0.05).Conclusion Coverage of medical insurance and effective antiviral therapy for the patients with CHB could affect their QOL.

Objectives To investigate the effects of seasonal changes on peritoneal dialysis associated peritonitis (PDAP) in patients on peritoneal dialysis (PD),and to provide evidence for clinical prevention and treatment of PDAP.Methods All episodes of PD-related peritonitis during clinic follow-up in maintenance PD patients from Jan 1st,2007 to Dec 31st,2015 in Peking University People's Hospital were reviewed.The incidence of peritonitis,laboratory indexes,pathogens and clinical outcomes in different seasons were recorded and analyzed.One-way ANOVA and chi square test were employed to compare the incidence of PDAP and related data in different seasons,and Pearson correlation was used to analyze correlations between PDAP rate and monthly mean temperature and mean humidity.Results During nine years,a total of 119 PD patients occurred 190 times of peritonitis during home PD.The PDAP rate in summer was the highest,0.21 episodes/year,followed by spring (0.16 episodes/year) and autumn (0.16 episodes/risk year),but there was no significant difference among peritonitis rates in four seasons.There were significant positive correlation between monthly mean temperature,monthly mean humidity and the peritonitis rate (mean temperature:r=0.828,P ＜ 0.01;mean humidity r=0.657,P ＜ 0.05).(2) As for bacteria,in Summer the PDAP rate caused by Staphylococcus aureus and Coagulase negative staphylococcus (CoNS),and Gram-negative bacteria was higher than that in other seasons,but there was no statistical difference.There were significant positive correlation between monthly mean temperature,mean humidity and the rate of CoNS peritonitis (mean temperature:r=0.704,P ＜ 0.05;mean humidity:r=0.607,P ＜ 0.05).(3) There were no statistical difference among results of PD related peritonitis in different seasons about general situation,clinical manifestation,causes of peritonitis and laboratory index before peritonitis episodes.PD procedure-related problems were the main cause of peritonitis in summer and autumn.(4) The cure rate of all peritonitis was 90％.The highest cure rate was in autumn and winter,while the lowest cure rate was in summer,but no statistical difference.Among the peritonitis episodes with treatment failure,52.6％ occurred in summer.Conclusions There is some correlation between the rate of PDAP and seasons.Higher temperature and higher humidity were significantly correlated with higher peritonitis rate,especially the rate of CoNS peritonitis.The prognosis of PDAP in summer was relatively poor,with higher proportion of hospitalization and lower cure rate.

OBJECTIVETo systematically optimize the cultivation conditions of adventitious roots of Pseudostellaria heterophylla.

METHODTissue cultivation technology and ultraviolet spectrophotometry were adopted to observe the effect of inoculum volume, sucrose concentration, inorganic salt concentration, number of cultivation days, gradual scale-up cultivation and bubble different angles of bioreactor on the growth of adventitious roots of P. heterophylla, and determine the content of constituents such as saponin, polysaccharide and amino acid.

RESULTThe propagation multiple of adventitious roots reached the maximum when the inoculum was 6 g in a 1 L culture shake flask. With the increase in sucrose concentration, the dry weight propagation multiples of adventitious roots followed an up and down trend. The inorganic salt concentration in a cultivation dish had a greater effect on the growth of adventitious roots, particularly 3/4 MS was the most favorable for the growth of adventitious roots. The growth curve of P. heterophylla was "S", with the biomass reaching the maximum at the 28th day.

CONCLUSIONThe inoculum volume, sucrose concentration, inorganic salt concentration, gradual scale-up cultivation and angles of bubble bioreactor had a significant effect on the growth of adventitious roots of P. heterophylla. The contents of saponin and amino acid in adventitious roots were higher than that in cultivated P. heterophylla, whereas the polysaccharide content were lower than that in cultivated P. heterophylla.

