ABSTRACT
Objective:To develop and validate a nomogram for predicting the 1-and 3-year survival rates of patients receiving peritoneal dialysis.Methods:Patients who underwent peritoneal dialysis for the first time in Zhujiang hospital from January 1, 2010 to December 31, 2017 were enrolled. The patients from January 1, 2014 to December 31, 2017 were enrolled in a training dataset. Baseline clinical data were collected and the primary endpoint was all-cause death. Cox proportional hazard regression models were used to analyze risk factors affecting the survival rates. Nomograms were generated using the R rms package. The Harrell' concordance index (C-index), receiver operating characteristic curve and calibration curve were used to verify the performance of the model. Patients who underwent peritoneal dialysis from January 1, 2010 to December 31, 2013 were then selected to validate the external predictive accuracy of the prediction models.Results:The prediction cohort enrolled 457 patients, with a median follow-up time of 27.67(18.37, 39.22) months, and 64 patients (14.00%) died during follow-up. The 1-and 3-year cumulative survival rates were 96.4% and 83.0%. Multivariate analysis showed that aging (every 1 year old increase, HR=1.07, 95% CI 1.04-1.09, P<0.001), stroke ( HR=3.63, 95% CI 1.93-6.85, P<0.001), higher cholesterol (every 1 mmol/L increase, HR=1.51, 95% CI 1.20-1.89, P<0.001), higher neutrophil-to-lymphocyte ratio (every 1 increase, HR=1.12, 95% CI 1.05-1.20, P=0.001), and lower albumin ( HR=0.89, 95% CI 0.82-0.95, P=0.001) were independent risk factors affecting the survival rates of PD patients. The C-index of the prediction cohort and the validation cohort were 0.815(95% CI 0.765-0.865) and 0.804(95% CI 0.744-0.864, respectively). Both internally and externally verified calibration curves showed that the predicted results were close to the actual survival rates. Conclusion:Based on age, blood total cholesterol level, stroke history, and NLR, the prognosis prediction model of peritoneal dialysis patients established with nomogram can help predict the 1-year and 3-year survival rates of peritoneal dialysis patients.
ABSTRACT
OBJECTIVE@#To explore the effect of telmisartan on the expression of metadherin in the kidney of mice with unilateral ureter obstruction.@*METHODS@#Eighteen male C57 mice were randomized into sham-operated group, model group and telmisartan treatment group. In the latter two groups, renal interstitial fibrosis as the result of unilateral ureter obstruction (UUO) was induced by unilateral ureteral ligation with or without telmisartan intervention. Renal pathological changes of the mice were assessed using Masson staining, and immunohistochemistry and Western blotting were used to detect the expression of extracellular matrix proteins and metadherin in the kidney of the mice. In the experiment, cultured mouse renal tubular epithelial cells (mTECs) were stimulated with transforming growth factor-β1 (TGF-β1) and transfected with a siRNA targeting metadherin, and the changes in the expressions of extracellular matrix proteins and metadherin were detected using Western blotting.@*RESULTS@#The expressions of extracellular matrix proteins and metadherin increased significantly in the kidney of mice with UUO ( < 0.05). Intervention with telmisartan significantly lowered the expressions of extracellular matrix proteins and metadherin and alleviated the pathology of renal fibrosis in mice with UUO ( < 0.05). In cultured mTECs, siRNA-mediated knockdown of metadherin obviously reversed TGF-β1-induced increase in the expressions of extracellular matrix proteins and metadherin.@*CONCLUSIONS@#Telmisartan can suppress the production of extracellular matrix proteins and the expression of metadhein to attenuate UUO-induced renal fibrosis in mice.
Subject(s)
Animals , Male , Mice , Angiotensin II Type 1 Receptor Blockers , Antihypertensive Agents , Extracellular Matrix Proteins , Metabolism , Fibrosis , Kidney , Metabolism , Pathology , Membrane Proteins , Genetics , Metabolism , Mice, Inbred C57BL , RNA, Small Interfering , Random Allocation , Telmisartan , Pharmacology , Transforming Growth Factor beta1 , Pharmacology , Ureteral Obstruction , MetabolismABSTRACT
Objective:To optimize the formula of metronidazole and borneol sustained-release films. Methods: The mass ratio of Rhizoma Bletillae polysaccharide and polyvinyl alcohol 124(PVA-124) and the dosage of glycerol and sodium carboxymethyl cellulose ( CMC-Na) as the influencing factors ,the appearance of films and the release rate of metronidazole at 0. 5h and 4h as the comprehen-sive evaluation indices, the formula of the film-forming materials was optimized by orthogonal test. Results:The mass ratio of Rhizoma Bletillae polysaccharide and PVA-124 was the key factor affecting the quality of the films. When the mass ratio of Rhizoma Bletillae pol-ysaccharide and PVA-124 was 20∶80, and the dosage of glycerol was 3. 5g and that of CMC-Na was 0. 14g, the appearance of the films was satisfied, the release rate of metronidazole at 0. 5h and 4h was 25. 17% and 69. 64%, respectively, and the average cumulative re-lease rate at 8h was over 90%. Conclusion:The films prepared by the optimized formula are flat, smooth, clean and moderately soft, which can not only remain the drug release characteristics of the films made by the original formula, but also exhibit the pharmacologi-cal effect of Rhizoma Bletillae.