Relationship between acute kidney injury before thoracic endovascular aneurysm repair and in-hospital outcomes in patients with type B acute aortic dissection

Objective Acute kidney injury （AKI） frequently occurs after catheter-based interventional procedures and increases mortality. However, the implications of AKI before thoracic endovascular aneurysm repair （TEVAR） of type B acute aortic dissection （AAD） remain unclear. This study evaluated the incidence, predictors, and in-hospital outcomes of AKI before TEVAR in patients with type B AAD. Methods Between 2009 and 2013, 76 patients were retrospectively evaluated who received TEVAR for type B AAD within 36 h from symptom onset. The patients were classified into no-AKI vs. AKI groups, and the severity of AKI was further staged according to kidney disease： im- proving global outcomes criteria before TEVAR. Results The incidence of preoperative AKI was 36.8%. In-hospital complications was significantly higher in patients with preoperative AKI compared with no-AKI （50.0% vs. 4.2%, respectively; P 〈 0.001）, including acute renal failure （21.4% vs. O, respectively; P 〈 0.001）, and they increased with severity of AKI （P 〈 0.001）. The maximum levels of body tem- perature and white blood cell count were significantly related to maximum serum creatinine level before TEVAR. Multivariate analysis showed that systolic blood pressure on admission （OR： 1.023; 95% CI： 1.003-1.044; P ： 0.0238） and bilateral renal artery involvement （OR： 19.076; 95% CI： 1.914 190.164; P = 0.0120） were strong predictors of preoperative AKI. Conclusions Preoperative AKI frequently occurred in patients with type B AAD, and correlated with higher in-hospital complications and enhanced inflammatory reaction. Systolic blood pressure on admission and bilateral renal artery involvement were major risk factors for AKI before TEVAR.

Emerging role of vitamin D_(3)in alleviating intestinal structure injury caused by Aeromonas hydrophila in grass carp(Ctenopharyngodon idella)

Bacterial pathogens destroy the structural integrity of functional organs in fish,leading to severe challenges in the aquaculture industry.Vitamin D_(3)(VD_(3))prevents bacterial infections and strengthens immune system function via vitamin D receptor(VDR).However,the correlation between VD_(3)/VDR and the structural integrity of functional organs remains unclarified.This study aimed to investigate the influence of VD_(3)supplementation on histological characteristics,apoptosis,and tight junction characteristics in fish intestine during pathogen infection.A total of 540 healthy grass carp(257.24±0.63 g)were fed different levels of VD_(3)(15.2,364.3,782.5,1,167.9,1,573.8,and 1,980.1 IU/kg)for 70 d.Subsequently,fish were challenged with Aeromonas hydrophila,a pathogen that causes intestinal inflammation.Our present study demonstrated that optimal supplementation with VD_(3)(1)alleviated intestinal structural damage,and inhibited oxidative damage by reducing levels of oxidative stress biomarkers;(2)attenuated excessive apoptosisrelated death receptor and mitochondrial pathway processes in relation to p38 mitogen-activated protein kinase signaling(P<0.05);(3)enhanced tight junction protein expression by inhibiting myosin light chain kinase signaling(P<0.05);and(4)elevated VDR isoform expression in fish intestine(P<0.05).Overall,the results demonstrated that VD_(3)alleviates oxidative injury,apoptosis,and the destruction of tight junction protein under pathogenic infection,thereby strengthening pathogen defenses in the intestine.This finding supports the rationale for VD_(3)intervention as an essential practice in sustainable aquaculture.

An emerging role of vitamin D_(3) in amino acid absorption in different intestinal segments of on-growing grass carp(Ctenopharyngodon idella)

Vitamin D_(3)(VD_(3)),an essential nutrient for animals,has been demonstrated to stimulate the uptake of certain amino acids.However,the role of VD_(3) in the intestine,the primary site for digestion and absorption of nutrients,remains poorly characterized.Here,the grass carp(Ctenopharyngodon idella)was studied to assess the influence of different doses of VD_(3)(15.2,364.3,782.5,1,167.9,1,573.8,and 1,980.1 IU/kg)on growth performance,intestinal morphology,digestive absorption,amino acid transport,and potential signaling molecule levels in a feeding experiment.As a result,dietary VD_(3) improved growth performance,intestinal structure,and digestive and brush border enzyme activities.Additionally,most intestinal free amino acids and their transporters were upregulated after VD_(3) intake,except for Ala,Lys,Asp,Leu,solute carrier(SLC)7A7,SLC1A5,and SLC1A3 mRNA in different segments,Leu and SLC6A14 mRNA in the proximal intestine,and SLC7A5 mRNA in the mid and distal intestine.In the crucial target of rapamycin(TOR)signal pathway of amino acid transport,the gene and protein expression of TOR,S6 kinase 1,and activating transcription factor 4 were elevated,whereas 4E-binding protein 1 was decreased,further suggesting an advanced amino acid absorption capacity in the fish due to VD_(3) supplementation.Based on percentage weight gain,feed efficiency,and trypsin activity,the VD_(3) requirements of on-growing grass carp were estimated to be 968.33,1,005.00,and 1,166.67 IU/kg,respectively.Our findings provide novel recommendations for VD_(3) supplementation to promote digestion and absorption capacities of fish,contributing to the overall productivity of aquaculture.

A new insight on copper:Promotion of collagen synthesis and myofiber growth and development in juvenile grass carp(Ctenopharyngodon idella)

Copper(Cu)is a trace element,essential for fish growth.In the current study,in addition to growth performance,we first explored the effects of Cu on collagen synthesis and myofiber growth and development in juvenile grass carp(Ctenopharyngodon idella).A total of 1080 fish(11.16±0.01 g)were randomly divided into 6 treatments(3 replicates per treatment)to receive five doses of organic Cu which were Cu citrate(CuCit)at 0.99(basal diet),2.19,4.06,6.15,and 8.07 mg/kg,and one dose o inorganic Cu(CuSO_(4)·5H_(2)O at 3.15 mg/kg),for 9 weeks.The results showed appropriate Cu level(4.06 mg kg)enhanced growth performance,improved nutritional Cu status,and downregulated Cu-transporting ATPase 1 mRNA levels in the hepatopancreas,intestine,and muscle of juvenile grass carp.Meanwhile collagen content in fish muscle was increased after Cu intake,which was probably due to the following pathways:(1)activating CTGF/TGF-β1/Smads signaling pathway to regulate collagen transcription;(2upregulating of La ribonucleoprotein domain family 6(LARP6)mRNA levels to regulate translation initiation;(3)increasing proline hydroxylase,lysine hydroxylase,and lysine oxidase activities to regulate posttranslational modifications.In addition,optimal Cu group increased myofiber diameters and the frequency of myofibers with diameter>50μm,which might be associated with upregulation of cyclin B cyclin D,cyclin E,proliferating cell nuclear antigen,myogenic determining factor(MyoD),myogenic factor 5,myogenin(MyoG),myogenic regulatory factor 4 and myosin heavy chain(MyHC)and down regulation of myostatin mRNA levels,increasing protein levels of MyoD,MyoG and MyHC in fish muscle Finally,based on percentage weight gain(PWG),serum ceruloplasmin(Cp)activity and collagen conten in fish muscle,Cu requirements were determined as 4.74,4.37 and 4.62 mg/kg diet(CuCit as Cu source of juvenile grass carp,respectively.Based on PWG and Cp activity,compared to CuSO_(4)·5H_(2)O,the efficacy of CuCit were 131.80%and 115.38%,respectively.Our findings provide new insights into Cu supple mentation to promote muscle growth in fish,and help improve the overall productivity of aquaculture.