Publications by authors named "Fanna Liu"

20 Publications

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Effects of andrographolide on renal tubulointersticial injury and fibrosis. Evidence of its mechanism of action.

Phytomedicine 2021 Oct 9;91:153650. Epub 2021 Jul 9.

Guangdong Pharmaceutical University, Guangzhou 510006, China; Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangzhou 510006, China; Key Laboratory of Glucolipid Metabolic Disorder, Ministry of Education, Guangzhou 510006, China; Institute of Chinese Medicine, Guangdong TCM Key Laboratory for Metabolic Diseases, Guangzhou 510006, China. Electronic address:

Background: Diabetic nephropathy (DN) is associated with renal interstitial injury and fibrosis. Our previous study showed that andrographolide protected against the progression of DN and high glucose (HG)-induced mesangial dysfunction. However, the protective effects of andrographolide on renal tubular epithelial cells have not been fully elucidated.

Purpose: To determine the protective effects of andrographolide on renal tubular damage and explore the underlying mechanism.

Study Design: Human tubular epithelial cells (HK-2 cells) were treated with andrographolide (5 and 10 μM) under HG conditions. Diabetic mice were treated with andrographolide (i.p. 2 and 4 mg/kg, twice per week).

Methods: Western blotting, reverse transcription-polymerase chain reaction (RT-PCR), immunofluorescence and flow cytometry were used to analyze the effects of andrographolide on renal tubular injury and fibrotic mechanisms in HK-2 cells. The protective effects of andrographolide against renal tubulointerstitial injury and fibrosis were investigated in diabetic mice fed a high-fat diet (HFD). Renal interstitial tissue was collected at sacrifice for immunohistochemistry, immunofluorescence analysis, RT-PCR and Western blotting to analyze the effects of andrographolide on renal tubular injury and fibrosis.

Results: In vitro assay results indicated that andrographolide (5 and 10 μM) effectively inhibited HG-induced apoptosis, epithelial-mesenchymal transition (EMT) and collagen deposition in HK-2 cells. Mechanistically, HG stimulated mitochondrial reactive oxygen species (mtROS)-mediated NOD-like receptor family and pyrin domain-containing protein 3 (NLRP3) inflammasome activation and EMT in tubular epithelial cells, and andrographolide (5 and 10 μM) inhibited these effects by ameliorating mitochondrial dysfunction. In vivo, treatment with andrographolide (2 and 4 mg/kg) inhibited renal tubular cell apoptosis, EMT and tubulointerstitial fibrosis, mitochondrial dysfunction and NLRP3 inflammasome activation in diabetic mice.

Conclusion: Andrographolide (5 and 10 μM) prevents HG-induced renal tubular cell damage, and andrographolide (2 and 4 mg/kg) protects against the progression of diabetic tubular injury and fibrosis in mice by suppressing mitochondrial dysfunction and NLRP3 inflammasome activation.
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http://dx.doi.org/10.1016/j.phymed.2021.153650DOI Listing
October 2021

The Association of Coagulation Indicators and Coagulant Agents With 30-Day Mortality of Critical Diabetics.

Clin Appl Thromb Hemost 2021 Jan-Dec;27:10760296211026385

Department of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.

Diabetes, regarded as a global health concerned disease, was focused by the World Health Organization (WHO). Patients with diabetes may have a hypercoagulable and hypo-fibrinolysis state. There is lots of research about cardiovascular effects on diabetes patients, but less about the coagulation system. This study is designed to investigate the relationship between coagulation indicators and 30-day mortality of critical diabetes patients. In this retrospective, single-center study, we included adult patients diagnosed with diabetes. Data, including demographic, complication, laboratory tests, scoring system, and anticoagulant treatment, were extracted from Medical Information Mart for Intensive Care (MIMIC-III). The receiver operating characteristic (ROC) curve and Kaplan-Meier curve were applied to predict the association of mortality and coagulation indicators. Cox hazard regression model and subgroup analysis were used to analyze the risk factors associated with 30-day mortality. A total of 4026 patients with diabetes mellitus were included in our study, of whom 3312 survived after admitted to the hospital and 714 died. Cox hazard regression showed anticoagulant therapy might decrease the risk of 30-day mortality after adjusted. In age <70 subgroup analysis, we found that patients with PTT <26.8 s or lightly increased PT may increase odds of 30-day hospital death (HR, 95%CI, 2.044 (1.376, 3.034), 1.562 (1.042, 2.343)). When age >70, lightly increased PTT may reduce the risk of mortality, but PT >16.3 s, a high level of hypo-coagulation state, increase risk of mortality (HR, 95%CI, 0.756 (0.574, 0.996), 1.756 (1.129, 2.729)). Critical diabetes patients may benefit from anticoagulant agents. The abnormal coagulant function is related to the risk of 30-day mortality.
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http://dx.doi.org/10.1177/10760296211026385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312190PMC
July 2021

