Analysis of early death in critically ill patients with acute promyelocytic leukaemia in the HICU.

This study was conducted to identify the characteristics and risk factors for early death in critically ill acute promyelocytic leukaemia (APL) patients in the Hemato-oncology ICU (HICU). A total of 44 APL patients from 2017 to 2023 were included. The mortality among APL patients in the HICU was high (27/44, 61.36%). Compared with patients who survived, nonsurvivors had a longer prothrombin time (P = 0.002), lower fibrinogen (P = 0.022), higher white blood cell count (P = 0.004) and higher creatinine (P = 0.037) on hosipital admission. Severe bleeding was the most frequent complication (34 cases, 77.27%), which occurred either preinduction or on Day 5 (IQR 3-7.5 days) of induction. Cerebral bleeding associated with consciousness disturbance was the main reason for HICU admission (18 cases, 40.9%). The leading cause of death was fatal haemorrhage (18/34, 52.94%), which occurred either preinduction or on Day 4 (IQR 3-7 days) of induction. Another common cause of death was sepsis (8/18, 44.44%), which occurred on Day 12 (IQR 9.5-24.75 days) during induction. In conclusion, the main cause of death in APL patients treated in the HICU was primary being attributed to fatal bleeding, followed by sepsis.

Macrophages in ulcerative colitis: A perspective from bibliometric and visual analysis.

Objectives: Despite the many reported studies on macrophages in ulcerative colitis (UC), the overall research trends in this field are unclear. This study evaluates the research trends and hotspots regarding macrophages in UC using bibliometric analysis. Methods: A systematic search was conducted in the Web of Science database to identify publications related to macrophages in UC from 2012 to 2021. R package 'bibliometrix', VOSviewers, CiteSpace and Microsoft Excel were utilised for the bibliometric analysis. Results: 1074 articles published between 2012 and 2021 were analysed. The number of publications on macrophages in UC showed a consistently increasing trend, with USA and China as the leading contributors to this field. Notably, Georgia State University and Nanjing University contributed significantly to this field. Among the authors, Wang Y had the highest productivity, while Wu X received the most citations. The journal Gut was identified as the most authoritative journal in this field. Co-citation analysis revealed that the exploration of the mechanisms of macrophages in UC through in vivo and in vitro experiments was the primary focus of research. Moreover, the emerging research hotspots included keywords such as 'macrophage polarization', 'gut microbiota' and 'NLRP3 inflammasome'. Conclusions: Research on macrophages in UC holds significant value and practical implications. Additionally, China demonstrated prolific output in this field, while the USA had the most influential contributions. Currently, research hotspots are centred around the modulation of gut microbiota to regulate macrophage polarization and macrophage pyroptosis as potential strategies for mitigating UC.

A New Scoring System for Predicting Mortality in Hematological Malignancies with Sepsis: A Derivation and Validation Study.

Objective: This study aimed to derive and validate a prognostic scoring system to identify patients with hematological malignancies (HMs) and sepsis who have a high mortality rate. Methods: Cohorts for derivation and validation were created from all data. Using univariate and multivariate analysis, the independent variables connected to 28-day mortality in the derivation cohort were found. A receiver operating characteristic (ROC) curve was used to compare the predictive power and determine their cutoff points. These risk variables were given a score weighted by risk prediction function, and a new scoring system was also developed. The area under the ROC curve (AUROC) and sensitivity and specificity for mortality of the risk category of the new scoring system were compared with Sequential Organ Failure Assessment (SOFA) score. Results: 90 (45.22%) of the 199 patients passed away within 28 days. Ninety-nine patients made up the derivation cohort, with 47 (47.47%) fatalities. Ages in the non-survival group were higher (61.47 ± 14.53 vs 55.13 ± 15.66) than in the survival group. As independent predictors of death, multivariable analysis identified SOFA score (OR 1.442, 95% CI 1.035, 2.009), age (OR 1.242, 95% CI 1.026, 1.503), and prothrombin time (PT) (OR 1.213, 95% CI 1.030, 1.430). The AUROC with 95% CI of the new scoring system and its sensitivity and specificity to mortality were virtually all superior to SOFA score in both derivation and validation cohorts: AUROC (0.757 vs 0.716), Sensitivity (75 vs 67.3%), and Specificity (68.1% vs 63.8%) are the Derivation cohort; Validation cohort: Sensitivity (91.2% vs 84.2%), AUROC (0.792 vs 0.733), and Specificity (58.1% vs 58.1%). The model was correctly calibrated, according to the Hosmer-Lemeshow test. Conclusion: The new scoring system was more accurate in predicting 28-day mortality among patients with HMs and sepsis than the SOFA score.

