维持性血液透析患者并发上消化道出血的临床分析

目的探讨维持性血液透析患者并发上消化道出血的临床特点及相关因素。方法选取56例维持性血透并发上消化道出血患者作为实验组,51例维持性血透无上消化道出血患者为对照组;比较分析两组间肾功能（BUN、Cr）、血钙（Ca^2＋）、凝血酶原时间（PT）、血小板（PLT）、血浆白蛋白（ALB）、血红蛋白（Hb）、幽门螺杆菌（Hp）感染率、甲状旁腺激素（IPTH）、血清胃泌素（SG）、单次kt／v值、每周透析时间等指标。结果实验组与对照组在BUN、Cr、血Ca2＋、PT、ALB、Hb、Hp感染率、IPTH、SG、每周透析时间等指标方面差异均有统计学意义（P〈0．叭或P〈0．05）,而两组间单次kt／v值、PLT数量比较差异无统计学意义（P〉0．05）。结论肾功能损害、低血C矿、Hp感染、继发性甲状旁腺功能亢进、SG增高、营养不良、透析不充分可能是维持性血透患者并发上消化道出血的危险因素,临床上应及早干预这些危险因素。     

维持性血液透析患者胃黏膜病变与血清胃蛋白酶原水平变化

目的 探讨维持性血液透析(MHD)患者胃黏膜病变及血清胃蛋白酶原(PG)水平的变化情况.方法 选择2015年1月至2016年12月期间我院收治的62例MHD患者纳入观察组,随机选择同期62例健康体检者纳入对照组,比较两组受检者的血清PGⅠ、PGⅡ和PGⅠ/PGⅡ水平;对观察组患者进行胃镜检查以观察胃黏膜病变情况.结果 观察组患者最常见的胃黏膜病变为慢性糜烂性胃炎(35.48%)、胃十二指肠溃疡(32.26%)及慢性出血性胃炎(25.81%);观察组患者的PGⅠ和PGⅠ/PGⅡ比值均分别为(212.4±85.6)μg/L和(20.8±5.6),明显高于对照组的(106.3±43.2)μg/L和(11.4±3.9),差异均有统计学意义(P<0.05).结论 慢性糜烂性胃炎、胃十二指肠溃疡及慢性出血性胃炎是维持性血液透析患者常见胃黏膜病变,且患者常伴有PGⅠ和PGⅠ/PGⅡ比值的增高.     

血液灌流联合耳穴贴压治疗维持性血液透析并发症疗效观察

目的:探讨血液灌流联合耳穴贴压治疗维持性血液透析(Manitenance Hemodialysis,MHD)并发症的疗效。方法:MHD患者90例随机分为治疗组和对照组1及对照组2,每组30例,治疗1个月,治疗组在血液透析(Hemodialysis,HD)基础上做血液灌流加耳穴贴压治疗,对照组1在透析基础上联合血液灌流治疗,对照组2仅行血透治疗。观察三组患者治疗前、后的实验室检查指标(肾功能、甲状旁腺激素、β2微球蛋白、电解质)变化与临床症状(皮肤瘙痒、骨痛、睡眠障碍、出汗异常)的变化。结果:治疗后,治疗组和对照组1各临床症状明显改善,且治疗组患者睡眠障碍和出汗异常改善显著多于对照组1,两者比较差异有统计学意义(P0.05)。对照组2各临床症状未出现明显改善。治疗组和对照组1甲状旁腺激素、β2微球蛋白、钙、磷及肌酐、尿素氮水平与治疗前比较差异有统计学意义(P0.05)。对照组2治疗前后肌酐、尿素氮水平比较差异有统计学意义(P0.05),而甲状旁腺激素、β2微球蛋白、钙、磷水平比较差异无统计学义意义(P0.05)。结论:血液灌流能有效清除甲状旁腺激素、β2微球蛋白等中的分子毒素,纠正钙磷代谢紊乱,联合耳穴贴压治疗能更明显缓解MHD病发症的临床症状,其疗效要优于单纯血液灌流和常规血液透析。     

Tumor-specific MAGE proteins as regulators of p53 function

Since its discovery in 1991, the knowledge about the tumor specific melanoma antigen gene (MAGE-I) family has been continuously increasing. Initially, MAGE-I proteins were considered as selective targets for immunotherapy. More recently, emerging data obtained from different cellular mechanisms controlled by MAGE-I proteins suggest a key role in the regulation of important pathways linked to cell proliferation. This is in part due to the ability of some MAGE-I proteins to control the p53 tumor suppressor. In this review, we focus on the mechanisms proposed to explain how MAGE-I proteins affect p53 functions.     

GPCR mediated regulation of synaptic transmission

Synaptic transmission is a finely regulated mechanism of neuronal communication. The release of neurotransmitter at the synapse is not only the reflection of membrane depolarization events, but rather, is the summation of interactions between ion channels, G protein coupled receptors, second messengers, and the exocytotic machinery itself which exposes the components within a synaptic vesicle to the synaptic cleft. The focus of this review is to explore the role of G protein signaling as it relates to neurotransmission, as well as to discuss the recently determined inhibitory mechanism of Gβγ dimers acting directly on the exocytotic machinery proteins to inhibit neurotransmitter release.     

