Comparable prognosis in different neonatal histidine-tryptophan-ketoglutarate dosage management.

BACKGROUND: Histidine-tryptophan-ketoglutarate (HTK) is a solution commonly used for organ transplantation. However, there is no certified fixed regimen for on-pump heart surgery in neonates. We aimed to retrospectively evaluate the outcomes related to different HTK dosages and to analyze the safety of high-dosage perfusion. METHODS: A total of 146 neonates who underwent on-pump heart surgery with single-shot HTK perfusion were divided into two groups according to HTK dosages: a standard-dose (SD) group (n = 63, 40 mL/kg < HTK ≤ 60 mL/kg) and a high-dose (HD) group (n = 83, HTK >60 mL/kg). Propensity score matching (PSM) was performed to control confounding bias. RESULTS: The SD group had a higher weight (3.7 ±â€Š0.4 vs. 3.4 ±â€Š0.4 kg, P < 0.0001), a lower proportion of complete transposition of the great artery (69.8% vs. 85.5%, P = 0.022), a lower cardiopulmonary bypass (CPB) time (123.5 [108.0, 136.0] vs. 132.5 [114.8, 152.5] min, P = 0.034), and a lower aortic x-clamp time (82.9 ±â€Š27.1 vs. 95.5 ±â€Š26.0 min, P = 0.005). After PSM, 44 patients were assigned to each group; baseline characteristics and CPB parameters between the two groups were comparable. There were no significant differences in peri-CPB blood product consumption after PSM (P > 0.05). The incidences of post-operative complications were not significantly different between the two groups. There were no significant differences in ventilation time, intensive care unit stay, and post-operative hospital stay (P > 0.05). Follow-up echocardiography outcomes at 1 month, 3 to 6 months, and 1 year showed that left ventricular ejection fraction and end-diastolic dimension were comparable between the two groups. CONCLUSIONS: In neonatal on-pump cardiac surgery patients, single-shot HD (>60 mL/kg) HTK perfusion had a comparable heart protection effect and short-term post-operative prognosis as standard dosage perfusion of 40 to 60 mL/kg. Thus, this study provides supporting evidence of the safety of HD HTK perfusion.

[Synergistic effects by P and N pollution to fluctuation behavior/bloom of algae along the Three-Gorges valley].

Absorption rate coefficient of algae omega(i) to nutrients such as N and P could be used for describing algal increases/decreases velocity in water areas in theory. omega(i) raise might correspond to algal quickly growth and to ccelerate absorption of N and P while omega(i) decrease might correspond to algal decompose and release of N and P. According to locale measuring data along the Three-Gorges valley and algal dynamics model of nutritious absorption we have obtained some interest 3-dimension figures in which omega(i) will varies up and down obviously with N and P concentration in special bound to show a synergistic effects of N and P that might reveal an inner behavior of algal bloom/decompose. The research results explain in reason: (1) algal blooms do will happen in one special P/N range in a certain water system; (2) when omega(1) and omega(2) ascend rapidly and simultaneously in positive direction at same time algae would bloom, and when omega(1) and omega(2) descend sharply and simultaneously in negative direction at same time algae would decompose; (3) The velocity of algal bloom is not only same approximately as one of algal decompose, but also its variety has evidently periodic fluctuation. All of these could reveal effectively mechanism of nutritious absorption/release as algal bloom/decompose.