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Background Peritoneal dialysis (PD) is an important renal replacement therapy for patients with end-stage renal disease. PD-related hydrothorax is a rare but serious complication in PD patients, produced by the movement of peritoneal dialysate through pleuroperitoneal fistulas. In previous reports, patients with hydrothorax secondary to PD were usually recommended to discontinue PD and transfer to hemodialysis (HD). Herein, we describe another method of managing this complication-with an adjusted PD prescription and continuous drainage of pleural effusion, patients could continue PD without recurrence of hydrothorax. Case summary In this report, we present the medical records of 2 patients with hydrothorax secondary to PD. We recommended intermittent PD with continuous drainage of pleural effusion. A type 18Ga soft catheter was placed to drain pleural effusion. Ultrasound-guided thoracentesis was performed, and the soft catheter was placed in the pleural cavity for a long period (3 mo and 2 mo, respectively). The pleural catheter was removed when no fluid was drained from the pleural cavity. After several months, pleuroperitoneal fistulas were closed in both patients and PD was continued. These patients did not transfer to HD, had no recurrence of hydrothorax and were still treated with PD after 1 year. Conclusion These 2 case reports show that continuous drainage of pleural effusion with an 18Ga soft catheter is a useful method for hydrothorax secondary to PD.

Wavelength signals play a vital role in refractive development. This study aimed to explore the retinal transcriptome signature in these processes.Guinea pigs were randomly divided into three groups exposed to white, blue, or green environmental light for eight weeks. Refraction and axial length were evaluated every 4 weeks, and the retinal transcriptome was profiled at 8 weeks.Compared with the white group, ocular refraction significantly decreased and ocular axial length significantly extended in the green group whereas these parameters showed opposite trends in the blue group. RNA-sequencing showed that, compared with the white group, 184 and 171 differentially expressed genes (DEGs) were found in the blue and green groups, respectively. Among these DEGs, only 31 overlapped. These two sets of DEGs were enriched in distinct biological processes and pathways. There were 268 DEGs between the blue and green groups, which were primarily enriched in the extracellular matrix, and metabolism, receptor activity, and ion binding processes. In addition, nine human genes, including ECEL1, CHRND, SHBG, PRSS56, OVOL1, RDH5, WNT7B, PEBP4, CA12, were identified to be related to myopia development and wavelength response, indicating the potential role of these genes in human wavelength-induced myopia.In this study, we identified retinal targets and pathways involved in the response to wavelength signals in emmetropization.

Secretory phospholipase A2 group IB (sPLA2-IB) and M-type phospholipase A2 receptor (PLA2R) are closely associated with proteinuria in idiopathic membranous nephropathy (IMN). Podocytes constitute an important component of glomerular filtration, and high basal autophagy is indispensable for podocyte function. The current study aimed to analyze the relationship between sPLA2-IB and podocyte autophagy in IMN and determine whether sPLA2-IB mediates abnormal autophagy regulation in podocytes. The serum sPLA2-IB level and podocyte autophagy were detected, and clinical data were collected from IMN patients with different proteinuria levels. Then, the effects of sPLA2-IB on autophagy signaling pathways were evaluated in cultured human podocytes treated with sPLA2-IB, rapamycin, p38 inhibition, and PLA2R-siRNA in vitro. We found that IMN patients with nephrotic-range proteinuria have a significantly higher level of sPLA2-IB and fewer autophagosomes than those with non-nephrotic-range proteinuria. In vitro sPLA2-IB-induced insufficient autophagy in podocytes and promoted podocyte injury via activation of the mTOR/ULK1ser757 signaling pathway. Moreover, inhibition of p38 MAPK evidently abrogated sPLA2-IB-induced autophagy and the activation of mTOR/ULK1ser757 . Additionally, PLA2R silencing demonstrated that sPLA2-IB-induced abnormal autophagy was also PLA2R-dependent. In conclusion, the results revealed that sPLA2-IB downregulated autophagy and contributed to podocyte injury via PLA2R though activation of the p38MAPK/mTOR/ULK1ser757 signaling pathway.

