Purpose:This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury(AKI)in children undergoing congenital cardiac surgery.Methods:We conduct...Purpose:This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury(AKI)in children undergoing congenital cardiac surgery.Methods:We conducted a prospective nested case-control study in children(age<18 years)undergoing congenital heart surgery with cardiopulmonary bypass(CPB)at the Fuwai Hospital between April 01,2022 and July 30,2022.Cases were individuals who developed AKI within the first postoperative 7 days(AKI group)and controls were those without AKI(Non-AKI group)according to KDIGO criteria.AKI and Non-AKI groups unmatched and 1:1 matched by age,sex,and baseline serum creatinine were separately analyzed.Multivariate logistic and conditional logistic regressions were used to assess the associations between blood glucose variables and AKI.Results:688 consecutively approached patients were included in the final analysis.On multivariate analysis,intra-CPB(adjusted odds ratio[OR]0.802;95%confidence interval[CI],0.706 to 0.912;p=0.001)and post-CPB(adjusted OR 0.830;95%CI,0.744 to 0.925;p=0.001)blood glucose levels were associated with postoperative AKI.There were no significant differences in pre-CPB blood glucose(adjusted OR 0.926;95%CI,0.759 to 1.129;p=0.446)or intraoperative glycemic fluctuations(adjusted OR 0.905;95%CI,0.723 to 1.132;p=0.382)between AKI and Non-AKI groups.Results based on matched cases and controls were consistent with those from the unmatched analyses.Conclusion:Higher intraoperative blood glucose levels during and after CPB were protective factors against postoperative AKI in pediatric patients after congenital heart surgery.展开更多
An oxic-anoxic-oxic(O-A-O)system followed by coagulation and ozonation processes was used to study the treatment of coking wastewater.In the O-A-O process,the removals of NH4+-N,total nitrogen and COD were 91.5-93.3%,...An oxic-anoxic-oxic(O-A-O)system followed by coagulation and ozonation processes was used to study the treatment of coking wastewater.In the O-A-O process,the removals of NH4+-N,total nitrogen and COD were 91.5-93.3%,91.3-92.6%and 89.1-93.8%,respectively when employing hydraulic residence times of 60 h for the biochemical system.High removal of NH4+-N was obtained due to the placement of an aerobic tank in front of A-O system which can mitigate the inhibitory effect of toxic compounds in coking wastewater on nitrifying bacteria.Addition of methanol into the anoxic reactor greatly increased the removal of total nitrogen,indicating that denitrifiers can hardly use organic compounds in coking wastewater as carbon source for denitrification.COD values of the effluent from the O-A-O system were still higher than 260 mg/L even with a prolonged time of 160 h mainly due to the high refractory properties of residual compounds in the effluent.The subsequent coagulation and ozonation processes resulted in the COD removal of 91.5%-93.3%and reduced the relative abundance of large molecular weight(MW)organics(>1 kDa)from 55.8%to 20.93%with the ozone,PAC and PAM dosages of 100,150 and 4 mg/L respectively.Under these conditions,the COD value and concentration of polycyclic aromatic hydrocarbons in the final effluent were less than 80 and 0.05 mg/L,respectively,which meet the requirement of the Chinese emission standard.These results indicate that the combined technology of O-A-O process,coagulation and ozonation is a reliable way for the treatment of coking wastewater.展开更多
基金the CAMS Innovation Fund for Medical Sciences(CIFMS)(2021-I2M-C&T-B-036).
文摘Purpose:This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury(AKI)in children undergoing congenital cardiac surgery.Methods:We conducted a prospective nested case-control study in children(age<18 years)undergoing congenital heart surgery with cardiopulmonary bypass(CPB)at the Fuwai Hospital between April 01,2022 and July 30,2022.Cases were individuals who developed AKI within the first postoperative 7 days(AKI group)and controls were those without AKI(Non-AKI group)according to KDIGO criteria.AKI and Non-AKI groups unmatched and 1:1 matched by age,sex,and baseline serum creatinine were separately analyzed.Multivariate logistic and conditional logistic regressions were used to assess the associations between blood glucose variables and AKI.Results:688 consecutively approached patients were included in the final analysis.On multivariate analysis,intra-CPB(adjusted odds ratio[OR]0.802;95%confidence interval[CI],0.706 to 0.912;p=0.001)and post-CPB(adjusted OR 0.830;95%CI,0.744 to 0.925;p=0.001)blood glucose levels were associated with postoperative AKI.There were no significant differences in pre-CPB blood glucose(adjusted OR 0.926;95%CI,0.759 to 1.129;p=0.446)or intraoperative glycemic fluctuations(adjusted OR 0.905;95%CI,0.723 to 1.132;p=0.382)between AKI and Non-AKI groups.Results based on matched cases and controls were consistent with those from the unmatched analyses.Conclusion:Higher intraoperative blood glucose levels during and after CPB were protective factors against postoperative AKI in pediatric patients after congenital heart surgery.
基金the National Natural Science Foundation of China(Project No.20907072)for the financial support of this work.
文摘An oxic-anoxic-oxic(O-A-O)system followed by coagulation and ozonation processes was used to study the treatment of coking wastewater.In the O-A-O process,the removals of NH4+-N,total nitrogen and COD were 91.5-93.3%,91.3-92.6%and 89.1-93.8%,respectively when employing hydraulic residence times of 60 h for the biochemical system.High removal of NH4+-N was obtained due to the placement of an aerobic tank in front of A-O system which can mitigate the inhibitory effect of toxic compounds in coking wastewater on nitrifying bacteria.Addition of methanol into the anoxic reactor greatly increased the removal of total nitrogen,indicating that denitrifiers can hardly use organic compounds in coking wastewater as carbon source for denitrification.COD values of the effluent from the O-A-O system were still higher than 260 mg/L even with a prolonged time of 160 h mainly due to the high refractory properties of residual compounds in the effluent.The subsequent coagulation and ozonation processes resulted in the COD removal of 91.5%-93.3%and reduced the relative abundance of large molecular weight(MW)organics(>1 kDa)from 55.8%to 20.93%with the ozone,PAC and PAM dosages of 100,150 and 4 mg/L respectively.Under these conditions,the COD value and concentration of polycyclic aromatic hydrocarbons in the final effluent were less than 80 and 0.05 mg/L,respectively,which meet the requirement of the Chinese emission standard.These results indicate that the combined technology of O-A-O process,coagulation and ozonation is a reliable way for the treatment of coking wastewater.
