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AIMS AND OBJECTIVES: To investigate knowledge, attitudes, and practices regarding the application of the Injury Severity Score (ISS) among emergency department nurses in China and the factors influencing these variables. BACKGROUND: ISS is the first trauma scoring method to be developed and the most widely used in clinical practice. The correct application of the ISS by emergency department nurses plays an important role in assisting in the diagnosis and treatment of trauma patients, and it is crucial to understand nurses' knowledge, attitudes and practices. DESIGN: A cross-sectional multicentre study. METHODS: Nurses from the emergency departments of 25 grade II and grade III hospitals in Gansu Province, China participated in this study. Data was collected online using a self-administered questionnaire. Student's t-test or analysis of variance was performed to compare the differences between the groups. Multiple logistic regression analysis identified factors influencing nurses' knowledge, attitudes and practices regarding applying ISS. A STROBE checklist was used to report findings. RESULTS: Among 459 nurses, a good level of attitude and passing levels of knowledge and practice regarding applying the ISS were revealed. Nurses in higher hospital grades, who had been exposed to ISS and received training had higher levels of knowledge and practices. Previous exposure to the ISS and training related to it were factors that influenced nurses' attitudes. CONCLUSIONS: Chinese emergency department nurses' knowledge, attitudes and practices of applying the ISS still need to be improved. Hospitals and nursing managers should provide training opportunities for nurses about ISS knowledge and practices, while grade II hospitals should pay more attention to training and continuing education in this area. RELEVANCE TO CLINICAL PRACTICE: In hospitals, nursing managers may benefit from enhancing related education and training to promote the emergency department nurses' knowledge and practice of the ISS, by developing specific curricula and providing continuing education and training opportunities, while grade II hospitals should pay more attention to training and continuing education in this area. NO PATIENT OR PUBLIC CONTRIBUTIONS: This study focused on emergency department nurses' knowledge, attitudes, and practices regarding the application of the ISS. The research questions and design were derived from clinical nursing practice, literature review, and expert panel review, and patients or the public are temporarily not involved.
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Sweat wearable sensors enable noninvasive and real-time metabolite monitoring in human health management but lack accuracy and wearable applicability. The rational design of sensing electrode materials will be critical yet challenging. Herein, we report a dual aerogel-based nonenzymatic wearable sensor for the sensitive and selective detection of uric acid (UA) in human sweat. The three-dimensional porous dual-structural aerogels composed of Au nanowires and N-doped graphene nanosheets (noted as N-rGO/Au DAs) provide a large active surface, abundant access to the target, rapid electron transfer pathways, and a high intrinsic activity. Thus, a direct UA electro-oxidation is demonstrated at the N-rGO/Au DAs with a much higher activity than those at the individual gels (i.e., Au and N-rGO). Moreover, the resulting sensing chip displays high performance with a good anti-interfering ability, long-term stability, and excellent flexibility toward the UA detection. With the assistance of a wireless circuit, a wearable sensor is successfully applied in the real-time UA monitoring on human skin. The obtained result is comparable to that evaluated by high-performance liquid chromatography. This dual aerogel-based nonenzymatic biosensing platform not only holds considerable promise for the reliable sweat metabolite monitoring but also opens an avenue for metal-based aerogels as flexible electrodes in wearable sensing.
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Técnicas Biossensoriais , Grafite , Dispositivos Eletrônicos Vestíveis , Humanos , Técnicas Biossensoriais/métodos , Grafite/química , Suor/química , Ácido Úrico/análise , Técnicas EletroquímicasRESUMO
BACKGROUND: Chimeric antigen receptor T (CAR-T) cell therapy, a new adoptive cell therapy, has been widely used to treat lymphoma patients. Immune checkpoint blockade may improve the cytotoxicity of CAR-T cells by reducing the failure of CAR-T cells and improving antitumor activity. It has shown promising efficacy. METHOD: We searched PubMed, the Cochrane Library, Embase and Web of Science from January 2012 to August 2022 to find data reporting the results of CAR-T cells therapy combined with PD-1 in tumor patients. An updated search was conducted in October 2023. The partial response rate (PR), complete response rate (CR), objective response rate (ORR), mortality rate, and incidence of adverse reactions were calculated. RESULTS: We analyzed 57 lymphoma patients from 5 clinical trials. The pooled partial, complete and overall response rates were 21% (95% CI 0.06-0.39, I2 = 0.37%), 27% (95% CI 0.03-0.60, I2 = 60.43%) and 65% (95% CI 0.23-0.98, I2 = 76.31%), respectively. The pooled incidence of cytokine release syndrome, neutropenia, fever, and fatigue was estimated to be 57% (95% CI 0.08-0.99, I2 = 85.20%), 47% (95% CI 0.14-0.81, I2 = 74.17%), 59% (95% CI 0.27-0.89, I2 = 60.23%), and 50% (95% CI 0.13-0.87, I2 = 73.89%), respectively. CONCLUSION: CAR-T-cell therapy combined with anti-PD-1 immunotherapy in the treatment of lymphoma patients has efficacy, and the most common adverse effect is fever. REGISTRATION: The protocol was registered in prospero, with the registration number CRD42022342647.
