Volume 91  ·   Issue 02  ·  2011

The purpose of the treatment of recurrent and metastatic breast cancer is to relieve the symptoms of patients, improve the quality of life and prolong the survival time of patients [1]. The general strategy of prolonging the survival of patients with recurrent and metastatic breast cancer should be to choose reasonable comprehensive treatment, choose the best first-line treatment, mainly systemic treatment, combined with reasonable local treatment.

Objective To investigate the value of guide wire location under mammography for a resection of subclinical breast lesions. Methods A total of 79 patients presenting with abnormal mammography but unpalpable lesions received a guide wire pre-operative location under mammography. And 82 lesions were successfully located and resected for pathological examination. Results All 82 lesions were located with a high accuracy. The pathological examination revealed breast fibroma (n = 4), mammary gland hyperplasia with calcification ( n = 58 ), intraductal papiloma ( n = 2), fat necrosis with calcification ( n =3), mammary atypical hyperplasia ( n = 5 ), breast inflammation ( n = 1 ) and breast cancer ( n = 9).Conclusion The technique of guide wire location under mammography is highly accurate for pre-operative location of subclinical breast lesions. It is valuable for an early diagnosis of unpalpable breast lesions.

Objective To explore the association between polymorphism of cytochrome P450 1 Al Gene 3'-UTR (3'-untranslated region ) 6235T-C and breast cancer with abnormal Hilit in Chinese Han population of Xinjiang. Methods The breast cancer patients were divided into four body fluids according to Uighur medical theories. And the technique of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was employed to detect the genotypic and allelic frequencies of 6235T-C polymorphism situated in 3'-untranslated region of CYP1A1 gene in 137 breast cancer patients with abnormal Hilit and 148 normal control subjects in Han population of Xinjiang province. Results ( 1 ) Significant differences in the genotypic and allelic distribution frequencies of CYP1A1 gene 3'-UTR6235T-C were found between breast cancer patients with abnormal Sapra Hilit and controls ( x2 = 8. 790, P = 0. 012;x2 = 7. 102,P = 0. 008 ). The frequencies of CC genotype and C allele were significantly higher in breast cancer patients with abnormal Sapra Hilit ( 16. 4% vs 39. 8% ) than in controls ( 4. 7% vs 25. 7% ). ( 2 ) Significant differences in the genotypes and allelic distribution frequencies of CYP1A1 gene 3'-UTR6235T-C were found between breast cancer patients with abnormal Savda Hilit and controls ( x2 = 6. 638, P = 0. 036;x2 =5. 824, P =0. 016). And the frequencies of TC, CC genotypes and C allele were significantly higher in breast cancer patients with abnormal Savda Hilit ( 56. 9%, 9. 8%, 39. 2% ) than those of the controls (41.9%, 4.7%, 25.7%). Conclusion The CC genotype and C allele of 6235T-C polymorphism of CYP1Al may be linked with breast cancer with abnormal Sapra Hilit and abnormal savda Hilit in Chinese Hah population of Xinjiang province. But they are not correlated with the susceptibility to breast cancer with abnormal Balgham Hilit.

