Indocyanine green plasma clearance rate and 99mTc-galactosyl human serum albumin single-photon emission computed tomography evaluated preoperative remnant liver

BACKGROUND Preoperative evaluation of future remnant liver reserves is important for safe hepatectomy.If the remnant is small,preoperative portal vein embolization(PVE)is useful.Liver volume analysis has been the primary method of preoperative evaluation,although functional examination may be more accurate.We have used the functional evaluation liver using the indocyanine green plasma clearance rate(KICG)and 99mTc-galactosyl human serum albumin single-photon emission computed tomography(99mTc-GSA SPECT)for safe hepatectomy.AIM To analyze the safety of our institution’s system for evaluating the remnant liver reserve.METHODS We retrospectively reviewed the records of 23 patients who underwent preoperative PVE.Two types of remnant liver KICG were defined as follows:Anatomical volume remnant KICG(a-rem-KICG),determined as the remnant liver anatomical volume rate×KICG;and functional volume remnant KICG(frem-KICG),determined as the remnant liver functional volume rate based on 99mTc-GSA SPECT×KICG.If either of the remnant liver KICGs were>0.05,a hepatectomy was performed.Perioperative factors were analyzed.We defined the marginal group as patients with a-rem-KICG of<0.05 and a f-rem-KICG of>0.05 and compared the postoperative outcomes between the marginal and not marginal(both a-rem-KICG and f-rem-KICG>0.05)groups.RESULTS All 23 patients underwent planned hepatectomies.Right hepatectomy,right trisectionectomy and left trisectionectomy were in 16,6 and 1 cases,respectively.The mean of blood loss and operative time were 576 mL and 474 min,respectively.The increased amount of frem-KICG was significantly larger than that of a-rem-KICG after PVE(0.034 vs 0.012,P=0.0273).The not marginal and marginal groups had 17(73.9%)and 6(26.1%)patients,respectively.The complications of Clavian-Dindo classification grade II or higher and post-hepatectomy liver failure were observed in six(26.1%)and one(grade A,4.3%)patient,respectively.The 90-d mortality was zero.The marginal group had no significant difference in postoperative outcomes(prothrombin time/international normalised ratio,total bilirubin,complication,post-hepatectomy liver failure,hospital stay,90-d,and mortality)compared with the not-marginal group.CONCLUSION Functional evaluation of the remnant liver enabled safe hepatectomy and may extend the indication for hepatectomy after PVE treatment.

Comparison of GFR by Creatinine Clearance with Estimated GFR by Various Prediction Equations in a Bangladeshi Population

Glomerular filtration rate （GFR） is considered as the best marker of kidney function. Evaluation of various prediction equations to estimate GFR is rare in our population. The aim of this study was to compare GFR estimated by various prediction equations with GFR by creatinine clearance （GFRer） in Bangladeshi population. Serum creatinine and 24 hours urinary creatinine concentrations were measured in 216 adult Bangladeshi subjects （100 males and 116 females）. Creatinine clearance rate was calculated and adjusted for body surface area to obtain GFRcr. GFR was also calculated by CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffe, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations and compared with GFRcr. Results were expressed as mean ＋ SD and compared by two-tailed paired t-test, precision （r2） and receiver-operating characteristic curve. Mean ± SD of age of the total subjects was 57.15 ±10.96 years. The mean GFILzr was 42.41 ± 22.95 mL/min/1.73m2. Estimated GFR （eGFR） by CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffc 1, Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations were 8.19 ± 13.80, 5.30 ±13.61, 11.54 ± 16.86, 8.66± 18.64, 17.25 ± 19.98, 10.86 ± 22.48, 14.60 ± 17.92, 12.18 ± 16.42, 39.86 ± 21.96 and 20.47 ± 20.49 mL/min/1.73m2 higher than GFR, （P 〈 0.001）. The precision （r2） of eGFRs were 0.7114, 0.6924, 0.6431, 0.4802, 0.5048, 0.5921, 0.6286, 0.6158, 0.1635, and 0.5586 for CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffe 1, Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations, respectively. The area under receiver-operating characteristic curve was the lowest for MDRD4 equation. This study revealed that GFR estimated by standardized MDRD4 variables equation is closer to creatinine clearance rate in the study population.

