Objective To investigate the clinical characterastics of uremia pruritus and the value of treatment by bacillus coagulans. Methods The clinical data of 312 patients with maintenance hemodialysis were collected. The incidence rate, clinical manifestation and correlation factors of uremia pruritus were analyzed. Then, 40 refractory pruritus patients were divides into 2 groups by random digits table, with 20 patients in each group. The patients in experiment group were treated by bacillus coagulans, and the patients in control group were given vitamin E. The relieve of pruritus in two groups was compared. Results In 312 patients, 158 patients didn′t have pruritus, 56 patients had mild pruritus, 68 patients had moderate pruritus , and 30 patients had severe pruritus. The levels of urea nitrogen, creatinine, calcium, ferroprotein in different degree of pruritus patients had no significant differences (P>0.05), but the levels of phosphorus, calcium-phosphorus product, immunoreactive parathyroid hormone (iPTH), C reactive protein (CRP), interleukin (IL)-1 and IL-6 increased with the severity of pruritus (P<0.05). Logistic regression analysis showed that the levels of CRP, IL-6, iPTH were risk factors for pruritus (P<0.01 or <0.05). The VAS scores of moderate and severe pruritus patients in experiment group after treatment were significantly decreased compared with that before treatment (P<0.05). The levels of CRP, IL-1 and IL-6 before and after treatment in control group had no significant differences (P>0.05). The levels of CRP, IL-1 and IL-6 after treatment in experiment group significantly decreased (P<0.05). The rate of pruritus was very high , and there was markedly positive correlation between pruritus and serium inorganic phosphorus、iPTH and CRP. Bacillus coagulans can alleviate pruritus. Conclusions On the basis of maintenance hemodialysis, bacillus coagulans can regulate the intestinal flora, alleviate inflammatory reaction, and help to release the symptom of pruritus.

Objective:To investigate the impact of obstructive sleep apnea(OSA)on cardiac structure and function in elderly patients with type 2 diabetes mellitus(T2DM).Methods:This was a case-control study.Elderly patients with T2DM aged 65 years and above at the Department of Geriatrics of Tianjin Medical University General Hospital were consecutively enrolled in this study, and eventually 61 patients with complete general information were included.All patients were examined with polysomnography(PSG). They were divided into the T2DM group and the T2DM+ OSA group based on whether there was concurrent OSA.Differences in cardiac structure and function were compared between the two groups and between patients with mild OSA and those with moderate-severe OSA.The correlation of OSA with cardiac structure and function in T2DM patients was analyzed by using Pearson correlation and multiple linear regression analysis.Results:The left ventricular ejection fraction(LVEF)was lower in the T2DM+ OSA group than in the T2DM group(52.38±4.70 % vs.56.34±5.92%, t=2.892, P=0.005). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness increased in the T2DM+ OSA group compared with the T2DM group(21.50±1.49 mm vs.20.55±1.05 mm, 10.21±0.88 mm vs.9.52±1.04 mm, 10.42±0.83 mm vs.9.83±0.83 mm, t=-2.670, -2.770 and -2.716, P=0.010, 0.007 and 0.009). LVEF was lower in patients with moderate-severe OSA than in those with mild OSA group(50.58±3.55% vs.55.83±4.83%, t=3.813, P=0.001). The anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness were greater in patients with moderate-severe OSA than in those with mild OSA(21.86±1.39 mm vs.20.79±1.46 mm, 10.48±0.82 mm vs.9.69±0.75 mm, 10.68±0.80 mm vs.9.92±0.64 mm, t=-2.231, -2.871 and -2.943, P=0.032, 0.007 and 0.006). Pearson correlation analysis showed that the Apnea Hypopnea Index(AHI)was correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( r=-0.425, 0.340, 0.458 and 0.473, P=0.001, 0.007, <0.001 and <0.001). After adjusting for age, body mass index, systolic blood pressure and triglycerides, multiple linear regression analysis showed that AHI was also correlated with LVEF, the anteroposterior diameter of the right ventricle, inter-ventricular septum thickness and left ventricular posterior wall thickness( β=-0.385, 0.520, 0.604 and 0.388, P=0.036, 0.011, 0.001 and 0.039). Conclusions:OSA aggravates cardiac remodeling and systolic insufficiency in T2DM patients and may be related to the severity of intermittent hypoxia.

