Objective To investigate health beliefs and fluid status in diabetic peritoneal dialysis patients, to explore the relation between fluid status and health beliefs in diabetic peritoneal dialysis patients. Methods The data were collected from the peritoneal dialysis center in Ningxia Medical University General Hospital from January 2014 through January 2015. A total of 64 diabetic peritoneal dialysis patients were recruited and investigated with health beliefs scale, fluid status and laboratory index, the influencing factors were analyzed with Logistic regression. Results Levels of perceived barriers in diabetic peritoneal dialysis patients was the lowest. The score of perceived barriers, levels of albumin and daily water intake in pedal edema diabetic peritoneal dialysis patients were 35.34±10.31, (29.90±4.51) g/L,(860.34±516.71) ml/d, and the results in the non-pedal edema patients were 31.67±12.47, (32.72±6.87) g/L, (872.22±271.85) ml/d, the difference was significant (t=-1.99,2.09,-3.07, P<0.05 or 0.01). Perceived barriers in diabetic peritoneal dialysis patients was positively correlated with edematous level (r=0.16,P<0.05) and perceived capacity balancing was negatively correlated with edematous level (r=-0.25,P<0.05). Regression analysis showed that marital status,dialysis age,daily water intake and perceived barriers were the main factors influencing fluid control in diabetic peritoneal dialysis patients. Conclusions Fluid control in diabetic peritoneal dialysis patients is affected by their health beliefs, this indicates that diabetic peritoneal dialysis patients must have insufficient awareness of fluid status and fluid adherence. It is suggested that they should establish comprehensive health beliefs.

Objective:To observe the effect of combining Chinese medicine and tuina along the meridians on motor function and activities of daily living (ADL) in patient with post-stroke upper limb spasticity. Methods:A total of 220 patients with post-stroke upper limb spasticity were randomly allocated into a treatment group (n=110) and a control group (n=110). Patients in the treatment group received tuina along the meridians combined with spasticity-alleviating and collateral-unblocking Chinese medicine, whereas patients in the control group received routine rehabilitation therapy. Patients in both groups were treated for 3 weeks. Then the patients’ motor function, ADL and muscle tone were evaluated before and after treatment using the Fugl-Meyer assessment scale (FMA), modified Barthel index (MBI) and modified Ashworth scale (MAS). Results:After treatment, the FMA scores, MBI scores, and muscle (shoulder intortor, elbow flexors and wrist flexors) tones were significantly improved (P<0.05), but the improvement was more significant in the treatment group than that in the control group (P<0.05). Conclusion:Tuina along the meridians combined with spasticity-alleviating and collateral-unblocking Chinese medicine can substantially alleviate muscle tone on the affected side and remarkably improve the patients’ motor function and ADL.

Objective To investigate the effect ofpeptidoglycan from Staphylococcus aureus on the release of several chemokines including intedeukin 8 (IL-8), regulated upon activation, normal T cell expressed and secreted (RANTES), macrophage-derived chemokine (MDC) by normal human epidermal keratinocytes (KCs) and the role of Toll-like receptor 2 (TLR2) in this process. Methods KCs were derived from the foreskin of a healthy boy and propagated. After 2 - 4 passages, KCs were collected and treated with various concentrations (3, 10, 30 and 100 mg/L) of peptidoglycan for 24 hours or with peptidoglycan of 100 mg/L for varying durations (3, 6, 12, 36 hours). A fi'action of KCs were pretreated with functional grade purified anti-TLR2 monoclonal antibody before the treatment with peptidoglycan of 100 mg/L. After additional 12-hour culture following the treatment, enzyme linked immunosorbent assay was used to detect the level of IL-8, RANTES and MDC in culture supernatants of KCs. Results KCs spontaneously released IL-8 and RANTES. Peptidoglycan increased the production of IL-8 but decreased that of RANTES by KCs. The levels of IL-8 were 209.96 ± 10.31 ng/L, 250.28 ± 9.52 ng/L, 285.11 ± 10.28 ng/L, 359.40 ± 6.93 ng/L in KCs treated with peptidoglycan of 3, 10, 30, 100 mg/L, respectively, compared to 135.41 ± 14.37 ng/L in untreated KCs (all P < 0.05). On the contrary, a significant decrement was seen in the secretion of RANTES by KCs treated with peptidoglycan of 10, 30, 100 mg/L compared with untreated KCs (110.72 ± 8.51 ng/L, 90.50 ±2.45 ng/L, 49.89 ± 13.74 ng/L vs 149.94 ± 18.71 ng/L, all P < 0.05). The monoclonal antibody to TLR-2 could markedly suppress the promotion of IL-8 production by peptidoglycan, but had no obvious influence on the inhibition of RANTES production by peptidoglycan. MDC could not be detected in the culture super-natants of KCs with or without peptidoglycan stimulation. Conclusion Peptidoglycan could inhibit RANTES secretion but induce IL-8 production by KCs likely via TLR2.

