A simplified protocol for individualized regional citrate anticoagulation for hemodialysis: A single-center, randomized clinical study.

INTRODUCTION: The lack of individualized treatment protocols and complicated procedures are important factors limiting the use of regional citrate anticoagulation (RCA) technology in hemodialysis. This study aims to validate the safety and efficacy of a simplified individualized RCA protocol for hemodialysis. MATERIALS AND METHODS: From June 2019 to August 2019, 45 patients with active bleeding or bleeding tendency undergoing maintenance hemodialysis in the Nephrology Department of the First Affiliated Hospital of Nanchang University were randomly divided into a modified conventional RCA protocol group with a low-flux dialyzer, a simplified individualized RCA protocol group with a high-flux dialyzer, and a simplified individualized RCA protocol group with a low-flux dialyzer. RESULTS: A total of 45 patients were included in this study. The mean age of the patients was 57.38 ±â€Š19.05 years, and 78% were men. Forty-three patients completed 4 hours of hemodialysis, and the median total clotting scores in the 3 groups were 11, 12, and 12. Compared with the modified conventional RCA protocol group with a low-flux dialyzer, the 2 simplified individualized RCA protocol groups had better clotting scores for the dialyzer, arterial bubble trap, and single-pool urea clearance index (spKt/VBUN) and lower costs. Moreover, these parameters did not differ between the 2 simplified individualized RCA protocol groups. No electrolyte or acid-base imbalances or citrate poisoning was observed in any of the 3 groups. Adverse events did not differ significantly among the 3 groups. CONCLUSIONS: The simplified individualized RCA protocol is safe, effective, and easy to implement. Therefore, this protocol can be promoted for clinical practice. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Study Registry under registration number ChiCTR1900023801.

Diffusive flux of CH4 and N2O from agricultural river networks: Regression tree and importance analysis.

River networks in subtropical agricultural hilly region become an inconvenient greenhouse gas (GHG, methane and nitrous oxide) source because of the influence of human activities, which has caused large uncertainties for refinement of national GHG inventories and their global budget. Based on field monitoring experiments at high temporal resolution, we employed regression tree and importance analysis to identify quantitatively factors that influence the diffusive flux of GHGs to provide a scientific basis for reducing GHG emissions and controlling regional carbon and nitrogen losses. The results indicate that significant spatiotemporal variation of methane (CH4) nitrous oxide (N2O) diffusion occurs in all the four reaches (W1, W2, W3 and W4) of Tuojia river networks. Among them, W1 contributed lowest CH4 (22.55 µg C m-2 h-1) and N2O (5.00 µg N m-2 h-1) diffusive flux than the other three (P < 0.05), while W4 offered highest CH4 (166.15 µg C m-2 h-1) and N2O (30.47 µg N m-2 h-1) diffusive flux but with no statistically significant difference between W2 and W3 due to homogeneous extraneous nutrition loading into the two reaches. W4 also contributed largest cumulative flux of CH4 (14.55 kg C ha-1 yr-1) and N2O (2.69 kg N ha-1 yr-1) in Tuojia River networks (P < 0.05). Furthermore, the regression tree and importance analysis indicate that, in the anaerobic environment, dissolved oxygen saturation controlled the production and diffusion for both CH4 and N2O. The findings of this investigation highlighted that decision support tools provide an effective pathway to enhance the GHG mitigation technology research in agroecosystems and simultaneously shed light on the global campaign on refinement of national GHG inventories as well as regional nutrient management.

Assessment of Indirect N2O Emission Factors from Agricultural River Networks Based on Long-Term Study at High Temporal Resolution.

Assessment of indirect emission factors (EF5r) of nitrous oxide (N2O) from agricultural river networks remains challenging, and results are uncertain due to limited data availability. This study compared two methods of assessing EF5r using data from long-term observations at high temporal resolution in a typical agricultural catchment in subtropical central China. The concentration method (method 1) and the Intergovernmental Panel on Climate Change (IPCC) 2006 method (method 2) were employed to evaluate the emission factor. EF5r estimated using method 1 (i.e., EF5r1) was 0.00077 ± 0.00025 (0.00038-0.00097). EF5r calculated using method 2 (i.e., EF5r2) was lower than EF5r1, with a mean value of 0.00004 (0.000015-0.00012). Both EF5r1 and EF5r2 were significantly lower than the IPCC 2006 default value of 0.0025, suggesting that N2O emissions from China and world river networks may be grossly overestimated. A complex N2O production pathway and diffusion mechanism were responsible for the transfer of N2O from the sediment to river water and then to the atmosphere. These findings provide essential data for refining national greenhouse gas inventories and contribute evidence for downward revision of indirect emission factors adopted by the IPCC.

