Objective:To study the effects of different calcium ion concentrations on epithelial mesenchymal transformation (EMT) of human peritoneal mesothelial cell (HPMC) via endoplasmic reticulum stress (ERS).Methods:HPMC cell line HMrSV5 was cultured in vitro and treated in groups. The cells in the control group, high calcium group 1, and high calcium group 2 were treated with medium containing calcium ion concentrations of 1.25, 1.75, and 2.25 mmol/L, respectively. The solvent control group was treated with medium containing 1.25 mmol/L physiological calcium ion concentration and 0.1% dimethyl sulfoxide (DMSO), the high calcium+solvent group was treated with medium containing 2.25 mmol/L calcium ion concentration and 0.1% DMSO, the high calcium+4-phenylbutyric acid (4-PBA) group was treated with medium containing 2.25 mmol/L calcium ion concentration and 1 mmol/L ERS inhibitor 4-PBA, and each group was treated for 48 hours. Morphological changes of cells in each group were observed under light microscope. The expressions of epithelial cell phenotype marker zonula occluden-1 (ZO-1) and mesenchymal cell phenotype marker α-smooth muscle actin (α-SMA) in the cells were observed by immunofluorescence staining. The expressions of EMT marker genes E-cadherin, ZO-1, α-SMA and Vimentin were detected by fluorescence quantitative polymerase chain reaction (PCR). The expressions of ERS marker proteins phosphorylated protein kinase R-like endoplasmic reticulum kinase (p-PERK), phosphorylated eukaryotic initiation factor 2α (p-eIF2α), transcription activating factor 4 (ATF4) and C/EBP homologous protein (CHOP) were detected by Western blotting. Results:Compared with the control group, the morphology of HMrSV5 cells became slender and fibrotic, the fluorescence intensity of ZO-1 increased, and the fluorescence intensity of α-SMA decreased in high calcium 1 and high calcium 2 groups, indicating that the cells transformed from epithelial cells to mesenchyme cells. The mRNA expressions of E-cadherin and ZO-1 were significantly decreased, while the mRNA expressions of α-SMA and Vimentin and the protein expressions of p-PERK, p-eIF2α, ATF4 and CHOP were significantly increased, moreover, the expressions of the above marker genes or proteins in the high calcium 2 group was more obvious than those in the high calcium 1 group [E-cadherin mRNA (2 -ΔΔCt): 0.53±0.05 vs. 0.75±0.09, ZO-1 mRNA (2 -ΔΔCt): 0.42±0.06 vs. 0.69±0.06, α-SMA mRNA (2 -ΔΔCt): 1.81±0.16 vs. 1.32±0.14, Vimentin mRNA (2 -ΔΔCt): 2.05±0.22 vs. 1.48±0.16, p-PERK protein (p-PERK/β-actin): 0.81±0.09 vs. 0.59±0.06, p-eIF2α protein (p-eIF2α/β-actin): 0.87±0.10 vs. 0.50±0.06, ATF4 protein (ATF4/β-actin): 0.93±0.10 vs. 0.72±0.06, CHOP protein (CHOP/β-actin): 0.79±0.09 vs. 0.46±0.04, all P < 0.05]. Compared with the solvent control group, the morphological changes of cells, the expressions of EMT marker genes and ERS marker proteins after high calcium ion concentration of 2.25 mmol/L were consistent with those in the high calcium 2 group than control group. Compared with the high calcium+solvent group, the cell morphology recovered the characteristics of polygonal and pebble-like epithelial cells in the high calcium+4-PBA group, the fluorescence intensity of ZO-1 increased, the fluorescence intensity of α-SMA decreased, and the mRNA expressions of E-cadherin and ZO-1 in the cells were significantly increased [E-cadherin mRNA (2 -ΔΔCt): 0.86±0.09 vs. 0.57±0.04, ZO-1 mRNA (2 -ΔΔCt): 0.81±0.06 vs. 0.48±0.05, both P < 0.05], the mRNA expressions of α-SMA and Vimentin and the protein expressions of p-PERK, p-eIF2α, ATF4 and CHOP were significantly decreased [α-SMA mRNA (2 -ΔΔCt): 1.21±0.13 vs. 1.77±0.15, Vimentin mRNA (2 -ΔΔCt): 1.30±0.14 vs. 1.94±0.20, p-PERK protein (p-PERK/β-actin): 0.38±0.04 vs. 0.92±0.11, p-eIF2α protein (p-eIF2α/β-actin): 0.34±0.05 vs. 1.05±0.13, ATF4 protein (ATF4/β-actin): 0.57±0.06 vs. 0.97±0.11, CHOP protein (CHOP/β-actin): 0.51±0.04 vs. 0.90±0.12, all P < 0.05]. Conclusion:High calcium ion concentrations of 1.75 mmol/L and 2.25 mmol/L promote EMT of HPMC via activating ERS.

