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1.
Front Public Health ; 9: 754348, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34722452

RESUMO

Background: Although numerous studies are conducted every year on how to reduce the fatality rate associated with sepsis, it is still a major challenge faced by patients, clinicians, and medical systems worldwide. Early identification and prediction of patients at risk of sepsis and adverse outcomes associated with sepsis are critical. We aimed to develop an artificial intelligence algorithm that can predict sepsis early. Methods: This was a secondary analysis of an observational cohort study from the Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University. A total of 4,449 infected patients were randomly assigned to the development and validation data set at a ratio of 4:1. After extracting electronic medical record data, a set of 55 features (variables) was calculated and passed to the random forest algorithm to predict the onset of sepsis. Results: The pre-procedure clinical variables were used to build a prediction model from the training data set using the random forest machine learning method; a 5-fold cross-validation was used to evaluate the prediction accuracy of the model. Finally, we tested the model using the validation data set. The area obtained by the model under the receiver operating characteristic (ROC) curve (AUC) was 0.91, the sensitivity was 87%, and the specificity was 89%. Conclusions: This newly established machine learning-based model has shown good predictive ability in Chinese sepsis patients. External validation studies are necessary to confirm the universality of our method in the population and treatment practice.


Assuntos
Inteligência Artificial , Sepse , Humanos , Unidades de Terapia Intensiva , Aprendizado de Máquina , Estudos Retrospectivos , Sepse/diagnóstico
2.
J Transl Med ; 19(1): 431, 2021 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-34656132

RESUMO

BACKGROUND: High morbidity and mortality due to carbapenem-resistant Gram-negative bacilli (CR-GNB) has led to the resurgence of polymyxin B (PMB) use in the last decade. The aim of our multicenter, real-world study was to evaluate the effectiveness and safety of PMB in the treatment of CR-GNB infections. METHODS: The real-world study included patients treated with intravenous PMB for at least 7 days during the period of October 2018 through June 2019. Associations between these clinical features and 28-day mortality or all-cause hospital mortality were explored through univariate analyses and multivariable logistic regression. RESULTS: The study included 100 patients. Many patients presented with combined chronic conditions, septic shock, mechanical ventilation, and the presence of Klebsiella pneumoniae. The mean duration of PMB therapy was 11 days (range 7-38 days). Temperature (38 °C vs 37.1 °C), white blood cells (14.13 × 109/l vs 9.28 × 109/l), C-reactive protein (103.55 ug/l vs 47.60 ug/l), procalcitonin (3.89 ng/ml vs 1.70 ng/ml) and APACHE II levels (17.75 ± 7.69 vs 15.98 ± 7.95) were significantly decreased after PMB treatment. The bacteria eradication rate was 77.65%. The overall mortality at discharge was 15%, and 28-day mortality was 40%. Major adverse reactions occurred in 16 patients. Nephrotoxicity was observed in 7 patients (7%). CONCLUSIONS: Our results provide positive clinical and safety outcomes for PMB in the treatment of CR-GNB. Timely and appropriate use of PMB may be particularly useful in treating patients with sepsis in CR-GNB infections.


Assuntos
Infecções por Bactérias Gram-Negativas , Polimixina B , Antibacterianos/efeitos adversos , Carbapenêmicos/efeitos adversos , Bactérias Gram-Negativas , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Humanos , Polimixina B/efeitos adversos
3.
Bioengineered ; 12(1): 8555-8569, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34637688

