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【Objective】 To explore the mechanism of macrophage-inducible C-type lectin (Mincle) and microinflammatory state in uremia. 【Methods】 SD rats were randomly divided into uremia group and sham operation group. The morphology and permeability of intestinal tissue, the morphology of intestinal tissue and macrophages were observed by transmission electron microscope, the expression of Mincle was detected in intestinal tissue sections, and the expressions of Toll-like receptor 4 (TLR-4) and NF-kappa B (NF-κB) protein on the surface of macrophages were detected by Western blotting. After the plasma was separated, the levels of endotoxin, C-reactive protein (CRP), interleulin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by Limulus lysate dynamic turbidimetric assay, and enzyme-linked immunosorbent assay (ELISA). The data were analyzed with IBM SPSS19.0 software. 【Results】 The expression of Mincle in the jejunum, ileum, and colon in uremia group was higher than that in sham-operation group (P<0.05). The expressions of TLR4 and NF-κB protein significantly differed in the ileum, jejunum and colon in uremia group (P<0.001). The levels of endotoxin, CRP, IL-6, and TNF-α were significantly increased in uremia group compared with sham-operation group (P<0.05). 【Conclusion】 In uremia, Mincle on the surface of intestinal macrophages increases and further through TLR4/NF-κB pathway mediates the transformation of intestinal macrophages to M1 type, releasing inflammatory products and causing systemic microinflammation.
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Objective:To explore the effect of Rehmanniae Radix combined with Scrophulariae Radix on renal microinflammation in diabetic nephropathy (DN) rats. Methods:50 Sprague Dawley (SD) rats were adaptively fed for 1 week, and then 10 rats were randomly selected as the blank control group, and the rest were treated with STZ intraperitoneal injection combined with high-fat diet to induce DN model. After 4 weeks, the successful modeled rats were randomly divided into model group, Rehmannia glutinosa Scrophularia group (5.25 g/kg) and metformin group (200 mg/kg), with 10 rats in each group. After 8 weeks of administration, fasting blood glucose was measured by blood glucose meter; microalbuminuria was measured by benzalkonium chloride turbidimetry; serum cystatin, TNF-α, IL-6 and hs-CRP levels were measured by ELISA kit; renal pathological changes were detected by HE staining, Masson staining and PAS staining; the expression of MCP-1, NF-κB (total) and p-NF-κB protein in renal tissue was detected by Western blot.Results:Compared with the model group, the body weight of rats in DHXS group was significantly decreased ( P<0.05). The content of fasting blood glucose[(18.06 ± 5.69) mmol/L vs. (29.42 ± 0.63)mmol/L], 24-hour urine protein [(11.02 ± 1.77)mg/d vs. (31.61 ± 0.65)mg/d], serum cystatin [(208.16 ± 12.07)ng/ml vs. (278.05 ± 19.33)ng/ml], TNF-α [(9.13 ± 1.46)pg/ml vs. (73.16 ± 8.30)pg/ml], IL-6[(4.27 ± 1.07)pg/ml], hs-CRP[(219.36 ± 22.02)ng/ml vs. (266.97 ± 15.80)ng/ml] in DHXS group were significantly decreased ( P<0.05), and the expression level of p-NF-κB (0.49 ± 0.07 vs. 0.84 ± 0.12) and MCP-1 (0.44 ± 0.02 vs. 0.64 ± 0.11) in renal tissue of rats in DHXS group were significantly reduced ( P<0.05). Conclusion:Rehmanniae Radix combined with Scrophulariae Radix can protect kidney by inhibiting the over activation of NF-κB, and reducing the expression of MCP-1 related protein to reduce renal micro inflammation.
