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Breast cancer (BC) remains a significant health concern worldwide, with metastasis being a primary contributor to patient mortality. While advances in understanding the disease's progression continue, the underlying mechanisms, particularly the roles of long non-coding RNAs (lncRNAs), are not fully deciphered. In this study, we examined the influence of the lncRNA LINC00524 on BC invasion and metastasis. Through meticulous analyses of TCGA and GEO data sets, we observed a conspicuous elevation of LINC00524 expression in BC tissues. This increased expression correlated strongly with a poorer prognosis for BC patients. A detailed Gene Ontology analysis suggested that LINC00524 likely exerts its effects through RNA-binding proteins (RBPs) mechanisms. Experimentally, LINC00524 was demonstrated to amplify BC cell migration, invasion and proliferation in vitro. Additionally, in vivo tests showed its potent role in promoting BC cell growth and metastasis. A pivotal discovery was LINC00524's interaction with TDP43, which leads to the stabilization of TDP43 protein expression, an element associated with unfavourable BC outcomes. In essence, our comprehensive study illuminates how LINC00524 accelerates BC invasion and metastasis by binding to TDP43, presenting potential avenues for therapeutic interventions.
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Neoplasias da Mama , RNA Longo não Codificante , Feminino , Humanos , Bioensaio , Neoplasias da Mama/genética , Transformação Celular Neoplásica , Ontologia Genética , RNA Longo não Codificante/genéticaRESUMO
Circular RNA circSKA3 (spindle and kinetochore-related complex subunit 3) has been identified as a prognostic factor in ischemic stroke. The objective of this study was to investigate the association of circSKA3 with the risk of extracranial artery stenosis (ECAS) and plaque instability in patients with ischemic stroke. We constructed a competing endogenous RNA (ceRNA) network regulated by circSKA3 based on differentially expressed circRNAs and mRNAs between five patients and five controls. Gene Ontology (GO) analysis was performed on the 65 mRNAs within the network, revealing their primary involvement in inflammatory biological processes. A total of 284 ischemic stroke patients who underwent various imaging examinations were included for further analyses. Each 1 standard deviation increase in the log-transformed blood circSKA3 level was associated with a 56.3% increased risk of ECAS (P = 0.005) and a 142.1% increased risk of plaque instability (P = 0.005). Patients in the top tertile of circSKA3 had a 2.418-fold (P < 0.05) risk of ECAS compared to the reference group (P for trend = 0.02). CircSKA3 demonstrated a significant but limited ability to discriminate the presence of ECAS (AUC = 0.594, P = 0.015) and unstable carotid plaques (AUC = 0.647, P = 0.034). CircSKA3 improved the reclassification power for ECAS (NRI: 9.86%, P = 0.012; IDI: 2.97%, P = 0.007) and plaque instability (NRI: 36.73%, P = 0.008; IDI: 7.05%, P = 0.04) beyond conventional risk factors. CircSKA3 played an important role in the pathogenesis of ischemic stroke by influencing inflammatory biological processes. Increased circSKA3 was positively associated with the risk of ECAS and plaque instability among ischemic stroke patients.
