ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease 2019 (COVID-19), which has become a public health emergency of international concern1. Angiotensin-converting enzyme 2 (ACE2) is the cell-entry receptor for severe acute respiratory syndrome coronavirus (SARS-CoV)2. Here we infected transgenic mice that express human ACE2 (hereafter, hACE2 mice) with SARS-CoV-2 and studied the pathogenicity of the virus. We observed weight loss as well as virus replication in the lungs of hACE2 mice infected with SARS-CoV-2. The typical histopathology was interstitial pneumonia with infiltration of considerable numbers of macrophages and lymphocytes into the alveolar interstitium, and the accumulation of macrophages in alveolar cavities. We observed viral antigens in bronchial epithelial cells, macrophages and alveolar epithelia. These phenomena were not found in wild-type mice infected with SARS-CoV-2. Notably, we have confirmed the pathogenicity of SARS-CoV-2 in hACE2 mice. This mouse model of SARS-CoV-2 infection will be valuable for evaluating antiviral therapeutic agents and vaccines, as well as understanding the pathogenesis of COVID-19.
Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/pathology , Coronavirus Infections/virology , Lung/pathology , Peptidyl-Dipeptidase A/genetics , Peptidyl-Dipeptidase A/metabolism , Pneumonia, Viral/pathology , Pneumonia, Viral/virology , Transgenes , Angiotensin-Converting Enzyme 2 , Animals , Antigens, Viral/immunology , Antigens, Viral/metabolism , Betacoronavirus/immunology , Betacoronavirus/metabolism , Bronchi/pathology , Bronchi/virology , COVID-19 , Coronavirus Infections/immunology , Disease Models, Animal , Epithelial Cells/pathology , Epithelial Cells/virology , Female , Humans , Immunoglobulin G/immunology , Lung/immunology , Lung/virology , Lymphocytes/immunology , Macrophages, Alveolar/immunology , Macrophages, Alveolar/virology , Male , Mice , Mice, Transgenic , Pandemics , Pneumonia, Viral/immunology , Receptors, Complement 3d/genetics , Receptors, Complement 3d/metabolism , SARS-CoV-2 , Virus Replication , Weight LossABSTRACT
Globally, prostate cancer is the most commonly diagnosed tumor and a cause of death in older men. Abiraterone, an orally administered irreversible CYP17 inhibitor, is employed to treat prostate cancer. However, abiraterone has several clinical limitations, such as poor water solubility, low dissolution rate, low bioavailability, and toxic side effects in the liver and kidney. Therefore, there is a need to identify high-efficiency and low-toxicity water-soluble abiraterone derivatives. In this work, we aimed to design and synthesize a series of abiraterone derivatives by methoxypoly(ethylene glycol) (mPEG) modification. Their antitumor activities and toxicology were analyzed in vitro and in vivo. The most potent compound, 2e, retained the principle of action on the CYP17 enzyme target and significantly improved the abiraterone water solubility, cell permeability, and blood safety. No significant abnormalities were observed in toxicology. mPEG-modification significantly improved abiraterone's antitumor activity and efficiency while reducing the associated toxic effects. The finding will provide a theoretical basis for future clinical application of mPEG-modified abiraterone.
Subject(s)
Androstenes , Antineoplastic Agents , Polyethylene Glycols , Prostatic Neoplasms , Solubility , Male , Humans , Androstenes/pharmacology , Androstenes/chemistry , Animals , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/pathology , Antineoplastic Agents/pharmacology , Antineoplastic Agents/chemistry , Polyethylene Glycols/chemistry , Mice , Cell Line, Tumor , Xenograft Model Antitumor Assays , Steroid 17-alpha-Hydroxylase/antagonists & inhibitors , Steroid 17-alpha-Hydroxylase/metabolismABSTRACT
Eucommiae Cortex is one of important traditional Chinese medicines (TCMs) used in Asia for preventing and treating osteoporosis induced by estrogen deficiency. However, the low exposure of prototype components in Eucommiae Cortex in vivo is difficult to interpret its efficacy. Under the guidance of UPLC-Q/TOF-MS, 42 metabolites including 32 lignans and 10 phenolics, 21 of which were new compounds, were isolated from rat urine and feces after oral administration of aqueous extract of E. ulmoides Oliv. by various chromatographic techniques. Their structures were determined based on extensive physicochemical analyses and spectral data. Their absolute configurations were determined by experimental and calculated ECD spectra, along with the calculated NMR with DP4 evaluation. Additionally, all isolated metabolites were evaluated for their estrogen-like activities, and there are 15 metabolites having estrogen-like effects after assessing influences in MCF-7 cells. Further, Dual Luciferase Reporter Gene Assay was used to determine their activation with estrogen receptor, M10 and M11 mixtures, M14, M19, M33, M27, M31, M38-M41 could activate ERα, and M19 and M41 could activate ERß. These results not only clarify the pharmacological substances of Eucommiae Cortex, but also provide a basis for guiding its clinical application.
