Chinese visceral adiposity index and its transition patterns: impact on cardiovascular and cerebrovascular diseases in a national cohort study.

BACKGROUND: Obesity affects approximately 800 million people worldwide and may contribute to various diseases, especially cardiovascular and cerebrovascular conditions. Fat distribution and content represent two related yet distinct axes determining the impact of adipose tissue on health. Unlike traditional fat measurement indices, which often overlook fat distribution, the Chinese visceral adiposity index (CVAI) is a novel metric used to assess visceral fat accumulation and associated health risks. Our objective is to evaluate its association with the risk of cardiovascular and cerebrovascular diseases. METHODS: A nationwide longitudinal study spanning 9 years was conducted to investigate both the effects of baseline CVAI levels (classified as low and high) and dynamic changes in CVAI over time, including maintenance of low CVAI, transition from low to high, transition from high to low, and maintenance of high CVAI. Continuous scales (restricted cubic spline curves) and categorical scales (Kaplan-Meier curves and multivariable Cox regression analyses) were utilized to evaluate the relationship between CVAI and cardiovascular and cerebrovascular diseases. Furthermore, subgroup analyses were conducted to investigate potential variations. RESULTS: Totally 1761 individuals (22.82%) experienced primary outcomes among 7717 participants. In the fully adjusted model, for each standard deviation increase in CVAI, there was a significant increase in the risk of primary outcomes [1.20 (95%CI: 1.14-1.27)], particularly pronounced in the high CVAI group [1.38 (95%CI: 1.25-1.54)] compared to low CVAI group. Regarding transition patterns, individuals who consistently maintained high CVAI demonstrated the highest risk ratio compared to those who consistently maintained low CVAI [1.51 (95%CI: 1.31-1.74)], followed by individuals transitioning from low to high CVAI [1.22 (95% CI: 1.01-1.47)]. Analysis of restricted cubic spline curves indicated a positive dose-response relationship between CVAI and risk of primary outcomes (p for non-linear = 0.596). Subgroup analyses results suggest that middle-aged individuals with high CVAI face a notably greater risk of cardiovascular and cerebrovascular diseases in contrast to elderly individuals [1.75 (95% CI: 1.53-1.99)]. CONCLUSION: This study validates a significant association between baseline levels of CVAI and its dynamic changes with the risk of cardiovascular and cerebrovascular diseases. Vigilant monitoring and effective management of CVAI significantly contribute to early prevention and risk stratification of cardiovascular and cerebrovascular diseases.

A case of acquired thrombotic thrombocytopenic purpura induced by acute severe hepatitis E: successfully treated by plasma exchange and rituximab.

With its low morbidity and high mortality rates, thrombotic thrombocytopenic purpura (TTP) has imposed a critical physical and economic burden on both society and individuals. Thrombocytopenia commonly occurs in severe liver failure, and a variety of hepatitis viruses are known to induce immune thrombocytopenic purpura. However, TTP is extremely rare in hepatitis E virus infection. We hereby report a case of a 53-year-old male who present with TTP caused by severe hepatitis E, and the patients achieved successful recovery after treatment. Therefore, we propose considering AMAMTS13 testing as an essential and beneficial approach for accurately diagnosing and treating patients with severe hepatitis or infection with notable platelet decline.

Characteristics and Outcomes of Traumatic Cardiac Arrests in the Pan-Asian Resuscitation Outcomes Study.

