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1.
Arch Biochem Biophys ; 747: 109755, 2023 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-37714252

RESUMO

Vascular endothelial dysfunction is the initial step in atherosclerosis (AS). AS tends to occur at vascular bifurcations and curves, and endothelial cells(ECs) are highly susceptible to injury due to mechanical forces induced by disturbed flow (DF) with inconsistent blood flow directions. However, the pathogenesis of endothelial cell dysfunction in AS remains unclear and needs further study. Here, we found that Piezo1 expression was significantly increased in DF- and oxidized low-density lipoprotein(ox-LDL)-treated HUVECs in vitro and a model of atherosclerotic plaque growth in ApoE-/- mice fed a Western diet. Furthermore, Piezo1 upregulated autophagy levels in the HUVECs model, which was reversed by Piezo1 knockdown with a lentivirus-mediated shRNA system. Mechanistically, the level of Yes-associated protein (YAP), a transcriptional coactivator in the Hippo pathway, was significantly elevated in the DF- and ox-LDL-induced HUVECs model, and this effect was further inhibited by Piezo1 knockdown. Moreover, the Piezo1 agonist Yoda1 inhibited the protein level of microtubule-associated protein 1 light chain 3-II(LC3-II) and increased the protein level of sequestosome1(p62/SQSTM1) in a dose-dependent manner, while significantly promoting the protein expression and nuclear translocation of YAP. The YAP inhibitor CA3 weakened Yoda1-mediated inhibition of autophagy. Our results suggest that Piezo1 may regulate endothelial autophagy by promoting YAP activation and nuclear translocation, thereby contributing to vascular endothelial dysfunction.

2.
Sci Rep ; 13(1): 15269, 2023 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-37709785

RESUMO

The construction of cross passages using the tunnel boring machine (TBM) method represents an emerging construction technique with numerous advantages. However, owing to the scarcity of application instances, the safety control methodologies and the regulatory patterns concerning environmental impacts remain inconclusive. In this study, a cross passage excavated using the TBM method-the first of its kind in the Tianjin area-was investigated. We identified the key risk control measures for the construction and analysed the TBM operating parameters, monitored ground and building settlements, and monitored mainline tunnel deformations and mechanical responses, revealing the ground and tunnel structure deformation patterns. The following conclusions are drawn. (1) The ground surrounding the cross-passage break-out opening was stabilised by performing secondary grouting and small-range freezing, and the break-in opening was excavated using a completely enclosed steel sleeve. These measures prevented water and sand inflows during the excavation of the break-out and break-in openings in the silt and silty sand strata. (2) The torsional moment of the cutter disc was large during the break-out phase. Break-out mainline tunnel displacement monitoring data indicated that the thrust had a significant effect on the mainline tunnel during the break-out phase. (3) The TBM tunnelling caused ground loss. The ground settlement exhibited a U-shaped distribution along the cross-passage axis, with the maximum settlement being 10 mm. (4) During the break-out phase, the deformation of the break-out mainline tunnel exhibited a duck-egg-shaped distribution. The clearance convergence of the break-out mainline tunnel was within ± 4, and the clearance convergence of the break-in mainline tunnel was controlled within ± 1 mm.

3.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 40(4): 792-798, 2023 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-37666771

RESUMO

Sodium alginate (SA) is a kind of natural polymer material extracted from kelp, which has excellent biocompatibility, non-toxicity, biodegradability and abundant storage capacity. The formation condition of sodium alginate gel is mild, effectively avoiding the inactivation of active substances. After a variety of preparation methods, sodium alginate microspheres are widely used in the fields of biomaterials and tissue engineering. This paper reviewed the common methods of preparing alginate microspheres, including extrusion, emulsification, electrostatic spraying, spray drying and coaxial airflow, and discussed their applications in biomedical fields such as bone repair, hemostasis and drug delivery.


