Objective To elucidate the prevalence and risk factors of cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients on peritoneal dialysis (PD), and to investigate the associated problems in treatment. Methods A total of 254 PD patients in our division were enrolled in this study. CVD history, laboratory measurements, examinations of carotid atherosclerosis and left ventricular hypertrophy by ultrasonography were collected and associated factors were analyzed. The median follow-up time was 49 months. Results The overall prevalence of CVD was 37% (93/254). Diabetes, longer dialysis duration, hypertfiglyceridemia, hypoalbuminemia, hypoprealbuminemia were commonly found in the patients with new CVD event. The patients without pre-existing CVD had the higher Ccr, Kt/V, D/Pr, nPCR, serum albumin level. In those with pre-existing CVD, the hypertriglyceridemia and the duration of dialysis were independent predictors of progression of CVD. Differences of LAD, LVST, LVMI and IMT were significant between with and without pre-existing CVD groups. Kaplan-Meier curves showed that the presence of CVD was the independent risk factor of survival. Alb<330 g/L, LAD>39.6 mm and peritonitis were risk factors of CVD. Conclusion The prevalence of CVD in PD patients is quite high. CVD history should be realized, dialysis adequacy should be maintained, and peritonitis should be prevented.

How to eliminate the background of other tissue and to protrude the blood vessel information is the basic requirements in DSA. Because of the complexity and non-linearity of the X-ray imaging process, the common DSA technique cannot completely remove other tissue's image which lapped over the vessels. By experiments, this paper analyses and corrects the imaging process of the actual DSA system based on the "equivalent single energy" model, and the results indicate the validity of this method.
Algorithms ; Aluminum ; Angiography, Digital Subtraction ; methods ; Humans ; Image Processing, Computer-Assisted ; methods ; Plastics ; Radiographic Image Enhancement ; methods ; Reproducibility of Results ; Sensitivity and Specificity

Objective To evaluate the efficacy and safety of short-term restriction of dietary protein intake (DPI) supplemented with α-keto acids on chronic hepatitis B patients complicated with chronic kidney diseases (CKD). Methods A prospective randomized controlled trial was carried out.Seventeen chronic hepatitis B patients with CKD were randomized to either low DPI with α-keto acid-supplemented (sLP) or low DPI (LP) group for 3 months.Low-protein diet (LPD) was individualized with total energy intake 125.52-146.44 kJ·kg-1 ·d-1,and protein intake of 0.6-0.8 g·kg-1·d-1.α-keto acid was supplied in a dosage of 0.1 g·kg-1·d-1.Nutritional indexes were recorded and other clinical indexes were measured to evaluate the efficacy and safety respectively. Results The urine protein excretion level and microalbuminuria were significantly decreased at the end of the observation period in the sLP group compared to the basal value and the LP group [24 h urine protein:baseline (4.52±1.74) g,the 1st month (3.19±1.52) g,the 2nd month (2.19±1.1) g,the 3rd month (1.64±0.77) g,P＜0.05; microalbuminyria:baseline (2855.43±248.03) mg/L,the 1st month (2157.14±218.15) mg/L,the 2nd month (1681.57±146.18) mg/L,the 3rd month (924.29±83.33) mg/L,P＜0.05].No significant difference was found in Scr and eGFR.Nutritional indexes (SGA,serume albumin) were significantly higher at the end of 3 months in the sLP group (P＜0.05).No obvious side-effect occurred. Conclusions Short-term restriction of DPI is safe,and when combined with α-keto acids,can increase serum protein and decrease urine protein excretion in chronic hepatitis B patients complicated with CKD without significant sideeffect.

AIM AND METHODSThe effect of intrahippocampal microinjection of noradrenaline (NA) and its receptors antagonists and agonists on cellular immune functions were investigated in normal and adrenalectomy rat by determine the proliferative activity of Con A-stimulated splenic lymphocytes in MTT method and natural killer (NK) cell activity.

