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1.
Food Chem ; 456: 139859, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38870800

RESUMO

κ-Carrageenan (CG) was employed to mask the bitterness induced by 50% KCl in surimi gels to achieve salt reduction and gel performance improvement. The combination of KCl and CG (KCl + CG) yielded the increased textural characteristics and water-holding capacity (WHC) of surimi gels and facilitated the transition of free water to immobilized water. In addition, the KCl + CG supplement increased the turbidity and particle size of myofibrillar protein (MP) sols but decreased the surface hydrophobicity in a dose-dependent manner. The hydrophobic interactions and disulfide bonds played crucial roles in maintaining the stability of MP gels. The specific binding of potassium ions to the sulfate groups of CG limited the release and diffusion of potassium ions from the surimi gels during oral processing, effectively masking the bitterness perception and maintaining the saltiness perception. This study provides a promising strategy to reduce the utilization of sodium salt in surimi products.

2.
BMJ Open ; 14(6): e079212, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38858161

RESUMO

INTRODUCTION: Severe septic cardiomyopathy (SCM) is one of the main causes of refractory septic shock (RSS), with a high mortality. The application of venoarterial extracorporeal membrane oxygenation (ECMO) to support the impaired cardiac function in patients with septic shock remains controversial. Moreover, no prospective studies have been taken to address whether venoarterial ECMO treatment could improve the outcome of patients with sepsis-induced cardiogenic shock. The objective of this study is to assess whether venoarterial ECMO treatment can improve the 30-day survival rate of patients with sepsis-induced refractory cardiogenic shock. METHODS AND ANALYSIS: ExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated is a prospective, multicentre, non-randomised, cohort study on the application of ECMO in SCM. At least 64 patients with SCM and RSS will be enrolled in an estimated ratio of 1:1.5. Participants taking venoarterial ECMO during the period of study are referred to as cohort 1, and patients receiving only conventional therapy without ECMO belong to cohort 2. The primary outcome is survival in a 30-day follow-up period. Other end points include survival to intensive care unit (ICU) discharge, hospital survival, 6-month survival, quality of life for long-term survival (EQ-5D score), successful rate of ECMO weaning, long-term survivors' cardiac function, the number of days alive without continuous renal replacement therapy, mechanical ventilation and vasopressor, ICU and hospital length of stay, the rate of complications potentially related to ECMO treatment. ETHICS AND DISSEMINATION: The trial has been approved by the Clinical Research and Application Institutional Review Board of the Second Affiliated Hospital of Guangzhou Medical University (2020-hs-51). Participants will be screened and enrolled from ICU patients with septic shock by clinicians, with no public advertisement for recruitment. Results will be disseminated in research journals and through conference presentations. TRIAL REGISTRATION NUMBER: NCT05184296.


Assuntos
Oxigenação por Membrana Extracorpórea , Choque Cardiogênico , Choque Séptico , Oxigenação por Membrana Extracorpórea/métodos , Humanos , Choque Séptico/terapia , Choque Séptico/mortalidade , Choque Séptico/complicações , Estudos Prospectivos , Choque Cardiogênico/terapia , Choque Cardiogênico/mortalidade , Cardiomiopatias/terapia , Estudos Multicêntricos como Assunto , Masculino , Unidades de Terapia Intensiva , Feminino , Adulto , Taxa de Sobrevida
3.
Front Nutr ; 11: 1275522, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38476599