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Linfoma , Receptores de Antígenos Quiméricos , Humanos , Imunoterapia Adotiva/efeitos adversos , Imunoterapia Adotiva/métodos , Receptores de Antígenos de Linfócitos T , Linfócitos T , Antígenos CD19 , Linfoma/terapia , Linfoma/etiologia , Imunoterapia/efeitos adversos , Terapia Baseada em Transplante de Células e TecidosRESUMO
The gut microbiota is closely related to the development of sepsis. The aim of this study was to explore changes in the gut microbiota and gut metabolism, as well as potential relationships between the gut microbiota and environmental factors in the early stages of sepsis. Fecal samples were collected from 10 septic patients on the first and third days following diagnosis in this study. The results showed that in the early stages of sepsis, the gut microbiota is dominated by microorganisms that are tightly associated with inflammation, such as Escherichia-Shigella, Enterococcus, Enterobacteriaceae, and Streptococcus. On sepsis day 3 compared to day 1, there was a significant decrease in Lactobacillus and Bacteroides and a significant increase in Enterobacteriaceae, Streptococcus, and Parabacteroides. Culturomica_massiliensis, Prevotella_7 spp., Prevotellaceae, and Pediococcus showed significant differences in abundance on sepsis day 1, but not on sepsis day 3. Additionally, 2-keto-isovaleric acid 1 and 4-hydroxy-6-methyl-2-pyrone metabolites significantly increased on sepsis day 3 compared to day 1. Prevotella_7 spp. was positively correlated with phosphate and negatively correlated with 2-keto-isovaleric acid 1 and 3-hydroxypropionic acid 1, while Prevotella_9 spp. was positively correlated with sequential organ failure assessment score, procalcitonin and intensive care unit stay time. In conclusion, the gut microbiota and metabolites are altered during sepsis, with some beneficial microorganisms decreasing and some pathogenic microorganisms increasing. Furthermore, Prevotellaceae members may play different roles in the intestinal tract, with Prevotella_7 spp. potentially possessing beneficial health properties and Prevotella_9 spp. potentially playing a promoting role in sepsis.
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Microbioma Gastrointestinal , Sepse , Humanos , Fezes/microbiologia , Enterobacteriaceae , Sepse/microbiologia , RNA Ribossômico 16SRESUMO
BACKGROUND: The purpose of this paper was to systematically evaluate the application value of artificial intelligence in predicting mortality among COVID-19 patients. METHODS: The PubMed, Embase, Web of Science, CNKI, Wanfang, China Biomedical Literature, and VIP databases were systematically searched from inception to October 2022 to identify studies that evaluated the predictive effects of artificial intelligence on mortality among COVID-19 patients. The retrieved literature was screened according to the inclusion and exclusion criteria. The quality of the included studies was assessed using the QUADAS-2 tools. Statistical analysis of the included studies was performed using Review Manager 5.3, Stata 16.0, and Meta-DiSc 1.4 statistical software. This meta-analysis was registered in PROSPERO (CRD42022315158). FINDINGS: Of 2193 studies, 23 studies involving a total of 25 AI models met the inclusion criteria. Among them, 18 studies explicitly mentioned training and test sets, and 5 studies did not explicitly mention grouping. In the training set, the pooled sensitivity was 0.93 [0.87, 0.96], the pooled specificity was 0.94 [0.87, 0.97], and the area under the ROC curve was 0.98 [0.96, 0.99]. In the validation set, the pooled sensitivity was 0.84 [0.78, 0.88], the pooled specificity was 0.89 [0.85, 0.92], and the area under the ROC curve was 0.93 [1.00, 0.00]. In the subgroup analysis, the areas under the summary receiver operating characteristic (SROC) curves of the artificial intelligence models KNN, SVM, ANN, RF and XGBoost were 0.98, 0.98, 0.94, 0.92, and 0.91, respectively. The Deeks funnel plot indicated that there was no significant publication bias in this study (P > 0.05). INTERPRETATION: Artificial intelligence models have high accuracy in predicting mortality among COVID-19 patients and have high prognostic value. Among them, the KNN, SVM, ANN, RF, XGBoost, and other models have the highest levels of accuracy.
