To investigate the effects of pyruvate (Pyr)-based peritoneal dialysis solutions (P-PDS) on neutrophilic nitric oxide (NO) generation, we incubated human peripheral neutrophils in dL-lactate (Lac, 40 mM)-based PDS and equimolar P-PDS, and Hanks' balanced salt solution at various pH and high glucose (HG) levels, respectively. The production of NO in various test solutions was determined based on the Griess reaction. Acidic pH, high Lac, and HG induced an acute and substantial inhibition of neutrophilic NO, whereas Pyr in PDS significantly improved the NO generation in both acidic pH and physiological pH, and also in HG conditions. The Pyr protection may be associated with the improvement of glucose metabolic pathways in addition to its alkalization.

Objective Peripheral arterial disease (PAD) is a common clinical manifestation of the systemic atherosclerotic process, and the ankle-brachial index (ABI) is an ideal tool to diagnose PAD. Currently, there have been few long-term follow-up studies focused on the associations of the ABI with all-cause mortality and cardiovascular disease (CVD) mortality in Chinese MetS patients. The aim of this study was to evaluate the usefulness of ABI to predict the prognosis of CVD in hospitalized Chinese patients with metabolic syndrome (MetS). Methods Participants from multi-center departments were followed up from November 2004 to January 2011. The study sample actually comprised 1,266 valid participants whose age was " 35 years. Patients were separated into four groups, with an ABI ! 0.4, 0.41-0.7, 0.71-0.9 and 0.91-1.4. An ABI ! 0.9 was defined as PAD, and subjects with an ABI >1.4 were excluded because of the false negative rate. Factors related to allcause and cardiovascular mortality were observed by Cox models and the log rank test. Potential confounding variables with values of p<0.10 were adjusted for the multivariate analysis. Results An abnormal ABI value was strongly, independently, and inversely correlated with the all-cause and cardiovascular mortality. After adjusting for age and other covariates, Cox models revealed that an abnormal ABI value was still correlated with the all-cause mortality (relative risk/RR/=1.82, 95% confidence interval/CI/=1.45-2.34 p<0.01), and CVD mortality (RR=1.88, 95% CI=1.51-2.90 p<0.01). Conclusion An abnormal ABI value was not only a significant and independent risk factor for CVD, but also for the survival rate in Chinese MetS patients. Routine ABI evaluation could therefore be helpful for identifying high risk patients, especially MetS patients.

Cost savings per admission amounted to approximately 10% of the hospitalization cost by the elimination of unnecessary postoperative routine laboratory blood studies and observational ICU stay without waiving patient care in the current volatile, cost-conscious healthcare environment in Taiwan.