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This Meta-analysis was designed to evaluate the effects of Bailing Capsules on microinflammation and nutritional status of maintenance hemodialysis patients, and to determine its efficacy and safety. The randomized controlled trials concerning the intervention of microinflammation and nutritional status in maintenance hemodialysis patients with Bailing Capsules were searched from Chinese and English databases including CNKI, Wanfang, VIP, PubMed, EMbase, and Cochrane Library. A total of 16 articles were obtained, involving 1 095 cases. As revealed by Meta-analysis,(1)Bailing Capsules lowered the levels of serum high sensitivity C-reactive protein(SMD=-0.92, 95%CI[-1.05,-0.80], P<0.000 01), interleukin-6(SMD=-1.49, 95%CI[-1.96,-1.02], P<0.000 01), and tumor necrosis factor-α(SMD=-1.48, 95%CI[-1.68,-1.28], P<0.000 01) in patients with maintenance hemodialysis, thus alleviating microinflammation.(2)Bailing Capsules elevated the levels of serum hemoglobin(SMD=1.37, 95%CI[1.21, 1.54], P<0.000 01), albumin(SMD=0.78, 95%CI[0.57, 0.98], P<0.000 01), and triglyceride(SMD=0.29, 95%CI[0.07, 0.50], P=0.01) in patients with hemodialysis to improve their nutritional status.(3)Bailing Capsules reduced the incidence of cardiovascular events(RR=0.45, 95%CI[0.34, 0.59], P<0.000 01).(4)A total of six patients presented with mild gastrointestinal discomfort after receiving Bailing Capsules, and no serious adverse reactions were observed. The sequential analysis showed that the sample size of this Meta-analysis had reached the expected value. Meanwhile, the grade of evidence quality suggested that the outcome indicators were mainly low or extremely low in quality. In conclusion, Bailing Capsules might have potential advantages in alleviating microinflammation, improving nutritional status, and reducing the incidence of cardiovascular events. However, in view of the low quality and evidence of the included literature, high-quality clinical trials are needed to further confirm the efficacy and safety of Bailing Capsules.
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Humanos , Cápsulas , Doenças Cardiovasculares/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Estado Nutricional , Diálise Renal/efeitos adversosRESUMO
Objective:To investigate the effects of Yishen Decoction via colonic dialysis on intestinal flora and microinflammation in patients with chronic kidney disease (CKD) stages 3-5. Methods:A total of 156 patients with stage 3-5 CKD from the Second Affiliated Hospital of Guizhou University of Chinese medicine from October 2019 to October 2020 who met the inclusion criteria were divided into 2 groups of 78 patients according to the random number table method. The control group was given colonic dialysis treatment, the treatment group was given Yishen Decoction transcolonic dialysis treatment on the basis of the control group, and both groups were treated for 8 weeks. TCM syndrome scores were performed before and after treatment, serum levels of CRP, IL-6, and TNF-α were measured by ELISA, and SCR, BUN, and uric acid (UA) levels were detected by a fully automated biochemical analyzer. Fresh feces were collected from the patients, anaerobic culture and aerobic culture were performed, and the numbers of Bifidobacterium, Lactobacillus acidophilus, and Escherichia coli were counted to evaluate the clinical efficacy. Results:The total effective rate was 97.4% (76/78) in the treatment group and 84.6% (66/78) in the control group, and the difference was statistically significant ( χ2=7.847, P=0.005). At 4 and 8 weeks after treatment, the scores of lumbar and knee tenderness( t=6.596, 8.792), eating less and being dull ( t=12.060, 24.140) and pale complexion ( t=7.983, 12.300) in the treatment group were significantly lower than those in the control group ( P<0.01); the levels of bifidobacterium ( t=4.037, 2.358) and Lactobacillus acidophilus ( t=7.352, 2.092) were significantly higher than those in the control group, while the levels of Escherichia coli ( t=3.822, 6.084) were significantly lower than those in the control group ( P<0.01 or P<0.05). The serum CRP ( t=9.326, 12.300), IL-6 ( t=4.591, 4.716), TNF-α ( t=9.304, 9.775), SCr ( t=17.630, 11.530), BUN ( t=2.674, 2.248), UA ( t=10.860, 13.160) were significantly lower than those in the control group ( P<0.01 or P<0.05). Conclusion:Yishen Decoction can improve intestinal microecological status, inhibit microinflammatory response and relieve clinical symptoms for the patients with stage 3-5 CKD.