The 6-hour lactate clearance rate in predicting 30-day mortality in cardiogenic shock

Background Early evaluation of prognosis in cardiogenic shock(CS)is crucial for tailored treatment selection.Both lactate clearance and lactate levels are considered useful prognostic biomarkers in patients with CS.However,there is yet no literature comparing the 6-hour lactate clearance rate(Δ6Lac)with lactate levels measured at admission(L1)and after 6 h(L2)to predict 30-day mortality in CS.Methods In this observational cohort study,95 patients with CS were treated at Department of Intensive Care Unit,Yiwu Central Hospital between January 2020 and December 2022.Of these,88 patients met the eligibility criteria.The lactate levels were measured after admission(L1)as the baseline lactate value,and were measured after 6 h(L2)following admission.The primary endpoint of the study was survival rate at 30 days.A receiver operating characteristic curve was used for data analysis.Univariate and multivariate Cox regression analyses were performed based onΔ6Lac.Kaplan–Meier(KM)survival curves were generated to compare the 30-day survival rates among L1,L2,andΔ6Lac.Results TheΔ6Lac model showed the highest area under the curve value(0.839),followed by the L2(0.805)and L1(0.668)models.TheΔ6Lac model showed a sensitivity of 84.2%and specificity of 75.4%.The L1 and L2 models had sensitivities of 57.9%each and specificities of 89.9%and 98.6%,respectively.The cut-off values forΔ6Lac,L1,and L2 were 18.2%,6.7 mmol/L,and 6.1 mmol/L,respectively.Univariate Cox regression analysis revealed a significant association betweenΔ6Lac and 30-day mortality.After adjusting for five models in multivariate Cox regression,Δ6Lac remained a significant risk factor for 30-day mortality in patients with CS.In our fifth multivariate Cox regression model,Δ6Lac remained a risk factor associated with 30-day mortality(hazard ratio[HR]=5.14,95%confidence interval[CI]:1.48 to 17.89,P=0.010)as well as L2(HR=8.42,95%CI:1.26 to 56.22,P=0.028).The KM survival curve analysis revealed that L1>6.7 mmol/L(HR=8.08,95%CI:3.23 to 20.20,P<0.001),L2>6.1 mmol/L(HR=25.97,95%CI:9.76 to 69.15,P<0.001),andΔ6Lac≤18.2%(HR=8.92,95%CI:2.95 to 26.95,P<0.001)were associated with a higher risk of 30-day mortality.ConclusionsΔ6Lac is a better predictor for 30-day mortality in CS than lactate levels at admission.It has a predictive value equivalent to that of lactate level at 6 h after admission,making it an important surrogate indicator for evaluating the suitability as well as poor prognosis after CS treatment.We found that a cut-off value of 18.2%forΔ6Lac provided the most accurate assessment of early prognosis in CS.

Effect of Fouling on Feeding, Oxygen Consumption and Waste Excretion of Pearl Oyster Pinctada martensii in Daya Bay Cultivation

Biofouling is a particular problem in the pearl oyster culture. It may reduce the growth and survival rates of the cultured species. Foulers are often themselves filter feeders, and are therefore potential competitors for food resource with the cultured species. Fouling organisms may also reduce the oxygen supply. A study was conducted to measure the impact of foulers on feeding oxygen consumption, and waste excretion. POM, ammonia, phosphate and oxygen concentration were measured in various treatments （cultured species, foulers）. This study showed that fouling organisms had significant effect on food uptake, oxygen consumption and waste excretion. The clearance rate, ammonia and phosphate release rate, oxygen consumption rate of the fouled pearl oyster were greater than those of the clean pearl oysters. Other foulers that settled on cages or buoys also contributed much to phytoplankton depletion, oxygen consumption and concentration increase of ammonia and phosphate in water. Therefore, this study showed us that foulers were important competitors in the pearl oyster cultivation of Daya Bay in November 2005.

Effects of Rare Earth Ce on Nonspecific Immunity in Mice

Mice were watered with cerous nitrate solution (2, 20, 200 mg·kg-1) according to daily drinking water volume for 50 days and the effects of cerous nitrate on nonspecific immunity in mice were investigated. The results showed that the total number of peripheral white blood cell, the clearance rate of charcoal particles, the indices of thymus and spleen were increased on different degrees, and associated with the watering dose, noting that these indices were increased significantly by cerous nitrate at a dose of 20 mg·kg-1 compared with control group. Therefore, it was concluded that the nonspecific immunity could be improved by rare earth Ce in mice.

