Value of heparin-binding protein in the diagnosis of severe infection in children: a prospective study. / è‚ç´ ç»“åˆè›‹ç™½å¯¹å„¿ç«¥é‡ç—‡æ„ŸæŸ“è¯Šæ–­ä»·å€¼çš„å‰çž»æ€§ç ”ç©¶.

OBJECTIVES: To study the value of heparin-binding protein (HBP) in the diagnosis of severe infection in children. METHODS: This study was a prospective observational study. The medical data of children who were admitted to the pediatric intensive care unit due to infection from January 2019 to January 2020 were collected. According to the diagnostic criteria for severe sepsis and sepsis, the children were divided into a severe sepsis group with 49 children, a sepsis group with 82 children, and a non-severe infection group with 33 children. The three groups were compared in terms of related biomarkers such as plasma HBP, serum C-reactive protein, serum procalcitonin, and platelet count. The receiver operating characteristic (ROC) curve was plotted to investigate the value of plasma HBP level in the diagnosis of severe infection (including severe sepsis and sepsis). RESULTS: The severe sepsis and sepsis groups had a significantly higher plasma HBP level on admission than the non-severe infection group (P<0.05). Compared with the sepsis and non-severe groups, the severe sepsis group had significantly higher serum levels of C-reactive protein and procalcitonin and a significantly lower platelet count (P<0.05). Plasma HBP level had an area under the ROC curve of 0.590 in determining severe infection, with a sensitivity of 38.0% and a specificity of 82.4% (P<0.05). CONCLUSIONS: There is an increase in plasma HBP level in children with severe infection, and plasma HBP level has a lower sensitivity but a higher specificity in the diagnosis of severe infection and can thus be used as one of the markers for the judgment of severe infection in children.

Prognostic value of thromboelastography for trauma-induced coagulopathy / 医学研究生学报

Objective Coagulation disorder is an independent risk factor of death in trauma patients. This study aimed to investigate the prognostic value of thromboelastography (TEG) for patients with trauma-induced coagulopathy.Methods This retrospective study included 124 cases of trauma-induced coagulopathy treated in our Department of Critical Care Medicine from September 2015 to July 2018. We collected the clinical data and laboratory Results of the patients within 2 hours after admission, divided the patients into a survival group (n=108) and death group (n=16) according to their 90-day prognosis after trauma, and compared the TEG parameters between the two groups. Using logistic regression analysis and ROC curves, we identified the optimal prognostic factors and compared the platelet (PLT) count and mortality rate among those with different cut-off values.Results In comparison with the survival group, the death group showed a significant increase in the clot formation time (CFT) (3.2 \[2.2-4.8\] vs 5.2 \[5.0-9.8\] min, P45.65 mm (86 \[46-114\] vs 116 \[84-171\]×109/L, P<0.05), and mortality was remarkably higher in the former than in the latter group (31.8% vs 1.2%, P<0.05).Conclusion Among the TEG parameters, MA / maximal clot strength is a valuable indicator for the prognosis of trauma-induced coagulopathy, and MA<45.65 mm indicates early PLT dysfunction and poor prognosis.

A physiologic role for serotonergic transmission in adult rat taste buds.

Of the multiple neurotransmitters and neuropeptides expressed in the mammalian taste bud, serotonin remains both the most studied and least understood. Serotonin is expressed in a subset of taste receptor cells that form synapses with afferent nerve fibers (type III cells) and was once thought to be essential to neurotransmission (now understood as purinergic). However, the discovery of the 5-HT1A serotonin receptor in a subset of taste receptor cells paracrine to type III cell suggested a role in cell-to-cell communication during the processing of taste information. Functional data describing this role are lacking. Using anatomical and neurophysiological techniques, this study proposes a modulatory role for serotonin during the processing of taste information. Double labeling immunocytochemical and single cell RT-PCR technique experiments documented that 5-HT1A-expressing cells co-expressed markers for type II cells, cells which express T1R or T2R receptors and release ATP. These cells did not co-express type III cells markers. Neurophysiological recordings from the chorda tympani nerve, which innervates anterior taste buds, were performed prior to and during intravenous injection of a 5-HT1A receptor antagonist. These experiments revealed that serotonin facilitates processing of taste information for tastants representing sweet, sour, salty, and bitter taste qualities. On the other hand, injection of ondansetron, a 5-HT3 receptor antagonist, was without effect. Collectively, these data support the hypothesis that serotonin is a crucial element in a finely-tuned feedback loop involving the 5-HT1A receptor, ATP, and purinoceptors. It is hypothesized that serotonin facilitates gustatory signals by regulating the release of ATP through ATP-release channels possibly through phosphatidylinositol 4,5-bisphosphate resynthesis. By doing so, 5-HT1A activation prevents desensitization of post-synaptic purinergic receptors expressed on afferent nerve fibers and enhances the afferent signal. Serotonin may thus play a major modulatory role within peripheral taste in shaping the afferent taste signals prior to their transmission across gustatory nerves.

