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To construct an early clinical prediction model for AVF dysfunction in patients undergoing Maintenance Hemodialysis (MHD) and perform internal and external verifications. We retrospectively examined clinical data from 150 patients diagnosed with MHD at Hefei Third People's Hospital from January 2014 to June 2023. Depending on arteriovenous fistula (AVF) functionality, patients were categorized into dysfunctional (nâ =â 62) and functional (nâ =â 88) cohorts. Using the least absolute shrinkage and selection operator(LASSO) regression model, variables potentially influencing AVF functionality were filtered using selected variables that underwent multifactorial logistic regression analysis. The Nomogram model was constructed using the R software, and the Area Under Curve(AUC) value was calculated. The model's accuracy was appraised through the calibration curve and Hosmer-Lemeshow test, with the model undergoing internal validation using the bootstrap method. There were 11 factors exhibiting differences between the group of patients with AVF dysfunction and the group with normal AVF function, including age, sex, course of renal failure, diabetes, hyperlipidemia, Platelet count (PLT), Calcium (Ca), Phosphorus, D-dimer (D-D), Fibrinogen (Fib), and Anastomotic width. These identified factors are included as candidate predictive variables in the LASSO regression analysis. LASSO regression identified age, sex, diabetes, hyperlipidemia, anastomotic diameter, blood phosphorus, and serum D-D levels as 7 predictive factors. Unconditional binary logistic regression analysis revealed that advanced age (ORâ =â 4.358, 95% CI: 1.454-13.062), diabetes (ORâ =â 4.158, 95% CI: 1.243-13.907), hyperlipidemia (ORâ =â 3.651, 95% CI: 1.066-12.499), D-D (ORâ =â 1.311, 95% CI: 1.063-1.616), and hyperphosphatemia (ORâ =â 4.986, 95% CI: 2.513-9.892) emerged as independent risk factors for AVF dysfunction in MHD patients. The AUC of the predictive model was 0.934 (95% CI: 0.897-0.971). The Hosmer-Lemeshow test showed high consistency between the model's predictive results and actual clinical observations (χ2â =â 1.553, Pâ =â .092). Internal validation revealed an AUC of 0.911 (95% CI: 0.866-0.956), with the Calibration calibration curve nearing the ideal curve. Advanced age, coexisting diabetes, hyperlipidemia, blood D-D levels, and hyperphosphatemia are independent risk factors for AVF dysfunction in patients undergoing MHD.
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Fístula Arteriovenosa , Diabetes Mellitus , Hiperlipidemias , Hiperfosfatemia , Humanos , Modelos Estatísticos , Prognóstico , Estudos Retrospectivos , Nomogramas , FósforoRESUMO
The objective of the study was to evaluate the contribution of insulin resistance and ß cell dysfunction to gestational diabetes mellitus (GDM) in Chinese women stratified by pre-pregnant body mass index (BMI). A total of 847 pregnant women were enrolled. They were divided into low BMI and high BMI groups according to the median of pre-pregnancy BMI. The homeostasis model assessment of insulin resistance (HOMA-IR) and ß cell function (HOMA-ß), Matsuda index, and 60-min insulinogenic index (IGI60) were used to evaluate insulin resistance and ß cell function. In all the participants, 150 (17.71%) were diagnosed with GDM. ROC analyses showed that in the low BMI group, the association of ß cell dysfunction (IGI60 or HOMA-ß) with GDM was stronger than that of insulin resistance (Matsuda index or HOMA-IR), while in the high BMI group, the association of ß cell dysfunction with GDM was weaker than that of insulin resistance (all P < 0.05). Among all GDM patients, 47.33% demonstrated predominant insulin resistance (Matsuda index < 25th percentile), and 46% had predominant ß cell defect (IGI60 < 25th percentile). In the low BMI group, 15.09% of GDM patients demonstrated predominant insulin resistance, and 62.26% of GDM patients had predominant ß cell defect, whereas in the high BMI group, 64.95% of GDM patients demonstrated mainly insulin resistance and 36.08% of GDM patients had mainly ß cell defect. In women with low BMI, ß cell dysfunction is the major etiologic factor, whereas, in women with high BMI, insulin resistance is the predominant etiologic factor in the development of GDM.
