Clinical outcomes,quality of life,and costs evaluation of peritoneal dialysis management models in Shanghai Songjiang District: a multi-center and prospective cohort study

Background: The new Family-Community-Hospital (FCH) three-level comprehensive management aimed to improve the efficiency and scale of peritoneal dialysis (PD) to meet the increased population of end-stage renal disease (ESRD). Our study focused on the clinical outcomes, quality of life, and costs evaluation of this model in a multi-center and prospective cohort study.Methods: A total of 190 ESRD patients who commenced PD at Shanghai Songjiang District were enrolled. According to different PD management models, patients were divided into the Family-Community-Hospital three-level management model (n = 90) and the conventional all-course central hospital management model (n = 100). The primary outcome was clinical outcomes of PD. The secondary outcomes were health-related quality of life (HRQOL) and medical costs evaluation.Results: Compared to conventional management, community-based FCH management achieved a similar dialysis therapeutic effect, including dropout rate (p = 0.366), peritonitis rate (p = 0.965), patient survival (p = 0.441), and technique survival (p = 0.589). Follow-up data showed that similar levels of the renal and peritoneal functions, serum albumin, cholesterol and triglyceride, PTH, serum calcium, and phosphorus between the two groups (all p > 0.05). HRQOL survey showed that the FCH management model helped to improve the psychological status of PD patients, including social functioning (p = 0.006), role-emotional (p = 0.032), and mental health (p = 0.036). FCH management also reduced the hospitalization (p = 0.009) and outpatient visits (p = 0.001) and saved annual hospitalization costs (p = 0.005), outpatient costs (p = 0.026), and transport costs (p = 0.006).Conclusions: Compared with conventional management, community-based FCH management achieved similar outcomes, improved psychological health, reduced medical budgets, and thus had a good social prospect.     

Removal of copper ions by functionalized biochar based on a multicomponent Ugi reaction

Copper is widely present in the natural environment and inevitably poses a risk to both human health and the natural environment. Biochar is an inexpensive, clean and sustainable sorbent material that can be used as a resource for copper removal, and there is interest in new ways to chemically treat biochar to tune its unique properties and modify its atomic structure. In this study, biochar was oxidized, and then polyethyleneimine (PEI) modified chitosan and carboxylated biochar were economically compounded through a multicomponent Ugi reaction to effectively remove Cu(ii). PEI enhances the adsorption of Cu(ii) within an optimum solution pH range of 3.5–5.5. The adsorption process follows a pseudo-second-order kinetic model. When the dosage of BC-NH2 was 4 g L⁻¹ and the temperature was 303 K, the maximum adsorption capacity calculated by the Langmuir model was 26.67 mg g⁻¹. The adsorption process of Cu(ii) on BC-NH2 was heat-trapping and spontaneous. BC-NH2 showed good selectivity for K⁺ and Mg²⁺, and BC-NH2 desorbed by NaOH showed better adsorption performance than H₂SO₄ in the adsorption–desorption cycle. Characterization by SEM, EDS, BET, FTIR, TGA and XPS showed successful coupling and that the amide group of BC-NH2 had chelated with Cu(ii). This atomically economical multicomponent Ugi reaction provides a new option for preparing composite materials that effectively remove heavy metals.

Polyethyleneimine-modified chitosan and carboxylated biochar were economically compounded by a multicomponent Ugi reaction to produce products rich in amide functional groups.     

4-Pentenoyl-isoleucyl-chitosan oligosaccharide and acrylamide functional monomer-dependent hybrid bilayer molecularly imprinted membrane for sensitive electrochemical sensing of bisphenol A

In this work, an electrochemical sensor was designed for trace monitoring of bisphenol A (BPA) by decorating a hybrid bilayer molecularly imprinted membrane (MIM) on a multi-walled carbon nanotube-modified glassy carbon electrode. When BPA in the MIM was eluted, a composite molecularly imprinted electrochemical sensor was constructed. Under optimal conditions, the developed sensor showed two linear relationships between ΔI_p and BPA concentration in the range of 0.04 μM to 8 μM, as well as good selectivity and stability, and was also applied to detect BPA in water samples with desirable recoveries ranging from 92.0% to 107.0%.

A hybrid bilayer molecularly imprinted membrane-dependent electrochemical sensor was developed for bisphenol A assay based on 4-pentenoyl-isoleucyl-chitosan oligosaccharide and acrylamide functional monomers.     

