Endoplasmic reticulum protein of 57 kDa sulfhydration promotes intestinal calcium absorption to attenuate primary osteoporosis.

Endogenous hydrogen sulfide (H2S) plays an important role in bone metabolism. However, the exact role of H2S in intestinal calcium and phosphorus absorption and its potential in preventing and treating primary osteoporosis remains unknown. Therefore, this study aimed to investigate the potential of H2S in promoting intestinal calcium and phosphorus absorption and alleviating primary osteoporosis. We measured the apparent absorptivity of calcium, femoral bone density, expression and sulfhydration of the duodenal endoplasmic reticulum protein of 57 kDa (ERp57), duodenal cystathionine γ-lyase (CSE) expression, and serum H2S content in adult and old CSE-knockout and wild-type mice. We also assessed intracellular reactive oxygen species (ROS) and Ca2+ content in CSE-overexpressing or knockout intestinal epithelial cell (IEC)-6 cells. In senile mice, CSE knockout decreased endogenous H2S, ERp57 sulfhydration, and intestinal calcium absorption and worsened osteoporosis, which were partially reversed by GYY4137, an H2S donor. CSE overexpression in IEC-6 cells increased ERp57 sulfhydration, protein kinase A and C activity, and intracellular Ca2+, whereas CSE knockout exerted the opposite effects. Furthermore, hydrogen peroxide (H2O2) stimulation had similar effects as in CSE knockout, which were reversed by pretreatment with sodium hydrosulfide before H2O2 stimulation and restored by DL-dithiothreitol. These findings suggest that H2S attenuates primary osteoporosis by preventing ROS-induced ERp57 damage in intestinal epithelial cells by enhancing ERp57 activity and promoting intestinal calcium absorption, thereby aiding in developing therapeutic interventions to prevent osteoporosis.

Effect of Paricalcitol Combined with Cinacalcet on Calcium and Phosphorus Metabolism in Patients Receiving Maintenance Hemodialysis.

This study was designed to compare the beneficial effects of paricalcitol combined with or without cinacalcet on calcium and phosphorus metabolism in patients undergoing maintenance hemodialysis (MHD). A total of 140 patients who received MHD in our hospital from March 2021 to March 2022 were randomly divided into a control group (intravenous paricalcitol, n = 70) and a test group (intravenous paricalcitol combined with oral cinacalcet, n = 70). Clinical baseline data and relevant laboratory parameters before treatment were compared. Additionally, calcium, phosphorus, intact parathyroid hormone in serum were measured and compared between the 2 groups before treatment and 1, 2, 3, 4, 5, 6, 9, 10, and 12 months after treatment. As a result, comparison before treatment demonstrated no significant difference in baseline data such as age, sex, and most laboratory parameters between the 2 groups (P > .05), but there was a significant difference in mean corpuscular volume (P < .001). The serum phosphorus level decreased and calcium level increased significantly in the 2 groups after treatment, while the intact parathyroid hormone level showed no significant change within 12 months of treatment (P > .05). In addition, the combined treatment for 6-12 months caused a much lower phosphorus level (P < .05) and higher calcium level (P < .05) than the treatment with paricalcitol alone, and the difference increased with the extension of treatment time. Collectively, paricalcitol combined with cinacalcet, which is more effective than paricalcitol alone, has a positive effect on calcium and phosphorus metabolism in patients receiving MHD.

Characteristics of blood uric acid level and its correlation with metabolic indexes in obese adolescentsu / 公共卫生与预防医学

