[Analysis of clinical characteristics and molecular genetics in eighteen patients with 1q21.1 microdeletion syndrome].

OBJECTIVE: To explore the clinical characteristics of 1q21.1 microdeletion by using single nucleotide polymorphism microarrays (SNP array). METHODS: Eighteen cases of 1q21.1 microdeletion syndrome diagnosed at the Longgang District Maternal and Child Health Care Hospital of Shenzhen City from June 2017 to December 2022 were selected as the study subjects. Clinical data of the patients were collected. Results of chromosomal karyotyping and SNP assay were retrospectively analyzed. RESULTS: Among the 18 cases with 1q21.1 microdeletions, 13 had a deletion between BP3 and BP4, 4 had a deletion between BP1/BP2 and BP4, whilst 1 had a proximal 1q21.1 deletion (between BP2 and BP3) involving the Thrombocytopenia-absent radius (TAR) region. The deletions had spanned from 360 kb to 3.9 Mb, which encompassed the GJA5, GJA8, CHD1L, RBM8AB and other morbid genes. In three families, the proband child has inherited the same 1q21.1 microdeletion from their parents, whose clinical phenotype was normal or slightly abnormal. The clinical phenotypes of 1q21.1 microdeletion had included cognitive or behavioral deficits in 9 cases (9/18, 50.0%), growth retardation in 8 cases (8/18, 44.4%), craniofacial deformities in 7 cases (7/18, 38.8%), cardiovascular malformations in 5 cases (5/18, 27.8%), and microcephaly in 3 cases (3/18, 16.7%). CONCLUSION: 1q21.1 microdeletion syndrome has incomplete penetrance and varied expression such as intellectual impairment, growth and development delay, and microcephaly, with a wide range of non-specific phenotypes.

Prenatal diagnosis, pregnancy determination and follow up of sex chromosome aneuploidy screened by non-invasive prenatal testing from 122 453 unselected singleton pregnancies: A retrospective analysis of 7-year experience.

The phenotype of SCA patients are diversities, make prenatal counseling and parental decision-making following the prenatal diagnosis of SCA more complicated and challenging. NIPT has higher sensitivity and specificity in screening trisomy 21 syndrome, but the effectiveness of NIPT in detecting SCA is still controversial. This study is a large-scale retrospective cohort of positive SCA screened from unselected singleton pregnancies by non-invasive prenatal testing (NIPT) from a single prenatal center of a tertiary hospital. Clinical information, indications, diagnostic results, ultrasound findings, pregnancy determinations, and follow-up were reviewed and analyzed. 596 cases of SCA positive were screened out of 122 453, giving a positive detection rate of 0.49%. 510 cases (85.6%) conducted with amniocentesis to detect fetal chromosome, of which 236 were confirmed as true positive of SCA with PPV of 46.3% (236/510). Of the 236 cases confirmed as true positive SCA, 114 cases (48.3%)chose to terminate the pregnancy (93.0%, 65.3%, 15.4% and 10.9% for 45,X, 47,XXY, 47,XXX and 47,XYY, respectively), 122 cases (51.7%) elected to continue the pregnancy. In conclusions, NIPT as a first-tier routine method for screening autosomal aneuploidies, also could play an important role in screening SCA. Low-risk pregnant women are the main indication for the detection of SCA as NIPT test provides to non-selective population. For 47,XXX and 47,XYY with mild phenotype, couples would like to continue the pregnancy. But for 45,X and 47,XXY, parents apt to terminate pregnancy no matter ultrasound abnormalities were found or not.

Influencing factors of clinical efficacy of roxadustat among hemodialysis patients.

OBJECTIVE: To explore independent influencing factors for clinical efficacy of roxadustat in hemodialysis patients. METHODS: Hemodialysis patients treated with roxadustat were enrolled. The plasma trough concentrations of roxadustat were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). A multiple logistic regression model was established to determine the factors that affect clinical efficacy of roxadustat in patients undergoing hemodialysis. RESULTS: A total of 67 hemodialysis patients were enrolled in the study. The results showed that age, blood trough concentration of roxadustat, and baseline hemoglobin (Hb) level were independent factors of clinical efficacy of roxadustat (OR = 1.06, p = .025 for age; OR = 1.001, p = .037 for plasma concentration; and OR = 0.941, p = .003 for baseline Hb), with an AUC score of 0.859. CONCLUSIONS: Age, blood trough concentration of roxadustat, and baseline Hb level were independent influencing factors of the response to roxadustat in hemodialysis patients.

