[A multicenter cross-sectional study on chronic critical illness and surgery-related chronic critical illness in China].

Objective: To understand the prevalence, diagnosis and treatment of chronic critical illness (CCI) in China. Methods: The clinical data of 472 adult patients admitted to ICU in 53 hospitals, including basic information, disease-related data, nutrition program, etc., were collected on May 10, 2019, by means of multi-center cross-sectional study. If surgical intervention was needed or the occurrence of the disease was directly related to the surgery, ICU patients were regarded as surgical ICU cases (n=211). In this study, the diagnostic criteria for CCI were: (1) admission to ICU >14 days;(2) combined with persistent organ dysfunction. The prevalence,distribution and treatment of CCI and surgery-related CCI were recorded and analyzed. The Mann-Whitney U test, chi-square test or Fisher exact test were used for comparative analysis. Results: Among the 472 ICU patients from 53 hospitals, 326 were male (69.1%) and 146 were female (30.9%). The prevalence of CCI was 30.7% (145/472). Among 211 surgery-related ICU patients, 57 developed CCI with a prevalence of 27.0%. As compared to non-CCI patients, higher APACHE II score [median (IQR) 13.5 (10.0, 18.3) vs. 11.0 (7.0, 16.0), U=2970.000, P=0.007], higher Charlson comorbidity index [median (IQR) 4.0 (2.0, 7.0) vs. 3.0 (1.0, 5.0), U= 3570.000, P=0.036] and higher ratio of breath dysfunction [68.4% (39/57) vs. 48.1% (74/154), χ(2)=6.939, P=0.008] and renal dysfunction [42.1% (24/57) vs. 18.2% (28/154), χ(2)=12.821, P<0.001] were found in surgery-related CCI patients. While SOFA score, Glasgow coma score and other visceral function were not significantly different between surgery-related CCI and non-CCI patients (all P>0.05). NUTRIC score showed that surgery-related CCI patients had higher nutritional risk [43.9% (25/57) vs. 26.6%(41/154), U=5.750, P=0.016] and higher ratio of mechanical ventilation [66.7% (38/57) vs. 52.3% (79/154), χ(2)=3.977, P=0.046] than non-CCI patients. On the survey day, the daily caloric requirements of 50.2% (106/211) of surgery-related ICU patients were calculated according to the standard adult caloric intake index (104.6 to 125.5 kJ·kg(-1)·d(-1), 1 kJ=0.239 kcal), and the daily caloric requirements of 46.4% (98/211) of patients were calculated by physicians according to the severity of the patient's condition. 60.2% (127/211) of nutritional support therapy was enteral nutrition (including a combination of enteral and parenteral nutrition), while the remaining patients received parenteral nutrition (24.6%, 52/211), simple glucose infusion (9.0%, 19/211), or oral diet (6.2%, 13/211). The target calorie of CCI group was 104.6 (87.9, 125.5) kJ·kg(-1)·d(-1), and the actual calorie intake accounted for 0.98 (0.80, 1.00) of the target calory. In the non-CCI group, the target calorie was 104.6 (87.9, 125.5) kJ·kg(-1)·d(-1), and the actual calorie consumed accounted for 0.91 (0.66, 1.00) of the target calorie. There was no statistically significant difference between two groups (P=0.248, P=0.150). Conclusion: The prevalence of CCI and surgery-related CCI in ICU is high, along with severe complications, respiratory and renal dysfunction and mechanical ventilation. Surgical patients admitted to ICU are at high nutritional risk, and active and correct nutritional support is essential for such patients.

Enhancing surface immobilization of bioactive molecules via a silica nanoparticle based coating.

Surface modification is of significant interest in biomaterials, biosensors, and device biocompatibility. Immobilization of bioactive or biomimetic molecules is a common method of disguising a foreign body as host tissue to decrease the foreign body response (FBR) and/or increase device-tissue integration. For example, in neural interfacing devices, immobilization of L1, a neuron-specific adhesion molecule, has been shown to increase neuron adhesion and reduce inflammatory gliosis on and around the implants. However, the activity of modified surfaces is limited by the relatively low concentration of the immobilized component, in part due to the low surface area of flat surfaces available for modification. In this work, we demonstrate a novel method for increasing the device surface area by attaching a layer of thiolated silica nanoparticles (TNPs). This coating method results in an almost two-fold increase in the immobilized L1 protein. L1 immobilized nanotextured surfaces showed a 100% increase in neurite outgrowth than smooth L1 immobilized surfaces without increasing the adhesion of astrocytes in vitro. The increased bioactivity observed in the cell assay was determined to be mainly due to the higher protein surface density, not the increase in surface roughness. In addition, we tested immobilization of a superoxide dismutase mimic (SODm) on smooth and roughened substrates. The SODm immobilized rough surfaces demonstrated an increase of 145% in superoxide scavenging activity compared to chemically matched smooth surfaces. These results not only show promise in improving biomimetic coating for neural implants, but may also improve surface immobilization efficacy in other fields such as catalysts, protein purification, sensors, and tissue engineering devices.

