Risk Factors of Enternal Nutrition Intolerance in Septic Patients: A Case-control Study.

OBJECTIVE: This study aimed to investigate the incidence of enteral nutrition intolerance (ENI) in patients with sepsis and explore potential risk factors. METHODS: A case-control study was conducted in patients with sepsis who were receiving enteral nutrition (EN) at a tertiary hospital in China. The included patients were divided into the ENI group and the non-ENI group. Univariate and multivariate analyses were performed to identify the risk factors for ENI. RESULTS: A total of 859 patients were included in the study. Among them, 288 (33.53%) patients experienced symptoms of ENI, including diarrhea, vomiting, bloating, and gastric retention. Logistic regression analysis revealed that the Acute Physiology and Chronic Health Evaluation H (APACHE H) score, thoracocentesis, and usage of cardiotonic drugs (namely, inotropes) were independent predictors of the ENI. CONCLUSION: The incidence of ENI is relatively high in patients with sepsis, especially in those who have higher APACHE H scores, have undergone thoracocentesis, and have received inotropes.

Ixeris sonchifolia: a review of its traditional uses, chemical constituents, pharmacology and modern applications.

Ixeris sonchifolia (IS), principally its dried form, is widely used as traditional and folk medicines in some Asian countries, especially China. In this review, we summarized its traditional uses, chemical constituents, quality control measures, pharmacological activities, therapeutic evaluation, toxicity evaluation and clinical applications. 130 chemical constituents isolated from IS have been reported, including flavones, sesquiterpenes, triterpenes, phenylpropanoids, organic acids and others. They showed various pharmacological activities, such as protecting cardiocerebral vascular system, anticancer effect and antiviral etc. The quality control evaluation studies, clinical applications, other possible applications and suggestions for future research also were discussed. The aim of this review is to critically appraise the available literature and suggest directions for further development of IS to improve its medical value and use.

Influences of local habitat, tributary position, and dam characteristics on fish assemblages within impoundments of low-head dams in the tributaries of the Qingyi River, China.

Low-head dam impoundments modify local habitat and alter fish assemblages; however, to our knowledge, the pattern of how fish assemblages in the impoundments relate to local habitat, tributary position, and dam characteristics is still unclear. We used data collected in 62 impoundments created by low-head dams in headwater streams of the Qingyi River, China, to examine relationships between fish assemblages and local habitat, tributary position, and dam characteristics. We also assessed the relative importance of the three groups of factors in determining fish species richness and composition. Linear regression models showed that fish species richness was related to substrate heterogeneity, confluence link, and dam number upstream. Redundancy analysis showed that fish species compositions were influenced by substrate heterogeneity, confluence link, dam height, dam numbers upstream and downstream. Overall, dam characteristics were more important in affecting fish species richness but less important in determining fish species composition than local habitat (i.e., substrate heterogeneity) and tributary position. Our results suggest that low-head dam may affect fish species richness in impoundments by modifying local habitat and constraining fish movement, and the relative abundances of those fish species may depend more on species habitat presences and stream size than on impoundment size and number.

Increased expressions of TLR2 and TLR4 on peripheral blood mononuclear cells from patients with Alzheimer's disease.

BACKGROUND: Toll-like receptors 2 (TLR2) and TLR4 are involved in the microglia-mediated inflammatory response, Aß plaque formation and Aß clearance in Alzheimer's disease (AD). Our previous studies have shown that variants in the TLR2 and TLR4 genes are associated with the risk of AD. Therefore, we hypothesize that there may be significant changes in TLR2 and TLR4 expressions on peripheral blood mononuclear cells (PBMCs) from patients with AD when compared to healthy control subjects. METHODS: Sixty patients with late-onset AD (LOAD) and 60 healthy controls matched for sex and age were recruited. Flow cytometry (FCM) was used to detect expressions of TLR2 and TLR4 proteins and real-time quantitative RT-PCR was performed to determine TLR2 and TLR4 mRNAs. RESULTS: Compared with controls, expressions of TLR2 and TLR4 mRNAs were up-regulated in LOAD patients (TLR2/beta-actin mRNA: 0.390±0.204 versus 0.281±0.167, P<0.01; TLR4/beta-actin mRNA: 0.503±0.195 versus 0.322±0.183, P<0.01). The proteins levels were higher in LOAD patients than in controls (TLR2: 97.12±1.67% versus 41.07±18.44%, P<0.01, TLR4: 66.56±23.74% versus 14.83±4.31, P<0.01). In both cases, either AD or control group, TLR2 and TLR4 mRNAs expressions were positively correlated with the levels of proteins (TLR2: r=0.980 and 0.976,P<0.01; TLR4: r=0.938 and 0.970, P<0.01), respectively. There were significant negative correlations between TLR levels and MMSE score (TLR2: r=-0.32; P=0.01; TLR4: r=-0.29; P=0.02). In addition, CC genotype can increase the expression of TLR4 in AD patients. CONCLUSION: This study gives the first evidence that expressions of TLR2 and TLR4 in PBMCs were markedly elevated in LOAD patients.

