Prospective Evaluation of the Peripheral Perfusion Index in Assessing the Organ Dysfunction and Prognosis of Adult Patients With Sepsis in the ICU.

Background: The peripheral perfusion index (PI) reflects microcirculatory blood flow perfusion and indicates the severity and prognosis of sepsis. Method: The cohort comprised 208 patients admitted to the intensive care unit (ICU) with infection, among which 117 had sepsis. Demographics, medication history, ICU variables, and laboratory indexes were collected. Primary endpoints were in-hospital mortality and 28-day mortality. Secondary endpoints included organ function variables (coagulation function, liver function, renal function, and myocardial injury), lactate concentration, mechanical ventilation time, and length of ICU stay. Univariate and multivariate analyses were conducted to assess the associations between the PI and clinical outcomes. Sensitivity analyses were performed to explore the associations between the PI and organ functions in the sepsis and nonsepsis groups. Result: The PI was negatively associated with in-hospital mortality (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.15 to 0.55), but was not associated with 28-day mortality. The PI was negatively associated with the coagulation markers prothrombin time (PT) (ß -0.36, 95% CI -0.59 to 0.13) and activated partial thromboplastin time (APTT) (ß -1.08, 95% CI -1.86 to 0.31), and the myocardial injury marker cardiac troponin I (cTnI) (ß -2085.48, 95% CI -3892.35 to 278.61) in univariate analysis, and with the PT (ß -0.36, 95% CI -0.60 to 0.13) in multivariate analysis. The PI was negatively associated with the lactate concentration (ß -0.57, 95% CI -0.95 to 0.19), mechanical ventilation time (ß -23.11, 95% CI -36.54 to 9.69), and length of ICU stay (ß -1.28, 95% CI -2.01 to 0.55). Sensitivity analyses showed that the PI was significantly associated with coagulation markers (PT and APTT) and a myocardial injury marker (cTnI) in patients with sepsis, suggesting that the associations between the PI and organ function were stronger in the sepsis group than the nonsepsis group. Conclusion: The PI provides new insights for assessing the disease severity, short-term prognosis, and organ function damage in ICU patients with sepsis, laying a theoretical foundation for future research.

The Exosome-Mediated Bone Regeneration: An Advanced Horizon Toward the Isolation, Engineering, Carrying Modalities, and Mechanisms.

Exosomes, nanoparticles secreted by various cells, composed of a bilayer lipid membrane, and containing bioactive substances such as proteins, nucleic acids, metabolites, etc., have been intensively investigated in tissue engineering owing to their high biocompatibility and versatile biofunction. However, there is still a lack of a high-quality review on bone defect regeneration potentiated by exosomes. In this review, the biogenesis and isolation methods of exosomes are first introduced. More importantly, the engineered exosomes of the current state of knowledge are discussed intensively in this review. Afterward, the biomaterial carriers of exosomes and the mechanisms of bone repair elucidated by compelling evidence are presented. Thus, future perspectives and concerns are revealed to help devise advanced modalities based on exosomes to overcome the challenges of bone regeneration. It is totally believed this review will attract special attention from clinicians and provide promising ideas for their future works.

Comprehensive treatment of deep frostbite of multiple fingers after trauma: A case report.

BACKGROUND: Frostbite is becoming increasingly common in urban environments, and severe cases can lead to tissue loss. The treatment goal is to preserve tissue and function; the sooner appropriate treatment is administered, the more tissue can be saved. However, not every patient with deep frostbite seeks medical care promptly. CASE SUMMARY: We report the case of a 73-year-old male patient who was lost in the wilderness for 2 d due to trauma and confusion. He experienced deep frostbite on multiple fingers. Treatment should not be discontinued for patients with deep frostbite who present after the optimum treatment timing. Bullae that no longer form (bloody) blisters within 24 h of aspiration should be removed. Mucopolysaccharide polysulfate cream has clinical value in frostbite treatment. The patient was transferred to Chinese Academy of Medical Sciences and Peking Union Medical College Hospital 12 h after being rescued. The patient had contraindications for thrombolysis, the most effective treatment, due to intracranial hemorrhage and presenting past the optimum treatment timing. We devised a comprehensive treatment plan, which involved delayed use vasodilators and high-pressure oxygen therapy at day 49 post-injury. We experimented with mucopolysaccharide polysulfate cream to treat the frostbite. The aim of the treatment was to safeguard as much tissue as possible. In the end, the fingers that suffered from frostbite were able to be partially preserved. CONCLUSION: The case indicated that patients with severe frostbite who missed the optimal treatment time and had contraindications for thrombolysis could still partially preserve the affected limbs through comprehensive treatment.

