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Objective Chronic pre-dialysis hyponatremia is not rare in maintenance hemodialysis (MHD) patients. However, the association between chronic pre-dialysis hyponatremia and mortality is uncertain due to multiple potential confounders such as hyperglycemia, fluid overload, and malnutrition. This study aimed to more comprehensively evaluate the association between chronic pre-dialysis hyponatremia and clinical outcomes in MHD patients. Methods We analyzed the data of 194 MHD patients with regular real-time measurements of pre-dialysis serum sodium from July 2015 to March 2021. Hyponatremia was defined as SNa ≤ 135 mmol/L and normonatremia as SNa > 135 mmol/L and Results Among the total of 194 patients, 24 patients died and 45 new MACE occurred during a mean 35.2-month follow-up period. The baseline pre-dialysis SNa level was 137.1 ± 2.8 mmol/L (127–144 mmol/L). Kaplan–Meier survival analysis showed that there were no significant differences in all-cause mortality or new MACE between hyponatremia and normonatremia groups according to baseline pre-dialysis SNa or glucose-corrected SNa (gcSNa). The mean values of both TASNa and time-averaged glucose-corrected SNa (TAgcSNa) were 136.9 ± 2.4 mmol/L and 138.3 ± 2.0 mmol/L, respectively. Kaplan–Meier survival analysis showed that patients with pre-dialysis hyponatremia had higher all-cause mortality or new MACE compared with normonatremia patients whether grouped on TASNa or TAgcSNa. Cox models showed an increased risk of all‐cause mortality and new MACE in MHD patients with pre-dialysis hyponatremia based on TASNa or TAgcSNa. Even after full adjustment including time-dependent age and dialysis vintage, gender, diabetes, time-averaged weight gain (TAWG), and serum albumin, patients with pre-dialysis hyponatremia based on TASNa (HR 2.89; 95% CI 1.18–7.04; model 3) or TAgcSNa (HR 5.03; 95% CI 1.87–13.57; model 3) had approximately twofold or fourfold greater risk of all-cause mortality, respectively, compared with those with normonatremia. The risk of new MACE was also significantly elevated in patients with pre-dialysis hyponatremia based on TASNa (HR 3.86; 95% CI 2.13–7.01; model 1) or TAgcSNa (HR 2.43; 95% CI 1.14–5.15; model 1). After adjustment for time-dependent age and dialysis vintage, gender, diabetes, TAWG, and serum albumin, patients with pre-dialysis hyponatremia based on TASNa (HR 2.33; 95% CI 1.16–4.68; model 3) had a higher risk of new MACE compared with those with normonatremia. Conclusions Pre-dialysis time-averaged hyponatremia is independently associated with increased risks of all-cause mortality or new MACE in MHD patients. The baseline SNa level is not a predictor of clinical outcomes due to its variation over time. Hyperglycemia, fluid overload, and malnutrition do not have a significant impact on the risk association between chronic hyponatremia and all-cause mortality or new MACE in MHD patients.

Purpose In prior analyses, blood pressure (BP) was related to rapid kidney function decline (RKFD). However, studies of this relationship in populations of advanced age are lacking. In the present study, we therefore examined the relationship between BP and RKFD in a population of 284 hypertensive Chinese individuals over the age of 80. Patients and methods All study participants were diagnosed with hypertension (systolic BP [SBP] 160-200 mmHg; diastolic BP [DBP] 5mL/min per 1.73 m2 per year during follow-up. The Cox regression models (competing risk models) were used for calculating hazard ratios (HRs) to examine the relationship between SBP, DBP, pulse pressure (PP) and RKFD. Results Over a 3.3-year median follow-up period, 68 study participants (23.9%) were diagnosed with RKFD, while 35 (12.3%) died. After adjusting for confounding variables, we determined that each 10 mmHg rise in SBP and PP was associated with a 34% and 110% increase, respectively, in RKFD risk (adjusted HR: 1.34, 95% confidence interval [CI]: 1.05-1.71 for SBP, p=0.02; HR: 2.10, 95% CI: 0.87-5.08 for PP, p=0.10). In addition, we determined that each 10 mmHg increase in DBP was linked to a 10% reduction in RKFD risk (adjusted HR: 0.90, 95% CI: 0.70-1.14, p=0.37). Conclusion Our results indicate that SBP, but not DBP or PP, is positively correlated with RKFD risk in a very elderly hypertensive Chinese population.

In the current research work, safranine T (ST) was chosen to be the guest, and the preparation of carbon dots (CDs) was done by a one-step hydrothermal methodology with citric acid (CA) to be the p...

