A nomogram for predicting 28-day mortality in elderly patients with acute kidney injury receiving continuous renal replacement therapy: a secondary analysis based on a retrospective cohort study.

BACKGROUND: Acute kidney injury (AKI) is a common and serious condition, particularly among elderly patients. It is associated with high morbidity and mortality rates, further compounded by the need for continuous renal replacement therapy in severe cases. To improve clinical decision-making and patient management, there is a need for accurate prediction models that can identify patients at a high risk of mortality. METHODS: Data were extracted from the Dryad Digital Repository. Multivariate analysis was performed using least absolute shrinkage and selection operator (LASSO) logistic regression analysis to identify independent risk factors and construct a predictive nomogram for mortality within 28 days after continuous renal replacement therapy in elderly patients with acute kidney injury. The discrimination of the model was evaluated in the validation cohort using the area under the receiver operating characteristic curve (AUC), and calibration was evaluated using a calibration curve. The clinical utility of the model was assessed using decision curve analysis (DCA). RESULTS: A total of 606 participants were enrolled and randomly divided into two groups: a training cohort (n = 424) and a validation cohort (n = 182) in a 7:3 proportion. A risk prediction model was developed to identify independent predictors of 28-day mortality in elderly patients with AKI. The predictors included age, systolic blood pressure, creatinine, albumin, phosphorus, age-adjusted Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score. These predictors were incorporated into a logistic model and presented in a user-friendly nomogram. In the validation cohort, the model demonstrated good predictive performance with an AUC of 0.799. The calibration curve showed that the model was well calibrated. Additionally, DCA revealed significant net benefits of the nomogram for clinical application. CONCLUSION: The development of a nomogram for predicting 28-day mortality in elderly patients with AKI receiving continuous renal replacement therapy has the potential to improve prognostic accuracy and assist in clinical decision-making.

Genomics-Microbiome Based Assessment of Bidirectional Causality Between Gut Microbiota and Psoriasis.

Background: Traditional observational studies have found a possible risk association of the gut microbiota for psoriasis. Meanwhile, psoriasis may also affect the changes in the gut microbiota. However, the available evidence does not demonstrate a reciprocal relationship between the gut microbiota and psoriasis. This limits our understanding on the role of the gut microbiota in the mechanisms of psoriasis. Methods: To address this question we used Mendelian randomization, a novel epidemiological approach, and acquired the largest current gut microbiota GWAS data from the MiBioGen consortium as well as psoriasis GWAS data from the FinnGen consortium, and performed two-sample bidirectional MR analyses using a multiple MR analysis approach. Finally, the robustness of the results was assessed by sensitivity analysis. Results: Our results indicate that five bacterial genera are causally related to psoriasis and psoriasis is causally related to four bacterial genera. Conclusion: These results suggest a bidirectional causal influence of psoriasis on the gut microbiota. Our results somewhat challenge the causal inferences of previous observational studies. We found that the specific bacterial genera with a risk effect on psoriasis were different from those found to characterize psoriasis in previous observational studies, and that these psoriasis-characterizing genera were inversely associated with psoriasis.

Successful Treatment of Psoriasis Combined with Bullous Pemphigoid with Dupilumab: A Case Report.

Psoriasis is an immune-mediated chronic inflammatory disease that can be combined with complications such as diabetes, cardiovascular disease, obesity, and kidney disease. The comorbidity of psoriasis with autoimmune bullous diseases (AIBD) has been reported previously in several cases, the most frequent of which is bullous pemphigoid (BP). The underlying mechanisms of psoriasis with BP are not clear and there are no uniform treatment criteria. Based on previous case reports, the coexistence of psoriasis and BP may be related to inflammatory activity, medications, phototherapy, and infection. We report a case of a psoriasis patient who developed BP after taking Chinese herbal compounds and was successfully treated with dupilumab, which is the first reported case of applying dupilumab to treat psoriasis with BP comorbidities.

