The Correlation between Serum Lipoprotein(a) and Risk of Mortality in Patients on Peritoneal Dialysis.

BACKGROUND: Patients with peritoneal dialysis commonly have severe disorders of lipid metabolism, with particularly severe changes in serum lipoprotein(α) [Lp(α)]. Serum Lp(α) may play a role in the risk of mortality in peritoneal dialysis patients. The aim was to investigate the correlation between high serum Lp(α) levels and all-cause mortality and death from cardiovascular events and infection in peritoneal dialysis patients. METHODS: Three hundred and ninety-two patients with end-stage kidney disease who started peritoneal dialysis treatment between March 1, 2007 and May 31, 2020, were selected. Clinical data of all enrolled patients after 3 months of peritoneal dialysis were collected. Based on the median value of serum Lp(α) level, all enrolled patients were divided equally into a high serum Lp(α) level group (> 275.95 mg/L, n = 196) and a low serum Lp(α) level group (< 275.95 mg/L, n = 196). SPSS25.0 statistical software was used to analyze the factors affecting serum Lp(α) levels and the correlation between high serum Lp(α) levels and all-cause mortality and death from cardiovascular events and infection in peritoneal dialysis patients. RESULTS: Binary multivariate logistic regression analysis showed that higher low-density lipoprotein (LDL) levels (OR = 1.614, 95% CI: 1.261 - 2.068, p = 0.000) and high Body Mass Index (BMI) levels (OR = 1.063, 95% CI: 1.004 - 1.126, p = 0.036) were the risk factors for the high serum Lp(α) levels. High serum albumin levels (OR = 0.959, 95% CI: 0.927 - 0.991, p = 0.014) and high parathyroid hormone levels (OR = 0.999, 95% CI: 0.997 - 1.000, p = 0.010) were protective factors for the high serum Lp(α) levels. The cumulative survival of patients in the high serum Lp(α) level group was lower in death from cardiovascular events as shown by Kaplan-Meier survival analysis (Log-rank test χ2 = 4.348, p = 0.037). Multivariate Cox regression analysis showed that high serum Lp(α) levels were an independent risk factor for death from cardiovascular events in peritoneal dialysis patients (HR = 1.002, 95% CI: 1.001 - 1.003, p = 0.001). CONCLUSIONS: The occurrence of high serum Lp(α) levels in peritoneal dialysis patients was positively associated with LDL and BMI, and negatively associated with serum albumin and parathyroid hormone levels. High serum Lp(α) levels were related to the risk of death from cardiovascular events in peritoneal dialysis patients.

The change of gut microbiota-derived short-chain fatty acids in diabetic kidney disease.

BACKGROUND: Previous studies found the dysbiosis of intestinal microbiota in diabetic kidney disease (DKD), especially the decreased SCFA-producing bacteria. We aimed to investigate the concentration of the stool and serum short-chain fatty acids (SCFAs), gut microbiota-derived metabolites, in individuals with DKD and reveal the correlations between SCFAs and renal function. METHODS: A total of 30 participants with DKD, 30 participants with type 2 diabetes mellitus (DM), and 30 normal controls (NC) in HwaMei Hospital were recruited from 1/1/2018 to 12/31/2019. Participants with DKD were divided into low estimated glomerular filtration rate (eGFR)(eGFR<60ml/min, n=14) and high eGFR (eGFR≥60ml/min, n=16) subgroups. Stool and serum were measured for SCFAs with gas chromatograph-mass spectrometry. RESULTS: The DKD group showed markedly lower levels of fecal acetate, propionate, and butyrate versus NC (p<0.001, p<0.001, p=0.018, respectively) [1027.32(784.21-1357.90)]vs[2064.59(1561.82-2637.44)]µg/g,[929.53(493.65-1344.26)]vs[1684.57(1110.54-2324.69)]µg/g,[851.39(409.57-1611.65)] vs[1440.74(1004.15-2594.73)]µg/g, respectively, and the lowest fecal total SCFAs concentration among the groups. DKD group also had a lower serum caproate concentration than that with diabetes (p=0.020)[0.57(0.47-0.61)]vs[0.65(0.53-0.79)]µmol/L. In the univariate regression analysis, fecal and serum acetate correlated with eGFR (OR=1.013, p=0.072; OR=1.017, p=0.032). The correlation between serum total SCFAs and eGFR showed statistical significance (OR=1.019, p=0.024) unadjusted and a borderline significance (OR=1.024, p=0.063) when adjusted for Hb and LDL. The decrease in serum acetate and total SCFAs were found of borderline significant difference in both subgroups (p=0.055, p=0.050). CONCLUSION: This study provides evidence that in individuals with DKD, serum and fecal SCFAs levels (fecal level in particular) were lowered, and there was a negative correlation between SCFAs and renal function.

