Development and validation of a clinical prediction model for prognostic factors in patients with primary pontine hemorrhage.

We aimed to develop a prognostic model for primary pontine hemorrhage (PPH) patients and validate the predictive value of the model for a good prognosis at 90 days. A total of 254 PPH patients were included for screening of the independent predictors of prognosis, and data were analyzed by univariate and multivariable logistic regression tests. The cases were then divided into training cohort (n=219) and validation cohort (n=35) based on the two centers. A nomogram was developed using independent predictors from the training cohort to predict the 90-day good outcome and was validated from the validation cohort. Glasgow Coma Scale score, normalized pixels (used to describe bleeding volume), and mechanical ventilation were significant predictors of a good outcome of PPH at 90 days in the training cohort (all P<0.05). The U test showed no statistical difference (P=0.892) between the training cohort and the validation cohort, suggesting the model fitted well. The new model showed good discrimination (area under the curve=0.833). The decision curve analysis of the nomogram of the training cohort indicated a great net benefit. The PPH nomogram comprising the Glasgow Coma Scale score, normalized pixels, and mechanical ventilation may facilitate predicting a 90-day good outcome.

Development and validation of a clinical prediction model for prognostic factors in patients with primary pontine hemorrhage

Abstract We aimed to develop a prognostic model for primary pontine hemorrhage (PPH) patients and validate the predictive value of the model for a good prognosis at 90 days. A total of 254 PPH patients were included for screening of the independent predictors of prognosis, and data were analyzed by univariate and multivariable logistic regression tests. The cases were then divided into training cohort (n=219) and validation cohort (n=35) based on the two centers. A nomogram was developed using independent predictors from the training cohort to predict the 90-day good outcome and was validated from the validation cohort. Glasgow Coma Scale score, normalized pixels (used to describe bleeding volume), and mechanical ventilation were significant predictors of a good outcome of PPH at 90 days in the training cohort (all P<0.05). The U test showed no statistical difference (P=0.892) between the training cohort and the validation cohort, suggesting the model fitted well. The new model showed good discrimination (area under the curve=0.833). The decision curve analysis of the nomogram of the training cohort indicated a great net benefit. The PPH nomogram comprising the Glasgow Coma Scale score, normalized pixels, and mechanical ventilation may facilitate predicting a 90-day good outcome.

The role and clinical significance of microRNA-29a-3p in the development of hypopharyngeal carcinoma

Abstract Objective MicroRNA-29a-3p has been reported in a variety of cancers, but its role in hypopharyngeal cancer remains unclear. This study was to determine the role of microRNA-29a-3p in the occurrence and development of hypopharyngeal cancer. Methods 40 patients with hypopharyngeal cancer who underwent surgery in the Affiliated Hospital of Jining Medical University from April 2013 to November 2017 were selected for this study. The cancer tissue samples of the patients were collected, and the patients were followed up for three years. The expression of microRNA-29a-3p in tissue samples was detected by in situ hybridization with fluorescent probe, and the relationships among microRNA-29a-3p and clinicopathological factors, postoperative recurrent-metastasis, survival time were studied. Immunohistochemical was used to detect the expression of Ki67 and E-cadherin in tissue samples. Results Combined with HE staining results showed that microRNA-29a-3p expression was relatively high in non-cancer tissue cells (red blood cells and fibroblasts in tumor interstitial vessels), but was relatively low in cancer tissue and cells. According to the follow-up data of 40 patients with hypopharyngeal cancer, tumor size, T-stage, tumor differentiation, postoperative recurrent-metastasis of hypopharyngeal cancer patients were significantly negatively correlated with microRNA-29a-3p (p< 0.05). Immunohistochemica results further confirmed that microRNA-29a-3p was negatively correlated with the expression of Ki67 and E-cadherin. The survival time of patients positively related with microRNA-29a-3p expression (p< 0.05). Moreover, ROC curve analysis showed that the area under the curve of the combined detection of miRNA-29a-3p+Ki67+E-cadherin was larger than that of the single detection of the three indexes. Conclusions The expression of microRNA-29a-3p is closely related to the occurrence, development and prognosis of hypopharyngeal cancer, and it affects the proliferation and invasion. This indicates that microRNA-29a-3p serves as a therapeutic target for the occurrence and development of hypopharyngeal cancer. The evidence of study designs of this study is IV using "Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence".

The role and clinical significance of microRNA-29a-3p in the development of hypopharyngeal carcinoma.

OBJECTIVE: MicroRNA-29a-3p has been reported in a variety of cancers, but its role in hypopharyngeal cancer remains unclear. This study was to determine the role of microRNA-29a-3p in the occurrence and development of hypopharyngeal cancer. METHODS: 40 patients with hypopharyngeal cancer who underwent surgery in the Affiliated Hospital of Jining Medical University from April 2013 to November 2017 were selected for this study. The cancer tissue samples of the patients were collected, and the patients were followed up for three years. The expression of microRNA-29a-3p in tissue samples was detected by in situ hybridization with fluorescent probe, and the relationships among microRNA-29a-3p and clinicopathological factors, postoperative recurrent-metastasis, survival time were studied. Immunohistochemical was used to detect the expression of Ki67 and E-cadherin in tissue samples. RESULTS: Combined with HE staining results showed that microRNA-29a-3p expression was relatively high in non-cancer tissue cells (red blood cells and fibroblasts in tumor interstitial vessels), but was relatively low in cancer tissue and cells. According to the follow-up data of 40 patients with hypopharyngeal cancer, tumor size, T-stage, tumor differentiation, postoperative recurrent-metastasis of hypopharyngeal cancer patients were significantly negatively correlated with microRNA-29a-3p (p < 0.05). Immunohistochemica results further confirmed that microRNA-29a-3p was negatively correlated with the expression of Ki67 and E-cadherin. The survival time of patients positively related with microRNA-29a-3p expression (p < 0.05). Moreover, ROC curve analysis showed that the area under the curve of the combined detection of miRNA-29a-3p+Ki67+E-cadherin was larger than that of the single detection of the three indexes. CONCLUSIONS: The expression of microRNA-29a-3p is closely related to the occurrence, development and prognosis of hypopharyngeal cancer, and it affects the proliferation and invasion. This indicates that microRNA-29a-3p serves as a therapeutic target for the occurrence and development of hypopharyngeal cancer. The evidence of study designs of this study is IV using "Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence".

