RESUMO
As a biodegradable and biocompatible protein derived from collagen, gelatin has been extensively exploited as a fundamental component of biological scaffolds and drug delivery systems for precise medicine. The easily engineered gelatin holds great promise in formulating various delivery systems to protect and enhance the efficacy of drugs for improving the safety and effectiveness of numerous pharmaceuticals. The remarkable biocompatibility and adjustable mechanical properties of gelatin permit the construction of active 3D scaffolds to accelerate the regeneration of injured tissues and organs. In this Review, we delve into diverse strategies for fabricating and functionalizing gelatin-based structures, which are applicable to gene and drug delivery as well as tissue engineering. We emphasized the advantages of various gelatin derivatives, including methacryloyl gelatin, polyethylene glycol-modified gelatin, thiolated gelatin, and alendronate-modified gelatin. These derivatives exhibit excellent physicochemical and biological properties, allowing the fabrication of tailor-made structures for biomedical applications. Additionally, we explored the latest developments in the modulation of their physicochemical properties by combining additive materials and manufacturing platforms, outlining the design of multifunctional gelatin-based micro-, nano-, and macrostructures. While discussing the current limitations, we also addressed the challenges that need to be overcome for clinical translation, including high manufacturing costs, limited application scenarios, and potential immunogenicity. This Review provides insight into how the structural and chemical engineering of gelatin can be leveraged to pave the way for significant advancements in biomedical applications and the improvement of patient outcomes.
Assuntos
Gelatina , Alicerces Teciduais , Humanos , Gelatina/química , Alicerces Teciduais/química , Engenharia Tecidual , Colágeno , Polietilenoglicóis , Materiais Biocompatíveis/químicaRESUMO
Cluster synchronization in synthetic networks of coupled chaotic oscillators is investigated. It is found that despite the asymmetric nature of the network structure, a subset of the oscillators can be synchronized as a cluster while the other oscillators remain desynchronized. Interestingly, with the increase in the coupling strength, the cluster is expanding gradually by recruiting the desynchronized oscillators one by one. This new synchronization phenomenon, which is named "scalable synchronization cluster," is explored theoretically by the method of eigenvector-based analysis, and it is revealed that the scalability of the cluster is attributed to the unique feature of the eigenvectors of the network coupling matrix. The transient dynamics of the cluster in response to random perturbations are also studied, and it is shown that in restoring to the synchronization state, oscillators inside the cluster are stabilized in sequence, illustrating again the hierarchy of the oscillators. The findings shed new light on the collective behaviors of networked chaotic oscillators and are helpful for the design of real-world networks where scalable synchronization clusters are concerned.
RESUMO
The accurate prediction and assessment of effluent quality in wastewater treatment plants (WWTPs) are paramount for the efficacy of sewage treatment processes. Neural network models have exhibited promise in enhancing prediction accuracy by simulating and analyzing diverse influent parameters. In this study, a back propagation neural network hybrid model based on a tent chaotic map and sparrow search algorithm (Tent_BP_SSA) was developed to predict the effluent quality of sewage treatment processes. The prediction performance of the propose hybrid model was compared with traditional neural network models using five performance indicators (MAE, RMSE, SSE, MAPE and R2). Specifically, in comparison with the prior Tent_BP_SSA, Tent_BP_SSA2 demonstrated notable enhancements, with the R2 increasing from 0.9512 to 0.9672, while MAE, RMSE, SSE, and MAPE decreased by 9.62%, 18.84%, 24.80%, and 47.10%, respectively. These indicators collectively affirm that the utilization of higher-order input parameters ensures improved accuracy of the Tent_BP_SSA2 hybrid model in predicting effluent quality. Moreover, the Tent_BP_SSA2 model exhibited robust prediction ability (R2 of 0.9246) when applied to assess the effluent quality of an actual sewage treatment plant. The incorporation of integrated models comprising the sparrow search optimizing algorithm, tent chaotic mapping, and higher-order magnitude decomposition of input parameters has demonstrated the capacity to enhance the accuracy of effluent quality prediction. This study illuminates novel perspectives on the prediction of effluent quality and the assessment of effluent warnings in WWTPs.