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Objective:To investigate the effects of hemodialysis (HD) and hemoperfusion (HP) combination treatment on maintenance hemodialysis (MHD) patients. Methods:A total of 80 MHD patients in Chongming Branch of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from July 2017 to July 2018 were randomly divided into two groups, i.e., HD+HP group (n=40) and HD group (n=40). The patients were followed up every 3 months for 1 year. The changes of laboratory indexes, dialysis adequacy indicators and quality of life scores of Kidney Disease Quality of Life-Short Form (KDQOL-SF) were compared between the two groups, and the prognosis, causes of death and adverse events were recorded. Results:At the end of one-year treatment, levels of parathyroid hormone (PTH), β2-microglobulin (β2-MG), high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and left ventricular mass index (LVMI) were significantly lower in HD+HP group than those in HD group (P0.05). The overall mortality rates of HD+HP group and HD group were 12.5% and 32.5%, respectively. No significant adverse events were observed during the follow-up. Conclusion:The effects of HD combined with HP on clearing middle and large molecular toxins, reducing microinflammation status, and improving renal anemia and left ventricular hypertrophy are better than those of only HD. There may be potential advantages of HD and HP combination in improving quality of life in MHD patients as well.
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OBJECTIVE: To investigate the effect of probiotic on protein energy wasting and micro-inflammation in peritoneal dialysis patients. METHODS: One hundred and twelve patients who underwent peritoneal dialysis at the nephrology department of Guizhou provincial people's hospital in 2017, were randomly divided into intervention group(n=56) and control group(n=56), which were treated probiotic and placebo respectively two months, and collected biochemical, inflammatory, physical measurement and bioelectrical impedance index before and after treatment. RESULTS: The prevalence of protein-energy wasting was 64.29% and 60.71%in intervention group and control group, respectively. Compared with control group, patients in intervention group had lower urea nitrogen, triglyceride, low density lipoprotein, high-sensitivity C-reactive protein and interleukin-6 and higher serum albumin levels, and these differences were statistically significant(P<0.05). Physical measurement results showed that the upper arm muscle circumference of intervention group was increased compared to control group, and the change was statistically significant(P<0.05). Biological resistance testing results showed that the fat percentage of intervention group was significantly higher than that of control group(P<0.05).CONCLUSION: The treatment of probiotic could improve protein energy wasting and micro-inflammation in continuous peritoneal dialysis patients.
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Androgenetic alopecia (AGA) is the most common type of non-cicatricial alopecia.Many researches have indicated that the pathogenesis of AGA involves genetic background,abnormal metabolism of sex hormones and follicle miniaturization,hair follicle microintlammation and environmental factors.Among them,genetic susceptibility is the most important factor for the individual difference of AGA,and follicle miniaturization induced by abnormal sex hormone metabolism and/or hair follicle microinflammation is the last step in the occurrence of AGA.
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Objective To investigate the improvement effects of sericin on the retinal oxidative stress and micro-inflammatory state in diabetic rats.Methods A diabetic rat model was established by using high-fat and high-sugar diet and intraperitoneal injection of streptozotocin.Then 24 diabetic rats were randomly divided into sericin treatment group and diabetic model group,with 12 rats for each group,and additional 12 normal rats with the same age were collected as a normal control group.Next,the rats in the sericin treatment group received sericin solution,while the other two groups was given the same amount of normal saline once a day for 35 days.After the agent intervention,the content of malondialdehyde (MDA) and glutathione (GSH) in the retina of all rats were detected by related kits.The expressions of nuclear factor erythroid 2-related factor 2 (Nrf2),heme oxygenase 1 (HO-1),nuclear factor-κB (NF-κB) and tumor necrosis factor-α (TNF-α) protein were detected by Western blot,and finally,the retinal morphology was examined by hematoxylin-eosin staining in the 3 groups.Results The content of MDA,NF-κB and TNF-α protein expression in the sericin treatment group was (4.145 ±0.282) mmol· gprot-1,0.232 ±0.027 and 0.761 ±0.058,respectively,which was significantly lower than that in the diabetic model group [(6.813 ± 0.446) mmol · gprot-1,0.334 ± 0.024 and 0.994 ± 0.084] (all P ＜ 0.05).The content of GSH,Nrf2 and HO-1 protein expression in rat retina in the sericin treatment group was (78.518 ± 4.317) mg · gprot 1,0.591 ± 0.054 and 0.954 ± 0.091,respectively,which was significantly higher than that in the diabetic model group [(59.890 ± 5.932) mg · gprot-1,0.351 ± 0.044 and 0.585 ± 0.054] (all P ＜ 0.05).The diabetic model group presented the disorder arrangement of the neurocyte in different levels in the retina,irregular and swollen inner limiting membrane,vacuoles in the ganglion cells,but in the sericin treatment group,the morphology of retinal layers was more regular and mildly disorderly arranged.The pathological damages in the retina were alleviated significantly.Conclusion Sericin can ameliorate oxidative stress and inflammation in diabetic retina,thereby delaying the development of diabetic retinopathy.