Objective: To observe the effects of electroacupuncture on the histopathological changes and serum indexes of rats' liver, and to investigate the mechanism of electroacupuncture in treating hepatic fibrosis of rats. Methods: The rat model of hepatic fibrosis was induced with carbon tetrachloride. Then, the rats were divided into electroacupuncture group, medicine group, and model group. The collagen of liver, and serum hyaluronic acid (HA), laminin (LN), procollagen (PⅢNP), and collagen Ⅳ (C-Ⅳ) were detected with morphologic methods and radioimmunoassay. Results: Compared with normal rats, the collagen was hyperplasia in the liver tissue, and the contents of the serum HA, LN, and PⅢ NP were higher in the model group. The collagen area of liver tissue, and the contents of the serum HA, and LN were lower in rats treated with electroacupuncture than model rats. The contents of serum of PⅢ NP, and C-Ⅳ changed little. Conclusion: Electroacupuncture had some effects of prevention and treatment, and the mechanism may relate to the effects of electroacupuncture in protecting liver cells, inhibiting synthesis of extracellular matrix, and promoting the breakup of collagen.

Aim To explore the lipid-lowering mecha-nisms of curcumin from the molecular levels and pro-vide scientific basis for clinical development of lipid-lowering drugs.Methods Using oil red O staining and enzymic to determinate the levels of cholesterol in HepG2 cells.Moreover,uptaking of DiI-LDL was also measured.The expressions of mRNA and protein were detected by RT-Q-PCR and Western blot.Results The red lipid droplets and the levels of TC and FC sig-nificantly increased in HepG2 cells after treated with curcumin.The orange red fluorescence was higher than that of control.Curcumin could promote the expression levels of mRNA and protein of SREBP2 and LDLR, what′s more,curcumin could reduce the expression of the mature PCSK9 level and IDOL protein.Conclu-sion Curcumin accelerates LDL-C uptake probably via downregulating the expression of PCSK9 and IDOL in HepG2 cells.

Objective:To observe the impact of herb-partitioned moxibustion and electroacupuncture on hyaluronic acid(HA),procollagen Ⅲ(PC Ⅲ)and collagen Ⅳ(CⅣ)of intestinal fibrosis in rats with Crohn's disease(CD),and discuss the effect and the mechanism of acupuncture on treating intestinal fibrosis of rats.Methods:SD rats were randomly divided into control group,model group,herb-partitioned moxibustion group,electroacupuncture group and medicine group.The model of CD was developed by trinitrobenzene sulfonic acid.Masson stain was used to observe the collagen fibers hyperplasia in colon and radioimmunoassay was adopted to detect the content of HA,PC Ⅲ and C Ⅳ in serum.Results:Compared with the control group,the proliferation of colonic collagen fibers,as well as the HA,PC Ⅲ and CⅣ in serum increased in the model group.Compared with the model group,the expression of collagen fibers,serum HA,PC Ⅲ and C Ⅳ decreased in the herb-partitioned moxibustion group,electroacupuncture group and medicine group.The expression of collagen fibers serum HA,PC Ⅲ and C Ⅳ in the herb-partitioned moxibustion group were lower than in the electroacupuncture group and medicine group.Conclusion:Herb-partitioned moxibustion and electroacupuncture effectively improved the pathological state of intestinal fibrosis in rats with CD and reduced the content of HA,PC Ⅲ and C Ⅳ in serum.