Analysis between ABO blood group and clinical outcomes in COVID-19 patients and the potential mediating role of ACE2.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the most common coronavirus that causes large-scale infections worldwide. Currently, several studies have shown that the ABO blood group is associated with coronavirus disease 2019 (COVID-19) infection and some studies have also suggested that the infection of COVID-19 may be closely related to the interaction between angiotensin-converting enzyme 2 (ACE2) and blood group antigens. However, the relationship between blood type to clinical outcome in critically ill patients and the mechanism of action is still unclear. The current study aimed to examine the correlation between blood type distribution and SARS-CoV-2 infection, progression, and prognosis in patients with COVID-19 and the potential mediating role of ACE2. With 234 patients from 5 medical centers and two established cohorts, 137 for the mild cohort and 97 for the critically ill cohort, we found that the blood type A population was more sensitive to SARS-CoV-2, while the blood type distribution was not relevant to acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and mortality in COVID-19 patients. Further study showed that the serum ACE2 protein level of healthy people with type A was significantly higher than that of other blood groups, and type O was the lowest. The experimental results of spike protein binding to red blood cells also showed that the binding rate of people with type A was the highest, and that of people with type O was the lowest. Our finding indicated that blood type A may be the biological marker for susceptibility to SARS-CoV-2 infection and may be associated with potential mediating of ACE2, but irrelevant to the clinical outcomes including ARDS, AKI, and death. These findings can provide new ideas for clinical diagnosis, treatment, and prevention of COVID-19.

The longitudinal relation between violence exposure in daily life, hostile automatic thoughts, and cyber-aggression.

Cyber-aggression is a serious social problem worldwide. Its risks have been frequently explored, and violence exposure in daily life has been regarded as an important risk factor of cyber-aggression. However, the longitudinal association between violence exposure in daily life and cyber-aggression has not yet been examined, and the mechanisms underlying the link between violence exposure and cyber-aggression remain largely unclear. Based on the General Aggression Model and Script Theory, we explored the circular relation between violence exposure in daily life, hostile automatic thoughts, and cyber-aggression. The current study adopted a longitudinal design to address these issues among 941 college students. The results indicated violence exposure in daily life predicted hostile automatic thoughts and cyber-aggression 6 months later; hostile automatic thoughts predicted violence exposure and cyber-aggression 6 months later; and cyber-aggression predicted hostile automatic thoughts and violence exposure 6 months later. Moreover, each of them plays a mediating role in the association between the other two variables. These results support and expand the General Aggression Model and Script Theory that violence exposure, aggressive cognition, and aggression facilitate each other. This also provides theoretical guidance on reducing cyber-aggression in daily life.

Wumei pills attenuates 5-fluorouracil-induced intestinal mucositis through Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB pathway and microbiota regulation.

BACKGROUND: Radiotherapy and chemotherapy can kill tumor cells and improve the survival rate of cancer patients. However, they can also damage normal cells and cause serious intestinal toxicity, leading to gastrointestinal mucositis[1]. Traditional Chinese medicine is effective in improving the side effects of chemotherapy. Wumei pills (WMP) was originally documented in the Treatise on Exogenous Febrile Diseases. It has a significant effect on chronic diarrhea and other gastrointestinal diseases, but it is not clear whether it affects chemotherapy-induced intestinal mucositis (CIM). AIM: To explore the potential mechanism of WMP in the treatment of CIM through experimental research. METHODS: We used an intraperitoneal injection of 5-fluorouracil (5-Fu) to establish a CIM mouse model and an oral gavage of WMP decoction (11325 and 22650 mg/kg) to evaluate the efficacy of WMP in CIM. We evaluated the effect of WMP on CIM by observing the general conditions of the mice (body weight, food intake, spleen weight, diarrhea score, and hematoxylin and eosin stained tissues). The expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1ß, and myeloperoxidase (MPO), as well as the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB (TLR4/MyD88/NF-κB) signaling pathway proteins and tight junction proteins (zonula occludens-1, claudin-1, E-cadherin, and mucin-2) was determined. Furthermore, intestinal permeability, intestinal flora, and the levels of short-chain fatty acids (SCFA) were also assessed. RESULTS: WMP effectively improved the body weight, spleen weight, food intake, diarrhea score, and inflammatory status of the mice with intestinal mucositis, which preliminarily confirmed the efficacy of WMP in CIM. Further experiments showed that in addition to reducing the levels of TNF-α, IL-1ß, IL-6, and MPO and inhibiting the expression of the TLR4/MyD88/NF-κB pathway proteins, WMP also repaired the integrity of the mucosal barrier of mice, regulated the intestinal flora, and increased the levels of SCFA (such as butyric acid). CONCLUSION: WMP can play a therapeutic role in CIM by alleviating inflammation, restoring the mucosal barrier, and regulating gut microbiota.

Influence of alternating electric field on deep dewatering of municipal sludge and changes of extracellular polymeric substance during dewatering.

