Long-term mortality in patients with end-stage renal disease undergoing hemodialysis and peritoneal dialysis: a propensity score matching retrospective study.

BACKGROUND: Hemodialysis (HD) and peritoneal dialysis (PD) are effective ways to treat end-stage renal disease (ERSD). This study aimed to investigate the differences in survival and the factors that influence it in patients with end-stage renal disease treated with HD or PD. METHODS: We retrospectively analyzed factors related to all-cause death with renal replacement therapy and compared the long-term mortality between HD and PD strategies in patients with ESRD who started HD or PD treatment in our renal HD center between January 1, 2008, and December 1, 2021. RESULTS: Overall, 1,319 patients were included, comprising 690 and 629 patients in the HD and PD groups, respectively, according to the inclusion criteria. After propensity matching, 922 patients remained, with 461 (50%) patients each in the two groups. There were no significant differences in the 1-, 2-, 3-, and 4-year mortality rates between the HD and PD groups (all p > .05). However, the 5- and 10-year mortality rates of the matched patients were 15.8%. 17.6% in the HD group and 21.0%. 27.3% in the PD group, respectively. The 5- and 10-year mortality rates were significantly lower in the HD group (all p < .05) as compared to the PD group. After matching, Kaplan-Meier curve analysis with log-rank test was performed, which showed a significant difference in the survival rates between the two groups (p = .001). Logistic multifactor regression analysis revealed that age, weight, hypertension, serum creatinine, and combined neoplasms influenced the survival rate of patients with ESRD (p < .05). In contrast, age, hypertension, parathyroid hormone (PTH), serum creatinine, and peripheral vascular diseases (PVD) influenced the survival rate of patients in the HD group (p < .05), and age and weight influenced the survival rate of patients in the PD group (p < .05). CONCLUSIONS: This study found that long-term mortality rates were higher in the PD group than that in the HD group, indicating that HD may be superior to PD.

A New Formulation of Random Genetic Drift and Its Application to the Evolution of Cell Populations.

Random genetic drift, or stochastic change in gene frequency, is a fundamental evolutionary force that is usually defined within the ideal Wright-Fisher (WF) population. However, as the theory is increasingly applied to populations that deviate strongly from the ideal model, a paradox of random drift has emerged. When drift is defined by the WF model, it becomes stronger as the population size, N, decreases. However, the intensity of competition decreases when N decreases and, hence, drift might become weaker. To resolve the paradox, we propose that random drift be defined by the variance of "individual output", V(k) [k being the progeny number of each individual with the mean of E(k)], rather than by the WF sampling. If the distribution of k is known for any population, its strength of drift relative to a WF population of the same size, N, can be calculated. Generally, E(k) and V(k) should be density dependent but their relationships are different with or without competition, leading to opposite predictions on the efficiency of random drift as N changes. We apply the "individual output" model to asexual cell populations that are either unregulated (such as tumors) or negatively density-dependent (e.g., bacteria). In such populations, the efficiency of drift could be as low as <10% of that in WF populations. Interestingly, when N is below the carrying capacity, random drift could in fact increase as N increases. Growing asexual populations, especially tumors, may therefore be genetically even more heterogeneous than the high diversity estimated by some conventional models.

Numerical simulation of wind sand movement in straw checkerboard barriers.

Straw checkerboard barrier (SCB) is the most representative antidesertification measure and plays a significant role in antidesertification projects. Large-eddy simulation and discrete-particle tracing were used to numerically simulate the wind sand movement inside the straw checkerboard barrier (SCB), study the movement characteristics of sand particles, find the transverse velocities of sand particles and flow field, and obtain the contour of the transverse velocity of coupled wind field within the SCB. The results showed that 1) compared with that at the inlet of the SCB, the sand transport rate inside the SCB greatly decreases and the speed of sand grain movement also evidently drops, indicating that the SCB has very good sand movement preventing and fixing function; 2) within the SCB there exists a series of unevenly distributed eddies of wind sand flow, their strength decreases gradually with increasing the transverse distance; 3) affected by eddies or reflux, sand particles carried by the wind sand flow have to drop forward and backward the two interior walls inside the SCB, respectively, forming a v-shaped sand trough; 4) the sand transport rate gradually decreases with increasing number of SCBs, which reveals that the capacity of the wind field to transport sand particles decreases. This research is of significance in sandstorm and land desertification control.