Amino Acids ; metabolism ; Biomass ; Bioreactors ; Caryophyllaceae ; growth & development ; metabolism ; Plant Roots ; growth & development ; metabolism ; Polysaccharides ; metabolism ; Saponins ; metabolism ; Spectrophotometry, Ultraviolet ; Time Factors ; Tissue Culture Techniques ; instrumentation ; methods

With the modernization of traditional Chinese medicine, medicinal plants resources cannot meet the request of Chinese medicine industry. Medicinal plants adventitious roots culture in a large scale is an important way to achieve Chinese medicine industrialization. However, how to establish good adventitious roots culture system is its key, such as plant hormones, explant, sucrose, innoculum and salt strength.
Medicine, Chinese Traditional ; methods ; trends ; Plant Growth Regulators ; pharmacology ; Plant Roots ; drug effects ; growth & development ; Plants, Medicinal ; drug effects ; growth & development ; Tissue Culture Techniques ; methods

Objective To investigate the prevalence and related factors of peritoneal calcification in peritoneal dialysis(PD)patients with long dialysis duration,and to explore the relationship between peritoneal calcification and vascular calcification.Methods This cross-section study enrolled PD patients who had received PD for more than 4 years in Peking University People's Hospital.Peritoneal calcification and abdominal aortic calcification were reviewed by CT scan.Demographic data,clinical characteristics,laboratory data including calcium phosphorus metabolism indexes(Ca,P,ALP and iPTH)and PD adequacy were collected.The influencing factors of peritoneal calcification were analyzed by Logistic regression analysis.The correlation between peritoneal calcification and abdominal aortic calcification were tested by Spearman correlation analysis.SPSS 19.0 was used for statistical analysis.Results(1)Seventy-nine PD patients were enrolled:32 males(40.5％);mean age was(58.7±13.1)years and average PD duration was 77.25(58.00,88.00)months.The major primary diseases were glomerulonephritis(46.8％)and diabetic nephropathy(30.4％).(2)6 patients(7.6％)had CT-detectable peritoneal calcification.77(97.5％)patients were found with various degrees of peritoneal thickening.The prevalence of peritoneal calcification was 7.6％in patients with PD duration more than 4 years,10.3％in patients with PD duration more than 6 years,18.8％in patients with PD duration more than 8 years and 40.0％in patients with PD duration more than 10 years,showing an increasing trend.Compared with non-peritoneal calcification group,the patients in peritoneal calcification group received higher doses of Vitamin D(P ＜ 0.001)and lower triglyceride levels(P=0.041).The patients were divided into two groups according to whether dialysis duration was longer than 9 years,and the proportion of patients with long PD duration in peritoneal calcification group was higher(P=0.013).Logistic regression analysis showed that PD duration,calcium and phosphorus metabolism indexes were not independent risk factors of peritoneal calcification.High vitamin D dose was an independent risk factor for peritoneal calcification(B=2.667,OR=14.394,95％CI 1.655-125.165,P=0.016).(3)74 patients were found with abdominal aortic calcification in different degrees,and the prevalence rate of abdominal aortic calcification was 93.7％.Spearman correlation analysis showed that there was no correlation between peritoneal calcification and vascular calcification(r=0.70,P=0.542).Conclusions The prevalence of peritoneal calcification in long PD duration patients is low.Peritoneal calcification may be associated with high Vitamin D dose and long PD duration.

OBJECTIVETo study cultivation of Panax ginseng adventitious roots in bubble bioreactors.

METHODThe adventitious roots were obtained through tissue culture different types of bioreactors. The contents of ginsenosides Re, Rb1 and Rg1 were determined by HPLC while the contents of polysaccharides were determined by ultraviolet spectrophotometry.

RESULTThe results showed that of the three types tested, the most efficient bioreactor for cultivation of the ginseng adventitious roots was the cone-type bioreactors (with the 120 degrees ), in which, the growth curve of adventitious roots was S-shaped. The maximum biomass was obtained on the 40th day, with the fresh weight, dry weight and growth rate reaching the maximum, which were 113.15 g, 9.62 g and 63.13 times respectively, and the concomitant contents of polysaccharide and ginsenoside were 2.73% and 2.25 mg x g(-1).

