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BACKGROUND: Arteriovenous fistula (AVF) is the preferred vascular access for patients undergoing haemodialysis (HD). AVF malfunction remains a major clinical problem and is a significant independent risk factor for death. Although far-infrared (FIR) therapy has been shown to reduce complications and improve the patency rate of AVFs in various studies, it has been cautiously recommended by the Kidney Disease Outcome Quality Initiative (KDOQI) guidelines for AVF care due to insufficient evidence. Therefore, it is necessary to identify more effective methods for preventing AVF dysfunction. Many in vitro studies and few clinical studies have examined the effects of near-infrared (NIR) therapy on the vasculature. This study will examine the effects of NIR therapy on AVF. METHODS: A randomised, controlled, open-label, multicentre trial will compare the effect of NIR on AVF patency after 1 year of therapy with that of a control group of patients with existing AVF. One group of patients received NIR treatment above their AVFs, whereas the control group received regular care. The primary outcome is the primary fistula patency rate within 12 months. In addition, acute changes in inflammatory, vasodilatory and haemodynamic parameters after a single treatment in the first 40 participants will be examined. This study was registered in the Clinical Trials Registry (ChiCTR2300071305) at https://register.clinicaltrials.gov/. DISCUSSIONS: This study will explore the long-term and acute effects of NIR on AVFs. The study findings will provide information that can be used to develop new technical support for the prevention of AVF dysfunction in patients undergoing haemodialysis.
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Objective:To establish nursing quality indicator system for freestanding hemodialysis facilities and identify the weight values of indicators.Methods:With the structure-process-outcome quality model as the framework, the literature analysis method, field survey and semi-structure interview were used to form the indicators item pool. Through Delphi method, experts were consulted for two rounds. The indicator weight was calculated by AHP.Results:The indicator system of this study included 3 primary indicators, 15 secondary indicators and 46 tertiary indicators. Among the primary indicators, the process quality indicator had the largest weight (0.493), followed by the outcome quality indicator (0.310), and the structure quality indicator had the smallest weight (0.196).The process quality were the main evaluation contents. According to the indicator weight, the main manpower allocation (0.131) in secondary indicators had the highest weight, and the proportion of nurses with different hemodialysis work experiences (0.108) in the tertiary indicators had the highest weight.Conclusion:The indicator system of this study is scientific and integrated, which can be used as a nursing quality evaluation tool to verify its practicability in clinical nursing practice.
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Objective:To investigate the protective effect and mechanism of low-intensity pulsed ultrasound on human periodontal ligament stem cells (hPDLSCs) injured by high glucose.Methods:hPDLSCs were cultured in vitro and randomly divided into normal control group, high glucose model group and three low intensity pulsed ultrasound groups (30, 60, 90 mW/cm 2). Cells in the high glucose model group and three low intensity pulsed ultrasound groups were treated with high glucose medium (glucose 40 mmol/L) for 48 h to establish high glucose model. Cells in the normal control group were treated with normal medium (glucose 11 mmol/L). After modeling, three low intensity pulsed ultrasound groups were treated with low-frequency pulse for 20 min each day for 7 days at a dose of 30, 60 and 90 mW/cm 2 respectively. After 7 days, the proliferation ability of each group was determined by MTT assay. The changes of cell cycle and apoptosis were detected by flow cytometry. The level of Caspase-3, Caspase-6, and Caspase-9 was detected by colorimetry. The levels of Wnt1, Wnt10b and β-catenin genes and proteins were detected by reverse transcription PCR and Western Blot respectively. Results:Compared with the hPDLSCs in the normal control group, the hPDLSCs in the high glucose model group have the following changes except for the cell cycles (all P>0.05), i.e. the activity of the cells was decreased and the apoptosis was increased (all P<0.05), the activities of Caspase-3, Caspase-6, and Caspase-9 were increased (all P<0.05), and the expressions of Wnt1, Wnt10b and β-catenin genes and proteins were decreased (all P<0.05). Compared with the hPDLSCs in the high glucose model group, the hPDLSCs in low-intensity pulsed ultrasound groups have the following changes expect for the cell cycles (all P>0.05), i.e. cell viabilities were increased (all P<0.05), proliferation abilities were increased (all P<0.05), apoptosis rates were decreased (all P<0.05), the activities of Caspase-3, Caspase-6, Caspase-9 were decreased (all P<0.05), and the expressions of Wnt1, Wnt10b and β-catenin genes and proteins were up-regulated ( P<0.05). Among the three low-intensity pulsed ultrasound groups, when the ultrasonic intensity is 90 mW/cm 2, the above-mentioned index changes most obviously (all P<0.05). Conclusions:Low-intensity pulsed ultrasound can significantly alleviate the hPDLSCs damage induced by high glucose, which may be achieved by reducing the activities of Caspase-3, Caspase-6 and Caspase-9, and up-regulating the expression of Wnt1, Wnt10b and β-catenin.
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This article is born out of an oral history study of 31 elderly homosexual men in four cities in China. It shows the ways in which major events of Chinese history since the birth of the People's Republic in 1949 intervene in personal lives and, in turn, how personal lives are drawn into larger historical events. One of the major themes running through these life narratives is that of love and duty. The interrelationship, as well as the tensions, between duty and love is a central part of the experiences of elderly Chinese homosexual men; their lives have been beset by hardships and duty, as well as by the joys of love, and these have an impact on their health and wellbeing. The experience of one individual, Mr Peng, illustrates the important yet shifting ways in which love and duty have been twinned throughout key life events. His narrative indicates an intricate interweaving of love for family, love for Deng, his male partner of 20 years, and love for his wife, as well as duty to family and to a patron. The inseparable couplet of love and duty served as the source of hardship and pain, but also of protection and great joy.