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Diabetes Gestacional , Resistência à Insulina , Feminino , Humanos , Gravidez , Diabetes Gestacional/diagnóstico , Índice de Massa Corporal , Insulina , Glicemia/análiseRESUMO
Abstract@#On October 13 2023, the Beijing Economic and Technological Development Area Center for Disease Control and Prevention recAAAAAeived a report from a school indicating an outbreak of fever among students in Class 2, Grade 4. An on-site epidemiological investigation was immediately conducted. A total of 14 cases were reported, all of whom were students, with an attack rate of 34.15%. The onset of illness was concentrated between October 6 and 15, with the main clinical symptoms being fever, cough and fatigue. There were no cases of hospitalization, severe illness or death. Seven cases tested positive for Mycoplasma pneumoniae P1-Ⅱ. Based on the on-site investigation and laboratory test results, it was an outbreak of influenza-like illness caused by Mycoplasma pneumoniae infection. The likely cause of the spread was cases infecting other classmates through respiratory droplets while attending class. The outbreak occurred only in one class and did not spread to neighboring classes. Schools should actively carry out health education to raise awareness among parents for reporting infectious diseases, and strengthen morning and afternoon screenings to improve the sensitivity of identification.
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The compound pollutants formed by microplastics and cadmium present a significant potential threat to the soil-based ecosystem, and it is urgent to carry out relevant ecotoxicological studies. However, the lack of appropriate test methods and scientific mathematical analysis models has restricted the progress of research. Based on an orthogonal test design, a ternary combined stress test was performed to study the effect of microplastics and cadmium on earthworms. This study used the particle size and concentration of microplastics as well as the concentration of cadmium as test factors. Using the improved factor analysis model and the TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) method, a new model was constructed according to the response surface methodology to analyze the acute toxic effects on earthworms under the combined stress of microplastics and cadmium. In addition, the model was tested in a soil-polluted environment. The results show that the model can perfectly integrate the spatiotemporal cross effects of the concentration and time of the applied stress, and the scientific data analysis process ensures the efficient development of ecotoxicological research in the actual compound pollution environment. Moreover, the results of the filter paper test and soil test showed that the equivalent toxicity ratio of cadmium concentration, microplastic concentration, and microplastic particle size to earthworms as 26:35:39 and 23:36:41, respectively. In terms of the interaction effect, a certain positive interaction was observed between the cadmium concentration and that of the microplastics and their particle size, while a negative interaction was observed between the concentration of microplastics and their particle size. This research provides a test basis and model reference for early monitoring of the health of contaminated soils and assessments of ecological safety and security.
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Oligoquetos , Poluentes do Solo , Animais , Cádmio/análise , Microplásticos/toxicidade , Plásticos , Ecossistema , Poluentes do Solo/análise , SoloRESUMO
This study aimed to explore the effect of an inoculation, Lelliottia sp., on the corn straw compost's physico-chemical properties, composition, and the succession of bacterial community structure. The compost community composition and succession changed after Lelliottia sp. inoculation. Inoculation increased the bacterial community diversity and abundance in the compost to promote composting. The inoculated group entered the thermophilic stage on the first day, lasting 8 days. Judging the pile maturity based on the carbon:nitrogen ratio and germination index values, the inoculated group reached the maturity standard, which was 6 days faster than the control group. The relationship between environmental factors and bacterial communities was comprehensively analyzed using redundancy analysis. Temperature and carbon:nitrogen ratio were the main environmental factors driving the succession of bacterial communities, to provide basic information on the changes of physicochemical indexes and bacterial community succession in Lelliottia sp. inoculated maize straw composting, providing assistance for practical composting applications of this strain.