Homogeneous oxidation of SO2 in the tail gas incinerator of sulfur recovery unit.

The formation and emission of sulfur trioxide (SO3) in sulfur recovery unit has received increasing attention due to its adverse effects on the operation of plant and environment. Due to the excess oxygen, high concentration of SO2 and high temperature, SO3 formation in the sulfur recovery unit tail gas incinerator may significantly increase. A small horizontal tube reactor was employed to simulate the homogeneous oxidation of SO2 in the tail gas incinerator. The SO3 concentration was measured with a controlled condensation method at the outlet of the reactor. The present work focuses on the gas-phase chemistry and examines the impact of different combustion parameters and atmospheres on the formation of SO3 in the tail gas incinerator. Experiment results show that the increased O2 and SO2 concentrations along with increasing temperature are favorable for enhancing SO3 formation over the range of tested parameters. The presence of water vapor has an enhancing effect of SO2 oxidation in the experiments conducted. No significant effect of CO2 was found to the oxidation of SO2.

Gene regulatory network stabilized by pervasive weak repressions: microRNA functions revealed by the May-Wigner theory.

Food web and gene regulatory networks (GRNs) are large biological networks, both of which can be analyzed using the May-Wigner theory. According to the theory, networks as large as mammalian GRNs would require dedicated gene products for stabilization. We propose that microRNAs (miRNAs) are those products. More than 30% of genes are repressed by miRNAs, but most repressions are too weak to have a phenotypic consequence. The theory shows that (i) weak repressions cumulatively enhance the stability of GRNs, and (ii) broad and weak repressions confer greater stability than a few strong ones. Hence, the diffuse actions of miRNAs in mammalian cells appear to function mainly in stabilizing GRNs. The postulated link between mRNA repression and GRN stability can be seen in a different light in yeast, which do not have miRNAs. Yeast cells rely on non-specific RNA nucleases to strongly degrade mRNAs for GRN stability. The strategy is suited to GRNs of small and rapidly dividing yeast cells, but not the larger mammalian cells. In conclusion, the May-Wigner theory, supplanting the analysis of small motifs, provides a mathematical solution to GRN stability, thus linking miRNAs explicitly to 'developmental canalization'.

Progress of anti-vascular endothelial growth factor drugs for the treatment of retinopathy of prematurity / 国际眼科杂志(Guoji Yanke Zazhi)

Retinopathy of prematurity(ROP)is a proliferative vascular disorder of the immature retina, and it is a major eye disease that causes blindness in children of developing and developed countries. Retinal laser photocoagulation and cryotherapy are the conventional treatment used for ROP but could cause permanent damage to retina, with a risk of complications such as visual field defect and high myopia. With more normal growth of retinal function and convenience and shorter time than coagulation therapy, intravitreal injection of anti-vascular endothelial growth factor(VEGF)agents has gradually gained popularity and has even been advocated as the treatment of choice in treating zone I, zone II posterior or aggressive ROP. However, the serious systemic complications, minimum effective dose and late recurrence caused by anti-VEGF drugs in the treatment of ROP still need to be further studied. This review focuses on the use of anti-VEGF agents for the treatment of ROP.

Overview of the main biological mechanisms linked to changes in periodontal ligament stem cells and the inflammatory microenvironment / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Periodontitis is a complex chronic inflammatory disease. The invasion of pathogens induces the inflammatory microenvironment in periodontitis. Cell behavior changes in response to changes in the microenvironment, which in turn alters the local inflammatory microenvironment of the periodontium through factors secreted by cells. It has been confirmed that periodontal ligament stem cells (PDLSCs) are vital in the development of periodontal disease. Moreover, PDLSCs are the most effective cell type to be used for periodontium regeneration. This review focuses on changes in PDLSCs, their basic biological behavior, osteogenic differentiation, and drug effects caused by the inflammatory microenvironment, to provide a better understanding of the influence of these factors on periodontal tissue homeostasis. In addition, we discuss the underlying mechanism in detail behind the reciprocal responses of PDLSCs that affect the microenvironment.

