Clinical characteristics and related risk factors of disease severity in 101 COVID-19 patients hospitalized in Wuhan, China.

Coronavirus disease 2019 (COVID-19) broke out in December 2019. Due its high morbility and mortality, it is necessary to summarize the clinical characteristics of COVID-19 patients to provide more theoretical basis for future treatment. In the current study, we conducted a retrospective analysis of the clinical characteristics of COVID-19 patients and explored the risk factors for the severity of illness. A total of 101 COVID-19 patients hospitalized in Leishenshan Hospital (Wuhan, China) was classified into three sub-types: moderate (n = 47), severe (n = 36), and critical (n = 18); their clinical data were collected from the Electronic Medical Record. We showed that among the 101 COVID-19 patients, the median age was 62 years (IQR 51-74); 50 (49.5%) patients were accompanied by hypertension, while 25 (24.8%) and 22 (21.8%) patients suffered from diabetes and heart diseases, respectively, with complications. All patients were from Wuhan who had a definite history of exposure to the epidemic area. Multivariate logistic regression analysis revealed that older age, diabetes, chronic liver disease, percentage of neutrophils (N%) > 75%, CRP > 4 mg/L, D-dimer > 0.55 mg/L, IL-2R > 710 U/mL, IL-8 > 62 pg/mL, and IL-10 > 9.1 pg/mL were independent variables associated with severe COVID-19. In conclusion, we have identified the independent risk factors for the severity of COVID-19 pneumonia, including older age, diabetes, chronic liver disease, higher levels of N%, CRP, D-dimer, IL-2R, IL-8, and IL-10, providing evidence for more accurate risk prediction.

Detection of target DNA with a novel Cas9/sgRNAs-associated reverse PCR (CARP) technique.

This study develops a new method for detecting target DNA based on Cas9 nuclease, which was named as CARP, representing CRISPR- or Cas9/sgRNAs-associated reverse PCR. This technique detects target DNA in three steps: (1) cleaving the detected DNA sample with Cas9 in complex with a pair of sgRNAs specific to target DNA; (2) ligating the cleaved DNA with DNA ligase; (3) amplifying target DNA with PCR. In the ligation step, the Cas9-cut target DNA was ligated into intramolecular circular or intermolecular concatenated linear DNA. In the PCR step, the ligated DNA was amplified with a pair of reverse primers. The technique was verified by detecting HPV16 and HPV18 L1 genes in nine different human papillomavirus (HPV) subtypes. The technique also detected the L1 and E6-E7 genes of two high-risk HPVs, HPV16 and HPV18, in the genomic DNA of two HPV-positive cervical carcinoma cells (HeLa and SiHa), in which no L1 and E6-E7 genes were detected in the HPV-negative cervical carcinoma cell, C-33a. By performing these proof-of-concept experiments, this study provides a new CRISPR-based DNA detection and typing method. Especially, the CARP method developed by this study is ready for the clinical HPV detection, which was supported by the final clinical sample detection. Graphical abstract CRISPR-associated reverse PCR (CARP) can be used to detect and type target DNA in a simple three-step procedure, cutting, ligation, and amplification.

On-nylon membrane detection of nucleic acid molecules by rolling circle amplification.

Positively-charged nylon membrane (NM) is a general solid-phase support for nucleic acid detection due to its convenient immobilization of nucleic acid materials by direct electrostatic adherence and simple UV crosslinking. Rolling circle amplification (RCA) is a widely used isothermal DNA amplification technique for nucleic acid detection. Near-infrared fluorescence (NIRF) is a new fluorescence technique with high sensitivity due to low background. This study developed a simple method for detecting nucleic acid molecules by combining the advantages of NM, RCA and NIRF, named NIRF-based solid phase RCA on nylon membrane (NM-NIRF-sRCA). The detection system of this method only need two kinds of nucleic acid molecules: target-specific probes with a RCA primer (P) at their 3' end and a rolling circle (RC). The detection procedure consists of four steps: (1) immobilizing detected nucleic acids on NM by UV crosslinking; (2) hybridizing NM with specific probes and RC; (3) amplifying by a RCA reaction containing biotin-dUTP; (4) incubating NM with NIRF-labeled streptavidin and imaging with a NIRF imager. The method was fully testified by detecting oligonucleotides, L1 fragments of various HPV subtypes cloned in plasmid, and E.coli genomic DNA. This study thus provides a new facile method for detecting nucleic acid molecules.