Microcirculation and Mitochondria: The Critical Unit.

Critical illness is often accompanied by a hemodynamic imbalance between macrocirculation and microcirculation, as well as mitochondrial dysfunction. Microcirculatory disorders lead to abnormalities in the supply of oxygen to tissue cells, while mitochondrial dysfunction leads to abnormal energy metabolism and impaired tissue oxygen utilization, making these conditions important pathogenic factors of critical illness. At the same time, there is a close relationship between the microcirculation and mitochondria. We introduce here the concept of a "critical unit", with two core components: microcirculation, which mainly comprises the microvascular network and endothelial cells, especially the endothelial glycocalyx; and mitochondria, which are mainly involved in energy metabolism but perform other non-negligible functions. This review also introduces several techniques and devices that can be utilized for the real-time synchronous monitoring of the microcirculation and mitochondria, and thus critical unit monitoring. Finally, we put forward the concepts and strategies of critical unit-guided treatment.

Hypoxia-inducible factor-1α is a biomarker for predicting patients with sepsis.

OBJECTIVE: This study aimed to investigate the potential value of serum hypoxia-inducible factor-1α (HIF-1α) concentrations as a biomarker in patients with sepsis. METHODS: The enrolled patients were divided into the following four groups: the intensive care unit (ICU) control group (n = 33), infection group (n = 29), septic nonshock group (n = 40), and septic shock group (n = 94). An enzyme-linked immunosorbent assay was used to measure serum HIF-1α concentrations on ICU admission. Clinical parameters and laboratory test results were also collected. RESULTS: Serum HIF-1α concentrations were significantly higher in the infection group, septic nonshock group, and septic shock group than in the ICU control group. Moreover, HIF-1α concentrations were associated with a better predictive ability for diagnosing sepsis than the Acute Physiology and Chronic Health Evaluation II score, procalcitonin concentrations, and lactate concentrations. Patients with sepsis and HIF-1α concentrations >161.14 pg/mL had a poor prognosis. CONCLUSIONS: Serum HIF-1α concentrations are a useful biomarker for the diagnosis of sepsis and predicting the prognosis of patients.

Identification of key genes for IgA nephropathy based on machine learning algorithm and correlation analysis of immune cells.

INTRODUCTION: The pathogenesis and progression mechanism of Immunoglobulin A nephropathy (IgAN) is not fully understood. There is a lack of panoramic analysis of IgAN immune cell infiltration and algorithms that are more efficient and accurate for screening key pathogenic genes. METHODS: RNA sequencing (RNA-seq) data sets on IgAN were downloaded from the Gene Expression Omnibus (GEO) database, including GSE93798, GSE35489, and GSE115857. The RNA-seq data set of kidney tissue as control samples were downloaded from the Genotype-Tissue Expression (GTEx) database. Three machine learning algorithms-weighted gene co-expression network analysis (WGCNA), least absolute shrinkage and selection operator (LASSO), and support vector machine-were used to identify the key pathogenic gene sets of the IgAN disease. The ssGSEA method was applied to calculate the immune cell infiltration (ICI) of IgAN samples, whereas the Spearman test was used for correlation analysis. The receiver operator characteristic curve (ROC) was used to evaluate the diagnostic efficacy of key genes. The correlation between the key genes and ICI was analyzed using the Spearman test. RESULTS: A total of 177 genes were screened out as differentially expressed genes (DEGs) for IgAN, including 135 up-regulated genes and 42 down-regulated genes. The DEGs were significantly enriched in the inflammatory- or immune-related pathways (gene sets). Activating transcription factor 3 (AFT3), C-X-C Motif Chemokine Ligand 6 (CXCL6), and v-fos FBJ murine osteosarcoma viral oncogene homolog B (FOSB) were identified using WGCNA, support vector machine, and LASSO algorithms. These three genes revealed good diagnostic efficacy in the training and test cohorts. The CXCL6 expression positively correlated with activated B cells and memory B cells. CONCLUSION: ATF3, FOSB, and CXCL6 genes were identified as potential biomarkers of IgAN. These three genes exhibited good diagnostic efficacy for IgAN. We described the landscape of immune cell infiltration for IgAN. Activated B cells and memory B cells were more highly expressed in the IgAN samples than in the control samples. CXCL6 seems crucial to the pathogenesis of IgAN and may induce IgAN by enriching immune cells. Our study may contribute to developing CXCL6 inhibitors that target B cells for IgAN therapy.