[Clinical and genetic features of ring chromosome 13 syndrome: an analysis of one case].

A girl aged 5 months was admitted due to developmental delay. Physical examination showed delayed physical development, unusual facies (microcephalus, hypertelorism, low-set ears, wide nasal bridge, and short philtrum), and an absence of the labium minus at one side. The peripheral blood karyotype was 46,XX,r(13)(p11q33)[82]/45,XX,-13[10]/46,XX,r(13;13)(p11q33;p11q33)[8], and array-based comparative genomic hybridization showed an 87.5 Mb duplication in 13q11q33.2 region and an 8.2 Mb deletion in 13q33.2q34 region. Fluorescence in situ hybridization showed terminal depletion of the long arm of the ring chromosome 13. The girl was diagnosed with ring 13 syndrome. This syndrome has various clinical phenotypes and is closely associated with the amount and site of the loss of genetic material in chromosomal band and different rates of chimerism.

Tissue engineered esophagus scaffold constructed with porcine small intestinal submucosa and synthetic polymers.

Acellular porcine small intestinal submucosa (SIS) has been successfully used for reconstructing esophagus with half circumferential defects. However, repairing full circumferential esophageal defects with SIS has been restricted due to the latter's poor mechanical properties. In the present study, synthetic polyesters biomaterial poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) and poly(lactide-co-glycolide) (PLGA) have been used to improve the mechanical properties of SIS. Feasibility of SIS/PHBHHx-PLGA composite material scaffold for esophageal tissue engineering has been assessed through a series of testing. The appropriate mixing ratio of PHBHHx and PLGA polymers has been determined as 5:5 by mechanical testing and in vitro degradation experiment. The morphology of constructed membranous and tubular scaffolds was also characterized. As confirmed by enzyme-linked immunosorbent assay, the contents of VEGF and TGF-ß have respectively reached 657 ± 18 ng mL(-1) and 130 ± 4 pg mL(-1) within the SIS/PHBHHx-PLGA specimens. Biocompatibility of the SIS/PHBHHx-PLGA specimens with rat bone marrow mesenchymal stem cells (MSCs) was also evaluated by scanning electron microscopy and a live-dead cell viability assay. Actin filaments of MSCs on the composite materials were labeled. Biological safety of the extract from SIS/PHBHHx-PLGA specimens, measured as hemolysis rate, was all lower than 5%. Compared with SIS and SIS/PHBHHx-PLGA specimens, inflammatory reaction provoked by the PHBHHx-PLGA specimens in rats was however more severe. Our results have suggested that SIS/PHBHHx-PLGA composite material can offer a new approach for esophageal tissue engineering.

Association of LAPTM4B gene polymorphism with breast cancer susceptibility.

BACKGROUND: Lysosome associated protein transmembrane 4 beta (LAPTM4B) was a cancer-associated gene that is mapped to chromosome 8q22 with seven exons and six introns. LAPTM4B gene polymorphism has been reported to be significantly associated with susceptibility of several solid tumors. METHODS: We performed a case-control study was to investigate the association between LAPTM4B polymorphism and the risk of breast cancer in 732 breast cancer patients and 649 controls. RESULTS: A significant difference in the frequency of LAPTM4B*2 was observed between the patients and the controls (P < 0.01). Using the LAPTM4B*1/1 genotype as a reference, we found that LAPTM4B allelic variation was significantly associated with breast cancer occurrence, with adjusted odds ratios of 1.387 (95%CI = 1.111-1.730) for LAPTM4B*1/2 and 1.592 (95% CI = 1.043-2.430) for LAPTM4B*2/2 genotype. CONCLUSION: Our results suggested that LAPTM4B*2 is associated with an increased risk of breast cancer in the Chinese women population and may be a risk factor of breast cancer.