Matrine inhibits transforming growth factor-β1-induced epithelial mesenchymal transdifferentiation in human peritoneal mesothelial cells by regulating the expression of Snail2 / 中华肾脏病杂志

Objective:To study the effect of matrine on the expression of transcription factor Snail2 in peritoneal mesothelial cells epithelial-mesenchymal transition (EMT) induced by transforming growth factor-β1 (TGF-β1).Methods:Human peritoneal mesothelial cells were stimulated by TGF-β1 and treated with matrine. The experiment was divided into six groups (control group, TGF-β1-induced group (5 ng/ml), TGF-β1+0.4 mg/ml matrine intervention group, TGF-β1+0.6 mg/ml matrine intervention group, TGF-β1+0.8 mg/ml matrine intervention group and TGF-β1+1.0 mg/ml matrine intervention group). The expressions of Snail2, E-cadherin, α-smooth muscle actin (α-SMA), Fibronectin and collagen (Col)Ⅲ were detected by real-time fluorescence quantitative PCR and Western blotting. The protein phosphorylation levels of Smad2, Smad3 and extracellular signal-regulated kinase (ERK)1/2 were detected by Western blotting.Results:The mRNA and protein expressions of Snail2, α-SMA, Fibronectin and ColⅢ were up-regulated after being stimulated by TGF-β1 (5 ng/ml) in human peritoneal mesothelial cells, while the mRNA and protein expression of E-cadherin was down-regulated. TGF-β1 (5 ng/ml) could up-regulate the protein phosphorylation levels of Smad2, Smad3 and ERK1/2. Matrine (0.4, 0.6, 0.8, 1.0 mg/ml) could down-regulate the mRNA and protein expression levels of Snail2, α-SMA, Fibronectin and ColⅢ after being stimulated by TGF-β1 in human peritoneal mesothelial cells. Matrine could down-regulate the protein phosphorylation of ERK1/2, and up-regulate the mRNA and protein expression levels of E-cadherin with treatment of TGF-β1 in human peritoneal mesothelial cells.Conclusions:TGF-β1 can induce EMT of human peritoneal mesothelial cells. Matrine may inhibit TGF-β1-induced EMT of human peritoneal mesothelial cells by down-regulating the expression of Snail2 through the ERK1/2 signaling pathway.

Analysis of risk factors and continuous detection time of serum creatinine in patients with acute renal injury during cardiopulmonary bypass / 中国综合临床

Objective:To investigate the risk factors of acute kidney injury (AKI) in patients undergoing cardiopulmonary bypass (CPB) during cardiac surgery, and to determine the relationship between preoperative biochemical examination and intraoperative CPB time and the incidence of AKI.Methods:From October 2017 to October 2018, the clinical data of cardiopulmonary bypass patients admitted to the First Affiliated Hospital of Guangxi Medical University were analyzed retrospectively.Logistic regression was used to analyze the influence of patients′ basic diseases, preoperative biochemical examination and cardiopulmonary bypass time on postoperative AKI.At the same time, the changes of serum creatinine in patients with AKI 7 days after operation were analyzed to provide help for the early diagnosis of AKI after operation.Results:A total of 370 patients with cardiopulmonary bypass were included.Logistic regression analysis results: diabetes basic history( OR=5.226, 95% CI: 1.084-25.191, P=0.039), the increase of age ( OR=1.041, 95% CI: 1.018-1.065, P<0.001), BMI ( OR=1.127, 95% CI: 1.043-1.218, P=0.003), urea nitrogen ( OR=1.211, 95% CI: 1.077-1.360, P=0.001), and CPB time ( OR=1.013, 95% CI: 1.006-1.020, P<0.001) were the risk factors of postoperative AKI in patients with cardiopulmonary bypass.The detection rate of AKI was 4.19%(9/215), 51.63%(111/215), 87.91%(189/215), 97.67%(210/215), 99.07%(213/215), 100%(215/215) and 100%(215/215) on the first day, the third day, the fourth day, the fifth day, the seventh day, respectively. Conclusion:Diabetes history, age, BMI, Urea nitrogen and CPB times are risk factors of AKI patients after CPB.In order to reduce the rate of misdiagnosis, creatinine should be detected for at least 4 consecutive days in clinical observation of post-operative serum creatinine.