Dietary Plant Protein and Mortality Among Patients Receiving Maintenance Hemodialysis: A Cohort Study.

Am J Kidney Dis 2021 May 28. Epub 2021 May 28.

National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China. Electronic address:

Rationale & Objective: Although greater dietary intake of protein has been associated with beneficial health effects among patients receiving maintenance hemodialysis (MHD), the effects of plant protein intake are less certain. We studied the association of the proportion of protein intake derived from plant sources with the risk of mortality among patients receiving MHD and explored factors that may modify these associations.

Study Design: Prospective observational cohort study.

Setting & Participants: 1,119 Chinese hemodialysis patients aged over 18 years receiving MHD in 2014-2015.

Predictors: The proportion of plant protein intake to total protein intake.

Outcomes: All-cause mortality and cardiovascular disease (CVD) mortality.

Analytical Approach: Segmented regression models were fit to examine the association of plant protein intake proportion with the risk of all-cause mortality and CVD mortality. Multivariable-adjusted Cox proportional and cause-specific hazards models were used to estimate the hazard ratios (HR) and 95% CI for these outcomes.

Results: The means of plant protein intake normalized to ideal body weight and plant protein intake proportion were 0.6±0.2 (SD) g/kg per day and 0.538±0.134, respectively. During a median follow-up period of 28.0 months, 249 deaths occurred, with 146 of these deaths resulting from CVD. Overall, there was a U-shaped association between plant protein intake proportion and the risk of all-cause mortality, with an inflection point at 45%. Among patients with a plant protein intake proportion<45%, there was a 17% lower rate of mortality with each 5% greater plant protein intake proportion (HR, 0.83 [95% CI, 0.73-0.96]). Among patients with plant protein intake proportion≥45%, there was a 9% greater rate of mortality with each 5% greater plant protein intake proportion. A similar U-shaped association was observed for CVD mortality, with an inflection point at 44%.

Limitations: Observational study, potential unmeasured confounding.

Conclusions: There was a U-shaped association between plant protein intake proportion and the risk of all-cause and cardiovascular mortality in MHD patients. If confirmed, these findings suggest a potential avenue to improve outcomes in this patient population.
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http://dx.doi.org/10.1053/j.ajkd.2021.03.023DOI Listing
May 2021

Prognostic Value of Serum Magnesium in Mortality Risk among Patients on Hemodialysis: A Meta-Analysis of Observational Studies.

Kidney Dis (Basel) 2021 Jan 4;7(1):24-33. Epub 2020 Nov 4.

Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China.

Background: Previous studies have reported that serum magnesium (Mg) deficiency is involved in the development of heart failure, particularly in patients with end-stage kidney disease. The association between serum Mg levels and mortality risk in patients receiving hemodialysis is controversial. We aimed to estimate the prognostic value of serum Mg concentration on all-cause mortality and cardiovascular mortality in patients receiving hemodialysis.

Methods: We did a systematic literature search in PubMed, EMBASE, Cochrane Library, and Web of Science to identify eligible studies that reported the prognostic value of serum Mg levels in mortality risk among patients on hemodialysis. We performed a meta-analysis by pooling and analyzing hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: We identified 13 observational studies with an overall sample of 42,967 hemodialysis patients. Higher all-cause mortality (adjusted HR 1.58 [95% CI: 1.31-1.91]) and higher cardiovascular mortality (adjusted HR 3.08 [95% CI: 1.27-7.50]) were found in patients with lower serum Mg levels after multivariable adjustment. There was marked heterogeneity ( = 79.6%, < 0.001) that was partly explained by differences in age stratification and study area. In addition, subgroup analysis showed that a serum Mg concentration of ≤1.1 mmol/L might be the vigilant cutoff value.

