Effect of ozone sterilization on controlling leaf mildew and gray mold tomato disease in a glasshouse and its influence on other growth parameters.

BACKGROUND: In order to explore the effect of ozone sterilization treatment on tomato disease control and increase fruit setting rate, this study took 906 pink fruit tomato as test material, used a small ozone generator to carry out ozone treatment single-factor test, and then selected orthogonal table to guide the ozone treatment combination. The effects of different ozone treatment concentration, ozone treatment duration and ozone treatment times on the growth, disease and fruit setting rate of potted tomato were analyzed. RESULTS: Different ozone treatment had effects on leaf mildew, gray mold and fruit setting rate of tomato. The influence degree of three factors on leaf mildew, gray mold and fruit setting rate was from large to small, a > b > c, a > c > b, b > a > c. A quadratic regression model was established with the control effect of tomato leaf mildew, gray mold and fruit setting rate as response values, and the optimal parameter combination was determined: The ozone treatment concentration was 0.0465 g kg-1, the ozone treatment time was 30 min, and the ozone treatment times were twice a week. In this case, the control efficiency of tomato leaf mildew was 95.02%, the control effect of gray mold was 99.49%, and the fruit setting rate was 76.5%. The test parameters were accurate and reliable. CONCLUSION: The ozone sterilization method proposed in this article is safe and green, and can provide theoretical support for the recovery and reconstruction of tomato disease in a glasshouse. © 2024 Society of Chemical Industry.

The effects of bisphenol S exposure on the growth, physiological and biochemical indices, and ecdysteroid receptor gene expression in red swamp crayfish, Procambarus clarkii.

The experiment was conducted to investigate the effects of Bisphenol S (BPS) on growth, physiological and biochemical indices, and the expression of ecdysteroid receptor (ECR) of the red swamp crayfish (Procambarus clarkii). The gene encoding ECR was isolated from red swamp crayfish by homologous cloning and rapid amplification of cDNA ends (RACE). The ECR transcripts were 1757 bp long and encoded proteins of 576 amino acids. The quantitative real-time PCR (qRT-PCR) analysis showed that the ECR gene was expressed in various tissues under normal conditions, and the highest level was observed in the ovary and the lowest level was observed in the muscle (P < 0.05). Then, the experiment was designed with four different BPS concentrations (0, 1, 10, and 100 µg/L), BPS exposure for 14 days, three parallel groups, and a total of 240 red swamp crayfish. At 100 µg/L BPS, the survival rate, weight gain rate, and relative length rate were decreased significantly (P < 0.05). Malonaldehyde (MDA) content reached the highest level at 100 µg/L BPS. When BPS concentration was higher than 10 µg/L, the activities of superoxide dismutase (SOD) and catalase (CAT) were significantly lower than those of the control group (P < 0.05). The expression levels of the ECR gene in ovary, intestinal, gill, and hepatopancreas tissues were significantly increased after BPS exposure (P < 0.05). The ECR gene expression in ovaries and Y-organs was significantly higher than other groups in 10 µg/L BPS (P < 0.05). The expressions of the tumor necrosis factor -α (TNF-α) and interleukin-6 (IL-6) genes in the hepatopancreas gradually increased, and the highest expression was observed exposed in 100 µg/L BPS (P < 0.05). This research will provide novel insights into the health risk assessment of BPS in aquatic organisms.

Recombinant immunotoxin induces tumor intrinsic STING signaling against head and neck squamous cell carcinoma.

The innate immune stimulator of interferon genes (STING) pathway is known to activate type I interferons (IFN-I) and participate in generating antitumor immunity. We previously produced hDT806, a recombinant diphtheria immunotoxin, and demonstrated its efficacy against head and neck squamous cell carcinoma (HNSCC). However, it's unknown whether the tumor-intrinsic STING plays a role in the anti-HNSCC effects of hDT806. In this study, we investigated the innate immune modulation of hDT806 on HNSCC. hDT806 significantly upregulated the level of STING and the ratio of p-TBK1/TBK1 in the HNSCC cells. Moreover, intratumoral hDT806 treatment increased the expression of STING-IFN-I signaling proteins including IFNA1, IFNB, CXCL10 and MX1, a marker of IFN-I receptor activity, in the HNSCC xenografts. Overexpression of STING mimicked the hDT806-induced upregulation of the STING-IFN-I signaling and induced apoptosis in the HNSCC cells. In the mouse xenograft models of HNSCC with STING overexpression, we observed a significant suppression of tumor growth and reduced tumor weight with increased apoptosis compared to their control xenograft counterparts without STING overexpression. Collectively, our data revealed that hDT806 may act as a stimulator of tumor-intrinsic STING-IFN-I signaling to inhibit tumor growth in HNSCC.