Assuntos
Esgotos , Purificação da Água , Redes Neurais de Computação , AlgoritmosRESUMO
OBJECTIVE: To analyse potential differences towards liver impairment status on vinyl chloride monomer(VCM) exposed population from technique under acetylene hydrochlorination to the one of ethylene oxychlorination respectively and to explore the possible reasons, which will pave the way for occupational health promotion in terms of hazard reduction. METHODS: a cross-sectional study was initiated between June and September in 2022 towards 2 groups of VCM exposed population from the facility of acetylene hydrochlorination(n=78) and the one of ethylene oxychlorination(n=69) in a PVC petrochemical complex enterprise(abbreviation of H) in Tianjin City. The demographic information concerning age, gender, messages on occupational history, field investigation were inquired through questionnaire interview. Then, venous blood(4 mL/person) and urine(10-50 mL/person) were collected during the physical exam phase and indices of 8-hydroxy-2 deoxyguanosine(8-OHdG) in blood and thiodiglycolic acid(TDGA) in urine were detected through ELISA and solid phase extraction-ion chromatography respectively. RESULTS: The 2 groups of population were matched well in terms of average age distribution and gender composition ratio, with significant differences on population composition ratio were found on variables of working years, alcohol consumption and daily sleeping duration(P<0.01 or P<0.05). It was found that the average content of TDGA in acetylene hydrochlorination group was(0.81±0.05)mg/L while the content in ethylene oxychlorination group reached to(0.83±0.06)mg/L, noteworthy differences were only found among 6 posts in the acetylene hydrochlorination group and 5 others in the ethylene oxychlorination group after classification for specific posts, however, the average concentration of 8-OHdG in acetylene hydrochlorination group(122(78.3, 168.8) µg/m~3) was different from the one in ethylene oxychlorination group(101.7(79.6, 149.7) µg/m~3)(Z=6.82, P<0.05). Moreover, a series of positive correlations in moderate intensity between 8-OHdG concentration and TDGA content were observed among posts of polymerization cleaners(r=0.53), aggregation operators(r=0.47), maintenance repairers(r=0.45), sampling operators(r=0.41) in acetylene hydrochlorination group(P<0.05) and posts of cracking reactants(r=0.64), DCS operators(r=0.51), oxychlorination operators(r=0.50) and chemical loaders(r=0.44) in ethylene oxychlorination group(P<0.05). Liver function indices such as content on ALT(χ~2=15.41, P<0.01), AST(χ~2=9.95, P<0.01) and ALP(χ~2=3.79, P<0.01) were different in the 2 groups population with statistical significance, then proportions on population composition ratio that exceeded normal ranges of indices on ALT, AST, AST/ALT ratio, ALP and Alb/Glb ratio were higher in acetylene hydrochlorination group than ones in ethylene oxychlorination group with great significance(P<0.05), so as to the abnormalities in liver B altrosonography test between groups(χ~2=17.33, P<0.01). Binary logistic regression model indicated that 8-OHdG concentration in blood that exceed 90 µg/m~3, TDGA content in urine that exceed 0.60 mg/L, working years that were over 10a, alcohol consumption, sleeping duration less than 6 h per day and male workers were potential risky factors for liver impairment(P<0.05). CONCLUSION: The degree on liver impairment status was higher in acetylene hydrochlorination group than ones in in ethylene oxychlorination group under the same PVC factory, which might be associated with the oxidative stress injury induced from the combination of higher VCM concentration at workplaces, longer cumulative exposure time, longer working years, alcohol consumption habits and sleep shortage caused by shift work patterns.
