While introducing the indications of low-density lipoprotein (LDL) apheresis, LDL absorption systems were reviewed generally. As the key components for binding LDL, four kinds of ligands which are synthesized by different principles are: 1. Positively charged peptides designed according to state charge force between ligand and LDL; 2. Peptides designed according to structural characteristics of the binding site between LDL and its receptors; 3. Antibody of Lp (a) obtained by immunizing mammals with designed peptides with the characteristics of Lp (a); 4. Segments of LDL binding proteins (LBPs) synthesized with genetic engineering method based on the specific binding of LBPs to LDL. Requirements of matrices carrying these ligands are also considered. Finally, future developments in treatments of familial hypercholesterolemia by means of blood purification using synthesized peptides are overlooked.
Adsorption ; Drug Carriers ; Drug Design ; Female ; Hemoperfusion ; instrumentation ; methods ; Humans ; Hyperlipoproteinemia Type II ; blood ; therapy ; Ligands ; Lipoproteins, LDL ; blood ; isolation & purification ; Male ; Peptides ; chemical synthesis ; therapeutic use ; Receptors, LDL ; chemistry

Grafting of poly (ethylene glycol) (PEG) on the surface of polysulfone (PSF) sheets by simultaneous or sequential UV irradiation with 4-azidobenzoic acid as the photocoupler was carried out. Water contact angle measurements showed that there was a great improvement of hydrophilicity on the grafted surface. X-ray photoelectron spectroscopy suggested that the area covered by PEG be 77.3% and 41.9% respectively after grafting by simultaneous and sequential pathways. With atomic force microscope (AFM), obvious difference in the shape and the phase mode was observed between surfaces of PEG-g-PSF sheets made by these two pathways. Evidences implied that simultaneous pathway would produce a branched PEG layer on the surface, while sequential pathway was coupled with a "pan-cake" PEG layer on it. This study provides the foundation for further advancement in tethering brush-like PEG on PSF hollow fiber membranes.
Azides ; chemistry ; Biocompatible Materials ; chemistry ; Coated Materials, Biocompatible ; chemistry ; Membranes, Artificial ; Microscopy, Atomic Force ; Polyethylene Glycols ; chemistry ; Polymers ; chemistry ; Sulfones ; chemistry ; Ultraviolet Rays

ObjectiveToinvestigate the prevalence, awareness and risk factors of chronic kidney disease (CKD) among community adult population in Shanghai, China, in order to provide early diagnosis and treatment of CKD, and informations for national health policy makers.MethodsTwo thousand five hundred and ninety six residents (≥ 18 years old) were randomly selected from community population in Changning district of Shanghai, China. They were interviewed and tested for albuminuria -morning spot urine albumin to creatinine ratio [ACR, abnormal: ≥ 17 mg/g (male), ≥25 mg/g (female)], reduced renal function-estimated GFR by abbreviated MDRD equation [abnormal: <60 ml ·rain-1 (1.73 m2)-1] and hematuria-morning spot urine dipstick confirmed by urine microscopy. The associations among demographic characteristics, healthy characteristics (e.g. diabetes and hypertension) and indicators of kidney damage were examined. The investigators and neighborhood committee were well trained. Those who had semiquantitative positive were detected again by albuminuria-morniag spot urine albumin to creatinine ratio after three months. ResultsTwo thousand five hundred and fifty four residents with complete data were enrolled in the study. Albuminuria was detected in 6.3% of subjects, reduced renal function in 5.8%, hematuria in 1.2%. Approximately 11.8% of these subjects had at least one indicator of kidney damage. The awareness rate of CKD was 8.2%. The Logistic regression model showed that hyperuricemia, nephrolithiasis, anemia, diabetes, central obesity, hypertension and age contributed to the development of CKD. ConclusionsThe prevalence of CKD in community adult population in Shanghai is 11.8%, And the awareness rate of CKD is 8.2%. Hyperuricemia, nephrolithiasis, anemia, diabetes, central obesity, hypertension and age are risk factors of CKD.

