Objective:To explore the effects of hyperbaric oxygen-assisted hemoperfusion on renal function and immune inflammatory cytokines in patients with end-stage diabetic nephropathy (ESDN).Methods:A total of 92 patients with ESDN admitted to the Department of Nephrology of the Second People’s Hospital of Lianyungang from June 2016 to December 2017 were randomly divided into control group ( n=46) and observation group ( n=46). The control group was given conventional treatment and the combination of hemodialysis with hemoperfusion, while the observation group was treated with hyperbaric oxygen on the basis of the treatments of the control group. The levels of fasting blood glucose (FBG), 24-hour urinary protein (24 h Upro), blood urea nitrogen, creatinine (Cr), uric acid and albumin (ALB), and the contents of immune inflammatory cytokines such as interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-17 (IL-17), monocyte chemoattractant protein-1 (MCP-1), and hypersensitive C-reactive protein (hs-CRP) were compared between the two groups before and after treatment. Results:After treatment, the levels of FBG, renal function indicators, and the contents of immune inflammatory cytokines in the two groups were significantly improved in comparison with those before treatment ( P<0.05). The levels of Cr, 24 h Upro, and ALB in the observation group were (482.54±166.46) μmol/L, (1 095.34±154.78) mg, and (33.04±3.91) g/L, respectively, which were significantly better than those in the control group ( P<0.05). The improvements in IL-6, IL-10, IL-17, MCP-1, and hs-CRP contents in the observation group were significantly better than those in the control group ( P<0.05). The incidences of complications such as hypoglycemia, hypoxemia, hypotension, infection, and cardio-cerebrovascular events in the observation group were also significantly lower than those in the control group ( P<0.05). Conclusion:Hyperbaric oxygen-assisted hemoperfusion can effectively inhibit vascular endothelial injury due to inflammatory irritation and restore renal microvascular circulation to improve renal function by reducing the contents of IL-6, IL-17, MCP-1, and hs-CRP, and increasing IL-10 content in ESDN patients.

Objective:To explore the effects of hyperbaric oxygen-assisted hemoperfusion on renal function and immune inflammatory cytokines in patients with end-stage diabetic nephropathy (ESDN).Methods:A total of 92 patients with ESDN admitted to the Department of Nephrology of the Second People’s Hospital of Lianyungang from June 2016 to December 2017 were randomly divided into control group ( n=46) and observation group ( n=46). The control group was given conventional treatment and the combination of hemodialysis with hemoperfusion, while the observation group was treated with hyperbaric oxygen on the basis of the treatments of the control group. The levels of fasting blood glucose (FBG), 24-hour urinary protein (24 h Upro), blood urea nitrogen, creatinine (Cr), uric acid and albumin (ALB), and the contents of immune inflammatory cytokines such as interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-17 (IL-17), monocyte chemoattractant protein-1 (MCP-1), and hypersensitive C-reactive protein (hs-CRP) were compared between the two groups before and after treatment. Results:After treatment, the levels of FBG, renal function indicators, and the contents of immune inflammatory cytokines in the two groups were significantly improved in comparison with those before treatment ( P<0.05). The levels of Cr, 24 h Upro, and ALB in the observation group were (482.54±166.46) μmol/L, (1 095.34±154.78) mg, and (33.04±3.91) g/L, respectively, which were significantly better than those in the control group ( P<0.05). The improvements in IL-6, IL-10, IL-17, MCP-1, and hs-CRP contents in the observation group were significantly better than those in the control group ( P<0.05). The incidences of complications such as hypoglycemia, hypoxemia, hypotension, infection, and cardio-cerebrovascular events in the observation group were also significantly lower than those in the control group ( P<0.05). Conclusion:Hyperbaric oxygen-assisted hemoperfusion can effectively inhibit vascular endothelial injury due to inflammatory irritation and restore renal microvascular circulation to improve renal function by reducing the contents of IL-6, IL-17, MCP-1, and hs-CRP, and increasing IL-10 content in ESDN patients.

Objective To investigate the value of serum amyloid A (SAA) and retinol binding protein (RBP) in diagnosis of early type 2 diabetic kidney disease (DKD).Methods A total of 182 type 2 diabetic patients hospitalized in department of Endocrinology and Nephrology of Lianyungang Second People's Hospital from January to December 2017 were randomly collected as subjects.According to urinary albumincreatinine ratio (UACR),all subjects were divided into three groups of normal albuminuria group (NA,60 cases),microalbuminuria group (MA,63 cases) and clinical proteinuria (CP,59 cases).In the same period,60 healthy persons were selected as normal control (NC).The levels of serum SAA and RBP were detected by automatic biochemical analyzer.Receiver operating curve (ROC) was used to analysis the diagnostic efficiency of DKD and the risk factors of DKD were further estimated.Results The levels of SAA were (6.88±2.82) and (37.21±20.58) mg/L in control group and case group.And levels of serum SAA in the NA group,MA group and CP group were (16.33±5.98),(40.97± 15.62),(54.43±22.91) mg/L respectively.The levels of RBP were (37.56± 10.51) and (69.26±21.23) mg/L in control group and case group.And levels of RBP in the NA group,MA group and CP group were (52.66 ± 14.31),(69.66 ± ± 15.52),(85.70± 19.51) mg/L respectively.The concentrations of serum SAA and RBP in type 2 diabetic patients were significantly higher than those normal controls (t =10.36,P＜0.05;t =11.11,P＜0.05) and increased with DKD progression (F =83.6,P＜ 0.05;F =59.2,P＜ 0.05).Diagnostic sensitivity of serumSAA,RBP in DKD was 81.8％ and 84.1％ respectively.Diagnostic sensitivity of combined detection was 90.9％.Regression analysis showed that SAA,RBP and UACR were independent risk factors for DKD (OR (95％ CI) =1.391 (1.068-1.812),1.212 (1.085-1.353),1.148 (1.038-1.270);all P ＜0.05).Conclusion Both of serum SAA and RBP were significantly elevated in diabetic patients with renal injury so that they had great value in early diagnosis of DKD.