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Objective To observe the influence of Chinese medicine skin dialysis on traditional Chinese medicine (TCM) syndrome scores and microinflammation in patients with chronic renal failure(CRF). Methods A total of 180 patients with CRF were divided into groups A, B and C, 60 cases in each group. All of the 3 groups were given conventional treatment, and additionally, group A was given Chinese medicine skin dialysis, and group B was given pure water dialysis. Meanwhile, 60 healthy volunteers served as normal control group (group D), and had no any medication. The course of treatment lasted for one month. Before and after treatment, we examined the scores of TCM syndromes and the levels of 24-hour urinary protein, serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), albumin (ALB), immunoglobulin A(IgA), immunoglobulin G (IgG) , immunoglobulin M(IgM), interleukin 6 (IL-6) , interleukin 1(IL-1), hyper-sensitive C reactive protein (hs-CRP), and tumor necrosis factor alpha (TNF-α). Results After treatment, the scores of TCM syndromes and the levels of 24-hour urinary protein, SCr, BUN, eGFR, IL-6, IL-1, hs-CRP, and TNF-α in the 3 groups were decreased (P < 0.05 compared with those before treatment), and were markedly lower in group A than those in group B and group C (P<0.05); serum levels of IgA, IgG, IgM and ALB in the 3 groups were increased(P < 0.05 compared with those before treatment), and the levels in group A were significantly higher than those in group B and group C (P < 0.05). However, the levels of observation indexes did not arrive to the levels of group D(P<0.05). Conclusion Chinese medicine skin dialysis is effective on relieving the symptoms of CRF patients and enhancing the therapeutic effect through decreasing inflammatory mediators, inhibiting micro-inflammation and improving nutritional status.
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Objective To investigate the effects of Huangkui Capsules on oxidative stress and micro-inflammation state in diabetic nephropathy patients with maintenance hemodialysis. Methods Forty-six patients with diabetic nephropathy who had received maintenance hemodialysis for over six month in Gansu Provincial People's Hospital were randomly divided into observation group (23 cases) and treatment group (23 cases) from January to December in 2014. Twenty healthy subjects who had physical examinations were selected as the control group at the same time. Observation group were given conventional hemodialysis for 4 hours, 3 times a week; treatment group were given conventional hemodialysis combined with Huangkui Capsules, orally, 2.5 g each time, 3 times a day. Both groups were treated for 8 weeks. Blood was collected before and after treatment for detection of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), white blood cell (WBC), malondialdehyde (MDA), cycle of advanced oxidation protein products (AOPP), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels. Results The levels of IL-6, TNF-α, AOPP, WBC, MDA and hs-CRP were significantly higher in the observation group and the treatment group compared with the control group before treatment (P0.05). After treatment, the levels of IL-6, hs-CRP, MDA and AOPP increased in the observation group (P0.05);The levels of AOPP, TNF-α, hs-CRP, WBC, MDA and IL-6 in treatment group significantly decreased (P<0.01), GSH-Px and SOD significantly increased (P<0.01); there was statistical significance between the observation group and the treatment group (P<0.01). Conclusion Micro-inflammation state and oxidative stress exist generally in diabetic nephropathy maintenance hemodialysis patients. Huangkui Capsules can improve oxidative stress and micro-inflammation state in diabetic nephropathy maintenance hemodialysis patients.
