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Objective:To explore the correlation between plasma sclerostin (SOST) and bone turnover markers and inflammatory factors in hemodialysis patients.Methods:One hundred and eight patients admitted to Changsha Central Hospital Affiliated to Nanhua University from January 2018 to May 2019 were selected. The levels of plasma SOST at admission and at 3, 6 and 12 months of dialysis were determined by enzyme-linked immunosorbent assay. They were divided into low- SOSTgroup (56 cases) and high- SOSTgroup (52 cases) based on the mean value of SOST. The levels of serum bone turnover markers β-Ⅰ collagen carboxy-terminal peptide (β-CTX) and osteocalcin (OC), propeptide of type Ⅰ procollagen (PINP), full parathyroid hormone (iPTH), N-terminal osteocalcin (N-MID-OC), inflammatory factors interleukin-1β (IL-1β), interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) were compared between the two groups, abdominal aortic calcification (ACC) score was performed, and Pearson linear correlation analysis was used to analyze the relationship between SOST level of hemodialysis patients and bone turnover markers, inflammatory factors and ACC scores.Results:The baseline levels of β-CTX, OC, PINP, iPTH, and N-MID-OC in the low- SOST group were higher than those in the high- SOST group: (976.03 ± 205.27) ng/L vs. (781.34 ± 150.45) ng/L, (175.31 ± 50.49) ng/L vs. (125.75 ± 40.17) ng/L, (321.45 ± 82.14) μg/L vs. (259.41 ± 75.36) μg/L, (345.26 ± 102.65) ng/L vs. (198.52 ± 45.71) ng/L, (19.96 ± 5.01) μg/L vs. (17.41 ± 4.23) μg/L, the differences were statistically significant ( P<0.05). The baseline levels of IL-1β, IL-6, CRP, TNF-α and ACC scores in the low- SOST group were higher than those in the high- SOST group: (19.31 ± 6.01) ng/L vs. (15.23 ± 4.75) ng/L, (76.85 ± 20.34) ng/L vs. (57.98 ± 15.02) ng/L, (8.15 ± 2.36) mg/L vs. (7.23 ± 1.79) mg/L, (178.37 ± 55.52) ng/L vs. (157.42 ± 10.15) ng/L, (5.96 ± 1.78) scores vs. (5.11 ± 1.15) scores, the differences were statistically significant ( P<0.05). After treated for 3, 6 and 12 months, the levels of β-CTX, OC, PINP, iPTH, N-MIC-OC in hemodialysis patients were increased, the level of SOST was decreased, the levels of IL-1β, IL-6, CRP, TNF-α increased and ACC scores were increased, the differences were statistically significant ( P<0.05). The Pearson linear correlation analysis showed that SOST level and bone turnover markers β-CTX ( r = -0.465, P<0.001), OC( r = -0.498, P<0.001), PINP( r = -0.511, P<0.001), iPTH ( r = -0.396, P = 0.012), N-MID -OC ( r = -0.323, P = 0.031) and inflammatory factors IL-1β( r = -0.305, P = 0.046), IL-6( r = -0.318, P = 0.041), CRP( r = -0.327, P = 0.034) and TNF-α( r = -0.378, P = 0.024) in hemodialysis patients were negatively correlated, and negatively correlated with abdominal aortic calcification scores ( r = -0.301, P = 0.048). Conclusions:Plasma SOST level in hemodialysis patients is lower, which is negatively correlated with bone turnover markers, inflammatory factors, and calcification scores. Low SOST level can induce vascular calcification by mediating bone metabolism disorders and aggravating the body′s inflammatory response, and increase the risk of hemodialysis vascular calcification.
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Objective@#To evaluate the status of dietary diversity and determinants among school age left behind children.@*Methods@#A total of 501 children aged 9-10 years in Sheyang Mini Cohort Study were enrolled from Sheyang City in Jiangsu Province during 2019. A questionnaires survey was administrated to collect left behind and socioeconomic information. Twenty four hour dietary recall survey was conducted, dietary diversity score (DDS 10 and DDS) and food variety score (FVS) were computed according to Food and Agriculture Organization (FAO). Weight and height of children were measured and sex and age standardized body mass index was used to define obesity. Multivariable regression models were preformed to explore the determinants of dietary diversity in school age left behind children.@*Results@#The proportion of left behind children was 40.9%. The mean value and standard deviation of three kinds of dietary diversity score (DDS 10 , DDS, FVS) in left behind children were (5.69±1.31)(6.55±1.44) and (13.48± 4.23 ), respectively. All of these were lower than that in non left behind children (DDS 10 :5.99±1.29; DDS:6.79±1.40; FVS:14.15±4.22). Significant difference in DDS 10 between left behind and non left behind children was observed ( P =0.01). The results of multivariable regression demonstrated that gender, passive smoking, family education level and family economic status were related to dietary diversity scores ( P <0.05).@*Conclusion@#Dietary diversity in school age left behind children was not optimistic and gender, passive smoking, parental education level, family economic status and left behind situation play a critical role in dietary diversity among these children.
