High-resolution neutronics model for ^(238)Pu production in high-flux reactors

We proposed and compared three methods(filter burnup,single energy burnup,and burnup extremum analysis)to build a high-resolution neutronics model for 238Pu production in high-flux reactors.The filter burnup and single energy burnup methods have no theoretical approximation and can achieve a spectrum resolution of up to~1 eV,thereby constructing the importance curve and yield curve of the full energy range.The burnup extreme analysis method combines the importance and yield curves to consider the influence of irradiation time on production efficiency,thereby constructing extreme curves.The three curves,which quantify the transmutation rate of the nuclei in each energy region,are of physical significance because they have similar distributions.A high-resolution neutronics model for ^(238)Pu production was established based on these three curves,and its universality and feasibility were proven.The neutronics model can guide the neutron spectrum optimization and improve the yield of ^(238)Pu by up to 18.81%.The neutronics model revealed the law of nuclei transmutation in all energy regions with high spectrum resolution,thus providing theoretical support for high-flux reactor design and irradiation production of ^(238)Pu.

Mathematical Modeling of the Dynamic Exchange of Solutes in a Prototype Hemodialyzer

Hemodialysis (HD) is one type of procedure for eliminating toxic chemicals and infusing bicarbonate in patients with end-stage renal disease (ESRD). Research and development in the hemodialyzer industry have, hitherto, depended mostly on empirical evidence to optimize HD therapy. This is often costly and involves numerous clinical trials. Developing a comprehensive time-dependent mathematical model to examine the dynamic exchange of solutes (HCO-3 and pCO2), blood pH and H+ ions in a prototype hollow-fiber hemodialyzer is essential in optimizing future design and improvement. A comprehensive mathematical model which is represented by a coupled set of transport equations and delineates the blood and dialyzate compartments of the hemodialyzer, and includes bicarbonate-buffering reaction in the blood channel and bicarbonate replenishment mechanism in the dialysate, is used to describe the time-dependent bulk concentration and exit concentration of solutes, blood pH and H+ ions in the hollow-fiber prototype hemodialyzer. A numerical simulation of the model is used to test several time-dependent bulks and exit concentration profiles of solutes in the blood and dialyzate. Results obtained from the numerical solution of the model show the bulk and exit concentrations of solute at various distances along the blood and dialyzate channels at different times. This modeling exercise will also allow us in our next study to examine some physical mechanisms of the hemodialyzer.

Clinical Application of PES Membrane Dialyzer

Objective The dialysate membrane can be classified into acetate membrane and synthetic membrane,while the latter can be further divided into polysulfone,polyacrylonitrile,etc.Polyethersulfone membrane is high molecular membrane material with excellent biocompatibility,stable mechanical properties,high temperature and pressure resistance,and good cleaning performance,which has been applied for more than 10 years.This trial is to assess the safety and efficacy of hollow polysulfone membrane fiber dialyzer with pattern number Enttex^(TM)-16LF(E60)for hemodialysis in patients with acute or chronic renal failure due to multiple factors.Methods Totally 76 patients receiving maintenance hemodialysis were included in a two-site,random,open label,two-stage,positive crossover and non inferiority validation study.The clinical efficacy and safety of the test device were observed,which was a hollow fiber dialyzer produced by Guangzhou Enttex Medical Products Co.,Ltd.,with polyethersulfone membrane imported from Germany.It was a low flux dialyzer with the pattern number of EnttexTM-16LF(E60).Inclusion criteria:①patients with acute or chronic renal failure due to various reasons who needed hemodialysis;②18 to 80 years old,gender unlimited;③patients who received stable dialysis for more than 3 months,regular hemodialysis 3 times a week,4 h at each time,blood flow rate of 200~350ml/min;④using bicarbonate dialysate at a flow rate of 500ml/min;⑤patients with arteriovenous fistula or who received artificial blood vessel puncture dialysis;received anticoagulation by heparin or low molecular weight heparin.Exclusion criteria:①patients needing heparin free dialysis for severe anemia,tumor and active bleeding;②patients with severe cardiac(gradeⅢcardiac function),hepatic(severe hepatitis and cirrhosis)and pulmonary diseases(severe respiratory failure).Results Comparison of parameters,including the changes of Kt/V,general creatinine and urea clearance rates and URR(urea reduction rate)shows no statistical significance in differences between the two devices,indicating that the test and control devices can equally and effectively eliminate toxins including creatinine and urea,etc.PPP and MITTP results are consistent.Comparison of ultrafiltration rates between two groups of patients shows no statistical difference.PPP and MITTP results are consistent,indicating that both the test device and control device can effectively eliminate water.In MITTP,electrolytes including K^+,Na^+,Cl^-,Ca^2+,HCO3^-,etc.show no statistical significance in difference between the test and control devices before and after dialysis(P>0.05).After treating by using test and control devices,body weight,serum potassium and phos-phorus all significantly decrease(P<0.001);serum Ca^2+,PO2,PCO2and HCO3^-all significantly increase(P<0.001).These results indicate that both the test and control devices can effectively eliminate serum potassium and phosphorus,and eliminate excess water in body,maintain the balance between liquid and electrolytes in patients.PPP and MITTP results are consistent.Conclusion This clinical trial confirms that hollow polyethersulfone membrane fiber dialyzer can be safely and effectively used in hemodialysis therapy.

