The relation of various metabolic bone markers in renal hemodialysis patients classified by serum estradiol levels

The bone metabolic markers showed the significant differences in age and sex of the hemodialysis patients with renal insufficiency. It is likely that the evaluations of bone change and biochemical metabolic markers should be based on serum estradiol level, sex and age of the renal hemodialysis patients.     

Effect of age on markers of bone metabolism in renal hemodialysis patients

Bone metabolic markers were investigated in the male hemodialysis patients within and over 60 years old and the female hemodialysis patients within and over 50 years old. Our results indicated that bone metabolic markers were more increased in the lower values of serum estradiol in the male patients, but inversely were more enhanced in higher values of serum estradiol in the female patients.     

The correlation of serum parathyroid hormones among patients with dementia of vascular type, hemodialysis, and bone-joint disorders

PTH levels were analysed in sera of patients receiving maintenance hemodialysis, with the vascular type of dementia and orthopedic patients with bone-joint disorders, using PTH assay kits. There were significant interrelationship among all kinds of PTH levels in the hemodialysis patients, but not in patients with the vascular type of dementia and the bone-joint disorders. Renal functions might be responsible for fragmentation of PTH in blood stream. These results suggested that the measurement of PTH levels is needed to examine various kinds of amino-sequence of PTH levels in keeping normal function of kidney.     

Parathyroid hormone and bone mineral content in male and female patients receiving hemodialysis

Relative bone mineral content in the lumbar spine was measured by phantom B-MAs with the apparatus of computerized tomography in order to study the relationships between bone mineral content with age and parathyroid hormone in sera of randomized out- and in-patients and the hemodialysis patients. There exists a significant difference between male and female in the loss of bone mineral content of three groups.     

Comparative study for aluminum determination in bone by atomic absorption techniques and inductively coupled plasma atomic emission spectroscopy

A comparative investigation was carried out on the suitability of atomic absorption spectrometry and inductively coupled plasma atomic emission spectroscopy for aluminum determination in bone. Both techniques give reliable results but the nitrous oxide-acetylene flame method was not found to be sensitive enough to accurately measure low aluminum content. A suitable method for sample treatment is also described. Quantitation of aluminum in bone from patients on regular hemodialysis is also done.     

Effect of gender, season, and vitamin D status on bone biochemical markers in Saudi diabetes patients

Biochemical bone turnover markers (BTMs) provide important information on the diagnosis, therapy and monitoring of metabolic bone diseases. They are evident before measurable changes in bone mineral density (BMD) take place. A total of 35 adult Saudi patients (23 males; 12 females) with type 2 diabetes and diagnosed to be vitamin D deficient were recruited in this prospective study. Here we investigated the effects of gender, season, and vitamin D status on bone biochemical markers of bone remodeling. Anthropometry and blood samples were collected at different intervals. Metabolic parameters and bone biomarkers were measured routinely and by ELISA. Both males and females had a significant increase in their vitamin D status over time, but no significant changes in the bone biomarkers were observed in females. In males there was a significant increase in circulating levels of corrected calcium and OPN (p = 0.004 and 0.01 respectively) and a significant decrease in crosslaps (p = 0.005). In all subjects there was a modest but significant positive relationship between vitamin D status and OC (R = 0.34; p = 0.04). In conclusion, our study demonstrates that changes in bone remodeling markers are affected by season, gender, and possibly vitamin D status. This gender difference may well reflect the physiologic pathway responsible for the higher peak bone mass achieved in males compared to females.     

In vivo monitoring of skeletal aluminum burden in patients with renal failure

In vivo neutron activation analysis was used to examine the total body and partial body (hand) aluminum levels in patients with end-stage renal failure. Patients maintained on chronic hemodialysis had higher mean body burdens of aluminum than, did those clinically managed without dialysis. Approximately 70% of the patients examined indicated elevated levels of body or skeletal aluminum. A significant correlation was observed between the in vivo aluminum/calcium ratio obtained for the hand measurement and the increase in serum aluminum levels following a disferroxamine infusion test. The direct in vivo monitoring of hand Al/Ca values in patients may provide an alternate choice to bone biopsy for the detection of aluminum intoxication.     

Past,Present, and Future of Artificial Kidney Treatment

The past has seen the evolution of hemodialysis from a very complex operation to a systematized approach which allows the procedure to be instituted by minimally trained individuals. The first big advance in the application of hemodialysis to the problem of chronic renal insufficiency came in 1960 when a permanently implanted arteriovenous plastic fistulae was established. Improvements in dialyzer design and the logistics of hemodialysis since then have resulted in expansion of hemodialysis facilities. There is still a deficit between facilities available and suitable patients in need of therapy. Closure of this gap will depend upon a cheap, small, disposable dialyzer which most patients can operate themselves. In addition, an improvement in kidney transplantation results will remove many patients from the pool of those needing hemodialysis. It is likely that other medical applications of hemodialysis will be discovered in the future.     

