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Objective: To explore the risk factors for carbapenem-resistant Enterobacterales (CRE) infection and death. Methods: A case-control analysis of 482 inpatients in 18 secondary or tertiary hospitals in Beijing in 2018 was conducted. Patients infected by CRE were selected as the case group (n=247), and infected by carbapenem susceptible Enterobacterales (CSE) as the control group (n=235). The risk factors and clinical prognosis of CRE infection were analyzed by single factor analysis and multivariate logistic regression analysis. Results: CRE were resistant to most antimicrobials, but were highly sensitive to colistin and tigecycline, with sensitivity of 94.0% and 99.5%, respectively. Multivariate analysis showed that prior 30-day tracheal intubation (OR=2.607, 95%CI: 1.655-4.108, P<0.001), empirical treatment using third or fourth generation cephalosporins (OR=2.339, 95%CI: 1.438-3.803, P=0.001), carbapenems (OR=2.468, 95%CI: 1.610-3.782, P<0.001) and quinolones (OR=2.042, 95%CI: 1.268-3.289, P=0.003) were independent risk factors for CRE infection. Mechanical ventilation (OR=3.390, 95%CI: 1.454-7.904, P=0.005), heart failure (OR=4.679, 95%CI: 1.975-11.083, P<0.001), moderate or severe liver disease (OR=3.057, 95%CI: 1.061-8.806, P=0.038), prior 30-day quinolones exposure (OR=2.882, 95%CI: 1.241-6.691, P=0.014) and septic shock (OR=7.772, 95%CI: 3.505-17.233, P<0.001) were independent risk factors for death after CRE infection. Conclusions: Reducing the use of antimicrobials and invasive procedures such as prior 30-day tracheal intubation may reduce the probability of CRE infection. Grading the severity of the underlying disease in patients with CRE infection, as well as predicting and preventing the occurrence of septic shock will help reduce the risk of death.
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Enterobacteriaceae Resistentes a los Carbapenémicos , Infección Hospitalaria , Infecciones por Enterobacteriaceae , Antibacterianos/uso terapéutico , Carbapenémicos , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones por Enterobacteriaceae/epidemiología , Humanos , Pronóstico , Factores de RiesgoRESUMEN
OBJECTIVE: To study the expression of ALK protein in pulmonary adenocarcinoma as detected by Ventana immunohistochemistry, with correlation of clinicopathologic features. METHODS: Immunohistochemical study for ALK protein using Ventana ALK (D5F3) kit was carried in 7 371 pulmonary adenocarcinoma samples. The clinicopathologic features were subsequently analyzed. RESULTS: ALK fusion protein was detected in 446 of the 7 371 lung adenocarcinoma samples studied (6.05%). The ALK positivity rate in small biopsy samples was higher than that in surgical specimens [9.02% (153/1 696) versus 5.16% (293/5 675); P<0.01]. ALK fusion protein expression correlated with patient age, sample type and smoking history. ALK positivity rate in each age group increased with younger patient age. ALK positivity rate was 45.45% (10/22) in patients younger than 30 years old. The positivity rate of ALK fusion protein in adenocarcinoma in-situ, minimally invasive adenocarcinoma and invasive adenocarcinoma was 0, 0.48% (2/418) and 5.63% (291/5 165), respectively. The differences of ALK positivity rate amongst different subtypes had statistical significance (P<0.01). Invasive mucinous adenocarcinoma had highest ALK positivity rate, followed by invasive adenocarcinoma with predominantly solid pattern. CONCLUSIONS: ALK fusion protein is more often found in young patients with pulmonary adenocarcinoma, especially in those younger than 30 years old. ALK fusion protein is rarely expressed in early-stage pulmonary adenocarcinoma. Invasive mucinous adenocarcinoma and invasive adenocarcinoma with solid pattern have higher ALK positivity rate than other adenocarcinoma subtypes.