Objective To explore the characteristics of blood uric acid levels and its correlation with calcium and phosphorus levels, and glucose and lipid metabolism in obese adolescents in weight-loss training camps. Methods In this study, 357 obese adolescents aged 12-18 were selected as the research subjects, and 135 normal-weight adolescents were selected as the controls. The body shape and blood uric acid characteristics of the subjects were measured and analyzed. Further, 59 subjects were selected from the obese adolescents for blood calcium, blood phosphorus and glucose and lipid metabolism index tests to analyze the correlation between blood uric acid level and calcium, phosphorus, and glucose and lipid metabolism indicators. Results The average blood uric acid level of obese adolescents was (527.12±122.94)μmol/L, (566.58±122.51)μmol/L for boys, and (468.35±97.79)μmol/L for girls. The blood uric acid level of the obesity group was significantly higher than that of the control group (P<0.001 for boys, P<0.05 for girls), and it was higher in boys than in girls (P<0.01). Obese adolescents with high uric acid accounted for 73.39%. The HOMA-IR of obese adolescents was 5.79±3.04. The blood uric acid level was significantly correlated with blood calcium, total cholesterol, and low-density lipoprotein cholesterol (P<0.05). Gender and low-density lipoprotein cholesterol were the main influencing factors of blood uric acid (P<0.05). Conclusion Obese adolescents have high blood uric acid levels, low calcium and high phosphorus in the body, and a higher incidence of insulin resistance. There exists a positive correlation between the blood uric acid level and the body's calcium and phosphorus metabolism and glucose and lipid metabolism in obese adolescents. Clinical monitoring of lipid metabolism indicators such as low-density lipoprotein has certain reference value for the prevention and treatment of hyperuricemia.

Recommended levels of calcium and non-phytate phosphorus for yellow-feathered broilers (finisher phase).

OBJECTIVE: This study examined the effects of dietary calcium (Ca) and non-phytate phosphorus (NPP) on performance, tibial characteristics, meat quality and plasma biochemical variables in yellow-feathered broilers during 85 to 105 d of age. METHODS: A total of 720 heads of 85-d broilers were allocated into 9 groups and provided with three levels of Ca (0.65%, 0.75%, 0.85%), and NPP (0.25%, 0.30%, 0.35%) in diets for 21 d. RESULTS: The final body weight (FW), average daily gain (ADG), average daily feed intake (ADFI), and feed to gain ratio (F:G) were affected (p<0.05) by dietary Ca. From the quadratic regressions, the optimal level of Ca in diet were 0.71% for FW and ADG, and 0.67% for ADFI. Dietary Ca and NPP both significantly affected tibial breaking strength and density. From the quadratic regressions, the optimal level of Ca and NPP in diet were 0.81% and 0.37% for tibial density. The shear force of breast muscle of broilers given 0.75% or 0.85% Ca were lower than that in birds with 0.65% Ca and drip loss of birds given 0.65% or 0.75% Ca was lower than that in birds with 0.85% Ca (p<0.05). The drip loss of birds given 0.25% NPP was lowest among all NPP treatments (p<0.05). Calcium affected (p<0.05) the plasmal contents of phosphorus, osteocalcin (OC), parathyroid hormone (PTH) and calcitonin and the contents of OC and PTH were also influenced by dietary NPP. CONCLUSION: Dietary Ca and NPP level affected tibial characteristics, meat quality and biochemical variables in plasma of finisher-phase yellow-feathered broilers (85 to 105 d) and Ca also affected growth performance. Dietary 0.71% Ca and 0.30% NPP were enough for growth performance, while considering the growth performance, tibial characteristics, meat quality and biochemical variables together, 0.75% Ca and 0.37% NPP were recommended.

Low protein diet combined with α-keto acid improves calcium and phosphorus metabolic disorders and nutritional status in hemodialysis patients: a meta-analysis / 中华临床营养杂志

Objective:To systematically evaluate the effects of low protein diet combined with α-keto acid on calcium and phosphorus metabolism and nutritional status in patients undergoing hemodialysis.Method:Randomized controlled Trials were searched in Cochrane Library, Web of Science, PubMed, Embase, CBM, CNKI, Wanfang and VIP databases from the establishment of respective database until July 2021, and meta-analysis is conducted using RevMan 5.4.Results:A total of 8 studies including 556 patients were selected. Meta-analysis showed that after receiving low protein diet combined with α-keto acid, patients demonstrated significantly reduced blood phosphorus [MD = -0.17, 95% CI (-0.25, -0.7), P < 0.01], calcium- phosphorus product [MD = -6.17, 95% CI (-6.67, -5.58), P < 0.01] and parathyroid hormone levels [MD = -35.36, 95% CI (-40.89, -29.83), P < 0.01]. There was no significant difference in serum calcium [MD = 0.03, 95% CI (-0.00, 0.07), P = 0.08] and serum albumin [MD = 0.41, 95% CI (-0.12, 0.95), P = 0.13]. Conclusion:Low protein diet combined with α-keto acid can reduce the levels of serum phosphorus, calcium-phosphorus product and parathyroid hormone in hemodialysis patients while the effects on serum calcium and serum albumin are undetermined and need further verification.

