The effect of intradialytic combined exercise on hemodialysis efficiency in end-stage renal disease patients: a randomized-controlled trial

Purpose

Insufficient dialysis is a difficult problem for patients undergoing hemodialysis, and causes cardiovascular complications and increases mortality. Increasing aerobic exercise and resistance exercise have been shown to be beneficial to physical fitness of patients undergoing hemodialysis, but a few studies have focused on combined exercise (combination of aerobic and resistance exercise training) and the interaction effect of combined exercise and intervention duration on hemodialysis efficiency. This study aimed to investigate the effects of 24-week combined exercise on hemodialysis efficiency, blood pressure, exercise capacity, and quality of life in patients undergoing hemodialysis.

Methods

In total, 47 eligible subjects were randomly allocated to exercise group and control group. The intervention group performed a 24-week, three times weekly, and moderate-intensity intradialytic combined exercise. Patients in the control group received usual care. The primary outcome was hemodialysis efficiency, which recorded every 4 weeks. Secondary outcomes included blood pressure, exercise capacity, and quality of life, measured at baseline and after 24 weeks of intervention.

Results

In intervention group, sp Kt/V significantly improved by 13.2%, and systolic blood pressure and diastolic blood pressure significantly decreased by 8.5 mmHg and 6.5 mmHg, respectively. The 6-min walking distance increased significantly by 43 m (9.8%), but there was no significant change in quality of life.

Conclusion

Combined exercise and intervention duration had an interaction effect on hemodialysis efficiency. Combined exercise improved blood pressure and physical fitness for patients undergoing hemodialysis, but did not affect quality of life. The extensive benefits of combined exercise provide evidence for the exercise development for patients undergoing hemodialysis.

     

龙牡壮骨颗粒对小鼠性激素水平的影响

摘 要 目的:探讨龙牡壮骨颗粒对性激素水平的影响。方法: 昆明小鼠雌雄各30只,以该制剂溶于水制成溶液剂为供试药,以双蒸水为空白对照。受试小鼠按性别随机分为龙牡壮骨颗粒雌性高、等效剂量组和龙牡壮骨颗粒雄性高、等效剂量组,给药14 d,观察对血清睾酮、雌二醇含量和骨指标的影响。结果:龙牡壮骨颗粒能显著提高小鼠骨干重、骨密度、骨量,等效剂量龙牡壮骨颗粒组还能明显提高雄性小鼠骨湿重（P=0.022）,等效剂量龙牡壮骨颗粒对小鼠性激素水平无影响（P=0.855）。高剂量龙牡壮骨颗粒显著降低雄性小鼠雌二醇水平（P=0.048）。结论: 与临床剂量等效的龙牡壮骨颗粒对小鼠骨质有增强作用,同时对小鼠性激素水平无影响。     

他克莫司联合小剂量泼尼松治疗儿童特发性膜性肾病致酮症酸中毒

1例8岁男性患儿因特发性膜性肾病应用他克莫司（1.25 mg,1次/12 h）联合泼尼松（12.5 mg,隔日1次）口服治疗。5周后,患儿相继出现多饮、多尿、呕吐、嗜睡、脱水征。实验室检查：空腹葡萄糖22.4 mmol/L,动脉血酸碱度7.24,标准碳酸氢盐12 mmol/L,尿酮体（＋＋＋）。诊断为酮症酸中毒。停用他克莫司,给予静脉补液（2125 ml/d）及重组人胰岛素2.5 U/h持续静脉输注。10 h后血酸碱度7.40,空腹葡萄糖8.5 mmol/L,连续2次检测尿酮体均为阴性,改为三餐前皮下注射重组人胰岛素6.25 U。3周后,患儿空腹葡萄糖5.9 mmol/L。     

Studies on the inhibitory models of pyrazoline derivatives as EGFR kinase inhibitors by 3D-QSAR and molecular docking

The development of EGFR kinase inhibitors attracts much attention of research for treating of cancer in recent years. In this work, based on a dataset composed of 46 EGFR kinase inhibitors, the combination of three-dimensional quantitative structure–activity relationship (3D-QSAR), molecular docking was applied to reveal structural characteristics impacting the inhibitory activity of EGFR, and to provide a better understanding of the binding modes between inhibitors and EGFR kinase. 3D-QSAR models of pyrazoline derivatives were established to reveal how steric, electrostatic, hydrophobic, and H-bond acceptor interactions contribute to inhibitors’ bioactivities, which were unanimous in the docking results. Furthermore, based on the most active compound, several new molecules with high inhibitory activity were obtained.     

全胃多发类癌一例

1 临床资料 患者女,46岁。因进食后腹胀小适1年余,期间无腹痛、恶心、呕吐、反酸、暖气、呕血、黑便等症状,于当地乡镇卫生院就诊,行上消化道钡餐造影检查,诊断为慢性萎缩性胃炎,给予促胃肠动力、抑酸、保护胃黏膜等保守治疗后症状缓解。此后反复发作腹胀不适,为求进一步诊断与治疗患者于2012年8月28日来我院普通外科就诊。患者自述慢性萎缩性胃炎病史10余年、体格检查：胸部和腹部均无阳性体征。     

A comparison of biomechanical changes on femoral head following rotational acetabular osteotomy and eccentric rotational acetabular osteotomy in normal cadaveric hip

Purpose

Both rotational acetabular osteotomy (RAO) and eccentric rotational acetabular osteotomy (ERAO) are effective procedures for young patients with developmental dysplasia of the hip. However, no comparative study of biomechanical changes has been reported following these two procedures. We therefore explored the stress changes on femoral head after RAO and ERAO under different load conditions.

Materials and methods

Twelve female cadaveric hips without deformity were divided into RAO group and ERAO group. Stress value on femoral head was measured preoperatively and postoperatively after the vertical force was loaded on the cadaveric spine from 0 to 500 N. Stress change value was then calculated base on the measurements.

Results

In the RAO group, preoperative stress increased when loading on spine became larger, but postoperative stress changed its increasing trend into decreasing when the load was greater than 200 N (turning point). Same phenomenon was found in the ERAO group (turning point was 300 N). However, the difference between preoperative and postoperative stress was not statistically significant in both RAO and ERAO groups. Stress change value from each procedure showed similar trends. With the load growth, stress change increased firstly and then decreased, but the difference between RAO and ERAO was not statistically significant.

Conclusions

Both RAO and ERAO could correct the abnormal biomechanical effect of dysplastic hip; moreover, they may have similar biomechanical effects on femoral head, obtaining the same clinical outcomes. Non-biomechanical factors (surgical trauma, technical complexity, etc.) also play important roles in procedure selection.     

Association of nitric oxide synthase 3 (NOS3) 894 G>T polymorphism with prognostic outcomes of anthracycline in Chinese patients with acute myeloid leukaemia

The aim of the present study was to investigate the influence of the nitric oxide synthase 3 (NOS3) 894 G>T polymorphism on prognostic outcomes of anthracycline in Chinese patients with de novo intermediate‐risk acute myeloid leukaemia (AML) and to examine the gene expression level in relation to genetic variation. In all, 225 Chinese patients with intermediate‐risk AML (at the complete remission stage) treated with anthracycline were enrolled in the study. The 894 G>T polymorphism of the NOS3 gene was analysed by allele‐specific matrix‐assisted laser desorption ionization time‐of‐flight. Expression of NOS3 mRNA was tested in 72 patients of known genotype for NOS3 894 G>T. The clinical characteristics of these patients were obtained from medical records. Survival analysis showed that patients with AML (GG genotype) had a longer overall survival (OS; P = 0.006). After adjusting for age, gender, leucocyte count, haemoglobin level, platelet level, French, American and Britain (FAB) classification, lactate dehydrogenase levels, Eastern Cooperative Oncology Group Performance Status, nucleophosmin gene and fms‐related tyrosine kinase 3 gene, multivariate survival analysis showed that the NOS3 894 G>T polymorphism appeared to be a predicting factor for OS (P = 0.014; hazard ratio = 1.856). However, no significant associations between the NOS3 894 G>T polymorphism and relapse‐free survival and relapse in patients with AML were observed. Gene expression levels were significantly higher in patients with the GG genotype than in patients with the GT and TT genotypes (P = 0.033). The findings suggest that the NOS3 894 G>T variant may be a biomarker for the prediction of OS in Chinese patients with AML.     

眼黏膜相关淋巴瘤并骨髓侵犯一例伴文献分析

目的观察眼附属器黏膜相关淋巴瘤的临床特点。方法报告1例双眼同时起病的眼附属器黏膜相关样淋巴组织（MALT）结外边缘区B细胞淋巴瘤（OAML）并骨髓侵犯一例,结合文献对该类型淋巴瘤病因、临床表现、免疫组化、分子生物学改变、治疗进行探讨。结果OAML大部分为局限性病变,单侧多见,晚期播散型少见。结论OAML为惰性过程,相关至死率低,对于IE可给予放疗,加用免疫化学治疗可降低复发,对于IVE期患者需全身化疗,总体预后良好。     

注射用益气复脉治疗分水岭脑梗死的效果分析

目的 观察注射用益气复脉治疗急性分水岭脑梗死的临床效果.方法 80例急性分水岭脑梗死患者完全随机分为观察组（40例）,对照组（40例）.2组均给予抗血小板聚集、调脂、调控血压、改善微循环及保护脑细胞等治疗,观察组在此基础上加用注射用益气复脉,5.2 g/d静脉滴注,共10 d.治疗前后应用美国国立卫生研究院卒中量表（NIHSS）进行神经功能缺损评分.结果 2组患者治疗后NIHSS评分均低于本组治疗前[观察组（8.4±2.5）分比（13.2±2.3）分,对照组（9.6±3.2）分比（13.4±2.7）分],观察组治疗后NIHSS评分明显低于对照组（P＜0.05）.观察组治疗有效率为85.0％（34/40）,明显高于对照组的65.0％ （26/40）（P＜0.05）.2组均无明显不良反应.结论 注射用益气复脉治疗分水岭脑梗死安全、有效.