Assuntos
Alginatos , Procedimentos de Cirurgia Plástica , Materiais Biocompatíveis , Sistemas de Liberação de Medicamentos , Microesferas
4.
Phytomedicine ; 120: 155042, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37659296

RESUMO

BACKGROUND: Although the development of therapies for heart failure (HF) continues apace, clinical outcomes are often far from ideal. Unc51-like-kinase 1 (ULK1)-mediated mitophagy prevents pathological cardiac remodeling and heart failure (HF). Molecularly ULK1-targeted agent to enhance mitophagy is scanty. HYPOTHESIS/PURPOSE: This study aimed to investigate whether Ginsenoside Rg3 (Rg3) can activate ULK1 to trigger FUNDC1-mediated mitophagy for protecting heart failure. METHODS: Molecular docking and surface plasmon resonance were used to detect the ULK1 binding behavior of Rg3. Established HF model in rats and transcriptome sequencing were used to evaluate the therapeutic effect and regulatory mechanism of Rg3. Loss-of-function approaches in vivo and in vitro were performed to determine the role of ULK1 in Rg3-elicited myocardial protection against HF. FUNDC1 recombinant plasmid of site mutation was applied to elucidate more in-depth mechanisms. RESULTS: Structurally, a good binding mode was unveiled between ULK1 and Rg3. In vivo, Rg3 improved cardiac dysfunction, adverse remodeling, and mitochondrial damage in HF rats. Furthermore, Rg3 promoted Ulk1-triggered mitophagy both in vivo and in vitro, manifested by the impetus of downstream Fundc1-Lc3 interaction. Of note, the protective effects conferred by Rg3 against mitophagy defects, pathological remodeling, and cardiac dysfunction were compromised by Ulk1 gene silencing both in vivo and in vitro. Mechanistically, Rg3 activated mitophagy by inducing ULK1-mediated phosphorylation of FUNDC1 at the Ser17 site, not the Ser13 site. CONCLUSION: Together these observations demonstrated that Rg3 acts as a ULK1 activator for the precise treatment of HF, which binds to ULK1 to activate FUNDC1-mediated mitophagy.


Assuntos
Ginsenosídeos , Insuficiência Cardíaca , Animais , Ratos , Mitofagia , Simulação de Acoplamento Molecular , Insuficiência Cardíaca/tratamento farmacológico , Ginsenosídeos/farmacologia , Proteína Homóloga à Proteína-1 Relacionada à Autofagia , Proteínas de Membrana , Proteínas Mitocondriais
5.
Materials (Basel) ; 16(16)2023 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-37629836

RESUMO

To investigate the effect of Mn and other metal dopants on the photoelectronic performance of CsPbCl3 perovskites, we conducted a series of theoretical analyses. Our findings showed that after Mn mono-doping, the CsPbCl3 lattice contracted and the bonding strength increased, resulting in a more compact structure of the metal octahedral cage. The relaxation of the metal octahedral cage, along with the Jahn-Teller effect, results in a decrease in lattice strain between the octahedra and a reduction in the energy of the entire lattice due to the deformation of the metal octahedron. These three factors work together to reduce intrinsic defects and enhance the stability and electronic properties of CsPbCl3 perovskites. The solubility of the Mn dopant is significantly increased when co-doped with Ni, Fe, and Co dopants, as it compensates for the lattice strain induced by Mn. Doping CsPbCl3 perovskites reduces the band gap due to the decreased contributions of 3d orbitals from the dopants. Our analyses have revealed that strengthening the CsPbCl3 lattice and reducing intrinsic defects can result in improved stability and PL properties. Moreover, increasing Mn solubility and decreasing the bandgap can enhance the PLQY of orange luminescence in CsPbCl3 perovskites. These findings offer valuable insights for the development of effective strategies to enhance the photoelectronic properties of these materials.

6.
Small ; : e2303848, 2023 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-37649216

RESUMO

The preservation and accessibility of pores are prerequisites to the application of metal-organic frameworks (MOFs). Activation is a key step to eliciting rich features of pores, but it needs a repeated solvent-exchange process which is tedious and time/cost-consuming. Herein, a facile strategy for highly-efficient activation of MOFs utilizing rotating packed bed is proposed. With the tremendous enhancement of molecular mixing and mass transfer in high-gravity and strong-shearing surrounding, nine representative MOFs are completely activated within 2 h without structural change. Compared with conventional process, this activation displays surprising efficiency by accelerating the diffusion of solvents and redissolution of residual reactants in the pores. The complete activation time can be significantly shortened by over 90%. As a proof-of-concept, the methane storage of as-activated UiO-66 is five times that of as-synthesized UiO-66. This strategy provides a potential platform with industrial worth for the activation of MOF materials with ultra-high efficiency and versatility.

