A Low Prognostic Nutritional Index Is a Risk Factor for High Peritoneal Transport Status in Patients Undergoing Peritoneal Dialysis.

OBJECTIVES: A high peritoneal transport status is a risk factor for mortality and causes technical failure in patients on peritoneal dialysis (PD). High peritoneal transport status is associated with malnutrition and inflammation in patients with PD. The prognostic nutritional index (PNI) is a marker determined by the serum albumin level and lymphocyte count in the peripheral blood. The aim of this study is to investigate the association between PNI and high peritoneal transport status in patients with PD. METHODS: We retrospectively investigated patients with PD from January 1, 2013 to May 31, 2020, in 4 PD centers. Patients with PD were divided into 2 groups according to PNI quartiles: the low PNI group (PNI ≤ 36.6) and the high PNI group (PNI > 36.6). The demographics and clinical and laboratory baseline data of the 2 groups were collected and compared. The association between PNI and high peritoneal transport status was analyzed by multivariate logistic regression analysis. RESULTS: A total of 404 patients with PD were enrolled in our study. A total of 77 (19.06%) patients had high peritoneal transport status. After adjusting for age, sex, body mass index, hypertension, diabetes mellitus, residual urine volume, current smoking status, pre-existing cardiovascular disease, hemoglobin, white blood cell count, triglycerides, and intact parathyroid hormone, low PNI levels were significantly associated with high peritoneal transport status (odds ratio 3.42, 95% confidence interval 1.82-5.18, P = .0056). Subgroup analysis showed that there was no interaction among PNI and age, sex, diabetes, body mass index, pre-existing cardiovascular disease, or current smoking. CONCLUSION: As a marker for malnutrition and inflammation, a low level of PNI is an independent risk factor for high peritoneal transport status in patients with PD.

Serum uric acid to creatinine ratio as a risk factor for mortality among patients on continuous ambulatory peritoneal dialysis: a multi-center retrospective study.

BACKGROUND: Serum uric acid to serum creatinine ratio (SUA/Scr) has emerged as a new biomarker, which is significantly associated with several metabolic diseases. However, no study has investigated the association between SUA/Scr and mortality among patients on continuous ambulatory peritoneal dialysis (CAPD). METHODS: In this multicenter retrospective cohort study, we enrolled CAPD patients in eight tertiary hospitals in China from 1 January 2005 to 31 May 2021. Cox proportional hazard models were used to determine the relationship between SUA/Scr and mortality. RESULTS: A total of 2480 patients were included; the mean age was 48.9 ± 13.9 years and 56.2% were males. During 12648.0 person-years of follow-up, 527 (21.3%) patients died, of which 267 (50.7%) deaths were caused by cardiovascular disease. After multivariable adjustment for covariates, per unit increase in SUA/Scr was associated with a 62.9% (HR, 1.629 (95% confidence interval (CI) 1.420-1.867)) and 73.0% (HR, 1.730 (95% CI 1.467-2.041)) higher risk of all-cause and cardiovascular mortality. Results were similar when categorized individuals by SUA/Scr quartiles. Compared with the lowest quartile of SUA/Scr, the highest and the second highest quartile of SUA/Scr had a 2.361-fold (95% CI 1.810-3.080) and 1.325-fold (95% CI 1.003-1.749) higher risk of all-cause mortality, as well as a 3.701-fold (95% CI 2.496-5.489) and 2.074-fold (95% CI 1.387-3.100) higher risk of cardiovascular mortality. Multivariable-adjusted spline regression models showed nonlinear association of SUA/Scr with mortality in CAPD patients. CONCLUSIONS: Higher levels of SUA/Scr were associated with higher risk of all-cause and cardiovascular mortality in CAPD patients.

Deep Learning of Morphologic Correlations To Accurately Classify CD4+ and CD8+ T Cells by Diffraction Imaging Flow Cytometry.