OBJECTIVE: To evaluate the diagnostic value of vibration perception threshold (VPT) in diabetic peripheral neuropathy (DPN) by the receiver operating characteristic curve (ROC) and to establish its cut-off threshold. METHODS: All patients had the VPT examination and nerve conduction velocity (NCV) examination. NCV examination showed that 283 patients with Type 2 diabetes were divided into a DPN group (n=151) and an NDPN group (n=132). The VPT diagnosis was evaluated by Youden index, sensitivity, specificity and the area under ROC curve. The best cut-off threshold was defined by the Youden index. RESULTS: 1) The NCV was significantly slower, while the VPT was higher in the DPN group than those in the NDPN group (both P values <0.05). 2) The VPT and NCV of both sides of the limb had no difference in all patients. 3) With NCV as the golden diagnosis criterion, the area under ROC of VPT was 0.707, the best cut-off threshold was 10.54 V, the sensitivity was 0.596, the specificity was 0.848, and the Youden index was 0.445. 4) The diagnosis ratio of NCV combined with VPT was 60.4%, significantly higher than that of NCV alone (P<0.05). CONCLUSION Compared with NCV examination, VPT has good diagnostic value for DPN. The best cut-off value is 10.54 V.
Adult ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Neuropathies ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Neural Conduction ; physiology ; Perception ; Peripheral Nervous System Diseases ; diagnosis ; ROC Curve ; Sensory Thresholds ; physiology ; Vibration

Primary sarcopenia is age-related and can lead to falls, osteoporosis, fractures, malnutrition, frailty, sarcopenic obesity, and even loss of independent living silks in patients, which all increase the risk of hospitalization and the cost of healthcare.Early diagnosis of sarcopenia is an effective means to prevent these adverse events.This paper reviewed relevant studies conducted in China and other countries on imaging techniques for the diagnosis of sarcopenia, and examines the advantages and disadvantages of different techniques, in order to sort out well-grounded principles for clinical practice and future improvement in the management of sarcopenia.

Objective:To explore the application of collaborative nursing combined with medical integration model in minimally invasive surgery for pediatric urinary calculi, to provide clinical guidance for minimally invasive surgical nursing of urinary calculi in children.Methods:From December 2020 to July 2022, 90 children who underwent minimally invasive surgery for urinary calculi in Children′s Hospital Affiliated to Zhejiang University Medicine College were selected as subjects by quasi experiment. According to the time sequence of enrollment, they were divided into observation group ( n = 45) and control group ( n = 45). The control group was given routine nursing mode nursing, and the observation group was given collaborative nursing combined with medical integration mode nursing. The clinical related indicators, pain, anxiety and complications were compared between the two groups. Results:In the observation group, the operation time, the amount of bleeding during operation, the first time to get out of bed after operation, the rate of stone removal immediately after operation and the rate of stone removal 1 month after operation were (75.48 ± 5.92) min, (168.75 ± 17.28) ml, (6.12 ± 1.05) h, 84.44%(38/45) and 97.77%(44/45), respectively. The control group was (78.39 ± 6.75) min, (178.30 ± 19.25) ml, (6.84 ± 1.23) h, 64.44 % (29/45) and 82.22 %(37/45), respectively, the differences were statistically significant ( t/ χ2 = 2.17, 2.48, 2.99, 4.73, 6.05, all P<0.05). The Face, legges, Activity, Cry, Consolability Behavioral Tool scores of the observation group at 1 d, 3 d and 7 d after operation were 6.28 ± 1.21, 5.35 ± 1.37 and 2.87 ± 0.65, respectively, and those of the control group were 7.05 ± 1.55, 5.95 ± 1.25 and 3.21 ± 0.73, respectively, the differences were statistically significant ( t = 2.63, 2.17, 2.33, all P<0.05). The Modified Yale Preoperative Anxiety Scale and Frankl Compliance Scale Scores in the observation group at the day before discharge hospital were 55.28 ± 5.52, 3.60 ± 0.40, while in the control group were 60.02 ± 8.56, 2.82 ± 0.61, the differeces were significat ( t = 3.12, 3.02, both P<0.05). The incidence of complications was 2.22 %(1/45) in the observation group and 15.56 %(7/45) in the control group, the difference was significant ( χ2 = 4.94, P<0.05). Conclusions:The application of collaborative nursing combined with medical care integration model in minimally invasive surgery of urinary calculi in children has a significant effect.

