Development of a prediction model for enteral feeding intolerance in intensive care unit patients: A prospective cohort study.

BACKGROUND: Enteral nutrition (EN) is essential for critically ill patients. However, some patients will have enteral feeding intolerance (EFI) in the process of EN. AIM: To develop a clinical prediction model to predict the risk of EFI in patients receiving EN in the intensive care unit. METHODS: A prospective cohort study was performed. The enrolled patients' basic information, medical status, nutritional support, and gastrointestinal (GI) symptoms were recorded. The baseline data and influencing factors were compared. Logistic regression analysis was used to establish the model, and the bootstrap resampling method was used to conduct internal validation. RESULTS: The sample cohort included 203 patients, and 37.93% of the patients were diagnosed with EFI. After the final regression analysis, age, GI disease, early feeding, mechanical ventilation before EN started, and abnormal serum sodium were identified. In the internal validation, 500 bootstrap resample samples were performed, and the area under the curve was 0.70 (95%CI: 0.63-0.77). CONCLUSION: This clinical prediction model can be applied to predict the risk of EFI.

Benefits of Early Ambulation in Elderly Patients Undergoing Lumbar Decompression and Fusion Surgery: A Prospective Cohort Study.

OBJECTIVE: To evaluate the effects of early ambulation on elderly patients' postoperative physical functional outcomes, complications, 90-day readmission rate, and the length of postoperative hospital stay. METHODS: This is a prospective cohort study conducted between June 2019 and December 2019. The study enrolled 86 elderly patients (39 males) with newly diagnosed lumbar degenerative disease undergoing single-segment decompression and fusion surgerywere enrolled. Of all 86 patients, 39 voluntarily joined the early ambulation group, and 47 joined the regular ambulation group. The early ambulation group included patients ambulated within 4 h postoperatively, whereas the regular ambulation group included patients who were ambulatory at a minimum of 24 h after surgery. Participants' baseline characteristics, surgical information, ambulation ability, degree of pain, functional scores, postoperative complications, 90-day readmission rate, and length of postoperative hospital stay were recorded. RESULTS: Participants' baseline demographic characteristics were balanced between the early ambulation group and the regular ambulation group. The operative time and blood loss were similar between groups. The time before the first-time ambulation was 4 ± 0.5 h in the early ambulation group and 28 ± 4.5 h in the regular ambulation group. Ambulating distance was significantly longer in the early ambulation group compared with the regular ambulation group on the 1st (63 ± 45 vs 23 ± 60 m), the 2nd (224 ± 100 vs 101 ± 130 m), and the 3rd (280 ± 102.5 vs 190 ± 170 m) ambulation days based on generalized estimating equation analyses. Generalized estimating equation analyses also demonstrated that the ambulating time was longer in the early ambulation group compared with the regular ambulation group on the 1st (10 ± 5 vs 10 ± 5 min), the 2nd (19 ± 7 vs 15 ± 5 min), and the 3rd (22 ± 16.5 vs 27 ± 12 min) ambulation days. Patients in the regular ambulation group experienced a higher degree of pain than the early ambulation group patients, with an odds ratio of 1.627 (P = 0.002). Short-term functional independence was superior in the early ambulation group, with a lower Roland-Morris disability questionnaire score (P = 0.008) and Oswestry disability index (P < 0.001). The incidences of postoperative urinary retention (early ambulation group: 7.7%, regular ambulation group: 25.5%, P = 0.030) and ileus (early ambulation group: 0%, regular ambulation group: 12.8%, P = 0.030) were significantly higher in the regular ambulation group. The prevalence of at least one complication rate was significantly lower in the early ambulation group than in the regular ambulation group (early ambulation group, 23.1%; regular ambulation group, 46.8%, P = 0.022). The duration of indwelling of the drainage catheter was shorter in the early ambulation group (early ambulation group, 68 ± 24 h; regular ambulation group, 78 ± 20 h, P = 0.001), and the length of the postoperative hospital stay was also shorter in the early ambulation group (early ambulation group, 4 ± 0 days; regular ambulation group: 5 ± 2 days, P < 0.001). However, there was no statistical difference in the 90-day readmission rate between groups. CONCLUSION: Early ambulation improved patients' postoperative functional status, decreased the incidence of complications, and shortened postoperative hospital stay in elderly patients undergoing lumbar decompression and fusion surgery.

[Concurrent Collection of Ammonia Gas and Aerosol Ammonium in Urban Beijing During National Celebration Days Utilizing an Acid-Coated Honeycomb Denuder in Combination with a Filter System].