RESUMO

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that poses a great threat to women's health. MiR-1224-5p is downregulated in the follicular fluid of patients with PCOS, but its role remains largely unknown. In this study, mice were treated with dehydroepiandrosterone (DHEA) to establish an in vivo model of PCOS. We found that enhanced activation of NLRP3 inflammasome was accompanied by downregulation of miR-1224-5p in ovarian tissue of PCOS mice. The effect of miR-1224-5p was further explored in TNF-α-treated human granulosa-like tumor (KGN) cells. Upregulation of miR-1224-5p suppressed TNF-α-induced secretion of DHEA and testosterone. MiR-1224-5p attenuated TNF-α-induced inflammation by inhibiting NLRP3 inflammasome activation, IL-1ß synthesis, and nuclear factor kappa B (NF-κB) p65 nuclear translocation. Notably, miR-1224-5p decreased the expression of Forkhead box O 1 (FOXO1) and its downstream gene thioredoxin interaction protein (TXNIP). Luciferase reporter assay confirmed FOXO1 as a target of miR-1224-5p. Upregulation of FOXO1 abolished miR-1224-5p-induced activation of NLRP3 inflammasome, demonstrating that miR-1224-5p might inhibit NLRP3 inflammasome activation through regulating FOXO1. This study provided novel insights into the pathogenesis of PCOS and suggested that miR-1224-5p might be a promising target for treating PCOS.

4.
Transl Androl Urol ; 10(8): 3267-3274, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34532251

RESUMO

Background: Beclin-1 is an autophagy gene and higher levels suggest mammalian testicular damage. Our study aims at exploring the role of Beclin-1 in non-obstructive azoospermia (NOA) patients and clarifying the predictive value of Beclin-1for sperm retrieval in microdissection testicular sperm extraction (micro-TESE). Methods: In the present study, 62 NOA patients were finally recruited. Serum hormone including luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol II (E2), testosterone (T) and prolactin (PRL), as well as testicular volume were measured. Testicular histopathology was diagnosed by two independent pathologists. The expression of Beclin-1 was detected by real-time PCR in testicular tissue. Results: Our study illustrated that Beclin-1 was differently expressed in three pathological types of NOA. Compared with hypospermatogenesis (HS, P=0.002) or maturation arrest (MA, P=0.049), Beclin-1 showed significantly up-regulated in Sertoli cell-only syndrome (SCOS) group. Moreover, Beclin-1 expression was obviously positive related with serum LH (rho =0.269, P=0.036), meanwhile significantly negative correlation with testicular volume (rho =-0.370, P=0.003), serum T (rho =-0.326, P=0.010), Johnsen score (rho =-0.318, P=0.012), and pathologic type (rho =-0.452, P<0.001). Furthermore, a logistic regression model demonstrated that Beclin-1 is an important predictor of failed sperm retrieval (OR =0.001, P=0.007), which exhibited a pretty AUC =78.6 (P=0.001). Conclusions: Beclin-1 may play a critical role in spermatogenesis. Elevated Beclin-1 may be obviously associated with lower chances of positive sperm retrieval.

5.
Artigo em Inglês | MEDLINE | ID: mdl-34545677

RESUMO

A bis(pyridyl)amine-bipyridine-iron(II) framework (Fe(BPAbipy)) of complexes 1-3 is reported to shed light on the multistep nature of CO2 reduction. Herein, photocatalytic conversion of CO2 to CO even at low CO2 concentration (1 %), together with detailed mechanistic study and DFT calculations, reveal that 1 first undergoes two sequential one-electron transfer affording an intermediate with electron density on both Fe and ligand for CO2 binding over proton. The following 2 H+ -assisted Fe-CO formation is rate-determining for selective CO2 -to-CO reduction. A pendant, proton-shuttling α-OH group (2) initiates PCET for predominant H2 evolution, while an α-OMe group (3) cancels the selectivity control for either CO or H2 . The near-unity selectivity of 1 and 2 enables self-sorting syngas production at flexible CO/H2 ratios. The unprecedented results from one kind of molecular catalyst skeleton encourage insight into the beauty of advanced multi-electron and multi-proton transfer processes for robust CO2 RR by photocatalysis.

