Objective To explore the risk factors for acute thrombosis of arteriovenous fistulae(AF)in maintenance hemodialysis(MHD)patients and the construction of a Nomogram prediction model.Methods A total of 418 patients who underwent MHD treatment in the outpatient clinic of the Third Affiliated Hospital of Xinxiang Medical University from December 2020 to December 2022 were selected for the study.The patients were divided into the acute thrombosis group(n=32)and non-acute thrombosis group(n=386)according to whether acute thrombosis of AF was formed or not.The influencing factors affecting acute thrombosis of AF in MHD patients were analyzed using univariate and multivariate analysis.A Nomogram predic-tion model was established based on their independent risk factors,and Bootstrap was used to validate the efficacy of the Nomo-gram model.Results The complicated diabetes,complicated hypotension,puncture failure on dialysis,calcium-phosphorus product,hypersensitive C-reactive protein(hs-CRP),total cholesterol(TC),and low density lipoprotein-cholesterol(LDL-C)levels in patients in the acute thrombosis group were significantly higher than those in the non-acute thrombosis group(P＜0.05);logistic regression analysis showed that diabetes,hypotension,puncture failure on dialysis,calcium-phosphorus product elevation,high hs-CRP and high LDL-C level were the independent risk factors affecting acute thrombosis of AF in patients undergoing MHD(P＜0.05);the Nomogram model was constructed based on the 6 independent risk factors,and the consistency index(C-index)of the model was 0.893(95％confidence interval:0.833-0.928);in addition,its calibration curve and the standard curve were well fitted,the area under the curve was 0.918.Conclusion Diabetes,hypotension,puncture failure during dialysis,calcium-phosphorus product elevation,and high levels of hs-CRP and LDL-C are the risk factors for acute thrombosis of AF in patients undergoing MHD,and the Nomogram model constructed based on the independent risk factors has excellent predictive ability in predicting the occurrence of acute thrombosis of AF in patients undergoing MHD,which can help in the early screening of patients with high risk of clinical acute thrombosis.

Objective To compare the value of TACE+microwave ablation(MWA)+programmed death-1(PD-1)and TACE+MWA for treating primary hepatic carcinoma(PHC).Methods Data of 80 PHC patients who underwent TACE+MWA+PD-1(observe group)or TACE+MWA treatment(control group)were retrospectively analyzed(each n=40).The baseline data,therapeutic efficacy of PHC and complications were compared between groups.Results No significant difference of baseline data was found between groups(all P＞0.05).The objective response rate(ORR)of observe group and control group was 90.00％and 72.50％,respectively,while the disease control rate(DCR)was 97.50％and 95.00％,respectively,with no significant difference between groups(both P＞0.05).The median overall survival(OS)of observe group and control group was 30.80 months and 15.70 months,respectively,while the median progression free survival(PFS)was 23.35 months and 6.80 months,respectively.OS and PFS of observe group were both longer than those of control group(both P＜0.05).No significant difference of the incidence of complications was detected between groups(all P＞0.05),and all were improved after symptomatic treatment.Conclusion TACE+MWA+PD-1 was superior to TACE+MWA for treating PHC.

Objective To comparatively observe the efficacy and safety of TACE combined with 125I seeds implantation or lenvatinib for treating hepatocellular carcinoma(HCC)complicated with portal vein tumor thrombosis(PVTT).Methods Totally 52 HCC patients complicated with type Ⅱ or type Ⅲ PVTT were enrolled and divided into TACE combined with 125I seeds group(group A,n=27)and TACE combined with lenvatinib group(group B,n=25).Objective response rate(ORR),overall survival(OS)and incidence rate of adverse reaction were compared between groups.Results ORR,the median OS,median OS of type Ⅱ PVTT and median OS of type Ⅲ PVTT was 70.37%(19/27),13.6 months,14.1 months and 13.2 months in group A,and 32.00%(8/25),11.3 months,12.3 months and 10.4 months in group B,respectively.The above indexes in group A were all better than those in group B(all P＜0.05).In group A,the incidence rate of adverse reaction was 48.15%(13/27),and no serious complication occurred.In group B,the incidence rate of adverse reaction was 88.00%(22/25),and severe drug toxicity was noticed in 5 cases(5/25,20.00%).Conclusion The efficacy and safety of TACE combined with 125I seeds were both better than those of TACE combined with lenvatinib for treating HCC complicated with PVTT.