Association between coagulation indicators and all-cause mortality in sepsis-related acute kidney injury patients / 中华肾脏病杂志

Objective@#To explore the association between coagulation indicators and all-cause mortality in sepsis-related acute kidney injury (AKI) patients.@*Methods@#Clinical data of patients with sepsis-related AKI admitted to the First Affiliated Hospital of Guangxi Medical University from June 10, 2016 to June 10, 2018 were retrospectively analyzed. The patients were divided into death group and survival group according to the outcome of 28 d. The risk factors of all-cause mortality in sepsis-related AKI patients were analyzed. Receiver operating characteristic curve (ROC) was used to evaluate the prognostic value of independent risk factor for the death of sepsis-related AKI patients and Kaplan-Meier method was used to draw the survival curve.@*Results@#A total of 214 patients with sepsis-related AKI were enrolled into this study. Their age was (57.90±16.96) years old, and the ratio of male to female was 2.57∶1. There was at least one abnormal coagulation indicator in 74.77%(160/214) of patients, and multiple organ dysfunction syndrome (MODS) in 37.38% of patients. The 28-day all-cause mortality was 28.04%(60/214). Prothrombin time, activated partial thrombin time (APTT), international standardized ratio, thrombin time, procalcitonin, abnormal coagulation indicators and the incidence of MODS in the death group were higher than those in the survival group, while body weight, hemoglobin, the percent of neutrophile granulocyte, platelet count, prothrombin activity, serum albumin and the proportion of renal replacement therapy (RRT) were lower than those in the survival group (all P<0.05). Cox regression analysis suggested that sepsis-related AKI patients with prolonged APTT had a higher risk for all-cause death (HR=2.610, 95%CI 1.077-6.326, P=0.034). The Kaplan-Meier survival curve indicated that 28 d survival rate of APTT extension group was lower than that of the non-APTT extension group (37.1% vs 70.6%, Log-rank χ2=16.881, P<0.001), and the average survival time was shorter than that of the non-APTT extension group (21.79 d vs 24.73 d).@*Conclusions@#Coagulation abnormalities are common in patients with sepsis-related AKI, which are also correlated to the all-cause death. APTT extension is an independent risk factor for the all-cause death in sepsis-related AKI patients.

Association between coagulation indicators and all-cause mortality in sepsis-related acute kidney injury patients / 中华肾脏病杂志

Objective To explore the association between coagulation indicators and all-cause mortality in sepsis-related acute kidney injury (AKI) patients. Methods Clinical data of patients with sepsis-related AKI admitted to the First Affiliated Hospital of Guangxi Medical University from June 10, 2016 to June 10, 2018 were retrospectively analyzed. The patients were divided into death group and survival group according to the outcome of 28 d. The risk factors of all-cause mortality in sepsis-related AKI patients were analyzed. Receiver operating characteristic curve (ROC) was used to evaluate the prognostic value of independent risk factor for the death of sepsis-related AKI patientsand Kaplan-Meier method was used to draw the survival curve. Results A total of 214 patients with sepsis-related AKI were enrolled into this study. Their age was (57.90±16.96) years old, and the ratio of male to female was 2.57:1. There was at least one abnormal coagulation indicator in 74.77％(160/214) of patients, and multiple organ dysfunction syndrome (MODS) in 37.38％ of patients. The 28-day all-cause mortality was 28.04％(60/214). Prothrombin time, activated partial thrombin time (APTT), international standardized ratio, thrombin time, procalcitonin, abnormal coagulation indicators and the incidence of MODS in the death group were higher than those in the survival group, while body weight, hemoglobin, the percent of neutrophile granulocyte, platelet count, prothrombin activity, serum albumin and the proportion of renal replacement therapy (RRT) were lower than those in the survival group (all P<0.05). Cox regression analysis suggested that sepsis-related AKI patients with prolonged APTT had a higher risk for all-cause death (HR=2.610, 95％CI 1.077-6.326, P=0.034). The Kaplan-Meier survival curve indicated that 28 d survival rate of APTT extension group was lower than that of the non-APTT extension group (37.1％ vs 70.6％, Log-rank χ2=16.881, P<0.001), and the average survival time was shorter than that of the non-APTT extension group (21.79 d vs 24.73 d). Conclusions Coagulation abnormalities are common in patients with sepsis-related AKI, which are also correlated to the all-cause death. APTT extension is an independent risk factor for the all-cause death in sepsis-related AKI patients.

Correlation analysis between homocysteine level and acute kidney injury after cardiac valve replacement surgery / 中华肾脏病杂志