Since 2013, the Chinese government implemented the Air Pollution Prevention and Control Action Plan. As a result, the atmospheric concentrations of sulfate reduced significantly, whereas the nitrate concentrations remain relatively high due to the excess of ammonia (NH3). To date, there is no official observation network monitoring NH3 concentrations in China. Previous studies have focused on NH3 or ammonium (NH4+) separately. These limitations hinder a complete understanding of their dynamic changes due to the rapid gas-to-particle conversion. In this study, the concentrations of NH3 and NH4+ were measured concurrently in urban Beijing during autumn 2019 utilizing an acid-coated denuder-filter combination with a time resolution from 2 h (PM2.5>35 µg·m-3) to 5 h (PM2.5<35 µg·m-3). The mean concentrations of NH3 and NH4+ during the study were (4.1±2.9)µg·m-3 and (1.7±1.4) µg·m-3, respectively. The temporal patterns of NH3 or NH4+ coincided with that of PM2.5, CO, and NO2 throughout the sampling period. The diurnal distributions of NH3 were bimodal, both on polluted (PM2.5>75 µg·m-3) and non-polluted (PM2.5<75 µg·m-3) days, peaking at 21:30-05:30 and 05:30-08:30, respectively. The NH3 concentrations on polluted days were relatively lower during 17:30-21:30, which may be related to higher wind speeds. In contrast to NH3, NH4+ had an obvious peak during 17:30-21:30 due to the formation of ammonium nitrate. The meteorological conditions favor the gas-to-particle conversion on polluted days, resulting in a lower NH3/NH4+ ratio of 0.8. However, this value may reach 2.8 on non-polluted days. The concentrations of NH3, CO, NO2, SO2, and PM2.5 in the emission control period showed a significant increase greater than or comparable to those in the non-control period by 54.2%, 40.4%, 33.3%, 0%, and 49.4%, respectively. This result shows that the stagnant conditions offset the benefit of emission control actions implemented during and before the National Celebration Day.

[Metabolism Changes of Main Active Ingredients During Liquid Fermentation of Cordyceps militaris].

Objective: To study the accumulation and changes of main active ingredients during liquid fermentation of Cordyceps militaris. Methods: The militaris varity GIM5. 270 was selected to extended fermentation time to 20 days on the basic fermentation condition. Meanwhile, the accumulation and dynamic changes of biomass, polysaccharide, cordycepic acid, adenosine and cordycepin in the fermentation system were detected by the analytical method of contents per 24 hour. Results: The foundation culture medium composed of complex nitrogen sources could reach a higher biomass level than single nitrogen sources. In addition, with the development of time, the mycelial biomass increased, the contents of polysaccharide and cordycepic acid( D-mannitol) increased firstly and then decreased, the contents of adenosine decreased gradually and cordycepin( 3-deoxy adenosine) increased gradually. Conclusion: The whole system is observed autolyzed phenomenon caused by absorbing self-generated nutrients. In this study, the dynamic changes of the main active ingredients in the fermentation system are researched and the optimum collecting time is determined, which provides evidence for reaching a better yield of the active ingredients.

Cecropin suppresses human hepatocellular carcinoma BEL- 7402 cell growth and survival in vivo without side-toxicity.

Conventional chemotherapy against hepatocellular carcinoma typically causes various side effects. Our previous study showed that cecropin of Musca domestica can induce apoptosis in human hepatocellular carcinoma BEL-7402 cells in vitro. However, whether cecropin inhibits BEL-7402 cell in vivo and the question of possible side effects remained undentified. The present study confirmed tumor-inhibitory effects of cecropin in vivo, and furthermore strongly suggested that cecropin cytotoxicity in BEL-7402 cells in vivo may be mainly derived from its pro-apoptotic action. Specifically, we found that cecropin exerted no obvious side effects in tumor-bearing mice as it had no significant hematoxicity as well as visceral toxicity. Therefore, cecropin may be a potential candidate for further investigation as an antitumor agent against hepatocellular carcinoma.

Effect of lipopolysaccharide mediating early- and late- activated THP-1 macrophages on ECV304 endothelial cell dysfunction: dysregulation of secretion of VEGF and proliferation and migration of ECV304.

OBJECTIVE: To investigate the different effects of lipopolysaccharide (LPS) mediating early and late activated THP-1 macrophages (Mφ) on ECV304 endothelial cell dysfunction: dysregulation of secretion of VEGF and proliferation, and migration of ECV304. METHODS: The inflammatory Mφ was divided into early phase (2 h) group and late phase (24 h) group according the different exposure time to LPS. Then the inflammatory Mφ and ECV304 were co-cultured via transwell chambers in both non-contacting and contacting systems. The levels of VEGF were determined by ELISA, and the proliferation index and apoptosis of ECV304 were analyzed by FACSCalibur. The migration of ECV304 was tested by modified Boyden chamber assay. RESULTS: The level of VEGF and the proliferation of ECV304 cell were increased more apparently in early-phase Mφ-treated group. But the proportion of early apoptotic and late apoptotic/necrotic cells in late-phase Mφ-treated group were higher than that of the former. Migration rate of ECV304 was enhanced in early-phase Mφ-treated group. All those effects were more significant in contacting system comparing with no-contacting system. CONCLUSION: Early-activated macrophages (mediated by LPS) could increase the secretion of VEGF and promote the proliferation and migration of ECV304; while the late-activated macrophages could promote/enhance the apoptosis of ECV304 more significant in contacting system when (it was) compared with no-contacting system.