The purpose of the present study was to explore the effects of emodin on renal injury in a BXSB mouse model of lupus and its mechanisms. BXSB mice were fed different concentrations of emodin (0, 5, 10 and 20 mg/kg.d), and the levels of intercellular adhesion molecule-1 (ICAM-1), tumor necrosis factor-α (TNF-α) and fibronectin (FN) levels in the glomeruli and serum levels of the anti-dsDNA antibody were determined. Mesangial cells (MCs) were cultured in vitro, and IgG-type anti-dsDNA antibody and/or emodin were added to the MC culture supernatant. In addition, TNF-α small interfering RNA (siRNA) was transfected into MCs to explore the mechanism of action of emodin. The results showed that the mice fed emodin presented decreases in the urinary protein content and glomerular TNF-α, ICAM-1 and FN levels (P

Recent studies suggested that serum secretory phospholipase A2 group IB (sPLA2-IB) was increased in idiopathic membranous nephropathy (IMN). However, the interference of high lipemia on the sPLA2-IB levels was not taken into account in these studies. The present study aimed to investigate the correlation between sPLA2-IB and lipemia, and the clinical merit of sPLA2-IB in the prediction of prognosis of IMN patients. A total of 64 IMN patients, 39 immunoglobulin A nephropathy (IgAN) patients and 64 healthy controls were included in the study. The levels of serum sPLA2-IB, lipemia and proteinuria were measured. Fifty IMN patients were followed up for 6 months. Pathologic stages were made for all IgAN and IMN patients. The results showed that the levels of serum sPLA2-IB, cholesterol and low-density lipoprotein cholesterol (LDL-C) were significantly higher, and the levels of albumin and high-density lipoprotein cholesterol (HDL-C) were significantly lower in IMN patients than in healthy controls and IgAN patients. Serum sPLA2-IB levels were also found to be higher in IgAN patients than in heathy controls, but the association of serum sPLA2-IB levels with proteinuria, cholesterol and albumin was only shown in IMN patients. Antibody against M-type receptor for secretory phospholipase A2 (PLA2R1) was positive in 81.3% IMN patients. Glomerular sPLA2-IB deposition, podocyte fused processes, and density deposition on thickened basement membrane were seen in IMN patients, but not in IgAN patients. IMN patients with lower sPLA2-IB and proteinuria levels were found to have better outcome after the 6-month follow-up. In IMN patients, sPLA2-IB levels were significantly increased in both serum and renal tissue. In conclusion, serum sPLA2-IB was closely correlated with proteinuria, albumin and cholesterol, and IMN patients with lower sPLA2-IB levels were more likely to achieve a better outcome.

Secretory phospholipase A2 group IB (sPLA2-IB) and M-type phospholipase A2 receptor (PLA2R) are closely associated with proteinuria in idiopathic membranous nephropathy (IMN). Podocytes constitute an important component of glomerular filtration, and high basal autophagy is indispensable for podocyte function. The current study aimed to analyze the relationship between sPLA2-IB and podocyte autophagy in IMN and determine whether sPLA2-IB mediates abnormal autophagy regulation in podocytes. The serum sPLA2-IB level and podocyte autophagy were detected, and clinical data were collected from IMN patients with different proteinuria levels. Then, the effects of sPLA2-IB on autophagy signaling pathways were evaluated in cultured human podocytes treated with sPLA2-IB, rapamycin, p38 inhibition, and PLA2R-siRNA in vitro. We found that IMN patients with nephrotic-range proteinuria have a significantly higher level of sPLA2-IB and fewer autophagosomes than those with non-nephrotic-range proteinuria. In vitro sPLA2-IB-induced insufficient autophagy in podocytes and promoted podocyte injury via activation of the mTOR/ULK1

Objective Alterations in the gut microbiota and host responses have been implicated in the progression of end-stage renal disease, increased cardiovascular risk, uremic toxicity, and inflammation. The purpose of this study was to evaluate the clinical efficacy of probiotics on malnutrition and health-related quality of life in patients undergoing peritoneal dialysis (PD). Design and Methods A total of 116 patients undergoing PD were randomly divided into an intervention group (n = 58) and a control group (n = 58). The intervention group received a daily dose of probiotics (1 × 109 CFU/day, i.e., 2 capsules, tid) for 2 months, while the control group did not receive probiotics during the same period. Biochemical indicators, physical measurements, and scores on the SF-36 were measured before and 2 months after the intervention. Results A total of 98 patients completed the study (50 in the intervention group and 48 in the control group). Among patients receiving probiotics, the levels of high-sensitivity C-reactive protein and interleukin-6 decreased after 2 months of treatment, while the serum albumin levels, upper arm circumference, and triceps skinfold thickness increased significantly. The probiotic group had higher scores on the physical functioning and social functioning domains than the control group after 2 months. Conclusions Probiotics could significantly decrease the serum levels of high-sensitivity C-reactive protein and interleukin-6 and increase the serum albumin levels, upper arm circumference, and triceps skinfold thickness in patients undergoing PD. As a result, malnutrition and health-related quality of life partially improved after probiotic supplementation in patients undergoing PD.

