Objective To evaluate the quality of life (QOL) in continuous ambulatory peritoneal dialysis (CAPD) patients and analyze the non-medical factors influencing QOL in order to explore the possible way to improve QOL in peritoneal dialysis (PD) patients.Methods Seventy-nine chronic renal failure patients treated with PD included in the present study.Investigated their age,sex,working status,education,medical burden and family support.Patients' QOL was evaluated by international questionnaire-KDQOL/SF-36.Patients' anxiety/depmssion status was evaluated by Hamilton depression questionnaire.Results (1)The SF-36 with its eight scales of CAPD patients were markedly lower than ordinary people (P＜0.05 or＜0.01).(2) Comparing with those on work,the patients without work got lower SF-36 scores[(45.78±16.93) seores vs (32.65±12.26) scores,P＜0.05].Comparing with those who had medical care,the patients without medical care got much lower SF-36 scores [(49.62±13.20) scores vs (33.85±6.24) scores,P＜0.05].Patients with higher income had better QOL.(3) Patients cared by their children and companion had the higheat SF-36 [(68.33±14.73) scores],while those cared by nursemaid or themselves had the lowest [(27.98±15.77) scores].(4) Among the 79 patients,43 patients (54.4%) were anxiety and 12 patients (15.2%) were depression.QOL was negatively correlated with anxiety index and depression index.Conclusion The QOL of CAPD patients are remarkably low,which is deeply influenced by many non-medical factors such as working status,medical burden,family support and emotional status.

Objective To investigate the interrelationship among urinary albumin elimination rate(UAER),serum adiponectin(ADPN)and blood glucose level in patients with type 2 diabetic nephropathy(DN). Methods A total of 89 type 2 diabetic patients and 30 healthy people as control were enrolled in the study.According to UAER,the diabetic patients were divided into three groups:normal group(35 cases,UAER＜30 mg/24 h),microalbuminura group (32 cases,UAER 30-300 mg/24 h)and macroalbuminura group(22 cases,UAER＞300 mg/24 h).Serum adiponectin was measured by ELISA.Body mass index (BMI),waist hip radio(WHR),fasting plasma glucose(FPG),2-hour plasma glucose(2hPG),glycated haemoglobin(HbAlc),blood lipid and UAER were measured routinely.Data were compared among groups. Results Serum adiponectin level was lower in diabetic patients than that in healthy control group(P＜0.05).Among diabetic patients.serum adiponectin of macroalbuminura group was significantly higher than that of normal and microalbuminura groups[(67.74±14.89)vs(39.36±13.92),(54.38±10.14)ng/L,P＜0.051.Multiple regression analysis showed 2hPG,HbAlc,BMI,disease course,UAER and DBP were closely associated with the level of serum adiponectin. Correlation analysis indicated serum adiponectin was positively correlated with age (r=0.255), disease course (r=0.405), HDL (r=0.501)and UAER (r=0.843); while negatively with HbAlc (r=-0.479), FPG (r=-0.436), 2hPG(r=-0.418),BMI (r=-0.479) and WHR (r= -0.531), all P＜0.01. Conclusions Serum adiponectin is positively correlated with UAER and negatively correlated with FPG. Blood glucose level is one of the main factors affecting serum adiponectin. Strict controlling of blood glucose level is beneficial to higher level of ADPN.

Objective To compare the clinical conditions between the diabetics and non-diabetics at their initiation of peritoneal dialysis.Methods Sixty-seven patients aged over 50 years (27 type 2 diabetic and 40 non-diabetic patients) were included in the study.Patients’ residual renal function,nutritional status,comorbidities and physical activity were evaluated.Results Compared with nondiabetic patients,the serum creatinine,albumin and prealbumin levels,hand grip and physical activity were significantly lower and the nutritional status were significantly worse in diabetic patients,whereas the residual renal function and indices of comorbidity were significantly higher in diabetic patients as compared to nondiabetics.Conclusions The time choice for dialysis is combiningly determined by residual renal function,clinical status,comordity and nutritional status.And CAPP should be in time.