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Background and purposeThe worldwide pandemic of coronavirus disease 2019 (COVID-19) greatly challenges public medical systems. With limited medical resources, the treatment priority is determined by the severity of patients. However, many mild outpatients quickly deteriorate into severe/critical stage. It is crucial to early identify them and give timely treatment for optimizing treatment strategy and reducing mortality. This study aims to establish an AI model to predict mild patients with potential malignant progression. MethodsA total of 133 consecutively mild COVID-19 patients at admission who was hospitalized in Wuhan Pulmonary Hospital from January 3 to February 13, 2020, were selected in this retrospective IRB-approved study. All mild patients were categorized into groups with or without malignant progression. The clinical and laboratory data at admission, the first CT, and the follow-up CT at the severe/critical stage of the two groups were compared. Both multivariate logistic regression and deep learning-based methods were used to build the prediction models, with their area under ROC curves (AUC) compared. ResultsMultivariate logistic regression depicted 6 risk factors for malignant progression: age >55years (OR 5.334, 95%CI 1.8-15.803), comorbid with hypertension (OR 5.093, 95%CI 1.236-20.986), a decrease of albumin (OR 4.01, 95%CI 1.216-13.223), a decrease of lymphocyte (OR 3.459, 95%CI 1.067-11.209), the progressive consolidation from CT1 to CTsevere (OR 1.235, 95%CI 1.018-1.498), and elevated HCRP (OR 1.015, 95%CI 1.002-1.029); and one protective factor: the presence of fibrosis at CT1 (OR 0.656, 95%CI 0.473-0.91). By combining the clinical data and the temporal information of the CT data, our deep learning-based models achieved the best AUC of 0.954, which outperformed logistic regression (AUC: 0.893), ConclusionsOur deep learning-based methods can identify the mild patients who are easy to deteriorate into severe/critical cases efficiently and accurately, which undoubtedly helps to optimize the treatment strategy, reduce mortality, and relieve the medical pressure.
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OBJECTIVE： To evaluate the effects of clinical pharmacist-led ischemic stroke management， and to provide reference for chronic disease management. METHODS： Totally 184 patients with ischemic stroke who were hospitalized in neurology department of the First Hospital of Hebei Medical University from May to August 2018 were included prospectively， and then divided into control group （92 cases） and intervention group （92 cases） by random number method. Control group did not receive clinical pharmacist intervention. In the intervention group， clinical pharmacists were the leader in the pharmaceutical care during the hospitalization， the medication education at discharge， and pharmacy follow-up after discharge. The rate of medication compliance （antiplatelet drugs， antihypertensive drugs， hypoglycemic drugs and lipid-lowering drugs） and the rate of secondary prevention and control indicators of ischemic stroke， such as blood pressure， blood glucose [glycated hemoglobin （HbA1c）] and blood lipid [low-density lipoprotein cholesterol （LDL-C）] were investigated between 2 groups at 6 months after discharge. The incidence of adverse drug reaction and the rate of rehospitalization were compared between 2 groups at 6 months after discharge. RESULTS： The number of patients in the intervention group and the control group was 84 and 82， respectively. At 6 months after discharge， the compliance rate of antiplatelet drugs in the intervention group was 96.43％， which was higher than 95.13％ of control group， but the difference was not statistically significant. The good compliance rates of antihypertensive drugs， hypoglycemic drugs and lipid-lowering drugs in the intervention group were 92.86％， 91.67％ and 77.38％， which were higher than 78.57％， 69.70％ and 60.98％ of control group， with statistical significance （P＜0.05）. The qualified rate of index of blood pressure was 89.29％ in intervention group， which was higher than 76.79％ of control group， but the difference was not statistically significant. The qualified rates of HbA1c and LDL-C in the intervention group were 80.56％ and 66.67％， which were higher than 57.58％ and 48.785 of control group， with statistical significance （P＜0.05）. The incidence of total adverse drug reactions in the intervention group was 15.48％， which was lower than 20.73％ of control group， but the difference was not statistically significant. The total rehospitalization rate in the intervention group was 7.14％， which was lower than 17.86％ of control group， the difference was statistically significant （P＜0.05）. CONCLUSIONS： The management of ischemic stroke patients with clinical pharmacists as the leading factor can improve the patient’s medication compliance， improve the qualified rate of secondary prevention and control indicators of ischemic stroke， and reduce the rate of rehospitalization.
