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Despite obvious advantages of peritoneal dialysis (PD), mechanical complications are responsible for the failure of PD at early stage. Suture fixation in laparoscopic PD catheter method could reduce mechanical complications. In our study, a simple method to fix PD catheter was developed.Tenckhoff catheter placement was performed in 49 consecutive patients. In the technique, only two trocars were used. With the help of syringe needle and forceps, a loop of silk was prepared at the abdominal wall. The PD catheter was thread through the loop. The silk ligature was tied subcutaneously keeping the catheter suspended from the abdominal wall. Primary outcomes were catheter-related complications. Secondary outcomes were 6-month catheter survival rates and death within 30 days. Data were analyzed retrospectively.The average operation time was 49.7 ± 15.8 min. Minimum follow-up time was 6 months. No catheter displacement or hernia was detected. One patient had omental wrapping after silk suture rupture, 2 patients had outflow obstruction, and 3 patients had leakage. No one died within 30 days postoperatively. Catheter survival was 95.8% at 6 months.The method we described greatly reduced the risk of catheter displacement and omental wrap. Also, the required instrument and laparoscopic skill were simple.

Background: We investigated the diagnostic value of the ratio of high sensitivity troponin to cystatin C in CKD patients with stage ≥ 3 chronic kidney disease (CKD) and acute myocardial infarction. Methods: We retrospectively analyzed 401 patients with suspected acute myocardial infarction (AMI) who underwent coronary angiography in the chest pain center at our hospital during 2013–2019. Among the 196 patients studied, 113 were placed in an AMI group and 83 in a non-AMI group. Results: There were no significant differences in age, sex, or the presence of hypertension, diabetes, gout/hyperuricemia, stroke, tumor, or epidermal growth factor receptors between the two groups (P > 0.05). A correlation analysis showed that there was a positive correlation between CysC and Cr, with a correlation coefficient of 0.872 (P < 0.001). A receiver operating characteristic curve for the high-sensitivity cardiac troponin T (hs-cTnT)/CysC ratio showed an area under the curve value of 0.925 (P < 0.001), with sensitivity of 78.4% and specificity of 94.0%. Conclusion: The hs-TnT/CysC ratio can thus be used as an index to predict AMI in patients with stage≥ 3 CKD.

Background The effectiveness of oral hydration in preventing contrast-induced acute kidney injury (CI-AKI) in patients undergoing coronary angiography or intervention has not been well established. This study aims to evaluate the efficacy of oral hydration compared with intravenous hydration and other frequently used hydration strategies. Methods PubMed, Embase, Web of Science, and the Cochrane central register of controlled trials were searched from inception to 8 October 2017. To be eligible for analysis, studies had to evaluate the relative efficacy of different prophylactic hydration strategies. We selected and assessed the studies that fulfilled the inclusion criteria and carried out a pairwise and network meta-analysis using RevMan5.2 and Aggregate Data Drug Information System 1.16.8 software. Results A total of four studies (538 participants) were included in our pairwise meta-analysis and 1754 participants from eight studies with four frequently used hydration strategies were included in a network meta-analysis. Pairwise meta-analysis indicated that oral hydration was as effective as intravenous hydration for the prevention of CI-AKI (5.88 vs. 8.43%; odds ratio: 0.73; 95% confidence interval: 0.36-1.47; P>0.05), with no significant heterogeneity between studies. Network meta-analysis showed that there was no significant difference in the prevention of CI-AKI. However, the rank probability plot suggested that oral plus intravenous hydration had a higher probability (51%) of being the best strategy, followed by diuretic plus intravenous hydration (39%) and oral hydration alone (10%). Intravenous hydration alone was the strategy with the highest probability (70%) of being the worst hydration strategy. Conclusion Our study shows that oral hydration is not inferior to intravenous hydration for the prevention of CI-AKI in patients with normal or mild-to-moderate renal dysfunction undergoing coronary angiography or intervention.