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Objective To evaluate the relationship of serum thrombospondin?1(TSP?1)with the micro?inflammation in maintenance hemodialysis(MHD),and to explore its clinical prognosis value in the MHD patients. Methods A total of 84 MHD patients in our hospital were enrolled and prospectively followed for 2 years. The serum levels of TSP?1 and clinical inflammatory markers were detected. Patients were divided into groups according to different serum TSP?1 levels. The clinical inflammatory markers were detected by using ELISA analysis. Pearson simple correlation analysis method was applied to analyze the correlation between TSP?1 levels and inflammation related indicators. At the same time the prognosis and turnover of MHD patients was analyzed by using Kaplan Meier survival curve and survival rate was compared by Deleted:compared log?rank test. Cox regression analysis was used to calculate the hazard ratio (HR) and Deleted:using 95% confidence interval (CI). Results The indexes of blood lipid and inflammatory factors in the TSP?1 high?level groups were higher than that in TSP?1 low?level groups (P<0.05). Correlation analysis showed that the serum TSP?1 level was positively correlated with the serum lipid and inflammatory factors. Survival curve analysis showed that the mortality rate of TSP?1 high?level group was higher than that of TSP?1 low?level groups. Cox hazards analysis revealed that the patients with high?level TSP?1 had a higher risk for mortality than these TSP?1 low?level patients. This predictive value still existed after multivariate adjustment for age,blood lipid,serum albumin and other factors (P < 0.001). Conclusion The serum TSP?1 levels were associated with micro?inflammation and had a significant value in predicating the prognosis of MHD patients.
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Objective To explore the effects of heterozygous blood purification on clearance of β2-microglohulin (β2-MG) and alleviation of microinflammatory state in patients on maintenance hemodialysis.Methods A total of 128 patients on maintenance hemodialysis for more than 6 months in the First Affiliated Hospital of Chongqing Medical University and the First Branch of the First Affiliated Hospital of Chongqing Medical University were enrolled and divided into the routine hemodialysis group and heterozygous blood purification group,64,cases in each group.The serum levels of β2-MG,high-sensitive C reactive protein (hs-CRP) and interleukin-6 (IL-6) of patients in the two groups were measured before and 6 months after the initiation of hemodialysis.Results After 6 months of treatment,the serum levels of β2-MG,hs-CRP and IL-6 were decreased in heterozygous blood purification group,compared with those before treatment,the differences were statistically significant (P＜0.05).In routine hemodialysis group,the serum level of β2-MG was decreased,and serum levels of hs-CRP and IL-6 were increased,,compared with those before treatment,no statistically significant difference was found (P＞0.05).Moreover,after 6 months of treatment,the serum levels of β2-MG,hsCRP and IL-6 in heterozygous blood purification group were significantly lower than those in the routine hemodialysis group (P＜ 0.05).Conclusion Heterozygous blood purification couldefficiently remove middle molecule toxins from blood,and alleviate microinflammatory status in patients on maintenance hemodialysis.
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Objective To explore the effects of heterozygous blood purification on clearance of β2-microglohulin (β2-MG) and alleviation of microinflammatory state in patients on maintenance hemodialysis.Methods A total of 128 patients on maintenance hemodialysis for more than 6 months in the First Affiliated Hospital of Chongqing Medical University and the First Branch of the First Affiliated Hospital of Chongqing Medical University were enrolled and divided into the routine hemodialysis group and heterozygous blood purification group,64,cases in each group.The serum levels of β2-MG,high-sensitive C reactive protein (hs-CRP) and interleukin-6 (IL-6) of patients in the two groups were measured before and 6 months after the initiation of hemodialysis.Results After 6 months of treatment,the serum levels of β2-MG,hs-CRP and IL-6 were decreased in heterozygous blood purification group,compared with those before treatment,the differences were statistically significant (P＜0.05).In routine hemodialysis group,the serum level of β2-MG was decreased,and serum levels of hs-CRP and IL-6 were increased,,compared with those before treatment,no statistically significant difference was found (P＞0.05).Moreover,after 6 months of treatment,the serum levels of β2-MG,hsCRP and IL-6 in heterozygous blood purification group were significantly lower than those in the routine hemodialysis group (P＜ 0.05).Conclusion Heterozygous blood purification couldefficiently remove middle molecule toxins from blood,and alleviate microinflammatory status in patients on maintenance hemodialysis.
