Objective: To investigate the effect of Astragalus on peritoneal macrophages function in stable continuous ambulatory peritoneal dialysis(CAPD) patients. Methods: 28 stable CAPD patients were included in this study.All the patients were treated with peritoneal dialysis fluid containing Astragalus(20 ml/2 L) in vivo for one week.Peritoneal macrophages function such as phagocytosis ratio、bactericidal ratio、excretion of cytokines(TNF-? and NO) and mitochondrial dehydrogenases activity(MTT assay) were examined ex vivo just before and after the treatment. In vitro,peritoneal macrophages isolated from effluent were incubated with RPMI 1640、CDF or CDF containing various concentrations of Astragalus. Then peritoneal macrophages function mentioned above were examined again and compared. Results:No significant difference was found in TNF-? level in effluent between before and after the treatment (100?63)ng/L vs (116?60)ng/L, (P=0.192). While comparing with pre-treatment, peritoneal macrophages function was improved significantly after the addition of Astragalus into dialysate (phagocytosis ratio: (34.8?12.7)% vs (43.4?9.3)%,P0.05).The results in these two groups were significantly lower than those in Astragalus groups(P0.05). While significant decreasing in NO level and mitochondrial dehydrogenases activity were observed in 8% Astragalus groups as compared with those in 2% Astragalus group(P

Objective: To investigate the effect of Astragalus mongholicus injection(AM) on the secretion and mRNA expression of transforming growth factor((TGF-?1)) and basic fibroblast growth factor(bFGF) in cultured human peritoneal mesothelial cells((HPMC).) Methods: HPMC got from patients underwent surgical operation were cultured in vitro.At first,cells from the third passage were incubated with RPMI1640 culture medium containing 0.1% FBS for 24 hours.Then,they were divided into control group,PDS group,AM group 1,AM group 2 and AM group 3 for testing.Each group was supplemented with equal volum of RPMI1640 culture medium containing 20% FBS.After 24 hour incubating,mitochondrial dehydrogenases activity(MTT assay),the levels of TGF-?1 and bFGF in supernatant of the cell culture and the mRNA expression of TGF-?1 and bFGF were detected.Results: Significant decrease of mitochondrial dehydrogenase activities were observed in PDS group as compared with those in control group and AM groups(P0.05).The levels of TGF-?1 and bFGF in supernatant of the cell culture were significantly lower in control group than those in PDS group.Marked lower levels of TGF-?1 and bFGF were found in AM group 1,AM group 2 and AM group 3 as compared with those in PDS group(P0.05).The mRNA expressions of TGF-?1 and bFGF in PDS group increased significantly as compared with those in control group.And significant mRNA expressions of TGF-?1 and bFGF were found in PDS group when compared with those in AM groups(P

Objective:To investigate the effects of Astragalus on the the apoptosis of cultured human peritoneal mesothelium induced by peritoneal dialysis solution(PDS). Methods:Using RPM1640 culture medium as control,PDS group(commercial PDS containing 1.5% glucose without Astragalus),Astragalus group 1(commercial PDS containing 1.5% glucose and 1% Astragalus) and Astragalus group 2(commercial PDS containing 1.5% glucose and 2% Astragalus) were tested to explore the apoptosis of cultured human peritoneal mesothelial cell in each group.The activity of caspase-3,the terminal deoxynucleotidyl transferase(TdT) mediated dUTP nick end labeling(TUNEL) and flow cytometry analysis were used in apoptosis analysis in this study. Results: The activity of caspase-3 in the control group was defined as 1,the relative activity of caspase-3 in PDS group、 Astragalus group 1 and Astragalus group 2 were 3.26?0.91,(1.87?)0.43 and 1.67?0.32 respectively.The activity of caspase-3 in PDS group was significantly higher than those in the Astragalus group 1 and Astragalus group 2(P

Objective:To investigate the impact of Puerarin on oxidative stress in patients undergoing continuous ambulatory peritoneal dialysis(CAPD).Methods: Thirty-eight patients CAPD were randomly divided into two groups,an experimental group(n=19) receiving peritoneal dialysis fluid containing Puerarin(50 mg/2L) in vivo for two weeks and a control group(n=19) receiving dialysis fluid without Puerarin.The concentrations of oxidative stress markers in the serum and effluent such as glutathione(GSH),total-superoxide dismutase(T-SOD),malondialdehyde(MDA),Kt/V and creatinine clearance rate of the two groups(Ccr) were measured and compared before and after the treatment.Results: After the treatment,the concentrations of GSH and T-SOD in the serum and effluent were significantly higher(P

