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Background: Brucella infection is uncommon among peritoneal dialysis (PD) patients in non-endemic areas, and the occurrence of both peritonitis and abdominal aortitis is rare. Case presentation: In December 2023, a 63-year-old male patient undergoing PD was admitted to Shaoxing Second Hospital due to fever, abdominal pain, and cloudy dialysate. Upon physical examination, diffuse mild abdominal pain and tenderness were observed. Subsequent investigation into the patient's medical history revealed consumption of freshly slaughtered lamb from local farmers 3 days prior to the onset of symptoms. Various diagnostic tests, including routine blood tests, procalcitonin levels, and PD fluid analysis, indicated the presence of infection. Abdominal computed tomography (CT) imaging revealed localized lumen widening of the abdominal aorta with surrounding exudative changes. On the sixth day in the hospital, blood and PD fluid cultures confirmed Brucella melitensis infection. The patient was diagnosed with brucella-associated peritonitis and aortitis. Treatment was adjusted to include rifampin and doxycycline for 6 weeks, and the decision was made to keep the PD catheter. Remarkably, the patient exhibited resolution of peritonitis and abdominal aortitis within the initial week of the adjusted treatment. Currently, the patient continues to receive ongoing clinical monitoring. Conclusion: Brucella is rare but can cause PD-associated peritonitis and arteritis. Prompt diagnosis and treatment can lead to a good outcome in PD patients. Dual therapy is effective, but the need for catheter removal is unclear. Consider international guidelines and patient factors when deciding on catheter removal.
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Background: Icodextrin is a type of peritoneal dialysis (PD) osmolyte that can be extended retention times (8-16 h) and may offer a viable alternative to conventional glucose dialysis solutions for PD patients. Nonetheless, prolonged use of icodextrin may lead to allergic rash, and rarely severe skin lesions. Case presentation: In February 2024, a 45-year-old male was admitted to the Department of Nephrology at Shaoxing Second Hospital presenting with a 3-day history of intense generalized pruritic erythematous rash. Physical examination revealed diffuse erythematous pruritic rash and exfoliative rash, particularly on the abdominal. Abnormal laboratory findings included elevated eosinophil count and total IgE levels, indicative of an allergic rash. Standard anti-allergic regim was initiated. However, on the third day in the hospital, the patient developed new pustules on his neck and arms. Subsequent historical investigation uncovered that the individual had previously administered icodextrin 2 weeks prior due to volume overload, and the last intraperitoneal administration time was second day of hospitalization. The dermatologist rendered a diagnosis of generalized exfoliative rash and acute localized exanthematous pustulosis (ALEP) induced by icodextrin, and initiated prophylactic antimicrobial therapy accordingly. Furthermore, the patient declined to undergo a skin biopsy. Noteworthy is the observation that the rash ameliorated and the pustules resolved by the seventh day post-admission. Presently, the patient is still under clinical follow-up. Conclusion: This article aims to report the first case of severe allergic rash caused by icodextrin in Chinese PD patients and highlight the potential for icodextrin to trigger ALEP. A literature review of similar cases found that severe allergic rash induced by icodextrin is rare, the underlying mechanism remains poorly understood, and the prognosis is positive with proper treatment.
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Petal morphogenesis has a profound influence on the quality of ornamental flowers. Most current research on petal development focuses on the early developmental stage, and little is known about the late developmental stage. Previously, it was reported that the GEG gene [a gerbera homolog of the gibberellin-stimulated transcript 1 (GAST1) from tomato] negatively regulates ray petal growth during the late stage of development by inhibiting longitudinal cell expansion. To explore the molecular mechanisms of the role of GEG in petal growth inhibition, an ethylene insensitive 3-like 1 (EIL1) protein was identified from a Gerbera hybrida cDNA library by yeast one-hybrid screening. Direct binding between GhEIL1 and the GEG promoter was confirmed by electrophoretic mobility shift and dual-luciferase assays. The expression profiles of GhEIL1 and GEG were correlated during petal development, while a transient transformation assay suggested that GhEIL1 regulates GEG expression and may be involved in the inhibition of ray petal elongation and cell elongation. To study the effect of ethylene on ray petal growth, a hormone treatment assay was performed in detached ray petals. The results showed that petal elongation is limited and promoted by ACC and 1-MCP, respectively, and the expression of GhEIL1 and GEG is regulated and coordinated during this process. Taken together, our research suggests that GhEIL1 forms part of the ethylene signaling pathway and activates GEG to regulate ray petal growth during the late developmental stage in G. hybrida.