A self-prepared experimental device made of plexiglass with alternating power supply system was used to study the deep dewatering of municipal dewatered sludge. Considering the reduction rate of sludge water content (Wr) as the index, factors affecting enhanced electric settlement of sludge such as exchange electrode method, voltage gradient, sludge thickness, and mechanical pressure were studied, and the dewatering mechanism was elucidated. The single-factor experiment combined with the surface response method based on the Box-Behnken central experimental design was performed. With Wr as the response value, the voltage gradient conditions, time ratio, and sludge thickness were optimized. Pearson correlation analysis showed that the reduction of proteins/polysaccharides was beneficial to improving the sludge dewatering effect. Tightly bound extracellular polymeric substances (TB-EPSs) showed a significant influence on the sludge dewatering effect. Under the action of the external electric field, particles with negative charge moved toward the anode sludge, water with partial positive charge flowed to the cathode, and the sludge cellular structure was damaged. This resulted in the dissolution of a large number of EPSs and the release of bound water. The anode sludge cake got thickened due to the accumulation of the sludge particles, leading to the increase in resistance. The TB-EPS was deconstructed by the ohmic heating to improve the sludge dewatering effect and achieve deep dewatering. Scanning electron microscopy results showed that the drying problem of anode sludge was alleviated during the dewatering process.

Airway malacia in premature infant twins with bronchopulmonary dysplasia: Two case reports.

Premature infants who require surgery for retinopathy of prematurity often exhibit bronchopulmonary dysplasia. Reactive airway is a clinical manifestation of bronchopulmonary dysplasia. We describe premature infant twins who had difficulty with positive pressure ventilation during anesthesia. Both cases occurred during induction of anesthesia for binocular anterior chamber puncture and vitreous cavity injection. The most likely cause in each case was airway malacia. We recommend that endotracheal intubation is performed in infant patients with low body weight; the possibility of airway malacia occurrence should be considered, especially for infants with comorbid bronchopulmonary dysplasia.

The Cyclophilin ROC3 Regulates ABA-Induced Stomatal Closure and the Drought Stress Response of Arabidopsis thaliana.

Drought causes a major constraint on plant growth, development, and crop productivity. Drought stress enhances the synthesis and mobilization of the phytohormone abscisic acid (ABA). Enhanced cellular levels of ABA promote the production of reactive oxygen species (ROS), which in turn induce anion channel activity in guard cells that consequently leads to stomatal closure. Although Cyclophilins (CYPs) are known to participate in the biotic stress response, their involvement in guard cell ABA signaling and the drought response remains to be established. The Arabidopsis thaliana gene ROC3 encodes a CYP. Arabidopsis roc3 T-DNA mutants showed a reduced level of ABA-activated S-type anion currents, and stomatal closure than wild type (WT). Also, roc3 mutants exhibited rapid loss of water in leaf than wild type. Two complementation lines of roc3 mutants showed similar stomatal response to ABA as observed for WT. Both complementation lines also showed similar water loss as WT by leaf detached assay. Biochemical assay suggested that ROC3 positively regulates ROS accumulation by inhibiting catalase activity. In response to ABA treatment or drought stress, roc3 mutant show down regulation of a number of stress responsive genes. All findings indicate that ROC3 positively regulates ABA-induced stomatal closure and the drought response by regulating ROS homeostasis and the expression of various stress-activated genes.

Acute glucose fluctuation promotes in vitro intestinal epithelial cell apoptosis and inflammation via the NOX4/ROS/JAK/STAT3 signaling pathway.

High blood glucose commonly occurs in patients with diabetes mellitus, but little is known of its effects on intestinal epithelial cells, or its associated mechanisms of action therein. In the present study, intestinal epithelial cells were assigned to five groups: i) The normal glucose (NG) group, incubated in 5.0 mmol/l glucose; ii) the constant high glucose (CHG) group, treated with 25.0 mmol/l glucose; iii) the intermittent high glucose (IHG) group, treated with alternating doses of 5.0 and 25.0 mmol/l glucose every 8 h; iv) the mannose group, cultured in 25.0 mmol/l mannose (the osmotic control); and v) the IHG glucose + GKT137831 group, pretreated with 100 nmol/l NADPH oxidase 4 (NOX4) inhibitor, GKT137831, and then exposed to IHG. TNF-α, IL-1 and IL-6 levels were quantified using ELISA kits. Intestinal epithelial cell apoptosis was assessed by flow cytometry and oxidative stress was evaluated by reactive oxygen species (ROS) and malondialdehyde (MDA) detection. The expression levels of proteins associated with apoptosis and involved in the signal transduction of Janus kinase (JAK)/STAT3 pathway were assessed using western blot analysis. The results indicated that NOX4 expression was significantly higher in the CHG group than in the NG group (P<0.01), but lower than in the IHG group (P<0.001). The IHG group exhibited apoptosis and oxidative stress accompanied by the most significant increase in MDA, ROS and inflammatory cytokine levels (P<0.001), which was followed by that of the CHG group. Additionally, the IHG group exhibited reduced Bcl-2, as well as enhanced Bax and cleaved caspase-3 levels compared with the CHG group (P<0.001). Furthermore, the level of phosphorylated (p-)JAK/p-STAT3 was increased to a greater extent in the IHG group than in the CHG group (P<0.001). In conclusion, the findings of the present study indicated that CHG may trigger intestinal epithelial cell apoptosis and inflammation through the NOX4/ROS/JAK/STAT3 pathway, which may be aggravated by acute glucose fluctuation.