[Effects of ERα gene overexpression on bone mineral density and calcium and phosphorus metabolism inovariectomized osteoporosis mice].

Objective: To investigate the effects of estrogen receptor α (ERα) gene overexpression on bone metabolism and calcium and phosphorus metabolism in ovariectomized osteoporosis mice, and to provide experimental basis for targeted gene therapy of osteoporosis. Methods: Thirty SPF female mice were randomly divided into sham operation group, model group and ERα overexpression group with 10 mice in each group. After the model was established, the ERα overexpression group was transfected with recombinant adenovirus vector carrying mouse ERα gene by intraspinal injection. The model group was transfected with empty virus, and the sham operation group was not treated. The expression of ERα gene in bone tissue of mice was detected by quantitative Real-time PCR (qRT-PCR). Bone mineral density (BMD) of mouse femur was measured after modeling. Trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular segregation (Tb.Sp), bone volume fraction (BV/TV) and biomechanical strength of femur were measured by micro-CT scanning. Serum levels of calcium (Ca), phosphorus (P), osteocalcin (BGP) and alkaline phosphatase (ALP) were measured by automatic biochemical analyzer. The expressions of tissue inhibitor of metalloproteinases 1 (TIMP-1) and monocyte chemotactic protein 1 (MCP-1) in bone homogenate were detected by Immunohistochemistry. Results: Compared with sham operation group, the expression level of ERα gene in bone tissue of model group was decreased significantly, the levels of BMD, BV/TV, Tb. Th, maximum load, rigidity coefficient, Ca and P were decreased, while the levels of Tb. Sp, BGP and ALP were increased significantly (P＜0.05). Compared with the sham operation group, the expression level of TIMP-1 protein in the bone tissue of the model group was significantly decreased, while that of MCP-1 protein was increased, while that of the ERα overexpression group was increased while that of MCP-1 was decreased (P＜0.05).The levels of ERα gene expression, BMD, BV/TV, TB. Th, maximum load, rigidity coefficient, Ca and P in the ERα overexpression group were significantly higher than those in the model group, while Tb. Sp, BGP and ALP were significantly lower (P＜0.05). Compared with the sham operation group, mean optical density of TIMP-1 in the bone tissue of the model group was significantly decreased, while that of MCP-1 was significantly increased, and that of the ERα overexpression group was significantly increased while that of MCP-1 was significantly decreased (P＜0.05). Conclusion: ERα gene overexpression can improve osteoporosis by regulating bone mineral density, bone parameters, bone metabolism, calcium and phosphorus metabolic indicators and the expression levels of TIMP-1 and MCP-1 in tissues.

Hydrogen sulfide inhibits calcium and phosphorus loss after fracture by negatively regulating glucocorticoid/glucocorticoid receptor α.

AIMS: Post-fracture calcium and phosphorus excretion is greater than influx, which might be caused by stress. Glucocorticoid is known to enhance calcium and phosphorous excretion, and hydrogen sulfide (H2S) has been shown to exert inhibitory effects on glucocorticoid. Therefore, this study explored whether H2S could inhibit calcium and phosphorus loss after fracture by regulating glucocorticoid and/or its receptor. MAIN METHODS: The following properties were analyzed in rats with femur fractures: serum and urinary calcium and phosphorus (by colorimetry); bone turnover markers alkaline phosphatase, serum type 1 collagen amino terminal peptide, type 1 procollagen carboxy terminal peptide, and anti-tartaric acid phosphatase (by ELISA); factors related to calcium-phosphorus metabolism including glucocorticoid, parathyroid hormone, calcitonin, fibroblast growth factor 23, and 1,25(OH)2D3 (by ELISA); and sulfhydration of glucocorticoid receptor α in the kidney (by immunoprecipitation linked biotin-switch assay), after supplementing with mifepristone, the H2S donor GYY4137 or H2S generating enzyme inhibitors aminooxyacetic acid and propargylglycine. KEY FINDINGS: Serum H2S decreased and glucocorticoid secretion increased in rats post-fracture. The glucocorticoid receptor inhibitor mifepristone partly blunted calcium and phosphorus loss. Furthermore, supplementation with GYY4137 reduced glucocorticoid secretion; inhibited glucocorticoid receptor α activity by sulfhydration; downregulated vitamin D 1α-hydroxylase expression; and upregulated 24-hydroxylase, calbindin-D28k, and sodium phosphate cotransporter 2a expression in the kidney; thereby inhibiting calcium and phosphorus loss induced by fracture. Moreover, inhibiting endogenous H2S generation showed opposite effects. SIGNIFICANCE: Our findings suggest that H2S antagonized calcium and phosphorus loss after fracture by reducing glucocorticoid secretion and inhibiting glucocorticoid receptor α activity by sulfhydration.