Subject(s)
Drugs, Chinese Herbal , Lignans , Rats , Animals , Drugs, Chinese Herbal/pharmacology , Drugs, Chinese Herbal/analysis , Chromatography, High Pressure Liquid/methods , Medicine, Chinese Traditional , Estrogens/pharmacology , Lignans/pharmacologyABSTRACT
BACKGROUND: The prognostic nutritional index (PNI) and serum chloride level are related to adverse outcomes in patients with heart failure. However, little is known about the relationship between the PNI and serum chloride level in predicting the poor prognosis of patients with acute decompensated heart failure (ADHF). METHODS AND RESULTS: We reviewed 1221 consecutive patients with ADHF admitted to the First Affiliated Hospital of Kunming Medical University from January 2017 to October 2021. After excluding patients with in hospital death, missing follow-up data, missing chloride data, missing lymphocyte (LYM) count data, or missing serum albumin data, 805 patients were included. PNI was calculated using the formula: serum albumin (ALB) (g/L) + 5 × LYM count (10^9/L). Patients were divided into 4 groups according to the quartiles of the PNI, and the highest PNI quartile (PNI Q4: PNI ≥ 47.3) was set as the reference group. The patients in the lowest PNI quartile (PNI Q1: PNI < 40.8) had the lowest cumulative survival rate, and mortality risk decreased progressively through the quartiles (log-rank χ2 142.283, P < 0.0001). Patients with ADHF were divided into 8 groups by quartiles of PNI and median levels of serum chloride. After adjustment, the hazard ratio (HR) for all-cause mortality in ADHF patients in Group 1 was 8.7 times higher than that in the reference Group 8. Furthermore, the addition of serum chloride level and PNI quartile to the Cox model increased the area under the Receiver operating characteristic (ROC) curve by 0.05, and the area under the ROC curve of the new model was higher than that of the original model with traditional risk factors. CONCLUSIONS: Both the lowest PNI quartiles and low chloride level indicate a higher risk of all-cause death in patients with ADHF.
Subject(s)
Biomarkers , Chlorides , Heart Failure , Nutrition Assessment , Humans , Heart Failure/blood , Heart Failure/mortality , Heart Failure/diagnosis , Heart Failure/physiopathology , Male , Female , Prognosis , Chlorides/blood , Aged , Retrospective Studies , Acute Disease , Biomarkers/blood , Predictive Value of Tests , Risk Assessment/methods , Middle Aged , China/epidemiology , Risk Factors , ROC Curve , Survival Rate/trends , Nutritional Status , Aged, 80 and over , Follow-Up StudiesABSTRACT
BACKGROUND: Social alienation refers to the state of feeling isolated, helpless, and unsatisfied due to maintaining distance from others or avoiding social interaction and activities. This phenomenon is caused by a lack of social skills, social anxiety, physical health problems, and other reasons. Older maintenance hemodialysis patients are exposed to a higher risk of social alienation. However, previous studies have been performed using the total score of the scale, which does not allow the identification of the characteristics of various patient groups with different levels of social alienation. In contrast, latent profile analysis can classify individuals into different categories based on continuous observational indicators, which improves accuracy and provides a more objective assessment by accounting for the uncertainty of variables. Given the concealed nature of social alienation and the differences in characteristics and treatment measures between different profiles, developing a predictive model for social alienation in older maintenance hemodialysis patients holds significance. OBJECTIVE: To explore the latent profile analysis of social alienation in older maintenance hemodialysis patients and to develop and validate a predictive model for social alienation in this population. METHODS: A total of 350 older maintenance hemodialysis patients were selected as the study subjects using convenience sampling. A cross-sectional survey was conducted using a general information questionnaire, the Generalized Alienation Scale, and the Self-Perceived Burden Scale. Based on the results of the Generalized Alienation Scale, a latent profile analysis was performed, followed by univariate analysis and multinomial logistic regression to develop a predictive model. The effectiveness of the predictive model was evaluated in terms of its authenticity, reliability, and predictive ability. RESULTS: Three hundred nineteen valid questionnaires were collected. The social alienation of older maintenance hemodialysis patients based on latent profile analysis were divided into three profiles, which were named the low/medium/high-symptom groups, comprising 21%, 38.9%, and 40.1% of participants, respectively. Based on male, monthly social activity hours, Age-Adjusted Charlson Comorbidity Index, dialysis age, and Self-Perceived Burden Scale, a predictive model of social alienation for older maintenance hemodialysis patients was developed, and the Hosmer-Lemeshow tests showed no statistical significance (P > 0.05). The model has high predictive efficiency in authenticity, reliability and predictability. CONCLUSION: Older maintenance hemodialysis patients exhibited moderate to high levels of social alienation. The latent profile analysis based method was used to divide patients into low/medium/high-symptom profiles, and the predictive model demonstrates excellent authenticity, reliability, and predictability.
