AIM: To clarify the relationship between the change of serum amylase level and post-ERCP pancreatitis. METHODS: Between January 1999 and December 2002, 1291 ERCP-related procedures were performed. Serum amylase concen...AIM: To clarify the relationship between the change of serum amylase level and post-ERCP pancreatitis. METHODS: Between January 1999 and December 2002, 1291 ERCP-related procedures were performed. Serum amylase concentrations were measured before the procedure and 3, 6, and 24 h afterward. The frequency and severity of post-ERCP pancreatitis and the relationship between these phenomena and the change in amylase level were estimated. RESULTS: Post-ERCP pancreatitis occurred in 47 patients (3.6%). Pancreatitis occurred in 1% of patients with normal amylase levels 3 h after ERCP, and in 1%, 5%, 20%, 31% and 39% of patients with amylase levels elevated 1-2 times, 2-3 times, 3-5 times, 5-10 times and over 10 times the upper normal limit at 3 h after ERCP, respectively (level < 2 times vs ≥ 2 times, P < 0.001). Of the 143 patients with levels higher than the normal limit at 3 h after ERCP followed by elevation at 6 h, pancreatitis occurred in 26%. In contrast, pancreatitis occurred in 9% of 45 patients with a level higher than two times the normal limit at 3 h after ERCP followed by a decrease at 6 h (26% vs 9%, P < 0.05). CONCLUSION: Post-ERCP pancreatitis is frequently associated with an increase in serum amylase level greater than twice the normal limit at 3 h after ERCP with an elevation at 6 h. A decrease in amylase level at 6 h after ERCP suggests the unlikelihood of development of post-ERCP pancreatitis.展开更多
AIM： TO investigate the protective effects and possible mechanisms of Veratrum nigrum L. var. ussuriense Nakai alkaloids （VnA） on hepatic ischemia/reperfusion （I/R） injury in rats. METHODS： Forty male Wistar rat...AIM： TO investigate the protective effects and possible mechanisms of Veratrum nigrum L. var. ussuriense Nakai alkaloids （VnA） on hepatic ischemia/reperfusion （I/R） injury in rats. METHODS： Forty male Wistar rats were randomly divided into four experimental groups （n = 10 in each）： （A） Control group （the sham operation group）; （8） I/R group （pretreated with normal saline）; （C） Small-dose （10 μg/kg） VnA pretreatment group; （D） Large-dose （20 μg/kg） VnA pretreatment group. Hepatic ischemia/ reperfusion （Hepatic I/R） was induced by occlusion of the portal vein and the hepatic artery for 90 min, followed by reperfusion for 240 min. The pretreatment groups were administered with VnA intraperitoneally, 30 min before surgery, while the control group and I/R group were given equal volumes of normal saline. Superoxide dismutase （SOD） activity, myeloperoxidase （MPO） activity and nitric oxide （NO） content in the liver tissue at the end of reperfusion were determined and liver function was measured. The expression of intercellular adhesion molecule-1 （ICAM-1） and E-selectin （ES） were detected by immunohistochemical examinations and Western blot analyses. RESULTS： The results showed that hepatic I/R elicited a significant increase in the plasma levels of alanine aminotransferase （ALT： 74.53 ± 2.58 IU/L vs 1512.54 ± 200.76 IU/L, P 〈 0.01） and lactic dehydrogenase （LDH： 473.48 ± 52.17 IU/L vs 5821.53 ± 163.69 IU/L, P 〈 0.01）, as well as the levels of MPO （1.97 ± 0.11 U/g vs 2.57 ± 0.13 U/g, P 〈 0.01） and NO （69.37 ± 1.52 μmol/g protein vs 78.39 ± 2.28 μmol/g protein, P 〈 0.01） in the liver tissue, all of which were reduced by pretreatment with VnA, respectively （ALT： 1512.54 ± 200.76 IU/L vs 977.93 ± 89.62 IU/L, 909.81 ± 132.76 IU/L, P 〈 0.01, P 〈 0.01; LDH： 5821.53 ± 163.69 IU/L vs 3015.44 ± 253.01 IU/L, 2448.75 ± 169.4 IU/L, P 〈 0.01, P 〈 0.01; MPO： 2.57 ± 0.13 U/g vs 2.13 ± 0.13 U/g, 2.07 ± 0.05 U/g, P 〈 0.01, P 〈 0.01; NO： 78.39 ± 2.28 μmol/g protein vs 71.11 ± 1.73 μmol/g protein, 68.58 ± 1.95 μmol/g protein, P 〈 0.05, P 〈 0.01）. The activity of SOD （361.75 ± 16.22 U/rag protein vs 263.19 ± 12.10 U/rag protein, P 〈 0.01） in the liver tissue