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Objectives: To validate the feasibility of intravoxel incoherent motion imaging (IVIM) for monitoring renal injury and uric acid-lowering efficacy in a rat model of hyperuricaemia., Methods: A total of 92 rats were analysed and categorized into 4 groups: control (CON), hyperuricaemia (HUA), allopurinol intervention (ALL), and combined intervention (COM). Eight rats were randomly selected from each group and underwent IVIM scanning on days 0, 1, 3, 5, 7, and 9. Quantitative magnetic resonance values (D, D*, and f values) measured from the different renal anatomical regions. Quantitative histopathological analysis was performed to assess renal tubular injury using neutrophil gelatinase-associated lipocalin (NGAL), and renal fibrosis using alpha-smooth-muscle-actin (α-SMA). Pearson's correlation analysis was used to determine the correlation between IVIM-derived parameters and the expression of NGAL and α-SMA., Results: The D values of the HUA, ALL, and COM groups generally showed a downward trend over time, and this fluctuation was most significant in the HUA group. The D values showed significant intergroup differences at each point, whereas only a few discrepancies were found in the D* and f values. In addition, the renal D value was negatively correlated with the positive staining rates for NGAL and α-SMA (P < .05), except for the lack of correlation between Dos and α-SMA (P > .05)., Conclusion: IVIM could be a noninvasive and potential assessment modality for the evaluation of renal injury induced by hyperuricaemia and its prognostic efficacy., Advances in Knowledge: IVIM could be a surrogate manner in monitoring renal damage induced by hyperuricaemia and its treatment evaluation., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Institute of Radiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Objective: To investigate the psychological effect of physical function dependence on maintenance hemodialysis (MHD) patients and their primary family caregivers. Methods: The study was a cross-sectional survey. The MHD patients in the hemodialysis centre, the Third Affiliated Hospital of Guangzhou Medical University from March 2022 to June 2022 were enrolled. The patients' demographics and laboratory data were collected. Katz and Lawton-Brody questionnaires were used to assess patients' physical function, and Five Item Mental Health Inventory (MHI-5) was used to evaluate the psychological conditions of the patients and their primary family caregivers. Multiple linear regression analysis was used to analyze the influencing factors of MHI-5 scores of the patients and their primary family caregivers. Results: A total of 116 patients were included, with 61 males and 55 females. There were 47 patients (40.5%) with physical function dependence. In the physical function dependence group, serum albumin ( t =-2.512, P =0.013), MHI-5 scores of patients and their primary family caregivers ( t =-8.461, P < 0.001; t =-8.533, P < 0.001) and male ratio ( χ 2 =8.467, P =0.002) were significantly lower, and the age ( t =9.754, P < 0.001) and the proportions of hypertension ( χ 2 =20.421, P < 0.001), diabetes ( χ 2 =10.470, P =0.002), cardiovascular and cerebrovascular diseases ( χ 2 =9.898, P =0.003) were significantly higher than those in the normal physical function group. The incidence of mental disorders in MHD patients was 39.7%(46/116), and the incidence of mental disorders in the physical function dependence group was significantly higher than that in the normal physical function group [72.3%(34/47) vs . 17.4%(12/69), χ 2 =35.275, P < 0.001]. The incidence of mental disorders in the primary family caregivers was 32.8%(38/116), and the incidence of mental disorders in the primary family caregivers of physical function dependence group was significantly higher than that in the normal physical function group [66.0%(31/47) vs . 10.1%(7/69), χ 2 =39.536, P < 0.001]. The incidence of mental disorders in the primary family caregivers of MHD patients who were not spouses was significantly higher than that of spouses [46.0%(29/63) vs . 17.0%(9/53), χ 2 =11.028, P =0.001], and in physical function dependence group, the incidence of mental disorders in non-spouses was significantly higher than that in spouses [80.6%(25/31) vs . 37.5%(6/16), χ 2 =8.749, P =0.003]. Multiple linear analysis showed that bathing ( β =-5.182, P =0.015), doing laundry ( β =-7.053, P < 0.001), taking medication ( β =-8.680, P =0.003), and female patients ( β =-2.982, P =0.030) were the influencing factors of MHI-5 scores decline in MHD patients. Bathing ( β =-4.404, P =0.032), preparing meals ( β =-3.954, P =0.041), managing money ( β =-5.067, P =0.021), and female patients ( β =-2.466, P =0.042) were the influencing factors of MHI-5 scores decline in primary family caregivers. Conclusions: The incidence of physical function dependence in MHD patients is high, and its manifestations and influencing factors are diverse. The incidence of mental disorders in MHD patients and their primary family caregivers is also high, especially in patients with physical function dependence and non- spouse family caregivers. Clinicians should pay attention to and assess the physical function dependence of MHD patients as early as possible, and intervene in time. At the same time, they should also pay attention to the mental health of MHD patients and their primary family caregivers.