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Inteligência Artificial , COVID-19 , Humanos , Sensibilidade e Especificidade , COVID-19/diagnóstico , Curva ROC , ChinaRESUMO
Bottom-up assembly of higher-order cytomimetic systems capable of coordinated physical behaviours, collective chemical signalling and spatially integrated processing is a key challenge in the study of artificial multicellularity. Here we develop an interactive binary population of coacervate microdroplets that spontaneously self-sort into chain-like protocell networks with an alternating sequence of structurally and compositionally dissimilar microdomains with hemispherical contact points. The protocell superstructures exhibit macromolecular self-sorting, spatially localized enzyme/ribozyme biocatalysis and interdroplet molecular translocation. They are capable of topographical reconfiguration using chemical or light-mediated stimuli and can be used as a micro-extraction system for macroscale biomolecular sorting. Our methodology opens a pathway towards the self-assembly of multicomponent protocell networks based on selective processes of coacervate droplet-droplet adhesion and fusion, and provides a step towards the spontaneous orchestration of protocell models into artificial tissues and colonies with ordered architectures and collective functions.
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Células Artificiais , Células Artificiais/químicaRESUMO
Aerogels derived from the colloidal nanoparticles featured with hierarchical interconnected pore-rich networks guarantee their great potentials in various applications. Herein, the controllable assembly of three-dimensional aerogels based on Au nanoparticles (Au NPs) and reduced graphene oxide (rGO) nanosheets as building blocks via a bottom-up approach have been systematically clarified. The difference of building blocks and their assembly sequence were crucially to the final aerogel morphologies and electrochemical properties. Specifically, the highly porous graphene-gold dual aerogels (rGO-Au DAGs) with interconnected rGO nanosheets and Au nanowires showed high conductivity, large surface area and good biocompatibility. Thus, it was employed as an excellent matrix to immobilize enzyme for high-efficient bioelectrocatalysis. Taking bilirubin oxidase as an example, a more positive on-set potential (0.60 V) and a larger catalytic current density (0.77 mA cm-2@0.40 V) than those of other rGO-Au assemblies were achieved for direct bioelectrocatalytic O2 reduction. This study will provide an efficient strategy for unique dual-structural aerogels design and shed light to develop new functional materials for bioelectrocatalytic applications such as biosensors and biofuel cells.
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Living systems create complex structures and functions by mastering self-organization in a variety of equilibrium and non-equilibrium states. Mimicking the dynamical phenomena with synthetic cell-like entities (protocells) under non-equilibrium conditions offers an important step toward the representation of minimum life. Here, the cell-sized coacervate microdroplets assembled from associative metallosurfactant coacervation via liquid-liquid phase separation (LLPS) that exhibits non-equilibrium behaviors are reported. The compartmentalized protocell coacervates display collective dynamics that synchronize into system oscillations, showing autonomous death/regeneration and contraction/expansion cycles with external redox stress. The collective oscillation of abiotic metallosurfactant microdroplets can sustain both in solution and at the colloidal interface, allowing for dynamic sequestration, mass transport, and passing through nanosized channels, reminiscent of red blood cells that can deform and squeeze through narrow capillaries. The design of self-oscillating cell-sized constructs will shed a light on the creation of life-like soft materials with autonomous motion driven by complex chemical stimuli, which can be further used as nonbiological models for dynamic aggregates and intercellular communication.