RESUMO

Background: Soluble transferrin receptor (sTfR)/log ferritin index (sTfR Index) can be used to assess the entire spectrum of iron status, and is valuable in evaluating iron status in population studies. There is still a lack of evidence on the association between sTfR index and all-cause mortality. Object: To explore the association between sTfR index and all-cause mortality, as well as mortality due to cardiovascular disease (CVD) and cancer. Method: Data were from the National Health and Nutrition Examination Survey (NHANES) between 2003 to 2020. Participants aged 16 years and older who had complete data of serum ferritin and sTfR were included. Pregnant individuals or those with ineligible data on death or follow-up were excluded from the analysis. Baseline sTfR index was calculated by baseline sTfR/log (ferritin) and classified as three tertile. We performed the Cox proportional hazard regression to assess the association of sTfR index (both continuous and categorical scale) with all-cause and cause-specific mortality and further assess the non-linear relationship between sTfR index and the outcomes with restricted cubic spline. Result: In this study, 11,525 participants, a total of 231 (2.0%) all-cause deaths occurred during a median follow-up of 51 months. The risk of all-cause mortality, CVD-related mortality, and cancer-related mortality was higher in participants with highest tertile of sTfR index. After confounding factors adjustment, participants with highest tertile of sTfR index were associated with an increased risk of all-cause mortality (HR: 1.71, 95% CI: 1.14-2.57) as compared with lowest tertile. Additionally, sTfR index per SD increment was associated with a 25% increasing risk of all-cause mortality (HR: 1.25, 95% CI: 1.08-1.45, p = 0.003) and a 38% cancer-related mortality (HR: 1.38, 95% CI: 1.07-1.77, p = 0.018). These associations remained robust after adjusting for the serum ferritin as well as in various subgroups stratified by age, sex, smoking statue, hypertension, diabetes, and CVD. Spline analysis showed that there is approximately linear relationship between sTfR index with all-cause mortality (p for non-linear = 0.481). Moreover, ferritin was not a predictor of all-cause death after adjustment for confounding factors. Significance: This cohort study demonstrated a significant association between sTfR index increment and an increased risk of all-cause and cancer-related mortality, independent of ferritin levels.

4.
PLoS One ; 19(1): e0296303, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38215080

RESUMO

This paper presents a study on the low-velocity impact response of lightweight steel foam concrete (LSFC) composite slabs. The LSFC composite slab consisted of a W-shaped steel plate, foam concrete and oriented strand board (OSB). Low-velocity impact tests on the LSFC composite slabs were conducted by employing an ultra-high heavy-duty drop hammer testing machine. The tests revealed the failure mode, impact force and displacement response of LSFC composite slabs. The effects of density and thickness of foam concrete and drop height on the peak impact force and energy absorption ratio were investigated. A finite element (FE) model was set up to predict the impact resistance of the LSFC composite slabs, and a good agreement between simulation and test results was achieved. In addition, an equivalent-single-degree-of-freedom (ESDOF) model was set up to predict the displacement response of the LSFC composite slabs under impact loading.


Assuntos
Placas Ósseas , Aço , Simulação por Computador
5.
Photoacoustics ; 34: 100569, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38046637

RESUMO

We present a rapid and high-resolution photoacoustic imaging method for evaluating the liver function reserve (LFR). To validate its accuracy, we establish alcoholic liver disease (ALD) models and employ dual-wavelength spectral unmixing to assess oxygen metabolism. An empirical mathematical model fits the photoacoustic signals, obtaining liver metabolism curve and LFR parameters. Liver oxygen metabolism significantly drops in ALD with the emergence of abnormal hepatic lobular structure. ICG half-life remarkably extends from 241 to 568 s in ALD. A significant decline in LFR occurs in terminal region compared to central region, indicated by a 106.9 s delay in ICG half-life, likely due to hepatic artery and vein damage causing hypoxia and inadequate nutrition. Reduced glutathione repairs LFR with a 43% improvement by reducing alcohol-induced oxidative damage. Scalable photoacoustic imaging shows immense potential for assessing LFR in alcoholic-related diseases, providing assistance to early detection and management of liver disease.

6.
Front Med (Lausanne) ; 10: 1272871, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37964887

RESUMO

Objective: This study aimed to assess whether ß-blockers are associated with mortality in patients with sepsis. Method: We conducted a retrospective cohort study of patients with sepsis using the Medical Information Market for Intensive Care (MIMIC)-IV and the emergency intensive care unit (eICU) databases. The primary outcome was the in-hospital mortality rate. The propensity score matching (PSM) method was adopted to reduce confounder bias. Subgroup and sensitivity analyses were performed to test the stability of the conclusions. Results: We included a total of 61,751 patients with sepsis, with an overall in-hospital mortality rate of 15.3% in MIMIC-IV and 13.6% in eICU. The inverse probability-weighting model showed that in-hospital mortality was significantly lower in the ß-blockers group than in the non-ß-blockers group [HR = 0.71, 95% CI: 0.66-0.75, p < 0.001 in MIMIC-IV, and HR = 0.48, 95% CI: 0.45-0.52, p < 0.001 in eICU]. In subgroups grouped according to sex, age, heart rate, APSIII, septic shock, and admission years, the results did not change. Conclusion: ß-blocker use is associated with lower in-hospital mortality in patients with sepsis, further randomized trials are required to confirm this association.