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Compostagem , Zea mays , Esterco/microbiologia , Solo , Bactérias , Enterobacteriaceae , Carbono , NitrogênioRESUMO
The widespread use but low recovery rate of agricultural films has led to microplastic accumulation in farmlands, which poses a serious threat to the health of the soil ecosystem. There is an urgent need for early warning and monitoring of soil microplastics pollution, as well as the performance of bioremediation research. In this study, earthworms were used as test organisms to carry out toxicological tests under low-density polyethylene (LDPE) stress. A canonical correlation analysis model (CCA) was established to analyze the relationship between oxidative stress and microbial community. A path analysis model (PA) was also constructed to examine the detoxification mechanism of earthworms under LDPE stress. The results showed that low concentrations (100 and 500 mg/kg) of LDPE did not cause oxidative damage to earthworms but stimulated their physiological metabolism. Meanwhile, 1000 mg/kg LDPE concentrations caused oxidative damage to earthworms and altered their internal microbial community structure. Furthermore, at 1500 mg/kg LDPE concentrations, the oxidative stress to the earthworms is aggravated, and their physiological responses work in conjunction with the microbial community to cope with the adverse condition. Lastly, treatment with 2000 mg/kg LDPE induced the appearance of LDPE tolerant populations in the microbial community in vivo. Taken together, our results provide a theoretical basis for revealing the physiological response of earthworms when challenged in a polluted environment and provide a model for pollution remediation and ecological security monitoring of soil ecosystems.
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Microbiota , Oligoquetos , Poluentes do Solo , Animais , Polietileno/toxicidade , Polietileno/metabolismo , Plásticos/metabolismo , Oligoquetos/metabolismo , Análise de Correlação Canônica , Poluentes do Solo/análise , Microplásticos/metabolismo , Estresse Oxidativo , Solo/químicaRESUMO
Air pollutants can cause serious harm to human health and a variety of respiratory diseases. This study aimed to explore the associations between air pollutants and outpatient visits for influenza-like illness (ILI) under urbanization process in the sub-center of Beijing. The data of ILI in sub-center of Beijing from April 1, 2014 to December 31, 2020 were obtained from Beijing Influenza Surveillance Network. A generalized additive Poisson model was applied to examine the associations between the concentrations of air pollutants and daily outpatient visits for ILI when controlling meteorological factors and holidays. A total of 322,559 patients with ILI were included. The results showed that in the early urbanization period, the effects of PM2.5, PM10, SO2, O3, and CO on lag0 day, and PM2.5, PM10, O3, and CO on lag1 day were not significant. In the later urbanization period, AQI and the concentrations of PM2.5, PM10, SO2, NO2 and CO on lag1 day were all significantly associated with an increased risk of outpatient visits for ILI, which increased by 0.34% (95%CI 0.23%, 0.45%), 0.42% (95%CI 0.29%, 0.56%), 0.44% (95%CI 0.33%, 0.55%), 0.36% (95%CI 0.24%, 0.49%), 0.91% (95%CI 0.62%, 1.21%) and 0.38% (95%CI 0.26%, 0.49%). The concentration of O3 on lag1 day was significantly associated with a decreased risk of outpatient visits for ILI, which decreased by 0.21% (95%CI 0.04%, 0.39%). We found that the urbanization process had significantly aggravated the impact of air pollutants on ILI outpatient visits. These findings expand the current knowledge of ILI outpatient visits correlated with air pollutants under urbanization process.
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Poluentes Atmosféricos , Influenza Humana , Viroses , Humanos , Urbanização , Pequim/epidemiologia , Influenza Humana/epidemiologia , Pacientes Ambulatoriais , Material ParticuladoRESUMO
The above article, published online on 5 December 2022, on Wiley Online Library (https://doi.org/10.1002/jbt.23057), has been withdrawn by agreement between the journal Editor in Chief, Hari Bhat, and Wiley Periodicals, LLC. The withdrawal has been agreed due to a technical error at the publisher that caused the article to be mistakenly published online although publication had been canceled because the authors did not approve their proof.
