During acute gout flares, serum uric acid (SUA) levels may remain within the normal range, making diagnosis based solely on SUA unreliable. A systematic evaluation incorporating clinical symptoms and imaging (ultrasound, dual-source CT) is essential to detect monosodium urate (MSU) crystal deposition. Normal-SUA gout often presents with more pronounced inflammation, fever, elevated white blood cell count and C-reactive protein, and may occur after surgery or hemodialysis. Tophi can appear at typical or atypical sites (e.g., face, neck). No specific treatment guidelines exist, but lowering SUA to <360 μmol/L (6 mg/dl) reduces gout flares and promotes MSU dissolution. Emerging therapies—including anti-IL-1β monoclonal antibodies, NLRP3 inhibitors, uricases, and green tea components—show promise in controlling attacks and dissolving crystals without affecting SUA levels.

AIMS:Microalbuminuria, common in diabetes, lacks clarity as a predictor of diabetes onset. This study examines its association with incident type 2 diabetes (T2DM) and clinical implications. METHODS:This prospective cohort analysis utilized data from 411,389 UK Biobank participants with baseline urine albumin-to-creatinine ratio (UACR) measurements. Cox proportional hazards regression models, supplemented by restricted cubic spline analyses, were implemented to longitudinally evaluate the association between UACR levels and incident T2DM risk. RESULTS:Over an average follow-up duration of 13.8 years (range: 13.1-14.6 years), 15,942 new cases of diabetes were identified. After adjusting for potential confounders, the hazard ratios for incident T2DM were 1.31 (95% CI: 1.17-1.45) for UACR between 3-30 mg/mmol and 2.20 (95% CI: 1.58-3.06) for UACR > 30 mg/mmol, when compared to a reference UACR of <3 mg/mmol. These results remained stable across multiple sensitivity analyses, including those addressing potential confounding factors such as body mass index, insulin resistance, uric acid levels, and estimated glomerular filtration rate using the creatinine-cystatin C equation (eGFRcr-cys). CONCLUSION:This large-scale cohort study demonstrates that microalbuminuria serves as a clinical predictor of elevated risk for incident T2DM in adults. Routine UACR screening in high-risk populations may enhance early detection and intervention.

Numerous studies have shown that dyslipidemia increases the risk of atherosclerotic cardiovascular disease (ASCVD) and significantly impacts the occurrence and progression of diabetic kidney disease (DKD). Early interventions for lipid metabolism disorders in DKD may improve renal function. This article reviews the clinical characteristics of dyslipidemia, mechanisms of lipid-induced renal injury, and advances in lipid-lowering therapy in DKD. We searched PubMed, Web of Science, and EMBASE to identify relevant articles, using keywords such as “diabetic kidney disease”, “diabetic nephropathy”, “diabetes”, “dyslipidemia”, “kidney”, “cardiovascular disease”, and “lipid therapy”. High triglyceride (TG) and low high-density lipoprotein (HDL) are associated with increased risks of albuminuria and estimated glomerular filtration rate (eGFR) decline. Abnormal lipid metabolism may damage glomerular podocytes and renal tubular epithelial cells via ectopic lipid deposition, eventually impairing glomerular filtration function and increasing urinary albumin excretion. Lipid-lowering therapies can ameliorate lipid accumulation, downregulate inflammatory mediator expressions, and alleviate renal fibrosis. Fibrate and statin applications exhibit beneficial effects, reducing albuminuria and slowing eGFR decline in early DKD. However, the long-term effects of statins and fibrates on renal outcomes remain controversial. Pro-protein convertase subtilisin/kexin 9 (PCSK9)-targeted interventions have minimal side effects on the kidneys and seem effective in reducing inflammation and improving renal impairment compared with statins and fibrates. In addition, LDL apheresis (LDL-A) and double filtration plasmapheresis (DFPP) are promising clinical applications in diabetic patients with severe hypercholesterolemia or lipid-lowering drug intolerance.

