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Lu J.-R.,7th Peoples Hospital | Yi Y.,Fudan University | Tian J.,455th Hospital of PLA | Xiong C.-X.,7th Peoples Hospital | And 3 more authors.
Blood Purification

Background: The goal of this study was to investigate underlying factors of parathyroid dysfunction in elderly patients undergoing maintenance hemodialysis. Methods: A total of 286 patients on maintenance hemodialysis were included. Hemoglobin, serum creatinine (Scr), blood urea nitrogen (BUN), serum calcium, serum phosphorus (P), intact parathyroid hormone (iPTH), and serum albumin (Alb) were measured and analyzed both before and after dialysis. Results: A higher incidence of low iPTH level (<150 pg/l) was observed in the elderly group than that in the non-elderly group (55.8 vs. 36.7%, p < 0.05). Elderly patients had a shorter dialysis duration, lighter dry weight, lower concentrations of BUN, Scr, P, iPTH, Alb and standard protein nitrogen present rate (nPNA) compared to that of non-elderly group patients (p < 0.05). Conclusions: Low iPTH level occurs more frequently in elderly hemodialysis patients. Furthermore, age, serum P, serum Alb and nPNA were independently associated with a low iPTH level. © 2014 S. Karger AG, Basel. Source

Yi Y.,Fudan University | Lu J.-R.,7th Peoples Hospital | Tian J.,455th Hospital of PLA | Ma J.,Fudan University | And 2 more authors.
Experimental and Clinical Cardiology

Objective: We aimed to evaluate the treatment effect of continuous venovenous hemofiltration (CVVH) in maintenance hemodialysis (MHD) patients with refractory hypertension (RH). Methods:A total of 56 MHD patients with RH were selected to CVVH group. The changing of blood pressure, dry body weight, levels of intact parathyroid hormone (iPTH), renin (RA), angiotensin I, II (AT I, AT II), aldosterone (Ald) in plasma were observed before and after CVVH. Another 58 MHD patients with normal blood pressure were selected as control group. Results:1. 56 MHD patients with RH undergone 3-5 times (average 3.8 times) CCVH treatment. 36 cases were significant effciency, 12 cases were effciency, 8 cases were invalid .The significant effective is 64.3%,effective rate is 85.7%. 2. Mean arterial pressure (MAP) decreased from 137.8±6.3 to 104.2±6.8 mmHg, and the average dry body weight (DBW) decreased from 60.6±8.1 to 58.1±7.6 Kg in CVVH group. 3. The plasma levels of RA ATI, ATII, Ald and iPTH after treatment decreased significantly compared with those before treatment in CVVH group, P <0.05; while there was no significant change in the level of RA, ATI, ATII, Ald and iPTH between before and after treatment in control group. Conclusion: CVVH is effective methods in treatment of MHD patients with RH, and its antihypertensive mechanisms was associated with remove of the excess water and sodium and the decrease in plasma levels of RA, AT I, ATII, Ald, iPTH. Source

Li Y.,Shanghai JiaoTong University | Shi H.,Shanghai JiaoTong University | Wang W.-M.,Shanghai JiaoTong University | Peng A.,Tongji University | And 16 more authors.
Medicine (United States)

This was the first multicenter, cross-sectional survey to assess the prevalence of anemia, patient awareness, and treatment status in China. Data of patients with chronic kidney disease (CKD; age, 18-75 years; both out-and inpatients) from 25 hospitals in Shanghai, seeking medical treatment at the nephrology department, were collected between July 1, 2012 and August 31, 2012. The prevalence, awareness, and treatment of anemia in patients with nondialysis CKD (ND-CKD) were assessed. Anemia was defined as serum hemoglobin (Hb) levels ≤12g/dL in women and ≤13g/dL in men. A total of 2420 patients with ND-CKD were included. Anemia was established in 1246 (51.5%) patients: 639 (51.3%) men and 607 (48.7%) women. The prevalence of anemia increased with advancing CKD stage (χ2 trend=675.14, P<0.001). Anemia was more prevalent in patients with diabetic nephropathy (68.0%) than in patients with hypertensive renal damage (56.6%) or chronic glomerulonephritis (46.1%, both P<0.001). Only 39.8% of the anemic patients received treatment with erythropoietin and 27.1% patients received iron products; furthermore, 22.7% of the patients started receiving treatment when their Hb level reached 7g/dL. The target-achieving rate (Hb at 11-12g/dL) was only 8.2%. Of the 1246 anemia patients, only 7.5% received more effective and recommended intravenous supplementation. Anemia is highly prevalent in patients with ND-CKD in China, with a low target-achieving rate and poor treatment patterns. The study highlights the need to improve multiple aspects of CKD management to delay the progression of renal failure. © 2016 Wolters Kluwer Health, Inc. All rights reserved. Source

Li H.,455th Hospital of PLA
Zhongguo yi liao qi xie za zhi = Chinese journal of medical instrumentation

The codes of medical consumptive materials is the base for standardized and information management. This article analyzes in detail the structure and meanings of five common-used classification codes in management including registration certificate code, bar code of high-value medical consumptive materials, charging code, medical insurance code and account code. The disadvantages of current coding method and solving program are suggested. Source

Liu N.,455th Hospital of PLA | Tian J.,455th Hospital of PLA | Cheng J.,455th Hospital of PLA | Zhang J.,455th Hospital of PLA
Journal of Cellular Biochemistry

Bone marrow-derived mesenchymal stem cells (BMSCs) can migrate to the injured kidney after acute kidney injury (AKI) with limited efficiency. This study investigated the effect of CXCR4 overexpression on BMSC migration to the AKI kidney and the possible mechanisms. CXCR4 gene-modified BMSCs (CXCR4-BMSCs) and null-BMSCs were prepared and transplanted into the AKI mice. Blood indicators, histology, expression of stromal cell-derived factor 1 (SDF-1), and BMSC migration were investigated. Hypoxia/re-oxygenation-pretreated renal tubular epithelial cells (HR-RTECs) were prepared to generate AKI in vitro. The chemotaxis experiment was performed using the transwell chamber. The phosphorylation of AKT and MAPK in the BMSCs was also investigated. The CXCR4-BMSCs showed a remarkable expression of CXCR4. The SDF-1 expression in the AKI renal tissue was increased. CXCR4-BMSCs transplantation sharply increased the accumulation of BMSCs in the renal tissue, which was consistent with a greater improvement of renal function. The in vitro experiments showed that the migration of BMSCs to the HR-RTEC culturing chamber was CXCR4-dependent, and could be fully inhibited by AMD3100, a CXCR4-specific antagonist. The migration could also be partly blocked by either LY294002 (PI3K inhibitor) or PD98059 (MAPK inhibitor). Phosphorylated Akt and MAPK were increased in the BMSCs co-cultured with HR-RTECs and their expression was the highest in the CXCR4-BMSCs, which could be recovered by AMD3100. Overexpression of CXCR4 gene could enhance BMSC migration to the kidney area after AKI. The SDF-1/CXCR4 axis via its activation of PI3K/AKT and MAPK in BMSCs could be the possible mechanisms underlying this function. © 2013 Wiley Periodicals, Inc. Source

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