Objective To investigate the relationship between preoperative serum homocysteine (Hcy) level and acute kidney injury (AKI) after cardiac valve replacement surgery. Methods The data of the inpatients who accepted cardiac valve replacement surgery, age≥18 years, no renal replacement therapy before surgery, non - renal decompensation and preoperative serum creatinine (Scr)＜178 μmol/L, survival within 48 h after surgery, and with preoperative serum Hcy data in the First Affiliated Hospital of Guangxi Medical University from January 1, 2015 to December 31, 2017 was retrospectively analyzed. AKI was diagnosed in patients whose Scr increased more than 26.5 μmol/L (0.3 mg/dl) within 48 hours or 1.5 times higher than baseline within 7 days after surgery. According to this, patients were divided into AKI group and non-AKI group, and the affecting factors for AKI were compared between the two groups. Multivariate logistic regression was used to analyze the independent influencing factors of AKI. The relationship between serum Hcy level and AKI incidence was analyzed by Spearman correlation analysis. Whether the AKI occurred and serum Hcy levels were used as variables to map the receiver operating characteristic curve (ROC), and was used to assess the value of preoperative serum Hcy level for predicting AKI after cardiac valve replacement surgery. Results A total of 810 subjects were included in the study, including 375 males and 435 females. They were (50±11) years old (19-78 years old). Among them, 329 patients with AKI occurred within 7 days after heart valve replacement, and the incidence rate was 40.6% (male 45.9%, female 36.1%). The serum Hcy level in the AKI group was higher than that in the non-AKI group [(15.74±4.55) μmol/L vs (13.87 ± 3.85) μmol/L, t=6.106, P＜0.01]. Multivariate logistic regression analysis showed age (OR=1.030, 95% CI 1.014-1.045, P＜0.001), extracorporeal circulation time (OR=1.011, 95% CI 1.007-1.016, P＜0.001), Scr (OR=1.014, 95%CI 1.005-1.023, P=0.002), serum Hcy (OR=1.059, 95% CI 1.017-1.103, P=0.006), high level of Hcy (＞13.64 μmol/L) (OR=1.465, 95%CI 1.059-2.027, P=0.021) and moderate to severe hyperhomocystinemia (16≤Hcy≤100 μmol/L) [with normal HHcy (Hcy＜10 μmol/L) as reference, OR=2.180, 95% CI 1.245-3.816, P=0.006] were independent influencing factors of AKI after cardiac valve replacement surgery. Spearman correlation analysis showed that the incidence of postoperative AKI increased with the increase of preoperative serum Hcy level (rs=0.927, P＜0.001). The results of ROC curve showed that the area under the curve of the preoperative serum Hcy level predicting AKI after heart valve replacement was 0.701, and the cutoff value was 13.64 μmol/L, with the sensitivity 61.3%, specificity 70.9%. Conclusions Preoperative serum Hcy level is an influencing factor for AKI after cardiac valve replacement surgery. The higher the level of preoperative serum Hcy, the higher the incidence of AKI after cardiac valve replacement surgery. Patients with preoperative serum Hcy levels＞13.64 μmol/L have an increased risk of AKI after cardiac valve replacement surgery.

Relationship between serum 25-hydroxycholecalciferol deficiency and the risk of peritoneal dialysis associated peritonitis / 中华肾脏病杂志

Objective To investigate the relationship between serum 25-hydroxycholecalciferol [25(OH)D3] deficiency and the risk of peritoneal dialysis associated peritonitis.Methods Baseline clinical data (before the peritoneal dialysis catheter insertion) of peritoneal dialysis patients treated with CAPD in the First Affiliated Hospital of Guangxi Medical University from May 1,2013 to February 1,2016 were retrospective analyzed.All the patients were followed-up until July 31,2016.According to the baseline serum 25(OH)D3 levels,patients were divided into deficiency group (25(OH)D3 ＜ 15 ng/ml) and non deficiency group (25(OH)D3 ≥ 15 ng/ml),the baseline clinical data of the two groups were also analyzed.Kaplan-Meier method was used to compare the time-to-peritonitis of two groups.Cox proportional hazard model was used to analyze the relationship between the 25(OH)D3 deficiency and the risk of peritonitis.ROC curve was used to analyze the predictive value of the baseline serum 25(OH)D3 for the risk of PDAP in peritoneal dialysis patients.Results Compared with the 25(OH)D3 non deficiency group,25(OH)D3 deficiency group had a significant increase incidence of peritonitis,high diastolic blood pressure and mean arterial pressure,but serum albumin,total serum protein decreased significantly (P ＜ 0.05).Kaplan-Meier survival analysis showed that,compared with 25(OH)D3 non deficiency group,the time-to-peritonitis episode of patients with 25(OH)D3 deficiency were shorter (P ＜ 0.05).Cox proportional hazard model showed that after adjusting for age,sex,hemoglobin,serum albumin,C-reactive protein,total Kt/V,eGFR,diabetes or not,25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis (HR 5.247,95％CI 1.180-23.340,P ＜ 0.05).ROC curve showed the area under the curve that baseline serum 25(OH)D3 deficiency predict the occurrence of PDAP was 0.714,and the best cut-off point of baseline serum 25(OH)D3 was 11.35 ng/ml (sensitivity 75％,specificity 63％).Conclusions Peritoneal dialysis associated peritonitis occurred earlier in peritoneal dialysis patients whose baseline serum 25(OH)D3 deficiency.Baseline serum 25(OH)D3 deficiency is the independent risk factor of peritoneal dialysis associated peritonitis,which may predict the incidence of peritoneal dialysis associated peritonitis.