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Objective To investigate micro-inflammatory state and protein-energy wasting (PEW) states in maintenance peritoneal dialysis(MPD) patients,then analysis of the correlation between them.Methods Ninty-six cases of MPD patients in this Hospital were selected from March 2012 to September 2015.The status of nutrition were assessed by Quantitative Subjective and global Assessment(SGA),malnutrition-inflammation score(MIS) and albumin(Alb),micro-inflammatory state was assessed by enzyme-linked immunoassay(ELISA) method serum hypersensitive c-reactive protein (hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6).At the same time,various serological markers like serum Alb,serum total protein(TP),serum prealbumin(PA),hemoglobin(Hb),transferrin(TF),serum creatinine(Scr),urea nitrogen(BUN),cholesterol(Teh) were measured.Results The incidence of PEW in MPD patients was 36.50％,among which 62.86 ％ of them were over 65 years old,57.10％ were over 2 years of dialysis time and 40.00％ with diabetic nephropathy.MPD patients with hs-CRP＞5 mg/L accounted for 58.33％,of which over 65 year old accounted for 42.86％,MPD age longer than 2 years accounted for 60.71％,32.14％ of them with diabetic nephropathy.The proportion of diabetic nephropathy,average age,dialysis duration time,hs-CRP,TNF-α and IL-6 in PEW group were higher than non-PEW group(P＜0.05);BM,TP,Alb,PA,Hb,TCh,MAC and MAMC were lower ban non-PEW group(P＜0.05).Compared with the hs-CRP≤5 mg/L group,average age,the time of dialysis duration,TNF-α,IL-6 were higher and TP,Alb,PA,TF,Hb,the proportion of Kt/V≥1.72 were lower in the hs-CRP＞5 mg/L group.After the correction of age,sex,dialysis ages,it was found that the level of hs-CRP in MPD patients was negatively correlated with the level of Alb,PA,TF,Tch,Scr,TG;The level of IL-6 was negatively correlated with the levels of Alb,PA,TF,Tch,TG.The level of TNF-α in MPD patients showed different degrees of negative correlation with the leves of Alb,PA,TF,TG,Tch(all P＜0.05).Multivariate analysis showed that elderly,the time of dialysis duration,the microinflammatory state,and hypoalbuminemia were the independent risk factors of PEW.Conclusion PEW and micro-inflammatory state are very common in PHD patients.Patients with longer duration of dialysis,elderly or associated with diabetic nephropathy are more likely to suffer PEW and micro-inflammatory.Elderly,the time of dialysis duration,microinflammatory state,hypoalbuminemia are the independent risk factors of PEW.
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Objective To investigate the clinical characterastics of uremia pruritus and the value of treatment by bacillus coagulans. Methods The clinical data of 312 patients with maintenance hemodialysis were collected. The incidence rate, clinical manifestation and correlation factors of uremia pruritus were analyzed. Then, 40 refractory pruritus patients were divides into 2 groups by random digits table, with 20 patients in each group. The patients in experiment group were treated by bacillus coagulans, and the patients in control group were given vitamin E. The relieve of pruritus in two groups was compared. Results In 312 patients, 158 patients didn′t have pruritus, 56 patients had mild pruritus, 68 patients had moderate pruritus , and 30 patients had severe pruritus. The levels of urea nitrogen, creatinine, calcium, ferroprotein in different degree of pruritus patients had no significant differences (P>0.05), but the levels of phosphorus, calcium-phosphorus product, immunoreactive parathyroid hormone (iPTH), C reactive protein (CRP), interleukin (IL)-1 and IL-6 increased with the severity of pruritus (P0.05). The levels of CRP, IL-1 and IL-6 after treatment in experiment group significantly decreased (P<0.05). The rate of pruritus was very high , and there was markedly positive correlation between pruritus and serium inorganic phosphorus、iPTH and CRP. Bacillus coagulans can alleviate pruritus. Conclusions On the basis of maintenance hemodialysis, bacillus coagulans can regulate the intestinal flora, alleviate inflammatory reaction, and help to release the symptom of pruritus.