Evans syndrome is a rare syndrome associated with the simultaneous or sequential development of autoimmune hemolytic anemia (AIHA) and idiopathic thrombocytopenic purpura (ITP). Furthermore, acute kidney injury (AKI) is a syndrome characterized by the rapid loss of kidney excretory function and is most often secondary to extrarenal events. However, AKI has rarely been recorded in Evans syndrome without systemic autoimmune disease and malignant tumors of the blood and lymphatic system. Herein, we report the case of a patient who exhibited Evans syndrome presenting with AKI. A 73-year-old woman presented with diarrhea, anuria, low platelet count, and developed a progressive increase of blood urea nitrogen and serum creatinine, as well as anemia with a positive direct Coombs test. We excluded hemolytic uremic syndrome, ITP, and leukemia. Treatment with antibiotics, rehydration therapy, and hemodialysis resulted in partial remission; thus, we diagnosed the patient with Evans syndrome presenting with AKI. The patient was successfully treated by the addition of steroid treatment. When AKI presents with hemolysis and thrombocytopenia, physicians should consider Evans syndrome, which can be appropriately treated when detected early.

Rare category identification is an important task in many application domains, ranging from network security, to financial fraud detection, to personalized medicine. These are all applications which require the discovery and characterization of sets of rare but structurally-similar data entities which are obscured within a larger but structurally different dataset. This paper introduces RCLens, a visual analytics system designed to support user-guided rare category exploration and identification. RCLens adopts a novel active learning-based algorithm to iteratively identify more accurate rare categories in response to user-provided feedback. The algorithm is tightly integrated with an interactive visualization-based interface which supports a novel and effective workflow for rare category identification. This paper (1) defines RCLens’ underlying active-learning algorithm; (2) describes the visualization and interaction designs, including a discussion of how the designs support user-guided rare category identification; and (3) presents results from an evaluation demonstrating RCLens’ ability to support the rare category identification process.

The course of Compiling Principles has always been difficult for students to understand, for the related algorithms are quite complex, and not all students possess the ability to comprehend those algorithms easily. In order to facilitate the learning of compiling techniques, we have designed a special compiler which displays the whole process of compiling for observing, and it's suitable to assist teaching work. Based on the subset of C grammar, this compiler can show the executing process of compiling algorithms with abundant graphs and messages. As an assistant tool for teaching, not only does it contribute to the quick, efficient understanding of compiling principles, but it also add some fun to the course.

To investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients.Sixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy.Patients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy.In the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

To analyze the quantity and size distribution of 24-hour urinary extracellular vesicles (uEVs) from healthy adults.The 24-hour uEVs from 9 healthy adults were isolated by hydrostatic filtration dialysis (HFD). The effectiveness of uEVs enrichment was evaluated using Western blotting and transmission electron microscopy (TEM). The quantity and size distribution of the uEVs was analyzed with BCA protein quantification, TEM, and nanoparticle tracking analysis (NTA).uEVs with different sizes and morphologies were observed under TEM. Western blotting confirmed the expression of TSG101 in all the uEV fractions from the 9 donors, ranging from 132.50 to 760.70 ng/mL. NTA results showed that the number of 24-hour uEVs amount ranged from 3.56 × 10¹² particles to 5.12 × 10¹² particles, with a CV of 14.23%. The proportion of the vesicles with a diameter40 nm was 0.04%-0.69% with a number range of (1.80-26.49)× 10⁹ particles; the proportion of vesicles with a diameter of 40-100 nm (which is consistent with the size of exosomes)was 22.07%-42.08% with a number range of (1.00-1.77)× 10¹² particles. The proportion of vesicles with a diameter of 100-1000 nm (consistent with the size of microvesicles) was 57.88%-77.85% with a number range of (2.09-3.86)× 10¹² particles.The established HFD method allows efficient and convenient isolation of uEVs from a large amount of urine samples. The 24-hour uEVs from healthy adults show narrow differences between individuals and thus can be an ideal source of samples for relevant studies.