Objective To explore the predicting value of plasma asymmetric dimethylarginine (ADMA) in cardiac structure and function of patients with chronic kidney diseases (CKD).Methods A total of 100 CKD patients were enrolled in this cross-sectional study.According to staging of the K-DOQI guideline,CKD patients were divided into five groups.Twenty healthy people were enrolled as control.Plasma level of ADMA was determined by reversed-phase high performance liquid chromatography.Cardiac structure and function were detected by color echocardiography.Results Plasma levels (μmol/L) of ADMA in CKD stage 3 to 5 patients (1.3318±0.4684,1.5712±0.4210,2.1093±0.7714) were significantly higher than those in CKD stage 1,2 patients (0.4387±0.2575,0.4809±0.2846) and healthy control (0.4611±0.1615) (all P＜ 0.01).Meanwhile,ADMA level of CKD stage 5 was significantly higher as compared to CKD stage 3-4.The left ventricular mass index (LVMI) was significantly higher in stage 4-5 patients than that in stage 1-3 and healthy control.Plasma ADMA was positively correlated with LVMI (r=0.476,P=0.028) and negatively correlated with left ventricular ejection fraction (EF) (r=-0.327,P=0.041).Multivariate stepwise Logistic regression analysis revealed plasma ADMA level was an independent predictors for EF (OR=0.984,P＜0.01).Conclusions Plasma level of ADMA begins to increase in CKD patients of stage 3 and rises proportionally to the decline of renal function.Plasma ADMA level is useful in predicting the cardiovascular complications of CKD patients.

Researches have demonstrated that gradually increased morbidity and mortality of cardiovascular disease may be related to vitamin D deficiency.But there are few randomized controlled studies about preventing cardiovas-cular events via vitamin D supplementation.This article summarizes investigate progress for related matter recently.

Objective To study the correlation of serum hepcidin with residual renal function and micro-inflammation state in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods Thirty-four stable CADP patients were involved in this study as observers (CAPD group),who had accepted CAPD treatment more than three months; twenty non-dialysis patients with stage 5 of chronic kidney disease were selected as control group.According to the level of high sensitivity Creactive protein (hs-CRP),CAPD patients were divided into two subgroups.There were 14 patients in the hsCRP elevated group (hs-CRP ＞ 3.00 mg/L) and 20 patients in the hs-CRP normal group.In addition,there had been 14 patients with residual renal function in CAPD group.Serum hepcidin was measured by ELISA.Serum Ferritin (FER),hs-CRP,routine blood and biochemistry were measured by routine methods.Calculated estimated glomerular filtration rate (eGFR).Pearson correlation and linear regression were used to assess the correlation of serum hepcidin with other laboratory parameters in CAPD patients.Results (1) Serum hepcidin was significantly higher in CAPD patients than control group,but eGFR was significantly lower (P ＜ 0.01).(2) Serum hepcidin levels of no residual renal function patients increased more significantly in CAPD group (P ＜ 0.05).(3) Serum hepcidin levels were higher in hs-CRP elevated group than hs-CRP normal group (P ＜ 0.05).(4) Pearson correlation analyses revealed that serum hepcidin was positively correlated with hs-CRP (r=0.501) and FER (r=0.847,all P ＜ 0.01),and was negatively correlated with Hb (r=-0.919),TRF (r=-0.751),TIBC (r=-0.532,all P ＜ 0.05).(5) Multiple linear regression analysis showed that ferritin and hs-CRP were closely associated with serum hepcidin level in CAPD.Conclusions Serum hepcidin level markedly elevate in CAPD patients,especially in the patients with no residual renal function and micro inflammatory state increased more significantly.

Patients receiving long-term anticoagulation therapy of vitamin K antagonist (VKA)may face risk of bleeding when receive surgery or invasive operation,and perioperative interruption of VKA may increase risk of thromboembolism.Bridging anticoagulation therapy with therapeutic dose of heparin group drugs may avoid throm-boembolic events induced by temporary interruption of VKA therapy during perioperative period.This article made a relative discussion.