Conclusion: A lower serum Mg level was associated with higher all-cause mortality and cardiovascular mortality in patients receiving hemodialysis.
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http://dx.doi.org/10.1159/000510513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879293PMC
January 2021

Machine learning prediction models for prognosis of critically ill patients after open-heart surgery.

Sci Rep 2021 Feb 9;11(1):3384. Epub 2021 Feb 9.

Department of Nephrology, The First Affiliated Hospital of Jinan University, 613 W.Huangpu Avenue, Guangzhou, 510632, China.

We aimed to build up multiple machine learning models to predict 30-days mortality, and 3 complications including septic shock, thrombocytopenia, and liver dysfunction after open-heart surgery. Patients who underwent coronary artery bypass surgery, aortic valve replacement, or other heart-related surgeries between 2001 and 2012 were extracted from MIMIC-III databases. Extreme gradient boosting, random forest, artificial neural network, and logistic regression were employed to build models by utilizing fivefold cross-validation and grid search. Receiver operating characteristic curve, area under curve (AUC), decision curve analysis, test accuracy, F1 score, precision, and recall were applied to access the performance. Among 6844 patients enrolled in this study, 215 patients (3.1%) died within 30 days after surgery, part of patients appeared liver dysfunction (248; 3.6%), septic shock (32; 0.5%), and thrombocytopenia (202; 2.9%). XGBoost, selected to be our final model, achieved the best performance with highest AUC and F1 score. AUC and F1 score of XGBoost for 4 outcomes: 0.88 and 0.58 for 30-days mortality, 0.98 and 0.70 for septic shock, 0.88 and 0.55 for thrombocytopenia, 0.89 and 0.40 for liver dysfunction. We developed a promising model, presented as software, to realize monitoring for patients in ICU and to improve prognosis.
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http://dx.doi.org/10.1038/s41598-021-83020-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873187PMC
February 2021

Identification of a novel interplay between intestinal bacteria and metabolites in Chinese patients with IgA nephropathy via integrated microbiome and metabolome approaches.

Ann Transl Med 2021 Jan;9(1):32

The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.

Background: Immunoglobulin A nephropathy (IgAN) is the most common form of primary glomerulonephritis. The intestinal microbial ecosystem and metabolic network of IgAN have not been systematically analyzed. The present study aims to improve understanding of the gut microbiota and its metabolic capabilities to facilitate the development of diagnostic, therapeutic, and prognostic methods for IgAN.

Methods: We characterized the gut microbiota and metabolic patterns of fecal and serum samples of IgAN patients and healthy controls from the south of China using 16s ribosomal RNA gene sequencing and liquid chromatography-tandem mass spectrometry, respectively, and bioinformatics approaches.

Results: We found that the relative abundances of and were higher in IgAN patients, whereas and were lower. Changes in the gut microbiota of IgAN affected the metabolism and absorbance of microbiota-associated metabolites, in particular polyunsaturated fatty acids, free amino acid, and oligopeptides, and activated the phenylalanine metabolism pathway, thereby constructing a unique metabolic system of IgAN. We identified six pivotal metabolites, including bilirubin, trimethoprim, stearamide, phenylalanine, cis-9,10-epoxystearic acid, and phosphatidylethanolamine 17:0, that connected the metabolic networks of the gut and blood. Additionally, 5-hydroxyeicosatetraenoic acid and 5-hydroxy-6E,8Z,11Z-eicosatrienoic acid were shown to be associated with the classification of glomerular sclerosis.

Conclusions: We establish a relational network between microbiota, fecal metabolites, and serum metabolites in IgAN. The core microbiota and metabolites identified have promising value in therapeutic applications.
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http://dx.doi.org/10.21037/atm-20-2506DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7859797PMC
January 2021

Higher dietary fibre intake is associated with lower CVD mortality risk among maintenance haemodialysis patients: a multicentre prospective cohort study.

Br J Nutr 2021 Jan 20:1-9. Epub 2021 Jan 20.

National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515, Guangzhou, People's Republic of China.

