Chinese Journal of Blood Purification

12 October 2020, Volume 19 Issue 10 Previous Issue    Next Issue

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Efficacy analysis of double plasma molecular adsorption system in the treatment of hyperbilirubinemia 2020, 19 (10):  649-652.  doi: 10.3969/j.issn.1671-4091.2020.09.001 Abstract ( 102 )   PDF (427KB) ( 195 )   【Abstract】Objective To observe the clinical effects of double plasma molecular adsorption system in the treatment of hyperbilirubinemia patients and to investigate the optimal adsorbed plasma volume. Methods A retrospective analysis was performed for the 18 patients with hyperbilirubinemia treated with double plasma molecular adsorption system in the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine. Patients were grouped according to the total plasma adsorption volume in a single treatment. Their laboratory indicators including blood routine, coagulation function, and liver and kidney functions before and after the treatment were analyzed. Results A total of 24 times of double plasma molecular adsorption systems were used in the 18 patients, of which 2 cases were markedly effective, 15 cases were effective, and one case was ineffective, with a total effective rate of 94.44%. After the treatment, serum total bilirubin (t=16.424, P＜0.001), direct bilirubin (t=4.324, P＜0.001), platelet count (t=5.124, P＜0.001) plasma fibrinogen (t=2. 237, P=0.039) and C-reactive protein (t=3.519, P=0.003) decreased, and prothrombin time increased (t=0.245, P=0.041). The ratio of total adsorbed plasma volume in a single treatment to total plasma volume in normal individuals (4000 ml) was used to divide the patients into 5 groups: 1.5～2.5 times, 2.5～3.5 times, 3.5～4.5 times, 4.5～5.5 times and 5.5～6.5 times groups. The rate of the total bilirubin reduction was higher in 2.5～3.5 times group than in 1.5～2.5 times group (t=-2.633, P=0.017), but had no significant differences among other groups (P＞0.05). Conclusion The double plasma molecular adsorption system was effective in treating hyperbilirubinemia. The total adsorbed plasma volume in a single treatment in the range of 2.5 to 3.5 times of total plasma volume will have a better therapeutic effect. Metrics

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Application of modified percutaneous technique of peritoneal dialysis catheter placement in urgent-start peritoneal dialysis patients  2020, 19 (10):  653-655.  doi: 10.3969/j.issn.1671-4091.2020.10.002 Abstract ( 289 )   PDF (400KB) ( 781 )   【Abstract】Objective This study assessed the efficacy and safety of the modified percutaneous peritoneal dialysis catheter placement in urgent-start peritoneal dialysis patients. Methods A total of 76 patients diagnosed as end-stage renal disease were enrolled, they were divided into group A (with modified percutaneous placement of peritoneal dialysis catheter,n=34)and groupB (with conventional placement of peritoneal dialysis catheter,n=42).The demographic and clinical characteristics,past abdominal operation history,surgery time,hospital stay after operation,early and late complications were observed. Results The operative time of group A was shorter than that of group B (t=-6.142，P=0.009)，the incidence of leakage in group A was lower than group B within one month (χ２=8.341，P=0.001)，the incidence of catheter displacement in group A was lower than group B within one month(χ２=7.523，P=0.003)，the incidence of rectus abdominis hemorrhage in group A was higher than group B (χ２=5.272，P=0.018); the incidence of catheter displacement in group A was lower than group B after one month (χ ２=11.724，＜0.001)，the incidences of omentum wrapping (χ ２=0.659，P=0.191), peritonitis (χ２=0.091，P=0.958), pleuro-abdominal fistula (χ２=0.148，P=0.809) and hernia (χ２=0.148，P=0.809) showed no difference between the two group. Conclusions The modified percutaneous placement of peritoneal dialysis catheter is effective, safe and easy to learn, which reduce leakage and catheter displacement significantly compared with conventional placement of peritoneal dialysis catheter, and worth clinical promotion in urgent-start peritoneal dialysis patients. Metrics