was decreased after I/R, which was enhanced by VnA pretreatment （263.19 ± 12.10 U/rag protein vs 299.40 ± 10.80 U/rag protein, 302.09 ＋ 14.80 U/rag protein, P 〈 0.05, P 〈 0.05）. Simultaneously, the histological evidence of liver hemorrhage, polymorphonuclear neutrophil infiltration and the overexpression of ICAM-1 and E-selectin in the liver tissue were observed, all of which were attenuated in the VnA pretreated groups. CONCLUSION： The results demonstrate that VnA pretreatment exerts significant protection against hepatic I/R injury in rats. The protective effects are possibly associated with enhancement of antioxidant capacity, reduction of inflammatory responses and suppressed expression of ICAM-1 and E-selectin.展开更多
The acute （15 minutes-4 hours） effects of exposure to the inhaled DEE （diesel exhaust emitted） on blood parameters of Guinea pigs Cavia porcellus were assessed via CBC （complete blood count） as an indicator usin...The acute （15 minutes-4 hours） effects of exposure to the inhaled DEE （diesel exhaust emitted） on blood parameters of Guinea pigs Cavia porcellus were assessed via CBC （complete blood count） as an indicator using an automated blood analyzer machines （Cell DYN 1700）. The results showed significant changes in some parameters in comparison with control animals started as early as 15 minutes and intensified by the continuous exposure time, leading to significant increase （p 〈 0.05） in the number of both WBC （white blood cells）, PLT （blood platelets） and decrease in numbers of RBC （red blood corpuscles） while hemoglobin percentages （Hb%） showed an insignificant （p 〉 0.05） fluctuating rhythm. The percentages of both Neutrophil and Lymphocyt recorded a significant increase （p 〈 0.05） 1 hour post-exposure to the DEE while other WBCs showed less changes. It is concluded that blood components are so sensitive to DEE and do respond quicker to inhaled pollutants via changes in some components of WBC% but decrease in RBC% and the likelihood of blood clotting due to increase in blood platelets. These results indicate the acute toxic risks of the exposure to DEE of mechanics and technicians who work in vicinity of DEE sources or/and spend most daily hours in semi closed areas.展开更多
Aggressive angiomyxoma （AAM） is a rare tumour that often occurs in soft tissues of the female genital tract. Eight cases of AAM are reported in this article, and the clinical features and ultrasound and magnetic res...Aggressive angiomyxoma （AAM） is a rare tumour that often occurs in soft tissues of the female genital tract. Eight cases of AAM are reported in this article, and the clinical features and ultrasound and magnetic resonance imaging （MRI） results of the eight cases are reviewed and summarized. The main complaints of all the patients were palpable and painless masses in the vulva or scrotum. The lesions were mainly located in the vulva, pelvis, and perineal region, with a large scope of involvement. The sonographic features of AAM were characteristic. On sonography, all of the masses were of irregular shape and showed hypoechogenicity, with a heterogeneous inner echotexture. Intratumoural and peritumoural blood fows were detected by colour Doppler imaging. On real-time ultrasonic imaging, prominent deformation of the lesions was observed bycompressing the masses with the probe. Some special imaging features were also revealed, including a la-minated or swirled appearance of inner echogenicity, and a fnger-like or tongue-like growth pattern. On MRI imaging, the lesions showed intermediate-intensity signals and intermediate to high-intensity signals on TI-weighted and T2-weighted sequences. A rapid and uneven enhancement pattern was demonstrated. After the comparison of sonographic features with MRIand pathological findings, we found the relevance of the ultrasonographic characteristics with MRI and his-tological features of AAM. Ultrasound can be a valuable imaging method for the preoperative diagnosis, eva-luation of scope, and follow-up of AAM.展开更多