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BACKGROUND: Emergency department healthcare professionals have the most contact with patients in cardiac arrest, and their physical and mental state has a significant impact on the quality of cardiopulmonary resuscitation and patient outcomes. However, there is limited research discussing the experience of resuscitation by emergency department healthcare professionals. AIM: To explore the experiences of emergency department healthcare professionals in performing cardiopulmonary resuscitation. METHODS: A descriptive phenomenological study. The study used purposive sampling and selected 9 nurses and 6 physicians from the emergency departments of four general hospitals of different levels in western China between May 2022 and October 2022. Semi-structured interview guides and face-to-face interviews were used to collect information. Colaizzi analysis was used to analyze the data. RESULTS: The study identified 3 themes and 11 sub-themes. These themes and sub-themes include 1) emotional experience (A sense of achievement, A sense of powerlessness and trauma, Stress, Empathy, Psychological resilience strengthens), 2) cognitive growth (Understanding CPR rationally, Increasing concern for personal and family health, Mastering self-relaxation methods), and 3) the desire for continued development (Seeking professional development, Hoping for professional psychological assistance, Strengthening team support). CONCLUSIONS: The experience of performing cardiopulmonary resuscitation by healthcare professionals in emergency departments is dynamic, with changes in mood and cognitive growth. Managers in hospitals should pay attention to their experiences and need at different stages of career development and actively carry out targeted cognitive guidance, skills training, and psychological support to help them achieve professional development and physical and mental health. At the same time, to promote the development of CPR for all, it is recommended that the authorities actively improve the public infrastructure for first aid and related policy protection.
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OBJECTIVES: The purpose of this study was systematically and quantitatively to assess the value of the neutrophil-to-lymphocyte ratio (NLR) for the diagnosis of neonatal sepsis by systematic review and meta-analysis. DESIGN: Systematic review and meta-analysis. METHODS: Eight major databases, including The Cochrane, PubMed, Embase, Web of Science, CNKI, Wanfang, China Biomedical Literature Database and VIP Database, were systematically searched for NLR diagnoses of neonatal sepsis from inception to June 2022. Two investigators independently conducted the literature search, screening, data extraction and quality evaluation with the Quality Assessment of Diagnostic Accuracy Studies-2 checklist. Statistical analysis was performed using Review Manager V.5.3, Stata V.16.0, R (V.3.6.0) and Meta-DISC V.1.4. RESULTS: A total of 14 studies comprising 1499 newborns were included in this meta-analysis. With a cut-off value ranging from 0.1 to 9.4, the pooled sensitivity of the NLR in the diagnosis of neonatal sepsis was 0.74 (95% CI: 0.61 to 0.83), the pooled specificity was 0.88 (95% CI: 0.73 to 0.95), the positive likelihood ratio (LR+) was 6.35 (95% CI: 2.6 to 15.47), the negative likelihood ratio (LR-) was 0.30 (95% CI: 0.19 to 0.46), the diagnostic OR (DOR) was 12.88 (95% CI: 4.47 to 37.08), area under the curve (AUC) was 0.87 (95% CI: 0.84 to 0.89). In the subgroup analysis of early-onset neonatal sepsis, the pooled sensitivity was 0.75 (95% CI: 0.47 to 0.91), the pooled specificity was 0.99 (95% CI: 0.88 to 1.00), the LR+ was 63.3 (95% CI: 5.7 to 696.8), the LR- was 0.26 (95% CI: 0.10 to 0.63), the DOR was 247 (95% CI: 16 to 3785) and the AUC was 0.97 (95% CI: 0.95 to 0.98). CONCLUSIONS: Our findings suggest that the NLR is a helpful indicator for the diagnosis of early neonatal sepsis, but it still needs to be combined with other laboratory tests and specific clinical manifestations.
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Sepse Neonatal , Sepse , Recém-Nascido , Humanos , Sepse Neonatal/diagnóstico , Neutrófilos , Biomarcadores , Área Sob a Curva , Linfócitos , Sensibilidade e Especificidade , Sepse/diagnósticoRESUMO
Improving the utilization of noble metals is extremely urgent for fuel cell electrocatalysis, while three-dimensional hierarchical noble metal aerogels with abundant sites and channels are proposed to reinforce their electrocatalytic performances and decrease their amounts. Herein, novel Pd aerogels with tunable surface chemical states were prepared through a facile in situ electrochemical activation, starting with PdO x aerogels by the hydrolysis method. The hierarchical porous Pd aerogels showed unprecedented high activity towards the electrocatalytic oxidation of fuels including methanol (2.99 A mgPd -1), ethanol (8.81 A mgPd -1), and others in alkali, outperforming commercial catalysts (7.12- and 13.66-fold, corresponding to methanol and ethanol). Theoretical investigation unveiled the hybrid surface states with metallic and oxidized Pd species in Pd aerogels to regulate the adsorption of intermediates and facilitate the synergistic oxidation of adsorbed *CO, resulting in enhanced activity with the MOR as the model. Therefore, efficient Pd aerogels through the in situ electrochemical activation of PdO x aerogels were proposed and showed great potential for fuel cell anodic electrocatalysis.
