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Introduction: Hypertension remains the leading cause of death worldwide and one of the world's great public health problems (WHO). Affecting 1 billion people worldwide, systemic hypertension remains the most common, readily identifiable and reversible risk factor for myocardial infarction, stroke, heart failure, atrial fibrillation, aortic dissection and peripheral arterial disease. In this study, total serum calcium levels and corrected serum calcium levels of essential hypertension patients are compared and correlated with matched normotensive controls. Aim of the study: To compare the total and corrected serum calcium levels among patients with newly detected essential hypertension and normotensive controls. Materials and methods: This study was a cross sectional study, with cases and controls enrolling 100 newly detected essential hypertension patients as cases and 50 suitable healthy individuals with normal blood pressure as controls, as per JNC-8 guidelines. Cases were selected from those who visited hypertension clinic and those who were admitted in wards during the study period. Controls were selected from those who attended medical outpatient department for minor ailments and healthy volunteers. Serum calcium and phosphorus levels were estimated using standard levels and the interpretation was done with blood pressure values. Results: Group A was the study group which included 100 newly detected essential hypertensive patients. Group B was the control group which included 50 normotensive individuals. In Group A, 52 (52%) were males and 48 (48%) were females and in Group B, 26 (52%) were males and 24 (48%) were females. There was a negative correlation noted between the total and corrected serum calcium levels as against the systolic blood pressure. There was no correlation noted between the total and corrected serum calcium levels as against the diastolic blood pressure.
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Objective To explore the predictive value of dynamic serum phosphorus levels in the evaluation of prognosis in patients with sepsis. Methods A retrospective study was conducted. The septic patients admitted to intensive care unit (ICU) of the Second People's Hospital of Changzhou from January 2016 to June 2017 were enrolled, who were ≥18 years old and whose length of ICU stay > 72 hours. These patients were divided into survival group and death group according to 28-day outcome. The general information, the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score within 24 hours of ICU admission, the serum phosphorus at 1, 3, 5, 7 days after admission were collected. Receiver operating characteristic curve (ROC) was plotted according to the dynamic serum phosphorus levels and APACHE Ⅱ score for evaluating the predictive value of 28-day prognosis. Kaplan-Meier survival curve was used to analyze the 28-day cumulative survival rate between two groups of patients, who were divided according to the corresponding time of the serum phosphorus cut-off value. Results ① Eighty-five patients with sepsis were enrolled, among whom 25 cases were in the death group and the mortality was 29.4%. APACHE Ⅱ score in the death group was significantly higher than that in the survival group (22.28±3.98 vs. 16.05±5.44, P < 0.01), the rate of using vasoactive drugs was significantly higher than that in the survival group [64.0% (16/25) vs. 31.7% (19/60), P < 0.01], but there was no significant difference in the length of invasive mechanical ventilation and ICU stay between two groups.② The level of serum phosphorus was increased in survival group along with time of the treatment, and the death group showed a downward trend. The levels of serum phosphorus at 3, 5, 7 days after admission to ICU in death group were significantly lower than those in survival group (mmol/L: 0.90±0.24 vs. 1.05±0.19 at 3 days, 0.96±0.16 vs. 1.11±0.17 at 5 days, 0.83±0.19 vs. 1.21±0.14 at 7 days, all P < 0.01).③ROC curve analysis showed that APACHE Ⅱ score and serum phosphorus level on the 7th day could significantly predict 28-day mortality in patients with sepsis, and the areas under ROC curve (AUC) of them were 0.813 and 0.945 respectively (both P < 0.01). The AUC of serum phosphorus level on the 3rd day and 5th day were 0.692 and 0.745 respectively (both P < 0.01). Based on serum phosphorus cut-off value 1.01 mmol/L on the 7th day to evaluate the predictive value of 28-day mortality, the sensitivity was 91.7%, the specificity was 84.0%, the positive and negative likelihood ratios were 5.73 and 0.10 respectively. ④ Kaplan-Meier survival analysis showed that the 28-day survival rate was significantly higher and the length of survival was significantly longer if the serum phosphorus were higher than the cut-off value at different time points of ICU admission. The 28-day survival rate was significantly higher and the length of survival was significantly longer in the patients with serum phosphorus > 1.01 mmol/L than those serum phosphorus ≤ 1.01 mmol/L on the 7th day [28-day survival rate: 93.2% (55/59) vs. 22.7% (5/22), χ2= 49.697, P = 0.000; survival period (days): 27.1±3.6 vs. 19.8±7.8, t = 4.768, P =0.000]. Conclusion The continuous decline of serum phosphorus indicates poor prognosis, and the serum phosphorus level on the 7th day is one of the most important indicator to evaluate the prognosis of patients with sepsis.