Identification of novel NF-κB transcriptional targets in TNFα-treated HeLa and HepG2 cells.

Identification of target genes of NF-κB is critical for deeply understanding its biological functions. Here, we identified five novel NF-κB target genes. Firstly, we found that 20 NF-κB potential target genes (PTGs) identified by ChIP-Seq and Genechip assay were enriched into the KEGG term of Pathways in cancer, 16 of them were enriched into the KEGG pathways of small cell lung cancer, chronic myeloid leukemia, basal cell carcinoma, pancreatic cancer, and colorectal cancer. Among these PTGs, there are many documented NF-κB target genes. Therefore, NF-κB may play important role in cancer progression by transcriptionally regulating these genes. Apart from the known target genes, we also found some novel PTGs including CYCS, MITF, FZD1, FZD8, and PIAS1. We subsequently demonstrated whether NF-κB transcriptionally control the five PTGs. The ChIP-Seq assay revealed that NF-κB/p65 bound to these genes in TNFα-treated HeLa. The bioinformatic analysis indicated that the NF-κB binding regions (i.e., ChIP-Seq peaks) contained κB sites and NF-κB/RelA DNA-binding motif. The ChIP-qPCR assay also confirmed that NF-κB bound to these regions in both TNFα-treated HeLa and HepG2 cells. The reporter construct showed that NF-κB could regulate luciferase expression via its binding region. Finally, qPCR and Western blot assay demonstrated that NF-κB indeed regulated the expression of these genes in the TNFα-treated HeLa and HepG2 cells. In a word, CYCS, MITF, FZD1, FZD8, and PIAS1 were identified as bona fide NF-κB target genes. These findings provide more insights into the role of NF-κB in cancers.

NF-κB target microRNAs and their target genes in TNFα-stimulated HeLa cells.

As a transcription factor, NF-κB was demonstrated to regulate the expressions of miRNAs. However, only a few miRNAs have been identified as its targets so far. In this study, by using ChIP-Seq, Genechip and miRNA-Seq techniques, we identified 14 NF-κB target miRNAs in TNFα-stimulated HeLa Cells, including miR-1276, miR-1286, miR-125b-1-3p, miR-219-1-3p, miR-2467-5p, miR-3200-3p, miR-449c-5p, miR-502-5p, miR-548d-5p, miR-30b-3p, miR-3620-5p, miR-340-3p, miR-4454 and miR-4485. Of these miRNAs, 8 detected miRNAs were also NF-κB target misRNAs in TNFα-stimulated HepG2 cells. We also identified 16 target genes of 6 miRNAs including miR-125b-1-3p, miR-1286, miR-502-5p, miR-1276, miR-219-1-3p and miR-30b-3p, in TNFα-stimulated HeLa cells. Target genes of miR-125b-1-3p and miR-1276 were validated in HeLa and HepG2 cells by transfecting their expression plasmids and mimics. Bioinformatic analysis revealed that two potential target genes of miR-1276, BMP2 and CASP9, were enriched in disease phenotypes. The former is enriched in osteoarthritis, and the latter is enriched in Type 2 diabetes and lung cancer, respectively. These findings suggested that this little known miRNA might play roles in these diseases via its two target genes of BMP2 and CASP9. The expression of miR-125b-1 regulated by NF-κB has been reported in diverse cell types under various stimuli, this study found that its expression was also significantly regulated by NF-κB in TNFα-stimulated HeLa and HepG2 cells. Therefore, this miRNA was proposed as a central mediator of NF-κB pathway. These findings provide new insights into the functions of NF-κB in its target miRNA-related biological processes and the mechanisms underlying the regulation of these miRNAs.

Purified cell wall from the probiotic bacterium Lactobacillus gasseri activates systemic inflammation and, at higher doses, produces lethality in a rat model.