OBJECTIVE: Little is known about survival outcomes after traumatic cardiac arrest in Asia, or the association of Utstein factors with survival after traumatic cardiac arrests. This study aimed to describe the epidemiology and outcomes of traumatic cardiac arrests in Asia, and analyze Utstein factors associated with survival. METHODS: Traumatic cardiac arrest patients from 13 countries in the Pan-Asian Resuscitation Outcomes Study registry from 2009 to 2018 were analyzed. Multilevel logistic regression was performed to identify factors associated with the primary outcomes of survival to hospital discharge and favorable neurological outcome (Cerebral Performance Category (CPC) 1-2), and the secondary outcome of return of spontaneous circulation (ROSC). RESULTS: There were 207,455 out-of-hospital cardiac arrest cases, of which 13,631 (6.6%) were trauma patients aged 18 years and above with resuscitation attempted and who had survival outcomes reported. The median age was 57 years (interquartile range 39-73), 23.0% received bystander cardiopulmonary resuscitation (CPR), 1750 (12.8%) had ROSC, 461 (3.4%) survived to discharge, and 131 (1.0%) had CPC 1-2. Factors associated with higher rates of survival to discharge and favorable neurological outcome were arrests witnessed by emergency medical services or private ambulances (survival to discharge adjusted odds ratio (aOR) = 2.95, 95% confidence interval (CI) = 1.99-4.38; CPC 1-2 aOR = 2.57, 95% CI = 1.25-5.27), bystander CPR (survival to discharge aOR = 2.16; 95% CI 1.71-2.72; CPC 1-2 aOR = 4.98, 95% CI = 3.27-7.57), and initial shockable rhythm (survival to discharge aOR = 12.00; 95% CI = 6.80-21.17; CPC 1-2 aOR = 33.28, 95% CI = 11.39-97.23) or initial pulseless electrical activity (survival to discharge aOR = 3.98; 95% CI = 2.99-5.30; CPC 1-2 aOR = 5.67, 95% CI = 3.05-10.53) relative to asystole. CONCLUSIONS: In traumatic cardiac arrest, early aggressive resuscitation may not be futile and bystander CPR may improve outcomes.

Oxidative stress-related circulating miRNA-27a is a potential biomarker for diagnosis and prognosis in patients with sepsis.

BACKGROUND: Oxidative stress plays a critical role on the processes of sepsis, and several microRNAs have been identified that may regulate the occurrence of oxidative stress. However, the relation between oxidative stress-related microRNA 27a (miR-27a) and sepsis is unknown. The present study aimed to determine the value of circulating miR-27a for the diagnosis and prognosis of sepsis. METHODS: This retrospective study included 23 patients with sepsis and 25 without sepsis treated at the emergency intensive care unit (EICU) or our institution between January 2019 and January 2020. Levels of circulating miR-27a and levels of oxidative stress-related indicators were measured and compared between sepsis and non-sepsis patients. Receiver operating characteristic (ROC) curve analysis was used to determine diagnostic efficiency of miR-27a. RESULTS: Circulating miR-27a levels in sepsis patients were higher than those in non-sepsis patients (p < 0.05), and levels were significantly higher in patients that died than those that lived (p < 0.05). In patients with sepsis, circulating miR-27a level was positively correlated with serum malondialdehyde (MDA) level (rs = 0.529, p = 0.007), and negatively correlated with serum glutathione peroxidase (GSH-Px) level (rs = - 0.477, p = 0.016). No significant correlation was observed between circulating miR-27a and serum superoxide dismutase (SOD) in sepsis patients (rs = - 0.340, p = 0.096). The area under the ROC curve (AUC) of miR-27a level for prediction of sepsis was 0.717 (p = 0.009) and for 28-day mortality was 0.739 (p = 0.003). CONCLUSIONS: This study showed that circulating miR-27a level is correlated with oxidative stress and mortality in patients with sepsis, and may serve as a potential non-invasive molecular biomarker.

Bone marrow-derived mesenchymal stem cells attenuate myocardial ischemia-reperfusion injury via upregulation of splenic regulatory T cells.