Evaluation by using radionuclide uptake of bone in Paget's disease of bone: special reference to treatment with calcitonin

Bone scintigraphy using 99mTc-MDP was performed on 2 patients with Paget's disease of bone before and after the treatment with a synthetic eel calcitonin analogue [Asu1,7)-eel calcitonin, ECT] at a dose of 40 U per day. All pagetic lesions showed markedly the increased accumulation of the radionuclide. The uptake ratio, defined as the count rate of 99mTc-MDP over each bone lesion to that over the control bone, was calculated. The response to the calcitonin therapy was evaluated with the uptake ratio of the radionuclide. The uptake ratio decreased markedly within the first 3 months of the treatment, in association with a palliation of bone pain, while the serum alkaline phosphatase activities which had been within the normal range or slightly high before the treatment did not show any significant change or did not reflect a clinical feature (e.g. bone pain) with the treatment. Thus, the uptake ratio on the bone scintigram seemed to offer the most sensitive and most reliable information for the evaluation of calcitonin treatment of Paget's disease of bone.     

Editorial: lanthanide compounds for therapeutic and diagnostic applications

The medical applications of lanthanides are diverse: MRI contrast agents, hypophosphatemic agents for kidney dialysis patients, luminescent probes in cell studies, and for palliation of bone pain in osteosarcoma.     

优质护理在腹股沟疝合并糖尿病围手术期中的效果和体会

目的分析在腹股沟疝合并糖尿病患者的围手术期护理中,优质护理的临床应用价值。方法选取九江市第一人民医院于2014年1月至2015年1月收治的60例腹股沟疝合并糖尿病患者为研究对象,将所选患者随机分为对照组与干预组,对照组患者接受常规围手术期护理,干预组患者则接受优质护理,对比两组患者的术后疼痛情况、住院时间、并发症发生情况。结果干预组患者的术后疼痛程度明显弱于对照组患者,住院时间较短,并发症发生例数明显少于对照组患者,两组患者的数据经对比后差异存在统计学意义(P0.05)。结论在腹股沟疝合并糖尿病患者围手术期临床护理中,优质护理应用效果较好,值得推广。     

Polymorphisms in two genes, IL-1B and ACE, are associated with erythropoietin resistance in Korean patients on maintenance hemodialysis

Genetic polymorphisms may be linked to inter-individual differences in erythropoietin (EPO) resistance. We investigated the -511C/T polymorphism of the IL-1B gene and the I/D polymorphism of the ACE gene for any association with EPO resistance index (ERI) in maintenance hemodialysis patients (n=167). Because EPO responsiveness is multi-factorial, we also included other possible influences (age, sex, time on dialysis, ACE inhibitor or angiotensin receptor blocker use, ferritin, transferrin saturation, intact PTH, high sensitivity C-reactive protein, albumin, Kt/V, and presence of diabetes mellitus) on ERI in our analyses. Multiple regression analysis showed significant association of the IL-1B-511CC and ACE DD polymorphisms with ERI (P=0.038 and P=0.004 in the recessive model, respectively). The combination (C) of alleles of two loci showed that C1 (I-T) was significantly associated with ERI in the co-dominant and recessive models (P=0.005 and P=0.0001, respectively). Subjects who did not carry C1 showed significantly decreased ERI (10.10+/-5.15 IU/kg weight/g hemoglobin) compared to other study subjects (C1/C1 and C1/-; 12.97+/-4.90 and 15.12+/-7.43 IU/kg weight/g hemoglobin, respectively). Our study indicates that the IL-1B-511C/T and ACE I/D polymorphisms may be useful genetic markers of EPO requirement in hemodialysis patients. These findings might also provide a new perspective on therapeutic approaches to the treatment of end stage renal disease patients with anemia.     

维持性血液透析患者血清铁调素水平与心血管疾病的关系研究

目的观察分析维持性血液透析患者血清铁调素水平与心血管疾病的关系。方法选择惠州市第三人民医院2014年12月至2016年12月期间收治的维持性血液透析患者54例作为观察组,包含20例患者出现心血管疾病,另外选择接受体检的健康人25例作为对照组。结果观察组患者的血清铁调素水平、晚期氧化蛋白物及IL-6均显著高于对照组,比较差异具有统计学意义(P0.05);观察组发生心血管疾病患者血清铁调素水平显著高于非心血管疾病患者,数据比较差异具有统计学意义(P0.05)。结论血液透析患者血清铁调素水平与心血管疾病具有相关性,即可作为血透患者发生心血管疾病的新的独立危险因素,但需要进一步验证。     

Infrared spectroscopy in hemodialysis: reagent-free monitoring of patient detoxification by infrared spectroscopy

A method for monitoring hemodialysis based on quantitative infrared spectroscopic determination of the molecules dialyzed from patient blood is reported. The measurements are reagent-free and aim at real-time and in-line monitoring of the hemodialysis patient. A flow cell using attenuated total reflection infrared spectroscopy is coupled downstream of the dialysis filter unit. A calibration model has been developed from real hemodialysis samples analyzed by chemical reference analysis and from artificially mixed dialysis samples. The infrared monitoring of hemodialysis includes quantitative determination of urea as the lead substance, as well as glucose, lactate, and creatinine, all at a precision only limited by the chemical reference analysis. The flow cell can be fitted to all standard hemodialysis systems. Preliminary tests with hemodialysis patients have demonstrated that detoxification can be clearly monitored. Furthermore, these experiments demonstrate that a wide, real-time control of the patient’s physiological parameters is possible with this method, which could lead to increased patient safety.     