Toll-like receptor 2 -196 to -174 del polymorphism influences the susceptibility of Han Chinese people to Alzheimer's disease.

BACKGROUND: Toll-like receptor 2 (TLR2) represents a reasonable functional and positional candidate gene for Alzheimer's disease (AD) as it is located under the linkage region of AD on chromosome 4q, and functionally is involved in the microglia-mediated inflammatory response and amyloid-ß clearance. The -196 to -174 del polymorphism affects the TLR2 gene and alters its promoter activity. METHODS: We recruited 800 unrelated Northern Han Chinese individuals comprising 400 late-onset AD (LOAD) patients and 400 healthy controls matched for gender and age. The -196 to -174 del polymorphism in the TLR2 gene was genotyped using the polymerase chain reaction (PCR) method. RESULTS: There were significant differences in genotype (P = 0.026) and allele (P = 0.009) frequencies of the -196 to -174 del polymorphism between LOAD patients and controls. The del allele was associated with an increased risk of LOAD (OR = 1.31, 95% CI = 1.07-1.60, Power = 84.9%). When these data were stratified by apolipoprotein E (ApoE) ε4 status, the observed association was confined to ApoE ε4 non-carriers. Logistic regression analysis suggested an association of LOAD with the polymorphism in a recessive model (OR = 1.64, 95% CI = 1.13-2.39, Bonferroni corrected P = 0.03). CONCLUSIONS: Our data suggest that the -196 to -174 del/del genotype of TLR2 may increase risk of LOAD in a Northern Han Chinese population.

Genetic association of TLR4/11367 polymorphism with late-onset Alzheimer's disease in a Han Chinese population.

The amyloid beta-protein (A-ß) deposits in the brains of patients with Alzheimer's disease (AD) are closely associated with innate immune responses that were assumed to play a pivotal role in the pathogenesis of AD. Toll-like receptor 4 (TLR4) is thought to contribute to Aß clearance. Studies have reported the presence and functional significance of the TLR4/11367 polymorphism in a Han Chinese population. To evaluate the involvement of the TLR4/11367 polymorphism in the risk of late-onset Alzheimer's disease (LOAD), we performed a case-control study to analyze the genotype and allele distributions of the TLR4/11367 polymorphism in a Han Chinese population (137 LOAD cases and 137 healthy controls). There were significant differences in genotype and allele frequencies between LOAD cases and controls (genotype P<0.001, allele P<0.001). After stratification by APOE ε4-carrying status, the C allele of the TLR4/11367 polymorphism was still significantly associated with LOAD in APOE ε4 non-carriers (OR=5.77, 95% CI=3.03-11.00, P<0.001) and carriers (OR=2.03, 95% CI=1.03-3.98, P=0.04). In addition, a logistic regression analysis also conferred positive association between TLR4/11367C and LOAD (dominant model: ORa=3.08, 95% CI=1.60-5.93, P=0.001; recessive model: ORa=8.79, 95% CI=3.31-23.36, P<0.001; additive model: ORa=2.75, 95% CI=1.73-4.37, P<0.001) after adjustment for age, gender, and the APOE ε4 carrier status. This study gives the first evidence that the TLR4/11367 polymorphism was associated with LOAD in a Han Chinese population.

Association between late-onset Alzheimer's disease and microsatellite polymorphisms in intron II of the human toll-like receptor 2 gene.