New insights into the function of lipid droplet-related proteins and lipid metabolism of salt-stimulated porcine biceps femoris: label-free quantitative phosphoproteomics, morphometry and bioinformatics.

BACKGROUND: Lipid droplets (LDs) are important multifunctional organelles responsible for lipid metabolism of postmortem muscle. However, the dynamics in their building blocks (cores and layers) and phosphorylation of lipid droplet-related proteins (LDRPs) regulating meat lipolysis remain unknown at salt-stimulated conditions. RESULTS: LDRPs extracted from cured porcine biceps femoris (1% and 3% salt) were subjected to label-free quantitative phosphoproteomic analysis and LDs morphological validation. Results indicated that 3% salt curing significantly decreased triglyceride (TG) content with increase in glycerol and decrease in LDs fluorescence compared to 1% salt curing. Comparative phosphoproteomics showed that there were significant changes in phosphorylation at 386 sites on 174 LDRPs between assayed groups (P < 0.05). These differential proteins were mainly involved in lipid and carbohydrate metabolism. Curing of 3% salt induced more site-specific phosphorylation of perilipin 1 (PLIN1, at Ser81) and adipose triglyceride lipase (ATGL, at Ser399) than 1%, whereas the phosphorylation (at Ser600) of hormone-sensitive lipase (HSL) was up-regulated. Ultrastructure imaging showed that LDs were mostly associated with mitochondria, and the average diameter of LDs decreased from 2.34 µm (1% salt) to 1.73 µm (3% salt). CONCLUSION: Phosphoproteomics unraveled salt-stimulated LDRPs phosphorylation of cured porcine meat provoked intensified lipolysis. Curing of 3% salt allowed an enhanced lipolysis than 1% by up-regulating the phosphorylation sites of LDRPs and recruited lipases. The visible splitting of LDs, together with sarcoplasmic disorganization, supported the lipolysis robustness following 3% salt curing. The finding provides optimization ideas for high-quality production of cured meat products. © 2023 Society of Chemical Industry.

Underlying formation mechanisms of ultrasound-assisted brined porcine meat: The role of physicochemical modification, myofiber fragmentation and histological organization.

Ultrasound treatment has been a good hurdle technique for meat curing processing, where both physical and chemical consequences can be involved towards final quality of obtained products. However, the specific correlation between ultrasound parameters and muscle fiber fragmentation and myofibrillar microstructural changes during curing deserve further evaluation. In present study, we comparatively studied the effect of ultrasound-assisted brining (UAB) and static brining (SB) on the muscle proteolysis events and microstructural/morphological variation of porcine meat as well as the physicochemical indices and histological characteristics. The results showed that UAB (20 kHz, 315 W for 1 h) could markedly enhance the muscle proteolysis with higher free-/peptide-bound alpha-amino-nitrogen (α-NH2-N) content (P < 0.05) than SB treatment and greatly improved the fragmentation of muscle fiber tissues of cured meat. Meanwhile, UAB processing favored more opening structures of myofibrillar proteins with more hydrophobic groups being exposed. The quantitative histological analysis revealed that, compared with SB treatment, UAB could significantly increase the gap between muscle fibers and the swelling of the perimysium (P < 0.01), proving an efficient curing process with better textural and water holding properties.

Analysis of the Whole-Genome Sequences from an Equus Parent-Offspring Trio Provides Insight into the Genomic Incompatibilities in the Hybrid Mule.

Interspecific hybridization often shows negative effects on hybrids. However, only a few multicellular species, limited to a handful of plants and animals, have shown partial genetic mechanisms by which hybridization leads to low fitness in hybrids. Here, to explore the outcome of combining the two genomes of a horse and donkey, we analyzed the whole-genome sequences from an Equus parent-offspring trio using Illumina platforms. We generated 41.39× and 46.21× coverage sequences for the horse and mule, respectively. For the donkey, a 40.38× coverage sequence was generated and stored in our laboratory. Approximately 24.86 million alleles were discovered that varied from the reference genome. Single nucleotide polymorphisms were used as polymorphic markers for assigning alleles to their parental genomic inheritance. We identified 25,703 Mendelian inheritance error single nucleotide polymorphisms in the mule genome that were not inherited from the parents through Mendelian inheritance. A total of 555 de novo single nucleotide polymorphisms were also identified. The rate of de novo single nucleotide polymorphisms was 2.21 × 10-7 in the mule from the Equus parent-offspring trio. This rate is obviously higher than the natural mutation rate for Equus, which is also consistent with the previous hypothesis that interracial crosses may have a high mutation rate. The genes associated with these single nucleotide polymorphisms are mainly involved in immune processes, DNA repair, and cancer processes. The results of the analysis of three genomes from an Equus parent-offspring trio improved our knowledge of the consequences of the integration of parental genomes in mules.