INTRODUCTION: One proposed benefit of probiotic therapy is that probiotic bacterial cell-wall binding to intestinal cell pathogen-recognition receptors activates protective innate immunity. However, in critically ill patients, intestinal epithelium disruption by shock or other insults may compromise this compartmentalized response and cause systemic bacteria and cell-wall translocation. The effects of intravascular introduction of probiotic bacterial cell wall are unclear. METHODS: We investigated 24-hour infusions of purified cell wall from Lactobacillus gasseri ATC33323 (L. gasseri), a probiotic bacterium, in Sprague-Dawley rats (n = 49). RESULTS: Increasing cell-wall doses (0 (control), 10, 20, 40, 80, or 160 mg/kg over 24 hours) produced dose-ordered decreases in survival measured after 168 hours (11 survivors/11 total (100%), seven of seven (100%), seven of seven (100%), six of eight (75%), five of eight (63%), and one of nine (11%), respectively, P < 0.0001). The L. gasseri cell wall was equally or more lethal than Staphylococcus aureus cell wall, which was previously studied (100% to 88% survival with the same increasing doses). During challenge, compared with controls, L. gasseri cell wall produced increases in blood IL-1ß, IL-10, tumor necrosis factor-α, migratory inhibitory protein-1α, monocyte chemotactic protein-1, and nitric oxide, and decreases in neutrophils, lymphocytes, and platelets that were greater with higher versus lower doses (P ≤ 0.05). Medium-dose cell wall (40 and 80 mg/kg combined) progressively decreased blood pressure and increased heart rate, and all doses increased lactate, hepatic transaminases, and creatinine phosphokinase (P ≤ 0.05). CONCLUSION: Although L. gasseri, like other probiotic bacteria, is considered safe, its cell wall can stimulate the maladaptive inflammatory response associated with pathogenic bacteria. Such effects deserve study, especially regarding critically ill patients.

Effect of silencing the E74B gene on the development and metamorphosis of Helicoverpa armigera.

BACKGROUND: The growth and development transition of insects are mainly mediated by ecdysone. As one of the ecdysone-induced transcription factors, E74 is involved in many physiological processes of insect growth and development. However, E74 and its function in Helicoverpa armigera remains unclear. RESULTS: In this study, E74B, a subtype of the E74, was identified for the first time in H. armigera. Bioinformatics analysis showed that H. armigera E74B shared the highest homology with E74B in Bombyx mori, which belongs to the E26 transformation-specific (ETS) superfamily. The expression profile showed that the transcription level of HaE74B increased in the late stages of fourth to sixth instars compared with the early stages; it was also high in the pupa and midgut. Moreover, we investigated the function of HaE74B through RNA interference and 20E rescue experiments. The results showed silencing of E74B affected the molting and growth of larvae, resulting in the death of more than 60% of larvae. In addition, it also seriously affected the metamorphosis of H. armigera, which reduced the pupae rate, the eclosion rate of the pupae, and fecundity. Application of 20E partially restored the defects in the molting, development and pupae rate of H. armigera. CONCLUSION: Taken together, these results demonstrated that HaE74B plays a critical role in the growth, development, and metamorphosis of H. armigera, which serves as a molecular target and sets out a theoretical foundation for RNAi-mediated control of this key pest. © 2023 Society of Chemical Industry.

Predictive value of CD86 for the occurrence of sepsis (Sepsis-3) in patients with infection.

This prospective observational study explored the predictive value of CD86 in the early diagnosis of sepsis in the emergency department. The primary endpoint was the factors associated with a diagnosis of sepsis. The secondary endpoint was the factors associated with mortality among patients with sepsis. It enrolled inpatients with infection or high clinical suspicion of infection in the emergency department of a tertiary Hospital between September 2019 and June 2021. The patients were divided into the sepsis and non-sepsis groups according to the Sepsis-3 standard. The non-sepsis group included 56 patients, and the sepsis group included 65 patients (19 of whom ultimately died). The multivariable analysis showed that CD86% (odds ratio [OR] = 1.22, 95% confidence interval [CI]: 1.04-1.44, P = 0.015), platelet count (OR = 0.99, 95%CI: 0.986-0.997, P = 0.001), interleukin-10 (OR = 1.01, 95%CI: 1.004-1.025, P = 0.009), and procalcitonin (OR = 1.17, 95%CI: 1.01-1.37, P = 0.043) were independent risk factors for sepsis, while human leukocyte antigen (HLA%) (OR = 0.96, 05%CI: 0.935-0.995, P = 0.022), respiratory rate (OR = 1.16, 95%CI: 1.03-1.30, P = 0.014), and platelet count (OR = 1.01, 95%CI: 1.002-1.016, P = 0.016) were independent risk factors for death in patients with sepsis. The model for sepsis (CD86%, platelets, interleukin-10, and procalcitonin) and the model for death (HLA%, respiratory rate, and platelets) had an area under the curve (AUC) of 0.870 and 0.843, respectively. CD86% in the first 24 h after admission for acute infection was independently associated with the occurrence of sepsis in the emergency department.

