Objective To explore risk factors for cardiac valve calcification (CVC) in maintenance hemodialysis (MHD) patients and evaluate its impact on cardiovascular events and mortality. Methods Retrospective selection of 223 patients with MHD admitted to the Department of Nephrology of Jinshan Hospital, Fudan University from June 30, 2019 to June 30, 2024, and enrollment completed within one week of June 30, 2019. Patients were divided into CVC and non-CVC groups. Baseline data and 5-year follow-up data were collected. The binary logistic regression analysis was performed to explore the risk factors for CVC. Kaplan-Meier survival curve was used to analyze the survival rate of patients. Cox proportional hazard regression model was applied to evaluate the impact of CVC on the survival rates of MHD patients. Results Totally, 223 MHD patients with an average age of (58.4±13.5) years and an average dialysis duration of (64.0±55.4) months were involved. Among them, 136(61.0%) were males, 117(52.5%) were complicated with CVC. Age, dialysis duration, diabetic kidney disease (DKD), the serum corrected total calcium and phosphate, intact parathyroid hormone (iPTH), high-sensitive C-reactive protein (hsCRP), and homocysteine (Hcy) were independent related factors for CVC (P＜0.05). Both all-cause mortality (46.6% vs 28.7%) and cardiovascular mortality (33.3% vs 16.0%) were significantly higher in the CVC group than those in the non-CVC group (P＜0.01). Conclusions Age, dialysis duration, the primary disease, calcium and phosphate, and inflammation- and nutrition-related serum indicators are associated with CVC in MHD patients. CVC significantly increases mortality risk of MHD patients.

Objective To explore the correlation between serum fibroblast growth factor-23(FGF23),Klotho protein levels and cardiac valve calcification(CVC)in patients with maintenance hemodialysis(MHD).Methods A total of 169 MHD patients in the Blood Purification Center of Jinshan Hospital,Fudan University from January 2022 to January 2023 were selected.The patients'CVC status was examined by color Doppler echocardiography.Results There were 111 CVC cases,accounting for 65.68%.Compared with the non-CVC group,the CVC group had significantly higher levels of FGF23,β2-microglobulin,brain natriuretic peptide(BNP),age,and the proportion of male,while significantly lower levels of Klotho,predialysis creatinine,hemoglobin,plasma albumin and iPTH(P＜0.05).Pearson/Spearman correlation coefficient analysis showed that FGF23,age,β2-microglobulin and BNP were significantly positively correlated with CVC(r=0.20,0.41,0.15,0.28,0.12),while Klotho,predialysis creatinine,hemoglobin,plasma albumin and iPTH were significantly negatively correlated with CVC(r=﹣0.16,﹣0.17,﹣0.16,﹣0.17,﹣0.16).Unconditioned binary logistic regression analysis showed that FGF23,Klotho,age and β2-microglobulin were independent risk factors for CVC in MHD patients.Conclusions MHD patients are prone to CVC.Serum FGF23 protein level is significantly positively correlated with CVC,while Klotho protein level is significantly negatively correlated with CVC.FGF23,Klotho,age and β2-microglobulin are independent risk factors for CVC in MHD patients.

Objective:The aim of this article is to explore the effective coping styles of social and psychological adjustment for post-burn patients, and to provide the recommendation for effective coping with the physical and psychosocial recovery of post-burn patients.Methods:The in-depth interview was conducted from 12 burn patients through convenience sampling. Thematic analysis method was used to analyze the data.Results:Effective psychosocial coping styles for the post-burn psychosocial changes include three main core themes: personal resilience, social and professional support, and metallization.Conclusion:We have found that patients′ resilience, effective social support systems, and higher metallization functions are effective ways for post-burn adjustment. Future psychological services and psychosocial rehabilitation need to focus on these aspects to provide patients with comprehensive and systematic psychological rehabilitation services.

Objective To evaluate the effect of anisodamine on endoplasmic reticulum stress during acute kidney injury (AKI) in rats.Methods Forty-two nale Sprague-Dawley rats,weighing 200-220 g,were randomly divided into 3 groups:control group (group C,n =6),AKI group (n =18) and anisodamine group (group AD,n =18).AKI was induced by intramuscular injection of 50％ (v/v) glycerol 10 ml/kg into bilateral hind limbs in groups AKI and AD.In addition,anisodamine 10 mg/kg was injected intraperitoneally 20 min before intramuscular injection of glycerol in group AD.In group C the rats received intramuscular injection of normal saline 10 ml/kg into bilateral hind limbs.Six rats were chosen immediately after injection of normal saline in group C or at 1,6 and 24 h after glycerol injection in groups AKI and AD and then anethetized with intraperitoneal pentobarbital.The animals were sacrificed and kidney specimens were obtained and cut into sections which were stained with hematoxylin and eosin for pathological examination.The pathological changes of the renal tubules were scored.The expression of glucose-regulated protein 78 (GRP78) and oxygen-regulated protein 150 (ORP150) in renal tissues was determined by immuno-histochemistry and Western blot.Results Compared with group C,the pathological scores were significantly increased and the expression of GRP78 and ORP150 was up-regulated at all time points in groups AKI and AD (P ＜ 0.01).Compared with group AKI,the pathological scores were significantly decreased and the expression of GRP78 and ORP150 was down-regulated at all time points in group AD (P ＜ 0.05 or 0.01).Conclusion Anisodamine can ameliorate AKI through inhibiting endoplasmic reticulum stress in renal tubular epithelial cells and decreasing endoplasmic reticulum stress-induced cell apoptosis in rats.