OBJECTIVETo assess the association of three polymorphisms (14-bpINS/DEL, +3035C/T and +3142C/G) in the 3' untranslated region (3'UTR) of HLA-G gene and systemic lupus erythematosus (SLE) in Yunnan.

METHODSA case-control study has been carried out on 206 SLE patients and 212 healthy controls. Genotypes of 14-bpINS/DEL (rs1704), +3035C/T (rs17179108) and +3142C/G (rs1063320) loci of 3'UTR of the HLA-G gene were determined with DNA sequencing.

RESULTSAllelic and genotypic frequencies of 14-bpINS/DEL and +3142C/G did not differ significantly between the two groups (P > 0.05). The frequencies of +3035T allele was significantly higher in the SLE group compared with the control group (P < 0.01, OR=1.604, 95% CI: 1.186-2.169). With a dominant inheritance model, the odd ratio of dominant genotype (CT+TT) was 2.004 (95% CI: 1.345-2.987, P=0.0006) in the SLE group.

CONCLUSIONThe 14-bpINS/DEL and +3142C/G polymorphisms in the 3'UTR of the HLA-G gene are not associated with susceptibility to SLE in Yunnan, whilst the T allele of +3035C/T may be a risk factor for SLE.

3' Untranslated Regions ; genetics ; Case-Control Studies ; China ; Female ; Genetic Predisposition to Disease ; HLA-G Antigens ; genetics ; Humans ; Lupus Erythematosus, Systemic ; genetics ; Male ; Polymorphism, Genetic

Objective:To evaluate the feasibility and applicability of using phospholipid-hybridization method for preparing biomimetic microbubbles (Bio-MBs) ultrasound contrast agents.Methods:Leukocyte biomimetic microbubbles (MB leu), platelet biomimetic microbubbles (MB pla) and erythrocyte biomimetic microbubbles (MB ery) were prepared by multiple steps: film-hydration, phospholipid-hybridization, mechanical oscillation. The size and zeta potential of Bio-MBs were measured by dynamic light scattering. A laser scanning confocal microscopy experiment was performed to confirm the presence of membrane proteins on the shell of Bio-MBs. The fluorescence of FITC-labeled typical membrane protein was evaluated using a flow cytometer. Sodium dodecyl sulfate polyacrylamide gel electrophoresis was used to characterize the membrane protein. Biosafety of Bio-MBs was evaluated by CCK-8 counting kit, blood and major organs. The contrast enhancement effect and stability were observed in vitro and in vivo. An in vivo fluorescence imaging system was performed to evaluate the distribution of Bio-MBs. The application value of biomimetic microbubbles was measured by ultrasound molecular imaging by using ischemia-reperfusion rat models and acute hepatitis rat models. Results:Bio-MBs with spherical shape distributed homogenously, without obvious aggregation. The membrane proteins were successfully integrated into the shell of Bio-MBs.The diameter of three Bio-MBs was similar to that of control microbubbles (MB con) ( P>0.05), three Bio-MBs had a lower zeta potential than MB con ( P<0.05). The Bio-MBs had an appreciable performance in vitro and in vivo biosafety. The Bio-MBs retained the main proteins inherited from cell membrane. Contrast enhanced ultrasound imaging in vitro and in vivo showed that the Bio-MBs had a stable imaging ability.MB leu and MB pla have good targeted imaging effect in two disease models. Conclusions:A series of Bio-MBs ultrasound contrast agents, which have high stability, biosafety and targeted imaging efficiency, were successfully prepared by using phospholipid-hybridization method. This fabrication method for obtaining Bio-MBs can be applied to different clinical scenarios with different cell types in the future.