AIM:To investigate high-density lipoprotein ( HDL) subclass distribution and to analyze the rela-tionship between HDL subclasses with plasma glucose and lipids in metabolic syndrome ( MS) .METHODS:Apolipopro-tein A-I ( apoA-I) contents of plasma HDL subclasses were determined by two-dimensional gel electrophoresis associated with immunodetection .The concentrations of lipids and apolipoproteins in the plasma were measured by an automated bio -chemical analyzer .RESULTS:Compared with the controls , the levels of fasting plasma glucose ( FPG) , total cholesterol (TC), triglyceride ( TG), low-density lipoprotein cholesterol ( LDL-C), LDL-C/high-density lipoprotein cholesterol (HDL-C), apolipoprotein B100(apoB100), apoB100/apoA-I, systolic blood pressure (SBP), body mass index (BMI) and HDL3b were increased in the MS patients (P<0.05).Meanwhile, HDL-C, apoA-I and preβ2-HDL, HDL2a and HDL2b were decreased in the MS patients (P<0.01).With the increase in the plasma glucose level , the contents of HDL2a and HDL2b were decreased in the MS patients (P<0.05), while preβ1-HDL was increased (P<0.05).With the decrease in the HDL-C level, the content of HDL2b was decreased in the MS patients (P<0.01), while preβ1-HDL was increased (P<0.01).With the increase in the TG level and the decrease in the HDL-C level, the content of HDL2b had a decrea-sing trend and the content of small-particle preβ1-HDL had an increasing trend , indicating that HDL maturation metabolism was disrupted.The correlation analysis showed that FPG was negatively correlated with the levels of HDL 2a and HDL2b, HDL-C was negatively correlated with the level of preβ1-HDL and positively correlated with the level of HDL 2b , and TG was positively correlated with the levels of preβ1-HDL and HDL3b .CONCLUSION:With the increases in the plasma glucose and TG, and the decrease in HDL-C in the MS patients, HDL particles have minifying tendency , and the maturation me-tabolism of HDL particles is disrupted .

Aim To explore the effects of niacin on LDL-C uptake and metabolism in HepG2 cells,and to clarify the functions of niacin in lipid-lowering and slo-wing the atherosclerosis process,thus to provide a sci-entific basis for niacin as a lipid-lowering drug in clini-cal development.Methods Oil red O staining was used to observe HepG2 cells after lipid uptake.Enzy-matic method was used to determine the content of in-tracellular free cholesterol (FC)and total cholesterol (TC).The LDLR levels on the surface of cell mem-brane were detected by immunofluorescence flow cy-tometer.The mRNA and protein expressions of LDLR, SREBP2 and PCSK9 were analyzed by qPCR and Western blot.Results The results of oil red O staining showed that the rate of oil red O-positive cells and the number of red lipid droplets were significantly in-creased in niacin group than control group.Niacin sig-nificantly increased the levels of TC and FC in HepG2 cells(P <0.05 ).What’s more,niacin significantly upregulated the expression of LDLR and significantly downregulated the protein expression of PCSK9,while it had no effect on the expression of SREBP2.Conclu-sion Niacin accelerates LDL-C uptake probably via downregulating the expression of PCSK9 and reducing the degradation of LDLR protein in HepG2 cells.

