OBJECTIVE: Identification of new risk factors is needed to improve prediction of adverse outcomes in patients with three-vessel disease (TVD). The present study aimed to evaluate the prognostic values of serum chloride and sodium levels in patients with TVD. METHODS: We used data from a prospective cohort of consecutive patients with angiographically confirmed TVD. The primary endpoint was all-cause death. Cox proportional hazard regression was used to analyze the relationship of serum chloride and sodium levels with long-term outcomes of TVD patients. RESULTS: A total of 8,318 participants with available serum chloride and sodium data were included in this analysis. At baseline, patients in the low tertiles group of serum chloride level (⪕ 102.0 mmol/L) or serum sodium level (⪕ 139.0 mmol/L) had more severe disease conditions. During a median follow-up of 7.5-year, both low serum chloride level and low serum sodium level were found to be associated with an increased risk for mortality in univariate analysis. However, when both parameters were incorporated into a multivariate model, only low serum sodium level remained to be an independent predictor of all-cause death (hazard ratio: 1.16, 95% confidence interval: 1.01-1.34, P = 0.041). Modest but significant improvement of discrimination was observed after incorporating serum sodium level into the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery score. CONCLUSION Serum sodium level is more strongly associated with long-term outcomes of TVD patients compared with serum chloride level. Low serum sodium level is an independent risk factor for mortality, but only provides modest prognostic information beyond an established risk model.
Aged ; China ; epidemiology ; Chlorides ; blood ; Coronary Artery Disease ; blood ; diagnosis ; mortality ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Sodium ; blood

One hundred sixty-three patients with graded degrees of uncomplicated stable chronic renal failure were studied to investigate the quantitative relationship between serum acid-base and electrolyte composition and serum creatinine level. Even in patients with a mild degree of renal failure, the serum total carbon dioxide (tCO2) content was reduced significantly. Progressive decrements in tCO2 were noted in the more severe degrees of renal failure with the reciprocal relationship between tCO2 and serum creatinine concentration. Depending upon the degree of chronic renal failure, the type of metabolic acidosis was different. In patients with a moderate degree of renal failure, hyperchloremic acidosis was noted with anion gap remaining normal. As the renal failure progressed to a more severe degree, this pattern of hyperchloremic acidosis changed to anion gap acidosis with a normal serum chloride level. The highest anion gap was 25 mEq/L in the patient with serum creatinine concentration 24.7mg/dL.
Acid-Base Equilibrium* ; Acidosis/etiology* ; Adult ; Carbon Dioxide/blood ; Chlorides/blood ; Creatinine/blood ; Electrolytes/blood* ; Human ; Hyperkalemia/etiology ; Kidney Failure, Chronic/blood* ; Kidney Failure, Chronic/complications ; Middle Age ; Sodium/blood

OBJECTIVETo evaluate the effects of sequential colon dialysis (SCD), hemodialysis (HD) and peritoneal dialysis (PD) on the serum level of uric acid (UA) in patients with hyperuricemia.

METHODSA total of 293 patients with mild, moderate and severe degree of hyperuricemia were randomly assigned to three groups according to digital randomized method, and treated with SCD, HD and PD respectively. The serum level of UA was determined with unicase-peroxidase conjugate method, the blood levels of K+, Na+, Cl-, Ca2+ were determined by automatic biochemical analysor, and changes of body weight were measured before and after dialysis.

RESULTSIn the 293 cases, the three modes of dialysis showed no difference in lowering uric acid in patients of mild degree (P > 0.05). But the HD did show a better efficacy than that of the other two in severe degree patients (P<0.01), while in patients of moderate degree, significant difference (P<0.01) showed between HD and SCD, PD and SCD, but not between HD and PD (P > 0.05). No obvious effect of the various modes of dialysis on the level of K+, Na+, Cl-, Ca2+, body weight.

CONCLUSIONSCD can decrease the serum level of UA effectively and reduce the incidence of complication of hyperuricemia to some extent, as hemodialysis and peritoneal dialysis can.

Administration, Rectal ; Adolescent ; Adult ; Aged ; Calcium ; blood ; Chlorides ; blood ; Colon ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Hyperuricemia ; blood ; therapy ; Male ; Middle Aged ; Peritoneal Dialysis ; methods ; Potassium ; blood ; Renal Dialysis ; methods ; Sodium ; blood ; Uric Acid ; blood ; Young Adult

OBJECTIVETo study the expression and mechanism of WNK4 gene regulated by aldosterone.