Assuntos
Hepatopatias , Exposição Ocupacional , Cloreto de Vinil , Humanos , Masculino , Cloreto de Vinil/toxicidade , Estudos Transversais , Etilenos , Alcinos , Exposição Ocupacional/efeitos adversosRESUMO
OBJECTIVE: The aim of this study is to investigate the dynamic changes and interrelationships between leukocyte components and inflammatory markers in the early stages and sepsis stage in severe burns, and explore their potential clinical significance. METHODS: This is a 5-year retrospective cohort study involving 107 patients with severe burns (the total body surface area of burn (TBSA) > 50%), in which, neutrophil count, lymphocyte count, monocyte count, the ratio of the product of monocyte and lymphocyte count to neutrophil count (MLPN), procalcitonin (PCT), C-reactive protein (CRP), capillary leakage index (CLI) and creatinine (Scr) were investigated. RESULTS: Within one week after injury, the leukocyte components and MLPN showed a V-shaped change, with a peak immediately after injury and a trough on the 4th or 5th day after injury, while CRP showed a continuous upward trend, and the leukocyte compositions of all patients were negatively correlated with CRP values. The counts of leukocytes components and CRP values in deceased patients were higher than those in surviving patients within 2 days after injury. In the resorption stage, although no significant difference in lymphocyte and monocyte counts between surviving and deceased patients was found, the monocyte and lymphocyte counts in deceased patients were lower than those in surviving patients on the 5th to 7th day after injury, while neutrophils counts and CRP values remained higher than those in surviving patients. And the dynamic changes of MLPN were consistent with those of leukocyte compositions and opposite to those of PCT values. Moreover, MLPN were negatively correlated with CRP, CLI, and Scr values in the early stage of severe burns. In sepsis stage, as the condition worsened, the values of CRP, PCT and neutrophil counts continuously increased with varying degree, while lymphocyte and monocyte counts, and MLPN showed continuously decrease, but rebounded to increase before death. And the occurrence of the trough of monocyte counts was earlier than that of lymphocyte counts, a negative correlation between neutrophil counts and PCT values was found. CONCLUSION: The results of this study revealed the dynamic interrelationships between leucocyte components and inflammatory indicators in the early stages and sepsis stage in severe burns, reflecting the different weightings of inflammatory responses and immune dysfunction in different disease stages and its correlation with outcomes, which providing useful clinical information for dynamic immunomodulatory therapy. Moreover, dynamic monitoring of MLPN value can provide timely information for clinical evaluation.
RESUMO
OBJECTIVE: As an immune/inflammatory indicator, the application of monocyte-lymphocyte ratio (MLR) in the treatment of severe burns is lacking. The aim of this study was to investigate the dynamic changes of the MLR value in the early stage of severe burns and its clinical value. METHODS: This is a 5-year retrospective cohort study involving 100 patients with severe burns (II-III degree and total body surface area (TBSA) >50%), in which the lymphocyte count, monocyte count, MLR value, C-reactive protein (CRP), creatinine (Scr), and capillary leakage index (CLI) were evaluated soon after injury, and 30-day mortality rates were investigated. RESULTS: The MLR values in non-survivors with severe burns were higher than those in survivors in the first two days after injury, while the values on the 3rd, 5th, 6th and 7th day after injury were lower than those in survivors. The differences between the 6th and 7th days after injury were statistically significant. According to the results of logistic and Cox regression analysis, the MLR values on the 6th day after injury were independent predictors of mortality, and the area under the ROC curve of the 6th day MLR for severe burn-delayed death prediction was 0.658 (95% confidence interval, 0.541-0.774), and the optimal cut-off value was 0.991. The 30-day mortality rates differed significantly between the MLR6 ≥0.991 group and the MLR6≤0.991 group (P<0.05). Within one week after injury, the MLR values were negatively correlated with Scr, CRP and CLI levels for severe burns. CONCLUSIONS: Our results revealed the dynamic characteristics of the MLR value in the early stage of severe burns, reflecting important changes in the immune/inflammatory related stress response soon after injury, low MLR level was associated with the worsening of disease condition.
Assuntos
Queimaduras , Monócitos , Humanos , Estudos Retrospectivos , Linfócitos , Contagem de Leucócitos , PrognósticoRESUMO
Model-free reconstruction of bifurcation diagrams of Chua's circuits using the technique of parameter-aware reservoir computing is investigated. We demonstrate that (1) reservoir computer can be utilized as a noise filter to restore the system dynamics from noisy signals; (2) for a single Chua circuit, a machine trained by the noisy time series measured at several sampling states is capable of reconstructing the whole bifurcation diagram of the circuit with a high precision; and (3) for two coupled chaotic Chua circuits with mismatched parameters, the machine trained by the noisy time series measured at several coupling strengths is able to anticipate the variation of the synchronization degree of the coupled circuits with respect to the coupling strength over a wide range. Our studies verify the capability of the technique of parameter-aware reservoir computing in learning the dynamics of chaotic circuits from noisy signals, signifying the potential application of this technique in reconstructing the bifurcation diagram of real-world chaotic systems.