Impact of posture and recovery methods on sports injuries / Impacto da postura no esporte e métodos de recuperação nas lesões esportivas / Impacto de la postura y métodos de recuperación en las lesiones deportivas

ABSTRACT Introduction Exercise methods with incorrect posture or inadequate repetitive movements may cause irreversible long-term body damage. There is a growing interest in ergonomics in martial arts, but taekwondo lacks studies. Objective Evaluate the postural ergonomics impact on injuries and rehabilitation in taekwondo athletes. Methods 13 taekwondo team members from a sports academy had their posture and injury characteristics evaluated. Research methods, experimental and mathematical statistics investigated the athletes' postural and body diagnosis, confronting the information with their injury history, pain, and injury duration. Results Nine athletes suffered injuries and pain in the pelvic girdle and ankle joints; the odds are 69.23%, pelvic girdle and ankle joints have the highest frequency of injuries, followed by knee injuries (46.15%), and foot joints (30.77%). Injuries to the thigh, wrist, and shoulder joints were detected in 23.08% of athletes. Conclusions The results of this study indicate postural dysfunctions can be corrected with motor function evaluation and early rehabilitation based on ergonomic sports posture. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução Métodos de exercício com postura incorreta ou movimentos repetitivos inadequados podem causar danos corporais irreversíveis à longo prazo. Há um crescente interesse sobre a ergonomia nas artes marciais porém o taekwondo carece de estudos. Objetivo Avaliar o impacto da ergonomia postural nas lesões e a reabilitação em atletas de taekwondo. Métodos 13 membros da equipe de taekwondo de uma academia esportiva tiveram suas posturas e características de lesão avaliadas. Usando método de pesquisa, experimental e estatística matemática, investigou-se os dados de diagnóstico postural e corporal dos esportistas confrontando as informações com o histórico de lesões, dor e tempo de lesão. Resultados Há 9 atletas que sofreram lesões e dores na cintura pélvica e articulações do tornozelo, as probabilidades são de 69,23%, as articulações da cintura pélvica e do tornozelo têm a maior frequência de lesões; seguida por lesões no joelho (46,15%), e as articulações dos pés (30,77%). Lesões nas coxas, articulações do pulso e ombros foram detectadas em 23,08% esportistas. Conclusões Os resultados deste estudo mostram que as disfunções posturais podem ser corrigidas com avaliação da função motora e a reabilitação precoce baseados na postura ergonômica do esporte. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción Los métodos de ejercicio con posturas incorrectas o movimientos repetitivos inadecuados pueden causar daños corporales irreversibles a largo plazo. Existe un creciente interés por la ergonomía en las artes marciales, pero el taekwondo carece de estudios. Objetivo Evaluar el impacto de la ergonomía postural en las lesiones y en la rehabilitación de los atletas de taekwondo. Métodos Se evaluaron las posturas y las características de las lesiones de 13 miembros del equipo de taekwondo de una academia deportiva. Utilizando el método de investigación, experimental y estadística matemática, se investigaron los datos de diagnóstico postural y corporal de los atletas, confrontando la información con su historial de lesiones, el dolor y el tiempo de lesión. Resultados Hay 9 atletas que sufrieron lesiones y dolor en las articulaciones de la cintura pélvica y el tobillo, las probabilidades son del 69,23%, las articulaciones de la cintura pélvica y el tobillo tienen la mayor frecuencia de lesiones; seguidas de las lesiones de rodilla (46,15%), y las articulaciones del pie (30,77%). Se detectaron lesiones en las articulaciones del muslo, la muñeca y el hombro en el 23,08% de los atletas. Conclusiones Los resultados de este estudio muestran que las disfunciones posturales pueden corregirse con la evaluación de la función motora y la rehabilitación temprana basada en la postura deportiva ergonómica. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Role of Lipids in Phosphine Resistant Stored-Grain Insect Pests Tribolium castaneum and Rhyzopertha dominica.