To study the clinical features of bronchial-pulmonary arterial fistula, and to analyze its imaging features.In continuous five months, 502 patients for pulmonary angiography were analyzed by pulmonary/aortic arterial two-phase scanning. The 128-slice MSCT (Siemens Definition AS 128) was used with the following parameters: the speed of 0.5 s/weeks, the collimator width of 64 × 0.6 mm, the pitch of 0.9, the tube voltage of 120 kV, the contrast agent of 300 mg/ml (1.2 ml/kg) , and the flow rate of 4.3 ml/s. Automatic trigger technology was used, while the threshold of the main pulmonary artery trunk was set to 80 HU. After 4 s delay, the pulmonary-arterial phase was scanned for 3-5 s. Then, the aortic-arterial phase was taken after 12 s. Finally, the clinical features and CTA two-phase images were analyzed by two radiologists, respectively. The diagnozied criteria of CTA images for bronchial-pulmonary arterial fistula were as following.In pulmonary/aortic arterial two-phase scanning, pulmonary artery or aortic artery could be displayed, respectively. The filling defect of fistula's pulmonary artery was observed in pulmonary arterial phase. However, the filling defect of fistula's pulmonary artery had significant filling in aortic arterial phase, with the similar density intensity of aortic artery.In addition, the thicken bronchial artery were observed in the fistula area.In all 502 patients, 65 positive cases of the bronchial-pulmonary arterial fistula included 37 male cases and 28 female cases with ages from 45 to 83 years (69 ± 11). The clinical symptoms included hemoptysis (32%), anhelation (69%), hypoxia (66%), the raise of D2 dimer (70%), and pulmonary hypertension (64%). CTA two-phase images features: In the pulmonary-arterial phase, the intensity difference of pulmonary/aortic was [322 ± 122 (100-751)] HU. The local filling defect in the proximal pulmonary artery (12%) and the filling defect in the whole pulmonary artery (88%) were observed in 65 positive cases.In the aortic-arterial phase, the intensity difference of pulmonary/aortic was [251 ± 89 (85-428)] HU. The local enhancement in the proximal pulmonary artery (24%) and the enhancement in the whole pulmonary artery (76%) were observed in 58 positive cases. The visible thicken bronchial artery were observed in the fistula area of all cases.In 65 cases of bronchial-pulmonary arterial fistula, the fistula lesions contained 56 cases of lung lesions (including 35 cases of honeycomb lung, 16 cases of atelectasis, and 3 cases of chronic mass-like pneumonia) and 9 cases of vascular lesions (including 4 cases of chronic pulmonary artery embolism, 3 cases of congenital vascular malformation, 1 case of pulmonary arthritis, and 1 case of pulmonary artery aneurysm). 437 cases of non bronchial-pulmonary arterial fistula had 4 cases of of vascular lesions and 76 cases of lung lesions. There were significant statistic difference between the fistula and vascular lesions or lung lesions (the value of χ(2): 37.51 or 165.11, all values of P0.001).The disease of bronchial-pulmonary arterial fistula usually occurred in the chronic pneumonia and the pulmonary vascular lesions. The CT pulmonary/aortic arterial two-phase scanning could detect the homodynamic changes to diagnosis this disease correctly. The pulmonary embolism need be differentiated.

Purpose Urinary extracellular vesicles (uEVs) are a novel source of biomarkers. However, urinary Tamm-Horsfall Protein (THP; uromodulin) interferes with all vesicle isolation attempts, precipitates with normal urinary proteins, thus, representing an unwanted "contaminant" in urinary assays. Thus, the aim is to develop a simple method to manage THP efficiently. Experimental design The uEVs are isolated by hydrostatic filtration dialysis (HFD) and treated with a defined solution of urea to optimize release of uEVs from sample. Presence of uEVs is confirmed by transmission electron microscopy, Western blotting, and proteomic profiling in MS. Results Using HFD with urea treatment for uEV isolation reduces sample complexity to a great extent. The novel simplified uEV isolation protocol allows comprehensive vesicle proteomics analysis and should be part of any urine analytics to release all sample constituents from THP trap. Conclusions and clinical relevance The method brings a quick and easy protocol for THP management during uEV isolation, providing major benefits for comprehensive sample analytics.