Quercetin Regulates Calcium and Phosphorus Metabolism Through the Wnt Signaling Pathway in Broilers.

This study intended to explore the effect and mechanism of different doses of dietary quercetin on calcium and phosphorus metabolism to provide an experimental basis for preventing leg disease in broilers. A total of 480 1-day-old healthy Arbor Acre broilers were randomly allotted into four groups (0, 0.02, 0.04, 0.06%) for 42 days. Compared with control, 0.06% quercetin significantly increased the unit weight and the relative weight of tibia in broilers (P < 0.05). Meanwhile, phosphorus content and bone mineral density (BMD) were significantly increased by 0.06% dietary quercetin supplementation in tibia (P < 0.05). Ash of tibia was significantly increased by 0.04 and 0.06% quercetin in broilers (P < 0.05). In addition, 0.06% quercetin significantly increased the content of serum calcium-binding protein (CB), estradiol (E2), osteocalcin (OC), alkaline phosphatase (ALP), and calcitonin (CT) (P < 0.05); 0.04% quercetin significantly increased 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) (P < 0.05) content in serum of broilers. The content of serum parathyroid (PTH) was significantly decreased by 0.02 and 0.06% quercetin (P < 0.05) in broilers. Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that the Wnt signaling pathway was a key signaling pathway of calcium and phosphorus metabolism in broilers which was significantly regulated by quercetin. The differentially expressed genes (DEGs) from transcriptome sequencing were validated with real-time quantitative PCR (RT-qPCR). In conclusion, 0.06% dietary quercetin supplementation improved calcium and phosphorus metabolism by regulating the Wnt signaling pathway in broilers.

[Primary hyperparathyroidism and vitamin D deficiency].

Primary hyperparathyroidism (PHPT) is the third most common endocrine disease after diabetes mellitus and thyroid pathology. Recent epidemiological and experimental data have shown that long-term maintenance of low vitamin D levels in the blood can lead to the development of hyperplastic processes in the cells of the parathyroid glands, followed by autonomous production of parathyroid hormone. In PHPT vitamin D insufficiency or deficiency according to various sources occurs with a frequency of 5377% of cases. The literature review indicates more severe disease in patients with concomitant vitamin D deficiency. The expediency of preoperative assessment of vitamin D levels in all patients with PHPT in order to minimize the risk of hypocalcemia after parathyroidectomy is discussed. This article presents the relationship between vitamin D deficiency and PHPT, as well as possible methods for correcting vitamin D deficiency in PHPT. Molecular and cellular mechanisms of the occurrence of pathological processes in the parathyroid glands under conditions of low vitamin D levels are presented.

Disorders of Calcium and Phosphorus Metabolism and the Proteomics/Metabolomics-Based Research.

Since calcium and phosphorus play vital roles in a multitude of physiologic systems, disorders of calcium and phosphorus metabolism always lead to severe consequences such as skeletal-related and cardiovascular morbidity, or even life-threatening. Physiologically, the maintenance of calcium and phosphorus homeostasis is achieved via a variety of concerted actions of hormones such as parathyroid hormone (PTH), vitamin D, and fibroblast growth factor (FGF23), which could be regulated mainly at three organs, the intestine, kidney, and bone. Disruption of any organ or factor might lead to disorders of calcium and phosphorus metabolism. Currently, lacking of accurate diagnostic approaches and unknown molecular basis of pathophysiology will result in patients being unable to receive a precise diagnosis and personalized treatment timely. Therefore, it is urgent to identify early diagnostic biomarkers and develop therapeutic strategies. Fortunately, proteomics and metabolomics offer promising tools to discover novel indicators and further understanding of pathological mechanisms. Therefore, in this review, we will give a systematic introduction on PTH-1,25(OH)2D-FGF23 axis in the disorders of calcium and phosphorus metabolism, diagnostic biomarkers identified, and potential altered metabolic pathways involved.