The two major subtypes of human T cells, CD4+ and CD8+, play important roles in adaptive immune response by their diverse functions. To understand the structure-function relation at the single cell level, we isolated 2483 CD4+ and 2450 CD8+ T cells from fresh human splenocytes by immunofluorescent sorting and investigated their morphologic relations to the surface CD markers by acquisition and analysis of cross-polarized diffraction image (p-DI) pairs. A deep neural network of DINet-R has been built to extract 2560 features across multiple pixel scales of a p-DI pair per imaged cell. We have developed a novel algorithm to form a matrix of Pearson correlation coefficients by these features for selection of a support cell set with strong morphologic correlation in each subtype. The p-DI pairs of support cells exhibit significant pattern differences between the two subtypes defined by CD markers. To explore the relation between p-DI features and CD markers, we divided each subtype into two groups of A and B using the two support cell sets. The A groups comprise 90.2% of the imaged T cells and classification of them by DINet-R yields an accuracy of 97.3 ± 0.40% between the two subtypes. Analysis of depolarization ratios further reveals the significant differences in molecular polarizability between the two subtypes. These results prove the existence of a strong structure-function relation for the two major T cell subtypes and demonstrate the potential of diffraction imaging flow cytometry for accurate and label-free classification of T cell subtypes.

Platelet-to-lymphocyte ratio and the first occurrence of peritonitis in peritoneal dialysis patients.

BACKGROUND: Platelet-to-lymphocyte ratio (PLR) has been used as a potential biomarker of inflammation-related diseases, but its role in the peritoneal dialysis-related peritonitis (PDRP) is still uncertain. This study was aimed to investigate the association between PLR and the new-onset PDRP in peritoneal dialysis (PD) patients. METHODS: In this multicenter retrospective study, 1378 PD Chinese PD patients were recruited from four centers, who were divided into the high PLR group (HPG) and the low PLR group (LPG) according to the cutoff value of PLR. The correlation between PLR and the new-onset PDRP was assessed using the Cox regression model analysis. RESULTS: During follow-up, 121 new-onset PDRP events were recorded. Kaplan-Meier survival curve showed a higher risk of new-onset PDRP in the HPG (log-rank test, P < 0.001). After adjusting for confounding factors, the Cox regression model showed the risk of new-onset PDRP was higher in the HPG than that in the LPG (HR 1.689, 95%CI 1.096-2.602, P = 0.017). Competitive risk model analysis showed that significant differences still existed between the two PLR groups in the presence of other competitive events (P < 0.001). CONCLUSION: PLR is independently associated with the new-onset PDRP in PD patients.

Water-Recyclable Chitosan-Based Ion-Imprinted Thermoresponsive Hydrogel for Rare Earth Metal Ions Accumulation.

The demand for rare earth metal increases rapidly in the modern high-tech industry and therefore the accumulation of rare earth metal ions from an aqueous environment becomes a significant concern worldwide. In this paper, a water-recyclable chitosan-based La3+-imprinted thermoresponsive hydrogel (CLIT) was prepared to accumulate La3+ from solution. The CLIT was characterized by DSC, FITR, Raman spectroscopy, XPS, and SEM, which revealed obvious reversible thermosensitivity and imprinted sites of La3+ ions. An adsorption capacity of 112.21 mg/g to La3+ ions was achieved on CLIT under its optimum adsorption conditions (pH 5, 50 °C, 60 min). The adsorption could be well illustrated by second-order kinetics and Freundlich isotherm models. The La3+-adsorbed CLIT could be recycled only by rinsing with 10 °C cold water, with a desorption rate of 96.72%. After ten cycles of adsorption-desorption, CLIT retained good adsorption capability. In the solution containing six ions, the adsorption coefficients kLa3+/Mn+ of CLIT were 2.04-3.51 times that of non-imprinted hydrogel, with kLa3+/Y3+, kLa3+/Gd3+, kLa3+/Al3+, kLa3+/Fe3+ and kLa3+/Cu2+ being 1.67, 2.04, 3.15, 2.72 and 4.84, respectively.

A Synergistic Anti-Cancer Effect of Troglitazone and Lovastatin in a Human Anaplastic Thyroid Cancer Cell Line and in a Mouse Xenograft Model.