Effects of enhanced hygiene measures on severe diarrhea and anastomotic leak after colorectal cancer surgery: the experience of a tertiary referral hospital in China.

Background: The 2019 novel coronavirus (COVID-19) global pandemic has greatly changed the mode of hospital admissions. This study summarized and analyzed the incidence of severe diarrhea and anastomotic leakage during different periods for colorectal cancer surgery. Methods: From January 2017 to September 2020, 2,619 colorectal operations were performed in Peking Union Medical College Hospital. In contrast with previous years, enhanced hand hygiene training, more frequent ventilation of the wards, and separate bed treatments for patients were implemented in 2020. Data on incidence of severe diarrhea and anastomotic leakage were retrieved and collected. Results: The number of cases of severe diarrhea after colorectal surgery was 32 (4.60%), 24 (3.33%), 32 (3.83%), and 11 (2.99%) in 2017, 2018, 2019, and 2020 respectively, while the incidence of anastomotic leakage was 3.30% (23/696), 3.75% (27/720), 2.87% (24/835), and 2.17% (8/368), respectively. There was no significant difference in the incidence of postoperative severe diarrhea or anastomotic leakage across the various years. Conclusions: The number of colorectal surgeries in 2020 was significantly decreased due to the COVID-19 pandemic. Among the different years, no difference was observed regarding the incidence of postoperative flora disorder or anastomosis leakage. Enhanced hygiene measures during the COVID-19 epidemic partially contributed to the decrease of severe diarrhea and anastomotic leakage.

Bidirectional tandem-pumped high-brightness 6†kW level narrow-linewidth confined-doped fiber amplifier exploiting the side-coupled technique.

In this work, a bidirectional tandem-pumped high-power narrow-linewidth confined-doped ytterbium fiber amplifier is demonstrated based on side-coupled combiners. Benefiting from the large-mode-area design of the confined-doped fiber, the nonlinear effects, including stimulated Raman (SRS) and stimulated Brillouin scattering (SBS), are effectively suppressed. While the transverse mode instability (TMI) effect is also mitigated through the combination of confined-doped fiber design and the bidirectional tandem pumping scheme. As a result, narrow-linewidth fiber laser with 5.96 kW output power is obtained, the slope efficiency and the 3-dB linewidth of which are ∼81.7% and 0.42 nm, respectively. The beam quality is well maintained during the power scaling process, being around M2 = 1.6 before the TMI occurs, and is well kept (M2 = 2.0 at 5.96 kW) even after the onset of TMI. No SRS or SBS is observed at the maximum output power, and the signal-to-noise ratio reaches as high as ∼61.4 dB. To the best of our knowledge, this is the record power ever reported in narrow-linewidth fiber lasers. This work could provide a good reference for realizing high-power high-brightness narrow-linewidth fiber lasers.

3 kW power-level all-fiberized superfluorescent fiber source with linear polarization and near-diffraction-limited beam quality.

In this paper, we demonstrate a high-power linearly polarized all-fiberized superfluorescent fiber source (SFS) with near-diffraction-limited beam quality. The laser system is based on a master oscillator power amplifier configuration, which mainly consists of a polarization-maintained (PM) broadband SFS and multistage PM fiber amplifiers. A linearly polarized fiber laser over 3 kW is obtained at a pump power of about 4.3 kW with the corresponding slope efficiency of 71.9%. The polarization extinction ratio and the beam quality (M2 factor) of the output laser are about 12.7 dB and 1.18, respectively, at the maximum output power. To the best of our knowledge, this is the highest output power of a linearly polarized broadband SFS with near-diffraction-limited beam quality.

3.96 kW All-Fiberized Linearly Polarized and Narrow Linewidth Fiber Laser with Near-Diffraction-Limited Beam Quality.

In this paper, we realize a 3.96 kW all-fiberized and polarization-maintained (PM) amplifier with narrow linewidth and near-diffraction-limited beam quality. Based on a master oscillator power amplifier (MOPA) configuration seeded with phase-modulated single-frequency laser, a 3.96 kW signal laser is achieved with a 3 dB linewidth of 0.62 nm at the pump power of 5.02 kW. At the maximum output power, the polarization extinction ratio (PER) is ~13.9 dB, and the beam quality (M2 factor) is M2x = 1.31, M2y = 1.41. As far as we know, this is the maximum output power of PM narrow linewidth fiber laser with near-diffraction-limited beam quality and all-fiber format.

