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BACKGROUND: High Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR) were associated with worse prognosis of patients with sepsis. In-hospital mortality has been reported to be higher in patients with coronary artery disease (CAD) and sepsis than those with sepsis alone. However, the relationship between NLR, MLR, PLR and mortality in septic patients with coronary artery disease (CAD) remains unclear. The study aimed to explore the association between NLR, MLR, PLR and 28-day all-cause mortality in septic patients with CAD. METHODS: We performed an observational cohort study of septic patients with CAD from the Medical Information Mart for Intensive Care (MIMIC)-IV database between 2008 and 2019. The patients were categorized by three group (Q1: low levels, Q2: medium levels, Q3: high levels) based on tertiles of NLR, MLR, and PLR. The associations between NLR, MLR, PLR and 28-day all-cause mortality were examined using the Cox proportional hazards model. Subsequently, we applied receiver operating characteristic (ROC) analysis for predicting 28-day mortality in septic patients with CAD by combining NLR, MLR and PLR with the modified sequential organ failure assessment (mSOFA) scores. RESULTS: Overall 1,175 septic patients with CAD were included in the study. Observed all-cause mortality rates in 28 days were 27.1%. Multivariate Cox proportional hazards regression analysis results showed that 28-day all-cause mortality of septic patients with CAD was significantly related to rising NLR levels (adjusted hazard ratio [aHR]: 1.02; 95% confidence interval [CI]: 1.01-1.02; P < 0.001), MLR levels (aHR: 1.29; 95%CI: 1.18-1.41; P < 0.001), and PLR levels (aHR: 1.0007; 95%CI: 1.0004-1.0011; P < 0.001). Meanwhile, the higher levels (Q3) group of NLR, MLR, and PLR also had a higher risk of 28-day all-cause mortality than the lower (Q1) group. The area under the ROC curve of NLR, MLR, PLR, and mSOFA score were 0.630 (95%CI 0.595-0.665), 0.611 (95%CI 0.576-0.646), 0.601 (95%CI 0.567-0.636) and 0.718 (95%CI 0.689-0.748), respectively. Combining NLR, MLR, and PLR with mSOFA scores may improve ability of predicting 28-day mortality (AUC: 0.737, 95%CI 0.709-0.766). CONCLUSION: Higher levels of NLR, MLR and PLR were associated with 28-day all-cause mortality in septic patients with CAD. Further investigation will be needed to improve understanding of the pathophysiology of this relationship.
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Plaquetas , Enfermedad de la Arteria Coronaria , Linfocitos , Monocitos , Neutrófilos , Sepsis , Humanos , Masculino , Femenino , Sepsis/mortalidad , Sepsis/sangre , Estudios Retrospectivos , Enfermedad de la Arteria Coronaria/mortalidad , Enfermedad de la Arteria Coronaria/sangre , Anciano , Persona de Mediana Edad , Pronóstico , Bases de Datos Factuales , Curva ROC , Recuento de Linfocitos , Mortalidad Hospitalaria , Recuento de PlaquetasRESUMEN
Aim: The study aimed to analyze the associations between estimated pulse wave velocity (ePWV) and 5-year mortality in atherosclerotic cardiovascular disease (ASCVD) patients with and without standard modifiable risk factors (SMuRFs), which included smoking status, hypertension, diabetes, and hypercholesterolemia. Methods: The present retrospective cohort study utilized data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016. Patients with ASCVD who completed both the questionnaire survey and serum testing were included. Patients were categorized into the ≥1 SMuRF group if they had at least one SMuRF, while those without any SMuRFs were classified into the SMuRF-less group. The ePWV, which was calculated using the age and mean blood pressure, was evenly divided into three categories: low (Q1), medium (Q2), and high (Q3). Multivariable weighted Cox proportional-hazard regression analyses were utilized to explore the risk factors associated with 5-year mortality in patients with and without SMuRFs. And restricted cubic spline curve (RCS) was used to assess their nonlinear correlation. Results: A total of 1901 patients with ASCVD were included in the study. For the patients in ≥1 SMuRF group, the Q3 group included patients who were older, with a higher proportion of males, more comorbidities, and a lower body mass index than the Q1 group (P<0.05). The Cox proportional-hazard regression model results revealed, the Q3 group had a higher risk of 5-year mortality than the Q1 group [hazard ratio (HR) 4.30, 95% confidence interval (CI) (2.66, 6.95), P<0.001]. RCS demonstrated a linear trend between high level of ePWV and decreased risks of mortality. Similar results were observed in the SMuRF-less group [HR 10.62, 95% CI (1.22, 92.06), P=0.032]. Conclusion: A high level of ePWV signified a higher risk of 5-year mortality in ASCVD patients with and without SMuRFs.