Interactions between unfolding/disassembling behaviors, proteolytic subfragments and reversible aggregation of oxidized skeletal myosin isoforms at different salt contents.

Myosin filament plays a critical role in water-trapping and thermodynamic regulation during processing of brined muscle foods. The redox state and availability of proteolytic/antioxidant enzymes affected by salt may change the ion-binding capacity of myosin consequently contributing to swelling and rehydration. Thus, this study investigated the impact of different salt content (0%, 1%, 2%, 3%, 4%, 5% NaCl) and oxidation in vitro (10 mM H2O2/ascorbate-based hydroxyl radical (OH)-generating system) on the oxidative stability, solubility/dispersion capacity, chymotrypsin digestibility, aggregation site and the microrheological properties of isolated porcine myosin. The result showed that, brining at 2% salt exposed more sulfhydryl groups and inhibited the formation of disulfide bond, whereby smaller dispersed structure (diameter within 10-50 nm) and higher Ca2+-ATPase activity of the denatured myosin were observed. Accordingly, gel electrophoresis showed that myosin S1 and HMM subunits were highly oxidized and susceptible to reversible assembles. Despite enhanced hydrophobic interactions between swelled myosin at 3% salt content, ≥4% salt greatly promoted the exposure/polarization of tryptophan and cross-linking structures, mainly occurring at myosin S2 portion. The results of micro-rheology proved that oxidized myosin formed a tighter heat-set network following rehydration at high ion strength (≥4% salt), suggesting an increased inter-droplet resistance and macroscopic viscosity. This work is expected to give some useful insights into improved texture and functionality of engineered muscle foods.

Advanced Lipidomics in the Modern Meat Industry: Quality Traceability, Processing Requirement, and Health Concerns.

Over the latest decade, lipidomics has been extensively developed to give robust strength to the qualitative and quantitative information of lipid molecules derived from physiological animal tissues and edible muscle foods. The main lipidomics analytical platforms include mass spectrometry (MS) and nuclear magnetic resonance (NMR), where MS-based approaches [e.g., "shotgun lipidomics," ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), matrix-assisted laser desorption and ionization time-of-flight mass spectrometry (MALDI-TOF-MS)] have been widely used due to their good sensitivity, high availability, and accuracy in identification/quantification of basal lipid profiles in complex biological point of view. However, each method has limitations for lipid-species [e.g., fatty acids, triglycerides (TGs), and phospholipids (PLs)] analysis, and necessitating the extension of effective chemometric-resolved modeling and novel bioinformatic strategies toward molecular insights into alterations in the metabolic pathway. This review summarized the latest research advances regarding the application of advanced lipidomics in muscle origin and meat processing. We concisely highlighted and presented how the biosynthesis and decomposition of muscle-derived lipid molecules can be tailored by intrinsic characteristics during meat production (i.e., muscle type, breed, feeding, and freshness). Meanwhile, the consequences of some crucial hurdle techniques from both thermal/non-thermal perspectives were also discussed, as well as the role of salting/fermentation behaviors in postmortem lipid biotransformation. Finally, we proposed the inter-relationship between potential/putative lipid biomarkers in representative physiological muscles and processed meats, their metabolism accessibility, general nutritional uptake, and potency on human health.

Exploring the Meaning in Life and the Influencing Factors among Patients Undergoing Hemodialysis in Macau.

Introduction: The meaning in life (ML) is a significant predictor of the physical and mental health of patients with chronic diseases, and its construct is culturally specific.As a group between normal people and the patients with advanced cancer, patients with End-Stage Kidney Disease (ESKD) who are undergoing hemodialysis (HD) are often outside of research focus on ML. Objectives: This study was to investigate the status of ML of patients on HD in Macau of China and to analyze the influence of social-demographic characteristics and disease-related factors on their ML. The study findings would inform the development of evidence-based interventions in nursing care for this patient population. Methods: This study employed a cross-sectional survey design. Eligible participants were recruited by convenient sampling from the largest HD center in Macau in January 2020. The participants' social-demographic and disease-related characteristics were collected, and their ML status was assessed by the Meaning in Life Scale for Hemodialysis Patients (MLSHP). SPSS 22.0 software was used to analyze the data. Results: Questionnaires were distributed to 249 potential participants who were patients on HD, and 238 patients replied to the questionnaires effectively. The effective response rate was 95.58% (238/249). The average score of ML for the patients was 93.75 ± 10.00, which was 72% of the total score of 130 on the ML scale. Gender, religious belief, duration of dialysis treatment, and symptom-related distress had impacts on ML levels (p < .05), with religious belief being a particularly strong predictor (p < .001). Conclusion: The level of ML for patients on HD in Macau is relatively high. Different demographic or disease-related factors impact participants' ML, supporting or contradicting previous studies. While the study findings are meaningful under the local cultural contexts, they have implications for nurses in other places to develop evidence-based interventions for patients on HD.