Relationship between dietary phosphorus intake and nutritional status and calcium and phosphorus metabolism in patients with chronic kidney disease / 中华肾脏病杂志

Objective@#To evaluate the dietary phosphorus intake of non-dialysis patients with chronic kidney disease (CKD) 3-5 stage, and to explore the relationship between dietary phosphorus intake, nutritional status, and calcium and phosphorus metabolism.@*Methods@#A cross-sectional study was conducted. Non-dialysis patients of CKD 3-5 stage in Huashan Hospital outpatient clinic were selected. Three-day dietary diaries, anthropometric indicators, subjective global assessment (SGA) scores, blood and 24-hour urine biochemical indicators were collected. According to the median dietary phosphorus intake (873 mg/d), the patients were divided into high phosphorus intake group (≥ 873 mg/d) and low phosphorus intake group (<873 mg/d). The differences of characteristics, anthropometric indicators, SGA scores, blood and urine biochemical indicators between the two groups were compared. Multivariate linear regression analysis was used to analyze the correlation between dietary phosphorus intake and different kinds of food intake.@*Results@#A total of 118 patients were enrolled. The daily energy intake was (25.48±4.45) kcal/kg, protein intake was (0.88±0.22) g/kg and phosphorus intake was(862.85±233.02) mg/d. There were no significant differences in body mass index and SGA scores between high phosphorus intake group and low phosphorus intake group. The waist circumference, hip circumference, waist-hip ratio and leg circumference of male patients in high phosphorus intake group were higher than those in low phosphorus intake group (all P<0.05). There were no significant differences in anthropometric indicators between the two groups of female patients. The serum levels of intact parathyroid hormone (iPTH), sodium, triglyceride, blood RBC count, alanine aminotransferase, 24-hour urine urea nitrogen, 24-hour urine creatinine and 24-hour urine phosphate in the high phosphorus intake group were higher than those in the low phosphorus intake group (all P<0.05). Multivariate regression analysis showed that pork and chicken contributed the most to dietary phosphorus intake, followed by fish and dairy.@*Conclusions@#The daily dietary phosphorus intake of non-dialysis of CKD 3-5 stage patients is slightly higher than the recommended intake. The increase of dietary phosphorus intake may lead to the increase of serum iPTH and sodium levels. Proper control of dietary phosphorus intake will not impair the nutritional status of CKD patients.

Content Determination of Indicator Components in Jianpi Yishen Pills and the Effects on Calcium ，Phosphorus Metabolism and Inflammatory Factors in CRF Model Rats / 中国药房