7.
Photoacoustics ; 33: 100546, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38021291

RESUMO

Photoacoustic (PA) theranostics is a new emerging field that uniquely combines diagnosis and treatment in one modality. However, its current status is compromised by the indispensable dependence on nonreversible phase-change nanoprobes that provides one-time-only action. Here, we demonstrate a picosecond-laser-pumped ultrafast PA cavitation technique for highly efficient shockwave theranostics, guaranteeing sustained PA cavitation by using non-phase-change nanoprobes. Theoretical simulations validate that, when compressing the excitation laser pulse width to hundred-picosecond, the thermal confinement effects of a conventional nanoprobe will induce transient heating of the extremely thin surrounding liquid layer of the nanoprobes beyond its cavitation point in a localized area at nanoscale, resulting in intense cavitation and PA shockwaves by the environment rather than the nanoprobes. Both cellular and mouse model experiments have demonstrated the highly effective anti-tumor effects. This method provides a sustainable, reproducible, and highly effective strategy for PA theranostics, prefiguring great potential for the clinical applications.

8.
Front Endocrinol (Lausanne) ; 14: 1266730, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38027184

RESUMO

Background: Klinefelter's syndrome (KS) was once considered infertile due to congenital chromosomal abnormalities, but the presence of focal spermatozoa changed this. The key to predict and promote spermatogenesis is to find targets that regulate focal spermatogenesis. Objective: To explore the trend of fertility changes in KS patients at different ages and identify potential therapeutic targets. Methods: Bibliometric analysis was used to collect clinical research data on KS from the Web of Science Core Collection (WoSCC) from 1992 to 2022. A cross-sectional study was conducted on 75 KS patients who underwent microscopic testicular sperm extraction (mTESE) from 2017 to 2022 in the real world. The reproductive hormones, testicular histopathology, androgen receptors, insulin-like factor 3 (INSL3) receptors and sperm recovery rate (SRR) were analyzed. Results: Male infertility, dysplasia, Sertoli cells, Leydig cells, testosterone and spermatogenesis were the research focuses related to KS. Luteinizing hormone (LH), testosterone, and INSL3 were evaluation indicators of Leydig cell function that fluctuate with age. Testosterone and LH peaked at ages 13-19 and 30-45, while INSL3 only peaked at ages 13-19. 27 patients (27/75) recovered sperm through mTESE and experienced SRR peaks at the ages of 20, 28, 34, and 37. The SRR of fibrosis patients was 46.15%, fatty degeneration was 7.14%, and melanosis was 40.00%. The INSL3 and androgen receptors were highly expressed and roughly balanced in focal spermatogenesis. Conclusion: Abnormal metabolism of Leydig cells led to imbalanced expression of INSL3 and androgen receptors, which might be a potential target for spermatogenesis in KS.


Assuntos
Infertilidade Masculina , Síndrome de Klinefelter , Doenças Metabólicas , Humanos , Masculino , Células Intersticiais do Testículo/patologia , Síndrome de Klinefelter/complicações , Síndrome de Klinefelter/genética , Síndrome de Klinefelter/tratamento farmacológico , Estudos Transversais , Receptores Androgênicos/genética , Recuperação Espermática , Sêmen/química , Espermatogênese/fisiologia , Testosterona/uso terapêutico , Hormônio Luteinizante , Infertilidade Masculina/genética , Infertilidade Masculina/tratamento farmacológico , Doenças Metabólicas/tratamento farmacológico
9.
Nanoscale ; 15(41): 16539-16551, 2023 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-37791688

RESUMO

Recently, photoacoustic (PA) cavitation-mediated therapy has become the focus of research owing to its advantage of inhibiting drug or radiation resistance; however, its application is limited because it relies on nanodroplets with one-time action. Herein, we demonstrate a femtosecond-laser-pumped ultrafast PA cavitation technique for highly efficient shockwave theranostics using niobium carbide (Nb2C) coated with polyvinylpyrrolidone-40000 (PVP), producing sustainable PA cavitation with non-phase-change nanoprobes, which effectively gets rid of the dependence on nanodroplets, guaranteeing multiple treatments. Under femtosecond (fs) laser irradiation, given that the thermal confinement regime could be well satisfied, the Nb2C-PVP nanosheets (NSs) were quickly heated, forming localized overheated nanospots with the temperature exceeding the phase-transition threshold of the surroundings, leading to precise cavitation and explosion at the tumor sites. The experiments at the cellular level showed the significant anti-tumor effects of this method. Notably, the mouse model experiments showed a relative tumor volume inhibition rate of more than 90%, demonstrating the high precision and good efficacy of the proposed anti-tumor method. This method provides a sustainable and highly effective strategy for PA theranostics, indicating its great potential for clinical applications.