Experimental study on the impact of signal bandwidth on the transverse mode instability threshold of fiber amplifiers.

In this work, we conduct a detailed experimental study on the impact of signal bandwidth on the TMI threshold of fiber amplifiers. Both the filtered superfluorescent fiber sources and the phase-modulated single-frequency lasers are employed to construct seed lasers with different 3 dB spectral linewidths ranging from 0.19 nm to 7.97 nm. The TMI threshold of the fiber amplifier employing those seed lasers are estimated through the intensity evolution of the signal laser, and different criteria have been utilized to characterize the spectral linewidth of the seed lasers. Notably, the experimental results reveal that the TMI threshold of fiber amplifiers grows, keeps constant, and further grows as a function of spectral linewidth of seed lasers. Our experimental results could provide a well reference to understand the mechanism of the TMI effect and optimize the TMI effect in high-power fiber amplifiers.

Resuscitation fluids as drugs: targeting the endothelial glycocalyx.

ABSTRACT: Fluid resuscitation is an essential intervention in critically ill patients, and its ultimate goal is to restore tissue perfusion. Critical illnesses are often accompanied by glycocalyx degradation caused by inflammatory reactions, hypoperfusion, shock, and so forth, leading to disturbed microcirculatory perfusion and organ dysfunction. Therefore, maintaining or even restoring the glycocalyx integrity may be of high priority in the therapeutic strategy. Like drugs, however, different resuscitation fluids may have beneficial or harmful effects on the integrity of the glycocalyx. The purpose of this article is to review the effects of different resuscitation fluids on the glycocalyx. Many animal studies have shown that normal saline might be associated with glycocalyx degradation, but clinical studies have not confirmed this finding. Hydroxyethyl starch (HES), rather than other synthetic colloids, may restore the glycocalyx. However, the use of HES also leads to serious adverse events such as acute kidney injury and bleeding tendencies. Some studies have suggested that albumin may restore the glycocalyx, whereas others have suggested that balanced crystalloids might aggravate glycocalyx degradation. Notably, most studies did not correct the effects of the infusion rate or fluid volume; therefore, the results of using balanced crystalloids remain unclear. Moreover, mainly animal studies have suggested that plasma may protect and restore glycocalyx integrity, and this still requires confirmation by high-quality clinical studies.

["Water-pathogen" theory-based Juanyin Tongluo Recipe for varicocele complicated with oligozoospermia: A clinical observation].

OBJECTIVE: To observe the clinical efficacy of the "water-pathogen" theory-based Juanyin Tongluo Recipe (JTR) in the treatment of varicocele (VC) complicated with oligozoospermia and its effects on the semen parameters, sperm morphology, sperm DNA fragmentation index (DFI) and testis volume of the patient. METHODS: Ninety-two VC patients complicated with oligozoospermia were randomly assigned to receive JTR (n = 47) and Maizhiling Tablets (the control group, n = 45), respectively, both for three months, followed by comparisons of the clinical effects, total sperm count, sperm motility, percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS), sperm DNA fragmentation index (DFI) and testis volume of the patients before and after medication, and the pregnancy rate after treatment between the two groups. RESULTS: The total rate of effectiveness was significantly higher in the JTR than in the control group (87.23% vs 68.89%, P < 0.05). Compared with the baseline, the patients showed dramatic improvement after treated with JTR in the sperm count (ï¼»16.35 ± 3.52ï¼½ vs ï¼»43.82 ± 6.02ï¼½ ×106, P < 0.05), sperm motility (ï¼»17.37 ± 6.76ï¼½% vs ï¼»36.68 ± 11.32ï¼½%, P < 0.05), PMS (ï¼»13.42 ± 5.62ï¼½% vs ï¼»31.03 ± 7.47ï¼½%, P < 0.05), MNS (ï¼»1.91 ± 0.13ï¼½% vs ï¼»4.06 ± 0.11ï¼½%, P < 0.05), and sperm DFI (ï¼»43.32 ± 7.84ï¼½% vs ï¼»26.98 ± 6.87ï¼½%, P < 0.05), and even better than in the control group (sperm count ï¼»15.78 ± 3.84ï¼½ vs ï¼»31.53 ± 5.62ï¼½ ×106, P < 0.05; sperm motility ï¼»19.41 ± 6.24ï¼½% vs ï¼»31.32 ± 9.73ï¼½%, P < 0.05; PMS ï¼»14.01 ± 4.98ï¼½% vs ï¼»20.71 ± 6.49ï¼½%, P < 0.05; MNS ï¼»1.88 ± 0.14ï¼½% vs ï¼»3.12 ± 0.09ï¼½%, P < 0.05; sperm DFI ï¼»41.42 ± 9.62ï¼½% vs ï¼»34.13 ± 5.73ï¼½%, P < 0.05; sperm DFI, P < 0.05). And the rate of natural pregnancy was significantly higher in the JTR group than in the control (40.43% vs 20%, P < 0.05). No statistically significant difference, however, was observed in the testis volume before and after treatment between the JTR group (ï¼»11.53 ± 1.24ï¼½ vs ï¼»10.89 ± 1.17ï¼½ ml, P > 0.05) and the control (ï¼»10.94 ± 1.34ï¼½ vs ï¼»10.65 ± 1.52ï¼½ ml, P > 0.05). CONCLUSION: Juanyin Tongluo Recipe can increase the total sperm count, sperm motility, percentages of PMS and MNS and sperm DFI, and improve the rate of natural pregnancy in VC patients complicated with oligozoospermia.

