Chinese Journal of Blood Purification

12 February 2008, Volume 7 Issue 2 Previous Issue    Next Issue

专家笔谈

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The new concept of blood purification: Recent progress in the theory and technology of blood purification WANG Zhi-gang 2008, 7 (2):  59-60.  Abstract ( 314 )   HTML ( 0 )   PDF (497KB) ( 431 )   Metrics

论著

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Relationship between the single nucleotide polymorphisms in three candidate genes and the glucocorticoid-induced osteoporosis SUIi Man-shu;NA Shi-ping;XIE Ru-juan;LIU Rui-chan;JIA Xi-bei 2008, 7 (2):  61-64.  Abstract ( 504 )   HTML ( 0 )   PDF (605KB) ( 235 )   【Abstract】Objective To explore the relationship between the 3 single nucleotide polymorphisms (SNPs) in three candidate genes, i.e., A163G in osteoprotegerin (OPG), Gln223Arg in leptin receptor (LEPR) and C161T in peroxisome proliferator-activated receptor (PPARγ), and the glucocorticoid-induced osteoporosis (GIO) in Chinese population. Methods We used the method of polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) to identify the SNPs of A163G in OPG, Gln223Arg in LEPR and C161T in PPARγ in 208 normal controls, 168 cases without GIO and 104 cases with GIO. Bone mineral density at lumbar spine and femoral neck was measured by using dual-energy X-ray absorption-metry (DEXA). Results By analysis of GIO with the respective SNPs, we obtained that the incidence of A163G in OPG and C161T in PPARγ as well as their related allele frequencies were significantly different between GIO cases and normal controls (p<0.05). When GIO was evaluated with the 3 SNPs, we found that the genotype rate of homologous GG at 163 in OPG in association with TT at 161 in PPARγ was significantly high in GIO cases (OR=2.04, 95%CI=1.26～3.67, P=0.02). Conclusion The SNPs of A163G in OPG and C161T in PPARγ may correlate with the glucocorticoid-induced osteoporosis in Chinese population, and these 2 SNPs may synergically interact in glucocorticoid-induced osteoporosis. Metrics

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Study of serum 8-hydroxy-2’-deoxyguanosine level in patients with end stage renal diseases WANG Zhe;LI Xue-zhu;YAN Hai-dong 2008, 7 (2):  65-68.  Abstract ( 696 )   HTML ( 0 )   PDF (627KB) ( 382 )   【Abstract】Objective A growing body of evidence suggests that oxidative stress is enhanced in patients with end stage renal diseases (ESRD) and is involved in pathogenesis of related chronic complications. Reactive oxygen species (ROS) may cause DNA damage and increase of cancer mortality in ESRD patients. But the detailed mechanism still remains unclear, and the degree of DNA oxidative damage in ESRD patients has not been well examined. We measured serum 8-hydroxy-2'-deoxyguanosine (8-OHdG), a product derived from interaction of oxygen radicals with deoxyguanosine, as well as nitric oxide (NO) and malondialdehyde (MDA) in patients with ESRD to investigate the degree of DNA oxidative damage and its related factors in ESRD. Methods Forty subjects were enrolled in this study, in which 15 subjects were non-dialysis ESRD patients (CRF group), 15 were ESRD patients undergoing regular hemodialysis (HD group), and 10 age- and sex-matched health people were selected as controls. Patients in this study had no inflammatory or malignant diseases, and no supplement with vitamin C, E and iron ion. Smokers and patients with positive hepatitis C virus antibody or hepatitis B surface antigen were excluded. Serum 8-OHdG was measured by an enzyme-linked immunosorbent assay (ELISA) kit, NO was measured by a modified cadmium particle reduction method, and MDA was measured by a thiobarbital product chromatometry method. Results Serum 8-OHdG was significantly higher in CRF group and HD group before and after hemodialysis than in normal subjects (P< 0.01). In HD patients, serum 8-OHdG was increased after hemodialysis, as compared with that before hemodialysis (P<0.05). In addition, serum NO and MDA were also significantly higher in CRF group and HD group before and after hemodialysis than in normal subjects (P<0.05). Serum 8-OHdG had a significant positive correlation with serum creatinine (r = 0.368, P＜0.05) and NO (r =0.453, P＜0.01), but had an insignificant correlation with age, sex, blood urea nitrogen, hemoglobin and hematocrit (P>0.05). Conclusion Serum 8-OHdG was increased in ESRD patients, indicating that DNA oxidative damage is enhanced in those patients. Serum 8-OHdG is a good and reliable parameter for the evaluation of oxidative stress degree in ESRD. Metrics

