Objective To investigate the correlation of peripheral blood follicle suppressor-like protein L(FSTL-1)and chitosanidase 1(CHIT-1)levels with cardiovascular diseases(CVD)in hemodialysis patients and their clinical value.Methods A total of 150 hemodialysis patients treated in Chongqing Liangjiang New Area People's Hospital from January 2021 to June 2023(case group)and 60 healthy people who underwent medical checkups(control group)were selected.The case group consisted of 62 patients who had CVD(CVD group)and 88 patients who did not have CVD(non-CVD group).Enzyme-linked immunosorbent assay was used to detect the levels of FSTL-1 and CHIT-1 in peripheral blood.The levels of FSTL-1 and CHIT-1 among the groups were compared,and the correlation between the levels of FSTL-1 and CHIT-1 with the Gensini scores,high-sensitivity C-reactive protein(hs-CRP),troponin T(cTnT),and left ventricular ejection fraction(LVEF)were analyzed by Pearson's correlation test.Multivariate Logistic regression was used to analyze the influencing factors affecting the occurrence of CVD.Receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of FSTL-1 and CHIT-1 for the occurrence of CVD.Results The levels of FSTL-1 and CHIT-1 were higher in the CVD group and non-CVD group than those in the control group(F=229.200,273.200,P＜0.05),and the levels of FSTL-1 and CHIT-1 in the CVD group were higher than those in the non-CVD group(P＜0.05).The peripheral blood FSTL-1 and CHIT-1 levels in hemodialysis patients were positively correlated with Gensini score,cTnT,hs-CRP(r=0.662,0.724,0.712,r=0.679,0.502,0.341,P＜0.05)and negatively correlated with LVEF(r=-0.463,-0.581,P＜0.05).Compared with the non-CVD group,CVD group had longer chronic kidney disease duration,higher hs-CRP,cTnT,Gensini score,FSTL-1,CHIT-1(P＜0.05),and lower LVEF(P＜0.05).High levels of cTnT,FSTL-1,and CHIT-1 were independent risk factors for CVD in hemodialysis patients(P＜0.05).The area under the curve of the com-bined detection of peripheral blood FSTL-1 and CHIT-1 levels for predicting the occurrence of CVD in hemo-dialysis patients was 0.852(95％CI:0.789-0.915),which was significantly larger than those of the single index of FSTL-1 and CHIT-1(Z=-2.084,-3.112,P=0.038,0.002).Conclusion The increased levels of peripheral blood FSTL-1 and CHIT-1 levels in CVD patients are correlated with cardiovascular injury,cardiac function,and inflammatory indexes in hemodialysis patients,which are independent risk factors affecting the occurrence of CVD in hemodialysis patients,and the combined detection of the two could improve the predic-tive efficacy for the occurrence of CVD in hemodialysis patients.

Objective To evaluate the effect of early enteral nutrition (EN) on the pancreatic exocrine secretion in dogs with acute necrotizing panereatitis (ANP). Methods ANP model was induced by injection of mixtured solution of 5% sodium tanrecholate and trypsin into the pancreatic duct. Thirty dogs were randomly divided into total parenteral nutrition (TPN) group (n=5), duodenal PEPTI-2000VARIENT (DP) group (n=5), duodenal Nutrison MuhiFibre (DN) group (n=5), jejunal PEPTI-2000VARIENT (JP) group (n=5), jejunal Nutrison MuhiFibre (JN) group (n=5). The dogs were treated by either TPN or EN 24 hours after ANP model induction and the nutrition support lasted for 5 days. Serum amylase, LDH, lipase, secretin (SEC), cholecystokinin (CCK) and gastrin were measured at 1, 2, 3, 4, 5 d. Pancreatic juice was collected for 3 hours after TPN or EN started, and the amount of pancreatic juice and levels of proteinase, amylase, lipase, HCO3-, K+, Cl-, Na+ were determined. Dogs in each group were sacrificed at day 7. Histological and ultra-structure changes of the pancreatic tissues were evaluated pathologically. Results The levels of serum amylase, LDH, lipase, CCK, amount of pancreatic secretion and K+, Cl+, Na+ were not significantly different among these groups. The levels of plasma SEC and gastrin, HCO3-, proteinase, amylase, lipase in the duodenal nutrition groups were significantly higher than those in TPN group (P<0.05). The above mentioned parameters in the jejunal nutrition group were significantly lower than those in the duodenal group (P<0.05) and higher than those in the TPN group without significant difference. Among the 2 jejunal nutrition groups, the levels of plasma gastrin, HCO3- in pancreatic juice, proteinase, amylase, lipase in the JP group were significantly higher than those in the JN group (P<0.05). The above mentioned parameters in the DP group were significantly lower than those in the DN group (P<0.05). The amount of pancreatic secretion, HCO3-,K+, Cl+, Na+ were not significantly different among these groups. The pathological changes were similar among these groups, and the extent of pathological changes was relatively better in the JP group. The amount and density of intracytoplasm zymogen granules of pancreatic acinar cell were not significantly lower than those in the TPN group. Conclusions The delivery of nutrients to the proximal jejunum with elemental low-fat diets did not increase the pancreatic exacrine activity.