Anaplastic thyroid cancer (ATC) is a malignant subtype of thyroid cancers and its mechanism of development remains inconclusive. Importantly, there is no effective strategy for treatment since ATC is not responsive to conventional therapies, including radioactive iodine therapy and thyroid-stimulating hormone suppression. Here, we report that a combinational approach consisting of drugs designed for targeting lipid metabolism, lovastatin (an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, HMGCR) and troglitazone (an agonist of peroxisome proliferator-activated receptor gamma, PPARγ), exhibits anti-proliferation in cell culture systems and leads to tumor regression in a mouse xenograft model. The composition contains a sub-lethal concentration of both drugs and exhibits low toxicity to certain types of normal cells. Our results support a hypothesis that the inhibitory effect of the combination is partly through a cell cycle arrest at G0/G1 phase, as evidenced by the induction of cyclin-dependent kinase inhibitors, p21cip and p27kip, and the reduction of hyperphosphorylated retinoblastoma protein (pp-Rb)-E2F1 signaling. Therefore, targeting two pathways involved in lipid metabolism may provide a new direction for treating ATC.

Ectopia cordis with a double outlet right ventricle, large ventricular septal defect, malposed great arteries and left ventricular hypoplasia.

Ectopia cordis, defined as partial or complete displacement of the heart outside of the thoracic cavity, is a rare congenital malformation. If not surgically corrected during the early years of life, ectopia cordis can prove to be a fatal abnormality. However, due to the presence of multiple intracardiac and extracardiac malformations, a corrective surgery might not always be successful. The pathology of ectopia cordis with a double outlet right ventricle, large ventricular septal defect, malposed great arteries and left ventricular hypoplasia is discussed, highlighting the complexities involved in such a rare disorder.

An effective moisture interference correction method for maize powder NIR spectra analysis.

The detection of maize starch content is of great significance for maize processing industry and near-infrared spectroscopy (NIRS) is an ideal rapid detection technology. However, the interference of moisture in maize is a bottleneck problem that affects the accuracy of NIRS quantitative analysis. In this study, we proposed methods based on external parameter orthogonalization (EPO) combined with wavelength selection algorithms to bring more accurate analytical results. Two groups of maize starch samples with different moisture content distributions were investigated to compare the predictive performance of NIRS models. The results showed that the model built using EPO combined with the synergy interval partial least squares (EPO-siPLS) algorithm exhibited the superior prediction accuracy, whose RMSEP/RMSEPck is improved by 9.7 % compared with that of siPLS model, 25.3 % compared with that of EPO-PLS, and 45.8 % compared with that of the PLS model. This study provides a more accurate and robust new method for rapid detection of maize starch and offers new insights for its application.

[Adsorption Properties of Magnetic Phosphorous Camellia Oleifera Shells Biochar to Sulfamethoxazole in Water].

Magnetic phosphorous biochar （MPBC） was prepared from Camellia oleifera shells using phosphoric acid activation and iron co-deposition. The materials were characterized and analyzed through scanning electron microscopy （SEM）， X-ray diffractometry （XRD）， specific surface area and pore size analysis （BET）， Fourier infrared spectroscopy （FT-IR）， and X-ray photoelectron spectroscopy （XPS）. MPBC had a high surface area （1 139.28 m2·g-1） and abundant surface functional groups， and it could achieve fast solid-liquid separation under the action of an external magnetic field. The adsorption behavior and influencing factors of sulfamethoxazole （SMX） in water were investigated. The adsorbent showed excellent adsorption properties for SMX under acidic and neutral conditions， and alkaline conditions and the presence of CO32- had obvious inhibition on adsorption. The adsorption process conformed to the quasi-second-order kinetics and Langmuir model. The adsorption rate was fast， and the maximum adsorption capacity reached 356.49 mg·g-1. The adsorption process was a spontaneous exothermic reaction， and low temperature was beneficial to the adsorption. The adsorption mechanism was mainly the chemisorption of pyrophosphate surface functional groups （C-O-P bond） between the SMX molecule and MPBC and also included hydrogen bonding， π-π electron donor-acceptor （π-πEDA） interaction， and a pore filling effect. The development of MPBC adsorbent provides an effective way for resource utilization of waste Camellia oleifera shells and treatment of sulfamethoxazole wastewater.

