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1.
Ann Transl Med ; 10(8): 470, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35571390

RESUMO

Background: Sepsis is a life-threatening disease with high mortality. Early diagnosis is critical as early treatment improves outcomes. The protein levels of glucose regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP), markers of endoplasmic reticulum stress (ERS) activation, were reported increasing rapidly and continuously in the serum of patients with sepsis. Therefore, they might serve as a potential biomarker for sepsis diagnosis. This study aimed to analyze the role of GRP78 and CHOP in the diagnosis of patients with sepsis. Methods: This study enrolled a total of 92 infected patients with or without sepsis who were admitted to the intensive care unit (ICU) from February 1, 2018 to September 30, 2018. According to 2016 SCCM/ESICM Sepsis 3.0 diagnostic criteria, patients with sepsis were allocated into group I (sepsis infected group) and patients without sepsis were allocated into group II (non-sepsis infected group). Serum samples were collected on days 1, 2, 3, and 7 after admission to ICU, and the concentrations of GRP78 and CHOP in the serum were analyzed by enzyme-linked immunosorbent assay (ELISA). The diagnostic ability of GRP78, CHOP, and other traditional inflammatory markers was assessed with receiver operating characteristic (ROC)/area under the ROC curves (AUC) analysis. Patients were shortly follow-up for the 28-day mortality. Results: Serum GRP78 and CHOP levels in group I patients were higher than that in group II patients (P=0.021, P=0.00, respectively). When GRP78 was used to diagnose sepsis, the maximum area under the ROC curve (AUC) was 0.771 (95% CI: 0.662-0.880) and the optimal threshold was 157.29 ng/L (sensitivity, 75.0%; specificity, 73.1%) on day 2. When CHOP was used for the diagnosis of sepsis, the maximum AUC was 0.813(95% CI: 0.721-0.906) and the optimal threshold was 4.915 ng/L (sensitivity, 57.7%; specificity, 96.2%) on day 2. Conclusions: Compared with traditional inflammatory markers, ERS-related specific proteins GRP78 and CHOP have better sensitivity and specificity in the diagnosis of sepsis, which is helpful for clinicians in the diagnosis of sepsis.

2.
Crit Care ; 26(1): 122, 2022 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-35505432

RESUMO

BACKGROUND: Current sedatives have different side effects in long-term sedation. The sequential use of midazolam and dexmedetomidine for prolonged sedation may have distinct advantages. We aimed to evaluate the efficacy and safety of the sequential use of midazolam and either dexmedetomidine or propofol, and the use of midazolam alone in selected critically ill, mechanically ventilated patients. METHODS: This single-center, randomized controlled study was conducted in medical and surgical ICUs in a tertiary, academic medical center. Patients enrolled in this study were critically ill, mechanically ventilated adult patients receiving midazolam, with anticipated mechanical ventilation for ≥ 72 h. They passed the spontaneous breathing trial (SBT) safety screen, underwent a 30-min-SBT without indication for extubation and continued to require sedation. Patients were randomized into group M-D (midazolam was switched to dexmedetomidine), group M-P (midazolam was switched to propofol), and group M (sedation with midazolam alone), and sedatives were titrated to achieve the targeted sedation range (RASS - 2 to 0). RESULTS: Total 252 patients were enrolled. Patients in group M-D had an earlier recovery, faster extubation, and more percentage of time at the target sedation level than those in group M-P and group M (all P < 0.001). They also experienced less weaning time (25.0 h vs. 49.0 h; HR1.47, 95% CI 1.05 to 2.06; P = 0.025), and a lower incidence of delirium (19.5% vs. 43.8%, P = 0.002) than patients in group M. Recovery (P < 0.001), extubation (P < 0.001), and weaning time (P = 0.048) in group M-P were shorter than in group M, while the acquisition cost of sedative drug was more expensive than other groups (both P < 0.001). There was no significant difference in adverse events among these groups (all P > 0.05). CONCLUSIONS: The sequential use of midazolam and dexmedetomidine was an effective and safe sedation strategy for long-term sedation and could provide clinically relevant benefits for selected critically ill, mechanically ventilated patients. TRIAL REGISTRATION: NCT02528513 . Registered August 19, 2015.


