Correlation Between Blood-pressure Levels and Frailty Index and Adverse Health Events in Older Adults With ESRD With Hypertension.

Context: End-stage renal disease (ESRD) refers to the development of chronic kidney disease to stage 5. Elevated blood pressure is one of the main symptoms of older adults with ESRD. The severity and difficulty of curing ESRD with hypertension in older adults has attracted a great deal of attention from the medical community. Objective: The study intended to analyze the correlation between blood-pressure level and FRAIL scores and adverse health events for older adults with ESRD and hypertension. Design: The research team performed a narrative review by searching hospital medical record system databases. The search used the keywords endpoint renal disease and hypertension. The research team also conducted a prospective case-control study. Setting: The study took place at Peking University International Hospital. Participants: Participants were 168 older adults with ESRD and hypertension, ESRD only, or hypertension only who had received a diagnosis and treatment at the hospital between October 2022 and September 2023 as well as healthy individuals who were members of the community. Groups: The study included four groups, each with 42 participants: (1) the ESRD + hypertension group, (2) the ESRD group, (3) the hypertension group, and (4) the healthy group. Outcome Measures: The research team: (1) measured systolic and diastolic blood pressure, (2) assessed patients' debilitation using the FRAIL score; and (3) determined the incidence of adverse health events-heart disease, stroke, cancer, arthritis, and chronic obstructive pulmonary disease (COPD). Based on participants' blood pressures, the research team: (1) divided the ESRD with hypertension group into the hypertension grade I, hypertension grade II, and hypertension grade III groups, and (2) compared the blood pressures, FRAIL scores, and incidence of adverse health events among those three groups. The team performed a Pearson correlation analysis to analyze the correlation between blood pressure and the FRAIL scores and adverse health events for the ESRD with hypertension group. Results: The ESRD + hypertension group's mean systolic and diastolic blood pressure and FRAIL score and its incidence of adverse health events were significantly higher than those: (1) of the ESRD group, with P = .028, P = .048, P = .037, and P = .008, respectively; (2) of the hypertension group, with P = .017, P = .035, P = .025, and P = .037, respectively; and (3) of the healthy group, with P = .042, P = .341, P = .372, and P = .482, respectively. The hypertension grade III's systolic and diastolic blood pressure, FRAIL score, and incidence of adverse health events were significantly higher than those: (1) of the hypertension grade I group, with P = .009, P = .015, P = .003, and P = .055, respectively, and (2) of the grade II group, with P = .078, P = .089, P = .001, and P = .006, respectively. A significant positive correlation existed between the blood-pressure level and the FRAIL score (P = .041) and incidence of adverse health events (P = .032). Conclusions: Older adults with ESRD and hypertension had significantly higher blood pressure levels and FRAIL scores and more adverse health events. A significant positive correlation existed between blood pressure level and frailty scores and incidence of adverse health events.

Effect of 28-day administration of Psoraleae Fructus water extract on early liver injury in rats / 中国中药杂志

This study aims to investigate the hepatotoxicity of Psoraleae Fructus water extract and the underlying mechanism in rats. Forty-eight rats were randomly assigned into four groups: a blank group and low-(BZGL, 6.25 g·kg~(-1)), medium-(BGZM, 12.5 g·kg~(-1)), and high-dose(BGZH, 25 g·kg~(-1)) Psoraleae Fructus water extract groups. The rats were treated for 28 days, and toxicity and mortality were observed daily. After 28 days, the rats were sacrificed, and the body weight, liver index, and liver-to-brain ratio were calculated. The morphological changes in the liver tissue were observed, and the serum levels of related biochemical indicators were measured. The results showed that compared with the blank group, Psoraleae Fructus water extracts of different doses decreased the body weight, increased the liver index and liver-to-brain ratio, and caused liver hypertrophy and pathological changes. Pathological examination revealed that the rats in Psoraleae Fructus water extract groups had bile duct hyperplasia, inflammatory cell infiltration, and liver cell fibrosis. Compared with the blank group, BGZL elevated the levels of alanine transaminase(ALT), α-glutathione S-transferase(α-GST), and total bile acid(TBA)(P<0.05), and BGZM and BGZH elevated the levels of ALT, TBA, α-GST, γ-glutamyl transferase(γ-GT), purine nucleoside phosphorylase(PNP), ornithine carbamoyltransferase(OCT), and arginase(ArgI)(P<0.05). Compared with the blank group, Psoraleae Fructus water extracts of different doses down-regulated the mRNA and protein levels of bile salt export pump(BSEP) and farnesoid X receptor(FXR) and up-regulated the mRNA and protein levels of tumor necrosis factor-α(TNF-α), nuclear factor kappaB(NF-κB), and cholesterol 7 alpha-hydroxylase(CYP7A1)(P<0.05). The results suggested that Psoraleae Fructus water extract caused toxicity in rats, showing a dose-toxicity relationship. Psoraleae Fructus water extract may cause liver damage, which may be due to its effect on liver bile acid secretion and induction of inflammation.