Natural ventilation cooling effectiveness classification for building design addressing climate characteristics.

The evaluation of natural ventilation potential for effective sustainable options and innovative green building design strategies is of great interest to architects, researchers and governments. From a retrospective review, we found that the potential evaluation of natural ventilation (NV) cooling effectiveness in the same category based on similar meteorological uncertainty, research objectives and objects showed significant differences. Uncertainties added and uncertainty propagation (both model form uncertainties and parameter uncertainties) could result in large discrepancies between simulation outcomes and real scenarios, especially in the design performance modeling (DPM) phase. In this conceptual design stage, a few parameters are available and therefore decisive. It is necessary to review and identify the key performance indicators and explore the extent to which deviations are caused by inconsistencies or biases in model information. As a basis for more concrete research, we propose statistical tests based on quantitative evaluations to explore the rule of natural ventilation potential volatility and identify whether there is a significant potential improvement resulting from the critical parameter enhancement with the optimal relationship. The showcase is applied in China, where there has been a significant amount of criticism regarding the current building climate zoning due to the perceived coarseness of the system and where there has been an active exploration into the possibility of redefining building climate zoning with a view toward improving its accuracy and effectiveness.

Highly Efficient Photodynamic Hydrogel with AIE-Active Photosensitizers toward Methicillin-Resistant Staphylococcus aureus Ultrafast Imaging and Killing.

Methicillin-resistant Staphylococcus aureus (MRSA) causes great health hazards to society because most antibiotics are ineffective. Photodynamic treatment (PDT) has been proposed to combat MRSA due to the advantage of imaging-guided no-drug resistance therapy. However, the traditional photosensitizers for PDT are limited by aggregation-caused quenching for imaging and low photodynamic antibacterial efficiency. In this work, we synthesize a new aggregation-induced emission (AIE) photosensitizer (APNO), which can ultrafast distinguish between Gram-positive and Gram-negative bacteria within 3 s by AIE-active photosensitizer imaging. Meanwhile, APNO can generate antibacterial reactive oxygen species under light irradiation, which holds potential for antibacterial PDT. Then, APNO is loaded by PHEAA hydrogel to obtain a highly efficient photodynamic hydrogel (APNO@gel). In vitro results show complete inhibition of MRSA by APNO@gel under lower-power light irradiation. Transcriptome analysis is performed to investigate antibacterial mechanism of APNO@gel. Most importantly, APNO@gel also exhibits significant inhibition and killing ability of MRSA in the MRSA wound infection model, which will further promote rapid wound healing. Therefore, the photodynamic hydrogel provides a promising strategy toward MRSA ultrafast imaging and killing.

Automatic Detection of Scalp High-Frequency Oscillations Based on Deep Learning.

Scalp high-frequency oscillations (sHFOs) are a promising non-invasive biomarker of epilepsy. However, the visual marking of sHFOs is a time-consuming and subjective process, existing automatic detectors based on single-dimensional analysis have difficulty with accurately eliminating artifacts and thus do not provide sufficient reliability to meet clinical needs. Therefore, we propose a high-performance sHFOs detector based on a deep learning algorithm. An initial detection module was designed to extract candidate high-frequency oscillations. Then, one-dimensional (1D) and two-dimensional (2D) deep learning models were designed, respectively. Finally, the weighted voting method is used to combine the outputs of the two model. In experiments, the precision, recall, specificity and F1-score were 83.44%, 83.60%, 96.61% and 83.42%, respectively, on average and the kappa coefficient was 80.02%. In addition, the proposed detector showed a stable performance on multi-centre datasets. Our sHFOs detector demonstrated high robustness and generalisation ability, which indicates its potential applicability as a clinical assistance tool. The proposed sHFOs detector achieves an accurate and robust method via deep learning algorithm.

mRNA sequencing reveals the distinct gene expression and biological functions in cardiac fibroblasts regulated by recombinant fibroblast growth factor 2.