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BACKGROUND: Sepsis is a common cause of mortality in critically ill patients, and chronic obstructive pulmonary disease (COPD) is one of the most common comorbidities in septic patients. However, the impact of COPD on patients with sepsis remained unclear. Therefore, the purpose of this study aimed to assess the effect of COPD on the prognosis of septic patients based on Medical Information Mart for Intensive Care (MIMIC-III) database. METHODS: In this retrospective study based on the (MIMIC)-III database version 1.4 (v1.4), we collected clinical data and 28-day all-cause mortality from patients with sepsis in intensive care unit (ICU) and these patients met the diagnostic criteria of Sepsis 3 on ICU admission between 2008 and 2012. International Classification of Diseases (ICD-9) (4660, 490, 4910, 4911, 49120, 49121, 4918, 4919, 4920, 4928, 494, 4940, 4941, 496) was used to identified COPD. We applied Kaplan-Meier analysis to compare difference of 28-day all-cause mortality between septic patients with and without COPD. Cox proportional-hazards model was applied to explore the risk factor associated with 28-day all-cause mortality in patients with sepsis. RESULTS: Six thousand two hundred fifty seven patients with sepsis were included in this study, including 955 (15.3%) patients with COPD and 5302 patients without COPD (84.7%). Compared with patients without COPD, patients with COPD were older (median: 73.5 [64.4, 82.0] vs 65.8 [52.9, 79.1], P < 0.001), had higher simplified acute physiology score II (SAPSII) (median: 40.0 [33.0, 49.0] vs 38.0 [29.0,47.0], P < 0.001) and greater proportion of mechanical ventilatory support (MV) (55.0% vs 48.9%, P = 0.001). In our study, septic patients with COPD had higher 28-day all-cause mortality (23.6% vs 16.4%, P < 0.001) than patients without COPD. After adjusting for covariates, the results showed that COPD was an independent risk factor for the 28-day all-cause mortality of patients with sepsis (HR 1.30, 95%CI: 1.12-1.50, P = 0.001). CONCLUSIONS: COPD was an independent risk factor of 28-day all-cause mortality in septic patients. Clinically, septic patients with COPD should be given additional care.