Changes of Nogo-A expression in hippocampus and striatum of rats under low estrogen condition / 解剖学报

[Abstract] Objective To elucidate the important role of Nogo-A in climacteric neurodegeneration such as memory impairment by observing memory function and the expression of Nogo-A in hippocampus and striatum of rats under low estrogen condition. Methods Fouthy-five female SD rats were divided into sham operation group, ovariectomized group and ovariectomized estrogen treatment group with 15 rats in each group. Medication was given 2 weeks after ovariectomized. Estrogen treatment group was subcutaneously injected in groin with estrogen [25 μg/ (kg.d)] dissolved in sterile sesame oil. The sham operation group and the ovariectomized group were given the same amount of aseptic sesame oil. Samples were collected after 6 weeks of drug treatment. The difference of memory function of rats in three groups was observed by conditioned fear training experiment, and the expression of Nogo-A in hippocampus and striatum was observed by immunohistochemistry and Western blotting. Results Compared with the sham and estrogen treatment group, memory function in ovariectomized group decreased significantly and the number of Nogo-A positive neurons in hippocampus and striatum of ovariectomized rats was significantly higher than that of sham operation group (P 0. 05). The result of immunoblotting was consistent with the above-mentioned immunohistochemical result. Conclusion The increased expression of Nogo-A in hippocampus and striatum under low estrogen condition may be one of the key reasons for memory impairment in climacteric women.

Effect of Alcohol Extract of Spore Powder of Lasiosphaera Calvatia on Wound Healing of Full-thickness Skin Defect in Mice / 中国实验方剂学杂志

ObjectiveTo compare the effect of different solvent extracts of spore powder and fruiting body of Lasiosphaera Calvatia on fibroblasts and wound healing of full-thickness skin defect， in order to screen the optimal medication part of Lasiosphaera Calvatia. MethodThe effect of water extract and alcohol extract of spore powder and fruiting body on cell proliferation and cell migration of mouse skin fibroblasts （MSF） were examined in vitro. Cell proliferation and activity test （CCK-8） method was used for cell proliferation， scratch assay was used for cell migration， flow cytometry was conducted to explore cell cycle， enzyme-linked immunosorbent assay （ELISA） was used to determine the production of collagen Ⅰ and Ⅲ. At the same time， a full-thickness skin defect wound model was established to investigate the therapeutic effect of different solvent extracts of spore powder. Ultraviolet-visible spectrophotometry was used to measure the contents of index components in different solvent extracts. ResultThe water extract of spore powder and fruiting body had certain cytotoxicity， while the alcohol extract could promote proliferation， migration and production of collagen Ⅰ and Ⅲ of MSF， and the effect of spore powder was significantly higher than that of fruiting body. When the concentration was 10 mg·L-1， the cell proliferation rate of alcohol extract of spore powder was as high as （159.22±15.95）%， and could promote MSF from the G0/G1 phase to S phase and G2/M phase with an increased proliferation index. The alcohol extract also promoted the migration of fibroblasts， secreted collagen Ⅰ and Ⅲ. On in vivo model， the alcohol extract of spore powder significantly accelerated wound healing on mice， effectively promoted the complete epithelialization of wound tissue， and generated new collagen fiber. The results of determination showed that the contents of polyphenols and flavonoids in the alcohol extract were higher than the alcohol extract of fruiting body. ConclusionThe alcohol extract of spore powder in Lasiosphaera Calvatia has active components in the treatment of wounds with good development prospect， and the medicinal components may be polyphenols and flavonoids.

Current application status and prospect of hybrid coronary revascularization / 中国胸心血管外科临床杂志

@#Hybrid coronary revascularization (HCR) combining with coronary artery bypass grafting (CABG) has a long-term patency of left internal mammary artery to left anterior descending artery (LIMA-LAD) grafting, and the percutaneous coronary intervention (PCI) has a minimal invasiveness. It provides an alternative revascularization for patients with coronary heart disease. For patients who meet the HCR indications, most studies suggest that HCR can significantly reduce perioperative trauma, and offer favorable mid- and long-term prognosis, which is comparable with traditional revascularization strategies. Based on the major research results in this field in the past 10 years, we review the current application status and discuss the potential future direction of HCR in this paper.

