ObjectiveTo explore the potential mechanism of Shenqi Jianxin Formula （参芪健心方） in the treatment of chronic heart failure （CHF） from the perspective of regulating mitochondrial autophagy via the PTEN-induced kinase 1 （PINK1）/E3 ubiquitin ligase （Parkin） pathway. MethodsMale SD rats were subjected to abdominal aortic constriction to establish the CHF model. Twenty-four successfully modeled rats were randomly divided into the model group， sacubitril/valsartan group， and low- and high-dose Shenqi Jianxin Formula groups， with 6 rats in each group. Six other rats were set as the sham surgery group， which were only separated the abdominal aorta and then closed the abdomen. Rats in the low-dose and high-dose Shenqi Jianxin Formula groups were given intragastric administration of Shenqi Jianxin Formula suspension at doses of 4.41 g/（kg·d） and 17.64 g/（kg·d）， respectively； the sacubitril/valsartan group received intragastric administration of sacubitril/valsartan sodium tablet suspension at 10 mg/（kg·d）； the sham surgery group and the model group were given normal saline at 10 ml/（kg·d） via intragastric gavage. The intervention lasted for 4 consecutive weeks. Cardiac function indices including left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） were detected， and serum brain natriuretic peptide （BNP） content was measured. HE staining and Masson staining were used to observe myocardial histopathological changes. Transmission electron microscopy was employed to examine the ultrastructure of cardiac tissues. Quantitative real-time polymerase chain reaction （Rt-qPCR） was performed to determine the mRNA expressions of PINK1/Parkin pathway-related factors and autophagy-associated proteins including Beclin-1， p62， and microtubule-associated protein 1 light chain 3 （LC3） in myocardial tissues. ResultsCompared with the sham surgery group， the model group showed significant decreases in LVEF and LVFS levels， an increase in serum BNP content， down-regulated mRNA and protein expressions of PINK1， Parkin and Beclin-1 in cardiac tissues， up-regulated mRNA and protein expressions of p62， as well as significant reductions in LC3B mRNA expression， phosphorylated PTEN-induced kinase 1 （p-PINK1） and phosphorylated E3 ubiquitin ligase （p-Parkin） protein levels， and the ratio of microtubule-associated protein 1 light chain 3-Ⅱ to microtubule-associated protein 1 light chain 3-Ⅰ （LC3Ⅱ/LC3Ⅰ） （P＜0.05）. Pathological results revealed obvious myocardial cell edema， necrosis and degeneration， increased disorder of myocardial fiber arrangement， extensive inflammatory cell infiltration， moderate to severe mitochondrial swelling， a few mitochondrial vacuolar changes， and no obvious autophagy in the field of vision in the model group. Compared with the model group， all the above indicators were significantly improved in the high-dose Shenqi Jianxin Formula group and the sacubitril/valsartan group （P＜0.05）. Moreover， the improvement of each index in the high-dose Shenqi Jianxin Formula group was superior to that in the low-dose group （P＜0.05）. In the high-dose Shenqi Jianxin Formula group， myocardial myofibrils were arranged regularly with orderly orientation， the striated structure was clear， and necrotic cells significantly reduced. ConclusionShenqi Jianxin Formula can activate the PINK1/Parkin signaling pathway in myocardial tissues， enhance mitochondrial autophagy， and clear dysfunctional mitochondria， thereby improving cardiac function and delaying the progression of CHF.

Objective: Establishment of a HPLC method for six chemical components in Saposhnikovia divaricata (prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisamminoside, sec-O-glucosylhamaudol, psoralen, and imperatorin), comparison of the advantages and disadvantages of the dual-standard linear calibration method and the relative retention time method, and investigation of the feasibility of the linear calibration using two reference substances for qualitative analysis of multiple components in Saposhnikovia divaricata.
Methods: A HPLC method was employed, using 21 different brands and models of C18 columns. The mobile phase consisted of acetonitrile (A) and 0.02% phosphoric acid aqueous solution (B), with gradient elution (0-20 min, 18%A; 20-45 min, 18%A-50%A; 45-60 min, 50%A). The column temperature was set at 30 ℃, the flow rate was 1 mL·min^-1, and the detection wavelength was 254 nm.
Results: The results predicted by the linear calibration using two reference substances were accurate and superior to those of the relative retention time method, and the six components exhibited good linear relationships within their respective ranges.