High fibre intake is associated with reduced mortality risk in both general and chronic kidney disease populations. However, in dialysis patients, such data are limited. Therefore, the association between dietary fibre intake (DFI) and the risk of all-cause and CVD mortality was examined in this study. A total of 1044 maintenance haemodialysis (MHD) patients from eight outpatient dialysis centres in China were included in this study. Data on DFI were collected using 24-h dietary recalls for 3 d in a week and were normalised to actual dry weight. The study outcomes included all-cause and CVD mortality. Over a median of 46 months of follow-up, 354 deaths were recorded, of which 210 (59 %) were due to CVD. On assessing DFI as tertiles, the CVD mortality risk was significantly lower in patients in tertiles 2-3 (≥0·13 g/kg per d; hazard ratio (HR) 0·71; 95 % CI 0·51, 0·97) compared with those in tertile 1 (<0·13 g/kg per d). A similar but non-significant trend was found for the association between DFI (tertiles 2-3 v. tertile 1; HR 0·83; 95 % CI 0·64, 1·07) and all-cause mortality. In summary, higher DFI was associated with lower CVD mortality risk among Chinese MHD patients. This study emphasises the significance of DFI in MHD patients and provides information that is critical for the improvement of dietary guidelines for dialysis patients.
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http://dx.doi.org/10.1017/S0007114521000210DOI Listing
January 2021

Relationship between Serum Uric Acid and Mortality Risk in Hemodialysis Patients: A Multicenter Prospective Cohort Study.

Am J Nephrol 2020 16;51(10):823-832. Epub 2020 Oct 16.

National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China,

Background: Several studies have reported that low serum uric acid (SUA) levels are related to increased risk of mortality in maintenance hemodialysis (MHD) patients. However, the possible detrimental effects of high SUA on the mortality risk have not been well examined. Moreover, the possible effect modifiers for the SUA-mortality association have not been fully investigated. To address the aforementioned gap, we aimed to explore the nonlinear relationship between SUA levels and all-cause and cardiovascular disease (CVD) mortality risk, and to examine any possible effect modifiers in MHD patients.

Methods: We conducted a multicenter, prospective cohort study among 1,018 MHD patients from 8 hemodialysis centers. The primary outcome was all-cause mortality, and the secondary outcomes were CVD mortality and non-CVD mortality.

Results: The mean value for SUA in the total population was 8.5 ± 1.9 mg/dL. The lowest and highest quintiles of SUA were <7.0 and >10.1 mg/dL, respectively. Over a median follow-up of 45.6 months, 343 deaths were recorded, of which 202 (58.9%) were due to CVD. When SUA was assessed as quintiles, a significantly higher risk of all-cause mortality was found in patients in quintile 1 (<7.0 mg/dL; hazard ratio [HR], 1.33; 95% confidence interval [CI]: 1.02-1.73) or quintile 5 (≥10.1 mg/dL; HR, 1.47; 95% CI: 1.09-2.00), compared to those in quintiles 2-4 (7-10.1 mg/dL). Moreover, the U-shaped SUA-mortality association was mainly found in those with lower C-reactive protein levels (<3 compared with ≥3 mg/L; p for interaction = 0.018). Similar trends were found for CVD mortality and non-CVD mortality.

Conclusion: There was a U-shaped relationship between SUA levels and the risk of all-cause mortality, CVD mortality, and non-CVD mortality in MHD patients.
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http://dx.doi.org/10.1159/000509258DOI Listing
September 2021

Identification of Key Genes and Prognostic Analysis between Chromophobe Renal Cell Carcinoma and Renal Oncocytoma by Bioinformatic Analysis.

Biomed Res Int 2020 11;2020:4030915. Epub 2020 Jan 11.

Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou 510632, China.