Insects rely on lipids as an energy source to perform various activities, such as growth, flight, diapause, and metamorphosis. This study evaluated the role of lipids in phosphine resistance by stored-grain insects. Phosphine resistant and susceptible strains of the two main stored-grain insects, Tribolium castaneum and Rhyzopertha dominica, were analyzed using liquid chromatography-mass spectroscopy (LC-MS) to determine their lipid contents. Phosphine resistant strains of both species had a higher amount of lipids than susceptible stains. Significant variance ratios between the resistant and susceptible strains of T. castaneum were observed for glycerolipids (1.13- to 53.10-fold) and phospholipids (1.05- to 20.00-fold). Significant variance ratios between the resistant and susceptible strains of R. dominica for glycerolipids were 1.04- to 31.50-fold and for phospholipids were 1.04- to 10.10-fold. Glycerolipids are reservoirs to face the long-term energy shortage. Phospholipids act as a barrier to isolate the cells from the surrounding environment and allow each cell to perform its specific function. Thus, lipids offer a consistent energy source for the resistant insect to survive under the stress of phosphine fumigation and provide a suitable environment to protect the mitochondria from phosphine. Hence, it was proposed through this study that the lipid content of phosphine-resistant and phosphine-susceptible strains of T. castaneum and R. dominica could play an important role in the resistance of phosphine.

Physical changes in taekwondo athletes caused by strengthening the core / Alterações físicas nos atletas de taekwondo provocadas pelo fortalecimento do core / Cambios físicos en los atletas de taekwondo causados por el fortalecimiento del core

ABSTRACT Introduction: Taekwondo is a complete sport with combative nature among related sports. Their athletes need a higher strike force in the legs and a body with relatively high sensitivity and stability. The center of force production, from which all movements originate, is called the core. Objective: The purpose of this study is to analyze possible physical changes in Taekwondo athletes caused by strengthening the core. Methods: Baseline data from core training was recorded using various scientific analysis methods. Rigorous methods of comparison were also employed. The six indices of athletic ability were tested in experimental and control groups in Taekwondo athletes. Results: The data in the athletes' strength and exercise styles before and after core strengthening showed significant differences. Conclusion: Strengthening the core of athletes can rapidly improve the development of physical strength. Core strengthening is an effective procedure for improving strength training in Taekwondo athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O Taekwondo é o esporte mais completo com natureza combativa entre os esportes relacionados. Seus atletas precisam ter maior força de ataque nas pernas e um corpo com sensibilidade e estabilidade relativamente altas. O centro de produção de força, de onde se originam todos os movimentos é chamado de core. Objetivo: O objetivo deste estudo é analisar as possíveis alterações físicas nos atletas de Taekwondo provocadas pelo fortalecimento do core. Métodos: Dados basais do treinamento no core foram registrados usando uma variedade de métodos de análise científica. Foram empregados também, rigorosos métodos de comparação. Os 6 índices de capacidade atlética foram testados em grupos experimentais e de controle nos atletas de Taekwondo. Resultados: Os dados na força dos atletas e nos estilos de exercício antes e depois do fortalecimento do core mostraram grandes diferenças. Conclusão: O fortalecimento no core dos atletas pode melhorar rapidamente o desenvolvimento da força física. O fortalecimento do core mostrou-se um procedimento eficaz de melhora no treinamento de força nos atletas de Taekwondo. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El taekwondo es el deporte de naturaleza combativa más completo entre los deportes relacionados. Sus atletas necesitan tener una mayor fuerza de ataque en las piernas y un cuerpo con una sensibilidad y estabilidad relativamente altas. El centro de producción de la fuerza, desde donde se originan todos los movimientos, se llama core. Objetivo: El propósito de este estudio es analizar los posibles cambios físicos en los atletas de Taekwondo causados por el fortalecimiento del core. Métodos: Se registraron los datos de referencia del entrenamiento básico utilizando diversos métodos de análisis científico. También se emplearon métodos rigurosos de comparación. Los 6 índices de capacidad atlética se probaron en grupos experimentales y de control en atletas de Taekwondo. Resultados: Los datos en la fuerza de los atletas y en los estilos de ejercicio antes y después del fortalecimiento del core mostraron grandes diferencias. Conclusión: El fortalecimiento del core de los atletas podría mejorar rápidamente el desarrollo de la fuerza física. Se ha demostrado que el fortalecimiento del core es un procedimiento eficaz para mejorar el entrenamiento de la fuerza en los atletas de taekwondo. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Associação da hipertensão com a gravidade e a mortalidade de pacientes hospitalizados com COVID-19 em Wuhan, China: Estudo unicêntrico e retrospectivo / Association of hypertension with severity and mortality in hospitalized patients with COVID-19 in wuhan, China: A single-centered, retrospective study

Resumo Fundamento A doença Coronavírus 2019 (COVID-19), causada pela síndrome respiratória aguda grave Coronavírus 2 (SARS-CoV-2), espalhou-se pelo mundo. Objetivo Investigar a associação entre a hipertensão e a gravidade/mortalidade de pacientes hospitalizados com COVID-19 em Wuhan, China. Métodos Um total de 337 pacientes diagnosticados com COVID-19 no Sétimo Hospital da cidade de Wuhan, de 20 de janeiro a 25 de fevereiro de 2020, foram inseridos e analisados em um estudo de caso unicêntrico e retrospectivo. O nível de significância adotado para a análise estatística foi 0,05. Resultados Dos 337 pacientes com diagnóstico confirmado de COVID-19, 297 (87.8%) tiveram alta do hospital e 40 pacientes (22,9%) morreram. A idade média foi de 58 anos (variando de 18 a 91 anos). Havia 112 (33,2%) pacientes diagnosticados com hipertensão no momento da internação (idade média, 65,0 anos [variação, 38-91 anos]; sendo 67 homens [59,8%, IC95%: 50,6%-69,0%], p=0,0209). Pacientes com hipertensão apresentaram uma porção significativamente maior de casos graves (69 [61,6%, IC95%: 52,5%-70,8%] vs. 117 [52,0%, IC95%: 45,4%-58,6%] em pacientes graves e 23 [19,3%, IC95%: 12,9%-28,1%] vs. 27 [12,0%, IC95%: 7,7%-16,3%] em pacientes críticos, p=0,0014) e maiores taxas de mortalidade (20 [17,9%, IC95%: 10,7%-25,1%] vs. 20 [8,9%, IC95%: 5,1%-12,6%, p=0,0202). Além disso, pacientes hipertensos apresentaram níveis anormais de vários indicadores, como linfopenia e inflamação, e nas funções cardíacas, hepáticas, renais e pulmonares no momento da internação. O grupo de pacientes com hipertensão também demonstrou níveis maiores de TNT e creatinina próximo da alta. Conclusão A hipertensão está altamente associada à gravidade ou mortalidade da COVID-19. Um tratamento agressivo deve ser considerado para pacientes hipertensos com COVID-19, principalmente com relação a lesões cardíacas e dos rins.

