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。     

Aluminium(III) as a promoter of cellular oxidation

Aluminium has been known as a neurotoxic agent to experimental animals since the last century (Arch. Exp. Pharmacol. 40 (1897) 98). However, great interest arose in it bioinorganic chemistry as well biology when it was demonstrated to be the causative agent in pathologies related to the long-term dialysis treatment of uremic subjects with renal failure (Life Chem. 11 (1994) 197), and as a potential etiopathogenic cofactor for several neurodegenerative diseases. The inorganic biochemistry of aluminium is still largely to be discovered. In this review the pro-oxidative property of aluminium toward biological membrane will be presented and its implications in involvement in human pathology will be discussed in an interdisciplinary frame from the bioinorganic point of view.     

Profiling of uremic serum by high-resolution gas chromatography-electron-impact, chemical ionization mass spectrometry

A fast and reliable procedure for gas chromatographic profiling of components in ultrafiltrated uremic serum has been developed, using glass capillary columns. Sample pretreatment consists of ultrafiltration, evaporation and silylation. Some twenty components are identified by electron-impact and chemical ionization mass spectrometry. A comparison is made between profiles of sera from a series of uremic patients, before and after hemodialysis, and from non-uremic sera. Significant differences are found between these profiles. A "dialysis ratio" is introduced as a parameter for the removal of retained components by hemodialysis treatment.     

尿毒症患者血清中中分子物质的提取及性质的初步表征

从尿毒症患者血清及腹透液中得到的中分子量物质,具有相同的凝胶色谱行为及紫外、红外吸收行为,它们在206和235nm处,有特征紫外吸收峰;在波数为3246,1516,1122和613cm~(-1)处,有特征红外吸收峰。中分子物经离子交换色谱进一步分离,发现起决定紫外及红外吸收行为的成分集中于第3子峰;其自由氨基酸和肽类物质含量均低于3％。     

血液灌流吸附清除中分子物质的实验研究

我们从所研制的系列树脂中筛选出对中分子物质(MMS)吸附作用较好的5种吸附树脂,并将其中HP-A_3和HP-A_9用于尿毒症患者血浆体外模拟灌流和急性肾衰大鼠血液灌流。应用MMS总量测定法和Sephadex G25凝胶层析法研究树脂对MMS的吸附清除作用。结果表明,这两种树脂体内、外清除MMS作用显著,HP-A_9树脂体内清除效果更好,其血液相容性也更为理想,有希望应用于临床治疗某些MMS堆积的疾病。     

A computational strategy for metabolic network construction based on the overlapping ratio: Study of patients’ metabolic responses to different dialysis patterns

BackgroundUremia is a worldwide epidemic disease and poses a serious threat to human health. Both maintenance hemodialysis (HD) and maintenance high flux hemodialysis (HFD) are common treatments for uremia and are generally used in clinical applications. In-depth exploration of patients’ metabolic responses to different dialysis patterns can facilitate the understanding of pathological alterations associated with uremia and the effects of different dialysis methods on uremia, which may be used for future personalized therapy. However, due to variations of multiple factors (i.e., genetic, epigenetic and environment) in the process of disease treatments, identification of the similarities and differences in plasma metabolite changes in uremic patients in response to HD and HFD remains challenging.MethodsIn this study, a computational strategy for metabolic network construction based on the overlapping ratio (MNC-OR) was proposed for disease treatment effect research. In MNC-OR, the overlapping ratio was introduced to measure metabolic reactions and to construct metabolic networks for analysis of different treatment options. Then, MNC-OR was employed to analyze HD-pattern-dependent changes in plasma metabolites to explore the pathological alterations associated with uremia and the effectiveness of different dialysis patterns (i.e., HD and HFD) on uremia. Based on the networks constructed by MNC-OR, two network analysis techniques, namely, similarity analysis and difference analysis of network topology, were used to find the similarity and differences in metabolic signals in patients under treatment with either HD or HFD, which can facilitate the understanding of pathological alterations associated with uremia and provide the guidance for personalized dialysis therapy.ResultsSimilarity analysis of network topology suggested that abnormal energy metabolism, gut metabolism and pyrimidine metabolism might occur in uremic patients, and maintenance of both HFD and HD therapies have beneficial effects on uremia. Then, difference analysis of network topology was employed to extract the crucial information related to HD-pattern-dependent changes in plasma metabolites. Experimental results indicated that the amino acid metabolism was closer to the normal status in HFD-treated patients; however, in HD-treated patients, the ability of antioxidation showed greater reduction, and the protein O-GlcNAcylation level was higher. Our findings demonstrate the potential of MNC-OR for explaining the metabolic similarities and differences of patients in response to different dialysis methods, thereby contributing to the guidance of personalized dialysis therapy.     