Background:Frailty is a critical geriatric syndrome associated with adverse surgical outcomes, yet preoperative risk prediction models for older adults undergoing abdominal surgery remain underdeveloped. This study aimed to identify frailty risk factors and establish a predictive nomogram in this population. Methods:We enrolled 790 older patients undergoing abdominal surgery at Hunan Provincial People's Hospital from February 2022 to September 2022. Frailty was assessed using the Tilburg Frailty Index. Univariate analysis, LASSO regression and multivariate analysis were used in turn to identify independent risk factors for frailty. The nomogram was developed based on the independent risk factors. The sample was randomly divided into a test group (75%) and a validation group (25%). The area under the curve (AUC) of the receiver operating characteristic (ROC) was calculated to assess the predictive performance of the nomogram. Results:The prevalence of frailty among older patients undergoing abdominal surgery was 74.18%. Eight independent risk factors were identified: advanced age (OR=1.32), lower BMI (OR=1.28), limited education (OR=1.45), laparoscopy (OR=1.67), tumor comorbidity (OR=2.01), diabetes (OR=1.89), antihyperlipidemic drug use (OR=1.53), and elevated interleukin-6 (OR=1.76). The nomogram demonstrated acceptable discrimination, with AUCs of 0.748 (the test group) and 0.707 (the validation group). Conclusion:Our findings demonstrate a nomogram to predict the probability of frailty for older patients undergoing abdominal with acceptable predictive performance. The nomogram is helpful in guiding further targeted and effective intervention and prevention efforts to decrease frailty and improve health outcomes.

BackgroundOver-proliferation of mesangial cells (MCs) is one of the main pathological changes in the early stages of diabetic kidney disease (DKD). Roxadustat, an oral hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitor, is widely studied in different models of kidney disease. Whether roxadustat has beneficial effect on the proliferation of MCs and DKD remains unknown.MethodsThe optimal concentration of roxadustat for inhibiting MC proliferation was determined using CCK-8 and colony formation assays. Changes in the cell cycle were detected using flow cytometry, and changes in cell cycle-related proteins were screened using quantitative reverse transcription polymerase chain reaction. Reverse experiments were applied using Trp53-/- cell line. Co-immunoprecipitation was used to verify the interaction between HIF-1α and p53 and predict sites of interaction. Finally, a corresponding in vivo verification was performed.ResultsOptimal concentrations of high glucose (30 mM) and roxadustat (100 μM) were established. Roxadustat showed anti-proliferation effect on MCs through S-phase arrest. HIF-1α/p53/p21 and downstream cyclins (cyclin A1, cyclin A2, and cyclin E1) showed corresponding changes. A reverse experiment confirmed that HIF-1α affected cell cycle and proliferation through p53, and co-immunoprecipitation results showed a interaction between HIF-1α and p53. Molecular docking predicted the possible interaction between Lys328, Pro332, Arg245, and Lys251 of HIF-1α and Ala222, Tyr226, Glu225, and Asp265 of p53, respectively. Finally, animal experiments demonstrated similar effect of roxadustat in db/db mice.ConclusionRoxadustat regulates and inhibits cell proliferation of MCs via the HIF-1α/p53/p21 pathway. This may be a potential therapeutic target in the early stages of diabetic kidney disease.

This meta-analysis aims to investigate the impact of abnormalities in mineral metabolic markers, including serum phosphate and calcium, intact parathyroid hormone (iPTH), and fibroblast growth factor 23 (FGF23) on the risk of fractures in patients with chronic kidney disease (CKD). A systematic search was conducted across MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register for Controlled Trials. The outcomes were association of mineral metabolic markers with the risk of fractures in patients with chronic kidney disease. Pooled risk estimates and 95

Background and aims: Triglyceride (TG)-lowering therapy is efficient for the prevention of cardiovascular disease (CVD) in the general population; however, for diabetic individuals, it is more controversial. The purpose of this study was to pool the results from randomized controlled trials (RCTs) to clarify whether the lowering of TG is beneficial for the prevention of CVD events, stroke, and mortality in subjects with diabetes. Methods: MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register for Controlled Trials were searched to identify the relevant literature. We included randomized controlled trials (RCTs) to assess the association of triglyceride-lowering therapy with the prevention of CVD events, stroke, and mortality in diabetic patients. Results: Overall, 19 studies were included in this meta-analysis. Compared with the control groups, TG lowering was associated with a decreased risk of CVD events (RR = 0.91, 95% CI 0.87-0.95, p = 0.000) and CVD mortality (RR = 0.93, 95% CI 0.86-1.00, p = 0.047). There was no significant correlation between TG-lowering therapy and the incidence of stroke and all-cause mortality (RR = 0.93, 95% CI 0.86-1.02, p = 0.129 and RR = 0.97, 95% CI 0.93-1.01, p = 0.107, respectively). Subgroup analysis showed that the decreased CVD risk resulting from TGlowering therapy was independent of age, sex, region, duration of follow-up, degree of TG reduction and glycemic control. Conclusions: TG-lowering therapy is associated with a reduction in CVD events and cardiovascular-specific mortality, but not in stroke and all-cause mortality. Future large, multicenter RCTs will further confirm these conclusions.