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BACKGROUND: Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey (HSOPS 1.0), developed by the U.S. Agency for Healthcare Research and Quality in 2004, has been widely adopted in the United States and internationally. An updated version, the SOPS Hospital Survey 2.0 (HSOPS 2.0), released in 2019, has not yet been applied in China. The aim of the present study was to translate HSOPS 2.0 into Chinese version with cross-cultural adaptations and test its psychometric properties. METHODS: A convenience sample was used. Hospital nurses (N = 1013) and a sub-set (n = 200) was invited for the re-test. A three-stage study was conducted. Firstly, the HSOPS 2.0 was translated by a panel. Secondly, the content validity was tested using the two-round Delphi method and cognitive interview. Next, the construct validity was tested by the confirmatory factor analysis and further demonstrated by the convergent validity, discriminant validity, and correlations with the outcome of patient safety. Thirdly, the reliability was tested by internal consistency reliability and re-test reliability. RESULTS: The "float or PRN" and "manager" words were deleted as considered unfitted for the Chinese health care system. The content validity index provided evidence of strong content validity (I-CVI = 0.84 ~ 1.00, S-CVI = 0.98). Confirmatory factor analysis revealed a good model fit (χ2/df = 4.05, RMSEA = 0.06, CFI = 0.94) and acceptable factor loadings (0.41 ~ 0.97). Convergent validity, and discriminant validity supported the factorial structure of the Chinese version of HSOPS 2.0. Further evidence for the construct validity was derived from correlations with the outcome of patient safety (r = 0.10 ~ 0.41). A good internal consistency (Cronbach's α = 0.68 ~ 0.93, McDonald's omega = 0.84 ~ 0.96) and test-retest reliability (ICC = 0.78 ~ 0.95) showed acceptable reliability. Additionally, Chinese nurses reported markedly lower scores for three dimensions, including "Response to Error", "Communication Openness", and "Reporting Patient Safety Events", when comparing the findings of this study with those from U.S. research utilizing the HSOPS 2.0. CONCLUSION: The Chinese version of HSOPS 2.0 demonstrated good validity and reliability in a Chinese sample of hospital nurses, which suggests that it can be used to measure nurse-perceived patient safety culture in future research and practice. Psychometric properties of the Chinese version of HSOPS 2.0 among other Chinese healthcare professionals remain to be confirmed.
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BACKGROUND: Polymorphisms in peroxisome proliferator-activated receptor-γ pro12Ala (PPAR-γ Pro12Ala) have been associated with Non-alcoholic Fatty Liver Disease (NAFLD) in several studies. However, the results of these studies are not entirely consistent. Thus, we performed a meta-analysis to investigate the association between the PPAR-γ Pro12Ala polymorphisms and NAFLD. METHODS: Studies were identified by searching PubMed database and manual assessment of the cited references in the retrieved articles. Study-specific relative risks (RRs) and 95 % confidence intervals (CIs) were estimated using a random-effect model. Study quality was assessed using the Newcastle-Ottawa scale. RESULTS: Relevant medical researches show that 11 studies have been conducted on the analysis of NAFLD for meta-analysis, with a total of 2404 cases and 3959 participating controls. Meta-analysis results show that PPAR-γ Pro12Ala polymorphism and NALAD Ala alleles[no association between dominance model (OR = 0.968, 95%CI: 0.734-1.276, P = 0.815); Pro/Ala vs. Pro/Pro (OR = 0.930, 95 % CI: 0.701-1.233, P = 0.612); Ala/Ala vs. Pro/Pro (OR = 1.220, 95 % CI: 0.668-2.230, P = 0.518); recessive model (OR = 0.907, 95 % CI: 0.516-1.596, P = 0.736)]. Moreover, stratification by ethnicity also revealed that no matter it is in Caucasian populations or in Asian populations, NAFLD has no association with the PPAR-γ Pro12Ala polymorphism. CONCLUSIONS: According to the meta-analysis, both in Asians and Caucasian populations, the PPAR-γ Pro12Ala polymorphism can't be demonstrated to have any link with susceptibility to NAFLD.