The present techniques of clinical and histopathological diagnosis hardly distinguish chromophobe renal cell carcinoma (ChRCC) from renal oncocytoma (RO). To identify differentially expressed genes (DEGs) as effective biomarkers for diagnosis and prognosis of ChRCC and RO, three mRNA microarray datasets (GSE12090, GSE19982, and GSE8271) were downloaded from the GEO database. Functional enrichment analysis of DEGs was performed by DAVID. STRING and Cytoscape were applied to construct the protein-protein interaction (PPI) network and key modules of DEGs. Visualized plots were conducted by the R language. We downloaded clinical data from the TCGA database and the influence of key genes on the overall survival of ChRCC was performed by Kaplan-Meier and Cox analyses. Gene set enrichment analysis (GSEA) was utilized in exploring the function of key genes. A total of 79 DEGs were identified. Enrichment analyses revealed that the DEGs are closely related to tissue invasion and metastasis of cancer. Subsequently, 14 hub genes including ESRP1, AP1M2, CLDN4, and CLDN7 were detected. Kaplan-Meier analysis indicated that the low expression of CLDN7 and GNAS was related to the worse overall survival in patients with ChRCC. Univariate Cox analysis showed that CLDN7 might be a helpful biomarker for ChRCC prognosis. Subgroup analysis revealed that the expression of CLDN7 showed a downtrend with the development of the clinical stage, topography, and distant metastasis of ChRCC. GSEA analysis identified that cell adhesion molecules cams, B cell receptor signaling pathway, T cell receptor signaling pathway, RIG-I like receptor signaling pathway, Toll-like receptor signaling pathway, and apoptosis pathway were associated with the expression of CLDN7. In conclusion, ESRP1, AP1M2, CLDN4, PRSS8, and CLDN7 were found to distinguish ChRCC from RO. Besides, the low expression of CLDN7 was closely related to ChRCC progression and could serve as an independent risk factor for the overall survival in patients with ChRCC.
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http://dx.doi.org/10.1155/2020/4030915DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977339PMC
September 2020

The association between dietary energy intake and the risk of mortality in maintenance haemodialysis patients: a multi-centre prospective cohort study.

Br J Nutr 2020 02 8;123(4):437-445. Epub 2019 Nov 8.

National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou 510515, People's Republic of China.

Maintenance haemodialysis (MHD) is the use of a machine to filter wastes, salts and fluid from blood for at least 3 months to prolong the life of patients with advanced kidney failure. Although low dietary energy intake (DEI) has been observed in MHD patients, few studies have related DEI to the risk of mortality. To explore this relationship, a study included 1039 MHD patients from eight centres was conducted. DEI was assessed by three 24-h diet recalls and was normalised to ideal body weight (IBW). All-cause mortality and CVD mortality were the primary and secondary outcomes, respectively. During a median follow-up of 28 months, a U-shaped relationship was observed between DEI and all-cause or CVD mortality. The risk of all-cause mortality decreased significantly with the increase of DEI in participants with DEI <167·4 kJ/kg IBW per d (hazard ratio (HR) 0·98; 95 % CI 0·96, 1·00) and increased significantly with the increase of DEI in those with DEI ≥167·4 kJ/kg IBW per d (HR 1·12; 95 % CI 1·04, 1·20). Similarly, the risk of CVD mortality decreased with the increase of DEI in participants with DEI <152·7 kJ/kg IBW per d (HR 0·96; 95 % CI 0·93, 0·99) and increased with the increase of DEI in participants with DEI ≥152·7 kJ/kg IBW per d (HR 1·11; 95 % CI 1·04, 1·18). In summary, there was a U-shaped association between DEI and all-cause or CVD mortality, with a turning point at about 167·4 and 152·7 kJ/kg IBW per d, respectively, in MHD patients.
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http://dx.doi.org/10.1017/S0007114519002861DOI Listing
February 2020

Comparison of three nutritional screening tools for predicting mortality in maintenance hemodialysis patients.

Nutrition 2019 Nov - Dec;67-68:110532. Epub 2019 Jun 25.

Division of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Nanfang Hospital, Southern Medical University, Guangzhou, China. Electronic address:

Objectives: The aim of this study was to compare the effect of different nutritional screening tools on predicting the risk for mortality in patients on maintenance hemodialysis (MHD).

Methods: A cohort of 1025 patients on MHD were enrolled from eight hospitals. The malnutrition-inflammation score (MIS), objective score of nutrition on dialysis (OSND), and geriatric nutritional risk index (GNRI) were measured at baseline. All-cause mortality and cardiovascular (CV) mortality were the major study outcomes.

Results: The median follow-up duration was 28.1 mo. The MIS (per SD increase, hazard ratio [HR], 1.35; 95% confidence interval [CI], 1.18-1.55), the OSND (per SD decrease, HR, 1.24; 95% CI, 1.09-1.42), and the GNRI (per SD decrease, HR, 1.26; 95% CI, 1.10-1.43) were significantly associated with the risk for all-cause mortality. More importantly, the mortality predictability of the MIS appears similar to the GNRI (P = 0.182) and greater than the OSND (MIS versus OSND: P = 0.001; GNRI versus OSND: P = 0.045). Similar results were found for CV mortality.