OBJECTIVE： To establish the method for the content determination of astragaloside Ⅳ， emodin and chrysophanol in Jianpi yishen pills （JYP） and to investigate the effects of JYP on calcium， phosphorus metabolism and inflammatory factors in chronic renal failure （CRF） model rats. METHODS： HPLC method was adopted. The determination of astragaloside Ⅳ， emodin and chrysophanol was perform on Agilent Zorbax SB-C18， Agilent TC C18 column， respectively； mobile phase consisted of acetonitrile-water （36 ∶ 64， V/V） and methanol-0.1％ phosphoric acid solution （75 ∶ 25， V/V）； the detectors were evaporative light-scattering detector and diode-array detector （detection wavelength of 254 nm）； the column temperatures were set at 30 ℃and 25 ℃ at the flow rate of 1.0 mL/min； the sample sizes were 20 and 10 μL. SD rats were randomly divided into normal group， model group， Niaoduqing group （1.80 g/kg） and JYP low-dose， medium-dose and high-dose groups （1.71， 3.43， 6.85 g/kg）， with 10 rats in each group. Except for normal group， CRF model of other groups were established by 5/6 nephrectomy in other groups. Four months after modeling， normal group and model group were given constant volume of water intragastrically； admi- nistration groups were given relevant medicine intragastrically， once a day， for consecutive 12 weeks. The levels of serum creatinine （Scr）， urea nitrogen （BUN）， parathyroid hormone （PTH） and inflammatory factors （IL-6， TNF-α） were measured by ELISA. Methyl thymol blue colorimetric method and phosphomolybdic acid method were used to detect the contents of blood calcium and phosphorus. Correlation of inflammatory factors with related calcium and phosphorus metabolism indexes （blood calcium， blood phosphorus， PTH） were investigated with Pearson assay. RESULTS： The linear range of astragaloside Ⅳ， emodin and chrysophanol were 54.537-381.759， 2.960-20.720， 6.318-44.223 μg/mL， respectively. The limits of quantitation were 0.010， 0.288， 0.216 μg/mL； the limits of detection were 0.003， 0.096， 0.072 μg/mL. RSDs of precision， reproducibility and stability tests were all lower than 3.0％. The recoveries were 97.18％-102.33％（RSD＜3％，n＝9）. After modeling （before medication）， serum contents of Scr and BUN in model group and administration group were increased significantly， compared with normal group （P＜0.01）. After medication， above indexes of administration group were decreased significantly， compared with model group and the same group before medication （P＜0.01）. Compared with normal group， the content of blood calcium were decreased significantly， while the contents of IL-6 and TNF-α were increased significantly （P＜0.01）. Compared with model group， the content of blood calcium were increased significantly in JYP medium-dose and high-dose groups， while serum content of PTH in Niaoduqing group， serum contents of PTH and IL-6 in JYP medium-dose and high-dose groups as well as serum content of TNF-α in administration group were decreased significantly （P＜0.05 or P＜0.01）. JYP had no significant effect on blood phosphorus in rats， and there was no correlation of inflammatory factors with related calcium and phosphorus metabolism indexes （P＞0.05）. CONCLUSIONS： The established content determination method is simple， specific and sensitive， and can be used for content determination of astragaloside Ⅳ， emodin and chrysophanol in JYP. JYP can improve renal function of CRF model rats， relieve calcium metabolism disorder and inhibit the expression of inflammatory factors.

The role of vitamin D and its analogues in the treatment of oral mucosal diseases and periodontal diseases / 口腔疾病防治

@#Vitamin D is an essential nutrient in the body. In recent years, increasing attention has been paid to its role in regulating immunity and anti-inflammatory effects. However, the application of vitamin D in vivo may produce some side effects, such as hypercalcemia and hypercalciuria. Some analogs of vitamin D obtained through molecular modification can reduce the side effects while retaining a similar regulatory action as that of vitamin D. The supplementation of vitamin D or the use of vitamin D analogs may contribute to the prevention and treatment of immune inflammatory diseases. This article reviews the role of vitamin D and its analogues in the prevention and treatment of oral mucosal diseases and periodontal diseases. The literature review results show that vitamin D and its analogues can protect the integrity of the oral mucosal barrier, prevent or delay the occurrence of oral lichen planus, and provide a reference value for the prevention and treatment of periodontitis.

Effects of different hemodialysis methods on calcium and phosphorus metabolism in uremia patients / 中国基层医药

Objective To observe the effect of different hemodialysis methods on calcium and phosphorus metabolism in uremic patients .Methods 130 patients with uremia who underwent hemodialysis were divided into maintenance hemodialysis group ( HD group ) and maintenance hemodialysis filtration group ( HDF group ) according to different dialysis methods ,65 cases in each group .The HD group was treated with maintenance hemodialysis .The HDF group received high -throughput polysulfone membrane dialyzer ,the two groups received dialysis for 6 months. The Ca2+,serum phosphorus (P3+),parathyroid hormone (iPTH),1,25 dihydroxyvitamin D[1,25(OH)2D] were measured before and after treatment in both two groups .Results The total effective rate was 76.92％ in the HD group and 84.62％in the HDF group.There was no statistically significant difference between the two groups (χ2 =1.25,P=0.535).After treatment,Ca2+in the two groups was statistically significantly increased compared with before treatment(t=4.841,P=0.00;t=8.600,P=0.00),and Ca2+in the HDF group was higher than that in the HD group (t=4.410,P=0.00).After treatment,P3+in the two groups was significantly decreased compared with before treatment(t=14.580,P=0.00;t=19.260,P=0.00),and P3+in the HDF group was lower than that in the HD group(t=6.500,P=0.00).After treatment,iPTH in the two groups was significantly decreased compared with before treatment(t=58.800,P=0.00;t=65.730,P=0.00),and iPTH in the HDF group was significantly lower than that in the HD group (t=8.380,P=0.00).After treatment,the 1,25(OH)2D levels in the two groups were significantly higher than those before treatment (t=18.970,P=0.00;t=21.650,P=0.00),and 1,25(OH)2D level in HDF group was significantly higher than HD group (t=3.250,P=0.001).Conclusion Compared with maintenance hemodialysis , maintenance hemodialysis filtration has more positive effect on calcium and phosphorus metabolism in uremic patients ,and it has significant effect on lowering blood phosphorus and increasing serum calcium level,so it is more suitable for clinical use .