Assuntos
Dexmedetomidina , Propofol , Adulto , Estado Terminal/terapia , Dexmedetomidina/efeitos adversos , Humanos , Hipnóticos e Sedativos/farmacologia , Hipnóticos e Sedativos/uso terapêutico , Midazolam/efeitos adversos , Propofol/efeitos adversos , Respiração Artificial
3.
J Food Biochem ; : e14235, 2022 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-35579221

RESUMO

It has been reported that the aqueous extract from Oxalis corniculate has excellent pharmacological effects, but its polysaccharide as the major ingredient in the aqueous extract has not been reported. When the temperature of 50°C, ultrasonic power of 270 W, time of 25 min, solid to liquid ratio of 30 ml·g-1 , the optimal O. corniculate polysaccharide (OCP) yield was 9.45%. The physicochemical properties indicated that OCP-3, as the major fraction of OCP, was an acidic polysaccharide with 31.5 kDa, and it mainly consisted of arabinose (47.83%), galacturonic acid (17.81%), and galactose (14.25%). In addition, OCP-3 displayed an excellent antioxidant activity in vitro, including scavenging free radical, anti-lipid peroxidation, and protecting plasmid DNA from oxidative damage. Meanwhile, OCP-3 significantly reduced the levels of malondialdehyde and protein carbonyl by significantly increasing the activity of superoxide dismutase, catalase, and glutathione peroxidase, which protected the HEK 293 cell and Caenorhabditis elegans from oxidative damage. All the results suggested that OCP-3 might be the major active ingredient of the aqueous extract from O. corniculate, and OCP-3 might be a potent antioxidant supplement in the food, cosmetics, and medical industries. PRACTICAL APPLICATIONS: Oxalis corniculate is a kind of wild vegetable and ethnomedicine, and it is widely distributed in temperate zones. Unfortunately, its utilization rate is low compared to its yield. Our research suggested that the polysaccharide of OCP-3 from O corniculate might be used as a potent antioxidant supplement in the food, cosmetics, and medical industries.

4.
Int J Biol Macromol ; 209(Pt B): 2165-2174, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35500783

RESUMO

The diurnal changes in the expression profiles of starch synthesis related enzymes (SSREs) has been previously studied in transitory starches, while its influences on storage starch molecular structures in the rice endosperm during seed development have not been elucidated. In this study, the changes in the transcript levels of starch synthesis related genes (SSRGs), the protein abundances and enzyme activities of SSREs as well as starch molecular structures in rice endosperm at 10 days after flowering (DAF) over the diurnal cycle were analyzed. It was found that the expression profiles of SSRG and the protein contents of SSREs displayed different diurnal patterns between two indica rice varieties with medium- and high-amylose content (AC), respectively. The expression levels of SSRGs were higher in the light time, and most SSREs also accumulated during this period except debranching enzymes. Amylose synthesis displayed distinct diurnal patterns in two rice varieties, which is attributed to the diurnal changes in the protein content of granule-bound starch synthase I (GBSSI), but amylopectin chain-length distributions (CLDs) remained unaltered due to its vast numbers of branches. The results provide the first step to understand the roles of each enzyme isoform involved in starch synthesis in response to diurnal regulation in rice endosperm.

6.
Eur J Immunol ; 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35476255

RESUMO

The pancreas contains exocrine glands, which release enzymes (e.g., amylase, trypsin, and lipase) that are important for digestion and islets, which produce hormones. Digestive enzymes and hormones are secreted from the pancreas into the duodenum and bloodstream, respectively. Growing evidence suggests that the roles of the pancreas extend to not only the secretion of digestive enzymes and hormones but also to the regulation of intestinal homeostasis and inflammation (e.g., mucosal defense to pathogens and pathobionts). Organ crosstalk between the pancreas and intestine is linked to a range of physiological, immunological, and pathological activities, such as the regulation of the gut microbiota by the pancreatic proteins and lipids, the retroaction of the gut microbiota on the pancreas, the relationship between inflammatory bowel disease, and pancreatic diseases. We herein discuss the current understanding of the pancreas-intestinal barrier axis and the control of commensal bacteria in intestinal inflammation.