Conclusion: The established linear calibration using two reference substances accurately predicts the retention times of the target components. This method is stable and reliable, providing a reference for the establishment of digital standards in traditional Chinese medicine.

ObjectiveTo explore the associations among depressive symptoms, psychological resilience, and mental health literacy in adolescents, so as to provide new insights for interventions targeting adolescent depressive symptoms. MethodsA stratified multistage cluster sampling method was employed to select 2 723 students aged 10‒18 years from primary and secondary schools at different educational stages in Putuo District of Shanghai from December 2024 to January 2025. The Patient Health Questionnaire-9 (PHQ-9, total score0‒27, with a score ≥10 indicating positive depressive symptoms), the Resilience Scale for Chinese Adolescents (RSCA , total score 27‒135), and a mental health core knowledge awareness questionnaire (total score 0‒10) were utilized to assess depressive symptoms, psychological resilience, and mental health literacy, respectively. A network model was constructed using the nine PHQ-9 items (including anhedonia, depressed mood, sleep problems, fatigue, appetite problems, guilt, trouble concentrating, psychomotor symptoms, and self-harm or suicidal thoughts), five RSCA dimensions (including goal orientation, emotion regulation, positive cognition, family support, and interpersonal assistance), and the total mental health literacy score as nodes to analyze the association structure among these nodes. Standardized node strength, standardized expected influence, and standardized bridge expected influence were calculated. ResultsThe PHQ-9 score was 4.62±5.27, yielding a positive screening rate for depressive symptoms of 15.28%. The scores of the RSCA and mental health literacy were 97.71±20.58 and 9.00 (8.00, 10.00), respectively. Network analyses revealed that emotion regulation and depressed mood were core nodes in the network (standardized strength values were 1.74 and 0.97); they constituted the main connection between depressive symptoms and psychological resilience networks (edge weight was -0.17). Mental health literacy and positive cognition served as the main bridge nodes linking depressive symptoms and psychological resilience (standardized bridge expected influence values were 1.42 and 1.27). ConclusionDepressed mood, emotion regulation, positive cognition, and mental health literacy are closely associated with depressive symptoms, psychological resilience, and mental health literacy in adolescents. Strengthening interventions targeting emotion regulation, positive cognition and mental health literacy may contribute to the prevention and control of depressive symptoms among adolescents.

ObjectiveTo explore the clinical potential of magnetic resonance elastography （MRE） for assessing the stiffness of common intracranial tumors. MethodsA retrospective analysis was conducted on 47 patients with brain tumors who underwent surgical treatment at The First Affiliated Hospital of Sun Yat-sen University between April 2023 and September 2024. The cohort included 10 cases of glioma， 12 cases of vestibular schwannoma， and 25 cases of meningioma. All patients underwent multiparameter MRI and MRE preoperatively. After co-registering MRE images with contrast-enhanced 3D T1-weighted images， three regions of interest （ROIs） were placed in the areas of maximum and minimum tumor stiffness respectively to measure the shear stiffness values， and the mean was calculated as the average shear stiffness. Additionally， one ROI was placed in the white matter and one in the grey matter of the posterior horn of the lateral ventricle at the basal ganglia level to obtain normal reference values. A neurosurgeon， blind to the MRE results， graded the intraoperative tumor stiffness based on surgical videos using a 5-point scale （1： soft； 5： hard）. Intraclass correlation coefficient （ICC） was used to assess inter-observer consistency. Analysis of variance （ANOVA） and nonparametric tests were employed to compare the differences of shear stiffness values between groups. Spearman correlation analysis was used to examine the correlation between elasticity values and clinicopathological parameters. The discriminatory efficacy of shear stiffness values for tumor types was evaluated with receiver operating characteristic （ROC） curves. ResultsThe ICCs for elasticity values measured by two physicians in the hardest and softest tumor areas were 0.868 and 0.831， respectively （both P＜ 0.01）. The maximum， minimum， and average shear stiffness values of meningiomas［（1.91±0.28） m/s， （1.66±0.25） m/s， （1.78±0.26） m/s， respectively］ were significantly higher than those of gliomas［（1.59±0.23） m/s， （1.42±0.23） m/s， （1.50±0.22） m/s， respectively （P＜0.05）］. The shear stiffness values of vestibular schwannomas［（1.70±0.30） m/s， （1.51±0.23） m/s， （1.61±0.26） m/s， respectively） were lower than those of meningiomas and higher than those of gliomas， but these differences were not statistically significant （both P＞0.05）. The shear stiffness values of white matter were significantly higher than that of grey matter［（1.63±0.08） m/s vs. （1.39±0.12） m/s， P＜0.05）］. In the overall sample， the maximum， minimum， and average shear stiffness values were significantly positively correlated with the intraoperative hardness grade （r_s = 0.591， r_s = 0.541， r_s = 0.571， respectively； all P＜0.001）， negatively correlated with WHO grade （r_s = -0.458， r_s = -0.458， r_s = -0.480， respectively； all P＜0.01）， but showed no correlation with Ki-67 （all P＞0.05）. ConclusionMRE can be used to assess the stiffness of intracranial tumors and to some extent differentiate between tumor types， which aids in formulating more individualized preoperative surgical plans.