After myocardial injury, cardiac fibroblasts (CFs) differentiate into myofibroblasts, which express and secrete extracellular matrix (ECM) components for myocardial repair, but also promote myocardial fibrosis. Recombinant fibroblast growth factor 2 (FGF2) protein drug with low molecular weight can promote cell survival and angiogenesis, and it was found that FGF2 could inhibit the activation of CFs, suggesting FGF2 has great potential in myocardial repair. However, the regulatory role of FGF2 on CFs has not been fully elucidated. Here, we found that recombinant FGF2 significantly suppressed the expression of alpha smooth muscle actin (α-SMA) in CFs. Through RNA sequencing, we analyzed mRNA expression in CFs and the differently expressed genes regulated by FGF2, including 430 up-regulated genes and 391 down-regulated genes. Gene ontology analysis revealed that the differentially expressed genes were strongly enriched in multiple biological functions, including ECM organization, cell adhesion, actin filament organization and axon guidance. The results of gene set enrichment analysis (GSEA) show that ECM organization and actin filament organization are down-regulated, while axon guidance is up-regulated. Further cellular experiments indicate that the regulatory functions of FGF2 are consistent with the findings of the gene enrichment analysis. This study provides valuable insights into the potential therapeutic role of FGF2 in treating cardiac fibrosis and establishes a foundation for further research to uncover the underlying mechanisms of CFs gene expression regulated by FGF2.

Treatment of direct blending dye wastewater and recycling of dye sludge.

A new sorbent material, barium sulfate-Direct Blending Yellow D-3RNL hybrid (BSD), was synthesized and characterized by various methods. Both the anionic dyes, Reactive Brilliant Red X-3B and Weak Acid Green GS were hardly adsorbed by the BSD material, while the sorption of Ethyl Violet (EV) and Victoria Blue B were extremely obvious. The sorption of cationic dyes obeyed the Langmuir isotherm model, which depended on the electric charge attraction. The saturation amount of EV adsorbed onto the BSD material approached to 39.36 mg/g. The sorption of EV changed little with pH from 3 to 12 while it increased with increasing levels of electrolyte. A dye wastewater sampled from Jinjiang Chemicals was treated, and the color removal rate was more than the COD removal rate. In addition, the cationic dye-BSD sludge was utilized as a colorant fill-in coating. The light stability and thermal stability of the colorant was measured and exhibited good features. This work provided a simple and eco-friendly method for dye wastewater treatment with recycling of waste.

EFFECTS OF SHENFU INJECTION ON SUBLINGUAL MICROCIRCULATION IN SEPTIC SHOCK PATIENTS: A RANDOMIZED CONTROLLED TRIAL.

ABSTRACT: Background and Objective: The optimization of macrocirculatory hemodynamics is recommended by current sepsis guidelines. However, microcirculatory dysfunction is considered the cause of severe sepsis. In the present study, we designed to verify whether the application of Shenfu injection (SFI) restores microcirculation, thereby improving tissue perfusion and inhibiting organ dysfunction, resulting in improved outcomes. Design: We conducted a prospective, single-center, randomized, double-blind, placebo-controlled clinical trial. Intervention: Patients were randomly assigned to group receiving SFI (n = 20) or placebo (n = 20) for 5 days. We administered SFI or glucose injection for 5 days and blinded the investigators and clinical staff by applying light-proof infusion equipment that concealed therapy allocation. Measurements and Results: We measured the systemic dynamics and lactate levels, biomarkers of endothelial dysfunction, and inflammatory cytokines in the plasma. The parameters of sublingual microcirculation were assessed using side-stream dark-field imaging. Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) score, total dose, and duration of vasopressor use, emergency intensive care unit (EICU) stay, and 28-day mortality were evaluated. After treatment with SFI, the disturbance of the sublingual microcirculation was considerably alleviated, as indicated by the significant increase in total vessel density, perfused vessel density, and microvascular flow index. Moreover, the plasma biomarker levels of endothelial dysfunction, including Ang-2, Syn-1, and ET-1, were reversed after SFI treatment. Importantly, the SFI group had a more favorable prognosis than the control group in terms of the APACHE-II score, SOFA score, duration of vasopressor administration, and length of EICU stay. However, the difference in mortality at day 28 was not statistically different between the SFI (15%, 3/20) and placebo (25%, 5/20) groups ( P = 0.693). Conclusions : Shenfu injection provided apparent effects in improving sublingual microcirculatory perfusion in patients with septic shock, and this protection may be related with the inhibition of endothelial dysfunction and vasodilatory effects.