A clinical study of myocardial viability in predicting the improvement of cardiac function after coronary artery bypass grafting in patients with ischemic heart failure / 中国胸心血管外科临床杂志

@#Objective    To explore the predictive value of myocardial vitality in the improvement of cardiac function after coronary artery bypass grafting (CABG) in patients with ischemic heart failure. Methods    From December 8, 2015 to November 12, 2018, 46 patients with ischemic heart failure who underwent CABG operation alone were collected retrospectively. There were 41 males and 5 females with an average age of 60.4±8.0 years. The myocardial vitality and number of different types of myocardium were measured. The clinical data of patients in the left ventricular ejection fraction (LVEF) improvement group (≥5%) and non-improvement group (<5%) were compared and analyzed. The  correlation between each index and LVEF improvement was analyzed by logistic multivariate regression analysis, and the boundary value of hibernating myocardium between LVEF improvement and non-improvement was obtained by receiver operating characteristic (ROC) curve. Results    There were significant differences in the number of hibernating myocardium (15.0%±12.3% vs. 4.3%±4.5%, P=0.000), the number of normal myocardium (74.7%±13.7% vs. 82.4%±8.6%, P=0.027), and cardiac function classification (NYHA) development (−0.7±0.7 vs. −0.3±0.5, P=0.047) between the two groups, but there was no significant difference in other indexes between the two groups (P>0.05). Logistic regression analysis showed that the number of hibernating myocardium was an independent factor affecting the improvement of LVEF after CABG in patients with ischemic heart failure (OR=1.366, 95%CI 1.033-1.807, P=0.029). The ROC curve showed that the threshold value, sensitivity and specificity of hibernating myocardium were 15.0%, 43.8% and 100.0%, respectively. Conclusion    The percentage of hibernating myocardium to left ventricular wall area ≥15.0% can accurately predict the improvement of LVEF in patients with ischemic heart failure after CABG. Preoperative myocardial vitality assessment has important diagnostic value in predicting the improvement of cardiac function in patients with ischemic heart failure after simple CABG.

Comparative study of curriculum setting between Chinese and American medical college and its inspirations: a case study of Peking University and Pittsburgh University / 中华医学教育探索杂志

Objective To explore the differences of curricula setting of medical students in China and the United States,and the enlightenment for medical education in China.Methods The curriculum of the 8-year students in Grade 2010 of Peking University was compared with the schedule of medical students in the same grade at the Pittsburgh University,specifically for the number of courses,the distribution of courses,the training of innovative abilities,and the doctor-patient communication courses.All the data were analyzed by SPSS 20.0,and t test and chi-square test were used for statistical analysis.Results The total number of courses in the two medical schools was similar.The number of study weeks per year for Peking University was (41.6 ± 8.7) weeks while that of Pittsburgh University was (39.6 ± 8.5)weeks,without statistically significant difference (t =1.414,P=0.200).Courses of both universities were distributed from comprehensive courses to medical courses and from basic courses to clinical courses,and the professional courses were similar.Innovative ability training and doctor-patient communication education were reflected in the curriculum of both universities,but the training courses of the University of Pittsburgh began earlier and the form was more flexible.Among them,there was a total of 47 learning hours of the doctor-patient communication lecture in Peking University while the number of Pittsburgh University was 140 learning hours,including lectures and communication with standard patients and real patients.The difference was statistically significant (~=67.45,P=0.000).Conclusion After more than 20 years of medical education reform,the curricula of medical students in China have basically reached the level of developed countries.Professional courses are similar to those of medical schools in developed countries.However,it is still necessary to strengthen the cultivation of innovative ability and medical humanities education.

Effect of infusion pressure on retinal structure and function during cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#With cataract surgery become commonly performed, to pursue efficiency of the surgery, ophthalmologists prefer to increase vacuum during phacoemulsification. High vacuum can cause the instability of the anterior chamber, requiring increased infusion pressure to maintain the stability. However, high infusion pressure can affect the structure and function of the retina. This article reviews the studies of effect of infusion pressure during cataract surgery on retinal structure and function.