AIM： To investigate the predictive value of low freeT3 for long-term mortality in chronic hemodialysis （HD） patients and explore a possible causative role of chronic infammation.METHODS： One hundred fourteen HD pa...AIM： To investigate the predictive value of low freeT3 for long-term mortality in chronic hemodialysis （HD） patients and explore a possible causative role of chronic infammation.METHODS： One hundred fourteen HD patients （84 males） consecutively entered the study and were assessed for thyroid function and two established markers of inflammation, high sensitivity C-reactive protein （hsCRP） and interleukin-6 （IL-6）. Monthly blood samples were obtained from all patients for three consecutive months during the observation period for evaluation of thyroid function and measurement of infammatory markers. The patients were then divided in two groups based on the cut-off value of 1.8 pg/mL for mean plasma freeT3, and were prospectively studied for a mean of 50.3 ± 30.8 mo regarding cumulative survival. The prognostic power of low serum fT3 levels for mortality was assessed using the Kaplan-Meier method and univariate and multivariate regression analysis.RESULTS： Kaplan-Meier survival curve showed a negative predictive power for low freeT3. In Cox regression analysis low freeT3 remained a significant predictor of mortality after adjustment for age, diabetes mellitus, hypertension, hsCRP, serum creatinine and albumin. Regarding the possible association with inflammation, freeT3 was correlated with hsCRP, but not IL-6, and only at the frst month of the study.CONCLUSION： In chronic hemodialysis patients, low plasma freeT3 is a significant predictor of all-cause mortality. Further studies are required to identify the underlying mechanisms of this association.展开更多
Renal tubules regulate blood pressure and humoral homeostasis. Mediators that play a significant role in regulating the transport of solutes and water include angiotensin Ⅱ （AngⅡ） and nitric oxide （NO）. AngⅡca...Renal tubules regulate blood pressure and humoral homeostasis. Mediators that play a significant role in regulating the transport of solutes and water include angiotensin Ⅱ （AngⅡ） and nitric oxide （NO）. AngⅡcan signifcantly raise blood pressure via effects on the heart, vasculature, and renal tubules. AngⅡ generally stimulates sodium reabsorption by triggering sodium and fuid retention in almost all segments of renal tu-bules. Stimulation of renal proximal tubule （PT） trans-port is thought to be essential for AngⅡ-mediated hy-pertension. However, AngⅡ has a biphasic effect on in vitro PT transport in mice, rats, and rabbits： stimulation at low concentrations and inhibition at high concentra-tions. On the other hand, NO is generally thought to inhibit renal tubular transport. In PTs, NO seems to be involved in the inhibitory effect of AngⅡ. A recent study reports a surprising fnding： AngⅡ has a mono-phasic stimulatory effect on human PT transport. De-tailed analysis of signalling mechanisms indicates that in contrast to other species, the human NO/guanosine 3’,5’-cyclic monophosphate/extracellular signal-regulat-ed kinase pathway seems to mediate this effect of Ang Ⅱ on PT transport. In this review we will discuss recent progress in understanding the effects of AngⅡ and NO on renal tubular transport.展开更多
The anemia of chronic kidney disease and hemodialysisis characterized by chronic inflammation and releaseof cytokines, resulting in the upregulation of the ironhormone hepcidin, also increased by iron therapy andreduc...The anemia of chronic kidney disease and hemodialysisis characterized by chronic inflammation and releaseof cytokines, resulting in the upregulation of the ironhormone hepcidin, also increased by iron therapy andreduced glomerular filtration, with consequent reduc-tion in iron absorption, recycling, and availability to theerythron. This response proves advantageous in theshort-term to restrain iron availability to pathogens, buultimately leads to severe anemia, and impairs the re-sponse to