The application value of continuous nursing for home oxygen therapy of patients in the stable phase of chronic obstructive pulmonary disease.

OBJECTIVE: To analyze the application value of continuous nursing in improving the effects of home oxygen therapy for patients in the stable phase of chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: Patients in the stable phase of COPD (n=106) were selected and divided into the control group and observation group based on parity digit of their admission number. There were 53 cases in each group. The patients in the control group received COPD health education at discharge, while the observation group received continuous nursing. The effect of home oxygen therapy in both groups after 3 months was compared. RESULTS: The compliance in the observation group for home oxygen therapy was significantly higher than that in the control group. Blood gas analysis and various indicators of pulmonary function in the control group at follow-up visits were not changed compared with those before. In contrast, partial pressure of blood oxygen and blood oxygen saturation of the observation group were lower than those before discharge. With the increasing partial pressure of carbon dioxide in arterial blood, the indicators of pulmonary function became lower than before. Comparing the various indexes between both groups at follow-up visits, the differences were statistically significant (p<0.05). The self-care ability and quality of life scores of patients in the observation group were higher than those of the control group, and the differences were statistically significant (p<0.05). CONCLUSIONS: By establishing health records and network platforms, continuous nursing can provide continuous health education and supervision for patients with COPD, which can effectively improve oxygen therapy compliance, self-care ability and quality of life. It has good application and promotional value.

Recent progress in surface-enhanced Raman spectroscopy for biological and biomedical applications: from cells to clinics.

The application of surface-enhanced Raman spectroscopy (SERS) in biological and biomedical detection schemes is feasible due to its excellent molecular specificity and high sensitivity as well as the capability of SERS to be performed in complex biological compositions. SERS-based investigation of cells, which are the basic structure and functional unit of organisms, represents the starting point of this review. It is demonstrated that SERS provides a deep understanding of living cells as well as their microenvironment which is needed to assess the development of diseases. The clinical relevance of SERS is proved by its application for the detection of cancer cells and tumour margins under in vivo conditions and examples for theranostic approaches are discussed. This review article provides a comprehensive overview of the recent progress within the last 3 years.

Surface-enhanced Raman spectroscopy and microfluidic platforms: challenges, solutions and potential applications.

The exhaustive body of literature published in the last four years on the development and application of systems based on surface-enhanced Raman spectroscopy (SERS) combined with microfluidic devices demonstrates that this research field is a current hot topic. This synergy, also referred to as lab-on-a-chip SERS (LoC-SERS) or nano/micro-optofluidics SERS, has opened the door for new opportunities where both techniques can profit. On the one hand, SERS measurements are considerably improved because the processes previously performed on a large scale in the laboratory and prone to human error can now be carried out in nanoliter volumes in an automatic and reproducible manner; on the other hand, microfluidic platforms need detection methods able to sense in small volumes and therefore, SERS is ideal for this task. The present review not only aims to provide the reader an overview of the recent developments and advancements in this field, but it also addresses the key aspects of fundamental SERS theory that influence the interpretation of SERS spectra, as well as the challenges brought about by the experimental conditions and chemometric data analysis.

Sublethal effects of imidacloprid on the fecundity, longevity, and enzyme activity of Sitobion avenae (Fabricius) and Rhopalosiphum padi (Linnaeus).

The aphid species Sitobion avenae and Rhopalosiphum padi are the most important pests in wheat growing regions of many countries. In this study, we investigated the sublethal effects of imidacloprid on fecundity, longevity, and enzyme activity in both aphid species by comparing 3-h exposure for one or three generations. Our results indicated that 3-h exposure to sublethal doses of imidacloprid for one generation had no discernible effect on the survival, fecundity, longevity, or enzyme activity levels of aphids. However, when pulse exposures to imidacloprid were sustained over three generations, both fecundity and longevity were significantly decreased in both S. avenae and R. padi. Interestingly, the fecundity of R. padi had almost recovered by the F5 generation, but its longevity was still deleteriously affected. These results indicated that R. padi laid eggs in shorter time lags and has a more fast resilience. The change in reproduction behavior may be a phenomenon of R. padi to compensate its early death. If this is stable for the next generation, it means that the next generation is more competitive than unexposed populations, which could be the reason underlying population outbreaks that occur after longer-term exposure to an insecticide. This laboratory-based study highlights the sublethal effects of imidacloprid on the longevity and fecundity of descendants and provides an empirical basis from which to consider management decisions for chemical control in the field.

Association between interleukin 17A gene polymorphisms and risk of coronary artery disease.