Analysis of risk factors for cerebral apoplexy in the recipients after renal transplantation / 器官移植

Objective To analyze the risk factors for cerebral apoplexy in the recipients after renal transplantation. Methods Clinical data of 376 renal transplant recipients who were followed up regularly were retrospectively analyzed. The recipients were divided into cerebral apoplexy group (39 cases) and non-cerebral apoplexy group (337 cases) according to the occurrence of cerebral apoplexy. The risk factors of cerebral apoplexy were analyzed using single factor analysis and COX proportional hazards regression model. Results The 376 recipients were followed up for a median duration of 55 months, among whom 39 recipients suffered from cerebral apoplexy, with a cumulative incidence of 10.4%. Single factor analysis indicated that there were significant differences in age ≥40 years old at transplantation, duration of dialysis ≥12 months before transplantation, estimated glomerular filtration rate (eGFR) <30 mL/(min·1.73m2), incidence of hypertension, diabetes and dyslipidemia between cerebral apoplexy group and non-cerebral apoplexy group (all P<0.05).Multivariate analysis indicated that the independent risk factors for cerebral apoplexy occurred in the recipients after renal transplantation were age ≥40 years old [hazard ratio (HR) =1.110, 95% confidence interval (CI)=1.067-1.154,P=0.000],duration of dialysis≥12 months before transplantation(HR=1.044,95%CI=1.021-1.067,P=0.000)and eGFR<30 mL/(min·1.73m2)(HR=2.448,95%CI=1.197-5.005,P=0.014).Conclusions The independent risk factors for cerebral apoplexy in the recipients after renal transplantation include age≥40 years old, long duration of dialysis before transplantation and renal insufficiency.

Development and clinical applications of therapeutic contact lenses / 国际眼科杂志(Guoji Yanke Zazhi)

Therapeutic contact lenses, a great invention on optometry, have been widely used on clinical therapy of ocular surface diseases due to its specialty on material and structure. As a result, relevant researches and development should be focused on the optimization of its material making it more adaptable for clinical therapy. In this review, we discuss the progress in developing material of therapeutic contact lenses and mainly illustrate its mechanism and clinical application together with its complications and potential improvements.

Recent research progress on natural medicines in treatment of cadmium toxicity / 中国中药杂志

Cadmium contamination of environment is a subject of serious international concern. Bioaccumulation of cadmium occurs primarily through ingestion of contaminated water and food. Cadmium poisoning came into prominence with the "itai-itai" disease event in Japan in the 1950s. It could also cause damages to liver, kidney, lung and other organs. Thus, the treatment of cadmium poisoning has become a research hotspot. Researchers are trying their best to explore prophylactic and therapeutic medicines for prevention and treatment of cadmium-induced poisoning. So far, chelation therapy, the conventional treatment for heavy metal toxicity, is reported to have a number of safety and efficacy issues. Natural medicines have a variety of advantages such as extensive sources, high safety, less adverse reactions, and thus have great potentials in treating cadmium poisoning. In this review, the progress in the antagonistic effects of natural drugs in cadmium poisoning and their therapeutic mechanisms were summarized in order to provide certain references for the future development and in-depth study of antagonistic substances.

Applications of Isolated-Check Visual Evoked Potential in Early Stage of Open-Angle Glaucoma Patients / 中华医学杂志(英文版)