【Objective】 To investigate the correlation of serum exosomal microRNA-301a (miR-301a) with cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. 【Methods】 A total of 211 patients with diabetic nephropathy treated with peritoneal dialysis from June 2019 to June 2020 in the First Hospital Affiliated of Hebei North University were selected as study subjects. Serum exosomal miR-301a was detected by real-time fluorescence quantitative polymerase chain reaction. The patients were divided into high miR-301a group and low miR-301a group based on the median of miR-301a; the clinical data of the two groups were compared. The correlation of miR-301a with high-sensitivity C-reactive protein (hs-CRP) was analyzed by Spearman. Linear regression was applied to analyze the factors associated with the effect of miR-301a. The patients were followed up for two years. Kaplan-Meier and Log-Rank were conducted to compare the cumulative incidence of cardiovascular and cerebrovascular events between the two groups, and COX regression and restricted cubic spline were used to analyze the level-effect relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis. 【Results】 Thirty-seven cases (17.54%) of cardiovascular and cerebrovascular events occurred during follow-up. The hs-CRP level and dialysis duration were lower in low miR-301a group than in high miR-301a group (P<0.05). There was a positive correlation between miR-301a and hs-CRP (rs=0.237, P=0.001). Linear regression analysis showed that hs-CRP was independently associated with miR-301a (P<0.05). The cumulative cardiovascular and cerebrovascular event rate in low miR-301a group was 3.70% (4/108), which was lower than that in high miR-301a group [32.04% (33/103), P<0.001]. COX regression analysis showed that high serum albumin level was an independent protective factor for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy,while high hs-CRP level and miR-301a >1.46 were independent risk factors for cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy. Restricted cubic spline fitting COX regression analysis showed a non-linear relationship between miR-301a and cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy (P<0.05). 【Conclusion】 hs-CRP is independently associated with miR-301a in diabetic nephropathy peritoneal dialysis patients. High miR-301a level suggests a high risk of cardiovascular and cerebrovascular events after peritoneal dialysis in diabetic nephropathy.

【Objective】 To evaluate the quality of suspended red blood cells (SRBC) under low-pressure and hypoxic conditions, in order to lay a theoretical foundation for airline delivery, air drop and storage of SRBC on plateau. 【Methods】 The low-pressure and hypoxic conditions (0.026 MPa and 0.047 MPa) were simulated by a pressure control device. SRBC were divided into 3 groups (5 bags/group, 1.5 U/bag). Each group was stored in 0.026 MPa environment at 2℃-6℃ for 24 hours (named 0.026 MPa), in 0.047MPa environment at 2℃-6℃ for 7 days (named 0.047 MPa), and in a blood storage refrigerator at 4℃ (named the control), respectively. The storage cell characteristics were examined on day 2, 9, 14, 28 and 35. 【Results】 We found that HCT, MCV, K⁺, Na⁺, FHb, hemolytic ratio, 2, 3-DPG and rheological properties in group 0.026 MPa and 0.047 MPa were not significant different compared with that in control (P>0.05). The consumptions of Glu in group 0.026 MPa and 0.047 MPa were significantly higher (P<0.05), and a transient increase in LAC concentration of group 0.026 MPa and 0.047MPa were observed, compared to the control. 【Conclusion】 The conditions of low-pressure and hypoxia have no significant effect on the quality of suspended red blood cells.

Most of the existing near-infrared noninvasive blood glucose detection models focus on the relationship between near-infrared absorbance and blood glucose concentration, but do not consider the impact of human physiological state on blood glucose concentration. In order to improve the performance of prediction model, particle swarm optimization (PSO) algorithm was used to train the structure paramters of back propagation (BP) neural network. Moreover, systolic blood pressure, pulse rate, body temperature and 1 550 nm absorbance were introduced as input variables of blood glucose concentration prediction model, and BP neural network was used as prediction model. In order to solve the problem that traditional BP neural network is easy to fall into local optimization, a hybrid model based on PSO-BP was introduced in this paper. The results showed that the prediction effect of PSO-BP model was better than that of traditional BP neural network. The prediction root mean square error and correlation coefficient of ten-fold cross-validation were 0.95 mmol/L and 0.74, respectively. The Clarke error grid analysis results showed that the proportion of model prediction results falling into region A was 84.39%, and the proportion falling into region B was 15.61%, which met the clinical requirements. The model can quickly measure the blood glucose concentration of the subject, and has relatively high accuracy.
Algorithms ; Blood Glucose ; Humans ; Neural Networks, Computer

