Cytokines,adipocytokines and inflammatory markers in patients on continuous ambulatory peritoneal dialysis and hemodialysis

Background: Cytokines are essential mediators of immune response. Chronic renal failure patients suffer from chronic inflammation that results from factors such as impaired renal function, accumulation of uremic toxins and bio incompatibility of dialyzer membranes. These patients are also at increased risk of cardiovascular diseases. We have evaluated cytokines, adipocytokines and inflammatory markers in patients with chronic renal failure undergoing hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD).

Material and methods: We have determined serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), leptin and ghrelin levels of chronic renal failure patients treated with either HD (n?=?20) or CAPD (n?=?20). TNF-α, IL-6, ghrelin and leptin measurements were performed by commercially available kits based on enzyme-linked immunosorbent assay (ELISA) method. hsCRP levels were determined by turbidimetric methods.

Results: Serum TNF-α and IL-6 levels of patients on HD were significantly higher than those of the ones on CAPD (p?<?0.05). Ghrelin, leptin and hsCRP concentrations were similar in both groups.

Conclusions: We can conclude that cytokine production is more obvious in HD process.     

Review of non‐invasive ventilation in the emergency department: clinical considerations and management priorities

Aims and objectives. We aimed to synthesise evidence from published literature on non‐invasive ventilation to inform nurses involved in the clinical management of non‐invasive ventilation in the emergency department. Background. Non‐invasive ventilation is a form of ventilatory support that does not require endotracheal intubation and is used in the early management of acute respiratory failure in emergency departments. Safe delivery of this intervention requires a skilled team, educated and experienced in appropriate patient selection, available devices and monitoring priorities. Design. Systematic review. Method. A multi‐database search was performed to identify works published in the English language between 1998–2008. Search terms included: non‐invasive ventilation, continuous positive airway pressure and emergency department. Inclusion and exclusion criteria for the review were identified and systematically applied. Results. Terminology used to describe aspects of non‐invasive ventilation is ambiguous. Two international guidelines inform the delivery of this intervention, however, much research has been undertaken since these publications. Strong evidence exists for non‐invasive ventilation for patients with acute exacerbation of congestive heart failure and chronic obstructive pulmonary disease. Non‐invasive ventilation may be delivered with various interfaces and modes; little evidence is available for the superiority of individual interfaces or modes. Conclusions. Early use of non‐invasive ventilation for the management of acute respiratory failure may reduce mortality and morbidity. Though international guidelines exist, specific recommendations to guide the selection of modes, settings or interfaces for various aetiologies are lacking due to the absence of empirical evidence. Relevance to clinical practice. Monitoring of non‐invasive ventilation should focus on assessment of response to treatment, respiratory and haemodynamic stability, patient comfort and presence of air leaks. Complications are related to mask‐fit and high air flows; serious complications are few and occur infrequently. The use of non‐invasive ventilation has resource implications that must be considered to provide effective and safe management in the emergency department.     

Diagnostic and therapeutic approach to coexistent chronic obstructive pulmonary disease and obstructive sleep apnea

The high prevalence of both obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in Western societies is well documented. However, OSA frequently remains unrecognized and untreated among patients with COPD. Patients with both conditions have a greater risk for fatal and nonfatal cardiovascular events compared with patients with COPD or OSA alone. Efficacious treatment with continuous positive airway pressure reduces the risk of cardiovascular complications in patients with OSA. The aim of the present review is to discuss the diagnostic approach to patients with both conditions and to delineate the benefits of timely recognition and treatment of OSA in patients with COPD.     

The application value of continuous nursing intervention on quality of life in patients with stroke: A protocol for systematic review and meta-analysis

Background:Individual characteristics, physical function disability, emotional, as well as cognitive symptoms, along with the general health discernment might be associated or impact the quality of life of patients suffering from stroke directly or indirectly. Appropriate continuous nursing intervention is required to enhance the quality of life of patients with stroke. Therefore, the present study will be conducted to systematically investigate the application value of continuous nursing intervention for improving the quality of life of patients experiencing stroke.Methods:We will conduct a comprehensive search of electronic databases such as MEDLINE, Cochrane Library, CINAHL, EMBASE, Scopus, Chinese National Knowledge Infrastructure, and WanFang databases to identify relevant publications. We will only include studies published in English or Chinese languages. Accordingly, randomized controlled trials evaluating the application value of continuous nursing intervention for improving the quality of life of patients suffering from stroke will be included. We will use 2 independent authors to conduct study selection, extract data, and evaluate the quality of the included studies. In case of any discrepancies, they will be addressed by consensus. Also, we will use RevMan 5.3 software to carry out the statistical analysis.Results:The current study will summarize high-quality evidence to systematically explore application value of continuous nursing intervention for improving the quality of life in patients with stroke.Conclusion:The present study will summarize the direct and indirect pieces of evidence to ascertain whether continuous nursing intervention can improve the quality of life in patients with stroke.Ethics and dissemination:Ethical approval will not be required.Registration number:April 25, 2021.osf.io/xnrzt/ (https://osf.io/xnrzt/).     

连续性不卧床腹膜透析治疗艾滋病并发终末期肾脏病(附一例报道)

目的：观察连续性不卧床腹膜透析（CAPD）对艾滋病（acquired immunodeficiency syndrome,AIDS）并发终末期肾脏病（ESRD）的疗效。方法：一例确诊为艾滋病的男性患者,合并慢性丙型肝炎、血友病甲（Ⅷ因子缺乏）和糖尿病,高效抗逆转录病毒治疗（HAART）1年后出现蛋白尿及肾功能不全,进展至ESRD后行CAPD治疗,观察CAPD前后残余肾功能、贫血、钙磷代谢、心功能、营养状况等变化,并进行透析充分性及并发症评估。结果：患者行CAPD治疗后高血压、贫血、氮质血症、酸中毒及心功能均明显改善,体重稳定,无水肿,Kt/V2.01/周,nPCR1.133g/（kg.d）。存在营养不良-炎症-心血管疾病综合征及代谢紊乱。结论：AIDS并发ESRD行CAPD作为肾脏替代治疗可取得满意疗效。