Prosapogenin A induces apoptosis in human cancer cells in vitro via inhibition of the STAT3 signaling pathway and glycolysis.

Signal transducer and activator of transcription 3 (STAT3) is considered to be an oncogene. Blocking STAT3 signaling may induce growth arrest and apoptosis in different types of tumors. Cancer cells utilize the glycolytic pathway to maintain cell growth even when adequate oxygen is present. Glycolysis inhibition is a potential therapeutic modality. In the present study, the effects of Prosapogenin A (PSA) from the traditional Chinese medicine, Veratrum, on apoptosis, the STAT3 signaling pathway and glycometabolism in cancer cells were investigated. The results indicated that PSA induced growth inhibition and apoptosis in HeLa, HepG2 and MCF-7 cells. PSA inhibited the STAT3 signaling pathway and modulated the expression of glycometabolism-related genes. The results indicate that the inhibition of the STAT3 signaling and glycometabolism pathways contributes to the PSA-mediated apoptosis of HeLa, HepG2 and MCF-7 cells.

The neuropeptides CCK and NPY and the changing view of cell-to-cell communication in the taste bud.

The evolving view of the taste bud increasingly suggests that it operates as a complex signal processing unit. A number of neurotransmitters and neuropeptides and their corresponding receptors are now known to be expressed in subsets of taste receptor cells in the mammalian bud. These expression patterns set up hard-wired cell-to-cell communication pathways whose exact physiological roles still remain obscure. As occurs in other cellular systems, it is likely that neuropeptides are co-expressed with neurotransmitters and function as neuromodulators. Several neuropeptides have been identified in taste receptor cells including cholecystokinin (CCK), neuropeptide Y (NPY), vasoactive intestinal peptide (VIP), and glucagon-like peptide 1 (GLP-1). Of these, CCK and NPY are the best studied. These two peptides are co-expressed in the same presynaptic cells; however, their postsynaptic actions are both divergent and antagonistic. CCK and its receptor, the CCK-1 subtype, are expressed in the same subset of taste receptor cells and the autocrine activation of these cells produces a number of excitatory physiological actions. Further, most of these cells are responsive to bitter stimuli. On the other hand, NPY and its receptor, the NPY-1 subtype, are expressed in different cells. NPY, acting in a paracrine fashion on NPY-1 receptors, results in inhibitory actions on the cell. Preliminary evidence suggests the NPY-1 receptor expressing cell co-expresses T1R3, a member of the T1R family of G-protein coupled receptors thought to be important in detection of sweet and umami stimuli. Thus the neuropeptide expressing cells co-express CCK, NPY, and CCK-1 receptor. Neuropeptides released from these cells during bitter stimulation may work in concert to both modulate the excitation of bitter-sensitive taste receptor cells while concurrently inhibiting sweet-sensitive cells. This modulatory process is similar to the phenomenon of lateral inhibition that occurs in other sensory systems.

GABA expression in the mammalian taste bud functions as a route of inhibitory cell-to-cell communication.

Recent advances have underscored cell-to-cell communication as an important component of the operation of taste buds with individual taste receptor cells (TRCs) communicating with one another by means of a number of neurotransmitters and neuropeptides, although functional roles are not yet understood. Here, we characterize the presence, distribution pattern, phenotype, and functional consequences of a previously undescribed inhibitory route within the taste bud mediated by the classic neurotransmitter GABA and its receptors. By using immunocytochemistry, subsets of TRCs within rat taste buds were identified as expressing GABA, and its synthetic enzyme glutamate decarboxylase (GAD). GAD expression was verified with Western blotting. Immunofluorescent studies revealed complex coexpression patterns of GAD with the TRC protein markers gustducin, neural cell adhesion molecule, protein gene product 9.5, and synaptosomal-associated protein of 25 kDa that collectively outline hardwired signaling pathways of GABAergic TRCs. RT-PCR and immunocytochemistry demonstrated that both GABA(A) and GABA(B) receptors are expressed in the taste bud. The later was observed in a subset TRCs paracrine to GAD-expressing TRCs. Physiological effects of GABA were examined by patch clamp recordings. GABA and the GABA(A) agonists muscimol and isoguvacine enhanced isolated chloride currents in a dose-dependent manner. Also, GABA and the GABA(B) agonist baclofen both elicited increases of the inwardly rectifying potassium currents that could be blocked by the GABA(B) receptor antagonist CGP 35348 and the G protein blocker GDP-betaS. Collectively, these data suggest that GABAergic TRCs are able to shape the final chemosensory output of the bud by means of processes of cell-to-cell modulation.