0.05.Food appetite and physical status were improved in most of the patients after the treatment of peritoneal dialysis. The serum albumin level after peritoneal dialysis was significant higher as compared with the pre-dialysis state,(37.1?4.4)g/L vs (33.7?5.4) g/L,P

ObjectiveToexploretheeffectof ceremideonprocess of peritoneal mesothelial cells(PMCs) apoptosis induced by peritoneal dialysis solution(PDS).Methods PMCs were cultured with normal DMEM,1.5％ PDS and 4.25％ PDS.4.25％ mannitol was used as high osmotic pressure control.Ceremide were detected by LC-MS-MS.Flow cytometry was used in apoptosis analysis.Bax,p53 and bcl-2 protein expressions were detected by Western blotting.Results (1) PDS caused the increase of intracellular ceremide in PMCs,and normal and high osmotic pressure controls had no such effect.As the acidic sphigomyelinase inhibitor,desipramine significantly inhibited the production of ceramide induced by 4.25％ PDS [(56.08±12.24) μg/L vs (91.25:t:15.89) μg/L,P＜0.01]. (2) Compared with 1.5％ PDS,4.25％ PDS stimulated PMCs apoptosis (26.65％±6.21％ vs 4.04％±1.86％,P＜0.01),up-regulated bax and p53 proteins expression (P＜0.01),and down-regulated bcl-2 protein exprssion(P＜0.05).Desipramine obviously inhibited the apoptosis induced by 4.25％ PDS,decreased bax and p53 proteins expression,increased bcl-2 protein expression(P＜0.05).Exogenous C2-ceremide reversed the effect of desipramine(P＜0.05).Conclusion The increase of intracellular ceremide may play an important role in the PMCs apoptosis induced by high glucose PDS.

Objective To investigate the effects of fasudil on expressions of Bcl-2 and Bax in cerebral cortex of model rats with subarachnoid hemorrhage (SAH). Methods Thirty rats were divided into sham operation group, SAH group and SAH+fasudil group, 10 rats in each group. Double injection of blood into occipital cistern method was used for SAH model in SAH group and SAH+fasudil group. In the sham operation group, the blood injection was instead by normal saline. In the SAH+fasudil group, at 30 min after the second injection of blood, rats were administrated with intraperitoneal injection of fasudil at a dose of 3 mg/kg. The general situation, neurological score, TUNEL staining for cortex cell apoptosis, immune histochemical staining and Western blotting assay for Bcl-2 and Bax protein expression were compared 24 h after the operation between the three groups. Results Compared with the sham operation group, rats in SAH group and SAH +fasudil group appeared obvious neurological deficits. The neurological score was significantly lower in SAH group ( 2.68 ± 0.31) than that of sham operation group (5.00±0.00). The neurological score was significantly higher in SAH+fasudil group (3.27 ± 0.35) compared with that of SAH group (2.68 ± 0.31, P<0.05). There was obvious cell apoptosis in SAH group and SAH+fasudil group, and the apoptosis was less in SAH+fasudil group than that of SAH group (P<0.05). The level of Bcl-2 expression was significantly lower in SAH group than that of sham operation group, and Bax expression was significantly higher in SAH group than that of sham operation group (P<0.05). The level of Bcl-2 expression was significantly higher in SAH+fasudil group than that of SAH group, but Bax expression was significantly lower in SAH+fasudil group than that of SAH group (P<0.05). Conclusion Fasudil can improve the neurological damage in rats with SAH, which may be related with the regulation of apoptosis related proteins Bcl-2 and Bax.

Objective To investigate the technique and effect of tunneled cuffed catheter as long-term hemodialysis access and the prevention of its related complications.Methods Permcath cuffed dual lumen catheter wag implanted in patients by the standard Seldinger technique,that a guidewire wss inserted into deep central vein, following by the insertion of the cuffed catheter through a peel-away sheath.The catheter related complications were observed.Urea reduce rate(URR),the Kt/V,the normalized protein catabolic rate(nPCR)and the time-averaged BUN concentration(TACurea)were measured as the index of the effect of hemodislysis.The effects were compared to those of arteriovenous fistula(AVF)within the same period(in 20 cases).Results In the total of 25 patients, 23 catheters were implanted in the internal jugular vein (21 cases at right,two at left side),one in the subclavian vein and one in the external jugular vein.Except for that one case died of cerebral infarction,all patients were using the catheter in well condition.Catheter related thrombosis or underfed occurred in 4 cases for 9 times, which became fluent after thrombolytic therapy or the adjustment of catheters.Catheter related infections occurred in 2 cases,and were successfully treated with anti-inflammation therapy.The average URR was 71.03%,Kt/V was 1.29,TAC urea was 12.74 mmol/L,and nPCR was 0.93 g/(kg·d)in all 25 patients,which was not significant different compared to patients with AVF((URR 72.46%,Kt/V 1.31,TACurea 12.86 mmol/L,nPCR 0.94 g/(kg·d)).Conclusions Cuffed dual lumen catheter for long-term aecegs in persistent hemodialysis has good effect on hemodialysis. Good catheter implanting technique and prevention of complications may improve the application of the catheter.