AKBA inhibits radiotherapy resistance in lung cancer by inhibiting maspin methylation and regulating the AKT/FOXO1/p21 axis.

Acetyl-keto-b-boswellic acid (AKBA) functions in combating human malignant tumors, including lung cancer. However, the function of AKBA in regulating the radioresistance of lung cancer and its underlying mechanism still need to be elucidated. Radiation-resistant lung cancer cells (RA549) were established. Quantitative real-time polymerase chain reaction (QRT-PCR) and Western blot were employed to examine the messenger RNA (mRNA) and protein expressions. After being treated with AKBA and different doses of X-ray, cell proliferation and survival were examined using colony formation assay and cell-counting kit-8 (CCK-8) assay. The cellular localization of Forkhead box 1 (FOXO1) was measured by immunofluorescence (IF). Flow cytometry was employed to analyze cell cycle and apoptosis. In addition, in vivo experiment was performed to determine the effect of AKBA on the sensitivity of tumors to radiation. Herein, we found that AKBA could enhance the radiosensitivity in RA549, suppress cell proliferation, induce cell apoptosis and arrest cell cycle. It was observed that maspin was lowly expressed and hypermethylated in RA549 cells compared to that in A549 cells, while these changes were all eliminated by AKBA treatment. Maspin knockdown could reverse the regulatory effects of AKBA on radioresistance and cellular behaviors of RA549 cells. In addition, we found that AKBA treatment could repress the phosphorylation of Serine/Threonine Kinase (AKT), and FOXO1, increase the translocation of FOXO1 and p21 level in RA549 cells, which was abolished by maspin knockdown. Moreover, results of tumor xenograft displayed that AKBA could enhance the sensitivity of tumor to radiation through the maspin/AKT/FOXO1/p21 axis. We discovered that AKBA enhanced the radiosensitivity of radiation-resistant lung cancer cells by regulating maspin-mediated AKT/FOXO1/p21 axis.

Data fusion strategy based on ultraviolet-visible spectra and near-infrared spectra for simultaneous and accurate determination of key parameters in surface water.

Chemical oxygen demand (COD), ammonia nitrogen (AN) and total nitrogen (TN) are the key parameters to reflect the degree of surface water pollution. Ultraviolet - visible (UV-Vis) spectroscopy and near - infrared (NIR) spectroscopy are ideal techniques for rapid monitoring of these indicators. In this study, a strategy based on the fusion of UV-Vis and NIR spectral data (UV-Vis-NIR) for water quality detection was proposed to further improve the quantitative analysis accuracy of spectroscopic methods. Seventy river samples with different levels of pollution were used for spectroscopic analysis. The UV-Vis-NIR fusion spectrum of each water sample was obtained by directly splicing sample's UV-Vis spectrum and NIR diffuse transmission spectrum. The UV-Vis-NIR fusion models were optimized through using different variable selection algorithms. The results show that the UV-Vis-NIR fusion models for surface water COD, AN and TN achieves better prediction results (the root mean square errors of prediction are 6.95, 0.195, and 0.466, respectively) than single-spectroscopic based models. Since better prediction performances were shown under different optimization conditions, the robustness of fusion models were also better than the single-spectroscopic based models. Therefore, the data fusion strategy proposed in this study has a promising application prospect for further accurate and rapid monitoring of surface water quality.

Biomimetic mineralization by confined diffusion with viscous hyaluronan network: Assembly of hierarchical flower-like supraparticles.