Case report and literature review on a large MBC with ulceration.

RATIONALE: Metaplastic breast cancer (MBC) is a rare tumor of the breast, and skin ulceration of breast tumors is a difficult clinical problem that reduces the patient's quality of life. PATIENT CONCERNS: There are currently no Standard Treatment Guidelines for MBC at present, and the treatment for the skin ulceration of breast tumors is limited in clinics. DIAGNOSIS: Here, we report the case of a patient with a large MBC and skin ulceration, accompanied by exudation and odor. INTERVENTION: The combined treatment of albumin paclitaxel and carrelizumab (anti-PD-1 immunotherapy) was effective in reducing the tumor, but it increased the severity of the skin ulceration. After taking traditional Chinese medicine, the skin ulceration healed completely. Then the patient underwent a mastectomy and radiotherapy. OUTCOMES: The patient has a high quality of life and was in good condition after the comprehensive treatment. LESSONS: This suggests that traditional Chinese medicine may have a good auxiliary therapeutic effect on the skin ulceration of MBC.

Is it sufficient to evaluate bone marrow involvement in newly diagnosed lymphomas using 18F-FDG PET/CT and/or routine iliac crest biopsy? A new approach of PET/CT-guided targeted bone marrow biopsy.

BACKGROUND: To investigate whether PET/CT-guided bone marrow biopsy adds complementary information for evaluation of bone marrow involvement (BMI) in newly diagnosed lymphomas. METHODS: Patients with newly diagnosed lymphomas that received both 18F-FDG PET/CT and bone marrow biopsy (BMB) were included in this retrospective study. PET/CT classification of bone lesions was classified as isolated, multifocal (2 lesions or more), diffuse (homogeneous uptake of the entire axial skeleton), or negative. BMBs included PET/CT-guided targeted BMB and/or the routine unilateral iliac crest biopsy. Of 34 patients with focal lesions on PET/CT scan, 30 received both PET/CT-guided targeted BMB and iliac crest biopsy, and 4 patients received targeted biopsy without iliac crest biopsy. The final diagnosis of BMI depends on BMB results. RESULTS: A total of 299 patients with lymphomas were included. PET/CT classification of bone lesions was isolated (16/5.4%), multifocal (67/22.4%), diffuse (52/17.4%), and negative (164/54.8%). If only positive iliac crest biopsy was considered as the reference standard, the sensitivity of 18F-FDG PET/CT for identifying focal and diffuse BMI was 48 and 56%, respectively, and the respective specificities were 70 and 83%. Three of 30 patients (10.0%) with focal lesions on PET/CT were confirmed to be false-positive by targeted BMB, and 25 of 30 patients (83.3%) with focal lesions on PET/CT were confirmed as false-negative by iliac crest biopsy. CONCLUSION: It is insufficient to evaluate BMI in newly diagnosed lymphomas using both 18F-FDG PET/CT and routine iliac crest biopsy. 18F-FDG PET/CT imaging should be performed before BMB. In focal bone lesions, PET/CT-guided targeted BMB may complement the results of possible false-positive PET/CT and false-negative iliac crest biopsy findings. However, in diffuse and negative lesions, iliac crest biopsy cannot be safely omitted.

[Spatio-temporal variation of water requirement and meteorological impact factors of cotton in North Xinjiang, China.] / åŒ—ç–†åœ°åŒºæ£‰èŠ±ä½œç‰©éœ€æ°´é‡æ—¶ç©ºæ¼”å˜åŠå ¶æ°”è±¡å½±å“å› å­.