Objective To evaluate the clinical value of GeneSearchTM BLN Assay as an intraoperative diagnostic method of sentinel lymph node (SLN) for breast cancer patients. Methods A total of 479 consecutive patients from six centers were involved in this prospective study. The SLNs were identified,dissected and then sectioned along the short axis into multiple blocks. The odd blocks were tested intraoperatively by the above-mentioned assay and the even blocks assessed post-operatively by histopathologic examination. The 4 -6 μm thick stepwise sectioning permanent HE slides were prepared every 150 μm and one block yielded 6 slides. In addition, the even blocks of 136 patients were prepared for frozen section (F S) and all blocks of 156 patients evaluated intra-operatively by touch imprint cytology (TIC). Results In the node basis analysis, its accuracy, sensitivity, specificity, positive predict value (PPV) and negative predict value (NPV) were 93.0%, 85.6%, 94. 6%, 76.6% and 96.9% respectively. Its sensitivity was similar to that of FS ( 84. 9%, P = 0. 885 ) and significantly higher than that of TIC (70. 0%, P = 0. 007 ).When assessing nodes with macro-metastases, its sensitivity was similar to that of FS (93.6% vs 95.6%,P =0. 558) and significantly higher than that of TIC (93.6% vs 80.9%, P = 0. 011 ). When assessing nodes with micro-metastases, it had a higher sensitivity than that of FS (57.5% vs 44.4%, P =0. 356) and TIC (57. 5% vs 30. 8%, P =0. 094). In the patient basis analysis, the accuracy, sensitivity, specificity,PPV and NPV were 91.4%, 87. 5%, 92. 9%, 81.8% and 95. 3% respectively. Its sensitivity was similar to that of FS (84. 5%, P =0. 576) and significantly higher than that of TIC (75.0%, P =0. 049). After adjustment, it had the accuracy, sensitivity, specificity, PPV and NPV of 91.7%, 83. 5%, 95.2%,88. 3% and 93.0% respectively. Its sensitivity was higher than that of FS (72. 1%, P = 0.054) and significantly higher than that of TIC ( 66. 7%, P= 0. 011 ). The two had no significant difference in the sensitivity and specificity. After a learning curve of around 10 cases, it could be performed in a median time of around 35 min. The threshold cycle time values of MG and CK-19 were 36 and 31 respectively. The type of metastases could be estimated approximately according to the cycle time values. The cycle time values of MG under 33 indicated SLN macro-metastases and those of 33 - 36 denoted micro-metastases. The values of CK-19 under 29 indicated SLN macro-metastases and those of 29 -31 denoted micro-metastases. Conclusion As an accurate and rapid intra-operative assay for breast sentinel lymph nodes, the GeneSearchTM BLN Assay may replace FS and TIC in general medical practice.

Objective To investigate the concordance and correlation between fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) assessment for HER-2 status in breast cancer patients and analyze their relationship to clinical characteristics. Methods A total of 128 samples of breast cancer tissue were analyzed retrospectively. FISH was employed to detect the HER-2 gene amplification. And the FISH findings were compared with IHC test results by analyzing the concordance and correlation between two results. And their relationships to the clinical characteristics were analyzed. Results The overall coincidence rate of IHC and FISH was 90. 6% ( kappa = 0.405, P = 0. 000 ). And the discordance was mainly found in the IHC ( + + ) group. A positive correlation was found between the two results ( r =0. 655, P=0. 000). The ER (estrogen receptor) expression was negatively correlated with HER-2 gene amplification and the expression of Her-2 protein ( r = - 0. 300, P = 0. 001;r = - 0. 223, P = 0.011 ).There was a negative correlation between ER/PR status and HER-2 gene amplification (r = -0.213, P=0.016). The similar results were found in subgroup analysis. Tumor grade was negatively correlated with the expression of Her-2 protein ( r = - 0. 293, P = 0. 008 ), but not with HER-2 gene amplification ( P ＞0. 05). Conclusion IHC is a preferred method to detect the Her-2 status in breast cancer. The strong positive expression ( + + + ) of HER-2 protein tested by IHC is strongly consistent with HER-2 gene amplification by FISH. But HER-2 gene amplification should be further detected by FISH in patients with HER-2 positive expression ( + - + + ) in order to guide the clinical diagnosis and treatment. ER, ER/PR (progesterone receptor)status and tumor grade are correlated with HER-2 gene amplification and/or the expression of Her-2 protein. This study helps improve the accuracy of judging HER-2 gene amplification according to the clinical and pathological features such as ER status and the results of IHC.

Objective To study the relationship between the decline of age-related renal function and central arterial pressure (CAP) in Uygur healthy population. Methods A total of 638 healthy Uygur inhabitants from Hetian region, Xinjiang province were enrolled. They were divided into 4 groups according to their ages. Their blood pressure, serum creatinine and other indicators were detected. eGFR (estimated glomerular filtration rate) was calculated by the formula of Chinese-based MDRD (Modification of Diet in Renal Disease). CAP was measured by a pulse wave analyzer including central arterial systolic blood pressure (C-SBP), central arterial pulse pressure (C-PP), augmentation pressure (AP), augmentation index (AIX) and other components. Results CAP and brachial arterial pressure tended to increase and renal function declined with age. There were gender differences in renal function. Both AP and AIX changed with age ( P ＜ 0. 05 ). In each group, AP and AIX increased even more significantly in females ( P ＜ 0. 01 ).The average age of subjects with a high AIX was 52 y ± 12 y. And it was elder than that of those with a low AIX (44 y ± 13 y, P =0. 000). The renal function of those with a high AIX was lower than those with a low AIX [(121 ±25) ml. min. (1.73 m2) -1]vs (131 ±33) ml. min. (1.73 m2) -1, P=0. 000]. The levels of C-PP and AP were much higher in those with a high AIX ( P = 0. 00). The results of multivariate analysis showed that eGFR was negatively correlated with the level of AIX ( P ＜ 0. 01 ). And it had no relationship with the brachial artery pressure ( P ＞ 0. 05 ). Conclusion Central arterial pressure is associated with the decline of age-related renal function. Monitoring of CAP may help to screen the high-risk patients in the elderly population. This study provides rationales for new therapeutics of protecting the aging of kidneys.