Antitumor Efficacy of EGFR-Targeted Recombinant Immunotoxin in Human Head and Neck Squamous Cell Carcinoma.

Over 90% of head and neck squamous cell carcinoma (HNSCC) overexpresses the epidermal growth factor receptor (EGFR). However, the EGFR-targeted monotherapy response rate only achieves 10-30% in HNSCC. Recombinant immunotoxin (RIT) often consists of an antibody targeting a tumor antigen and a toxin (e.g., diphtheria toxin [DT]) that kills cancer cells. We produced a humanized RIT, designated as hDT806, targeting overexpressed EGFR and investigated its effects in HNSCC. Distinct from the EGFR-targeted tyrosine kinase inhibitor erlotinib or antibody cetuximab, hDT806 effectively suppressed cell proliferation in the four HNSCC lines tested (JHU-011, -013, -022, and -029). In JHU-029 mouse xenograft models, hDT806 substantially reduced tumor growth. hDT806 decreased EGFR protein levels and disrupted the EGFR signaling downstream effectors, including MAPK/ERK1/2 and AKT, while increased proapoptotic proteins, such as p53, caspase-9, caspase-3, and the cleaved PAPR. The hDT806-induced apoptosis of HNSCC cells was corroborated by flow cytometric analysis. Furthermore, hDT806 resulted in a drastic inhibition in RNA polymerase II carboxy-terminal domain phosphorylation critical for transcription and a significant increase in the γH2A.X level, a DNA damage marker. Thus, the direct disruption of EGFR signaling, transcription inhibition, DNA damage, as well as apoptosis induced by hDT806 may contribute to its antitumor efficacy in HNSCC.

[Field investigation of standardized construction of intensive care unit in county-level public hospitals in Dizhou City, Guizhou Province].

OBJECTIVE: To investigate the standardized construction of critical care departments in different cities and counties of Guizhou province to promote the homogenization development of critical care medicine in Guizhou Province. METHODS: Using research methods such as field investigation and data collection, the public hospitals of 88 counties and urban areas in 9 prefectures and cities of Guizhou province were divided into five routes: southeast, northeast, northwest, southwest, and Guiyang. To design the survey form for the standardized construction of ICU, the e-form was sent to the director of ICU or his/her designated personnel by email or wechat 2-3 days in advance. Check the authenticity of data item by item on site, and leave the hospital after checking the receipt form. RESULTS: From April to July 2021, the survey and research data collection was completed for 146 public hospitals (excluding provincial hospitals) with intensive care departments in 88 counties and cities of 9 dizhou cities in Guizhou Province, including 24 Grade-III Level A hospitals. 122 Grade-II and above hospitals (including 8 Grade-III Level B hospitals, 11 Grade-III comprehensive hospitals, 97 Level-II A hospitals, 3 Level-II B hospitals, and 3 Level-II comprehensive hospitals). 146 public hospitals have a total of 80 983 beds and 104 017 open beds. The department of Critical Care has 2 035 beds. The ratio of actual beds in ICU to total beds in hospital was 2.51%. From 1999 to 2010, 18 (12.33%) established departments, and from 2011 to 2021, 128 (87.67%) established departments. The total area of the discipline is 113 355.48 m2, with an average bed area of 55.70 m2. There were 97 hospitals with 1.5-2.0 m bed spacing, accounting for 66.44%, and 49 hospitals with 2.1- > 2.5 m spacing, accounting for 33.56%. The number of negative pressure wards: 1 in each of 43 hospitals, accounting for 29.45%; 103 hospitals did not have, accounting for 70.55%. The number of single rooms: 288 in 140 hospitals, accounting for 95.89%; 6 hospitals did not have, accounting for 4.11%. Central oxygen supply: 138 hospitals have (94.52%); 8 hospitals did not have, accounting for 5.48%. Natural ventilation: in 129 hospitals with 88.36%; 17 hospitals did not have, accounting for 11.64%. Specialized ICU construction: 66 hospitals, accounting for 45.21%; none in 80 hospitals, accounting for 54.79%. There are 3 712 doctors and nurses in 146 public hospitals. The total number of doctors was 1 041, and the ratio of doctors to beds was 0.51:1. The total number of nurses was 2 675, and the ratio of nurses to beds was 1.31:1. CONCLUSIONS: All 88 counties and districts in 9 prefectures and cities of Guizhou province have established intensive care medicine departments. The standardization of the discipline construction has been significantly improved. Lack of talents is still an important factor restricting the rapid development of the discipline.

[A special type of blood pressure reduction: a case of carbon dioxide ejection syndrome].