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Adenocarcinoma Mucinoso/enzimología , Adenocarcinoma/enzimología , Neoplasias Pulmonares/enzimología , Proteínas de Neoplasias/metabolismo , Proteínas Tirosina Quinasas Receptoras/metabolismo , Adenocarcinoma/patología , Adenocarcinoma del Pulmón , Adenocarcinoma Mucinoso/patología , Adulto , Quinasa de Linfoma Anaplásico , Femenino , Humanos , Inmunohistoquímica , Hibridación Fluorescente in Situ , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana EdadRESUMEN
Skeletal muscle growth is regulated by both positive and negative factors, such as myogenic regulatory factors (MRFs) and myostatin (MSTN), and involves both hyperplasia and hypertrophy. In the present study, morphological changes during muscle development in Megalobrama amblycephala were characterized and gene expression levels were measured by quantitative real-time polymerase chain reaction (qRT-PCR) analysis in juvenile [60, 90, 120, and 180 days post-hatching (dph)] and adult fish. Our results show that during muscle development, the frequency of muscle fibers with a diameter <20 µm dramatically decreased in both red and white muscles, with a concomitant increase in the frequency of >30 µm fibers in red muscle and >50 µm fibers in white muscle. At 90-120 dph, the ratio of hyperplastic to hypertrophic areas in red and white muscles increased, but later decreased at 120-180 dph. The effect of hypertrophy was significantly larger than hyperplasia during these phases. qRT-PCR indicated MRF and MSTN (MSTNa and MSTNb) genes had similar expression patterns that peaked at 120 dph, with the exception of MSTNa. This new information on the molecular regulation of muscle growth and rapid growth phases will be of value to the cultivation of M. amblycephala.
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Cyprinidae/crecimiento & desarrollo , Cyprinidae/genética , Regulación del Desarrollo de la Expresión Génica , Desarrollo de Músculos/genética , Músculos/anatomía & histología , Envejecimiento , Animales , Estatura , Peso Corporal , Proteínas de Peces/genética , Proteínas de Peces/metabolismo , Humanos , Hipertrofia , Fibras Musculares Esqueléticas/metabolismoRESUMEN
Apolipoprotein E (APOE) is recognized for its importance in lipoprotein metabolism and cardiovascular disease. We evaluated the association between APOE rs4420638 genotypes and circulating lipid concentrations along with the risk of coronary heart disease (CHD). We conducted a case-control study involving 1508 individuals to investigate the contribution of rs4420638 to the risk of CHD in Han Chinese. In addition, we performed a meta-analysis to evaluate the association between rs4420638 and CHD in Europeans and Asians. The results show that rs4420638 is significantly correlated with increased CHD risk in male Han Chinese [P = 0.040, odds ratio (OR) = 1.34, 95% confidential interval (95%CI) = 1.01-1.78] and is likely to increase the risk of CHD under the dominant model in males (P = 0.036, OR = 1.38, 95%CI = 1.02-1.88). A further subgroup analysis by rs4420638 genotype found a significant association of rs4420638 AA with high-density lipoprotein cholesterol (HDL-C) (P = 0.012) and APOA-I levels (P = 0.0001) in males. The meta-analysis suggests that rs4420638 significantly increases the risk of CHD (OR = 1.18, 95%CI = 1.14-1.22, P < 0.0001, fixed-effect method). Our case-control study shows that rs4420638 genotype AA has a significant association with the concentrations of circulating HDL-C and APOA-I in CHD in Han Chinese males. The meta-analysis suggests that rs4420638 is associated with CHD risk in Europeans and Asians.
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Apolipoproteína A-I/sangre , Apolipoproteínas E/genética , HDL-Colesterol/sangre , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/genética , Polimorfismo Genético/genética , Anciano , Estudios de Casos y Controles , Humanos , Masculino , Persona de Mediana EdadRESUMEN
This study examined carcass yields and meat quality traits between Baicheng-You (BCY) chickens and Arbor Acres (AA) broilers. Thirty birds for each strain were selected and slaughtered at market ages of 49 d for AA broilers and 120 d for BCY. The results showed that BCY chickens had lower dressing (2.99%), semi-evisceration (5.10%), breast muscle (5.80%), and abdominal fat (1.55%) than those for AA broilers (P < 0.05). However, the leg muscle (%) of BCY chickens was greater (3.14%) than that of AA broilers (P < 0.05). The meat pH45min and pH24h value variations of these 2 breeds were within the normal range (5.53-6.70). The meat color density (optical density, OD) of thigh muscle was darker than breast muscles in both strains (P < 0.05). The cooking loss (%) of breast and thigh muscles of BCY chickens (18.81 and 20.20%, respectively) was also significantly lower (P < 0.05) than that of same muscles of AA broilers (26.41 and 27.33%, respectively). The shear force of breast meat in both breeds was lower (P < 0.05) than that of their thigh meat. The moisture of breast muscle of BCY chickens (72.93%) was lower (P < 0.05) than breast muscles of AA broilers (74.43%). The CP content of breast muscles was greater (P < 0.05) than its thigh muscles of same strain, but it had no significant (P > 0.05) difference of CP content in the same muscles of the 2 strains. The intramuscular fat (IMF) content was greater (P < 0.05) in thigh muscles of BCY chickens (6.80%) than those of AA broilers (4.28%), and inosine-5'-monophosphate (IMP) content was greater (P < 0.05) in breast and thigh muscles of BCY chickens (IMP: 3.79 and 1.47 mg/g) than same muscles in AA broilers (1.42 and 0.47 mg/g). In this study, muscle from 120-d-old BCY chickens was judged to have better quality traits with regard to cooking loss, drip loss, contents of IMF, and IMP compared with meat from 42-d-old AA broilers. At the same time, greater carcass yields, greater thigh pH24, and lower IMF content were observed in AA broilers compared with the BCY chickens.