The correlation between TLR2 gene -597T/C polymorphism and primary ANCA associated small vasculitis of Han population in Guangxi / 实用医学杂志

Objective To investigate the correlation between Toll-like receptor2 (TLR2) gene promoter region -597T/C polymorphism and primary ANCA associated small vasculitis (AAV) in Guangxi Han people. Methods A case contrastive control study was adopted in the study. Patients with AAV (patients group, n=110) and healthy people (control group, n = 200) were recruited. Associated serum indexes were detected and polymorphisms of TLR2 gene promoter 597T/C were analyzed by polymerase chain restricted fragment length polymorphisms (PCR-RFLP). Results (1)Three TLR2-597T/C genotypes were discovered in 110 AAV patients, namely, TT, TC and CC, with the frequency of 54.55%,40.00% and 5.45% respectively. And the frequencies of allele T and C were 74.55% and 25.45%. In control group, the genotype frequencies of TT, TC and CC were 56.00%,40.50% and 3.50%, with 76.25% of allele T and 23.75% of allele C. No significant differences were found in neither genotype distribution nor allele frequencies between the patients group and control group ( P > 0 . 05 ) . ( 2 ) Significant differences were found in the incidence of proteinuria rate and the hemoglobin (P< 0.05)in AAV patients. (3)There was no significant difference between AI and CI in TT, TC and CC genotype in AAV patients. Conclusions Polymorphism of TLR2-597T/C may be correlated with the incidence of proteinuria and the level of hemoglobin, while no obvious correlation with the genetic susceptibility of ANCA in vasculitis patients of Guangxi Han people.

Analysis of clinical features and risk factors for adult nephrotic syndrome with pulmonary thromboembolism / 天津医药

Objective To investigate the clinical features and risk factors of adult nephrotic syndrome with pulmonary thromboembolism (PTE). Methods Sixty patients diagnosed with nephrotic syndrome and clinically suspected with PTE were enrolled in this retrospective study. Patients were divided into PTE group (n=32) and no-PTE group (n=28) according to the results of computed tomographic pulmonary angiography (CTPA). The single factor analysis and Logistic repres?sion analysis were used to analyse risk factors including age, gender, onset time, clinical symptoms, laboratory examination and pathological types. According to the independent risk factors, the receiver-operating characteristic curve (ROC curve) was used to determine PTE threshold value based on the evaluation index in nephrotic syndrome. Results Single factor analysis showed that there were significant differences in disease duration, hemoglobin, serum albumin, total cholesterol, low-density lipoprotein cholesterol, D-dimer and physical examination in P2 hyperthyroidism between two groups (P <0.05). Logistic regression analysis showed that D-dimer was independent risk factor of PTE. The analysis of ROC curve indi?cated that D-dimer optimal threshold was 1 015.50μg/L. Conclusion D-dimer is an independent risk factor of PTE in pa?tients with nephrotic syndrome. When D-dimer is greater than 1 015.50μg/L, should pay attention to the occurrence of PTE.

Relationship between polymorphism site rs5744168 of TLR5 and AAV / 实用医学杂志

Objective To investigate the relationship between putative rs5744168 of Toll-like receptors 5 (TLR5)and ANCA associated small vasculitis (AAV) in Guangxi Han nationality. Methods Polymorphism was analyzed by polymerase chain restricted fragments length polymorphism in 120 cases with AAV and 212 controls. Results (1)There were two genotypes of CC and CT in AAV group and control group. The frequencies distribution of CC and CT in 120 AAV patients were 82.50% and 17.50% respectively and the frequencies of allele C and T 91.25% and 8.75%,respectively. In controls,the genotypefrequencies of CC and CT were 88.68% and 11.3%, and frequencies of allele C and T 94.34% and 5.66%, respectively. No significant difference was found in either genotype distribution or allele frequencies between the patients and the controls ( P > 0 . 05 ) . ( 2 ) Significant reductions in the incidence of BUN, uric acid, quantitative test of 24 h urinary protein and erythrocyte sedimentation rate(ESR) were found in CC genotype (P < 0.05). (3) Binary regression model with a logit link function found total cholesterol was related with AAV. Conclusion The susceptibility of AAV in Guangxi Han population has nothing to do with the polymorphism of rs5744168.In AAV patients, polymorphism of rs5744168 may be associated with ESR, BUN, uric acid and quantitative test of 24 h urinary protein levels.