7.
Adv Sci (Weinh) ; : e2303207, 2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37639212

RESUMO

Tissue-infiltrating neutrophils (TINs) secrete various signaling molecules to establish paracrine communication within the inflammatory milieu. It is imperative to identify molecular mediators that control this secretory phenotype of TINs. The present study uncovers a secretory neutrophil subset that exhibits increased pro-inflammatory cytokine production and enhanced migratory capacity which is highly related with periodontal pathogenesis. Further analysis identifies the OTU domain-containing protein 1 (OTUD1) plays a regulatory role in this secretory neutrophil polarization. In human and mouse periodontitis, the waning of inflammation is correlated with OTUD1 upregulation, whereas severe periodontitis is induced when neutrophil-intrinsic OTUD1 is depleted. Mechanistically, OTUD1 interacts with SEC23B, a component of the coat protein II complex (COPII). By removing the K63-linked polyubiquitin chains on SEC23B Lysine 81, the deubiquitinase OTUD1 negatively regulates the COPII secretory machinery and limits protein ER-to-Golgi trafficking, thus restricting the surface expression of integrin-regulated proteins, CD9 and CD47. Accordingly, blockade of protein transport by Brefeldin A (BFA) curbs recruitment of Otud1-deficient TINs and attenuates inflammation-induced alveolar bone destruction. The results thus identify OTUD1 signaling as a negative feedback loop that limits the polarization of neutrophils with secretory phenotype and highlight the potential application of BFA in the treatment of periodontal inflammation.

8.
Int J Biol Macromol ; 250: 126202, 2023 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-37573916

RESUMO

The formation of three dimensional network structure is critical in determining mechanical properties of natural rubber (NR). Consequently, it is vital to regulate crosslinking network of NR by controlling vulcanization process. Inspired by our previous studies on contribution of non-rubber components (NRCs) to the excellent properties of NR, we find octylamine in NRCs decreases the activation energy (Ea) of vulcanization from 82.73 kJ/mol to 44.34 kJ/mol, thereby reducing vulcanization time from 18.67 min to 2.71 min. From microscopic perspective, octylamine tends to coordinate with zinc ions to improve dispersion of ZnO in NR. And octylamine promotes ring-opening reaction of S8 to favor formation of polysulfide intermediates. Therefore, the incorporation of octylamine remarkably improves vulcanization efficiency, which contributes to the formation of a more homogeneous network with higher crosslinking density, enhancing remarkably the strength and toughness of NR. As a result, the tensile strength and fracture energy of samples are as high as 31.15 MPa and 68.88 kJ/m2, respectively. In addition, even with a 60 % reduction in ZnO content, the NR samples still maintain high vulcanization efficiency and excellent mechanical properties after the addition of octylamine, which provides a green and feasible way to alleviate the environmental pollution caused by ZnO.

9.
Chemotherapy ; : 1-7, 2023 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-37591210

RESUMO

INTRODUCTION: Monitoring of AUC24 was updated recommendation in the guideline for the therapeutic drug monitoring (TDM) of vancomycin in Chinese pharmacological society published in 2020. Vancomycin pharmacokinetic profiles are diverse and unique in critically ill patients because of the drastic variability of the patients' physiological parameters, while the study for population pharmacokinetic (PPK) models in Chinese critically ill patients has been rarely reported. The objectives of this study were to construct a PPK model to describe the pharmacokinetic characteristics of vancomycin in critically ill patients and to individualize vancomycin dosing by model-informed Bayesian estimation for maintenance of AUC24 target at 400-650 mg h/L recommended by the 2020 guideline. METHODS: Vancomycin with different dosing was administered intravenously over 1 h for critically ill patients, TDM was started at 48 h or 72 h since initiation of vancomycin therapy for patients. Blood samples were collected from patients for trough concentrations or Cmax. Vancomycin concentrations were determined by high-performance liquid chromatography method with ultraviolet detection. PPK model was performed using the nonlinear mixed-effect model (NONMEM®). Individual PK parameters for critically ill patients treated with vancomycin were estimated using a post hoc empirical Bayesian method based on the final PPK model. AUC24 was calculated as the total daily dose divided by the clearance (L/h). RESULTS: The PPK of vancomycin was determined by a one-compartment model with creatinine clearance as fixed effects. The PK estimates in the final model generally agreed with the median estimates and were contained within the 95% CI generated from the bootstrap results, indicating good precision and stability in the final model. The visual predictive check plots showed the adequate predictive performance of the final PK model and supported a good model fit. The model-informed Bayesian estimation was used to predict the AUC24 of critically ill patient by the acquired TDM results, and the dosing adjustment by maintenance of AUC24 at 400-650 mg h/L had made a great therapeutic effect for the case. CONCLUSION: This study established a PPK model of vancomycin in Chinese critically ill patients, and individualized dosing of vancomycin by model-informed Bayesian estimation to maintain an AUC24 target at 400-650 mg h/L has been successfully applied in clinic. This result supports the continued use of model-informed Bayesian estimation to vancomycin treatment in critically ill patients.