RESULTS(1) In normal group, the proliferative activity of Con A-Stimulated splenic lymphocytes were inhibited and the activity of NK cell were reduced with microinjection NA and beta1-, beta2-adrenergic receptor agonists Dobutamine (Dob, 4 microl, 6.0 x 10(-3) moL/L), Metaproterenol (Met, 4 microl, 8.0 x 10(-3) mol/L), compared with their intensity of effect, NA > Met > Dob; the immunosuppression effect induced by NA was partly hindered by alpha- and beta-receptor antagonists, phentolamine (Phen, 2 microl, 1.6 x 10(-2) mol/L) and propranolol (Prop, 2 microl, 1.6 x 10(-3) mol/L), and the action of Prop was more evident. (2) In adrenalectomy group, immunosuppression effect induced by NA was unconspicuous.

CONCLUSIONThe results suggested that NA in hippocampus could inhibit distinctly cellular immune functions, which was predominantly mediated by beta2- adrenergic receptor with a minor contribution of beta1- and alpha- adrenergic receptors. Moreover, keeping intact construction and function of adrenal gland have an important role in the effect of NA on cellular immune function.

Adrenergic Agonists ; pharmacology ; Animals ; Hippocampus ; drug effects ; Immunity, Cellular ; drug effects ; Killer Cells, Natural ; immunology ; Lymphocytes ; immunology ; Microinjections ; Norepinephrine ; pharmacology ; Rats ; Rats, Wistar ; Spleen ; cytology ; immunology

OBJECTIVETo test the effect of recombinant interleukin-4 (IL-4) and recombinant osteoprotegerin (OPG) in suppressing bone resorption induced by polyethylene wear particles..

METHODSA cranial bone allograft was introduced into the air pouches induced on the back of BALB/c mice, followed by injection of 1 ml suspension of polyethylene particles into the pouches. The mouse models were then divided into 3 groups to receive injections of saline (control), IL-4 alone, or IL-4 and OPG into the pouches. The tissues were harvested 21 days after bone implantation for molecular and histological analyses.

RESULTSPolyethylene wear particles-stimulated inflammatory responses (increased cellular infiltration and IL-1 and TNF production) were markedly reduced by IL-4 treatment either alone or combined with OPG (P<0.05). Polyethylene particles significantly increased tartrate-resistant acid phosphatase (TRAP) staining and bone absorption of the implanted bone graft, and IL-4 treatment, either alone or combined with OPG, obviously reduced the osteolysis induced by polyethylene particles (P<0.05).

CONCLUSIONIL-4 offers protection against polyethylene wear debris-induced inflammation and bone resorption in this mouse model. IL-4 combined with OPG can be a feasible and effective therapeutic approach to the treatment and prevention of polyethylene wear debris-associated osteolysis and aseptic loosening of the prosthetic components.

Animals ; Bone Resorption ; chemically induced ; prevention & control ; Disease Models, Animal ; Female ; Interleukin-4 ; pharmacology ; Mice ; Mice, Inbred BALB C ; Orthopedic Fixation Devices ; adverse effects ; Osteolysis ; chemically induced ; prevention & control ; Osteoprotegerin ; pharmacology ; Polyethylene ; antagonists & inhibitors ; Recombinant Proteins ; pharmacology

OBJECTIVETo compare the difference in the clinical efficacy on cervical spondylosis between acupuncture at three lines of cervical Jiaji (EX-B 2) and oral administration of jingfukang granules.

METHODSThree hundred cases of cervical spondylosis were divided into an acupuncture group and a medication group, 150 cases in each one. In the acupuncture group, according to the different types of cervical spondylosis, acupuncture was applied at three lines of cervical Jiaji (EX-B 2), once a day. In the medication group, jingfukang granules were prescribed for oral administration, one bag each time, three times a day. The treatment of ten days made one session in the two groups and two sessions were required totally. Before and after two sessions of treatment, the clinical assessment scale for cervical spondylosis (CASCS) was adopted to evaluate the score of subjective symptoms, clinical physical signs and adaptability as well as the total score in the patients of the two groups and the efficacy was compared.

RESULTSThe patients' symptoms and physical signs were alleviated, the adaptability was improved and the score of each item and the total score were increased in the two groups after treatment (all P<0.01). The improvements in the acupuncture group were better than those in the medication group (all P<0.01). The curative and markedly effective rate was 90.7% (136/150) in the acupuncture group, better than 66.0% (99/150) in the medication group (P<0.01).