Research progress of nocturnal hemodialysis / 第二军医大学学报

Hemodialysis is one of the main treatment methods for patients with end stage renal disease (ESRD), and conventional hemodialysis (CHD) is the most widely used one. With the development of dialysis technology, the survival time of hemodialysis patients is significantly prolonged, but the mortality remains high. Nocturnal hemodialysis (NHD) was proposed in 1963 as a new type of dialysis, and it has greatly extended time of dialysis as compared with CHD. NHD has advantages in controlling blood pressure and cardiovascular function, correcting anemia, improving calcium and phosphorus metabolism and nutritional status, and enhancing quality of life of hemodialysis patients.

Research on the relationship of serum sclerostin level and bone density in maintenance hemodialysis patients / 中国综合临床

Objective To investigate whether serum sclerostin level is an indicator of the prognosis in patients with maintenance hemodialysis(MHD).Methods The clinical data of MHD patients treated in Yan′an University Affiliated Hospital in recent 3 years were collected to record their basic information and routine blood biochemical indexes.Serum Sclerostin levels were measured by ELISA calcaneus,while bone mineral density(BMD)was measured by quantitative ultrasound(QUS);correlation analysis was applied to screen the indicators affecting BMD.Logiest regression was used to look for protective factors and risk factors of low bone density;The correlation between serum sclerostin level and bone mineral density was analyzed,and ROC curve was used to explore whether serum sclerostin level could be used to predict low level bone mineral density.Results The median serum sclerostin concentration of 62 patients was 166.74(105.87,311.90)pmol/L.Spearman correlation analysis showed that serum sclerostin levels were positively correlated with BMI,serum calcium and 25(OH)VitD levels(r= 0.327,0.323,0.257,P= 0.010,0.049,0.044),while negatively correlated with lg[iPTH],spKt/v,triglyceride(TG),low density lipoprotein cholesterol(LDL-C)(r=-0.254,-0.279,-0.186,-0.314,P=0.046,0.012,0.027,0.031).Serum Sclerostin level was not related with serum phosphorus,alkaline phosphatase(AKP),high density lipoprotein cholesterol(HDL-C)and LDL(P>0.05) .Correlation analysis showed serum sclerostin levels were significantly and positively correlated with BMD(r=0.328,P=0.009).Logistic regression showed that serum sclerostin level was a risk factor for BMD(OR=1.17,95%CI(0.928~1.474);P=0.008).The ROC curve was established,and the area under the curve of serum sclerostin diagnosis was 87.9%.Conclusion Serum sclerostin levels are positively correlated with bone mineral density.And serum sclerostin levels may become a marker to predict the prognosis in MHD patients.

Research progress of nocturnal hemodialysis / 第二军医大学学报

Hemodialysis is one of the main treatment methods for patients with end stage renal disease (ESRD),and conventional hemodialysis (CHD) is the most widely used one.With the development of dialysis technology,the survival time of hemodialysis patients is significantly prolonged,but the mortality remains high.Nocturnal hemodialysis (NHD) was proposed in 1963 as a new type of dialysis,and it has greatly extended time of dialysis as compared with CHD.NHD has advantages in controlling blood pressure and cardiovascular function,correcting anemia,improving calcium and phosphorus metabolism and nutritional status,and enhancing quality of life of hemodialysis patients.