The Clinical Randomized Controlled Trial on the Safety and Efficacy of Polyethersulfone Membrane Dialyzer in the Maintenance of Hemodialysis Patients

Objective:To observe the safety and efficacy of polyethersulfone membrane dialyzer used by chronic renal failure patients in clinical maintenance hemodialysis(MHD).Methods:From January to February 2009,36 patients were recruited from Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.The experiment was approved by the ethnical committee of Xinhua Hospital and under permissions from patients.All the patients were randomized into polyethersulfone group(PES,n=18) and polysulfone group(PS,n=18).Hemodialysis was given by using Fresenius 4008S capacity-controlled dialyser and ultra-purified bicarbonate dialysate,more than 3.5 h each time,three times per-week,followed by heparin anticoagulation for a week,three times totally.Changes in blood urea nitrogen(BUN),serum creatinine(Scr),phosphate(P2+),hemoglobin and albumin levels were determined for the efficacy and safety evaluation.Results:The serum BUN,Scr and P2+ concentrations significantly reduced after hemodialysis with different dialyzers,and the decrease amplitude of two groups was equivalent(P>0.05).The clearance rate of the serum BUN and Scr had no significant difference among two groups(P>0.05).The clearance rate(ml/min) of the serum P2+ was 144.57±27.83 v.s.117.15±22.77 in two groups.The clearance rate of the serum P2+ in PES group was more than that in PS group,and the difference was significant between two groups(P=0.0001).It was indicated that PES and PS membrane could efficiently eliminate serum micromolecule solute in MHD patients,so PES membrane excelled PS membrane in eliminating serum P2+.The hemodialysis safety index,for example serum hemoglobin,albumin and blood pressure,had no significant difference between the two groups before and after hemodialysis(P>0.05).Conclusion:The efficacy and safety of the PES hollow fiber membrane dialyzer is equivalent to that of the imported PS membrane dialyzer in hemodialysis for MHD patients.The PES membrane excels PS membrane in eliminating serum P2+.

安徽省血液透析患者尿毒症瘙痒患病率调查及影响因素分析

目的探究安徽省维持性血液透析(MHD)患者尿毒症瘙痒(UP)患病率及其影响因素。方法收集在安徽省27家血透中心进行MHD的患者,并对其临床资料进行比较。结果共3025例MHD患者,UP患病率为63.3%,其中轻度UP 55.9%,中重度UP 7.4%。皖南、皖中以及皖北总UP患病率分别为75.4%、63.6%以及57.9%。年龄段在≤30岁、31~50岁、51~70岁以及≥71岁对应总UP患病率分别为53.5%、59.8%、65.4%以及65.9%。总UP和中重度UP患病率随着年龄的增加而增加(P<0.01)。UP组患者年龄、透析龄、高血压比例、25-α羟维生素D_(3)[25(OH)D_(3)]水平、使用低通量透析器比例以及使用含钙磷结合剂患者的比例高于无UP组,而UP组透析后舒张压、血红蛋白水平、血液透析滤过(>2周/次)比例低于无UP组(P<0.05)。中重度UP组患者年龄、高血压比例、糖尿病比例均高于轻度UP组,而非含钙磷结合剂使用比例低于轻度UP组(P<0.05)。二分类Logistic回归分析表明高25(OH)D_(3)水平与MHD患者UP的高风险相关(P<0.05),高通量透析器的使用与MHD患者UP的低风险相关(P<0.05)。结论安徽省维持性血液透析患者UP患病率为63.3%。皖南地区的UP患病率最高,总UP和中重度UP患病率随着年龄的增加而增加。高25(OH)D_(3)水平是MHD患者UP发生的危险因素,而高通量透析器的使用能够降低MHD患者UP风险。