erythropoietin （Epo） and iron. Homozygosityfor the common C282Y and H63D HFE polymorphismsinfluence iron metabolism by hampering hepcidin re-lease by hepatocytes in response to increased ironstores, thereby resulting in inadequate inhibition othe activity of Ferroportin-1, inappropriately high ironabsorption and recycling, and iron overload. However, in hemodialysis patients, carriage of HFE mutations may confer an adaptive beneft by decreasing hepcidin release in response to iron infusion and infammation, thereby improving iron availability to erythropoiesis,anemia control, the response to Epo, and possibly sur-vival. Therefore, anti-hepcidin therapies may improve anemia management in hemodialysis. However, HFE mutations directly favor hemoglobinization indepen-dently of hepcidin, and reduce macrophages activation in response to inflammation, whereas hepcidin might also play a benefcial anti-infammatory and anti-micro-bic action during sepsis, so that direct inhibition of HFE-mediated regulation of iron metabolism may represent a valuable alternative therapeutic target. Genetic stud-ies may offer a valuable tool to test these hypotheses and guide the research of new therapies.展开更多
AIM To examine whether hemodialysis(HD) patients with restless legs syndrome(RLS) are subjects of greater fatigue and impaired quality of life(QoL) compared to HD patients without RLS.METHODS Eighty five stable HD pat...AIM To examine whether hemodialysis(HD) patients with restless legs syndrome(RLS) are subjects of greater fatigue and impaired quality of life(QoL) compared to HD patients without RLS.METHODS Eighty five stable HD patients participated in this study. According to their RLS status, the patients were dividedinto the RLS group(n = 23) and the non-RLS group(n = 62). QoL, fatigue, sleep quality, daily sleepiness and depression symptoms were assessed by using various questionnaires. Finally, biochemical parameters including iron, ferritin, hemoglobin, hematocrit and parathormone were assessed. RESULTS The HD patients with RLS scored worse in all the questionnaires used in the study(P < 0.05). The patients with RLS were more likely to receive the HD therapy on the morning shift, whilst 43.5% of the RLS patients reported to experience the RLS symptoms also during HD. The severity of RLS was correlated with fatigue, depression score and sleep quality(P < 0.05). CONCLUSION HD patients with RLS are subject to lower QoL related parameters and greater fatigue compared to HD patients without RLS. RLS should be successfully managed in order to improve the QoL of the sufferers.展开更多
文摘AIM: To clarify the relationship between the change of serum amylase level and post-ERCP pancreatitis. METHODS: Between January 1999 and December 2002, 1291 ERCP-related procedures were performed. Serum amylase concentrations were measured before the procedure and 3, 6, and 24 h afterward. The frequency and severity of post-ERCP pancreatitis and the relationship between these phenomena and the change in amylase level were estimated. RESULTS: Post-ERCP pancreatitis occurred in 47 patients (3.6%). Pancreatitis occurred in 1% of patients with normal amylase levels 3 h after ERCP, and in 1%, 5%, 20%, 31% and 39% of patients with amylase levels elevated 1-2 times, 2-3 times, 3-5 times, 5-10 times and over 10 times the upper normal limit at 3 h after ERCP, respectively (level < 2 times vs ≥ 2 times, P < 0.001). Of the 143 patients with levels higher than the normal limit at 3 h after ERCP followed by elevation at 6 h, pancreatitis occurred in 26%. In contrast, pancreatitis occurred in 9% of 45 patients with a level higher than two times the normal limit at 3 h after ERCP followed by a decrease at 6 h (26% vs 9%, P < 0.05). CONCLUSION: Post-ERCP pancreatitis is frequently associated with an increase in serum amylase level greater than twice the normal limit at 3 h after ERCP with an elevation at 6 h. A decrease in amylase level at 6 h after ERCP suggests the unlikelihood of development of post-ERCP pancreatitis.