Subject(s)
Renal Dialysis , Social Alienation , Humans , Male , Cross-Sectional Studies , Female , Renal Dialysis/psychology , Aged , Social Alienation/psychology , Aged, 80 and over , Middle AgedABSTRACT
BACKGROUND: Balanced propofol sedation is extensively used in endoscopic retrograde cholangiopancreatography (ERCP), but sedation-related adverse events (SRAEs) are common. In various clinical settings, the combination of dexmedetomidine with opioids and benzodiazepines has provided effective sedation with increased safety. The aim of this investigation was to compare the efficacy and safety of dexmedetomidine and propofol for sedation during ERCP. METHODS: Forty-one patients were randomly divided into two groups: the dexmedetomidine (DEX) group and the propofol (PRO) group. Patients in the DEX group received an additional bolus of 0.6 µg kg-1 dexmedetomidine followed by a dexmedetomidine infusion at 1.2 µg kg-1 h-1, whereas the PRO group received 1-2 mg kg-1 of propofol bolus followed by a propofol infusion at 2-3 mg kg-1 h-1. During ERCP, the primary outcome was the incidence of hypoxemia (SpO2 < 90% for > 10 s). Other intraoperative adverse events were also recorded as secondary outcomes, including respiratory depression (respiratory rate of < 10 bpm min-1), hypotension (MAP < 65 mmHg), and bradycardia (HR < 45 beats min-1). RESULTS: The incidence of hypoxemia was significantly reduced in the DEX group compared to the PRO group (0% versus 28.6%, respectively; P = 0.032). Patients in the PRO group exhibited respiratory depression more frequently than patients in the DEX group (35% versus 81%, respectively; P = 0.003). There were no significant differences in terms of hypotension and bradycardia episodes between groups. During the procedures, the satisfaction scores of endoscopists and patients, as well as the pain and procedure memory scores of patients were comparable between groups. CONCLUSION: In comparison with propofol, dexmedetomidine provided adequate sedation safety with no adverse effects on sedation efficacy during ERCP. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2200061468, 25/06/2022.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde , Dexmedetomidine , Hypnotics and Sedatives , Propofol , Humans , Dexmedetomidine/administration & dosage , Dexmedetomidine/adverse effects , Cholangiopancreatography, Endoscopic Retrograde/methods , Propofol/administration & dosage , Propofol/adverse effects , Male , Female , Hypnotics and Sedatives/administration & dosage , Hypnotics and Sedatives/adverse effects , Middle Aged , Prospective Studies , Single-Blind Method , Aged , Adult , Hypoxia/prevention & control , Conscious Sedation/methodsABSTRACT
Objective: To investigate the clinical value of stressor perception-based meticulous nursing measures during the perioperative period of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods and Design: A prospective randomized trial was conducted involving 104 AMI patients undergoing PCI from March 2021 to March 2022. Patients were divided into an "intervention group" and a "routine group" based on consultation numbers, with equal cases in each group. PCI procedures were performed by the same group of doctors in both groups and that basic treatment measures were similar. Intervention and Comparison: The intervention group received meticulous nursing measures based on stressor perception during the perioperative period, while the routine group received standard care. Outcome measures: The study compared treatment effects, perioperative sleep quality, negative emotion scores, and perioperative complication rates between the two groups. Results Overview: The patients in the intervention group and the conventional group were statistically similar in terms of operative time, X-ray fluoroscopy time, contrast agent dosage, catheter lab nurse preparation time, catheter lab-balloon dilation time, portal-ball time, and PCI success rate (P > .05). In the post-PCI assessment of negative emotions in both groups, the total scores of depression, anxiety, extroverted irritability, and negative emotion scores in the intervention group were higher than those in the routine group (P < .05). In the post-PCI assessment of sleep quality in both groups, subjective sleep quality score, sleep delay score, and total PSQI score in the intervention group were lower than those in the routine group (P < .05). The rate of surgical complications was 7.69% in the intervention group and 15.38% in the routine group, and the differences between the two groups were not statistically significant (P > .05). Conclusion: While meticulous nursing measures based on stressor perception did not notably enhance the effectiveness of PCI, they did significantly improve patients' negative emotions and sleep quality.