Assuntos
Neoplasias , Técnicas Fotoacústicas , Animais , Camundongos , Neoplasias/patologia , Lasers , Povidona , Técnicas Fotoacústicas/métodos
10.
ACS Nano ; 17(15): 14604-14618, 2023 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-37471572

RESUMO

Accurately monitoring the three-dimensional (3D) temperature distribution of the tumor area in situ is a critical task that remains challenging in precision cancer photothermal (PT) therapy. Here, by ingeniously constructing a polyethylene glycol-coated tungsten-doped vanadium dioxide (W-VO2@PEG) photoacoustic (PA) nanothermometer (NThem) that linearly and reversibly responds to the thermal field near the human-body-temperature range, the authors propose a method to realize quantitative 3D temperature rendering of deep tumors to promote precise cancer PT therapy. The prepared NThems exhibit a mild phase transition from the monoclinic phase to the rutile phase when their temperature grows from 35 to 45 °C, with the optical absorption sharply increased ∼2-fold at 1064 nm in an approximately linear manner in the near-infrared-II (NIR-II) region, enabling W-VO2@PEG to be used as NThems for quantitative temperature monitoring of deep tumors with basepoint calibration, as well as diagnostic agents for PT therapy. Experimental results showed that the temperature measurement accuracy of the proposed method can reach 0.3 °C, with imaging depths up to 2 and 0.65 cm in tissue-mimicking phantoms and mouse tumor tissue, respectively. In addition, it was verified through PT therapy experiments in mice that the proposed method can achieve extremely high PT therapy efficiency by monitoring the temperature of the target area during PT therapy. This work provides a potential demonstration promoting precise cancer PT therapy through quantitative 3D temperature rendering of deep tumors by PA NThems with higher security and higher efficacy.


Assuntos
Nanopartículas , Neoplasias , Técnicas Fotoacústicas , Camundongos , Animais , Humanos , Fototerapia/métodos , Terapia Fototérmica , Temperatura , Neoplasias/diagnóstico por imagem , Neoplasias/terapia , Neoplasias/patologia , Diagnóstico por Imagem , Técnicas Fotoacústicas/métodos
11.
Photoacoustics ; 31: 100516, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37313359

RESUMO

Neurovascular imaging is essential for investigating neurodegenerative diseases. However, the existing neurovascular imaging technology suffers from a trade-off between a field of view (FOV) and resolution in the whole brain, resulting in an inhomogeneous resolution and lack of information. Here, homogeneous-resolution arched-scanning photoacoustic microscopy (AS-PAM), which has an ultrawide FOV to cover the entire mouse cerebral cortex, was developed. Imaging of the neurovasculature was performed with a homogenous resolution of 6.9 µm from the superior sagittal sinus to the middle cerebral artery and caudal rhinal vein in an FOV of 12 × 12 mm2. Moreover, using AS-PAM, vascular features of the meninges and cortex were quantified in early Alzheimer's disease (AD) and wild-type (WT) mice. The results demonstrated high sensitivity to the pathological progression of AD on tortuosity and branch index. The high-fidelity imaging capability in large FOV enables AS-PAM to be a promising tool for precise brain neurovascular visualization and quantification.