文摘AIM： TO investigate the protective effects and possible mechanisms of Veratrum nigrum L. var. ussuriense Nakai alkaloids （VnA） on hepatic ischemia/reperfusion （I/R） injury in rats. METHODS： Forty male Wistar rats were randomly divided into four experimental groups （n = 10 in each）： （A） Control group （the sham operation group）; （8） I/R group （pretreated with normal saline）; （C） Small-dose （10 μg/kg） VnA pretreatment group; （D） Large-dose （20 μg/kg） VnA pretreatment group. Hepatic ischemia/ reperfusion （Hepatic I/R） was induced by occlusion of the portal vein and the hepatic artery for 90 min, followed by reperfusion for 240 min. The pretreatment groups were administered with VnA intraperitoneally, 30 min before surgery, while the control group and I/R group were given equal volumes of normal saline. Superoxide dismutase （SOD） activity, myeloperoxidase （MPO） activity and nitric oxide （NO） content in the liver tissue at the end of reperfusion were determined and liver function was measured. The expression of intercellular adhesion molecule-1 （ICAM-1） and E-selectin （ES） were detected by immunohistochemical examinations and Western blot analyses. RESULTS： The results showed that hepatic I/R elicited a significant increase in the plasma levels of alanine aminotransferase （ALT： 74.53 ± 2.58 IU/L vs 1512.54 ± 200.76 IU/L, P 〈 0.01） and lactic dehydrogenase （LDH： 473.48 ± 52.17 IU/L vs 5821.53 ± 163.69 IU/L, P 〈 0.01）, as well as the levels of MPO （1.97 ± 0.11 U/g vs 2.57 ± 0.13 U/g, P 〈 0.01） and NO （69.37 ± 1.52 μmol/g protein vs 78.39 ± 2.28 μmol/g protein, P 〈 0.01） in the liver tissue, all of which were reduced by pretreatment with VnA, respectively （ALT： 1512.54 ± 200.76 IU/L vs 977.93 ± 89.62 IU/L, 909.81 ± 132.76 IU/L, P 〈 0.01, P 〈 0.01; LDH： 5821.53 ± 163.69 IU/L vs 3015.44 ± 253.01 IU/L, 2448.75 ± 169.4 IU/L, P 〈 0.01, P 〈 0.01; MPO： 2.57 ± 0.13 U/g vs 2.13 ± 0.13 U/g, 2.07 ± 0.05 U/g, P 〈 0.01, P 〈 0.01; NO： 78.39 ± 2.28 μmol/g protein vs 71.11 ± 1.73 μmol/g protein, 68.58 ± 1.95 μmol/g protein, P 〈 0.05, P 〈 0.01）. The activity of SOD （361.75 ± 16.22 U/rag protein vs 263.19 ± 12.10 U/rag protein, P 〈 0.01） in the liver tissue was decreased after I/R, which was enhanced by VnA pretreatment （263.19 ± 12.10 U/rag protein vs 299.40 ± 10.80 U/rag protein, 302.09 ＋ 14.80 U/rag protein, P 〈 0.05, P 〈 0.05）. Simultaneously, the histological evidence of liver hemorrhage, polymorphonuclear neutrophil infiltration and the overexpression of ICAM-1 and E-selectin in the liver tissue were observed, all of which were attenuated in the VnA pretreated groups. CONCLUSION： The results demonstrate that VnA pretreatment exerts significant protection against hepatic I/R injury in rats. The protective effects are possibly associated with enhancement of antioxidant capacity, reduction of inflammatory responses and suppressed expression of ICAM-1 and E-selectin.