[Baihe Yuzi Prescription improves asthenospermia by up-regulating the expression of CFTR in the sperm].

OBJECTIVE: To observe the therapeutic efficacy of Baihe Yuzi Prescription (BYP) in the treatment of clinical syndrome-free asthenospermia and its effects on semen parameters, sperm DNA fragmentation index (DFI) and the expression of the cystic fibrosis transmembrane conductance regulator (CFTR) in the sperm. METHODS: We randomly divided 112 patients with clinical syndrome-free asthenospermia into a control group (n = 55) and an experimental group (n = 57), the former treated orally with L-carnitine liquid combined with vitamin E capsules and the latter with BYP in addition, both for 3 months. After treatment, we obtained the total sperm count, sperm motility, percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS), sperm DFI and expression of CFTR in the sperm, and compared the above parameters between the two groups of patients before and after medication. RESULTS: The total effectiveness rate was significantly higher in the experimental group (82.46%) than in the control (65.45%) (P < 0.05). Compared with the baseline, the patients in the experimental group showed significant improvement after treatment in the total sperm count (��53.5��3.5�� vs ��86.5��3.9�� ��106, P < 0.05), sperm motility (��23.5��3.5��% vs ��38.8��3.7��%, P < 0.05), PMS (��20.1��3.2��% vs ��30.3��3.3��%, P < 0.05), MNS (��2.3��0.3��% vs ��3.9��0.4��%, P < 0.05), sperm DFI (��37.3��3.1��% vs ��25.2��3.4��%, P < 0.05) and the expression of CFTR (P < 0.05), and even better improvement than the controls in sperm motility (��23.8��3.7��% vs ��30.2��3.4��%, P < 0.05), PMS (��19.6��3.1��% vs ��25.3��2.9��%, P < 0.05), MNS (��2.4��0.4��% vs ��3.1��0.3��%, P < 0.05), and sperm DFI (��36.6��3.3��% vs ��30.3��3.1��%, P < 0.05). The total sperm count and the expression of CFTR, however, were not significantly improved in the control group after treatment (P > 0.05). CONCLUSION: Baihe Yuzi Prescription can increase sperm count and motility, improve sperm morphology and DFI in patients with clinical syndrome-free asthenospermia, which may be related to the up-regulated expression of CFTR in the sperm.

Rhodium nanoparticles confined in titania nanotubes for efficient Hydrogen evolution from Ammonia Borane.

Designing efficient catalysts for hydrogen evolution from hydrolysis of ammonia borane (AB) have attracted considerable attention. Rhodium (Rh) based catalysts with rational design present remarkable catalytic performance for the reaction. Herein, we report the confined Rh@TiO2 catalysts synthesized by atomic layer deposition combining with the sacrificial template approach, in which the Rh nanoparticles are uniformly confined on the inner surface of the porous titania nanotubes. The optimized catalysts show high catalytic activity with a turnover frequency value of 334.1 molH2·molRh-1·min-1 and better durability. Mechanistic investigation demonstrates that the cleavage of OH bands in water should be the rate determining step, and the appropriate concentration of NaOH can further enhance the hydrogen evolution activity. The catalysts can also achieve the hydrogenation of various organic substrates using AB as the hydrogen source. In addition, our present strategy is general and can be extended to the synthesis of other confined catalysts for various catalytic reactions.

Prognostic Significance of the Fission1/Parkin Ratio for Sepsis: A Prospective Cohort Study.

