Emerging blood exosome-based biomarkers for preclinical and clinical Alzheimer's disease: a meta-analysis and systematic review.

Blood exosomes, which are extracellular vesicles secreted by living cells into the circulating blood, are regarded as a relatively noninvasive novel tool for monitoring brain physiology and disease states. An increasing number of blood cargo-loaded exosomes are emerging as potential biomarkers for preclinical and clinical Alzheimer's disease. Therefore, we conducted a meta-analysis and systematic review of molecular biomarkers derived from blood exosomes to comprehensively analyze their diagnostic performance in preclinical Alzheimer's disease, mild cognitive impairment, and Alzheimer's disease. We performed a literature search in PubMed, Web of Science, Embase, and Cochrane Library from their inception to August 15, 2020. The research subjects mainly included Alzheimer's disease, mild cognitive impairment, and preclinical Alzheimer's disease. We identified 34 observational studies, of which 15 were included in the quantitative analysis (Newcastle-Ottawa Scale score 5.87 points) and 19 were used in the qualitative analysis. The meta-analysis results showed that core biomarkers including Aß1-42, P-T181-tau, P-S396-tau, and T-tau were increased in blood neuron-derived exosomes of preclinical Alzheimer's disease, mild cognitive impairment, and Alzheimer's disease patients. Molecules related to additional risk factors that are involved in neuroinflammation (C1q), metabolism disorder (P-S312-IRS-1), neurotrophic deficiency (HGF), vascular injury (VEGF-D), and autophagy-lysosomal system dysfunction (cathepsin D) were also increased. At the gene level, the differential expression of transcription-related factors (REST) and microRNAs (miR-132) also affects RNA splicing, transport, and translation. These pathological changes contribute to neural loss and synaptic dysfunction. The data confirm that the above-mentioned core molecules and additional risk-related factors in blood exosomes can serve as candidate biomarkers for preclinical and clinical Alzheimer's disease. These findings support further development of exosome biomarkers for a clinical blood test for Alzheimer's disease. This meta-analysis was registered at the International Prospective Register of Systematic Reviews (Registration No. CRD4200173498, 28/04/2020).

Experimental and theoretical enthalpies of formation of glycine-based sulfate/bisulfate amino acid ionic liquids.

The experimental and theoretical enthalpies of formation of several structural-similar glycine-based sulfate/bisulfate amino acid ionic liquids including glycine sulfate (Gly(2)SO(4), 1), glycine bisulfate (GlyHSO(4), 2), N,N-dimethylglycine sulfate ([DMGly](2)SO(4), 3), N,N-dimethylglycine bisulfate ([DMGly]HSO(4), 4), N,N-dimethylglycine methyl ester sulfate ([DMGlyC(1)](2)SO(4), 5), N,N-dimethylglycine methyl ester bisulfate ([DMGlyC(1)]HSO(4), 6), N,N,N-trimethylglycine methyl ester sulfate ([TMGlyC(1)](2)SO(4), 7), and N,N,N-trimethylglycine methyl ester bisulfate ([TMGlyC(1)]HSO(4), 8) were studied. Their experimental enthalpies of formation were obtained from the corresponding energies of combustion determined by the bomb calorimetry method. The enthalpies of formation of these amino acid ionic liquids are in the range from -1406 kJ mol(-1) to -1128 kJ mol(-1). Systematic theoretical study on these amino acid ionic liquids were performed by quantum chemistry calculation using the Gaussian03 suite of programs. The geometric optimization and the frequency analyses are carried out using the B3LYP method with the 6-31+G** basis set. Their calculated enthalpies of formation were derived from the single point energies carried out with the HF/6-31+G**, B3LYP/6-31+G**, B3LYP/6-311++G**, and MP2/6-311++G** level of theory, respectively. The relevance of experimental and calculated enthalpies of formation was studied. The calculated enthalpies of formation are in good agreement with their experimental data in less than 3% error.

Application of emergency severity index in pediatric emergency department.

BACKGROUND: The purpose of triage is to identify patients needing immediate resuscitation, to assign patients to a pre-designed patient care area, and to initiate diagnostic/therapeutic measures as appropriate. This study aimed to use emergency severity index (ESI) in a pediatric emergency room. METHODS: From July 2006 to August 2010, a total of 21 904 patients visited the International Department of Beijing Children's Hospital. The ESI was measured by nurses and physicians, and compared using SPSS. RESULTS: Nurses of the hospital took approximately 2 minutes for triage. The results of triage made by nurses were similar to those made by doctors for ESI in levels 1-3 patients. This finding indicated that the nurses are able to identify severe pediatric cases. CONCLUSION: In pediatric emergency rooms, ESI is a suitable tool for identifying severe cases and then immediate interventions can be performed accordingly.