6.
Ann Acad Med Singap ; 50(6): 474-480, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34195754

RESUMO

INTRODUCTION: The apolipoprotein E (APOE) gene is a promising candidate for the diagnosis of hyperlipoproteinaemia and atherosclerosis. Polymorphisms in APOE have been reported to result in differential efficacies of statin drugs in atherosclerotic cardiovascular disease. METHODS: We classified the APOE genotypes of 225 patients treated with atorvastatin, and analysed the relation between genotypes and serum lipid levels. RESULTS: The baseline serum levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were significantly lower in carriers of APOE ε3 than of APOE ε4 genotypes. The serum levels of TC and LDL-C decreased significantly after 1 month of atorvastatin treatment. Atorvastatin has a higher significant effect in reducing serum TC and LDL-C levels in patients with the APOE ε4 genotype. CONCLUSION: Polymorphism in the APOE gene is related to the efficacy of atorvastatin in reducing the serum levels of TC and LDL-C.


Assuntos
Apolipoproteínas E , Aterosclerose , Doenças Cardiovasculares , Inibidores de Hidroximetilglutaril-CoA Redutases , Apolipoproteínas E/genética , Aterosclerose/tratamento farmacológico , Aterosclerose/genética , Genótipo , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Lipídeos
7.
J Int Med Res ; 49(4): 300060521995273, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33866841

RESUMO

OBJECTIVE: To examine the clinical effects of revision endoscopic frontal sinus surgery (RESS) through modified agger nasi (MAN)-middle turbinate resection on refractory chronic rhinosinusitis (CRS). METHODS: We reviewed 156 patients who were treated for refractory CRS from February 2012 to August 2014. These patients had been diagnosed with refractory CRS by computed tomography and endoscopy and had received several surgical and medical treatments in the past, but their condition had not been cured. They were divided into the observation group (RESS through MAN-middle turbinate resection, n = 78) and the control group (endoscopic sinus surgery, n = 78). Complete or partial control of the patient's symptoms and signs suggested that the treatment was effective, and no improvement in the symptoms and signs indicated that the treatment was ineffective. RESULTS: The 6-month treatment efficacy rate was significantly higher in the observation group (91.03%) than in the control group (71.79%). The observation group had a significantly lower complication rate (7.69%) and recurrence rate (3.85%) than the control group (17.95% and 12.82%, respectively). CONCLUSION: RESS through MAN-middle turbinate resection together with adequate perioperative preparation has a significant effect on the outcome of refractory CRS and is worthy of clinical promotion.


Assuntos
Endoscopia/métodos , Seio Frontal/cirurgia , Sinusite Frontal/cirurgia , Procedimentos Cirúrgicos Nasais/métodos , Rinite/cirurgia , Adolescente , Adulto , Idoso , Doença Crônica , Feminino , Seio Frontal/diagnóstico por imagem , Sinusite Frontal/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Reoperação , Estudos Retrospectivos , Rinite/diagnóstico por imagem , Resultado do Tratamento , Conchas Nasais/diagnóstico por imagem , Conchas Nasais/cirurgia
8.
Front Oncol ; 11: 630260, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33928026

RESUMO

N6-methyladenosine (m6A) is a common form of mRNA modification regulated by m6A RNA methylation regulators and play an important role in the progression of gastric cancer (GC). However, the prognostic role of m6A-related lncRNA in gastric cancer has not been fully explored. This study aims at exploring the biological function and prognostic roles of the m6A-related lncRNA signature in gastric cancer. A total of 800 m6A-related lncRNAs were identified through Pearson correlation analysis between m6A regulators and all lncRNAs. Eleven m6A-related lncRNA signatures were identified through a survival analysis and the Kaplan-Meier (KM) curve analysis results suggest that patients in the low-risk group have a better overall survival (OS) and disease-free survival (DFS) outcome than the high-risk group. Also, the lncRNA signature can serve as an independent prognostic factor for OS and DFS. The gene set enrichment analysis (GSEA) result suggests that patients in the high-risk group were mainly enriched in the ECM receptor interaction, focal adhesion, and cytokine-cytokine receptor interaction pathway, while the low-risk group was characterized by the base excision repair pathway. We further constructed an individualized prognostic prediction model via the nomogram based on the independent prognostic factor for the OS and DFS, respectively. In addition, some candidate drugs aimed at GC risk group differentiation were identified using the Connective Map (CMAP) database. Lastly, four subgroups (C1, C2, C3, and C4) were identified based on the m6A-related lncRNA expression, through a consensus clustering algorithm. Among them, C1 and C2 have a greater likelihood to respond to immune checkpoint inhibitor immunotherapy, suggesting that the C1 and C2 subgroup might benefit from immunotherapy. In conclusion, the m6A-related lncRNA signature can independently predict the OS and DFS of GC and may aid in development of personalized immunotherapy strategies.