Abstract Background Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. Objective To investigate the association between hypertension and severity/mortality in hospitalized patients with COVID-19 in Wuhan, China. Methods A total of 337 patients diagnosed with COVID-19 at the Seventh Hospital of Wuhan City, from January 20 to February 25, 2020, were enrolled and analyzed in a retrospective, single-center case study. The significance level adopted in the statistical analysis was 0.05. Results Of the 337 patients with confirmed diagnosis of COVID-19, 297 (87.8%) were discharged from the hospital and 40 patients (22.9%) died. The median age was 58 years (range, 18-91 years). There were 112 (33.2%) patients diagnosed with hypertension at admission (median age, 65.0 years [range, 38-91 years]; 67 [59.8%, 95%CI: 50.6%-69.0%] men, p=0.0209). Patients with hypertension presented a significantly higher portion of severe cases (69 [61.6%, 95%CI:52.5%-70.8%] vs. 117 [52.0%, 95%CI: 45.4%-58.6%] in severe patients and 23 [19.3%, 95%CI:12.9%-28.1%] vs. 27 [12.0%, 95%CI: 7.7%-16.3%] in critical patients, p=0.0014) and higher mortality rates (20 [17.9%, 95%CI: 10.7%-25.1%] vs. 20 [8.9%, 95%CI: 5.1%-12.6%, p=0.0202). Moreover, hypertensive patients presented abnormal levels of multiple indicators, such as lymphopenia, inflammation, heart, liver, kidney, and lung function at admission. The hypertension group still displayed higher levels of TnT and creatinine at approaching discharge. Conclusion Hypertension is strongly associated with severity or mortality of COVID-19. Aggressive treatment may be considered for COVID-19 patients with hypertension, especially regarding cardiac and kidney injury.

Association of diabetes with severity and mortality in hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective study.

OBJECTIVE: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. The aim this study was to investigate the association of diabetes with severity and mortality among hospitalized patients with COVID-19 in Wuhan, China. METHODS: This retrospective, single-center case study enrolled a total of 564 patients diagnosed with COVID-19 at the Seventh Hospital of Wuhan City, between January 20 and March 15, 2020. RESULTS: Among the 564 patients with confirmed COVID-19, 509 (85.1%) were discharged and 55 (9.8%) died. The median age was 59 years (range, 10-93 years). A total of 85 (15.1%) patients were diagnosed with diabetes on admission (median age, 65.0 [range, 34-91] years). Patients with diabetes had significantly higher proportions of critical cases (24 [28.2%] vs. 66 [13.8%]) and in-hospital mortality (17 [20%] vs. 38 [7.9%]). Moreover, patients with diabetes presented abnormal levels of multiple indicators concerning lymphopenia, inflammation, heart, liver, kidney, and lung function on admission, while diabetic patient group still display higher troponin T (TnT) levels when approaching discharge. The Kaplan-Meier survival curve indicated a trend toward poorer survival in diabetic patients compared to non-diabetic patients, also evidenced by abnormal laboratory biomarker changes regarding multiple system impairments among COVID-19 patients with diabetes with in-hospital death. CONCLUSION: The detailed clinical investigation of 564 hospitalized patients with COVID-19 indicated a considerable association between diabetes and COVID-19 severity or mortality. Thus, more intensive treatment may be considered for COVID-19 patients with diabetes, especially regarding to cardiac injury.

Association of Hypertension with Severity and Mortality in Hospitalized Patients with COVID-19 in Wuhan, China: A Single-centered, Retrospective Study. / Associação da Hipertensão com a Gravidade e a Mortalidade de Pacientes Hospitalizados com COVID-19 em Wuhan, China: Estudo Unicêntrico e Retrospectivo.