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Hepatopatia Gordurosa não Alcoólica , PPAR gama , Povo Asiático , Predisposição Genética para Doença , Genótipo , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/genética , PPAR gama/genética , Polimorfismo GenéticoRESUMO
Hand, foot, and mouth disease (HFMD) is an infectious disease that usually occurs in children under 5 years and is caused by a group of enteroviruses. This study aimed to investigate the epidemiological characteristics of HFMD clusters from 2016 to 2020 in Tongzhou, Beijing, and explored the genetic evolution of CV-A6. The HFMD case information came from the Information System of China Center for Disease Control and Prevention (CDC), as well as the clusters information verification and on-site investigation by Tongzhou CDC. ARIMA model was applied to forecast HFMD clusters in 2020. Totally 440 HFMD clusters were reported during 2016-2020. The large peak of the clusters occurred in April-July, followed by a smaller peak in October-November during 2016-2019. However, in 2020, the two peaks disappeared. The main site of HFMD clusters was childcare facilities (65.0%) and mostly occurred in urban areas (46.1%). The detection rate of CV-A6 was the highest (36.1%), and cases with CV-A6 infection had the highest proportion of fever. The phylogenetic analysis based on CV-A6 VP1 gene showed that the predominant strains mainly located in Group F during 2016-2017, while changed into Group A during 2018-2020. HFMD clusters presented seasonality, mainly located in childcare facilities and urban areas, and CV-A6 was the major causative agent. Targeted prevention and control measures should be taken to reduce HFMD clusters.
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Enterovirus , Doença de Mão, Pé e Boca , Pequim/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Enterovirus/genética , Doença de Mão, Pé e Boca/epidemiologia , Humanos , Lactente , FilogeniaRESUMO
Background: The changing pattern of pathogen spectrum causing herpangina in the time of coronavirus disease 2019 (COVID-19) pandemic was unknown. The purpose of this study was to investigate the changes on the molecular epidemiology of herpangina children during 2019-2020 in Tongzhou district, Beijing, China. Method: From January 2019 to December 2020, children diagnosed with herpangina were recruited by the staff from Tongzhou Center for Disease Control and Prevention (CDC) in Beijing. Viral RNA extraction from pharyngeal swabs was used for enterovirus (EV) detection and the complete VP1 gene was sequenced. The phylogenetic analysis was performed based on all VP1 sequences for EV genotypes. Result: A total of 1,331 herpangina children were identified during 2019-2020 with 1,121 in 2019 and 210 in 2020, respectively. The predominant epidemic peak of herpangina children was in summer and autumn of 2019, but not observed in 2020. Compared to the number of herpangina children reported in 2019, it decreased sharply in 2020. Among 129 samples tested in 2019, 61 (47.3%) children were detected with EV, while 22.5% (20/89) were positive in 2020. The positive rate for EV increased since June 2019, peaked at August 2019, and decreased continuously until February 2020. No cases were observed from February to July in 2020, and the positive rate of EV rebounded to previous level since August 2020. Four genotypes, including coxsackievirus A6 (CV-A6, 9.3%), CV-A4 (7.8%), CV-A10 (2.3%) and CV-A16 (10.1%), were identified in 2019, and only three genotypes, including CV-A6 (9.0%), CV-A10 (6.7%) and CV-A16 (1.1%), were identified in 2020. The phylogenetic analysis showed that all CV-A6 strains from Tongzhou located in Group C, and the predominant strains mainly located in C2-C4 subgroups during 2016-2018 and changed into C1 subgroup during 2018-2020. CV-A16 strains mainly located in Group B, which consisting of strains widely distributed around the world. Conclusions: The predominant genotypes gradually shifted from CV-A16, CV-A4 and CV-A6 in 2019 to CV-A6 in 2020 under COVID-19 pandemic. Genotype-based surveillance will provide robust evidence and facilitate the development of public health measures.