Impact of work-related musculoskeletal disorders on work ability among workers / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To assess the impact of work-related musculoskeletal disorders (WRMDs) on work ability among workers.</p><p><b>METHODS</b>A total of 1686 workers in various occupations, such as administration and education, were enrolled as subjects using the random cluster sampling method. The WRMDs and work ability of all subjects were evaluated using standardized Nordic questionnaires for the analysis of musculoskeletal symptoms and the Work Ability Index (WAI) scale, respectively. Comparison of work ability and its classification between the disease group and the non-disease group was performed by paired t test, RxC table χ2 test, and the Wilcoxon rank-sum test. The relationship between work duration and work ability was analyzed by the Spearman correlation test and a multi-level model.</p><p><b>RESULTS</b>(1). The work ability of workers in the disease group was significantly lower than that in the non-disease group (P<0.0 1). (2) There were significant differences in work ability between workers with different work durations (<10 years, 10-20 years, and ≥20 years) (F=22.124, P< 0.01). With the increase in work duration, the work ability of workers declined in both groups, and the work ability of workers in the disease group (Spearman coefficient rs=-0. 172, P<0.01) had a more significant decline than that in the non-disease group (Spearman coefficient rs=-0.104, P<0.01). WRMDs were important risk factors for the decrease in work ability among workers. (3) There were significant differences in constituent ratios and levels of work ability classification between the disease group and the non-disease group (χ2=121.097, P<0.01; Z=-10.699, P<0.01). The proportions of workers with poor and medium work ability in the disease group were significantly higher than those in the non-disease group, while the proportion of works with excellent work ability in the disease group was significantly lower than that in the non-disease group. The similar characteristics in constituent ratios and levels of work ability classification could be found between the disease group and the non- disease group in various occupations (P<0.01).</p><p><b>CONCLUSION</b>WRMDs have a harmful effect on the work ability of workers, and the work ability of workers substantially declines with the increase in exposure time (work duration).</p>

The correlation between toll-like receptor 9 gene 2848G/A polymorphism and primary anti-neutrophil ;cytoplasmic antibodies associated small vasculitis / 中华风湿病学杂志

Objective To investigate the correlation between toll-like receptor 9 (TLR9) gene 2848G/A polymorphism and primary antineutrophil cytoplasmic antibodies (ANCA) associated small vasculitis (AAV). Methods A case-control study was performed among 135 patients diagnosed with AAV and 140 disease-free control and we test the serum biochemical parameter. Polymorphism was analyzed by polymerase chain restricted fragments length polymorphism. As for statistic method, according to the character of data, we performed t-test, chi-square test, Spearman grade related analysis and one-way ANOVA. Results ① The frequencies of AA, GG, GA genotype of TLR9 2848 in AAV patients were 14.07%, 38.52%, and 47.71%, respectively; ② Significant increase in IgM was observed in AA genotype than GG+GA genotype in AAV patients (F=4.561, P0.05). Conclusion AA, GA and GG genotypes are detected in TLR9 2848G/A in patients with AAV in Guangxi, without significant correlation with susceptibility to primary AAV in Guangxi.

Glucocorticoid combined with mycophenolate mofetil versus cyclophosphamide in the treatment for adult refractory nephrotic syndrome:a Meta-analysis / 天津医药

Objective To systematically review the efficacy and safety of mycophenolate mofetil versus cyclophosphamide in adults with refractory nephrotic syndrome. Methods The randomized controlled trials of mycophenolate mofetil and cyclophosphamide treatment for refractory nephrotic syndrome were searched from Cochrane library, PubMed, Embase, Wanfang, VIP and CNKI till March 2014. The relevant studies were screened according to inclusion criteria and exclusion criteria. The quality of the included studies was evaluated. Meta-analyses were performed by using RevMan 5.2 software. The indexes were analyzed including the complete remission rate, efficiency, serum albumin, and adverse reaction after completing the treatment for adults with refractory nephrotic syndrome. Results There were 9 RCTs, a total of 467 patients were enrolled. The result of the meta-analysis showed that mycophenolate mofetil could significantly increase complete remission rate (RR=1.45, 95%CI=1.17～1.81, P=0.000 7) and efficiency rate (RR=1.23, 95%CI=1.11～1.36, P＜0.000 1). It can also enhance the level of serum albumin (WMD=2.73, 95%CI=1.42～4.04, P＜0.000 1) and decrease 24-hour urinary protein (SMD=-0.63, 95%CI=-1.16～-0.10, P=0.02) compared with cyclophosphamide in the treatment of refractory nephrotic syndrome. There was no significant difference in the serum level of cholesterol between mycophenolate mofetil group and cyclophosphamide group (SMD=0.31, 95%CI=-0.23～0.84, P=0.26 ). The incidence rates of liver dysfunction (RR=0.13,95%CI=0.06～0.28, P＜0.000 01), leukopenia (RR=0.10, 95%CI=0.04～0.23, P＜0.000 01), gastrointestinal reaction (RR=0.21, 95%CI=0.11～0.39, P＜0.000 01) and alopecia (RR=0.08, 95%CI=0.02～0.29, P＜0.000 01) were significantly lower in mycophenolate mofetil group than those of cyclophosphamide group. There were no significant differences in respiratory tract infection rate (RR=0.68, 95%CI=0.41～1.14, P=0.14) and lung infection rate (RR=0.58, 95%CI=0.31～1.08, P=0.09) between the two groups. Conclusion The safety and efficacy are better in the treatment of refractory nephrotic syndrome using mycophenolate mofetil than that of cyclophosphamide.