Introduction: Fission1 (Fis1) and parkin are key proteins related to mitochondrial fission and mitophagy, respectively. This study aimed to assess the prognostic value of the Fis1/parkin ratio as a biomarker in patients with sepsis. Methods: Consecutive patients with sepsis (n = 133) or simple infection (n = 24) were enrolled within 24 h of arrival at the intensive care unit (ICU). Serum levels of Fis1, parkin, mitofusin2 (Mfn2), and peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) were measured by enzyme-linked immunosorbent assay (ELISA) upon ICU admission. Clinical parameters and standard laboratory test data were also collected. All patients received follow-up for at least 28 days. Results: Patients with sepsis presented with significantly decreased serum levels of parkin, Mfn2, and PGC-1α, but an increased serum Fis1 level and Fis1/parkin, Fis1/Mfn2, and Fis1/PGC-1α ratios at ICU admission. Relative to patients with simple infections, the ratios were remarkably elevated in septic patients-particularly septic shock patients. The area under the receiver operating characteristic (ROC) curve of the Fis1/parkin ratio was greater than that of Fis1, parkin, Mfn2, and PGC-1α levels as well as that of the Fis1/Mfn2 and Fis1/PGC-1α ratios for prediction of 28-day mortality due to sepsis. All of the ratios were significantly higher in non-survivors than survivors at the 28-day follow-up examination. Fis1/parkin ratio was found to be an independent predictor of 28-day mortality in patients with sepsis. Conclusions: The Fis1/parkin ratio is valuable for risk stratification in patients with sepsis and is associated with poor clinical outcomes for sepsis in the ICU.

Proliferation of Highly Cytotoxic Human Natural Killer Cells by OX40L Armed NK-92 With Secretory Neoleukin-2/15 for Cancer Immunotherapy.

Adoptive natural killer (NK) cell transfer has been demonstrated to be a promising immunotherapy approach against malignancies, but requires the administration of sufficient activated cells for treatment effectiveness. However, the paucity of clinical-grade to support the for large-scale cell expansion limits its feasibility. Here we developed a feeder-based NK cell expansion approach that utilizes OX40L armed NK-92 cell with secreting neoleukin-2/15 (Neo-2/15), a hyper-stable mimetic with a high affinity to IL-2Rßγ. The novel feeder cells (NK92-Neo2/15-OX40L) induced the expansion of NK cells with a 2180-fold expansion (median; 5 donors; range, 1767 to 2719) after 21 days of co-culture without added cytokines. These cells were highly cytotoxic against Raji cells and against several solid tumors in vivo. Mechanistically, NK92-Neo2/15-OX40L induced OX40 and OX40L expression on expanded NK cells and promoted the OX40-OX40L positive feedback loop, thus boosting NK cell function. Our data provided a novel NK cell expansion mechanism and insights into OX40-OX40L axis regulation of NK cell expansion.

Serum Mitochondrial Quality Control Related Biomarker Levels are Associated with Organ Dysfunction in Septic Patients.

BACKGROUND: To investigate the feasibility and the value of using mitochondrial quality control (MQC)-related proteins as biomarkers in septic patients. METHODS: The enrolled subjects were divided into four groups: healthy control group (n = 30), intensive care unit (ICU) control group (n = 62), septic nonshock group (n = 40), and septic shock group (n = 94). Serum levels of peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), fission protein 1 (Fis1), mitofusin2 (Mfn2), and Parkin were measured by enzyme-linked immunosorbent assay at the time of enrollment for all groups. Clinical parameters and laboratory test results were also collected. RESULTS: The levels of MQC-related biomarkers between any two of the four groups were significantly different (P < 0.001 for all). The serum levels of PGC-1α, Mfn2, and Parkin were lowest in healthy individuals; the levels were dramatically higher in the ICU control group compared with the others, and they decreased progressively from the septic nonshock group to the septic shock group. However, the pattern for Fis1 was inverse; the more severe the condition was, the higher the level of Fis1. Moreover, there was moderate correlation between MQC-related biomarkers and the SOFA score (PGC-1α, r = -0.662; Fis1, r = 0.609; Mfn2, r = -0.677; Parkin, r = 0.-0.674, P < 0.001 for all). CONCLUSIONS: The serum levels of PGC-1α, Fis1, Mfn2, and Parkin were significantly correlated with organ dysfunction and reflected the disease progression and severity. The dynamic surveillance of these four biomarkers could be beneficial to predict outcome and guide treatment.