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The risk factors of restless legs syndrome in maintenance peritoneal dialysis 2020, 19 (10):  656-659.  doi: 10.3969/j.issn.1671-4091.2020.10.003 Abstract ( 339 )   PDF (422KB) ( 792 )   【Abstract】Purpose To investigate the prevalence and risk factors for restless legs syndrome (RLS) in maintenance peritoneal dialysis (PD) patients. Methods The maintenance PD patients treated in The Second Hospital of Anhui Medical University between Mar 1, 2013 and Nov 31, 2013, regularly followed-up for over 3 months, and with the age of ≥18 to ≤75 years old were enrolled in this study. Demographic information, laboratory indicators, depression and RLS assessment data were collected. We measured the severity of RLS by using the rating scale from the International Restless Legs Syndrome Study Group (IRLSSG). For patients continuing to use PD between Mar 1, 2015 and Nov 31, 2015, their data were collected again and the relationship between the indicators and the occurrence of RLS was re-evaluated. Results There were 71 PD cases in the study. At baseline, 31 (43.7%) were diagnosed with RLS (RLS+ group). Compare to the RLS- group, the incidence of depression and the levels of serum phosphorus and parathyroid hormone were significantly higher in the RLS+ group (χ2=9.291, P=0.002; t=-2.668, P=0.010; Z=-2.274, P= 0.023). Correlation analysis suggested depression, serum phosphorus and parathyroid hormone were positively correlated with RLS (r=0.362, P=0.002; r=0.322, P=0.006; r=0.276, P=0.022). Logistic regression analysis showed that depression and higher serum phosphorus were the risk factors for RLS at baseline (OR=5.465, 95% CI=1.712～17.439, P=0.004;OR=3.597, 95% CI=1.190～10.867, P=0.023). According to the rating scale of IRLSSG in the RLS+ group, 35.5% were mild RLS, 29.0% were moderate RLS, and 35.5% were severe or very severe RLS. Patients with severer RLS had longer dialysis duration (Z=-3.711, P＜0.001), higher body mass index (t=-2.244, P=0.038), higher sensitive C-reactive protein (Z=-2.595, P=0.009), and lower alkaline phosphatase (t=2.106, P=0.049). Of the 55 patients who completed the second assessment, 35 (63.6%) were diagnosed with RLS, similar to the incidence at baseline (χ2=2.981, P=0.108). Logistic regression model indicated that parathyroid hormone at baseline was the risk factors for RLS in the follow-up period (OR=1.003, 95% CI=1.000～1.006, P=0.027) and for persistent RLS (OR=1.005, 95% CI=1.000～1.009, P=0.030). Conclusion The prevalence of RLS in this series of maintenance PD patients was 43.7%. Patients with RLS were more likely to have depression and higher levels of serum phosphorus and parathyroid hormone. Depression,higher levels of serum phosphorus and parathyroid hormone were the risk factors for RLS.. Metrics

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A study on blood pressure fluctuation during hemodialysis dialysis sessions and the correlation with volume load  2020, 19 (10):  660-663.  doi: 10.3969/j.issn.1671-4091.2020.10.004 Abstract ( 366 )   PDF (460KB) ( 938 )   【Abstract】Objective To analyze the characteristics of blood pressure fluctuation during hemodialysis sessions in maintenance hemodialysis (MHD) patients, and to explore the correlation with volume load. Methods A total of 231 MHD patients admitted to the blood purification center of Hangzhou Traditional Chinese Medicine Hospital from December 2017 to June 2018 were enrolled in this study. According to the blood pressure variation during dialysis sessions, they were divided into hypertension group (△SBP ≥10mmHg), stable group (-20mmHg＜ △SBP ＜10mmHg) and hypotension group (△SBP ≤-20mmHg). The volume indicators of overhydration (OH), intracellular water (ICW), extracellular water (ECW) and total body water (TBW) were measured before and after the sessions by using bioelectrical impedance. General clinical data and laboratory indicators were also recorded. Results ①There were 43 patients (19%) in the hypertension group, 119 patients (51%) in the stable group, and 69 patients (30%) in the hypotension group. In the hypertension group, blood pressure reached the peak after the end of dialysis sessions. In the hypotension group, blood pressure was at the lowest level in the third hour in dialysis sessions, followed by a slight increase. ②Compared with the stable group, ultrafiltration volume was lower in the hypertension group (t=3.861, P＜0.001), and was higher in the hypotension group (t=3.885, P＜0.001). ③ Compared with the stable group, post-dialytic OH and ECW/TBW were higher in the hypertension group (t=2.386, P=0.018; t=2.317, P=0.021). ROC analysis showed that the area under the curves of post-dialytic OH and ECW/TBW to determine hypertension were 0.621 (95% CI: 0.546～0.697, P=0.004) and 0.604 (95% CI: 0.526～0.682, P=0.012) respectively. Conclusion Unstable blood pressure during hemodialysis sessions was frequently seen in MHD patients. In the hy-potension group, blood pressure reduced to the lowest in the third hour in dialysis sessions, suggesting that ultrafiltration volume is related to the hypotension. In the hypertension group, blood pressure reached a peak after dialysis, suggesting the presence of chronic volume overload, especially the extracellular water overload. Metrics