Purpose: It is unknown whether febuxostat can delay the progression of kidney dysfunction and reduce kidney endpoint events. The aim was to evaluate the renoprotective effect of febuxostat in patients with hyperuricemia or gout by performing a meta-analysis of randomized controlled trials (RCTs). Methods: MEDLINE, Web of science, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register for Randomized Controlled Trials were searched. The main outcomes included kidney events (serum creatinine doubling or progression to end-stage kidney disease or dialysis). The secondary outcomes were the rate of change in the estimated glomerular filtration rate (eGFR) and changes in the urine protein or urine albumin to creatinine ratio from baseline to the end of follow-up. We used random-effects models to calculate the pooled risk estimates and 95% CIs. Results: A total of 16 RCTs were included in the meta-analysis. In comparison with the control group, the patients who received febuxostat showed a reduced risk of kidney events (RR = 0.56, 95% CI 0.37-0.84, p = 0.006) and a slower decline in eGFR (WMD = 0.90 mL/min/1.73 m(2), 95% CI 0.31-1.48, p = 0.003). The pooled results also revealed that febuxostat use reduced the urine albumin to creatinine ratio (SMD = -0.21, 95% CI -0.41 to -0.01, p = 0.042). Conclusion: Febuxostat use is associated with a reduced risk of kidney events and a slow decline in eGFR. In addition, the urine albumin to creatinine ratio decreased in febuxostat users. Accordingly, it is an effective drug for delaying the progression of kidney function deterioration in patients with gout. [GRAPHICS]

Given the reduced immune response to vaccines in older populations, this study aimed to evaluate the efficacy of COVID-19 vaccinations and its impact on breakthrough infection, hospital admission, and mortality in the elderly. We carried out a systemic review and meta-analysis where MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and Cochrane Central Register for Controlled Trials were queried to identify relevant literature. We included randomized controlled trials (RCTs), non-randomized trials, prospective, observational cohort, and case–control studies assessing breakthrough infection, hospital admission, and mortality after coronavirus 2 (SARS-CoV-2) vaccination in the elderly (≥ 60 years old). Overall, 26 studies were included in this meta-analysis. Compared with the unvaccinated group, the vaccinated group showed a decreased risk of SARS-CoV-2 infection after 28–34 (relative risk [RR] = 0.42, 95

INTRODUCTION:To summarize the clinical experiences with double plasma purification (DPP).METHOD:Using Plasauto iQ automatic blood purification system, model KM-9000 for DPP.RESULTS:A total of 603 patients with different entity undergoing 811 purification procedures were included in this study. The most common purification modes were dual filtration plasma plasmapheresis (DFPP). Hyperlipidemia was the lead entity, 423 patients with hyperlipidemia performed DFPP, and two cases of severe acute pancreatitis caused by extremely high triglyceride levels completely recovered after two consecutive DFPP treatments. DFPP combined with immunosuppressants tended to decrease independent HD and reduced HD frequency in 53 patients with antineutrophil cytoplasmic antibody-associated vasculitis. Two patients developed hypotensive or hypoglycemia episodes, respectively, during purification procedures.CONCLUSION:DPP is rapid for the treatment of patients with severe hyperlipidemia and acute pancreatitis caused by severely high triglyceride levels. For those who are intolerant to statins，DPP provides another treatment choice. DPP process is safe.