Study on current status of work-related musculoskeletal disorders evaluation / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To characterize the distribution of work-related musculoskeletal disorders (WRMD) among the occupational population.</p><p><b>METHODS</b>A total of 1686 people of various occupations were recruited with random cluster sampling. Standardized Nordic questionnaires for the analysis of musculoskeletal systems were used to evaluate WRMD at the neck, shoulder, or lower back in the past one year. The annual prevalence of WRMD was determined. Difference analysis was performed with t-test, ANOVA, or chi-square test. The relationship between personal characteristics and WRMD was analyzed by unconditional logistic regression.</p><p><b>RESULTS</b>(1) WRMD were most frequently observed at the neck, followed by the lower back, and was least observed at the shoulder (P < 0.05). The prevalence of WRMD among mental workers was significantly higher than those among physical workers and mental-physical workers (P < 0.01). The prevalence of WRMD among female workers was significantly higher than that among male workers (P < 0.05). (2) In general, the prevalence of WRMD significantly rose with the increases in age (<30, 30∼, 40∼, and ≥ 50 years) or working years (<10, 10∼, and ≥ 20 years) (P < 0.05). (3) In the face of sickness or injury, physical workers and mental workers showed a relatively high absence rate but a relatively low medical visiting rate (13.05%). (4) Unconditional logistic regression analysis showed that mental work, gender, and working year were the main influential factors for WRMD among workers.</p><p><b>CONCLUSION</b>Workers of different types of occupation, genders, ages, and working years have different risks of WRMD at the neck, shoulder, and lower back.</p>

Association study of TGFβ1-509 C/T and TCRCα-575 A/G polymorphisms with primary ANCA associated vasculitis in family / 中华检验医学杂志

Objective To investigate the relationship between TGFβ1-509 C/T, TCRCα-575 A/G SNPs and primary AAV using a transmission disequilibrium theory based pedigree analysis Methods Genotypes of 264 individuals from 88 AAV families include patients, their parents, brothers and sisters were determined by PCR-RFLP and direct sequencing. Transmission disequilibrium test(TDT) and HRR were employed for the data analysis to observe the transmission disequilibrium of TGF31-509 C/T and TCRCα -575 A/G polymorphisms. Results No transmission disequilibrium from heterozygous parents onto the patients was found in the trios analyzed by TDT for either TGFβ1-509 C/T (observed C/T = 36/28, expected C/T =33. 5/30. 5, x2 =0.51, P＞0.05) or TCRCo-575 A/G ( observed A/G = 29/39, expected A/G = 33.5/34. 5, x2 = 1. 59, P ＞ 0. 05 ). The genotype-based HRR and haplotype-based HRR showed there was no increased risk of AAV in the observed trios for either -509 C/T polymorphism of TGFβ1 (transmitted genotype CC/CT/TT =12/20/6, allele C/T = 44/32; nontransmitted genotype CC/CT/TT = 10/19/9,allele C/T =39/37, genotype-based HRR x2 =0.81, P ＞0. 05, haplotype-based HRR x2 =0. 66, P＞0. 05,HRR = 1.30) or -575 A/G polymorphism of TCRCα ( transmitted genotype AA/AG/GG = 9/18/12, allel A/G = 36/42; nontransmitted genotype AA/AG/GG = 15/15/9, allel A/G = 35/33, genotype-based HRR x2=2. 20, P ＞0. 05. Haplotype-based HRR x2 =0. 41, P ＞0. 05, HRR =0. 81 ). The deviation of HRR coefficient was not excessive(1.00). Conclusion TGFβ1-509 C/T and TCRCo-575 A/G polymorphism may not be associated with the genetic susceptibility of primary AAV in Guangxi Han population.

Electrolyte changes and dialysis adequacy in patients underwent continued ambulatory peritoneal dialysis for 1 month / 中国综合临床