BACKGROUND: Myocardial ischemia-reperfusion injury (MIRI) is the main pathological manifestation of cardiovascular diseases such as myocardial infarction. The potential therapeutic effects of bone marrow-derived mesenchymal stem cells (BM-MSCs) and the participation of regulatory T cells (Tregs) in MIRI remains to be defined. METHODS: We used the experimental acute MIRI that was induced in mice by left ascending coronary ischemia, which were subsequently randomized to receive immunoglobulin G (IgG) or anti-CD25 antibody PC61 with or without intravenously injected BM-MSCs. The splenectomized mice underwent prior to experimental MIRI followed by intravenous administration of BM-MSCs. At 72 h post-MIRI, the hearts and spleens were harvested and subjected to cytometric and histologic analyses. RESULTS: CD25+Foxp3+ regulatory T cells were significantly elevated after MIRI in the hearts and spleens of mice receiving IgG + BM-MSCs and PC61 + BM-MSCs compared to the respective control mice (all p < 0.01). This was accompanied by upregulation of interleukin 10 and transforming growth factor ß1 and downregulation of creatinine kinase and lactate dehydrogenase in the serum. The post-MIRI mice receiving BM-MSCs showed attenuated inflammation and cellular apoptosis in the heart. Meanwhile, splenectomy compromised all therapeutic effects of BM-MSCs. CONCLUSION: Administration of BM-MSCs effectively alleviates MIRI in mice through inducing Treg activation, particularly in the spleen.

The histone H3 lysine-27 demethylase UTX plays a critical role in colorectal cancer cell proliferation.

BACKGROUND: Ubiquitously transcribed tetratricopeptide repeat, X chromosome (UTX) is an H3K27me3 demethylase, a permissive mark associated with active gene transcription. UTX has been linked to various human cancers. Colorectal cancer (CRC) ranks 3rd among the most common cancers worldwide. However, the role of UTX in colorectal cancer has rarely been reported. METHODS: RT-qPCR, immunoblotting assays (WB), and immunohistochemistry staining were conducted to explore the UTX expression levels in CRC tissues and surrounding normal tissues. CCK-8 assays, colony formation assays, and flow cytometry were also used to determine the potential role of UTX in CRC cell proliferation in vitro. A cell line-derived xenograft model was performed to determine on the role of UTX in HCT116 cell proliferation in vivo. The protein expression levels of UTX, KIF14, AKT, and GAPDH were examined by WB. RESULTS: Compared with surrounding normal tissues, UTX was upregulated in CRC tissues. Knockdown of UTX significantly inhibited proliferation and caused G0/G1 cell cycle arrest in CRC cell lines, and overexpression of UTX significantly promoted proliferation in CRC cells. Furthermore, knockdown of UTX significantly inhibited tumour growth in vivo. In addition, knockdown of UTX decreased the expression of KIF14 and pAKT and increased the expression of P21. CONCLUSIONS: Our findings indicate that knockdown of UTX inhibits CRC cell proliferation and causes G0/G1 cell cycle arrest through downregulating expression of KIF 14 and pAKT. Thus, UTX may serve as a novel biomarker in CRC.

[Fosfomycin tromethamine inhibits the expressions of TNF-α, IL-8 and IL-6 in the prostate tissue of rats with chronic bacterial prostatitis].