BACKGROUND: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. OBJECTIVE: To investigate the association between hypertension and severity/mortality in hospitalized patients with COVID-19 in Wuhan, China. METHODS: A total of 337 patients diagnosed with COVID-19 at the Seventh Hospital of Wuhan City, from January 20 to February 25, 2020, were enrolled and analyzed in a retrospective, single-center case study. The significance level adopted in the statistical analysis was 0.05. RESULTS: Of the 337 patients with confirmed diagnosis of COVID-19, 297 (87.8%) were discharged from the hospital and 40 patients (22.9%) died. The median age was 58 years (range, 18-91 years). There were 112 (33.2%) patients diagnosed with hypertension at admission (median age, 65.0 years [range, 38-91 years]; 67 [59.8%, 95%CI: 50.6%-69.0%] men, p=0.0209). Patients with hypertension presented a significantly higher portion of severe cases (69 [61.6%, 95%CI:52.5%-70.8%] vs. 117 [52.0%, 95%CI: 45.4%-58.6%] in severe patients and 23 [19.3%, 95%CI:12.9%-28.1%] vs. 27 [12.0%, 95%CI: 7.7%-16.3%] in critical patients, p=0.0014) and higher mortality rates (20 [17.9%, 95%CI: 10.7%-25.1%] vs. 20 [8.9%, 95%CI: 5.1%-12.6%, p=0.0202). Moreover, hypertensive patients presented abnormal levels of multiple indicators, such as lymphopenia, inflammation, heart, liver, kidney, and lung function at admission. The hypertension group still displayed higher levels of TnT and creatinine at approaching discharge. CONCLUSION: Hypertension is strongly associated with severity or mortality of COVID-19. Aggressive treatment may be considered for COVID-19 patients with hypertension, especially regarding cardiac and kidney injury.

FUNDAMENTO: A doença Coronavírus 2019 (COVID-19), causada pela síndrome respiratória aguda grave Coronavírus 2 (SARS-CoV-2), espalhou-se pelo mundo. OBJETIVO: Investigar a associação entre a hipertensão e a gravidade/mortalidade de pacientes hospitalizados com COVID-19 em Wuhan, China. MÉTODOS: Um total de 337 pacientes diagnosticados com COVID-19 no Sétimo Hospital da cidade de Wuhan, de 20 de janeiro a 25 de fevereiro de 2020, foram inseridos e analisados em um estudo de caso unicêntrico e retrospectivo. O nível de significância adotado para a análise estatística foi 0,05. RESULTADOS: Dos 337 pacientes com diagnóstico confirmado de COVID-19, 297 (87.8%) tiveram alta do hospital e 40 pacientes (22,9%) morreram. A idade média foi de 58 anos (variando de 18 a 91 anos). Havia 112 (33,2%) pacientes diagnosticados com hipertensão no momento da internação (idade média, 65,0 anos [variação, 38-91 anos]; sendo 67 homens [59,8%, IC95%: 50,6%-69,0%], p=0,0209). Pacientes com hipertensão apresentaram uma porção significativamente maior de casos graves (69 [61,6%, IC95%: 52,5%-70,8%] vs. 117 [52,0%, IC95%: 45,4%-58,6%] em pacientes graves e 23 [19,3%, IC95%: 12,9%-28,1%] vs. 27 [12,0%, IC95%: 7,7%-16,3%] em pacientes críticos, p=0,0014) e maiores taxas de mortalidade (20 [17,9%, IC95%: 10,7%-25,1%] vs. 20 [8,9%, IC95%: 5,1%-12,6%, p=0,0202). Além disso, pacientes hipertensos apresentaram níveis anormais de vários indicadores, como linfopenia e inflamação, e nas funções cardíacas, hepáticas, renais e pulmonares no momento da internação. O grupo de pacientes com hipertensão também demonstrou níveis maiores de TNT e creatinina próximo da alta. CONCLUSÃO: A hipertensão está altamente associada à gravidade ou mortalidade da COVID-19. Um tratamento agressivo deve ser considerado para pacientes hipertensos com COVID-19, principalmente com relação a lesões cardíacas e dos rins.

Association of diabetes with severity and mortality in hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective study

ABSTRACT Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. The aim this study was to investigate the association of diabetes with severity and mortality among hospitalized patients with COVID-19 in Wuhan, China. Subjects and methods: This retrospective, single-center case study enrolled a total of 564 patients diagnosed with COVID-19 at the Seventh Hospital of Wuhan City, between January 20 and March 15, 2020. Results: Among the 564 patients with confirmed COVID-19, 509 (85.1%) were discharged and 55 (9.8%) died. The median age was 59 years (range, 10-93 years). A total of 85 (15.1%) patients were diagnosed with diabetes on admission (median age, 65.0 [range, 34-91] years). Patients with diabetes had significantly higher proportions of critical cases (24 [28.2%] vs. 66 [13.8%]) and in-hospital mortality (17 [20%] vs. 38 [7.9%]). Moreover, patients with diabetes presented abnormal levels of multiple indicators concerning lymphopenia, inflammation, heart, liver, kidney, and lung function on admission, while diabetic patient group still display higher troponin T (TnT) levels when approaching discharge. The Kaplan-Meier survival curve indicated a trend toward poorer survival in diabetic patients compared to non-diabetic patients, also evidenced by abnormal laboratory biomarker changes regarding multiple system impairments among COVID-19 patients with diabetes with in-hospital death. Conclusion: The detailed clinical investigation of 564 hospitalized patients with COVID-19 indicated a considerable association between diabetes and COVID-19 severity or mortality. Thus, more intensive treatment may be considered for COVID-19 patients with diabetes, especially regarding to cardiac injury.

The complete plastid genome and phylogenetic analysis of Gracilaria chilensis.

Gracilaria chilensis is an economically important species of macroalgae. The plastid genome sequence of G. chilensis is 185,640 bp with a GC content of 29.34%. A total of 236 genes were determined, containing 203 protein-encoding genes, three rRNA genes, 30 tRNA genes, and one intron (with intronic ORF) inserted into the trnM gene. The gene content and structure of Gracilariaceae species were relatively well conserved. The phylogenetic analysis, based on the red algal plastid genomes, suggested that G. chilensis had a closer relationship with Gracilaria tenuistipitata var. liui in Gracilaria.