Biomolecules-mediated biomimetic mineralization has been extensively investigated and applied to fabricate nano-assemblies with unique hierarchical architectures and salient properties. The confined-source ion diffusion plays a key role in the biomineralization process, but little investigative efforts have focused on it. Here, we developed a simple method to mimic the in vivo condition by a confined diffusion method, and hydroxyapatite nanoflower assemblies (HNAs) with exquisite hierarchical architectures were obtained. The HNAs were assembled from needle-like hybrid nanocrystals of hydroxyapatite and hyaluronan. The results revealed that the strong interactions between ions and hyaluronan led to the nucleation of hydroxyapatite and the following aggregation. The combination of the external diffusion field and the internal multiple interactions induced the self-assembling processes. Additionally, HNAs with colloid stability and excellent biocompatibility were proved to be a promising cargo carrier for intranuclear delivery. This work presents a novel biomimetic mineralization strategy based on confined diffusion system for fabricating delicate hydroxyapatite, which offers a new perspective for the development of biomimetic strategies.

Biocompatible, bacteria-targeting resveratrol nanoparticles fabricated by Mannich molecular condensation for accelerating infected wound healing.

Excessive reactive oxygen species (ROS) and long-term inflammation can delay wound healing and cause tissue damage, while bacterial infection aggravates the wound environment further. It is impossible to resolve all these thorny problems simultaneously with a wound dressing that has only one function. The antioxidative and anti-inflammatory properties of resveratrol (Res) have been proven. However, the effect of Res is non-selective, and high levels of Res can inhibit cell growth and promote oxidation. Res is also difficult to dissolve and possesses insufficient antibacterial properties, so its role is limited. In this study, Res was assembled via Mannich reaction into nanoparticles and functionalized by phenylboric acid, giving rise to targeting bacteria and solving the water-insoluble dilemma of Res. In comparison with Trolox, the assembled Res NPs performed better at scavenging ABTS and DPPH free radicals. Furthermore, Res NPs that targeted bacteria also showed high biocompatibility at concentrations five times higher than pure Res. The activities of Res NPs were comparable to free Res in downregulating the expression of inflammatory cytokines, and reducing intracellular excessive ROS. The gel embedded with Res NPs accelerated the formation of granulation tissue, collagen deposition, and re-epithelialization, facilitating wound healing. The present study suggests that functionalized polyphenol-based materials are preferably suited to the development of tissue engineering biomaterials.

Engineered fabrication of EGCG-UV absorber conjugated nano-assemblies for antioxidative sunscreens with broad-band absorption.

Applying sunscreen is a common, convenient, and effective measure to protect skin from ultraviolet (UV) damage, but most of UV absorbers in the present commercially available sunscreens are accompanied with the insufficiencies in terms of efficacy and biosafety. The use of nanotechnology to combine conventional UV absorbers with biocompatible natural products is a feasible strategy to combat these deficiencies. Herein, a simple, green and engineering preparation of broad-band sunscreens was demonstrated by the molecular assembly of a UV absorber aminobenzoic acid (ABA) and polyphenol extracted from green tea (EGCG). Spherical and negatively-charged EGCG/ABA nanoparticles (EA NPs) were simply synthesized with a wide range of particle size from 54.6 to 715.1 nm. These NPs had the satisfactory biocompatibility and antioxidative activity, and could protect fibroblasts from oxidative-stress damage. The formulations containing 10 wt% EA NPs further exhibited broad-spectrum UV absorption and lower UV transmittance than commercial sunscreens. It is believed that this study would spur the utilization of natural reproducible sources for developing biosafe sunscreens with strong anti-UV capability. Indeed, this simple nanotechnology aimed at tackling the biosafe risk of conventional UV absorbers provides a feasible solution strategy with green tea extracts.

Injectable hyaluronic acid/hydroxyapatite composite hydrogels as cell carriers for bone repair.