To analyse the clinical data of reoperations in congenital heart disease and discuss the management strategy of reoperation for congenital heart disease.
 Methods: We retrospectively studied the clinical data for patients underwent reoperation in congenital heart disease in Cardiovascular Surgery, Second Xiangya Hospital, Central South University from January 2007 to December 2015. Demographic and operative details, in-hospital mortality and major postoperative complications were analysed.
 Results: A total of 8 647 congenital heart disease surgery procedures were performed, including 147 (1.7%) reoperations. Among the patients, residual septal defect repair (30 cases, 20.4%), planed staged operation (28 cases, 19.0%), and Fontan procedure (20 cases, 13.6%) were the most common kinds of reoperation. In addition, 140 (95%) operations were through repeat sternotomies, 144 (98%) patients underwent operation with cardiopulmonary bypass, and 100 (68%) with cardiac arrest. Cardiopulmonary bypass and aortic cross clamp were maintained for 21-447 (135.5±87.8) minutes and 0-202 (49.9±49.7) minutes. There were 10 in-hospital deaths with a total mortality of 6.8%. The major complications included low cardiac output syndrome (24 cases, 16.3%), renal dysfunction (7 cases, 4.8%), respiratory insufficiency (14 cases, 9.5%), unplanned reoperations for drainage of haemorrhagic cardiac tamponade (4 cases), and delayed sternal closure (2 cases).
 Conclusion: Repeat sternotomy is the main way of reoperation, but it is not a major risk for operative mortality and morbidity. Improving the management of complex malformation, standardizing the follow-up, choosing the right timing of surgery, and reducing surgical complications will help reduce the risk of reoperation.
Cardiopulmonary Bypass ; Heart Defects, Congenital ; surgery ; Humans ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Treatment Outcome

【Objective】 To analyze the implementation and problems in the process of the first policy of serious illness benefits for voluntary blood donors in China, therefore provide reference for other provinces and cities to formulate care policies for voluntary blood donors. 【Methods】 The number of blood donors who received serious illness benefits and the proportion to the total number of blood donors in that year were obtained by Excel, and their basic demographic information, illness and reasons for failing to receive benefits were analyzed. 【Results】 From 2015 to 2019, a total of 198 blood donors applied for serious illness benefits, and 159 received benefits (638 000 yuan), accounting for 0.017% of the total number of voluntary blood donors in Nanjing. The average age of the recipients was 52.66, with the proportion of males (63.5%) higher than that of females (36.5%). 52.8% (the highest proportion) got benefits of 5 000 yuan. 39 applicants failed to obtain serious illness benefits, among which 27 applicants failed during 2017 to 2018 due to unidentifiable funding source. But after Nanjing Blood Donation Regulations clarified the funding sources, the implementation of serious illness benefits policy was continued in 2018. 【Conclusion】 The implementation of serious illness benefits for voluntary blood donors presented the Nanjing municipal government's care for voluntary blood donors. The legalization of this policy is conducive to the continuity and stability of policy implementation. Relevant departments and blood centers should continue to strengthen the policy publicity and make sure the policy is implemented effectively.

OBJECTIVES: The integrated model of prenatal diagnosis and postnatal treatment for congenital heart disease (CHD) leads to an increasing number of operation in infants. This study aims to reveal the risk factors for postoperative early mortality and delayed recovery in infants less than 3 months old, who underwent surgical treatment for CHD in the Department of Cardiovascular Surgery, Second Xiangya Hospital, Central South University during the past 5 years. METHODS: Clinical variables were collected via medical records. Delayed recovery was defined as the time of postoperative intubation, or cardiac intensive cure unit (CICU) stay, or hospital stay longer than its third quartile. Risk factors for early postoperative prognosis and the odds ratio (OR) were analyzed with logistic regression analysis. RESULTS: A total of 511 infants underwent surgical treatment for CHD from January 2016 to June 2020 were retrospectively reviewed, including 217 (42.5%) infants with complex CHD. The median age was 60 days (3 hours-90 days); and median weight was 4.5 (1.7- 8.4 kg). There were 26 postoperative mortalities, making the incidence at 5.1%, including 5 (5/294, 0.7%) mortalities in patients with uncomplicated CHD, and 21 (9.6%) mortalities in patients with complex CHD. Based on multivariable analysis, risk factors for postoperative mortality were diagnosis of complex CHD (OR=5.53, P<0.001), weight under 4.0 kg (OR=9.86, P<0.001), preoperative symptoms (OR=3.17, P=0.012), and emergency operation (OR=11.66, P<0.001). The median time for postoperative intubation, CICU stay, and hospital stay were 21.0 (0.3-979.0) hours, 3.0 (0.5-91.0) days, and 11.5 (3.0-105.0) days, respectively. A total of 177 (34.6%) infants delayed recover, with risk factors including diagnosis of complex CHD (OR=3.41, P=0.001), weight under 4.0 kg (OR=4.55, P<0.001), and preoperative symptoms (OR=3.91, P<0.001). CONCLUSIONS Surgical treatment for infants (<3 months) with CHD is still a challenge, particularly for infants with complex CHD and weight under 4.0 kg. We can improve the prognosis of CHD treatment in infants by establishing the integrated model of prenatal diagnosis and postnatal treatment to choose the most suitable time window, avoid symptoms before surgery, and reduce emergency operation.
Female ; Heart Defects, Congenital/complications* ; Humans ; Infant ; Length of Stay ; Middle Aged ; Postoperative Period ; Pregnancy ; Prognosis ; Retrospective Studies ; Risk Factors