Effect of combining different calcium concentration dialysate on calcium balance in peritoneal dialysis patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Calcium and phosphorus metabolic disturbance are common in dialysis patients and associated with increased morbidity and mortality. Therefore, maintaining the balance of calcium and phosphate metabolism and suitable intact parathyroid hormone (iPTH) level has become the focus of attention. We investigated the effects of different peritoneal dialysate calcium concentrations on calcium phosphate metabolism and iPTH in continuous ambulatory peritoneal dialysis (CAPD) patients.</p><p><b>METHODS</b>Forty stable CAPD patients with normal serum calcium were followed for six months of treatment with 1.25 mmol/L calcium dialysate (DCa1.25, PD4, 22 patients) or a combination of 1.75 mmol/L calcium dialysate (DCa1.75, PD2) and PD4 (18 patients) twice a day respectively. Total serum calcium (after albumin correction), serum phosphorus, iPTH, alkaline phosphatase (ALP) and blood pressure were recorded before and 1, 3 and 6 months after treatment commenced.</p><p><b>RESULTS</b>No significant difference was found in baseline serum calcium, phosphorus between the two patient groups, but the levels of iPTH were significantly different. No significant changes were found in the dosage of calcium carbonate and active vitamin D during 6 months. In the PD4 group, serum calcium level at the 1st, 3rd, 6th months were significantly lower than the baseline (P < 0.05). There was no significant difference in serum phosphorus after 6 months treatment. iPTH was significantly higher (P < 0.001) at the 1st, 3rd, and 6th months compared with the baseline. No differences were seen in ALP and blood pressure. In the PD4+PD2 group, no significant changes in serum calcium, phosphorus, iPTH, ALP and BP during the 6-month follow-up period.</p><p><b>CONCLUSIONS</b>Treatment with 1.25 mmol/L calcium dialysate for six months can decrease serum calcium, increase iPTH, without change in serum phosphorus, ALP, and BP. The combining of PD4 and PD2 can stabilize the serum calcium and avoid fluctuations in iPTH levels.</p>

Effects of bifidobacteria on respiratory and gastrointestinal tracts in neonates receiving mechanical ventilation / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of bifidobacterium on respiratory and gastrointestinal tracts in neonates receiving mechanical ventilation.</p><p><b>METHODS</b>The eligible neonates were randomly assigned into two groups: observed (n=38) and control (n=43). The observed group was given bifidobacteria daily (one capsule per time, for 7 days) by nasal feeding from the next day after mechanical ventilation. Gastric pH, gastric bacteria colonization, feeding intolerance, weight gain, the incidence of ventilator-associated pneumonia (VAP), and the homology between the bacteria isolated from intra-gastric colonization with those causing VAP were observed.</p><p><b>RESULTS</b>The incidence of gastric pH≤3 in the observed group was significantly higher than that in the control group 3, 5 and 7 days after mechanical ventilation (P<0.01). The rate of gastric bacteria colonization in the observed group was significantly lower than that in the control group 5 and 7 days after mechanical ventilation (P<0.01). The incidences of feeding intolerance and VAP in the observed group were significantly lower than those in the control group (P<0.05, P<0.01, respectively). The rate of homology of the bacteria isolated from intra-gastric colonization with those causing VAP in the observed group was significantly lower than that in the control group (P<0.01). There were no significant differences in the weight gain between the two groups.</p><p><b>CONCLUSIONS</b>Bifidobacterium can decrease gastric pH, gastric bacteria colonization and feeding intolerance, thus blocks the infection route "stomach-oropharynx-respiratory tract" indirectly and decreases the incidence of endogenous VAP in neonates receiving mechanical ventilation.</p>