Objective To investigate mineral bone metabolic conditions of pre-dialysis patients with chronic kidney disease (CKD),and obtain useful information about the management and treatment of CKD.Methods The levels of serum calcium,phosphate,25-HydroxyvitaminD [25 (OH) VitD],and intact parathyroid hormone (iPTH) were compared.Then a correlation analysis was performed for 25 (OH)VitD.Results Hypocalcemia,hyperphosphatemia,secondary hyperparathyroidism and inadequate of 25 (OH) VitD appeared early in CKD2.Deficiency of 25 (OH)VitD was widespread in CKD2 ～ 5.Multiple linear regression analysis showed that 25 (OH) VitD was independently associated with adjusted level of calcium (P =0.002),application of calcium carbonate (P =0.038),and application of calcitriol (P =0.049) (R square =0.360,P =0.000).Conclusions Mineral bone disorder emerges early in CKD2.More attention should be paid to the management of 25 (OH)VitD.

Objective To study the effect of long session hemodialysis (LSHD) on the quality of life in maintenance hemodialysis (MHD) patients.Methods A total of 40 MHD patients in our dialysis center were enrolled in the study.Quality of life was investigated by SF-36 table.Sleep questionnaire survey concluded the Athens insomnia scale (AIS),Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS).Clinical data were collected.Forty MHD patients were equally divided into HD and LSHD groups according to clinical data and sleep quality score for prospective study.Hemodialysis dose of HD group was 4 h thrice weekly,and of LSHD group was 8 h thrice weekly.The trial lasted for 6 months.Changes of life quality were compared between two groups.Results As compared to HD group,LSHD group had significant higher Kt/V (1.73±0.36 vs 1.41±0.23,P＜0.05),higher levels of serum hemoglobin [(124.67±9.08) vs (110.55±9.01) g/L,P＜0.01] and albumin [(45.01±2.66) vs (39.28±2.63) g/L,P＜0.01].better sleep quality score (16/20 vs 5/20,P=0.001) and higher blood pressure control proportion (14/20 vs 5/20,P=0.010),higher score of SF-36 (P＜0.05).Conclusion LSHD can improve the life quality of MHD patients by increasing sleep quality and nutrition level.

Secondary hyperparathyroidism (SHPT) is the common complication in chronic kidney disease patients,especially in those with hemodialysis,which is associated with cardiovascular events and mortality.Active vitamin D and its analogues are classic treatment for SHPT,but some patients are resistant to active vitamin D,and ablation would be a choice for such cases.The purpose of this review is to provide current progress in ablation for SHPT.

Objective: To establish a mouse model of osteoarthritis (OA) and study the bone microarchitecture and bone metabolism of tibial subchondral bone in early stage of OA. Methods: The mouse model of post-traumatic osteoarthritis (PTOA) with anterior cruciate ligament (ACLT) was established by using c57 mice. The Sham operation group served as the control group. All mice were fed with conventional diet. All mice were sacrificed after 4 weeks. The degeneration of knee joint was observed by HE staining and Safranin O-Fast Green staining. The number of osteoclasts was counted by TRAP staining. Micro CT was used to analyze the quantitative parameters of the microstructure of tibia subchondral bone in mice. Serum levels of bone resorption biomarker CTX I and cartilage degeneration marker CTX II were determined. Results: After ACLT 4 weeks, the average score of OARSI in ACLT group was 3.2, which was higher than that in Sham group, and the joint degeneration occurred in mice, presenting the pathological characteristics of early OA. Compared with the sham operation phase, the total subchondral bone volume (TV) of ACLT group was 4.72 mm³, increased by 13.6%; the bone trabecular resolution (Tb.Sp) was 0.130 and 0.154 mm, respectively, and the ACLT group also increased by 18.8%; the bone volume/tissue volume (BV/TV) was 0.470 and 0.294, respectively, and the ACLT group decreased by 48.9%; the bone trabecular thickness (Tb.Th) was 0.162 and 0.083 mm groups, ACLT decreased by 37.5%. Trap staining showed that the number of osteoclasts per unit volume in ACLT group was 72, which was significantly higher than that in sham operation group. The CTX I of mice in the sham operated ACLT group and sham operated group were 20.9 ng/ml and 18.29 ng/ml, with an increase of 48.9% in the ACLT group; the CTX II of mice in the ACLT group and sham operated group were 35.5 ng/ml and 28.6 ng/ml, with an increase of 24.1% in the ACLT group. Conclusion ACLT Mouse model can successfully construct early OA, which confirms the early loss of osteochondral bone and the pathological changes of osteoclast activation in OA, and provides a new specific target for the treatment of OA.