Preliminary Study on the Differences in Hydrocarbons Between Phosphine-Susceptible and -Resistant Strains of Rhyzopertha dominica (Fabricius) and Tribolium castaneum (Herbst) Using Direct Immersion Solid-Phase Microextraction Coupled with GC-MS.

Phosphine resistance is a worldwide issue threatening the grain industry. The cuticles of insects are covered with a layer of lipids, which protect insect bodies from the harmful effects of pesticides. The main components of the cuticular lipids are hydrocarbon compounds. In this research, phosphine-resistant and -susceptible strains of two main stored-grain insects, T. castaneum and R. dominica, were tested to determine the possible role of their cuticular hydrocarbons in phosphine resistance. Direct immersion solid-phase microextraction followed by gas chromatography-mass spectrometry (GC-MS) was applied to extract and analyze the cuticular hydrocarbons. The results showed significant differences between the resistant and susceptible strains regarding the cuticular hydrocarbons that were investigated. The resistant insects of both species contained higher amounts than the susceptible insects for the majority of the hydrocarbons, sixteen from cuticular extraction and nineteen from the homogenized body extraction for T. castaneum and eighteen from cuticular extraction and twenty-one from the homogenized body extraction for R. dominica. 3-methylnonacosane and 2-methylheptacosane had the highest significant difference between the susceptible and resistant strains of T. castaneum from the cuticle and the homogenized body, respectively. Unknown5 from the cuticle and 3-methylhentriacontane from the homogenized body recorded the highest significant differences in R. dominica. The higher hydrocarbon content is a key factor in eliminating phosphine from entering resistant insect bodies, acting as a barrier between insects and the surrounding phosphine environment.

The Emulation and Adaptation of a Global Model of Clinical Practice Guidelines on Chronic Heart Failure in BRICS Countries: A Comparative Study.

Whilst knowledge about diseases is universal, access to health care is not equally distributed. During the last decade, the countries of BRICS (Brazil, Russia, India, China, South Africa) have become important actors on the global health scene, pushing for universal, affordable, and more equal access to health care. Although non-communicable diseases place a significant burden on all populations and health systems, low- and middle-income countries (LMIC), such as BRICS, have been affected particularly hard. Approximately 80 percent of worldwide deaths from non-communicable diseases occur in LMIC. We examined if guidelines concerning chronic heart failure from BRICS countries are influenced by global scripts and if these guidelines have converged or diverged in an inter-state context. Our analysis shows that guidelines on heart failure published in BRICS predominantly rely on models initially formulated by European or American cardiological organisations. Guidelines from BRICS deviate from these models to some extent, in particular with regard to specific epidemiological conditions. Except for the Indian guideline, they do not, however, extensively engage with BRICS-specific aspects of costs, access to and affordability of health care services. We interpret these results through the lens of sociological theories on globalisation. Consistent with neoinstitutionalism, recommendations for clinical practice guidelines have spread in BRICS countries in a rather isomorphic fashion. Notwithstanding, some local medical traditions have also been included into these guidelines through localised adaptation and variation.

Serum- and glucocorticoid-inducible kinase 3 is a potential oncogene in nasopharyngeal carcinoma / Quinase 3 sérica induzida por glicocorticoide é um potencial oncogene no carcinoma nasofaríngeo

Abstract Introduction: Serum- and glucocorticoid-inducible kinase 3, a serine/threonine kinase that functions downstream of the PI3K signaling pathway, plays a critical role in neoplastic processes. It is expressed by various tumors and contributes to carcinogenesis. Objective: The objective was to investigate serum- and glucocorticoid-inducible kinase 3 expression in nasopharyngeal carcinoma, to study the anti-tumor effects of serum- and glucocorticoid-inducible kinase 3 shRNA by inhibiting its expression in nasopharyngeal carcinoma cells and to discuss the potential implications of our findings. Methods: Serum- and glucocorticoid-inducible kinase 3 protein expression in nasopharyngeal carcinoma cell lines (CNE-1, CNE-2, HNE-1, HONE-1, and SUNE-1) and the human immortalized nasopharyngeal epithelium cell line NP69 were assayed by western blotting. Serum- and glucocorticoid-inducible kinase 3 expression in 42 paraffin-embedded nasopharyngeal carcinoma tissues were performed by immunohistochemistry. MTT assay, flow cytometry, and scratch tests were performed after CNE-2 cells were transfected with the best serum- and glucocorticoid-inducible kinase 3 shRNA plasmid selected by western blotting using lipofectamine to study its effect on cell proliferation, apoptosis, and migration. Results: Serum- and glucocorticoid-inducible kinase 3 was overexpressed in human nasopharyngeal carcinoma tissues and cells. Serum- and glucocorticoid-inducible kinase 3 expression decreased markedly after CNE-2 cells were transfected with the serum- and glucocorticoid-inducible kinase 3 shRNA, leading to strong inhibition of cell proliferation and migration. In addition, the apoptosis rate increased in CNE-2 cells after serum- and glucocorticoid-inducible kinase 3 knockdown. Conclusion: Serum- and glucocorticoid-inducible kinase 3 expression was more frequently observed as the nasopharyngeal epithelium progresses from normal tissue to carcinoma. This suggests that serum- and glucocorticoid-inducible kinase 3 contributes to the multistep process of NPC carcinogenesis. Serum- and glucocorticoid-inducible kinase 3 represents a target for nasopharyngeal carcinoma therapy, and a basis exists for the further investigation of this adjuvant treatment modality for nasopharyngeal carcinoma.