Abstract Background Cardiac valvular calcification (CVC) is prevalent in haemodialysis (HD) patients. Its association with mortality in Chinese incident haemodialysis (IHD) patients remains unknown. Methods A total of 224 IHD patients who had just begun HD therapy at Zhongshan Hospital, Fudan University, were enrolled and divided into two groups according to the detection of cardiac valvular calcification (CVC) by echocardiography. The patients were followed for a median of 4 years for all-cause mortality and cardiovascular mortality. Results During follow-up, 56 (25.0%) patients died, including 29 (51.8%) of cardiovascular disease. The adjusted HR related to all-cause mortality was 2.14 (95% CI, 1.05–4.39) for patients with cardiac valvular calcification. However, CVC was not an independent risk factor for cardiovascular mortality in patients who had just begun HD therapy. Conclusion CVC at baseline is an independent risk factor for all-cause mortality in HD patients and makes an independent contribution to the prediction of all-cause mortality. These findings support the use of echocardiography at the beginning of HD.

Background: Considering the indeterminate effects following the administration of three doses of the SARS-CoV-2 vaccine to patients under dialysis, the present study aimed to evaluate the immunogenicity rates of patients who received the three-dose vaccine. Methods: MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register for Controlled Trials were searched to select the relevant literature to perform the present review. We included randomized controlled trials, non-randomized trials, prospective, observational cohort, and case-control studies to assess the humoral and cellular immune responses following the administration of the three-dose SARS-CoV-2 vaccine to patients receiving dialysis. Results: Overall, 38 studies are included in the meta-analysis presented in this paper. For patients on dialysis, the overall humoral antibody response rate is 97% following three doses of mRNA or viral vector vaccines and 100% following four doses of the SARS-CoV-2 vaccine. A subgroup analysis shows that the antibody response rate is 96% for patients on hemodialysis (HD) and 100% for those receiving peritoneal dialysis (PD). The antibody response rate in the different immunogen-vaccinated groups tends to be higher than that in the same immunogen-vaccinated group (99% vs. 96%). For those who exhibit no response following two doses of the vaccine, the third and fourth doses can elevate the antibody response rate to 81%, and that number for low responders increases to 96%. However, the pooled results obtained from the relatively few trials conducted indicate that the positive T-cell response rate only increases to 59% following three doses of the vaccine. The antibody response rate is not different between dialysis and non-dialysis groups (relative risk = 0.95, 95% CI 0.90–1.02) following three doses of the vaccine. The relative risks for a SARS-CoV-2 breakthrough infection, all-cause mortality, and hospital admissions are 0.59 (95% CI 0.30–1.04), 0.63 (95% CI 0.35–1.12), and 0.53 (95% CI 0.37–0.74), respectively, when comparing three doses with two doses of the vaccine administered to the dialysis population. Conclusions: The third or fourth dose of the SARS-CoV-2 vaccine significantly increases the immunogenicity rates in dialysis patients, and this beneficial effect does not vary with the type of vaccine (the same or different immunogen vaccination), dialysis modality (HD or PD), or previous low response following the administration two doses of the vaccine. We believe that healthcare workers should encourage patients receiving dialysis to receive a third or fourth vaccine dose to strengthen their immunity against SARS-CoV-2.

目的:观察硫酸吲哚酚(IS)对3T3-L1脂肪细胞氧化应激和炎症的影响及EGCG干预的效应.方法:以3T3-L1脂肪细胞为研究对象,分为对照组(control)、IS组(100μmol/L、IS250μmol/L、IS500μmol/L)、IS+EGCG组(IS 250μmol/L+EGCG5μmol/L、IS250μmol/L+EGCG10μmol/L、IS250μmol/L+EGCG20μmol/L).干预24 h后,CCK-8法检测细胞活力,生化试剂盒检测细胞内活性氧(ROS)含量及NADPH氧化酶活性,ELISA方法检测细胞培养上清液中TNF-α、IL-6及MCP-1含量.结果:不同试剂干预24 h后,与对照组相比,IS100、250、500μmol/L和EGCG5、10、20μmol/L对细胞活力无影响;与对照组相比,IS250、500μmol/L组细胞内ROS水平明显增加,细胞培养上清液中TNF-α、IL-6及MCP-1明显增加,差异有统计学意义(P<0.05);加入NADPH氧化酶抑制剂apocynin后,IS250μmol/L组细胞内ROS水平明显降低,细胞培养上清液中TNF-α、IL-6及MCP-1含量明显下降,差异有统计学意义(P<0.05).与IS250μmol/L组相比,加入EGCG10、20μmo/L干预后,细胞内ROS水平明显下降、NADPH氧化酶活性明显降低,细胞培养上清液中TNF-α、IL-6及MCP-1含量明显下降(P<0.05).结论:EGCG可改善IS诱导的3T3-L1脂肪细胞氧化应激和炎症,其作用与其抑制NADPH氧化酶有关.