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The relationship between parathyroid weight and blood biochemical levels in patients with refractory secondary hyperparathyroidism 2020, 19 (10):  664-668.  doi: 10.3969/j.issn.1671-4091.2020.10.005 Abstract ( 288 )   PDF (398KB) ( 673 )   【Abstract】Objective To evaluate the relationship between parathyroid weight and pre-operative blood biochemical levels, especially pre-operative serum total parathyroid hormone level (iPTH), in patients with refractory secondary hyperparathyroidism (SHPT). Methods Clinical data of the 43 patients with refractory SHPT and undergoing the first parathyroidectomy (PTX) in Sir Run Run Shaw Hospital from January 2018 to December 2019 were retrospectively reviewed. Multivariate linear regression was used to analyze the relationship between the total weight of parathyroid glands and the biochemical levels of corrected serum calcium, blood phosphorus, alkaline phosphatase (ALP) and iPTH before PTX as well as dialysis age of the patients. The relationship between the weight, volume and maximum diameter of parathyroid gland and the iPTH level was investigated by Spearman’s rank correlation coefficient. Results A total of 169 parathyroid glands were found and resected during operation in the 43 patients. Spearman’s rank correlation showed that parathyroid weight was positively correlated with parathyroid volume (r=0.915, P＜0.001) and maximum length diameter (r=0.778, P＜0.001), but iPTH had no correlation with parathyroid weight (r=0.143, P= 0.361) and volume (r=0.080, P=0.611). Conclusion In patients with refractory SHPT, the pre-operative blood biochemical levels including iPTH may not reflect the actual hyperplasia of parathyroid gland and cannot fully represent the function of parathyroid gland. Metrics

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Clinical application of ultrasound- guided percutaneous insertion of peritoneal dialysis catheters 2020, 19 (10):  669-672.  doi: 10.3969/j.issn.1671-4091.2020.10.006 Abstract ( 310 )   PDF (457KB) ( 760 )   【Abstract】Objective To investigate the feasibility, safety, method and effect of ultrasound-guided percutaneous insertion of peritoneal dialysis (PD) catheters. Method This retrospective study involved 23 patients who underwent ultrasound-guided percutaneous PD catheter insertion. Peritoneal puncture and the insertion of the PD catheter were guided by ultrasound. The patients were followed up for at least 6 months. The effect of ultrasonography to display the surgical procedure, technical success ratio, and incidence of complications including bleeding, intestinal injury, catheter displacement, blockage, leakage, encapsulation and peritonitis, and estimated technical survival rate of the PD catheters were evaluated. Results Ultrasonography could clearly display the surgical procedure. The technical success ratio was 100.0%. Catheter displacement occurred in one patient, and was corrected after conservative treatment. Change from PD to hemodialysis occurred in one case due to the poor dialysis adequacy. No other major complications were found. The estimated technical survival rates of the PD catheters at 6, 12, 18 and 24 months were 100.0%, 100.0%, 100.0% and 75.0%, respectively. Conclusions Ultrasound-guided percutaneous PD catheter insertion is a safe, feasible and minimal invasive method with better effects in short and medium terms. Metrics

