Impact of volume indices in bioelectrical impedance measurement on the assessment of cardiac function indices by echocardiography in hemodialysis patients.

INTRODUCTION: Cardiovascular events resulting from volume overload are a primary cause of mortality in hemodialysis patients. Bioelectrical impedance analysis (BIA) is significantly valuable for assessing the volume status of hemodialysis (HD) patients. In this article, we explore the correlation between the volume index measured by BIA and the cardiac function index assessed by echocardiography (ECG) in HD patients. METHODS: Between April and November 2018, we conducted a cross-sectional study involving randomly selected 126 maintenance HD patients. Comprehensive data on medical history and laboratory test results were collected. Subsequently, we investigated the correlation between volume indices measured by BIA and cardiac function parameters by ECG. RESULTS: We discovered a significant correlation between the volume indices measured by BIA and various parameter of cardiac function. The Left Ventricular Hypertrophy (LVH) group exhibited higher levels of the percentage of Extracellular Water (ECW%) and the percentage of Total Body Water (TBW%) compared to the Non-LVH group. Extracellular Water (ECW) and Third Interstitial Fluid Volume (TSFV) were identified as independent risk factors for Left Ventricular Mass (LVM), and both demonstrated a high predictive value for LVM. ECW% emerged as an independent risk factor for the Left Ventricular Mass Index (LVMI), with a high predictive value for LVMI. CONCLUSION: ECW and TSFV were found to be positively associated with cardiac function parameters in HD patients.

Tumor-associated macrophage membrane-camouflaged pH-responsive polymeric micelles for combined cancer chemotherapy-sensitized immunotherapy.

The low immunogenicity and tumor immunosuppressive microenvironment (TIM) are two major obstacles for cancer immunotherapy. Synergistically immunogenic cell death induction and tumor-associated macrophages depletion could perfectly overcome this limitation. Herein, a tumor-associated macrophage (TAMs) membrane-camouflaged pH-responsive doxorubicin (DOX) loaded hyaluronic acid (HA)-g-poly (histidine) polymeric micelles (DHP@M2) was fabricated for the first time. DHP@M2 could effectively accumulated into tumor regions via TAMs membrane mediated immune camouflage. In acidic tumor microenvironment, particle size of DHP was enlarged due to decrease hydrophobic interaction of inner core, which caused a "membrane escape effect" to expose inner HA residue. Together high expression of α4ß1 integrin, DHP@M2 could reach CD44/VCAM-1 dual-targetability to facilitate intracellular DOX accumulation for efficient ICD induction. Meanwhile, TAMs membrane could absorb colony stimulating factor 1(CSF1) through high expression of its receptor (CSF1R) on TAMs membrane to deplete TAMs in tumor tissues and relieved TIM. This strategy could efficiently induce cytotoxic T lymphocyte (CTLs) infiltration for antitumor immune response and inhibit tumor progression in 4T1 tumor bearing Balb/c mice. Therefore, DHP@M2 is suitable for cancer chemotherapy-sensitized immunotherapy.

Tacrolimus alleviates LPS-induced AKI by inhibiting TLR4/MyD88/NF-κB signalling in mice.

Lipopolysaccharide (LPS)-induced sepsis-associated acute kidney injury (SA-AKI) is a model of clinical serious care syndrome, with high morbidity and mortality. Tacrolimus (TAC), a novel immunosuppressant that inhibits inflammatory response, plays a pivotal role in kidney diseases. In this study, LPS treated mice and cultured podocytes were used as the models of SA-AKI in vivo and in vitro, respectively. Medium- and high-dose TAC administration significantly attenuated renal function and renal pathological manifestations at 12, 24 and 48 h after LPS treatment in mice. Moreover, the Toll-like receptor 4 (TLR4)/myeloid differential protein-88 (MyD88)/nuclear factor-kappa (NF-κB) signalling pathway was also dramatically inhibited by medium- and high-dose TAC administration at 12, 24 and 48 h of LPS treatment mice. In addition, TAC reversed LPS-induced podocyte cytoskeletal injury and podocyte migratory capability. Our findings indicate that TAC has protective effects against LPS-induced AKI by inhibiting TLR4/MyD88/NF-κB signalling pathway and podocyte dysfunction, providing another potential therapeutic effects for the LPS-induced SA-AKI.

Target delivery selective CSF-1R inhibitor to tumor-associated macrophages via erythrocyte-cancer cell hybrid membrane camouflaged pH-responsive copolymer micelle for cancer immunotherapy.