Objective:To investigate the effect of hemoglobin (Hb) volatility on cardiovascular prognosis in peritoneal dialysis (PD) patients.Methods:Retrospective cohort study was designed. Patients undergoing stable PD for more than 3 months and followed up regularly for at least 1 year were enrolled from May 1, 2013 to October 31, 2014 in the General Hospital of Ningxia Medical University. According to the Hb variation based on the mean changes in Hb standard deviation at 1 month, 3 months, 6 months, 12 months over baseline Hb, all patients were divided into low volatility group (≤10 g/L), moderate volatility group (>10-20 g/L) and high volatility group (>20 g/L), and baseline information were compared among these groups. Kaplan-Meier survival analysis and Cox regression equation were used to analyze the relationship between Hb variation and cardiovascular mortality and all-cause mortality. Besides, the patients were divided into qualified group (Hb≥110 g/L) and substandard group (Hb<110 g/L) by the Hb level at the study endpoint (cardiovascular death and all-cause death) according to KDIGO guidelines and relevant literature. Cox regression analysis was used to analyze the relationship between Hb variation and cardiovascular death in qualified group or substandard group. Multivariate linear regression analysis was used to analyze the related factors of Hb fluctuation in PD patients.Results:A total of 267 patients were enrolled. There were 160 males (59.93%) in this study. The age was (52.66±13.72) years old, and the median dialysis age was 37(21, 61) months. The patients' baseline Hb (before dialysis) was (80.16±14.89) g/L and at the end of the study Hb was (105.34±22.08) g/L. Body mass index and baseline Hb levels in the high volatility group were lower than those in low volatility group and moderate volatility group (all P<0.05). Both moderate and high volatility groups had lower estimated glomerular filtration rate than that in low volatility group, and high volatility group had higher urea nitrogen level than that in low volatility group (all P<0.05). The amount of erythropoietin usage in the high volatility group was higher than that in moderate volatility group ( P<0.05). The Kaplan-Meier survival analysis results showed that there was no significant difference in survival rate for all-cause death (Log-rank χ2=0.735, P=0.693) and cardiovascular death (Log-rank χ2=2.961, P=0.228) in different Hb volatility groups. Cox regression analysis showed that after adjusting for age, sex, serum creatinine, and blood albumin, higher Hb volatility was associated with a lower risk of cardiovascular death ( HR=0.972, 95% CI 0.947-0.999, P=0.040). After adjusting for related confounding factors, higher Hb volatility was still a protective factor for cardiovascular death in the substandard group ( HR=0.946, 95% CI 0.903-0.992, P=0.022), but there was no significant correlation between Hb fluctuation and all-cause death. Multivariate linear regression analysis results showed that the fluctuation level of Hb was positively correlated with Kt/V ( B=4.682, 95% CI 2.480-6.884, P<0.001) and erythropoietin dosages ( B=0.001, 95% CI 0-0.001, P=0.003), and negatively correlated with baseline Hb ( B=-0.554, 95% CI -0.651--0.457, P<0.001). Conclusions:High Hb variability is a protective factor for cardiovascular death in PD patients with lower Hb level (substandard Hb). Adopting a reasonable program to correct anemia timely to reach the standard level has a greater impact on reducing risk of cardiovascular death in PD patients than Hb variation in anemia treatment.

Objective:To explore the status of volume management behavior in patients with peritoneal dialysis, and to explore the relationship between health belief and volume management behavior.Methods:Convenient sampling was used to select 129 patients who underwent regular dialysis in the peritoneal dialysis center of the General Hospital of Ningxia Medical University from January to December 2019. The general condition questionnaire, Health Belief Scale, and Capacity Management Behavior Scale for patients with peritoneal dialysis were used.Results:The total score of the Capacity Management Behavior Scale of peritoneal dialysis patients was 20.23±3.54. Among all the entries: "Weigh and record the infusion volume and drainage volume" and "Regular monitoring of renal function and electrolytes and other related examinations as directed by the doctor" scored higher; while the item "Eat less high-salt and high-sodium food and adjust fluid intake according to the amount of ultrafiltration, edema and urine output" item scored lower; single factor analysis found that different educational levels, different employment conditions, whether had diabetes mellius and different over hydration had statistical significance ( F value was 3.911, t values were 2.409, 4.990, 6.070, P<0.05). The dimension of the perception maintenance capacity balance disorder was negatively correlated with the total score and each dimension of the capacity management behavior( r values were -0.243, -0.260, -0.299, P<0.05) , and the liquid intake self-efficacy dimension is positively correlated with the total score and each dimension of the capacity management behavior ( r values were 0.329, 0.397, 0.393, P<0.05). Conclusions:The level of capacity management behavior of peritoneal dialysis patients needs to be improved; employment status, and whether he has diabetes or not are the influencing factors of the patients' capacity management behavior; in health beliefs, perception of maintenance of volume balance disorders and self-efficacy and peritoneal dialysis are correlated with patients' capacity management behaviors.