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Pollos/fisiología , Carne/análisis , Fibras Musculares Esqueléticas/fisiología , Músculo Esquelético/fisiología , Animales , Pollos/genética , Pollos/crecimiento & desarrollo , Femenino , MasculinoRESUMEN
A thermostable novel lectin with a molecular weight of 30.4 kDa was isolated from dried fruiting bodies of Agaricus arvensis. It was a dimer made up of two 15.2 kDa subunits. The lectin was unadsorbed on DEAE-cellulose in 10 mM phosphate buffer (pH 7.5), subsequently adsorbed on CM-cellulose in 10 mM NaAc buffer (pH 4.6) and then on SP-Sepharose in 10 mM NaAc buffer (pH 4.6), and finally purified by fast protein liquid chromatography-gel filtration on Superdex 75. The hemagglutinating activity of the lectin was stable at temperatures up to 90 °C. The activity was preserved in concentrations of NaOH solution up to 50 mM, but was sensitive to HCl and declined to 12.5% in 12.5 mM HCl. The activity was unaffected by Ca(2+), Mn(2+), Zn(2+) and Mg(2+) ions, but was activated by Al(3+) and Fe(3+) ions. Among the carbohydrates tested, only inulin could inhibit the hemagglutinating activity of the lectin. It did not exhibit anti-HIV reverse transcriptase activity. Proliferation of HepG2 and MCF7 tumor cells was inhibited by the lectin with an IC(50) of 1.64 and 0.82 µM, respectively. The lectin was devoid of antifungal activity. The lectin has a remarkable thermostablity and a unique N-terminal amino acid sequence, TYAVLNFVYG. The present report is the first report on a lectin from wild mushroom Agaricus arvensis.
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Agaricus/química , Proteínas Fúngicas/aislamiento & purificación , Lectinas/aislamiento & purificación , Línea Celular , Proliferación Celular/efectos de los fármacos , Cromatografía Liquida/métodos , Proteínas Fúngicas/química , Hemaglutinación , Pruebas de Hemaglutinación , Hemaglutininas/química , Hemaglutininas/aislamiento & purificación , Hemaglutininas/metabolismo , Humanos , Lectinas/química , Lectinas/metabolismo , Peso Molecular , Unión Proteica , Multimerización de Proteína , Estabilidad Proteica , TemperaturaRESUMEN
From the dried fruiting bodies of the toxic mushroom Inocybe umbrinella, a novel lectin with a molecular mass of 17 kDa has been isolated with about 160-fold purification. The purification protocol comprised ion exchange chromatography on DEAE-cellulose, and CM-cellulose, and gel filtration on Superdex 75. Among the carbohydrates tested, raffinose, d-melibiose, alpha-lactose and d(+)-galactose could inhibit the hemagglutinating activity of the lectin. The hemagglutinating activity was stable between 10 and 60 degrees C, in 12.5-100mM HCl, and in 50mM NaOH. The hemagglutinating activity was inhibited by Ca(2+), Mn(2+)and Mg(2+) ions, but was unaffected by Fe(3+), Zn(2+) and Al(3+) ions. The lectin inhibited HIV-1 reverse transcriptase with an IC(50) of 4.7+/-0.2 microM. Proliferation of tumor cells including hepatoma HepG2 cells and breast cancer MCF7 cells was inhibited by the lectin with an IC(50) of 3.5+/-0.2 microM and 7.4+/-0.3 micoM, respectively. The lectin has a unique N-terminal amino acid sequence, DGVLATNAVA. It did not exhibit antifungal activity. The present report is the first on an Inocybe lectin and represents one of the very few reports on lectins from toxic mushrooms.