Based on daily data of 25 meteorological stations in North Xinjiang during 1961-2013, the FAO Penman Monteith equation and crop coefficient method were used to estimate water requirements as well as irrigation water demands of cotton during all growth stages. The results suggested that cotton water requirement in each growth period had been decreasing in the past 53 years. Besides, crop water demand declined most significantly at the blossing and boll forming stage, with change rate of -0.15 mm·a-1. Furthermore, there were various multiscale cycle changes during the growth period. the water demand of crops in each growth period roughly changed as 'high low high' in the large periodic scale around 30 a and, as 'low high low' in the 15-17 a of the mesoscale cycle, but had no obvious cyclical characteristics on the interannual scale. Average crop water demands decreased roughly from west to east across North Xinjiang. The mutation results showed that the crop water demand decreased significantly in each growth period, especially in the northwest and southwest of North Xinjiang. In addition, cotton water demand was positively correlated with ave rage wind speed, sunshine hours and average temperature during each growth period, and negatively correlated with relative humidity. The results would provide basic data for timely quantitative irrigation and improving water use efficiency of cotton in North Xinjiang.

Metabolic imaging for guidance of curative treatment of isolated pelvic implantation metastasis after resection of spontaneously ruptured hepatocellular carcinoma: A case report.

Spontaneous rupture of hepatocellular carcinoma (HCC) is a life-threatening complication and its prognosis is significantly poor because of the high recurrence rate after initial hepatectomy. Resection of isolated extrahepatic metastasis of HCC has been advocated to obtain a possibility of long-term survival. However, it is a challenge for clinicians to detect implantation metastasis of spontaneously ruptured HCC. Accurate re-staging plays the most important role in making a decision on isolated metastasis resection. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is useful in detecting intra-abdominal implantation metastasis from a variety of malignancies and shows superior accuracy to conventional imaging modalities in determining the location of metastasis. We present one patient with a new isolated pelvic implantation metastasis detected by 18F-FDG PET/CT and pathologically confirmed by PET/CT-guided percutaneous biopsy, who had a history of resection of spontaneously ruptured HCC two years ago. The patient's condition was stable at the 6-mo follow-up after resection of the isolated pelvic metastasis.

[Study on influence of traffic and meteorological factors on inhalable particle matters of different size].

To study the effects of meteorological and traffic factors on the PM2.5 and PM10 concentrations, 28 samples were taken in the Third Ring Road of Beijing, and dust fall weight, velocity of vehicle, traffic volume, temperature, humidity, wind speed, PM2.5 and PM10 concentration data were collected for these samples. Analysis of the collected data on dust fall weight indicated that the traffic had a significant impact on the air quality. The average dust fall weights in the road and away from the traffic source were 0. 284g and 0. 016 g, respectively. The results of the partial experiment indicated that concentrations of PM2.5 and PM10 in residential areas were lower than those in road, furthermore, the PM2.5 at night was often higher than that during daytime, and the mean values of the difference in PM2.5 and PM10 were 101074 n.(cf)-1 and 15386 n.(cf)-1, respectively. Through analysis using the best subset prediction model, it was indicated that PM2.5 and PM10 were both most significantly influenced by temperature and humidity, followed by wind speed, velocity of vehicle and traffic volume. Comparing with PM10, the velocity of vehicle, traffic volume and wind speed had a more significant influence on PM2.5.

[Impact of dust-fall on spectral features of plant leaves].

In order to build inversion model of dust-fall weight by hyperspectral data, 30 samples were collected in Beijing. Through electronic balance and Analytical Spectral Devices FieldSpec Pro (ASD) analysis, the "dust leaves" and the "clean leaves" weight and spectral reflectance were determined respectively, which also obtained information of dust weight and spectral features. Then, based on tradition and partial least squares (PLS) model's analysis, the relationship between dust weight and spectral reflectance was explored. The results showed that 350-700, 780-1 300 and 1 900-2 500 nm bands had apparently variations when they response to the different dust weights. In general, there was a negative relationship between dust weight and spectral reflectance, the maximum negative value -0.8 occurred at 737 band which belonged to near-infrared bands. In the analysis of dust weight with multi-band, it was indicated that NDVI index which was formed by 948 and 945 bands had a significant correlation (r = 0.76) to dust. Finally, through accuracy assessment of regression model, the PLS could obtain a more accurate result than the traditional model.