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Objective To investigate the perioperative rate of allogeneic red blood cell (RBC) transfusion in adolescent scoliosis(AS) that underwent posterior correction surgeries, and to identify its risk factors. Methods This study was a retrospective cohort study. Anesthetic data of adolescent scoliosis patients who underwent posterior correction surgeries from January 2015 to May 2017 in Peking Union Medical College Hospital were collected and analyzed. The clinical variables were subsequently compared between patients who received allogeneic RBC transfusion(transfusion group) and those who did not (non-transfusion group). Binary logistic regression analysis was performed to identify risk factors in perioperative allogeneic RBC transfusion in these patients. Results The study enrolled 469 patients. The perioperative rate of allogeneic RBC transfusion was 30.5% and the independent risk factors leading to it included corrected body mass index (BMI) (OR=0.887, 95% CI: 0.815-0.966, P＜0.01),other type of scoliosis (OR=3.847, 95% CI: 1.660-8.917, P＜0.01) (compared with idiopathic scoliosis), preoperative anemia (OR=6.322, 95% CI: 2.053-19.473, P＜0.01), the number of fused levels more than 12.5 (OR=3.554, 95% CI: 2.174-5.885, P＜0.001), preoperative Cobb angle larger than 64.5° (OR=2.381, 95% CI: 1.356-4.178, P＜0.01) and osteotomy (OR=7.551, 95% CI: 3.258-17.503,P＜0.001). The postoperative transfer rate to intensive care unit(ICU)(P＜0.001) in transfusion group was higher, with longer hospital stay length(P＜0.001) and higher cost(P＜0.001), than that in the non-transfusion group. Conclusions The risk factors for perioperative allogeneic RBC transfusion in AS include corrected BMI, other type of scoliosis, preoperative anemia, the number of fused levels more than 12.5, preoperative Cobb angle larger than 64.5° and osteotomy.

Phycoerythrin and polysaccharides have significant commercial value in medicine, cosmetics, and food industries due to their excellent bioactive functions. To maximize the production of biomass, phycoerythrin, and polysaccharides in Porphyridium purpureum, culture media were supplemented with calcium gluconate (CG), magnesium gluconate (MG) and polypeptides (BT), and their optimal amounts were determined using the response surface methodology (RSM) based on three single-factor experiments. The optimal concentrations of CG, MG, and BT were determined to be 4, 12, and 2 g L−1, respectively. The RSM-based models indicated that biomass and phycoerythrin production were significantly affected only by MG and BT, respectively. However, polysaccharide production was significantly affected by the interactions between CG and BT and those between MG and BT, with no significant effect from BT alone. Using the optimized culture conditions, the maximum biomass (5.97 g L−1), phycoerythrin (102.95 mg L−1), and polysaccharide (1.42 g L−1) concentrations met and even surpassed the model-predicted maximums. After optimization, biomass, phycoerythrin, and polysaccharides concentrations increased by 132.3%, 27.97%, and 136.67%, respectively, compared to the control. Overall, this study establishes a strong foundation for the highly efficient production of phycoerythrin and polysaccharides using P. purpureum. [ABSTRACT FROM AUTHOR]

Vascular calcification (VC) is an independent risk factor for cardiovascular mortality in end-stage renal disease (ESRD) patients. The pathogenesis of VC is complicated and unclear. Uremic toxins produced by gut microbiota can promote VC. This study aims to identify the differences in gut microbiota between the different VC groups and the main bacteria associated with VC in hemodialysis (HD) patients in an attempt to open up new preventive and therapeutic approaches and define the probable mechanism for VC in HD patients in the future. A total of 73 maintenance HD patients were enrolled in this cross-sectional study. According to the abdominal aortic calcification (AAC) scores, the participants were divided into the high AAC score group and the low AAC score group. High-throughput sequencing of the gut microbiota was performed and the results were evaluated by alpha diversity, beta diversity, species correlation, and model predictive analyses. The prevalence of VC was 54.79% (40/73) in the study. The majority of phyla in the two groups were the same, including Firmicutes, Actinobacteriota, Proteobacteria, and Bacteroidota. The microbial diversity in the high AAC score group had a decreasing trend (p = 0.050), and the species abundance was significantly lower (p = 0.044) than that in the low AAC score group. The HD patients with high AAC scores showed an increased abundance of Proteobacteria and decreased abundances of Bacteroidota and Synergistota at the phylum level; increased abundances of Escherichia-Shigella, Ruminococcus_gnavus_group, and Lactobacillus; and decreased abundances of Ruminococcus and Lachnospiraceae_NK4A136_group at the genus level (p<0.05). Escherichia-Shigella and Ruminococcus_gnavus_group were positively correlated with VC, and Ruminococcus, Adlercreutzia, Alistipes, and norank_f__Ruminococcaceae were negatively correlated with VC. Escherichia-Shigella had the greatest influence on VC in HD patients, followed by Ruminococcus and Butyricimonas. Our results provide clinical evidence that there was a difference in gut microbiota between the different VC groups in HD patients. Escherichia–Shigella, a lipopolysaccharide (LPS)-producing bacterium, was positively correlated with VC and had the greatest influence on VC. Ruminococcus, a short-chain fatty acid (SCFA)-producing bacterium, was negatively correlated with VC and had the second strongest influence on VC in HD patients. The underlying mechanism is worth studying. These findings hint at a new therapeutic target. [ABSTRACT FROM AUTHOR]

To analyze the literature status and research hotspots of Science Citation Index (SCI)-related ostomy in the world and to provide references for scientific research and clinical work in the stoma care field.

Background Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of kidney failure in children with phenotypic and genotypic heterogeneity. Our objective was to describe the genetic spectrum and identify the risk factors for kidney failure in children with CAKUT. Methods Clinical and genetic data were derived from a multicentre network [Chinese Children Genetic Kidney Disease Database (CCGKDD)] and the Chigene database. A total of 925 children with CAKUT who underwent genetic testing from 2014 to 2020 across China were studied. Data for a total of 584 children were obtained from the CCGKDD, including longitudinal data regarding kidney function. The risk factors for kidney failure were determined by the Kaplan–Meier method and Cox proportional hazards models. Results A genetic diagnosis was established in 96 of 925 (10.3%) children, including 72 (8%) with monogenic variants, 20 (2%) with copy number variants (CNVs) and 4 (0.4%) with major chromosomal anomalies. Patients with skeletal abnormalities were more likely to have large CNVs or abnormal karyotypes than monogenic variants. Eighty-two patients from the CCGKDD progressed to kidney failure at a median age of 13.0 years (95% confidence interval 12.4–13.6) and 24 were genetically diagnosed with variants of PAX2, TNXB, EYA1, HNF1B and GATA3 or the 48,XXYY karyotype. The multivariate analysis indicated that solitary kidney, posterior urethral valves, bilateral hypodysplasia, the presence of certain variants and premature birth were independent prognostic factors. Conclusions The genetic spectrum of CAKUT varies among different subphenotypes. The identified factors indicate areas that require special attention. [ABSTRACT FROM AUTHOR]