The performance of cloud radio access network (C-RAN) is limited by the finite capacities of the backhaul links connecting the centralized processor (CP) with the base-stations (BSs), especially when the backhaul is implemented in a wireless medium. This paper proposes the use of wireless multicast together with BS caching, where the BSs pre-store contents of popular files, to augment the backhaul of C-RAN. For a downlink C-RAN consisting of a single cluster of BSs and wireless backhaul, this paper studies the optimal cache size allocation strategy among the BSs and the optimal multicast beamforming transmission strategy at the CP such that the user's requested messages are delivered from the CP to the BSs in the most efficient way. We first state a multicast backhaul rate expression based on a joint cache-channel coding scheme, which implies that larger cache sizes should be allocated to the BSs with weaker channels. We then formulate a two-timescale joint cache size allocation and beamforming design problem, where the cache is optimized offline based on the long-term channel statistical information, while the beamformer is designed during the file delivery phase based on the instantaneous channel state information. By leveraging the sample approximation method and the alternating direction method of multipliers (ADMM), we develop efficient algorithms for optimizing cache size allocation among the BSs, and quantify how much more cache should be allocated to the weaker BSs. We further consider the case with multiple files having different popularities and show that it is in general not optimal to entirely cache the most popular files first. Numerical results show considerable performance improvement of the optimized cache size allocation scheme over the uniform allocation and other heuristic schemes., Accepted and to appear in IEEE Journal on Selected Areas in Communications, Special Issue on Caching for Communication Systems and Networks

The interest in application of Additive Manufacturing (AM) to nuclear industry stems not only from the benefits of design freedom and shortened lead time, but also from the possibility of enhancing the performance through microstructure control. One of the most important requirements for in-core structural material in nuclear power plants is helium resistance. The Laser Powder Bed Fusion (LPBF) processed 304L stainless steel possesses strong defect sinks such as high densities of dislocation-surrounded sub-grains and dispersed nano-inclusions. In this work the LPBF processed 304L in as-built and solution-annealed conditions along with a conventionally rolled counterpart were implanted with 350 keV He+ ion at 300 °C to 0.24 dpa (displacement per atom). Transmission Electron Microscopy (TEM) observations indicate significantly higher helium resistance of the as-built LPBF 304L compared to the other two samples. The sink strengths in the three samples are calculated based on the measurements of the microstructural features using simplified equations for the correlation between microstructural characteristics and helium tolerance. Based on the calculation, the cellular sub-grains and the dispersed nano-inclusions are the primary and secondary contributors to the helium resistance of LPBF 304L steel.

This paper studies the energy efficiency of the cloud radio access network (C-RAN), specifically focusing on two fundamental and different downlink transmission strategies, namely the data-sharing strategy and the compression strategy. In the data-sharing strategy, the backhaul links connecting the central processor (CP) and the base-stations (BSs) are used to carry user messages -- each user's messages are sent to multiple BSs; the BSs locally form the beamforming vectors then cooperatively transmit the messages to the user. In the compression strategy, the user messages are precoded centrally at the CP, which forwards a compressed version of the analog beamformed signals to the BSs for cooperative transmission. This paper compares the energy efficiencies of the two strategies by formulating an optimization problem of minimizing the total network power consumption subject to user target rate constraints, where the total network power includes the BS transmission power, BS activation power, and load-dependent backhaul power. To tackle the discrete and nonconvex nature of the optimization problems, we utilize the techniques of reweighted $\ell_1$ minimization and successive convex approximation to devise provably convergent algorithms. Our main finding is that both the optimized data-sharing and compression strategies in C-RAN achieve much higher energy efficiency as compared to the non-optimized coordinated multi-point transmission, but their comparative effectiveness in energy saving depends on the user target rate. At low user target rate, data-sharing consumes less total power than compression, however, as the user target rate increases, the backhaul power consumption for data-sharing increases significantly leading to better energy efficiency of compression at the high user rate regime., Comment: 14 pages, 8 figures, accepted by JSAC Energy-Efficient Techniques for 5G Wireless Communication Systems special issue