Rationale & Objectives Estimated glomerular filtration rate (eGFR) using creatinine and cystatin C (eGFRcr-cys) may be less accurate compared to measured GFR (mGFR) in China than in North America, Europe, and Australia due to variation across regions in their non-GFR determinants. The non-GFR determinants of β2-microglobulin (B2M) and β-trace protein (BTP) differ from those of creatinine and cystatin C. Thus, the average eGFR using all 4 markers (eGFRavg) could be more accurate than eGFRcr-cys in China. Study Design Diagnostic test study. Setting & Participants 1,066 participants in Shanghai and Beijing with creatinine and cystatin C and 666 participants with all 4 filtration markers. Tests Compared Index tests were previously developed equations for eGFR using creatinine, cystatin C, B2M, and BTP and combinations. The reference test was mGFR using plasma clearance of iohexol. We compared the performance of eGFRavg to eGFRcr-cys using the proportion of participants with errors in eGFR >30% of mGFR (1 − P30) and root mean square error (RMSE) of the regression of eGFR on mGFR on the logarithmic scale. We also compared classification and reclassification of mGFR categories using eGFRavg compared to eGFRcr-cys. Outcomes Accuracy was significantly better for eGFRavg (1 − P30 of 10.4% and RMSE of 0.214) compared to eGFRcr-cys (1 − P30 of 13.8% and RMSE of 0.232; P = 0.004 and P = 0.006, respectively). However, improvements in accuracy did not generally translate into significant improvement in classification or reclassification of mGFR categories. Limitations Study population may not be generalizable to clinical settings other than large urban medical centers in China. Conclusions A panel of endogenous filtration markers including B2M and BTP in addition to creatinine and cystatin C may improve GFR estimation in China. Further study is necessary to determine whether GFR estimation using B2M and BTP can be improved and whether these improvements lead to useful clinical applications., Graphical abstract

Background According to statistics, there are about 350 million patients with depression in the world, causing serious social and economic burden. Huanglian Wendan decoction has a certain clinical effect on depression. This study is based on network pharmacology and molecular docking to study the mechanism of Huanglian Wendan decoction in the treatment of depression. Method The active components and action targets of Huanglian Wendan decoction were obtained by searching the literature in database, and the related targets of depression were obtained. protein interaction network was constructed by STRING database, component-target network was constructed by Cytoscape3.9.0 software, enrichment analysis was carried out in KEGG database and R software package clusterprofiler, and molecular docking between active components and key antidepressant targets was carried out by AUTODOCK molecular docking software. Result We obtained 180 active components of Huanglian Wendan decoction and 171 targets related to depression, among which IL-6, JUN, TNF, TP53 and VEGFA may be the key targets of depression. Through the enrichment analysis of KEGG pathway, we obtained 58 signal pathways related to depression. Molecular docking showed that luteolin could form the best complex with IL-6 and TP53, beta-carotene could form the best complex with JUN and VEGFA, and kaempferol could form the best complex with TP53. Conclusion The antidepressant mechanism of Huanglian Wendan decoction may be related to its regulation of inflammatory factors and their activities, and has the potential to be called a complementary or alternative therapy for clinical depression.

Purpose Previous studies have identified that electrocardiographic pattern of left ventricular hypertrophy (ECG LVH) is associated with mortality, but studies of its correlation in the oldest-old hypertensive population is extremely limited. We investigated the correlation between ECG LVH and mortality in a hypertensive Chinese population aged 80 years and older. Patients and methods In this study, we included 284 Chinese participants older than 80 years. All included participants with hypertension (sitting systolic blood pressure [BP] 160 to 200 mmHg; sitting diastolic BP

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of vitamin A for preventing acute LRTIs in children up to seven years of age.

Background. Coronary heart disease is characterized by the formation of arterial plaque. If not taken seriously, it will cause serious consequences such as myocardial infarction and heart failure. Zhishi Xiebai Guizhi Decoction first appeared in “Synopsis of Prescriptions of the Golden Chamber” and is a representative prescription for the treatment of coronary heart disease. This study aims to explain the mechanism of Zhishi Xiebai Guizhi Decoction in the treatment of coronary heart disease through network pharmacology and clinical trials. Methods. We first identified the core compounds of Zhishi Xiebai Guizhi Decoction and their potential targets through TCMSP. Then, We analyzed the molecular targets of Zhishi Xiebai Guizhi Decoction in coronary heart disease with OMIM and GeneCards databases. After the common targets were screened out, we manage to figure out the pathways of these target genes through STRING. Finally, we verify the treatment results in clinical trials. Results. Through network pharmacology analysis, we discovered that several core compounds of Zhishi Xiebai Guizhi Decoction have anti-inflammatory effects and are of great significance to treatment of cardiovascular diseases. The mechanism may be closely related to PPARγ, inflammation, TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway. Clinical trials have also proved the key role of inflammation. Conclusions. Zhishi Xiebai Guizhi Decoction may play a role in treating coronary heart disease by activating PPARγ. TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway are potential mechanisms as well. The application of network pharmacology can provide a novel method for the research of Chinese herbal medicine. We hope that Zhishi Xiebai Guizhi Decoction will be recognized as a complementary or alternative treatment for coronary heart disease.