Subject(s)
Myocardial Infarction , Percutaneous Coronary Intervention , Humans , Prospective Studies , Treatment Outcome , Myocardial Infarction/surgery , Myocardial Infarction/complications , PerceptionABSTRACT
Cell fate instability is a crucial characteristic of aging and appears to contribute to various age-related pathologies. Exploring the connection between bioactive substances and cell fate stability may offer valuable insights into longevity. Therefore, the objective of this study was to investigate the potential beneficial effects of ginseng oligopeptides (GOPs) isolated from Panax ginseng C. A. Meyer at the cellular level. Disruption of homeostasis of human umbilical vein endothelial cells (HUVECs) and PC-12 was achieved by culturing them in the growth medium supplemented with 200 µM of H2O2, and 25, 50, and 100 µg/mL GOPs for 4 h. Then, they were cultured in a H2O2-free growth medium containing different concentration of GOPs. We found that GOP administration retards the oxidative stress-induced cell instability in HUVECs by increasing cell viability, inhibiting the cell cycle arrest, enhancing telomerase (TE) activity, suppressing oxidative stress and an inflammatory attack, and protecting mitochondrial function. Furthermore, we hypothesized that GOPs may promote mitochondrial biosynthesis by upregulating PGC-1α expression. Similarly, GOPs positively regulated cell stability in PC-12; notably, the protective effect of GOPs on PC-12 mainly occurred through the inhibition of autophagic cell death of neuronal cells, while the protective effect on mitochondria was weak. In conclusion, it is evident that GOPs demonstrate potential beneficial effects in maintaining cell fate stability, thereby potentially contributing to an enhanced health span and overall well-being.
Subject(s)
Antioxidants , Panax , Humans , Antioxidants/pharmacology , Human Umbilical Vein Endothelial Cells/metabolism , Panax/chemistry , Hydrogen Peroxide/metabolism , Plant Extracts/pharmacology , Oxidative Stress , Oligopeptides/pharmacologyABSTRACT
BACKGROUND: Nurses' nursing competence and nutritional care literacy directly affect patients' health and safety. Self-directed learning ability was pervasive throughout the entire work process of nursing work and was the basis for improving both. However, there are few studies has explored the mechanism from the perspective of nutritional care literacy. The purpose of this study was to analyze the relationship between self-directed learning ability and nursing competence, and to explore the mediating role of nutritional care literacy between self-directed learning and nursing competence among clinical nurses in China. METHODS: A cross-sectional survey was conducted among 805 clinical nurses recruited from seven general hospitals in Hunan Province, China, between January 25 and March 6, 2022. The self-directed learning ability, nutritional care literacy and nursing competence of nurses were evaluated through investigation. A total of 799 questionnaires were received, resulting in an response rate of 99.25%.We performed an intermediary modeling to examine the mediating roles of nutritional care literacy on the relationship between self-directed learning ability and nursing competence in clinical nurses. RESULTS: Self-directed learning ability was positively correlated with nutritional care literacy (r=0.792, P<0.001) and nursing competence (r=0.696, P<0.001). Nutritional care literacy was positively correlated with nursing competence (r=0.658, P<0.001). Nutritional care literacy mediated the relationship between self-directed learning ability and nursing competence. The mediating effect accounted for 32.48% of the total effect and 48.10% of the direct effect . CONCLUSIONS: This study confirmed the positive correlation between self-directed learning ability, nutritional care literacy, and nursing competence. Nutritional care literacy played a mediating role in the relationship between self-directed learning ability and nursing competence. The findings not only provide a novel strategy for cultivating nursing professionals and improving nurse disease care abilities, but also offer a new perspective for nursing educators and managers.
ABSTRACT
Semiconductor heterojunction engineering and three-dimensional (3D) architecture construction have been considered highly desirable strategies to enhance photocatalytic performance. Herein, a BiOI/ZnO composite photocatalyst with a 3D flower-like architecture was successfully prepared, which was stably immobilized on three-dimensional porous lignocellulosic biomass Juncus effusus (JE) fiber. The outstanding photocatalytic performance of the BiOI/ZnO-JE fiber was confirmed by the degradation of tetracycline hydrochloride (TC, 90%), ciprofloxacin (CIP, 79%), and norfloxacin (NOR, 81%). The enhanced photocatalytic activities were mainly attributed to the synergistic absorption performance of the lignocellulosic JE and the effective transfer and separation of charges. Moreover, the hydroxyl (·OH) and superoxide radicals (·O2-) are the main reactive species in the photocatalytic process according to the analysis. This work may provide a novel perspective for constructing high-performance lignocellulosic-based photocatalytic materials.