Effects of temperature on the respiratory metabolism,feeding and expression of three heat shock protein genes in Anadara broughtonii

Anadara broughtonii is one of the main commercially important species of shellfish in northern China.A.broughtonii lives in relatively stable subtidal zone where the clam could respond to environmental changes with minimum energy.Therefore,slight fluctuations in water environment may have a great impact on physiological processes such as feeding and metabolism.Large-scale mortality often occurs during the intermediate rearing processes,and high temperatures in summer are considered the leading cause of mortality.To understand the physiological and molecular response patterns of A.broughtonii at high temperatures and to estimate the appropriate metabolism temperature for A.broughtonii,the effects of temperature on the respiratory metabolism and food intake at different growth stages were studied.The response patterns of heat shock protein genes to heat stress and post-stress recovery were also explored.Results show that the temperature and growth stage of A.broughtonii were two important factors affecting metabolism and feeding.The optimum temperature for feeding and physiological activities in each shell-length group was 24℃.The temperature at which the peak metabolic rate occurred in each shell-length group increased with the increase in shell length.With the increase in heat stress,the expression of three heat shock protein genes(Abhsp60,Abhsp70,and Abhsp90)in the tissues of two size groups of A.broughtonii increased significantly when temperature was above 24℃and reached a peak at 30℃.After heat shock at 30℃for 2 h,the expression of the three heat shock protein genes rapidly increased,peaked at 2 h after the heat shock,and then gradually decreased to the level of the control group at 48 h after the heat shock.The three heat shock protein genes respond rapidly to heat stress and can be used as indicators to the cellular stress response in A.broughtonii under an environmental stress.

Niche differentiation among facultative filter feeders: Insights from invasive Ponto-Caspian mysids

The degree of dietary specialization has a fundamental impact on the ecological function and interactions of suspension feeders.While niche differentiation by food particle size is common among obligate suspension feeders,its role is not evident in facultative ones.In this study,we aimed at providing new insights on the matter by focusing on sympatric mysid species.As mysids use different mechanisms for raptorial and filter-feeding,they represent a more adequate model system than for example,the more extensively studied copepods.We made morpholog-ical measurements on the 4 coexisting invasive Ponto-Caspian mysid species to determine the areas and mesh sizes of their filters.We also quantified their clearance rates on the microalga Cryptomonas sp.in a laboratory experiment to reveal how morphological differences manifest in their overall filtering capacity.We found relatively small but consistent differences in the primary filter area among the species,indicating that morphological constraints due to the enclosed position of the setae might limit the possibility for differentiation.The primary filter mesh sizes were small in all 4 species(0.69-2.73μm)with moderate but consistent intraspecific differences,suggesting that the benefit of being able to capture small particles might outweigh the pressure for differentiation.The observed clearance rates were in accordance with the morphological characteristics of the species,highlighting that auxiliary filters(present in one of the species,Limnomysis benedeni)are needed to increase filtering capacity considerably.Our study confirmed that food particle size can contribute to the niche differentiation of facultative filter feeders,but also indicated that they can tolerate a higher overlap than obligate ones.The observed differences were related to the habitat preferences and predatory potentials of the species,suggesting that complementarity among the different niche axes might further facilitate theircoexistence.

Queue clearance rate method for estimating passenger car equivalents at signalized intersections

This study explored the use of queue clearance rate method for estimating passenger car equivalent （PCE） at signalized intersections. PCE was estimated based on the assumption that the rate at which a queue of vehicles clears the intersection is a function of its composition. Results of this method were compared with the results estimated by some popular techniques. A fourqegged intersection was simulated in VISSIM software and different techniques were used to convert the traffic mix into a uniform one. Parameters of VISSIM were modified to closely reflect the traffic behaviour under heterogeneous traffic conditions. All approaches of the intersection were loaded to saturated conditions and accuracy of estimated PCEs were established by comparing converted flow （PCE/h） with the capacity of an all-car traffic stream. Method based on saturation flow delivered the best result, but its use was limited to traffic composed only of two types of vehicles. Results of regression and optimization techniques were almost similar and the converted flow was close to the capacity of all-car stream. However, accuracy of these methods strongly relied on the correct measurement of saturation flow. Queue clearance rate method did not require value of saturation flow and yielded good estimates of PCE throughout the simu- lation runs. The maximum difference between the converted flow and capacity estimated with all car situations was found to be less than 10% in all cases considered in this study.

