腹膜透析与高通量血液透析对老年终末期肾病患者氧化应激水平及细胞免疫功能的影响

目的比较腹膜透析(PD)与高通量血液透析(HFHD)对老年终末期肾病患者氧化应激状态、免疫功能的影响。方法选取2016年1月—2018年6月在陕西省核工业二一五医院肾内科血液净化中心进行规律透析治疗的维持性透析患者140例,根据不同透析方法分为PD组和HFHD组,每组70例。PD组采用PD治疗;HFHD组采用高通量血液透析治疗。观察并比较两组透析前后氧化应激状态、细胞免疫功能及治疗期间并发症发生情况。结果HFHD组治疗前后超氧化物歧化酶(SOD)、谷胱甘肽氧化物酶(GSHPx)及血清丙二醛(MAD)的差值高于PD组(P<0.05)。HFHD组治疗前后CD^+4、CD^+3及CD^+4/CD^+8的差值高于PD组(P<0.05);两组治疗前后CD^+8的差值比较,差异无统计学意义(P>0.05)。两组患者透析治疗期间心血管意外、脑血管意外、感染和营养不良等并发症发生率比较,差异无统计学意义(P>0.05)。结论相对于PD,HFHD能更有效地降低老年终末期肾病患者的氧化应激水平,提高机体免疫功能。

A consistency contribution based bayesian network model for medical diagnosis

This paper presents an effective Bayesian network model for medical diagnosis. The proposed approach consists of two stages. In the first stage, a novel feature selection algorithm with consideration of feature interaction is used to get an undirected network to construct the skeleton of BN as small as possible. In the second stage for greedy search, several methods are integrated together to enhance searching performance by either pruning search space or overcoming the optima of search algorithm. In the experiments, six disease datasets from UCI machine learning database were chosen and six off-the-shelf classification algorithms were used for comparison. The result showed that the proposed approach has better classification accuracy and AUC. The proposed method was also applied in a real world case for hypertension prediction. And it presented good capability of finding high risk factors for hypertension, which is useful for the prevention and treatment of hypertension. Compared with other methods, the proposed method has the better performance.

From Osteoblast to Osteoclast: New Insights of Yin-Yang Theory in Bone Remodeling

Yin-Yang theory plays critical role in traditional Chinese medicine(TCM) science. However, there are many competing interpretations of YinYang theory in the context with the development in biology, and no consensus has been established. Here we first propose that osteoblast should be regarded as Yin, while osteoclast should be considered as Yang in bone remodeling compartment(BRC). Our conceptions are consistent with the following key findings: 1)osteoblast and osteoclast both derive from the embryonic ectoderm; 2)osteoblast and osteoclast work collaboratively in BRC to maintain bone homeostasis; 3)the activities of osteoblast and osteoclast are coupled to remain dynamic balance;4)osteoblast and osteoclast exert their function in ceaseless successions. Moreover, we argue that Yin-Yang relationships exist between osteoblast and osteoclast: osteoblast secretes the receptor activator for nuclear factor-κB ligand(RANKL) and the monocyte/macrophage colony-stimulating factor(M-CSF) and osteoprotegerin(OPG) to positively or negatively regulate osteoclast differentiation and function.Meanwile, osteoclast and bone resorption in turn release cytokines, such as transforming growth factor-β(TGF-β), insulin-like growth factor-1(IGF-1) from bone matrix, to regulate osteoblast differentiation and function. Next, the unlimited division of Yin-Yang can be applied to divide sublevel of Yin-Yang inside osteoblast or osteoclast. Finally, Yin-Yang relationship of osteoblast and osteoclast is relative. Therefore, we come into the conclusion that the relationships between osteoblast and osteoclast as established in contemporary biology reflect the classic Yin-Yang in bone remodeling. The new Yin-Yang concepts of osteoblast and osteoclast may strengthen basic theory and clinical practice in TCM.

New Insights into the Molecular Basis of Kidney Governing Bone Theory

Kidney governing bone theory plays an important role in treating bone metabolic disease such as osteoporosis, and many tonifying kidney prescriptions/herbs are widely used in Traditional Chinese Medicine(TCM). However, the exact biological basis of kidney governing bone theory in the context of new advances in biology is still not fully established. In this paper, the content of kidney governing bone theory in biology has been fully demonstrated from different aspects. We first propose that bone and kidney mutually affect each other in pathology and physiology, particularly through homeostasis of calcium, phosphorus and fibroblast growth factor-23(FGF-23). Next, we identify that tonifying kidney prescriptions/herbs exert bone protective effects, thus treating osteoporosis by regulating bone formation and bone resorption.Furthermore, the exact molecular mechanisms of tonifying kidney prescriptions, herbs and their effective components in treating osteoporosis have been systematically reviewed. Finally, we come into the conclusion that kidney regulating bone mineral homeostasis, bone protective effects of tonifying kidney herbs and regulatory effects on bone homeostasis are all the manifestations of kidney governing bone theory.Therefore, the new insights into kidney governing bone theory in biology will promote the development of clinical practices, and drugs discovery in treating osteoporosis.

Septation of the Intrapericardial Arterial Trunks in the Ear Human Embryonic Heart

Background： Outflow tract （OFT） septation defects are a common cause of congenital heart disease. Numerous studies have focused on the septation mechanism of the OFT, but have reported inconsistent conclusions. This study, therefore, aimed to investigate the septation of the aortic sac and the OFT in the early embryonic human heart. Methods： Serial sections of 27 human embryonic hearts from Carnegie stage （CS） 10 to CS19 were immunohistochemically stained with antibodies against α-smooth muscle actin （α-SMA） and myosin heavy chain. Results： At CS10-CS11, the OFT wail was an exclusively myocardial structure that was continuous with the aortic sac at the margin of the pericardial cavity. From CS13 onward, the OFT was divided into nonmyocardial and myocardial portions. The cushion formed gradually, and its distal border with the OFT myocardium was consistently maintained. The aortic sac between the fourth and sixth aortic arch arteries was degenerated. At CS16, the α-SMA-positive aortopulmonary septum formed and fused with the two OFT cushions, thus septating the nonmyocardial portion of the OFT into two arteries. At this stage, the cushions were not fused. At CS19, the bilateral cushions were fused to septate the myocardial portion of the OFT. Conclusions： Data suggest that the OFT cushion is formed before the aortopulmonary septum is formed. Thus, the OFT cushion is not derived from the aortopuhnonary septum. In addition, the nonmyocardial part of the OFT is septated into the aorta and pulmonary trunk by the aortopulmonary septum, while the main part of the cushion fuses and septates the myocardial portion of the OFT.

Bilateral Lower Limb and Abdominal Elephantiasis Due to Erysipelas

To the Editor： Elephantiasis results from chronic lymphedema and is characterized by gross enlargement of the arms, legs, or genitalia. It occurs due to various obstructive diseases of the lymphatic system. The most common form of lymphedema is secondary lymphedema involving resection or ablation of the regional lymph nodes by surgery, radiation, tumor invasion, direct trauma, or an infection. We present an unusual case of bilateral lower limb and abdominal elephantiasis due to extensive lymph node destruction by erysipelas.