不同时间点追加肝素钠盐水对透析器重度凝血改善作用的回顾性研究

目的探究不同时间点追加肝素钠盐水对维持性血液透析(MHD)患者透析中发生透析器重度凝血的改善作用。方法纳入2021年11—至2022年11月中国中医科学院西苑医院透析中心进行MHD治疗,在治疗开始2h内发生透析器重度凝血的患者,查阅电子病历收集患者基线资料、透析中各参数资料、相关病例记录。根据追加肝素钠的时间点分为治疗组和对照组两组。两组均采用先回冲200mL生理盐水,治疗组采用再次引血前通过透析机肝素泵追加浓度为625U/mL(5mg/mL)的肝素钠盐水1 mL并给予维持量1 mL/h,直至透析结束前30min停止;对照组采用再次引血后通过同种方法追加相同剂量肝素钠盐水。比较两组流程对重度凝血透析器的改善作用。结果本研究共纳入12例MHD患者,治疗组6例患者均完成4h正常透析治疗,对照组中4例完成正常治疗,2例因透析器及血管路重度凝血提前回血下机。下机后凝血等级评估,治疗组中,4例患者无凝血为0级;2例患者透析器1级凝血。对照组中,2例透析器为3级凝血,动脉壶、静脉壶均存在少量凝血块;3例透析器为2级凝血;1例透析器为1级凝血。凝血等级评估经比较两组存在统计学差异(P<0.05)。结论于再次引血前追加肝素钠盐水的方法,可以有效缓解透析器重度凝血的状况,恢复透析器的功能,避免血液丢失,优于再次引血开始体外循环后再追加的方式。

血液透析机预防性维护对设备不良事件故障发生情况的改善成果

目的探讨对于血透设备,实施预防性维护保养后,能否产生积极的效果,减少故障发生率和降低不良事件以及保障患者的医疗服务,和医疗设备预防性维护保养的必要性。方法对2020年至2022年血透设备故障发生情况的鱼骨图总结分析,寻找故障发生情况和不良事件产生之间的关系,及实施项目管理(PM)后不良事件和维修费用的对比进行探讨。结果数据显示,预防性维护保养对设备的故障发生情况和不良事件有改善作用,积极地减少了故障发生次数。结论工程师应积极从被动维修转变为主动维护保养,实施预防性维护,消除不应且不必要发生的故障,确保设备的运行稳定性,减少设备不良事件的发生。

血液透析机预防性维护保养重要性分析

本文阐述了血液透析机的基本原理和工作原理。以高邮市人民医院不同型号的血液透析机发生的故障作为案例分析,相应地引出平时对于血液透析机的预防性维护保养的重要性,并以图表形式表明预防性维护保养带来的可观效果。血透机工程师应做到被动维修到主动预防维护的转变,确保血透机工作性能的稳定性,消除不应且不必要存在的故障,保障透析的正常运行。而此操作对于血透机故障率降低和工程师的临床技术价值有着重要意义。

The Adverse Event Profile in Patients Treated with Transferon^TM(Dialyzable Leukocyte Extracts): A Preliminary Report

Background: Dialyzable leukocyte extracts (DLE) are heterogeneous mixtures of peptides less than 10 kDa in size that are used as immunomodulatory adjuvants in immune-mediated diseases. TransferonTM is DLE manufactured by National Polytechnic Institute (IPN), and is registered by Mexican health-regulatory authorities as an immunomodulatory drug and commercialized nationally. The proposed mechanism of action of TransferonTM is induction of a Th1 immunoregulatory response. Despite that it is widely used, to date there are no reports of adverse events related to the clinical safety of human DLE or TransferonTM. Objective: To assess the safety of TransferonTM in a large group of patients exposed to DLE as adjuvant treatment. Methods: We included in this study 3844 patients from our Clinical Immunology Service at the Unit of External Services and Clinical Research (USEIC), IPN. Analysis was performed from January 2014 to November 2014, searching for clinical adverse events in patients with immune-mediated diseases and treated with TransferonTM as an adjuvant. Results: In this work we observed clinical nonserious adverse events (AE) in 1.9% of patients treated with TransferonTM (MD 1.9, IQR 1.7 - 2.0). AE were 2.8 times more frequently observed in female than in male patients. The most common AE were headache in 15.7%, followed by rash in 11.4%, increased disease-related symptomatology in 10%, rhinorrhea in 7.1%, cough in 5.7%, and fatigue in 5.7% of patients with AE. 63% of adverse event presentation occurred from day 1 to day 4 of treatment with TransferonTM, and mean time resolution of adverse events was 14 days. In 23 cases, the therapy was stopped because of adverse events and no serious adverse events were observed in this study. Conclusion: TransferonTM induced low frequency of nonserious adverse events during adjuvant treatment. Further monitoring is advisable for different age and disease groups of patients.

