Clinical research on individualized hemodialysis preventing unconventional hypotension in diabetic nephropathy patient.

OBJECTIVE: This study aims to evaluate the effectiveness of individualized hemodialysis for unconventional hypotension in diabetic nephropathy patients. METHODS: A total of 60 patients were selected and randomly divided into study group and control group. The control group used the standard dialysis model, while the study group used the individualized hemodialysis scheme, in which the dialysis was performed using an individualized dialysis machine temperature control, pattern of natrium, and pattern of step ultrafiltration in combination with dialysate-containing glucose. RESULTS: The total occurrence rate of hypotension, dry weight standard-reaching rate, and blood quality during and after dialysis in the study group were superior to those in the control group (P < 0.05). Furthermore, the symptom scores in the study group (dizziness score, chest distress score, sweating score, muscle spasm score, gastrointestinal symptom score, and temporary mind change score) were lower than those in the control group (P < 0.05). The serum sodium, potassium, and chloride concentration in these two groups after dialysis was not statistically different (P > 0.05). CONCLUSION: The combined application of low temperature, pattern of natrium, pattern of step ultrafiltration, and dialysate-containing glucose individualization is safe and effective for preventing and controlling the occurrence of intradialytic hypotension (IDH), improve symptoms, and improve the dry weight standard-reaching rate.

Mangiferin prevents diabetic nephropathy progression and protects podocyte function via autophagy in diabetic rat glomeruli.

Diabetic nephropathy (DN) is one of the most severe microangiopathies of diabetes mellitus and is a leading cause of end stage renal disease. Numerous studies suggest that podocyte injury contributes to progressive proteinuria. Podocytes are highly specialized, terminally differentiated cells that are unable to proliferate, autophagy plays a key role in maintaining the structure and function of podocytes. Autophagy impairment is involved in the pathogenesis of podocyte loss, which leads to massive proteinuria in DN. In the present study, we investigated the effects of mangiferin on nephropathy in streptozotocin (STZ)-induced diabetic rats; we focused on pathological factors related to autophagy in podocytes and the AMPK-mTOR-ULK1 pathway. The results showed that chronic treatment with mangiferin significantly decreased albuminuria, inhibited glomerular extracellular matrix expansion and restored the expression of nephrin, a podocyte marker, in diabetic rats; these results suggest that mangiferin delayed the process of DN and protected the podocytes. In addition, mangiferin induced autophagy, as shown by the up-regulation of LC3 II and the down-regulation of p62 in both DN rats and podocytes. Transmission electron microscope analyses showed that mangiferin increased the number of autophagosomes in the podocytes of DN rats. This underlying mechanism was associated with the up-regulation of AMPK phosphorylation, the down-regulation of mTOR phosphorylation and the up-regulation of p-ULK1. Taken together, mangiferin delayed the progression of DN and protected the podocytes by enhancing autophagy under diabetic conditions via the AMPK-mTOR-ULK1 pathway. These findings provide new insights into the molecular mechanisms underlying the renoprotective effects of mangiferin in DN.

Salvaged allogeneic hematopoietic stem cell transplantation for pediatric chemotherapy refractory acute leukemia.