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The giant roundworm Ascaris infects pigs and people worldwide and causes serious diseases. The taxonomic relationship between Ascaris suum and Ascaris lumbricoides is still unclear. The purpose of the present study was to investigate the genetic diversity and population genetic structure of 258 Ascaris specimens from humans and pigs from 6 sympatric regions in Ascaris-endemic regions of China using existing simple sequence repeat data. The microsatellite markers showed a high level of allelic richness and genetic diversity in the samples. Each of the populations demonstrated excess homozygosity (Ho 0). According to a genetic differentiation index (Fst=0.0593), there was a high-level of gene flow in the Ascaris populations. A hierarchical analysis on molecular variance revealed remarkably high levels of variation within the populations. Moreover, a population structure analysis indicated that Ascaris populations fell into 3 main genetic clusters, interpreted as A. suum, A. lumbricoides, and a hybrid of the species. We speculated that humans can be infected with A. lumbricoides, A. suum, and the hybrid, but pigs were mainly infected with A. suum. This study provided new information on the genetic diversity and population structure of Ascaris from human and pigs in China, which can be used for designing Ascaris control strategies. It can also be beneficial to understand the introgression of host affiliation.
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Humans , Ascaris lumbricoides , Ascaris suum , Ascaris , China , Gene Flow , Genetic Structures , Genetic Variation , Microsatellite Repeats , SwineABSTRACT
OBJECTIVE:To establish a method for the concentration determination of gabapentin (GBP) in human plasma.METHODS:After precipitated by methanol,using sulfamethoxazole as intemal standard,LC-MS/MS method was adopted.The determination was performed on Diamonsil C18 column with mobile phase consisted of water (containing 0.05％ formic acid)-methanol using a gradient elution program at the flow rate of 1 mL/min.The column temperature was 30 ℃,and sample size was 20 μL.The ESI was equipped and quantitative analysis was operated in positive ion and MRM mode.The mass transition ion-pairs were followed as m/z 172.0→154.1(GBP) and m/z 279.0→124.0 (internal standard).RESULTS:The linear range of GBP was 13.4-10 720.4 ng/mL (r=0.992 3,n=5).The limit of quantitation was 13.4 ng/mL,and the minimum detection limit was 4.0 ng/mL.RSDs of inter-day and intra-day were all lower than 10％.Relative errors ranged-4.93％-5.10％.The recoveries ranged 86.2％-90.3％ (RSD＜5％,n=6),and matrix effects ranged 87.6％-92.1％.The plasma concentration of GBP in 10 epileptic patients ranged 2 075.19-4 078.87 ng/mL (n=20).CONCLUSIONS:The method is proved to be sensitive,specific,practical and suitable for plasma concentration monitoring and pharmacokinetic study of GBP in epileptic patients.
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Objective To investigate the effect of H 2 S and its synthetase inhibitor propargylglycine ( PAG) on the autophagic function in caerulein-induced acute pancreatitis ( AP) mice.Methods A total of 60 male BALB/c mice were randomly divided into control , AP, NaHS and PAG group using random number method.AP was induced in mice via hourly intraperitoneal injection of caerulein (50 μg/kg) continuously for 6 hours.NaHS and PAG group received NaHS (10 mg/kg) or PAG (50 mg/kg) 1 h before the AP induction . A equal volume of normal saline solution was injected in control group and AP group .All the mice were killed at 12 h after the first caerulein injection and blood sample was collected for the detection of serum amylase and lipase content.Deproteinization spectrometry was used to detect serum H 2 S content, and pancreatic tissue was pathological examined and scored . Real-time PCR detected mRNA expression of CSE , and the protein expression of LC3-Ⅱ/LC3 Ⅰand p62 was measured using Western blot .Results Serum amylase, lipase, H2S, CSE mRNA, LC3Ⅱ/LC3Ⅰand p62 were (2 700 ±100)U/L, (70 ±20)U/L,(22.9 ±1.7)mmol/L, 1.0 ±0.1,0.419 ±0.080, 0.227 ±0.140 in control group; (17 290 ±500)U/L,(520 ±40)U/L, (31.3 ± 3.0)mmol/L, 5.4 ±0.4, 1.184 ±0.120, 1.985 ±0.210 in AP group; (27 784 ±1 200)U/L, (900 ± 80)U/L,(38.6 ±3.3)mmol/L, 6.9 ±0.9,1.600 ±0.210, 4.229 ±0.050 in NaHS group; (13 750 ± 2 000)U/L,(370 ±20)U/L, (24.5 ±2.1)mmol/L, 4.2 ±0.5, 0.745 ±0.130, 1.203 ±0.080 in PAG group.All those biomarkers detected above in AP group significantly increased compared with control group , which were much lower than those in NaHS group , but higher than those in PAG group , and the differences were statistically significant (all P<0.05).Pancreatic histological damage in NaHS group was more severe than that in AP group , which in PAG group was less severe than that in AP group .Conclusions PAG could greatly decrease serum amylase and lipase level , and reduce the damage on autophagy and the severity of AP .