Carbon dioxide (CO2) ejection syndrome is common after artificial pneumoperitoneum, and it often attracts the attention of anesthesiologists because of its rapid changes in vital signs. CO2 ejection syndrome is not uncommon in critically ill patients, and may occur after mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). There are few relevant reports about CO2 ejection syndrome, and a considerable number of clinicians have little understanding of the pathological changes. A case of AECOPD patient with CO2 ejection syndrome after endotracheal intubation was admitted to the intensive care unit (ICU) of the Affiliated Hospital of Guizhou Medical University. After treatment, such as fluid expansion, vasoactive drugs and ventilator assistance, the patient's condition improved and was transferred out of the ICU. It is expected to provide some references by summarizing the diagnosis and treatment of this case and reviewing relevant literature reports.

Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study.

Background: Noninvasive ventilation (NIV) has been reported to be beneficial for patients with acute respiratory failure in intensive care unit (ICU); however, factors that influence the clinical outcome of NIV were unclarified. We aim to determine the factors that predict the failure of NIV in critically ill patients with acute respiratory failure (ARF). Setting. Adult mixed ICU in a medical university affiliated hospital. Patients and Methods. A retrospective clinical study using data from critical adult patients with initial NIV admitted to ICU in the period August 2016 to November 2017. Failure of NIV was regarded as patients needing invasive ventilation. Logistic regression was employed to determine the risk factor(s) for NIV, and a predictive model for NIV outcome was set up using risk factors. Results: Of 101 included patients, 50 were unsuccessful. Although more than 20 variables were associated with NIV failure, multivariate logistic regression demonstrated that only ideal body weight (IBW) (OR 1.110 (95%1.027-1.201), P=0.009), the maximal heart rate during NIV period (HR-MAX) (OR 1.024 (1.004-1.046), P=0.021), the minimal respiratory rate during NIV period (RR-MIN) (OR 1.198(1.051-1.365), P=0.007), and the highest body temperature during NIV period (T-MAX) (OR 1.838(1.038-3.252), P=0.037) were independent risk factors for NIV failure. We set up a predictive model based on these independent risk factors, whose area under the receiver operating characteristic curve (AUROC) was 0.783 (95% CI: 0.676-0.899, P < 0.001), and the sensitivity and specificity of model were 68.75% and 71.43%, respectively, with the optimal cut-off value of 0.4863. Conclusion: IBW, HR-MAX, RR-MIN, and T-MAX were associated with NIV failure in patients with ARF. A predictive model based on the risk factors could help to discriminate patients who are vulnerable to NIV failure.

[Discussion on the undergraduate education mode of critical care medicine majoring in clinical medicine].

OBJECTIVE: To discuss the feasibility of offering specialized courses of critical care medicine in undergraduate clinical medicine education, so as to alleviate the shortage of critical care medicine staffs and lay a foundation for improving the success rate for the treatment of critical cases. METHODS: The undergraduates majoring in clinical medicine from 2008 to 2011 in Guizhou Medical University (the former Guiyang Medical College) were enrolled. After they had been enrolled in the undergraduate education for 3 years and were ready for Grade four, which meant basic medicine teaching had been completed and clinical medicine teaching was about to start, they were introduced and preached to each discipline, including critical care medicine. The undergraduates were free to choose professional direction of clinical training in Grade four. Students majoring in clinical medicine from 2012 to 2014 were free to choose their major direction when they entered the school. RESULTS: From September 2011 to July 2019, the university had cultivated 246 undergraduates majoring in clinical critical care medicine from 2008 to 2014, and the critical care medicine professional team of affiliated hospital had undertaken 540 teaching hours. By July 2019, all students had graduated on time, with an employment rate of 100%. Forty students took postgraduate programs in our school and other schools, accounting for 16.3%. CONCLUSIONS: Professional education of critical care medicine in the undergraduate course of clinical medicine can mobilize students' interest in learning and subjective initiative, which is conducive to career selection. During the clinical training, the students can identify and timely cure critical care cases in the early stage, and partly alleviate the current shortage of critical care medical staffs.

[Analysis of prognostic risk factors of bloodstream infection in intensive care unit patients].

