Association of Dose and Frequency on the Survival of Patients on Maintenance of Hemodialysis in China: A Kaplan-Meier and Cox-Proportional Hazard Model Analysis.

BACKGROUND Dialysis frequency and dose are controversial prognostic factors of hemodialysis morbidity and mortality. The aim of this study was to find out the effect of frequency and dosage of dialysis on mortality and survival in a group of Chinese hemodialysis patients. MATERIAL AND METHODS In total, 183 patients seen from February 2008 to January 2018, who were on maintenance hemodialysis for at least 3 months, were included in the study cohort. An anonymized database of age, gender, diabetic status, comorbidities, date of initiation of dialysis, hematological characters, biochemical variables, and status of survived or died was established from DICOM (Digital Imaging and Communications in Medicine) files of patients. Kaplan-Meier and Cox-proportional hazard model was used for calculation of survival over time at 95% confidence level. RESULTS Overall, the 10-year survival rate was 27%. Kaplan-Meier analysis showed patient survival as 94% at one-year, 59% at 5-years, and 27% at 10-years. Hemoglobin, serum albumin, calcium, potassium, phosphorous, calcium-phosphorous-products, and hemodialysis frequency and the dose had a significant effect on survival. Cox regression proportional hazard model showed that patients with serum albumin level of >4 g/dL were better associated with survival. Patients who underwent twice-weekly hemodialysis had 4.26 times less chance of survival as compared to patients with thrice-weekly hemodialysis. A higher dialysis dose of >1.2 spKt/V offered better survival as compared to a lower dose of <1.2 spKt/V. CONCLUSIONS Hypoalbuminemia, hemodialysis time, and hemodialysis frequency were significantly associated with mortality.

Disposition of Astragaloside IV via Enterohepatic Circulation Is Affected by the Activity of the Intestinal Microbiome.

Astragaloside IV (ASIV) is a typical bioactive constituent of Radix Astragali. The study aimed to investigate the enterohepatic circulation of ASIV and evaluate the impact of activity of intestinal microbiota on the deposition of ASIV. The amounts of ASIV and its metabolites were quantified by an LC-MS/MS method. ASIV was metabolized by intestinal bacteria to form brachyoside B (Bra B), cyclogaleginoside B (Cyc B), cycloastragenol (CA), iso-cycloastragenol (iso-CA), and dehydrogenated metabolite of CA (CA-2H). CA and iso-CA circulated in blood besides ASIV when rats received ASIV intragastrically or intravenously. After rats were intragastrically administered 10 mg/kg ASIV, the AUC0-t values of ASIV, CA, and iso-CA were 109 ± 55, 26.8 ± 17.9, and 77.9 ± 35.1 nM·h, respectively. The plasma distribution of ASIV was significantly affected by bile duct drainage when ASIV was administered through the duodenum. ASIV, Bra B, and Cyc B were secreted from bile after duodenal administration of ASIV. Antibiotics markedly inhibited the metabolism of ASIV in intestinal microbiota. After rats were pretreated with antibiotics, the AUC0-t of iso-CA was 4.8 times less than that in control rats and the concentration of CA became undetectable. Variations in intestinal microbiota may change the disposition of ASIV and subsequently influence its potential health benefits.

Prognosis of psychomotor and mental development in premature infants by early cranial ultrasound.

BACKGROUND: It is of high incidence of brain injuries in premature infants, so it is necessary to diagnose and treat the brain injury early for neonatal clinical practice. We are aimed to investigate the relationship between early postnatal cranial ultrasonography and psychomotor and mental development in prematrue infants at the age of 12 months. METHODS: Two-hundred and eight premature infants were selected and underwent follow-up from January, 2007 to November, 2012. Cranial ultrasonography was performed on them. The developmental outcomes of these premature infants at the age of 12 months were assessed by the psychomotor developmental index (PDI) scale and mental development index (MDI). The relationship between ultrasonic gray-scale value and PDI and MDI was analyzed. RESULTS: The worse prognosis for psychomotor and mental development was associated with the gestational age, Apgar score(1 min), gender, chorioamnionitis, duration of mechanical ventilation and duration of mechanic ventilation. The differences between the prognosis of psychomotor and mental development, and peri-intraventricular hemorrhage (PIVH) and periventricular white matter damage (PWMD), were statistically significant (P<0.05). There were also significant differences between the early postnatal ultrasonic gray-scale value and prognoses of both psychomotor development and mental development (P<0.05). There were negative correlations between ultrasonic gray-scale and both PDI and MDI (r=-0.753, P<0.05; r=-0.764, P<0.05). CONCLUSIONS: The early postnatal cranial ultrasonography can assist to predict the prognosis of psychomotor and mental development for premature infants. The higher grade of PIVH and PWMD was associated with the worse prognosis of psychomotor and mental development.

A validated LC-MS/MS method for the rapid quantification of vilazodone in rat plasma: application to a pharmacokinetic study.

A rapid and sensitive LC-MS/MS method was developed for the quantification of vilazodone in rat plasma using escitalopram as internal standard. After extracted with organic solvent, post-treatment samples were chromatographed on an Agela C18 column. An isocratic mobile phase of acetonitrile: 5mM ammonium acetate: formic acid (35:65:0.1, v/v/v) was applied at a flow rate of 0.25mL/min. Detection was performed using multiple reaction-monitoring (MRM) modes at m/z 442.4→155.3 for vilazodone and m/z 325.1→109.0 for escitalopram. The method was linear in the concentration range of 1.0-100ng/mL with a correlation coefficient ≥0.993. The intra- and inter-assay precision (%RSD) values were within 13.4%, and intra- and inter-day accuracy (%RE) ranged from -9.8 to 6.9%. The total analysis time was 2.2min. The LC-MS/MS method was fully validated for its sensitivity, selectivity, stability, matrix effect and recovery. The data indicated that the developed method was rapid, specific and sensitive. This method was further and successfully applied in the pharmacokinetics study of vilazodone in rat.