ObjectiveTo investigate the effect and mechanism of Yishen Tongluo prescription in protecting mice from oxidative stress injury in diabetic kidney disease （DKD） via the nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1）/NAD（P）H quinone oxidoreductase 1 （NQO1） signaling pathway. MethodsSpecific pathogen-free （SPF） male C57BL/6 mice were assigned into a control group （n=10） and a modeling group （n=50）. The DKD model was established by intraperitoneal injection of streptozotocin. The mice in the modeling group were randomized into a model group， a semaglutide （40 μg·kg^-1） group， and high-， medium-， and low-dose （18.2， 9.1， 4.55 g·kg^-1， respectively） Yishen Tongluo prescription groups， with 10 mice in each group. The treatment lasted for 12 weeks. Blood glucose and 24-h urine protein levels were measured， and the kidney index （KI） was calculated. Serum levels of creatinine （SCr）， blood urea nitrogen （BUN）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST） were assessed. The pathological changes in the renal tissue were evaluated by hematoxylin-eosin， periodic acid-Schiff， periodic acid-silver methenamine， and Masson’s trichrome staining. Enzyme-linked immunosorbent assay kits were used to measure the levels of β2-microglobulin （β2-MG）， neutrophil gelatinase-associated lipocalin （NGAL）， kidney injury molecule-1 （KIM-1）， liver fatty acid-binding protein （L-FABP）， nitric oxide synthase （NOS）， glutathione （GSH）， total antioxidant capacity （T-AOC）， and 8-hydroxy-2'-deoxyguanosine （8-OHdG）. Immunohistochemical staining was performed to examine the expression of Kelch-like ECH-associated protein 1 （Keap1） and malondialdehyde （MDA）. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR） and Western blot were employed to determine the mRNA and protein levels， respectively， of factors in the Nrf2/HO-1/NQO1 signaling pathway. ResultsCompared with the control group， the DKD model group showed rises in blood glucose， 24-h urine protein， KI， SCr， BUN， and ALT levels， along with glomerular hypertrophy， renal tubular dilation， thickened basement membrane， mesangial expansion， and collagen deposition. Additionally， the model group showed elevated levels of β2-MG， NGAL， KIM-1， L-FABP， NOS， and 8-OHdG， lowered levels of GSH and T-AOC， up-regulated expression of MDA and Keap1， and down-regulated expression of Nrf2， HO-1， NQO1， and glutamate-cysteine ligase catalytic subunit （GCLC） （P<0.05）. Compared with the model group， the semaglutide group and the medium- and high-dose Yishen Tongluo prescription groups showed reductions in blood glucose， 24-h urine protein， KI， SCr， BUN， and ALT levels， along with alleviated pathological injuries in the renal tissue. In addition， the three groups showed lowered levels of β2-MG， NGAL， KIM-1， L-FABP， NOS， and 8-OHdG， elevated levels of GSH and T-AOC， down-regulated expression of MDA and Keap1， and up-regulated expression of Nrf2， HO-1， NQO1， and GCLC （P<0.05）. ConclusionYishen Tongluo prescription exerts renoprotective effects in the mouse model of DKD by modulating the Nrf2/HO-1/NQO1 signaling pathway， mitigating oxidative stress， and reducing renal tubular injuries.

