Effect of a multidisciplinary nutrition management model in patients with critical illness: A randomized trial.

BACKGROUND: Managing nutrition in critically ill patients involves many medical fields. However, the nutrition management of critically ill patients has not been comprehensive enough to achieve multidisciplinary team cooperation in China and many other countries. Furthermore, there is no standardized management model or process. AIM: To explore the multidisciplinary cooperative nutrition management model for critically ill patients in the ICUs in China, verify its clinical effect and provide a clinical practice reference for the nutrition management of critically ill patients. STUDY DESIGN: A multidisciplinary cooperative nutrition management team, including ICU doctors, ICU nurses, clinical nutritionists, clinical pharmacists and radiologists, was established for critically ill patients. According to a literature review and domestic guidelines, the standardized process of nutritional management for critically ill patients was constructed through the Delphi expert consultation method. One hundred thirty-two patients in the ICU were randomly divided into an experimental group and a control group. A routine nutrition management mode, which was the nutrition management plan mainly formulated by the ICU doctor in charge only and the ICU nurses responsible for the implementation and monitoring of nutrition support, was implemented in the control group. And a multidisciplinary nutrition management mode, which was the nutrition management implemented by the multidisciplinary teams with the standardized nutrition management process for critically ill patients, was adopted in the experimental group. The early nutritional support rate, nutritional indexes (serum albumin, preprotein, haemoglobin and hs-CPR), mechanical ventilation time, ICU hospitalization days and hospitalization expenses of the two groups were compared. RESULTS: The early nutritional support rates of the experimental group and the control group were 89.39% and 69.7%, respectively (χ2 = .002, p = .031). Serum albumin (35.4 vs. 33.1 g/L), preprotein (153.2 vs. 125.9 mg/L) and haemoglobin (97.5 vs. 90.6 g/L) in the experimental group were significantly higher than in the control group (p = .000, .016, .033). The days of hospitalization in the ICU of the experimental group were shorter than in the control group (5.1 vs. 7.1, p = .039). High-sensitivity C-reactive protein, the days of mechanical ventilation and ICU hospitalization expenses of the experimental group were lower than in the control group; however, the difference was not statistically significant (p = .713, .068, .489). CONCLUSIONS: Because of the severity and complexity of patients' diseases, it is necessary to implement multidisciplinary nutrition management for critically ill patients. Research shows that the multidisciplinary nutrition management standardized process for critically ill patients that was constructed in this study can effectively improve nutritional indexes such as serum albumin, preprotein and haemoglobin, shorten the length of stay in the ICU and promote the rehabilitation of patients, and this process be widely used in the clinic. RELEVANCE TO CLINICAL PRACTICE: Structured multidisciplinary nutrition management operational processes can guide clinical practice. They could be widely used in the clinical nutrition management of critically ill patients in critical care units or other departments.

MicroRNA-30b regulates the polarity of retinal ganglion cells by inhibiting semaphorin-3A.

Purpose: Retinal ganglion cell (RGC) polarity plays an important role in optic nerve regeneration. This study was designed to investigate whether semaphorin-3A (Sema3A) is involved in the regulation of RGC polarity and Sema3A protein expression. Methods: Cultured primary RGCs were treated with Fc-Sema3A or Sema3A siRNA or transfected with purified miR-30b recombinant adenoassociated virus (rAAV). The polarity of the RGCs was observed with immunofluorescence. A western blot analysis of phosphorylated protein kinase A (p-PKA), the downstream effector molecule phosphorylated glycogen synthase kinase 3 beta (GSK-3ß), and collapsing response mediator protein 2 (CRMP2) was performed. Results: We found that Sema3A could statistically significantly promote dendritic branching while inhibiting the growth of axons in RGCs. miR-30b overexpression and Sema3A siRNA could statistically significantly promote the growth of axons while inhibiting the growth of dendrites from RGCs. Additionally, miR-30b could restrain the expression of Sema3A protein and its downstream PKA/GSK-3ß/CRMP2 signaling pathways. Conclusions: The results indicate that Sema3A promotes dendritic growth and inhibits axonal growth, which is not conducive to the early repair of optic nerve injury. The overexpression of miR-30b can overcome this problem, and may represent a new target for the treatment of nerve injury and regeneration in the future.

Chidamide-based 3-drug combination regimen reverses molecular relapse post transplantation in AML1-ETO-positive acute myeloid leukemia.