Degradation of phenol by photocatalysis using TiO2/montmorillonite composites under UV light.

Composites of titanium (IV) oxide combined with montmorillonite (MMT) with various TiO2/MMT were prepared for photocatalysis application. The prepared samples were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), diffuse reflectance UV-visible spectroscopy, and X-ray photoelectron spectroscopy (XPS). The main influential factors such as the TiO2/MMT dose, calcined temperature, and pH value of the solution were studied. The main intermediates of phenol degradation were determined by high performance liquid chromatography (HPLC). The results showed that the average size of TiO2 nanoparticles was decreased from 22.51 to 10.66 nm through the immobilization on MMT. The components in the interlayer domain were replaced by titanium pillars, and the pillaring reaction proceeded in the interlayer domain, the basic skeleton of MMT was unchanged, and TiO2 was dispersed on the surface of the MMT. When the initial concentration of phenol is 10 mg/L, the phenol solution pH is 6, and the UV light irradiation time is 240 min; the phenol degradation rate of 30%TiO2/MMT composite is 89.8%, which is better than MMT (11.5%) and pure TiO2 (58.8%). It shows that TiO2 loaded on MMT improves its photocatalytic activity. The phenol reaction process detected by HPLC showed that it had undergone through hydroquinone and benzoquinone, and finally converted into maleic acid and carbon dioxide and small molecules. The possible photocatalysis mechanism is presented.

Clinical efficacy analysis of peritoneal dialysis in end-stage renal disease with cirrhotic patients / 中华肾脏病杂志

Objective:To investigate the efficacy and safety of peritoneal dialysis (PD) in end-stage renal disease (ESRD) patients with liver cirrhosis (LC).Methods:Clinical data of PD patients receiving regular treatment followed up for≥6 months, and aged≥18 years in the Third Affiliated Hospital of Hebei Medical University Peritoneal Dialysis Center from January 1, 2013 to March 31, 2020 were retrospectively collected. The patients were divided into LC-PD group and non-LC-PD group according to whether they had LC or not. Propensity score matching (PSM) was used to match the LC-PD group and the non-LC-PD group with 1∶4 ratio. The baseline clinical data, dialysis adequacy, peritonitis and clinical outcomes between the two groups were compared. Kaplan-Meier survival curve and Log-rank test were used to compare the survival rate and technical survival rate between the two groups.Results:A total of 241 PD patients were included in this study. After PSM, 13 cases in LC-PD group and 52 cases in non-LC-PD group were included. Compared with non-LC-PD group, patients in LC-PD group had lower baseline urine volume ( Z=-3.546, P<0.001) and serum albumin ( Z=-2.609, P=0.009). At the follow-up of 3, 6, 12 and 24 months, total serum protein ( t=-3.319, P=0.002), serum albumin ( t=-4.019, P<0.001), triglyceride ( Z=-2.263, P=0.024), and serum phosphorus ( Z=-2.173, P=0.030) in the LC-PD group were lower than those in non-LC-PD group. During the follow-up period of 2 years, the patients in the LC-PD group had significantly higher serum albumin than baseline values ( χ2=16.901, P=0.001), and there was no statistically significant difference between the two groups ( χ2=0.155, P=0.694). The decline rate of residual kidney Kt/V in the LC-PD group was slower than that in the non-LC-PD group ( χ2=44.589, P<0.001). The incidence of peritonitis in LC-PD group was higher than that in the non-LC-PD group, with a statistically significant difference (0.59/patient-year vs 0.20/patient-year, Z=-2.135, P=0.033). The composition ratio of pathogenic bacteria in both groups was mainly gram-positive bacteria (10/25 vs 11/30) and proportion of Streptococcus in LC-PD group was higher than that in non-LC-PD group (4/10 vs 0/11, P=0.035). The proportion of Escherichia coli in the first peritonitis was higher than that in LC-PD group (4/9 vs 1/22, P=0.017). The Kaplan-Meier survival curve results showed no statistically significant difference in survival rate (Log-rank χ2=0.491, P=0.484) and technical survival rate (Log-rank χ2=0.408, P=0.523) between the two groups. Conclusions:PD is a safe and effective treatment mode for ESRD patients with LC, and the survival rate and technical survival rate are comparable to those patients without LC. The incidence of peritonitis in patients with LC-PD in our dialysis center is higher than that in the non-LC-PD patients, and gram-positive bacterial infections are the mainstay, suggesting that attention should be paid to strengthening patient management and training.