10.
Eur Radiol ; 2023 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-37610442

RESUMO

OBJECTIVE: To develop a comprehensive nomogram based on MRI intra- and peritumoral radiomics signatures and independent risk factors for predicting parametrial invasion (PMI) in patients with early-stage cervical adenocarcinoma (AC) and adenosquamous carcinoma (ASC). METHODS: A total of 460 patients with IB to IIB cervical AC and ASC who underwent preoperative MRI examination and radical trachelectomy/hysterectomy were retrospectively enrolled and divided into primary, internal validation, and external validation cohorts. The original (Ori) and wavelet (Wav)-transform features were extracted from the volumetric region of interest of the tumour (ROI-T) and 3mm- and 5mm-peritumoral rings (ROI-3 and ROI-5), respectively. Then the Ori and Ori-Wav feature-based radiomics signatures from the tumour (RST) and 3 mm- and 5 mm-peritumoral regions (RS3 and RS5) were independently built and their diagnostic performances were compared to select the optimal ones. Finally, the nomogram was developed by integrating optimal intra- and peritumoral signatures and clinical independent risk factors based on multivariable logistic regression analysis. RESULTS: FIGO stage, disruption of the cervical stromal ring on MRI (DCSRMR), parametrial invasion on MRI (PMIMR), and serum CA-125 were identified as independent risk factors. The nomogram constructed by integrating independent risk factors, Ori-Wav feature-based RST, and RS5 yielded AUCs of 0.874 (0.810-0.922), 0.885 (0.834-0.924), and 0.966 (0.887-0.995) for predicting PMI in the primary, internal and external validation cohorts, respectively. Furthermore, the nomogram was superior to radiomics signatures and clinical model for predicting PMI in three cohorts. CONCLUSION: The nomogram can preoperatively, accurately, and noninvasively predict PMI in patients with early-stage cervical AC and ASC. CLINICAL RELEVANCE STATEMENT: The nomogram can preoperatively, accurately, and noninvasively predict PMI and facilitate precise treatment decisions regarding chemoradiotherapy or radical hysterectomy in patients with early-stage cervical AC and ASC. KEY POINTS: The accurate preoperative prediction of PMI in early-stage cervical AC and ASC can facilitate precise treatment decisions regarding chemoradiotherapy or radical hysterectomy. The nomogram integrating independent risk factors, Ori-Wav feature-based RST, and RS5 can preoperatively, accurately, and noninvasively predict PMI in early-stage cervical AC and ASC. The nomogram was superior to radiomics signatures and clinical model for predicting PMI in early-stage cervical AC and ASC.

11.
Adv Healthc Mater ; : e2301809, 2023 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-37571957

RESUMO

3D printing has been widely applied for preparing artificial blood vessels, which will bring innovation to cardiovascular disorder intervention. However, the printing resolution and anti-infection properties of small-diameter vessels (Φ < 6 mm) have been challenging in 3D printing. The primary objective of this research is to design a novel coaxial 3D-printing postprocessing method for preparing small-size blood vessels with improved antibacterial and angiogenesis properties. The coaxial printing resolution can be more conveniently improved. Negatively charged polyvinyl alcohol (PVA) and alginate (Alg) interpenetrating networks artificial vessels are immersed in positively charged chitosan (CTS) solution. Rapid dimensional shrinkage takes place on its outer surface through electrostatic interactions. The maximum shrinkage size of wall thickness can reach 61.2%. The vessels demonstrate strong antibacterial properties against Escherichia coli (98.8 ± 0.5%) and Staphylococcus aureus (97.6 ± 1.4%). In rat dorsal skin grafting experiments, Cu2+ can promote angiogenesis by regulating hypoxia-inducible factor-1 pathway. No artificial blood vessel blockage occurs after 5 days of blood circulation in vitro.