Conclusions: Each of the three nutritional screening tools was significantly associated with an increased risk for all-cause and CV mortality. The mortality predictability of the MIS was similar to the GNRI and greater than the OSND.
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http://dx.doi.org/10.1016/j.nut.2019.06.013DOI Listing
September 2020

p53 induces miR-199a-3p to suppress mechanistic target of rapamycin activation in cisplatin-induced acute kidney injury.

J Cell Biochem 2019 10 30;120(10):17625-17634. Epub 2019 May 30.

Department of Nephrology, The Affiliated Jiangmen TCM Hospital of Jinan University, Jiangmen, Guangdong, P. R. China.

How p53 participates in acute kidney injury (AKI) progress and what are the underlying mechanisms remain illusive. For this issue, it is important to probe into the role of p53 in cisplatin-induced AKI. We find that p53 was upregulated in cisplatin-induced AKI, yet, pifithrin-α inhibites the p53 expression to attenuated renal injury and cell apoptosis both in vivo cisplatin-induced AKI mice and in vitro HK-2 human renal tubular epithelial cells. To knock down p53 by siRNA significantly decreased the miRNA, miR-199a-3p, expression in HK-2 cells. Blockade of miR-199a-3p significantly reduced cisplatin-induced cell apoptosis and inhibited caspase-3 activity. Mechanistically, we identified that miR-199a-3p directly bound to mechanistic target of rapamycin (mTOR) 3'-untranslated region and overexpressed miR-199a-3p reduce the expression and phosphorylation of mTOR. Furthermore, we demonstrated that p53 inhibited mTOR activation through activating miR-199a-3p. In conclusion, our findings reveal that p53, upregulating the expression of miR-199a-3p affects the progress of cisplatin-induced AKI, which might provide a promising therapeutic target of AKI.
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http://dx.doi.org/10.1002/jcb.29030DOI Listing
October 2019

Implementing Assisted Peritoneal Dialysis in Renal Care: a Chinese-German Perspective.

Kidney Blood Press Res 2018 31;43(5):1646-1654. Epub 2018 Oct 31.

Department of Nephrology, The First Affiliated Hospital of Jinan University, Guangzhou,

Assisted PD (assPD) is an option of home dialysis treatment for dependent end-stage renal patients and worldwide applied in different countries since more than 40 years. China and Germany shares similar trends in demographic development with a growing proportion of elderly referred to dialysis treatment. So far number of patients treated by assPD is low in both countries. We analyze experiences in the implementation process, barriers, and benefits of ass PD in the aging population to provide a model for sustainable home dialysis treatment with PD in both countries. Differences and similarities of different factors (industrial, patient and facility based) which affect utilization of assPD are discussed. AssPD should be promoted in China and Germany to realize the benefits of home dialysis for the aging population by providing a structured model of implementation and quality assurance.
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http://dx.doi.org/10.1159/000494679DOI Listing
January 2019

Bioinformatic identification of key genes and analysis of prognostic values in clear cell renal cell carcinoma.

Oncol Lett 2018 Aug 30;16(2):1747-1757. Epub 2018 May 30.

Department of Nephrology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, Guangdong 510632, P.R. China.

The present study aimed to identify new key genes as potential biomarkers for the diagnosis, prognosis or targeted therapy of clear cell renal cell carcinoma (ccRCC). Three expression profiles (GSE36895, GSE46699 and GSE71963) were collected from Gene Expression Omnibus. GEO2R was used to identify differentially expressed genes (DEGs) in ccRCC tissues and normal samples. The Database for Annotation, Visualization and Integrated Discovery was utilized for functional and pathway enrichment analysis. STRING v10.5 and Molecular Complex Detection were used for protein-protein interaction (PPI) network construction and module analysis, respectively. Regulation network analyses were performed with the WebGestal tool. UALCAN web-portal was used for expression validation and survival analysis of hub genes in ccRCC patients from The Cancer Genome Atlas (TCGA). A total of 65 up- and 164 downregulated genes were identified as DEGs. DEGs were enriched with functional terms and pathways compactly related to ccRCC pathogenesis. Seventeen hub genes and one significant module were filtered out and selected from the PPI network. The differential expression of hub genes was verified in TCGA patients. Kaplan-Meier plot showed that high mRNA expression of enolase 2 () was associated with short overall survival in ccRCC patients (P=0.023). High mRNA expression of cyclin D1 () (P<0.001), fms related tyrosine kinase 1 () (P=0.004), plasminogen () (P<0.001) and von Willebrand factor () (P=0.008) appeared to serve as favorable factors in survival. These findings indicate that the DEGs may be key genes in ccRCC pathogenesis and five genes, including and , may serve as potential prognostic biomarkers in ccRCC.
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http://dx.doi.org/10.3892/ol.2018.8842DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036467PMC
August 2018

