Objective　The aim of this paper was to investigate the changes in cyclic 3'5'-guanosine monophosphate (cGMP) before and after hemodialysis to estimate the value of cGMP to the dry boby-weight. Methods: Plasma cGMP levels (by radioimmunoassay), cardiothoracic ratio (CTR), and the body weight (BW) before and after hemodialysis were determined in chronic hemodialysis patients and clinical signs and symptoms were observed at the same time. Results　① The predialytic cGMP value of the patients was significantly higher than that of healthy controls (P<0.05). ② The postdialytic cGMP level was significantly lower than the predialytic cGMP level (P<0.01). ③ Postdialytic CTR and BW values were significantly lower than predialytic values (P<0.01). ④Compared to those of predialysis, postdialytic clinic signs and symptoms of the patients were significantly relieved. Conclusions　① The plasma cGMP level can sensitively reflect the hydration state and is a reliable marker for dry body-weight estimation.②The measurement of plasma cGMP combined with clinical parameters and radiological indexes permit a more accurate dry body-weight estimation.

BACKGROUND: It has been considered that Cestrum nocturnum L. (CNL) has the effects of antiarrhythmia, local anesthesia and central inhibition.OBJECTIVE: To investigate the analgesic effect of CNL extract on mice,so as to find new drugs for clinical treatment of pain.DESIGN: A randomized control observation.SETTING: Center of Modern Education and Department of Pharmacology,Gannan Medical College.MATERIALS: The experiments were carried out in the laboratory of scientific research center, Gannan Medical College between March and April in 2005. ① A total of 150 healthy adult Kunming mice were used in four independent experiments. ② Drugs: CNL extract was provided by the Department of Phytochemistry, Shenyang Pharmaceutical University (batch number: 2002080901), morphine hydrochloride injection by Shenyang No.1Pharmaceutical Factory (batch number: 000305), and naloxone hydrochloride injection by Yanqiao (Hunan) Pharmaceutical Co. Ltd., (batch number:20021109).METHODS: ① Effects of CNL extract on writhing times induced by acetic acid: Forty female mice were randomly divided into four groups with10 mice in each, and they were treated with intraperitoneal injections of 0.02 mL/g saline, 0.10 and 0.20 mg/g CNL extract and 0.10 mg/g aminophenazone respectively. The intraperineal injection of 6 g/L glacial acetic acid was given after 15 minutes. The writhing times of mice within 15 minutes were observed and recorded in each group. ② Effects of CNL extract on the pain induced by hot pla in mice: Forty female mice were randomly divided into four groups with 10 mice in each, and they were treated with intraperineal injections of 0.02 mL/g saline, 0. 10 and 0.20 mg/g CNL extract and 0.10 mg/g morphine respectively. The pain responses were detected at 15, 30 and 60 minutes after administration. ③ The antagonistic effect of naloxone on morphine and CNL extract to the pain induced by hot plate in mice: Thirty female mice were randomly divided into three groups ith 10 mice in each group, and they were given intraperitoneal injections of 0.02 mL/g saline, naloxone 0.004 mg/g +morphine 0.01 mg/g and naloxone 0.004 mg/g+CNL extract 0.01 mg/g respectively. The pain responses were detected at 15, 30 and 60 minutes after administration respectively. ④ Effects of CNL extract on electrostimulation induced pain in mice: Forty mice were randomly divided into four groups with 10 mice in ach group, and they were administrated with intraperineal injections of 0.02 mL/g saline, 0.10 and 0.20 mg/g CNL extract and 1 g/L morphine respectively. Repeated electrostimulations were given at 20, 35, 50 and 70minutes after administration, and the pain responses were detected by means of electrostimulation.MAIN OUTCOME MEASURES: ① Writhing times; ② Time for the pain response induced by hot plate; ③ Analgesic rate induced by electrostimulation.RESULTS: Totally 150 healthy adult Kunming mice were used in the four independent experiments, and all were involved in the analysis of results. ①Writhing times in the mice: 0.10 and 0.20 mg/g CNL extracts and 0.10 mg/g aminophenazone had very significant analgesic effects on writhing induced byacetic acid in mice, and the writhing times after administration were all fewer than those in the saline group (20.2±10.8, 14.5±7.6, 7.6±4.5,50.6±15.5, P ＜ 0.01), and the analgesic effects of CNL extract were dosedependently. ② Time for the pain response induced by hot plate: 0.10 and 0.20 mg/g CNL extracts had significant analgesic effects on the pain in duced by hot plate, and the time for pain sensation at 15, 30 and 60 minutes after administration were all longer than those in the saline group (P ＜ 0.05 or P ＜ 0.01), and the analgesic effect was dose-dependently. The times for pain sensation at each time point after administration in the naloxone 0.004 mg/g+CNL extract 0.01 mg/g group were all longer than those in the saline group, but those were close between the naloxone 0.004 mg/g+morphine 0.01 mg/g group and the saline group. ③ Analgesic rate induced by electrostimulation in the mice: The analgesic rates at20, 35, 50 and 70minutes after administration in the CNL extract 0.10 and 0.20 mg/g groups were all higher than those in the saline group (P ＜ 0.01).CONCLUSION: Our data suggested that CNL extract has obvious analgesic effect, and the analgesic intensity is dose-dependently. Naloxone, an opiate receptor antagonist, can antagonize the analgesic effect of morphine,but cannot antagonize that of CNL extract on mice with pain induced by hot plate, which indicates that CNL extract exert its analgesic role not through binding with opiate receptor.