The features comparison between patients in the ICU and general wards and between patients with different outcomes: a 2020 COVID-19 study.

BACKGROUND: The novel 2019 coronavirus (COVID-19) has largely abated in China; however, sporadic or imported cases are still a concern, while in other countries, the COVID-19 pandemic persists as a major health crisis. METHODS: All patients enrolled in this study were diagnosed with COVID-19 from February 21, 2020 to April 14, 2020 in Wuhan. We retrospectively analyzed the patients admitted to the ICU (137 patients) and general wards (114 patients) of Wuhan Leishenshan Hospital in China. The population characteristics, symptoms, and laboratory examination results between the patients in the ICU and those in the general wards were compared. Furthermore, the differences between the deceased patients in the ICU and those discharged from the ICU were compared. RESULTS: There were significant differences between the two groups in terms of symptoms, including fever, shortness of breath, no presence of complications, presence of 1 complication, and presence of 3 or more complications (P<0.05). There were also significant differences between the patients in terms of the laboratory examination results including elevated urea nitrogen, creatinine, direct bilirubin, aspartate aminotransferase, total protein, albumin, creatine kinase, lactate dehydrogenase, procalcitonin, erythrocyte sedimentation rate, white blood cells, C-reactive protein, prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, interleukin 6, interleukin 8, interleukin 10, interleukin 2 receptor, tumor necrosis factor-α, troponin I, phosphokinase isoenzyme-MB, and B-type natriuretic peptide; and decreased platelets, lymphocyte absolute value, and eosinophil absolute value (<0.05). There were 45 patients who died in ICU and 57 improved and discharged patients. There were significant differences between the two groups in the number of patients that had 1 complication and 3 or more complications (P<0.05). There were also significant differences in the laboratory examination results between the patients including elevated urea nitrogen, total bilirubin, direct bilirubin, aspartate aminotransferase, procalcitonin, white blood cells, interleukin 8, interleukin 10, phosphokinase isoenzyme-MB, and B-type natriuretic peptide; and decreased platelets and eosinophil absolute value (P<0.05). CONCLUSIONS: Our findings highlight that the identified determinants may help to improve treatment of COVID-19 patients, to predict the risk of developing severe illness and to optimizing arrangement of health resources.

Clinical characteristics and risk factors for mortality in patients with coronavirus disease 2019 in intensive care unit: a single- center, retrospective, observational study in China.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a potentially life-threatening contagious disease which has spread all over the world. Risk factors associated with the clinical outcomes of COVID-19 pneumonia in intensive care unit (ICU) have not yet been well determined. METHODS: This was a retrospective, single-centered, observational study, in which 47 patients with confirmed COVID-19 were consecutively enrolled from February 24 to April 5, 2020. The patients were registered from the ICU of Leishenshan Hospital in Wuhan, China. Clinical characteristics and outcomes were collected and compared between survivors and non-survivors. Multivariable logistic regression was performed to analyze the risk factors of death in patients with COVID-19. RESULTS: The study cohort included 47 adult patients with an average age of 70.55±12.52 years, and 30 (63.8%) patients were men. Totally 15 (31.9%) patients died. When compared to survivors, nonsurvivors showed a higher proportion of septic shock [6 (40%) patients vs. 3 (9.4%) patients], disseminated intravascular coagulation [3 (21.4%) vs. 0], and had higher score of APACHE II (25.07±8.03 vs. 15.56±5.95), CURB-65 {3 [2-4] vs. 2 [1-3]}, Sequential Organ Failure Assessment (SOFA) {7 [5-9] vs. 3 [1-6]}, higher level of D-dimer {5.74 [2.32-18] vs 2.05 [1.09-4.00]} and neutrophil count {9.4 [7.68-14.54] vs. 5.32 [3.85-9.34]}. SOFA score (OR 1.47; 95% CI: 1.01-2.13; P=0.0042) and the lymphocyte count (OR 0.02; 95% CI: 0.00-0.86; P=0.042) on admission were independently risk factors for mortality. Patients with higher lymphocyte count (>0.63×109 /L) and lower SOFA score (≤4) on admission had a significantly better prognosis than those with lower lymphocyte count (≤0.63×109 /L) and higher SOFA score (>4) in overall survival. CONCLUSIONS: Higher SOFA score and lower lymphocyte count at admission were connected with poor prognosis of patients with COVID-19 in ICU. Lymphocyte count may serve as a promising prognostic biomarker.