9.
J Healthc Eng ; 2022: 9689769, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35392145

RESUMO

The objective of this study was to discuss the health management of elderly patients in the community and the management of community rehabilitation under the support of the new Internet of Things (IoT). The IoT technology was adopted to monitor the wearable devices through mobile medical physiological data. The heart rate, blood pressure, respiratory rate, and other physiological indicators of the elderly were collected in real time. The support vector machine (SVM) algorithm was selected as the core algorithm for the elderly physiological index disease risk assessment, the fuzzy comprehensive evaluation method was adopted as the core method of the elderly disease risk quantitative assessment model to process the physiological indicators, and finally, a reasonable physiological index processing model and quantitative indicators of disease risk were obtained. The data on vascular disease were selected from the MIMIC database. In addition, the advantages and disadvantages of the SVM algorithm and the Backpropagation Neural Network (BPNN) algorithm were compared and analysed. The final verification results showed that the fusion accuracy of the SVM processing MIMIC database and the University of California Irvine (UCI) dataset was 0.8327 and 0.8045, respectively, while the fusion accuracy of the BPNN algorithm in processing the same data was 0.7792 and 0.7288, respectively. It was obvious that the fusion accuracy of the SVM algorithm was higher than that of the BPNN algorithm, and the accuracy difference of the SVM algorithm was lower than that of the BPNN algorithm in different groups of data. In the verification of the elderly disease risk quantitative assessment model, the results were consistent with the selected data, which verified the effectiveness of the design model in this study. Therefore, it can be used as a quantitative assessment model of general elderly physiological indicators of disease risk and can be applied to the community medical communication management system. It proved that the model of medical communication and rehabilitation services for elderly patients in the community constructed in this study can definitely help the development of community service for the elderly.


Assuntos
Internet das Coisas , Idoso , Algoritmos , Comunicação , Humanos , Redes Neurais de Computação , Seguridade Social , Máquina de Vetores de Suporte
10.
Pediatr Radiol ; 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35384483

RESUMO

BACKGROUND: Magnetic resonance imaging (MRI)-based liver iron quantification is the standard of care to guide chelation therapy in children at risk of hemochromatosis. T2* relaxometry is the most widely used technique but requires third-party software for post-processing. Vendor-provided three-dimensional (3-D) multi-echo Dixon techniques are now available that allow inline/automated post-processing. OBJECTIVE: The purpose of our study was to evaluate the diagnostic accuracy of a volumetric multi-echo Dixon technique using conventional T2* relaxometry as the reference standard in a pediatric and young adult population. MATERIALS AND METHODS: In this retrospective study, we queried the radiology information system to identify all MRIs performed for liver iron quantification from July 2015 to January 2020. All patients had undergone T2* relaxometry on a 1.5-tesla (T) scanner for liver iron concentration (LIC) estimation. In addition, a 3-D multi-echo Dixon was performed using Siemens Healthineers LiverLab (Erlangen, Germany). Two readers independently estimated liver R2* and T2* on the multi-echo Dixon by drawing free-hand regions of interest on the scanner-generated R2* and T2* maps. Conventional T2*-relaxometry-based LIC was the reference standard. We estimated interobserver agreement by concordance correlation coefficient (CCC). We used Bland-Altman analysis and Pearson correlation coefficient (r) to compare LIC by the two methods. RESULTS: Fifty-four MRIs on 38 patients (22 females) were available for analysis. Mean patient age was 11.8 years (standard deviation [SD] 5.3 years). Reference standard LIC ranged 1.1-21.1 (median 6.8) mg/g dry weight of liver. The concordance between readers for T2* estimation using 3-D multi-echo Dixon was substantial (CCC 0.99, confidence interval 0.99-1.00). Bland-Altman plot showed that all observations were clustered around the zero bias line if the LIC average was ≤8 mg/g, and r was very strong (reader 1 r=0.93, reader 2 r=0.92, both P-values <0.001). With increasing LIC, there was a pattern of poor agreement on the Bland-Altman plot, with observations crossing the lower limits of agreement, and r was very weak (reader 1 r=0.05, P-value 0.84; reader 2 r=0.17, P-value 0.44). CONCLUSION: Vendor-based 3-D multi-echo Dixon allows for excellent interobserver correlation in liver T2* estimation. LIC estimated by this method has a very strong correlation with conventional T2* relaxometry if liver iron overload is mild-moderate (LIC ≤8 mg/g).