OBJECTIVE: To investigate the effects of fosfomycin tromethamine (FT) on the expressions of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), and interleukin-6 (IL-6) in the prostate tissue of the rats with chronic bacterial prostatitis (CBP). METHODS: We randomly divided 70 male SD rats into 7 groups of equal number: blank control, CBP model control, positive control, 14 d low-dose FT, 7 d low-dose FT, 14 d high-dose FT, and 7 d high-dose FT. The CBP model rats in the latter five groups were treated intragastrically with levofloxacin at 100 mg/kg/d for 30 days and FT at 200 mg/kg/d for 14 and 7 days and at 300 mg/kg/d for 14 and 7 days, respectively. Then we collected the prostate tissue from the animals for determination of the levels of TNF-α, IL-8 and IL-6 by ELISA. RESULTS: Compared with the blank controls, the CBP model rats showed significantly increased levels of TNF-α (ï¼»19.83 ± 6.1ï¼½ vs ï¼»32.93 ± 6.21ï¼½ ng/g prot, P <0.01), IL-8 (ï¼»8.26 ± 0.52ï¼½ vs ï¼»16.2 ± 2.84ï¼½ ng/g prot, P <0.01) and IL-6 (ï¼»1.55 ± 0.11ï¼½ vs ï¼»2.51 ± 1.06ï¼½ ng/g prot, P <0.05) in the prostate tissue. In comparison with the CBP model controls, the levels of TNF-α and IL-8 were remarkably decreased in the groups of positive control (ï¼»20.54 ± 5.78ï¼½ ng/g prot, P <0.01; ï¼»12.43 ± 4.02ï¼½ ng/g prot, P <0.05), 14 d low-dose FT (ï¼»21.95 ± 6.48ï¼½ ng/g prot, P <0.01; ï¼»11.11 ± 2.86ï¼½ ng/g prot, P <0.01), 7 d low-dose FT (ï¼»23.8 ± 6.93ï¼½ ng/g prot, P <0.05; ï¼»12.43 ± 4.02ï¼½ ng/g prot, P <0.05), 14 d high-dose FT (ï¼»19.97 ± 2.58ï¼½ ng/g prot, P <0.01; ï¼»8.83 ± 1.32ï¼½ ng/g prot, P <0.01), and 7 d high-dose FT (ï¼»21.97 ± 3.38ï¼½ ng/g prot, P <0.01; ï¼»12.68±1.97ï¼½ ng/g prot, P <0.05). No statistically significant differences were observed between the positive control and FT groups in the contents of TNF-α, IL-8 or IL-6 (P >0.05). The expression of IL-6 was markedly reduced in the 14 d high-dose FT group as compared with the model controls (ï¼»1.76 ± 0.46ï¼½ vs ï¼»2.51 ± 1.06ï¼½ ng/g prot, P<0.05) but exhibited no significant difference between the CBP model control and the other groups (P >0.05). CONCLUSIONS: Fosfomycin tromethamine inhibits the expressions of TNF-α, IL-8 and IL-6 in the prostate tissue, suppresses its inflammatory reaction, promotes the repair of damaged prostatic structure, and thus contributes to the treatment of chronic bacterial prostatitis in rats.

[Association of sperm DNA integrity with seminal plasma oxidative stress and its influence on in vitro fertilization in infertile males].

OBJECTIVE: To investigate the association of sperm DNA integrity with semen routine parameters and seminal plasma oxidative stress and its influence on in vitro fertilization (IVF) in males with infertility. METHODS: Using sperm chromatin dispersion (SCD), we detected sperm DNA damage in 433 infertile men undergoing IVF. Based on the sperm DNA fragmentation index (DFI), we divided the patients into a low DFI (lt;30%) and a high DFI ( ≥30%) group and then compared sperm concentration, the percentage of progressively motile sperm (PMS), the contents of malondialdehyde (MDA) and total antioxidant capacity (TAC) in the seminal plasma, and the rates of fertilization, cleavage and high-quality embryos between the two groups of patients. RESULTS: Compared with the low DFI group, the high DFI group showed significantly decreased rates of PMS (ï¼»48.6±16.7ï¼½ vs ï¼»29.2±16.8ï¼½%, P<0.01) and fast PMS ï¼»19.0±9.1ï¼½ vs ï¼»9.4±6.6ï¼½%, P<0.01), but no statistically significant difference in sperm concentration (ï¼»51.4±30.9ï¼½ vs ï¼»52.3±32.4ï¼½ ×106/ml, P>0.05). The content of MDA in the seminal plasma was markedly higher in the high DFI than in the low DFI group (ï¼»2.28±0.26ï¼½ vs ï¼»0.95±0.18ï¼½ nmol/L, P<0.01) but that of TAC remarkably lower in the former than in the latter (ï¼»10.2±3.5ï¼½ vs ï¼»33.2±7.9ï¼½ U/L, P<0.01). The rate of fertilization was significantly lower in the high DFI than in the low DFI group (ï¼»58.9±30.0ï¼½ vs ï¼»77.2±25.0ï¼½%, P<0.01), but there were no significant differences between the two groups in the rates of cleavage (ï¼»70.7±35.6ï¼½ vs ï¼»80.4±15.6ï¼½%P>0.05) and high-quality embryos (ï¼»40.4±31.3ï¼½ vs ï¼»41.7±29.4ï¼½%,P>0.05). CONCLUSIONS: Sperm DNA damage is associated with seminal oxidative stress and may affect the outcomes of IVF by reducing the rate of fertilization.