12.
Integr Med Res ; 12(3): 100969, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37546234

RESUMO

Background: Traditional Chinese Medicine (TCM), integrating patient preferences into decision-making process, has been widely used in the multimodality therapy of lung cancer. This study aimed to estimate patient preferences for treatment and shared decision-making (SDM) modes concerning inpatient TCM treatment of lung cancer in Shanghai in order to provide a basis for clinical decision-making process on TCM therapy for lung cancer. Methods: This study was conducted among patients (n = 347) from nine tertiary hospitals in Shanghai by discrete-choice experiment (DCE) survey and Shared Decision-Making Questionnaire-patient version (SDM-Q-9) survey. The DCE was developed with the inclusion of the most relevant attributes at appropriate levels for the TCM treatment of lung cancer. The empirical data analyses of patients were performed using mixed logit models. Additionally, subgroup analysis was conducted. Results: In total, 347 respondents completed the questionnaire. All attributes' coefficients were statistically significant for patients' preferences. Patients showed strong preferences for increasing disease control rate, relieving nausea and vomiting, reducing the risk of side effects, and were concerned about monthly out-of-pocket costs. Subgroup analysis indicated that patients with a lower SDM-Q-9 score and those who were satisfied with medical services emphasized more importance of higher disease control rate. Furthermore, most of the patients (90.20%) self-reported a high willingness to use SDM during the decision-making process. Conclusion: In Shanghai, patients mainly preferred SDM and considered disease control rate as the most essential attribute in the TCM treatment of lung cancer. The study findings could underscore the importance of considering patients' preferences and promote SDM.

13.
Front Public Health ; 11: 1118207, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37546303

RESUMO

Background: The digital divide has grown because of the deepening digitalization of the Chinese society and the intersection between high-end technology and the age structure. Older adults show an increasing level of weakness in digital life integration. What digital development can bring to older adults is a pressing concern. Objective: This study aims to investigate how smart device use affects older adults' health status and offers an empirical reference for improving their digital literacy and health. Methods: The data in this study were collected from an offline survey conducted from December 2021 to April 2022, which obtained 1110 valid samples of older adults This study used a multivariate ordered logit model, mediating effect model, and heterogeneity test to analyze the impact of smart device use on the health status of older adults. Results: Smart device use has a significant positive effect on the self-rated, physical, and psychological health of older adults, and this positive effect is more pronounced among older adults living in urban areas or with a higher age. The average net effect of smart devices on each health status of older adults is 0.161 for self-rated health, 0.155 for physical health, and 0.071 for psychological health. In-depth research found that older adults' attitudes toward smart devices played a mediating role in the influence of smart device use on self-rated and psychological health respectively. Conclusions: The study found that smart device use had a positive effect on the health status of older adults and that the performance expectations and individualized needs of older adults exhibited an effective linkage between smart devices and health status. Smart device use could improve the overall health of older adults, especially the urban and low-age older adults. Promoting the understanding of the practicality of smart devices for older adults and the aging-oriented transformation of smart devices is an effective way to improve the health status of older adults. The findings provide theoretical support for the wide application of smart devices in older adults, and can effectively help eHealth practitioners implement accurate geriatric health support strategies.