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Objective To investigate the relationship among age,menopausal status,serum 25 (OH)VD and skeletal metabolism index as PTH (Parathyroid Hormone),CA(Calcium),P (Phosphorus) and boned mineral density (BMD) of climacteric female in Xi'an.Methods 352 cases of healthy women at the age of 40～60 were collected who did routine examination in outpatient building of the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to April 2016.According to the results of skeletal density test,all subjects were divided into 3 groups as the normal group (T＞-1),the reduction group (-2.5＜T＜-1),the osteoporosis group (T＜-2.5).Electrochemiluminescent immunoassay (ECLIA) was used to detect levels of serum 25 (OH)VD,PTH,CA and P.Kruskal-Wallis test and chi-square test were used to analyze differences of age,serum 25(OH)VD,PTH,CA and P in different levels of bone mineral density groups.Results Compared with bone density normal group 2.24(2.18～2.29)mmol/L,serum CA levels of bone mineral density reduction group 2.27 (2.20 ～ 2.32)mmol/L and osteoporosis group 2.27(2.23～2.33)mmol/L were significantly higher (Z=9.669,P＜0.01).Serum P levels of bone mineral density reduction group 1.15 (1.09～ 1.23)mmol/L and osteoporosis group 1.18 (1.09～ 1.25)mmol/L were obviously higher than bone density normal group,1.11 (0.99 ～ 1.23) mmol/L (Z =13.64,P＜ 0.01).Ages of osteoporosis group 54(50～57) years and bone mineral density reduction group 51 (47～ 54) years were significantly older than Bone density normal group 47(43～50) years (Z=73.08,P＜0.01).The rate of menopause in osteoporosis group and bone mineral density reduction group were significantly higher than in bone density normal group (x2 =13.81,P＜ 0.01).There was no statistical difference in serum 25(OH)VD and PTH between groups.Conclusion This study found boned density of climacteric women is more likely correlated with age,menopause status and levels of serum CA and P.There was not enough evidence to prove that 25 (OH)VD and PTH have effect on skeletal density.Therefore,to monitor and detect the menopause status and levels of serum CA and P of climacteric female is critical for the prevention and treatment on osteoporosis of women.
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Objective To investigate effect of the transtheoretical model and stages of change (TTM) on self-management paradigm,serum calcium and phosphorus levels in patients undergoing maintenance hemodialysis (MHD).Methods Total 140 MHD patients were separated into two groups as the intervention group (65 of 70 cases completed with TTM) and the control group (63 of 70 cases completed with routine nursing care) by random number table.Data obtained by using hyperphosphatemia related knowledge questionnaires and Self-management Rating Scale before and after intervention.The levels of serum calcium and phosphorus between the above groups were compared.Results The scores of self-management behavior were higher in control group after 3 months intervention,the differences was statistically significant (P ＜ 0.05),in which the scores of problem solving (2.97 ± 0.28),self care activities (2.99±0.28),relationships (3.13±0.35) and emotional treatment (2.80 ± 0.32) in experimental group was apparently higher than control group at the same time,the scores were (2.63±0.32),(2.67±0.38),(2.76±0.42),(2.44±0.36) respectively in conrtol group,t values were-0.907,-7.68,-6.03 and-8.43,respectively.And also,there was statistically significant difference between the two groups in serum phosphorus level [(1.81±0.49) mmol/L vs.(2.56±0.69) mmol/L],the product of calcium and phosphorus [(55.33±14.45) mg2/dl2 vs.(72.35±20.94) mg2/dl2],serum parathyroid hormone [238.00 (130.35,413.85) ng/L vs.297.75 (155.02,760.37) ng/L] (t=11.01,8.43,Z=-2.09,P＜0.05).Conclusions TTM is conducive to promote behavior change,improve self-management conduct,and also reduce serum phosphorus level in MHD patients.
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Objective To compare the levels of serum phosphorus,bone alkaline phosphatase and 25-hydroxyvitamin D3 in preterm infants with very low birth weight, and provide evidence for early screening, prevention of metabolic bone disease in preterm infants.Methods A total of 110 newborns who met the inclusion criteria were selected in pediatric ward in our hospital.The case group included 60 preterm infants with very low birth weight and control group included 50 full term infants.Fasting blood were taken from the subjects at week 1, 4, and 12 respectively, and ELISA was conducted to quantitatively detect the serum levels of phosphorus, bone alkaline phosphatase and 25-hydroxyvitamin D.Results The increase of serum 25-hydroxyvitamin D3 in case group was smaller than that in control group;the levels of serum phosphorus had no significant difference between two groups.In case group, the level of bone alkaline phosphatase increased at week 1,4, and 12, and the 25-hydroxyvitamin D3 level had significant difference at week 12 (P＜0.05).The abnormal rate of 25-hydroxyvitamin D3 level was 26.7％ for case group and 0％ for control group.Conclusion There were significant differences between case group and control group in levels of bone alkaline phosphatase and 25-hydroxyvitamin D3, suggesting that detecting the serum levels of bone alkaline phosphatase and 25-hydroxyvitamin D3 would facilitate the early diagnosis of metabolic bone disease in preterm infants.