Objective To investigate the alterations of peripheral blood T lymphocyte subsets in patients with sepsis and septic acute kidney injury, and explore the clinical significance.Methods Fifty-five patients with sepsis and forty-three patients with septic acute kidney injury were enrolled in this study. At the same period, thirty healthy subjects were enrolled as the control group.T lymphocyte subsets inclu-ding CD3 +T, CD4 +T, CD8 +T cells, and CD4 +T/CD8 +T in peripheral blood were detected by flow cy-tometry, and acute physiology and chronic health evaluation Ⅱ( APACHE Ⅱ) were graded within twenty-four hours after admission.Then, correlation of the APACHEⅡscores and T lymphocyte subsets was ana-lyzed.Results In the septic acute kidney injury group, peripheral blood CD3 +T, CD4 +T cell percenta-ges, and CD4 +T/CD8 +T ratio were significantly lower than those in the control group and the sepsis group (all P <0.05).In the septic acute kidney injury group with stage 3, CD3+T, CD4 +T cell percentages, and CD4 +T/CD8 +T ratio in the patients were significantly lower than those in stage 1 and stage 2 ( all P <0.05).In the septic acute kidney injury group,CD3 +T, CD4 +T cell percentages, and CD4 +T/CD8 +T ra-tio were significantly lower in dead group than those in survival group (all P <0.05).APACHEⅡscores in patients with sepsis were significantly negatively correlated with peripheral blood CD4 +T cell percentages and CD4 +T/CD8 +T ratio ( r =-0.645,-0.492, allP <0.05).Conclusions There are varying de-grees of cellular immune imbalance in patients with sepsis and septic acute kidney injury, characterized by decline of circulating CD3 +T, CD4 +T cell percentages, and CD4 +T/CD8 +T ratio.CD4 +T cell percenta-ges and CD4 +T/CD8 +T ratio are closely related to the severity and prognosis of septic acute kidney injury.