Effects of Lanthanum Carbonate on Calcium and Phosphorus Metabolism in Maintenance Hemodialysis Patients with High Calcium and High Phosphorus / 中国药房

OBJECTIVE:To investigate the effects of lanthanum carbonate on calcium and phosphate metabolism in maintenance hemodialysis(MHD)patients with high calcium and high phosphorus. METHODS:A total of 40 MHD patients with high calcium and high phosphorus in our hospital during May 2014-May 2015 were divided into control group(22 cases)and observation group (18 cases)according to therapy plan. Both groups received diet guidance and MHD treatment. Control group was given Hydrotalcite chewable tablets 1 g,during meal,tid. Observation group was additionally given Lanthanum carbonate chewable tablets 500 mg(for patients with blood phosphorus ≥2.26 mmol/L)or 250 mg(for patients with blood phosphorus <2.26 mmol/L),during meal,tid (adjusting after 4 weeks).Both groups received treatment for 3 months.The calcium and phosphorus metabolism indexes[blood calci-um,blood phosphorus,calcium and phosphorus product,immunoreactive parathyroid hormone(iPTH)and alkaline phosphatase] and phosphorus reducing efficacies were observed in 2 groups before and after treatment,and the occurrence of ADR was recorded. RE-SULTS:Before treatment,there was no statistical significance in calcium and phosphorus metabolism indexes between 2 groups(P>0.05).After treatment,there was no statistical significance in calcium and phosphorus metabolism indexes of control group,iPTH or alkaline phosphatase of observation group compared to before treatment(P>0.05);blood calcium,blood phosphorus,calcium and phosphorus product of observation group were significantly lower than before treatment and also lower than control group at corre-sponding time,with statistical significance(P<0.05).Total response rate of phosphorus reducing in observation group(88.89%)was significantly higher than control group(40.91%),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between observation group(11.11%)and control group(4.55%)(P>0.05). CONCLUSIONS:The lanthanum carbonate can effectively decrease blood calcium and blood phosphorus levels in MHD patients with good safety.

Research progress in metabolic bone disease of prematurity / 临床儿科杂志

Metabolic bone disease of prematurity (MBDP) is an important chronic disease in the neonates. The metabolic abnormalities of calcium, phosphorus, vitamin D and others in premature can lead to decline of bone mineral content, decrease of trabecular bone quantity, thinning of cortical bone, etc., which can cause rickets in severe cases and even fracture. Low gestational age and low birth weight of premature are important risk factors for metabolic bone disease. The diagnosis relies on clinical features as well as laboratory, radiological and ultrasonographic examinations. The treatment includes reinforcement of the passive movement, supplementiation of the calcium, phosphorus and vitamin D, better prevention and so on. Early detection, early diagnosis, and early treatment can reduce the incidence of sequelae of metabolic bone disease, and reduce the long-term impact on premature infants.

Effects of Lanthanum Carbonate on Calcium and Phosphorus Metabolism in Maintenance Hemodialysis Patients with High Calcium and High Phosphorus / 中国药房

OBJECTIVE:To investigate the effects of lanthanum carbonate on calcium and phosphate metabolism in maintenance hemodialysis(MHD)patients with high calcium and high phosphorus. METHODS:A total of 40 MHD patients with high calcium and high phosphorus in our hospital during May 2014-May 2015 were divided into control group(22 cases)and observation group (18 cases)according to therapy plan. Both groups received diet guidance and MHD treatment. Control group was given Hydrotalcite chewable tablets 1 g,during meal,tid. Observation group was additionally given Lanthanum carbonate chewable tablets 500 mg(for patients with blood phosphorus ≥2.26 mmol/L)or 250 mg(for patients with blood phosphorus <2.26 mmol/L),during meal,tid (adjusting after 4 weeks).Both groups received treatment for 3 months.The calcium and phosphorus metabolism indexes[blood calci-um,blood phosphorus,calcium and phosphorus product,immunoreactive parathyroid hormone(iPTH)and alkaline phosphatase] and phosphorus reducing efficacies were observed in 2 groups before and after treatment,and the occurrence of ADR was recorded. RE-SULTS:Before treatment,there was no statistical significance in calcium and phosphorus metabolism indexes between 2 groups(P>0.05).After treatment,there was no statistical significance in calcium and phosphorus metabolism indexes of control group,iPTH or alkaline phosphatase of observation group compared to before treatment(P>0.05);blood calcium,blood phosphorus,calcium and phosphorus product of observation group were significantly lower than before treatment and also lower than control group at corre-sponding time,with statistical significance(P<0.05).Total response rate of phosphorus reducing in observation group(88.89%)was significantly higher than control group(40.91%),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between observation group(11.11%)and control group(4.55%)(P>0.05). CONCLUSIONS:The lanthanum carbonate can effectively decrease blood calcium and blood phosphorus levels in MHD patients with good safety.