Early Mental Health and Quality of Life in Discharged Patients With COVID-19.

Aim: This study aimed to analyze the early mental health (MH) and quality of life (QoL) of discharged patients with coronavirus disease 2019 (COVID-19), which can provide a scientific basis for the further development of intervention programs. Methods: In total, 108 subjects participated in this study, including an experimental group (90 patients diagnosed with COVID-19 from March to April 2020 and hospitalized in Wuhan China Resources & WISCO General Hospital, Wuhan, China, 83.3%) and a control group (18 healthy participants, 16.7%). Their MH and QoL were measured through the 12-item Short Form Health Survey version 2 (SF-12v2), the Self-rating anxiety scale (SAS), the Self-rating depression scale (SDS), and the International Physical Activity Questionnaire (IPAQ). The results of questionnaires were compared between these two groups. Results: (1) Comparison of anxiety status: among 90 discharged patients with COVID-19, 30 patients (33.3%) had a state of anxiety. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of anxiety and more severe anxiety symptoms (P < 0.05). (2) Comparison of depression status: among 90 discharged patients with COVID-19, 29 patients (32.2%) had a state of depression. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of depression and more severe depression symptoms (P < 0.05). (3) Comparison of QoL: 78 patients (86.7%) presented a decrease in physical health-related quality of life (HRQoL) and 73 patients (81.1%) presented a decrease in psychology-related QoL. The SF-12v2 physical component summary (PCS) and the SF-12v2 mental component summary (MCS) of patients were significantly lower than those of healthy people, especially in physical function (PF), vitality (VT), social function (SF), and mental health (MH) (all P < 0.05). (4) Gender differences in mental health and the QoL among patients with COVID-19: women had more severe anxiety/depression symptoms than men (P < 0.05). The scores of women in all dimensions of SF-12V2 were lower than those of men, and there were statistically significant differences between the two groups in PCS, PF, general health (GH), VT, and role-emotional (RE) (P < 0.05). Conclusion: During the early phase after being discharged, patients with COVID-19 might experience negative emotions, such as anxiety or depression, and also problems with reduced QoL, especially among female patients. Therefore, an intervention plan should focus on strengthening psychological condition and improving physical function, and gender-specific rehabilitation programmes should be adapted to improve psychological status and QoL.

Evaluation on effect of improved sterilized transparent dressing on indwelling status of indwelling needle / 重庆医学

Objective To conduct the contrastive analysis on the indwelling time of fixing indwelling needle by cutting sterile transparent dressing and non-cutting sterile transparent dressing.Methods A total of 236 inpatients in this hospital from August to December 2016 were selected.The patients with odd at last number of admission number served as the experimental group (119 cases),while the patients with even at the last number of admission number served as the control group(117 cases).The indwelling needle type was 18GA,the puncture was once success and the fluid infusion course was more than 5 d.The experimental group used the cutting sterile transparent dressing for fixing the indwelling needle and the extension tube vas completely exposed to the outside of dressing,while the control group adopted the conventional indwelling needle application fixation mode.The blood returning plugging pipe rate,average indwelling time and phlebitis occurrence at 24,48,72,96,＞ 96 h after indwelling needle were recorded.Results The blood returning plugging tube situation at 48,72,96,＞96 h after indwelling needle in the experimental group was superior to that in the control group,the difference was statistically significant(P＜0.05);the average indwelling time in the experimental group was (72.12 ± 3.25)h,while which in the control group was (59.34--3.78) h,and the difference was statistically significant (P＜0.05).Seven cases of phlebitis occurred in the experimental group and 9 cases in the control group,the difference was not statistically significant(P＞0.05).Conclusion Applying cutting sterile transparent dressing for fixing the indwelling needle reduces the plugging pipe rate due to returning blood coagulation,extends the indwelling needle use time,increase the patient's satisfaction,moreover does not increase the phlebitis occurrence risk.