CONCLUSIONThe results showed that the most efficient bioreactor for cultivation of the ginseng adventitious roots was the cone-type bioreactors (with the 120 degrees). These results provide a theoretical reference for developing an efficient production process of active metabolites of ginseng in the scale-up cultivation.

Biomass ; Bioreactors ; classification ; standards ; Chromatography, High Pressure Liquid ; Ginsenosides ; metabolism ; Panax ; genetics ; metabolism ; Plant Roots ; genetics ; metabolism ; Polysaccharides ; metabolism ; Reproducibility of Results ; Spectrophotometry, Ultraviolet ; Time Factors ; Tissue Culture Techniques ; methods

Peritoneal dialysis (PD)-related peritonitis is recognized as a common complication of peritoneal dialysis. Eosinophilic peritonitis is a rare type of non-infection PD-related peritonitis. Eosinophilic peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients was first reported in 1967. The cause of eosinophilic peritonitis is obscure, however it may be related to some etiologies: (1) hypersensitivity to PD materials, including catheter or dialysate; (2) bacteria, fungal or mycobacterium tuberculosis infection. Clinical investigations include asymptomatic cloudy PD effluent, fever, abdominal pain and eosinophil count elevate in PD effluent. Eosinophilic peritonitis is usually mild and self-limited. With the development of PD, more eosinophilic peritonitis cases and researches were reported. Here, we report a patient on CAPD with eosinophilic peritonitis. A 71-year-old female patient developed end-stage renal disease for 4 years and underwent CAPD (2 000 mL of 1.5% dialysis solution with four exchanges daily) for 5 months. With a history of unclean food, she was hospitalized for complaints of diarrhea, fever and cloudy peritoneal effluent for 10 days. Dialysis effluent showed an elevated white blood cell (WBC) count of 1 980 cell/mm³, with 60% polymorphonuclear cells. She was diagnosed as PD-related peritonitis, and therapy was initiated with intraperitoneal ceftazidime 1 g once a day and vancomycin 500 mg every other day. She was admitted to the hospital as the symptoms were not relieved. Her peripheral blood cell count showed a total WBC count of 6 940 cells/mm³, 36.8% eosinophil. Her PD effluent analysis showed turbidity, total WBC count of 1 480 cells/mm³, and 83% polymorphonuclear cells. Her dialysate bacteria culture, fungus culture, polymerase chain reaction for Mycobacterium tuberculosis (TB-PCR), acid-fast stain were all negative. On admission day 4, the treatments were changed to levofloxacin 200 mg once a day and vancomycin 500 mg every other day. After two weeks of antibiotics treatment, patient's symptoms were not completely improved and her dialysis effluent remained cloudy. Her blood eosinophil count elevated to 36.8%，eosinophil proportion in PD effluent>90% and PD effluent pathological findings showed eosinophil>90%. Eosinophilic peritonitis was diagnosed and a decision was made to give loratadine daily dose of 10 mg orally. The possible reasons might be the patient's allergy to some components of PD solution or connection systems in the beginning of PD, and this bacterial peritonitis episode, as well as the application of vancomycin, might lead to the fact that eosinophilic peritonitis acutely developed. For there was no improvement in clinical symptoms, loratadine was stopped, and the patient was discharged 18 days later, and received follow-up closely. Two months later, eosinophil count in blood and PD fluid decreased to normal range with no symptom. This case reminds us that in any PD-related peritonitis patient with prolonged symptoms after appropriate antibiotic therapy, and typical clinical symptoms, the diagnosis of eosinophilic peritonitis should be considered. For the count and percentage of eosinophils are not routinely reported in most laboratories, doctors need to contact the department of laboratory and the department of pathology, to confirm the cell count and proportion of eosinophils in dialysis effluent, so as to make the definite diagnosis, which can not only avoid antibiotics overuse, but also avoid antibiotics-induced eosinophilic peritonitis (such as vancomycin).
Aged ; Anti-Bacterial Agents/therapeutic use* ; Eosinophilia/etiology* ; Female ; Humans ; Kidney Failure, Chronic/therapy* ; Peritoneal Dialysis, Continuous Ambulatory/adverse effects* ; Peritoneum ; Peritonitis/etiology*