[Clinical study of anti-Mullerian hormone in prediction of ovarian aging].

OBJECTIVE: To explore the serum anti-Mullerian hormone (AMH) level in women of childbearing age with normal menstrual cycles. METHODS: A total of 1 423 women with regular menstrual cycles were selected and divided into 5 groups according to their ages, i.e. ≤ 25, 26-30, 31-35, 36-40, ≥ 41 years. Their serum levels of AMH were measured, and the relationship between AMH and age was analyzed. RESULTS: The serum AMH levels of 5 groups according to ages (≤ 25, 26-30, 31-35, 36-40, ≥ 41 years) were 3.62, 3.10, 2.27, 1.07, 0.45 µg/L, respectively. The comparison of serum AMH levels in different age groups had significant difference (P < 0.01). Serum AMH level declined with increasing age, and dropped significantly after 36. The serum AMH level and age showed a negative correlation with significant difference (r = -0.374, P < 0.01). Quadratic regression of logAMH proximally reflected the relationship between AMH and age. CONCLUSION: AMH determination for women of childbearing age could provide reference for the evaluation of ovarian function.

Safety analysis of tooth extraction in elderly patients with cardiovascular diseases.

BACKGROUND: This study aimed to evaluate the safety of tooth extraction in elderly patients with cardiovascular diseases. MATERIAL AND METHODS: A total of 13 527 patients underwent tooth extraction at the Affiliated Ninth People's Hospital of Shanghai Jiaotong University. Age, sex, and diseases were analyzed. Cardiac monitoring during tooth extraction was performed in 7077 elderly patients with hypertension and other chronic diseases, and the influence of various factors on safety of tooth extraction was evaluated. Additionally, 89 patients with primary hypertension were recruited, and electrocardiogram was monitored with a general monitor or a Holter monitor, and the detection rate of cardiovascular events was compared between the 2 groups. RESULTS: The elderly accounted from 75.3%, and patients aged 70-79 years had highest proportion. The most frequent comorbidities were hypertension, coronary heart disease, arrhythmia, cerebrovascular accident, and diabetes. In analysis of factors influencing the safety of tooth extraction in the elderly, a significant difference was noted in systolic blood pressure at different time points. In addition, change in heart rate was different between males and females. Detection rate of cardiovascular events by use of a Holter monitor was significantly higher than with a general monitor. CONCLUSIONS: Hypertension was the most common comorbidity in elderly patients undergoing tooth extraction, followed by coronary heart disease and arrhythmia. Advanced age and increased comorbidity may increase the risk of complications. Risk score can be used to rapidly determine risk for complications during tooth extraction. The Holter monitor is superior to the general monitor in identifying cardiovascular events in high-risk elderly patients undergoing tooth extraction, and can be used in this population.

Factors affecting the production of sugarcane yield and sucrose accumulation: suggested potential biological solutions.

Environmental stresses are the main constraints on agricultural productivity and food security worldwide. This issue is worsened by abrupt and severe changes in global climate. The formation of sugarcane yield and the accumulation of sucrose are significantly influenced by biotic and abiotic stresses. Understanding the biochemical, physiological, and environmental phenomena associated with these stresses is essential to increase crop production. This review explores the effect of environmental factors on sucrose content and sugarcane yield and highlights the negative effects of insufficient water supply, temperature fluctuations, insect pests, and diseases. This article also explains the mechanism of reactive oxygen species (ROS), the role of different metabolites under environmental stresses, and highlights the function of environmental stress-related resistance genes in sugarcane. This review further discusses sugarcane crop improvement approaches, with a focus on endophytic mechanism and consortium endophyte application in sugarcane plants. Endophytes are vital in plant defense; they produce bioactive molecules that act as biocontrol agents to enhance plant immune systems and modify environmental responses through interaction with plants. This review provides an overview of internal mechanisms to enhance sugarcane plant growth and environmental resistance and offers new ideas for improving sugarcane plant fitness and crop productivity.