RESUMO
Biofouling remains a persistent challenge within the domains of biomedicine, tissue engineering, marine industry, and membrane separation processes. Multifunctional hydrogels have garnered substantial attention due to their complex three-dimensional architecture, hydrophilicity, biocompatibility, and flexibility. These hydrogels have shown notable advances across various engineering disciplines. The antifouling efficacy of hydrogels typically covers a range of strategies to mitigate or inhibit the adhesion of particulate matter, biological entities, or extraneous pollutants onto their external or internal surfaces. This review provides a comprehensive review of the antifouling properties and applications of hydrogels. We first focus on elucidating the fundamental principles for the inherent resistance of hydrogels to fouling. This is followed by a comprehensive investigation of the methods employed to enhance the antifouling properties enabled by the hydrogels' composition, network structure, conductivity, photothermal properties, release of reactive oxygen species (ROS), and incorporation of silicon and fluorine compounds. Additionally, we explore the emerging prospects of antifouling hydrogels to alleviate the severe challenges posed by surface contamination, membrane separation and wound dressings. The inclusion of detailed mechanistic insights and the judicious selection of antifouling hydrogels are geared toward identifying extant gaps that must be bridged to meet practical requisites while concurrently addressing long-term antifouling applications.
Assuntos
Incrustação Biológica , Hidrogéis , Hidrogéis/farmacologia , Hidrogéis/química , Incrustação Biológica/prevenção & controle , Interações Hidrofóbicas e Hidrofílicas , SilícioRESUMO
BACKGROUND: Microbiome-directed therapies are increasingly utilized to optimize thyroid function in both healthy individuals and those with thyroid disorders. However, recent doubts have been raised regarding the efficacy of probiotics, prebiotics, and synbiotics in improving thyroid function. This systematic review aimed to investigate the potential relationship between probiotics/prebiotics and thyroid function by analyzing the impact on thyroid hormone levels. METHODS: We conducted a comprehensive systematic review and meta-analysis of randomized controlled trials that investigated the effects of probiotics, prebiotics, and synbiotics on free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), and thyroid stimulating hormone receptor antibody (TRAb) levels. We searched for articles from PubMed, Scopus, Web of Science, and Embase up until April 1st, 2023, without any language restriction. Quantitative data analysis was performed using a random-effects model, with standardized mean difference (SMD) and 95% confidence interval as summary statistics. The methods and results were reported according to the PRISMA2020 statement. RESULTS: A total of eight articles were included in this review. The meta-analysis showed no significant alterations in TSH (SMD: -0.01, 95% CI: -0.21, 0.20, P = 0.93; I2: 0.00%), fT4 (SMD: 0.04, 95% CI: -0.29, 0.21, P = 0.73; I2: 0.00%) or fT3 (SMD: 0.45, 95% CI: -0.14, 1.03, P = 0.43; I2: 78.00%), while a significant reduction in TRAb levels was observed (SMD: -0.85, 95% CI: -1.54, -0.15, P = 0.02; I2: 18.00%) following probiotics/prebiotics supplementation. No indication of publication bias was found. CONCLUSIONS: Probiotics/prebiotics supplementation does not influence thyroid hormone levels, but may modestly reduce TRAb levels in patients with Graves' disease.
Assuntos
Prebióticos , Probióticos , Glândula Tireoide , Humanos , Probióticos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Simbióticos , Glândula Tireoide/fisiologia , Hormônios Tireóideos/metabolismo , TireotropinaRESUMO
The inflammatory damage caused by thrombus formation and dissolution can increase the risk of thrombotic complications on top of cell death and organ dysfunction caused by thrombus itself. Therefore, a rapid and precise thrombolytic therapy strategy is in urgent need to effectively dissolve thrombus and resist oxidation simultaneously. In this study, Ce-UiO-66, a cerium-based metal-organic framework (Ce-MOF) with reactive oxygen species (ROS) scavenging properties, encapsulated by low-immunogenic mesenchymal stem cell membrane with inflammation-targeting properties, is used to construct a targeted nanomedicine Ce-UiO-CM. Ce-UiO-CM is applied in combination with external ultrasound stimulation for thrombolytic therapy in rat femoral artery. Ce-UiO-66 has abundant Ce (III)/Ce (IV) coupling sites that react with hydrogen peroxide (H2O2) to produce oxygen, exhibiting catalase (CAT) activity. The multi-cavity structure of Ce-UiO-66 can generate electron holes, and its pore channels can act as micro-reactors to further enhance its ROS scavenging capacity. Additionally, the porous structure of Ce-UiO-66 and the oxygen produced by its reaction with H2O2 may enhance the cavitation effects of ultrasound, thereby improving thrombolysis efficacy.