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OBJECTIVE:To establish a method for the content determination of Esomeprazole sodium for injection. METH-ODS:UPLC-MS/MS was performed. The column of ZORBAX Eclipse Plus C18 with 0.1% formic acid-methanol(73∶27,V/V)at a flow rate of 0.3 ml/min,column temperature was 35℃,analysis time was 5 min,injection volume was 2μl;ionization mode was positive ion mode,ion source temperature was 150 ℃,capillary voltage was 3.0 kV,cone voltage was 50 V,cone flow was 150 L/Hr,desolvation temperature was 450 ℃,desolvation gas flow was 900 L/Hr,nebuliser pressure was 7.0 Bar,parent ion scan range was 100-800 mz/mz,working mode was multiple reaction monitoring mode. RESULTS:The linear range of esomeprazole was 0.2-20.0 ng/ml(r=0.999 7);the limit of quantitation was 50 pg/ml;RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 99.93%-100.05%(RSD=0.1%,n=9). CONCLUSIONS:The method is simple and accurate,and can be used for content determination of Esomeprazole sodium for injection.
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Objective No related training experience, no systematic training before military training, psychological negative emotions(tension and anxiety) and low frequency of physical activities(less than three times a week) have been considered as crucial risk factors of high intensive military training induced acute kidney injury.This paper aims to discuss whether these risk factors can be used for screening high risk groups.Methods Soldiers were divided into 5 groups based on the questionnaire survey:Group1 had no risk factor, Group2 had 1 risk factor, Group3 had 2 risk factors, Group4 had 3 risk factors, and Group5 had 4 risk factors.Urine samples were collected after 6 h and 24 h of 5 km armed military training.Kidney injury indicators were compared such as urine protein, urine occult blood test, urine micro-albumin ( mALB) , urine N-acetyl-β-D-glucosaminidase( NAG) among different groups.Results As the risk factors increased, the incidence of positive urinary protein 6 h after training increased (x2 =101.8,P<0.001),and the levels of mALB and NAG of urine samples were elevated as well.The analysis among moderate and high risk groups(Group3-5) showed that the levels of mALB and NAG of urine samples 24 h after training increased with the number of risk factors.The mean value of these injury indicators reached to the maximum in Group 5.Conclusion No related training experience, no systematic training before military training, psychological negative emotions( tension and anxiety) and low frequency of physical activi-ties(less than three times a week) are independent risk factors of high intensive military training induced acute kidney inju-ry,which can be used for screening high risk individuals during training.
