Objective To investigate the association of red cell distribution width (RDW) with all-cause and cardiovascular disease (CVD)-related mortality in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).Methods A retrospective analysis was performed on 207 patients who initiated CAPD for more than 3 months between July 2005 and March 2016 in the First Hospital Affiliated to Zhengzhou University.Baseline data on demographic,clinical and biochemical variables as well as comorbidities were obtained;medications and clinic outcomes were recorded.According to receiver operator characteristic curve (ROC) analysis,patients were divided into high RDW (RDW ＞ 15.1％) and low RDW (RDW≤ 15.1％) groups.The data of two groups were compared and Spearman's correlation analysis was used to explore the association of RDW with clinical and biochemical parameters.Survival curves were calculated using Kaplan-Meier method.Cox regression model was employed to analyze risk factors of all-cause and CVD-related mortality.Results In this study,207 CAPD patients were enrolled.The overall median survival time was 80 months.And the median survival time of high RDW group (68 patients) and low RDW group (139 patients) were 59 months and 96 months,respectively.There were statistical differences in diastole pressure,hemoglobin,hematocrit,serum albumin,intact parathyroid hormone (iPTH),eGFR,cholesterol,lipoprotein a,4-hour dialysate-to-plasma ratio for creatinine (4hD/Pcr),total Ccr (P ＜ 0.05,respectively);the two groups also varied in the proportion of chronic obstructive pulmonary disease,cardiovascular disease and hyperlipidemia,as well as in the use of iron supplements,angiotensin-converting enzyme (ACE) inhibitors or angiotensin Ⅱ receptor blockers (ARB),and beta-receptor blockers (P＜0.05,respectively).Cardiovascular event was a leading cause of mortality.Kaplan-Meier survival curves showed that the high RDW group had higher all-cause and CVD-related mortality compared with the low RDW group (P ＜ 0.01).The 1-year,3-year,and 5-year patient survivals of the high RDW and low RDW group were 87.97％ vs 97.01％,58.02％ vs 81.53％,and 41.62％ vs 67.96％,respectively,demonstrating significant differences (P=0.001).Multivariate Cox regression analysis showed that high RDW was independent risk factor for all-cause mortality (HR=1.212,95％CI:1.007-1.458,P=0.042) and CVD-related mortality (HR=1.697,95％ CI:1.030-2.795,P=0.038).Conclusion RDW is associated with mortality risks in CAPD patients and can be stratified as a valuable indicator for the risk of death.

Objective To investigate whether the JAK2/STAT3 signaling pathway is involved in the epithelial-mesenchymal transition (EMT) of peritoneal mesothelial cells in uremic peritoneal dialysis (PD) rats.Methods A total of 48 male Sprague-Dawley (SD) rats were randomly separated into six groups:normal control group (NC group,n=8),sham group (n=8),uremic group (n=8),PD group (n=8),S3I-201 control group (n=8) and S3I-201 group (n=8).Uremic model generated by 5/6 nephrectomy surgery in rats was established.The rats of PD group,S3I-201 control group and S3I-201 group received daily infusion of 4.25％ glucose-based peritoneal dialysate fluid (3 ml/100 g) from PD catheters for 28 days.Rats of S3I-201 group were injected with STAT3 inhibitor S3I-201 (2.5 mg/kg) solution from the catheters every other day;the same dose of the solvent of S3I-201 was simultaneously given to S3I-201 control group rats.After PD for 28 days,peritoneal function,pathologic changes,and microvessel density (MVD) were evaluated.Creatinine,urea nitrogen and interleukin-6 (IL-6) concentration in blood and dialysate,and protein and mRNA levels of phospho-JAK2 (p-JAK2),phospho-STAT3 (p-STAT3),E-cadherin,alpha-smooth muscle actin (α-SMA) and vascular endothelial growth factor (VEGF) in peritoneum were determined.Results Uremia and peritoneal dialysate could aggravate the peritoneal function and elevate peritoneal thickness and MVD.They could also increased the concentration of IL-6 in blood and dialysate and the expression levels of α-SMA,VEGF,p-JAK2 and p-STAT3 in peritoneum,while lowering E-cadherin expression in peritoneum.These manifestations were even more remarkable in PD group compared to those in uremic group.There was no statistical difference between the S3I-201 control group and the PD group as regards all the index (all P ＞ 0.05).Compared with the S3I-201 control group,the rats treated with S3I-201 showed better peritoneal function.S3I-201 could reduce peritoneal thickness (P＜0.05),MVD (P＜0.05),the concentration of IL-6 in blood and dialysate,the mRNA and protein expression of α-SMA,VEGF,p-JAK2 and p-STAT3 (all P ＜ 0.05),while enhance the mRNA and protein expression of E-cadherin (all P ＜ 0.05).Conclusions After STAT3 is inhibited,the peritoneal thickness,MVD and IL-6 concentration in PD rats are decreased,and EMT is also inhibited,while peritoneal function is improved.The JAK2/STAT3 signaling pathway may thus be involved in the process of EMT of peritoneum in uremic peritoneal dialysis rats by regulating the expression of IL-6.