Epidemiology Trend of Urogenital System Disorders of Hospitalized Patients in an Eastern Chinese City from 2017 to 2019.

OBJECTIVE: To evaluate trends in the prevalence and clinical characteristics of urogenital diseases in hospitalized patients of secondary and tertiary hospitals in Ningbo, an east coast city in China, from 2017 to 2019. METHODS: We collected the data on hospitalized patients in Ningbo secondary and tertiary hospitals from January 1, 2017 to December 31, 2019. The data included age, sex, and diagnosis identified using the International Classification of Diseases (ICD) codes, which were obtained from Ningbo National Health Information Platform. We quantified the epidemiology (age/sex-specific) trend of urogenital system disorders. RESULTS: From January 2017 to December 2019, there were 256750 hospitalized patients with urogenital system disorders. These hospitalized patients comprised more women than men (1.45:1.00). The number of hospitalized patients with these diseases significantly increased over the 3 years (77505, 89167, and 90078, respectively; Z = 20.03, p < 0.001). The highest prevalence of these diseases was in the 40- to 64-year-old age group (47.37%), followed by the 18- to 39-year-old age group (23.94%). Over the 3 years, the five most common diseases in hospitalized male patients were male reproductive organ disorders, urolithiasis, tubulointerstitial disease, renal failure, and glomerular disease; Whereas the five most common diseases in hospitalized female patients were non-inflammatory disorders of the female genital tract, benign or dynamic undetermined tumors of the female reproductive organs, disorders of breast (according to ICD-10, disorders of breast (N60-N64) were involved in urogenital system diseases (N00-N99)), inflammatory diseases of female pelvic organs, and renal tubulointerstitial disease. In addition, the number of inpatients with renal tubulointerstitial disease significantly increased from 5952 to 9616 over the 3 years (rank increased from 6 to 3). CONCLUSIONS: Patients with urogenital system disorders significantly increased over the 3 years, occurring more often in women and most commonly in young and middle-aged people, which warrants more attention in clinical practice.

Molecular characterization of matrix metalloproteinase gene family across primates.

Deregulation of matrix metalloproteinases (MMPs) contributes considerably to cancers, psychiatric disorders, macular degeneration and bone diseases. The use of humans in the development of MMPs as prognostic biomarkers and therapeutic targets is complicated by many factors, while primate models can be useful alternatives for this purpose. Here, we performed genome-enabled identification of putative MMPs across primate species, and comprehensively investigated the genes. Phylogenetic topology of the MMP family showed each type formulates a distinct clade, and was further clustered to classes, largely agreeing with classification based on biochemical properties and domain organization. Across primates, the excess of candidate sites of positive selection was detected for MMP-19, in addition to 1-3 sites in MMP-8, MMP-10 and MMP-26. MMP-26 showed Ka/Ks value above 1 between human and chimpanzee copies. We observed two copies of MMP-19 in the old-world monkey genomes, suggesting gene duplication at the early stage of or prior to the emergence of the lineage. Furin-activatable MMPs demonstrate the most variable properties regarding Domain organization and gene structure. During human aging, MMP-11 showed gradually decreased expression in testis, so as MMP-2, MMP-14, MMP15 and MMP-28 in ovary, while MMP-7 and MMP-21 showed elevated expression, implying their distinct roles in different reproductive organs. Co-expression clusters were formed among human MMPs both within and across classes, and expression correlation was observed in MMP genes across primates. Our results illuminate the utilization of MMPs for the discovery of prognostic biomarkers and therapeutic targets for aging-related diseases and carry new messages on MMP classification.

Association between subtypes of metabolic syndrome and prognosis in patients with stage I endometrioid adenocarcinoma: A retrospective cohort study.