METHODSWistar rats were treated with aldosterone and potassium water. Serum aldosterone and ion as well as urine ion were measured. The expression of WNK4 gene in kidney tissues was detected by real-time PCR. Kidney-derived HEK293 cells were cultured, transfected with pGL3-WNK4, and then stimulated by aldosterone. After 24 h of transfection, luciferase activities of the plasmid were detected.

RESULTSCompared with those of the controls, serum aldosterone and urine K(+) of experimental rats were significantly elevated, whilst urine Na(+) was significantly decreased. And urine Cl(-) was significantly increased only in the group of high K(+). Serum K(+), Na(+) and Cl(-) showed no significant difference. Expression of WNK4 gene in kidney tissues was significantly decreased. The luciferase activity of pGL3-WNK4-484 plasmid has decreased after stimulated with aldosterone, while the activity of pGL3-WNK4-275 showed no change.

CONCLUSIONAldosterone can down-regulate the expression of WNK4 through binding with regulatory element in the upstream of the gene.

Aldosterone ; blood ; pharmacology ; Animals ; Cell Line ; Chlorides ; blood ; Gene Expression Regulation ; drug effects ; Humans ; Kidney ; metabolism ; Male ; Potassium ; blood ; Promoter Regions, Genetic ; Protein-Serine-Threonine Kinases ; genetics ; metabolism ; Rats ; Sodium ; blood ; Transcriptional Activation ; drug effects

The hypoglycemic effects after oral administration of vanadium have been studied previously in many species such as rats, mice and even humans. However, there has been no prior report on the glucose lowering effect of vanadium on diabetic dogs. Therefore, the purpose of this study was to evaluate the hypoglycemic effects of oral vanadium on diabetic dogs. Diabetes mellitus in the dogs studied was induced by alloxan monohydrate intravenous injection. The dogs were divided into two groups, one was the diabetic control (DC) group (n = 4) and the other was the vanadium treated (DV) group (n = 6). Fresh water was supplied to the dogs in the DC group, but sodium metavanadate solution (0.1~0.2 mg/ml) was given to the dogs in DV group from one week after the alloxan injection. The fasting glucose levels, fructosamine and serum chemistry profiles were compared between the two groups weekly for three weeks. The fasting blood glucose levels in DV group were significantly lower than those in the DC group (p < 0.01). Fructosamine levels in the DV group were also lower than those in the DC group (p < 0.05). The serum chemistry profiles were not significantly different in comparisons between the two groups. However, the cholesterol levels were significantly lower in the DV group compared to the DC group (p < 0.05). Our findings showed that oral vanadium administration had a hypoglycemic effect on chemically induced diabetic dogs.
Alanine Transaminase/blood ; Alkaline Phosphatase/blood ; Animals ; Aspartate Aminotransferases/blood ; Blood Glucose/metabolism ; Blood Urea Nitrogen ; Chlorides/blood ; Cholesterol/blood ; Creatinine/blood ; Diabetes Mellitus, Experimental/blood/*drug therapy ; Dog Diseases/blood/*drug therapy ; Dogs ; Female ; Fructosamine/blood ; Hypoglycemic Agents/*pharmacology ; Male ; Pancreas/drug effects/pathology ; Potassium/blood ; Random Allocation ; Sodium/blood ; Triglycerides/blood ; Vanadates/*pharmacology

OBJECTIVETo assess the efficacy and safety of reduced osmolarity oral rehydration salts (ROORS) in treatment of mild to moderate dehydration caused by acute diarrhea in children.

METHODSA multicenter, randomized, double-blind, positive drug controlled clinical trial was conducted in 125 cases aged 1 to 17 years. These children with acute diarrhea and signs of dehydration were randomly assigned to receive either ROORS (trial group, n = 62) or oral rehydration salts II (ORS II) (control group, n = 63). The volume of intravenous infusion were recorded. The improvements of systemic symtoms and signs, diarrhea, dehydration and total scores were compared between the two groups. The adverse events and changes of electrolyte and other laboratory tests during treatment were also observed and analyzed.