Dietary inflammatory index is associated with Vitamin D in CKD patients.

OBJECTIVES: Multiple observational studies have shown that low serum level of 25-hydroxyvitamin D (25(OH)D) in patients with chronic kidney disease (CKD) have been associated with a faster progression of kidney disease and a higher risk of all-cause mortality. We aim to assess the association between dietary inflammatory index (DII) with Vitamin D in adults with CKD. METHOD: The National Health and Nutrition Examination Survey appropriated participants from 2009 to 2018 were enrolled. The patients who were under the age of 18, pregnant, and having incomplete data were excluded. DII score were calculated based on a single 24-h dietary recall interview for each participant. Mutivariable regression analysis and subgroup analysis were utilized to determine the independent associations between vitamin D with DII in CKD patients. RESULTS: In total, 4283 individuals were finally included. The results showed a negative association between DII scores and 25(OH)D with statistical significance (ß = - 1.83, 95% CI - 2.31, - 1.34, P < 0.001). In subgroup analysis stratified by gender, low eGFR, age and diabetes, the negative association between DII scores and 25(OH)D was still significant (all P for trend < 0.05). The results from interacion test indicated that the magnitude of the association was the same for the population with and without low eGFR (P for interacion = 0.464). CONCLUSION: Higher consumption of pro-inflammatory diet correlates negatively with the 25(OH)D level in CKD patients with and without low eGFR. Anti-inflammatory diet management may reduce the reduction of vitamin D in CKD patients.

The relationship between dietary inflammatory index and bone mineral density in CKD patients.

INTRODUCTION: Chronic systemic inflammation was proposed as a critical factor in the development of osteoporosis. We aim to investigate the effect of the DII on bone mineral density (BMD) in CKD patients. METHODS: 2276 participants from NHANES were enrolled. The DII score was calculated based on a single 24-h dietary recall. Total BMD was measured using Dual-energy x-ray absorptiometry. A multiple-stepwise linear regression model was used to determine associations between BMD and DII in CKD patients. RESULTS: When DII >0.35, a negative correlation was obtained between DII and BMD (all ß = -0.008 and p < 0.05). In subgroup analysis, BMD levels decreased across increasing tertiles of the DII for patients with non-osteoporosis, postmenopause, and low eGFR (p for trend ≤0.01). CONCLUSION: Higher consumption of pro-inflammatory diet correlates negatively with the BMD levels in CKD patients.

Lactiplantibacillus plantarum fermentation enhanced the protective effect of kiwifruit on intestinal injury in rats: Based on mitochondrial morphology and function.

Fermented foods have protective effects on body health. In our previously study, we found Lactiplantibacillus plantarum fermentation enhanced antioxidant activity of kiwifruit in vitro digestion. Then, in this work we explored the protective effect of fermented kiwi on intestinal injury induced by acute lipopolysaccharide (LPS) stress. Compared to non-fermented kiwi pulp (KP), Lactiplantibacillus plantarum fermented kiwi pulp (FKP-LP) contained more peptides, hormones and vitamins contents, lesser nucleic acid and carbohydrate contents. FKP-LP could relieve the intestinal injury by improving morphological of tight junction and upregulating tight junction proteins mRNA expression. Fermented kiwi maintained the mitochondrial morphology, mitochondrial respiratory function, and mitochondrial homeostasis, and relieved the LPS induced injury by regulating the contents of energy substances, and the respiratory chain complex enzyme activity through the pathway of AMPK and its downstream factors including PGC-1α, NRF1, NRF2, TFAM, and ULK2.

Radiosensitizing effects of pyrogallol-loaded mesoporous or-ganosilica nanoparticles on gastric cancer by amplified ferroptosis.

Radiotherapy (RT) incorporated multidisciplinary treatment is producing excellent clinical results, but its efficacy in treating late-stage gastric cancer is constrained by radioresistance and RT-related toxicity. Especially, since reactive oxygen species are the pivotal effectual molecules of ionizing radiation, improving ROS production by nanoparticles and other pharmacological modulation to amplify oxidation of polyunsaturated fatty acids and subsequent ferroptotic cell death is shown to enhance cancer cell radioresponse. Herein, we constructed a nanosystem by loading Pyrogallol (PG), a polyphenol compound and ROS generator, into mesoporous organosilica nanoparticles named as MON@pG. The nanoparticles exhibit proper size distribution with amplified ROS production and substantial glutathione depletion under X-ray radiation in gastric cancer cell line. Meanwhile, MON@PG enhanced radiosensitivity of gastric cancer in xenograft tumor model by ROS-mediated accumulation of DNA damage and apoptosis. Furthermore, this augmented oxidative process induced mitochondrial dysfunction and ferroptosis. In summary, MON@PG nanoparticles show the capacity to improve RT potency in gastric cancer by disrupting redox balance and augmenting ferroptosis.