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The independent influencing factors for interdialytic blood pressure variability in adult maintenance hemodialysis patients 2020, 19 (10):  673-677.  doi: 10.3969/j.issn.1671-4091.2020.10.007 Abstract ( 237 )   PDF (436KB) ( 740 )   【Abstract】Objective To explore the independent influencing factors for interdialytic blood pressure variability (BPV) in adult maintenance hemodialysis (MHD) patients. Methods A total of 505 adult MHD patients treated in Handan Central Hospital between Jan 2015 and Sept 2019 were retrospectively analyzed. The coefficient of interdialytic systolic blood pressure (SBP) variation was calculated from the standard deviation of SBP / average SBP value x 100%. According to the interquartile values (120, 130, 140 and 150) of the coefficient of interdialytic SBP variation, the patients were divided into 4 groups: low coefficient of variation group (n=127), medium coefficient of variation group (n=126), high coefficient of variation group (n=126), and extremely high coefficient of variation group (n=126). Clinical data, laboratory indicators and use of drugs were compared among the 4 groups. Logistic regression model was used to analyze the independent influencing factors for the coefficient of interdialytic SBP variation. Results In medium coefficient of variation group, dialysis time was less than the other 3 groups (t=3.556, 3.674 and 4.403 respectively; P=0.024, 0.028 and 0.018 respectively). In low coefficient of variation group, patients with type 2 diabetes were more than those in the other 3 groups (χ2=5.567, 5.567 and 4.764 respectively; P=0.027, 0.031 and 0.020 respectively), and ultrafiltration volume was higher than that in the other 3 groups (t=3.653, 3.528 and 4.039 respectively; P=0.027, 0.031 and 0.020 respectively). In low coefficient of variation group, interdialytic body weight gain was less than that in the other 3 groups (t=3.525, 3.611 and 3.334 respectively; P=0.037, 0.039 and 0.044 respectively). In high coefficient of variation group, serum calcium was higher than that in the other 3 groups (t=3.346, 3.211 and 3.509 respectively; P=0.031, 0.036 and 0.030 respectively). In extremely high coefficient of variation group, patients using calcium channel blockers were less than those in the other 2 groups (χ2=5.534 and 6.588; P=0.012 and 0.010). Logistic regression analysis showed that the higher interdialytic body weight gain was the independent risk factor for coefficient of interdialytic SBP variation, and that the increase of ultrafiltration volume and the use of calcium channel blockers were the independent protective factors for coefficient of interdialytic SBP variation. Conclusion The size of interdialytic body weight gain, the ultrafiltration volume, and the use of calcium channel blockers were independently correlated with the interdialytic BPV in adult MHD patients. Metrics

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Lower whole blood zinc level independently associated with anemia in maintenance Hemodialysis patients 2020, 19 (10):  678-682.  doi: 10.3969/j.issn.1671-4091.2020.10.008 Abstract ( 335 )   PDF (472KB) ( 724 )   【Abstract】Objective To explore the relationship between whole blood zinc level and anemia in maintenance hemodialysis (MHD) patients. Methods This single- center and cross- sectional study included 150 MHD patients treated in Guangzhou Red Cross Hospital in September 2019. Clinical data and medications were collected, and blood routine, serum biochemical indexes and whole blood zinc were measured before dialysis. The patients were divided into 2 groups: the anemia group (n=98) and the non-anemia group (n=52). Clinical characteristics of the two groups were analyzed. Univariate and multivariate analyses were used to determine the relevant factors of anemia. The value of whole blood zinc for the diagnosis of anemia was analyzed by receiver operating characteristic curve (ROC). Results Compared with the non-anemic group, the anemic group had lower whole blood zinc (t=0.608, P<0.001). Spearman analysis showed positive correlation between whole blood zinc level and Hb (r=0.711, P<0.001). Multivariate dichotomous logistic regression indicated that low whole blood zinc and gender were the independently related factors for anemia in MHD patients (OR=0.331, 95% CI:0.219～0.502, P<0.001; OR=2.770, 95% CI：1.0147～6.690, P=0.024). ROC curve suggested that the optimal threshold of whole blood zinc level for the diagnosis of anemia in MHD patients was 5.95mg/L (AUC=0.824, 95% CI：0.755-0.893, P<0.001). Conclusion Low whole blood zinc is an independent factor for anemia in MHD patients. Keeping whole blood zinc above 5.95mg/L may reduce the risk of anemia. Metrics