Assuntos
Cério , Estruturas Metalorgânicas , Espécies Reativas de Oxigênio , Terapia Trombolítica , Animais , Cério/química , Cério/farmacologia , Ratos , Estruturas Metalorgânicas/química , Estruturas Metalorgânicas/farmacologia , Terapia Trombolítica/métodos , Espécies Reativas de Oxigênio/metabolismo , Modelos Animais de Doenças , Trombose/tratamento farmacológico , Trombose/metabolismo , Masculino , Ratos Sprague-Dawley , Peróxido de Hidrogênio/metabolismoRESUMO
BACKGROUND: Many equations to estimate the resting energy expenditure (REE) of patients with burns are currently available, but which of them provides the best guide to optimize nutrition support is controversial. This review examined the bias and precision of commonly used equations in patients with severe burns. METHODS: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases was undertaken on June 1, 2023, to identify studies comparing predicted REE (using equations) with measured REE (by indirect calorimetry [IC]) in adults with severe burns. Meta-analyses of bias and calculations of precisions were performed in each predictive equation, respectively. RESULTS: Nine eligible studies and 12 eligible equations were included. Among the equations, the Toronto equation had the lowest bias (26.1 kcal/day; 95% CI, -417.0 to 469.2), followed by the Harris-Benedict equation × 1.5 (1.5HB) and the Milner equation. The Ireton-Jones equation (303.4 kcal/day; 95% CI, 224.5-382.3) acceptably overestimated the REE. The accuracy of all of the equations was <50%. The Ireton-Jones equation had the relatively highest precision (41.2%), followed by the 1.5HB equation (37.0%) and the Toronto equation (34.7%). CONCLUSION: For adult patients with severe burns, all of the commonly used equations for the prediction of REE are inaccurate. It is recommended to use IC for accurate REE measurements and to use the Toronto equation, 1.5HB equation, or Ireton-Jones equation as a reference when IC is not available. Further studies are needed to propose more accurate REE predictive models.
Assuntos
Metabolismo Basal , Queimaduras , Adulto , Humanos , Queimaduras/metabolismo , Calorimetria Indireta , Metabolismo Energético , Apoio Nutricional , DescansoRESUMO
With the advancement of industrial economies, incidents involving spills of petroleum products have become increasingly frequent. The resulting pollutants pose significant threats to air, water, soil, plant and animal survival, as well as human health. In this study, microcrystalline cellulose served as the matrix and benzoyl peroxide (BPO) as the initiator, while butyl acrylate (BA) and N,N'-methylene bisacrylamide (MBA) were employed as graft monomers. Through free radical graft polymerization, cellulose-graft-poly(butyl acrylate-N,N'-methylene bisacrylamide) [Cell-g-P(BA-MBA)], possessing oil-adsorbing properties, was synthesized. The chemical structure, elemental composition, surface morphology and wetting properties of the graft polymerization products have been characterized, using infrared spectroscopy, elemental analysis, scanning electron microscopy and contact angle testing. The adsorption properties of Cell-g-P(BA-MBA) for various organic solvents and oils were then assessed. The experimental results demonstrated that Cell-g-P(BA-MBA) exhibited a maximum adsorption capacity of 37.55 g/g for trichloromethane. Adsorption kinetics experiments indicated a spontaneous and exothermic process involving physical adsorption, conforming to the Freundlich isotherm model. Furthermore, adsorption kinetics experiments revealed that Cell-g-P(BA-MBA) displayed favorable reuse and regeneration performance, maintaining its adsorption capacity essentially unchanged over fifteen adsorption-desorption cycles.
RESUMO
AIMS: Spinocerebellar Ataxia Type 3 (SCA3) is a rare genetic ataxia that impacts the entire brain and is characterized as a neurodegenerative disorder affecting the neural network. This study explores how alterations in the functional hierarchy, connectivity, and structural changes within specific brain regions significantly contribute to the heterogeneity of symptom manifestations in patients with SCA3. METHODS: We prospectively recruited 51 patients with SCA3 and 59 age-and sex-matched healthy controls. All participants underwent comprehensive multimodal neuroimaging and clinical assessments. In SCA3 patients, an innovative approach utilizing gradients in resting-state functional connectivity (FC) was employed to examine atypical patterns of hierarchical processing topology from sensorimotor to supramodal regions in the cerebellum and cerebrum. Coupling analyses of abnormal FC and structural connectivity among regions of interest (ROIs) in the brain were also performed to characterize connectivity alterations. Additionally, relationships between quantitative ROI values and clinical variables were explored. RESULTS: Patients with SCA3 exhibited either compression or expansion within the primary sensorimotor-to-supramodal gradient through four distinct calculation methods, along with disruptions in FC and structural connectivity coupling. A comprehensive correlation was identified between the altered gradients and the clinical manifestations observed in patients. Notably, altered fractional anisotropy values were not significantly correlated with clinical variables. CONCLUSION: Abnormal gradients and connectivity in the cerebellar and cerebral cortices in SCA3 patients may contribute to disrupted motor-to-supramodal functions. Moreover, these findings support the potential utility of FCG analysis as a biomarker for diagnosing SCA3 and assessing treatment efficacy.