CONCLUSIONAcupuncture at three lines of cervical Jiaji (EX-B 2) achieves the significant clinical efficacy on cervical spondylosis. This therapy is superior to relieving symptoms and physical signs and recovering adaptability as compared with jingfukang granules.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Spondylosis ; therapy ; Treatment Outcome ; Young Adult

Objective To investigate the prediction of diffusion kurtosis imaging(DKI)and intra voxel incoherent motion(IVIM)imaging global histogram parameters for the efficacy of neoadjuvant chemotherapy(NAC)in patients diagnosed with breast invasive ductal carcinoma.Methods A total of 69 patients with breast invasive ductal carcinoma confirmed by penetration pathology were retrospectively selected.Prior to undergoing NAC,all patients underwent sequential scans including MR conventional(T1WI,T2WI),dynamic contrast enhancement(DCE),DKI,and IVIM.After surgery,the patients were divided into significant group(40 patients)and non-significant group(29 patients)based on the efficacy of NAC,which was evaluated using the Miller-Payne(MP)grading method criteria.The differences in global histogram parameters of DKI[mean diffusivity(MD),mean kurtosis(MK)]and IVIM(D value,f value,D*value)between the significant group and the non-significant group were compared by the two-independent sample t-test and Mann-Whitney U test.In addition,the receiver operating characteristic(ROC)curve was plotted,and Spearman rank correlation analysis was used to evaluate the diagnostic efficacy and correlation of DKI and IVIM global histogram parameters in predicting NAC efficacy.The DeLong test was used to compare whether there was statistical significance in area under the curve(AUC)differences among histogram parameters.Results The DKI MD value(90th percentile,mean,median,maximum,range,root mean square),IVIM D value(mean,range,root mean square,median)and D*value(entropy,90th percentile)of patients with breast invasive ductal carcinoma in the significant group with efficacy of NAC were higher than those in the non-significant group,while the DKI MK value(mean and median)were lower than those in the non-significant group,and all the differences mentioned above were statistically significant(P＜0.05).The AUC,sensitivity and specificity of DKI combined with IVIM global histogram parameters were the highest,which were 0.816,72.41％and 90.00％,respectively.MD value,D value and D*value were negatively correlated with the efficacy of NAC in breast invasive ductal carcinoma.MK value was positively correlated with NAC efficacy significance.Conclusion DKI combined with IVIM global histogram parameters can effectively predict the efficacy of NAC in patients with breast invasive ductal carcinoma and provide effective value for clinical NAC preoperative efficacy evaluation.

OBJECTIVETo investigate the clinical and pathologic characteristics of anti-glomerular basement membrane(GBM) disease with normal renal function.

METHODSThe clinical and pathologic data of 6 patients with anti-GBM disease and normal renal function in Peking Union Medical College Hospital were reviewed retrospectively. Furthermore, 29 patients with anti-GBM disease and impaired renal function in the same period in the same hospital were enrolled as the control group. Factors that may influence the prognosis were analyzed.

RESULTSSix (17.1%) of all 35 patients maintained normal renal function for 12-133 months during follow-up. Five patients had microhematuria and proteinuria, one had pulmonary hemorrhage only, and three manifested as Goodpasture syndrome. Renal biopsies from 4 patients revealed linear deposition of IgG 2+-3+ along the glomerular capillary walls by immunofluorescence. As shown by normal light microscopy, mild mesangial proliferation and crescentic glomerulonephritis with a large amount of fibrinoid necrosis of glomerular capillary walls were observed in different patients; however, most pathological changes were mild. Five of these six patients were treated with immunosuppressive drugs and/or plasma exchange. Compared with the control group, the 6 patients with normal renal function had significantly higher hemoglobin[(77.97±20.62 vs.(99.67±19.80 g/L P=0.024], lower titers of anti-GBM antibody[(224.34 ± 145.79 vs.(80.23 ± 85.73 EU/ml P=0.027], and lower ratio of glomeruli with crescents[(0.58±0.29 vs.(0.17±0.27 ,P=0.005]. These 6 patients with normal renal function were followed up for 12-133 months, among whom 4 patients achieved complete remission and 2 had mild proteinuria and microhematuria.