Objective To observe the in vitro effect of leptin, alone or in combination with tumor necrosis factor-alpha (TNF-α) on inducible nitric oxide (NO) and on inducible matrix metallo-proteinase-1 3 (MMP-13) in rabbit articular chondrocytes. Methods The chondrocytes from the articular cartilage of 2-month-old rabbits were cultivated and identified, and the second filial generation chondrocytes were cocultured on plates with different concentrations of leptin alone or in combination with TNF-α for 48 h or 96 h after 12 h starvation. The concentration of NO and MMP-13 was measured in the chondrocytes culture supernatant fluid. The results were statistically analyzed. Results There was no significant difference in the concentrations of NO between the different concentrations of leptin alone groups and the blank control group (P ＞ 0. 05). In combination with the same concentration of TNF-α (10 ng/mL), leptin could dose-dependently increase the concentration of NO in the chondrocytes culture supernatant fluid in vitro. There was significant value in average concentration of MMP-13 on the main effect of both time and dose (P ＜0. 05) . No MMP-13 was detected in the blank control group. Conclusion Leptin can induce MMP-13 and have synergistic induction effect on NO with TNF-α in rabbit articular chondrocytes in vitro.

Objective To explore the effect and mechanism of relaxin on the production of extracellular matrix (ECM) excreted by high glucose stimulated human renal mesangial cells.Methods Cultured human mesangial cells (HMCs) were divided into three groups:(1) normal glucose group (NG,5.5 mmol/L D-glucose),(2) high glucose group (HG,30 mmol/L D-glucose),and (3) high glucose + relaxin group.Cell count kit (CCK8) was used to examine the cell proliferation.The levels of fibronectin and collagen type Ⅳ in the culture supernatants were examined with a solid-phase enzyme-linked immunoadsorbent assay (ELISA);Western blot method was used to detect the expression of α-smooth muscle actin (α-SMA) protein.The transforming growth factor-β1 (TGF-β1) mRNA expression was detected with quantitative polymerase chain reaction (qPCR) method.Results No proliferation and inhibition effects were observed in both normal and high glucose group.Compared to the normal glucose group,the levels of fibronectin,and collagen type Ⅳ increased significantly (57.28 ± 0.59 vs 41.85 ± 0.03,56.52 ± 0.88 vs 33.80 ± 0.24,P ＜ 0.01)after cultured 48 h in high concentration of glucose.Compared to the high glucose group,a significantly decreases of fibronectin and collagen type Ⅳ (47.08 ± 0.03 vs 57.28 ± 0.59,36.16 ± 0.52 vs 56.52 ±0.88,P ＜0.01) were observed in the relaxin treated group.The expressions of α-smooth muscle actin and TGF-β1 were decreased (P ＜0.01).Conclusions Relaxin can suppress the overproduction of ECM excreted by HMC cultured in high ambient glucose,and its mechanism is partly due to the inhibition of TGF-β1.

OBJECTIVE: To investigate the self-management behaviors of patients with type 2 diabetes mellitus (DM) in a community and to explore the relationship between self-management behaviors and the glycemic control. METHODS: A total of 211 type 2 DM patients in a community were selected by stratified random sampling. Patients were grouped according to the scores of self-management behaviors. The fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG) and glycated hemoglobin (HbA1C) level were tested. The differences between groups and relationship between self-management behaviors and glycemic control were analyzed. RESULTS: Self-management behaviors of most patients were not effective, and 2hPG and HbA1C were affected by different levels of the self-management behaviors (P<0.05). The self-management behaviors were negatively related to FPG (r=-0.277, P=0.015), 2hPG (r=-0.453, P=0.001), and HbA1C (r=-0.435, P=0.001). Glycemic control of the patients whose course of disease was over 5 years was significantly different due to different self-management behaviors. FPG level of the patients was positively related to alimentary control. The 2hPG level of the patients was positively related to alimentary control, medication persistence, and blood glucose self-monitoring. The HbA1C level of the patients was positively related to alimentary control and medication persistence. The times the patients received DM education, the way to use insulin, and the disease course of the patients were important factors to affect self-management behaviors of type 2 DM in the community. CONCLUSION Self-management behaviors of type 2 DM patients in the community are not effective. Satisfactory self-management behaviors, specially the control of 2hPG and HbA1C are beneficial to glycemic control. We can improve the self-management behaviors in type 2 DM patients by paying attention to the disease course, the treatment method, and the contents and effect of DM education.
Adult ; Aged ; Aged, 80 and over ; Attitude to Health ; Blood Glucose ; metabolism ; Blood Glucose Self-Monitoring ; statistics & numerical data ; China ; Community Networks ; Diabetes Mellitus, Type 2 ; blood ; psychology ; therapy ; Diet, Diabetic ; methods ; psychology ; Female ; Glycated Hemoglobin A ; analysis ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Self Care ; methods ; psychology ; Surveys and Questionnaires ; Young Adult

