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Phosphorus (P) is a vital nutrient for algal growth. Aside from soluble reactive P (SRP), organic P (OP) is used by algae via alkaline phosphatase (AP) hydrolysis, which can play an important role in supplying P. Enzymatically-hydrolysable OP (EHP) can potentially be used as an indicator of bioavailability of P other than SRP in natural waters. We investigated the ecological significance of alkaline phosphatase activity (APA), EHP concentration and P turnover time in the inflowing rivers of Lake Taihu (Taihu) during three hydrologic periods. Results indicated high SRP concentration and low SRP demand by algal suppressed APA in the inflowing rivers, the highest proportion of OP mineralization rate (v) to the maximum reaction velocity of AP (Vmax) is only 14.7%. P turnover time of the inflowing rivers was generally from 3 to 7 days and in exceptional cases, it could exceed 10 days. The high EHP reserve and the sufficient AP for OP mineralization render the rivers a significant source of utilizable OP, further exacerbating eutrophication of Taihu. [ABSTRACT FROM AUTHOR]

The material composition of road-deposited sediments (RDS) collected from five different sites was measured, and its effects on the pollution of selected heavy metals (zinc, chromium, and lead) were revealed. Results indicated that RDS mainly consisted of quartz, amorphous materials, and inorganic minerals including silicates and carbonates. Due to the different material composition with solids in different size ranges, the unit specific surface area load of selected heavy metals indicated an increasing trend with increasing solid size. The influence of material composition of RDS on heavy metal pollution was further investigated. It was found that the presence of quartz indicated a negative effect on the pollution of zinc, chromium, and lead due to the electrically neutral characteristic of quartz. The amorphous content was positively related to the selected metal pollution because most of amorphous materials originated from traffic-related sources. In addition, the metal pollution was proportional to the content of inorganic minerals (silicates, carbonates) and some clay minerals due to their high surface area and usually negatively charged surface. Taken together, the material composition of RDS indicated a crucial influence on heavy metal pollution. [ABSTRACT FROM AUTHOR]

Objective: To investigate correlation between early net fluid balance and the clinical outcomes of patients receiving extracorporeal cardiopulmonary resuscitation (ECPR)., Methods: Adult patients on ECPR admitted to the Department of Emergency in the First Affiliated Hospital of Nanjing Medical University from May 2015 to December 2020 were included. Net fluid balance for consecutive 4 days after ECPR was recorded. The primary outcome was survival to intensive care unit (ICU) discharge. We used multivariable logistic regression to assess the association between fluid status and clinical outcomes., Results: A total of 72 patients were enrolled and divided into two groups: the survivor group and the non-survivor group. The overall rate of survival to ICU discharge was 44.4%. Daily fluid balance (DFB) in the survivor group was lower than that in the non-survivor group at day 4 (-11.47 (-19.74, 8.7) vs. -5.08 (-12.94, 13.9) mL/kg, P=0.046), as was cumulative fluid balance (CFB) over the first 4 days (-36.03 (-51.45, 19.03) vs. -7.22 (-32.79, 21.02) mL/kg, P=0.009). Both continuous renal replacement therapy (CRRT) and CFB from days 1-4 were significantly correlated with survival to ICU discharge (OR=14.617, 95% CI: 1.344, 48.847, P=0.028; OR=1.261, 95% CI: 1.091, 1.375, P=0.003, respectively). CFB from days 1-4 was determined to have a roughly linear association with the log odds of survival to ICU discharge., Conclusion: Early negative fluid balance maybe associated with survival to ICU discharge in patients receiving ECPR., Competing Interests: None., (AJTR Copyright © 2023.)

Objective: To explore the clinical value of extracorporeal cardiopulmonary resuscitation (ECPR) combined with different targeted temperature management (TTM) for the treatment of cardiac arrest., Methods: From January 2018 to September 2020, ECPR was initiated in patients with cardiac arrest who did not have their spontaneous circulation restored after 20 minutes of traditional cardiopulmonary resuscitation (CPR). A total of 22 patients (observation group) given TTM were treated with Hico-variotherm 550 (HU 550) and 30 patients (control group) not given TTM were treated with a medical water circulation cooling blanket. The Glasgow Coma scale (GCS) score, serum neuron-specific enolase (NSE), survival rate and neurological prognosis after ECMO weaning were compared between the two groups., Results: There was no significant difference between the two groups in GCS score on the third and seventh days after resuscitation and serum NSE on the first and third day after treatment (P>0.05). Compared with the control group, the survival rate (40.91% vs 33.33%) and favorable neurological outcome (36.36% vs 26.67%) of patients in the observation group were slightly higher, but the differences were not statistically significant (all P>0.05). The incidence of shivering and body temperature fluctuation during rewarming in the observation group was lower than that in the control group (P<0.05)., Conclusion: HU550 poikilothermia water cabinet combined with ECMO can better control the targeted temperature of patients in a more accurate range and improve the survival rate; however, it exerts no statistical improvement in the incidence of complications., Competing Interests: None., (AJTR Copyright © 2022.)

Objective: To determine the predictive values of different critical scoring systems for survival rate after discharge in critically ill patients supported by extracorporeal membrane oxygenation (ECMO)., Methods: The clinical data of 34 critically ill patients supported by ECMO admitted to Department of Emergency of the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial People's Hospital) from July 2015 to September 2017 were retrospectively analyzed. The general information and the worst values of vital signs and related pathophysiological indicators within 12 hours before ECMO treatment of patients were collected, and sequential organ failure assessment (SOFA), multiple organs dysfunction score (MODS), simplified acute physiology score II (SAPS II), and acute physiology and chronic health evaluation IV (APACHE IV) scores were calculated. The patients were divided into survival group and non-survival group according to 28-day survival after hospital discharge. General clinical characteristics and aforementioned scores were compared between the two groups. Scoring systems for predicting prognosis were assessed by using the receiver operating characteristic (ROC) curve. The Kaplan-Meier method was used to depict the surviving curve., Results: Thirty-four patients were finally enrolled, 13 of whom were dead at the follow-up period of 28 days after hospital discharge, and 21 survived. Duration of ECMO support in non-survival group was significantly shorter than that in survival group (hours: 101.4±7.8 vs. 134.4±12.6), SOFA, SAPS II, and APACHE IV scores were significantly higher than those of survival group (SOFA score: 10.6±3.6 vs. 8.8±3.3, SAPS II score: 38.7±14.3 vs. 31.8±12.5, APACHE IV score: 46.5±15.5 vs. 38.1±11.3, all P < 0.05). There was no significant difference in gender, age, body mass index (BMI), vital signs or related pathophysiological indicators within 12 hours before ECMO treatment, or MODS score between the two groups. ROC curve analysis showed that the area under ROC curve (AUC) of SAPS II score for predicting 28-day survival rate was the highest, which was significantly higher than that of SOFA, MODS, and APACHE IV score (0.880 vs. 0.694, 0.654, 0.682, all P < 0.05). When the best cut-off value of SAPS II score was 43, the sensitivity was 81.2%, and the specificity was 77.9%. Kaplan-Meier survival analysis showed that 28-day survival rate after hospital discharge in patients with SAPS II score < 43 (n = 18) was significantly higher than that in patients with SAPS II score ≥ 43 (n = 16; χ 2 = 2.444, P = 0.018)., Conclusions: Four critical scoring systems of SOFA, MODS, SAPS II and APACHE IV have been proved to have good prognostic ability to predict 28-day survival after hospital discharge in critically ill patients supported by ECMO. Among them, SAPS II score system has more accurate prediction value.