Effect of Polylysine on Blood Clotting, and Red Blood Cell Morphology, Aggregation and Hemolysis.

Authors:
Wu Zhang Fanna Liu

J Nanosci Nanotechnol 2017 01;17(1):251-55

Polylysine has broad biomedical applications, though little is known about its hemocompatibility. Here, we studied the influence of polylysine on human red blood cells (RBCs) and blood clotting. We observed the morphology and aggregation and determined the hemolysis of RBCs incubated with polylysine. Plasma coagulation in the presence of polylysine was evaluated by measuring the activated partial thromboplastin time (APTT) and prothrombin time (PT). Human whole blood coagulation in the presence of polylysine was evaluated with the thromboelastograph (TEG). We found that polylysine at 0.01 mg/mL did not result in RBC aggregation or morphological change, while polylysine at ≥ 0.1 mg/mL caused RBC aggregation. The RBCs did not lyze in the presence of 0.01–0.5 mg/mL of polylysine. Polylysine at 0.001 mg/mL did not cause a significantly different APTT from the control, while polylysine at ≥ 0.01 mg/mL caused a significantly higher APTT than the control. Polylysine at ≤ 0.1 mg/mL did not cause a significantly different PT from the control, while polylysine at 1 mg/mL caused a significantly higher PT than the control. TEG parameters for whole blood coagulation in the presence of 0.01 mg/mL polylysine were within the normal range; while polylysine ≥ 0.1 mg/mL caused one or more abnormal TEG parameters. From these results, the effect of polylysine on RBC aggregation and blood coagulation was concentration-dependent. The results provide important information for the biomedical applications of polylysine.
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http://dx.doi.org/10.1166/jnn.2017.12593DOI Listing
January 2017

Patency and Complications of Translumbar Dialysis Catheters.

Semin Dial 2015 Jul-Aug;28(4):E41-7. Epub 2015 Mar 20.

Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio.

Translumbar tunneled dialysis catheter (TLDC) is a temporary dialysis access for patients exhausted traditional access for dialysis. While few small studies reported successes with TLDC, additional studies are warranted to understand the short- and long-term patency and safety of TLDC. We conducted a retrospective analysis of adult patients who received TLDC for hemodialysis access from June 2006 to June 2013. Patient demographics, comorbid conditions, dialysis details, catheter insertion procedures and associated complications, catheter patency, and patient survival data were collected. Catheter patency was studied using Kaplan-Meier curve; catheter functionality was assessed with catheter intervals and catheter-related complications were used to estimate catheter safety. There were 84 TLDCs inserted in 28 patients with 28 primary insertions and 56 exchanges. All TLDC insertions were technically successful with good blood flow during dialysis (>300 ml/minute) and no immediate complications (major bleeding or clotting) were noted. The median number of days in place for initial catheter, secondary catheter, and total catheter were 65, 84, and 244 respectively. The catheter patency rate at 3, 6, and 12 months were 43%, 25%, and 7% respectively. The main complications were poor blood flow (40%) and catheter-related infection (36%), which led to 30.8% and 35.9% catheter removal, respectively. After translumbar catheter, 42.8% of the patients were successfully converted to another vascular access or peritoneal dialysis. This study data suggest that TLDC might serve as a safe, alternate access for dialysis patients in short-term who have exhausted conventional vascular access.
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http://dx.doi.org/10.1111/sdi.12358DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836066PMC
May 2016

Enhanced mechanical properties and blood compatibility of PDMS/liquid crystal cross-linked membrane materials.

J Mech Behav Biomed Mater 2013 Apr 4;20:347-53. Epub 2013 Feb 4.

Department of Materials Science and Engineering, Jinan University, Guangzhou 510632, China.