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AVC Isquêmico , Humanos , Constrição Patológica , AVC Isquêmico/complicações , AVC Isquêmico/genética , Fatores de Risco , Ontologia Genética , RNA Circular , RNA Mensageiro , ArtériasRESUMO
BACKGROUND: The reversible maneuver that mimics the fluid challenge is a widely used test for evaluating volume responsiveness. However, passive leg raising (PLR) does have certain limitations. The aim of the study is to determine whether the supine transfer test could predict fluid responsiveness in adult patients with acute circulatory failure who do not have intra-abdominal hypertension, by measuring changes in cardiac index (CI). METHODS: Single-center, prospective clinical study in a 25-bed surgery intensive care unit at the Fudan University Shanghai Cancer Center. Thirty-four patients who presented with acute circulatory failure and were scheduled for fluid therapy. Every patient underwent supine transfer test and fluid challenge with 500 mL saline for 15-30 min. There were four sequential steps in the protocol: (1) baseline-1: a semi-recumbent position with the head of the bed raised to 45°; (2) supine transfer test: patients were transferred from the 45° semi-recumbent position to the strict supine position; (3) baseline-2: return to baseline-1 position; and (4) fluid challenge: administration of 500 mL saline for 15-30 min. Hemodynamic parameters were recorded at each step with arterial pulse contour analysis (ProAQT/Pulsioflex). A fluid responder was defined as an increase in CI ≥ 15% after fluid challenge. The receiver operating characteristic curve and gray zone were defined for CI. RESULTS: Seventeen patients were fluid challenge. The r value of the linear correlations was 0.73 between the supine transfer test- and fluid challenge-induced relative CI changes. The relative changes in CI induced by supine transfer in predicting fluid responsiveness had an area under the receiver operating characteristic curve of 0.88 (95% confidence interval 0.72-0.97) and predicted a fluid responder with 76.5% (95% confidence interval 50.1-93.2) sensitivity and 88.2% (95% confidence interval 63.6-98.5) specificity, at a best threshold of 5.5%. Nineteen (55%) patients were in the gray zone (CI ranging from -3 and 8 L/min/m2). CONCLUSION: The supine transfer test can potentially assist in detecting fluid responsiveness in patients with acute circulatory failure without intra-abdominal hypertension. Nevertheless, the small threshold and the 55% gray zone were noteworthy limitation. TRIAL REGISTRATION: Predicting fluid responsiveness with supine transition test (ChiCTR2200058264). Registered 2022-04-04 and last refreshed on 2023-03-26, https://www.chictr.org.cn/showproj.html?proj=166175 .
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Hipertensão Intra-Abdominal , Adulto , Humanos , Hipertensão Intra-Abdominal/diagnóstico , Hipertensão Intra-Abdominal/terapia , Estudos Prospectivos , China , Hidratação , Unidades de Terapia Intensiva , Solução SalinaRESUMO
Animal husbandry is a vital sector in China's agriculture sector, contributing to over one-third of its agricultural output, and more than 40% of farmers' income. However, this industry is vulnerable to risks arising from production and operation, such as disease outbreaks, natural disasters, and market fluctuations. Livestock insurance can help mitigate these risks, but the lack of reliable data on shed environments has hindered its effectiveness. The objective of this study is to propose a livestock shed environmental regulatory platform that utilizes blockchain and the Internet of Things to ensure data authenticity, real-time monitoring, and transparency in the regulatory process. The platform also automates the insurance process, reducing costs and improving efficiency. The proposed platform employs blockchain to ensure data authenticity and devices to monitor and collect real-time environmental data. It also utilizes smart contracts to automate the insurance process, from negotiating and signing contracts to making insurance claims. The system's design rationale, architecture, and implementation are detailed. The proposed platform has been implemented and currently manages over 300,000 livestock animals with more than 350,000 insurance contracts signed. The use of blockchain and the Internet of Things has ensured data authenticity, real-time monitoring, and transparency in the regulatory process, while the automation of the insurance process has reduced costs and improved efficiency. The proposed livestock shed environmental regulatory platform has the potential to improve the effectiveness of livestock insurance in China by addressing the critical issue of data reliability. The use of blockchain and the Internet of Things has enabled real-time monitoring, data authenticity, and transparency in the regulatory process, while the automation of the insurance process has improved efficiency and reduced costs. This platform could serve as a model for other countries looking to improve the effectiveness of their livestock insurance programs.