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The role and mechanism of transforming growth factor-RhoGTPase/Rho Kinase signaling pathway in hypoxia- induced trans- differentiation of rat glomerular endothelial cells 2020, 19 (10):  683-687.  doi: 10.3969/j.issn.1671-4091.2020.10.009 Abstract ( 273 )   PDF (551KB) ( 672 )   【Abstract】Purpose To investigate the effect and mechanism of hypoxia on the expression of TGF-β1 and the proteins relating to endothelial-to-mesenchymal transition (EndMT) in rat glomerular endothelial cells (rGECs). Methods rGECs were cultured in a hypoxia incubator, and the cells were randomly divided into 5 groups according to hypoxia treatment time. Cell proliferation activity, the expression of TGF-β1 and EndMT related proteins were then measured in the 5 cell groups. RhoA/ROCK blocker and TGF-β1 receptor blocker were added to the hypoxia treated cells at appropriate time, and then the following indicators were assayed: ①TGF-β1 in cell culture medium; ②TGF-β1 and EndMT related proteins; ③change of RhoA/ROCK activity. Results ①The proliferative activity of rGECs increased with the prolongation of hypoxia treatment time with the biggest activity after hypoxia treatment for 72 hours (2.040±0.110, F=546.63, P＜0.001)；②Compared with the normoxic group, the expressions of TGF-β1 (F=16.320, P＜0.001) and α-SMA (F=5.032, P=0.009) in the hypoxic group increased significantly, while CD-31 protein (F=9.882, P＜0.001) decreased significantly. ③Under the hypoxic circumstances and treated with RhoA/ROCK blocker and TGF-β1 blocker, α-SMA protein decreased (relative amount from 1.423 to 0.750 and 0.434 respectively) and CD-31 protein increased (relative amount from 0.741 to 0.779 and 0.934 respectively). Conclusion Hypoxia can increase cell proliferation and promote EndMT of rGECs. The use of TGF-β1 and RhoA/ROCK blockers under hypoxic conditions suggest that hypoxia environment promotes EndMT of rGECs via the TGF-β1-RhoA/ROCK signaling pathway. Metrics

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Analysis of psychological and cognitive functions in maintenance hemodialysis patients 2020, 19 (10):  688-691.  doi: 10.3969/j.issn.1671-4091.2020.10.010 Abstract ( 382 )   PDF (480KB) ( 1024 )   【Abstract】Objective To investigate the incidence and risk factors of psychological (anxiety and depression) and cognitive dysfunctions in patients undergoing maintenance hemodialysis (MHD). Methods Cognitive Emotion Regulation Questionnaire (CERQ), Center for Epidemiologic Studies Depression (CES- D) Scale, and Hospital Anxiety and Depression (HAD) Scale were used in this study. Results A total of 309 MHD patients completed the investigation. The median score of CERQ was 96.25 (86.21, 108.32). The CESD survey showed no depressive state in 181 cases (58.58%), possible depression state in 121 cases (39.48%), and 6 cases (1.94%) requiring psychological intervention. The prevalence of anxiety was 96.77% by using HAD scale. The rates of mild, moderate and severe anxiety were 35.60%, 50.49% and 10.68%, respectively. Multivariate linear regression analysis suggested that CES-D score was positively correlated with the use of catheter for hemodialysis (β=0.153, P=0.015) and negatively correlated with serum albumin level (β=-0.141, P=0.003). HAD score was positively correlated with dialysis frequency (β=0.145, P=0.022) and negatively correlated with albumin level (β=-0.146, P=0.002). Both CES-D score and HAD score were positively correlated with CERQ score (r=0.314 and 0.143; P=0.001 and 0.012). Conclusions MHD patients presented higher incidences of psychological and cognitive dysfunctions. Cognitive dysfunction increased the incidences of anxiety status and depression. Nutritional status was closely related to the psychological state in MHD patients. Metrics