Probiotics in preventing and treating chemotherapy-induced diarrhea: a meta-analysis.

BACKGROUND AND OBJECTIVES: To systematically assess the safety and effectiveness of probiotics in preventing and treating chemotherapy-induced diarrhea (CID), so as to provide the evidence-based evidence for clinical practice. METHODS AND STUDY DESIGN: Electronic databases, including EMbase, Cochrane Library, pubMed, CNKI, VIP, CBM, and Wanfang databases, were retrieved to search for the randomized controlled trials (RCTs) of CIDs among patients with malignant tumors treated with probiotics as of March 2019. Later, the Rev Man 5.3 statistical software was employed to extract data and assess the quality of the identified literature for metaanalysis. RESULTS: Finally, 13 RCTs involving a total of 1024 patients were included into the current metaanalysis. Results of this meta-analysis showed that the addition of probiotics to conventional symptomatic treatment could evidently reduce the total diarrhea rate in patients with cancer [RR=0.47, 95% CI (0.35, 0.63), p<0.00001] and grade III-IV diarrhea [RR=0.16, 95% CI (0.05, 0.42), p=0.0008], increase the total effective rate [OR=4.26, 95% CI (2.55, 7.12), p<0.00001], and shorten the duration of diarrhea [MD=-1.92, 95% CI (-1.96, - 1.88), p<0.00001]; meanwhile, the difference was statistically significant. But in patients with grade I-II diarrhea [RR=0.81, 95% CI (0.53, 1.24), p=0.34], the difference was not statistically significant. Besides, none of the enrolled study had reported adverse reactions. CONCLUSIONS: The application of probiotics before or during chemotherapy can effectively prevent the occurrence of CID among cancer patients. Moreover, the combination of probiotics in treating CID can also improve the therapeutic effect on CID, with less adverse events.

Performance of urinary neutrophil gelatinase-associated lipocalin, clusterin, and cystatin C in predicting diabetic kidney disease and diabetic microalbuminuria: a consecutive cohort study.

BACKGROUND: Tubular biomarkers have been regarded as emerging and promising markers for early diagnosis of diabetic kidney disease (DKD). The study was to determine the diagnostic capabilities of tubular biomarkers (urinary neutrophil gelatinase-associated lipocalin [NGAL], clusterin, and cystatin C) for DKD and diabetic microalbuminuria, and whether or not the tubular biomarkers appear earlier than microalbuminuria. METHODS: In this consecutive cohort study, 146 type 2 diabetes mellitus (T2DM) patients with a disease duration of ≥6 years were enrolled. Thirty age- and gender-matched subjects without any systemic diseases were recruited as the control group. Urinary samples collected before treatment were tested for NGAL, clusterin, and cystatin C. RESULTS: The levels of biomarkers were higher in patients with DKD (p < 0.001); and positively correlated with the urinary albumin creatinine ratio (UACR; p < 0.001). With respect to the diagnosis of DKD, the areas under the receiver operating characteristic curve (AUCs) for urinary NGAL, clusterin, and cystatin C were 0.816 (95% confidence interval [CI], 0.741-0.891), 0.775 (95% CI: 0.694-0.857), and 0.803 (95% CI: 0.722-0.884), respectively. The levels of urinary NGAL and cystatin C in the normoalbuminuria group (UACR <30 mg /g•Cr) were elevated compared with the control group, unlike urinary clusterin. There was no statistical difference in the levels of the three biomarkers between groups with different levels of haemoglobin A1C (HbA1c). The diagnostic AUCs for urinary NGAL, clusterin, and cystatin C in patients with diabetic microalbuminuria were 0.841 (95% CI: 0.775-0.907), 0.783(95% CI: 0.710-0.856), and 0.805 (95% CI: 0.733-0.877), respectively. CONCLUSIONS: Urinary NGAL, clusterin, and cystatin C may be promising biomarkers for diagnosing DKD and diabetic microalbuminuria. It is possible that urinary NGAL and cystatin C increase before the onset of microalbuminuria in T2DM patients.