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Gerbera hybrida is a cut-flower crop of global importance, and an understanding of the mechanisms underlying petal development is vital for the continued commercial development of this plant species. Brassinosteroids (BRs), a class of phytohormones, are known to play a major role in cell expansion, but their effect on petal growth in G. hybrida is largely unexplored. In this study, we found that the brassinolide (BL), the most active BR, promotes petal growth by lengthening cells in the middle and basal regions of petals, and that this effect on petal growth was greater than that of gibberellin (GA). The RNA-seq (high-throughput cDNA sequencing) technique was employed to investigate the regulatory mechanisms by which BRs control petal growth. A global transcriptome analysis of the response to BRs in petals was conducted and target genes regulated by BR were identified. These differentially expressed genes (DEGs) include various transcription factors (TFs) that were activated during the early stage (0.5 h) of BL treatment, as well as cell wall proteins whose expression was regulated at a late stage (10 h). BR-responsive DEGs are involved in multiple plant hormone signal pathways, hormone biosynthesis and biotic and abiotic stress responses, showing that the regulation of petal growth by BRs is a complex network of processes. Thus, our study provides new insights at the transcriptional level into the molecular mechanisms of BR regulation of petal growth in G. hybrida.
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Petal appearance is an important horticultural trail that is generally used to evaluate the ornamental value of plants. However, knowledge of the molecular regulation of petal growth is mostly derived from analyses of Arabidopsis thaliana, and relatively little is known about this process in ornamental plants. Previously, GEG (Gerbera hybrida homolog of the gibberellin [GA]-stimulated transcript 1 [GAST1] from tomato), a gene from the GA stimulated Arabidopsis (GASA) family, was reported to be an inhibitor of ray petal growth in the ornamental species, G. hybrida. To explore the molecular regulatory mechanism of GEG in petal growth inhibition, a mini zinc-finger protein (MIF) was identified using yeast one-hybrid (Y1H) screen. The direct binding of GhMIF to the GEG promoter was verified by using an electrophoretic mobility shift assay and a dual-luciferase assay. A yeast two-hybrid (Y2H) revealed that GhMIF acts as a transcriptional activator. Transient transformation assay indicated that GhMIF is involved in inhibiting ray petal elongation by activating the expression of GEG. Spatiotemporal expression analyses and hormone treatment assay showed that the expression of GhMIF and GEG is coordinated during petal development. Taken together, these results suggest that GhMIF acts as a direct transcriptional activator of GEG, a gene from the GASA protein family to regulate the petal elongation.
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Modified clay-based solid-phase phosphorous (P) sorbents are increasingly used as lake geoengineering materials for lake eutrophication control. However, some still dispute the feasibility of using these materials to control internal P loading from shallow eutrophic lakes. The lack of information about P behavior while undergoing frequent sediment resuspension greatly inhibits the modified minerals' use. In this study, a sediment resuspension generating system was used to simulate the effect of both moderate winds (5.1 m/s) and strong winds (8.7 m/s) on the stability of sediment treated by two geoengineering materials, Phoslock® (a lanthanum modified bentonite) and thermally-treated calcium-rich attapulgite. This study also presents an analysis of the P dynamics across the sediment-water interface of two shallow eutrophic lakes. In addition, the effect of wind velocity on P forms and P supply from the treated sediment were studied using chemical extraction and diffusive gradients in thin films (DGT) technique, respectively. Results showed that adding geoengineering materials can enhance the stability of surface sediment and reduce the erosion depth caused by wind accordingly. All treatments can effectively reduce soluble reactive phosphorus (SRP) concentration in overlying water when sediment is capped with thermally-treated calcium-rich attapulgite, which performs better than sediment mixed with modified attapulgite but not as well as sediment treated with Phoslock®. However, their efficiency decreased with the increase in occurrences of sediment resuspension. The addition of the selected geoengineering materials effectively reduced the P fluxes across sediment-water interface and lowered P supply ability from the treated sediment during sediment resuspension. The reduction of mobile P and enhancement of calcium bound P and residual P fraction in the treated sediment was beneficial to the long-term lake internal P loading management. All of the results indicated that the studied geoengineering materials are suitable for application in shallow eutrophic lakes with frequent sediment resuspension activity.