Purpose: To investigate the association between subtypes of metabolic syndrome (MetS) and prognosis of patients with stage I endometrioid adenocarcinoma. Patients and methods: Patients with stage I endometrioid adenocarcinoma who received surgical treatment as primary therapy at the Department of Gynecology of the Sun Yat-sen Memorial Hospital between June 2015 and December 2019 were retrospectively enrolled. According to the diagnosis criteria of MetS, the patients were categorized as patients without MetS, patients with MetS but without raised fasting plasma glucose (FPG, including previously diagnosed diabetes), and patients with MetS and raised FPG. All the included patients were followed from the dates of surgery until death, June 2021, or loss to follow-up, whichever came first, and cancer recurrence (including metastasis) was studied as the main outcome. Cox regression was used to evaluate the associations between subtypes of MetS and the study outcome adjusting for potential confounding factors. Results: Among the included 387 patients with stage I endometrioid adenocarcinoma, 193 (49.9%) were without MetS, 65 (16.8%) were with FPG not involving MetS, and 129 (33.3%) were with raised FPG involved MetS. With a median follow-up of 1,253 days, the cumulative incidence of cancer recurrence was 8.76% (95% confidence interval (CI) 2.5%-14.62%), 28.31% (95% CI 2.33%-47.38%), and 7.54% (95% CI 1.54%-13.17%), respectively. After adjusting for age, menopause, histological grade, tumor size, lymph-vascular space invasion, deep myometrial invasion, and treatments, comorbid FPG not involving MetS is a stronger risk factor of cancer recurrence than comorbid raised FPG involving MetS (hazard ratio 2.82 (95% CI 1.10-7.24) versus 1.18 (95% CI 0.45-3.13)) when compared to patients without MetS. Conclusion: Comorbid MetS generally presents as a risk factor of poor prognosis in patients with stage I endometrioid adenocarcinoma after surgical treatment, but the magnitude of the association may vary between subtypes, in which FPG not involving MetS appears to be predominant.

Successful application of roxadustat in the treatment of patients with anti-erythropoietin antibody-mediated renal anaemia: a case report and literature review.

Recombinant human erythropoietin (rHuEPO) has been used worldwide for treatment of renal anaemia due to its good curative effect. However, rHuEPO treatment is associated with a rare but severe complication because of the development of anti-EPO antibodies, which are difficult to treat. Currently, the main treatments for the anti-EPO antibodies include withdrawing the rHuEPO, providing blood transfusions and administrating steroid-based immunosuppressive agents. Although the above methods can alleviate anti-EPO-related anaemia, there are obvious side-effects such as decreased immunity and an increased risk of infection. Therefore, accurately identifying anti-EPO-related anaemia and effectively treating this complication is worth exploring. This current case report describes a 49-year-old female patient with chronic kidney disease that received rHuEPO subcutaneously and then developed anti-EPO antibody-mediated renal anaemia with her haemoglobin levels dropping to 37 g/l. The patient refused to be treated with steroids, so she received 120 mg roxadustat administered orally every 72 h and her Hb level increased to 110 g/l over a few months. This current case report demonstrates that roxadustat can be used to successfully treat anti-EPO antibody-mediated renal anaemia without the use of steroid-based immunosuppressants.

Epidemiology Trend of Urogenital System Disorders of Hospitalized Patients in an Eastern Chinese City from 2017 to 2019

Objective: To evaluate trends in the prevalence and clinical characteristics of urogenital diseases in hospitalized patients of secondary and tertiary hospitals in Ningbo, an east coast city in China, from 2017 to 2019. Methods: We collected the data on hospitalized patients in Ningbo secondary and tertiary hospitals from January 1, 2017 to December 31, 2019. The data included age, sex, and diagnosis identified using the International Classification of Diseases (ICD) codes, which were obtained from Ningbo National Health Information Platform. We quantified the epidemiology (age/sex-specific) trend of urogenital system disorders. Results: From January 2017 to December 2019, there were 256750 hospitalized patients with urogenital system disorders. These hospitalized patients comprised more women than men (1.45:1.00). The number of hospitalized patients with these diseases significantly increased over the 3 years (77505, 89167, and 90078, respectively; Z = 20.03, p < 0.001). The highest prevalence of these diseases was in the 40- to 64-year-old age group (47.37%), followed by the 18- to 39-year-old age group (23.94%). Over the 3 years, the five most common diseases in hospitalized male patients were male reproductive organ disorders, urolithiasis, tubulointerstitial disease, renal failure, and glomerular disease; Whereas the five most common diseases in hospitalized female patients were non-inflammatory disorders of the female genital tract, benign or dynamic undetermined tumors of the female reproductive organs, disorders of breast (according to ICD-10, disorders of breast (N60–N64) were involved in urogenital system diseases (N00–N99)), inflammatory diseases of female pelvic organs, and renal tubulointerstitial disease. In addition, the number of inpatients with renal tubulointerstitial disease significantly increased from 5952 to 9616 over the 3 years (rank increased from 6 to 3) (AU)