Recent studies have shown that serum secretory phospholipase A2 group IB (sPLA2-IB) is associated with proteinuric kidney diseases and plays a pivotal role in podocyte injury via its natural receptor. Arachidonic acid (AA), as a major metabolite of sPLA2-IB, regulates the actin bungling remodeling and contributes to the podocyte injury. However, the underlying mechanism of AA in the regulation of podocyte actin remodeling and human podocyte injury is unclear. Here, we reported that AA induced F-actin cytoskeletal ring formation and promoted protein kinase A (PKA), nephrin and c-Abl phosphorylation. Moreover, AA promoted c-Abl translocation from the nucleus to the cytoplasm and increased the recruitment of c-Abl to p-nephrin by the interaction between them. H89 (PKA inhibitor) provided protection against AA-induced F-actin bunching remodeling, down-regulated nephrin phosphorylation, and suppressed the c-Abl translocation and activation. STI571 (c-Abl inhibitor) also improved the AA associated F-actin bunching remodeling. In addition, H89 and STI571 both alleviated apoptosis and adhesion damage of podocyte. These results indicate that an excess of AA treatment is detrimental to the podocyte actin cytoskeleton and promotes podocyte injury due to the activation of PKA-c-Abl signaling.

This paper studies transmission strategies for the downlink of a cloud radio access network, in which the base stations are connected to a centralized cloud-computing based processor with digital fronthaul or backhaul links. We provide a system-level performance comparison of two fundamentally different strategies, namely the data-sharing strategy and the compression strategy, that differ in the way the fronthaul/backhaul is utilized. It is observed that the performance of both strategies depends crucially on the available fronthaul or backhaul capacity. When the fronthaul/backhaul capacity is low, the datasharing strategy performs better, while under moderate-to-high fronthaul/backhaul capacity, the compression strategy is superior. Using insights from such a comparison, we propose a novel hybrid strategy, combining the data-sharing and compression strategies, that allows for better control over the fronthaul/backhaul capacity utilization. An optimization framework for the hybrid strategy is proposed. Numerical evidence demonstrates the performance gain of the hybrid strategy., 15 pages, 8 figures, to appear in IEEE Transactions on Communications

The performance of cloud radio access networks ( $C$ -RAN) is limited by the finite capacities of the backhaullinks connecting the cloud with the base-stations (BSs). A promising approach to improving the performance of C-RAN is to augment the backhaul through BS caching, where the BSs pre-store some of the popular contents. In this paper, we first derive a multicast backhaul rate expression based on a joint cache-channel coding scheme, and show that, as compared to the uniform cache allocation, it is better to allocate larger cache sizes to the weaker BSs. Then, by leveraging the sample approximation method and the alternating direction method of multipliers, we develop an efficient algorithm to optimize the cache allocation by maximizing the BS expected file downloading rate from the cloud. Numerical results show considerable performance improvement of the optimized cache allocation scheme over heuristic schemes.

This paper provides a system-level performance comparison of two fundamentally different transmission strategies for the downlink of a cloud radio access network. The two strategies, namely the data-sharing strategy and the compression-based strategy, differ in the way the limited backhaul is utilized. While the data-sharing strategy uses the backhaul to carry raw user data, the compression strategy uses the backhaul to carry compressed beamformed signals. Although these strategies have been individually studied in the literature, a fair comparison of the two schemes under practical network settings is challenging because of the complexity in jointly optimizing user scheduling, beamforming, and power control for systemlevel performance evaluation, along with the need to optimize cooperation clusters for the data-sharing strategy and quantization noise levels for the compression strategy. This paper presents an optimization framework for both the data-sharing and compression strategies, while taking into account losses due to practical modulation in terms of gap to capacity and practical quantization in terms of gap to rate-distortion limit. The main conclusion of this paper is that the compression-based strategy, even with a simple fixed-rate uniform quantizer, outperforms the data-sharing strategy under medium to high capacity backhauls. However, the data-sharing strategy outperforms the compression strategy under low capacity backhauls primarily because of the large quantization loss at low backhaul capacity with compression.

In this paper, we investigate the beamforming optimization for the downlink of multiuser MISO (MU-MISO) system with finite-rate feedback, where the transmitter is only aware of a delayed and quantized version of the channel state information (CSI). By taking into consideration both CSI quantization error and feedback delay, we propose an improved beamforming optimization criterion by maximizing the signal-to-leakage-and-noise ratio (SLNR) averaged over CSI imperfection. A closedform expression for the optimized beamforming design is then presented. Numerical results verify that the proposed scheme is more robust to the CSI imperfection in finite-rate feedback system than conventional SLNR-based beamforming scheme as well as another well-known zero-forcing beamforming (ZFBF) scheme in terms of both sum rate and bit error rate (BER).