The natural polysaccharide/hydroxyapatite hydrogels are of great interest to bone tissue engineering, but the interfacial mismatch between rigid hydroxyapatite and soft polysaccharide phase in these hydrogels remains unsolved, which is unfavorable to achieving uniform dispersion of hydroxyapatite particles in the hydrogel matrices. Herein, hyaluronic acid (Hya), an extracellular matrix constituent, was chosen as the template for biological mineralization to synthesize Hya/hydroxyapatite hybrid particles (HAHs). The oxidized Hya/hydroxyapatite hybrid particles (OHAHs) were obtained by oxidating the Hya in the HAHs. These OHAHs were the ball-flower particles hybridized with ca. 22 % oxidized Hya. Then, different concentrations of OHAHs were introduced to prepare hydroxyapatite composite hydrogels (HCH) via Schiff-base reaction of oxidized Hya and carboxymethyl chitosan. The injectability and self-healing of HCH were evaluated and the introduction of OHAHs significantly increased the storage modulus. The gelation time of HCH showed a negative relation with the concentration of OHAHs while the storage modulus presented a positive correlation. MTT assays and live/dead staining of L929 cells co-cultured with HCH confirmed that the hydrogels had excellent cytocompatibility, and supported the adhesion and proliferation of cells under the three-dimension culture conditions. These injectable self-healing hydrogels suitable for cell encapsulation were potentially useful for bone defect repair.

Genome-Wide Identification and Expression Analysis of m6A Writers, Erasers, and Readers in Litchi (Litchi chinensis Sonn.).

N6-methyladenosine (m6A) RNA modification is the most prevalent type of RNA methylation and plays a pivotal role in the development of plants. However, knowledge of the m6A modification in litchi remains limited. In this study, a complete analysis of m6A writers, erasers, and readers in litchi was performed and 31 litchi m6A regulatory genes were identified in total, including 7 m6A writers, 12 m6A erases, and 12 readers. Phylogeny analysis showed that all three of the kinds of litchi m6A regulatory proteins could be divided into three groups; domains and motifs exhibited similar patterns in the same group. MiRNA target site prediction showed that 77 miRNA target sites were located in 25 (80.6%) litchi m6A regulatory genes. Cis-elements analysis exhibited that litchi m6A regulatory genes were mainly responsive to light and plant hormones, followed by environmental stress and plant development. Expression analysis revealed litchi m6A regulatory genes might play an important role during the peel coloration and fruit abscission of litchi. This study provided valuable and expectable information of litchi m6A regulatory genes and their potential epigenetic regulation mechanism in litchi.

Proteomics-based analysis of potential therapeutic targets in patients with peritoneal dialysis-associated peritonitis.

BACKGROUND: Peritoneal dialysis-associated peritonitis (PDAP) is the most common complication in peritoneal dialysis patients. We propose screening for characteristic expressed proteins in the dialysate of PDAP patients to provide clues for the diagnosis of PDAP and its therapeutic targets. METHODS: Dialysate samples were collected from patients with a first diagnosis of PDAP (n = 15) and from patients who had not experienced peritonitis (Control, n = 15). Data-independent acquisition (DIA) proteomic analysis was used to screen for differentially expressed proteins (DEPs). Co-expression networks were constructed via weighted gene co-expression network analysis (WGCNA) for detection of gene modules. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used for functional annotation of DEPs and gene modules. Hub proteins were validated using the parallel reaction monitoring (PRM) method. RESULTS: A total of 142 DEPs in the dialysate of PDAP patients were identified. 70 proteins were upregulated and 72 proteins were downregulated. GO and KEGG analysis showed that DEPs were mainly enriched in cell metabolism, glycolysis/glycogenesis and hypoxia-inducible factor-1 signaling pathway. Subsequently, a co-expression network was constructed and four gene modules were detected. Myeloperoxidase (MPO) and myeloperoxidase (HP) were the key proteins of the blue and turquoise modules, respectively. Additionally, PRM analysis showed that the expression of MPO and HP was significantly upregulated in the PDAP group compared to the non-peritonitis group, which was consistent with our proteomics data. CONCLUSION: MPO and HP were differentially expressed in the dialysate of PDAP patients and may be potential diagnostic and therapeutic targets for PDAP.

The association between diabetes coexisting with low levels of high-density lipoprotein cholesterol and peritoneal dialysis-related peritonitis.