OBJECTIVE: To explore the therapeutic effect of Bushen Yiqi Huoxue Decoction BYHD) in patients with diminished ovarian reserve (DOR). METHODS: A total of 180 patients with DOR diagnosed from December 2013 to December 2014 were equally assigned into progynova and duphaston (E+D) group, Zuogui Pill group and BYHD group with 60 cases in each by computerized randomization. Patients received E+D, Zuogui Pill or BYHD for 12 months, respectively. Follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E₂), anti-Müllerian hormone (AMH), antral follicle count (AFC), ovarian volume, endometrial thickness, and the resistance indices (RIs) of ovarian arteries and uterine arteries were observed before and after treatment. RESULTS: Nine women (4 from the E+D group, 3 from the Zuogui Pill group, and 2 from the BYHD group) withdrew from the study. After 6 months, Zuogui Pill and BYHD significantly decreased FSH and LH and increased endometrial thickness and AMH (all P<0.01). BYHD also resulted in E₂ elevation (P<0.05), ovary enlargement (P<0.05), AFC increase (P<0.01), and RI of ovarian arteries decrease (P<0.05). After 12 months, further improvements were observed in the Zuogui Pill and BYHD groups (all P<0.01), but BYHD showed better outcomes, with lower FSH, larger ovaries and a thicker endometrium compared with the Zuogui Pill group (all P<0.01). However, E+D only significantly increased endometrial thickness (P<0.01) and no significant improvements were observed in the RI of uterine arteries in the three groups. CONCLUSIONS BYHD had a favorable therapeutic effect in patients with DOR by rebalancing hormone levels, promoting ovulation, and repairing the thin endometrium. The combination of tonifying Shen (Kidney), benefiting qi and activating blood circulation may be a promising therapeutic strategy for DOR.
Anti-Mullerian Hormone/pharmacology* ; Drugs, Chinese Herbal ; Female ; Follicle Stimulating Hormone ; Humans ; Luteinizing Hormone ; Ovarian Reserve

Objective:To determine the epidemiology of hyperkalemia and influencing factors in a general population in Pinggu district of Beijing city.Methods:This study was a cross-sectional survey. The subjects were from the epidemiological survey population of chronic diseases in Pinggu district of Beijing city from March to May 2014. All participants completed a questionnaire, anthropological measurement, and venous blood samples collection to detect serum creatinine and potassium and so on. First void morning urine was collected to detect the albumin-creatinine ratio. Hyperkalemia and hypokalemia were defined as serum potassium level>5.0 mmol/L and≤3.5 mmol/L, respectively. Logistic regression analysis method was used to analyze the influencing factors of hyperkalemia.Results:Of the 10 252 people in this study, the prevalence of hyperkalemia was 6.17%(95% CI 5.70%-6.67%), the prevalence of hypokalemia was 0.61%(95% CI 0.47%-0.79%), and the prevalence of participants with serum potassium>5.5 mmol/L was 0.53%(95% CI 0.40%-0.69%). Multivariate logistic regression analysis results showed that males ( OR=1.269, 95% CI 1.074-1.498, P=0.005), diabetes ( OR=1.226, 95% CI 1.008-1.490, P=0.041), increased total cholesterol ( OR=1.219, 95% CI 1.119-1.329, P<0.001), and decreased estimated glomerular filtration rate ( OR=0.971, 95% CI 0.965-0.977, P<0.001) were significantly correlated with the increased risk of hyperkalemia. Usage of renin-angiotensin-aldosterone system inhibitors and diuretics were not found to be significantly associated with the risk of hyperkalemia ( OR=1.018, 95% CI 0.751-1.380, P=0.908; OR=0.638, 95% CI 0.229-1.781, P=0.391). Conclusions:The prevalence of HK in the general population is 6.17%. The male, decreased estimated glomerular filtration rate, diabetes, and increased total cholesterol are influencing factors of hyperkalemia.

Objective:To evaluate the immunogenicity of a novel influenza virus mRNA vaccine based on conserved antigens delivered by lipopolyplex (LPP) platform in a mouse model.Methods:Four copies of genes coding for extracellular domain of matrix 2 protein (M2e) and nucleoprotein (NP) of influenza A virus were synthetized after codon optimization. The fusion antigens were transcribed in vitro and delivered by LPP platform, named as LPP-4M2eNP. Expression of M2e and NP in eukaryotic cells was detected by immunofluorescence assay (IFA). BALB/c mice were inoculated intramuscularly twice with 10 μg or 30 μg LPP-4M2eNP vaccine at an interval of four weeks. Antibody response was detected by ELISA and cellular-mediated immunity (CMI) was detected by enzyme-linked immunospot assay (ELISPOT). Results:IFA showed that NP and M2e were expressed correctly in eukaryotic cells. Single dose immunization could induce significant antigen (NP, M2e)-specific CMI and antigen (NP, M2e)-specific antibody response was induced in mice with Th1 type bias after boost immunization. Moreover, NP-specific CMI was increased significantly after the second immunization, while no significant change in M2e-specific CMI was observed.Conclusions:Stronger CMI was triggered in mice by single dose of LPP-4M2eNP vaccine. Furthermore, robust humoral and cellular immune responses were induced after boost immunization. This study suggested that LPP-4M2eNP vaccine, which based on conserved antigen of influenza A and delivered by LPP platform, had great potential for development and application.

