A Frailty Assessment Tool to Predict In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.

Background: The exacerbation of chronic obstructive pulmonary disease (AECOPD) is a chronic, frequent, and life-threatening lung disease. In 2014, a frailty index (FI) based on deficits in commonly used laboratory tests (FI-Lab) was suggested to identify older adults at increased risk of death. Objective: We aim to study the prognostic value of the FI-Lab in older Chinese patients who were admitted because of AECOPD. Methods: We screened 1932 older patients hospitalized with AECOPD from September 2016 to June 2019 at Zhenjiang First People's Hospital, China. A multivariate logistic regression analysis was used to identify prognostic factors for in-hospital mortality. Results: A total of 77 survivors and 77 non-survivors were finally included in the study. Both the mean DECAF (including dyspnea, eosinopenia, consolidation, acidemia, and atrial fibrillation) score and the mean FI-Lab value of non-survivors were statistically higher than those of survivors (4.45 ± 0.80 versus 3.03 ± 0.90, P=0.000; 0.51 ± 0.13 versus 0.29 ± 0.10, P=0.000, respectively). Logistic regression analysis suggested that DECAF Rank and FI-Lab Rank were strongly related factors of death in AECOPD patients. The areas under the receiver-operating characteristic (ROC) curves were 0.906 for FI-Lab and 0.870 for DECAF (P=0.2991). Conclusion: FI-Lab is a simple, efficient, and objective tool to stratify the risk of in-hospital mortality of AECOPD.

Efficient production and characterization of homopolymeric poly(3-hydroxyvalerate) produced by Bacillus strain PJC48.

Aliphatic polyester, poly(3-hydroxyvalerate) (PHV), is commonly produced as a granular component in bacterial cells of various species. Based on 16S rDNA gene sequence analysis, strain PJC48 was identified as a Bacillus species. The current study is aimed to screen for a high-yield strain that can produce PHV efficiently and to increase PHV product yield by optimizing the fermentative process. We identified a high-producer strain based on Nile red staining. Characterization of the PHV produced by PJC48 by nuclear magnetic resonance spectroscopy revealed that it consisted of (R)-3-hydroxyvalerate monomers. The suggested model was validated by response surface methodology. Optimization of the PHV yield resulted in an increase of 32.75% compared to control, with a maximum production of 1.64 g/L after 48 H.

Draft Genome Sequence of a Polydroxyalkanoate-Synthesizing Bacterium, Bacillus sp. Strain PJC48, Isolated from Activated Sludge.

The genome sequence of a Bacillus strain is capable of synthesizing polyhydroxyalkanoates, and Bacillus sp. is considered a platform strain for the production of many biodegradable materials. Here, we present the sequence of the PJC48 strain genome, which is composed of three chromatin structures, an extracellular structure, and a cytoskeleton.

[Changes of plasma glucagon level in individuals with different glucose metabolism].

OBJECTIVE: To determine the levels of plasma glucagon and associated factors in individuals with different glucose metabolism. METHODS: One hundred and ten outpatient patients received an oral glucose tolerance test (OGTT) voluntarily. The patients were divided into three groups according to their OGTT results: normal glucose golerance (NGT) group (n=33), impaired glucose regulation (IGR) group (n=35), newly diagnosed type 2 diabetes (DM2) group (n=42). Plasma glucagon (GLC) and insulin (INS) at 0 min (0 h), 30 min (0.5 h), 60 min (1 h) and 120 min (2 h) were measured by radio immunity and electrochemiluminescence assay, respectively. We calculated the area of glucagon under the curve (AUCglc), the value of early phase glucagon secretion (deltaGLC = GLC(0.5 h) - GLC(0 h)) and the ratio of insulin to glucagon (INS/GLC). RESULTS: (1) There was no significant difference in the level of GLC(0 h) among the three groups (P > 0.05). (2) Patients in the IGR group had higher levels of GLC(0.5 h) and GLC(1 h), greater values of AUC(glc), and deltaGLC, and lower values of INS(0.5 h)/GLC(0.5 h) than those in the NGT group (P < 0.05). (3) Patients in the DM2 group had higher levels of GLC(0.5 h) and GLC(1 h), greater values of AUC(glc) and deltaGLC, and lower values of INS(0.5 h)/GLC(0.5 h) and INS(1 h)/GLC(1 h) than those in the NGT group (P < 0.05). (4) Patients in the DM2 group had higher levels of GLC(1 h), greater values of AUC(glc), and lower values of INS(0.5 h)/GLC(0.5 h), INS(1 h)/GLC(1 h), and INS(2 h)/GLC(2 h), than those in the IGR group (P < 0.05). (5) The multiple linear regression analysis showed that the value of AUC(glc). was positively correlated with HOMA-IR (adjust R2 = 0.219, P = 0.001). CONCLUSION: There are no significant differences in fasting plasma glucagon levels among the individuals with different glucose metabolism. Hypersecretion of glucagon and reduced glucagon suppressing effect of insulin occur in IGR patients, which is exacerbated when DM2 are developed. HOMA-IR is an important factor associated with glucagon hypersecretion.

[New perspectives in the treatment of diabetes by interfering with glucagon signaling pathway].

Glucagon, a hormone secreted from the alpha cell of the endocrine pancreas, is a major counterpart to insulin. After released into blood, glucagon will combine with its receptor in targeting tissues and form a compound, which then activates its signaling pathway, produces cAMP, promotes gluconeogenesis and glycogenolysis and inventually increases blood glucose. Researches recently display that it will be an important addition to treatment method by inhibiting synthesis and secretion of glucagon, neutralizing circulating glucagon, using glucagon receptor antagonists and prohibiting gene expression of glucagon receptor.