维持性血液透析治疗老年尿毒症的体会

目的探讨老年尿毒症患音维持性血液透析（MHD）的特点和临床疗效。方法维持性血液透析治疗老年尿毒症患者26例，观察其血透前后各种临床和生化指标的变化。结果血液透析前后患者体重、肾功能、血红蛋白及每日尿量差异有统计学意义（P〈0．001）。结论早期充分透析，坚持维持性血液透析，加强个体化透析，加强透析中及透析间期的管理，加强营养物质的摄入，防治并发症，可提高老年MHD患者生存率。     

组合型人工肾对维持性血透患者微炎症状态的影响

目的探讨组合型人工肾对维持性血透（maintenance hemodialysis,MHD）患者微炎症状态的影响。方法将42例MHD患者随机分为组合型人工肾组（HD＋HP）组和血液透析（HD）组,2组患者在首次治疗前后及,HD＋HP治疗8周后分别观察两组患者TNF-α、IL-6、CRP水平的变化。结果HD＋HP组治疗后,TNF-α、IL-6水平显著降低（P〈0.01）,CRP水平降低（P〈0.05）,治疗8周后复查比首次治疗后轻度降低,但无统计学意义（P〉0.05）;HD组治疗前后TNF-α、IL-6、CRP水平无统计学意义（P〉0.05）。结论组合型人工肾能有效降低MHD患者血清TNF-α、IL-6、CRP水平。通过本研究提示：进行间断的组合型人工肾治疗可以改善MHD患者微炎症状态。     

Brain natriuretic peptide as a cardiac marker of transient radiotherapy-related damage in left-sided breast cancer patients: A prospective study

PurposeOur study evaluated brain natriuretic peptide (BNP) changes over time after adjuvant radiotherapy (RT) in women with left-sided breast cancer investigating its correlation with heart dosimetric parameters.MethodsForty-three patients underwent clinical cardiac examination, electrocardiogram (ECG), echocardiography and BNP measurement before RT (T0) and 1 (T1), 6 (T6) and 12 months (T12) after. After T12 cardiac assessment was performed annually in each patient. Mean values and standard deviation (SD) of BNP, left ventricular ejection fraction (LVEF), V20, V25, V30, V45 and mean dose were calculated. Normalized BNP (BNPn) was calculated as follows: BNPnT1 = BNPT1/BNPT0, BNPnT6 = BNPT6/BNPT0, BNPnT12 = BNPT12/BNPT0. Absolute BNP and BNPn values were used for data analysis.ResultsMedian follow-up from the end of RT to the last check-up was 87 months (range 37–120 months). Minimum follow-up was 74 months except for two patients, who died at respectively 37 and 47 months after RT. In all patients LVEF did not change significantly (p = 0.22) after RT. BNP increased significantly (p < 0.001), particularly 1 and 6 months after RT. It slightly decreased after 12 months. BNP did not correlate with V20, V25, V30, V45, mean dose and MHD. All BNPn correlated significantly (p < 0.05) with V20, V25, V30, V45, mean dose and MHD. Four patients had a cardiac event; in the only subject who developed myocardial infarction, V20, V25, V30 and V45 were the highest and BNP increased from T1 and persisted high even at T12.ConclusionOur results confirm that BNP could be a useful minimally invasive marker of early RT related cardiac impairment.     

交流磁流体推进血液驱动装置的初步研究

磁流体推进是用于将导电流体（如海水、血液、液态金属等）进行增压，输送和推进的一种电工新技术。根据外加磁场特性的不同，磁流体推进可分为直流和交流两种方式。根据交流磁流体推进的基本原理和血液的导电特性，提出了一种新型的血液驱动装置——交流磁流体血液驱动泵。在这种血液驱动装置中，血液中没有运动的机械部件，也没有周期性的机械变形，因此这种驱动方式对血液没有机械挤压的破坏作用，降低了血液驱动过程中血液生化特性受到的消极影响。所以，这种新型的血液驱动方式的研究对人工心脏辅助装置有重要意义。     

综合治疗干预下维持性血液透析高血压患者季节性血压变化的影响因素

目的 探讨综合治疗干预下维持性血液透析(MHD)高血压患者季节性血压变化的影响因素.方法 选择我院血液净化中心2015年1月至2016年6月期间诊治的90例合并高血压的MHD患者为研究对象,均给予综合治疗干预,比较夏季与冬季血压、干体质量、透析间期体质量增加量(IDWG)、尿素清除分数(Kt/V)以及降压药的限定日剂量(DDD),采用Logistic回归分析方法分析夏冬季节血压变化的影响因素.结果 冬季患者收缩压、舒张压、干体质量、DDD、IDWG分别为(141.44±10.86)mmHg、(88.33±6.96)mmHg、(59.58±4.84)kg、(3.74±1.12)、(2.52±1.15)kg,均明显高于夏季的(137.52±10.43)mmHg、(84.41±6.25)mmHg、(59.58±4.84)kg、(3.42±1.03)、(2.11±0.93)kg,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,夏冬季节的干体质量差值是血压变化的独立影响因素(P<0.05).结论 在实施综合治疗干预的前提下,MHD高血压患者仍然存在季节性血压变化,干体质量增加是血压季节变化的独立影响因素.