Background Somnipathy and diabetes are independently associated with an increased risk of cardiovascular disease (CVD). However, whether a combination of both conditions is associated with a higher risk of CVD events remains uncertain. Therefore, the aim of this meta‐analysis was to clarify this association. Methods and Results We searched MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register for Controlled Trials. We included randomized controlled trials, nonrandomized trials, and prospective observational cohort studies that assessed the combined effect of diabetes and comorbid somnipathy on CVD risk and mortality for at least 1 year. Outcomes included CVD, coronary heart disease, stroke, and all‐cause mortality. Twelve studies involving 582 267 participants were included in the meta‐analysis. Patients with somnipathy and comorbid diabetes exhibited increased risks of CVD, coronary heart disease, stroke, and all‐cause mortality (risk ratio [RR], 1.27 [95% CI, 1.12–1.45], P<0.0001; RR, 1.40 [95% CI, 1.21–1.62], P<0.0001; RR, 1.28 [95% CI, 1.08–1.52], P=0.004, and RR, 1.56 [95% CI, 1.26–1.94], P<0.0001, respectively). Conclusions The coexistence of somnipathy and diabetes is associated with higher risks of CVD, coronary heart disease, stroke, and mortality than somnipathy or diabetes alone. Resolving sleep problems in patients with diabetes may reduce the risks of CVD, stroke, and mortality. Registration Information https://www.crd.york.ac.uk/prospero/. Identifier: PROSPERO CRD42021274566.

Background: The aim of this study was to analyze clinical features and short-term mortality in hemodialysis (HD) patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) omicron BA.2.2.1 variant. Methods: In a retrospective single-center case series, 102 consecutive hospitalized HD patients infected with the coronavirus omicron variant were assessed at Pudong Hospital in Shanghai, China, from April 6 to April 18, 2022; the final date of follow-up was May 16, 2022. Clinical, laboratory, chest CT, and treatment data were collected and analyzed. The association between these factors and all-cause mortality was studied using univariate and multivariate analyses. The relationship between lymphocyte count and short-term mortality was based on receiver operating characteristic (ROC) curve analysis. Kaplan-Meier analysis was used to assess overall survival. Results: In total, 102 patients were included in this study. The patients were divided into two groups: HD patients with pneumonia (N = 46) and without pneumonia (N = 56). Of the 102 patients, 12 (11.8%) died. Multivariate regression analysis revealed that all-cause mortality was correlated with lymphocyte counts and type B natriuretic peptide (BNP), C-reactive protein (CRP), and D-dimer levels (P < 0.05). The cut-off value of lymphocyte counts was 0.61 x 109/L for all-cause mortality. The overall survival rate was significantly different between HD patients with and without pneumonia (P < 0.05). Conclusions: Lymphocyte counts are important for the prediction of short-term mortality in HD patients with SARS-CoV-2 infection. HD patients with lung involvement have poorer survival rates than those without lung involvement. (c) 2022 The Authors. Published by Elsevier Ltd.

Aims: Considering the lack of evidence on statin use and the risk of cardiovascular disease (CVD) in patients with diabetes in primary and secondary prevention, this study aimed to evaluate the effect of statin use in individuals with diabetes for primary and secondary prevention.Data synthesis: The MEDLINE, Web of Science, Embase, ClinicalTrials.gov, and Cochrane Central Register for Controlled Trials databases were searched. We included studies that assessed the effect of statin use in individuals with diabetes for at least 1 year. The outcomes included CVD, allcause mortality, and stroke. A total of 24 studies including 2,152,137 patients with diabetes were included in the meta-analysis. Compared with statin non-users, patients who received statins showed a lower risk of CVD events (primary prevention: risk ratio [RR] = 0.80, 95% confidence interval [CI] 0.69-0.94, P = 0.006; secondary prevention: RR = 0.75, 95% CI 0.65-0.87, P < 0.0001). No association was observed between statin and non-statin users and the risk of all-cause mortality. The pooled results also revealed that statin use reduced the risk of ischemic stroke in patients with diabetes (primary prevention: RR = 0.83, 95% CI 0.70-0.97, P = 0.020; secondary prevention: RR = 0.74, 95% CI 0.63-0.85, P < 0.0001). Conclusions: Statin use significantly reduced the risk of CVD events and stroke, but not all-cause mortality, in individuals with diabetes undergoing both primary and secondary prevention. More data are required to verify the effects of statins in patients with diabetes.(c) 2022 The Author(s). Published by Elsevier B.V. on behalf of The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

