Objective To assess the medium and long term efficacy of hemodialysis combined with hemo-perfusion on the endothelial function in patients with maintance hemodialysis(MHD). Methods 60 stable MHD patients were enrolled in the research and randomly divided into 2 group. The observation group received hemodialy-is combined blood perfusion,and the control group received pure hemodialysis therapy. Blood was collected before and after treatment for 6 months for detection of serum C-reactive protein (CRP),hemoglobin (HB),albumin (ALB),advanced glycation end products(AGEs),homocysteine(Hcy)and intercellular cell adhesion molecule (ICAM). Results Plasma hs-CRP,AGEs,Hcy and ICAM decreased gradually after the treatment for 6 months. Compared with the indexes before treatment ,serum HGB and ALB increased significantly after the treatment for 6 months(P < 0.05). Conclusions Hemodialysis combined with hemoperfusion with an appropriate frequency and in a medium or long period is a safe ,convenient,and effective approach for MHD patients to pretect the endotheli-al function.

Objective:To observe the changes of abdominal aortic calcification and biochemical indicators after parathyroidectomy (PTX) in the maintenance hemodialysis (MHD) patients with secondary hyperparathyroidism (SHPT).Methods:The MHD patients with SHPT who were followed up for 2 years were analyzed retrospectively and divided into PTX surgery group ( n=26) and non-surgery group ( n=18) according to whether they underwent PTX, and then the abdominal aortic calcification score (AACS), intact parathyroid hormone (iPTH), blood calcium and phosphorus after 2 years were observed in the two groups. The PTX surgery group was divided into advanced group and non-advanced group according to whether abdominal aortic calcification had progressed or not 2 years after the operation. Indicators such as age, dialysis age, iPTH, blood calcium, blood phosphorus, calcium and phosphorus product were compared between the two groups to analyze the possible factors related to the development of abdominal aortic calcification. Results:A total of 44 patients meeting the inclusion criteria were included, with 26 in the PTX surgery group and 18 in the non-surgery group. The baseline data of the PTX surgery group and the non-surgery group showed statistical difference in the age of dialysis ( P<0.05), but no statistical differences in gender, age and history of hypertension. Compared with preoperative indicators, postoperative iPTH, blood calcium and phosphorus significantly reduced (all P<0.05), and there was no significant difference in AACS. There were 8 cases (30.77%) of accelerating progress of calcification, 8 cases (30.77%) of improvement in calcification, 10 cases (38.46%) of calcification stability. After 2 years, iPTH value of non-advanced group was significantly lower than advanced group [(20.62±6.44) ng/L vs (132.72±76.83) ng/L], while the preoperative AACS progress was higher in non-advanced group [(13.11±2.71) vs (2.00±1.41)] (all P<0.05). In non-surgery group, AACS was significantly higher after 2 years [(10.44±1.65) vs (8.05±1.26)], blood phosphorus and the product of blood calcium and phosphorus significantly decreased (all P<0.05) , and the levels of iPTH and blood calcium did not significantly change. Pearson correlation analysis showed that the decreased value between preoperative AACS and 2-year postoperative AACS was positively correlated with the decreased value of iPTH ( r=0.534, P=0.012), blood calcium ( r=0.643, P=0.004), blood phosphorus ( r=0.897, P<0.001) and calcium-phosphorus product ( r=0.568, P=0.021) , and negatively correlated with preoperative AACS ( r=-0.647, P=0.014). Conclusions:Small sample data shows that PTX can correct parathyroid hormone, calcium and phosphorus for long term, and prevent abdominal aortic calcification progression, even reverse vascular calcification. Whether abdominal aortic calcification improves or not may be associated with the decrease of iPTH, calcium, phosphorus and the product of blood calcium and phosphorus.

Objective : To investigate the effects of 6⁃gingerol on amyloid β ⁃protein(Aβ) induced apoptosis , oxidative stress and neuroinflammation in Alzheimer's disease(AD) rats by regulating Wnt/β⁃catenin signaling pathway. Methods : The rat model of AD was established by injecting Aβ into hippocampus of bilateral brain. The rats were randomly divided into six groups : control group , model group , low⁃dose 6⁃gingerol group , medium⁃dose 6⁃gingerol group , high⁃dose 6 ⁃gingerol group and positive control group. Nerve injury was evaluated by nerve injury score , brain water content was measured by dry/wet method , and hippocampal histological injury was measured by HE staining. The apoptosis of hippocampal cells was detected by flow cytometry and TUNEL staining. The protein levels of iNOS , IL⁃6 , TNF⁃α , SOD , GSH⁃Px and MDA were detected by ELISA. The mRNA and protein relative expression levels of Wnt and β ⁃catenin were detected by qRT⁃PCR and Western blot. Results : Compared with the model group , after 6⁃gingerol treatment , nerve injury score decreased , brain water content decreased , the apoptosis rate decreased , the expression of iNOS , IL⁃6 and TNF⁃α decreased , SOD and GSH⁃Px protein content increased , while MDA protein content decreased. The mRNA and protein relative expression levels of Wnt and β ⁃catenin were up⁃regulated. Conclusion 6 ⁃gingerol can reduce apoptosis , oxidative stress and neuroinflammation in AD rats by activating Wnt/β⁃catenin signaling pathway.