Objective To study the influence of hemodiafiltration on high-sensitivity C-reactive protein (hs-CRP),serum parathyroid hormone (iPTH) and cardiac function in uremic patients undergoing maintenance hemodialysis (MHD).Methods Forty patients with uremia were divided into hemodiafiltration (HDF) group (n =20) and hemodialysis(HD) group(n =20) by random numbers.Serum hs-CRP and iPTH were measured before treatment and at 6 months after treatment.Their left ventricular diastolic diameter (LVEDD),left ventricular end-systolic dimension (LVESD),interventricular septal thickness (IVST) and left ventricular ejection fraction(LVEF) were measured by echocardiogram.Ten healthy volunteers were recruited as the normal controls.Results After treatment,serum hs-CRP and iPTH decreased significantly in the HDF group (hs-CRP:(3.32±1.t4) mg/L vs.(7.84 ±2.21) mg/L,t =2.072,P =0.046;iPTH:(155.36 ±81.33) ng/L vs.(190.25 ±82.31) ng/L,t =2.121,P =0.023).No significant difference of serum hs-CRP and iPTH was observed in the HD group before and after treatment (hs-CRP:(7.91 ±2.11) mg/L vs.(7.68 ± 1.86) mg/L,t =1.731,P =0.111 ; iPTH:(177.43 ± 85.43) ng/L vs.(184.35 ± 87.21) ng/L,t =1.331,P =0.210).Color Doppler indices of cardiac structure of the HDF group significantly improved after treatment compared with before treatment (LVEDd:(55.3 ±3.7) mm vs.(58.8 ±4.3) mm,t =2.345,P =0.015 ;LVESd:(33.5 ±2.6) mm vs.(36.4±4.3) mm,t=2.178,P=0.046;IVST:(10.2±1.7) mmvs.(13.1 ±1.8) mm,t=2.630,P=0.012;LVEF:(55.3 ±2.6)％ vs.(42.5 ±3.3)％,t =2.860,P =0.010;LVMI:(132.5 ±9.1)g/m2 vs.(137.4 ± 8.7) g/m2,t =2.871,P =0.009).After treatment,cardiac structure of the HDF group was significantly better than that of the HD group (LVEDd:(55.3 ± 3.7) mm vs.(59.1 ± 4.2) mm,LVESd:(33.5 ±2.6) mm vs.(36.1 ±3.4) mm,IVST:(10.2±1.7) vs.(12.4 ±1.3) mm,LVEF:(55.3 ±2.6)％vs.(43.4±2.7)％,LVMI:(132.5 ±9.1) g/m2 vs.(139.4 ±8.9) g/m2;P ＜0.05).During the six month treatment,the incidence rate of cardiovascular events of the HDF group was significantly less than the HD group (36.39％(524/1440) vs.(72.08(1038/1440),x2 =21.583,P＜0.01).Conclusion HDF may efficiently remove iPTH,improve cardiac function of uremic patients,and help them recover from micro-inflammatory state.

The present paper is to study the center line of the plantar pressure of normal young people, and to find the relation between center line of the plantar pressure and gait stability and balance. The paper gives the testing principle and calculating methods for geometric center of plantar pressure distribution and the center of pressure due to the techniques of footprint frame. The calculating formulas in both x direction and y direction are also deduced in the paper. In the experiments carried out in our laboratory, the gait parameters of 131 young subjects walking as usual speed were acquired, and 14 young subjects of the total were specially analyzed. We then provided reference data for the walking gait database of young people, including time parameters, space parameters and plantar pressure parameters. We also obtained the line of geometry center and pressure center under the foot. We found that the differences existed in normal people's geometric center line and the pressure center line. The center of pressure trajectory revealed foot movement stability. The length and lateral changes of the center line of the plantar pressure could be applied to analysis of the plantar pressure of all kinds of people. The results in this paper are useful in clinical foot disease diagnosis and evaluation of surgical effect.
Foot ; physiology ; Gait ; Humans ; Pressure ; Reference Values ; Walking