Coronary artery disease (CAD) represents a leading cause of morbidity and mortality worldwide, and genetic factors contribute to the development of this disease. We conducted a case-control study to assess the association between interleukin 17A (IL17A) rs2275913 and rs3748067 polymorphisms and development of CAD. A total of 372 CAD patients and 372 healthy controls were recruited in our investigation between January 2013 and December 2014. Genotyping of IL17A rs2275913 and rs3748067 was carried out using polymerase chain reaction combined with restriction fragment length polymorphism. Logistic regression analysis revealed that CC [odds ratio (OR) = 3.81, 95% confidence interval (CI) = 2.11-7.16] and TC+CC (OR = 1.54, 95%CI = 1.11-2.14) rs3748067 genotypes were associated with an increased risk of CAD compared to the TT variant. Individuals carrying the TC+CC genotype were more likely to have a higher risk of CAD if they were smokers, with an adjusted OR (and 95%CI) of 2.20 (1.31-3.71). In conclusion, we suggest that the CC and TC+CC genotypes of rs3748067 are connected with increased risk of CAD in comparison to the wide-type genotype, particularly in smokers.

Investigation into the association between NLRP3 gene polymorphisms and susceptibility to type 2 diabetes mellitus.

We conducted a case-control study to investigate the role of three common polymorphisms (rs10754558, rs7512998, and rs12137901) of the gene NLR family, pyrin domain containing 3 (NLRP3) in the development of type 2 diabetes mellitus (T2DM). Between May 2013 and May 2014, 385 patients with T2DM and 401 control subjects were enrolled in our study. Genotyping of the three NLRP3 polymorphisms of interest was performed by polymerase chain reaction-restriction fragment length polymorphism. Unconditional logistic regression analyses showed that individuals carrying GG and GC+GG rs10754558 genotypes were at significantly increased risk of T2DM, with adjusted odds ratios (and 95% confidence intervals) of 1.81 (1.16-2.83) and 1.40 (1.04-1.88), respectively. In conclusion, we propose that the NLRP3 rs10754558 polymorphism contributes to the development of T2DM, but that rs7512998 and rs12137901 variants are not associated with susceptibility to this disease.

Neuronavigator-guided percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia.

BACKGROUND: Although radiofrequency thermocoagulation is considered as a primary treatment for most patients with trigeminal neuralgia, neuronavigator-guided percutaneous radiofrequency thermocoagulation has been rarely reported. The object of this study was to assess the clinical value of neuronavigator-guided percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia. METHODS: The radiofrequency thermocoagulation was performed in 100 cases of trigeminal neuralgia. The patients were positioned supine or sitting, under Hartel's technique (reported by Sweet and Wepsic J Neurosurg 40:143-156, 1974), by anterior lateral facial approaches. The Gasserian ganglions were acupunctured, assisted by intraoperative CT scanning (3-digital reconstruction) and electrophysiology in order to accurately locate target. RESULTS: The needles located in oval foramen at the first puncture, the direction and position could be defined according to the electrophysiology examination. The pain alleviated immediately after operation. There occurred no serious complication and other nerve injury in all patients despite face numbness only. CONCLUSIONS: 3D-CT and electrophysiology Gasser's ganglion locations can raise the success rate of puncture, enhance the safety and reduce the incidence of complication, showing high academic value and its promising future.

Nitrobenzene compounds inhibit expression of VCAM-1.

A series of nitrobenzene compounds has been discovered as potent inhibitors of VCAM-1 expression and, therefore, potential drug candidates for autoimmune and allergic inflammatory diseases. Structure-activity relationship (SAR) studies showed that a nitro group and two other electron-withdrawing groups are essential for these compounds to be potent inhibitors of VCAM-1 expression.

Cytogenetic analysis in workers occupationally exposed to nickel carbonyl.

Chromosomal aberration and sister-chromatid exchange (SCE) base-line frequencies and SCE frequencies induced by 10 ng/ml mitomycin C (MMC) were analysed in cultured peripheral lymphocytes of 65 workers occupationally exposed to nickel carbonyl Ni(CO)4. The subjects were divided into 4 groups: (1) control; (2) exposed to nickel carbonyl (= exposed); (3) cigarette smokers; (4) smoking-exposed. The results show that there are no significant differences in chromosomal aberration frequencies, breaks or gaps, between the various groups. However, the SCE base-line frequency of the smoking-exposed group, with an average of 7.7/cell, was significantly higher than that of the control group, with an average of 6.5/cell (P less than 0.01), and also than that of the exposed group with an average of 5.9/cell (P less than 0.01). Similarly, the SCE frequency induced by 10 ng/ml MMC in the smoking-exposed group which averaged 15.5/cell was significantly higher than that of the control group (average of 13.2/cell (P less than 0.05], and also than that of the exposed group with an average of 12.3/cell (P less than 0.01). Under our experimental conditions, it may be that the level of exposure was not high enough to elicit an increase in chromosomal aberrations and SCE frequencies in the non-smoker exposed group. The fact that an increase in SCE frequencies was only found in the smoking-exposed group implies that the two factors, smoking and exposure to nickel carbonyl, are jointly responsible for the result.