The use of non-invasive blood glucose detection techniques can help diabetic patients to alleviate the pain of intrusive detection, reduce the cost of detection, and achieve real-time monitoring and effective control of blood glucose. Given the existing limitations of the minimally invasive or invasive blood glucose detection methods, such as low detection accuracy, high cost and complex operation, and the laser source's wavelength and cost, this paper, based on the non-invasive blood glucose detector developed by the research group, designs a non-invasive blood glucose detection method. It is founded on dual-wavelength near-infrared light diffuse reflection by using the 1 550 nm near-infrared light as measuring light to collect blood glucose information and the 1 310 nm near-infrared light as reference light to remove the effects of water molecules in the blood. Fourteen volunteers were recruited for
Blood Glucose ; Diabetes Mellitus ; Humans ; Nonlinear Dynamics

Objective To evaluate the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment on two cases of infection with the critical Corona Virus Disease 2019 (COVID-19) complicated by fulminant myocarditis (FM) . Methods This study selects two COVID-19 cases comorbid with fulminant myocarditis and had been treated with ECMO in Shenzhen Third People's Hospital from January 2020 to February 2020. We compare the index of inflammation, immunization, D-dimer and lactic acid before and after ECMO treatment in 24 and 96 hours, cardiopulmonary function before and after ECMO treatment in 24, 48, 72, 96 hours,. We also analyze the complications and clinical outcomes of the two cases during the ECMO treatment. Results Both patients were elderly obese men with chronic cardiopulmonary disease. Comparing the laboratory test results and imaging data of the two patients, the acute lung injury score, oxygenation index, albumin level, hypersensitive C-reactive protein, lactate and lactate dehydrogenase levels in 2 patients after ECMO treatment were improved as compared with those before ECMO treatment. Finally, case 1 died of multiple organ failure and his cardiac function continued to deteriorate, while, case 2 successfully withdrew and his cardiac function gradually improved. Conclusions For critical COVID-19 patients with fulminant myocarditis, ECMO treatment can improve pulmonary function in the short term, provide valuable time for rescuing COVID-19 patients with fulminant myocarditis.

Objective To investigate the effect of Niaoduqing Granule on the quality of life and the activa-tion of TGF-β1/Smad signalling in chronic renal failure rats received peritoneal dialysis. Methods Thirty SD rats were used to establish peritoneal dialysis models and were randomly divided into the model group(group M),the low dose group(group L),and the high dose group(group H).The dosage of group L and group H was 2 and 4 g/(kg·d),respectively. The body mass,the number of independent activities,the index of renal hypertrophy, Scr,BUN,experssion of TGF-β1 and p-Samd2/3 were determined. Results The body weight growth rate was shown decreased as follows:group N>group H>group L>group M.The number of spontaneous activity of group M decreased significantly than those in other groups. Scr,BUN and kidney hypertrophy index were significantly different among the four groups.Compared with group M,BUN,Scr,kidney hypertrophy index,levels of TGF-β 1 and p-Samd2/3 were significantly decreased in group L and H. Levels of TGF-β1 and p-Samd2/3 were signifi-cant different between group L and H. Conclusions Niaoduqing Granule can improve the quality of life and re-duce the level of serum creatinine and urea nitrogen in chronic renal failure rats received peritoneal dialysis,and the mechanism may be associated with the regulation of TGF-β1/Smad signaling pathway.

Objective To compare the clinical characteristics of normal body mass index (BMI) polycystic ovary syndrome (PCOS) patients with or without insulin resistance (IR) , and analyze the related factors of IR. Methods From January 2013 to January 2017, 128 patients with normal BMI (18.5-23.9 kg/m2) PCOS patients were divided into A group (56 cases with IR) and B group (72 cases without IR) according to whether they had IR. The clinical indicators, sex hormones, glucose and lipid metabolism indexes of the two groups were statistically compared, and the related factors influencing insulin resistance index (HOMA-IR) were analyzed by Pearson. Results Compared with B group, the waist-to-hip ratio (0.91 ± 0.08 vs. 0.80 ± 0.07), Ferriman-Gallway scores [(4.87 ± 1.66) scores vs. (3.31 ± 1.29) scores], fasting blood glucose (FPG) [(5.19 ± 0.60) mmol/L vs. (4.77 ± 0.56) mmol/L], fasting insulin (FINS) [(17.89 ± 5.85) mU/L vs. (9.83 ± 3.87) mU/L], total cholesterol (TC)[(5.03 ± 1.42) mmol/L vs. (4.52 ± 0.62) mmol/L], triglyceride (TG)[(1.72 ± 1.05) mmol/L vs. (0.98 ± 0.26) mmol/L], low density lipoprotein cholesterol (LDL-C) [(3.10 ± 1.19) mmol/L vs. (2.55 ± 0.82) mmol/L] in A group were significantly increased, while high density lipoprotein cholesterol (HDL-C) [(1.28 ± 0.30) mmol/L vs. (1.52 ± 0.23) mmol/L] significantly reduced, the differences were statistically significant (P < 0.05). HOMA-IR was positively correlated with waist-to-hip ratio (r=0.397), FPG (r=0.461), FINS (r=0.992), TC (r=0.371), TG (r=0.354) and LDL-C (r=0.478), but negatively correlated with sex hormone binding globulin (r=-0.231) and HDL-C (r=-0.299). Conclusions The waist-to-hip ratio, Ferriman-Gallway scores, glucose and lipid metabolism in normal BMI PCOS patients with IR are significantly altered. The waist-to-hip ratio, FPG, FINS, TC, TG, LDL-C, HDL-C and sex hormone binding globulin are all related factors of HOMA-IR.

