/g, Z=-3.929, P<0.001] and serum phosphorus level [(1.42±0.37) mmol/L vs (1.85±0.44) mmol/L, t=4.984, P<0.001]. Meanwhile, such education significantly improved achievement rate of serum phosphorus (62.5% vs 41.7%, χ2=4.034, P=0.045). In addition, patients in long-term group answered more questions correctly (completely correct plus partially correct) about the causes (93.8% vs 72.6%, χ2=6.120, P=0.013), poor prognosis (78.1% vs 52.4%, χ2=6.372, P=0.012) of hyperphosphatemia as well as the types of food with high phosphate (65.6% vs 52.4%, χ2=1.650, P=0.199). Conclusion:Adequate dietary phosphate restriction education reduces serum phosphorus level and dietary phosphate intake, and improves the knowledge of hyperphosphatemia in MHD patients.
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Immunotherapy combined with targeted therapy can benefit the survival of patients with unresectable hepatocellular carcinoma. Atezolizumab combined with bevacizumab has achieved remarkable efficacy in patients with advanced hepatocellular carcinoma, but the efficacy of conversion therapy in patients with unresectable hepatocellular carcinoma still needs more evidences. The authors report the clinical efficacy of a case of unresectable hepatocellular carcinoma with hepatitis B virus related liver cirrhosis who was treated with immunotherapy plus targeted therapy combined with local treatment. Results show a good effect in patient without tumor recurrence after postoperative 9 months.
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The most serious problem facing the implantation of vascular graft in the body is the formation of blood clots. In order to solve this problem, various attempts have been made by the scientific community for many years. However, endothelialization is the fundamental method to solve thrombosis and keep vascular graft open for a long time. Poly （ε-caprolactone） (PCL) has the advantages of biodegradability, low cost and good mechanical properties. In recent years, it has been widely used as tissue engineering scaffolds, drug deliverys and so on. This article mainly reviews the endothelialization of small-caliber vascular graft based on PCL after implanted in different animal models, as well as the endothelialization of the same animal model but under different implantation conditions, and trying to find the reasons why small-caliber vascular grafts are still not ideal in clinical applications at different angles such as the different animal models and the different way about endothelialization, and provide references for future animal model selection.
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Objective To investigate the high-fat diet effect on morphology and stiffness of endothelial cells. Methods SD rats were randomly divided into high-fat diet group (AS group, n=3) and control group (CON group, n=3). Rat aortic endothelial cells were obtained from rat thoracic aorta by explant method. Cell morphology was observed under inverted microscopy. The mean fluorescent intensity of F-actin in two groups was calculated by immunofluorescence staining. Cell stiffness was measured by atomic force microscopy (AFM). Results The endothelial cells migrated from tissue plant on the 7th day and formed confluence after cultivation for 14 days. Endothelial cells were identified by factor Ⅷ immunofluorescence staining. Cells in AS group showed enhanced perimeter (P＜0.01), aspect ratio (P＜0.01), and area (P＞0.05), while less circularity (P＜0.01) compared with the cells in control group. The mean fluorescence intensity of F-actin in AS group was significantly higher than that in control group (P＜0.01). AFM showed that the cell stiffness of AS group was significantly higher than that of control group (P＜0.01). Conclusions High-fat diet would change the morphology and stiffness of endothelial cells, which might subsequently affect their normal function and become an important incentive to AS.