Objective: We aimed to explore a new method to reverse early relapse in patients with AML1-ETO-positive acute myeloid cell transplantation. Methods: A chidamide-based 3-drug combination regimen was used in our center to treat patients with AML1-ETO-positive AML post transplantation but negative flow cytometry results. A retrospective analysis was performed of the survival rate and possible influencing factors of patients with relapse treated with this regimen in our center from January 2018 to January 2022. Results: The overall response rate was 95.8% (23/24), and the median number of treatment courses was 4 (range, 3-12 courses). The total molecular complete response (MCR) was 79.1% (19/24) after all treatments, and the molecular complete response was 37.5% (9/24) after one cycle of treatment but reached 58.3% (14/24) after four cycles; overall, the proportion of MCR increased gradually with the increase in treatment cycles. The projected 5-year overall survival rate was 73.9%. The projected 5-year leukemia-free survival rate was 64.8%, and the projected 1-year cumulative relapse rate was 35.5%. The incidence of grade II-IV graft-versus-host diseases (GVHD) was 29.2% (7/24), and that of grade III-IV GVHD was 20.8% (5/24), which could be effectively controlled by glucocorticoid therapy combined with calcineurin inhibitors The total incidence of chronic GVHD was 29.2% (7/24), and all cases were localized chronic GVHD. The total infection rate was 33.3% (8/24), mainly involving bacterial and fungal infections, and the incidence of life-threatening infections was 4.17% (1/24). The treatment-related mortality rate was 0%; and the total mortality rate was 20.8% (5/24). Nausea and vomiting, thrombocytopenia, and neutropenia were common adverse reactions, all of which were Common Terminology Criteria for Adverse Events grade 2-3 events and reversible after drug withdrawal. In terms of immunity, Th1 cell counts gradually increased, Th17 cell counts gradually decreased, and the Th1/Th17 ratio gradually increased after treatment. The CD8+ T lymphocyte count increased gradually, while the CD4+ T lymphocyte count did not change significantly. Conclusion: Our chidamide-based 3-drug combination regimen led to a high remission rate and tolerable adverse reactions in patients with AML1-ETO-positive post-transplant relapse, and most patients can achieve long-term survival with this regimen.

Design of a flow-through voltammetric sensor based on an antimony-modified silver electrode for determining lithol rubine B in cosmetics.

Lithol Rubine B (LRB; the disodium salt of 3-hydroxy-4-[(4-methyl-2-sulfophenyl) azo]-2-naphthalenecarboxylic acid) was detected using high-performance liquid chromatography with an electrochemical (antimony film on silver) detector (HPLC-ECD). For direct current (DC) mode, with the current at a constant potential, and measurements with suitable experimental parameters, a linear concentration from 0.125 to 1.80 µg/mL was found. The detection limit of our method was approximately 2.0 ng/mL. An antimony-modified silver detector was used to demonstrate that LRB is electrochemically reduced in acidic media and to analyze commercial cosmetics to determine their LRB content. Findings using HPLC-ECD and HPLC with an ultraviolet detector were comparable.

Effect of silicon fertilizers on cadmium in rice (Oryza sativa) tissue at tillering stage.

Silicon has been found to enhance the plants' tolerance to heavy metal stress. In a field study, the effect of different types of Si-rich soil amendments (slag, ground slag, and diatomaceous earth) and fertilizers (activated slag, ground activated slag, and commercial Si fertilizer) on the distribution of soluble and insoluble forms of Cd in the rice plant organs grown on long-term cultivated paddy soil contaminated with Cd (central part of Hunan Province, China) was investigated. The soluble Si and Cd were tested in the apoplast and symplast of the roots, stems, and leaves of rice at a tillering stage. The Si-rich materials increased rice biomass by up to 15.5% and reduced the total leaf Cd by 8.5 to 21.9%. Commercial Si fertilizer was the most effective. Three main locations of the most active Si-Cd interactions were distinguished in the soil-plant system: soil, where monosilicic acid affords adsorption and fixation of the bioavailable Cd and root apoplast and apoplast above roots, where monosilicic acid can precipitate Cd. The transport of Cd to stems and leaves and the mobility of Cd in the soil depend on the content of monosilicic acid in the system.

Fungal endophytes of Alpinia officinarum rhizomes: insights on diversity and variation across growth years, growth sites, and the inner active chemical concentration.