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.

Objective:To explore the association between urinary stone disease (USD) and peripheral arterial disease (PAD).Methods:The study was based on the cross-sectional chronic diseases survey performed in Pinggu district, Beijing from March to May, 2014. All subjects completed a questionnaire, physical examination, renal ultrasound examination to detect USD, ankle-brachial index (ABI) examination to detect PAD (defined as ABI<0.9 on either side of the body), and brachial-ankle pulse wave velocity (baPWV) measurement to estimate arterial stiffness. Blood and first morning urine sample were detected for serum creatinine, blood glucose and so on.Results:There were 10 281 participants included in this study. Among these participants, the prevalences of USD and PAD were 5.66% and 3.95%, respectively. Compared with non-stone participants, the persistent USD formers had a higher prevalence of PAD (8.26% vs 3.90%, P<0.001) and baPWV [(16.3±3.5) m/s vs (15.5±3.2) m/s, P<0.001]. Even after adjusting the confounding factors, the persistent USD formers also had a 2.066-fold increased risk of PAD ( OR=2.066, 95% CI 1.276-3.343, P=0.003). In the subgroup analysis, persistent USD patients in older participants who were≥60 years old, women, chronic kidney disease, and central obesity had a significantly increased risk of PAD. Conclusions:In the present population, persistent USD is positively associated with a high risk of PAD and increased arterial stiffness. Patients with persistent USD should be screened for vascular diseases.

Objective To observe the effects of Siweiyuganzi prescription on anti-peroxidation and blood lipid levels in experimental rats with hyperlipidemia. Methods Sixty male Sprague-Dawley (SD) rats were divided into normal control group, hyperlipidemia model group, Xuezhikang group, Siweiyuganzi prescription large, medium and small dose group according to the random number table method, with 10 rats in each group. The hyperlipidemia rat model was established by intragastric feeding with high fat emulsion everyday 10 mL·kg-1·d-1; normal saline 10 mL/kg was given to the normal control group, twice a day by intragastric feeding; 3 dosages of Siweiyuganzi suspended fluid 12.8, 6.4, 4.3 g·kg-1·d-1 intragastric administrations were given to Siweiyuganzi prescription large, medium and small dose groups respectively; Xuezhikang suspended fluid 0.3 g·kg-1·d-1 was given to Xuezhikang group intragastrically;the same volume of normal saline was given to hyperlipidemia model group. After 4 weeks, the level changes of blood lipid, serum superoxide dismutase (SOD), malonaldehyde (MDA), hydroxymethylglutaryl Coenzyme A (HMG-CoA) were observed. Results Compared to those in the normal control group, the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), MDA, content and positive expression of HMG-CoA, alanine aminotransferase (ALT) were all higher in hyperlipidemia model group [TG (mmol/L): 6.59±0.72 vs. 4.32±0.36, TC (mmol/L): 7.10±0.25 vs. 5.98±0.40, LDL-C (mmol/L): 4.18±1.30 vs. 2.33±0.35, MDA (μmol/L): 26.05± 5.99 vs. 10.08±1.98, HMG-CoA content (ng/L): 54.60±2.90 vs. 48.73±3.09, HMG-CoA positive expression in liver tissue:(57.80±12.30)% vs. (22.00±4.92)%, ALT (U/L): 106.83±15.75 vs. 81.97±13.18]; SOD and high-density lipoprotein cholesterol (HDL-C) in hyperlipidemia model group were significantly decreased [SOD (kU/L): 295.47±37.51 vs. 345.13±19.76, HDL-C (mmol/L): 2.32±0.49 vs. 4.84±0.45, both P < 0.05]. Compared with the hyperlipidemia model group, the TG, TC, LDL-C, MDA, contents and positive expression of HMG-CoA in each group were significantly reduced, and the SOD and HDL-C were obviously increased, and the changes in the Siweiyuganzi high dose group were more significant than those of the Siweiyuganzi middle-and low-dose groups [TG (mmol/L): 4.70±0.46 vs. 5.40±0.31, 5.70±0.41, TC (mmol/L): 5.80±0.23 vs. 6.14±0.20, 6.56±0.32, LDL-C (mmol/L): 2.56±0.45 vs. 2.93±0.33, 3.28±0.32, HDL-C (mmol/L): 4.58±0.28 vs. 3.89±0.30, 3.59±0.08, SOD (kU/L): 381.45±20.68 vs. 360.60±30.16, 325.49±32.13, MDA (μmol/L): 16.98±5.39 vs. 17.89±5.37, 21.03±6.01, HMG-CoA content (ng/L): 50.58±0.77 vs. 52.16±0.66, 52.90±0.91, HMG-CoA positive expression in liver tissue: (27.90±6.03)% vs. (32.20±7.00)%, (43.00±8.39)%, all P < 0.05]. In the normal control group, there were positive cells scattered in the central vein area and loosely distributed around the portal area in the rat liver; in the hyperlipidemia model group, the positive cells were increased in the central vein area and the cells in relatively great number were seen around the portal area. While the positive cells in Xuezhikang group and in the high, medium and low dose Siweiyuganzi groups were decreased. Conclusion Siweiyuganzi prescription can regulate the levels of blood lipids, prevent and treat the lipid peroxidation caused by hyperlipidemia, and inhibit excessive expression of HMG-CoA in experimental rats with hyperlipidemia.