Subject(s)
Biomass , Photolysis , Zinc Oxide , Zinc Oxide/chemistry , Water Pollutants, Chemical/chemistry , CatalysisABSTRACT
A total of 11 active ingredients including psoralen, isopsoralen, bakuchiol, bavachalcone, bavachinin, corylin, coryfolin, isobavachalcone, neobavaisoflavone, bakuchalcone, and corylifol A from Psoraleae Fructus in the plasma samples of diabetic and normal rats were simultaneously determined by UHPLC-MS/MS. The pharmacokinetic parameters were calculated to elucidate the pharmacokinetic profiles of coumarins, flavonoids, and monoterpene phenols in normal and diabetic rats. The rat model of type 2 diabetes mellitus(T2DM) was induced by a high-sugar and high-fat diet combined with injection of 1% streptozotocin every two days. The plasma samples were collected at different time points after the rats were administrated with Psoraleae Fructus. The proteins in the plasma samples were precipitated by ethyl acetate, and the plasma concentrations of the 11 components of Psoraleae Fructus were determined by UHPLC-MS/MS. The pharmacokinetic parameters were calculated by DAS 3.0. The results showed that the pharmacokinetic beha-viors of 8 components including psoralen, isopsoralen, bakuchiol, and bavachinin from Psoraleae Fructus in both female and male mo-del rats were significantly different from those in normal rats. Among them, the coumarins including psoralen, isopsoralen, and corylin showed lowered levels in the blood of both female and male model rats. The flavonoids(bavachinin, corylifol A, and bakuchalcone) and the monoterpene phenol bakuchiol showed decreased levels in the female model rats but elevated levels in the male model rats. It is suggested that the dosage of Psoraleae Fructus should be reasonably adjusted for the patients of different genders at the time of clinical administration.
Subject(s)
Diabetes Mellitus, Experimental , Diabetes Mellitus, Type 2 , Drugs, Chinese Herbal , Furocoumarins , Phenols , Psoralea , Humans , Rats , Female , Male , Animals , Drugs, Chinese Herbal/pharmacokinetics , Tandem Mass Spectrometry/methods , Diabetes Mellitus, Experimental/drug therapy , Flavonoids/pharmacology , Ficusin , Coumarins , MonoterpenesABSTRACT
In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.).
Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/virology , Lung/diagnostic imaging , Pneumonia, Viral/virology , Adult , Betacoronavirus/genetics , Betacoronavirus/ultrastructure , Bronchoalveolar Lavage Fluid/virology , COVID-19 , Cells, Cultured , China , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/pathology , Epithelial Cells/pathology , Epithelial Cells/virology , Female , Genome, Viral , Humans , Lung/pathology , Lung/virology , Male , Microscopy, Electron, Transmission , Middle Aged , Phylogeny , Pneumonia, Viral/diagnostic imaging , Pneumonia, Viral/pathology , Radiography, Thoracic , Respiratory System/pathology , Respiratory System/virology , SARS-CoV-2ABSTRACT
BACKGROUND: Blastocystis is one of the important zoonotic parasites which can infect humans and various animals worldwide and has become a growing global public health concern. The study aims to obtain the data of Blastocystis infection and the information of the genetic characteristic. METHODS: In the present study, 489 fecal samples were collected from diarrhea outpatients in Ningbo, Zhejiang province, and were examined the presence of Blastocystis by polymerase chain reaction combined with sequencing. RESULTS: A total of 10 samples (2.04%, 10/489) were positive for Blastocystis with no significant difference among sex and age groups, respectively. Eight samples were successfully sequenced, and five zoonotic ST3 and three zoonotic ST1 with two new sequences were identified. CONCLUSIONS: We first demonstrated the occurrence of Blastocystis infection in diarrhea outpatients in Ningbo, with two zoonotic subtypes (ST1 and ST3) and two new sequences being characterized. Meanwhile, mixed infection of Blastocystis and E. bieneusi was found which indicates the importance of investigation of multiple parasites. Finally, more extensive studies will be needed to better understand the transmission of Blastocystis at human-animal-environment interface and provide evidence for the development of one health strategies for the prevention and control of such diseases.
