Objective: To investigate the early warning and prognostic evaluation of fecal calprotectin (FC), D-lactic acid, and bedside gastrointestinal ultrasound (B-GIUS) data for acute gastrointestinal injury (AGI) in sepsis patients.Main Method: Sepsis patients were grouped based on the presence or absence of AGI into AGI and non-AGI groups. Healthy volunteers of the same period were selected as the control group. FC, B-GIUS data, D-lactic acid, etc. were collected on the 1st, 3rd and 7th days of admission. Twenty-eight-day mortality was recorded.Main Results: FC, D-lactic acid levels, gastric antrum cross-sectional area, and small intestine wall thickness were significantly increased in group A and B (P < 0.05); furthermore, inner-to-outer diameter ratio and cross-sectional area of small intestine were lower than those in the control group (P < 0.05). FC, D-lactic acid, gastric antrum cross-sectional area and small intestine wall thickness in AGI group were higher than those in non-AGI group (P < 0.05). Inner-to-outer diameter ratio and cross-sectional area of small intestine in AGI group were smaller than those in non-AGI group (P < 0.05). There was no difference in the thickness, inner-to-outer diameter ratio nor the cross-sectional area ratio of colon between AGI and non-AGI groups (P > 0.05). AUC for D-lactic acid was 0.881, which was higher than FC's (0.74). When the D-lactic acid cutoff value was 22.16 μmol/L, the sensitivity was 77.9% and the specificity was 92% for the prediction of AGI in sepsis. AUC for the cross-sectional area of the gastrointestinal antrum was 0.657, which was higher than the small intestine thickness's (0.629). When the gastric antrum cross-sectional area was larger than 4.20 cm2, the sensitivity was 64% and the specificity was 65.3%.Conclusion: D-Lactic acid and FC were early diagnostic indicators for sepsis with AGI, and D-lactic acid was the superior indicator. The gastric antrum cross-sectional area and the small intestine wall thickness had an early warning effect, and the prediction of the gastric antrum cross-sectional area was superior to that of the latter. Because it is non-invasive and convenient, B-GIUS can help in the diagnosis of sepsis with AGI.
Peatlands, an important carbon pool in terrestrial ecosystems, are often characterised by a hummock-hollow microtopography, which has important implications for hydrologic conditions, biotic community structure and carbon cycling. However, dynamics of microtopography formation are poorly understood. Moss-inhabiting diatoms are sensitive to water table change and may be used to infer microtopography formation.Sixty-three surface moss samples were collected from four Sphagnum peatlands in the Changbai Mountains (north-eastern China), covering a water table gradient of 0-55 cm. Ordination analyses revealed that depth to the water table (DWT) was the determinant of diatom distribution, and its sole effect explained 15% of total variance in diatom composition. Accordingly, a diatom-based water table transfer function was developed using a weighted averaging model with inverse deshrinking (R 2 = 0.82, RMSEP = 5.63 cm with leave-one-out cross validation), and applied to diatom records of a Sphagnum hummock profile. Quantitative reconstruction of
Background: CKD has a high global prevalence with a consistent estimated global CKD prevalence of between 11 to 13% with the majority stage 3. Patients with CKD undergoing hemodialysis have low immunity and are prone to sepsis. Presepsin is a highly specific biomarker for the early diagnosis of sepsis because presepsin is increased in the blood in the early phase of infection and may be a helpful and valuable biomarker in early diagnosis of sepsis. Therefore, presepsin may have application for the early diagnosis of sepsis in patients with CKD.Purpose This prospective study evaluated the diagnostic value of serum presepsin (soluble CD14-ST) levels for sepsis in chronic kidney disease (CKD) and the influence of undergoing hemodialysis on serum presepsin Methods: This study included 291 patients with CKD and 101 patients with normal renal function and sepsis. Presepsin levels were increased in patients with CKD with or without sepsis or hemodialysis compared to controls, and were highest in patients with CKD and sepsis undergoing hemodialysis. Results: Presepsin levels were similar in patients with CKD with sepsis and no hemodialysis and patients with normal renal function and sepsis, but these levels were lower than in patients with CKD without sepsis undergoing hemodialysis. Presepsin, procalcitonin (PCT) and C-reactive protein (CRP) levels had diagnostic value for sepsis; however, presepsin was a better predictor of sepsis than PCT or CRP in patients with CKD not undergoing hemodialysis. Presepsin level had limited diagnostic value for sepsis in patients with CKD undergoing hemodialysis. In CKD complicated with sepsis, presepsin level was significantly correlated with CRP level, Sequential Organ Failure Assessment score, partial pressure of oxygen and body temperature; there was no correlation between presepsin level and these indicators in CKD without sepsis. Conclusion: These findings suggest physicians should incorporate information on biomarkers with medical history, clinical symptoms, physical signs, and other tests related to sepsis for its diagnosis in patients with CKD undergoing hemodialysis. Presepsin was a better predictor of sepsis in patients with CKD not undergoing hemodialysis.
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