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OBJECTIVE:To observe the clinical efficacy of Shengxuening tablets reducing the risk of microinflammation in maintenance hemodialysis(MHD)patients with renal anemia. METHODS:60 MHD patients were randomly divided into observa-tion group and control group with 30 cases in each group. The total dialysis times of all the patients were 12 h every week at blood flow of 200-250 ml/min and dialysis flow of 500 ml/min. Both groups received routine treatment;observation group was additional-ly given Shengxuening tablets orally 1.0 g,tid;control group was given ferrous succinate 0.2 g,tid,orally;both groups were giv-en subcutaneous injection of erythropoietin (EPO),10 000 IU/time,once a week;treatment for all of the patients lasted for 3 months. The fasting venous blood sample were collected at the beginning of treatment and in the morning every one months. The levels of hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor α(TNF-α),IL-6,hemoglobin(Hb),and hematocrit (Hct)were detected. RESULTS:After 3 months of treatment,total effective rate of 2 groups were 90.00%,the levels of hs-CRP、TNF-α、IL-6 in observation group were much lower than that before treatment and control group after treatment,with statistical sig-nificance(P<0.05 or P<0.01). No severe ADR was found in 2 groups,and the incidence of ADR in observation group(6.67%) was significantly lower than in control group (13.33%),with statistical significance (P<0.05). CONCLUSIONS:Shengxuening tablets have good curative effect,and they can reduce the risk of microinflammation due to the long-term use of EPO and chalybeate.
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OBJECTIVE:To compare therapeutic efficacies of Shengxuening tablet and Iron sucrose injection for anemia in maintenance hemodialysis(MHD)patients,and their effects on oxidative stress and micro-inflammation state. METHODS:80 pa-tients who had received MHD over half year were assigned into shengxuening group and iron sucrose group with 40 cases in each group. Both groups received MHD 3 times a week,4 h/time,blood flow of 200~300 ml/min;erythropoietin(EPO)was used at a dose of 10 000 IU/time hypodermically in each group. Shengxuening group was additionally given Shengxuening tablet orally,0.5 g/time,tid. Iron sucrose group was given Iron sucrose injection 100 mg 2 h intravenously via dialyser after the beginning of hemo-dialysis,twice a week,received iron treatment every one week until complete the total dose of 1 000 mg,to maintain ferritin be-tween 100~300 μg/L. The levels of Hb,Hct,SF,TSAT,hs-CRP,IL-6,TNF-α,MDA,SOD and GSH-Px were tested in 2 groups before and 12 weeks after the treatment. RESULTS:After 12 weeks of treatment,the levels of Hb,Hct,SF and TSAT in 2 groups were significantly increased,with statistical significance (P0.05). Compared with before treatment,the levels of hs-CRP,IL-6,TNF-α and MDA increased significantly in iron sucrose group,while SOD and GSH-Px levels declined significantly,with statistical significance (P<0.01). Above indicators of shengxuening group had no significant change,compared with before treatment;there was statistical significance between 2 groups after treatment(P<0.01). No obvious ADR was found in 2 groups. CONCLUSIONS:Therapeutic efficacy of shengxuening is simi-lar to that of iron sucrose in improving the anemia and iron deficiency status of MHD patients,but doesn't aggravate oxidative stress and micro-inflammation state. It is an safe and effective oral iron supplement drugs.
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Objective To investigate the correlation between plasma adiponectin level and microinflammation ,nutrition status in patients undergoing different blood purification treatment .Methods Totally 84 patients receiving maintenance hemodialysis over 6 months were randomly assigned to three groups for low‐flux hemodialysis(LFHD)group ,high‐flux hemodialysis(HFHD)group , high‐flux hemodialysis in combination with hemodiafiltration(HFHD+ HDF)group .The baseline and post treatment levels of total protein(TP) ,albumin(Alb) ,prealbumin(PA) ,hemoglobin(Hb) ,`ferritin(FER) ,C reactive protein(CRP) ,potassium(K+ ) ,sodium (Na+ ) ,calcium(Ca2+ ) ,phosphate(P3+ ) ,blood urea nitrogen(BUN) ,creatinine(Cr) ,urea acid(UA) ,intact parathyroid homone (iPTH) ,β2‐microglobulin(β2‐MG) ,cystatin C(Cys C) and adiponectin(ADPN) were compared among three groups .Results Be‐fore the treatment ,the levels of those biochemical indicators were of no significant difference among the three groups .After six months ,plasma ADPN level of HFHD ,HFHD+ HDF increased(P<0 .05) ,and were markedly higher than LFHD(P<0 .05) .In LFHD group ,serum PA ,β2‐MG increased(P<0 .05) after the treatment for six months .In HFHD group ,serum TP ,PA increased , and serum Fer ,CRP ,CysC decreased after the treatment(P<0 .05) .In HFHD+ HDF group ,serum PA ,Hb increased ,and serum Fer ,CRP ,β2‐MG ,Cysc ,BUN decreased after six months(P<0 .05) .After the treatment ,the serum Hb level of LFHD was lower than HFHD ,HFHD+ HDF(P<0 .05);the serum Fer ,CRP ,β2‐MG ,CysC of LFHD were higer than HFHD ,HFHD+ HDF(P<0 .05) .Correlation analysis showed that plasma ADPN level was inversely associated with Fer ,CRP ,CysC ,β2‐MG ,whereas was as‐sociated with PA ,Alb .Conclusion The different ways of hemodialysis could have an effect on the final levels of adiponectin in M HD patients .ADPN can be used as a meaningful indicator of microinflammation ,nutrition status in hemodialysis patients .