Resumo Introdução: A quinase 3 sérica induzida por glicocorticoide, uma serina/treonina quinase que funciona downstream da via de sinalização PI3K, desempenha um papel crítico nos processos neoplásicos. É expressa por vários tumores e contribui para a carcinogênese. Objetivo: Investigar a expressão de quinase 3 sérica induzida por glicocorticoide no carcinoma nasofaríngeo, estudar os efeitos antitumorais do shRNA da quinase 3 sérica induzida por glicocorticoide, que inibem sua expressão em células de carcinoma nasofaríngeo, e discutir as implicações potenciais de nossos achados. Método: A expressão de proteína quinase 3 sérica induzida por glicocorticoide em linhagens de células de carcinoma nasofaríngeo (CNE-1, CNE-2, HNE-1, HONE-1 e SUNE-1) e a linhagem de células humanas imortalizadas do epitélio nasofaríngeo NP69 foram avaliadas por Western blot. A expressão da quinase 3 sérica induzida por glicocorticoide em 42 tecidos de CNF embebidos em parafina foi feita por imuno-histoquímica. Testes com MTT, citometria de fluxo e testes de raspagem foram feitos após as células CNE-2 terem sido transfectadas com o melhor plasmídeo shRNA da quinase 3 sérica induzida por glicocorticoide selecionado por Western blot, com o uso de lipofectamina para estudar seu efeito na proliferação, apoptose e migração celular. Resultados: Foi observada uma sobre-expressão da quinase 3 sérica induzida por glicocorticoide em tecidos e células de carcinoma nasofaríngeo humanas. A expressão de quinase 3 sérica induzida por glicocorticoide diminuiu acentuadamente após as células CNE-2 terem sido transfectadas com o shRNA da quinase 3 sérica induzida por glicocorticoide, conduzindo a forte inibição de proliferação e migração celular. Além disso, a taxa de apoptose aumentou nas células CNE-2 após o knockdown da quinase 3 sérica induzida por glicocorticoide. Conclusão: A expressão de quinase 3 sérica induzida por glicocorticoide foi observada com maior frequência à medida que o epitélio nasofaríngeo progride de tecido normal para carcinoma. Isso sugere que a quinase 3 sérica induzida por glicocorticoide contribui para o processo multietapas da carcinogênese do carcinoma nasofaríngeo. A quinase 3 sérica induzida por glicocorticoide representa um alvo para a terapia do carcinoma nasofaríngeo e há uma base para a investigação adicional dessa modalidade de tratamento adjuvante para o carcinoma nasofaríngeo.

New Method of Analysis of Lipids in Tribolium castaneum (Herbst) and Rhyzopertha dominica (Fabricius) Insects by Direct Immersion Solid-Phase Microextraction (DI-SPME) Coupled with GC-MS.

Lipids play an essential role in providing energy and other physiological functions for insects. Therefore, it is important to determine the composition of insect lipids from cuticular and internal tissues for a better understanding of insect biology and physiology. A novel non-derivatization method for the analysis of lipids including fatty acids, hydrocarbon waxes, sterols in Tribolium castaneum (Herbst) and Rhyzopertha dominica (Fabricius) was explored using the direct immersion solid-phase microextraction (DI-SPME) coupled with gas chromatography-mass spectrometry (GC-MS). Nine extraction solvents, acetonitrile, methanol, hexane, ethanol, chloroform, acetonitrile and ethanol (1:1 v/v), acetonitrile and water (1:1 v/v), ethanol and water (1:1 v/v) and acetonitrile and ethanol and water (2:2:1 v/v/v) were selected and evaluated for the extraction of insect lipids with DI-SPME fiber. Acetonitrile extraction offered the best qualitative, quantitative, and number of lipids extracted from insects samples results. Acetonitrile extracted high-boiling point compounds from both species of tested insects. The range of hydrocarbons was C25 (pentacosane) to C32 (dotriacontane) for T. castaneum and C26 (11-methylpentacosane) to C34 (tetratriacontane) for R. dominica. The major compounds extracted from the cuticular surface of T. castaneum were 11-methylheptacosane (20.71%) and 3-methylheptacosane (12.37%), and from R. dominica were 10-methyldotriacontane (14.0%), and 15-methyltritriacontane (9.93%). The limit of detection (LOD) for the n-alkane compounds ranged between 0.08 (nonacosane) and 0.26 (dotriacontane) µg/g and for the fatty acids between 0.65 (arachidic acid) to 0.89 (oleic acid) µg/g. The study indicated that DI-SPME GC-MS is a highly efficient extraction and a sensitive analytical method for the determination of non-derivatized insect lipids in cuticular and homogenized body tissues.

Serum- and glucocorticoid-inducible kinase 3 is a potential oncogene in nasopharyngeal carcinoma.