Assuntos
Autoavaliação Diagnóstica , Nível de Saúde , Saúde Mental , Atitude
14.
World J Diabetes ; 14(7): 1112-1125, 2023 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-37547590

RESUMO

BACKGROUND: Commonly used glucocorticoids replacement regimens in patients with hypopituitarism have difficulty mimicking physiological cortisol rhythms and are usually accompanied by risks of over-treatment, with adverse effects on glucose metabolism. Disorders associated with glucose metabolism are established risk factors of cardiovascular events, one of the life-threatening ramifications. AIM: To investigate the glycometabolism profile in patients with hypopituitarism receiving prednisone (Pred) replacement, and to clarify the impacts of different Pred doses on glycometabolism and consequent adverse cardiovascular outcomes. METHODS: Twenty patients with hypopituitarism receiving Pred replacement [patient group (PG)] and 20 normal controls (NCs) were recruited. A flash glucose monitoring system was used to record continuous glucose levels during the day, which provided information on glucose-target-rate, glucose variability (GV), period glucose level, and hypoglycemia occurrence at certain periods. Islet ß-cell function was also assessed. Based on the administered Pred dose per day, the PG was then regrouped into Pred > 5 mg/d and Pred ≤ 5 mg/d subgroups. Comparative analysis was carried out between the PG and NCs. RESULTS: Significantly altered glucose metabolism profiles were identified in the PG. This includes significant reductions in glucose-target-rate and nocturnal glucose level, along with elevations in GV, hypoglycemia occurrence and postprandial glucose level, when compared with those in NCs. Subgroup analysis indicated more significant glucose metabolism impairment in the Pred > 5 mg/d group, including significantly decreased glucose-target-rate and nocturnal glucose level, along with increased GV, hypoglycemia occurrence, and postprandial glucose level. With regard to islet ß-cell function, PG showed significant difference in homeostasis model assessment (HOMA)-ß compared with that of NCs; a notable difference in HOMA-ß was identified in Pred > 5 mg/d group when compared with those of NCs; as for Pred ≤ 5 mg/d group, significant differences were found in HOMA-ß, and fasting glucose/insulin ratio when compared with NCs. CONCLUSION: Our results demonstrated that Pred replacement disrupted glycometabolic homeostasis in patients with hypopituitarism. A Pred dose of > 5 mg/d seemed to cause more adverse effects on glycometabolism than a dose of ≤ 5 mg/d. Comprehensive and accurate evaluation is necessary to consider a suitable Pred replacement regimen, wherein, flash glucose monitoring system is a kind of promising and reliable assessment device. The present data allows us to thoroughly examine our modern treatment standards, especially in difficult cases such as hormonal replacement mimicking delicate natural cycles, in conditions such as diabetes mellitus that are rapidly growing in worldwide prevalence.

15.
Technol Health Care ; 2023 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-37545280

RESUMO

BACKGROUND: The evolution of critical care medicine and nursing has aided and enabled the rescue of a large number of patients from numerous life-threatening diseases. However, in many cases, patient health may not be quickly restored, and the long-term prognosis may not be optimistic. OBJECTIVES: In this study, we aimed to develop and validate a prediction model for accurate, precise, and objective identification of the severity of chronic critical illness (CCI) in patients. METHODS: We used a retrospective case-control and prospective cohort study with no interventions. Patients diagnosed with CCI admitted to the ICU of a large metropolitan public hospital were selected. In the case-control study, 344 patients (case: 172; control:172) were enrolled to develop the prognosis prediction model of chronic critical illness (PPCCI Model); 88 patients (case:44; control: 44) in a prospective cohort study, served as the validation cohort. The discrimination of the model was measured using the area under the curve (AUC) of the receiver operating characteristic curve (ROC). RESULTS: Age, prolonged mechanical ventilation (PMV), sepsis or other severe infections, Glasgow Coma Scale (GCS), mean artery pressure (MAP), heart rate (HR), respiratory rate (RR), oxygenation index (OI), and active bleeding were the nine predictors included in the model. In both cohorts, the PPCCI model outperformed the Acute Physiology And Chronic Health Evaluation II (APACHE II), Modified Early Warning Score (MEWS), and Sequential Organ Failure Assessment (SOFA) in identifying deceased patients with CCI (development cohort: AUC, 0.934; 95%CI, 0.908-0.960; validation cohort: AUC, 0.965; 95% CI, 0.931-0.999). CONCLUSION: The PPCCI model can provide ICU medical staff with a standardized measurement tool for assessing the condition of patients with CCI, enabling them to allocate ward monitoring resources rationally and communicate with family members.