Inhibition of lncRNA NFIA-AS1 Alleviates Abnormal Proliferation and Inflammation of Vascular Smooth Muscle Cells in Atherosclerosis by Regulating miR-125a-3p/AKT1 Axis.

Vascular smooth muscle cells (VSMCs) are critical elements of the vascular wall and play a crucial role in the genesis and development of atherosclerosis (AS). Increasingly, studies have indicated that long noncoding RNAs (lncRNAs) regulate VSMC proliferation, apoptosis, and other biological processes. Nevertheless, the role of lncRNA NFIA-AS1 (hereinafter referred to as NFIA-AS1) in VSMCs and AS remains unclear. Quantitative real-time PCR (qRT-PCR) was performed to analyze the messenger RNA (mRNA) levels of NFIA-AS1 and miR-125a-3p. CCK-8 and EdU staining were performed to detect VSMC proliferation. VSMC apoptosis was evaluated by flow cytometry. The expression of various proteins was detected using western blotting. The levels of inflammatory cytokines secreted by VSMCs were measured by enzyme linked immunosorbent assay (ELISA). The binding sites of NFIA-AS1 and miR-125a-3p, as well as miR-125a-3p and AKT1, were analyzed using bioinformatics methods and validated using a luciferase reporter assay. The function of NFIA-AS1/miR-125a-3p/AKT1 in VSMCs was clarified through loss- and gain-of-functional experiments. We confirmed that NFIA-AS1 was highly expressed in AS tissues and VSMCs induced by oxidized low-density lipoprotein (Ox-LDL). Knockdown of NFIA-AS1 restrained the exceptional growth of Ox-LDL-induced VSMCs, promoted their apoptosis, and decreased the secretion of inflammatory factors and expression of adhesion factors. In addition, NFIA-AS1 regulated the proliferation, apoptosis, and inflammatory response of VSMCs through the miR-125a-3p/AKT1 axis, suggesting that NFIA-AS1 may be a potential therapeutic target for AS.

Surgery and Postoperative Care of Patients Undergoing Percutaneous Nephrolithotomy under the Guidance of B-Ultrasound Based on Smart Internet of Things.

At present, percutaneous nephrolithotomy has become an option for hospitals increasingly to treat calculus. However, due to the certain risk of percutaneous nephrolithotomy, it may lead to postoperative complications. Analyzing the preoperative factors of septic shock after percutaneous nephrolithotomy can provide guidance for reducing the incidence of septic shock after PCNL. This article establishes a logistic regression model based on preoperative factors, uses statistical methods, and uses the professional statistical software SPSS to create a database and analyze the data. The method of classification data analysis was used to determine various influencing factors including patient factors, stone factor, and preoperative factors and combined B-ultrasound guidance and percutaneous nephrolithotomy to reduce the risk of surgery. The experimental results found that the percutaneous nephroscope laser lithotripsy guided by the smart Internet of Things can effectively perform lithotripsy; in this paper, the preoperative data of different complications are obtained, and the risk of surgery is closely related to the operation time. The operation time exceeds 90 minutes and causes the risk of severe bleeding after PCNL. It is twice the operation time of less than 90 minutes and 5 times the operation time of less than 60 minutes.

3D Blockage Mapping for Identifying Familial Point Mutations in Single Amyloid-ß Peptides with a Nanopore.

Accurate discrimination of amyloid-ß (Aß) peptides containing familial point mutations would advance the knowledge of their roles in early-onset Alzheimer's disease. Herein, we simultaneously identified the mutant A21G, E22G, E22Q, and the wild-type (WT) Aß18-26 peptides with aerolysin nanopore using a 3D blockage mapping strategy. The standard deviation of current blockade fluctuations (σb ) was proposed as a new supplement to current blockage (Ib /I0 ) and duration time (tD ) to profile the blockage characteristics of single molecules. Although the WT and A21G Aß18-26 are indistinguishable in a traditional Ib /I0 -tD 2D description, ∼87 % of the blockade events can be accurately classified with half reduction of false identification using a combination of Ib /I0 , tD, and σb . This work offers an easy and reliable strategy to promote nanopore sensitivity of peptide mutants, leading to a more precise analysis of pathogenic mutations for developing effective diagnosis and treatment.