Objective: To investigate the mechanism of Yishen Tongluo Formula in ameliorating renal pyroptosis in diabetic nephropathy mice by regulating the toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)/nuclear factor-κB (NF-κB) signaling pathway. Methods: Sixty C57BL/6 male mice were randomly divided into control (10 mice) and intervention groups (50 mice) using random number table method. The diabetes nephropathy model was established by intraperitoneally injecting streptozotocin(50 mg/kg). After modeling, the intervention group was further divided into model, semaglutide (40 μg/kg), and high-, medium-, and low-dose Yishen Tongluo Formula groups (15.6, 7.8, and 3.9 g/kg, respectively) using random number table method. The high-, medium-, and low-dose Yishen Tongluo Formula groups were administered corresponding doses of medication by gavage, the semaglutide group received a subcutaneous injection of semaglutide injection, and the control group and model groups were administered distilled water by gavage for 12 consecutive weeks. Random blood glucose levels of mice in each group were monitored, and the 24-h urinary protein content was measured using biochemical method every 4 weeks; after treatment, the serum creatinine and urea nitrogen levels were measured using biochemical method. The weight of the kidneys was measured, and the renal index was calculated. Hematoxylin and eosin, periodic acid-Schiff, periodic Schiff-methenamine, and Masson staining were used to observe the pathological changes in renal tissue. An enzyme-linked immunosorbent assay was used to detect urinary β2-microglobulin (β2-MG), neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule-1 (KIM-1) levels. Western blotting and real-time fluorescence PCR were used to detect the relative protein and mRNA expression levels of nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3), Caspase-1, gasdermin D (GSDMD), interleukin-1β (IL-1β), and interleukin-18 (IL-18) in renal tissue. Immunohistochemistry was used to detect the proportion of protein staining area of the TLR4, MyD88, and NF-κB in renal tissue. Results: Compared with the control group, the random blood glucose, 24-h urinary protein, serum creatinine, urea nitrogen, and renal index of the model group increased, and the urine β2-MG, NGAL, and KIM-1 levels increased. The relative protein and mRNA expression levels of NLRP3, Caspase-1, GSDMD, IL-1β, and IL-18 in renal tissue increased, and the proportion of TLR4, MyD88, and NF-κB protein positive staining areas increased (P<0.05). Pathological changes such as glomerular hypertrophy were observed in the renal tissue of the model group. Compared with the model group, the Yishen Tongluo Formula high-dose group showed a decrease in random blood glucose after 12 weeks of treatment (P<0.05). The Yishen Tongluo Formula high- and medium-dose groups showed a decrease in 24-h urinary protein, creatinine, urea nitrogen, and renal index, as well as decreased β2-MG, NGAL, and KIM-1 levels. NLRP3, Caspase-1, GSDMD, IL-1 β, and IL-18 relative protein and mRNA expression levels were also reduced, and the proportion of TLR4, MyD88, and NF-κB protein positive staining areas was reduced (P<0.05). Pathological damage to renal tissue was ameliorated. Conclusion Yishen Tongluo Formula may exert protective renal effects by inhibiting renal pyroptosis and alleviating tubular interstitial injury in diabetic nephropathy mice by regulating the TLR4/MyD88/NF-κB signaling pathway.

Background Exposure to volatile organic compounds (VOCs) has been observed in both living and working environments. Volatile organic compounds metabolites (VOCMs) in urine can be used to assess the exposure to VOCs and potentially cause adverse effects on human body. Objective To quantitatively evaluate urinary VOCMs and their associations with renal function damage, and further trace the characteristics of potential environmental exposure to provide scientific evidence for effective prevention measures. Methods The study included a total of 6028 samples from four cross-sectional studies in the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018, with exposure and health outcomes matched. Generalized linear models were employed to assess the associations of urinary VOCMs (urinary creatinine adjusted) with urinary protein levels and estimated glomerular filtration rate (eGFR), with coviriables including gender, age, body mass index, education, smoking, alcohol consumption, exercise frequency, diabetes, and hypertension. Weighted quantile sum (WQS) approach was utilized to analyze the effects of mixed exposure and to rank the contribution of individual VOCMs. The associations between VOCMs and associated living environments and occupational exposure characteristics were further investigated. Results Among the enrolled study participants (n=6028), a total of 11 urinary VOCMs were measured, with 10 metabolites having a positive rate of over 80% (84.59%-99.99%). There were 604 individuals (10.0%) having urinary protein abnormalities and 2831 individuals (47.0%) with eGFR reduced. Through a single and a multiple generalized linear model, 5 VOCMs exhibited statistically significant associations with urinary protein abnormalities and/or reduced eGFR levels (P<0.05): N-acetyl-S-(N-methylaminocarbonyl)-L-cysteine (AMC), N-acetyl-S-(2-carboxyethyl)-L-cysteine (CEM), N-acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (DHB), 2-hydroxy-2-phenylacetic acid (MAD), and N-acetyl-S-(4-hydroxy-2-butenyl)-L-cysteine (MB3). The WQS index indicated a significantly positive association between VOCMs and urinary protein abnormalities, and DHB contributed the most. The analysis on the potential sources of VOCs exposure showed that those who worked as a private entrepreneur or an employee (vs. government employees), rent houses (vs. owned real estate), had less number of rooms in the residence, fueled cars at self-service gas stations, and inhaled paint fumes in the past 48 h associated with higher VOCMs (P < 0.05) and DHB contributed the most. Conclusion Multiple VOCMs in urine are associated with significantly kidney function injuries. The mixture exposure to VOCMs is significantly associated with higher risks of urinary protein abnormalities. Occupational category, housing ownership, ways to fuel a car, and inhalation of paint odors are closely related with VOCMs levels.