RESULTSThe overall effective rates in trial group and control group were 96.8% and 96.8%, respectively. The recovery of systemic symptoms, dehydration signs and diarrhea occurred in 96%, 97% and 78% patients in trial groups, and 96%, 98% and 85% patients in control group. The scores of symptoms and signs in both groups decreased significantly after treatment. All the above parameters and the number of cases who needed intravenous infusion (41 vs. 39) were not statistically different between two groups. However, the average volume of intravenously infused fluids in trial group was (450.98 +/- 183.07) ml, 24.5% less than that in the control group (597.30 +/- 343.37) ml (P < 0.05). The mean serum Na(+) concentration elevated from (137.48 +/- 4.55) mmol/L to (139.52 +/- 3.25) mmol/L (P < 0.01) in control group after treatment, but the change was not statistically significant in trail group. Serum K(+), Cl(-), HCO(3)(-) and other laboratory result did not change significantly after treatment. The total scores in both groups decreased obviously after treatment, but no significant difference was demonstrated between two groups (P > 0.05). A case in trial group had mild abdominal distention and recovered spontaneously.

CONCLUSIONROORS was shown to be effective and safe in the treatment of mild and moderate dehydration induced by acute diarrhea. Compared to ORS II, ROORS could decrease the intravenous supplement of fluid and lower the risk of hypernatremia.

Adolescent ; Child ; Child, Preschool ; Chlorides ; blood ; Dehydration ; etiology ; therapy ; Diarrhea ; complications ; therapy ; Double-Blind Method ; Female ; Fluid Therapy ; methods ; Humans ; Infant ; Infusions, Intravenous ; Male ; Osmolar Concentration ; Potassium ; blood ; Rehydration Solutions ; administration & dosage ; Sodium ; blood ; Treatment Outcome ; Water-Electrolyte Balance

BACKGROUND: Point-of-care (POC) tests are used increasingly due to fast results and simple test procedures, which enables rapid diagnosis and therapeutic monitoring. We evaluated the performance of the Piccolo xpress Chemistry Analyzer (Abaxis, USA) a POC chemistry analyzer. METHODS: Fourteen analytes, Na+, K+, Cl-, Ca2+, total carbon dioxide, AST, ALT, total bilirubin, alkaline phosphatase, blood urea nitrogen, creatinine, albumin, total protein, and glucose; were measured simultaneously with a 100 microliter of whole blood sample using a Comprehensive Metabolic Reagent disk. Within-run and total precision and linearity were evaluated according to CLSI EP15-A and EP6-A guidelines, respectively. Comparison with a central laboratory chemistry analyzer was performed using 144 patient samples. RESULTS: The coefficients of variations of within-run and total precision were all within 5% for three levels except for total carbon dioxide, ALT, alkaline phosphatase, total bilirubin, and creatinine in low level, and creatinine in middle level. The results of 14 analytes were linear within a commonly encountered range in clinical samples (r2> or =0.98). More than 10% of samples in Na+, AST, ALT, glucose, BUN did not satisfy CLIA analytical quality requirement. CONCLUSIONS: The Piccolo xpress Chemistry Analyzer can analyze multiple analytes with a minimal amount of whole blood in a short time. It showed an acceptable performance for precision, linearity and comparison with central laboratory analyzer. It can be useful as a screening tests modality in mobile clinics, ambulances, and field clinics for military use, and for pediatric patients from whom enough sample volume is difficult to obtain.
Alanine Transaminase/blood ; Alkaline Phosphatase/blood ; Aspartate Aminotransferases/blood ; Bilirubin/blood ; Blood Chemical Analysis/*instrumentation/methods/*standards ; Blood Glucose/analysis ; Calcium/blood ; Carbon Dioxide/blood ; Chlorides/blood ; Creatinine/blood ; Humans ; *Point-of-Care Systems ; Potassium/blood ; Quality Control ; Reproducibility of Results ; Serum Albumin/analysis ; Sodium/blood

OBJECTIVETo study the effects of alum, aluminum chloride and aluminum hydroxide on aluminum contents in serum and brain of mice with high performance capillary.

METHOD60 days after the mice were given daily alum, aluminum chloride and aluminum hydroxide with the same aluminum content of 14.25, 57 mg x kg(-1) x d(-1), respectively, the aluminum content in serum and brain of mice were determined with high performance capillary chromatography.

RESULTThe average recoveries of serum aluminum determination was 96.5%-103%. The average recoveries of brain aluminum assay was 92.2%-105.3%. Except control group, serum aluminum increased obviously. Brain aluminum increased in all the large doses groups. 2 weeks after the mice were stopped being given these drugs, serum and brain aluminum recovered to normal level, except aluminum chloride large doses group.