Correction: An engineered third electrostatic constriction of aerolysin to manipulate heterogeneously charged peptide transport.

[This corrects the article DOI: 10.1039/D1SC06459B.].

An engineered third electrostatic constriction of aerolysin to manipulate heterogeneously charged peptide transport.

Reading the primary sequence directly using nanopores remains challenging due to the complex building blocks of 20 proteinogenic amino acids and the corresponding sophisticated structures. Compared to the uniformly negatively charged polynucleotides, biological nanopores hardly provide effective ionic current responses to all heterogeneously charged peptides under nearly physiological pH conditions. Herein, we precisely design a N226Q/S228K mutant aerolysin which creates a new electrostatic constriction named R3 in-between two natural sensing regions for controlling the capture and translocation of heterogeneously charged peptides. At nearly physiological pH, the decoration of positive charges at this constriction gives a large velocity of electroosmotic flow (EOF), leading to a maximum 8-fold increase in frequency for the heterogeneously charged peptides with the net charge from +1 to -3. Even the duration time of the negatively charged peptide Aß35-25D4 in N226Q/S228K AeL also rises from 0.07 ± 0.01 ms to 0.63 ± 0.01 ms after introducing the third electrostatic constriction. Therefore, the N226Q/S228K aerolysin nanopore with three electrostatic constrictions realizes the dual goals of both capturing and decelerating heterogeneously charged peptides without labelling, even for the folded peptides.

Amyotrophic lateral sclerosis (ALS) linked mutation in Ubiquilin 2 affects stress granule assembly via TIA-1.

AIMS: The ubiquilin-like protein ubiquilin 2 (UBQLN2) is associated with amyotrophic lateral sclerosis and frontotemporal degeneration (ALS/FTD). The biological function of UBQLN2 has previously been shown to be related to stress granules (SGs). In this study, we aimed to clarify the regulatory relationship between UBQLN2 and SGs. METHODS: In this study, we transfected UBQLN2-WT or UBQLN2-P497H plasmids into cell lines (HEK293T, HeLa), and observed the process of SG dynamics by immunofluorescence. Meanwhile, immunoblot analyses the protein changes of stress granules related components. RESULTS: We observed that ubiquilin 2 colocalizes with the SG component proteins G3BP1, TIA-1, ATXN2, and PABPC1. In cells expressing WT UBQLN2 or P497H mutants, in the early stages of SG formation under oxidative stress, the percentage of cells with SGs and the number of SGs per cell decreased to varying degrees. Between WT and mutant, there was no significant difference in eIF2α activity after stress treatment. Interestingly, the UBQLN2 P497H mutant downregulates the level of TIA-1. In addition, the overexpression of the UBQLN2 P497H mutant inhibited the phosphorylation of 4E-BP1 and affected the nucleoplasmic distribution of TDP-43. CONCLUSIONS: Ubiquilin 2 colocalizes with the SG component proteins G3BP1, TIA-1, ATXN2, and PABPC1. It participates in regulating SG dynamics. And UBQLN2 mutation affects the assembly of stress granules by regulating TIA-1. In addition, the overexpression of the UBQLN2 P497H mutant inhibited the phosphorylation of 4E-BP1 and affected the nuclear and cytoplasmic distribution of TDP-43. These provide new insights into the role of UBQLN2 in oxidative stress and the pathogenesis of ALS.

Improved anti-organic fouling and antibacterial properties of PVDF ultrafiltration membrane by one-step grafting imidazole-functionalized graphene oxide.

At present, membrane fouling is a thorny issue that limits the development of polyvinylidene fluoride (PVDF) composite membrane, which seriously affects its separation performance and service lifespan. Herein, an imidazole-functionalized graphene oxide (Im-GO) with hydrophilicity and antibacterial performance was synthesized, and it was used as a modifier to improve the anti-organic fouling and antibacterial properties of PVDF membrane. The anti-organic fouling test showed that the maximum flux recovery ratios against bovine serum albumin and humic acid were 88.9% and 94.5%, respectively. Conspicuously, the grafted imidazole groups could effectively prevent the bacteria from growing on the membrane surface. It was gratifying that the antibacterial modifier Im-GO was almost not lost from the hybrid membranes even by the ultrasonic treatment, which was different from the conventional release-killing antibacterial agents. Owing to the long-term anti-organic fouling and antibacterial properties, Im-GO/PVDF hybrid membranes exhibit a great application potential in the fields of rough separation and concentration of biomedical products.