Determination of inorganic elements in iliac crests of rabbits by NAA

This paper deals with the osteoporosis model of New Zealand rabbits in order to study the function of inorganic elements for women patients with osteoporosis. The thirty cases of iliac crest are collected and determined using neutron activation analysis (NAA). The results show that the fluorine concentrations in the experimental group are higher than those in control group and the magnesium concentrations are significantly lower (P<0.001), but the concentrations of K, Na, Ca, Ba, Mn, Sr show no remarkable difference. Combined with the serum biochemical markers of bone formation and resorption, the physiological functions of some metal elements in bone are also discussed.     

The measurement of parathyroid hormone in sera of hemodialysis patients with renal insufficiency by employing the various kinds of parathyroid hormone kits

This study focussed on elucidating difference of blood PTH levels, by employing the various kinds of PTH kits. We carried out the measurements of PTH levels in sera of the hemodialysis patients with renal insufficiency presumably inactivated PTH degradative regulation in kidney. Our results showed the remarkable significant relationships among blood PTH levels of carboxyl and mid-region PTH and intact PTH in hemodialysis patients and was deduced that the difference of PTH levels by using various kinds of PTH kits was responsible of PTH cleavage effect in the kidney.     

Biochemical markers of bone metabolism in the assessment of osteoporosis.

Several biochemical markers are available for the study of bone metabolism. The characteristics of these markers are reviewed and their potential application in osteoporosis is examined. It is concluded that biochemical markers are potentially useful in identifying those at risk of developing osteoporosis, selecting appropriate treatment, monitoring therapy, and studying the pathogenesis of osteoporosis.     

Species identification by analysis of bone collagen using matrix‐assisted laser desorption/ionisation time‐of‐flight mass spectrometry

Species identification of fragmentary bone, such as in rendered meat and bone meal or from archaeological sites, is often difficult in the absence of clear morphological markers. Here we present a robust method of analysing genus‐specific collagen peptides by mass spectrometry simply by using solid‐phase extraction (a C18 ZipTip®) for peptide purification, rather than liquid chromatography/mass spectrometry (LC/MS). Analysis of the collagen from 32 different mammal species identified a total of 92 peptide markers that could be used for species identification, for example, in processed food and animal feed. A set of ancient (>100 ka@10°C) bone samples was also analysed to show that the proposed method has applications to archaeological bone identification. Copyright © 2009 John Wiley & Sons, Ltd.     

早期护理干预对维持性血液透析患者动静脉内瘘并发症发生率的影响

目的探讨早期护理干预对维持性血液透析患者动静脉内瘘并发症发生率的影响。方法选择2012年8月至2015年1月来江西省新余市新钢中心医院接受治疗的维持性血液透析患者96例作为研究对象。按照入院顺序抽签后随机分为实验组和对照组,对照组在透析的时候进行常规的护理,在此基础上,实验组进行早期护理干预。观察内瘘闭塞、动脉瘤样扩张发生率、并发症、生活质量评分(SF-36)。结果实验组内瘘闭塞、动脉瘤样扩张发生率低于对照组(P0.05)。实验组并发症发生率低于对照组(P0.05)。实验组生活质量评分高于对照组(P0.05)。结论早期护理干预能够降低维持性血液透析患者动静脉内瘘并发症发生率,提高患者生活质量。     

血液透析联合血液灌流治疗急性肾功能衰竭的临床效果分析

目的分析急性肾功能衰竭采取血液透析联合血液灌流治疗的临床效果。方法选取2010年1月—2015年1月期间惠州市中医医院收治的24例急性肾功能衰竭患者作为研究对象,按治疗方法的不同将本组患者分为两组,对照组12例患者接受单纯血液透析治疗,观察组12例患者接受血液透析联合血液灌流治疗,治疗2个月后,对两组患者的临床指标及临床效果进行统计对比。结果观察组治疗后CRP、Cr、BUN、MMS指标优于对照组,差异有统计学意义(P0.05);观察组治疗有效率为91.67%(11/12),高于对照组75.00%(9/12),差异有统计学意义(P0.05)。结论对急性肾功能衰竭患者的治疗,采取血液透析联合血液灌流治疗的临床效果显著,促进患者康复,在临床中具有良好的应用价值。