Resynthesis of phosphatidylinositol 4,5-bisphosphate mediates adaptation of the caffeine response in rat taste receptor cells.

Caffeine, a prototypic bitter stimulus, produces several physiological actions on taste receptor cells that include inhibition of KIR and KV potassium currents and elevations of intracellular calcium. These responses display adaptation, i.e. their magnitude diminishes in the sustained presence of the stimulus. Levels of the membrane lipid phosphatidylinositol-4,5-bisphosphate (PIP2) are well known to modulate many potassium channels, activating the channel by stabilizing its open state. Here we investigate a putative relationship of KIR and KV with PIP2 levels hypothesizing that inhibition of these currents by caffeine might be allayed by PIP2 resynthesis. Using standard patch-clamp techniques, recordings of either potassium current from rat posterior taste receptor cells produced essentially parallel results when PIP2 levels were manipulated pharmacologically. Increasing PIP2 levels by blocking phosphoinositide-3 kinase with wortmannin or LY294002, or by blocking phospholipase C with U73122 all significantly increased the incidence of adaptation for both KIR and KV. Conversely, lowering PIP2 synthesis by blocking PI4K or using the PIP2 scavengers polylysine or bovine serum albumin reduced the incidence of adaptation. Adaptation could be modulated by activation of protein kinase C but not calcium calmodulin kinase. Collectively, these data support two highly novel conclusions: potassium currents in taste receptor cells are significantly modulated by PIP2 levels and PIP2 resynthesis may play a central role in the gustatory adaptation process at the primary receptor cell level.

Expression, physiological action, and coexpression patterns of neuropeptide Y in rat taste-bud cells.

Recent studies have suggested that neuropeptides could play previously unrecognized functional roles in peripheral gustation. To date, two peptides, cholecystokinin and vasoactive intestinal peptide, have been localized to subsets of taste-bud (TB) cells (TBC) and one, cholecystokinin, has been demonstrated to produce excitatory physiological actions. This study extends our knowledge of neuropeptides in TBC in three significant ways. First, using techniques of immunocytochemistry and RT-PCR, evidence is presented for the expression of a third peptide, neuropeptide Y (NPY). Like other peptide expression patterns, NPY expression is circumscribed to a subset of cells within the taste bud. Second, using physiological studies, we demonstrate that NPY specifically enhances an inwardly rectifying potassium current via NPY-Y1 receptors. This action is antagonistic to the previously demonstrated inhibitory effect exerted by cholecystokinin on the same current, thus providing important clues to their signaling roles in the TB. Third, using the technique of double-labeled fluorescent immunocytochemistry, the relationship of three subsets of neuropeptide-expressing TB cells to one another was examined. Remarkably, NPY expressions, although fewer in number than either the cholecystokinin or vasoactive intestinal peptide subsets, overlapped 100% with either peptide. Collectively, these three observations transform previously suggestive roles of neuromodulation by peptides in TB cells to more concrete signaling pathways. The extensive colocalization of these peptides suggests they may be subject to similar presynaptic influences of release yet have antagonistic postsynaptic actions. The convergence or divergence of these postsynaptic actions awaits further investigation.

A paracrine signaling role for serotonin in rat taste buds: expression and localization of serotonin receptor subtypes.

Recent advances in peripheral taste physiology now suggest that the classic linear view of information processing within the taste bud is inadequate and that paracrine processing, although undemonstrated, may be an essential feature of peripheral gustatory transduction. Taste receptor cells (TRCs) express multiple neurotransmitters of unknown function that could potentially participate in a paracrine role. Serotonin is expressed in a subset of TRCs with afferent synapses; additionally, TRCs respond physiologically to serotonin. This study explored the expression and cellular localization of serotonin receptor subtypes in TRCs as a possible route of paracrine communication. RT-PCR was performed on RNA extracted from rat posterior taste buds with 14 prime sets representing 5-HT(1) through 5-HT(7) receptor subtype families. Data suggest that 5-HT(1A) and 5-HT(3) receptors are expressed in taste buds. Immunocytochemistry with a 5-HT(1A)-specific antibody demonstrated that subsets of TRCs were immunopositive for 5-HT(1A). With the use of double-labeling, serotonin- and 5-HT(1A)-immunopositive cells were observed exclusively in nonoverlapping populations. On the other hand, 5-HT(3)-immunopositive taste receptor cells were not observed. This observation, combined with other data, suggests 5-HT(3) is expressed in postsynaptic neural elements within the bud. We hypothesize that 5-HT release from TRCs activates postsynaptic 5-HT(3) receptors on afferent nerve fibers and, via a paracrine route, inhibits neighboring TRCs via 5-HT(1A) receptors. The ole of the 5-HT(1A)-expressing TRC within the taste bud remains to be explored.

Physiological phenotyping of cholecystokinin-responsive rat taste receptor cells.

