Objective:To study the relationship between plasma homocysteine (Hcy),serum folate,Vitamin B12 levels and Vascular dementia (VD).Methods:30 VD patients,58 patients with nondemented cerebral infarction and 30 normal subjects of the same age were recruited in to the study.Their plasma Hcy levels were measured by reversed phase high performance liquid chromatography (RP-HPLC),and the levels of serum folate and Vitamin B12 were also determined by radioimmune assay (RIA).Results:Mean of Plasma homocysteine concentrations were significantly higher in VD group than in the nondemented cerebral infarction group.Which were significantly higher in the nondemented cerebral infarction group than in the normal subjects of the same age.Serum folate levels in the VD group were significantly lower than those in the nondemented cerebral infarction group.Which were significantly lower than those of normal subjects.Conclusion:Hcy may be a new risk factor for the onset of VD.

Objective To investigate the association of residual renal function with intradialysis dialysis hypotension among maintenance hemodialysis patients. Methods Fifty-six patients who had underwent maintenance hemodialysis from March 2014 to November 2015 were enrolled according to researching protocol in this study. Data of baseline and clinical parameter of every hemodialysis session were collected. The patients were divided into two groups by 24 h urine output:urine group (24 h urine output≥100 ml, 22 patients)and no urine group (24 h urine output<100 ml, 34 patients). The clinical data were compared between two groups. Results In the 12 weeks’ treatment, 965 times hemodiafiltration were performed in 56 patients, and the rate of intradialysis hypotension was 24.04%(232/965). The rate of intradialysis hypotension in urine group was 19.28%(80/415), in no urine group was 27.64%(152/550), and there was significant difference (P=0.000). The levels of interdialytic weight gain, ultrafiltration volume, ultrafiltration percentage , pre-dialysis systolic and diastolic blood pressure in urine group were significantly lower than those in no urine group (P<0.01). The levels of pre-dialysis weight, intradialysis systolic blood pressure variability, intradialysis diastolic blood pressure variability, heart rate variability, hemoglobin, serum albumin in two groups had no significant differences (P>0.05). Pearson correlation analysis showed that residual glomerular filtration rate (rGFR) had negative correlation with interdialytic weight gain (r =- 0.257, P = 0.001). Kaplan-Meier analysis showed that with the increase of dialysis time, the rate of intradialysis hypotension increased. The comulative rate of intradialysis hypotension in no urine group was higher than that in urine group (log-rank = 14.67, P =0.000). Conclusions Residual renal function is associated with intradialysis hypotension, and it is important for clinician to consider a residual renal function protection schedule for maintenance hemodialysis patients.

Objective:To explore the predictive factors of renal replacement therapy (RRT) in extracorporeal membrane oxygenation (ECMO) patients.Methods:The clinical data of 68 ECMO patients treated at Emergence Department of Jiangsu Provincial Hospital from January 2015 to December 2018 were retrospectively analyzed. Vasoactive-inotropic score (VIS) was used to assess the usage of vasoactive-inotropic drugs on day 1, 2 and 3 of ECMO (24 h VIS, 48 h VIS, and 72 h VIS). According to received RRT or not, patients were divided into the RRT group and non-RRT group. Age, gender, weight, VIS, presence of cardiac arrest before ECMO, ECMO mode, and ECMO treatment time were compared. Logistic regression analysis was used to identify predictive factors for RRT in ECMO patients.Results:Of the enrolled patients, 73.5% of ECMO patients received RRT. The mean age, 24 h VIS, ECMO failure and mortality of the RRT group were significantly higher than those of the non-RRT group ( P <0.05). The use of RRT was 87.8% in elderly ECMO patients (> cutoff age of 38.5 years). According to the cutoff value of 24 h VIS (33.75), ECMO patients were divided into the high VIS group and low VIS group. The rates of RRT and mortality were both exceeded 90% in the high VIS group, which was significantly higher than that of the low VIS group ( P <0.05). Logistic regression analysis showed that age ( OR=1.223) and 24 h VIS ( OR=1.033) were predictive factors of RRT in ECMO patients ( P <0.05). Conclusions:Age and 24 h VIS show the predictive value for RRT in ECMO patients.