Objective To explore the effects of empathy technology on emotion regulation, sleep improvement and quality of life improvement in patients with first benign paroxysmal positional vertigo (BPPV). Methods A total of 100 patients with the first BPPV in The Second Affiliated Hospital of Naval Medical University from December 2023 to November 2024 were selected, and were divided into control group and observation group by random number table method. The patients in both groups received routine reduction treatment and outpatient follow-up every 3 months after discharge, with a total of 4 follow-up visits. The patients in control group received routine health and psychological education; on this basis, the patients in observation group received empathy technique intervention before, during, after reposition and during follow-up. The emotion, sleep and quality of life scales were evaluated before intervention and at the 4th outpatient follow-up. The recurrence rates of BPPV within 1 year after discharge were compared between the two groups. Results One year after discharge, self-rating anxiety scale (SAS), self-rating depression scale (SDS), symptom checklist 90 (SCL-90) and Pittsburgh sleep quality index (PSQI) scores in the observation group were lower than those in the control group, and multi-dimensional quality of life scores in the observation group was higher than that in the control group. These differences were statistically significant (P＜0.05). The recurrence rate of BPPV in the observation group was lower than that in the control group 1 year after discharge (P＜0.05). Conclusions Empathy technology intervention can further improve emotion, sleep quality, and quality of life, but reduce disease recurrence rate in first BPPV patients receiving routine treatment and health education, so it can be widely used in clinical practice.

Objective:To explore the predictive value of baseline complete blood count derivative marker levels for the occurrence of the first peritonitis in patients undergoing peritoneal dialysis (PD).Methods:This study was a retrospective cohort study. The data of inpatients who underwent PD catheterization in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from April 1, 2005 to February 29, 2024 were collected and followed up until June 1, 2024. According to the 2022 International Society for Peritoneal Dialysis guidelines for peritonitis prevention and treatment, the patients were divided into the peritonitis group and the non-peritonitis group. Basic demographic data and laboratory parameters of the patients were collected, and inflammatory markers derived from complete blood count were calculated, including the comprehensive index of systemic inflammation, the systemic inflammation response index (SIRI), the ratio of hemoglobin to platelets (HPR), and the ratio of monocytes to lymphocytes (MLR). Cox regression analysis was conducted to identify factors associated with the occurrence of peritonitis.Results:A total of 824 PD patients aged ≥18 years were included in this study. Among them, there were 398 males (48.30%), with an age of 42.06 (33.04, 52.01) years, and the follow-up time was 595.00 (173.50, 1 158.00) d. The proportion of conversion to hemodialysis or death in the peritonitis group was higher than that in the non-peritonitis group (40.91% vs. 13.58%, χ 2=56.173, P<0.001). The age of the peritonitis group was greater than that of the non-peritonitis group [45.05(34.92, 52.99) year old vs. 41.11(32.89, 51.46) year old, Z=-1.978, P=0.048], and the follow-up time was lower than that in the non-peritonitis group [529.50(146.25, 861.00) d vs. 627.00(177.00, 1 222.50)d, Z=-2.260, P=0.024]. A multivariate Cox analysis model was constructed based on the univariate Cox analysis. After adjusting for covariates, the results showed the comprehensive index of systemic inflammation ( HR=0.997, 95% CI 0.995-0.998, P<0.001), HPR ( HR=0.520, 95% CI 0.271-0.995, P=0.048), MLR ( HR=7.027, 95% CI 1.468-33.636, P=0.015) and SIRI ( HR=2.673, 95% CI 1.302-5.488, P=0.007) were the related factors for the first occurrence of peritonitis. Conclusion:The levels of inflammatory markers derived from baseline complete blood count, especially MLR, SIRI and HPR, are the independent influencing factors for the occurrence of the first peritonitis in patients with PD.

