Acute-phase response predicts erythropoietin resistance in hemodialysis and peritoneal dialysis patients

We defined erythropoietin (EPO) resistance by the ratio of the weekly EPO dose to hematocrit (Hct), yielding a continuously distributed variable (EPO/Hct). EPO resistance is usually attributed to iron or vitamin deficiency, hyperparathyroidism, aluminum toxicity, or inflammation. Activation of the acute-phase response, assessed by the level of the acute-phase C-reactive protein (CRP), correlates strongly with hypoalbuminemia and mortality in both hemodialysis (HD) and peritoneal dialysis (PD) patients. In this cross-sectional study of 92 HD and 36 PD patients, we examined the contribution of parathyroid hormone (PTH) levels, iron indices, aluminum levels, nutritional parameters (normalized protein catabolic rate [PCRn]), dialysis adequacy (Kt/V), and CRP to EPO/Hct. Albumin level serves as a measure of both nutrition and inflammation and was used as another independent variable. Serum albumin level (deltaR2 = 0.129; P < 0.001) and age (deltaR2 = 0.040; P = 0.040) were the best predictors of EPO/Hct in HD patients, and serum albumin (deltaR2 = 0.205; P = 0.002) and ferritin levels (deltaR2 = 0.132; P = 0.015) in PD patients. When albumin was excluded from the analysis, the best predictors of EPO/Hct were CRP (deltaR2 = 0.105; P = 0.003) and ferritin levels (deltaR2 = 0.051; P = 0.023) in HD patients and CRP level (deltaR2 = 0.141; P = 0.024) in PD patients. When both albumin and CRP were excluded from analysis in HD patients, low transferrin levels predicted high EPO/Hct (deltaR2 = 0.070; P = 0.011). EPO/Hct was independent of PTH and aluminum levels, PCRn, and Kt/V. High EPO/Hct occurred in the context of high ferritin and low transferrin levels, the pattern expected in the acute-phase response, not in iron deficiency. In well-dialyzed patients who were iron replete, the acute-phase response was the most important predictor of EPO resistance.     

Detection of serum TNF-α,IFN-γ,IL-6 and IL-8 in patients with hepatitis B

ＮＴＲＯＤＵＣＴＩＯＮＳｉｎｃｅＭｕｔｏ［１］ｒｅｐｏｒｔｅｄｔｈａｔＴＮＦαａｎｄＩＬ１ｗｅｒｅｒｅｌａｔｅｄｔｏｆｕｌｍｉｎａｎｔｈｅｐａｔｉｔｉｓ,ｔｈｅｓｔｕｄｉｅｓｏｎｔｈｅｒｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｃｙｔｏｋｉｎｅｓａ...     

综合干预措施控制人群肠道传染病的效果

张家港市位于苏南水网地区,全市85余万人口,面积998 km2,人口密度高达860人·km-2.全市工商经济和服务行业发达,外来流动人口达6000人·d-1,外来常住人口达10万人·a-1,而且本地人口流动量大,经对该市塘桥镇8000人调查,30%以上人口每天至少有一次不在家内用餐.农村人口以前普遍饮用河塘水及浅井水,其中饮用4 m～6 m深的井水者近40万人.     

在实践中提高对保健护理的认识

保健护理是护理实践的中心内容,是授权护理的前提,也是许多护理学理论研究的焦点。学生在学习中必须撑握人类躯体、心理和精神等方面的知识,但是仅有这些知识,却不了解保健护理的核心内容部分是远远不够的。尽管有许多书面材料提到保健护理是整体护理不可分割的部分,但要教育学生承认护理中的关护行为。并形成概念将保健护理作为专家护理实践的基础,仍具有挑战性。在社区医疗保健活动中,给注册护士-护理学士学位(RN-BSN)学生布置一项任务,给她们提供认识保健护理行为和交流范例的机会。按照要求,每个学生必须在“保健护理日志”中记录自己…     

Distribution of ankle--brachial index and the risk factors of peripheral artery disease in a multi-ethnic Asian population

Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis and is associated with increased cardiovascular morbidity and mortality. We describe the prevalence and risk factors of PAD in a multi-ethnic Asian population (Chinese, Malays and Indians) in Singapore. The Singapore Prospective Study Program recruited 4132 individuals between 2004 and 2006 in which the ankle-brachial index (ABI) was measured using the Smartdop? 20EX bi-directional blood flow detector. PAD was defined as ≤ 0.9 and a high ABI > 1.4, with ABI 1.11-1.20 as reference. The mean age (SD) of individuals in the study was 49.9 (11.8) years, with 51.8% females. PAD was present in 4.3% of the population and a high ABI (> 1.4) was rare. Malays and Indians had a higher risk (especially in females). Compared to those with an ABI between 1.11 and 1.20, those with PAD were more likely to be of Malay and Indian ethnicity, female sex, with higher systolic blood pressure and pulse pressure, with increased prevalence of diabetes mellitus, hypertension, albuminuria and renal impairment, and with a past history of stroke. In conclusion, in this large multi-ethnic Asian population, we document the distribution and risk factor associations for PAD. PAD shows an ethnic distribution similar to that of coronary artery disease in Singapore, with differences in sex distribution. Apart from traditional vascular risk factors, pulse pressure, renal impairment and a past history of stroke are important determinants of PAD.     

Associations of physical activity and television viewing time with retinal vascular caliber in a multiethnic Asian population

PURPOSE. The aim of this study was to examine the relationship of physical activity and television (TV) viewing time with retinal vascular caliber in a multiethnic Asian population. METHODS. Chinese, Indian, and Malay participants (n = 3866) were examined cross-sectionally in the Singapore Prospective Study Program (2004-2007). Leisure-time physical activity and TV viewing time were assessed by the use of an interviewer-administered questionnaire. Retinal arteriolar and venular calibers were measured from digital retinal photographs. RESULTS. After adjusting for demographic, behavioral, and medical factors, those in the lowest quartile of leisure-time physical activity had a wider venular caliber (by 1.51 μm; 95% confidence interval [CI], 0.01-2.92) compared with those in the highest quartile. Using sex- and ethnicity-specific quartiles, stronger associations were noted in males (2.23 μm; 95% CI, 0.10-4.38) and Chinese (2.52 μm; 95% CI, 0.44-4.59) participants. Females who watched >2 hours of TV per day had a narrow arteriolar caliber (by 1.28 μm; 95% CI, -2.56--0.03), compared with the arteriolar caliber of those who watched less TV. CONCLUSIONS. Lower physical activity and higher TV viewing time (in females) were adversely associated with retinal microvascular caliber among Asian adults. Additional cross-sectional and longitudinal studies are needed to further clarify the potential mediating role of the microvasculature in the relationship between these behavioral risk factors and poor cardiometabolic health outcomes.     

Analgesic effects of JCM-16021 on neonatal maternal separation-induced visceral pain in rats

AIM:To investigate the pharmacological effect of JCM-16021,a Chinese herbal formula,and its underlying mechanisms.METHODS:JCM-16021 is composed of seven herbal plant materials.All raw materials of the formula were examined according to the quality control criteria listed in the Chinese Pharmacopeia(2005).In a neonatal maternal separation(NMS)model,male SpragueDawley rats were submitted to daily maternal separation from postnatal day 2 to day 14,or no specific handling(NH).Starting from postnatal day 60,rats...     

Increased concentration of sialidases by HeLa cells might influence the cytotoxic ability of NK cells

ObjectiveCancer cells reportedly have the ability to escape from the immune system, mainly from natural killer (NK) cells. Although the real mechanisms are complicated, some inhibitors that are secreted from the cancer cells might play an important role. This study’s aim was to investigate the potential mediator released by cancer cells (HeLa) that contributes to the decreased cytotoxicity of NK cells.Methods and MaterialsAn NK-HeLa coculture system was used to test the hypothesis that the presence of the potential mediator from cancer cells contributes to the decreased cytotoxicity of NK cells.ResultsAfter coculturing with HeLa cancer cells, the cytotoxicity of NK cells was decreased. When the coculture medium and culture medium containing commercialized sialidase were used to culture NK cells, the cytotoxicity of the NK cells was also inhibited. However, cytotoxicity was partially restored by a sialidase inhibitor (DANA). Western blot analysis of the HeLa cells after coculturing with NK cells demonstrated increased Neu2 and Neu3 expression in HeLa cells.ConclusionsThe finding that Neu2 and Neu3 expression in cancer cells might be involved in the impaired function of NK cells, which could be restored by a sialidase inhibitor, provides a new concept that could be applied to the management of cancer.