There is an ongoing debate concerning the performance of salvaged allogeneic hematopoietic stem cell transplantation (allo-HSCT) in pediatric patients with acute refractory leukemia, in whom the prognosis is quite dismal. Few studies have ever been conducted on this subject. This may be partly due to missed opportunities by majority of the patients in such situations. To investigate the feasibility, evaluate the efficiency, and identify the prognostic factors of allo-HSCT in this sub-setting, the authors performed a single institution-based retrospective analysis. A total of 44 patients, of whom 28 had acute myeloid leukemia (AML), 13 had acute lymphocytic leukemia (ALL), and 3 had mixed phenotype leukemia (MPL), were enrolled in this study. With a median follow-up of 19 months, the estimated 2-year overall survival (OS) and progression free survival (PFS) were 34.3% (95% CI, 17.9-51.4%) and 33.6% (95% CI, 18.0-50.1%), respectively. The estimated 2-year incidence rates of relapse and non-relapse mortality (NRM) were 43.8% (95% CI 26.4-60.0%) and 19.6% (95% CI 9.1-32.9%), respectively. The estimated 100-day cumulative incidence of acute graft versus host disease (aGvHD) was 43.6% (95% CI 28.7-57.5%), and the 1-year cumulative incidence of chronic GvHD (cGvHD) was 45.5% (95% CI 30.5-59.3%). Compared with the previous studies, the multivariate analysis in this study additionally identified that female donors and cGvHD were associated with lower relapse and better PFS and OS. Male recipients, age younger than 10 years, a diagnosis of ALL, and the intermediate-adverse cytogenetic risk group were associated with increased relapse. On the contrary, extramedullary disease (EMD) and aGvHD were only linked to worse PFS. These data suggested that although only one-third of the patients would obtain PFS over 2 years, salvaged allo-HSCT is still the most reliable and best therapeutic strategy for refractory pediatric acute leukemia. If probable, choosing a female donor, better management of aGvHD, and induction of cGvHD promotes patient survival.

Curative effect of neutral macroporous resin hemoperfusion on treating hemodialysis patients with refractory uremic pruritus.

This study aims to investigate the efficacy and safety of neutral macroporous resin hemoperfusion in treating maintenance hemodialysis (MHD) patients with refractory uremic pruritus (RUP).Ninety patients were enrolled and were randomly divided into 3 groups: control group, experiment 1 group, and experiment 2 group. Clinical symptom scores of skin itching were recorded before and at 4 and 8 weeks after the treatment. In addition, serum parathyroid hormone (PTH), calcium (Ca), phosphorus (P), and C-reactive protein (CRP) were detected; and the calcium-phosphorus product ([Ca] × [P]) was calculated to compare the curative effect.VSA score, modified Duo pruritus score, and CRP: these indices decreased to some extent at 4 and 8 weeks after treatment in the 2 experiment groups, compared with pretreatment (P < 0.05); and differences among these 3 groups were statistically significant (P < 0.05). PTH, P, and [Ca] × [P]: these indices decreased to some extent at 4 and 8 weeks after treatment in the 2 experiment groups, compared with pretreatment (P < 0.05); and differences between the control and experiment 1 groups, as well as between the control and experiment 2 groups, were statistically significant (P < 0.05). However, the difference between the experiment 1 and experiment 2 groups were not statistically significant (P < 0.05).The effects of HA330 and HA130 resin hemoperfusion apparatus on secondary hyperparathyroidism and the disorder of calcium and phosphorus metabolism are similar. The mechanism may be related to its strong adsorption effect, and its capacity to widely remove inflammatory mediators, immune mediators, and endotoxins.

Simultaneous determination of ten steroid hormones in animal origin food by matrix solid-phase dispersion and liquid chromatography-electrospray tandem mass spectrometry.

An UPLC-MS/MS method for determination of ten steroid hormones in animal origin food has been developed with pretreatment of the samples by matrix solid-phase dispersion (MSPD). The MSPD conditions, including the dispersing sorbents, elution solvents, ratio of sorbent to sample and the volume of the elution solvent have been investigated and optimised, and the method has been evaluated and validated. The results showed that the developed method has satisfactory linearity between the MS/MS responses of the analytes and the concentration of the steroid hormones, and the limits of the detection can reach 0.01µg/kg for most of the analytes. The spiking recoveries of the steroid hormones in chicken, pork, beef and sausage samples were between 76.8% and 98.7% with RSDs lower than 10%. The results demonstrated that the developed approach has high sensitivity and repeatability, and can rapidly determinate the trace residues of steroid hormones in complex food matrices.

Quantum dots capped with dummy molecularly imprinted film as luminescent sensor for the determination of tetrabromobisphenol A in water and soils.

