目的:探讨血清骨唾液酸蛋白(BSP)与维持性血液透析(MHD)患者腹主动脉钙化的关系。方法:选取2016年5月至2017年2月于本院血液净化中心规律透析患者75例。检测患者血清BSP,并进行腹部侧位X平片拍摄,根据kauppila半定量积分方法进行腹主动...目的:探讨血清骨唾液酸蛋白(BSP)与维持性血液透析(MHD)患者腹主动脉钙化的关系。方法:选取2016年5月至2017年2月于本院血液净化中心规律透析患者75例。检测患者血清BSP,并进行腹部侧位X平片拍摄,根据kauppila半定量积分方法进行腹主动脉钙化评分(AACs),参考CORD分段方法,根据AAC得分将患者分为无或轻度钙化组(AACs≤4)、中度钙化组(5≤AACs≤15)和重度钙化组(AACs≥16)。Logistic回归分析MHD患者AAC的影响因素。受试者工作特征(ROC)曲线分析BSP对血管钙化的诊断价值。结果:75例MHD患者中发生腹主动脉钙化者56例(74.67%),AACs中位数为4(0,24)分,血清BSP中位数为20.12(18.63,24.21)ng/ml。中度钙化组、重度钙化组BSP水平均高于无或轻度钙化组[22.43(19.58,6.84)ng/ml、21.99(19.87,26.18)ng/ml vs 19.16(17.3,23.3)ng/ml,P<0.05]。Logistic回归分析发现BSP是AAC的独立危险因素(OR=1.175,95%CI 1.004~1.375,P<0.05)。ROC曲线分析发现,BSP诊断AAC的曲线下面积为0.718(95%CI为0.604~0.833,P=0.001),BSP诊断AAC的临界值为21.51 ng/ml,灵敏度为0.711,特异度为0.595。结论:血清BSP水平和MHD患者AAC的严重程度相关,高水平的BSP是AAC的独立危险因素。BSP对MHD患者腹主动脉钙化具有潜在诊断价值。展开更多
Secondary hyperthyroidism(SHPT)is a common complication of maintenance hemodialysis(MHD).In China the prevalence of chronic kidney disease(CKD)is 10.8%and there are about 0.2 million patients treated with maintenance ...Secondary hyperthyroidism(SHPT)is a common complication of maintenance hemodialysis(MHD).In China the prevalence of chronic kidney disease(CKD)is 10.8%and there are about 0.2 million patients treated with maintenance hemodialysis.These number are still increasing.Cinacalcet is a new calcium sensing receptor agonist to treat SHPT and the first calcimimetics be approved by Food and Drug Administration(FDA)to treat human.It can activate the calcium sensing receptor in parathyroid to improving control of parathyroid hormone(PTH),serum calcium,phosphorus,and calcium phosphorus product.Then decrease vascular calcification and parathyroid gland volume and reduce the occurrence of fracture and calcific uremic arteriolopathy(CUA).A better understanding of the clinical evaluation for Cinacalcet will hopefully help us to reduce the incidence of SHPT.展开更多
Calcitonin is a common medicine used in the treatment of osteoporosis,which could restrain the activity of osteoclasts,stop the loss of osteocalcin and reduce the transfer of osteocalcin.Calcitonin can also be used in...Calcitonin is a common medicine used in the treatment of osteoporosis,which could restrain the activity of osteoclasts,stop the loss of osteocalcin and reduce the transfer of osteocalcin.Calcitonin can also be used in the treatment of the pain-caused diseases which usually cause by hypercalcemia and others such like Paget's disease and bone tumors.As is approved by several clinic researches,calcitonin is powerful in adjusting the level of calcium,phosphorus and PTH during the treatment of renal osteodystrophy.In addition,it could improves the life quality of the patients who suffered from chronic kidney disease(CKD)and extending their life period.At present,several studies have shown us Calcitonin could be treated in renal osteodystrophy.However,the treatment experiences of Calcitonin are still lacking.Better understanding of the clinical evaluation for calcitonin in the treatment of renal osteodystrophy will hopefully help us to improve outcomes for these patients.展开更多
Fibroblast growth factor 23(FGF23)is a protein synthesized by bone cell and the osteoblast with endocrine function.The main role of FGF23 is to regulate serum phosphorus and 1,25(OH)2 D3 levels,it also plays an import...Fibroblast growth factor 23(FGF23)is a protein synthesized by bone cell and the osteoblast with endocrine function.The main role of FGF23 is to regulate serum phosphorus and 1,25(OH)2 D3 levels,it also plays an important role in calcium and phosphorus metabolism.The role of FGF23 in renal disease is to inhibit of phosphorus reabsorption,promote urinary phosphorus excretion and maintain a stable blood phosphorus level.Patients with chronic kidney disease(CKD)have more risk to suffer cardiovascular disease(CVD)which is related to the abnormal metabolism of calcium and phosphorus.FGF23,as newly discovered cardiovascular risk marker,several studies have shown that FGF23 level associates with multiple cardiovascular risk factors in CKD patients,especially in CKD patients with vascular calcification.To explore its pathogenesis of vascular calcification in CKD patients is particularly important,and that may help to take appropriate measures to improve the prognosis of CKD patients.展开更多