High-flux electron beams from laser wakefield accelerators driven by petawatt lasers

Laser wakefield accelerators （LWFAs） are considered to be one of the most compeuuve next- generation accelerator candidates. In this paper, we will study the potential high-flux electron beam production of an LWFA driven by petawatt-level laser pulses. In our three-dimensional particle-in-cell simulations, an optimal set of parameters gives -40 nC of charge with 2 PW laser power, thus -400 kA of instantaneous current if we assume the electron beam duration is 100 fs. This high flux and its secondary radiation are widely applicable in nuclear and QED physics, industrial imaging, medical and biological studies.

Progress of high-flux hemodialysis in clinical application, complications and treatment

Hemodialysis is the main method of clinical renal replacement therapy, and its effectiveness and safety have been widely confirmed. High-flux hemodialysis, as a constantly updating new mode in the field of blood purification, has effectively improved the efficiency of hemodialysis and reduced the incidence of hemodialysis complications. High-flux hemodialysis has been widely used in clinical practice, and mainly plays its role through adsorption, convection and dispersion. High-flux hemodialysis has some advantages not possessed by conventional hemodialysis, including protecting injured renal function, reducing the incidence of cardiovascular complications in hemodialysis patients, improving the patients' nutritional status, reducing the occurrence of renal osteopathy and delaying the occurrence time of dialysis-associated amyloidosis. However, high-flux hemodialysis also has some limitations, such as the elimination of drugs and nutrients, and the backfiltration caused by increased pressure on the dialysis membrane and dialysate side. In this review, the related progress of high-flux hemodialysis in clinical application, mechanism, complications and treatment are discussed in order to provide a reference for its more rational clinical use.

Effects of High-Flux Hemodialysis on Inflammatory Factors and Nutritional Status in Patients with Severe Renal Failure

Objective:To investigate the effects of high-flux hemodialysis on inflammatory factors and nutritional status in patients with severe renal failure.Methods:A total of 72 patients with severe renal failure who underwent dialysis treatment in the hospital from January 2017 to March 2019 were selected as the research subjects,and they were randomly divided into 2 groups with 36 patients each.The control group underwent low-flux hemodialysis,and the observation group underwent high-flux hemodialysis.The levels of inflammatory factors and nutritional status were compared between the two groups after treatment.Results:The levels of various inflammatory factors in the observation group were lower than those in the control group and the nutritional indexes were higher than those in the control group after 4 weeks of treatment(P<0.05).Conclusion:High-throughput hemodialysis in patients with severe renal failure can significantly reduce the levels of inflammatory factors and improve nutritional status.

Mapping the Wall-Region Dynamics of High-Flux Gas-Solid Riser Using Scaling Regions from the Solid Concentration Time Series

An experimental study of the gas-solid flow dynamics in the high-flux CFB riser was accomplished by analysing the scaling regions from solid concentration signals collected from a 76 mm internal diameters and 10 m high riser of a circulating fluidized bed (CFB) system. The riser was operated at 4.0 to 10.0 m/s gas velocity and 50 to 550 kg/m2s solids flux. Spent fluid catalytic cracking (FCC) catalyst particles of 67 μm mean diameter and 1500 kg/m3 density together with 70% to 80% humid air was used. Solid concentration data were analysed using codes prepared in FORTRAN 2008 to get correlation integrals at different embedding dimensions and operating conditions and plot their profiles. Scaling regions were identified by visual inspection method and their location on planes determined. Scaling regions were analysed based on operating conditions and riser spatial locations. It was found that scaling regions occupy different locations on the plane depending on the number of embedding dimensions and operating conditions. As the number of embedding dimensions increases the spacing between scaling regions decreases until it saturates towards higher embedding dimensions. Slopes of scaling regions increases with embedding dimensions until saturation where they become constant. Slopes of scaling regions towards the wall decrease while the number of scaling regions for a particular profile increases. The span of the scaling region is wider at the initial values of hyperspherical radius than its final values. The scaling regions in some flow development sections show multifractal behaviour for each embedding dimension which manifests into visible basin which is defined in this study as multifractal basin. Further, the end points of the scaling region for each correlation integral profile differ from each other as the embedding dimension changes. This study suggests that identification of scaling region by visual inspection method is useful in understanding the gas-solid flow dynamics in the High-Flux CFB riser system. Further studies are recommended on risers of different diameters and heights operated at low and high solid fluxes and different gas velocities for comparison or usage of time series of different signal types like pressure fluctuations.