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Blockchain , Seguro , Internet das Coisas , Animais , Gado , Reprodutibilidade dos Testes , Tecnologia , Criação de Animais DomésticosRESUMO
Nanozymes are a kind of nanomaterial mimicking enzyme catalytic activity, which has aroused extensive interest in the fields of biosensors, biomedicine, and climate and ecosystems management. However, due to the complexity of structures and composition of nanozymes, atomic scale active centers have been extensively investigated, which helps with in-depth understanding of the nature of the biocatalysis. Single atom nanozymes (SANs) cannot only significantly enhance the activity of nanozymes but also effectively improve the selectivity of nanozymes owing to the characteristics of simple and adjustable coordination environment and have been becoming the brightest star in the nanozyme spectrum. The SANs based sensors have also been widely investigated due to their definite structural features, which can be helpful to study the catalytic mechanism and provide ways to improve catalytic activity. This perspective presents a comprehensive understanding on the advances and challenges on SANs based sensors. The catalytic mechanisms of SANs and then the sensing application from the perspectives of sensing technology and sensor construction are thoroughly analyzed. Finally, the major challenges, potential future research directions, and prospects for further research on SANs based sensors are also proposed.
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Técnicas Biossensoriais , Nanoestruturas , Catálise , Ecossistema , Nanoestruturas/químicaRESUMO
BACKGROUND AND OBJECTIVE: Zishen Pingchan granule (ZPG), a traditional Chinese herbal recipe for treating Parkinson's disease (PD), is usually used as an add-on drug with some antiparkinsonian drugs in China. The objectives of this study were to evaluate the efficacy, safety, and tolerability of ZPG combined with pramipexole in the treatment of depression in PD (dPD). METHODS: A 12-week, multicenter, randomized, double-blind, and placebo-controlled study on ZPG was performed on a total of 200 patients who were treated with pramipexole but still had mild to moderate depressive symptoms. Patients were randomly divided into ZPG (n = 100) or placebo (n = 100). The primary effective result was the mean change from the baseline on the Hamilton Depression Scale 17 items (HAM-D-17) over 12 weeks and the clinical efficacy rate. Secondary endpoints were the mean change from the baseline in the Geriatric Depression Scale (GDS-15), Unified Parkinson's disease rating scale Part III (UPDRS III), Parkinson's quality of life scale (PDQ-8), and Parkinson's disease sleep scale (PDSS-2) over 12 weeks. RESULTS: After 12 weeks of treatment, ZPG significantly reduced the mean [95% confidence interval] HAMD score vs. placebo (- 1.43 scores [- 2.50, - 0.36]; p = 0.009). The clinical remission rate and responders of the ZPG group were higher than those of the placebo (46.1% vs. 31.0%; p = 0.041; 34.8% vs. 18.4%; p = 0.014). A significant improvement in the PDSS-2 score was also observed in the ZPG group compared with that in the placebo group (- 3.56 scores [- 5.77, - 1.35]; p = 0.002). A total of 7 patients (7.1%) in the ZPG group had mild adverse events (AEs) vs 9 patients (9%) in the placebo group. No severe AEs were observed in either group. The randomization and controlled clinical study revealed that ZPG was effective, safe, and well-tolerated. CONCLUSION: ZPG combined with pramipexole further reduced the depressive symptoms and improved the sleeping quality of PD patients. Trial registration The protocol was retrospectively registered at the Chinese Clinical Trial Registry, Unique identifier: ChiCTR1800019942, date of registration: December 9, 2018; http://www.chictr.org.cn/showproj.aspx?proj=30432.
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Doença de Parkinson , Idoso , Benzotiazóis/efeitos adversos , Depressão/complicações , Depressão/tratamento farmacológico , Método Duplo-Cego , Humanos , Doença de Parkinson/complicações , Doença de Parkinson/tratamento farmacológico , Pramipexol/uso terapêutico , Estudos Prospectivos , Qualidade de Vida , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
In this study, we propose a micro-sized photonic structure that extracts 89% of the intrinsic trapped photons from the spectrum conversion film into free space using the Monte-Carlo ray-tracing method. Furthermore, the spectrum of the spectral-shifting film can be accurately simulated based on a mean free path concept, providing the estimation of its overall performance including the external quantum efficiency and the self-absorption efficiency. The simulations show that the spectrum conversion film with micro-structures shows a two-fold increase in the total external quantum efficiency and a four-fold increase in the external quantum efficiency in the forward viewing direction compared to the planar spectrum conversion films without micro-structures.