CONCLUSIONAnti-GBM disease with normal renal function is not uncommon. Most patients have mild pathologic changes and good prognosis.

Adult ; Anti-Glomerular Basement Membrane Disease ; pathology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Kidney ; physiopathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

Objective To investigate the awareness rate,treatment rate and control rate of mineral and bone disorder in patients with moderate or advanced stage chronic kidney disease (CKD). Methods The awareness rate,treatment rate and control rate of mineral and bone disorder were evaluated based on a questionnaire and related laboratory examinations in 503 CKD stage 3 to 5 patients. Results The awareness rate of mineral and bone disorder in patients with moderate or advanced stage CKD was highest in hemodialysis patients,moderate in peritoneal dialysis patients and lowest in non-dialyzed patients (all P ＜0.01).The total scores of the questionnaire were lowest in non-dialyzed patients [6 (5,8)] and were significantly higher in peritoneal dialysis [11 (9,12)] and hemodialysis patients [13 (11,15)] (P＜0.01).The extent of awareness was negatively correlated with age (r=-0.11,P＜0.05),and positively correlated with educational background (r=0.226,P＜0.01),duration of CKD (r=0.597,P＜0.01) and duration of dialysis (r=0.366,P＜0.01).The source of knowledge was mainly from publicity and education made by medical staff,which accounted for 94.0％,79.5％ and 69.4％ respectively in nondialyzed,peritoneal dialysis and hemodialysis patients.The treatment rate was significantly higher in peritoneal dialysis (88.6％) and hemodialysis patients (96.9％) than that in non-dialyzed patients (58.2％) (all P＜0.01).According to K/DOQI guideline,the control rate of serum calcium,phosphorus,calcium and phosphorus product and parathyroid hormone (PTH) were much better in non-dialyzed patients as compared to dialyzed ones.The percentage of number of lab indicators meeting the standard was significantly higher in non-dialyzed patients as compared to dialyzed ones (P＜0.01).According to KDIGO guideline,the control rate of serum phosphorus was significantly lower in hemodialysis patients (23.6％) than that in peritoneal dialysis (36.9％) and non-dialyzed patients (46.7％) (P＜0.01). Conclusions In non-dialyzed patients with moderate or advanced stage CKD,the awareness rate and treatment rate of mineral and bone disorder are relatively low,and the control rate is relatively high.Whereas in dialyzed patients,the awareness rate and treatment rate are relatively high,and the control rate is relatively low.

OBJECTIVETo investigate single nucleotide polymorphisms(SNPs) and haplotypes of interleukin-18(IL-18) gene associated with the susceptibility to colorectal cancer(CRC).

METHODSTwo SNPs of IL-18 gene promoter -137G/C and -607C/A in 170 patients with CRC and 160 healthy controls matched by age and sex in a Chinese population were analyzed using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) strategy. Frequency of haplotypes and linkage disequilibrium of IL-18 gene in different groups were analyzed by SHEsis programs.

RESULTSThe distributions of IL-18 gene -607C/A polymorphism did not differ between CRC patients and healthy controls, but IL-18 gene -137G/C polymorphism was significantly different(P<0.05). The relative risk of C allele for CRC was 1.814 times of the G allele (OR=1.814,95% CI:1.246-2.642). Consistent with the results of the genotyping analyses, IL-18 -137G/C and -607C/A polymorphisms showed strong linkage disequilibrium(|D'|=0.945), frequency of the -137C/-607A haplotype in patients with CRC was significantly higher than that in healthy controls(P<0.05). The -137C/-607A haplotype was associated with a significantly increased risk of CRC(OR=1.637, 95% CI:1.100-2.437).

CONCLUSIONSIL-18 gene -137G/C polymorphism and -137C/-607A haplotype are associated with CRC. -137C allele may be an important genetic susceptibility gene for CRC.

Adult ; Case-Control Studies ; Colorectal Neoplasms ; genetics ; Female ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Interleukin-18 ; genetics ; Male ; Middle Aged ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide