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Chinese Journal of Blood Purification

    12 March 2008, Volume 7 Issue 3 Previous Issue    Next Issue
    专题
    Ideas of the diagnosis and treatment for refractory peritonitis
    GAN Hong-bing
    2008, 7 (3):  120-121. 
    Abstract ( 379 )   HTML ( 0 )   PDF (482KB) ( 421 )  
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    Common problems encountered in catheterization-related infections in peritoneal dialysis
    HAN Qin-feng
    2008, 7 (3):  122-123. 
    Abstract ( 404 )   HTML ( 0 )   PDF (457KB) ( 614 )  
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    Tuberculous peritonitis in peritoneal dialysis patients
    ZHAO Hui-ping;WANG Mei
    2008, 7 (3):  124-127. 
    Abstract ( 414 )   HTML ( 0 )   PDF (479KB) ( 277 )  
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    Diagnosis and treatment of fungal peritonitis
    YU Yuan;LIU Wen-hu
    2008, 7 (3):  128-129. 
    Abstract ( 386 )   HTML ( 0 )   PDF (482KB) ( 263 )  
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    论著
    Survival rate and multivariate analysis of prognostic factors in continuous ambulatory peritoneal dialysis patients
    CHEN Li-meng;XU Hong;ZHOU Zi-juan;LI Xue-mei;CUI Ying;YANG Wei;SUN Yang;LI Xue-wang
    2008, 7 (3):  130-133. 
    Abstract ( 642 )   HTML ( 0 )   PDF (617KB) ( 419 )  

    【Abstract】Objective The aim of this study was to identify risk factors influencing survival and to determine baseline peritoneal transport status in the prediction of subsequent survival in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods This study included all adult patients who commenced peritoneal dialysis in this hospital between Jan. 1, 1996, and Dec. 31, 2007, and had a peritoneal equilibration test (PET) performed within 6 months of peritoneal dialysis commencement. Times to death and death-censored technique failure were examined by Kaplan-Meier analyses and multivariate Cox proportional hazards models. Results The overall survival probability after 1 , 2 , 3 and 4 years was 91.1%,77.7%,68.7% and 55.8%, respectively. Patients with diabetes, higher peritoneal transport status, advanced age, serum albumin < 30 g/ L, had lower survival probabilities. PET was performed in 180 (78%) of the 232 patients who were treated with peritoneal dialysis in this hospital during the study period. In these patients, higher transport status was found to be a significant predictor of mortality (relative risk 2.70; 95% CI 1.03-7.05; P = 0.043, as compared to those with transport status lower than average). Cox regression showed that advanced age and diabetes were the independent prognostic predictors. The relative risk (RR) of mortality in diabetic patients was 2.96 times higher than that in non-diabetic patients (95% CI 1.62-5.38; P <0.0001). As age increased by 10 years, the RR increased 0.31 (P=0.039). Conclusion The prognosis of peritoneal dialysis patients can be preliminarily predicted before the initiation of peritoneal dialysis based on their age, primary diseases, peritoneal transport status and serum albumin.

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    Relationship between dyslipidemia and peritoneal dialysis catheter enwrapped by omentum
    HANG Yi-xiong;NING Jian-ping;ZHOU Qiao-ling;JING Yong-dong
    2008, 7 (3):  134-136. 
    Abstract ( 584 )   HTML ( 0 )   PDF (560KB) ( 208 )  

    【Abstract】 Objective To investigate the relationship between dyslipidemia and peritoneal dialysis catheter being enwrapped by omentum in peritoneal dialysis patients. Methods Fifteen patients with enwrapped catheters after placement of the catheter for peritoneal dialysis were enrolled in this study, and 30 patients without this complication were used as the controls. Blood lipid levels were compared between the patients and controls. The incidence of enwrapped catheters was also compared between the patients with dyslipidemia and those with normal lipid levels. Results Patients complicated with enwrapped catheters were found to have higher serum levels of triglycerides, cholesterol and low-density lipoproteins as well as lower serum level of apolipoprotein A1 than those without this complication. Conclusion Dyslipidemia is related to the enwrapping of peritoneal dialysis catheter by omentum, and is probably one of the risk factors for this complication.

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    Risk factors for cardiocerebral vascular diseases in peritoneal dialysis patients
    LI Xiao;REN Hong;XIE Jing-yuan;XU Yao-wen;WU Pei;CHEN Nan
    2008, 7 (3):  137-140. 
    Abstract ( 608 )   HTML ( 0 )   PDF (567KB) ( 398 )  
    【Abstract】 Objective To investigate the risk factors for cardiocerebral vascular diseases in peritoneal dialysis (PD) patients. Methods One hundred and sixty-three patients who initiated PD during Jan. 2002~Dec. 2006, in our department were recruited in this study and divided into three groups: group 1, without cardiocerebral vascular diseases; group 2, with cardiocerebral vascular diseases before PD; group 3, cardiocerebral vascular diseases developed in the course of PD. Patients’ body weight, hemoglobin, albumin, triglycerides, total cholesterol, lipoprotein A, high-sensitivity C-reactive protein, interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), ejection fraction (EF), and their disease history of diabetes and hypertension were collected. Results In the 163 PD patients, cardiocerebral vascular diseases were found in 121 cases (74.2%), of whom 75 patients were in group 2 and 46 patients in group 3. Before the end of Mar. 2007, 28 patients died, of whom 11 patients (39.3%) died of cardiocerebral vascular diseases. Diabetes and hypertension were found more in group 2 and 3 than in group 1. Hemoglobin were (94.3+22.4)g/L, (86.2+20.8)g/L and (86.8+18.1)g/L in group 1, 2 and 3, respectively (P<0.05). Serum albumin were (30.6+6.5)g/L, (27.3+5.1)g/L and (27.0+5.3)g/L in group 1, 2 and 3, respectively (P<0.01). Logistic regression analysis showed that diabetes, older catheterization age and lower EF were the risk factors for cardiocerebral vascular diseases in PD patients. Conclusion Diabetes, older catheterization age and lower EF are the risk factors related to cardiocerebral vascular diseases in PD patients. Intervention of these risk factors will improve their survival rate.
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    Discussion with the feasibility of accepting surgery and the periopreative management in patients with maintenance dialysis
    ZHAO Hui-ping;YAN Yu;CAI Mei-shun;LU Li-xia;WANG Mei
    2008, 7 (3):  141-144. 
    Abstract ( 1288 )   HTML ( 0 )   PDF (565KB) ( 362 )  
    Objective Discussion on maintenance dialysis patients with the feasibility of accepting surgery and perioperative management. Methods One-hundred-seventy-five maintenance dialysis patients (including hemodialysis and peritoneal dialysis) were selected into a retrospective study. Then we investigated their information related to the surgery, compared with the changes of hemoglobin、electrolyte、kidney function、 blood pressure between pre- and post-operation, record whether or not there were surgical complications, discuss the perioperative management and summarize the adjustment of dialysis programme during perioperative period. Results Among 175 cases of maintenance hemodialysis patients , 18 cases need surgical operation,accounting for 10.28% of dialysis patients.13 patients undergoing 18 cases of operations. Preoperative Hemoglobin (Hb) level were (97.35 t difference were found in the electrolytes、kidney functions and blood pressures between pre- and post-surgery. 2 cases of patients happened surgical complications which were hypotension and respiratory failure.1 patient died. The dialysis programmes need to be adjusted , different dialysis methods can be selected including continuous renal replacement therapy、without heparin hemodialysis、automatic peritoneal dialysis or continuous ambulatory peritoneal dialysis,according to the surgery conditions and the patientsConclusions Patients with maintenance dialysis have high risks of surgery. But after correct and appropriate perioperative management, most of them can tolerate surgery. Strengthen the perioperative management, especially the adjustment of dialysis modalities, will help to these patients to survive the perioperative period.
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    基础研究
    Transfer of plasmid expressing short hair RNA into mouse peritoneum mediated by polyamidoamine dendrimers
    YI Bin;LIU Fu-you;LIU Hong;PENG You-ming;YUAN Fang
    2008, 7 (3):  145-148. 
    Abstract ( 491 )   HTML ( 0 )   PDF (822KB) ( 194 )  
    【Abstract】Objectives To investigate the expression of pHK-shRNA plasmid mediated by polyamidoamine dendrimers(PAMAM)in mouse peritoneum. Methods Kunming mice were randomly divided into transfection group and control group, and were intraperitoneally injected with PAMAM G9/pHK-shRNA complex and saline, respectively. Parietal and visceral peritoneum were collected after the injection for 24h, 48h, 96h and 7d, and the expression of green fluorescent protein (GFP) in peritoneum was detected by fluorescence microscope and western blot. Results Expression of GFP was not detected in control group, and was detected in peritoneum of transfection group at all time points. Western blot and observation of tissue sections showed that the peak of the expression was at 48h after the transfection. Conclusions pHK-shRNA plasmid can be efficiently transferred into mouse peritoneal tissue by PAMAM, which provides an approach for in vivo experimental studies.
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    Transfection of shRNA expressing plasmid by calcium phosphate nanoparticles inhibits the high glucose-induced TGF-β1 expression in human peritoneal mesothelial cells
    LING Guang-hui;LIU Fu-you;PENG You-ming;DUAN Shao-bin;LIU Hong;LI Yin;LI Jun;LIU Ting
    2008, 7 (3):  149-152. 
    Abstract ( 958 )   HTML ( 0 )   PDF (578KB) ( 250 )  
    【Abstract】Objective Transforming growth factor-β1 (TGF-β1) is one of the key mediators in peritoneal fibrosis. Short hairpin RNAs (shRNA) transcribed under the control of U6 or H1 promoter in plasmid can trigger silence of the target gene in mammalian cells. We have developed TGF-β1 shRNA expression plasmids in a previous study. A novel nonviral vector calcium phosphate nanoparticle (CPNP) was also developed by means of a chemistry method. Transmission electron microscopy and Zeta potential demonstrated that CPNP was of 23.5~34.5 nm in diameter and had positive surface charges of +16.8 mV. In this study, we investigated the transfection of shRNA expressing plasmid mediated by CPNP on high glucose-induced TGF-β1 expression in human peritoneal mesothelial cells (HPMCs). Methods The TGF-β1 shRNA expression plasmid (pcDU6-A1-B1) was transfected into HPMCs mediated by CPNP. Transfected cells were then stimulated with 50mmol/L D-glucose for 48 hours, and the expression of TGF-β1 and fibronectin were evaluated Results TGF-β1 expression was upregulated significantly in control HPMCs stimulated with 50mmol/L D-glucose for 48 hours. Such induction was inhibited by the transfection of shRNA expression plasmid (pcDU6-A1-B1) into the cells mediated by CPNP. Fibronectin expression was also upregulated significantly by the stimulation of 50mmol/L D-glucose for 48 hours. The 50mmol/L D-glucose-induced fibronectin expression became insignificant in HPMCs transfected with the shRNA expression plasmid, as measured by enzyme-linked immunosorbent assay (ELISA). Conclusion The introduction of shRNA expression plasmid into HPMCs effectively inhibited high glucose-induced TGF-β1 expression in these cells. Calcium phosphate nanoparticles were useful for the introduction of this plasmid into HPMCs. shRNA expression plasmid introduced by calcium phosphate nanoparticles may be a promising approach for the gene therapy of peritoneal fibrosis.
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