Objective To investigate the expression and its clinical significance of Trop-2 in human pancreatic cancer. Methods Reverse transcription-polymerase chain reaction (RT-PCR) and immunofluorescence assay were used to characterize the expression of Trop-2 in human pancreatic cancer.The expression of Trop-2 protein in 31 tumor tissue samples, including peritumoral tissue from patients with pancreatic cancer, was detected with immunohistochemisty by tissue microarray. The clinicopathological characteristics and the tissue expression of Trop-2 protein were analyzed statistically. Results RT-PCR,immunofluorescence assay and immunohistochemisty by tissue microarray showed a high expression of Trop-2 in pancreatic cancer. The expression rate of Trop-2 was much higher in pancreatic cancer than that in peritumoral tissues (87. 1% vs 9. 7% ). And a high expression of Trop-2 in pancreatic cancer was correlated with the low-differentiated changes. It had statistical significance ( P ＜ 0. 05 ). In contrast, no statistically significant correlation was found between the expression of Trop-2 and gender or age. Conclusion The expression of Trop-2 is correlated with the development and malignancy of pancreatic cancer. As a clinical prognostic marker, Trop-2 may be a potential therapeutic target for pancreatic cancer.

Objective To investigate the effects of recombinant human interleukin 11 ( rhIL-11 ) on hematological malignacy after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods A total of 48 patients with hematological malignacy from January 2006 to June 2010 were alternately enrolled into a prospective randomized study. And they were assigned into the control and rhIL-11 injection groups.Later the investigators compared two groups with regards to hematopoietic reconstitution, graft versus host disease (GVHD) classification, clinical recurrence rate and disease-free survival. Results With the therapy of rhIL-11, the absolute neutrophil counts recovering to 0. 5 × 109/L and platelet recovering to 20 ×109/L were ( 15. 1 ± 1.6) and ( 18. 2 ±3.3) days respectively. And they were significantly lower than those in control group [( 16. 1 ± 1.6) vs (22. 4 ± 5.5 ) days, P = 0. 032, 0. 003]. The incidence of acute GVHD was surprisingly low in the study group ( 26. 1% vs 50. 0%, P = 0. 048 ) . There was no significant difference in chronic GVHD (36. 8% vs 38.9%, P =0. 899) or relapse rate (5. 1% vs 7.7%, P =0. 662)between two groups during a median follow-up period of 11.7 months. A trend of improved 3-year-disease-free survival was observed in the study group ( 65. 4% vs 50. 9%, P = 0. 637 ) . Conclusion The application of rhIL-11 after allo-HSCT may accelerate both neutrophil and platelet engraftment and lower the occurrence of acute GVHD.

Objective To investigate the expression of toll-like receptors (TLR1-TLR10) in human renal carcinoma cell 786-0 and normal renal cell HK-2 and discuss the significance of TLRs in the development of renal carcinoma. Methods Human renal carcinoma cell 786-0 ( experimental group) and normal renal cell HK-2 (control group) were cultured. The expression of TLR1-TLR10 was detected by realtime fluorogenic quantitative PCR (FQ-PCR). Results The FQ-PCR analysis demonstrated that 786-0 cell line and HK-2 cell line expressed TLR1-TLR6 and TLR8-TLR10 mRNA. Yet neither had an expression of TLR7. Moreover, the expression levels of TLR1, TLR2, TLR4, TLR5, TLR6, TLR8 and TLR10 in the experimental group were significantly higher than those in HK-2 cell line [(4.40 ±0.19) × 10-2, ( 1.77 ±0.24) × 10-2,(5.03 ±0.62) × 10-2,(3.93 ±0.86) × 10-2, (6.11 ±0.48) × 10-2,(1.89 ±0.47) ×10-2,(2.84±0.57) × 10-2 vs (0.84 ±0.27) × 10-2,(0.40 ±0.04) × 10-2,(0.95 ±0.73) × 10-2,(0.56±0.25) ×10-2,(0.49 ±0.16) × 10-2,(0.20 ±0.07) × 10-2,(0.27 ±0.08) × 10-2,P＜0.01].There was no significant change in the expressions of TLR3 and TLR9 between 786-0 and HK-2 cell line (P ＞0. 05). Conclusion The expressions of TLR1, TLR2, TLR4, TLR5, TLR6, TLR8 and TLR10 are significantly higher in 786-0 cell line than those in HK-2 cell line. They may play key roles in the development of renal carcinoma.