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Influenza-like illness (ILI) varies in intensity year by year, generally keeping a stable pattern except for great changes of its epidemic pattern. Of the most impacting factors, urbanization has been suggested as shaping the intensity of influenza epidemics. Besides, growing evidence indicates the nonpharmaceutical interventions (NPIs) to severe acute respiratory syndrome coronavirus 2 offer great advantages in controlling infectious diseases. The present study aimed to evaluate the impact of urbanization and NPIs on the dynamic of ILI in Tongzhou, Beijing, during January 2013 to March 2021. ILI epidemiological surveillance data in Tongzhou district were obtained from Beijing Influenza Surveillance Network and separated into three periods of urbanization and four intervals of coronavirus disease 2019 pandemic. Standardized average incidence rates of ILI in each separate stages were calculated and compared by using Wilson method and time series model of seasonal ARIMA. Influenza seasonal outbreaks showed similar epidemic size and intensity before urbanization during 2013-2016. Increased ILI activity was found during the process of Tongzhou's urbanization during 2017-2019, with the rate difference of 2.48 (95% confidence interva [CI]: 2.44, 2.52) and the rate ratio of 1.75 (95% CI: 1.74, 1.76) of ILI incidence between preurbanization and urbanization periods. ILI activity abruptly decreased from the beginning of 2020 and kept at the bottom level almost in every epidemic interval. The top decrease in ILI activity by NPIs was shown in 5-14 years group in 2020-2021 influenza season, as 92.2% (95% CI: 78.3%, 95.2%). The results indicated that both urbanization and NPIs interrupted the epidemic pattern of ILI. We should pay more attention to public health when facing increasing population density, human contact, population mobility, and migration in the process of urbanization. NPIs and influenza vaccination should be implemented as necessary measures to protect people from common infectious diseases like ILI.
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COVID-19 , Influenza Humana , Viroses , Pequim/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Pandemias , Estações do Ano , Urbanização , Viroses/epidemiologiaRESUMO
Objective: The correlation between low triiodothyronine (T3) syndrome and shorter survival in malignant tumor patients has been increasingly reported. The objective of the present study was to investigate the association between low T3 syndrome and survival in multiple myeloma (MM) patients. Methods: A total of 201 newly diagnosed MM patients were included in this retrospective study. All participants were divided into 2 groups based on serum free T3 (FT3) level: low T3 syndrome group (FT3 < 2.3â pg/mL) and non-low T3 syndrome group (FT3 ≥ 2.3â pg/mL). Baseline clinical characteristics, overall survival (OS) and progression free survival (PFS) were analyzed. Results: 80 (39.8%) patients had low T3 syndrome. Patients with low T3 syndrome had significantly lower blood hemoglobin and albumin, higher creatinine and ß2-microglobulin (ß2-MG), higher neutrophil/lymphocyte and (neutrophil + monocyte)/lymphocyte ratio, and more advanced ISS and R-ISS stages (all P < .05). Serum FT3 level was positively associated with blood hemoglobin and albumin, and negatively correlated with ß2-MG, creatinine, neutrophil/lymphocyte ratio, and (neutrophil + monocyte)/lymphocyte ratio (all P < .05). Patients with low T3 syndrome had significantly inferior OS time and PFS time (both P < .001). In multivariate Cox analysis, low T3 syndrome was found to be an independent factor associated with OS (P < .001) and PFS (P = .002). Receiver operator characteristic curve analyses showed that FT3 was a predictive marker for death during the entire follow-up period (the area under the curve [AUC] = 0.720, P < .001) and during 1 year (AUC = 0.747, P < .001). Conclusion: Low T3 syndrome might be useful for predicting survival in patients with newly diagnosed MM.
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Síndromes do Eutireóideo Doente , Mieloma Múltiplo , Albuminas , Creatinina , Síndromes do Eutireóideo Doente/complicações , Humanos , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Prognóstico , Estudos RetrospectivosRESUMO
The neutrophil to lymphocyte ratio (NLR) is a predictor of cardiovascular risk. However, little was known about the influence of sex in this relationship. The present study was designed to evaluate the association between NLR and coronary artery disease (CAD) risk and severity in males and females. A total of 810 patients (478 males and 332 females) who had undergone coronary angiography at the Beijing Chaoyang Hospital were enrolled. CAD severity was evaluated using the Gensini and SYNTAX scores. For males, the NLR was higher in CAD patients than that in non-CAD patients (all P < .001). But there was no significant difference in NLR between female CAD and non-CAD patients (P = .222). The NLR correlated with the Gensini and SYNTAX scores in male CAD patients (both P < .001), but this correlation was not found in female counterparts (both P > .10). Logistic regression analyses and receiver operator characteristic curve (ROC) analyses showed that the NLR was an independent risk factor and a predictor of CAD in males (both P < .01) but not in females (both P > .10). In conclusion, the NLR was closely related to the presence and severity of CAD in males but not in females.