A novel polydimethylsiloxane/liquid crystal cross-linked membrane (PDMS/LC) was prepared by using PDMS containing vinyl groups and LCs containing unsaturated linkages as matrix materials. Mechanical properties, liquid crystalline performance and blood compatibility of the PDMS/LC cross-linked membrane containing different LC contents and LC groups were investigated, respectively. The results showed that mechanical properties of the membrane increased more significantly than those of pure PDMS membranes. The PDMS/LC cross-linked membrane also possessed better membrane-forming ability, lower hemolysis rate, less platelets adhesion and more favorable anti-coagulant properties. Additionally, mechanical properties and blood compatibility of the membrane can be enhanced simultaneously and obviously due to the introduction of the cholesteric liquid crystals and the application of the preferred cross-linked reaction without byproducts.
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http://dx.doi.org/10.1016/j.jmbbm.2013.01.010DOI Listing
April 2013

Treatment of acute carbon monoxide poisoning with extracorporeal membrane trioxygenation.

Int J Artif Organs 2012 Dec;35(12):1070-6

Department of Nephrology Internal Medicine, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China.

Objective: To treat acute carbon monoxide poisoning (ACOP) with extracorporeal membrane trioxygenation (ECMO3), and to determine the efficacy and safety of ECMO3.

Method: Thirty-two New Zealand white rabbits were divided randomly into four groups including ECMO3 group (G1-ECMO3), oxygen treatment group (G2-FIO2), untreated ACOP group (G3-ACOP), and control group (G4-control). Rabbits in the first three groups were intraperitoneally injected with 99.99% CO at a dosage of 200 ml/kg, and those in the control group were treated with placebo. The dynamic changes in carboxyhemoglobin (COHb) concentration, blood oxygen saturation (SO2) level, base excess of blood (BE-B) as well as the vital signs of the rabbits were monitored.

Results: All the experimental rabbits had significantly higher levels of COHb (p = 0.000<0.05) than those in the control group after 30 min of CO injection with poisoning reactions. The respiration and heart rate of the rabbits in the ECMO3 group and FIO2 group were recovered to a level close to those of the rabbits in the control group by the end of the treatment, and they were significantly lower than those in the ACOP group (p = 0.000, <0.05). The COHb levels of rabbits in the G1-ECMO3 group were significantly lower than those in the G2-FIO2 and the G3-ACOP groups (F = 42.799, p = 0.000), and were similar to those in the CONTROL GROUP. AFTER 0.5 H OF TREATMENT, THE SO2 AND BE-B LEVELS OF RABBITS IN THE G1-ECMO3 AND THE G2-FIO2 GROUPS WERE HIGHER THAN THOSE IN THE G3-ACOP GROUP (P<0.05, P = 0.000<0.05).

Conclusions: ECMO3 treatment effectively lowered the COHb levels, increased SO2 levels, and cured acid poisoning, making it a safe and promising ACOP treatment strategy.
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http://dx.doi.org/10.5301/ijao.5000112DOI Listing
December 2012

Heparin/chitosan nanoparticle carriers prepared by polyelectrolyte complexation.

J Biomed Mater Res A 2007 Dec;83(3):806-12

Department of Materials Science and Engineering, Jinan University, Guangzhou, China, 510632.

In this study, novel nanoparticles were prepared by polyelectrolyte complexation between heparin and chitosan on simple and mild conditions. The size, polydispersity, zeta potential, and morphology of the nanoparticles were characterized. Entrapment studies of the nanoparticles were conducted using bovine serum albumin (BSA) as a model protein. Specifically, the effects of the pH value of chitosan solution, chitosan molecular weight (MW), chitosan concentration, heparin concentration, and BSA concentration on the nanoparticle size, the nanoparticle yield, and BSA entrapment were studied in detail. We found that, the size and the yield of the nanoparticles were affected by the above factors. The nanoparticle yield played a crucial role in BSA entrapment, namely, more nanoparticles could encapsulate more BSA. At length, suitably high pH value of chitosan solution, moderate chitosan MW, increasing both heparin concentration and chitosan concentration at an optimal concentration ratio favored more nanoparticles formed and consequently a higher BSA entrapment efficiency.
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http://dx.doi.org/10.1002/jbm.a.31407DOI Listing
December 2007
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