White matter hyperintensities (WMHs) are one of the main imaging biomarkers of cerebral small vessel disease (CSVD). With the development of neuroimaging technology, the WMH penumbra (WMH-P) has gradually become a research hotspot. WMH-P refers to the area of brain tissue microstructural integrity destruction or reduced blood flow perfusion around WMH lesions, which is not visible on conventional MRI sequences. It is not only a risk factor for the progression of WMHs, but also associated with clinical symptoms such as cognitive impairment and gait abnormalities in patients with CSVD, and is considered a new potential and reversible therapeutic target.

Objectives:To investigate the risk factors of sarcopenia in patients receiving maintenance peritoneal dialysis (MPD).Methods:One hundred and thirteen patients receiving maintenance MPD for ≥3 months during January and December 2017 were enrolled in this study. According to the Asian Working Group for Sarcopenia(AWGS)algorithm, there were 26 patients with sarcopenia accounting for 23.0% of all MPD patients. Demographic and anthropometric data were collected; laboratory tests were conducted, Kt/V urea and normalized protein equivalent of total nitrogen appearance were calculated; the bioelectrical impedance analysis (BIA) was performed and grip strength was tested. The nutritional status was evaluated with Subjective Global Assessment (SGA). Logistic regression was used to analyze the risk factors of sarcopenia in MPD patients. Results:BMI and dialysis dose of patients with sarcopenia were significantly lower than those without sarcopenia [(20.35±2.35) kg/m 2vs. (23.81±3.14) kg/m 2, t=-5.181, P<0.01; (5.57±1.83) L/d vs. (6.66±1.71) L/d, t=-2.795, P<0.01]. The bioelectrical impedance analysis showed that the total water content of patients with sarcopenia was higher than that of patients without sarcopenia [(35.44±6.40) kg vs. (28.52±4.89) kg, t=5.077, P<0.01]; while the protein content[(7.46±1.31) kg vs. (9.24±1.63) kg, t=-5.080, P<0.01] and skeletal muscle content [(20.54±4.18) kg vs. (25.88±4.95) kg, t=-4.980, P<0.01] of patients with sarcopenia were lower than those without sarcopenia. Multivariate analysis showed that decreased BMI( OR=0.934, 95 %CI: 0.723-0.998, P<0.01) and body protein ( OR=0.927, 95 %CI: 0.698-0.996, P<0.01), increased total body water( OR=1.382, 95 %CI: 1.053-1.813, P=0.02) were independent risk factors for sarcopenia in MPD patients. Conclusion:The incidence of sarcopenia in MPD patients is high, which is associated with the excessive volume load and malnutrition of patients.

Objective To explore whether voluntary wheel running affects liver oxidative stress by regulating the Nrf2/HO-1 pathway,thereby alleviating HFFC diet-related lipid deposition in the liver.Methods Eight-week-old C57BL/6J mice were randomly divided into a normal diet group(NC group,n=10)and high-fat,fructose,and cholesterol diet group(HFFC group,n=20)after 1 week of adaptive feeding.Ten weeks of feeding later,mice in the HFFC group were divided into a quiet group(HFFC group,n=10)and HFFC combined with exercise group(HFFC+EX group,n=10).HFFC+EX group mice were caged with voluntary running wheels for free movement,and the number of running wheels was recorded every day for 8 weeks.After the last treatment,the mice were sacrificed by fasting for 12 hours at an interval of 24 hours,and the blood and liver were collected for analysis.Results(1)Body weight,liver weight,and liver index of mice fed the HFFC diet were significantly higher than those of the NC group,which significantly decreased after exercise(P＜0.05).(2)Compared with the NC group,HDL-C and LDL-C in the HFFC group were significantly increased,and the LDL-C level was significantly decreased after 8 weeks of exercise(P＜0.05).(3)The liver fat droplet area and liver TG content in the HFFC group were significantly higher than those in the NC group,whereas those in HFFC+EX group were significantly decreased(P＜0.05).(4)Compared with the NC group,the content of oxidase MDA in the HFFC group were significantly increased,and nuclear translocation and gene expression of Nrf2 were significantly decreased.After exercise,the activities of SOD and T-AOC were significantly increased,and the nuclear translocation and gene expression of Nrf2 and expression levels of HO-1 and SOD-1 were significantly increased(P＜0.05).(5)The number of apoptotic hepatocytes and CHOP expression in the HFFC diet group were significantly higher than those in the NC group,whereas the number of apoptotic hepatocytes,and CHOP and Bax/Bcl-2 expression in the exercise group were significantly lower than those in the NC group(P＜0.05).Conclusions Voluntary wheel can alleviate HFFC diet induced liver lipid deposition by regulating the Nrf2/HO-1 pathway,thereby alleviating oxidative stress and reducing apoptosis in liver cells.