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Objective To analyze the complications after procedure for prolapse and hemorrhoids (PPH) in treating severe mucocutaneous hemorrhoids.Methods The clinical data of 550 patients with severe mucocutaneous hemorrhoids who were admitted to the Hangzhou Hospital of Nanjing Medical University from January 2005 to December 2013 were retrospectively analyzed.All the patients were treated by PPH or PPH + external hemorrhoids resection.The postoperative complications were recorded and assessed.Patients were followed up via outpatient examination and telephone interview till June 2014.Results Operation was successfully carried out on all the 550 patients.The operation time and duration of hospital stay were (15 ± 10)minutes and (4.2 ± 1.8)days,respectively.A total of 445 patients were followed up for 6-60 months,with the median time of 28 months.The overall incidence of complications was 14.61％ (65/445).Forty-five patients were complicated with anal pain,12 with hemorrhoid recurrence,7 with bleeding,5 with dysporia,4 with anastomotic stenosis and 2 with rectal and perianal infection.Of the 12 patients with hemorrhoids recurrence,5 was alleviated by medication and 7 received PPH for the second time.Of the 4 patients with anastomotic stricture,the condition of 2 patients were alleviated by anus dilatation,and the condition of 1 patient was alleviated by balloon dilatation under enteroscope,1 patient received circular incision of the stricture because of severe stricture and failed of conservative treatment.Of the 2 patients with rectal and perianal infection,1 was alleviated by intravenous and local medication,and the other patient who was complicated with anal fistula was alleviated by surgery.The condition of other patients was improved after symptomatic treatment.Conclusions PPH is effective and safe for the treatment of severe mucocutaneous hemorrhoids.The main complication is anal pain,and it could be cured or alleviated by symptomatic treatment.
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Objective To investigate the effect of bortezomib on proliferation and apoptosis of pancreatic cancer cell lines BxPC3,SW1990 and explore possible mechanisms of bortezomib's killing effect on cancer cells.Methods BxPC3,SW1990 cells were treated by using 1,10,50,100,500 nmol/L and 1,10 μmol/L of bortezomib,and cells without bortezomib treatment were considered as control group.The cell proliferation was determined by MTF assay,and apoptosis was determined by flow cytometry.Bak,Bax,Bcl2,Bcl-xl,survivin mRNA expressions were measured by RT-PCR,and Western blot was applied to determine the expressions of pro-caspase-3,cleaved-caspase-3,Bax,Bcl-2,surviving protein.Results When bortezomib concentration was higher than 50 nmol/L,it inhibited the proliferation of two cell lines in a dose and time-dependent manner.And with the same treatment the rate of proliferation inhibition of BxPC3 cells by bortezomib was greater than that of SW1990 cells,and the difference between the two cell lines was statistically significant (P ＜0.05).Apoptosis rates in the groups of BxPC-3 and SW1990 cells treated by 100 nmol/L bortezomib were (22.56 ± 4.23) ％ and (12.71 ± 2.23) ％,which were significantly higher than those in control group (2.15 ± 0.47) ％ and (2.32 ± 0.54) ％,P ＜ 0.05).In addition,apoptosis rate of BxPC3 cells was significantly higher than that of SW1990 cells (P＜0.05).Bak mRNA expression of BxPC3 and SW1990 cells after 100 nmol/L bortezomib treatment were not significantly changed,but the expression of Bax mRNA and protein was significantly increased (P ＜0.05).Bcl-2 mRNA and protein,as well as Bcl-xl mRNA expressions was significantly decreased (P ＜0.05).The expression of survivin mRNA and protein in BxPC3 cells were decreased,but were increased in SW1990 cells(P ＜0.05).The expression of pro-caspase-3 protein in the two cell lines was decreased,while the expression of cleaved-caspase-3 protein was increased (P ＜0.05).Conclusions Bortezomib can inhibit the proliferation of pancreatic cancer cell Iines BxPC-3 and SW1990 and induce apoptosis,and the effect on BxPC3 cells is more than that on SW1990 cells.The mechanism may depend on activation of the mitochondrial pathway of apoptosis,and be related to survivin-involved drug-resistance.
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Objective To probe into the preventive effect of Xinhuang tablet dissolved in vinegar on phlebitis caused by Doxorubicin? Methods The self-control study was performed in 30 patients treated by doxorubicin? In the initial course,33%magnesium sulfate by wet dressings was externally applied on the skin along the vein until completion of transfusion of chemotherapeutic drugs? In the second course,Xinhuang tablet dissolved in vinegar was used on the skin along the vein until completion of transfusion?The phlebitis rate by magnesium sulfate by wet dressings was compared to that by Xinhuang tablet dissolved in vinegar? Result The phlebitis rate in the initial course was 83?3% while 36?7% in the second course(P<0?01)? Conclusions Xinhuang tablet dissolved in vinegar applied on the skin may be of use for the prevention of phlebitis? It may reduce the damage and improve the quality of the life?