[Retracted] MicroRNA­122 affects cell aggressiveness and apoptosis by targeting PKM2 in human hepatocellular carcinoma.

Following the publication of both the above article and a corrigendum (doi: 10.3892/or.2021.8073) that was concerned with the correction of overlapping data panels in Figs. 6 and 7, it has been drawn to the Editors' attention by a concerned reader that the proposed replacement cell invasion assay shown in the revised version of Fig. 7A, and also flow cytometric data featured in Fig. 5A and C, were strikingly similar to data appearing in different form in other articles by different authors. Owing to the fact that these contentious data in the above article had already been published elsewhere, or were already under consideration for publication, prior to its submission to Oncology Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 34: 2054­2064, 2015; DOI: 10.3892/or.2015.4175].

Surface passivation for highly active, selective, stable, and scalable CO2 electroreduction.

Electrochemical conversion of CO2 to formic acid using Bismuth catalysts is one the most promising pathways for industrialization. However, it is still difficult to achieve high formic acid production at wide voltage intervals and industrial current densities because the Bi catalysts are often poisoned by oxygenated species. Herein, we report a Bi3S2 nanowire-ascorbic acid hybrid catalyst that simultaneously improves formic acid selectivity, activity, and stability at high applied voltages. Specifically, a more than 95% faraday efficiency was achieved for the formate formation over a wide potential range above 1.0 V and at ampere-level current densities. The observed excellent catalytic performance was attributable to a unique reconstruction mechanism to form more defective sites while the ascorbic acid layer further stabilized the defective sites by trapping the poisoning hydroxyl groups. When used in an all-solid-state reactor system, the newly developed catalyst achieved efficient production of pure formic acid over 120 hours at 50 mA cm-2 (200 mA cell current).

Role of TGF-ß1/Smad3 signaling pathway in secretion of type I and III collagen by vascular smooth muscle cells of rats undergoing balloon injury.

Antisense Smad3 adenoviral vectors were used to transfect vascular smooth muscle cells (VSMCs) from rats with balloon injury or infused into the rat balloon-catheter injured carotid arteries, and the role of TGF-ß1/Smad3 signaling pathway in the secretion of type I and III collagen by VSMCs following balloon injury was investigated. Antisense Smad3 adenoviral vectors were used to transfect these VSMCs (antisense Smad3 group). A total 90 rats were randomly assigned into blank control group, experiment group, negative control group. In the in vitro study, the expression of type I and III collagen was markedly reduced in the antisense Smad3 group when compared with the control groups (P < 0.05). In the in vivo study, the expression of type I and III collagen was significantly lower than that in the negative control group at 3 days, 1 week and 2 weeks after injury (P < 0.05). At 2 weeks and 3 months after injury, the lumen area in the antisense Smad3 group was markedly increased but the intimal area dramatically reduced when compared with the negative control (P < 0.05). We conclude that transfection of VSMCs with antisense Smad3 can reduce the secretion of type I and III collagen which then inhibit intimal hyperplasia.

[Corrigendum] HSP90 inhibits apoptosis and promotes growth by regulating HIF-1α abundance in hepatocellular carcinoma.

Subsequently to the publication of the above paper, the authors contacted the Editorial Office to explain that they had found several mistakes in Figs. 1B, 2B, 6B and 7B in their paper. The PCR results shown in Fig. 1B, the flow cytometric results in Figs. 2B and 6B, and the immunohistochemistry results in Fig. 7B were inadvertently chosen incorrectly when these images were selected from the pool of raw data. However, the authors retained access to their original data, and were able to re-assemble the data in these figures as they had intended. Consequently, the corrected versions of Figs. 1, 2, 6 and 7, containing the replacement data for Figs. 1B, 2B, 6B, and 7B, are shown below and on the next two pages. It should be emphasized that the errors that were made in assembling Figs. 1B, 2B, 6B and 7B did not have a major effect on either the results reported or the conclusions reached in this article. The authors are grateful to the Editor of International Journal of Molecular Medicine for allowing them the opportunity to publish this Corrigendum, and all of the authors agree to the publication of this Corrigendum. The authors sincerely apologize for their mistakes and regret any inconvenience that these errors may have caused. [International Journal of Molecular Medicine 37: 825­835, 2016; DOI: 10.3892/ijmm.2016.2482].