To investigate the clinical significance of platelet-neutrophil ratio in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis(AAV),a total of 128 patients were recruited and retrospectively analyzed in our department from March 2015 to July 2023.Spearman correlation analysis indicated that there was negative correlation between the level of PNR and Birmingham vasculitis activity score(BVAS)in AAV patients(r=-0.268,P=0.002).According to the PNR optimal cutoff value(26.4)determinated by X-tile bioinformatics software version 3.6.1 for predicting the survival rate,AAV patients were divided into high level PNR(HPNR)group(≥26.4)(n=105)and low level PNR(LPNR)group(<26.4)(n=23).Kaplan-Meier survival analysis showed that the survival rate of HPNR group was significantly higher than that of LPNR group(P<0.001).The level of PNR was correlated with poor prognosis of kidney(OR=2.54,95%CI:1.1-5.88,P=0.029).In conclusion,the level of PNR is closely related to disease activity and prognosis of AAV,and it might be a potential biomarker for predicting the disease activity and predicting the prognosis.

Objective To establish a solvent desorption inductively coupled plasma-mass spectrometry (ICP-MS) method for determination of iodine in workplace air. Methods Iodine in workplace air was collected with alkaline activated carbon tube and desorbed with 10.0 mL pure water or 20 mmol/L sodium bicarbonate solution. Rhenium-185 was used as an internal standard for quantification. The sample was determined in standard mode and kinetic energy discrimination collision (KED) mode by ICP-MS. Results In standard mode, iodine showed a good linear range in the concentration of 9.0 to 1 100.0 μg/L, with a correlation coefficient of 0.999 3 and a detection limit of 2.7 μg/L. In KED mode, iodine showed a good linear range in the concentration of 24.3 to 800.0 μg/L, with a correlation coefficient of 0.999 1 and a detection limit of 7.3 μg/L. The average desorption efficiency using pure water ranged from 99.1% to 106.7%, with within-run relative standard deviation (RSD) of 3.1% to 8.0% and between-run RSD of 4.9% to 9.3%. The average desorption efficiency using sodium bicarbonate solution ranged from 96.5% to 105.3%, with within-run RSD of 4.9% to 8.6% and between-run RSD of 2.5% to 9.9%. There were no statistical significant differences in the main effects of desorption solution, ICP-MS detection mode, their interaction on average desorption efficiency and within-run RSD (all P>0.05). Samples could be stored at room temperature for at least 7 days. Conclusion This method is highly sensitive, accurate, and suitable for the determination of iodine in workplace air. The sample pretreatment is simple and rapid.

Objective To investigate the clinical value of peripheral eosinophil count(PEC)in predicting the outcome of diabetic nephropathy(DN).Methods A retrospective cohort trial was conducted on 220 DN patients identified by renal biopsy in Department of Nephrology of Second Affiliated Hospital from Army Medical University from March 2021 to March 2023.Clinical data,results of routine blood test and renal function were collected.X-tile bioinformatics software version 3.6.1 was used to determine the optimal cut-off value of PEC for predicting survival.Cox proportional hazards model and Kaplan-Meier survival analysis were applied to analyze the prognosis.Results The level of PEC in DN patients was positively correlated with the levels of serum creatinine(Scr)(r=0.245),blood urea nitrogen(BUN)(r=0.237)and blood uric acid(UA)(r=0.252),and negatively with estimated glomerular filtration rate(eGFR)(r=-0.236).According to the optimal PEC cut-off value,DN patients were divided into high-level group(＞0.29×109/L,n=41)and low-level group(≤0.29 × 109/L,n=179).The levels of Scr(P＜0.001),BUN(P=0.001)and UA(P=0.005)were significantly higher,while the eGFR(P＜0.001)was obviously lower in the high-level group than the low-level group.Multivariate Cox regression analysis showed that the high level of PEC was associated with poor prognosis of DN(HR=2.20,95％CI:1.05～4.60,P=0.036).Kaplan-Meier survival analysis demonstrated that the incidence of end-stage renal disease(ESRD)was notably higher in the high-level group than the low-level group(P=0.024).Conclusion PEC level of DN patients is closely associated with the progression and prognosis of DN,and the count is a potential biomarker for predicting the prognosis of DN.