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Objective To investigate the effect of tannic acid on glomerular mesangial cells (GMC),and to clarify the mechanism of tannic acid in improving the pathological changes of diabetic nephropathy (DN)from the aspect of oxidative stress and micro-inflammation. Methods The glomerular mesangial cells were treated with glucose (30 mmol·L-1 )or advanced glycosylation end-products (AGEs)bovine serum albumin(BSA)(250 mg·L-1 )and then different concentrations of tannic acid (10,20,40 and 80μmol·L-1 )were added into the GMC.The cells cultured by normal glucose or treated with BSA were used as control groups and then the level of malonic dialdehyde (MDA), glutathione peroxidase (GSH-Px ), superoxide Dismutase (SOD ), CAT (Catalase ) activities and 8-hydroxy-2′-deoxyguanosine(8-OHdG)levels in the culture supernatant 48 h after culture were determined by colorimetry and ELISA method. The expressions of intercellular cell adhesion molecule-1 (ICAM-1 ) protein, monocyte chemotactic protein 1 (MCP-1 ) and ICAM-1 mRNA in GMC were detected by immunohistochemical staining and RT-PCR method.Results Compared with high glucose and AGEs groups,the MDA levels in tannic acid groups were reduced significantly(P<0.05);the activities of GSH-Px,SOD and CAT were increased significantly(P<0.05 or P<0.01);the 8-OHdG levels in annic acid groups were significantly reduced (P<0.05). Compared with high glucose and AGEs groups,the expressions levels of ICAM-1 protein in 40 and 80μmol· L-1 tannic acid groups were decreased (P<0.05 ). The mRNA expressions levels of MCP-1 and ICAM-1 were significantly lower than those in high glucose group (P<0.01 ).Conclusion Tannic acid could protect GMC against the damage of oxidative and inflammatory mediators,thereby delaying and improving the glomerular lesions of DN.
RESUMO
This article was aimed to discuss the mechanism of lactulose enema therapy to improve efficiency among maintenance hemodialysis (MHD) patients with uremic pruritus (UP) from the intervention of parathyroid hormone (PTH) and micro-inflammation state. A total of 60 cases of chronic kidney disease (CKD) stage 5, MHD patients with UP were randomly divided into 3 groups according to different intervention methods, which were the control group, loratadine and lactulose group. The integration of kidney disease treatment was adopted in the control group. In the loratadine group, on the basis of the control group medication, oral administration of loratadine, 10 mg/time, once a day, was combined. In the lactulose group, on the basis of the control group medication, lactulose enema, 30 mg/time, twice a day, was combined for 30 days. The pretreatment and posttreatment clinical curative effects were e-valuated among patients from 3 groups. Observation was also made on their itchy visual analogue scale (VAS) and serum PTH, high-sensitivity c-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6) lev-el, respectively. The results showed that there were significant improvements on VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) before and after treatment (P< 0.05 or P< 0.01). Compared to the control group, the posttreatment clinical total curative effects were significantly increased in both the loratadine group and lactulose group (P< 0.05); VAS, PTH and inflammation indexes (i.e., hs-CRP, TNF-α, IL-6) were significantly decreased (P< 0.05). There was no statistical difference of indexes mentioned above in the loratadine group and lactulose group. It was concluded that lactulose enema therapy improve PTH and micro-inflammation state among MHD patients with UP. It is one of the mechanisms to relieve skin itching.