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Objective To assess the renal safety of adefovir dipivoxil (ADV) in Chinese patients with chronic hepatitis B (CHB).Methods A retrospective study was performed on 1 013 CHB patients from Chinese ADV multicenter clinical trials (ADF30001 and ADF106632).All patients were administrated with ADV 10 mg daily.The serum creatinine and phosphorus levels were measured in different time pointsduring 104-week treatment.Nephrotoxicity was defined as an increase ≥44.2 μ mol/L from baseline in serum creatinine or a serum phosphorus value of ＜ 0.4845 mmol/L on two consecutive occasions.Paired t test was used to analyze serum creatinine and phosphorous data before treatment and at different time points during treatment.Results At week 28,week 52,week 80 and week 104,the median levels of serum creatinine were 74.963,76.996,76.820 and 77.969 μmol/L,respectively,and there were no significant differences from baseline (t =0.91,0.23,0.59 and 0.97,P ＞ 0.05).No patient experienced a ≥ 44.2 μmol/L increase from baseline.For serum phosphorus,the median levels at week 28,week 80 and week 104 were 1.098,1.088 and 1.048 mmol/L,and there were significant decreases from baseline (t =2.34,3.06 and 4.94,P ＜0.05 or ＜ 0.01).The cumulative incidence of serum phosphorus abnormality was 0.8％ (8/104).There were no confirmed serum phosphorous decreases to ＜ 0.4845 mmol/L.Conclusion Two years treatment with ADV (10 mg/d) does not result in marked nephrotoxicity,indicating that ADV 10 mg daily is well tolerated by Chinese patients.
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Objective To evaluate the clearance effect of hemodiafihration(HDF) and hemopeffusion combined with hemodialysis( HP + HD) on serum calcium,phosphorus and parathyroid hormone in patients with uremia.Methods Fifty-eight uremia patients treated with maintenance hemodialysis in our hospital from May 2009 to October 2010 were randomly divided into two groups:HDF group (n =29)and HP + HD group (n =29).Patients in HP + HD group underwent HD conventional treatment 5 times and HP + HD.treatment once every two weeks,while those in HDF group underwent HD treatment 5 times and HDF treatment once every two weeks.All subjects were treated for 12 weeks.Serum calcium,phosphorus and parathyroid hormone were detected and analyzed before and after the treatment.Results After therapy,the serum calcium ( [ 2.41 ± 0.32 ] mmol/L v.s.[ 2.22 ± 0.35 ] mmol/L,t =5.47,P ＜ 0.01 ),phosphorus( [ 1.98 ± 0.34 ] mmol/L v.s.[ 1.70 ± 0.31 ] mmol/L,t=8.13,P ＜0.01)and parathyroid hormone( [645.19 ± 184.52] ng/L v.s.[296.79 ± 103.54]ng/L,t =6.54,P ＜ 0.01 ) levels of HP + HD group decreased significantly.Similarly,the serum calcium ( [ 2.43 ± 0.33 ] mmol/ L v.s.[ 2.32 ± 0.37] mmol/L,t =6.72,P ＜ 0.01 ),phosphorus ( [ 1.97 ± 0.36 ] mmol/L v.s.[ 1.83 ± 0.35 ] mmol/L,t =6.47,P ＜ 0.01 ) and parathyroid hormone ( [ 639.47 ± 208.73 ] ng/L v.s.[ 409.91 ± 152.72 ] ng/L,t =5.27,P ＜ 0.01 ) levels of HDF group also decreased significantly.Comparison of the two blood purification methods indicated that the clearance effect of HP + HD on serum calcium,phosphorus and parathyroid hormone was significantly better than HDF( t =4.24 and t =7.24,P ＜ 0.01 ).Conclusion Both HDF and HD + HP could clear serum calcium,phosphorus and parathyroid hormone effectively,while the clearance effect of HD +HP is better than HDF.
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Objective To investigate the factors relevant to the vascular calcification in uiemic patients.Methods Eighty-five uiemic patients were enrolled in this study.The levels of fetuin-A,serum calcium,serum phosphorus,C-reactive protein and other parameters related to calcification were examined.B-ultrasound was used to detect carotid plaques.Results The Fetuin-A levels in patients with vascular calcification were significantly lower than those with non-vascular calcification[(2.34±0.95) μg/L vs (3.79±1.19) μg/L,t=5.94,P＜0.01],but serum calcium,serum phosphorus and C-reactive protein were higher than those non-vascular calcification [serum phosphorus (1.97±0.23) mmol/L vs (1.80±0.33) mmol/L,t=2.05,P＜0.05;calcium and phosphorus product (50.04±6.61) mg~2/dl~2 vs (44.84±9.75) mg~2/dl~2,t=2.05,P＜0.05;C-reactive protein (33.45±25.11)mmol/L vs (20.65±13.43) mmol/L,t=2.03,P＜0.05].Linear correlation analysis indicated that low fetuin-A level was correlated with C-reactive protein (r=-0.43,P＜0.01),calcium-phosphorus product (r=-0.32,P＜0.01),serum albumin concentration (r=0.37,P＜0.05) and phosphorus level (r=-0.36,P＜0.05).Conclusions The risk factors relevant to the vascular calcification are high serum phosphorus,calcium and phosphorus product and the micro-inflammatory status in uiemic patients.Vascular calcification is also correlated with low fetuinA level,adding exogenous Fetuin-A may become an effective means in preventing vascular calcification.