Background The mechanisms responsible for the pathogeneses of gestational hypertension and preeclampsia are unclear. Tumor necrosis factor-1α （TNF-1α） is a pro-inflammatory Th1-type cytokine. TNFA gene is located ...Background The mechanisms responsible for the pathogeneses of gestational hypertension and preeclampsia are unclear. Tumor necrosis factor-1α （TNF-1α） is a pro-inflammatory Th1-type cytokine. TNFA gene is located in the human leukocyte antigen （HLA） class Ⅲ region of the major histocompatibility complex （MHC） on chromosome 6. The high TNF-1α mRNA expression may be associated with the TNF2 （A） allele, which is the polymorphism of TNF-1α at position - 308 in promoter region. This study assessed whether the TNF2 （A） allele at position -308 plays a role in the alteration of blood pressure （BP） and urinary protein excretion during pregnancy. Methods The original prospective cohort study comprised 1623 pregnant women from January 2000 to October 2001. The G/A polymorphism was done by restriction fragment length polymorphism （RFLP） analysis with Nco I enzyme. Results The distributions of the G/A polymorphism of TNF-1α in the promoter region at position -308 were wild-type 72.4% and variant 27.6%, respectively. The frequency of TNF2 （A） allele was approximately 0.15 for Caucasian pregnant women in the study. It was not significantly different in the distributions of genotypes and G/A allele frequencies among the three groups of pregnant women with gestational hypertension, preexisting hypertension and normal blood pressure （P〉0.05）. The maternal blood pressure in the third trimester was significantly higher in the group of women possessing the TNF2 （A） allele compared to homozygous for the TNF1 （G） allele （systolic BE P〈0.01 and diastolic BE P〈0.05）. The elevated blood pressure in the TNF2 （A） group was accompanied by higher urinary protein excretion in the third trimester （P〈0.05）. The blood pressure and urinary protein excretion did not change apparently between the two groups in the first and second trimesters （P〉0.05）. Conclusions Maternal TNF2 （A） allele of TNF-1α promoter region at position -308 could play a role in the alteration of blood pressures and/or enhancement of urinary protein excretion during pregnancy, and might play an important role in the development of both gestational hypertension and preeclampsia.展开更多
文摘目的:探讨血清骨唾液酸蛋白(BSP)与维持性血液透析(MHD)患者腹主动脉钙化的关系。方法:选取2016年5月至2017年2月于本院血液净化中心规律透析患者75例。检测患者血清BSP,并进行腹部侧位X平片拍摄,根据kauppila半定量积分方法进行腹主动脉钙化评分(AACs),参考CORD分段方法,根据AAC得分将患者分为无或轻度钙化组(AACs≤4)、中度钙化组(5≤AACs≤15)和重度钙化组(AACs≥16)。Logistic回归分析MHD患者AAC的影响因素。受试者工作特征(ROC)曲线分析BSP对血管钙化的诊断价值。结果:75例MHD患者中发生腹主动脉钙化者56例(74.67%),AACs中位数为4(0,24)分,血清BSP中位数为20.12(18.63,24.21)ng/ml。中度钙化组、重度钙化组BSP水平均高于无或轻度钙化组[22.43(19.58,6.84)ng/ml、21.99(19.87,26.18)ng/ml vs 19.16(17.3,23.3)ng/ml,P<0.05]。Logistic回归分析发现BSP是AAC的独立危险因素(OR=1.175,95%CI 1.004~1.375,P<0.05)。ROC曲线分析发现,BSP诊断AAC的曲线下面积为0.718(95%CI为0.604~0.833,P=0.001),BSP诊断AAC的临界值为21.51 ng/ml,灵敏度为0.711,特异度为0.595。结论:血清BSP水平和MHD患者AAC的严重程度相关,高水平的BSP是AAC的独立危险因素。BSP对MHD患者腹主动脉钙化具有潜在诊断价值。
基金Guangdong Obers Blood Purification Aca demi cian Work station(2013B090400004)Guangdong University blood purifica tion technology and Engineering Re search Center(GCZX-A1104)+1 种基金Guangzhou en trepreneurial leader talent/LCY201215Guangdong Provincial Center for clinical engineer ing of blood purification(507204531040)
文摘Secondary hyperthyroidism(SHPT)is a common complication of maintenance hemodialysis(MHD).In China the prevalence of chronic kidney disease(CKD)is 10.8%and there are about 0.2 million patients treated with maintenance hemodialysis.These number are still increasing.Cinacalcet is a new calcium sensing receptor agonist to treat SHPT and the first calcimimetics be approved by Food and Drug Administration(FDA)to treat human.It can activate the calcium sensing receptor in parathyroid to improving control of parathyroid hormone(PTH),serum calcium,phosphorus,and calcium phosphorus product.Then decrease vascular calcification and parathyroid gland volume and reduce the occurrence of fracture and calcific uremic arteriolopathy(CUA).A better understanding of the clinical evaluation for Cinacalcet will hopefully help us to reduce the incidence of SHPT.