BACKGROUND: Low levels of high-density lipoprotein cholesterol (HDL-C) and diabetes are common in patients undergoing peritoneal dialysis (PD). The aim of this study was to investigate the association between the coexistence of diabetes with a low level of HDL-C and the first episode of peritoneal dialysis-related peritonitis (PDRP) in patients with PD. METHODS: We retrospectively investigated patients with PD from January 1, 2003, to May 31, 2020, in four PD centers. Patients with PD were divided into four groups: no comorbidities, low HDL-C only, diabetes only, and diabetes plus low HDL-C. The clinical and laboratory baseline data of the four groups were collected and compared. The association between diabetes coexisting with low HDL-C levels and the first episode of PDRP was analyzed by multivariate Cox regression analysis. RESULTS: A total of 1013 patients with PD were included in our study. The mean age was 49.94 ± 14.32 years, and 597 (58.99%) patients were males. A total of 301 (29.7%) patients had their first episodes of PDRP, and low HDL-C levels coexisted with diabetes in 72 patients with PD. After adjusting for confounding factors, a low level of HDL-C coexisting with diabetes was significantly associated with the first episode of PDRP in our study (hazard ratio: 2.81, 95% CI 1.32 ~ 4.73, p = 0.005). The associations among HDL-C, diabetes and PDRP were consistent in the following subgroups: sex, age, and pre-existing CVD (all P interaction > 0.05). CONCLUSIONS: Patients with both diabetes and low HDL-C levels were at higher risk for PDRP in patients with PD.

Injectable oxidized alginate/carboxylmethyl chitosan hydrogels functionalized with nanoparticles for wound repair.

Owing to its simple properties, the application of injectable hydrogel in wound repair is limited. Therefore, the multi-functionalization of injectable hydrogel to improve the therapeutic effect is imperative. Here, keratin nanoparticles (Ker NPs) with facilitating epithelization capability and nanosized-EGCG covered with Ag nanoparticles (AE NPs) with radicals scavenging capability were used to functionalize injectable oxidized alginate/carboxylmethyl chitosan hydrogel (KA hydrogel). The radical scavenging experiments proved the anti-oxidative capacity of AE NPs. Rheological test exhibited that the gelation time and storage modulus of KA hydrogel were about 216 s and 403 Pa. Additionally, wound healing experiment in vivo showed that KA hydrogel could accelerated wound healing, especially in the early stage, and improved the thickness of renascent epidermis by 21 %. In this work, Ker NPs and AE NPs functionalization endowed injectable hydrogels with the capabilities of scavenging radicals and facilitating epithelization, which is promising for the applications in wound repair.

The relationship between the prognostic nutritional index and new-onset pneumonia in peritoneal dialysis patients.

PURPOSE: As an indicator of nutrition and immunity, the prognostic value of the prognostic nutritional index (PNI) has been confirmed in various diseases. However, the relationship between PNI and the incidence of pneumonia in peritoneal dialysis (PD) patients remains unknown. The purpose of this study was to investigate the relationship between PNI and new-onset pneumonia in patients undergoing PD. METHODS: Thousand two hundred and nighty eight patients were enrolled in this multicenter retrospective study from February 1, 2010, to February 28, 2020. A total of 899 patients were included in the final statistical analysis. The patients were stratified into two groups by PNI quartiles. The primary endpoint was a new-onset pneumonia event. Cox regression model analysis was used to explore the association between PNI and the first occurrence of pneumonia. RESULTS: During a mean follow-up of 41.43 months, 147 patients developed new-onset pneumonia. Kaplan-Meier survival curves showed a significant difference in the incidence of the first presentation of pneumonia between the two groups, that patients in the low PNI group had a higher risk of pneumonia (P = 0.016). By adjusting for demographic parameters, comorbidities, and laboratory indicators, the Cox regression model showed that the high PNI group had less risk compared to the low PNI group (HR 0.479 95% CI 0.297-0.772, P = 0.003). There were no interactions in the subgroups as follows: diabetes, hypertension, age, and sex. CONCLUSIONS: Low PNI levels were independently associated with the first occurrence of pneumonia in PD patients. PNI was an independent predictor of new-onset pneumonia in PD patients.