OBJECTIVE: To explore the prognostic risk factors of bloodstream infection (BSI) in intensive care unit (ICU) patients, furthermore, to provide a reliable evidence for early warning and treatment for the critical patients with BSI. METHODS: A retrospective study was performed. The clinical data of patients with blood culture-positive admitted to ICU of the Affiliated Hospital of Guizhou Medical University from January 1 to September 30, 2019 were analyzed. The data including gender, age, proportion of basic diseases, acute physiology and chronic health evaluation II (APACHE II), the duration of mechanical ventilation after being diagnosed with BSI, length of stay in ICU, aggressive operation and blood product infusion after BSI, proportion of using continuous renal replacement therapy (CRRT) and continuous vasoactive agents for more than 72 hours after being diagnosed with BSI, and site of central venous catheterization were recorded. Meantime, the worst laboratory values within 72 hours after being diagnosed with BSI, information about pathogenic microorganism categories and distributions were collected and analyzed. The patients were divided into survival and death groups based on the the 28-day prognosis, and the differences of clinical data between the two groups were compared. Logistic regression analysis was used to select the independent prognostic risk factors of BSI. RESULTS: One hundred and fifty-four patients with positive results of BSI were enrolled, and the 156 strains of bacteria were detected, including 75 Gram positive (G+) bacteria strains, 70 Gram negative (G-) bacteria strains and 11 fungi strains among those BSI patients. The top five pathogenic microorganisms were Coagulase negative staphylococcus (35.9%), Klebsiella pneumonia (12.8%), Acinetobacter baumannii (9.0%), Enterococci (9.0%), and Escherichia coli (8.3%). There were 45 strains (60.0%) of multidrug-resistant strains in G+ bacteria and 40 strains of multidrug-resistant strains (57.1%) in G- bacterial strains, but in fungi there was only 1 strain (9.1%). There were 81 cases in survival group and 73 cases in death group according to 28-day prognosis. We found that there were no significant differences between the comparators in age, lenth of stay in ICU, duration for mechanical ventilation after being diagnosed with BSI, percentage of BSI with chronic obstructive pulmonary disease (COPD), hypertension, cardiovascular disease or chronic kidney dysfunction (all P > 0.05). In death group, the proportion of male was obviously lower than that of survival group [58.9% (43/73) vs. 75.3% (61/81), P < 0.05] and APACHE II score was significantly higher than that in survival group (27.1±7.0 vs. 19.5±6.7, P < 0.05). The mean arterial pressure (MAP) of death group on first 3 days of BSI was significantly lower than that of survival group [mmHg (1 mmHg = 0.133 kPa): 72.8±13.6 vs. 79.7±12.9, P < 0.05), in the death group, the proportion of patients complicated with diabetes, cancer [28.8% (29/73) vs. 12.3% (10/81), 19.2% (14/73) vs. 7.4% (6/81)], post-BSI CRRT and blood transfusion [39.7% (29/73) vs. 16.0% (13/81), 64.4% (47/73) vs. 46.9% (38/81)], and continuous use of asoactie drugs for ≥ 72 hours [37.0% (27/73) vs. 12.3% (10/81)] were significantly higher than those in the survival group (all P < 0.05). In death group, platelet count (PLT) was significantly decreased than that of survival group [×109/L: 124.93±98.21 vs. 181.15±116.39,P < 0.05], aspartate aminotransferase (AST) level was significantly higher than that of survival group [U/L: 75.40 (38.50, 140.95) vs. 56.20 (29.20, 85.70), P < 0.05], the rest of the laboratory indexes had no statistically significant differences between the two groups (all P > 0.05). The results of Logistic regression analysis showed that the APACHE II score [odds ratio (OR) = 1.279, 95% confidence interval (95%CI) was 1.158 to 1.412, P < 0.001], CRRT after BSI (OR = 3.522, 95%CI was 1.013 to 12.245, P = 0.048) were independent risk factors affecting the prognosis of patients with BSI, and MAP is a protective factor for prognosis (OR = 0.961, 95%CI was 0.927 to 0.996, P = 0.031). CONCLUSIONS: In our ICU, G+ bacteria are still dominant in bloodstream infection, G- bacteria take the second place. Besides, APACHE II score and CRRT after being diagnosed with BSI are the independent prognostic risk factors.

[Analysis of prognosis risk factors of critically ill patients after cardiac surgery: a consecutive 5-year retrospective study].