Effect of renal function and hemodialysis on the serum tumor markers in patients with chronic kidney disease

In patients with chronic renal failure,whether they have had hemodialysis or not,the specificity of some of the serum tumor markers for the diagnosis of the corresponding tumors is decreased while others remain as valuable as they are in patients with normal kidney function.The detection of tumor markers is extensively used for the diagnosis of corresponding tumors.It has been recently shown that some tumor markers are higher in patients with chronic kidney disease(CKD)than in the normal population.The effects of renal function and hemodialysis were examined on serum levels of some of the tumor markers including CEA,CA_(199),CA_(125),AFP,CA_(153),CA_(724),CYFRA21-1,NSE,SCC-Ag,PSA,and fPSA.The 232 non-dialysis patients with CKD and 37 chronic uremic patients treated with maintenance hemodialysis were enrolled in this study.The 232 non-dialysis patients were divided into three groups according to their Ccr.In group 1,Ccr wash25 mL/min.In group 2,Ccr was between 25 and 50 mL/min.In group 3,Ccr wasi50 mL/min.The male patients were also divided into three groups to compare the serum levels of PSA and fPSA among the three groups.Nine tumor markers in 37 uremic patients were tested.For comparison,37 non-dialysis patients with similar Ccr of the same age and gender served as controls.There existed significant differences in serum levels of CEA,CA_(199),CYFRA21-1,NSE,and SCC-Ag among different Ccr groups and the markers bore a negative correlation with Ccr.There were no significant differences among the three groups in the serum concentrations of CA_(125),AFP,CA_(153),CA_(724),PSA and fPSA.The serum levels of CA125 and NSE were significantly higher(P<0.01)in hemodialysis patients than in the nondialysis control patients.In patients with chronic renal failure,who were or were not on hemodialysis,the specificity of serum CEA,CA_(199),CYFRA21-1,NSE,CA_(125) and SCC-Ag for the diagnosis of the corresponding tumors was decreased while serum AFP,CA153,CA724,PSA and fPSA were as valuable as they were in patients with normal kidney function.Hemodialysis further increased the serum level of CA_(125) and NSE.

Litopenaeus vannamei immunestimulated with Macrocystis pyrifera extract:improving the immune response against Vibrio campbellii

Objective:To examine the immune responses of Litopenaeus vannamei after different treatments with a hot water extract of Macrocystis pyrifera(M.pyrifera)and a subsequent challenge with Vibrio campbellii(V.campbellii).Methods:A total of 184 adult white shrimp that were infected with V.campbellii(1×10^(6) CFU/shrimp)were immunostimulate by the hot-water extract from M.pyrifera via either injection(10μg)or immersion(350 mg/L),the experimental controls were injected with either saline solution or V.campbellii(1×10^(6) CFU/shrimp).The bacterial DNA depuration rate,antimicrobial activity and total hemocyte count were evaluated in hemolymph samples at 2,6,12,24,48 and 72 h post-infection.Results:Injected shrimp(10μg M.pyrifera extract)demonstrated the best clearance of bacterial infection,with 82%survival at 72 h post-infection(cellular response).Hemolymph from the immersed organisms had the best antimicrobial activity against Escherichia coli growth;specifically,the most efficient antimicrobial activity was observed at 24 h post-infection.Both types of immunostimulated shrimp had similar total hemocyte counts at 24 h post-infection(1.63-1.59 million/mL);however,after 72 h,injected shrimp had higher total hemocyte counts than immersed animals(2.59 v.s.0.56 million/mL).Conclusions:The injection of the M.pyrifera hot-water extract facilitated a more efficient response to V.campbellii infection due to the stimulation of the hemocytes of the shrimp.In other words,the cellular immune response was more efficient to eliminate bacterial infection than the humoral response in shrimp.