12.
Opt Lett ; 48(7): 1718-1721, 2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-37221749

RESUMO

Photoacoustic microscopy (PAM) has attracted increasing research interest in the biomedical field due to its unique merit of combining light and sound. In general, the bandwidth of a photoacoustic signal reaches up to tens or even hundreds of MHz, which requires a high-performance acquisition card to meet the high requirement of precision of sampling and control. For most depth-insensitive scenes, it is complex and costly to capture the photoacoustic maximum amplitude projection (MAP) images. Herein, we propose a simple and low-cost MAP-PAM system based on a custom-made peak holding circuit to obtain the extremum values by Hz data sampling. The dynamic range of the input signal is 0.01-2.5 V, and the -6-dB bandwidth of the input signal can be up to 45 MHz. Through in vitro and in vivo experiments, we have verified that the system has the same imaging ability as conventional PAM. Owing to its compact size and ultra-low price (approximately $18), it provides a new performance paradigm for PAM and opens up a new way for an optimal photoacoustic sensing and imaging device.

13.
Opt Lett ; 48(10): 2748-2751, 2023 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-37186756

RESUMO

Anisotropic two-dimensional (2D) materials, such as black phosphorus (BP), normally possess unique directional in-plane electrical, optical, and thermal properties that are highly correlated with their crystalline orientations. Nondestructive visualization of their crystalline orientation is an indispensable premise for the 2D materials to harness their distinctive strengths in optoelectronic and thermoelectric applications. Here, by photoacoustically recording the anisotropic optical absorption variation under linearly polarized laser beams, an angle-resolved polarized photoacoustic microscopy (AnR-PPAM) is developed, capable of non-invasively determining and visualizing BP's crystalline orientation. We theoretically deduced the physical relationship between the crystalline orientation and polarized photoacoustic (PA) signals, and experimentally proved the ability of AnR-PPAM to universally visualize BP's crystalline orientation regardless of its thickness, substrate, and encapsulation layer. This method provides a new, to the best of our knowledge, strategy for crystalline orientation recognition of 2D materials with flexible measurement conditions, prefiguring important potential for the applications of anisotropic 2D materials.

14.
Biochem Biophys Res Commun ; 656: 30-37, 2023 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-36947964

RESUMO

The widespread adoption of chimeric antigen receptor (CAR)-T cell therapy has been hindered by its complex and costly manufacturing process. Induced pluripotent stem cells (iPSCs) have shown promise as a cellular immunotherapy alternative, due to their unlimited self-renewal potential in culture and capacity to differentiate into functional immune cell types. However, it is imperative to carefully select the original cell for iPSC seed preparation, as iPSCs have been found to retain the epigenetic imprint of the original somatic cells. Additionally, the efficiency of reprogramming terminal differentiated cells for immunotherapy must be addressed. Our research highlights the superiority of lymphocyte-origin cells over embryonic stem cells in functional immune cell differentiation. Furthermore, blocking Fas-FasL induced apoptosis in T cells significantly improves iPSC generation. Interestingly, transient Fas suppression in T cells does not alter the expression of Fas in the resulting iPSCs or affect their differentiation potential. This finding brings up new avenues in the field of cellular immunotherapy and provides a solution for creating high-quality and suitable iPSCs for lymphocyte differentiation for immunotherapy purposes.


Assuntos
Células-Tronco Pluripotentes Induzidas , Reprogramação Celular , Linfócitos T , Diferenciação Celular
15.
Eur Spine J ; 32(3): 1068-1076, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36717400

RESUMO

PURPOSE: To investigate the imaging characteristics of thoracic ossification of ligamentum flavum (OLF) combined with dural ossification (DO) and the clinical efficacy of zoning laminectomy. METHOD: The clinical data of 48 patients with thoracic OLF combined with DO who underwent zoning laminectomy between June 2016 and May 2020 were retrospectively analyzed. The modified Japanese Orthopedic Association (mJOA) score was used to evaluate neurological function before and after surgery, and the clinical efficacy was evaluated according to the improvement rate. RESULTS: The symptoms of all patients significantly improved after the operation, and the average follow-up time was 27.8 (10-47) months. In addition, the average mJOA score had increased from 5.0 (2-8) preoperatively to 8.7 (6-11) postoperatively (t = 18.880, P < 0.05). The average improvement rate was 62.6% (25-100%), with 16 patients graded as excellent, 21 as good, and 11 as fair. Cerebrospinal fluid leakage occurred in 12 cases (25.0%), and all of them healed well after treatment. No postoperative aggravation of neurological dysfunction, wound infection or hematoma occurred. At the last follow-up, there was no recurrence of symptoms and kyphosis. CONCLUSION: The Zoning laminectomy described here is both safe and effective.