Objective To investigate the impact of continued ambulatory peritoneal dialysis (CAPD)for 1 month,thus to provide effective therapy to control the symptoms of uremia in early stage. Methods A total of 129 nephrotic patients in final stage were treated with CAPD ,dialysis adequacy were assessed after 1 month of CAPD. Complications and biochemical indicators were compared between before and after 1 month of CAPD. Results The dialysis adequacy was good at the end of 1 month of CAPD. Compared to before CAPD,The prevalence of edema after 1 month of CAPD significantly decreased compared to before CAPD (7.8%vs. 24.8% ,χ2 = 13.765, P ＜ 0.05 ). After CAPD gastrointestinal, symptom, such as nausea and vomit significantly decreased from 66.7% to 6. 2% ( χ2 = 101. 821, P ＜ 0. 05 ). Itch of skin significantly decreased from 22. 5% before CAPD to 6. 2% after CAPD(χ2 = 13.914,P ＜0. 05) . Hemoglobin increased significantly from (79. 10 ± 17.13 ) g/L to (96. 50 ± 18. 69 ) g/L after CAPD ( t = - 6. 333, P ＜ 0. 01 ), serum calcium was sisilar, ( 1.99 ± 0.30) mmol/L and (2.07 ± 0. 20) mmol/L at before and after CAPD respectively ( t = -1. 920,P ＞0. 05). Albumin was (30. 62 ±5.24) g/L before CAPD and after CAPD(31.84 ±5.64) g/L ,with no significant difference ( t= - 0.333, P ＞ 0. 05 ) . Serum inorganic phosphorus, kalemia, urea nitrogen and creatinine concentration significantly decreased from ( 2. 06 ± 0. 54 ) mmol/L, ( 4.30 ±: 0. 68 ) mmol/L, 22. 00( 15.87,30.03 ) mmol/L and 864. 00 ( 733.00,1046. 25 ) μmol/L to ( 1.72 ± 0. 52) mmol/L, ( 3.84 ± 0.47 )mmol/L , 17.00 ( 13.91,20. 91 ) mmol/L and 777. 50 ( 627.00, 1047.75 ) μnol/L, respectively ( t = 3.284,4. 669, Z = - 3.717 and - 2. 408, respectively,Ps ＜ 0. 01 or 0. 05 ).. The level of serum PTH increased slightly from [ 184. 80 ( 114. 21,369. 77) ng/L to 226. 26 ( 124. 22,335.92 ) ng/L, but the difference was not significant ( Z = - 0. 597, P ＞ 0. 05 ). Conclusion CAPD had significant effect in early stage of dialysis with good dialysis adequacy. Hypocalcemia and hyperphosphatemia can be improved. The levels of serum kalemia decreased. The iatients's quality of life significantly improved.

Association of TGFβ1-509 C/T gene polymorphism and ANCA associated vasculitis in Chinese Han population / 中国综合临床

Objective To investigate the association between TGFβ1-509 C/T gene polymorphism with primary ANCA associated vasculitis (AAV) in Chinese Han population . Methods The blood DNA and clinical data of 88 patients were collected, TGFβ1-509 C/T genotypes were determined by PCR-RFLP, 107 healthy individuals were tested as controL Clinical and pathological data of the patients with different genotype were compared. Results No significant difference was found in neither genotype distributions nor allele frequencies between the patients and the control (P > 0. 05). Significant difference was found in uria protien level of the three groups of patients with different genotypes(P <0.05) ,but not in blood pressure, serum urea nitrogen or creatinine, vasculitic damage index, birminghan vasculitis activity score (P > 0. 05 ). Significant difference was found in med-heavier glomerular mesangial proliferation of the three groups ( P < 0.05 ) , but not in lighter glomerular mesangial proliferation, glomerular sclerosis, crescent formation and tubule-interstitial fibrosis and atrophy. Conclusions In Chinese Han population, TGFβ1-509 C/T polymorphism might have no relationship to susceptibility of primary AAV, but might relate to uria protein and med-heavier degree of mesenterium proliferation.

The expression and significance of vascular endothelial growth factor and its soluble receptor sFlt-1 in the serum of patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective To investigate the serum concentration of vascular endothelial growth factor (VEGF) and its soluble receptor 1 (sFlt-1) in patients with systemic lupus erythematosus (SLE) and its correlation with clinic and pathologic parameters.Methods serum levels of VEGF and sFlt-1 in a group of 60 patients with SLE and 30 healthy controls were assessed by ELISA.Results The VEGF and sFlt-1 serum levels were higher in active SLE group than the control group (P＜0.01).The VEGF/sFlt-1 ratio in the control group was lower than that in the active SLE group.inactive SLE group and LN group (P＜0.01).Particularly the ratio increased in WHO class Ⅴ LN group compared to WHO classⅡ,Ⅲ,Ⅳ LN group (P＜0.05).The semm level of sFlt-1 was correlated to proteinuria (rs=0.6244,P＜0.01) and ESR (rs=0.4235,P＜0.01) and the serum levels of VEGF and sFlt-1 were correlated to the systemic lupus erythematosus disease activation index (SLEDAI) (rs=0.5046,P＜0.01 and rs=0.5152,P＜0.01,respectively).The serum level of VEGF was correlated with renal tissue activation index (RAI) (rs=0.3386.P＜0.05) and the serum levels of VEGF and sFlt-1 were not correlated to blood pressure,serum creatine,blood ureanitmgen,C3,C4,C-reative protein.The muhi-factors stepwise regression analysis indicated that serum VEGF was positively correlated with SLEDAI (R2=0.1 75,P＜0.05),serum sFlt-1 was positively correlated with ESR and proteinurine (R2=0.497,P＜0.05).Conclusion Serum VEGF and sFlt-1 are elevated in patients with active SLE and they can reflect the activity of the disease.The overcxpression of serum VEGF might be correlated to the proliferated glomerulonephritis and the overexpression of sFlt-1 contribhtes to proteinurla.The imbalance between these two factors may act an important role in SLE pathogenesis.