9.
Int J Biol Macromol ; 180: 523-532, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33745976

RESUMO

Nano silica (SiO2) is usually used as a common reinforcing agent in polymer materials, in which the interfacial interaction greatly affects the mechanical properties of the composites. The reinforcement effect of silica on non-polar polymer is restricted due to their poor compatibility. In this work, amphipathic lignin modified by quaternization and alkylation was used as a modifier for silica to prepare hydrophobic lignin/SiO2 nanoparticles by in-situ one-pot co-precipitation method. In alkaline solution, hydrophobic lignin and SiO2 (from Na2SiO3) were self-assembled to form nanospheres through electrostatic and hydrophobic interactions. The results showed that the lignin/SiO2 nanoparticles were highly hydrophobic nanospheres with macropores in the surface. When the lignin/SiO2 nanoparticles (10 wt%) were added to reinforce high-density polyethylene (HDPE), the mechanical properties of HDPE were improved with the strength of 24.5 MPa and the elongation of 1096%, which were increased by 10.4% and 14.3% compared with the control HDPE, because of the good compatibility and large bonding area. This work puts forward a new solution for the application of lignin in reinforcement of non-polar polymers.


Assuntos
Lignina/química , Nanocompostos/química , Nanopartículas/química , Polietileno/química , Dióxido de Silício/química , Álcalis/química , Interações Hidrofóbicas e Hidrofílicas , Fenômenos Mecânicos , Microscopia Eletrônica de Varredura , Modelos Químicos , Estrutura Molecular , Nanocompostos/ultraestrutura , Nanopartículas/ultraestrutura , Polímeros/química , Espectroscopia de Infravermelho com Transformada de Fourier , Eletricidade Estática , Propriedades de Superfície , Difração de Raios X
10.
Angew Chem Int Ed Engl ; 60(9): 4796-4803, 2021 02 23.
Artigo em Inglês | MEDLINE | ID: mdl-33205509

RESUMO

High-valent iron-nitrido species are nitrogen analogues of iron-oxo species which are versatile reagents for C-H oxidation. Nonetheless, C-H activation by iron-nitrido species has been scarcely explored, as this is often hampered by their instability and short lifetime in solutions. Herein, the hydrogen atom transfer (HAT) reactivity of an Fe porphyrin nitrido species (2 c) toward C-H substrates was studied in solutions at room temperature, which was achieved by nanosecond laser flash photolysis (LFP) of its FeIII -azido precursor (1 c) supported by a bulky bis-pocket porphyrin ligand. C-H bonds with bond dissociation enthalpies (BDEs) of up to ≈84 kcal mol-1 could be activated, and the second-order rate constants (k2 ) are on the order of 102 -104  s-1 m-1 . The Fe-amido product formed after HAT could further release ammonia upon protonation.

11.
Medicine (Baltimore) ; 99(44): e22941, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126361

RESUMO

INTRODUCTION: Ocular benign fibrous histiocytoma can involve corneoscleral limbus and adjacent cornea and usually has a good prognosis after surgical removal. Despite the low recurrence rate, we reported a rare case of ocular benign fibrous histiocytoma with twice recurrences after excision. PATIENT CONCERNS: A 12-year-old Chinese girl presented with two painless progressively enlarging masses in the right eye for 6 years. She once had the lesions excised 1 year ago. However, the primary lesions relapsed again. DIAGNOSIS: Histopathologic and immunohistochemical examinations of the excised samples supported the diagnosis of benign fibrous histiocytomas of the corneoscleral limbus. INTERVENTIONS: The patient underwent mass resection with limbal stem cell transplantation and amniotic membrane transplantation at first. As for the tumors' second recurrence, we performed extended excision combined with lamellar keratoplasty and amniotic membrane implantation. OUTCOMES: The corneal graft remained clear with no sign of tumor recurrence 3 years after the second surgery. CONCLUSION: Complete surgical resection with tumor-free margins is critical to reduce the recurrence of benign fibrous histiocytoma and appropriate ocular surface reconstruction is necessary to remedy tissue defect and maintain epithelial integrity.