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Objective To observe the effects of three treatment methods on renal anemia in maintenance hemodialysis patients with hyperparathyroidism secondary to uremia and analyze the influencing factors of erythropoietin (EPO) dosage. Methods A total of 55 maintenance hemodialysis patients with secondary hyperparathyroidism at the hemodialysis center of Huashan Hospital affiliated to Fudan University from January 2015 to December 2016 were retrospectively divided into three groups according to different treatment methods, parathyroidectomy +forearm transplantation group (surgery group, n=16), cinacalcet treatment group (n=6), and calcitriol treatment group (n=33), respectively. The hemoglobin level and erythropoietin dosage were measured before treatment and in the 3rd month, the 6th month and the 12th month after treatment. The changes of hemoglobin and erythropoietin dosage in the three groups before and after treatment were observed, and the mixed effect model was used to analyze the difference of the change of hemoglobin and erythropoietin dosage among three groups. Multiple linear regression analysis was used to analyze the influencing factors of EPO dosage after one year. Results The levels of intact parathyroid hormone (iPTH) in the surgery group and the cinacalcet group before treatment were significantly higher than that in the calcitriol group (both P<0.05). In the 12th month after treatment, the levels of iPTH decreased significantly in the patients of surgery group and the cinacalcet group compared with those before treatment (both P<0.05). The levels of serum alkaline phosphatase, serum calcium and serum phosphorus in the surgery group also decreased significantly compared with those before treatment (all P<0.05). The mixed effect model analysis showed that the hemoglobin level of surgery group was on an upward trend after the treatment, and the overall level was significantly higher than cinacalcet and calcitriol treatment group (P=0.007). There was no significant difference in the dosage change of erythropoietin (EPO) in the three groups over time. However, the intra-group comparison of the mixed effect model showed that the dosage of EPO in the 12th month was significantly lower than that of before the treatment in surgery group (P=0.007). Multiple linear regression analysis showed that dialysis vintage (B=-0.064, P=0.012) and ferritin ≥ 500 μg/L (B=0.645, P=0.032) were independent influencing factors of EPO dosage. The longer the dialysis vintage, the less EPO dosage, and more EPO dosage were observed in patients with ferritin ≥ 500 μg/L. Conclusions Parathyroidectomy and forearm transplantation is more effective in reducing EPO dosage and improving renal anemia in maintenance hemodialysis patients with secondary hyperparathyroidism. Dialysis vintage and ferritin are independent influencing factors for the dosage of EPO.
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Objective: Passive CLARITY is a whole-tissue clearing protocol, based on sodium dodecyl sulfate [SDS] clearing, for imaging intact tissue containing transgenic or immunolabeled fluorescent proteins. In this study, we present an improved passive CLARITY protocol with efficient immunolabeling without the need for electrophoresis or complex instrumentation
Materials and Methods: In this experimental study, after perfusion of C57BL/6N mice with phosphate-buffered saline [PBS] and then with acrylamide-paraformaldehyde [PFA], the quadriceps femoris muscle was removed. The muscle samples were post-fixed and degassed to initiate polymerization. After removing the excess hydrogel around the muscle, lipids were washed out with the passive CLARITY technique. The transparent whole intact muscles were labeled for vessel and neuron markers, and then imaged by confocal microscopy. Three-dimensional images were reconstructed to present the muscle tissue architecture
Results: We established a simple clearing protocol using wild type mouse muscle and labeling of vasculatures and neurons. Imaging the fluorescent signal was achieved by protein fixation, adjusting the pH of the SDS solution and using an optimum temperature [37degree C] for tissue clearing, all of which contributed to the superiority of our protocol
Conclusion: We conclude that this passive CLARITY protocol can be successfully applied to three-dimensional cellular and whole muscle imaging in mice, and will facilitate structural analyses and connectomics of large assemblies of muscle cells, vessels and neurons in the context of three-dimensional systems
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Langerhans-cell histiocytosis (LCH), the most common histiocytic disorder, is a reactive clonal proliferation and accumulation of CD1a+ / CD207+ dendritic cells in inflammatory lesion, characterized by its strong heterogeneity and changeable complexity including apparent inflammation and tumor features, which should be redefined as an inflammatory myeloid neoplasia. Recent research has shown that LCH is the consequence of misguided myeloid differentiation on account of genomic aberrances in the RAS-RAF-MEK-ERK pathway. These gene inhibitors may present more curative effects for the treatment of LCH. With further prospective clinical trial, molecular targeted therapy may combine with or even replace the traditional surgery plus chemotherapy as the first-line regimen in LCH.
