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Objective:To investigate the correlation between body composition and cardiovascular disease (CVD) in patients with chronic kidney disease (CKD).Methods:CKD patients who were hospitalized in the Department of Nephrology of Chongqing General Hospital from January 2017 to December 2019 and had complete clinical biochemical data were divided into CKD patients with CVD and CKD patients without CVD according to their medical history and corresponding auxiliary examinations. Clinical data were collected and anthropometric measurements were conducted. Skeletal muscle index (SMI), appendage lean mass/height 2, total body fat (TBF), visceral adipose tissue (VAT), bone mineral capacity, bone mineral density and et al, were measured by dual-energy X-ray absorptiometry. T test, U test and Chi-square test were used for statistical analysis. Logistic regression was used to analyze the relationship between body composition and CVD. Results:A total of 604 CKD patients were included in this study, including 560 patients (92.7%) with CKD stage 3, 44 patients (7.3%) with CKD stage 4, and 180 CKD patients with CVD (29.8%), 424 CKD patients without CVD (70.2%). Compared with CKD patients without CVD, the proportion of men, the proportion of hypertension, the proportion of diabetes, age, duration of CKD, systolic blood pressure, blood uric acid, waist to hip ratio and waist circumference were higher (all P<0.05), while low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and estimated glomerular filtration rate (eGFR) were lower in CKD patients with CVD (all P<0.05). In terms of body composition, SMI ( t=-11.964, P<0.001) and body mass index ( t=-4.462, P<0.001) in CKD patients with CVD were significantly lower than those in CKD patients without CVD, but VAT ( t=3.089, P=0.002) and TBF ( t=5.177, P<0.001) in CKD patients with CVD were significantly higher. After adjusting for confounders such as age, CKD duration, hypertension history, diabetes history, LDL-C, body mass index, eGFR, TBF, etc. by multivariate logistic regression analysis, the risk of CKD patients suffering from CVD increased significantly with the decrease of SMI [with SMI high tertile (36.37%-50.80%) as reference, SMI middle tertile (28.23%-36.31%): OR=1.49, 95% CI 1.24-1.71, P=0.003; SMI low tertile (15.28%-28.19%): OR=2.17, 95% CI 1.79-2.62, P<0.001], and VAT was not found to be associated with the risk of CVD in CKD patients ( P>0.05). Conclusion:Reduction of SMI is independently associated with CVD in CKD patients.
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Objective:To explore the application effect of flipped classroom teaching method in musculoskeletal ultrasound teaching for standardized residency training of ultrasound department.Methods:In the study, 30 residents in ultrasound department of The Second Affiliated Hospital of Chongqing Medical University were collected and divided into control group ( n=15) and experimental group ( n=15). The control group was taught by traditional teaching method and the flipped teaching method was adopted in the experimental group. All residents were trained for 3 months. At the end of the training, theoretical test and operating skill test as well as the questionnaire survey were performed to evaluate the effects of these 2 teaching methods. SPSS 17.0 was used for t test and chi-square test. Results:The experimental group were superior to the control group in the aspects of the theoretical test scores, operating skill test scores, improving learning efficiency, building clinical thinking patterns, improving self-study ability, and there were significant differences. The satisfaction degree of teaching methods in the experiment group was higher than that in the control group, with significant differences ( P<0.001). Conclusion:Flipped classroom teaching method can improve the teaching outcomes and quality to ensure smooth completion of the teaching objectives.
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Objective:To explore the agonistic CD40 antibody(CD40ScFv and CD40mAb)-mediated suppression of mouse breast cancer cell growth and change in tumor tissue Th1/Th2 balance,as well as the mechanism underlying its antitumor effect.Methods:The re-combinant plasmid containing the CD40ScFv gene fragment was transformed into the Rosetta strain of Escherichia coli to express and purify the recombinant functional CD40ScFv protein.The 4T1 mouse breast cancer cells were cultured in vitro.Balb/C tumor model mice were divided into CD40ScFv,CD40mAb agonist,and saline(NS group)groups,which were administered CD40ScFv,CD40mAb ago-nist,and saline,respectively,to observe the change in tumor volume.The tumor tissues were removed and enzyme-linked immunosor-bent assay(ELISA)was used to determine IL-12 concentration in the tumor tissue supernatants.The tumor infiltrating lymphocytes (TILs)were extracted by enzymatic digestion.The proportion of Th1 and Th2 cells in TILs was determined by flow cytometry.Results:The CD40ScFv protein was successfully identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and western blot.The molecular size and concentration of the purified protein were 27kDa and 1.12 mg/mL,respectively.The tumor sizes of the CD40ScFv and CD40mAb groups were(3.044±0.239)cm3and(2.749±0.261)cm3,respectively,which were significantly smaller(P<0.05)than that of the NS group(3.933±0.326)cm3.The tumor IL-12 concentration(determined by ELISA)in the CD40ScFv group(396.27±48.13)pg/mL and the CD40mAb agonist group(457.63±58.37)pg/mL were significantly higher(P<0.05)than that of the NS group(79.51±14.97) pg/mL.The results of flow cytometry showed that the excited Th1/Th2 cell ratios were 6.32±0.87 and 5.54±0.71 for the CD40ScFv and CD40mAb groups,respectively,which were significantly higher(P<0.05)than that of the NS group(1.79±0.38).Conclusions:The agonis-tic CD40 antibody inhibited tumor growth by regulating the Th1/Th2 ratio and IL-12 secretion via promotion of DC activation,which is one of the important mechanisms affecting Th1/Th2 balance in the tumor microenvironment
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ObjectiveTo investigate the protective effect of erythropoietin (EPO) on human renal tubular epithelial-mesenchymal transition (EMT) induced by high glucose. MethodsCultured HK-2 cells were divided into 5 groups: normal control group, osmolarity control group, high glucose group, high glucose with EPO (5 U/ml)group and high glucose with EPO (10 U/ml)group. The mRNA expression of α-SMA, TGF-β1, Smad2, ILK of cells were measured by RT-PCR. The levels of intracellular α-SMA and TGF-β1 protein were measured by immunocytochemistry. ResultsCompared with the control groups, mRNA expression of α-SMA, TGF-β1, Smad2, ILK and protein expression of α-SMA and TGF-β1 were increased after high glucose treatment (P<0.01). Compared with the high glucose group, EPO 5 U/ml or EPO 10 U/ml remarkably down-regulated the expression of α-SMA, TGF-β1, Smad2 and ILK (P<0.01). ConclusionEPO can inhibit the progression of EMT and the up-regulation of TGF-β1, Smad2 and ILK induced by high glucose.