Assuntos
Ligamento Amarelo , Ossificação Heterotópica , Humanos , Descompressão Cirúrgica/métodos , Osteogênese , Ligamento Amarelo/diagnóstico por imagem , Ligamento Amarelo/cirurgia , Estudos Retrospectivos , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/cirurgia , Ossificação Heterotópica/complicações , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/cirurgia
16.
Asian J Surg ; 46(2): 723-729, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35803890

RESUMO

OBJECTIVE: Spinal cord injury is a common occurrence during spinal surgery. In this study, we proposed a zoning laminectomy, which could reduce the incidence of nerve injury. We also discussed the safety and clinical efficacy of the zoning laminectomy for thoracic ossification of the ligamentum flavum (TOLF). METHODS: Forty-five patients with TOLF who underwent zoning laminectomy from October 2016 to February 2020 were included in the retrospective analysis. The Japan Orthopedic Association (JOA) score was used to evaluate clinical outcomes. Meanwhile, the occurrence of complications was recorded. RESULTS: All 45 patients underwent the operation successfully, and the mean follow-up period was 25.3 months, the mean operation time was 160.2 min, the average blood loss was 474.2 ml, and the average hospital time was 8.0 days. At the final evaluation, the JOA score was significantly higher than the preoperative JOA score (P < 0.001) and the overall recovery rate of the JOA score averaged 69.6%. Seventeen patients were graded as excellent, twenty-six as good, and two as fair. The complications included dural tears in nine patients (20.0%), cerebrospinal fluid leakage in seven patients (15.6%), deep infection in one patient (2.2%), and epidural hematoma in one patient (2.2%). All patients recovered well after treatment. Besides, there was no neurological deterioration and thoracic kyphosis occurred. CONCLUSIONS: Zoning laminectomy adopts a phased resection from "safe zone" to "danger zone" and defines the safe removal range of the lamina, which reduces the risks of spinal cord injury caused by instrument manipulation. Therefore, it is a safe and effective surgical option.


Assuntos
Ligamento Amarelo , Ossificação Heterotópica , Traumatismos da Medula Espinal , Humanos , Laminectomia , Osteogênese , Descompressão Cirúrgica , Ligamento Amarelo/cirurgia , Estudos Retrospectivos , Ossificação Heterotópica/cirurgia , Ossificação Heterotópica/complicações , Vértebras Torácicas/cirurgia , Resultado do Tratamento , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/cirurgia
17.
Front Public Health ; 10: 893683, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36016902

RESUMO

Background: Hemodynamic management is of paramount importance in patients with acute kidney injury (AKI). Central venous pressure (CVP) has been used to assess volume status. We intended to identify the optimal time window in which to obtain CVP to avoid the incidence of adverse outcomes in patients with AKI. Methods: The study was based on the Medical Information Mart for Intensive Care (MIMIC) IV database. The primary outcome was in-hospital mortality. Secondary outcomes included the number of ICU-free days and norepinephrine-free days at 28 days after ICU admission, and total fluid input and fluid balance during the first and second day. A time-dose-response relationship between wait time of CVP measurement and in-hospital mortality was implemented to find an inflection point for grouping, followed by propensity-score matching (PSM), which was used to compare the outcomes between the two groups. Results: Twenty Nine Thousand and Three Hundred Thirty Six patients with AKI were enrolled, and the risk of in-hospital mortality increased when the CVP acquisition time was >9 h in the Cox proportional hazards regression model. Compared with 8,071 patients (27.5%) who underwent CVP measurement within 9 h and were assigned to the early group, 21,265 patients (72.5%) who delayed or did not monitor CVP had a significantly higher in-hospital mortality in univariate and multivariate Cox regression analyses. After adjusting for potential confounders by PSM and adjusting for propensity score, pairwise algorithmic, overlap weight, and doubly robust analysis, the results were still stable. The HRs were 0.58-0.72, all p < 0.001. E-value analysis suggested robustness to unmeasured confounding. Conclusions: Among adults with AKI in ICU, increased CVP wait time was associated with a greater risk of in-hospital mortality. In addition, early CVP monitoring perhaps contributed to shortening the length of ICU stays and days of norepinephrine use, as well as better fluid management.