16.
Opt Lett ; 48(16): 4412-4415, 2023 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-37582045

RESUMO

We demonstrate a diaphragm-integrated ring waveguide coupler fabricated by the two-photon direct laser wring technique as an ultrasonic sensor, which is integrated on an optical fiber tip. The device consists of a micro-ring waveguide with a diameter of 5 µm functionalized as an optical fiber tip light reflection mirror and a straight waveguide connecting a diaphragm. The evanescent field coupling can be realized between the two waveguides, and the coupling efficiency can be changed due to the variation of the coupling gap induced by ultrasound. Accordingly, the light reflection can be changed. Based on the plate vibration theory, the vibration frequency can be changed through optimizing the diaphragm size. The experiments show that the device exhibits a high sensitivity and low noise equivalent acoustic signal level of 1.07 mPa/Hz1/2 at 100 kHz, which has great potential in various acoustic wave sensing applications.

17.
Surg Infect (Larchmt) ; 24(7): 588-597, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37582199

RESUMO

Background: This study aims to analyze the risk factors for post-operative pulmonary infection in patients with brain tumors by meta-analysis to provide a reference for its prevention. Methods: PubMed, Embase, Web of Science, Cochrane Library, Ovid, and four Chinese databases (CNKI, SinoMed, VIP, and Wanfang databases) were searched for studies covering risk factors of pulmonary infection in patients with brain tumors, limited to the duration from the dates of inception of the respective databases to December 31, 2022. The Newcastle-Ottawa scale was used to assess the evidence. A meta-analysis of the factors affecting the incidence of pulmonary infection was performed using Revman 5.4 software. Results: Twelve studies were selected, covering 35,615 patients with brain tumors, among whom pulmonary infection occurred in 1,635 cases with an accumulated incidence of 4.6%, including 38 related risk factors. Meta-analysis results indicated: history of chronic pulmonary disease (odds ratio [OR], 5.74; 95% confidence interval [CI], 1.34-24.51; p = 0.02], diabetes mellitus (OR, 1.58; 95% CI, 1.29-1.95; p < 0.0001), history of cardiovascular disease (OR, 3.97; 95% CI, 2.18-7.24; p < 0.00001), age ≥60 years (OR, 1.55; 95% CI, 1.12-2.15; p = 0.009)], operation time ≥3 hours (OR, 1.03; 95% CI, 1.00-1.05; p = 0.03], Glasgow Coma Scale (GCS) score <13 (OR, 3.5; 95% CI, 1.90-6.46; p < 0.0001), and the American Society of Anesthesiologists classification (ASA) ≥3 (OR, 2.03; 95% CI, 1.68-2.46; p < 0.00001) as independent risk factors. Conclusions: History of chronic pulmonary disease, diabetes mellitus, history of cardiovascular disease, age ≥60 years, operation time ≥3 hours, GCS score <13, and the ASA grade ≥3 are independent risk factors for post-operative pulmonary infection in patients with brain tumors, which nursing staff should be aware of.


Assuntos
Neoplasias Encefálicas , Doenças Cardiovasculares , Diabetes Mellitus , Pneumonia , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/cirurgia
18.
Front Neurol ; 14: 1206846, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37528854

RESUMO

Background: Due to disparities in medical resources in rural and urban areas as well as in different geographic regions in China, the effect of weekend versus weekday admission on the outcomes of acute ischemic stroke (AIS) patients is unknown. Our aim was to investigate whether the outcomes of AIS patients differ according to the day of admission in China. Methods: The data were extracted from the Chinese Acute Ischemic Stroke Treatment Outcome Registry (CASTOR), a multicenter prospective study database of patients diagnosed with AIS. The chi-square test (χ2) and logistic regression were used to assess mortality for weekday and weekend admissions among AIS patients stratified by rural or urban status and geographic region (including the eastern, northeastern, central, and western regions). Results: In total, 9,256 patients were included in this study. Of these patients, 57.2% were classified as urban, and 42.8% were classified as rural. A total of 6,760 (73%) patients were admitted on weekdays, and 2,496 (27%) were admitted on weekends. There was no significant difference in the mortality rate among patients admitted on weekends compared with those admitted on weekdays in urban (7.5% versus 7.4%) or rural areas (8.8% versus 8.1%; p > 0.05). The mortality rate was the highest among patients admitted on weekends and weekdays (11.6% versus 10.3%) in the northeastern area, without statistical significance before and after adjusting for the patients' background characteristics (p > 0.05). In addition, regression analysis revealed that the mortality of patients admitted on weekdays was more likely to be influenced by regional subgroup, hospital level and intravenous thrombolysis than that of patients admitted on weekends. Conclusion: The weekend effect was not observed in the mortality of patients with AIS regardless of rural-urban status or geographic region in China.