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Doença da Artéria Coronariana , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Linfócitos , Masculino , Neutrófilos , Valor Preditivo dos Testes , Índice de Gravidade de Doença , Caracteres SexuaisRESUMO
Object: The fluid management strategy in ARDS is not very clear. A secondary analysis of RCT data was conducted to identify patients with ARDS benefitting from a conservative strategy of fluid management. Methods: The data of this study were downloaded from the ARDS network series of randomized controlled trials (Conservative Strategy vs. Liberal Strategy in 2006). Based on the clinical feature of patients, within the first 24 h after admission, clustering was performed using the k-means clustering algorithm to identify the phenotypes of ARDS. Survival was analyzed using the Kaplan-Meier survival analysis to assess the effect of the two fluid management strategies on the 90-day cumulative mortality. Categorical/dichotomic variables were analyzed by the chi-square test. Continuous variables were expressed as the mean and standard deviation and evaluated through a one-way ANOVA. A P-value < 0.05 was defined as the statistically significant cut-off value. Results: A total of 1,000 ARDS patients were enrolled in this unsupervised clustering research study, of which 503 patients were treated with a conservative fluid-management strategy, and 497 patients were treated with a liberal fluid-management strategy. The first 7-day cumulative fluid balance in patients with the conservative strategy and liberal strategy were -136 ± 491 ml and 6,992 ± 502 ml, respectively (P < 0.001). Four phenotypes were found, and the conservative fluid-management strategy significantly improved the 90-day cumulative mortality compared with the liberal fluid-management strategy (HR = 0.532, P = 0.024) in patients classified as "hyperinflammatory anasarca" phenotype (phenotype II). The characteristics of this phenotype exhibited a higher WBC count (20487.51 ± 7223.86/mm3) with a higher incidence of anasarca (8.3%) and incidence of shock (26.6%) at baseline. The furthermore analysis found that the conservative fluid management strategy was superior to the liberal fluid management strategy in avoiding superinfection (10.10 vs. 14.40%, P = 0.037) and returned to assisted breathing (4.60 vs. 16.20%, P = 0.030) in patients classified as "hyperinflammatory anasarca" phenotype. In addition, patients with other phenotypes given the different fluid management strategies did not show significant differences in clinical outcomes. Conclusion: Patients exhibiting a "hyperinflammatory anasarca" phenotype could benefit from a conservative fluid management strategy.
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This work focuses on evaluating the therapeutic ability of betalain and its causal mechanisms in NSCLC both in vivo and in vitro. The experimental results demonstrated that betalain was able to reduce the viability of A549 cells dose dependently with undetectable toxicity toward normal human cells. Betalain also augmented the apoptotic cells of A549 and cell cycle arrest which was evidenced via increased in level of p53/p21 and decreasing levels of cyclin-D1 complex. Moreover, betalain also reduced the levels of p-PI3K, p-Akt, and mammalian target of rapamycin significantly, justifying the pro-apoptotic effect on A549 cells. The in vivo anticancer activity of betalain was determined further in nude mice injected with A549 cells. Xenograft in vivo experiments confirmed betalain administration of ameliorates the expression of pro-inflammatory cytokines, tumor markers with reduced toxic effect. Accordingly, this combined study provides significant insight on betalain as a therapeutic agent.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Animais , Apoptose , Betalaínas , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Proliferação de Células , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Camundongos , Camundongos Nus , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais , Serina-Treonina Quinases TOR/metabolismoRESUMO