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Cooperative coacervation of a porphyrin and a polycation electrolyte gives birth to photoactive membraneless protocells via liquid-liquid phase separation, where J-aggregates are formed to offer energy transduction pathways, rendering an adaptive platform for confining photocatalytic reactions within protocell compartments.
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Eletrólitos/química , Polieletrólitos/química , Porfirinas/química , Estrutura Molecular , Tamanho da Partícula , Processos FotoquímicosRESUMO
Background: The Delta variant of concern (VOC) is rapidly becoming the dominant strain globally. We report the clinical characteristics and severity of hospitalized patients infected with Delta and Beta VOCs during the local outbreak in Harbin, Heilongjiang Province, China, and the effect of vaccines on the Delta variant. Methods: We collected a total of 735 COVID-19 patients from the First Affiliated Hospital of Harbin Medical University, including 96 cases infected with the Delta VOC and 639 cases infected with the Beta VOC. Demographic, clinical characteristic and laboratory findings were collected and compared. Results: Differences in viral shedding, IgG and IgM levels, and the neutrophil-to-lymphocyte ratio were noted between the Delta and Beta VOCs (p < 0.05). Survival analysis of the two groups revealed longer viral shedding of the Delta VOC (p < 0.05). For the Delta VOC, the longer the vaccination period, the lower the IgG and IgM levels. IgM levels were higher in the convalescent plasma group, whereas lymphocyte counts were lower. Conclusions: Delta VOC virus shedding was longer compared with Beta VOC shedding. Vaccination with inactivated vaccines can reduce the severe illness rate of the Delta VOC. IgG and IgM levels are reduced as the time period between the first and second vaccine doses increases.
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Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has spread, data on the clinical characteristics of infected patients are limited. In this study, the demographic, clinical characteristics, and laboratory data of 310 SARS-CoV-2 Omicron variant patients treated at Haihe Hospital of Tianjin were collected and analyzed. Information on these patients was compared to 96 patients with the Delta variant of concern (VOC) and 326 patients with the Beta VOC during the previous coronavirus disease 2019 (COVID-19) outbreak in Harbin. Of the 310 patients infected with the Omicron variant, the median age was 35 years. Most patients were clinically classified as mild (57.74%), and the most common symptoms were cough (48.71%), fever (39.35%), and sore throat (38.26%). The results for different vaccination groups in the Omicron group showed that the median of "SARS-CoV-2 specific IgG" after 2 or 3 doses of vaccination was higher than the unvaccinated group (all Ps â< â0.05). Older age was associated with a higher proportion of moderate cases and lower asymptomatic and mild cases based on clinical classifications. Compared to the Delta and Beta groups, the median age of the Omicron group was younger. The total number of asymptomatic patients and mild patients in the Omicron virus group was higher than the Delta and Beta groups (60.97% vs. 54.17% vs. 47.55%). This study presented the clinical characteristics of the first group of patients infected with the Omicron variant in Tianjin, China, and compared their clinical features with patients infected by the Delta and Beta variants, which would increase our understanding of the characteristics of SARS-CoV-2 Omicron variant.
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COVID-19 , SARS-CoV-2 , Adulto , Anticorpos Antivirais , COVID-19/diagnóstico , China/epidemiologia , Humanos , Imunoglobulina G , SARS-CoV-2/genéticaRESUMO
BACKGROUND: Delayed neurocognitive recovery (dNCR) is a common complication of the central nervous system in elderly patients. Currently, it is not clear whether the occurrence of dNCR is associated with the intestinal microbiota and its related metabolites. This study investigated the preoperative intestinal microflora and faecal metabolites of dNCR patients. METHODS: Twenty-two elderly urological patients were divided into a dNCR group (D group) and a non-dNCR group (ND group) according to the postoperative Mini-Mental State Examination (MMSE) score on the first and third day after surgery. A postoperative MMSE score ≤ 2 points compared with the preoperative score was considered evidence of dNCR. We used a comprehensive method that combined 16S rRNA gene sequencing and untargeted metabolomics to study the preoperative intestinal microflora and faecal metabolites of the two groups, and conducted correlation analysis between them. RESULTS: Compared with the D group, the microbial community in the ND group was more abundant. At the family level, the ND group was significantly enriched in Lachnospiraceae, Peptostreptococcaceae and Muribaculaceae. At the genus level, the faecal microbiota of the ND group was differentially enriched in Agathobacter, Dorea, Fusicatenibacter, Coprococcus_2 and Romboutsia while that of the D group was differentially enriched in Anaerofilum. Untargeted metabolomics revealed significant differences in eight different metabolites between the two groups, including ribose, ethanol, leucine, maltose, pentadecanoic acid, malonic acid 1,3,4-dihydroxybenzoic acid and 3-hydroxypalmitic acid. In addition, differential metabolites were associated with the abundance of specific bacteria. CONCLUSIONS: The occurrence of dNCR may be associated with the intestinal flora and its related metabolite composition of patients before surgery.