Assuntos
Doença de Machado-Joseph , Imageamento por Ressonância Magnética , Humanos , Feminino , Masculino , Doença de Machado-Joseph/fisiopatologia , Doença de Machado-Joseph/diagnóstico por imagem , Doença de Machado-Joseph/complicações , Doença de Machado-Joseph/patologia , Pessoa de Meia-Idade , Adulto , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Encéfalo/patologia , Vias Neurais/fisiopatologia , Vias Neurais/diagnóstico por imagem , Estudos Prospectivos , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiopatologia , Rede Nervosa/patologia , Imagem de Tensor de Difusão/métodosRESUMO
Magnetic carbon-based catalysts with environmental friendliness have exhibited prominent effects on advanced oxidation processes. Herein, a multi-level FeCo/N-doped carbon nanosheet (FeCo/CNS) was synthesized by facile impregnation iron-cobalt salt onto cotton and followed by confined pyrolysis. We identified excellent advantages of the modified FeCo/CNS materials: (i) The convenience of the synthesis method and (ii) The dual effect of sterilization and contaminant degradation achieved through the FeCo/CNS-activated Peroxymonosulfate (PMS). The comparative experimental showed that FeCo/CNS could provide favorable catalytic performance, completely removing bisphenol A (BPA) and tetracycline (TC) within 5 min. Moreover, the potent sterilization properties against Staphylococcus aureus and Escherichia coli were also verified. Analysis of the degradation pathway confirmed the existence of intermediates, and toxicological research demonstrated that the toxicity of the degradation intermediates of BPA gradually decreased over time. Our research provided an excellent application of FeCo/CNS in PMS oxidation and sterilization inactivation.
Assuntos
Compostos Benzidrílicos , Carbono , Compostos de Ferro , Fenóis , Peróxidos , FerroRESUMO
In recent years, due to the shortage of blood products, some extensive burn patients were forced to adopt an "ultra-restrictive" transfusion strategy, in which the hemoglobin levels of RBC transfusion thresholds were < 7 g/dl or even < 6 g/dl. This study investigated the prognostic impacts of ultra-restrictive RBC transfusion in extensive burn patients. This retrospective multicenter cohort study recruited extensive burns (total body surface area ≥ 50%) from three hospitals in Eastern China between 1 January 2016 and 30 June 2022. Patients were divided into an ultra-restrictive transfusion group and a restrictive transfusion group depending on whether they received timely RBC transfusion at a hemoglobin level < 7 g/dl. 1:1 ratio propensity score matching (PSM) was performed to balance selection bias. Modified Poisson regression and linear regression were conducted for sensitive analysis. Subsequently, according to whether they received timely RBC transfusion at a hemoglobin level < 6 g/dl, patients in the ultra-restrictive transfusion group were divided into < 6 g/dl group and 6-7 g/dl group to further compare the prognostic outcomes. 271 eligible patients with extensive burns were included, of whom 107 patients were in the ultra-restrictive transfusion group and 164 patients were in the restrictive transfusion group. The ultra-restrictive transfusion group had a significantly lower RBC transfusion volume than the restrictive transfusion group (11.5 [5.5, 21.5] vs 17.3 [9.0, 32.5] units, p = 0.004). There were no significant differences between the two groups in terms of in-hospital mortality, risk of infection, hospital length of stay, and wound healing time after PSM or multivariate adjustment (p > 0.05). Among the ultra-restrictive transfusion group, patients with RBC transfusion threshold < 6 g/dl had a significantly higher hospital mortality than 6-7 g/dl (53.1% vs 21.3%, p = 0.001). For extensive burn patients, no significant adverse effects of ultra-restrictive RBC transfusion were found in this study. When the blood supply is tight, it is acceptable to adopt an RBC transfusion threshold of < 7 g/dL but not < 6 g/dL.