Objective: To explore the incidence and clinical characteristics of sarcopenia in hospitalized elderly patients with coronary heart disease and search for the related factors. Methods: This study was a single-center observational study. According to the inclusion criteria, elderly patients hospitalized with coronary heart disease from Peking Union Medical College Hospital between December 2017 and December 2018 were enrolled. The patients were divided into sarcopenic group and non-sarcopenic group according to the diagnostic criteria of the Asian Working Group for Sarcopenia. Activities of daily living of the patients were assessed (including ADL and IADL) . Comorbidity of the patients was evaluated by the Charlson comorbidity index (CCI). Long-term medication use of the patients was recorded to assesse whether there was polypharmacy. The nutritional status of the patients was examined by the mini nutritional assessment-short form (MNA-SF). The full tandem stance time of the patients was evaluated. The history of falls over the previous year, urinary incontinence, and living conditions of the patients were also recorded. Multivariate logistic regression was used to analyze the related factors for sarcopenia of elderly patients with coronary heart disease. Results: A total of 364 patients were enrolled in the study. The patients were aged 65-96 (74.6±6.5) years and there were 218 (59.9%) male patients. There were 264 cases of stable coronary heart disease and 100 cases of acute coronary syndrome. The median number of long-term used medication was 7. One hundred and fifty-two (41.8%) patients were complicated with type 2 diabetes, 38 (10.4%) patients were complicated with anxiety/depression, and 98 (26.9%) patients had the history of falls over the previous year. Eighty-two (22.5%) patients were complicated with urinary incontinence, 12 patients (3.3%) were complicated with malnutrition and 33 patients (9.2%) were living alone. There were 81 (22.3%) sarcopenic patients and 283 (77.7%) non-sarcopenic patients among all the hospitalized elderly patients with coronary heart disease. The sarcopenic patients were more older, with lower body mass index(BMI)(both P<0.001), higher CCI and more long-term used medication (both P<0.05), higher proportions of malnutrition, urinary incontinence, history of falls, and living alone (all P<0.05) compared to non-sarcopenic patients. ADL and IADL scores of sarcopenic patients were significantly lower than those of non-sarcopenic patients (both P<0.001). There was also a higher proportion of unable to accomplish full tandem stance among sarcopenic patients compared to non-sarcopenic patients (P<0.001). Moreover, higher hs-CRP level (P=0.047) , lower albumin level (P=0.004) and significantly lower prealbumin level (P<0.001) were observed in sarcopenic patients compared to non-sarcopenic patients. Stepwise multivariate binomial logistic regression analysis revealed that male (OR=5.036, 95%CI 1.782-14.230, P=0.002), low BMI (OR=0.883, 95%CI 0.796-0.980, P=0.019), as well as low prealbumin level (OR=0.990, 95%CI 0.980-1.000, P=0.045) were related factors for sarcopenia among elderly patients with coronary heart disease. Conclusions Sarcopenia is a geriatric condition commonly seen in hospitalized elderly patients with coronary heart disease. Male, low BMI, and low prealbumin level were the factors related to sarcopenia for older adults with coronary heart disease.