Objective:To explore the association between serum magnesium levels during catheterization in peritoneal dialysis (PD) patients and the failure of PD technology.Methods:It was a retrospective study. The baseline data, laboratory tests and clinical events of inpatients with end-stage renal disease aged ≥18 years who received PD catheterization for the first time from April 1, 2005 to February 29, 2024 were collected, and the follow-up was conducted until June 1, 2024. PD technique failure was defined as extubation for conversion to hemodialysis or patient death. The optimal cut-off value of serum magnesium (0.782 mmol/L) was determined based on the Youden index of the receiver operating characteristic curve for predicting the failure of PD technology. The patients were divided into high serum magnesium group and low serum magnesium group, and differences of baseline clinical data and follow-up outcomes between the two groups were compared. Kaplan-Meier method was used to compare the differences of PD technical survival rates between the two groups. Logistic regression model was used to analyze the related factors of baseline increased serum magnesium levels (0.785 mmol/L) in PD patients. Cox proportional hazards regression model was used to analyze the risk factors for the failure of PD technology.Results:A total of 706 PD patients were included in this study, with age of 43.89 (33.43, 53.70) years. Among them, 339 (48.02%) patients were male. The serum creatinine was (800.45±238.81) μmol/L. The follow-up time was 726.00 (216.00, 1 344.00) days. The incidence of peritonitis was 0.072 times per patient-year, and the failure rate of PD technique was 15.58% (110/706). There were 551 patients (78.05%) in the high serum magnesium group and 155 patients (21.95%) in the low serum magnesium group. Compared with the high serum magnesium group, the low serum magnesium group had significantly lower levels of serum creatinine ( t=-2.743, P=0.006), blood urea nitrogen ( t=-2.428, P=0.004), serum uric acid ( t=-2.346, P=0.005), red blood cell count ( t=-4.100, P<0.001), hemoglobin ( Z=-4.195, P<0.001), serum albumin ( t=-4.400, P<0.001), platelet count ( Z=-2.428, P=0.015), platelet-to-monocyte ratio ( Z=-2.541, P=0.011), serum calcium ( t=-7.463, P<0.001), serum phosphorus ( t=-3.052, P=0.001), prothrombin activity ( t=-3.052, P=0.005) and proportion of hyperphosphatemia ( χ2=6.924, P=0.009), and higher male proportion ( χ2=8.984, P=0.030), proportion of conversion to hemodialysis ( χ2=6.098, P=0.014), neutrophil percentage-to-albumin ratio ( Z=2.875, P=0.004), serum chloride ( Z=4.011, P<0.001), alkaline phosphatase ( Z=2.850, P=0.040), D-dimer ( Z=3.166, P=0.002), proportion of hypoalbuminemia ( χ2=7.543, P=0.006), and proportion of hypocalcemia ( χ2=39.836, P<0.001). Kaplan-Meier survival analysis showed that the PD technical survival rates in the peritonitis group and the low serum magnesium group were significantly lower than those in the control group and the high serum magnesium group, respectively (Log-rank test, χ2=9.332, P=0.002; χ2=7.856, P=0.005). Multivariate logistic regression analysis showed that the serum calcium ( OR=23.237, 95% CI 3.807-141.845) and serum chlorine level ( OR=0.919, 95% CI 0.858-0.985) were independently correlated with the increased serum magnesium. Multivariate Cox regression analysis showed that elevated baseline serum magnesium was an independent protective factor of PD technique failure ( HR=0.351, 95% CI 0.188-0.653). Conclusions:Elevated serum magnesium is an independent protective factor of PD technology failure. Maintaining an appropriate serum magnesium level may improve the prognosis of PD patients.