Objective To investigate the effect of Ang Ⅱ on the proliferation of vascular smooth muscle cell (VSMC) in rats after the transfection of ACE2 gene. Methods pm-ACE2 was transfected into the cultured VSMC by Lipofectamine 2000. The normal cell group, Ang Ⅱ group and pcDNA3. 1/Hygro( + )transfected + Ang Ⅱ group were taken as controls respectively. After the transfection of ACE2 gene, the cell proliferative effect of Ang Ⅱ on VSMC was investigated by cell counting kit-8 (CCK8) and cell cycle detection by fluorescence activated cell sorter (FACS). Results The (optical density) OD value of Ang Ⅱgroup was obviously higher than that of other groups. And it was obviously lower in the pm-ACE2 + Ang Ⅱgroup than the Ang Ⅱ group (0. 535 ± 0. 004 vs 0.866 ± 0.026, P ＜ 0. 05 ). Compared with other groups, the G0/G1 stage percentage of VSMC was obviously lower in the Ang Ⅱ group(58. 80% ±2. 00%, P ＜0. 05)while the percentage of S stage was obviously higher ( 35.90% ± 1.00%, P ＜ 0.05 ). Compared with the Ang Ⅱ group , the G0/G1 stage percentage of VSMC was obviously higher( 63. 90% ± 1.40%, P ＜ 0. 05 ) in the pm-ACE2 + Ang Ⅱ group while the percentage of S stage was obviously lower( 27.80% ± 0. 46%, P ＜0. 05 ). Conclusion The over-expression of ACE2 gene can inhibit the proliferation of Ang Ⅱ-induced VSMC.

Objective To investigate the effects of tumor antigen on the maturation phenotypes of dendritic cells through different treatments of antigenic exposure. Methods The necrosis and apoptosis of 4T1 mammary carcinoma cells were detected after an in vitro treatment of photodynamic therapy (PDT) or freezing-thawing. The supernatant of 4T1 cells was harvested and added into the culture of immature or mature dendritic cells (DCs). The immune phenotypes and morphological features of DCs were analyzed by flow cytometry and confocal laser scanning microscopy respectively. Results Necrosis predominated after these treatments. But the apoptotic ratio was higher in PDT cells than that in freezing-thawing cells (34. 7% ±9. 6% vs 16. 8% ± 5. 1%, P ＜ 0.05 ). After co-culturing with different supernatants, the immature DCs of PDT group showed more significant increases of positive rates of CD80 (22. 4% ±4. 6% ),CD86 (22. 5% ± 5. 6% ) and I-A/I-E (24. 3% ± 6. 3% ) versus the immature DCs of freezing-thawing group (17.3% ±3.3%, 18.0% ±4.7% and 20.7% ±3.1% respectively,P＜0. 05) and control group (14.2% ±3.0%、13.6% ±3.3% 、15.5% ±2.1%,P＜0.05). No difference was found between two groups of mature DCs (P ＞ 0. 05 ). Conclusion As compared with the treatment of freezing-thawing, PDT yields a higher apoptotic ratio of 4T1 cells and an elevated expression of maturation phenotypes in imature DCs.