Analysis of Flow Dynamics in the High-Flux Gas-Solid Riser Using Trajectory Distances across Attractors Reconstructed from Solid Concentration Signals

The study of the entrance and wall dynamics of a high-flux gas-solid riser was conducted using trajectory distances of the reconstructed attractors from solid concentration signals collected from a 76 mm internal diameters and 10 m high riser of a circulating fluidized bed (CFB) system. The riser was operated at 4.0 to 10.0 m/s gas velocity and 50 to 550 kg/m2s solids flux. Spent fluid catalytic cracking (FCC) catalyst particles with 67 μm mean diameter and density of 1500 kg/m3 together with 70% to 80% humid air was used. Solid concentration data were analyzed using codes prepared in FORTRAN 2008 to get trajectories of the reconstructed attractors and their distances apart. Trajectory distances were found to increase from the centre towards the wall indicating the expansion of the attractor. The probability density function (PDF) of the trajectory distances changes from single peak at the centre to multiple peaked profiles in the wall region. Multiple peaked profiles indicate multifractal flow behaviours. Cumulative distribution functions (CDF) of the trajectory distances changes from single S-shaped at the centre to multiple S-shaped profiles in some locations of the wall region indicating multifractal flow behaviours. The PDF distribution of these distances at the entrance section and in the wall region forms different types of statistical distributions showing differences in gas-solid flow structures in various spatial locations of the wall region and the entrance sections. Most of the distributions at the centre fall under the Gumbel max distribution for all flow development sections of the riser, especially at air velocities of 5.5 m/s and 8 m/s showing uniform flow structures. Further, it was found that increase of the number of the phase space reconstruction embedding dimension increases the trajectory distances between the state vectors leading to the expansion of the attractor.

Mapping Correlation Dimension along the Wall Region of a High-Flux Gas-Solid Riser Using Embedded Solid Concentration Time Series

Analysis of the entrance and wall dynamics of a high-flux gas-solid riser was conducted using embedded solid concentration time series collected from a 76 mm internal diameter and 10 m high riser of a circulating fluidized bed (CFB) system. The riser was operated at 4.0 to 10.0 m/s air velocity and 50 to 550 kg/m2s solids flux of spent fluid catalytic cracking (FCC) catalyst particles with 67 μm mean diameter and density of 1500 kg/m3. Data were analyzed using prepared FORTRAN 2008 code to get correlation integral followed by determination of correlation dimensions with respect to the hyperspherical radius and their profiles, plots of which were studied. It was found that correlation dimension profiles at the centre have single peak with higher values than the wall region profiles. Towards the wall, these profiles have double or multiple peaks showing bifractal or multifractal flow behaviors. As the velocity increases the wall region profiles become random and irregular. Further it was found that, as the height increases the correlation dimension profiles shift towards higher hyperspherical radius at the centre and towards lower hyperspherical radius in the wall region at r/R = 0.81. The established method of mapping correlation dimension profiles in this study forms a suitable tool for analysis of high-flux riser dynamics compared to other analyses approaches. However, further analysis is recommended to other gas-solid CFB riser of different dimensions operated at high-flux conditions using the established method.

Effect of high-flux and low-flux hemodialysis on the side metabolites and cytokines in patients with uremia

Objective:To study the effect of high-flux and low-flux hemodialysis on the side metabolites and cytokines in patients with uremia.Methods: A total of 50 patients with uremia who accepted high-flux hemodialysis and 140 patients with uremia who accepted low-flux hemodialysis in our hospital between March 2015 and March 2016 were selected and included in high-flux group and low-flux group respectively. Before and after dialysis, serum was collected respectively to determine the levels of side metabolites, calcium-phosphorus metabolism indexes and cytokines.Results: 3 months after dialysis, serum Ca levels of two groups of patients were not significantly different from those before dialysis while BUN, Scr,β2-MG, sTfR, P, PTH and AKP levels were significantly lower than those before dialysis;3 months after dialysis, serum BUN, Scr and Ca levels of high-flux group were not significantly different from those of low-flux group whileβ2-MG, sTfR, P, PTH, AKP, TNF-α, IL-1β, IL-6, IL-8 and IL-10 levels were significantly lower than those of low-flux group.Conclusion:Compared with low-flux hemodialysis, high-flux hemodialysis treatment of uremia can more effectively remove middle molecular and macromolecular toxins, correct calcium-phosphorus metabolism disorder and relieve micro-inflammatory state.