BACKGROUND: Hypoxia-inducible lipid droplet-associated (HILPDA) is considered to have tumorigenic activity, but its function in lung adenocarcinoma (LUAD) is rarely known. This work aimed to assess the regulatory functions as well as the in-depth mechanism of HILPDA in LUAD. METHODS: The expression of HILPDA in LUAD tissues was analyzed based on TCGA database, and then qRT-PCR was performed to confirm the HILPDA expression in LUAD cell lines. Kaplan-Meier analysis was used to measure the correlation of HILPDA expression and overall survival in patients with LUAD. Then, Cell-Counting Kit-8 (CCK-8), colony formation and transwell assays were performed to detect cell proliferation, invasion and migration. Moreover, the pathways closely related to the high HILPDA expression was analyzed by Kyoto Encyclopedia of genes and Genomes (KEGG) analysis. The levels of Cell cycle pathway-related proteins were assessed using western blotting. RESULTS: Herein, we revealed that HILPDA was expressed at high levels in LUAD tissues and cell lines, and LUAD patients with the higher HILPDA expression presented the shorter survival time. Down-regulation of HILPDA in Calu-3 cells can retard cell proliferation, migration and invasion as well as arrest cells in the G1 phase, whereas overexpression of HILPDA in A549 cells presented a marked promotion on these phenotypes. Moreover, we surveyed that knockdown of HILPDA restrained the activation of cell cycle pathway, while up-regulation of HILPDA led to opponent outcomes. CONCLUSIONS: In summing, HILPDA may act as an oncogenic factor in LUAD cells via modulating cell cycle pathway, which represent a novel biomarker of tumorigenesis in LUAD patients.
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Adenocarcinoma de Pulmão , Ciclo Celular/genética , Gotículas Lipídicas/patologia , Células A549 , Adenocarcinoma de Pulmão/genética , Adenocarcinoma de Pulmão/patologia , Biomarcadores Tumorais , Linhagem Celular Tumoral/patologia , Movimento Celular , Proliferação de Células , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , HipóxiaRESUMO
BACKGROUND: Herpangina is a highly infectious disease, which is usually prevalent in preschool children. METHODS: This study analyzed the clinical and pathogenic characteristics of herpangina children to demonstrate the epidemiology of herpangina. Clinical manifestations, laboratory indicators and pharyngeal swabs were collected from children with herpangina who were monitored by Tongzhou Center for Disease Control and Prevention in Beijing, 2008. Utilizing pharyngeal swabs, virus extraction and amplification were performed for nucleotide identification and sequencing. The phylogenetic analysis was conducted based on all sequences amplified in this study and strains retrieved from GenBank. RESULTS: Among 190 children with herpangina, 69.0% (131/190) were positive for enterovirus. Eight genotypes were identified, mainly including CV-A6 (39/131), CV-A4 (25/131), CV-A10 (24/131). The phylogenetic analysis showed one CV-A6 strain of Tongzhou was imported from Japan. CV-A10 strains were clustered into five groups (A-E). The dominant cluster of CV-A10 was Group E6 between 2009 and 2013, and converted to Group E5 after 2013. CV-A6 was the predominant pathogen causing herpangina in Tongzhou in 2018, followed by CV-A4 and CV-A10. CONCLUSIONS: The circulation of coxsackievirus had spatiotemporal cluster. In controlling the transmission of herpangina, the surveillance and reporting system should be enhanced.
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This work aimed to assess the role of TLR8 in cerebral I/R injury and its in-depth pathogenesis. Bioinformatics analysis indicated that TLR8 was up-regulated in patients with ischemic stroke than that in healthy control, and miR-18a-5p was the upstream regulatory of TLR8. Then, the rat pheochromocytoma PC12 cells were exposed in oxygen-glucose-deprivation/reoxygenation (OGD/R) conditions to construct a model in vitro. The functional experiments indicated that OGD/R can decline the viability and elevate the apoptosis of PC12 cells, while up-regulation of miR-18a-5p can alleviate OGD/R-induced cell injury. Notably, overexpression of TLR8 reverses the miR-18a-5p-mediated protection on OGD/R-induced cells injury. Finally, we found that up-regulation of miR-18a-5p obviously declined the protein levels of TLR4 and TLR7 as well as the phosphorylation of NF-κB, while overexpression of TLR8 canceled the decrease caused by miR-18a-5p up-regulation. In summing, our results illustrated that miR-18a-5p/TLR8 axis can mitigate OGD/R-induced cells injury through TLRs and NF-κB pathway.