Objective To investigate the effect of dantrolene on energy metabolism in rats with myocardial ischemia-reperfusion. Methods Forty-eight male rats were randomly divided into 3 groups:control group, ischemia-reperfusion group and dantrolene treatment group. With a Langendorff model system, the hearts were perfused with Krebs buffer for 30 min as pre-ischemia control. For ischemiareperfusion, the hearts were subjected to global ischemia for 30 min and reperfusion for 60 min. The dantrolene treatment group was perfused in the presence of 5 μmol/L dantrolene before ischemia.Tetrazolium chloride (TTC) staining, lactate dehydrogenase (LDH) release and hemodynamics were used to evaluate the tissue injuries. The effect of dantrolene on energy metabolism was evaluated by measuring the quantity of high-energy phosphates and the activity of 2 enzymes in purine salvage synthesis: hypoxanthineguanine phosphoribosyl transferase (HGPRT) and adenine phosphoribosyl transferase (APRT) by highperformance liquid chromatography (HPLC). Results The myocardial infarct size and LDH release in dantrolene treatment group were lower than those of ischemia-reperfusion hearts [22.1% vs 25.3%, (70 ± 6) U/g vs (116 ± 10) U/g, both P ＜0.05]. Dantrolene had no effect on the hemodynamics, except for a slight increase in coronary flow. The hearts receiving dantrolene showed a significantly higher levels of highenergy phosphates and a lower activity of HGPRT and APRT than those in the ischemia-reperfusion group [(7.63 ±0.72) nmol · mg-1 · min -1 vs (12.42 ± 1.12) nmol · mg-1 · min-1, (4.14 ±0.22) nmol ·mg-1·min-1 vs (4.57±0.39)nmol·mg-1· min -1 , both P ＜ 0. 05]. Conclusion Dantrolene is cardioprotective for ischemia-reperfusion injury through reducing infarct size and improving energy metabolism.

Objective To observe the effects of soluble epoxide hydrolase inhibitors-tAUCB on the uptake and degradation of ox-LDL in adipocytes. Methods 3T3-L1 preadipocytes were induced into differentiation and maturation. After a 24-hour starvation, the cells were stimulated with 1O0 ng/ml LPS and then tAUCB at various concentrations(0-100 μmol/L)were added for 24 h, or preincubated with the PPARγ (peroxisome proliferators activated receptor gamma) antagonist GW9662 (5 μmol/L). And the 0 μ mol/LtAUCB-treated group was taken as the blank control group. Then the uptake and degradation of ox-LDL in cells were measured by radioligand assay. The mRNA expressions of PPARγ and CD36 were detected by real-time PCR ( polymerase chain reaction). And the intracellular levels of protein expression of PPARγand CD36 were detected by Western blot. While ADP and TNF-α in supernatant were detected by ELISA. Results tAUCB could dose-dependently increase the uptake and degradation of ox-LDL in adipocytes. When stimulated with 10, 50, 1O0 μmol/L tAUCB, the uptake levels of ox-LDL were (35. 6 ±1.1 ) ng/mg, (39. 8 ± 1.6) ng/mg, (42. 6 ± 1.4) ng/mg cell protein and the degradation levels of ox-LDL (2879 ±54)ng/mg, (3082 ± 56)ng/mg, (3226 ± 68 )ng/mg cell protein. And they were significantly higher than those of the control group ( 28.9 ± 1.2) ng/mg、 (2791 ± 54) ng/mg respectively ( all P ＜ 0.05 ).However, after preincubation of GW9662, the uptake of ox-LDL were decreased to (30.6 ± 1.3) ng/mg,(31. 1 ± 1.7)ng/mg, (32. 1 ± 1.8 ) ng/mg cell protein whereas the degradation of ox-LDL decreased to (2788 ± 53 ) ng/mg, ( 2824 ± 70 ) ng/mg, ( 2874 ± 70) ng/mg cell protein. And the difference was statistically significant when it was compared with the corresponding tAUCB-treated group. With the rising concentration of tAUCB, tAUCB could dose-dependently increase the mRNA and protein expression of CD36 and PPARγ. tAUCB could dose-dependently decrease the levels of TNF-α and increase the levels of ADP in adipocytes. GW9662 could significantly inhibit those effects of tAUCB and reduce the uptake and degradation of ox-LDL and the expression of PPARγand CD36 in adipocytes. Conclusion tAUCB can upregulate the PPARγ expression in adipocytes and promote the uptake and degradation of ox-LDL in adipocytes via PPARγ-CD36 pathway. Meanwhile, the levels of ADP and TNF-α may be mediated through the activation of PPARγ.