Effects of Musca domestica cecropin on the adhesion and migration of human hepatocellular carcinoma BEL-7402 cells.

This study was designed to explore the effects of Musca domestica antimicrobial peptides cecropin on the adhesion and migration of human hepatocellular carcinoma BEL-7402 cells. The adhesive and migratory capacities were determined by adhesion assay and transwell assay, respectively. The changes in microvilli of tumor cells were determined by scanning electron microscopy (SEM). Western blotting and quantitative polymerase chain reaction (qPCR) were carried out to determine the expression levels of proteins related to adhesion and migration, such as matrix metalloproteinase-2 (MMP2), tissue inhibitors of metalloproteinase-2 (TIMP2), and epithelial cadherin (E-cadherin). We found that Musca domestica cecropin inhibited the adhesion and migration of BEL-7402 cells, which also displayed curling microvilli, increased ball structures on cell surface, gradually broken connections between tumor cells, and even disappeared microvilli on some cells. The expression of MMP2 was significantly reduced after cecropin treatment, while the levels of TIMP2 and E-cadherin were significantly increased. These results suggest that Musca domestica cecropin inhibits the adhesion and migration of human hepatocellular carcinoma BEL-7402 cells by destroying the microvilli of tumor cells and changing the expression of MMP2, TIMP2 and E-cadherin.

ß-defensin 2 as an adjuvant promotes anti-melanoma immune responses and inhibits the growth of implanted murine melanoma in vivo.

ß-defensin 2 is a small antimicrobial peptide of the innate immune system and has been thought to regulate anti-tumor immunity. However, little is known on whether ß-defensin 2 could modulate melanoma-specific NK and T cell responses. In this study, we first cloned the murine ß-defensin 2 gene by RT-PCR and generated the ß-defensin 2 stably expressing B16 cells (B16-mBD2). Subsequently, we evaluated whether vaccination with irradiated B16-mBD2 could modulate the growth of implanted B16 cells and determined the potential mechanisms underlying the action of B16-mBD2 vaccine in modulating the growth of B16 tumors in C57BL/6. We found that vaccination with irradiated B16-mBD2, but not with control B16-p or parental B16, inhibited the development and progression of B16 tumors, and prolonged the survival of tumor-bearing mice. However, vaccination with irradiated B16-mBD2 failed to inhibit the development of B16 tumors in the CD4(+)- or CD8(+)-depleted recipients. Furthermore, vaccination with irradiated B16-mBD2 stimulated strong NK activity and promoted potent B16-specific CTL responses, accompanied by augmenting IFN-γ and IL-12, but not IL-4, responses in the recipient mice. Moreover, vaccination with irradiated B16-mBD2 promoted the infiltration of CD8(+) and CD4(+) T, NK cells and macrophages in the tumor tissues. These data suggest ß-defensin 2 may act as a positive regulator, promoting anti-tumor NK and T cell responses in vivo. Therefore, ß-defensin 2 may be used for the development of immunotherapy for the intervention of melanoma.

[The target of Musca domestica cecropin on human hepatocellular carcinoma BEL-7402 cells].

Human hepatocellular carcinoma BEL-7402 cells were treated with 50 micromol/L Musca domestica cecropin for 12 h, and observed under scanning electron microscope. The effect of Musca domestica cecropin labeled with FITC (FITC-cecropin) on BEL-7402 cells was detected by laser scanning confocal microscopy. The scanning electron microscopy showed that most microvilli on the surface of BEL-7402 cells disappeared at 12 h after cecropin treatment. The laser scanning confocal microscopy revealed that most FITC-cecropin combined with BEL-7402 cell membrane, and partly in the cytoplasm.

The exploration of the antibacterial mechanism of fe3+ against bacteria

This study demonstrated that the bacteria could adsorb Fe3+ and reduce Fe3+ to Fe2+. Iron had significant bacteriostatic effects, which were directly proportional to the iron concentration and under the influence of pH and chelator. It presumed that the inhibition of Fe3+ acts through the formation of hydroxyl free radicals.

[Genotype, melanocortin 1 receptor and ultraviolet radiation].

Recent work on the melanocortin 1 receptor (MC1R) suggests that MC1R plays a central role in regulation of eumelanin (brown/black melanins) and phaeomelanin (red/yellow melanins) synthesis within the mammalian melanocyte. In the mouse,genetic studies show that the MC1R appears to be a unique, bifunctionally controlled receptor, activated by alpha-MSH and antagonized by agouti,both of which contribute to the variability seen in mammalian coat color. Variants of this receptor are associated with different animal's coat,human skin and hair colors. In addition, cutaneous pigmentation is a major determinant of the cutaneous response to ultraviolet radiation,and consequently of the risk of developing skin cancer. MC1R variants are a risk factor for melanoma susceptibility.