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Agaricales/química , Lectinas/aislamiento & purificación , Secuencia de Aminoácidos , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Cromatografía en Gel , Cromatografía por Intercambio Iónico , Transcriptasa Inversa del VIH/antagonistas & inhibidores , Pruebas de Hemaglutinación , Humanos , Concentración 50 Inhibidora , Lectinas/genética , Lectinas/farmacologíaRESUMEN
Candidate moderator configurations for a short-pulse second target station (STS) at the Oak Ridge National Laboratory Spallation Neutron Source (SNS) have been identified using a global optimizer framework built around the MCNPX particle transport code. Neutron brightness metrics were selected as the figure-of-merit. We assumed that STS would use one out of six proton pulses produced by an SNS accelerator upgraded to operate at 1.3 GeV proton energy, 2.8 MW power and 60 Hz repetition rate. The simulations indicate that the peak brightness can be increased by a factor of 5 and 2.5 on a per proton pulse basis compared to the SNS first target station for both coupled and decoupled para-hydrogen moderators, respectively. Additional increases by factors of 3 and 2 were demonstrated for coupled and decoupled moderators, respectively, by reducing the area of neutron emission from 100 × 100 mm(2) to 20 × 20 mm(2). This increase in brightness has the potential to translate to an increase of beam intensity at the instruments' sample positions even though the total neutron emission of the smaller moderator is less than that of the larger. This is especially true for instruments with small samples (beam dimensions). The increased fluxes in the STS moderators come at accelerated poison and de-coupler burnout and higher radiation-induced material damage rates per unit power, which overall translate into lower moderator lifetimes. A first effort was undertaken to group decoupled moderators into a cluster collectively positioning them at the peak neutron production zone in the target and having a three-port neutron emission scheme that complements that of a cylindrical coupled moderator.
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The diagnostic value of ultrasonography in cases with incomplete endocardial cushion defect which has been verified by subsequent operation was studied. By the M-mode ultrasound examination an enlarged right ventricle, a narrowed outflow tract of left ventricular and an abnormal pattern of mitral value were shown. By the aid of 2-DE its diagnostic accuracy in this disease was almost 100%. Characteristically the ostium primum (atrial septal) defect and anterior mitral cleft were demonstrated. And by pulsed Doppler the signs of mitral regurgitation and the spectral features of atrial shunt could be found. Therefore, it is proposed that ultrasonographic examination could readily take the place of traumatic angiocardiography in the diagnosis of this disease.
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Ecocardiografía , Defectos de la Almohadilla Endocárdica/diagnóstico , Defectos de los Tabiques Cardíacos/diagnóstico , Adolescente , Adulto , Niño , Ecocardiografía Doppler , Femenino , Humanos , MasculinoRESUMEN
In this work, we investigate the effect of neutron moderator dimensions on the performance of neutron scattering instruments at the Spallation Neutron Source (SNS). In a recent study of the planned second target station at the SNS facility, we have found that the dimensions of a moderator play a significant role in determining its surface brightness. A smaller moderator may be significantly brighter over a smaller viewing area. One of the immediate implications of this finding is that for modern neutron scattering instrument designs, moderator dimensions and brightness have to be incorporated as an integrated optimization parameter. Here, we establish a strategy of matching neutron scattering instruments with moderators using analytical and Monte Carlo techniques. In order to simplify our treatment, we group the instruments into two broad categories: those with natural collimation and those that use neutron guide systems. For instruments using natural collimation, the optimal moderator selection depends on the size of the moderator, the sample, and the moderator brightness. The desired beam divergence only plays a role in determining the distance between sample and moderator. For instruments using neutron optical systems, the smallest moderator available that is larger than the entrance dimension of the closest optical element will perform the best (assuming, as is the case here that smaller moderators are brighter).
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The Spallation Neutron Source (SNS) facility at the Oak Ridge National Laboratory is designed with an upgrade option for a future low repetition rate, long wavelength second target station. This second target station is intended to complement the scientific capabilities of the 1.4 MW, 60 Hz high power first target station. Two upgrade possibilities have been considered, the short and the long pulse options. In the short pulse mode, proton extraction occurs after the pulse compression in the accumulator ring. The proton pulse structure is thus the same as that for the first target station with a pulse width of ~0.7 µs. In the long pulse mode, protons are extracted as they are produced by the linac, with no compression in the accumulator ring. The time width of the uncompressed proton pulse is ~1 ms. This difference in proton pulse structure means that neutron pulses will also be different. Neutron scattering instruments thus have to be designed and optimized very differently for these two source options which will directly impact the overall scientific capabilities of the SNS facility. In order to assess the merits of the short and long pulse target stations, we investigated a representative suit of neutron scattering instruments and evaluated their performance under each option. Our results indicate that the short pulse option will offer significantly better performance for the instruments and is the preferred choice for the SNS facility.