Relationship of TCRCα-575A/G polymorphism with anti-neutrophil antibody associated vasculitis in Chinese Han population / 中国综合临床

Objective To investigate the relationship of TCRCα-575A/G polymorphism with anti-neutrophil antibody(ANCA) associated vasculitis in Chinese Han population. Methods 86 cases of ANCA associated vasculi-tis in Chinese Han population and 196 healthy subjects were enrolled. TCRCα-575A/G was genotyped by PCR-re-striction fragment length polymorphism (PCR-RFLP) assay. Case-control study was performed. Results No signifi-cant difference was found in either genotype distribution(AA,AG,GG) or allele frequencies between 86 patients and healthy subjects(P>0.05);But significant differences between AA group, AG group, and GG group in systolic pres-sure[(127.47±24.18)、(124.11±25.21)、(148.92±19.23) mm Hg],diastolic pressure [(75.35±14.12)、 (74.50±13.01)、(85.46±9.40) mm Hg],red blood cell count[(3.41±1.01)×109/L、(3.46±1.04)× 109/L、(2.68±0.67)×109/L] and hemoglobin [(90.45±20.69)、(100.66±29.80)、(77.61±15.81) g/L (P<0.05 for each) were found. The patients in GG group had higher blood pressure and more severe anaemia;By following the patients about (16.0±36.8) months,no statistics significance was found between groups with and without chronic renal failure in distributions and genetypes of TCRCα-575A/G (P>0.05 ). Conclusions In Chi-nese Han population,TCRCα-575A/G polymorphism might not be related to genetic susceptibility and chronic renal failure of ANCA associated vaseulitis;but G allele might be associated with more serious anaemia and hypertension.

Epidemiologic investigation of chronic kidney disease in adult urban population of Hezhou Guangxi / 中华肾脏病杂志

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in the adult urban population of Hezhou Guangxi. Methods One thousand and two hundred urban residents (older than 18 years) from Hezhou Guangxi were randomly selected using a random sampling. All the residents were interviewed. Their morning spot urine were tested to determine albumin to ereatinine ratio (abnormal:≥30 mg/g), and renal function [abnomal: eMDRD <60 ml·min-1·(1.73 m2)-1] was assessed. Morning spot urine dipstick of hematuria (abnormal:≥1 +) was confirmed by microscopy (abnormal: 3 red blood cells/HP). The associations among demographic characteristics, health eharacteristies and indicators of kidney damage were examined. Results Eligible data of 1069 subjects were enrolled in the study. The prevalence of albuminuria was 7.5%, hematuria 4.8%, and reduced eGFR 3.6%. The prevalence of kidney disease was 14.4% and the recognition was 1.4%. Age (OR 1.022, 95%CI 1.008-1.035), gender (OR 2.249, 95%CI 1.502-3.367), diabetes mellitus (OR 7.422, 95%CI 3.985-13.825) and hypertension (OR 4.397, 95% CI 2.601-7.432) were independently associated with CKD. Conclusions The prevalence of chronic kidney disease is 14.4% and the recognition is 1.4% in adult urban population of Hezhou Guangxi. Independent risk factors associated with chronic kidney disease are age, gender, diabetes mellitus and hypertension which is similar to those in developed countries and domestic big cities.

Relationship between the polymorphism of angiotensin converting enzyme gene and vascular complications in type 2 diabetes in Guangxi region / 中国实用内科杂志

Objectives To investigate the relationship between the insertion and deletion (I/D) polymorphism of human angiotensin converting enzyme (ACE) gene and the vascular complications in type 2 diabetes. Methods The I/D polymorphism of ACE gene was detected by polymerase chain reaction in 120 type 2 diabetic patients and 100 healthy controls. Results The frequency of DD genotype was significantly higher, while frequency of II genotype was lower in diabetic nephropathy patients (DN) than those in control group. The frequency of ID genotype was significantly higher, while frequency of II genotype was lower in type 2 diabetic patients with coronary heart disease (CHD), when compared to those without CHD. The frequencies of ACE genotypes in patients with diabetic retinopathy (DR) or hypertension (HP) were not different from those in control group and non-DR or non- HP patients. Conclusions ① There were relationships between the I/D polymorphism of ACE gene and DN and CHD in type 2 diabetes. ② The DD genotype and D allele of ACE gene might be as markers in predisposing DN, while II genotype and I allele as protective factors for DN in diabetes. The ID genotype might be as a marker in predisposing CHD, while II genotype as a protective factor for CHD in diabetes.③ There was no relationship between I/D polymorphism of ACE gene and HP or DR in diabetes in Guangxi region.