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Enfermedad Pulmonar Obstructiva Crónica , Sepsis , Humanos , Estudios Retrospectivos , Sepsis/complicaciones , Unidades de Cuidados Intensivos , Cuidados Críticos , PronósticoRESUMEN
BACKGROUND: Mechanical ventilation may cause pulmonary hypertension in patients with acute lung injury (ALI), but the underlying mechanism remains elucidated. METHODS: ALI was induced in rabbits by a two-hit injury, i.e., hydrochloric acid aspiration followed by mechanical ventilation for 1 h. Rabbits were then ventilated with driving pressure of 10, 15, 20, or 25 cmH2O for 7 h. Clinicopathological parameters were measured at baseline and different timepoints of ventilation. RNA sequencing was conducted to identify the differentially expressed genes in high driving pressure ventilated lung tissue. RESULTS: The two-hit injury induced ALI in rabbits was evidenced by dramatically decreased PaO2/FiO2 in the ALI group compared with that in the control group (144.5 ± 23.8 mmHg vs. 391.6 ± 26.6 mmHg, P < 0.001). High driving pressure ventilation (20 and 25 cmH2O) significantly elevated the parameters of acute pulmonary hypertension at different timepoints compared with low driving pressure (10 and 15 cmH2O), along with significant increases in lung wet/dry ratios, total protein contents in bronchoalveolar lavage fluid, and lung injury scores. The high driving pressure groups showed more pronounced histopathological abnormalities in the lung compared with the low driving pressure groups, accompanied by significant increases in the cross-sectional areas of myocytes, right ventricular weight/body weight value, and Fulton's index. Furthermore, the expression of the genes related to ferroptosis induction was generally upregulated in high driving pressure groups compared with those in low driving pressure groups. CONCLUSIONS: A rabbit model of ventilation-induced pulmonary hypertension in ALI was successfully established. Our results open a new research direction investigating the exact role of ferroptosis in ventilation-induced pulmonary hypertension in ALI.
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Background: Bronchiolitis obliterans (BO) is a chronic disease that can arise as a complication of severe childhood pneumonia and can also impact the long-term survival of patients after lung transplantation. However, the precise molecular mechanism underlying BO remains unclear. We aimed to identify BO-associated hub genes and their molecular mechanisms. Methods: BO-associated transcriptome datasets (GSE52761, GSE137169, and GSE94557) were downloaded from the Gene Expression Omnibus (GEO) database to identify differentially expressed genes (DEGs). Additional bioinformatics analyses, such as Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Protein-Protein Interaction (PPI) analyses, were performed to determine functional roles and DEG-associated regulatory networks. Prediction of hub genes using the 12 algorithms available in the Cytohubba plugin of Cytoscape software was also performed. Verification was performed using the BO mouse model. Results: Our results revealed 57 DEGs associated with BO, of which 18 were down-regulated and 39 were up-regulated. The Cytohubba plugin data further narrowed down the 57 DEGs into 9 prominent hub genes (CCR2, CD1D, GM2A, TFEC, MPEG1, CTSS, GPNMB, BIRC2, and CTSZ). Genes such as CCR2, TFEC, MPEG1, CTSS, and CTSZ were dysregulated in 2,3-butanedione-induced BO mice, whereas TFEC, CTSS, and CTSZ were dysregulated in nitric acid-induced BO mouse models. Conclusion: Our study identified and validated four novel BO biomarkers, which may allow further investigation into the development of distinct BO diagnostic markers and novel therapeutic avenues.
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[This corrects the article DOI: 10.3389/fimmu.2022.994295.].
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Purpose: Sepsis, with life-threatening organ failure, is caused by the uncontrolled host response to infection. Immune response plays an important role in the pathophysiology of sepsis. Immune-related genes (IRGs) are promising novel biomarkers that have been used to construct the diagnostic and prognostic model. However, an IRG prognostic model used to predict the 28-day mortality in sepsis was still limited. Therefore, the study aimed to develop a prognostic model based on IRGs to identify patients with high risk and predict the 28-day mortality in sepsis. Then, we further explore the circulating immune cell and immunosuppression state in sepsis. Materials and