Background Zinc is a trace element essential for normal fetal heart development, and excess zinc can be toxic. The relationship between maternal and fetal zinc levels and the development of congenital heart disease (CHD) in the offspring is unclear. Objective To study the effects of maternal and neonatal zinc exposure levels on the risk of developing CHD in the offspring. Methods The data and biological samples of the study subjects were derived from the birth cohort established by Gansu Provincial Maternity and Child Care Hospital in Lanzhou from 2010 to 2012. Questionnaire surveys were conducted at baseline in the first trimester and at follow-up visits in the second trimester, the third trimester, and 42 d after delivery. Maternal venous blood during the third trimester and neonatal umbilical venous blood at delivery were collected, and information on their birth outcomes was extracted from medical records. Ninety-seven children with CHD diagnosed by echocardiography at birth and confirmed at the follow-up after 42 d were selected as the case group, and 194 healthy full-term infants were selected as the control group, 1∶2 matched for maternal age and geographical location from the database. The zinc concentrations in whole blood of pregnant mothers and umbilical cord blood of fetuses in both groups were measured by inductively coupled plasma mass spectrometry. According to the quartiles P₂₅ and P₇₅ of zinc levels in the whole blood of pregnant mothers and neonatal cord blood in the control group, zinc exposure was divided into three groups: low, medium, and high. After adjusting for maternal vaginal bleeding in early pregnancy, pre-pregnancy folic acid and vitamin supplementation, birth weight, and umbilical cerclage confounders, a multiple conditional logistic regression model was applied to analyze the associations between maternal whole blood and fetal umbilical cord blood zinc levels and the risk of CHD in the offspring, and a further subgroup analysis was performed by disease classification. Results The medians (P₂₅, P₇₅) of maternal whole blood zinc levels in the case group and the control group were 5.034 (3.456, 6.644) and 4.693 (3.411, 5.646) mg·L⁻¹, respectively, with significant differences between the two groups (P=0.029). The medians (P_25, P₇₅) of neonatal cord blood zinc level was 2.153 (1.479, 2.405) mg·L⁻¹ in the case group and 1.636 (1.304, 1.979) mg·L⁻¹ in the control group, with significant differences between the two groups (P<0.001). The zinc levels of maternal whole blood and neonatal cord blood in the simple CHD group were significantly higher than those in the control group (P<0.05). The multiple conditional logistic regression model showed that compared with the maternal medium zinc exposure level group (3.41-5.65 mg·L⁻¹), the risk of offspring CHD was 2.225 times of the high exposure level group (>5.65 mg·L⁻¹) (OR=2.225, 95%CI: 1.017-4.868). Compared with the neonatal medium zinc exposure level group (1.30-1.98 mg·L⁻¹), the neonatal high exposure level group (>1.98 mg·L⁻¹) also had an increased risk of CHD (OR=4.132, 95%CI: 1.801-9.480). The subgroup analysis results showed that compared with corresponding medium exposure level groups, the risk of simple CHD in the offspring of the maternal high zinc exposure level group was increased (OR=4.081, 95%CI: 1.427-11.669), and the risks of simple CHD (OR=7.122, 95%CI: 2.126-23.854) and complex CHD (OR=5.165, 95%CI: 1.859-14.346) of neonates of the neonatal high zinc exposure level group were increased. Conclusion Under the exposure levels of the study population, high concentrations of zinc exposure in pregnant mothers and neonates may be associated with the incidence of CHD.