OBJECTIVE: To explore the risk factors affecting prognosis of critically ill patients following cardiac surgery, furthermore, to assess severity and keep alarm earlier. METHODS: A retrospective study was conducted. The clinical data of critically ill patients following cardiac surgery admitted to intensive care unit (ICU) of the Affiliated Hospital of Guizhou Medical University from January 1st 2014 to December 31st 2018 were enrolled. The clinical characteristics, acute physiology and chronic health evaluation II (APACHE II) and the worst laboratory examination within 24 hours after ICU admission, and the duration of mechanical ventilation, length of ICU stay, using continuous renal replacement therapy (CRRT), accepting vasoactive agents such as norepinephrine, dopamine or dobutamine and blood products such as red blood cells, plasma or platelets were recorded. The patients were divided into survival group and dead group based on discharge prognosis, and the difference in clinical data between the two groups was compared. Binary multivariate Logistic regression analysis was used to screen the risk factors affecting the prognosis of critically ill patients following cardiac surgery, and the receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of these risk factors. RESULTS: In total, 97 patients after cardiac operation were admitted to ICU during the five years. Thirty-two patients were excluded owing to age less than 16 years old, no more than 24 hours of the length of ICU stay, without the outcomes of myocardium enzymes or myocardium markers within the first 24 hours or admitted only for pacemaker. Finally, 65 patients met the criteria, with 40 survived and 25 died. Compared with survival group, APACHE II scores, the level of serum uric acid, serum creatinine (SCr), cardiac troponin T (cTnT), brain natriuretic peptide (BNP), procalcitonin (PCT) and the rate of patients accepting CRRT, vasoactive agents and blood products in dead group were significantly increased with significant differences; however, there was no statistically difference in gender, age, body weight index (BMI), distribution of types of cardiac surgery, ratio of patients suffered from hypertension and diabetes, mean arterial pressure (MAP), white blood cell (WBC), coagulation, length of ICU stay, or duration of mechanical ventilation between the two groups. Binary multivariate Logistic regression analysis showed that APACHE II scores [odds ratio (OR) = 1.123, 95% confidence interval (95%CI) = 1.004-1.257, P = 0.043] and cTnT (OR = 1.496, 95%CI = 1.038-2.158, P = 0.031) were the independent risk factors for prognosis of critical ill patients following cardiac surgery. ROC curve analysis showed that APACHE II score and cTnT had predictive value for prognosis of critical ill patients following cardiac surgery, the best was exerted when APACHE II score combined with cTnT, the area under the ROC curve (AUC) was 0.839, the joint prediction probability was 0.42, the sensitivity was 80.0%, and the specificity was 64.0%. CONCLUSIONS: APACHE II score and cTnT may be one of independent risk factors for prognosis of critical ill patients following cardiac surgery, and there will be far more greater predictive value when APACHE II score combined with cTnT.

[Development and construction mode of critical care medicine: 22 years of development and construction of intensive care units of Guizhou Medical University].

OBJECTIVE: To provide decision-making basis for promoting the rapid and healthy development of critical care medicine/intensive care unit (ICU) through discussing the mode of development and construction of the department of ICU. METHODS: The situations of ICU of Affiliated Hospital of Guizhou Medical University from July 1994 to December 2016 were analyzed and summed up. Data of the situations in different development stages included the location and area of the ward, the number of beds, the number of physicians and nurses, the structure of academic titles and educational levels, the number of patients admitted to ICU per year, the proportion of patients used ventilator per year, the mortality, the mode of the discipline management, the number of medical postgraduates and undergraduates trained in the ICU, the number of teaching hours, the achievements, the number of research projects, the number of published monographs and papers, the number of the multicenter trials that we participated in, the construction of the team, the personal honor, and so on. RESULTS: From 1994 to 2016, the department of ICU had three development stages: the initial development stage of the discipline (from July 1994 to March 2005), the standardization development stage of the discipline (from April 2005 to December 2015), the acceleration development stage of the discipline (from December 2015 to December 2016). The scale of the department expanded from an open unit with 6 beds which was shared with the department of cardiothoracic surgery to 6 enclosed units with 90 beds which were managed independently by the intensivists. The area of the department increased from less than 300 m2 to more than 7 000 m2. There were 46 beds in the mixed ICU, which covered an area of 4 210 m2. There was only one physician in 1994 while the number of the physicians increased to 19 in 2016. The number of nurses increased from 4 in 1994 to 69 in 2016. The proportion of highly educated talents significantly increased. Furthermore, from 1994 to 2016, the number of beds increased from 6 to 46; the number of patients admitted to ICU per year increased from 138 to 1 080; and the number of patients used ventilator increased from 24 to 1 057. The mean acute physiology and chronic health evaluation II (APACHE II) score was > 24.0 at admission, while < 12.6 at discharge. From 1997 to 2016, a total of 79 postgraduates had studied in the department, and 390 teaching hours we had undertaken. From 2011 to 2016, a total of 250 undergraduates had studied in the department, and 540 teaching hours we had undertaken. From 1994 to 2016, 8 achievements were obtained, 22 projects were undertook, 4 monographs were published, 6 books were edited that the physicians in the ICU as key editors, 104 papers were published, and 8 national multicenter trials that the physicians in the ICU were as key participants, and multiple team and individual honors were obtained. CONCLUSIONS: The construction of ICU hardware is the basis and prerequisite for the development of the discipline and the construction of ICU software is the soul and motivation of the discipline. The operation indexes of clinical medical treatment, teaching and scientific researches reflect the overall operation status of the discipline and the hospital.

Recombinant Immunotoxin Therapy of Glioblastoma: Smart Design, Key Findings, and Specific Challenges.