CONCLUSIONThe metabolism and excretion mechanism of aluminum in mice depends on the chemical states of the aluminum compound.

Administration, Oral ; Alum Compounds ; administration & dosage ; pharmacokinetics ; Aluminum ; blood ; metabolism ; Aluminum Compounds ; administration & dosage ; pharmacokinetics ; Aluminum Hydroxide ; administration & dosage ; pharmacokinetics ; Animals ; Brain ; metabolism ; Chlorides ; administration & dosage ; pharmacokinetics ; Electrophoresis, Capillary ; methods ; Male ; Mice

The effect of NaCl plus 3% chitosan on the systolic blood pressure of spontaneously hypertensive rats (SHR) were evaluated and compared with NaCl plus KCl (NaCl, 49.36% + KCl 49.36%) and chitosan or NaCl treatment alone. In SHR, administration of NaCl plus chitosan (44 mM Na/day) for two months significantly decreased the systolic blood pressure greater than of NaCl plus KCl and NaCl alone. NaCl plus chitosan resulted, though not statistically significant, in decreased urinary Na+ excretion and decreased blood urea nitrogen levels. Urinary creatinine of NaCl plus chitosan was slightly decreased compared to 3 treated groups. Serum electrolytes levels, however, remained unchanged. The combination of NaCl and chitosan may be superior to the conventional use of NaCl plus KCl or NaCl alone in the prevention of hypertension. Even though these supplementary diets have demonstrated potential anti-hypertensive effects in the experimental animal model, further research is needed before any recommendations can be made.
Angiotensin I/blood ; Angiotensin II/biosynthesis ; Animals ; Blood Pressure/*drug effects/physiology ; Blood Urea Nitrogen ; Body Weight/drug effects ; Chitosan/*administration & dosage ; Chlorides/blood/urine ; Creatinine/urine ; Heart/physiology ; Histocytochemistry ; Hypertension/*prevention & control ; Kidney/physiology ; Male ; Potassium/blood/urine ; Potassium Chloride/administration & dosage ; Random Allocation ; Rats ; Rats, Inbred SHR ; Sodium/blood/urine ; Sodium Chloride, Dietary/*administration & dosage ; Systole/drug effects/physiology

The hemodynamic effects of rapid intravenous (IV) administration of 10% dextran 40 in saline solution (D40) and 7.2% hypertonic saline solution (HSS) in calves were compared. Calves received isotonic saline solution (ISS), HSS or D40 (3 calves/group) and were monitored of blood pressure, and cardiac output (CO) for 180 min. HSS and D40 infusions induced a significant increase in relative plasma volume reaching 134.9 +/- 2.8 and 125.0 +/- 1.9%, respectively at the end of fluid infusion. In the HSS group, CO, cardiac index (CI) and stroke volume (SV) remained constant at low levels after 90 minutes despite the maximal values of CO, CI and SV at the end of infusion, reaching 21.0 +/- 6.3 l/min (p<0.05), 177.8 +/- 14.2 ml/min/kg (p < 0.001) and 0.20 +/- 0.03 l/beat (at t = 10 min, p < 0.001), respectively. In contrast, CI and SV in the D40 group showed significant increases to 14.7 +/- 2.9 l/min and 153.5 +/- 17.2 ml/min/kg, respectively, at the end of fluid infusion. And those values remained constant at higher levels than those of the before infusions values throughout the experimental periods. Positive effects for hemodynamic alternations of D40 in calf practice were milder and longer than those of HSS. Therefore, the D40 infusion should be explored as a possible treatment for dehydrated calves, since rapid infusion of D40 may be safe and more beneficial for rehydrating more than HSS treatment.
Animals ; Blood Pressure/drug effects ; Cardiac Output/drug effects ; Cattle ; Cattle Diseases/blood/pathology/physiopathology/*therapy ; Chlorides/blood ; Dextrans/*administration&dosage ; Heart Rate/drug effects ; Hypovolemia/blood/pathology/physiopathology/*therapy/*veterinary ; Infusions, Intravenous/veterinary ; Plasma Substitutes/*administration&dosage ; Plasma Volume/veterinary ; Potassium/blood ; Saline Solution, Hypertonic/*administration&dosage ; Sodium/blood