Background: Blood pressure (BP) control among primary care patients with hypertension is suboptimal. Home BP monitoring (HBPM) has been shown to be effective but is underused., Methods: This study was a quasi-experimental evaluation of the impact of the A CARE HBPM program on hypertension control. Nonpregnant adults with hypertension or cardiovascular disease risk factors were given validated home BP monitors and reported monthly average home BP readings by Internet or phone. Patients and providers received feedback. Change in average home and office BP and the percentage of patients achieving target BP were assessed based on patient HBPM reports and a chart audit of office BPs., Results: A total of 3578 patients were enrolled at 26 urban and rural primary care practices. Of these, 36% of participants submitted ≥2 HBPM reports. These active participants submitted a mean of 13.5 average HBPM reports, with a mean of 19.3 BP readings per report. The mean difference in home BP between initial and final HBPM reports for active participants was -6.5/-4.4 mmHg (P < .001) and -6.7/-4.7 mmHg (P < .001) for those with diabetes. The percentage of active participants at or below target BP increased from 34.5% to 53.3% (P < .001) and increased 24.6% to 40.0% (P < .001) for those with diabetes. The mean difference in office BP over 1 year between participants and nonparticipants was -5.4/-2.7 mmHg (P < .001 for systolic BP, P = .01 for diastolic BP) for all participants and -8.5/-1.5 mmHg (P = .014 for systolic BP, P = .405 for diastolic BP) for those with diabetes., Conclusions: An HBPM program with patient and provider feedback can be successfully implemented in a range of primary care practices and can play a significant role in BP control and decreased cardiovascular disease risk in patients with hypertension., (© Copyright 2015 by the American Board of Family Medicine.)

The mechanism underlying abnormally high transcription of the glial cell line-derived neurotrophic factor (GDNF) gene in glioma cells is not clear. In this study, to assess histone H3K9 acetylation levels in promoters I and II of the gdnf gene in normal human brain tissue, low- and high-grade glioma tissues, normal rat astrocytes, and rat C6 glioblastoma cells, we employed chromatin immunoprecipitation-polymerase chain reaction (ChIP-PCR), real-time PCR, and a pGL3 dual fluorescence reporter system. We also investigated the influence of treatment with curcumin, a histone acetyltransferase inhibitor, and trichostatin A (TSA), a deacetylase inhibitor, on promoter acetylation and activity and messenger RNA (mRNA) expression level of the gdnf gene in C6 cells. Compared to normal brain tissue, H3K9 acetylation in promoters I and II of the gdnf gene increased significantly in high-grade glioma tissues but not in low-grade glioma tissues. Moreover, H3K9 promoter acetylation level of the gdnf gene in C6 cells was also remarkably higher than in normal astrocytes. In C6 cells, curcumin markedly decreased promoter II acetylation and activity and GDNF mRNA expression. Conversely, all three measurements were significantly increased following TSA treatment. Our results suggest that histone H3K9 hyperacetylation in promoter II of the gdnf gene might be one of the reasons for its abnormal high transcription in glioma cells.