Assuntos
Neoplasias Oculares/cirurgia , Histiocitoma Fibroso Benigno/cirurgia , Recidiva Local de Neoplasia/cirurgia , Criança , Neoplasias da Túnica Conjuntiva/diagnóstico por imagem , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/cirurgia , Córnea/diagnóstico por imagem , Córnea/patologia , Neoplasias Oculares/diagnóstico por imagem , Neoplasias Oculares/patologia , Feminino , Histiocitoma Fibroso Benigno/diagnóstico por imagem , Histiocitoma Fibroso Benigno/patologia , Humanos , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/patologia , Tomografia de Coerência Óptica
12.
Angew Chem Int Ed Engl ; 59(38): 16561-16571, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-32500643

RESUMO

Reliable methods for enantioselective cis-dihydroxylation of trisubstituted alkenes are scarce. The iron(II) complex cis-α-[FeII (2-Me2 -BQPN)(OTf)2 ], which bears a tetradentate N4 ligand (Me2 -BQPN=(R,R)-N,N'-dimethyl-N,N'-bis(2-methylquinolin-8-yl)-1,2-diphenylethane-1,2-diamine), was prepared and characterized. With this complex as the catalyst, a broad range of trisubstituted electron-deficient alkenes were efficiently oxidized to chiral cis-diols in yields of up to 98 % and up to 99.9 % ee when using hydrogen peroxide (H2 O2 ) as oxidant under mild conditions. Experimental studies (including 18 O-labeling, ESI-MS, NMR, EPR, and UV/Vis analyses) and DFT calculations were performed to gain mechanistic insight, which suggested possible involvement of a chiral cis-FeV (O)2 reaction intermediate as an active oxidant. This cis-[FeII (chiral N4 ligand)]2+ /H2 O2 method could be a viable green alternative/complement to the existing OsO4 -based methods for asymmetric alkene dihydroxylation reactions.

13.
Chem Soc Rev ; 49(15): 5310-5358, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32568340

RESUMO

Direct C-H bond functionalization catalyzed by non-precious transition metals is an attractive strategy in synthetic chemistry. Compared with the precious metals rhodium, palladium, ruthenium, and iridium commonly used in this field, catalysis based on non-precious metals, especially the earth-abundant ones, is appealing due to the increasing demand for environmentally benign and sustainable chemical processes. Herein, developments in iron- and cobalt-catalyzed C(sp3)-H bond functionalization reactions are described, with an emphasis on their applications in organic synthesis, i.e., the synthesis of natural products and pharmaceuticals and/or their modification.


Assuntos
Produtos Biológicos/síntese química , Cobalto/química , Complexos de Coordenação/química , Ferro/química , Aminação , Catálise , Técnicas de Química Sintética , Técnicas Eletroquímicas , Ligação de Hidrogênio , Hidroxilação , Ligantes , Estrutura Molecular , Oxirredução , Processos Fotoquímicos
14.
Sci Rep ; 10(1): 7864, 2020 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-32398648