Investigations on the adsorbents for uremic middle molecular toxins (Ⅱ)——Influences of crosslinking agent chain length on the adsorption capacities of crosslinked chitosan adsorbents

Chitosan resins, which clinically served as adsorbents in hemoperfusion therapy, were prepared with reversed-phase suspension methodology using three differently structured crosslinking agents, methanal, glyoxal and glutaraldehyde. And the glyoxal and glutaraldehyde crosslinked chitosan resins were reduced with NaBH4 afterwards. By analyzing the results from FTIR and SEM, it was found that the reduction treatment to the adsorbents efficiently improved the chemical stability of these chitosan resins, and the shifts in crosslinking agents exerted influences over the morphologies of the adsorbents obviously. After being put to use in the adsorption tests upon some model uremic middle molecular toxins and BSA in vitro, all three adsorbents demonstrated a fairly realistic adsorption capability to the model toxins but little to BSA. And the adsorption process reached the equilibrium in a clinically qualified short time. But the adsorption capacities of these adsorbents to the model toxins were quite different. It     

Affinity adsorption mechanism studies of adsorbents C1-Zn(Ⅱ) for uremic middle molecular peptides containing Asp-Phe-Leu-Ala-Glu sequence

To exploit efficient adsorbents for removing middle molecular peptides containing DFLAE (DE5,a typical peptide sequence accumulated in uremic serum) sequence by hemoperfusion,we designed and synthesized three affinity adsorbents (C1-Zn2+,C2-Zn2+ and C3-Zn2+) that could have high affinity to DE5.Subsequently,we evaluated the corresponding adsorption ability of each adsorbent by static adsorption experiments and isothermal titration calorimetry (ITC).The results showed that C1-Zn2+ had the best adsorption abi...     

A general method for the quantitative determination of catecholamines in body fluids using off-line sample pretreatment and HPLC-ED analysis

Summary Reversed phase HPLC with electrochemical detection (HPLC-ED) was used for quantitative determination of adrenaline, noradrenaline, and dopamine in several complex biological matrices, including plasma, uremic plasma, and urine. Three different methods of sample preparation for use in this clinical chemistry were tested. These were adsorption of catecholamines on alumina, organic solvent extraction after complex formation with diphenylborate, and adsorption of catecholamines on a cation exchange gel followed by organic solvent extraction of the elute. The selectivity and precision of the three methods were evaluated. The organic solvent extraction proved to be more precise and selective than adsorption on alumina (adrenaline: cv=3.80% vs. 7.58%; noradrenaline: cv=1.70% vs. 4.26%); it also proved suitable for use in the routine quantitative determination of catecholamines in plasma from patients with normal renal function (creatinine <1.2 mg/dl). However when working with uremic plasma or urine, a more selective sample preparation was required. In this case the adsorption of catecholamines on a cation exchange gel followed by organic solvent extraction of the elute was sufficiently selective and precise and thus allowed a reliable quantitative determination of adrenaline and noradrenaline from rather complex biological matrices (adrenaline: cv=6.2%; noradrenaline: cv=2.8%). Use of this specific method showed that basal plasma catecholamine levels in dialysis patients are comparable to those found in patients with normal renal function (adrenaline: 47.7±22.2 pg/ml; noradrenaline: 310.3±121.4 pg/ml).     

Increased transport of theophylline into gastrointestinal lumen and gastrointestinal dialysis by activated charcoal in rats with hepatic cirrhosis

The characteristics of exsorption and/or excretion of theophylline into the small intestinal lumen in rats with hepatic cirrhosis (HC rats) induced by carbon tetrachloride were investigated by an in situ single-pass perfusion technique. The serum concentrations of theophylline after i.v. administration of aminophylline (10 mg/kg) in the HC rats were significantly higher than those in normal rats during the experimental period. Moreover, the exsorption of theophylline from blood into the intestinal lumen was significantly increased in the HC rats compared with the normal rats. Treatments with oral activated charcoal reduced the serum theophylline levels in the HC rats. Consequently, gastrointestinal dialysis by oral administration of activated charcoal may be a useful method to remove poisonous drugs from the blood in patients with hepatic failure (including cirrhosis), which decreases the systemic clearance.     