文摘The acute （15 minutes-4 hours） effects of exposure to the inhaled DEE （diesel exhaust emitted） on blood parameters of Guinea pigs Cavia porcellus were assessed via CBC （complete blood count） as an indicator using an automated blood analyzer machines （Cell DYN 1700）. The results showed significant changes in some parameters in comparison with control animals started as early as 15 minutes and intensified by the continuous exposure time, leading to significant increase （p 〈 0.05） in the number of both WBC （white blood cells）, PLT （blood platelets） and decrease in numbers of RBC （red blood corpuscles） while hemoglobin percentages （Hb%） showed an insignificant （p 〉 0.05） fluctuating rhythm. The percentages of both Neutrophil and Lymphocyt recorded a significant increase （p 〈 0.05） 1 hour post-exposure to the DEE while other WBCs showed less changes. It is concluded that blood components are so sensitive to DEE and do respond quicker to inhaled pollutants via changes in some components of WBC% but decrease in RBC% and the likelihood of blood clotting due to increase in blood platelets. These results indicate the acute toxic risks of the exposure to DEE of mechanics and technicians who work in vicinity of DEE sources or/and spend most daily hours in semi closed areas.
基金Supported by the International S and T Cooperation Program of China,No.2015DFA30440the National Natural Science Foundation of China,No.81301268Beijing Nova Plan,No.xxjc201812 and No.Z131107000413063
文摘Aggressive angiomyxoma （AAM） is a rare tumour that often occurs in soft tissues of the female genital tract. Eight cases of AAM are reported in this article, and the clinical features and ultrasound and magnetic resonance imaging （MRI） results of the eight cases are reviewed and summarized. The main complaints of all the patients were palpable and painless masses in the vulva or scrotum. The lesions were mainly located in the vulva, pelvis, and perineal region, with a large scope of involvement. The sonographic features of AAM were characteristic. On sonography, all of the masses were of irregular shape and showed hypoechogenicity, with a heterogeneous inner echotexture. Intratumoural and peritumoural blood fows were detected by colour Doppler imaging. On real-time ultrasonic imaging, prominent deformation of the lesions was observed bycompressing the masses with the probe. Some special imaging features were also revealed, including a la-minated or swirled appearance of inner echogenicity, and a fnger-like or tongue-like growth pattern. On MRI imaging, the lesions showed intermediate-intensity signals and intermediate to high-intensity signals on TI-weighted and T2-weighted sequences. A rapid and uneven enhancement pattern was demonstrated. After the comparison of sonographic features with MRIand pathological findings, we found the relevance of the ultrasonographic characteristics with MRI and his-tological features of AAM. Ultrasound can be a valuable imaging method for the preoperative diagnosis, eva-luation of scope, and follow-up of AAM.
文摘AIM： To investigate the predictive value of low freeT3 for long-term mortality in chronic hemodialysis （HD） patients and explore a possible causative role of chronic infammation.METHODS： One hundred fourteen HD patients （84 males） consecutively entered the study and were assessed for thyroid function and two established markers of inflammation, high sensitivity C-reactive protein （hsCRP） and interleukin-6 （IL-6）. Monthly blood samples were obtained from all patients for three consecutive months during the observation period for evaluation of thyroid function and measurement of infammatory markers. The patients were then divided in two groups based on the cut-off value of 1.8 pg/mL for mean plasma freeT3, and were prospectively studied for a mean of 50.3 ± 30.8 mo regarding cumulative survival. The prognostic power of low serum fT3 levels for mortality was assessed using the Kaplan-Meier method and univariate and multivariate regression analysis.RESULTS： Kaplan-Meier survival curve showed a negative predictive power for low freeT3. In Cox regression analysis low freeT3 remained a significant predictor of mortality after adjustment for age, diabetes mellitus, hypertension, hsCRP, serum creatinine and albumin. Regarding the possible association with inflammation, freeT3 was correlated with hsCRP, but not IL-6, and only at the frst month of the study.CONCLUSION： In chronic hemodialysis patients, low plasma freeT3 is a significant predictor of all-cause mortality. Further studies are required to identify the underlying mechanisms of this association.