RESUMO

Gratitude and joy are critical for promoting well-being. However, the differences between the two emotions and corresponding neural correlates are not understood. Here we addressed these issues by eliciting the two emotions using the same stimuli in an fMRI task. In this help reception task, participants imagined them in a situation where they need financial aid. Critically, we manipulated the benefactor's intention to provide help and the value of the benefit. Behaviorally, gratitude was stronger than joy when the benefactor-intention was strong and the benefit-value was low compared to other conditions. In parallel, gratitude activated mentalizing-related (e.g. precuneus) and reward-related regions (e.g. putamen) more strongly than joy in corresponding conditions compared to others. Moreover, gratitude was more negatively (or less positively) encoded in the region associated with mentalizing (i.e. the left superior temporal gyrus) than joy. Multivariate pattern analysis further demonstrated that the modulation patterns of benefactor-intention and benefit-value in mentalizing-related (e.g. precuneus, temporo-parietal junction) and reward-related regions (e.g. putamen, perigenual anterior cingulate/ventromedial prefrontal cortex) could distinguish the two emotions. The findings suggest that benefactor-intention and benefit-value appraisal and their neural correlates are critical in distinguishing gratitude and joy. Direct implications for gratitude interventions were discussed.


Assuntos
Encéfalo/fisiologia , Emoções/fisiologia , Intenção , Neurônios/fisiologia , Adulto , Encéfalo/citologia , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Modelos Neurológicos , Desempenho Psicomotor/fisiologia , Recompensa , Adulto Jovem
15.
Anal Chim Acta ; 1109: 1-8, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32252892

RESUMO

The cross-linked network of DUT-67/tubular polypyrrole (T-PPY) composites was first synthesized by in-situ growth zirconium - based metal-organic frameworks (DUT-67) with T-PPY. The introduction of T-PPY effectively increases conductivity of DUT-67/T-PPY composites, weakens accumulation of the DUT-67, and exposes more active sites of DUT-67. DUT-67/T-PPY/GCE manifests increased electrocatalytic activity toward reduction of nitrofurazone and ornidazole compared with DTU-67. A novel electrochemical sensor based on DUT-67/T-PPY was established to effectively detect two anti-infective drugs, respectively. Under optimized experimental conditions, the proposed sensor shows a wider linear range for nitrofurazone that is composed by two line segments (9.08-354.08 µM and 354.08-1004.04 µM). Meanwhile, the sensor also displays a linear response to ornidazole in the range of (0.7-100.5 µM and 100.5-250.4 µM) as well as a low LOD as 0.25 µM (S/N = 3). The proposed sensor was used for the detection of nitrofurazone and ornidazole in actual samples, and the satisfactory results were acquired. This research provides an efficient strategy for fabricating novel electrochemical sensor based on cross-linked network structure of T-PPY and MOFs.

16.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(1): 44-49, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-32148230