methods: The differentially expressed genes (DEGs), differentially expressed immune-related genes (DEIRGs), and differentially expressed transcription factors (DETFs) were obtained from the GEO, ImmPort, and Cistrome databases. Then, the TFs-DEIRGs regulatory network and prognostic prediction model were constructed by Cox regression analysis and Pearson correlation analysis. The external datasets also validated the reliability of the prognostic model. Based on the prognostic DEIRGs, we developed a nomogram and conducted an independent prognosis analysis to explore the relationship between DEIRGs in the prognostic model and clinical features in sepsis. Besides, we further evaluate the circulating immune cells state in sepsis. Results: A total of seven datasets were included in our study. Among them, GSE65682 was identified as a discovery cohort. The results of GSEA showed that there is a significant correlation between sepsis and immune response. Then, based on a P value <0.01, 69 prognostic DEIRGs were obtained and the potential molecular mechanisms of DEIRGs were also clarified. According to multivariate Cox regression analysis, 22 DEIRGs were further identified to construct the prognostic model and identify patients with high risk. The Kaplan-Meier survival analysis showed that high-risk groups have higher 28-day mortality than low-risk groups (P=1.105e-13). The AUC value was 0.879 which symbolized that the prognostic model had a better accuracy to predict the 28-day mortality. The external datasets also prove that the prognostic model had an excellent prediction value. Furthermore, the results of correlation analysis showed that patients with Mars1 might have higher risk scores than Mars2-4 (P=0.002). According to the previous study, Mars1 endotype was characterized by immunoparalysis. Thus, the sepsis patients in high-risk groups might exist the immunosuppression. Between the high-risk and low-risk groups, circulating immune cells types were significantly different, and risk score was significantly negatively correlated with naive CD4+ T cells (P=0.019), activated NK cells (P=0.0045), monocytes (P=0.0134), and M1 macrophages (P=0.0002). Conclusions: Our study provides a robust prognostic model based on 22 DEIRGs which can predict 28-day mortality and immunosuppression status in sepsis. The higher risk score was positively associated with 28-day mortality and the development of immunosuppression. IRGs are a promising biomarker that might facilitate personalized treatments for sepsis.
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Sepsis , Humanos , Pronóstico , Reproducibilidad de los Resultados , Terapia de Inmunosupresión , Factores de RiesgoRESUMEN
BACKGROUND: Cytomegalovirus (CMV) has high seroprevalence, and its active infection is associated with several adverse prognoses in adult patients with acute respiratory distress syndrome (ARDS). However, the role of active CMV infection in ARDS-associated fibroproliferation is unknown. This study aimed at determining the association between active CMV infection and lung fibroproliferation in adult patients with ARDS. METHODS: We retrospectively reviewed the medical records of all adult patients with ARDS who were admitted to the intensive care unit (ICU) from January 2018 to December 2020 at a national university-affiliated hospital in China. Study subjects were divided into active and non-active CMV infection groups based on CMV DNAemia within a 28-day ICU hospitalization. Lung fibroproliferation was measured using chest high-resolution computed tomography (HRCT) and N-terminal peptide of serum procollagen III (NT-PCP-III) within the first 28 days of ICU admission. Pulmonary fibrosis, clinical features, laboratory findings, treatment measures, and clinical outcomes were compared between the two groups. RESULTS: Among the 87 ARDS patients included in this study, the incidence of active CMV infection was 16.1% within the 28-day ICU admission period. In logistic regression analyze, active CMV infection was found to be associated with higher pulmonary fibrogenesis, pulmonary fibrosis score, and NT-PCP-III level (P < 0.05). The duration of ICU stay in ARDS patients with active CMV infection was significantly higher than in those without active CMV infection (P < 0.05). CONCLUSIONS: Among adult patients with ARDS, active CMV infection was related to poor clinical outcomes. Active CMV infection was associated with ARDS-associated fibroproliferation. Prophylactic and preemptive use of anti-CMV agents on pulmonary fibrosis should be assessed to determine a consensus therapeutic strategy.