Arterial stiffness acute changes following aerobic exercise in males with and without hypertension

While regular exercise exposure is considered the most effective therapy to reduce arterial stiffness, the effect of acute exercise training on arterial stiffness in adults with different blood pressure (BP) levels remains unclear. The authors aimed to investigate the effects of acute aerobic exercise on arterial stiffness in male with different BP levels. This cross‐sectional study utilized data for 1200 males aged 20–49 years from the Kailuan study cohort who participated in the fifth National Fitness Monitoring project. A total of 940 participants (621 in the non‐hypertensive group and 319 in the hypertensive group) aged 36.82 ± 7.76 who completed a twice‐quantitative cycle ergometer exercise and measure of brachial‐ankle pulse wave velocity (baPWV) at both the baseline and immediately after exercise were included in this study. The baPWV was decreased after acute aerobic exercise in the non‐hypertension and hypertension groups (Δ 40.29 [95% confidence interval [CI], −47.72 to −32.86] vs. Δ20.45 [95% CI, −31.32 to −9.58] cm/s). Participants without hypertension showed a greater decrease in baPWV (Δ 19.84 [95% CI, −33.83 to −5.84] cm/s) than participants with hypertension. Aerobic exercise had an acute positive effect on arterial stiffness. This study provides evidence of a greater reduction in arterial stiffness in individuals without hypertension than in those with hypertension.     

甲状腺内胸腺癌一例

甲状腺内胸腺癌是甲状腺肿瘤的独立病理类型,临床罕见,本文报道一例我院收治的64岁女性患者,因颈部肿块伴呼吸、吞咽困难就诊,术前穿刺结果示：伴胸腺样分化的甲状腺癌。行甲状腺左叶切除+甲状腺右叶大部切除+胸骨后甲状腺病损切除术,术后病理结果示：甲状腺内胸腺癌。术后进行放、化疗,随访6个月,患者生活质量改善。本文通过总结该病...     

SFRP2与Periostin的相互作用在瘢痕疙瘩形成机制中的研究

目的利用pull-down技术验证凋亡相关蛋白基因SFRP2（Secreted frizzled-related protein 2）和骨母细胞特异性因子-2 Periostin（Osteoblast-specific factor2）间的相互作用。方法构建能在哺乳动物细胞中表达带HA标签的Periostin融合蛋白（HA—Periostin）的重组载体pCMV—HA—Periostin,经酶切鉴定正确后,和表达带Myc标签的融合蛋白（Myc—SFRP2）的重组真核表达载体pCMV—HA—SFRP2,单独或共转染人293细胞,利用pull-down技术验证Periostin与SFRP2间的相互作用。结果成功构建重组载体pCMV—HA-Periostin．与抗Myc单克隆抗体沉淀Myc—SFRP2相互作用蛋白复合物后,可以检测到HA—PeMostin的表达。通过体外蛋白质结合实验证实了Periostin与SFRP2间的相互作用。结论成功构建带HA标签的Periostin融合蛋白（HA-Periostin）的重组载体,利用pull—down技术证实了Periostin与SFRP2间的存在相互作用。     

Intermittent Fasting: Potential Bridge of Obesity and Diabetes to Health?

Obesity has been an escalating worldwide health problem for decades, and it is likely a risk factor of prediabetes and diabetes. Correlated with obesity, the number of diabetic patients is also remarkable. A modest weight loss (5–10%) is critical to alleviate the risk of any other metabolic disease. Reduced energy intake has been an essential factor for weight loss reduction. As a new behavior intervention to lose weight, intermittent fasting (IF) attracts considerable attention and has become a popular strategy among young people. IF is a diet pattern that cycles between periods of fasting and eating on a regular schedule, involving various types, mainly Intermittent Energy Restriction and Time-Restricted Fasting. Accumulating evidence shows that short-term IF has a greatly positive effect in animal studies and contributes favorable benefits in human trials as well. Nevertheless, as an emerging, diverse, and relatively premature behavior intervention, there are still limited studies considering patients with obesity and type 2 diabetes mellitus. It is also a controversial intervention for the treatment of metabolic disease and cancer. The risks and challenges appear consequently. Additionally, whether intermittent fasting can be applied to long-term clinical treatment, and whether it has side effects during the long-term period or not, demands more large-scale and long-term experiments.     

预防性肠造口还纳术后切口疝的发生率、危险因素及预防进展

造口部位切口疝(SSIH)是预防性肠造口还纳术后常见的远期并发症之一,也是病人二次手术的主要原因之一,不仅给病人带来二次手术的痛苦,且修补后有一定的复发率。然而,国内临床医生对肠造口还纳这一术式较高的术后SSIH发生率未予重视,未能从预防性肠造口还纳术的手术特点来分析其危险因素。本文就肠造口还纳术后SSIH的发生率、危险因素和预防进展作一综述,以期提高临床医生对SSIH的认识和重视。