RESUMO

OBJECTIVE: To investigate the relationship between serum cholinesterase (SChE) level and the prognosis of patients with septic shock (SS). METHODS: A total of 594 patients with SS admitted to the First Affiliated Hospital of Zhengzhou University from June 2013 to June 2017 were enrolled. General data such as gender, age, acute physiology and chronic health evaluation II (APACHE II) score were recorded as well as routine blood test, procalcitonin (PCT), hepatic function, renal function, coagulation function and blood gas analysis parameters within 48 hours of SS diagnosis. The patients were followed by telephone from September to October in 2019, and the outcome was recorded. The primary outcome was all-cause death 28 days after discharge. The secondary outcomes were all-cause death in intensive care unit (ICU) and 2 years after discharge, and the length of ICU stay. The patients were divided into two groups according to prognosis of 28 days: the survival group and the death group. The clinical data of the two groups were compared. Multivariate Cox regression analysis was used to screen prognostic risk factors of 28 days in patients with SS. The receiver operating characteristic (ROC) curve was used to explore predictive value of liver function parameter SChE for 28-day prognosis of patients with SS. The patients were divided into two groups according to the levels of SChE: the low SChE group (SChE ≤ 4 000 U/L) and the normal SChE group (SChE > 4 000 U/L). Kaplan-Meier survival curves were used to compare the cumulative survival rates without endpoint event of patients with different SChE levels. RESULTS: A total of 385 patients with SS were enrolled according to the inclusion and exclusion criteria, and a total of 356 patients were followed up successfully, with a follow-up rate of 92.5% (356/385). There were 142 survival patients and 214 death patients at 28 days, with a 28-day mortality rate of 60.1% (214/356). There were 116 survival patients and 240 death patients at 2 years, with a 2-year mortality rate of 67.4% (240/356). Compared with the 28-day survival group, the patients in the death group were older and had higher APACHE II score, partial hepatic and renal function parameters, higher level of blood lactate (Lac) and lower levels of white blood cell count (WBC), platelet count (PLT) and SChE with statistically significant differences. Multivariate Cox regression analysis showed that the age [relative risk (RR) = 1.444, 95% confidence interval (95%CI) was 1.090-1.914, P = 0.010], APACHE II score (RR = 2.249, 95%CI was 1.688-2.997, P = 0.000), SChE (RR = 1.469, 95%CI was 1.057-2.043, P = 0.022), and Lac (RR = 2.190, 95%CI was 1.636-2.931, P = 0.000) were independent risk factors for 28-day mortality of patients with SS. The ROC curve analysis showed that SChE had a weak prognostic value for 28-day prognosis of patients with SS [the area under ROC curve (AUC) was 0.574]. However, the combined predictive value of SChE, APACHE II score and Lac was greater than APACHE II score or Lac alone for prediction (AUC: 0.807 vs. 0.785, 0.697), with a sensitivity of 79.9% and a specificity of 68.5%. Compared with the normal SChE group (n = 88), the 28-day mortality of patients in the low SChE group (n = 268) was significantly increased [63.1% (169/268) vs. 51.1% (45/88), P < 0.05], but ICU mortality [59.7% (160/268) vs. 48.9% (43/88)], 2-year mortality [69.8% (187/268) vs. 60.2% (53/88)] or the length of ICU stay [days: 4 (2, 7) vs. 5 (2, 9)] between the two groups showed no statistical significance (all P > 0.05). Kaplan-Meier survival curve analysis showed that the cumulative survival rate without endpoint event of patients in the low SChE group was significantly lower than that in the normal SChE group (Log-Rank test: χ2 = 5.852, P = 0.016). CONCLUSIONS: Increased risk of 28-day mortality in patients with SS whose SChE is below normal. The level of SChE is an independent risk factor for 28-day death in SS patients, and it is one of the indicators to evaluate the short-term prognosis of patients with SS.


Assuntos
Colinesterases/sangue , Choque Séptico/diagnóstico , APACHE , Humanos , Unidades de Terapia Intensiva , Prognóstico , Curva ROC , Estudos Retrospectivos , Choque Séptico/enzimologia , Choque Séptico/mortalidade
17.
Chem Sci ; 11(8): 2243-2259, 2020 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-32180931

RESUMO

Alkyl-substituted carbene (CHR or CR2, R = alkyl) complexes have been extensively studied for alkylcarbene (CHR) ligands coordinated with high-valent early transition metal ions (a.k.a. Schrock carbenes or alkylidenes), yet dialkylcarbene (CR2) complexes remain less developed with bis(dialkylcarbene) species being little (if at all) explored. Herein, several group 8 metal porphyrin dialkylcarbene complexes, including Fe- and Ru-mono(dialkylcarbene) complexes [M(Por)(Ad)] (1a,b, M = Fe, Por = porphyrinato dianion, Ad = 2-adamantylidene; 2a,b, M = Ru) and Os-bis(dialkylcarbene) complexes [Os(Por)(Ad)2] (3a-c), are synthesized and crystallographically characterized. Detailed investigations into their electronic structures reveal that these complexes are formally low-valent M(ii)-carbene in nature. These complexes display remarkable thermal stability and chemical inertness, which are rationalized by a synergistic effect of strong metal-carbene covalency, hyperconjugation, and a rigid diamondoid carbene skeleton. Various spectroscopic techniques and DFT calculations suggest that the dialkylcarbene Ad ligand is unique compared to other common carbene ligands as it acts as both a potent σ-donor and π-acceptor; its unique electronic and structural features, together with the steric effect of the porphyrin macrocycle, make its Fe porphyrin complex 1a an active and robust catalyst for intermolecular diarylcarbene transfer reactions including cyclopropanation (up to 90% yield) and X-H (X = S, N, O, C) insertion (up to 99% yield) reactions.