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Human neutrophil peptides 1-3 (HNP1-3), also known as human α-defensins, are the most abundant neutrophil granule proteins. The genes that encode HNP1-3, DEFA1/DEFA3, exhibit extensive copy number variations, which correlate well with their protein levels. Human and mouse studies have shown that increased copy numbers of DEFA1/DEFA3 worsen sepsis outcomes. Additionally, high concentrations of HNP1-3 in body fluids have been reported in patients with sepsis. However, direct evidence for the pathogenic role of HNP1-3 proteins during sepsis progression is lacking. In current study, sepsis was induced by means of cecal puncture and ligation. Various doses of HNP-1 (low dose with 0.5 mg/kg body weight and high dose with 10 mg/kg body weight) or phosphate buffer saline were intraperitoneally administered to mice at six hours after sepsis onset. Survival rate was monitored, and vascular permeability, endothelial cell pyroptosis, and immunofluorescence of endothelial adherens junction protein vascular endothelial-cadherin were evaluated. The administration of a high dose of HNP-1 after sepsis onset led to increased mortality, more severe liver injury, and increased vascular permeability in the liver and mesentery. The injection of high dose of HNP-1 did not directly induce liver endothelial cell death but destroyed interendothelial junctions in the liver. Moreover, genetic deficiency of nucleotide-binding oligomerization domain-like receptor protein-3 or caspase-1 abrogated the high mortality and disrupted liver interendothelial junctions caused by high dose of HNP-1 during sepsis. This study directly demonstrates that neutrophil defensins play a key role in regulating endothelial stability during sepsis development.
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Sepse , alfa-Defensinas , Animais , Peso Corporal , Variações do Número de Cópias de DNA , Defensinas , Humanos , Fígado/patologia , Camundongos , Neutrófilos , Sepse/patologia , alfa-Defensinas/genéticaRESUMO
AIMS: To examine how felt trust motivates nurses to desire to deliver better nursing services and how perspective taking makes nurses feel trusted by their patients. By introducing the concept of prosocial motivation into nursing research, this study further explored a boundary condition that influences the positive relationship between felt trust from patients and attitudes towards nursing service delivery. DESIGN: This study used a cross-sectional and survey design. METHOD: This study was conducted among 339 nurses on medical teams sent to support Hubei, China, during the COVID-19 pandemic in April 2020. RESULTS: The results indicate that felt trust from patients mediated the positive relationship between perspective taking and attitudes towards nursing service delivery. In addition, prosocial motivation moderated the relationship between felt trust from patients and attitudes towards nursing service delivery, such that the relationship was stronger when prosocial motivation was high (vs. low). Prosocial motivation also moderated the indirect effects of perspective taking on attitudes towards nursing service delivery via felt trust from patients. CONCLUSION: This study shows that despite the challenges posed by COVID-19, nurses who experience a high level of trust from patients are still eager to deliver high-quality nursing services, and this finding is especially salient among those with high prosocial motivation. IMPACT: This study introduces felt trust from patients as a new motivational mechanism that can induce nurses' willingness to deliver better nursing services. We suggest that nurses and nurse leaders should be aware of the significance of the trust relationship between nurses and patients. Nurses need to be trained to take patients' perspectives in the interaction process, which can make them feel trusted by patients and can consequently be motivated to deliver better nursing services.
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COVID-19 , Serviços de Enfermagem , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Pandemias , SARS-CoV-2 , Inquéritos e Questionários , ConfiançaRESUMO
Single-atom nanozymes (SANs) are one of the newest generations of nanozymes, which have been greatly developed in the past few years and exploited widely for many applications, such as biosensing, disease diagnosis and therapy, bioimaging, and so on. SANs, possessing dispersed single-atom structures and a well-defined coordination environment, exhibit remarkable catalytic performance with both high activity and stability. In this paper, the most recent progress in SANs is reviewed in terms of their advanced synthesis, characterization, functional mechanisms, performance validation/optimization, and biomedical applications. Several technical challenges hindering practical applications of SANs are analyzed, and possible research directions are also proposed for overcoming the challenges.