Recombinant immunotoxins (RITs) refer to a group of recombinant protein-based therapeutics, which consists of two components: an antibody variable fragment or a specific ligand that allows RITs to bind specifically to target cells and an engineered toxin fragment that kills the target cells upon internalization. To date, over 1,000 RITs have been generated and significant success has been achieved in the therapy of hematological malignancies. However, the immunogenicity and off-target toxicities of RITs remain as significant barriers for their application to solid tumor therapy. A group of RITs have also been generated for the treatment of glioblastoma multiforme, and some have demonstrated evidence of tumor response and an acceptable profile of toxicity and safety in early clinical trials. Different from other solid tumors, how to efficiently deliver the RITs to intracranial tumors is more critical and needs to be solved urgently. In this article, we first review the design and expression of RITs, then summarize the key findings in the preclinical and clinical development of RIT therapy of glioblastoma multiforme, and lastly discuss the specific issues that still remain to forward RIT therapy to clinical practice.

[Application of quality control chart in quality control for nosocomial infection in intensive care unit].

OBJECTIVE: To explore the application value of control chart in the management of nosocomial infection in intensive care unit (ICU) by using quality control chart to monitor the infections in ICU. METHODS: From October 2011 to June 2016, ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI), namely the three catheters, occurred in ICU of the Affiliated Hospital of Guizhou Medical University were monitored and recorded monthly, then the data was imput into the Excel, and the data was analyzed using SPSS. According to the properties of the data, control chart was derived for monitoring nosocomial infections, finding out problems and for taking actions on time. RESULTS: From October 2011 to June 2016, the numbers of new patients in ICU were 23-103 cases per month and the median was 45.00 (39.00, 55.50) cases per month. The numbers of new VAP patients were 0-7 cases per month which median was 3.00 (1.00, 4.00) cases per month and the VAP rates were 0-22.58 cases per 1 000 ventilation-days which median was 8.62 (3.28, 12.10) cases per 1 000 ventilation-days. The numbers of new CLABSI patients were 0-3 cases per month which median was 0.00 (0.00, 1.00) cases per month and the CLABSI rates were 0-14.82 cases per 1 000 catheter-days which median was 0.00 (0.00, 5.38) cases per 1 000 catheter-days. The numbers of new CAUTI patients were 0-8 cases per month which median was 1.00 (0.00, 2.00) cases per month and the CAUTI rates were 0-14.06 cases per 1 000 catheter-days which median was 3.02 (0.00, 5.86) cases per 1 000 catheter-days. 57 points of the three catheter-associated infections incidences were continuously monitored monthly, in which some data points overstepped the warning limit, only 1 CAUTI infection incidence overstepped the control limit, the other monthly three catheter-associated infections incidences were in the control range and had no abnormal arrangement occurred, so all of them were in a controlled state. By using the control chart, the situation of nosocomial infections were analyzed scientifically and intuitively, the existing problems were discussed in time, the improvement programs were made, and the three catheter-associated infections were in a controlled state. CONCLUSIONS: Control chart has the characteristics of simple operation, intuitive results, and finding problems on time, so it can be used in daily monitoring of nosocomial infection and is worthy of generalization.

A bivalent recombinant immunotoxin with high potency against tumors with EGFR and EGFRvIII expression.

EGFR and EGFRvIII are overexpressed in various types of cancer, serving as optimal targets for cancer therapy. Capitalizing on the high specificity of humanized antibody 806 (mAb806) to the EGFR and EGFRvIII overexpressed in cancer, we designed and generated a bivalent recombinant immunotoxin (RIT, DT390-BiscFv806) by fusing the mAb806-derived bivalent single-chain variable fragment with a diphtheria toxin fragment, DT390. In vitro, DT390-BiscFv806 efficiently internalized into the cells and exhibited high cytotoxicity against the U87 glioblastoma cells and the EGFRvIII-transfected U87 (U87-EGFRvIII) cells with a half maximal inhibition concentration (IC50) of 1.47 nM and 2.26 × 10(-4) nM, respectively. Notably, DT390-BiscFv806 was 4 orders of magnitude more potent against the U87-EGFRvIII cells than against the parent U87 cells. The cytotoxicity against a group of 6 head and neck squamous cell carcinoma cell lines were further analyzed, showing an IC50 ranging from 0.24 nM to 156 nM, depending on the expression level of EGFR/EGFRvIII. In animals, the U87-EGFRvIII tumor xenografts grew extremely faster than the parental U87, and systemic administration of DT390-BiscFv806 significantly inhibited the growth of established U87-EGFRvIII and U87 tumor xenografts, showing a growth inhibition rate of 76.3% (59.82-96.2%) and 59.4% (31.5-76.0%), respectively. In pathology, the RIT-treated tumors exhibited a low mitotic activity and a large number of degenerative tumor cells, compared with the control tumors. The results indicate that DT390-BiscFv806 is promising for treatment of various types of cancer, especially for those with high EGFR expression or with EGFR and EGFRvIII co-expression.