Zinc Metal-Organic Framework Growing on the Surface of Fruit Peels and Its Photocatalytic Activity.

The development of water treatment materials using environmentally friendly natural biomasses as substitutes plays an increasingly important role in environmental protection. Zeolitic imidazolate framework-8 (ZIF-8) is often used for the catalytic degradation of dye wastewater, but due to its small particle size, its disadvantage of easy agglomeration prevents it from being fully functional. Herein, we report an efficient method for synthesizing biomasses/ZIF-8 using four different fruit peels as carriers. ZIF-8 nanoparticles are in-situ grown uniformly on their surface. The Brunauer-Emmett-Teller surface area of shaddock peel/ZIF-8 was found to be 752.15 m2g-1. After catalytic activity comparison, the loose shaddock peel/ZIF-8 showed the fastest and most significant degradation efficiency of 94% in methylene blue aqueous solution and could be used multiple times through a simple washing process.

A study of the microwave actuation of a liquid crystalline elastomer.

We present a method for actuating LCE materials by microwave radiation. The microwave actuation performance of a polysiloxane-based nematic liquid crystalline elastomer (LCE) was investigated. The microwave-material interaction caused a dipolar loss, which created a heating effect to trigger the nematic-isotropic transition of the LCE matrix, thus leading to the deformation actuation of the LCE material. This energy conversion from radiant energy to thermal energy provided a contactless pathway to actuate the LCE material without the aid of other components acting as energy converters. The LCE demonstrated rapid maximum contraction upon microwave irradiation, and this microwave-stimulated response was fully reversible when the microwave irradiation was switched off. More importantly, the microwave actuation exhibited superiority relative to photo-actuation, which is the usual method of contactless actuation. The microwaves can penetrate the opaque thick barriers to effectively actuate the LCE due to their strong penetrability; they can also penetrate multiple LCE samples and actuate them almost simultaneously. By taking advantage of the salient features of microwave actuation, a microwave detector system, implementing the LCE as an actuator material, was fabricated. This demonstrated the performance of monitoring microwave irradiation intensities with good sensitivity and convenient manipulation.

Study on the population evolution of Ascaris lumbricoides and Ascaris suum based on whole genome resequencing.

Ascaris lumbricoides and Ascaris suum are parasitic nematodes that mainly parasitize the small intestines of people and pigs, respectively. Ascariasis seriously endangers human health and causes huge economic losses in the pig industry. A. lumbricoides and A. suum have similar morphologies and genetic structures, and occasionally these organisms cross-infect the alternate host. Therefore, their taxonomies are controversial. In this study, the whole genomes of A. lumbricoides (n = 6) and A. suum (n = 6) were resequenced using a HiSeq X Ten sequencing platform. Phylogenetic, principal component, and population structure analyses showed clear genetic differentiation between the two Ascaris populations. Linkage disequilibrium analysis indicated that the A. lumbricoides population was more primitive than the A. suum population. In the selective elimination analysis, 160 and 139 candidate regions were screened in A. lumbricoides and A. suum, respectively, and the selected regions were analyzed by Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. The A. lumbricoides population had no significant enrichment in GO terms, but two KEGG pathways, the RNA degradation and tyrosine metabolism pathways, were significantly enriched. Five GO entries and one KEGG pathway, the alanine, aspartate, and glutamate metabolism signaling pathway, were significantly enriched in the A. suum population. An analysis of the demographic histories of Ascaris populations revealed that A. lumbricoides and A. suum had similar trends in effective population size in different historical periods. Ascaris populations peaked about 1 million years ago and then began to decline. In the last glacial period, they dropped to a historical low and continued at this level until the last glacial maximum. This phenomenon may be associated with the cold climate at that time. This study provides new information on the genetic differentiation, evolutionary relationships, gene functional enrichment, and population dynamics of Ascaris populations, with implications for host differences, evolution, and classification of A. lumbricoides and A. suum.

Mesenchymal stem cells derived from iPSCs expressing interleukin-24 inhibit the growth of melanoma in the tumor-bearing mouse model.