Assuntos
Queimaduras , Transfusão de Eritrócitos , Humanos , Transfusão de Eritrócitos/efeitos adversos , Estudos de Coortes , Transfusão de Sangue , Queimaduras/terapia , Queimaduras/etiologia , Hemoglobinas/análiseRESUMO
BACKGROUND: Several models predicting mortality risk of burn patients have been proposed. However, models that consider all such patients may not well predict the mortality of patients with extensive burns. METHOD: This retrospective multicentre study recruited patients with extensive burns (≥ 50% of the total body surface area [TBSA]) treated in three hospitals of Eastern China from 1 January 2016 to 30 June 2022. The performances of six predictive models were assessed by drawing receiver operating characteristic (ROC) and calibration curves. Potential predictors were sought via "least absolute shrinkage and selection operator" regression. Multivariate logistic regression was employed to construct a predictive model for patients with burns to ≥ 50% of the TBSA. A nomogram was prepared and the performance thereof assessed by reference to the ROC, calibration, and decision curves. RESULT: A total of 465 eligible patients with burns to ≥ 50% TBSA were included, of whom 139 (29.9%) died. The FLAMES model exhibited the largest area under the ROC curve (AUC) (0.875), followed by the models of Zhou et al. (0.853) and the ABSI model (0.802). The calibration curve of the Zhou et al. model fitted well; those of the other models significantly overestimated the mortality risk. The new nomogram includes four variables: age, the %TBSA burned, the area of full-thickness burns, and blood lactate. The AUCs (training set 0.889; internal validation set 0.934; external validation set 0.890) and calibration curves showed that the nomogram exhibited an excellent discriminative capacity and that the predictions were very accurate. CONCLUSION: For patients with burns to ≥ 50ï¼ of the TBSA, the Zhou et al. and FLAMES models demonstrate relatively high predictive ability for mortality. The new nomogram is sensitive, specific, and accurate, and will aid rapid clinical decision-making.
Assuntos
Superfície Corporal , Queimaduras , Nomogramas , Curva ROC , Humanos , Queimaduras/mortalidade , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , China/epidemiologia , Modelos Logísticos , Medição de Risco/métodos , Idoso , Área Sob a Curva , Adulto JovemRESUMO
Liver impairment caused by VCM has been linked to irreversible damage such as fibrosis, necrosis, hepatocellular carcinoma, and liver angiosarcoma. However, the ability to detect abnormalities during initial phase have not been achieved so far. Thus, this study aimed to investigate the effect of interleukin 8 (IL-8) and C-X-C chemokines 2 (CXCR2) on screening for a VCM-exposed group (n = 227) from a PVC manufacturing factory compared to a control group (n = 110) in Tianjin City in 2020 with influence factors evaluation. Ambient concentrations of VCM and health archives from 2012 to 2018 were collected for establishing the dose-effect trend. A cross-sectional survey in 2020 was performed to measure TDGA, IL-8, CXCR2, 8-OHdG, SOD, GPX, CAT, MDA, and ROS levels. Results indicated a continuous increased incidence on liver abnormalities despite a fluctuated downward trend in cumulative time-weighted average (CTWA) VCM concentrations over the years. ALT, AST, and AST/ALT ratio all contributed to liver abnormalities that contained fatty liver, liver calcification, and liver cysts, IL-8 and CXCR2 correlated with each other strongly and showed significant associations with oxidative stress markers, even AST/ALT ratio. IL-8 (>1547 µg/m3) or CXCR2 (<139 µg/m3) influenced the AST/ALT ratio through reciprocal interactions under oxidative stress injury, CXCR2 (>222 µg/m3), working years of 21 to 30 (a) and 11 to 20 (a), TDGA (>1.52 mg/L), alcohol consumption, smoking habit, and a less sleeping duration of <4 h per day would also be potential factors affecting the AST/ALT ratio. In conclusion (1) even with decreased VCM concentrations in PVC manufacturing factories liver abnormalities that contained fatty liver, liver calcification, and liver cysts could still occur due to oxidative stress injury with involvement of IL-8 and CXCR2. The status of protective measure and appropriate mask types also play a role; (2) the AST/ALT ratio could be a specific indicator for detecting abnormalities when combined with liver B ultrasonography results before impairment altered from bad to worse; and (3) factors such as definite medication history, fully broken protective facilities, alcohol consumption, less sleeping duration, inappropriate mask types, and longer working years could also influence AST/ALT ratio alterations through complex interactions.