In the present study, the terminal-restriction fragment length polymorphism (T-RFLP) technique, combined with the use of a clone library, was applied to assess the baseline diversity of fungal endophyte communities associated with rhizomes of Alpinia officinarum Hance, a medicinal plant with a long history of use. A total of 46 distinct T-RFLP fragment peaks were detected using HhaI or MspI mono-digestion-targeted, amplified fungal rDNA ITS sequences from A. officinarum rhizomes. Cloning and sequencing of representative sequences resulted in the detection of members of 10 fungal genera: Pestalotiopsis, Sebacina, Penicillium, Marasmius, Fusarium, Exserohilum, Mycoleptodiscus, Colletotrichum, Meyerozyma, and Scopulariopsis. The T-RFLP profiles revealed an influence of growth year of the host plant on fungal endophyte communities in rhizomes of this plant species; whereas, the geographic location where A. officinarum was grown contributed to only limited variation in the fungal endophyte communities of the host tissue. Furthermore, non-metric multidimensional scaling (NMDS) analysis across all of the rhizome samples showed that the fungal endophyte community assemblages in the rhizome samples could be grouped according to the presence of two types of active indicator chemicals: total volatile oils and galangin. Our present results, for the first time, address a diverse fungal endophyte community is able to internally colonize the rhizome tissue of A. officinarum. The diversity of the fungal endophytes found in the A. officinarum rhizome appeared to be closely correlated with the accumulation of active chemicals in the host plant tissue. The present study also provides the first systematic overview of the fungal endophyte communities in plant rhizome tissue using a culture-independent method.

Development of quality of life scale in Chinese burn patients: cross-cultural adaptation process of burn-specific health scale - brief.

PURPOSE: This study was designed to develop and test a Chinese burn patient-specific quality of life (QOL) scale based on the burn-specific health scale - brief (BSHS - B) to provide an effective assessment tool to measure quality of life in Chinese burn patients. METHOD: Delphi method was used after the translation, back translation and pre-commissioning tests of BSHS - B, to amend the description of the items for cultural adaptation. The adapted Chinese version (ACV) of the BSHS - B was tested for internal consistency and validity of construct on a group of 271 burn patients from three major burn units in China. RESULTS: Thirty-eight items within six domains of ACV BSHS-B were developed with scoring '0-4' in each item. The mean total score for our study group was 98.36 (standard deviation (S.D.)=37.86), ranging from 13 to 150. The total Cronbach's alpha value was 0.97 and total split-half reliability was 0.98, demonstrating that the internal consistency of the ACV was very high. Pearson correlations among the six domains of ACV BSHS - B were statistically significant. Exploratory factor analysis results showed that the six-factor function explained 78.30% of total variance; each entry in the corresponding domain had a factor-loading value higher than 0.4, indicating that the scale has a good validity. CONCLUSION: The ACV of the BSHS - B showed good reliability and validity, and can be used as a tool for assessing the QOL in Chinese burn patients.

Synthesis, anticancer activities, interaction with DNA and mitochondria of manganese complexes.

Two new complexes [(Etdpa)MnCl(2)] and [(Adpa)Mn(Cl)(H(2)O)] (Etdpa = ethyl bis(2-pyridylmethyl)amino-2-propionate; Adpa = bis(2-pyridylmethyl)amino-2-propionic acid) were synthesized and characterized by spectral methods. The crystal structure of [(Etdpa)MnCl(2)] shows that the Mn(II) atom is coordinated by three N atoms (N1, N2, N3), one oxygen atom (O1) of the ligand (Etdpa) and two chloride atoms (Cl1, Cl2), forming a distorted octahedral geometry. The binding interaction between ct-DNA and the synthesized complexes was relatively weak, but they can inhibit the induced swelling of Ca(2+)-loaded mitochondria in a dose-dependent manner. The [(Adpa)Mn(Cl)(H(2)O)] can cause the obvious decrease of mitochondria membrane potential. The MTT (3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenpyltetra-zolium bromide) assay shows that the two Mn(II) complexes are more active against cancer cells. Especially [(Adpa)Mn(Cl)(H(2)O)] can inhibit the proliferation of glioma cells with IC(50) 9.5 µM. Experimental results indicate that the [(Adpa)Mn(Cl)(H(2)O)] could be a new potential antitumor complex to target the mitochondria.

Complete genome analysis of a highly pathogenic H5N1 influenza A virus isolated from a tiger in China.

An influenza A virus (A/Tig/SH/01/2005 (H5N1) was isolated from lung tissue samples of a dead zoo tiger with respiratory disease in China in July 2005. Complete genome analysis indicated that the isolate was highly identical to an H5N1 virus isolated from a migratory duck at Poyang lake in China in that year. The genotype of the isolate was K,G,D,5J,F,1J,F,1E, and phylogenetically it was a clade 2.2 virus. Molecular characterization of all of the gene segments revealed characteristics of highly pathogenic influenza A viruses. These results may help to identify molecular determinants of virulence and highlight the necessity for continuous surveillance.