11.
Ann Clin Lab Sci ; 52(2): 185-195, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35414497

RESUMO

OBJECTIVE: This study was designed to visualize the pan-cancer prognostic significance of PReferentially expressed Antigen in Melanoma (PRAME) and investigate the relationship between PRAME expression and tumor immunity. MATERIAL AND METHODS: We explored the expression patterns and prognostic value of PRAME across multiple cancers using data from the Cancer Genome Atlas, Genotype-Tissue Expression, and Cancer Cell Line Encyclopedia databases. Spearman's correlation test was used to evaluate correlations between PRAME expression and the tumor immune microenvironment, mutation indicators, and DNA methylation. Finally, the functions of PRAME and potential signaling pathway mechanisms were explored through Gene Set Enrichment Analysis (GSEA). RESULTS: Pan-cancer survival analysis indicated that PRAME was widely up-regulated in most tumors, and its high expression was indicative of poor overall survival in different cancer types. In addition, PRAME expression levels were strongly linked to immune infiltration, immune score, immune checkpoint, immune neoantigens, tumor mutation burden, microsatellite instability, mismatch repair, and DNA methyltransferase in a variety of cancers. GSEA analysis revealed that PRAME was related to the regulation of numerous signaling pathways implicated in tumor immunity and tumorigenicity. CONCLUSIONS: PRAME has the potential to serve as a prognostic pan-cancer biomarker and is correlated with tumor immunity. Its use may help shed light on optimum cancer therapies.


Assuntos
Carcinógenos , Neoplasias , Antígenos de Neoplasias/genética , Biomarcadores Tumorais/genética , Carcinogênese/genética , Humanos , Neoplasias/metabolismo , Prognóstico , Microambiente Tumoral/genética
12.
Front Med (Lausanne) ; 9: 862226, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35479952

RESUMO

Background: Evaluation of fluid responsiveness in intensive care unit (ICU) patients is crucial. This study was to determine whether changes in the cardiac index (CI) induced by a unilateral passive leg raising (PLR) test in spontaneously breathing patients can estimate fluid responsiveness. Methods: This was a prospective study, and 40 patients with spontaneous breathing activity who were considered for volume expansion (VE) were included. CI data were obtained in a semirecumbent position, during unilateral PLR, bilateral PLR, and immediately after VE. If the CI increased more than 15% in response to the expansion in volume, patients were defined as responders. Results: The results showed that a unilateral PLR-triggered CI increment of ≥7.5% forecasted a fluid-triggered CI increment of ≥15% with 77.3% sensitivity and 83.3% specificity with and an area under the receiver operating characteristic (ROC) curve of 0.82 [P < 0.001]. Compared with that for bilateral PLR, the area under the ROC curve constructed for unilateral PLR-triggered changes in CI (ΔCI) was not significantly different (p = 0.1544). Conclusion: ΔCI >7.5% induced by unilateral PLR may be able to predict fluid responsiveness in spontaneously breathing patients and is not inferior to that induced by bilateral PLR. Trial Registration: Unilateral passive leg raising test to assess patient volume responsiveness: Single-Center Clinical Study, ChiCTR2100046762. Registered May 28, 2021.

13.
Biomolecules ; 12(3)2022 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-35327646

RESUMO

Histamine intolerance (HIT) is a common disorder associated with impaired histamine metabolism. Notwithstanding, it is often misdiagnosed as other diseases because of its lack of specific clinical manifestations. HIT did not gain traction until the early 21st century. In this review, we will focus on the latest research and elaborate on the clinical manifestations of HIT, including its manifestations in special populations such as atopic dermatitis (AD) and chronic urticaria (CU), as well as the latest understanding of its etiology and pathogenesis. In addition, we will explore the latest treatment strategies for HIT and the treatment of specific cases.