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Clinical observation of high sensitivity C-reactive protein and interleukin-6 in relation to changes of cardiac structure and function in maintenance hemodialysis patients ZHANG Ben-xiang;YIN Zhong-cheng 2008, 7 (2):  69-70.  Abstract ( 1030 )   HTML ( 0 )   PDF (599KB) ( 404 )   【Abstract】 Objective To investigate the relationship between microinflammation and changes of cardiac structure and function in maintenance hemodialysis (NHD) patients. Methods We recruited 48 patients on maintenance hemodialysis in this blood purification center, and 20 normal individuals as the controls. Serum high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were measured. Cardiac structure and function were evaluated by ultrasonic cardiography. Results Serum hs-CRP, IL-6, left ventricular dimension (LVD), left atrial dimension (LAD), interventricular septum thickness (IVST) and left ventricular dimension posterior wall thickness (LVPWT) were significantly higher in MHD patients than in controls (p<0.01). Serum hs-CRP and IL-6 were positively correlated with the values of LAD, LVD, IVST and LVPWT in MHD patients. Doppler echocardiology showed that 80% of the MHD patients had heart diastolic dysfunction. Conclusion MHD patients had higher serum hs-CRP and IL-6, which may correlate with the changes of cardiac structures. Metrics

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The occurrence of malignancies and its related factors in patients with maintenance dialysis ZHAO Hui-ping;MENG Xian-wen;SUI Zhun;YAN Yu;LU Li-xia;WANG Mei 2008, 7 (2):  71-74.  Abstract ( 689 )   HTML ( 0 )   PDF (580KB) ( 396 )   【Abstract】 Objective To evaluate the incidence of malignancies and its related factors, clinical features and prognosis in patients on maintenance dialysis. Methods We recruited 166 maintenance hemodialysis or peritoneal dialysis patients into a cross-sectional study, to investigate the incidence of malignant tumors and the clinical features of the malignancies. We also used logistic regression analysis method to disclose the tumor-related factors. Results Among the 166 maintenance dialysis patients, 11 cases (6.62%) developed malignant tumors. Logistic regression analysis showed that age and hemoglobin level were the independent risk factors relateing to tumors. In the 11 patients, 36% of the patients had unexplained weight loss, and 82% exhibited refractory anemia. All of the patients with urinary tumors presented intermittent and painless gross hematuria. Early diagnosis was achieved in 5 patients, who could be treated with surgery (radical or palliative operation) and/or chemotherapy and whose survival time has been lasted for 4 to 29 months (average 14 months). The malignancies of the remaining 6 patients were diagnosed at late stage (3 to 6 months later), so that no specific therapy could be used and two of them died. Conclusions The incidence of malignant tumor was significantly higher in maintenance dialysis patients than in the general population. Age and hemoglobin level were two independent risk factors relating to malignant tumors. Early diagnosis and treatment are essential to improve their prognosis. Metrics

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Relationship between renin-angiotensin-aldosterone system and changes of structure and function in left ventricle in maintenance hemodialysis patients ZHANG Jin-zhen;LI Yue-hong;ZHOU Yu 2008, 7 (2):  75-77.  Abstract ( 584 )   HTML ( 0 )   PDF (606KB) ( 268 )   Objective We studied the relationship between the activity of renin-angiotensin-aldosterone system (RAAS) and the changes of structure and function in left ventricle in maintenance hemodialysis patients, for the improvement of patient抯 heart function and life quality. Methods We measured plasma angiotensin II and aldosterone by radioimmunoassay in 40 hemodialysis patients and 20 normal controls, and the results were compared with the changes of ultrasound cardiography. Result ① The incidence of RAAS hyperactivity and left ventricular hypertrophy (LVH) was much higher in hemodialysis patients than in controls. ② In hemodialysis patients, plasma angiotensinⅡ and aldosterone were positively correlated with left ventricular mass index (LVMI), and plasma angiotensin II was positively correlated with systolic pressure. In normal controls, however, there was no correlation between RAAS activity and LVMI. ③ In hemodialysis patients, LVH was positively correlated with systolic pressure and negatively correlated with hemoglobin and hematocrit values, but LVH had no correlation with patient抯 age, gender, dialysis age and serum creatinine. ④ In the hemodialysis patients with LVH and those without LVH, values of hemoglobin and systolic pressure were significantly different, but their age, dialysis age, diastolic pressure and creatinine before dialysis showed no difference. Conclusion The incidence of LVH was significantly higher in hemodialysis patients than in controls. The prevalence of LVH in hemodialysis patients was positively correlated with RAAS activity and negatively correlated with hemoglobin value. Metrics