Objective To investigate the effects of advanced glycation end products (AGEs) on the secretion of monocyte chemoattractant protein-1 (MCP-1) and interleukin-8 (IL-8) in vascular smooth muscle cells (VSMCs) and explore its possible intracellular signaling mechanism. Methods Primary rat VSMCs were isolated and identified. VSMCs were treated with glycation serum albumin (GSA), an important component of AGEs, in series of concentrations and time. The role of MAPK and NF-κB inhibitors was confirmed. The levels of MCP-1 and IL-8 were determined by enzyme-linked immunosorbent assay (ELISA). Results VSMCs were treated with GSA at the doses of 10 μg/ml, 100 μg/ml and 500 μg/ml respectively. In comparison with the control group, the levels of MCP-1 ( 13.01 ng/ml ± 0.12 ng/ml vs 7. 02 ng/ml ±0. 26 ng/ml, P＜0.05) and IL-8 (12. 6 ng/ml ±0. 86 ng/ml vs 3. 07 ng/ml ±0.35 ng/ml,P＜0.05) increased in the GSA-treated group, especially at the concentration of 100 μg/ml. After adjustment for cells proliferation, the levels of MCP-1 and IL-8 were still higher in the GSA-treated group.After a pretreatment of PDTC ( 10 μmol/L), SB203580 (5 μmol/L) and MG132 ( 10 μmol/L), the levels of MCP-1 and IL-8 decreased. However, it had no change when pretreated with PD98059 (20 μmol/L).Conclusion GSA promotes the secretion of MCP-1 and IL-8 in VSMCs. Such an effect is not dependent on cellular proliferation. It may be realized through an activation of NF-κB by p38MAPK-sensitive intracellular signaling pathway.

The patient was a 16-year-old male with recurrent fever and subcutaneous nodules for 3 and a half years and hepatosplenomegaly for 1 year. He was admitted to hospital on 21 December 2009. Three and a half years before this admission, the patient had no obvious inducement to develop fever, the highest body temperature was 40.0℃, and there were no accompanying symptoms such as chills, cough and abdominal pain.

To confirm whether long-term statin use is safe and effective in patients with non-alcoholic fatty liver disease (NAFLD), Dr. Vasilis Athyros, Hippokration University Hospital, Thessaloniki, Greece, and Dimitri Mikhailidis, University of London, and colleagues analyzed the Greek Atorvastatin and Coronary Heart Disease Evaluation Study (GREACE). The results were published on November 24, 2010<The Lancet>Published online.

In the United States, about 2/3 of adults are overweight or obese, while in developing countries, the proportion of overweight or obesity is at least 50%. Although some studies have confirmed that the mortality rate of cardiovascular disease, stroke and the incidence of some tumors increase significantly in obese people (BMI ≥30.0), the exact relationship between BMI and all-cause mortality is still unclear, and the relationship between ideal BMI and mortality is also unclear. In addition, the existence of many confounding factors (especially smoking and weight loss caused by concomitant diseases) also makes it difficult to explore the relationship between BMI and all-cause mortality.

In recent 10 years, with partial nephrectomy and minimally invasive surgery such as cryo and radiofrequency ablation partially replacing radical nephrectomy, and with the development of imaging, puncture biopsy of renal tumors has attracted increasing attention. However, the application of puncture biopsy in the diagnosis of renal tumors is still controversial, and most doctors believe that puncture biopsy can not significantly improve the diagnosis rate and influence the choice of clinical treatment plan. In fact, with the continuous improvement of image-guided puncture technology and molecular biology-genetic diagnosis technology, renal tumor biopsy has achieved good accuracy and safety.

Tuberculosis is an infectious disease that seriously endangers human health. About 1/3 of the world's population has been infected with tuberculosis bacteria, of which 1/10 may be transformed into active tuberculosis, and the rest are latently infected. Immunosuppressive states such as human immunodeficiency virus (HIV) co-infection, diabetes, tumor necrosis factor therapy, etc. easily trigger latent tuberculosis as active tuberculosis.

In the 1960s, home hemodialysis (HHD) began to appear abroad, and was widely used in the 1970s. In recent years, many studies have found that HHD has many advantages compared with other dialysis methods, such as low cost, easy acceptance for patients and intelligent equipment, especially its obvious clinical advantages, good prognosis, few complications and high survival rate [1]. Therefore, HHD has developed rapidly in many countries and regions in recent years [2], and has also been reported in Taiwan and Hong Kong [3].