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Objective To investigate the relationship between personality and social network profile-based information.Methods 438 college students were recruited,and Big five inventory NEO-FFI was applied to all subjects.The participants' Renren web profile information were recorded.Results ①Individuals with higher score of Extraversion had more friends (2.47 ± 0.29,2.34 ± 0.27,F =17.861,P =0.000),shared more (2.51 ± 0.56,2.32 ± 0.57,F =8.617,P =0.004),pasted more photographs (2.30 ± 0.51,2.14 ± 0.56,F =5.523,P =0.02).② There was a U shape correlation (t =2.258,P =0.024,t =2.115,P =0.035) between levels of neuroticism and numbers of blogs (0.66 ± 0.71) and photographs (1.92 ± 0.83).③There was no difference on numbers of friends (2.38 ± 0.31,2.39 ± 0.27,F =0.149,P =0.700) and e-gifts received (1.30 ± 0.52,1.26 ± 0.45,F =0.257,P=0.613) between participants of high and low levels of agreeableness.④ Individuals with higher scores in openness shared more with others(2.46 ± 0.57,2.29 ± 0.58,F =5.248,P =0.023).⑤ Individuals being more conscientious had more blogs(1.08 ±0.49,0.96 ±0.48,F=3.064,P=0.082).Conclusion There are significant differences about profile-based information among college students with different personality.
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Objective To investigate the relationship between social network behaviors and personality.Methods Both questionnaires including self-reported Renren questionnaire and the simplified Chinese version of NEO five-factor inventory (NEO-FFI) were completed in university students (n =509).Results (1) Individuals with higher score of Extraversion used Renren applications more frequently,such as using Wall (2.26 ± 0.51,2.10±0.40,t=3.163,P=0.002),Status Update (2.58 ±0.71,2.33 ±0.62,t =3.268,P=0.001),Image (2.05±0.88,1.81 ±0.72,t=2.628,P=0.009),and Photo (2.17 ±0.49,1.96 ±0.33,t=4.409,P＜0.01).(2)Individuals with higher score of Openness of Experience were more likely to use Gift (2.01 ± 0.49,1.83 ± 0.59,t =2.870,P =0.005).(3) Individuals who were willing to use Blacklist (41.93 ± 4.41,43.07 ± 4.72,t =2.207,P =0.028) and who were willing to send private messages (42.23 ± 4.79,43.27 ± 4.55,t =2.476,P =0.014) have higher score of Agreeableness.(4) Individuals who checked messages more often had higher score of Conscientiousness (41.59 ± 6.33,40.72 ± 5.67,37.56 ± 8.33,F =7.170,P =0.001).(5) Individuals with higher score of Neuroticism were more likely to be dependent to Renren (2.91 ± 1.01,2.48 ± 1.02,t =3.815,P ＜0.01).Individuals who were more likely to express their emotions on SNS had higher score of Neuroticism (33.10 ± 6.78,32.19 ± 6.16,31.36 ± 5.77,F=3.594,P =0.010).Conclusion The data suggest that the usage of social networking sites are related to personality factors.Personality can be used to predict university students' social networking behaviors.
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The expression and activity of NF-κB in the synovium of collagen-induced arthritis (CIA)rats was detected in order to investigate the possible therapeutic effects of triptolide on rheumatoid arthritis (RA). The experimental Wistar rat model of CIA was set up by intradermal injection of emulsion of bovine collagen Ⅱ and the successful rate of setting-up models was evaluated by arthritis index (AI). Rats were grouped randomly into three groups: normal, model and treatment group.The expression of TNF-α and IL-6 in synovial fluid was detected by ELISA, and the expression and activity of NF-κB in synovium by immunohistochemistry method and by electrophoretic mobility shift assay (EMSA) respectively. As compared with normal group, the expression of TNF-α and IL-6 in synovia (P＜0.05), and the expression and activity of NF-κB (P＜0.05) in synovium were increased in model group. There was statistical difference in above-mentioned indexes between model group and treatment group. Triptolide may play a protective role in RA via downregulating the expression and activity of NF-κB in synovium.