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Infecciones por Citomegalovirus , Fibrosis Pulmonar , Síndrome de Dificultad Respiratoria , Adulto , Citomegalovirus , Infecciones por Citomegalovirus/complicaciones , Humanos , Unidades de Cuidados Intensivos , Pulmón , Procolágeno , Fibrosis Pulmonar/etiología , Estudios Retrospectivos , Estudios SeroepidemiológicosRESUMEN
New noncentrosymmetric rare-earth metal gallium thioantimonates, Ln(4)GaSbS(9) were synthesized from stoichiometric element mixtures at 950 °C by high-temperature solid-state reactions. These compounds crystallize in orthorhombic space group Aba2 (no.41) with a = 13.799(3)-13.427(5) Å, b = 14.187(3)-13.756(5) Å, c = 14.323(3)-13.954(5) Å, V = 2804(2)-2577 (2) Å(3), and Z = 8 on going from Ln = Pr to Ho. The asymmetric building units, bimetallic polar (Sb(2)S(5)) units, and dimeric (GaS(4))(2) tetrahedra are in-phase aligned as an infinite single anionic chain of {[(Ga(2)S(6))(Sb(2)S(5))](10-)}(∞) that is further packed in a noncentrosymmetric pseudolayer motif perpendicular to the c axis. Three of the title compounds show large powder second harmonic generation (SHG) effects at 2.05 µm, and two of them also exhibit large transparency ranges (1.75 or 0.75 to 25 µm) in the middle-IR region. Significantly, the Sm-member exhibits the strongest SHG response among sulfides to date with intensity approximately 3.8 times that of the benchmark AgGaS(2). The band structures, indirect band gap nature, bonding strengths, and lone pair effects around Sb have also been studied by Vienna ab initio simulation package calculations.
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Antimonio/química , Galio/química , Rayos Infrarrojos , Elementos de la Serie de los Lantanoides/química , Azufre/química , Modelos Moleculares , Óptica y FotónicaRESUMEN
Presented here is a heterometallic organic framework [Na(2)(H(2)O)(10)](n)[CuZn(4)(mu(3)-OH)(4)(btec)(2)](n).2nH(2)O (1, btec = 1,2,4,5-benzenetetracarboxylate) that incorporates mixed Cu(2+)-Zn(2+) oxide chains and accommodates Na(+) cations as extraframework guest species; such a building mode is comparable to that of aluminosilicate zeolites where the porous framework combines two kinds of structural building units (such as [SiO(4)] and [AlO(4)]) and one kind of inorganic-templating cation.
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Uniform Cu(2)S nanodisks have been synthesized from a well-characterized layered copper thiolate precursor by structure-controlling solventless thermolysis at 200-220 degrees C under a N(2) atmosphere. The development from small Cu(2)S nanoparticles (diameter approximately 3 nm) to nanodisks (diameter 8.3 nm) and then to faceted nanodisks (diameter 27.5 nm, thickness 12.7 nm) is accompanied by a continuous phase transition from metastable orthorhombic to monoclinic Cu(2)S, the ripening of small particles by aggregation, and finally the crystallization process. The growth of the nanoproduct is constrained by the crystal structure of the precursor and the in situ-generated thiol molecules. Such controlled anisotropic growth leads to a nearly constant thickness of faceted nanodisks with different diameters, which has been confirmed by TEM observations and optical absorption measurements.
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A new Zn coordination polymer with the mixed ligands of 1,3,5-benzenetricarboxylate and 1,3-bis(4-pyridyl)propane has been hydrothermally synthesized, and an unusual distorted noninterpenetrated utp [or (10,3)-d] net has been defined.
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Monodisperse silver nanodisks are synthesized on the gram scale from a well-characterized layered silver thiolate precursor via thermolysis at 180-225 degrees C under a N(2) atmosphere. XRD, TEM, HRTEM, and AFM analyses indicate that the nanodisks generated at 180 degrees C over 2 h have an average diameter of about 16.1 nm (sigma = +/-12%) and a thickness of 2.3 nm (sigma = +/-14%), and they lie on their (111) faces. The disk shape is considered to be predestined by the crystal structure of the precursor. Important aspects regarding the stability of the precursor, the thermolysis temperature, and the annealing time, as well as a possible conversion mechanism, are discussed.
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The solvothermal reaction of CuCl(2).2H(2)O with pyridine-4-thiol and ethanol yielded a novel photoluminescent 3-D polymeric complex with an interesting decorated diamondoid network that is constructed of decanuclear copper(I) cluster units and mu(4)-Cl ligands. The in situ generation of CuSO(4).5H(2)O implies the spontaneous occurrence of desulfurization and redox reactions in the present system.