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Pesquisa Biomédica , Materiais Biomiméticos/química , Técnicas Biossensoriais , Nanoestruturas/químicaRESUMO
BACKGROUND: To explore the relationship of serum metal ions and Parkinson's disease (PD). METHODS: Hoehn-Yahr (H-Y) staging scale and other related rating scales were performed to evaluate the severity of PD patients. Substantia nigra (SN) volume was measured by sensitivity weighted imaging (SWI), and the levels of Fe, Cu, Zn, superoxide dismutase (SOD), and malondialdehyde (MDA) in serum were detected at the same time. The results were analyzed and compared to healthy control group. RESULTS: In this study, 33 patients with PD and 35 healthy individuals (control group) were recruited. As compared to the control group, the levels of serum Fe and Cu were significantly increased, whereas the levels of Zn and SOD were significantly decreased in the PD group. The dysosmia was correlated with the level of serum Zn, and the clinical severity was correlated with the decreased volume of SN and the level of serum SOD in PD patients. CONCLUSIONS: Our study suggests a correlation between the levels of serum metal ion and PD.
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Doença de Parkinson , Humanos , Íons , Malondialdeído , Doença de Parkinson/diagnóstico , Substância Negra , Superóxido DismutaseRESUMO
AIM: To assess the performance of front-line nurses, who believed they were living out their calling, during the coronavirus disease 2019 (COVID-19) pandemic. BACKGROUND: Although as a profession nursing generally requires high levels of performance, the disruption arising from an infectious disease outbreak increases the work stress and decreases the performance of front-line nurses. How this situation can be improved has yet to be thoroughly examined. METHOD: We used a snowball sampling technique to recruit 339 nurses who were originally from outside Hubei but volunteered to join medical teams going to Hubei to tackle COVID-19. RESULTS: Drawing on the theory of work as a calling, we found that living a calling had a positive effect on front-line nurses' performance through the clinical and relational care they provided. Perceived supervisor support strengthened these mediated relationships. CONCLUSION: Our findings indicate that despite the constraints associated with pandemics, front-line nurses who are living a calling are able to provide better clinical and relational care to infected patients, which in turn improves their performance. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this study suggest that hospitals can introduce career educational interventions to enhance nurses' ability to discern and live out their calling to improve their performance.
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COVID-19/epidemiologia , COVID-19/enfermagem , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos de Enfermagem Hospitalar/normas , Competência Clínica , Surtos de Doenças , Feminino , Humanos , Masculino , Estresse Ocupacional/epidemiologia , Pandemias , SARS-CoV-2RESUMO
Neural stem cell (NSC) transplantation has emerged as a promising approach for the treatment of neurological disorders such as cerebral ischemia. As the majority of newly generated cells from exogenous NSCs fail to integrate into the ischemic brain and establish functional synaptic networks, NSC transplantation for ischemic stroke experiences limited neurological function recovery. Augment of endogenous neurite growth in the process of NSC differentiation is an avenue to promote synaptic networks. Phosphatase and tensin homolog (PTEN), a tumor suppressor, has been established to regulate axon growth in the adult central nervous system. The aim of this study was to explore the role of PTEN on neurite growth during NSC differentiation. Our results revealed that the protein expression of PTEN was significantly increased during NSC differentiation, whereas the expression of phosphorylated S6 ribosomal (p-S6R) was markedly decreased. Small interfering RNA knockdown of PTEN in NSCs can accelerate neurite outgrowth during NSC differentiation. These results indicated a remarkable effect of PTEN inhibition on neuronal process after NSC differentiation, and identified a novel route to promote endogenous neurite growth in differentiated NSCs, which may facilitate the application of NSC transplantation in ischemic stroke.