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Culture , Homosexuality, Male/psychology , Love , Narration , Sexual Partners/psychology , Aged , China , Humans , Male , Spouses/psychologyABSTRACT
BACKGROUND:Ankylosing spondylitis is an autoimmune disease at high inflammatory state, and its pathogenesis is stil unclear. Besides, there is a lack of entirely satisfactory curative strategies. OBJECTIVE: To explore the immunoregulation capability of bone marrow mesenchymal stem cels from ankylosing spondylitis patients on macrophages and the potential therapeutic use of bone marrow mesenchymal stem cels from healthy donors on ankylosing spondylitis. METHODS: Bone marrow mesenchymal stem cels were extracted from 21 healthy donors and 25 ankylosing spondylitis patients respectively, and passage 4 cels were used in subsequent experiments. A human monocytic cel line was induced to differentiate into macrophages. The phenotypic markers of bone marrow mesenchymal stem cels and macrophages were detected by flow cytometry. Expressions of tumor necrosis factor-α and tumor necrosis factor-α-stimulated gene 6 (TSG-6) proteins in the supernatant of co-culture system were detected by ELISA. Quantitative real-time PCR was applied to detect the mRNA level of cytokines secreted by bone marrow mesenchymal stem cels and macrophages. RESULTS AND CONCLUSION:The typical mesenchymal stem cel surface markers were expressed in both bone marrow mesenchymal stem cels from healthy donors and patients with ankylosing spondylitis, and CD68 was detected positively in induced macrophages. The protein and mRNA levels of tumor necrosis factor-α secreted by macrophages co-cultured with bone marrow mesenchymal stem cels from patients with ankylosing spondylitis were obviously higher than those from healthy donors (P < 0.05). TSG-6 secreted by bone marrow mesenchymal stem cels from patients with ankylosing spondylitis was lower than that by bone marrow mesenchymal stem cels from healthy donors in both RNA transcriptional and protein levels (P < 0.05). Our study demonstrates that bone marrow mesenchymal stem cels from patients with ankylosing spondylitis shows abnormal immunoregulatory function on inhibiting the tumor necrosis factor-α secretion from macrophages, which reveals a mechanism of immune disorder in ankylosing spondylitis. The therapeutic mechanism of bone marrow mesenchymal stem cels from healthy donors may work by secreting enough TSG-6 to inhibit the activation of macrophages in patients with ankylosing spondylitis, and thereby to decrease the secretion of tumor necrosis factor-α. Cite this article:Sun SH, Wang P, Su CY, Xie ZY, Li YX, Li D, Wang S, Su HJ, Wu XH, Deng W, Wu YF, Shen HY. Bone marrow mesenchymal stem cels derived from patients with ankylosing spondylitis show abnormal immunoregulation capability on macrophages. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):13-19.
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Objective To investigate the energy intakes and energy consumption in continuous ambulatory peritoneal dialysis (CAPD) patients,and to identify the possible influence factors for overweight and obesity of CAPD patients.Methods A total of 115 CAPD patients were enrolled from May to December 2011 in Peking University Third Hospital.Based on body mass index (BMI),they were divided into normal group (18.5 kg/m2 ≤ BMI < 24 kg/m2,n =61) and obese group (BMI ≥ 24 kg/m2,n =54).Three-day dietary intakes including dietary energy,protein,fat,and carbohydrates intakes were collected.Glucose absorption from dialysate was measured.Three-day activities were recorded for the calculation of resting energy expenditure (REE) and total energy expenditure (TEE).Body composition of the patients was analyzed.Results There were no significant differences in age,height,dietary energy intake,protein intake,carbohydrate intakes,lean tissue mass,and hydration status between the two groups.Glucose absorption from dialysate and dietary fat intake were significantly higher in the obese group than in the normal group [(1 920.5 ± 506.3) kJ/d vs.(1 673.6 ±535.6) kJ/d,x2 =2.536,P=0.013; (62.5 ±19.8) g/dvs.(53.1 ±18.7) g/d,x2=2.575,P =0.011].Although REE was higher in the obese group as compared with the normal group [(5 066.8 ±1 029.3) kJ/d vs.(4 556.4 ± 799.1) kJ/d,x2 =2.979,P =0.004],there was no significant difference in TEE between the two groups [(7 819.9 ±728.0) kJ/d vs.(7 803.2 ± 1 092.0) kJ/d,x2 =0.770,P =0.939].Logistic regression showed that glucose absorption from dialysate and dietary fat intakes were risk factors for obesity in the study population (OR =1.003,95％ CI =1.000-1.007,P =0.029 ; OR =1.024,95％ CI =1.003-1.046,P =0.027).Conclusions Obese CAPD patients may absorb more glucose from peritoneal dialysate and consume more fat than non-obese CAPD patients,but TEE is not significantly different.It indicates that obese CAPD patients are at positive energy balance.Less use of high glucose dialysate and more physical exercises are recommended for these patients.
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Objective To develop an accurate understanding of the policy impact of China-UK HIV/AIDS Prevention and Care Project.Methods Questionnaires and face-to-face interviews were employed for 20 key informants in Beijing including government officials,NGO workers,medical professionals,scholars,police officers,and representatives of international organizations involved in AIDS issues in China.Results The project was noted for its scale and a strong guarantee for fund allocation.It was also noted for having broken some policy taboos.The experience gained from the project was integrated into local policy development and became the evidence base for national policymaking.Conclusion Guided by scientific evidence,the China-UK Project has produced excellent experience for developing national AIDS prevention and control strategy by applying pilot-study based management and making continuous improvement through practice,but its sustainability is challenged when the Project ends.
