Impact of dialysis modality choice on the survival of end-stage renal disease patients with congestive heart failure in southern China: A retrospective cohort study.

Background and object: Heart failure is one of the common complications in patients with end-stage renal disease (ESRD) and a major cause of death in these patients. The choice of dialysis modality for ESRD patients with congestive heart failure (CHF) is still inconclusive. The purpose of this study was to compare the prognosis of hemodialysis (HD) and peritoneal dialysis (PD) among ESRD patients with CHF and provide a basis for clinical decision-making. Materials and methods: This was a retrospective study conducted at Guangdong Provincial Hospital of Traditional Chinese Medicine that included patients with CHF requiring long-term renal replacement therapy between January 1, 2012 and December 31, 2017. The end of follow-up was December 31, 2020. All patients were divided into HD and PD groups and sub grouped by age, and we used univariate and multifactorial Cox regression analyses to calculate the relative hazard ratios (HR) of the different dialysis types and adjusted for differences in baseline data using propensity score matching (PSM). Result: A total of 121 patients with PD and 156 patients with HD were included in this study. Among younger ESRD patients (≤65 years of age) with CHF, the prognosis of HD was worse than that of PD [HR = 1.84, 95% confidence interval (CI) = 1.01-3.34], and this disadvantage remained significant in the fully adjusted model [sex, age at dialysis initiation, Charlson comorbidities index, body mass index, prealbumin, hemoglobin, and left ventricular ejection fraction (LVEF)] and after PSM. In the older group (>65 years of age), the prognosis of HD was better than that of PD (HR = 0.46, 95% CI = 0.25-0.85), and the protective effect remained in the fully adjusted model and after PSM. The aforementioned survival differences across the cohort were maintained in patients with preserved LVEF (>55%), but could not be reproduced in patients with reduced LVEF (≤55%). Conclusion: In southern China, PD is a better choice for younger patients with ESRD, CHF and preserved LVEF, and HD is the better option for older patients.

[Effect of paeonol on protecting endothelial cells of diabetic rats].

OBJECTIVE: To study the effect of paeonol on protecting endothelial cells of diabetic rats. METHODS: Streptozocin was used on rats to make diabetic models. Different dosages of paeonol were fed on all the model rats. PGI, TXA2, ET, CRP, ICAM-1, VCAM-1 and NO were tested after 30 day's therapy. RESULTS: Compared with control group PGI increased from 89.75 +/- 2.75, 89.97 +/- 7.28, 89.97 +/- 11.36 to 120.03 +/- 13.85, 108.34 +/- 11.25, 105.32 +/- 8.85, respectively. TXA2 decreased from 157.64 +/- 10.36, 156.64 +/- 11.35, 153.33 +/- 19.40 to 124.46 +/- 18.67, 136.40 +/- 18.15, 138.40 +/- 22.20, respectively. ET decreased from 181.68 +/- 5.10, 181.27 +/- 4.76, 181.04 +/- 4.19 to 140.55 +/- 3.01, 150.51 +/- 2.22, 161.02 +/- 3.76, respectively. CRP decreased from 41.63 +/- 7.37, 44.83 +/- 7.80, 42.06 +/- 7.21 to 28.62 +/- 5.45, 30.00 +/- 10.73, 37.09 +/- 4.94, respectively. ICAM-1 decreased from 225.77 +/- 11.96, 222.78 +/- 14.46, 225.17 +/- 10.03 to 190.93 +/- 12.67, 197.42 +/- 14.56, 200.64 +/- 15.36, respectively. VCAM-1 decreased from 566.72 +/- 24.46, 560.61 +/- 25.67, 359.61 +/- 42.75 to 506.26 +/- 37.26, 516.83 +/- 28.17, 527.02 +/- 43.47, respectively. NO had no change. CONCLUSIONS: Paeonol can protect the endothelial cells of diabetic rats.

[The summary of the clinic study of Zhi-Xin-Fang treating the heart failure resulting from cardiomyopathy].

OBJECTIVE: To observe the therapeutic and prognostic effects and to evaluate the safety of Zhi-Xin-Fang on heart failure resulting from cardiomyopathy. METHODS: 62 patients with cardiomyopathy combined with heart failure were treated with standard western medical therapy as treatment group. The other 60 patients with the same diseases were administered with both Zhi-Xin-Fang and standard western medicines as control. Several parameters were observed to evaluate the effect of Zhi-Xin-Fang on the heart failure, containing the therapeutic effect of clinical symptom and physical signs, the improvement of heart function and the ultrasonic caridogram. We also observed the effect of Zhi-Xin-Fang to relieve the clinical symptom and improve the heart function and quality of life and prognosis. RESULTS: As the NYHA classify for heart failure, the effective rate for the treatment group was 95% , more effective than the control group (effective rate: 80.65%) (P<0.05). There was significant improvement for LVEF and LVDS for both groups. However, the treatment group was better than the control group (P<0.05). The clinical symptom was significantly improved compared to the untreatment in both groups. The treatment group was better than the control group for effective rate (P<0.05) but not for the total effective rate. There was no significant difference for the function of liver and kidney, blood routine method, electrolyte compared to before for the two groups. CONCLUSION: The standard western medicines combined with Zhi-Xin-Fang is a good therapy for treating heart failure resulting from cardiomyopathy. The combined therapy can relieve the cinical symptom of heart failure, improve the heart function and quality of life. It is also safer for the patients. However, its long-term prognosis should be further studied in the future.

[Effect of cortex moutan on PGI2, TXA2, ET and NO in diabetic rats].

OBJECTIVE: To study the effect of Paeonol on PGI2, TXA2, ET and NO in diabetic rats. METHODS: Streptozocin was used on rats to make diabetic animal models. Different dosage of Paeonol were used on diabetic animal models. PGI2, TXA2, ET and NO were tested after 30 days therapy. RESULTS: Compared with those in the control group, the level of PGI2 increased and the contents of TXA2 and ET decreased in treatment group. Among them, the high dosage group was more obvious (P < 0.01). But the level of No Had no change. CONCLUSION: Paeonol can decrease the ET and TXA2 in diabetic rats, and increase PGI2 in diabetic rats.