Tumor-associated macrophages (TAMs) is a promising therapeutic target for cancer immunotherapy, while TAMs targeting therapy using nano-sized drug delivery system (NDDS) is a great challenge. To overcome these drawbacks, a novel erythrocyte-cancer cell hybrid membrane camouflaged pH-responsive copolymer micelle (dextran-grafted-poly (histidine) copolymer) was prepared to target deliver a selective CSF-1R inhibitor: BLZ-945 (shorten as DH@ECm) to TAMs for TAMs depletion. The prepared DH@ECm possessed favorable particle size (~190 nm) preferable immune camouflage and tumor homologies targeting characteristic when it was intravenously administrated into blood system. In tumor acidic microenvironment, DH@ECm possessed pH-responsive characteristic and unique "membrane escape effect" to facilitate recognition and internalization by TAMs via dextran-CD206 receptor specific interaction (about 3.9 fold than free drug), followed by TAMs depletion in vitro. For in vivo studies, DH@ECm could reverse tumor immune-microenvironment with the elevation of CD8+ T cells and possess sufficient tumor immunotherapy (inhibition rate: 64.5%). All the in vitro and in vivo studies demonstrated the therapeutical potential of DH@ECm for tumor immunotherapy.

Reverse first dorsal metacarpal artery flap repair of a right thumb epidermis granuloma: A case study.

One case of epidermal granuloma of the right thumb was diagnosed by color Doppler ultrasonography and pathologic examination. Epidermal granuloma resection and reverse island skin flap transplantation were performed to determine the therapeutic effect of a reverse first dorsal metacarpal artery flap repair of an epidermal granuloma of the right thumb. After effective intravenous combined general anesthesia, the skin in the surgical field was disinfected and sterile drapes were placed. An oblique incision was made over the underlying epidermis granuloma. The right palm of the reverse first dorsal metacarpal artery flap was chosen. The pedicle was carefully protected, and the flap was transplanted to the defective skin area. The incision was sutured after hemostasis. A palpable mass with the dimension of the right thumb of the patient was measured by color Doppler ultrasonography and physical examination pre-operatively. The palpable mass was oval in shape and protruded from the skin surface. The palpable mass had an unclear boundary with the surrounding skin and therefore the skin should be removed. If the tendon is exposed after the resection, complications may occur after operation, such as skin necrosis and tendon exposure. Intra-operatively, the mass was 1.5×1.0 cm in size and multi-cystic. The boundary between the palpable mass and the surrounding skin could not be discerned. The skin area (1.5×1.0 cm in size) was completely invaded by the palpable mass, which was closely adhered to the surrounding tissue. The palpable mass was carefully dissected with appropriate protection to the finger nerves and arteries. The palpable mass and affected skin were completely removed, leaving a defect area of ~1.5 ×1.0 cm without skin. The reverse first dorsal metacarpal artery flap was used to repair the defect area. The repaired flap had a good blood supply and peripheral circulation. The operation was successful, and the anesthesia effect was satisfactory. Treatment of a thumb epidermis granuloma with reverse first dorsal metacarpal artery flap was shown to be a feasible strategy with a broad clinical application.

The Relationship between Carotid Atherosclerosis, Inflammatory Cytokines, and Oxidative Stress in Middle-Aged and Elderly Hemodialysis Patients.

Objective. To identify the relationship between microinflammation, oxidative stress, and carotid arterial stiffness in hemodialysis patients. Methods. The CAS ß and PWV obtained by ultrasound technology were used to assess carotid arterial stiffness. We divided the patients into either the CAS group or the non-CAS group based on the presence or absence of CAS. The parameters of ALB, Ca, P, TC, HDL, LDL, TG, glucose, creatinine, and hs-CRP levels were routinely tested in both groups of patients. The levels of TNF- α , IL-6, and 8-isoprostane F2 α were measured by ELISA. Results. A total of 42 patients were enrolled in the CAS group and 20 patients were enrolled in the non-CAS group. No significant differences between the CAS group and the non-CAS group were observed with respect to age, dialysis duration, DBP, BUN, Cr, TC, TG, HDL, LDL, and Hb. However, SBP , pulse pressure, and 8-isoprostane levels of the CAS group were higher than those of the non-CAS group. The hs-CRP, TNF- α , and IL-6 levels were elevated in both groups but showed no significant differences. Conclusions. Maintenance of hemodialysis patients exhibits a microinflammatory state that may lead to atherosclerosis. The roles of hypertension and oxidative stress may be more important.

[Value of color Doppler flow imaging in the diagnosis of subclinical varicocele].

OBJECTIVE: To identify the value of color Doppler flow imaging (CDFI) in the diagnosis of sterility caused by subclinical varicocele (SVC). METHODS: The spermatic veins of 56 sterile patients with seminal abnormality were examined with CDFI and the internal diameters and the time of blood reflux of pampiniform plexus of the veins were observed. In addition, selective X-ray examination of internal spermatic veins was performed for contrast analysis. RESULTS: The diameter of the pampiniform plexus was (2.24 +/- 0.16) mm under the static condition and (2.67 +/- 0. 26) mm during the Valsalva test. The time of blood reflux was (1 487 +/- 203.66) ms. The accuracy of CDFI for diagnosing SVC was 92.8%. CONCLUSION: CDFI has been proved of more value in the diagnosis of SVC than that of clinical varicocele in the etiological screening of male sterility.