基础研究

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The influence of lactobacillus on the permeability of intestinal mucosa and the clearance of middle and low molecular uremic solutes in rats 2008, 7 (2):  78-80.  Abstract ( 216 )   HTML ( 0 )   PDF (615KB) ( 222 )   Objective To investigate the effect of intestinal lactobacillus on the maintenance of intestinal mucosa permeability and the clearance of middle and low molecular uremic solutes in rats. Methods Forty Sprague-Dawley rats were divided into 4 groups: normal control group (10 rats), with sham operation; pathological control group, 5/6 nephrotomized rats without treatment; lactobacillus treated group, 5/6 nephrotomized rats treated with lactobacilli; bifidobacterium treated group, 5/6 nephrotomized rats treated with bifidobacteria. Animal were sacrificed and blood and stool samples were taken after feeding the bacteria for one week. Middle molecular substance (MMS), urea and creatinine (Cr) in blood and stool were determined. Plasma D-lactic acid was measured by enzyme-coupled ultraviolet spectrophoto- metry. Results MMS, urea and Cr in blood and stool and D-lactic acid in plasma were increased in pathological control group (P＜0.01). In lactobacillus and bifidobacterium treated groups, however, plasma D-lactic acid, blood urea nitrogen and serum Cr decreased remarkably (P＜0.01), and urea nitrogen and Cr in stool increased (P＜0.01). Conclusions Bifidobacteria and lactobacilli can preserve the normal permeability of intestinal mucosa, promote the clearance of MMS, urea and Cr through intestinal tract, degrade intestinal urea and Cr, and thereby reduce blood urea and Cr. Metrics

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Statins protect human aortic smooth muscle cells from osteoblast transdifferentiation and calcification induced by high concentration phosphate ZHENG Mantao;XUE Jun;YOU Huaizhou;BAO Fuxiang;ZHOU Shikeng 2008, 7 (2):  81-84.  Abstract ( 576 )   HTML ( 0 )   PDF (650KB) ( 217 )   【Abstract】 Objective To investigate the role of statins on high concentration phosphate-induced osteoblast transdifferentiation and calcification of vascular smooth muscle cells. Method Human aortic smooth cells (HASMC) were cultured in normal control medium, normal phosphate medium (1.5mmol/L phosphate) and high phosphate medium (2.5mmol/L phosphate), respectively. The expression of core binding factor-α1 (cbf-α1) and osteopontin (OPN) was measured by real-time quantitative PCR after culture in the medium for 72 hours, and calcium concentration in the medium was also measured after the culture for 14 days. HASMC were then cultured in high phosphate medium containing 0.1 umol/L atorvastatin for 14 days, and calcium content in HASMC was determined. Results Real-time quantitative PCR showed that the expression of cbf-α1 was significantly higher in high phosphate group than in control group (50.02±0.38 vs. 1.02±0.35, P＜0.001), but without difference between normal phosphate group and control group (1.07±0.15 vs. 1.02±0.35, P＞0.05). The expression of OPN was also remarkably higher in high phosphate group than in control group (14.62±0.35 vs. 1.05±0.16). The calcium content in HASMC was significantly higher in high phosphate group than in control group (115±2.43 vs. 4.08±0.32, P＜0.001), but was similar in normal phosphate group and control group (5.01±0.21 vs. 4.08±0.32，P＞0.05). Atorvastatin significantly decreased the phosphate-induced calcium deposit (115±2.43 vs. 58±2.65 ug/mg protein, P＜0.01). Conclusion High phosphate induced osteoblast transdifferentiation and calcification of HASMC. The high phosphate induced calcification of HASMC could be inhibited by atorvastatin. Metrics

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The effect of high calcium and high phosphate on calcification of rat VSMCs WANG Ying;WANG Mei 2008, 7 (2):  85-89.  Abstract ( 617 )   HTML ( 0 )   PDF (733KB) ( 302 )   【Abstract】 Objective To investigate the effect of high phosphate and high calcium on calcification of rat vascular smooth muscle cells (VSMCs) and on the expression of specific VSMC and osteoblast markers. Methods VSMCs from explants of rat aortic media were cultured. Cells were divided into three groups: normal calcium and phosphate group (control group, culture medium containing 1.4mmol/L phosphate and 2.0mmol/L calcium), high calcium group (culture medium containing 1.4mmol/L phosphate and 2.8mmol/L calcium) and high phosphate group (culture medium containing 2.4mmol/L phosphate and 2.0mmol/L calcium). The first day of cells cultured in a specific medium was defined as day 0. Calcium deposition in cells was measured by atomic absorptiometry. The expression of smooth muscle lineage marker α-SMA and osteoblast markers Cbf-α1, collagen I and osteopontin (OPN) were detected by immunohistochemistry and western blotting. Results After culture for 10 days, calcium deposition increased significantly in high phosphate group and high calcium group (P＜0.01). In contrast, calcium deposition was trivial in control group. In response to high calcium or high phosphate media, rat VSMCs lost the expression of VSMC marker α-SMA and expressed higher level of Cbf-α1, collagen I and OPN. Conclusion High concentration of calcium and phosphate may directly stimulate rat VSMCs changing their phenotype that predisposes the cells to be calcified. Metrics