Clinical Experience of Diagnosis and Surgical Treatment of 6 Cases of Acute Subhepatic Appendicitis.

To summarize the experience of diagnosis and surgical treatment of 6 cases of acute subhepatic appendicitis. The clinical data of 6 patients with subacute appendicitis in Zhejiang Provincial People's Hospital from July 2018 to December 2019 were analyzed retrospectively. Results. There were 5 males and 1 female. All 6 cases were diagnosed as appendicitis by abdominal CT before operation. All patients underwent laparoscopic appendectomy without conversion to laparotomy. One case of ectopic appendix was located under the liver with absence of ascending colon, one case of ectopic appendix was located under the liver with ectopic ascending colon of transverse colon, one case of appendix head was located in the liver cyst, and the resection of liver cyst was performed at the same time, and three cases of retrocolonic appendix head were located under the liver. Postoperative pathology confirmed appendicitis. For patients with right upper abdominal pain and tenderness, the possibility of subhepatic appendicitis should be considered before operation. Emergency abdominal CT has more advantages than ultrasound. Laparoscopy can not only make a definite diagnosis but also perform appendectomy at the same time.

The Diagnostic Value of Mitochondrial Mass of Peripheral T Lymphocytes in Early Sepsis.

Background: Studies have shown that lymphocyte dysfunction can occur during the early stages of sepsis and that cell dysfunction is associated with mitochondrial dysfunction. Therefore, quantifying the mitochondrial function of lymphocytes in patients with sepsis could be valuable for the early diagnosis of sepsis. Methods: Seventy-nine patients hospitalized from September 2020 to September 2021 with Sepsis-3 were retrospectively analyzed and subsequently compared with those without sepsis. Results: Univariate analysis showed statistical differences between the data of the two groups regarding age, neutrophil/lymphocyte, procalcitonin (PCT), C-reactive protein, total bilirubin, serum creatinine, type B natriuretic peptide, albumin, prothrombin time, activated partial thromboplastin time, lactic acid, single-cell mitochondrial mass (SCMM)-CD3, SCMM-CD4, SCMM-CD8, and Acute Physiology and Chronic Health Evaluation II score (P < 0.05). Multivariate logistic regression analysis performed on the indicators mentioned above demonstrated a statistical difference in PCT, lactic acid, SCMM-CD4, and SCMM-CD8 levels between the two groups (P < 0.05). The receiver operating characteristic curves of five models were subsequently compared [area under the curve: 0.740 (PCT) vs. 0.933 (SCMM-CD4) vs. 0.881 (SCMM-CD8) vs. 0.961 (PCT + SCMM-CD4) vs. 0.915 (PCT+SCMM-CD8), P < 0.001]. Conclusion: SCMM-CD4 was shown to be a better diagnostic biomarker of early sepsis when compared with the traditional biomarker, PCT. Furthermore, the value of the combination of PCT and SCMM-CD4 in the diagnosis of early sepsis was better than that of SCMM-CD4 alone.

Pre-hospital airway management and survival outcomes after paediatric out-of-hospital cardiac arrests.