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Objective To explore the long-term dialysis therapies suitable for Chinese patients by comparison of the long-term clinical effect of daily ambulatory peritoneal dialysis ( DAPD ) and hemodialysis (HD) on patients with end-stage renal failure.Methods Forty-six outpatients and inpatients with end-stage renal failure were enrolled from our hospital and divided into group A (24 patients) and group B (22 patients) randomly.Participants in group A received HD treatmant,including conventional HD,hemodiafiltration (HDF),hemoperfusion (HP),etc.For three times in total 12 - 15 h each week;patients in group B received DAPD with a daily dialysate dose of 6 - 8 L and a replacement in every 3 - 4 h for each bag of peritoneal dialysate,as well as a break overnight.The subsequent long-term monitoring was performed,and the following variables were compared for the patients in these two groups:sufficiency of dialysis (i.e.Kt/V),nutritional status [ including SGA and sALB ),complication control ( including Hb,CO2CP,K+,Ca2+,P-,iPTH and blood pressure (MAP) ],infection incidence,employment rate and annual medical expense.The evaluation on daily activities of living was also performed using Barthel Index (BI) and the presence of depressive dsymptoms was assessed by HAMD.Results Patients in both group A and group B could survive under long-term dialysis,and there was no statistically significant difference in sufficiency of dialysis (Kt/V),nutritional status (SGA and sALB ),complication control ( Hb,CO2 CP,K +,Ca2 +,P -,and MAP) and infection incidence ( P ＞ 0.05 ).One year after dialysis,the urine volume [ (274 ± 102) ml vs.( 205 ± 86 ) ml,P =0.017 ],BI ( 82 ± 13 vs.73 ± 11,P =0.044) and employment rate (40.9％ vs.12.5％,P=0.044) of the patients in group B were higher than those of the patients in group A,but the ultra-filtration volume [ ( 1162 ± 124 ) ml vs.( 1542±136 ) ml,P ＜ 0.001 ],iPTH [ (77.5 ± 12.7 ) ng/L vs.( 104.4±11.3 ) ng/L,P ＜ 0.001 ],HAMD ( 8 ± 3 vs.18 ± 4,P ＜ 0.001 ) and annual medical expense [ (7.67±1.48 ) ng/L vs.( 11.35 ± 2.52 ) ng/L thousand yuan,P ＜ 0.001 ] were lower than those of the patients in group A.Five years after dialysis,B1 ( 80 ± 13vs.71 ± 14,P =0.029 ) and employment rate ( 36.4％ vs.8.3％,P =0.032 ) in group B were greater than those in group A,while iPTH [ (83.8 ± 13.4) ng/L vs.( 123.8 ± 12.4) ng/L,P ＜ 0.001 ],HAMD ( 8±2 vs.19 ± 2,P ＜ 0.001 ),and annual medical expense [ ( 10.32±1.64 ) thousand yuan vs.( 13.47 ±2.38 ) thousand yuan,P ＜ 0.001 ] were lower than those in group A,and there was no statistically significant difference in survival rate (70.8％ vs.86.4％,P=0.289) and dialysis duration [ ( 56.82 ± 6.13 ) mouths vs.(57.35 ± 6.30) months,P =0.774 ] between the two groups ( P ＞ 0.05 ).Conclusion The comparison between the patients treated by long-term DAPD and those treated by conventional HD shows that DAPD has a satisfactory clinical effect in the aspects of sufficiency of dialysis,maintainence of nutritional status,control of complications,regulation of blood pressure and decrease of infection incidence,and it is also superior in reducing depressive symptoms,ensuring better quality of life and mitigating economic burden of patients.
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ObjectiveTo observe the clinical characteristics and influential factors of pulmonary hypertension (PH) in maintenance hemodialysis (MHD) patients.MethodsOne hundred and two patients with MHD patients whose therapy time were all more than one year were enrolled from June 2008 to May 2009.Pulmonary arterial systolic pressure (PASP) and parameters related with cardiac structure and function were checked out by echocardiography.These patients were divided into two groups according to PASP:PH group[PASP≥35 mm Hg( 1 mm Hg =0.133 kPa)] and non-PH group(PASP ＜ 35 mm Hg).Gender,age,dialysis time,dialysis access and urine volume during dialysis was recorded.The blood biochemistry,parathyroid hormone(PTH),hemoglobin,postdialysis urea nitrogen was recorded too and Kt/V was calculated.ResultsPH was detocted in 26 MHD patients (25.5％,26/102).Right atrium transverse diameter,right atrium long diameter and pulmonary artery internal diameter in PH group [(32.00 ± 8.13),(41.00 ±9.15),(24.38 ± 3.88) mm] were higher than those in non-PH group [(27.44 ± 4.43),(36.45 ±8.88 ),(21.78 ± 2.46) mm] and LVEF in PH group [(55.59 ± 7.88 )％] was lower than that in non-PH group [(59.09 ± 5.69)％] (P ＜ 0.01 or ＜ 0.05).There were significant differences in calcium-phosphorus product,PTH,serum phosphorus and hemoglobin between PH group and non-PH group [(61.36 ± 17.83)mg2/dl2 vs.(53.24 ± 18.28) mg2/dl2,(365.95 ± 178.65) ng/L vs.(287.02 ±209.91 ) ng/L,(2.24 ±0.60)mmol/L vs.( 1.95 ± 0.68) mmol/L,(98.65 ± 25.69) g/L vs.( 114.29 ± 22.31 ) g/L] (P ＜ 0.05 ).Logistic regression found that PTH levels,hemoglobin and calcium-phosphorus product were the major risk factors for PH.ConclusionsMorbidity of PH in MHD patients is obviously high.Secondary hyperparathyroidism,anemia and high calcium-phosphorus product level may take part in the pathogenesis of PH in MHD patients.