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Uniform hexagonal Cu2S nanowires with 2-6 nm diameters, 0.1 to several mum in length, were made by precipitation and thermolysis at 155 degrees C for 120 min from a Cu-thiolate colloid with a viscosity of 93.5 mPa/s. The morphologies of the final nanoproducts are governable through control of the coordination chemistry of Cu ions and thiols and the association of the Cu/S fragments. The evolution of nanowires, with the polymerization and heating temperature, and the parameters affecting the viscosity of the colloid precursor are reported.
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The hydrothermal reaction of mellitic acid, 4,4'-bipydine, and Cu(CH(3)COO)(2).H(2)O gave rise to a novel 3D supramolecular architecture interpenetrated by three types of coordination polymer motifs. Two independent [[Cu(2)(mellitate)(4,4'-bpy)(H(2)O)(2)](2)(-)] 3D polymers incorporating helical substructures were interwoven into a 3D network with double-stranded helical tubes that host 1D linear polymers [Cu(4,4'-bpy)(H(2)O)(4)](2+)](n).
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The reaction of cadmium chloride with pyridine-2,6-dicarboxylic acid (PDA) and 98% H2SO4 in ethanol led to the formation of the title compound, bis[mu-6-(ethoxycarbonyl)pyridine-2-carboxylato]-1:2kappa4O6,N,O2:O2;1:2kappa4O2:O2,N,O6-bis[diaquachlorocadmium(II)] dihydrate, [Cd2(C9H8NO4)2Cl2(H2O)4].2H2O. PDA is esterified to monoethyl pyridine-2,6-dicarboxylate (MEPD) by the catalysis of H2SO4 during the reaction. The dinuclear Cd(II) complex lies about an inversion centre and the unique Cd atom has a pentagonal-bipyramidal geometry. The two Cd atoms are bridged by two carboxylate O atoms, forming a planar Cd2O2 unit. Stair-like chains are formed via O-H.Cl hydrogen bonds and these are further arranged into two-dimensional layers via hydrogen bonds involving solvate water molecules.
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The title compound, [Ag(2)(NO(3))(2)(C(5)H(5)NS)](n), was obtained from the reaction of silver nitrate with bis(4-pyridyl) disufide (4-PDS) in a mixture of ethanol and water, which suggests that the disulfide bond of 4-PDS can be cleaved under mild conditions. The structure of the title compound is a two-dimensional infinite array in which the asymmetric unit contains two Ag atoms, a pyridinium-4-thiolate molecule and two nitrate groups. Each pyridinium-4-thiolate molecule acts as a mu(4) bridge, linking four Ag atoms, with Ag-S bond distances of 2.4870 (19), 2.5791 (19), 2.5992 (19) and 2.848 (2) A. The Ag.Ag distances lie in the range 2.889 (2)-3.049 (1) A.
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The hydrothermal reaction of an aqueous solution of Cu(CH(3)COO)(2).H(2)O, 1,2,4,5-benzenetetracarboxylic acid and 4,4'-bipyridine gave rise to the interesting title three-dimensional polymer [[Cu(6)(btec)(3)(4,4'-bpy)(3)(H(2)O)(2)].2H(2)O](n) (btec is 1,2,4,5-benzenetetracarboxylate, C(10)H(2)O(8)(4-), and 4,4'-bpy is 4,4'-bipyridine, C(10)H(8)N(2)), in which each btec ligand links six copper(II) cations into a lamellar [Cu(6)(btec)(3)(H(2)O)(2)](n) subpolymer framework. There are two distinct diamine units and two distinct carboxylate units, with one of each lying across an inversion centre.
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A simultaneous redox, alkylation, self-assembly reaction under solvothermal conditions afforded a novel copper(I) chain polymer constructed of luminescent Cu3I4- and unprecedented EtS-4-C5H4N+Et components (Et = CH3CH2).