Subject(s)
Blastocystis Infections , Blastocystis , Animals , Humans , Blastocystis Infections/epidemiology , Blastocystis Infections/parasitology , Outpatients , Genetic Variation , Blastocystis/genetics , China/epidemiology , Feces/parasitology , Diarrhea/epidemiology , Prevalence , PhylogenyABSTRACT
OBJECTIVES: To evaluate the discriminatory capability of spectral CT-based radiomics to distinguish benign from malignant solitary pulmonary solid nodules (SPSNs). MATERIALS AND METHODS: A retrospective study was performed including 242 patients with SPSNs who underwent contrast-enhanced dual-layer Spectral Detector CT (SDCT) examination within one month before surgery in our hospital, which were randomly divided into training and testing datasets with a ratio of 7:3. Regions of interest (ROIs) based on 40-65 keV images of arterial phase (AP), venous phases (VP), and 120kVp of SDCT were delineated, and radiomics features were extracted. Then the optimal radiomics-based score in identifying SPSNs was calculated and selected for building radiomics-based model. The conventional model was developed based on significant clinical characteristics and spectral quantitative parameters, subsequently, the integrated model combining radiomics-based model and conventional model was established. The performance of three models was evaluated with discrimination, calibration, and clinical application. RESULTS: The 65 keV radiomics-based scores of AP and VP had the optimal performance in distinguishing benign from malignant SPSNs (AUC65keV-AP = 0.92, AUC65keV-VP = 0.88). The diagnostic efficiency of radiomics-based model (AUC = 0.96) based on 65 keV images of AP and VP outperformed conventional model (AUC = 0.86) in the identification of SPSNs, and that of integrated model (AUC = 0.97) was slightly further improved. Evaluation of three models showed the potential for generalizability. CONCLUSIONS: Among the 40-65 keV radiomics-based scores based on SDCT, 65 keV radiomics-based score had the optimal performance in distinguishing benign from malignant SPSNs. The integrated model combining radiomics-based model based on 65 keV images of AP and VP with Zeff-AP was significantly superior to conventional model in the discrimination of SPSNs.
Subject(s)
Multiple Pulmonary Nodules , Solitary Pulmonary Nodule , Humans , Tomography, X-Ray Computed/methods , Retrospective Studies , Multiple Pulmonary Nodules/diagnostic imaging , Solitary Pulmonary Nodule/diagnostic imaging , Solitary Pulmonary Nodule/pathologyABSTRACT
OBJECTIVES: To determine the incremental diagnostic value of radiomics signature of pericoronary adipose tissue (PCAT) in addition to the coronary artery stenosis and plaque characters for detecting hemodynamic significant coronary artery disease (CAD) based on coronary computed tomography angiography (CCTA). METHODS: In a multicenter trial of 262 patients, CCTA and invasive coronary angiography were performed, with fractional flow reserve (FFR) in 306 vessels. A total of 13 conventional quantitative characteristics including plaque characteristics (N = 10) and epicardial adipose tissue characteristics (N = 3) were obtained. A total of 106 radiomics features depicting the phenotype of the PCAT surrounding the lesion were calculated. All data were randomly split into a training dataset (75%) and a testing dataset (25%). Then three models (including the conventional model, the PCAT radiomics model, and the combined model) were established in the training dataset using multivariate logistic regression algorithm based on the conventional quantitative features and the PCAT radiomics features after dimension reduction. RESULTS: A total of 124/306 vessels showed functional ischemia (FFR ≤ 0.80). The radiomics model performed better in discriminating ischemia from non-ischemia than the conventional model in both training (area under the receiver operating characteristic (ROC) curve (AUC): 0.770 vs 0.732, p < 0.05) and testing datasets (AUC: 0.740 vs 0.696, p < 0.05). The combined model showed significantly better discrimination than the conventional model in both training (AUC: 0.810 vs 0.732, p < 0.05) and testing datasets (AUC: 0.809 vs 0.696, p < 0.05). CONCLUSIONS: The PCAT radiomics model showed good performance in predicting myocardial ischemia. Addition of PCAT radiomics to lesion quantitative characteristics improves the predictive power of functionally relevant CAD. KEY POINTS: ⢠Based on the plaque characteristics and EAT characteristics, the conventional model showed poor performance in predicting myocardial ischemia. ⢠The PCAT radiomics model showed good prospect in predicting myocardial ischemia. ⢠When combining the radiomics signature with the conventional quantitative features (including plaque features and EAT features), it showed significantly better performance in predicting myocardial ischemia.