Staphylococcus aureus α-toxin regulate miR-142 expression and inhibit macrophage phagocytosis / 国际检验医学杂志

Objective To explore the mechanism that Staphylococcus aureus(S.aureus) α-toxin(Hla) regulate miR-142 expression and inhibit macrophage phagocytosis.Methods BALB/C mice and RAW264.7 cells were infected with wild type S.aureus(WT S.aureus),Hla deletion S.aureus(△HlaS.aureus) or phosphate buffered saline(PBS),and the expression level of miR-142 of skin tissues and cells were detected.miR-142 mimics and inhibitor were then applied in the RAW264.7 culture to examine the effect on phagocytosis.Direct targeting of miR-142 on protein kinase Cα(PKCα) was assessed by luciferase assay and western blotting.Results miR-142 expression in △HlaS.aureus group were significantly down-regulated than WT S.aureus group(P<0.05).MiR-142 mimics inhibited RAW264.7 phagocytosis ability and inhibitor enhanced RAW264.7 phagocytosis ability.PKCα was directly targeted by miR-142.MiR-142 mimics significantly decreased the mRNA expression levels of PKCα in RAW264.7 cells(P<0.05).Conclusion Hla could promote miR-142 expression in macrophages.MiR-142 could inhibit macrophage phagocytosis through down-regulated PKCα.

Analysis of nutritional condition of patients undergoing continuous ambulatory peritoneal dialysis and nursing / 中国实用护理杂志

Objective To analyze the nutritional status of patients with continuous ambulatory peritoneal dialysis and explore reasonable and effective nursing measures.Methods Nutritional assessment was performed in 60 patients with continuous ambulatory peritoneal dialysis,using subjective integrated nutritional assessment,dietary analysis,measurement of biochemical indexes of the human body to analyze the factors that might affect the nutritional status of patients.Results 60 cases of malnutrition occurrd in 20 patients (33.3per cent),mainly due to insufficient protein and energy intake,inadequate dialysis,peritoneal inflammation,metabolic acidosis,psychosocial factors and not using erythropoietin,and so on.Conclusions Measures such as emphasis paid to malnutrition status of continuous ambulatory peritoneal dialysis patients,giving guidance of rational diet,performing full implementation of nursing measures according to the related factors,can improve the nutritional status of patients and improve patients' quality of life.

[Comparative study on five pretreatment methods for ICP-OES determination of mineral elements in Rosa rugosa].

Abstract Five different pretreatment methods, including dry ashing and microwave digestion with four acid systems (HNO3 + H2O2, HNO3 + H2O2 + HF, HNO3 + HClO4 and HNO3 + HClO4 + HF), were employed for digestion of the samples of Rosa rugosa. Nine major and trace elements were determined using ICP-OES method. The addition standard recovery rates indicate that, with the system of HNO3 + HClO4, better results can be obtained for most of the determined elements. With this method, except for Fe, the recovery rates are in the range of 95.4%-104.6%. For Fe, higher recovery rate (99%) was obtained with HNO3 + H2O2 + HF system.

Design and optimization of highly nonlinear low-dispersion crystal fiber with high birefringence for four-wave mixing.

We have proposed a novel type of photonic crystal fiber (PCF) with low dispersion and high nonlinearity for four-wave mixing. This type of fiber is composed of a solid silica core and a cladding with a squeezed hexagonal lattice elliptical airhole along the fiber length. Its dispersion and nonlinearity coefficient are investigated simultaneously by using the full vectorial finite element method. Numerical results show that the proposed highly nonlinear low-dispersion fiber has a total dispersion as low as +/-2.5 ps nm(-1) km(-1) over an ultrabroad wavelength range from 1.43 to 1.8 microm, and the corresponding nonlinearity coefficient and birefringence are about 150 W(-1) km(-1) and 2.5x10(-3) at 1.55 microm, respectively. The proposed PCF with low ultraflattened dispersion, high nonlinearity, and high birefringence can have important application in four-wave mixing.