Hedgehog signalling controls sinoatrial node development and atrioventricular cushion formation.

Smoothened is a key receptor of the hedgehog pathway, but the roles of Smoothened in cardiac development remain incompletely understood. In this study, we found that the conditional knockout of Smoothened from the mesoderm impaired the development of the venous pole of the heart and resulted in hypoplasia of the atrium/inflow tract (IFT) and a low heart rate. The blockage of Smoothened led to reduced expression of genes critical for sinoatrial node (SAN) development in the IFT. In a cardiac cell culture model, we identified a Gli2-Tbx5-Hcn4 pathway that controls SAN development. In the mutant embryos, the endocardial-to-mesenchymal transition (EndMT) in the atrioventricular cushion failed, and Bmp signalling was downregulated. The addition of Bmp2 rescued the EndMT in mutant explant cultures. Furthermore, we analysed Gli2+ scRNAseq and Tbx5-/- RNAseq data and explored the potential genes downstream of hedgehog signalling in posterior second heart field derivatives. In conclusion, our study reveals that Smoothened-mediated hedgehog signalling controls posterior cardiac progenitor commitment, which suggests that the mutation of Smoothened might be involved in the aetiology of congenital heart diseases related to the cardiac conduction system and heart valves.

[Effect of ethyl pyruvate on expression of inflammatory factors and mitogen-activated protein kinase proteins in renal ischemic/reperfusion injury in BABL/c mice].

OBJECTIVE: To investigate the effects of ethyl pyruvate (EP) on expression of proinflammatory related gene and proteins of mitogen-activated protein kinase (MAPK) in renal tissues in ischemic/reperfusion (I/R) injury in mice. METHODS: Fifty male BABL/c mice were randomly divided into sham operation group (n=8), model group (n=10), and EP treatment group (n=32). EP treatment group was subdivided into EP pretreatment group (administration of 40 mg/kg EP 30 minutes before reproduction of model, n=8), and 4, 6 and 12 hours treatment groups (administration of 40 mg/kg EP 4, 6 and 12 hours after reproduction of model, respectively, n=8 in each group). Bilateral renal artery was occluded with a microvascular clamp for 30 minutes to reproduce kidney I/R injury model, and the kidney was harvested at 24 hours after I/R. The mRNA expressions of interleukins (IL-1ß, IL-6), tumor necrosis factor-α (TNF-α), intercellular adhesion molecule-1 (ICAM-1) and high-mobility group box 1 (HMGB1) were determined by real time reverse transcription-polymerase chain reaction (RT-PCR). The changes in protein levels of MAPKs [extracellular regulated protein kinase 1/2 (ERK1/2), c-Jun N-terminal kinase (JNK), p38MAPK] were determined by Western blotting analysis. RESULTS: Real-time PCR assay showed that the mRNA expressions of IL-1ß, IL-6, TNF-α, ICAM-1, HMGB1 in renal tissue were much higher than those in sham operation group (IL-1ß: 12.05±8.08 vs. 3.18±1.13, IL-6: 10.26±6.85 vs. 0.81±0.34, TNF-α: 5.83±3.85 vs. 0.67±0.34, ICAM-1: 3.87±2.02 vs. 0.29±0.13, HMGB1: 652.82±78.50 vs. 112.31±32.50, all P<0.05); and the expression in EP treatment groups was markedly down-regulated than that in model group, especially in 12-hour treatment group (0.45±0.26, 0.66±0.13, 0.21±0.11, 0.05±0.02, 212.26±3.20, respectively, all P<0.05). Western blotting analysis revealed that the expression of the phosphorylated forms of ERK1/2, JNK, p38MAPK proteins was significantly higher than in sham operation group (p-ERK1/2: 1.13±0.38 vs. 0.48±0.34, p-JNK: 1.40±0.15 vs. 0.36±0.15, p-p38MAPK: 0.47±0.15 vs. 0.21±0.17, all P<0.05); the expression of the phosphorylated forms of ERK1/2, JNK, p38MAPK in each EP treatment group was significantly down-regulated compared with that in model group (all P<0.05). CONCLUSION: EP can effectively protect kidney from acute injury produced by I/R, which may be related to the regulation of proinflammatory genes and the MAPKs in renal tissue.