18.
Medicine (Baltimore) ; 99(13): e19563, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32221074

RESUMO

Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease, and its mortality rate is 10% to 20%. However, there are currently only a few markers to predict the prognosis in patients with TTP. We aimed to identify several clinical indices and laboratory parameters for predicting the prognosis of TTP at admission.A single-centre observational cohort study that included patients with TTP from the First Affiliated Hospital of Zhengzhou University in China was conducted from January 1, 2012 to November 30, 2018. The primary outcome was prognosis, including in-hospital mortality, major thromboembolic events, or failure to achieve remission at discharge. We used the random forest method to identify the best set of predictors.Eighty-seven patients with TTP were identified, of whom 12 died during the treatment. The total number of patients within-hospital mortality, major thromboembolic events, and failure to achieve remission at discharge was 58. The machine learning method showed that the D-dimer level was the strongest predictor of the primary outcome. Receiver operating characteristic (ROC) analysis demonstrated that the sensitivity and specificity of the D-dimer level alone for identifying high-risk patients were 78% and 81%, respectively, with an optimum diagnostic cut-off value of 770 ng/mL. The area under the ROC curve (AUC) was 0.80, and the 95% confidence interval (CI) was 0.70 to 0.90.This study found that the D-dimer level exhibited a good predictive ability for prognosis in patients with TTP. These findings may aid in the development of new and intensive treatment strategies to achieve remission among high-risk patients. However, external validation is necessary to confirm the generalizability of our approach across populations and treatment practices.


Assuntos
Mortalidade Hospitalar/tendências , Púrpura Trombocitopênica Trombótica/sangue , Púrpura Trombocitopênica Trombótica/complicações , Tromboembolia/etiologia , Adulto , Idoso , Biomarcadores , China , Comorbidade , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio , Humanos , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Prognóstico , Púrpura Trombocitopênica Trombótica/diagnóstico , Púrpura Trombocitopênica Trombótica/mortalidade , Curva ROC , Indução de Remissão , Estudos Retrospectivos , Fatores de Risco
19.
Angew Chem Int Ed Engl ; 59(5): 1845-1850, 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-31755156

RESUMO

Described herein is an IrIII /porphyrin-catalyzed intermolecular C(sp3 )-H insertion reaction of a quinoid carbene (QC). The reaction was designed by harnessing the hydrogen-atom transfer (HAT) reactivity of a metal-QC species with aliphatic substrates followed by a radical rebound process to afford C-H arylation products. This methodology is efficient for the arylation of activated hydrocarbons such as 1,4-cyclohexadienes (down to 40 min reaction time, up to 99 % yield, up to 1.0 g scale). It features unique regioselectivity, which is mainly governed by steric effects, as the insertion into primary C-H bonds is favored over secondary and/or tertiary C-H bonds in the substituted cyclohexene substrates. Mechanistic studies revealed a radical mechanism for the reaction.

20.
J Colloid Interface Sci ; 559: 226-235, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31629276

RESUMO

The paraffin is the widely used solid-liquid phase change material (PCM) with large fusion latent heat in thermal management, and vanadium dioxide (VO2) is a promising reversible solid-solid PCM with a near-ambient phase transition temperature (Tc = ~68 °C). In the real applications, the paraffin is always wrapped with inorganic or organic shells to stabilize the shape during the fusion/solidification with compromising large amounts of latent heat. Herein, we proposed the paraffin@VO2 PCM structure for the first time, which combines the solid-liquid paraffin PCM core and the solid-solid VO2 PCM shell. The paraffin@VO2 PCM structure is synthesized via an emulsion method starting with the Te/W-codoped VO2 microparticles and the paraffin wax (C26H54). This developed PCM structure shows a suitable Tc = 58.2 °C (ΔTc = 5.5 °C), a decent fusion latent heat 163 J/g and a largely enhanced thermal conductivity 1.53 W/mK, which should be promising for the high-efficient thermal management applications.

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