Subject(s)
Coronary Artery Disease , Coronary Stenosis , Fractional Flow Reserve, Myocardial , Myocardial Ischemia , Plaque, Atherosclerotic , Humans , Coronary Artery Disease/diagnostic imaging , Predictive Value of Tests , Myocardial Ischemia/diagnostic imaging , Coronary Angiography/methods , Computed Tomography Angiography , Adipose Tissue/diagnostic imagingABSTRACT
BACKGROUND: This study was undertaken to explore the predictive value of the advanced lung cancer inflammation index (ALI) combined with the geriatric nutritional risk index (GNRI) for all-cause mortality in patients with heart failure (HF). METHODS AND RESULTS: We enrolled 1123 patients with HF admitted to our cardiology department from January 2017 to October 2021. Patients were divided into four groups, according to the median ALI and GNRI. From the analysis of the relationship between the ALI and GNRI, we concluded that there was a mild positive linear correlation (r = 0.348, p < 0.001) and no interaction (p = 0.140) between the ALI and GNRI. KaplanâMeier analysis showed that the cumulative incidence of all-cause mortality in patients with HF was highest in Group 1 (log-rank χ2 126.244, p < 0.001). Multivariate Cox proportional hazards analysis revealed that ALI and GNRI were independent predictors of all-cause mortality in HF patients (ALI: HR 0.407, 95% CI 0.296-0.560, p < 0.001; GNRI: HR 0.967, 95% CI 0.954-0.980, p < 0.001). The area under the curve (AUC) for ALI combined with GNRI was 0.711 (p < 0.001), according to the time-dependent ROC curve. CONCLUSION: ALI and GNRI were independent predictors of all-cause mortality in HF patients. Patients with HF had the highest risk of all-cause mortality when the ALI was < 24.60 and the GNRI was < 94.41. ALI combined with the GNRI has good predictive value for the prognosis of HF patients.
Subject(s)
Heart Failure , Lung Neoplasms , Humans , Aged , Nutrition Assessment , Lung Neoplasms/diagnosis , Heart Failure/diagnosis , Prognosis , Inflammation/diagnosis , Nutritional Status , Risk Factors , Retrospective StudiesABSTRACT
BACKGROUND: Patients diagnosed withmajor depressive disorder (MDD) usually experience impaired cognitive functioning, which might negatively impact their clinical and functional outcomes. This study aimed to investigate the association of specific clinical factors with cognitive dysfunction in a group of MDD patients. METHODS: A total of 75 subjects diagnosed with recurrent MDD were evaluated during the acute stage. Their cognitive functions were assessed using the THINC-integrated tool (THINC-it) for attention/alertness, processing speed, executive function, and working memory. Clinical psychiatric evaluations, such as the Hamilton Anxiety Scale (HAM-A), the Young Mania Rating Scale (YMRS), the Hamilton Depression Scale (HAM-D), and the Pittsburgh Sleep Quality Index(PSQI), were used to assess patients' levels of anxiety, depression and sleeping problems. The investigated clinical variables were age, years of education, age at onset, number of depressive episodes, disease duration, presence of depressive and anxiety symptoms, sleep problems, and number of hospitalizations. RESULTS: The results revealed that significant differences were observed between the two groups in the THINC-it total scores, Spotter, Codebreaker, Trails, and PDQ-5-D scores (P < 0.001). The THINC-it total scores, Spotter, Codebreaker, Trails, and Symbol Check were significantly associated with age and age at onset(P < 0.01). In addition, regression analysis found that years of education was positively associated with the Codebreaker total scores (P < 0.05). the THINC-it total scores, Symbol Check, Trails, and Codebreaker were correlated with the HAM-D total scores(P < 0.05). Additionally, the THINC-it total scores, Symbol Check, PDQ-5-D and Codebreaker significantly correlated with the PSQI total scores (P < 0.05). CONCLUSION: We found a significant statistical association between almost all cognitive domains and different clinical aspects in depressive disorder, such asage, age at onset, severity of depression, years of education, and sleep problems. Additionally, education was shown to be a protective factor against processing speed impairments. Special considerations of these factors might help outline better management strategies to improve cognitive functions in MDD patients.