The amyloid beta protein (Aß) deposits in the brains of patients with Alzheimer's disease (AD) are closely associated with innate immune responses that were assumed to play a pivotal role in the pathogenesis of AD. Toll-like receptor 2 (TLR2) is thought to contribute to Aß clearance. Studies have reported the presence and functional implications of guanine-thymine (GT) repeat microsatellite polymorphisms in intron II of the human TLR2 gene. The present study evaluated the association of the microsatellite polymorphism and sporadic late-onset AD (LOAD) in the Han Chinese population. The numbers of (GT) repeats were counted in 137 AD patients and in 137 non-AD control subjects, using polymerase chain reaction and genescan analysis. The alleles were divided into three subclasses: (GT)16 or less as the S allele, (GT)17 to (GT)22 as the M allele, and (GT)23 or more as the L allele. Patients with AD had more S alleles (P<0.001; odds ratio (OR)=2.32; 95% confidence interval (CI)=1.57-3.42) and fewer L alleles (P=0.02; OR=0.66; 95% CI=0.46-0.93) than did healthy controls. Genotypes SS and SM were more common, whereas ML and SL were less common in patients with AD. In subgroup analyses, the genotypes including S alleles were associated with an increased risk of LOAD (OR=2.05, 95% CI=1.26-3.34), and this association was influenced by the presence of APOE ɛ4 alleles. This study demonstrates an association of microsatellite polymorphisms in intron II of the human TLR2 gene with risk for LOAD in Han Chinese.

[Regulation of heat shock protein 27/activating transcription factor-5 complex and its implication in podocyte apoptosis induced by high glucose].

OBJECTIVE: To investigate the regulation of heat shock protein (HSP)27/activating transcription factor (ATF)-5 complex in podocytes induced by high glucose and relevant mechanisms. METHODS: Mice kidney podocytes were cultured in culture fluid with D-glucose at normal concentration (5.5 mol/L) (Group NG) or with D-glucose at high concentration (30 mmol/L) (Group HG) cells of these 2 groups were collected at different time points after glucose stimulation to detect the cell apoptosis by Hoechst 33342 staining and fluorescence microscopy and flow cytometry. Western blotting was used to analyze the activation of extracellular signal-regulated kinase (ERK = MAPK) and p38 signaling pathway. The HSP27/ATF5 complex was assessed by co-immunoprecipitation. ERK pathway blocker PD98059 and p38 signal pathway blocker SB203580 were added into the culture fluid of Group HG and Group NG respectively, and then the podocytes were collected at different time points to detect the high glucose-induced HSP27/ATF5 complex and cell apoptosis. RESULTS: The apoptotic rate of the podocytes of Group HG 24 hours after high glucose incubation was 14.3% +/- 6.2%, and that 48 h after was 27.2% +/- 8.9%, significantly higher than that of Group NG (10.6% +/- 2.7%, P < 0.05). HSP27/ATF5 complex could detected in the cells of Group NG too, however, the level of HSP27/ATF5 complex in Group HG 12 hours after incubation was 195% +/- 36% that of Group NG (P < 0.05). Both the ERK signal pathway and p38 signal pathway of Group HG began to be activated 10 min after incubation, peaked 30 min after, remained at the highest level till 1 hour after, and returned almost to the baseline level 2 hours after. No activation of these 2 pathways was observed in Group NG. The HSP27/ATF5 complex level of the PD98059 + high glucose group was 109% +/- 19% that of Group NG, significantly lower than that of Group HG (211% +/- 46% that of Group NG, P < 0.05). The apoptotic rate of the PD98059 + high glucose group was 51% +/- 4%, significantly higher than that of PD98059 + normal glucose group (16% +/- 3%, P < 0.05) and that of Group HG (27% +/- 9%, P < 0.05). The apoptotic rate of the SB203580 + HG group was 16% +/- 6%, significantly lower than that of Group HG (27% +/- 9%, P < 0.05). The HSP27/ATF5 complex level of the SB230580 + HG group was 290% +/- 43% that of Group NG, not significantly different from that of Group HG (231% +/- 20% that of Group NG, P > 0.05). CONCLUSION: High glucose stimulates the formation of HSP27/ATF5 complex in podocytes through ERK signaling pathway but not P38 signaling pathway, and the HSP27/ATF5 complex may have a regulatory effect in podocyte apoptosis induced by high glucose.