INTRODUCTION: Serum- and glucocorticoid-inducible kinase 3, a serine/threonine kinase that functions downstream of the PI3K signaling pathway, plays a critical role in neoplastic processes. It is expressed by various tumors and contributes to carcinogenesis. OBJECTIVE: The objective was to investigate serum- and glucocorticoid-inducible kinase 3 expression in nasopharyngeal carcinoma, to study the anti-tumor effects of serum- and glucocorticoid-inducible kinase 3 shRNA by inhibiting its expression in nasopharyngeal carcinoma cells and to discuss the potential implications of our findings. METHODS: Serum- and glucocorticoid-inducible kinase 3 protein expression in nasopharyngeal carcinoma cell lines (CNE-1, CNE-2, HNE-1, HONE-1, and SUNE-1) and the human immortalized nasopharyngeal epithelium cell line NP69 were assayed by western blotting. Serum- and glucocorticoid-inducible kinase 3 expression in 42 paraffin-embedded nasopharyngeal carcinoma tissues were performed by immunohistochemistry. MTT assay, flow cytometry, and scratch tests were performed after CNE-2 cells were transfected with the best serum- and glucocorticoid-inducible kinase 3 shRNA plasmid selected by western blotting using lipofectamine to study its effect on cell proliferation, apoptosis, and migration. RESULTS: Serum- and glucocorticoid-inducible kinase 3 was overexpressed in human nasopharyngeal carcinoma tissues and cells. Serum- and glucocorticoid-inducible kinase 3 expression decreased markedly after CNE-2 cells were transfected with the serum- and glucocorticoid-inducible kinase 3 shRNA, leading to strong inhibition of cell proliferation and migration. In addition, the apoptosis rate increased in CNE-2 cells after serum- and glucocorticoid-inducible kinase 3 knockdown. CONCLUSION: Serum- and glucocorticoid-inducible kinase 3 expression was more frequently observed as the nasopharyngeal epithelium progresses from normal tissue to carcinoma. This suggests that serum- and glucocorticoid-inducible kinase 3 contributes to the multistep process of NPC carcinogenesis. Serum- and glucocorticoid-inducible kinase 3 represents a target for nasopharyngeal carcinoma therapy, and a basis exists for the further investigation of this adjuvant treatment modality for nasopharyngeal carcinoma.

Ambient PM2.5 and Stroke: Effect Modifiers and Population Attributable Risk in Six Low- and Middle-Income Countries.

BACKGROUND AND PURPOSE: Short-term exposure to ambient fine particulate pollution (PM2.5) has been linked to increased stroke. Few studies, however, have examined the effects of long-term exposure. METHODS: A total of 45 625 participants were interviewed and included in this study, the participants came from the Study on Global Ageing and Adult Health, a prospective cohort in 6 low- and middle-income countries. Ambient PM2.5 levels were estimated for participants' communities using satellite data. A multilevel logistic regression model was used to examine the association between long-term PM2.5 exposure and stroke. Potential effect modification by physical activity and consumption of fruit and vegetables was assessed. RESULTS: The odds of stroke were 1.13 (95% confidence interval, 1.04-1.22) for each 10 µg/m3 increase in PM2.5. This effect remained after adjustment for confounding factors including age, sex, smoking, and indoor air pollution (adjusted odds ratio=1.12; 95% confidence interval, 1.04-1.21). Further stratified analyses suggested that participants with higher levels of physical activity had greater odds of stroke, whereas those with higher consumption of fruit and vegetables had lower odds of stroke. These effects remained robust in sensitivity analyses. We further estimated that 6.55% (95% confidence interval, 1.97%-12.01%) of the stroke cases could be attributable to ambient PM2.5 in the study population. CONCLUSIONS: This study suggests that ambient PM2.5 may increase the risk of stroke and may be responsible for the astounding stroke burden in low- and middle-income countries. In addition, greater physical activity may enhance, whereas greater consumption of fruit and vegetables may mitigate the effect.

Application of the analytic hierarchy approach to the risk assessment of Zika virus disease transmission in Guangdong Province, China.

BACKGROUND: An international spread of Zika virus (ZIKV) infection has attracted global attention in 2015. The infection also affected Guangdong province, which is located in southern China. Multiple factors, including frequent communication with South America and Southeast Asia, suitable climate (sub-tropical) for the habitat of Aedes species, may increase the risk of ZIKV disease transmission in this region. METHODS: An analytic hierarchy process (AHP) method was used to develop a semi-quantitative ZIKV risk assessment model. After selecting indicators, we invited experts in related professions to identify the index weight and based on that a hierarchical structure was generated. Then a series of pairwise comparisons were used to determine the relative importance of the criteria. Finally, the optimal model was established to estimate the spatial and seasonal transmission risk of ZIKV. RESULTS: A total of 15 factors that potentially influenced the risk of ZIKV transmission were identified. The factor that received the largest weight was epidemic of ZIKV in Guangdong province (combined weight [CW] =0.37), followed by the mosquito density (CW = 0.18) and the epidemic of DENV in Guangdong province (CW = 0.14). The distribution of 123 districts/counties' RIs of ZIKV in Guangdong through different seasons were presented, respectively. CONCLUSIONS: Higher risk was observed within Pearl River Delta including Guangzhou, Shenzhen and Jiangmen, and the risk is greater in summer and autumn compared to spring and winter.

The complete mitochondrial genome of the economic red alga, Gracilaria chilensis.

Gracilaria chilensis is an economically important marine alga. In this study, we obtained complete mitogenome of G. chilensis by high-throughput sequencing, which was mapped as a circular molecule of 26,897 bp with 27.56% GC content and was identified 53 genes, including 25 protein-coding genes, 2 rRNA genes, 26 tRNA genes, and 1 group II intron inserted into the trnI gene. In addition, a 162-bp stable stem loop was found in intergenic regions, which was most likely associated with DNA transcription and replication. The Bayesian phylogenetic tree of Gracilariaceae revealed that G. chilensis and G. salicornia and G. changii shared a closer relationship than G. vermiculophylla in the genus Gracilaria.