Objective To investigate the relationship between liver cancer and the water environment, we analyzed the life expectancy in 14 counties (districts), which form the Huai River Basin with respect to liver cancer deaths in 2013 and changes in the surface water quality from 2004 to 2010. Methods The study area included the 14 counties (districts) of the Huai River Basin in China. We obtained surveillance data for all causes of death in the study area during 2013, as well as data for International Classification of Diseases,Tenth Edition(ICD-10) code C22 or liver cancer. Life expectancy and life expectancy after elimination of liver cancer were then calculated. Based on water quality monitoring data from the China Environment Yearbook 2005-2011, we analyzed the water environment of the Huai River Basin, and changes in the water quality. According to the“Encyclopedia of Rivers and Lakes in China”(Huai River Basin section), we divided the river basin into five categories: upstream basin (upstream);midstream, north shore of the basin (midstream-north);midstream, south shore of the basin (midstream-south);downstream basin (downstream); and the Yishusi River Basin. To calculate the life expectancy and life expectancy after elimination of liver cancer in the study area, we used the Nemerow Pollution Index (NPI), to investigate the relationship between liver cancer and the water environment. Results Life expectancy in the 14 study districts varied from 68.99 years (Shenqiu County) to 78.85 years (Jinhu County). Gains in life expectancy after elimination of liver cancer varied from 0.86 to 0.31 years. Midstream-north showed the greatest improvement, with overall gain in life expectancy of 0.77 years;this gain was 1.04 years for males and 0.40 years for females. Yishusi River Basin showed the least improvement, with overall gain in life expectancy of 0.41 years;this gain was 0.54 years for males and 0.24 years for females. For the 7 years from 2004 to 2010, midstream-north had the highest annual NPI values, at 2.08, 1.74, 1.64, 1.81, 1.41, 1.26, and 1.06, respectively. There was a positive correlation between NPI and life expectancy gain for both males and females (r=0.64, P=0.014). There was positive correlation between NPI and life expectancy gain among males alone (r=0.64, P=0.014); there was no significant correlation between NPI and life expectancy gain among females (r=0.44, P=0.115). Conclusion Liver cancer had a significant impact on life expectancy in the Huai River Basin. The gain in life expectancy was higher for males than for females. There is a possible relationship between liver cancer deaths and the water environment in the research area, but this study did not infer a causal association.

Objective To investigate the relationship between liver cancer and the water environment, we analyzed the life expectancy in 14 counties (districts), which form the Huai River Basin with respect to liver cancer deaths in 2013 and changes in the surface water quality from 2004 to 2010. Methods The study area included the 14 counties (districts) of the Huai River Basin in China. We obtained surveillance data for all causes of death in the study area during 2013, as well as data for International Classification of Diseases,Tenth Edition(ICD-10) code C22 or liver cancer. Life expectancy and life expectancy after elimination of liver cancer were then calculated. Based on water quality monitoring data from the China Environment Yearbook 2005-2011, we analyzed the water environment of the Huai River Basin, and changes in the water quality. According to the“Encyclopedia of Rivers and Lakes in China”(Huai River Basin section), we divided the river basin into five categories: upstream basin (upstream);midstream, north shore of the basin (midstream-north);midstream, south shore of the basin (midstream-south);downstream basin (downstream); and the Yishusi River Basin. To calculate the life expectancy and life expectancy after elimination of liver cancer in the study area, we used the Nemerow Pollution Index (NPI), to investigate the relationship between liver cancer and the water environment. Results Life expectancy in the 14 study districts varied from 68.99 years (Shenqiu County) to 78.85 years (Jinhu County). Gains in life expectancy after elimination of liver cancer varied from 0.86 to 0.31 years. Midstream-north showed the greatest improvement, with overall gain in life expectancy of 0.77 years;this gain was 1.04 years for males and 0.40 years for females. Yishusi River Basin showed the least improvement, with overall gain in life expectancy of 0.41 years;this gain was 0.54 years for males and 0.24 years for females. For the 7 years from 2004 to 2010, midstream-north had the highest annual NPI values, at 2.08, 1.74, 1.64, 1.81, 1.41, 1.26, and 1.06, respectively. There was a positive correlation between NPI and life expectancy gain for both males and females (r=0.64, P=0.014). There was positive correlation between NPI and life expectancy gain among males alone (r=0.64, P=0.014); there was no significant correlation between NPI and life expectancy gain among females (r=0.44, P=0.115). Conclusion Liver cancer had a significant impact on life expectancy in the Huai River Basin. The gain in life expectancy was higher for males than for females. There is a possible relationship between liver cancer deaths and the water environment in the research area, but this study did not infer a causal association.