BACKGROUND: Paediatric out-of-hospital cardiac arrest (OHCA) results in high mortality and poor neurological outcomes. We conducted this study to describe and compare the effects of pre-hospital airway management on survival outcomes for paediatric OHCA in the Asia-pacific region. METHODS: We performed a retrospective analysis of the Pan Asian Resuscitation Outcomes Study (PAROS) data from January 2009 to June 2018. PAROS is a prospective, observational, multi-centre cohort study from eleven countries. The primary outcomes were one-month survival and survival with favourable neurological status, defined as Cerebral Performance Category1 or 2. We performed multivariate analyses of the unmatched and propensity matched cohort. RESULTS: We included 3131 patients less than 18 years in the study. 2679 (85.6%) children received bag-valve-mask (BVM) ventilations, 81 (2.6%) endotracheal intubations (ETI) and 371 (11.8%) supraglottic airways (SGA). 792 patients underwent propensity score matching. In the matched cohort, advanced airway management (AAM: SGA and ETI) when compared with BVM group was associated with decreased one-month survival [AAM: 28/396 (7.1%) versus BVM: 55/396 (13.9%); adjusted odds ratio (aOR), 0.46 (95% CI, 0.29 - 0.75); p = 0.002] and survival with favourable neurological status [AAM: 8/396 (2.0%) versus BVM: 31/396 (7.8%); aOR, 0.22 (95% CI, 0.10 - 0.50); p < 0.001]. For SGA group, we observed less 1-month survival [SGA: 24/337 (7.1%) versus BVM: 52/337 (15.4%); aOR, 0.41 (95 %CI, 0.25-0.69), p = 0.001] and survival with favourable neurological status. CONCLUSION: In children with OHCA in the Asia-Pacific region, pre-hospital AAM was associated with decreased one-month survival and less favourable neurological status.

International multi-center real world implementation trial to increase out-of-hospital cardiac arrest survival with a dispatcher-assisted cardio-pulmonary resuscitation package (Pan-Asian resuscitation outcomes study phase 2).

BACKGROUND: Dispatcher-assisted CPR (DA-CPR) has the potential to deliver early bystander CPR (BCPR) and improve out-of-hospital cardiac arrest (OHCA) survival. This study in the Asia-Pacific evaluated the impact of a DA-CPR program on BCPR rates and survival. METHODS: This was a three-arm, prospective, multi-national, population-based, community-level, implementation trial. Cases between January 2009 and June 2018 from the Pan-Asian Resuscitation Outcomes Study were included. Sites either implemented a comprehensive (with quality improvement tool) or a basic DA-CPR package, or served as controls. Primary outcome was survival-to-discharge/30th day post-arrest. Secondary outcomes were BCPR and favorable neurological outcome. A before-after comparison was made within each country; this before-after change was then compared across the three groups using logistic regression. RESULTS: 170,687 cases were analyzed. Before-after comparison showed that survival to discharge was higher in the 'implementation' period in all three groups: comprehensive odds ratio (OR) 1.09, 95% confidence interval (CI; [1.0-1.19]); basic OR 1.14, 95% CI (1.08-1.2); and control OR 1.25, 95% CI (1.02-1.53). Comparing between groups, the comprehensive group had significantly higher change in BCPR (comprehensive vs control ratio of OR 1.86, 95% CI [1.66-2.09]; basic vs control ratio of OR 0.94, 95% CI [0.85-1.05]; and comprehensive vs basic ratio of OR 1.97, 95% CI [1.87-2.08]) and survival with favorable neurological outcome (comprehensive vs basic ratio of OR 1.2, 95% CI [1.04-1.39]). CONCLUSION: We evaluated the impact of a DA-CPR program across heterogeneous EMS systems and demonstrated that a comprehensive DA-CPR program had the most impact on BCPR and favorable neurological outcome.

Influence of a bacteriophage on the population dynamics of toxic dinoflagellates by lysis of algicidal bacteria.

A lytic phage (øZCW1) was isolated from an algicidal bacterium Pseudoalteromonas sp. strain SP48 that specifically kills the toxic dinoflagellate Alexandrium tamarense. We demonstrated that øZCW1 could trigger the growth of A. tamarense by inhibiting the growth of algicidal bacterium SP48. In contrast, the growth of A. tamarense was suppressed when cocultured with either SP48 or the øZCW1-resistant mutant of SP48. This study provides the first evidence of the indirect impact of bacteriophage on bloom-forming microalgae via phage lysis of alga-killing bacteria.