文摘Renal tubules regulate blood pressure and humoral homeostasis. Mediators that play a significant role in regulating the transport of solutes and water include angiotensin Ⅱ （AngⅡ） and nitric oxide （NO）. AngⅡcan signifcantly raise blood pressure via effects on the heart, vasculature, and renal tubules. AngⅡ generally stimulates sodium reabsorption by triggering sodium and fuid retention in almost all segments of renal tu-bules. Stimulation of renal proximal tubule （PT） trans-port is thought to be essential for AngⅡ-mediated hy-pertension. However, AngⅡ has a biphasic effect on in vitro PT transport in mice, rats, and rabbits： stimulation at low concentrations and inhibition at high concentra-tions. On the other hand, NO is generally thought to inhibit renal tubular transport. In PTs, NO seems to be involved in the inhibitory effect of AngⅡ. A recent study reports a surprising fnding： AngⅡ has a mono-phasic stimulatory effect on human PT transport. De-tailed analysis of signalling mechanisms indicates that in contrast to other species, the human NO/guanosine 3’,5’-cyclic monophosphate/extracellular signal-regulat-ed kinase pathway seems to mediate this effect of Ang Ⅱ on PT transport. In this review we will discuss recent progress in understanding the effects of AngⅡ and NO on renal tubular transport.
文摘The anemia of chronic kidney disease and hemodialysisis characterized by chronic inflammation and releaseof cytokines, resulting in the upregulation of the ironhormone hepcidin, also increased by iron therapy andreduced glomerular filtration, with consequent reduc-tion in iron absorption, recycling, and availability to theerythron. This response proves advantageous in theshort-term to restrain iron availability to pathogens, buultimately leads to severe anemia, and impairs the re-sponse to erythropoietin （Epo） and iron. Homozygosityfor the common C282Y and H63D HFE polymorphismsinfluence iron metabolism by hampering hepcidin re-lease by hepatocytes in response to increased ironstores, thereby resulting in inadequate inhibition othe activity of Ferroportin-1, inappropriately high ironabsorption and recycling, and iron overload. However, in hemodialysis patients, carriage of HFE mutations may confer an adaptive beneft by decreasing hepcidin release in response to iron infusion and infammation, thereby improving iron availability to erythropoiesis,anemia control, the response to Epo, and possibly sur-vival. Therefore, anti-hepcidin therapies may improve anemia management in hemodialysis. However, HFE mutations directly favor hemoglobinization indepen-dently of hepcidin, and reduce macrophages activation in response to inflammation, whereas hepcidin might also play a benefcial anti-infammatory and anti-micro-bic action during sepsis, so that direct inhibition of HFE-mediated regulation of iron metabolism may represent a valuable alternative therapeutic target. Genetic stud-ies may offer a valuable tool to test these hypotheses and guide the research of new therapies.
文摘AIM To examine whether hemodialysis(HD) patients with restless legs syndrome(RLS) are subjects of greater fatigue and impaired quality of life(QoL) compared to HD patients without RLS.METHODS Eighty five stable HD patients participated in this study. According to their RLS status, the patients were dividedinto the RLS group(n = 23) and the non-RLS group(n = 62). QoL, fatigue, sleep quality, daily sleepiness and depression symptoms were assessed by using various questionnaires. Finally, biochemical parameters including iron, ferritin, hemoglobin, hematocrit and parathormone were assessed. RESULTS The HD patients with RLS scored worse in all the questionnaires used in the study(P < 0.05). The patients with RLS were more likely to receive the HD therapy on the morning shift, whilst 43.5% of the RLS patients reported to experience the RLS symptoms also during HD. The severity of RLS was correlated with fatigue, depression score and sleep quality(P < 0.05). CONCLUSION HD patients with RLS are subject to lower QoL related parameters and greater fatigue compared to HD patients without RLS. RLS should be successfully managed in order to improve the QoL of the sufferers.