Kunhao Bai,1,2 Yujing Pan,3 Fanghong Lu,4 Yingxin Zhao,4 Fang Wang,1,5 Luxia Zhang1,5,6 1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People’s Republic of China; 2Department of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, People’s Republic of China; 3Renal Division, Department of Medicine, Peking University International Hospital, Beijing, People’s Republic of China; 4Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China; 5Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, People’s Republic of China; 6Center for Data Science in Health and Medicine, Peking University, Beijing, People’s Republic of China Background: Cognitive function has been suggested to be correlated with mortality, while studies regarding the association among the very elderly population with chronic kidney disease (CKD) are extremely limited.Aim: To explore the association between cognitive function and mortality among the very elderly Chinese population with CKD.Methods: This prospective study included 163 Chinese participants aged 80 years or older with CKD. CKD was defined as an estimated glomerular filtration rate

In this study, we developed a new fluorescent probe (CMM) based on coumarin dye and malononitrile, for highly sensitive and selective detection of hypochlorite ion (ClO−). CMM showed a 45-fold fluorescence enhancement at 459 nm in the presence of ClO− and displayed an excellent selectivity over other competing species. The probe featured a fast response time (

Objective: To explore the influence of traditional Chinese medicine (TCM) five-element music therapy on the expression of type II Ca2+/calmodulin-dependent protein kinase (CaMK-II) in calmodulin signal pathway in cerebral hippocampus tissues in rats with post-stroke depression (PSD), so as to explain the action mechanism of five-element music therapy in the treatment of PSD. Methods: A total of 40 male SD rats with body mass of (220 ± 30) g were selected as study subjects and randomized into normal group, PSD model group, music therapy group, music therapy + acupuncture group and Fluoxetine group, 8 rats in each group. After one week of adaptive feed, PSD models were made. The treatment started on post-molding d19. Music therapy group and music therapy + acupuncture group were treated for 7 days as one cycle, with 2 days of rest between treatment cycles, for consecutive 2 cycles, while Fluoxetine group was treated with continuous gavage since start of treatment, qd, until the end of treatment. Hippocampus tissues were collected from rats’ brains, after which quantitative polymerase chain reaction (qPCR) was used to detect the expression of CaMKⅡgene, while western blot (WB) to detect the expression of CaMKⅡprotein in rats’ hippocampi. Results: Relative to normal group, model group was evidently lower in expression of CaMKⅡgene and protein (P

Kunhao Bai,1,2,* Yujing Pan,3,* Fanghong Lu,4 Yingxin Zhao,4 Jinwei Wang,1,2 Luxia Zhang1,2 1Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People’s Republic of China; 2Peking University Institute of Nephrology, Peking University Health Science Center, Beijing, People’s Republic of China; 3Renal Division, Department of Medicine, Peking University International Hospital, Beijing, People’s Republic of China; 4Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China *These authors contributed equally to this work Background: Early-stage chronic kidney disease has been suggested to be correlated with cognitive decline, but the association has rarely been explored in the oldest old.Subjects and methods: This prospective study included 284 Chinese participants aged 80years or older with serum creatinine levels

Aim Non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to be associated with adverse effects including kidney injury, while relevant studies from developing countries are limited. We aimed to explore the status of NSAIDs use in China, as well as cross-sectional association between NSAIDs intake and presence of chronic kidney disease (CKD). Methods A national representative sample of 47 204 adults in China was used. Prevalence of regular NSAIDs use was reported. Age- and sex- matched controls of NSAIDs users were then selected. The association between NSAIDs use and kidney injury were analyzed using logistic regression. Results Altogether 1129 participants reported regular use of NSAIDs, with the adjusted prevalence of 3.6% (95% CI, 3.2%–3.9%). And 76.9% of them (n = 868) had taken phenacetin-containing analgesics, with an adjusted prevalence of 3.2% (95% CI, 2.9%–3.5%). After adjusting for potential confounders, long-term NSAIDs intake (≥48 months) was associated with eGFR< 60 mL/min per 1.73 m2, with an OR of 2.36 (95% CI, 1.28–4.37). Conclusion Regular use of NSAIDs, especially phenacetin-containing drugs, is prevalent in China. And long-term NSAIDs intake (≥48 months) was independently associated with reduced renal function.

Non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to be associated with adverse effects including kidney injury, while relevant studies from developing countries are limited. We aimed to explore the status of NSAIDs use in China, as well as cross-sectional association between NSAIDs intake and presence of chronic kidney disease (CKD).A national representative sample of 47,204 adults in China was used. Prevalence of regular NSAIDs use was reported. Age- and sex- matched controls of NSAIDs users were then selected. The association between NSAIDs use and kidney injury were analyzed using logistic regression.Altogether 1129 participants reported regular use of NSAIDs, with the adjusted prevalence of 3.6% (95% CI, 3.2%-3.9%). And 76.9% of them (n = 868) had taken phenacetin-containing analgesics, with an adjusted prevalence of 3.2% (95% CI, 2.9%-3.5%). After adjusting for potential confounders, long-term NSAIDs intake (≥ 48 months) was associated with eGFR60 mL/min per 1.73 m2, with an OR of 2.36 (95% CI, 1.28-4.37).Regular use of NSAIDs, especially phenacetin-containing drugs, is prevalent in China. And long-term NSAIDs intake (≥ 48 months) was independently associated with reduced renal function.