Objective To explore the effect of uremic clearance granule combined with losartan potassium on the microinflammation status and peritoneal function in patients underwent peritoneal dialysis (PD).Methods A total of 60 patients with end-stage renal disease (ESRD) who were admitted in our hospital from August 2014 to February 2016 for continuous ambulatory PD (CAPD) were included in the study and randomized into observation group and control group.The patients in the two groups were performed with CAPD.The patients in the control group were orally administrated with losartan potassium tablets.On this basis,the patients in the observation group were given uremic clearance granules.After 1-year treatment,the efficacy was evaluated.PET was performed in the beginning and at the end and 24 h urine volume and 24 h ultrafiltration volume were recorded.Meanwhile,RRF was determined.Hs-CRP,IL-6,TNF-α,TGF-β1,VEGF,and FN were detected.Results RRF,24h urine volume and 24h ultrafiltration volume in 1 year after treatment in the two groups were significantly reduced compared with treatment before (P ＜ 0.05),while PET was significantly elevated (P ＜ 0.05).The reduced degree of RRF,24 h urine volume and 24 h ultrafiltration volume in 1 year after treatment in the observation group was significantly less than that in the control group (P ＜ 0.0 5),and the elevated degree of PET was significantly less than that in the control group (P ＜ 0.05).Hs-CRP,IL-6,and TNF-α in 1 year after treatment in the two groups was significantly reduced compared with treatment before (P ＜ 0.05).The reduced degree of hsCRP,IL-6,and TNF-α in 1 year after treatment in the observation group was significantly greater than that in the control group (P ＜0.05).TGF-β1,VEGF,and FN in 1 year after treatment in the two groups were significantly elevated compared with treatment before (P ＜ 0.05).The elevated degree of TGF-β1,VEGF,and FN in 1 year after treatment in the observation group was significantly less than that in the control group.Conclusion Uremic clearance granule in combined with losartan potassium can effectively improve the microinflammation status,inhibit PF,protect the peritoneal function,and delay the reduction of RRF.

Objective To explore the effect of uremic clearance granule combined with losartan potassium on the microinflammation status and peritoneal function in patients underwent peritoneal dialysis (PD).Methods A total of 60 patients with end-stage renal disease (ESRD) who were admitted in our hospital from August 2014 to February 2016 for continuous ambulatory PD (CAPD) were included in the study and randomized into observation group and control group.The patients in the two groups were performed with CAPD.The patients in the control group were orally administrated with losartan potassium tablets.On this basis,the patients in the observation group were given uremic clearance granules.After 1-year treatment,the efficacy was evaluated.PET was performed in the beginning and at the end and 24 h urine volume and 24 h ultrafiltration volume were recorded.Meanwhile,RRF was determined.Hs-CRP,IL-6,TNF-α,TGF-β1,VEGF,and FN were detected.Results RRF,24h urine volume and 24h ultrafiltration volume in 1 year after treatment in the two groups were significantly reduced compared with treatment before (P ＜ 0.05),while PET was significantly elevated (P ＜ 0.05).The reduced degree of RRF,24 h urine volume and 24 h ultrafiltration volume in 1 year after treatment in the observation group was significantly less than that in the control group (P ＜ 0.0 5),and the elevated degree of PET was significantly less than that in the control group (P ＜ 0.05).Hs-CRP,IL-6,and TNF-α in 1 year after treatment in the two groups was significantly reduced compared with treatment before (P ＜ 0.05).The reduced degree of hsCRP,IL-6,and TNF-α in 1 year after treatment in the observation group was significantly greater than that in the control group (P ＜0.05).TGF-β1,VEGF,and FN in 1 year after treatment in the two groups were significantly elevated compared with treatment before (P ＜ 0.05).The elevated degree of TGF-β1,VEGF,and FN in 1 year after treatment in the observation group was significantly less than that in the control group.Conclusion Uremic clearance granule in combined with losartan potassium can effectively improve the microinflammation status,inhibit PF,protect the peritoneal function,and delay the reduction of RRF.