Objective To investigate the expression of cyclooxygenase-2 (COX-2) and epidermal growth factor receptor (EGFR) in astrecytomas, as well as the correlation between them. Methods The expression of COX-2, EGFR and PCNA were respectively detected by immunohistochmical (S-P) method in 68 astrocytomas and 5 cases normal brain tissue. Proliferation index (PI) was calculated and the correlation of COX-2, EGFR and PI was analyzed. Results COX-2 and EGFR were negative expression in normal brain tissue. The positive expression rate of COX-2 and EGFR in high grade astrocytomas was significantly higher than that in low grade astrocytomas(73.53% vs 44. 18% ,67.65% vs 38.24%, P <0. 01 ), and the PI was significantly higher than that in low grade astrocytumas as well as normal brain tissue(46.11 ± 10. 68vs 23. 04±6. 25,4. 52±0. 95, P <0. 01 ). The PI in COX-2 positive group was higher than that in negative group( P <0. 01 ). The positive expression rate of COX-2 in the group with EGFR positive expression was higher than that in the negative group. Conclusions The expression of COX-2 and EGFR was related to pathological feature of astrocytomas. COX-2 may promote the proliferation of tumor cells. There was a static correlation between the expression of EGFR and COX-2 in astrocytomas. EGFR signal transduction probably modulated the expression of COX-2 in astrocytomas cells.

Objective:To assess the prognostic value of modified Charlson comorbidity index (mCCI) combined with serum albumin for long-term prognosis in peritoneal dialysis (PD) patients.Methods:From January 1, 2007 to June 30, 2015, patients who started PD in Nanjing Drum Tower Hospital were enrolled in this retrospective cohort study. Clinical data including gender, age, underlying diseases, laboratory examination and prognosis were collected. The mCCI at the beginning of PD was calculated. Whether the duration of PD exceeded 5 years was used as an indicator to evaluate the prognosis. The patients were divided into≥5 years group and<5 years group according to the duration of PD, and the data were compared between the two groups. Cox regression model was constructed to analyze the influencing factors of all-cause death in PD patients. Multivariate logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the predictive value of mCCI and serum albumin levels on whether patients could maintain long-term PD.Results:Of the 183 patients included [males 106(57.9%), females 77(42.1%); (53.35±16.50) years old; 162 cases (88.5%) with hypertension, 55 cases (30.1%) with diabetes], 97 cases had PD duration for ≥5 years and 86 cases less than 5 years. The overall 5-year technical survival rate was 65.1%. At the beginning of PD, compared with the dialysis age≥5 years group, the patients in the dialysis age less than 5 years group had older age, higher mCCI, lower serum albumin level, and higher C-reactive protein (CRP) level (all P<0.05), but there were no significant differences in gender, education level, electrolyte, mean arterial pressure, high densitv lipoprotein (HDL), low-density lipoprotein (LDL) and PD adequacy index between the two groups (all P>0.05). Multivariate logistic regression analysis showed that increased age ( OR=1.022, 95% CI 1.000-1.043, P=0.046), increased mCCI ( OR=1.620, 95% CI 1.300-2.018, P<0.001) and decreased serum albumin ( OR=0.807, 95% CI 0.730-0.893, P<0.001) were independent predictors for the duration of PD<5 years. ROC curve analysis showed that the area under ROC curves ( AUC) of mCCI, serum albumin level and combined prediction probability of the two for the duration of PD<5 years were 0.647(95% CI 0.568-0.727), 0.655(95% CI 0.577-0.734), and 0.767(95% CI 0.700-0.835), respectively, indicating that the accuracy of combined parameters to predict survival outcome was higher than that of any single parameter. Multivariate Cox analysis showed that increased age ( HR=1.073, 95% CI 1.046-1.100, P<0.001), increased mCCI ( HR=1.198, 95% CI 1.044-1.375, P=0.010) and decreased serum albumin ( HR=0.904, 95% CI 0.843-0.969, P=0.004) were independent influencing factors for all-cause death in PD patients. Conclusions:Old age, high mCCI and low serum albumin level are influencing factors for dialysis age<5 years and all-cause death in PD patients. mCCI combined with serum albumin level can improve the accuracy of predicting the long-term dialysis in PD patients.