Effect of two different peritoneal dialysis modalities on wound infection in peritoneal dialysis patients: A meta-analysis.

Peritoneal dialysis(PD) is one of the most efficient methods in end-stage kidney disease, and it is very important for PD to perform well. No research has been conducted to evaluate the effect of various types of PD catheters on the prognosis of post-operative wound complications. While recent meta-analyses are in favour of straight tubing, there is still uncertainty as to whether direct or coiled PD is beneficial. The purpose of this meta-analysis was to compare the efficacy of direct and coiled PD catheters on the incidence of post-operative wound infection, bleeding and peritonitis. A comprehensive search was carried out on three databases, including PubMed and Embase, and a manual search was carried out on the links in the paper. The results showed that the incidence rate of bleeding after operation and the degree of infection among the straight and coiled pipes were compared. The results showed that there were no statistically significant differences in the incidence of post-operative wound infection among straight PD patients with coiled PD (OR, 0.79; 95% CI, 0.58-1.08 p = 0.13). No statistical significance was found in the case of PD with coiled tubing compared with that of straight PD group in wound leakage (OR, 1.17; 95% CI, 0.71-1.93 p = 0.55). No statistically significantly different rates of post-operative peritonitis were observed for coiled tubing compared with straight ones in PD patients (OR, 1.06; 95% CI, 0.78-1.45 p = 0.7). There is no statistical significance on the rate of wound infection, wound leakage and peritonitis among coiled and straight tube in PD.

Double Pump Sequential Constant Citrate Anticoagulation in General Hemodialysis.

Objective: To investigate the safety and efficacy of single-pump and double-pump sequential anticoagulation in general hemodialysis under the condition of constant citrate. Methods: A total of 32 patients with end-stage renal disease complicated with hemorrhage admitted by Zigong Third People's Hospital from December 2019 to December 2020 were collected. Randomly divided into single pump group (n = 17) and double pump group (n = 15). The coagulation of dialyzer and intravenous pot was compared between the two groups. Then, the changes of serum calcium before treatment, after 2 h treatment, and after the completion of the treatment, and the front of the blood pump and intravenous pot, as well as behind the intravenous pot were observed and recorded in the two groups. Then, single-pool clearance of urea/volume (spKt/V) was compared between the two groups. Results: There were few differences in dialyzer coagulation between the single pump group and double pump group. However, the single pump group had a significant increase in the number of intravenous pot coagulations than the double pump group. At 2 h for dialysis, the serum calcium level behind the intravenous pot in the double pump group was notably lower than that in the single pump group. And after the completion of dialysis, the serum calcium returned to pretreatment level. The Kt/v in both groups reached the normal standard without statistically significant difference. And there were no adverse reactions in the patients of both groups after dialysis. Conclusion: For hemodialysis patients with bleeding, dual-pump segmented anticoagulation is superior to single-pump anticoagulation in intravenous pot anticoagulation. Double pump segmented sequential constant citrate anticoagulation can be utilized as a new simple and effective anticoagulation method for clinical hemodialysis.

Development and validation of a model to predict acute kidney injury following wasp stings: A multicentre study.

OBJECTIVE: To establish and validate a model to predict acute kidney injury (AKI) following wasp stings. METHODS: In this multicentre prospective study, 508 patients with wasp stings from July 2015 to December 2019 were randomly divided into a training set (n = 381) and a validation set (n = 127) for internal and external validation. Risk factors were identified, and a model was established to predict the probability of AKI following multiple wasp stings using an individual nomogram and a predictive formula. The performances of the model were assessed by using the area under the curve (AUC), accuracy (ACC) of the receiver operating characteristic curve and decision curve analysis. RESULTS: The number of stings, aspartate aminotransferase >147 U/L, lactate dehydrogenase >477 U/L, time from stings to admission >12 h and activated partial thromboplastin time >49 s were demonstrated to be independent risk factors for AKI following wasp stings (all P value < 0.05) and were incorporated into the model. The performances of the model were validated (AUC = 0.950 [95% CI: 0.923 to 0.969], ACC = 0.916 and AUC = 0.953 [95% CI: 0.900 to 0.982], ACC = 0.906 in the training set and validation set, respectively). The predictive formula and the nomogram of the model could be utilized to predict AKI following wasp stings, which have sufficient accuracies, good predictive capabilities and good net benefits. CONCLUSION: The predictive formula and the individual nomogram of the model might serve as promising predictive tools to assess the probability of AKI following wasp stings.

Numerical Investigation of the Composite Action of Axially Compressed Concrete-Filled Circular Aluminum Alloy Tubular Stub Columns.

This paper studied the composite action of concrete-filled circular aluminum alloy tubular (CFCAT) stub columns under axial compression. A fine-meshed finite three-dimensional (3D) solid element model making use of a tri-axial plastic-damage constitutive model of concrete and elastoplastic constitutive model of aluminum alloy was established. A parametric study utilizing the verified finite element (FE) model was carried out and the analytical results were exploited to investigate the composite actions of concrete-filled circular aluminum alloy tubular stub columns subjected axial compression. Compared with the concrete-filled steel tube (CFCST) stub columns, the aluminum alloy tube exerted a weaker constraint effect on the infilled concrete due to its lower elastic modulus. Based on the FE analytical results and regression method, the composite action model of concrete-filled circular aluminum alloy tubular stub columns was proposed. By generalizing the stress nephogram of the concrete-filled circular aluminum alloy tubular stub column at the limit state, a design formula was proposed to estimate the ultimate bearing capacity the columns using the superposition method. The predicted results of the proposed formula show a good agreement with both the experimental and FE analytical results. The comparison between the proposed formula and current design methods indicates that the proposed formula is more accurate and convenient to use.