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Objective To investigate the dynamic changes and relationship between the serum levels of IL-1 β and sE-selectin in acute pancreatitis (AP) patients, and to study the predicative value for severity of AP.Methods Forty one patients with AP were divided into severe acute pancreatitis (SAP, 19 cases) group and mild acute pancreatitis (MAP, 22 cases) group.Their serum were collected at the 1st, 3rd, 7th, and 14th day after admission and the serum concentrations of IL-1 β and sE-selectin were detected by ELISA.Another 20healthy volunteers were selected as controls.Results The serum concentration of IL-1 β in control group was ( 18.71 ±2.43)ng/L, while they were (61.18 ±7.47)ng/L, (33.03 ±5.85)ng/L, (20.73 ±4.07)ng/L in MAP group at the 1st, 3rd, 7th day;and they were (86.91 ± 13.32) rng/L, (81.35 ± 12.71) ng/L,(64.93 ±5.99)ng/L, (21.40±49.13) ng/L at the 1st, 3rd, 7th and 14th day in SAP group.The serum concentration of IL - 1β of patients with SAP were markedly higher than those with MAP and normal controls on the 1st, 3rd, 7th day (P ＜0.05) and they decreased almost to normal on the 14th day.The serum concentration of sE-selectin was ( 10.69 ± 2.51 ) ng/ml, while they were ( 41.60 ± 6.85 ) ng/ml, ( 14.90 ±3.51)ng/ml, (9.85 ±2.88)ng/ml in MAP group at the 1st, 3rd, 7th day;and they were (84.73 ±15.37)ng/ml, ( 95.65 ± 13.06 ) ng/ml, ( 39.41 ± 3.73 ) ng/ml, ( 12.25 ± 2.29 ) ng/mlon the 1st, 3rd, 7 th and 14th day.The serum concentration of sE-selectin of patients with SAP were significantly higher than those with MAP and normal controls on the 1st, 3rd, 7th day (P ＜0.05 ) and there was no significant difference between SAP and control group on the 14th day.There was a positive correlation between the serum level of IL-1 β and sE-selectin in AP on the 1 st day after admission ( r = 0.851, P ＜ 0.01 ).Conclusions The serum concentrations of IL-1 β and sE-selectin are useful for AP severity predication.
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Objective To explore the feasibility and value of low dose CT scan for the diagnosis of pulmonary tuberculosis.Methods 150 patients with pulmonary tuberculosis underwent three doses CT scan (standard dose:150 mA;low-dose:15 mA and 30 mA) using GE dual slices helical CT.Besides the different tube current,other scan parameters including tube voltage,scan cycle,pitch,and collimation were the same in three dose groups.The scanned extent was from apexes to bases of lung.Image quality in standard group was compared with that in other two low dose groups and analyzed statistically by three radiologists.Results CT characteristics of pulmonary tuberculosis could be detected efficiently using low dose CT scan(30 mA) program,which was no significant as compared with the CT image using standard CT sose(P＞0.05).Howere,CT scan at 15 mA obviously affected on the diagnosis for both active and inactive pulmonary tuberculosis,the difference was significant (P＜0.05).Conclusion Low dose CT scan can replace totally the standard dose CT scan in diagnosing pulmonary tubercrulosis.