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Diferenciação Celular/fisiologia , Células-Tronco Neurais/metabolismo , Crescimento Neuronal/fisiologia , PTEN Fosfo-Hidrolase/metabolismo , Animais , Neurogênese/fisiologia , Ratos , Ratos Sprague-DawleyRESUMO
OBJECTIVE: To compare the diagnostic efficacy among three RT-PCR test kits for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid detection. METHODS: The throat swab samples from 40 hospitalized patients clinically diagnosed as coronavirus disease 2019 (COVID-19) and 16 hospitalized non-COVID-19 patients were recruited. The SARS-CoV-2 nucleic acid was detected in throat swab samples with RT-PCR test kits from Sansure Biotech ("Sansure" for short), Jiangsu Bioperfectus Technologies ("Bioperfectus" for short) and BGI Genomics ("BGI" for short). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and Kappa value were analyzed. The viral nucleic acid was extracted from the throat swab samples by one-step cleavage and magnetic bead methods, and the efficacy of two extraction methods was also compared. The results of magnetic bead method for nucleic acid extraction by two different extractors (Sansure Natch CS S12C Fully Automated Nucleic Acid Extraction System vs. Tianlong NP968-C Nucleic Acid Extractor) were also compared. RESULTS: The sensitivity, specificity, PPV, NPV and kappa value were 95.00%, 87.50%, 95.00%, 87.50%and 0.825 for Sansure kit; 90.00%, 87.50%, 94.74%, 77.78%and 0.747 for the Bioperfectus kit, and 82.50%, 81.25%, 91.67%, 65.00%and 0.593 for the BGI kit, respectively. The positive, negative and total coincident rates and kappa value of viral nucleic acid detection results using the samples extracted by one-step cleavage and magnetic bead methods were 95.24%, 100.00%, 96.43%and 0.909, respectively, but the one-step cleavage method took only 25 min, while the magnetic bead method required 180 min. The positive, negative and total coincident rates and kappa value of viral nucleic acid detection results using the samples extracted by the two different nucleic acid extractors were 85.00%, 100.00%, 89.29% and 0.764, respectively. CONCLUSIONS: The detection efficacy for SARS-CoV-2 nucleic acid by the Sansure kit is relatively higher and the one-step cleavage method has advantages of convenient operation and less time consuming.
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Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Kit de Reagentes para Diagnóstico , Betacoronavirus/genética , Betacoronavirus/isolamento & purificação , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , RNA Viral/genética , RNA Viral/isolamento & purificação , Kit de Reagentes para Diagnóstico/normas , SARS-CoV-2RESUMO
Optical patterns are produced on the surface of drawn linear polyethylene containing 2-(2H-benzotriazol-2-yl)-4,6-ditertpentylphenol (BZT), a photothermal dye, by direct laser writing. The photothermal dye absorbs the UV light and dissipates heat in the polyethylene film. This heat locally results in the melting, shrinking, and recrystallization of PE and the loss of the fibrillar crystalline morphology which is typical for these materials. By using this writing method, an optical image can be obtained by controlling the local UV irradiation dose with a pulsed UV laser. The optical image is visible with the naked eye but also between crossed polarizers giving an overt and covert authentication verification that might be interesting for anti-counterfeit applications.
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Lasers , Polietileno/química , Raios UltravioletaRESUMO
Lung cancer is a leading cause of cancer-related deaths with an increasing incidence and poor prognoses. To further understand the regulatory mechanisms of lipidomic profiles in lung cancer subtypes, we measure the profiles of plasma lipidome between health and patients with lung cancer or among patients with squamous cell carcinomas, adenocarcinoma or small cell lung cancer and to correct lipidomic and genomic profiles of lipid-associated enzymes and proteins by integrating the data of large-scale genome screening. Our studies demonstrated that circulating levels of PS and lysoPS significantly increased, while lysoPE and PE decreased in patients with lung cancer. Our data indicate that lung cancer-specific and subtype-specific lipidomics in the circulation are important to understand mechanisms of systemic metabolisms and identify diagnostic biomarkers and therapeutic targets. The carbon atoms, dual bonds or isomerism in the lipid molecule may play important roles in lung cancer cell differentiations and development. This is the first try to integrate lipidomic data with lipid protein-associated genomic expression among lung cancer subtypes as the part of clinical trans-omics. We found that a large number of lipid protein-associated genes significantly change among cancer subtypes, with correlations with altered species and spatial structures of lipid metabolites.
