Objective To observe the difference of vascular endothelial growth factor (VEGF) and myeloperoxidase (MPO) between diabetic and non-diabetic patients with maintenance hemodialysis (MHD),and to explore whether it was associated with duration of hemodialysis.Methods A total of 120 patients with MHD were divided into diabetic group (40 cases) and non-diabetic group (80 cases) according to the primary disease.The blood samples from the patients before dialysis were selected to test the serum VEGF and plasma MPO and other indicators.The blood samples from April 2012 to March 2013 were labeled diabetic group 1(40 cases) and non-diabetic group 1 (80 cases).The blood samples from April 2013 to March 2014 were labeled diabetic group 2 (40 cases) and non-diabetic group 2 (80 cases).Results The serum VEGF and plasma MPO levels were (74.63 ± 47.43) ng/L,(300.63 ± 235.37) μ g/L in diabetic group 1,and (63.69 ± 43.23) ng/L,(275.35 ± 216.32) μ g/L in non-diabetic group 1,and there were significant differences between two groups (P ＜ 0.05).The serum VEGF and plasma MPO levels were (83.32 ± 40.38) ng/L,(414.12 ±265.52) μg/L in diabetic group 2,and (70.89 ±39.74) rig/L,(289.45 ±202.85) μg/L in non-diabetic group 2,and there were significant differences between two groups (P ＜ 0.05).The correlation analysis showed that VEGF was positively correlated with MPO in diabetic group 1 and diabetic group 2 (r =0.632 and 0.763,P ＜ 0.05),and VEGF was positively correlated with MPO in non-diabetic group 1 and non-diabetic group 2 (r =0.610 and 0.713,P ＜ 0.05).Conclusions Compared with those in non-diabetic MHD patients,VEGF and MPO levels are significandy higher in diabetic MHD patients.In non-diabetic MHD patients and diabetic MHD patients,VEGF and MPO levels will rise gradually with duration of hemodialysis.The expressions of VEGF and MPO are associated with each other.

Objective To investigate the impact of ultrapure dialysate on long-term survival rate and complication in maintenance hemodialysis patients.Methods Seventy maintenance hemodialysis patients were selected,and they were divided into ultrapure dialysate group (36 cases) and control group (34 cases) by random digits table method.The 1-,3-,5-year mortality,death causes and the incidences of cardiovascular complication,infection,cerebrovascular accident were recorded.Results The 3-and 5-year mortality in ultrapure dialysate group were significantly lower than those in control group:30.6％ (11/36) vs.41.2％ (14/34) and 41.7％ (15/36) vs.82.4％ (28/34),and there were statistical differences (P ＜ 0.05).The mortality of infection in ultrapure dialysate group was significantly lower than that in control group:1/15 vs.21.4％ (6/28),and there was statistical difference (P ＜ 0.05).The incidences of cardiovascular complication,cerebrovascular accident,infection in ultrapure dialysate group were significantly lower than those in control group:47.2％ (17/36) vs.79.4％ (27/34),27.8％ (10/36) vs.41.2％ (14/34) and 41.7％ (15/36) vs.73.5％ (25/34),and there were statistical differences (P ＜ 0.05).Conclusion Ultrapure dialysate can increase long-term survival rate and decrease incidence of complication in maintenance hemodialysis patients.

Objective To study possible clinical relationships of myeloperoxidase (MPO) and carotid atherosclerosis in diabetic patients on maintenance hemodialysis(MHD).Methods Levels of plasma MPO and serum elastase (ELT) of diabetic patients on MHD were determined by enzyme-linked immunosorbent assay.Carotid intima media thickness(CIMT),quantity and area of carotid plaque were measured by B-mode ultrasonography.Results Plasma MPO was significantly higher after hemodialysis(HD) than before HD(414.6 (198.9,671.5) μg/L vs 176.4 (69.9,243.3) μg/L,Z =-4.51,P ＜ 0.01).There was no significant difference of serum ELT before and after HD(198.0(146.9,270.5) μg/L vs 230.9(40.2,308.0) μg/L,Z =-1.87,P ＞ 0.05).There was positive correlation between the age and CIMT,quantity or area of carotid plaqueor(correlation coefficient:0.764,0.416 and 0.446 respectively,P ＜ 0.01 or P ＜ 0.05),There was positive correlation between MPO level before HD and age,Levels of serum ELT before HD,or CIMT(correlation coefficient:0.592,0.476 and 0.810 respectively,P ＜ 0.01).There was positive correlation between MPO level after HD and levels of serum ELT after HD (correlation coefficient:0.364,P ＜ 0.05).There was no correlation between the levels of plasma MPO after HD and CIMT,quantity or area of carotid plaqueor (P ＞ 0.05).Conclusion (1) Age and MPO level before HD contribute to carotid atherosclerosis in patients on MHD.(2)There was no relation between higher MPO level after HD and carotid atherosclerosis.

Polyarteritis nodosa (PAN) is a rare vasculitis that mainly involves small and medium arteries. It often occurs at the points where the vessels bifurcate, leading to microaneurysm formation, thrombosis, aneurysm rupture and bleeding, and infarction of organs.About a third of cases are associated with hepatitis B virus (HBV) infection.All tissues and organs of the body can be affected, with skin, joints and peripheral nerves being the most common.The pathological changes were fibrinoid necrosis, inflammatory cell infiltration and luminal thrombosis in the acute stage, and fibrous hyperplasia in the chronic stage.Overall outcomes for the disease have improved in recent decades, mainly reflecting early diagnosis and more effective treatments.The main treatments for PAN are glucocorticoid and cyclophosphamide.Patients with HBV-associated PAN should receive antiviral therapy and plasma exchange.