We sincerely appreciate Dr. Kawada's comments in response to our metaanalysis.1 We agree with most of these opinions and would like to clarify our views here.

OBJECTIVE:To assess whether febuxostat use increases the risk of developing cardiovascular (CV) events, cardiac death, and all-cause mortalities.METHODS:The relevant literature was searched in several databases including MEDLINE (PubMed, January 1, 1966-February 29, 2020), Web of Science, EMBASE (January 1, 1974-February 29, 2020), ClinicalTrials. gov, and Cochrane Central Register of Controlled Trials. Manual searches for references cited in the original studies and relevant review articles were also performed. All studies included in this metaanalysis were published in English.RESULTS:In the end, 20 studies that met our inclusion criteria were included in our metaanalysis. Use of febuxostat was found not to be associated with an increased risk of all-cause mortality (RR 0.87, 95% CI 0.57-1.32, P = 0.51). Also, there was no association between febuxostat use and mortalities arising from CV diseases (CVD; RR 0.84, 95% CI 0.49-1.45, P = 0.53). The RR also revealed that febuxostat use was not associated with CVD events (RR 0.98, 95% CI 0.83-1.16, P = 0.83). Further, the likelihood of occurrence of CVD events was found not to be dependent on febuxostat dose (RR 1.04, 95% CI 0.84-1.30, P = 0.72).CONCLUSION:Febuxostat use is not associated with increased risks of all-cause mortality, death from CVD, or CVD events. Accordingly, it is a safe drug for the treatment of gout.

Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease. However, because of shared complications between DKD and chronic kidney disease (CKD), the description and characterization of DKD remain ambiguous in the clinic, hindering the diagnosis and treatment of early-stage DKD patients. Although estimated glomerular filtration rate and albuminuria are well-established biomarkers of DKD, early-stage DKD is rarely accompanied by a high estimated glomerular filtration rate, and thus there is a need for new sensitive biomarkers. Transcriptome profiling of kidney tissue has been reported previously, although RNA sequencing (RNA-Seq) analysis of the venous blood platelets in DKD patients has not yet been described. In the present study, we performed RNA-Seq analysis of venous blood platelets from three patients with CKD, five patients with DKD and 10 healthy controls, and compared the results with a CKD-related microarray dataset. In total, 2097 genes with differential transcript levels were identified in platelets of DKD patients and healthy controls, and 462 genes with differential transcript levels were identified in platelets of DKD patients and CKD patients. Through Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, we selected 11 pathways, from which nine potential biomarkers (IL-1B, CD-38, CSF1R, PPARG, NR1H3, DDO, HDC, DPYS and CAD) were identified. Furthermore, by comparing the RNA-Seq results with the GSE30566 dataset, we found that the biomarker KCND3 was the only up-regulated gene in DKD patients. These biomarkers may have potential application for the therapy and diagnosis of DKD, as well aid in determining the mechanisms underlying DKD.

目的:探讨双重滤过血浆置换(DFPP)对高胆固醇血症患者血小板mRNA的功能富集的影响.方法:纳入20例高胆固醇血症的患者,DFPP治疗前后,检测其前后血脂水平;留取静脉血标本提取血小板,标本采用RNA-Seq分析方法,对鉴定出的差异表达基因(DEGs)进行富集分析(GO/KEGG/Reactome).结果:DFPP治疗后,胆固醇、LDL-C、Lp(a)和sdLDL水平显著下降;与DFPP治疗前相比,DFPP治疗后血小板mRNA GO/KEGG/Reactome功能富集发生变化,筛选出几个重要的信号通路,如:cAMP信号通路、Rap1信号通路、NOD样受体信号通路、NF-κB信号通路等.结论:DFPP不仅能降低胆固醇水平,而且对血小板mRNA的功能富集产生影响.