Blood Urea Nitrogen to Serum Albumin Ratio as A New Prognostic Indicator in Critically Ill Patients with Diabetic Ketoacidosis: A Retrospective Cohort Study.

OBJECTIVE: To investigate the predictive value of the blood urea nitrogen to serum albumin ratio for in-hospital and out-of-hospital mortality in critically ill patients with diabetic ketoacidosis. METHODS: Data were obtained from the Medical Information Mart for Intensive Care III (MIMIC III) database, and all eligible participants were categorized into two groups based on the BAR cutoff value. Multiple logistic regression analysis was conducted to determine the association between BAR and in-hospital mortality. The Kaplan-Meier (K-M) analysis was performed to evaluate the predictive performance of BAR. Propensity score matching (PSM) was applied to control confounding factors between the low and high BAR groups. RESULTS: A total of 589 critically ill patients with diabetic ketoacidosis were enrolled. Patients with diabetic ketoacidosis with a higher BAR level were associated with higher in- and out-hospital mortality (all p<0.001). A significant 4-year survival difference was observed between the low and high BAR groups (p<0.0001). After PSM analysis, two PSM groups (202 pairs, n=404) were generated, and similar results were observed in the K-M curve (p<0.0001). DISCUSSION: Elevated BAR levels were associated with an increased risk of in-hospital mortality in critically ill patients with diabetic ketoacidosis, and BAR could serve as an independent prognostic factor in in-hospital and out-of-hospital mortality for patients diagnosed with diabetic ketoacidosis.

Low phosphorus impact on Moso bamboo (Phyllostachys edulis) root morphological polymorphism and expression pattern of the related genes.

Moso bamboo typically grows in phosphorus (P)-deficient soil that limits its growth and development. In this study, 10 Moso bamboo genotypes (Ph-1 to Ph-10) were evaluated for their responses to P deficiency during the seedling stage by growing them in both P-sufficient and P-deficient conditions. Adaptive responses to low P (LP) conditions were observed in the majority of genotypes. Under P deficiency conditions, the total biomass decreased in several genotypes, but at the same time, the root-to-shoot ratio increased. Principal component analysis identified two main comprehensive traits (PC1 and PC2) related to the root volume and surface area and P concentration and accumulation. Based on the analysis, two genotypes (Ph-6 and Ph-10) were identified with significantly different levels of tolerance to P deficiency. The results revealed that the genotype Ph-10 responded to P deficiency by significantly increasing the root surface area and volume, while simultaneously reducing the number of root cortex cells when compared with the genotype Ph-6, which showed the lowest tolerance (intolerant). The genotype Ph-10 exhibited a robust response to external LP conditions, marked by elevated expression levels of PHOSPHATE TRANSPORTERs and SYG1/PHO81/XPR1s. In situ Polymerase Chain Reaction (PCR) analysis also revealed distinct tissue-specific expression patterns of the genes in the roots, particularly highlighting the differences between Ph-6 and Ph-10. The results provide a foundation for elucidating the mechanism of LP tolerance, thus potentially contributing to developing high P-use efficiency in Moso bamboo species.

Effects of different phosphorus levels on tiller bud development in hydroponic Phyllostachys edulis seedlings.

An appropriate amount of phosphate fertilizer can improve the germination rate of bamboo buds and increase the bamboo shoot output. However, the underlying biological mechanisms of phosphate fertilizer in bamboo shoot development have not been systematically reported. Herein, the effects of low (LP, 1 µM), normal (NP, 50 µM) and high (HP, 1000 µM) phosphorus (P) on the growth and development of moso bamboo (Phyllostachys edulis) tiller buds were first investigated. Phenotypically, the seedling biomass, average number of tiller buds and bud height growth rate under the LP and HP treatments were significantly lower than those under the NP treatment. Next, the microstructure difference of tiller buds in the late development stage (S4) at three P levels was analyzed. The number of internode cells and vascular bundles were significantly lower in the LP treatments than in the NP treatments. The relative expression levels of eight P transport genes, eight hormone-related genes and four bud development genes at the tiller bud developmental stage (S2-S4) and the tiller bud re-tillering stage were analyzed with real-time polymerase chain reaction. The results showed that the expression trends for most P transport genes, hormone-related genes and bud development genes from S2 to S4 were diversified at different P levels, and the expression levels were also different at different P levels. In the tiller bud re-tillering stage, the expression levels of seven P transport genes and six hormone-related genes showed a downward trend with increasing P level. REV expression level decreased under LP and HP conditions. TB1 expression level increased under HP condition. Therefore, we conclude that P deficiency inhibits tiller bud development and re-tillering, and that P depends on the expression of REV and TB1 genes and auxin, cytokinin and strigolactones synthesis and transporter genes to mediate tiller bud development and re-tillering.

Association of the key genes in the pathophysiology between the Type 2 diabetes and Lung cancer.

BACKGROUND: Although several studies have demonstrated that preexisting diabetes mellitus (DM) may increase the risk of lung cancer (LC), rare research of the certain pathophysiology was reported up to now. METHODS: Aiming to identify the differentially expressed genes (DEGs) between type 2 diabetes mellitus (T2DM) and LC, gene expression profiles GSE55650 and GSE136043 were downloaded in the Gene Expression Omnibus (GEO) database. We carried out biological function analysis to seek significantly enriched pathways and functions for DEGs. A protein-protein interaction (PPI) network was performed to explore hub genes for diabetes and LC during Metformin's treatment. RESULTS: Finally, the study found that there were 756 genes overlapped between T2DM and LC samples. It contained 133 common genes up-regulated both in T2DM and LC (DEGs1), 275 independent genes down-regulated in LC (DEGs2), 246 common genes down-regulated in both (DEGs3), and 102 independent genes down-regulated in diabetes (DEGs4). Glycine, serine and threonine metabolism, arginine and proline metabolism, TGF-beta signaling pathway, and pathways in cancer were significantly enriched in DEGs2 and DEGs4. Four hub genes (C3, THBS1, CXCL1, and TTN) were identified after treatment of Metformin (P<0.05, T-test). CONCLUSION: Our findings demonstrated that the above-mentioned hub genes might play functional roles in the treatment of metformin for patients with diabetes and LC.