Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature.

BACKGROUND: Overt eosinophilic peritonitis (EP) is a relatively uncommon complication of peritoneal dialysis (PD), although not rare. Here we reported a case of EP relieved after changing dialysate.  CASE PRESENTATION: A 28-year old male patient developed cloudy PD effluents within the first month after PD started. Cytological study of PD effluents showed elevated white blood cells and polynuclear cells. Bacteria culture of PD effluents repeated for several times were all negative, and no pathogen was found by metagenomics next generation sequencing (mNGS). Antibiotic therapy for 28-day was ineffective. Based on these and increased eosinophils in peritoneal fluid, he was finally diagnosed as EP. PD dialysate was changed (consists of the same buffer agent and electrolytes, but is packed in bags that do not contain PVC), and the patient's PD effluent became clear. Of note, EP did not relapse 5 months later when the patient started to use the former PD solution again. CONCLUSION: Although PD effluent turbidity almost always represents infectious peritonitis, there are other differential diagnoses including EP. For patients with cloudy fluid accompanied by mild symptoms who do not response to antibiotic therapy, it is reasonable to consider the possibility of this disease. EP tends to heal spontaneously, however, antihistamines or glucocorticoids are required sometimes to avoid catheter obstruction. For patients with no obvious incentives, replacement of dialysate may be useful.

Tanshinone IIA attenuates peritoneal fibrosis through inhibition of fibrogenic growth factors expression in peritoneum in a peritoneal dialysis rat model.

BACKGROUND: Peritoneal fibrosis is a common complication of long-term peritoneal dialysis (PD) and is the main cause of dialysis inadequacy and PD withdrawal. It has been reported that Tanshinone IIA can ameliorate fibrosis in various tissues. In this report, we investigate the effects of Tanshinone IIA on peritoneal fibrosis in an animal model. METHODS: Forty rats were randomly divided into four groups (n = 10 per group) that received daily intraperitoneal injection of saline, 4.25% glucose-based peritoneal dialysis fluid (PDF), or PDF along with 50 or 100 mg/L Tanshinone IIA. Eight weeks later, the rats were sacrificed and peritoneal tissue samples were collected for analysis. The expression of transforming growth factor-ß1 (TGF-ß1) and connective tissue growth factor (CTGF) in parietal peritoneum was examined by immunohistochemistry. The mRNA and protein expression of TGF-ß1 and CTGF in omentum was examined by reverse transcription polymerase chain reaction or Western blot. RESULTS: Tanshinone IIA significantly suppressed submesothelial compact zone thickening and matrix accumulation induced by 4.25% glucose-based PDF. Tanshinone IIA also reduced TGF-ß1 and CTGF expression in parietal peritoneum as well as in omentum in a dose-dependent manner. CONCLUSION: Tanshinone IIA prevented the progression of peritoneal fibrosis in this rat model. Tanshinone IIA may be a novel therapy for peritoneal fibrosis in patients undergoing long-term PD.

Numerical investigation on three-dimensional dispersion and conversion behaviors of silicon tetrachloride release in the atmosphere.

The world has experienced heavy thirst of energy as it has to face a dwindling supply of fossil fuel and polycrystalline silicon photovoltaic solar energy technology has been assigned great importance. Silicon tetrachloride is the main byproducts of polysilicon industry, and it's volatile and highly toxic. Once silicon tetrachloride releases, it rapidly forms a dense gas cloud and reacts violently with water vapor in the atmosphere to form a gas cloud consisting of the mixture of silicon tetrachloride, hydrochloric acid and silicic acid, which endangers environment and people. In this article, numerical investigation is endeavored to explore the three dimensional dispersion and conversion behaviors of silicon tetrachloride release in the atmosphere. The k-ϵ model with buoyancy correction on k is applied for turbulence closure and modified EBU model is applied to describe the hydrolysis reaction of silicon tetrachloride. It is illustrated that the release of silicon tetrachloride forms a dense cloud, which sinks onto the ground driven by the gravity and wind and spreads both upwind and downwind. Complicated interaction occurs between the silicon tetrachloride cloud and the air mass. The main body of the dense cloud moves downwind and reacts with the water vapor on the interface between the dense cloud and the air mass to generate a toxic mixture of silicon tetrachloride, hydrogen chloride and silicic acid. A large coverage in space is formed by the toxic mixture and imposes chemical hazards to the environment. The exothermic hydrolysis reaction consumes water and releases reaction heat resulting in dehydration and temperature rise, which imposes further hazards to the ecosystem over the affected space.