Objective:To improve the understanding of hemodialysis complicated with mesenteric artery calcified stenosis and mesenteric ischemia through the analysis of the case and review of related literature.Methods:A case of hemodialysis with intractable abdominal pain as the main manifestation was reported, and its clinical features, diagnosis and treatment were summarized.Results:The case was a maintenance hemodialysis patient with persistent dull pain around the umbilicus, which worsens after meal and hemodialysis. The results showed multiple vascular calcification, superior mesenteric artery stenosis so the patient was diagnosed with chronic mesenteric ischemia. Mesenteric revascularization under intervention was planned but the guide wire failed to enter the superior mesenteric artery after repeated attempts during the operation. Surgical treatment was recommended, but the patient and family refused surgery and were discharged.Conclusions:Dialysis patients with intractable abdominal pain should be carefully identified and alert for mesenteric artery disease and mesenteric ischemia.

Adult ; Female ; Hernia ; etiology ; Herniorrhaphy ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; surgery ; Spinal Fractures ; complications ; surgery ; Young Adult

Objective:Renal involvement in primary Sjogren′s syndrome (pSS) has been considered rare, and recent studies have shown that there was a large difference in the prevalence of the disease, which has been reported to range from 0.03% to 67%. The meta-analysis was to determine the prevalence of renal involvement in pSS patients.Methods:The study on pSS renal involvement was conducted in Pubmed, Embase and Cochrane Library from January 2002 to May 2019. After logarithmic conversion of the prevalence rate, meta-analysis of random effect model was carried out to explore the prevalence of pSS renal involvement. Subgroup analysis and meta regression analysis were used to explore the source of heterogeneity. We also performed sensitivity analysis and assessments of publication bias by Begger′s test.Results:The meta-analysis included eighteen observational studies of 8 888 participants. The result in random effects model showed that the combined prevalence was 9.0% (95% CI: 6.0%-12.0%), with significant heterogeneity between these studies ( I2=97%, P<0.01). The source of heterogeneity was explained by a stratified analysis of region, type of study, and the diagnostic criteria for renal involvement. Sensitivity analysis showed that the result was robust and Begger′s test did not detect the presence of publication bias. Conclusions:The prevalence of renal involvement in pSS is 9.0%. Due to huge heterogeneity, large multicenter prospective studies will be needed to determine its prevalence and the relationship between pSS and kidney.

Objective:To investigate the status of vascular access in hemodialysis patients in our center.Methods:The general information of hemodialysis patients and types and complications of vascular access at Xiangya Hospital of Central South University from April 2015 to April 2016,were retrospectively analyzed.Results:Among 258 prevalent patients,87.60％ of them had arteriovenous fistula (AVF),while 12.40％ showed tunneled cuffed catheter.Of the 61 incident patients,80.33％ of them initiated dialysis with a non-tunneled and non-cuffed catheter,8.19％ with an AVF,9.84％ with a tunneled cuffed catheter,and 1.64％ with needle puncture.The types of AVF access included 76.55％ of wrist radiocephalic fistula,7.08％ of mid-forearm cephalic fistula,11.06％ of elbow brachiocephalic fistula,and 5.31％ of antecubital fistula and transposed basilic fistula.Seventy-seven (34.07％) patients with AVF suffered complications and wherein aneurysms accounted for 24.34％.Conclusion:In maintenance hemodialysis patients,autologous AVF is the prevalent vascular access.In the beginners for dialysis,non-tunneled and non-cuffed catheter are their choice.Additional efforts and incentives may be necessary to improve vascular access during the initiation ofhemodialysis.