<p><b>Background</b>Standard automated perimetry does not sufficiently detect early open-angle glaucoma (OAG) in the clinic. New visual function tests for early glaucoma damage are therefore needed. The present study evaluated whether an isolated-check visual evoked potential (icVEP) could be used to detect visual function abnormalities in early-stage OAG and to explore potential related factors.</p><p><b>Methods</b>This was a cross-sectional study. Thirty-seven OAG patients with early-stage visual field loss (mean deviation ≥ -6.00 dB) detected by the Humphrey Field Analyzer (30-2 SITA program) and 26 controls were included in this study. Optical coherence tomography (OCT) was used to detect retinal nerve fiber layer (RNFL) defects. The icVEP preferentially evaluates the magnocellular-ON pathway. VEPs were recorded and signal-to-noise ratios (SNRs) were derived based on multivariate analysis. Eyes that yielded an SNR ≤1 were considered abnormal. Receiver operating characteristic (ROC) curve analysis was used to estimate the accuracy of group classification. Correlations between SNRs and related factors were analyzed.</p><p><b>Results</b>Based on an SNR criterion of 1, the icVEP had a sensitivity of 62.2% and a specificity of 92.3% for diagnosing early-stage OAG with 74.6% classification accuracy. The ROC curve analysis, however, suggested that an SNR criterion of 0.93 would produce the highest classification accuracy (77.3%). Both RNFL thinning in the temporal superior quadrant on OCT and number of abnormal test points in the central 11° visual field (pattern deviation, P < 0.5%) significantly correlated with the SNR (P < 0.05).</p><p><b>Conclusions</b>The icVEP detected visual function abnormalities in approximately 3/5 of eyes with early-stage OAG with greater than 90% specificity. SNR correlated with both a decrease in RNFL thickness and severity of central visual field loss.</p>

Imaging and histological changes of the healing process of experimental sheep femoral fracture using different fixation methods / 中国组织工程研究

BACKGROUND: Microwave treatment is a common physical therapy method that can increase the temperature and blood circulation of deep tissues, and is used for improving fracture repair. However, microwave treatment cannot be used if there is surgically implanted metal plate or screw. OBJECTIVE: To observe the dame of microwave treatment to the tissues surrounding the titanium alloy implants. METHODS: Forty-four New Zealand white rabbits were randomized into experimental and control groups. The model of the fracture at the middle of the femur was established in all rabbits, and the rabbits in the experimental group were implanted with titanium alloy internal fixation systems. A 30-day microwave treatment (2 450 MHz, 20 W or 40 W, 20 minutes daily) was applied to the fracture site in all rabbits at 3 days after operation. RESULTS AND CONCLUSION: After 20 W of wave microwave treatment, the temperature of tissues around the implants showed no significant increase or severe heat injury. While, 40 W of wave microwave treatment significantly increased the temperature of tissues around the implants and the tissue was damaged severely. Our results indicate that, the low-dosage microwave treatment may be a promising method in the rehabilitation therapy of fractures with titanium alloy internal fixation.

Relationship among psychological distress, adult attachment,and social support in primary caregivers of cancer patients / 中国心理卫生杂志

Objective:To explore the relationship among psychological distress,adult attachment,and social support in primary caregivers of cancer patients.Methods:A total of 208 primary caregivers of cancer patients in one third grade hospital in Anhui Province were recruited.The 10-item Kessler Psychological Distress Scale(K10),Experiences in Close Relationships Inventory(ECR) and Social Support Questionnaire(SSQ) were used to explore psychological distress,adult attachment,and social support status.Results:The average K10 score was (21.5 ± 7.5).Multiple linear regression analysis indicated that caregiver gender,pressure on patient care,and attachment anxiety had positive prediction on psychological distress (β =2.30,3.02,0.13),while residence had negative prediction on psychological distress (β =-3.22).Conclusion:It suggests that the psychological distress is related to attachment anxiety and social support among the primary caregivers.

Advances of toxicity evaluation of cinnabar and compatibility necessity analysis / 中国中药杂志

Cinnabars are widely used in the clinic and shows unique efficacy, and it has been used in treating diseases for thousands of years either single-use or combination with other traditional Chinese medicines. Cinnabar mainly contains mercury, which displays obvious hepatotoxicity and nephrotoxicity. The safety of cinnabar and its rational use caused extensive attention. However, there are some misunderstanding that cinnabar shows equivalent toxicity to the toxicity of mercury compounds such as mercuric chloride and methylmercury in safety evaluation of cinnabar, which in our view exaggerates the toxicity. For traditional Chinese medicine containing cinnabar, some researchers questioned the medicinal value of cinnabar, and even proposed to remove cinnabar in order to avoid possible poisoning. This review reported adverse events, summarized its toxicity characteristics, mechanism and the medicinal value in preparations of traditional Chinese medicine. The significance of this paper is to further understand the toxicity of cinnabar and reduce its side effect in clinical application, and to provide a scientific basis for reasonable clinical application and a scientific understanding of cinnabar.