RESUMO
Reactive oxygen species (ROS) play an important role in biological milieu. Recently, the rapid growth in our understanding of ROS and their promise in antibacterial applications has generated tremendous interest in the combination of ROS generators with bulk hydrogels. Hydrogels represent promising supporters for ROS generators and can locally confine the nanoscale distribution of ROS generators whilst also promoting cellular integration via biomaterial-cell interactions. This review highlights recent efforts and progress in developing hydrogels derived from biological macromolecules with embedded ROS generators with a focus on antimicrobial applications. Initially, an overview of passive and active antibacterial hydrogels is provided to show the significance of proper hydrogel selection and design. These are followed by an in-depth discussion of the various approaches for ROS generation in hydrogels. The structural engineering and fabrication of ROS-laden hydrogels are given with a focus on their biomedical applications in therapeutics and diagnosis. Additionally, we discuss how a compromise needs to be sought between ROS generation and removal for maximizing the efficacy of therapeutic treatment. Finally, the current challenges and potential routes toward commercialization in this rapidly evolving field are discussed, focusing on the potential translation of laboratory research outcomes to real-world clinical outcomes.
Assuntos
Anti-Infecciosos , Hidrogéis , Hidrogéis/farmacologia , Hidrogéis/química , Espécies Reativas de Oxigênio , Polímeros/química , AntibacterianosRESUMO
Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is characterised by an uncontrolled inflammatory response, and current treatment strategies have limited efficacy. Although the protective effect of M2-like macrophages (M2φ) and their extracellular vesicles (EVs) has been well-documented in other inflammatory diseases, the role of M2φ-derived EVs (M2φ-EVs) in the pathogenesis of ALI/ARDS remains poorly understood. The present study utilised a mouse model of lipopolysaccharide-induced ALI to first demonstrate a decrease in endogenous M2-like alveolar macrophage-derived EVs. And then, intratracheal instillation of exogenous M2φ-EVs from the mouse alveolar macrophage cell line (MH-S) primarily led to a take up by alveolar macrophages, resulting in reduced lung inflammation and injury. Mechanistically, the M2φ-EVs effectively suppressed the pyroptosis of alveolar macrophages and inhibited the release of excessive cytokines such as IL-6, TNF-α and IL-1ß both in vivo and in vitro, which were closely related to NF-κB/NLRP3 signalling pathway inhibition. Of note, the protective effect of M2φ-EVs was partly mediated by miR-709, as evidenced by the inhibition of miR-709 expression in M2φ-EVs mitigated their protective effect against lipopolysaccharide-induced ALI in mice. In addition, we found that the expression of miR-709 in EVs derived from bronchoalveolar lavage fluid was correlated negatively with disease severity in ARDS patients, indicating its potential as a marker for ARDS severity. Altogether, our study revealed that M2φ-EVs played a protective role in the pathogenesis of ALI/ARDS, partly mediated by miR-709, offering a potential strategy for assessing disease severity and treating ALI/ARDS.
Assuntos
Lesão Pulmonar Aguda , Vesículas Extracelulares , MicroRNAs , Síndrome do Desconforto Respiratório , Humanos , Camundongos , Animais , Lipopolissacarídeos , Vesículas Extracelulares/metabolismo , Lesão Pulmonar Aguda/induzido quimicamente , Lesão Pulmonar Aguda/metabolismo , Lesão Pulmonar Aguda/patologia , Macrófagos/metabolismo , Síndrome do Desconforto Respiratório/induzido quimicamente , Síndrome do Desconforto Respiratório/metabolismo , MicroRNAs/metabolismoRESUMO
Angiogenesis is a prominent component during the highly regulated process of wound healing. The application of exogenous vascular endothelial growth factor (VEGF) has shown considerable potential in facilitating angiogenesis. However, its effectiveness is often curtailed due to chronic inflammation and severe oxidative stress in diabetic wounds. Herein, an inflammation-responsive hydrogel incorporating Prussian blue nanoparticles (PBNPs) is designed to augment the angiogenic efficacy of VEGF. Specifically, the rapid release of PBNPs from the hydrogel under inflammatory conditions effectively alleviates the oxidative stress of the wound, therefore reprogramming the immune microenvironment to preserve the bioactivity of VEGF for enhanced angiogenesis. In vitro and in vivo studies reveal that the PBNPs and VEGF co-loaded hydrogel is biocompatible and possesses effective anti-inflammatory properties, thereby facilitating angiogenesis to accelerate the wound healing process in a type 2 diabetic mouse model.