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Adenocarcinoma/sangue , Carcinoma de Células Escamosas/sangue , Lipídeos/sangue , Carcinoma de Pequenas Células do Pulmão/sangue , Adenocarcinoma/genética , Adenocarcinoma/patologia , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Feminino , Genômica , Humanos , Lipídeos/classificação , Lipídeos/genética , Masculino , Proteínas de Neoplasias/sangue , Proteínas de Neoplasias/genética , Proteômica , Carcinoma de Pequenas Células do Pulmão/genética , Carcinoma de Pequenas Células do Pulmão/patologiaRESUMO
Background: Vancomycin is a first-line antibiotic used for the treatment of severe gram-positive bacterial infections. Clinical guidelines recommend that the vancomycin trough concentration be 10-15 mg/L for regular infections and 15-20 mg/L for severe infections. We investigated whether increasing the vancomycin concentration would result in better clinical outcomes with sustainable adverse effects (AEs) in the Chinese population. Methods: A prospective, open, multicenter clinical observational study was performed in patients with gram-positive bacterial infections from 13 teaching hospitals. Patients received vancomycin therapeutic drug monitoring. Clinical, microbiological, and laboratory data were collected. Results: In total, 510 patients were enrolled, and 470 were evaluable, of whom 370 were adults and 100 were children; 35.53% had methicillin-resistant Staphylococcus aureus infections (vancomycin 50% minimum inhibitory concentration [MIC50] = 1, 90% minimum inhibitory concentration [MIC90] = 1), and 23.19% had Enterococcus species infections (vancomycin MIC50 = 1, MIC90 = 2). The average trough concentration was 10.54 ± 8.08 mg/L in adults and 6.74 ± 8.93 mg/L in children. The infection was eradicated in 86.22% of adults and 96% of children. Thirty-six vancomycin-related nephrotoxicity cases were reported in the enrolled population. No severe AEs or deaths were related to vancomycin therapy. Logistic regression analysis showed that trough concentration had no relationship with clinical outcomes (adults P = .75, children P = .68) but was correlated with adult nephrotoxicity (P < .0001). Vancomycin trough concentration had an applicable cut point at 13 mg/L. Conclusions: Our study shows that vancomycin trough concentration has no statistical correlation with clinical outcomes, and is an indicator of nephrotoxicity in the observed population. We found no evidence that increasing vancomycin trough concentration to 15-20 mg/L can benefit Chinese patients with complicated infections. Clinical Trials Registration: ChiCTR-OPC-16007920.
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Antibacterianos/uso terapêutico , Monitoramento de Medicamentos , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Vancomicina/uso terapêutico , Adolescente , Idoso , Criança , Pré-Escolar , China , Relação Dose-Resposta a Droga , Feminino , Hospitais de Ensino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Background: Our aims in this prospective study were to evaluate the correlations between pharmacokinetic/pharmacodynamic (PK/PD) indices and the clinical/microbiological efficacy of vancomycin and to identify an appropriate PK/PD target in the Chinese population to guide vancomycin treatment in the clinic. Methods: Adult patients from 11 hospitals in China with gram-positive infections who received vancomycin therapy for ≥5 days and who were under therapeutic drug monitoring (TDM) were enrolled in this study. A 1-compartment population PK model was established and validated. The correlations between PK/PD indices (Cmin, Cmax, 0-24 hour area under the curve (AUC0-24), and AUC0-24/minimum inhibitory concentration (MIC) and clinical outcomes (clinical efficacy and bacterial eradication) were evaluated. Results: In total, 402 adult Chinese patients were enrolled. Among them, 380 patients were evaluable for PK analysis, and 334 were evaluable for PK/PD analysis. In the final population PK model, creatinine clearance (CLCR) was the significant covariate on CL (typical value, 3.87 L/hour; between-subject variability (BSV), 12.5%), and age was the significant covariate on volume of distribution (V) (typical value, 45.1 L; BSV, 24.8%). The univariate analysis showed that Cmax, AUC0-24, and AUC0-24/MIC were significantly different or marginally significantly different (P values were 0.009, 0.0385, and 0.0509, respectively) between microbiological outcome groups with coagulase-negative Staphylococcus infections. However, there were no significant differences (P > .05) in the above PK parameters by multivariate logistic regression analysis, indicating there was no independently associated factor. Conclusions: No significant correlations were identified between PK/PD indices and the clinical or microbiological efficacy of vancomycin in Chinese patients. The necessity of vancomycin TDM based on trough concentration and the current treatment target of AUC0-24/MIC ≥400 need to be further evaluated and confirmed in additional prospective studies.