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Peri- operative risk assessment and management in patients receiving maintenance hemodialysis 2020, 19 (10):  692-695.  doi: 10.3969/j.issn.1671-4091.2020.10.011 Abstract ( 354 )   PDF (395KB) ( 910 )   【Abstract】Due to the growth of aged population and the higher incidences of hypertension and diabetes mellitus, chronic kidney disease (CKD) patients and those developed into end-stage renal disease requiring hemodialysis are increased. The number of hemodialysis patients necessarily treated with surgery under general anesthesia is also increased. There is no consensus about the best management for maintenance hemodialysis patients undergoing surgery. This article focuses on peri-operative risk assessment and management for maintenance hemodialysis patients, in order to provide a reference for surgical department to make clinical decisions and to help these patients survive the peri-operative period. Metrics

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Uremic pneumonitis 2020, 19 (10):  696-698.  doi: 10.3969/j.issn.1671-4091.2020.10.012 Abstract ( 182 )   PDF (262KB) ( 826 )   Metrics

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Significance of serum tumor markers in patients with chronic kidney disease 2020, 19 (10):  699-702.  doi: 10.3969/j.issn.1671-4091.2020.10.013 Abstract ( 204 )   PDF (271KB) ( 795 )   Metrics

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Efficacy of PTA combined with open surgery for the treatment of type I combined with type II stenosis in arteriovenous fistulas in upper limbs  2020, 19 (10):  706-709.  doi: 10.3969/j.issn.1671-4091.2020.10.015 Abstract ( 352 )   PDF (400KB) ( 735 )   【Abstract】Objective To investigate the surgical effect, long-term patency rate and economic benefit of PTA combined with open surgery for the treatment of type I combined with type II stenosis in arteriovenous fistulas in upper limbs. Methods A total of 40 patients having type I combined with type II stenosis in arteriovenous fistula were recruited in this study. They were divided into group A (PTA combined with open surgery), group B (ultrasound guided PTA), and group C (DSA guided PTA). Success rate of operation, changes of vessel diameter and blood flow after surgery, long-term patency rate, and medical expenses were compared among the 3 groups. Results The success rate of operation in group A was better than that in group B and group C (X2=8.556 and 4.609; P=0.010 and 0.052). Post-operative vessel diameter in group A was bigger than that in group B and group C (t=2.605 and 3.676; P=0.044 and 0.003). Post-operative brachial blood flow in group A was greater than that in group B and group C (t=2.764 and 2.482; P=0.030 and 0.058). Medical expenses of group B was lower than that of group A and group C (t=3.130 and -3.036; P=0.012 and 0.015). The long-term patency rate of group A was better than that of group B and group C (P=0.730). Conclusions PTA combined with open surgery to treat type I combined with type II stenosis in arteriovenous fistula has the advantages of higher success rate of operation, greater long-term patency rate, wider post-operative blood vessel diameter and more brachial artery blood flow, but has to use more vascular resources than ultrasound guided PTA and DSA guided PTA. Moreover, patients treated with PTA combined with open surgery have to pay more medical fees than those treated with ultrasound guided PTA. Metrics

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Effect of different dialysis blood flow on internal fistula complications in hemodialysis patients 2020, 19 (10):  710-713.  doi: 10.3969/j.issn.1671-4091.2020.10.016 Abstract ( 527 )   PDF (411KB) ( 906 )   【Abstract】Objective To explore the effect of different dialysis blood flow on complications of internal fistula in hemodialysis patients. Methods Forty patients undergoing autologous arteriovenous fistula (AVF) surgery for the first time and 40 patients using AVF for routine hemodialysis in The Second Affiliated Hospital of Wenzhou Medical University from January to March 2019 were enrolled in this study. Patients with new AVFs were randomly divided into model group (n=20) and control group (n=20). In model group, the dialysis blood flow was 160～200 ml/min at the beginning and increased to 220-250 ml/min after one month. In control group, the dialysis blood flow was initially 220～250 ml/min and increased to 280～310 ml/min after one month. Patients with mature AVFs were also randomly divided into model group (n=20) and control group (n=20). The dialysis blood flow was 220～250 ml/min in model group and was 280～310 ml/min in control group. All patients were dialyzed 3 times a week for 12 months. Dysfunction and complications of the AVFs were observed, related biochemical indicators were assayed, and dialysis sufficiency was evaluated in these groups. Results Dysfunction and complications of the AVFs were significantly reduced in the two model groups. In patients with new AVFs, the rate of AVF complications was significantly lower in model group than in control group (χ2=6.465, P=0.011). In patients with mature AVFs, the rates of AVF dysfunction (χ2=3.135, P=0.077) and AVF complications (χ2=3.135, P=0.077) had no differences between model group and control group. In patients with new AVFs and with mature AVFs, dialysis sufficiency was lower in model groups than in their respective control groups, but without statistical significance (Fisher exact analyses, P=0.451 and 0.407). Conclusion Reduction of dialysis blood flow can decrease the presence of AVF complications and improve the prognosis of AVF, without significant impact on dialysis sufficiency. Metrics