Objective:To explore the competency for the assistant general practitioners in China to provide theoretical support for the construction of the post competence model of assistant general practitioners and training and evaluation of assistant general practitioners.Methods:During January 22 to June 18, 2019, Using snowball sampling method and behavioral event interviews, 23 general practitioners and assistant general practitioners were interviewed in China, including 14 general practitioners in the superior performance group and 9 assistant general practitioners in the average performance group. The interview contents were coded and analyzed, and the statistical methods of t test and rank sum test of two independent samples were used to screen competency characteristics and construct the competence model of assistant general practitioners.Results:The total classification consistency and the total coding reliability coefficient was respectively 0.79, 0.87. 59 competency characteristics of assistant general practitioners were obtained including 3 differentiated competency characteristics "Understanding the medical and health system and related policies", "Critical thinking skills" and "General practitioner clinical thinking" and 10 baseline competency characteristics. There was no statistically significant difference between the average performance group and the superior performance group in the total frequency of competency [(29.4±12.7) times to (23.4±7.0) times, t=1.27, P=0.22]. Conclusion:The preliminary competency characteristics of assistant general practitioners have good reliability and can provide references for further exploration of the competency model.

Objective To investigate the protective effect of aralia total saponins on renal injury induced by streptozotocin (STZ) in type 2 diabetic mice, meanwhile to explore its protective mechanism. Methods Fifty male Kunming mice were randomly divided into the normal group, the model group and the aralia total saponins low, middle and high does groups. All the rats were given high fat diet 8 weeks and then received STZ 45 mg/kg to built type 2 diabetic mice model, except the noraml group. After the models establishment,the aralia total saponins low, middle and high does groups were given the aralia total saponins 30, 60, 120 mg/kg treatment, andthe normal group and the model group were given the equal normal saline, once each day. After 4th and 8th week administration, the urinary protein levels of 24 h in each group were detected. After the last treatment, all the mice were sacrificed to detected the changes of blood glucose, insulin and inflammatory related factors. Immunohistochemistry, Western blotting and real-time quantitative PCR were used to observe the expression of TLR2 and TLR2 in the kidney tissue. Results Compared with the model group, the low, middle and high does groups in 24-hour proteinuria, blood glucose, insulin resistance index decreased (P<0.05), the insulin increased(P<0.05). The serum TNF-α (16.66 ± 0.20 ng/L, 14.49 ± 0.27 ng/L, 13.52 ± 0.22 ng/L vs.20.33 ± 0.56 ng/L),IL-1β(0.46 ± 0.04 ng/L,0.44 ± 0.04 ng/L,0.37 ± 0.04 ng/L vs.0.55 ± 0.05 ng/L),NF-κB (28.71 ± 6.14 ng/L, 26.26 ± 5.48 ng/L, 25.69 ± 5.61 ng/L vs. 36.55 ± 8.90 ng/L) significantly decreased (P<0.05).The kidney TLR2 mRNA(1.92 ± 0.18,1.46 ± 0.23,1.28 ± 0.21 vs.2.69 ± 0.22),TLR4 mRNA(2.20 ± 0.19,2.08 ± 0.27,1.57 ± 0.22 vs.2.78 ± 0.23),TLR2 porteins(0.82 ± 0.11,0.52 ± 0.06,0.44 ± 0.07 vs.0.77 ± 0.13),TLR4 proteins(0.52 ± 0.04,0.42 ± 0.09,0.26 ± 0.06 vs.0.86 ± 0.12)significantly decreased(P<0.05). Conclusions The aralia total saponins can significantly reduce the blood glucose, insulin resistance index and 24-hour urinary protein in type 2 diabetic nephropathy of mice, increase the insulin, and analyzing its mechanism may be total saponins can inhibit the expression of TLR2 and TLR4 protein in the kidney, and further reduce the inflammatory response.