基金Guangzhou Development Zone entrepreneurship leading talent project(2017-L153)Guangdong University blood purification technology and Engineering Research Center(GCZX-A1104)+2 种基金Guangzhou entrepreneurial leader talent/LCY201215Guangdong Provincial Center for clinical engineering of blood purification(507204531040)Guangdong Obers Blood Purification A cademician Work station(2013B090400004)
文摘Calcitonin is a common medicine used in the treatment of osteoporosis,which could restrain the activity of osteoclasts,stop the loss of osteocalcin and reduce the transfer of osteocalcin.Calcitonin can also be used in the treatment of the pain-caused diseases which usually cause by hypercalcemia and others such like Paget's disease and bone tumors.As is approved by several clinic researches,calcitonin is powerful in adjusting the level of calcium,phosphorus and PTH during the treatment of renal osteodystrophy.In addition,it could improves the life quality of the patients who suffered from chronic kidney disease(CKD)and extending their life period.At present,several studies have shown us Calcitonin could be treated in renal osteodystrophy.However,the treatment experiences of Calcitonin are still lacking.Better understanding of the clinical evaluation for calcitonin in the treatment of renal osteodystrophy will hopefully help us to improve outcomes for these patients.
基金Construction of collaborative platform for clin ical re search and clinical research of blood purification(201604020175)Guang dong University blood purification tech nology and Engineering Research Center(GCZX-A1104)+2 种基金Guangdong Obers Blood Purification A ca demi cian Work station(2013B090400004)Guangdong Provincial Center for clinical en gineering of blood purification(507204531040)Guangzhou entrepreneurial leader talent/LCY201215
文摘Fibroblast growth factor 23(FGF23)is a protein synthesized by bone cell and the osteoblast with endocrine function.The main role of FGF23 is to regulate serum phosphorus and 1,25(OH)2 D3 levels,it also plays an important role in calcium and phosphorus metabolism.The role of FGF23 in renal disease is to inhibit of phosphorus reabsorption,promote urinary phosphorus excretion and maintain a stable blood phosphorus level.Patients with chronic kidney disease(CKD)have more risk to suffer cardiovascular disease(CVD)which is related to the abnormal metabolism of calcium and phosphorus.FGF23,as newly discovered cardiovascular risk marker,several studies have shown that FGF23 level associates with multiple cardiovascular risk factors in CKD patients,especially in CKD patients with vascular calcification.To explore its pathogenesis of vascular calcification in CKD patients is particularly important,and that may help to take appropriate measures to improve the prognosis of CKD patients.
基金This work was supported by a grant from the Else Kroener-Fresenius foundation.
文摘Background The mechanisms responsible for the pathogeneses of gestational hypertension and preeclampsia are unclear. Tumor necrosis factor-1α （TNF-1α） is a pro-inflammatory Th1-type cytokine. TNFA gene is located in the human leukocyte antigen （HLA） class Ⅲ region of the major histocompatibility complex （MHC） on chromosome 6. The high TNF-1α mRNA expression may be associated with the TNF2 （A） allele, which is the polymorphism of TNF-1α at position - 308 in promoter region. This study assessed whether the TNF2 （A） allele at position -308 plays a role in the alteration of blood pressure （BP） and urinary protein excretion during pregnancy. Methods The original prospective cohort study comprised 1623 pregnant women from January 2000 to October 2001. The G/A polymorphism was done by restriction fragment length polymorphism （RFLP） analysis with Nco I enzyme. Results The distributions of the G/A polymorphism of TNF-1α in the promoter region at position -308 were wild-type 72.4% and variant 27.6%, respectively. The frequency of TNF2 （A） allele was approximately 0.15 for Caucasian pregnant women in the study. It was not significantly different in the distributions of genotypes and G/A allele frequencies among the three groups of pregnant women with gestational hypertension, preexisting hypertension and normal blood pressure （P〉0.05）. The maternal blood pressure in the third trimester was significantly higher in the group of women possessing the TNF2 （A） allele compared to homozygous for the TNF1 （G） allele （systolic BE P〈0.01 and diastolic BE P〈0.05）. The elevated blood pressure in the TNF2 （A） group was accompanied by higher urinary protein excretion in the third trimester （P〈0.05）. The blood pressure and urinary protein excretion did not change apparently between the two groups in the first and second trimesters （P〉0.05）. Conclusions Maternal TNF2 （A） allele of TNF-1α promoter region at position -308 could play a role in the alteration of blood pressures and/or enhancement of urinary protein excretion during pregnancy, and might play an important role in the development of both gestational hypertension and preeclampsia.