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Antibacterianos/farmacocinética , Monitoramento de Medicamentos , Vancomicina/farmacocinética , Idoso , Antibacterianos/uso terapêutico , Área Sob a Curva , China , Feminino , Hospitais , Humanos , Pacientes Internados , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Modelos Estatísticos , Estudos Prospectivos , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus/efeitos dos fármacos , Resultado do Tratamento , Vancomicina/uso terapêuticoRESUMO
A novel kind of quantum dots, sulfur quantum dots (S dots), is synthesized by simply treating sublimated sulfur powders with alkali using polyethylene glycol-400 as passivation agents. The synthesized S dots exhibit excellent aqueous dispersibility, eminent photostability and temperature dependent photoluminescence (PL). An "assemble-fission" mechanism is proposed for the S dots formation in which "assembling" and "fission" are involved and contest each other. The ultimate morphologies of the S dots are dependent on the balance of the two forces. Guided by the assemble-fission mechanism, weakening the assembling effect is beneficial for obtaining monodisperse S dots, which can be achieved by pretreating of sulfur powder with nitric acid. PL wavelength of the S dots has been successfully tuned between green and blue light (from 550 to 440 nm) by simply controlling reaction time. A satisfactory quantum yield of 3.8% is obtained. Significant electrochemiluminescence of the S dots is observed in an annihilation reaction. Chemiluminescence from the S dots has been observed by direct oxidation. Taking advantage of unique and inherent antimicrobial activity of the sulfur particles, it is believed that this new emerging luminescent nanomaterial is highly promising in the development of new types of optoelectronic devices and tracer for live cells, in vivo imaging and diagnostics.
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Transplantation of bone marrow stromal cells (BMSCs) is a promising therapy for ischemic stroke, but the poor oxygen environment in brain lesions limits the efficacy of cell-based therapies. Here, we tested whether hypoxic preconditioning (HP) could augment the efficacy of BMSC transplantation in a rat ischemic stroke model and investigated the underlying mechanism of the effect of HP. In vitro, BMSCs were divided into five passage (P0, P1, P2, P3, and P4) groups, and HP was applied to the groups by incubating the cells with 1% oxygen for 0, 4, 8, 12, and 24 h, respectively. We demonstrated that the expression of hypoxia-inducible factor-1α (HIF-1α) was increased in the HP-treated BMSCs, while their viability was unchanged. We also found that HP decreased the apoptosis of BMSCs during subsequent simulated ischemia-reperfusion (I/R) injury, especially in the 8-h HP group. In vivo, a rat transient focal cerebral ischemia model was established. These rats were administered normal cultured BMSCs (N-BMSCs), HP-treated BMSCs (H-BMSCs), or DMEM cell culture medium (control) at 24 h after the ischemic insult. Compared with the DMEM control group, the two BMSC-transplanted groups exhibited significantly improved functional recovery and reduced infarct volume, especially the H-BMSC group. Moreover, HP decreased neuronal apoptosis and enhanced the expression of BDNF and VEGF in the ischemic brain. Survival and differentiation of transplanted BMSCs were also increased by HP, and the quantity of engrafted BMSCs was significantly correlated with neurological function improvement. These results suggest that HP may enhance the therapeutic efficacy of BMSCs in an ischemic stroke model. The underlying mechanism likely involves the inhibition of caspase-3 activation and an increasing expression of HIF-1α, which promotes angiogenesis and neurogenesis and thereby reduces neuronal death and improves neurological function.