An adsorption study of Sr2+ from saline sources by coconut shell charcoal

The adsorption potential of charcoal for the removal of heavy metal ions is well documented in the literature. However, its exploration for uptake of technologically valuable metal ions such as Sr²⁺ is poorly known. In this work, the batch adsorption study of Sr²⁺ ion from aqueous solution as well as from saline matrix (>3% of NaCl) onto charcoal has been carried out. The experiments were conducted with two charcoals, i.e., our prepared charcoal (coconut shell charcoal) and commercial charcoal. Strontium adsorption has been investigated as a function of its initial concentration, contact time, and varied mass of adsorbent. Equilibrium adsorption data were evaluated for Langmuir and Freundlich isotherm models. The adsorption capacities (mg/g) of Sr²⁺ present in the salt matrix onto coconut shell charcoal and commercial charcoal was found to be 18.4 and 22.2, respectively. Uptake of Sr²⁺ from subsoil brine onto coconut shell charcoal has been successfully demonstrated in this work.     

Long-term and stable correction of uremic anemia by intramuscular injection of plasmids containing hypoxia-regulated system of erythropoietin expression

Relative deficiency in production of glycoprotein hormone erythropoietin (Epo) is a major cause of renal anemia. This study planned to investigate whether the hypoxia-regulated system of Epo expression, constructed by fusing Epo gene to the chimeric phosphoglycerate kinase (PGK) hypoxia response elements (HRE) in combination with cytomegalovirus immediate-early (CMV IE) basal gene promoter and delivered by plasmid intramuscular injection, might provide a long-term physiologically regulated Epo secretion expression to correct the anemia in adenine-induced uremic rats. Plasmid vectors (pHRE-Epo) were synthesized by fusing human Epo cDNA to the HRE/CMV promoter. Hypoxia-inducible activity of this promoter was evaluated first in vitro and then in vivo in healthy and uremic rats (n = 30 per group). The vectors (pCMV-Epo) in which Epo expression was directed by a constitutive CMV gene promoter served as control. ANOVA and Student''s t-test were used to analyze between-group differences. A high-level expression of Epo was induced by hypoxia in vitro and in vivo. Though both pHRE-Epo and pCMV-Epo corrected anemia, the hematocrit of the pCMV-Epo-treated rats exceeded the normal (P < 0.05), but that of the pHRE-Epo-treated rats didn''t. Hypoxia-regulated system of Epo gene expression constructed by fusing Epo to the HRE/CMV promoter and delivered by plasmid intramuscular injection may provide a long-term and stable Epo expression and secretion in vivo to correct the anemia in adenine-induced uremic rats.     

Removal of Co(II) from dilute aqueous solutions by adsorption on charcoal and subsequent macroflotation of the sorbent

As a part of a research program on the treatment of radioactive process waste waters, sorbent macroflotation was tested to remove Co(II) from dilute aqueous solutions. Activated charcoal was used as the sorbent, and gelatin, cetylpyridinium chloride, dodecylamine or N-dodecylpyridinium chloride (NDPC) as the collector. In addition to the effect of the collector type on the percent removal, the effects of the pH, the charcoal and collector doses, the metal ion concentration, the ionic strength and the use of combinations of NDPC with other reagents have been investigated. At the optimum conditions removals better then 97% could be achieved in the pH range of 7.5–10.0 with NDPC plus a low concentration of a low-molecular-weight polyacrylamide. The results obtained are discussed in terms of hydrolysis of the metal ion and the electric state of both the charcoal and collector.     