Molecularly imprinted film with diphenolic acid (DPA) as dummy template molecule has been grafted on the surface of Mn-doped ZnS quantum dots (QDs) to develop a selective and sensitive sensor for rapid determination of tetrabromobisphenol A (TBBPA) in water and soils. The obtained DPA-MIP-QDs sensor has distinguished selectivity and high binding affinity to TBBPA. The fluorescence quenching fractions of the sensor presented a satisfactory linearity with the concentrations of TBBPA in the range of 0.1-100 µM, and its limit of detection can reach 0.015 µM. The sensor has been successfully applied to determine the TBBPA in water and soil samples, and the average recoveries of the TBBPA at various spiking levels ranged from 80.2% to 96.5% with relative standard deviation below 8.0%. The results provided a clue to develop sensors for rapid determination of hazardous materials from complex matrixes.

Dummy molecularly imprinted polymers on silica particles for selective solid-phase extraction of tetrabromobisphenol A from water samples.

Surface molecular imprinted polymers (MIPs) on silica gel particles for highly selective recognition of tetrabromobisphenol A (TBBPA) were prepared by a sol-gel process. Diphenolic Acid (DPA) and bisphenol A (BPA), whose structures were similar to that of TBBPA were selected as dummy template molecules, and 3-aminopropyltriethoxysilane (APTES) and tetramethoxysilane (TEOS) were chosen as functional monomer and cross-linker, respectively. The obtained materials were characterized by FT-IR with diffuse reflectance accessory and the results indicated polymers were successfully grafted on the surface of silica gel supporters. The maximum static adsorption capacities for TBBPA of the DPA-MIPs, BPA-MIPs and non-imprinted polymers (NIPs) were 45, 38 and 22 mg g(-1) respectively, and the results of dynamic adsorption showed that the adsorption equilibrium can be achieved within 15 min for DPA- and BPA-MIPs. Both the DPA- and BPA-MIPs have higher selectivity for TBBPA than that of NIP when they are used as the sorbents for the solid phase extraction (SPE), while the adsorption property of DPA-MIPs was superior to that of BPA-MIPs at low concentration levels of TBBPA. The results indicated DPA-MIPs had more high affinity binding sites for TBBPA, which demonstrated that the strong interactions between the template and the functional monomer were favorable to form high affinity binding sites and improve the selectivity of the polymers. A corresponding analytical method for determination of the TBBPA residues in environmental samples was developed. The recoveries of TBBPA in tap water, river water and lake water were in the range from 85% to 97% with relative standard deviations below 7%, and its limit of detection can reach 2 ng mL(-1).

Selective detection of neurotransmitter serotonin by a gold nanoparticle-modified glassy carbon electrode.

Gold nanoparticles (GNPs) were allowed to self-assemble onto a glassy carbon electrode (GCE) that was prior modified by L-cysteine. The modified electrode was then used as a voltammetric sensor in detecting the neurotransmitter serotonin. The electrode exhibited a linear voltammetric response for serotonin within a concentration range of 6.0 x 10(-8) M to 6 x 10(-6) M, with a detection limit of 2 x 10(-8) M. The detection of serotonin was found to be unaffected by the presence of epinephrine, dopamine, ascorbic acid and folic acid. The electrode was applied to detect serotonin added to human blood serum, with an average recovery value of 104.67%.

[Study on the relationship of airborne sensitization fungus and anaphylactic rhinitis in Wuhan].

OBJECTIVE: The aim of our studies is to explore the relation between superior sensitizing fungus and anaphylactic rhinitis, for directing the prevention, diagnosis and treatment of the disease. METHOD: Three hundred and ninety-two persons were treated by allergen skin test. Using 15 main sensitizing fungus, 90 anaphylactic rhinitis were examined. The serum level of IgE were examined, too. RESULT: In the allergen skin testing 239 cases (60.97%) were positive, the positive rate was higher than that in contrast group (t = 5.47, P < 0.01). The main fungus allergen were Rhizopus nigricans, Cuvularia and Altevnaria, the value of IgE in patients group was higher than that in control group (t = 5.47, P < 0.01). CONCLUSION: It proves that airborne sensitizing fungus are important causes of anaphylactic rhinitis.