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Microbioma Gastrointestinal , Humanos , Idoso , Microbioma Gastrointestinal/genética , RNA Ribossômico 16S/genética , Metaboloma , Fezes/microbiologia , MetabolômicaRESUMO
Introduction: The small intestine, as the main digestion and absorption site of the gastrointestinal tract, is often overlooked in studies, and the overall microbiota does not reflect the makeup of the microbiota in different segments of the intestine. Therefore, we aimed to exclude the influence of routine ICU treatment measures on sepsis patients and observed changes in the diversity and abundance of gut microbiota in different intestinal segments of septic mice. Methods: The mice were randomly divided into the CLP6h group and the sham group. The contents of the colon and small intestine of the experimental group and the control group were collected after 6 h. Results: After CLP, the number and structure of the gut microbiota in the colon changed most obviously, among which Bacteroidetes had the most significant changes. Akkermansia, D.Firmicutes_bacterium_M10_2, Blautia, Bifidobacterium, Lactobacillus, Candidatus_Arthromitus, and Muribaculaceae were changed in the colon. Lactobacillus, Bifidobacterium, Akkermansia, Blautia, Candidatus_Arthromitus, and Lachnospiraceae_NK4A136_group were changed in the small intestine. Discussion: Our experiment found that there were different numbers of unique and common gut microbiota in the small intestine and colon after sepsis, and the gut microbiota of the colon changed more drastically after sepsis than the small intestine. Thus, we should focus on protective gut microbiota and mucin-degrading microbes. We hope that these results will provide help for sepsis treatment in the future.
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Microbiota , Sepse , Animais , Camundongos , Bacteroidetes , Clostridiales , Colo/microbiologia , Intestino Delgado , Intestinos , LactobacillusRESUMO
As the preliminary synthetic analogs of living cells, protocells with life-like features serve as a versatile platform to explore the origin of life. Although protocells constructed from multiple components have been developed, the transition of primitive cellular compartments toward structural complexity and advanced function remains a scientific challenge. Herein, a programmable pathway is established to exploit a simple chemistry to construct structural transition of protocell models from emulsion droplets, nanocapsules to molecularly crowded droplets. The transitional process toward distinct cell-like compartments is driven by interfacial self-assembly of simple components and regulated by physicochemical cues (e.g., mechanical force, solvent evaporation, acid/base equilibrium) triggered dynamic covalent chemistry. These protocell models are further studied by comparing their compartmentalization behavior, sequestration efficiency, and the ability to enrich biomolecules (e.g., enzyme and substrate) toward catalytic reaction or biological activity within the compartments. The results showcase physiochemical cues-driven programmable transition of life-like compartments toward functionalization, and offer a new step toward the design of living soft materials.
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Células Artificiais/química , Fenômenos Biofísicos , Emulsões/química , Nanocápsulas/químicaRESUMO
As the basic unit of life, cells are compartmentalized microreactors with molecularly crowded microenvironments. The quest to understand the cell origin inspires the design of synthetic analogs to mimic their functionality and structural complexity. In this work, we integrate membraneless coacervate microdroplets, a prototype of artificial organelles, into a proteinosome to build hierarchical protocells that may serve as a more realistic model of cellular organization. The protocell subcompartments can sense extracellular signals, take actions in response to these stimuli, and adapt their physicochemical behaviors. The tiered protocells are also capable of enriching biomolecular reactants within the confined organelles, thereby accelerating enzymatic reactions. The ability of signal processing inside protocells allows us to design the Boolean logic gates (NOR and NAND) using biochemical inputs. Our results highlight possible exploration of protocell-community signaling and render a flexible synthetic platform to study complex metabolic reaction networks and embodied chemical computation.