BACKGROUND: Interleukin-24 (IL-24) is a therapeutic gene for melanoma, which can induce melanoma cell apoptosis. Mesenchymal stem cells (MSCs) show promise as a carrier to delivery anti-cancer factors to tumor tissues. Induced pluripotent stem cells (iPSCs) are an alternative source of mesenchymal stem cells (MSCs). We previously developed a novel non-viral gene targeting vector to target IL-24 to human iPSCs. This study aims to investigate whether MSCs derived from the iPSCs with the site-specific integration of IL-24 can inhibit the growth of melanoma in a tumor-bearing mouse model via retro-orbital injection. METHODS: IL-24-iPSCs were differentiated into IL-24-iMSCs in vitro, of which cellular properties and potential of differentiation were characterized. The expression of IL-24 in the IL-24-iMSCs was measured by qRT-PCR, Western Blotting, and ELISA analysis. IL-24-iMSCs were transplanted into the melanoma-bearing mice by retro-orbital intravenous injection. The inhibitory effect of IL-24-iMSCs on the melanoma cells was investigated in a co-culture system and tumor-bearing mice. The molecular mechanisms underlying IL-24-iMSCs in exerting anti-tumor effect were also explored. RESULTS: iPSCs-derived iMSCs have the typical profile of cell surface markers of MSCs and have the ability to differentiate into osteoblasts, adipocytes, and chondroblasts. The expression level of IL-24 in IL-24-iMSCs reached 95.39 ng/106 cells/24 h, which is significantly higher than that in iMSCs, inducing melanoma cells apoptosis more effectively in vitro compared with iMSCs. IL-24-iMSCs exerted a significant inhibitory effect on the growth of melanoma in subcutaneous mouse models, in which the migration of IL-24-iMSCs to tumor tissue was confirmed. Additionally, increased expression of Bax and Cleaved caspase-3 and down-regulation of Bcl-2 were observed in the mice treated with IL-24-iMSCs. CONCLUSION: MSCs derived from iPSCs with the integration of IL-24 at rDNA locus can inhibit the growth of melanoma in tumor-bearing mouse models when administrated via retro-orbital injection.

Reducing the actuation threshold by incorporating a nonliquid crystal chain into a liquid crystal elastomer.

Liquid crystal elastomers (LCEs) are important smart materials that can undergo reversible deformation in response to liquid crystal (LC) phase transitions. A low threshold temperature for LC phase transition is advantageous because the LCE material can be more conveniently actuated by the applied stimulus. In this work, we investigated the effect of a nonliquid crystal chain on the reduction of threshold temperature of the LC phase transition by linking a nonliquid crystal side chain, 4-methoxyphenyl-1-hexenyloxy (MOCH3), to the network backbone of a classical polysiloxane-based side-chain nematic LCE. The nematic-isotropic transition temperature (T ni) of the MOCH3 incorporated nematic LCE was lower than that of the normal nematic LCE without the incorporation of a nonliquid crystal chain by about 27 °C. Compared to the normal nematic LCE or its nanocomposite, the MOCH3 incorporated nematic LCE or its nanocomposite demonstrated more rapid thermo-actuated deformation or photo-actuated deformation, and can be actuated to attain full axial contraction at an obviously lowered temperature or by light with obviously lowered intensity, while the maximum contraction ratio basically did not vary. These research results indicate that some nonliquid crystal chains show potential for improving the characteristics and enhancing the application significance of LCE materials.

The psychological trajectory from diagnosis to approaching end of life in patients undergoing hemodialysis in China: A qualitative study.

BACKGROUND: In China, the number of patients diagnosed with end-stage renal disease has increased rapidly in recent years. Patients undergoing dialysis treatment often experience psychosocial challenges, such as death anxiety, which may potentially cause patients to withdraw from treatment. Nephrology nurses and other practitioners who provide direct care to patients undergoing hemodialysis must understand how these challenges are perceived by patients and affect their daily lives. AIM: This article investigated the psychological trajectory and life experiences of hemodialysis patients to provide complementary guidance for nurses and healthcare practitioners. METHOD: This study utilized a qualitative descriptive phenomenological design. Data were collected by conducting semistructured interviews and analyzed by content analysis.Data were collected through in-depth interviews from May to December 2014. The questions were designed to reveal the life experiences and perspectives of hemodialysis patients. Participants were selected by convenience sampling approach and recruited from outpatients receiving treatment in a blood-purification center in Jiangsu Province, China. RESULTS: Twenty-three participants were recruited. Three stages were extracted from the interview data: (1) afraid stage, (2) adapted stage, and (3) depression stage. Accordingly, three corresponding stages of physiological status were identified: (1) induced stage, (2) stable stage, and (3) severe complications or approaching-end-of-life stage. CONCLUSIONS: Patients undergoing dialysis exhibited differing psychological statuses at different physical stages. Thus, nurses must assess the psychophysiological symptoms of patients and design individual care plans for each stage. Future studies should focus on developing stage-specific nursing-care protocols.