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Objective To study the appropriate changing frequency of urinary drainage bag for patients with indwelling catheters using anti-reflux drainage bag in urological surgical department. Methods Of 78 in-patients with indwelling catheters using anti-reflux drainage bags 40 patients were selected randomly as the experimental group with no bag change,38 patients as the control group with bag change every day.Bloody urine samples were obtained from each drainage bag for germicuhure ev-ery day. Results Under situations of no difference existed in general information, duration of in-dwelling catheters,volume of drinking and urine and times of opening valve,the positive rate of urine germiculture was 7.5% and 10.5%( P>0.05 ),the incidence of symptomatic urinary tract infection (U-TI) was 2.5% and 2.6% in the experimental group and the control group (P>0.05). Conclusions There is no evidence for the necessity of anti-reflux drainage bag change every day for patients with in-dwelling catheters and bloody urine after operation in the urological surgical department. However the appropriate frequency of urinary drainage bag change needs additional study.
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OBJECTIVE: To observe the preventive and therapeutic effects of Yishen Huanji Decoction (YSHJD), a compound traditional Chinese herbal medicine, on military overtraining-induced kidney injury in a rat model. METHODS: Thirty SD rats were randomly divided into normal control group, untreated group and YSHJD-treated group. The military overtraining-induced kidney injury in rats was established by forcing to run on the treadmill for 8 weeks. The rats in YSHJD-treated group were administered with YSHJD at the same time. The 24-hour urines were collected every weekend for detecting the contents of urinary sediment, 24-hour urine total protein, 24-hour urine albumin and activity of N-acetyl-beta-D-glucosaminidase (NAG). The blood and renal tissues were collected after 8-week training, and the levels of serum urea nitrogen (BUN) and creatinine (SCr) were detected. Angiotensin II (Ang II) was detected by radioimmunoassay and activity of Na(+), K(+)-ATPase in kidney was analyzed by chemical colorimetric method. RESULTS: Compared with the normal control group, after 8-week training, the contents of 24-hour urine protein, activities of NAG in urine, and the levels of BUN and SCr in rats in the untreated group and YSHJD-treated group were obviously increased (P<0.05), and these parameters of the YSHJD-treated group were lower than those of the untreated group (P<0.05). The contents of Ang II in blood plasma and kidney of rats in the untreated group and YSHJD-treated group were higher than those of the normal control group (P<0.05), and had no statistical difference between the untreated group and YSHJD-treated group. Compared with the normal control group, the activity of Na(+), K(+)-ATPase in kidney of rats in the untreated group was obviously decreased (P<0.05), and had no statistical difference between the normal control group and YSHJD-treated group. CONCLUSION: YSHJD can protect against military overtraining-induced kidney injury in rats by decreasing the contents of 24-hour urine protein, BUN and SCr, and the activity of NAG, and increasing the activity of Na(+), K(+)-ATPase.
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Objective To evaluate the remineralization effect of casein phosphopeptide amorphous calcium phosphate(CPP-ACP) and fluoride complex on artificial enamel subsurface white spot lesions in vitro in order to provide a new method to treat the postorthodontic enamel demineralization.Methods Extracted premolar teeth for orthodontic reason were immersed into lactic acid gel to prepare artificial white spot lesions.Then the specimens were randomly assigned to seven groups:5.0%CPP-ACFP group,1.0% CPP-ACP group,0.1% CPP-ACPgroup,calcium phosphate saturated solution group,calcium phosphate saturated solution plus fluorid group,deionized water group.Lesion depths and mineral loss were quantitatively determined by microradiography in various groups.Results The lesion depths and mineral loss after remineralization in each group were significantly reduced(P0.05),but the lesion depths and mineral loss in these three groups were significantly lower than those in deionized water group(P
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Objective To investigate the effects of stress associated with nicotine on experimental periodontal breakdown of ligature-induced periodontitis in rats.Methods Forty male Wistar rats with the neck of left maxillary second molar ligated by nylon were used.The animals were randomly divided into four groups:Ni group,0.7 mg of nicotine?kg-1?d-1 (intraperitoneal); S group,stress (immobilization-12 h?d-1); Ni+S group,stress (immobilization-12 h?d-1) associated with an intraperitoneal injection of 0.7 mg of nicotine?kg-1?d-1; C group:saline solution. Two rats of each group were sacrificed at the day of 2,4,6,8,10 separately and the furcation areas of the second maxillary molars were examined histologically and histometrically.Results Intergroup analysis revealed a higher bone loss rate in the animals of Ni+S group compared with the other three groups,the absorption rate of alveolar bone at the day of 6,8,10 in experimental groups were higher than that in C group (P