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The high power target station at the Spallation Neutron Source (SNS) currently has about 20 completed neutron scattering instruments. With a broad coverage of the momentum transfer (Q)-energy (E) space, these instruments serve an extensive user community. In an effort to further expand the scientific capabilities of the SNS instrument suites, we propose a low background, inverse geometry Brillouin inelastic spectrometer for the SNS which will expand the Q-E coverage of the current instrument suite and facilitate the study of inelastic and quasi-elastic scatterings at low Q values. The possible location for the proposed instrument is either beamline 8 which views the decoupled water moderator, or beamline 14A, which views a cold, coupled super critical hydrogen moderator. The instrument parameters, optimizations, and performances at these two beamline locations are discussed.
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BACKGROUND: Monitoring of iodine nutrition depends chiefly on the urinary iodine concentration in representative samples from the population. International groups have recommended school-age children as a convenient group for surveys, because of their accessibility and young age, but the relevance of this group to others, especially pregnant women, is not well established. OBJECTIVE: The purpose was to compare different approaches to assessing iodine nutrition within communities, especially for pregnant and lactating women. DESIGN: In an urban and a rural site from each of the 11 Chinese provinces, covering a wide geographic and socioeconomic range, we measured the iodine content of household salt and drinking water, the thyroid volume in school children, and the urinary iodine concentration in five population subsets; in some sites we also assessed iodine in breast milk and thyroid size in adult women. RESULTS: The median urinary iodine concentrations for pregnant and lactating women were well below those of the schoolchildren from the same community in most study sites, the difference between medians, at overall level, being about 50 microg/l for the pregnant and 40 microg/l for the lactating, respectively. When ranked by median urinary iodine concentrations at overall level, the order of the groups was: all infants, schoolchildren, women of childbearing age, lactating women and pregnant women in both urban and rural sites. This relative distribution was constant among the study sites. From it, we derived a relationship to predict the median values for other groups, based on the data of schoolchildren. The median iodine content of salt was 30.9 ppm in urban sites and 31.3 ppm in rural sites, respectively, close to the nationally mandated 35 mg/kg. Water had low iodine content (3.7 microg/l) in both urban and rural sites except in a rural site from Tianjin. Ultrasonography showed that 6.5% of 1329 children in urban sites and 5.3% of 1431 children in rural sites had thyroid enlargement. Breast milk had a median iodine content of 135.9 microg/l in the urban and 157.5 microg/l in the rural. The goiter prevalence by palpation was low (2.0%) among all women examined (3367), but higher in pregnant women (2.7%) than in lactating women or other adult women. CONCLUSIONS: An effective iodized salt program has brought iodine sufficiency to most of China, but pregnant women in some areas may still risk deficiency and need further supplements. We suggest other countries and international agencies pay more attention to pregnancy, where iodine deficiency has its worst consequences.
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Yodo/deficiencia , Lactancia , Estado Nutricional , Complicaciones del Embarazo , Cloruro de Sodio Dietético/administración & dosificación , Adulto , Niño , China , Suplementos Dietéticos , Femenino , Humanos , Lactante , Recién Nacido , Yodo/administración & dosificación , Yodo/análisis , Yodo/orina , Leche Humana/química , Embarazo , Factores de Riesgo , Población Rural , Cloruro de Sodio Dietético/análisis , Glándula Tiroides/diagnóstico por imagen , Ultrasonografía , Población UrbanaRESUMEN
We have used a new approach involving simultaneous diffraction and small angle scattering to study the amorphous-to-crystalline phase transformation in Zr-based bulk metallic glass. In situ, time-resolved data provided the first direct demonstration of a phase separation prior to crystallization. There is evidence that nucleation and growth of the crystalline phase occur in separate stages, with different kinetics. Our data support the view that crystalline nucleation is achieved via short-range diffusion of small atoms (e.g., Ni), whereas the growth is dictated by long-range diffusion.