Subject(s)
Cognitive Dysfunction , Depressive Disorder, Major , Humans , Depressive Disorder, Major/psychology , Depression , East Asian People , Cognitive Dysfunction/complications , Cognitive Dysfunction/diagnosis , CognitionABSTRACT
Objective: Individuals with chronic obstructive pulmonary disease (COPD) are more likely to develop heart failure (HF) compared with the general population, and the presence of HF may contribute to reduced quality of life (QoL), increased hospitalizations and worse survival rates in patients with COPD. Our study examined the exercise capacity, QoL, mental health, family burden and rehospitalization rate of patients with comorbid COPD and chronic heart failure (CHF) after individualized inpatient and outpatient nursing care. Methods: A total of 100 patients with comorbid COPD and CHF admitted to Affiliated Hospital of Jiangnan University January 2021 to July 2022 were enrolled in our study and then randomly assigned to one of two groups of 50 patients: patients receiving traditional nursing care and patients receiving individualized nursing care. Exercise capacity, mental health, QoL and family burden were assessed by means of the 6-minute walk test (6MWT), Zung's Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), the short-form health survey (SF-36) and the Perceived Family Burden Scale (PFBS). Results: The patients receiving individualized nursing care had notable differences regarding distance walked in the 6MWT, the scores in all domains of both the physical and mental composites, SAS and SDS scores and PFBS scores of patients at on admission (T0), at discharge (T1) and at 2 months after discharge (T2) (P < .05). The patients receiving individualized nursing care walked longer distances on the 6MWT, more scores reflecting improved QoL and reduced SAS and SDS scores at both T1 and T2 compared with patients receiving traditional nursing care (P < .05). The patients receiving individualized nursing care exhibited decreased PFBS scores at T2 compared with patients receiving traditional nursing care (P < .05). None of the patients receiving individualized nursing care were rehospitalized, but 2 patients receiving traditional nursing care were rehospitalized due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute HF, respectively. Conclusion: Our study demonstrates that individualized inpatient and outpatient nursing care can enhance exercise capacity and improve QoL and mental health in patients with comorbid COPD and CHF.
Subject(s)
Heart Failure , Pulmonary Disease, Chronic Obstructive , Humans , Chronic Disease , Comorbidity , Heart Failure/complications , Heart Failure/epidemiology , Pulmonary Disease, Chronic Obstructive/epidemiology , Quality of LifeABSTRACT
BACKGROUND: The prevalence of COVID-19 highlights the shortage of human medical resources, and improving medical students' professional identity is crucial to improving this situation. The sources of confidence in overcoming COVID-19 and medical students' attention to COVID-19 were significant factors affecting their professional identity. However, no study has investigated the mediating role of medical students' attention to COVID-19 in their relationship. This study investigates the relationship between these three factors in three medical university students in Hunan Province. METHODS: A cross-sectional survey study that used convenience sampling method was conducted on 2775 medical students from three universities in the Hunan Province of China from March 15 to April 19, 2020. An intermediary model was established to evaluate the role of medical students' attention to COVID-19 in the sources of confidence in overcoming COVID-19 and the improvement of medical students' professional identity. RESULTS: The sources of confidence in overcoming COVID-19, medical students' attention to national crisis events, and the improvement of medical students' professional identity was positively associated with each other (ß = 0.328 ~ 0.464, P < 0.001). The mediating effect accounted for 23.3% of the total effect and 30.4% of the direct effect. Medical students' attention to COVID-19 partially mediates the relationship between the sources of confidence to overcome COVID-19 and the improvement of medical students' professional identity. CONCLUSIONS: This study found that the sources of confidence in overcoming COVID-19 and medical students' attention to national crisis events have a significant predictive effect on the improvement of medical students' professional identity. Medical students' attention to COVID-19 mediated the relationship between the sources of confidence to overcome COVID-19 and the improvement of medical students' professional identity. The findings have emphasized the theoretical and practical significance of professional identity education for medical students.
Subject(s)
COVID-19 , Students, Medical , Humans , COVID-19/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires , Social IdentificationABSTRACT
INTRODUCTION: As a folk herbal medicine, Trillium tschonoskii has been used for thousands of years. However, due to the complexity of the chemical constituents of this herb, few investigations have acquired a comprehensive understanding of its quality markers. OBJECTIVE: This study was conducted to characterise the chemical composition of T. tschonoskii and identify its potential quality markers. MATERIAL AND METHODS: A systematic analytical method based on ultra-high-performance liquid chromatography coupled with mass spectrometry (UHPLC-MS) was used to characterise the constituents of T. tschonoskii. Multivariate statistical analysis was performed to investigate the chemical differences between different tissues, as well as the relationship between chemical compositions and habitats. The potential quality markers were predicted via network pharmacology and molecular docking, then confirmed by cellular assays. RESULTS: A total of 77 compounds were co-isolated and identified, and among them, 26 were discovered from the genus Trillium for the first time. Ten batches of roots/rhizomes were explicitly clustered into five groups according to the climate types of the habitats, and the clusters of the fruits and roots/rhizomes from the same plants were independent due to the significant difference in chemical composition. Diosgenin had a good docking affinity with the relevant targets within the IL-17 pathway and cytokine pathway and could significantly inhibit TNF-α expression in hypoxic brain microvascular endothelial cells (BMECs). CONCLUSION: This is the first study to establish the chemical composition profile of T. tschonoskii by UHPLC-MS systematically, and diosgenin was confirmed to be a potential quality marker of T. tschonoskii for the treatment of headaches.