透析器溶血试验方法改进研究

目的对当前的溶血试验方法进行优化,使其可甄别有不良事件发生的透析器。方法从两方面优化现有的溶血试验方法,一方面将中空纤维与红细胞悬液的静态接触时间从60min增加到100min,另一方面增加静态接触后将中空纤维在红细胞悬液中滑动20次的动态接触。用改进后的方法对2种有不良事件发生过的透析器及另外3种透析器进行溶血试验。结果2种有不良事件发生透析器的溶血率远大于其余3种透析器,改进后的溶血试验方法可甄别出2种不良事件透析器。结论优化后的溶血试验方法对高危透析器有一定的甄别作用。

基于高效液相色谱-三重四极杆质谱联用方法评价透析器对蛋白结合类尿毒症毒素的清除效果

建立了一种评价透析器对硫酸吲哚酚、硫酸对甲酸和马尿酸3种蛋白结合类尿毒症毒素(PBUTs)清除效果的高效液相色谱-三重四极杆质谱联用方法。配制与透析患者体内PBUTs浓度相当的模拟液代替血液,进行透析模拟治疗,取透析前后的模拟液作为待测样品。样品经乙腈沉淀蛋白和超滤离心处理后,采用Hypersil GOLD VANQUISH C18(100 mm×2.1 mm,1.9μm)色谱柱分离,以5 mmol/L乙酸铵溶液和甲醇为流动相进行梯度洗脱,负离子选择反应监测(SRM)模式扫描,内标法进行定量分析。3种PBUTs在25~1 000 ng/mL范围内线性关系良好,相关系数(r)均大于0.99,定量下限为25 ng/mL;在75、250、750 ng/mL加标水平下,回收率为92.5%~114%,日内、日间相对标准偏差(RSD)均小于5.0%,基质效应为80.6%~105%。该方法成本低、前处理简单、分析速度快、回收率高,适用于透析器对PBUTs清除效果的评价。

16P低通量透析器与16H高通量透析器治疗对尿毒症患者疗效、肾功能及代谢情况的影响

目的:分析并比较16P低通量透析器与16H高通量透析器治疗对尿毒症患者的疗效、肾功能及代谢情况的影响。方法:选取2019年1月至2021年10月成飞医院收治的86例尿毒症患者作为此次研究对象,采用随机数表法进行分组,用不透光的信封进行分配隐藏,将患者分为对照组、研究组,各43例。对照组采用16P低通量透析器进行血液透析,研究组采用16H高通量透析器进行血液透析。对比两组的临床疗效以及治疗前、治疗3个月后的肾功能、代谢情况。结果:研究组的临床总有效率高于对照组(P<0.05)。治疗前,两组的肾功能指标及代谢指标对比差异无统计学意义(P>0.05)。治疗3个月后,研究组的血清肌酐(Scr)、尿素氮(BUN)、胱抑素C(CysC)、β_(2)微球蛋白(β_(2)-MG)水平均低于对照组(P<0.05);研究组的血钙水平高于对照组,血磷、甲状旁腺激素(PTH)水平均低于对照组(P<0.05)。结论:与16P低通量透析器相比,采用16H高通量透析器对尿毒症患者进行血液透析,能进一步提高临床疗效,改善患者的肾功能和代谢情况。

高通透析器配合改良预冲方式在无肝素透析患者中的应用

目的:探讨高通透析器配合膜加温预冲方式在无肝素透析患者中的应用效果。方法:选取在某三甲医院血液净化中心行无肝素血液透析的60例患者作为研究对象,采用自身对照法,前3次透析采用传统预冲方法的患者设为对照组,后3次透析采用改良后的预冲方法的患者设为观察组。比较两种预冲方法在无肝素透析过程中的有效透析治疗时间、更换管道次数、透析器或管路凝血情况以及患者满意度。结果:与对照组相比,观察组采用高通透析器配合膜加温后的预冲方法进行无肝素透析时,有效透析治疗时间更长,更换管道次数更少,透析器或管路凝血程度更轻,患者满意度更高,以上差异均有统计学意义(P<0.05)。结论:高通透析器配合膜加温预冲方法可降低无肝素透析凝血发生率,降低医疗成本,提高患者透析充分性和满意度,方便临床使用。