Assuntos
Injúria Renal Aguda , Listas de Espera , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Adulto , Pressão Venosa Central , Humanos , Incidência , Estudos Retrospectivos
18.
J Clin Med ; 11(14)2022 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-35887895

RESUMO

Background: the optimal timing of Transthoracic echocardiography (TTE) performance for patients with septic shock remains unexplored. Methods: a retrospective cohort study included patients with septic shock in the MIMIC-Ⅲ database. Risk-adjusted restricted cubic splines modeled the 28-day mortality according to time elapsed from ICU admission to receive TTE. The cut point when a smooth curve inflected was selected to define early and delayed group. We applied propensity score matching (PSM) to ensure our findings were reliable. Causal mediation analysis was used to assess the intermediate effect of fluid balance within 72 h after ICU admission. Results: 3264 participants were enrolled and the risk of 28-day mortality increased until the wait time was around 10 h (Early group) and then was relatively flat afterwards (Delayed group). A beneficial effect of early TTE in terms of the 28-day mortality was observed (HRs 0.73−0.78, all p < 0.05) in the PSM. The indirect effect brought by the fluid balance on day 2 and 3 was significant (both p = 0.006). Conclusion: early TTE performance might be associated with lower risk-adjusted 28-day mortality in patients with septic shock. Better fluid balance may have mediated this effect. A wait time within 10 h after ICU may represent a threshold defining progressively increasing risk.

19.
Foods ; 11(10)2022 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-35626991

RESUMO

ο-benzoquinone is a common intermediate which is mostly formed by the oxidation of phenolics or polyphenols containing catechol structure. ο-benzoquinone has an outstanding nucleophilic ability, while advanced glycation end products (AGEs) are nucleophilic and can undergo a nucleophilic addition reaction with ο-benzoquinone to mitigate the harmful effects of AGEs on the body. As common nucleophilic substances, amino acids existing in large quantities in food processing and in vivo may bind competitively with ο-benzoquinone, thus influencing the trapping of ο-benzoquinone with AGEs. In this study, cyclic voltammetry and coexistence experiments were used to compare the reactivities of Nε-(carboxymethyl) lysine (CML) and amino acids with 4-methylbenzoquinone (4-MBQ). The results showed that CML is more reactive with ο-benzoquinone than most amino acids, and even in complex systems, ο-benzoquinone still captured CML. Moreover, almost all adducts were identified by UPLC-QTOF-MS/MS, and their chemical formulas were deduced. Quantum chemistry accurately predicts the efficiency and site of reactions of ο-benzoquinone and nucleophiles to a certain extent, and found that a secondary amine has a greater reactivity with 4-MBQ than a primary amine in a similar molecular structure. In general, ο-benzoquinone could capture AGEs, thereby showing potential to reduce the harmfulness of AGEs.

20.
Gynecol Endocrinol ; 38(6): 499-502, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35532201

RESUMO

OBJECTIVE: This study aimed to investigate serum levels of adiponectin, and the mRNA expression of forkhead box C2 (FOXC2) and glucose transporter-4 (GLUT4) in visceral adipose tissue obtained from patients with gestational diabetes mellitus (GDM) and healthy pregnant women. METHODS: Venous blood samples were obtained from 60 pregnant women with gestational normal glucose tolerance (GNGT) and 21 patients with GDM. Visceral adipose tissues were obtained from 11 women with GDM and 30 with GNGT. Serum adiponectin levels were detected by enzyme-linked immunosorbent assay, and FOXC2 and GLUT4 mRNA expression were detected by quantitative polymerase chain reaction. RESULTS: Serum adiponectin concentrations were lower in the women with GDM than in the controls (p < .05). FOXC2 and GLUT4 mRNA expression were decreased in visceral adipose tissue of GDM women than in the controls (p < .05). Correlation analyses showed that FOXC2 tended to have a positive correlation with GLUT4 in GDM patients' visceral adipose tissue (p =.0564). CONCLUSION: Our results revealed that decreased adiponectin, FOXC2, and GLUT4 expression were associated with increased risk of GDM and the regulation mechanism of GLUT4 mediated by FOXC2 would be the focus of further studies.


Assuntos
Diabetes Gestacional , Resistência à Insulina , Adiponectina , Feminino , Humanos , Insulina , Resistência à Insulina/fisiologia , Gordura Intra-Abdominal/metabolismo , Gravidez , RNA Mensageiro/metabolismo
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