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A study on the preparation of sustainable ultra-pure dialysis water based on the adjustment of disinfectioncycle 2020, 19 (10):  714-716.  doi: 10.3969/j.issn.1671-4091.2020.10.017 Abstract ( 228 )   PDF (342KB) ( 701 )   【Abstract】Objective To prepare sustainable ultra-pure dialysis water from existing water treatment systems. Methods Through the investigation on the relationship between number of bacterial colonies and endotoxin content in dialysis water and disinfection time of the water treatment systems in the Center for Hemodialysis of Shaanxi Traditional Chinese Medicine Hospital, we tried to find out the best disinfection cycle at which bacterial number and endotoxin content in dialysis water satisfy the standards, and then set up this disinfection cycle for water treatment systems. Results The disinfection cycle of water treatment systems can be adjusted to one month to maintain the bacterial number and endotoxin content in dialysis water compliant with the ultra-pure water standards. Conclusions The disinfection cycle of the existing water treatment systems can be adjusted to obtain sustainable supply of ultra-pure dialysis water. Metrics

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Effect of the adaptive nursing based on the 1.2 sources on hemodialysis patients 2020, 19 (10):  717-720.  doi: 10.3969/j.issn.1671-4091.2020.10.018 Abstract ( 221 )   PDF (452KB) ( 693 )   【Abstract】Objective To study clinical effect of the adaptive nursing based on the theory of 1.2 sources on hemodialysis patients. Methods A total of 80 hemodialysis patients treated in the period from Jan. 2016 to Jan. 2017 were recruited. They were randomly divided into experimental group and control group with 40 cases in each group. The control group was treated with routine nursing, and the experimental group was treated with adaptive nursing based on the theory of 1.2 sources. Nursing compliance and satisfaction, self- care ability, quality of life, and incidence of adverse reactions were compared between the two groups. Results T he nursing compliance (72.5% vs. 92.5%, χ2=5.541, P=0.019) and satisfaction (62.5% vs. 95%, χ2=12.624, P< 0.001) were better in the experimental group than those in the control group. In the experimental group after active nursing care with the adaptive nursing based on the theory of 1.2 sources, many aspects including selfcare efficacy (115.71±4.06 vs. 129.34± 5.00, t=1.503, P<0.001), health knowledge [(21.47±3.06) vs. (25.19±3.42), t=1.242, P<0.001], self- care skills [(31.62 ± 2.50) vs. (34.09 ± 2.86), t=1.303, P<0.001],self- concept [(20.59±2.57) vs. (23.61±2.95), t=1.309, P<0.001], self-care responsibility [(19.37±2.14) vs. (25.07±3.06), t=2.043, P<0.001], physiological function [(68.20 ± 7.21) vs. (85.26 ± 9.37), t=1.688, P<0.001], and mental health [(51.96 ± 8.50) vs. (63.18 ± 9.74), t=1.313, P<0.001] improved significantly as compared with those in the control group. Moreover, the incidences of hypotension (15.00% vs. 2.50%, χ2=3.913, P=0.048) and catheter infection (15.70% vs. 2.50%, χ2=5.000, P=0.025) were lower in the experimental group than that in the control group. Conclusion Adaptive nursing based on the theory of 1.2 sources is an effective nursing method for hemodialysis patients. This nursing modality can significantly improve the quality of care, nursing satisfaction and the quality of life, and effectively reduce the incidence of adverse reactions such as hypotension and catheter infection. Metrics