Objective To study the effect of cell wall polysaccharide (CWP) of Thallus Laminariae (TL) on thrombosis and blood coagulation.Methods Thrombosis was induced by arteriovenous shunt,ligation of inferior vena cava and electric stimulation of common carotid artery,after intraperitoneal injection of CWP or nomal saline for 3 days.The weight of thrombus and the occlusion time were examined in the normal saline group and high-dose (100 mg/kg) and low-dose (20 mg/kg) groups of CWP of TL.Blood coagulation time (CT),plasma prothrombin time (PT) and partial thromboplastin time (APTT) were measured to observe the effect of CWP on blood coagulation.Results Compared with the control group,both high-dose CWP of TL and low-dose CWP can obviously decrease the weight of thrombus and prolong the occlusion time,CT and APTT.High-dose CWP could also prolong PT obviously,the differences being significant.Low-dosa CWP also prolong PT,but the difference was not significant statistically.Conclusion CWP of TL can inhibit the thrombus formation and blood coagulation in rats.

Objective To investigate the protective effect of erythropoietin (EPO)on the kidney of renal anemia rats and further explore the renoprotective action and possible mechanisms.Methods A total of 90 SD rats were randomly divided into 5 groups:normal control rats (NC),simple anemia group (SA),iron + EPO group (IR+EPO),erythropoietin group (EPO),and iron group (IR)with 18 in each.The rats were sacrificed after 4 weeks’ treatment with intragastrically-injected adenine.Serum creatinine (Scr),blood urea nitrogen (Bun),hemoglobin (Hb),hematocrit (Hct),and hepcidin were measured with automated hematology analyzer.The expressions of bone morphogenetic protein-6 (BMP-6 ),a serine/threonine kinase receptor-1 (SMAD-1 )and serine/threonine kinase receptor-4 (SMAD-4)in the kidney were detected by immunohistochemistry and Western blot.Results ①The results of general indicators:BUN and Scr in IR + EPO group and EPO group were lower than those in SA group (P <0.01).Hb and Hct in IR + EPO group and EPO group were increased significantly compared with those in SA group (P <0.01).Hepcidin was significantly increased in simple anemia group (P <0.01).② ELISA results showed that Hepcidin was lower in IR + EPO group and EPO group than in SA group (P <0.01).③ The results of pathological observation indicated that EPO could reduce rat renal pathology and function.④ Immunohistochemistry revealed that SMAD-4,SMAD-1 and BMP-6 were expressed in the rat glomerular cells and renal tubular epithelial cells.⑤ Western blot further indicated that the expression of SMAD-4 was significantly decreased in IR + EPO group and EPO group (P < 0.01 ).The expression of SMAD-1 in IR+EPO group and EPO group was decreased (P <0.05)while that of BMP-6 was elevated in IR+EPO group and EPO group (P <0.01 ).Conclusion The expression and secretion of hepcidin were inhibited by EPO via the BMP/SMAD pathway,which further corrects anemia and exerts a renal protective effect.

Objective To evaluate the hair-removal effect of intense pulsed light (IPL) on hirsutism of spina bifida occulta. Methods 8 patients with hirsutism of spina bifida occulta were treated 3 to 5 times, at 2 month intervals, with ELITE plus IPL. Its wavelength was 610~1000 nm, and spot size was 50 mm ? 10 mm. The macro pulse was composed of a series of micro pulses with equal intervals. The micro pulse duration was 5 ms, the number of micro pulse was 4-15, the interval of micro pulse (delay) was 2~20 ms, and the fluence was 22.3～38.3J/cm2. Results All of the patients were well tolerant under no anesthesia. The hairs were mostly or fully removed after 3 to 5 courses of treatment. Routine washing could be done and bandaging was not applied after treatment. There was no blister, infection, hyperpigmentation and scarring. Little vellus hair regrowth was observed after a 6~12 month follow-up. Conclusions IPL is an ideal method to depilate hirsutism of spina bifida occulta because of its credible effect, simple operation, rapid treatment and no serious complication.