不同炭吸附材料对溶液中Pb^2＋的吸附性能比较

为比较不同炭吸附材料木炭、竹炭、改性木炭和改性竹炭对溶液中铅（Ⅱ）的吸附性能,研究了pH值、吸附剂用量、吸附平衡时间等因素对吸附量的影响。动力学研究表明,它们对铅（Ⅱ）的吸附均可用准一级动力学方程描述,测定了不同炭对铅（Ⅱ）吸附的表观速率常数,Freundlich等温吸附模型能较好地描述吸附过程;以我国饮用水标准中铅的限值0．05mg／L为标准,研究了一定质量浓度及一定量含铅废水处理时,所需吸附剂投料量的估算方法和实验验证结果,结果表明,控制合适的吸附条件,竹炭能较完全有效地除去废水中的铅。     

Removal of trivalent chromium from tannery waste waters using bone charcoal

The ability of bone charcoal to remove Cr(III) from aqueous solutions by adsorption has been investigated. The adsorbent used was first characterised and then the adsorption was studied as a function of time and amount of charcoal. Tests were carried out with synthetic solutions whose Cr concentrations (500 mg L(-1)) were similar to those found in some effluents of Moroccan tannery industries. Cr removal efficiencies higher than 90% were obtained at pH 3.5 using 3 g of bone charcoal and a stirring time of about 30 min. Results of Cr removal by all sieved fractions of bone charcoal had shown the same interesting capabilities for Cr(III) retention. The cross interference with other elements was also investigated. Pre-treatment of bone charcoal by nitric acid led to an increase in its specific surface area but induced a drastic reduction in its Cr elimination abilities. Adsorption tests were also carried out using calcinated bone charcoal. The results obtained showed a similar percentage of Cr retention to those found with untreated bone charcoal. On the other hand, a double treatment of bone charcoal with HCl and NaOH provided an enhancement of Cr(III) retention. The role played by the mineral fraction of the solid phase of bone was thus evidenced.     

The Permeability of Polyester Film (PEN) to Copper Ions

Ion exchange membranes (IEM) are often applied in the processes of separation and purification solutions, primarily in the chemical, food, and pharmaceutical industries. Most are currently made from organic polymers, such as polyamide and polyimide. In this work, a study of the permeability of polyethylene naphthalate film (PEN) to copper Cu(II) (heavy metal), using the Donnan dialysis technique, has allowed us, first, to highlight a new anion exchange membrane (AEM), and second, to improve its capabilities for the elimination of copper ions after heat treatment.     

Milking of 234Th from uranium by the combined use of adsorption on active charcoal and anion exchange

A rapid and simple procedure for the preparation of carrier-free 234Th for use as a tracer has been devised. A 0.01 mol X dm-3 HCl solution (120 cm3) of uranium (1.6 mol X dm-3) is kept contact with active charcoal. After the bulk uranium solution is removed, 234Th adsorbed on the charcoal is eluted with a 6 mol X dm-3 HCl solution (120 cm3). A small amount of uranium remaining in the solution of 234Th is completely removed by passing the solution through anion-exchange column.     

Chromatographic evaluation of perfusion on charcoal in uraemia

Chromatography on Bio-Gel P-2 and high-performance liquid chromatography on RP-18 columns monitored with UV, fluorescence and electrochemical detectors have been used to evaluate the efficiency of granular, uncoated, active charcoal to remove from the ultrafiltrates of uraemic patients those organic substances accumulated in the blood that are not easily removed by dialysis. Chromatography on Bio-Gel P-2 and high-performance liquid chromatography on RP-18 columns carried out isocratically and monitored with an electrochemical detector seem very useful for clinical investigation as they increase the information obtained from routine haematochemical analyses such as blood urea nitrogen, creatinine, uric acid and electrolytes (calcium, phosphorus, sodium and potassium).     

Combustion experiments of polystyrene by use of a modified bayer-ICI-shell apparatus

The combustion of polystyrene by use of a quartz tube modified Bayer-ICI-Shell apparatus yields, beside the main component styrene, a lot of other products known as biological hazards like benzene, naphthalene and biphenyl. The experiments have been performed in air atmosphere. According to DIN 4102, technical polystyrene mainly used in the building industry has been burnt and the composition of the resulting combustion products has been compared with that produced from the Bayer-ICI-Shell (BIS) experiments. The fire gases adsorbed on charcoal XAD 4 and XAD 2 have been desorbed in carbon disulfide as a solvent.It is concluded that a combination of XAD 4 and charcoal is the most efficient adsorbent. In addition, a method for quantitative determination of fire gas containing decomposition products is discussed.     

血液灌流材料研究进展

血液灌流技术以其显著的疗效和新颖的治疗方法而发展迅速,目前其应用正日趋广泛,所治疗的疾病已经从药物中毒、肝肾疾病扩展到一系列免疫性疾病。本文综述了血液灌流材料的发展和研究进展,按照种类不同对材料的性质和应用进行了阐述,为血液灌流材料的制备和应用提供参考。