19.
BMC Cardiovasc Disord ; 23(1): 368, 2023 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-37479963

RESUMO

BACKGROUND: The X-linked inhibitor of apoptosis (XIAP) protein is encoded by the XIAP gene and is critical for multiple cell responses and plays a role in preventing cell death. XIAP mutations are associated with several diseases, primarily including hemophagocytic lymphohistiocytosis and inflammatory bowel disease (IBD). We report the clinical features and results associated with hemizygous mutation of the XIAP gene in a young male with Crohn's disease complicated with acute heart failure.This 16-year-old patient ultimately died of heart failure. CASE PRESENTATION: A young male of 16 years of age was initially diagnosed with Crohn's disease based on evidences from endoscopic and histological findings. Although supportive care, anti-infective drugs and biologics were administered consecutively for 11 months, his clinical manifestations and laboratory indices (patient's condition) did not improved. Additionally, the patient exhibited a poor nutritional status and sustained weight loss. Subsequently, acute heart failure led to the exacerbation of the patient's condition. He was diagnosed with wet beriberi according to thiamine deficiency, but the standard medical therapy for heart failure and thiamine supplementation did not reverse the adverse outcomes. Comprehensive genetic analysis of peripheral blood-derived DNA revealed a novel hemizygous mutation of the XIAP gene (c.1259_1262 delACAG), which was inherited from his mother. CONCLUSION: A novel XIAP mutation (c.1259_1262 delACAG) was identified in this study. It may be one of the potential pathogenic factors in Crohn's disease and plays an important role in the progression of heart failure. Additionally, thiamine deficiency triggers a vicious cycle.


Assuntos
Doença de Crohn , Insuficiência Cardíaca , Deficiência de Tiamina , Masculino , Humanos , Adolescente , Doença de Crohn/complicações , Doença de Crohn/diagnóstico , Doença de Crohn/genética , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/genética , Redução de Peso , Apoptose , Proteínas Inibidoras de Apoptose Ligadas ao Cromossomo X/genética
20.
Reprod Dev Med ; 7(2): 115-121, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37519480

RESUMO

Ovarian hyperstimulation syndrome (OHSS) is a frequent iatrogenic complication that arises during assisted reproduction and accounts for approximately 30% of all in vitro fertilization cycles. Using high-throughput sequencing, we investigated the peripheral blood transcriptome of patients with OHSS. Methods: Peripheral blood samples were obtained from 15 patients in each of the OHSS high-risk and low-risk groups on the ovum pick-up day. Subsequently, high-throughput sequencing was used to obtain the peripheral blood transcriptomes of five patients each from the high- and low-risk groups. Bioinformatic tools were used for mRNA expression profile mapping and screening of differentially expressed genes (DEGs). Bioinformatics techniques were also implemented in the Kyoto Encyclopedia of Genes Genomes (KEGG) signal pathway, Gene Ontology (GO) function, and protein-protein interaction (PPI) network analyses of DEGs. Results: A total of 20,031 genes were identified and 148 were found to be differentially expressed (P <0.05, |log2FC| > 0.58), with 52 upregulated and 96 downregulated genes. GO and KEGG analyses indicated that these genes were involved in extracellular corpuscles (GO: 0070062), plasma membrane (GO: 0005886), extracellular regions (GO: 0005576), immune system response (GO: 0006955), PI3K-Akt signaling pathways (hsa04151), cell adhesion molecules (CAMs, hsa04514), focal adhesion (hsa04510), and complement and coagulation cascades (hsa04610). The PPI network and realtime fluorescence quantitative polymerase chain reaction (qPCR) verification predicted that complement C3, von Willebrand factor, and vascular cell adhesion protein 1 proteins are highly implicated in OHSS and may serve as potential biomarkers for future OHSS studies. Conclusion: Transcriptome analysis revealed several DEGs related to OHSS risk factors in the peripheral blood, indicating that these DEGs may be novel players in OHSS development.

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