The recent discovery that subsets of rat taste receptor cells (TRCs) express the peptide cholecystokinin (CCK) and that subsets of TRCs respond to CCK with altered potassium currents or elevated intracellular calcium via CCK-A receptor has lead to the hypothesis that CCK may play a novel signaling role within the taste bud, perhaps modifying tastant responses by co-transmission with a classic transmitter. To better understand this phenomenon, CCK-responsive TRCs were characterized for sensitivity to two bitter stimuli, quinine or caffeine, or to the neurotransmitter ACh using a ratiometric procedure with the calcium sensitive dye fura-2. In characterizing TRC responses to quinine, it was observed that quinine-induced elevations of intracellular calcium were not due to endogenous fluorescence of the quinine molecule. Most (60-70%) CCK-responsive cells were also sensitive to either bitter stimuli or to cholinergic stimulation. These data suggest that TRCs expressing CCK-receptors also express receptors to bitter stimuli and/or muscarinic receptors. They further support the notion of a putative modulatory role of CCK with convergence of multiple inputs occurring at the level of intracellular calcium.

Expression and physiological actions of cholecystokinin in rat taste receptor cells.

Gustatory perception arises not only from intracellular transduction cascades within taste receptor cells but also from cell-to-cell communication among the cells of the taste bud. This study presents novel data demonstrating that the brain-gut peptide cholecystokinin (CCK) is expressed in subsets of taste receptor cells, and that it may play a signaling role unknown previously within the taste bud. Immunocytochemistry revealed positively stained subsets of cells within taste buds throughout the oral cavity. These cells typically displayed round nuclei with full processes, similar to those classified as light cells. Peptide expression was verified using nested PCR on template cDNA derived from mRNA extracted from isolated posterior taste buds. Multiple physiological actions of cholecystokinin on taste receptor cells were observed. An outward potassium current, recorded with the patch-clamp technique, was inhibited by exogenous application of sulfated cholecystokinin octapeptide in a reversible and concentration-dependent manner. Pharmacological analysis suggests that this inhibition is mediated by CCK-A receptors and involves PKC phosphorylation. An inwardly rectifying potassium current, typically invariant to stimulation, was also inhibited by cholecystokinin. Additionally, exogenous cholecystokinin was effective in elevating intracellular calcium as measured by ratiometric techniques with the calcium-sensitive dye fura-2. Pharmacology similarly demonstrated that these calcium elevations were mediated by CCK-A receptors and were dependent on intracellular calcium stores. Collectively, these observations suggest a newly discovered role for peptide neuromodulation in the peripheral processing of taste information.

Adrenergic signalling between rat taste receptor cells.

In taste buds, synaptic transmission is traditionally thought to occur from taste receptor cells to the afferent nerve. This communication reports the novel observation that taste receptor cells respond to adrenergic stimulation. Noradrenaline application inhibited outward potassium currents in a dose-dependent manner. This inhibition was mimicked by the beta agonist isoproterenol and blocked by the beta antagonist propranolol. The alpha agonists clonidine and phenylephrine both inhibited the potassium currents and elevated intracellular calcium levels. Inwardly rectifying potassium currents were unaffected by adrenergic stimulation. Experiments using the RT-PCR technique demonstrate that lingual epithelium expresses multiple alpha (alpha1a, alpha1b, alpha1c, alpha1d, alpha2a, alpha2b, alpha2c) and beta (beta1, beta2) subtypes of adrenergic receptors, and immunocytochemistry localized noradrenaline to a subset of taste receptor cells. Collectively, these data imply strongly that adrenergic transmission within the taste bud may play a paracrine role in taste physiology.

Dual actions of caffeine on voltage-dependent currents and intracellular calcium in taste receptor cells.

Although the numerous stimuli representing the taste quality of bitterness are known to be transduced through multiple mechanisms, recent studies have suggested an unpredicted complexity of the transduction pathways for individual bitter stimuli. To investigate this notion more thoroughly, a single prototypic bitter stimulus, caffeine, was studied by using patch-clamp and ratiometric imaging techniques on dissociated rat taste receptor cells. At behaviorally relevant concentrations, caffeine produced strong inhibition of outwardly and inwardly rectifying potassium currents. Caffeine additionally inhibited calcium current, produced a weaker inhibition of sodium current, and was without effect on chloride current. Consistent with its effects on voltage-dependent currents, caffeine caused a broadening of the action potential and an increase of the input resistance. Caffeine was an effective stimulus for elevation of intracellular calcium. This elevation was concentration dependent, independent of extracellular calcium or ryanodine, and dependent on intracellular stores as evidenced by thapsigargin treatment. These dual actions on voltage-activated ionic currents and intracellular calcium levels suggest that a single taste stimulus, caffeine, utilizes multiple transduction mechanisms.