Assuntos
Amina Oxidase (contendo Cobre) , Dermatite Atópica , Hipersensibilidade , Amina Oxidase (contendo Cobre)/metabolismo , Dermatite Atópica/diagnóstico , Histamina/metabolismo , Humanos , Hipersensibilidade/diagnóstico
14.
J Gastrointest Oncol ; 13(1): 56-66, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35284100

RESUMO

Background: Postoperative mortality and severe complications are associated with both long-term blood glucose management and the severity of stress hyperglycemia. The purpose of this study was to assess the predictive value of a novel index, the stress hyperglycemia ratio (SHR), for short-term mortality in critically ill patients following esophagectomy. Methods: A total of 356 patients who underwent esophagectomy for esophageal squamous cell carcinoma (ESCC) and were admitted to the intensive care unit (ICU) were included in this retrospective study. Based on the SHR values, patients were divided into low (SHR <1.14) or high (SHR ≥1.14) groups in the overall and diabetic populations. The major outcomes of this study were the 30- and 90-day all-cause mortalities. We used Cox proportional hazard regression, Kaplan-Meier survival analysis, and competing risk regression models to analyze the relationships between risk factors and outcomes. Results: The 30- and 90-day mortality in the high-SHR group were significantly higher compared to the low-SHR group in the total population (30-day: 1.3% vs. 10.5%, P<0.001; 90-day: 5.8% vs. 20.0%, P<0.001) and the diabetic population (30-day: 2.6% vs. 17.3%, P=0.026; 90-day: 5.1% vs. 36.5%, P<0.001). After adjusting for covariables, the risk of the 30-day mortality [1.770 (1.442, 3.170)] and 90-day mortality [1.869 (1.289, 3.409)] remained significant (P=0.035, P=0.045) in the total population. A similar result was observed in patients with diabetes [30-day: 1.642 (1.131, 2.710), P=0.015; 90-day: 2.136 (1.254, 3.946), P=0.005]. The Kaplan-Meier survival estimates for the 30-/90-day mortality also showed comparable results. The multivariable logistic regression analysis, including all glucose-related indices and the Acute Physiology and Chronic Health Evaluation (APACHE) II score, showed that SHR was independently correlated with the 30- and 90-day mortality; each 0.1-increase was related to a 3-4% elevation in the 30-/90-day mortality [odds ratio (OR), 1.044; 95% confidence interval (CI), 1.036-1.069; OR, 1.036; 95% CI, 1.021-1.051]. Conclusions: In this study, we found that a relative increase in blood glucose, as quantified by the SHR ≥1.14, was independently related to the higher 30-/90-day mortality in patients admitted to the ICU with severe complications following esophagectomy, while absolute hyperglycemia was not.

15.
Hum Exp Toxicol ; 41: 9603271221076107, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35264022

RESUMO

Diabetic retinopathy (DR) is a common diabetic complication that severely impacts the life quality of diabetic patients. Recently, cellular senescence in human retinal endothelial cells (HRECs) induced by high glucose has been linked to the pathogenesis of DR. Fluorometholone (FML) is a glucocorticoid drug applied in the treatment of inflammatory and allergic disorders of the eye. The objective of the present study is to investigate the protective function of FML on high glucose-induced cellular senescence in HRECs. The in vitro injury model was established by stimulating HRECs with 30 mm glucose. After evaluating the cytotoxicity of FML in HRECs, 0.05% and 0.1% FML were used as the optimal concentration in the entire experiment. It was found that the excessive released inflammatory factors including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8) in HRECs induced by high glucose were significantly suppressed by FML, accompanied by the inhibitory effects on the expression levels of vascular endothelial growth factor (VEGF) and tissue factor (TF). Declined telomerase activity and enhanced senescence-associated ß-galactosidase (SA-ß-gal) activity were found in high glucose-challenged HRECs, which were dramatically alleviated by FML, accompanied by the inactivation of the p53/p21 and retinoblastoma (Rb) signaling. Interestingly, FML ameliorated high glucose-induced dephosphorylation of Akt. Lastly, the protective effects of FML against high glucose-induced cellular senescence in HRECs were abolished by the co-treatment of the PI3K/Akt signaling inhibitor LY294002, suggesting the involvement of this pathway. Taken together, these data revealed that FML-inhibited high glucose-induced cellular senescence mediated by Akt in HERCs, suggesting a novel molecular mechanism of FML.


Assuntos
Proliferação de Células/efeitos dos fármacos , Senescência Celular/efeitos dos fármacos , Retinopatia Diabética/prevenção & controle , Células Endoteliais/efeitos dos fármacos , Fluormetolona/farmacologia , Substâncias Protetoras/farmacologia , Retina/efeitos dos fármacos , Animais , Células Cultivadas/efeitos dos fármacos , Diabetes Mellitus Experimental , Retinopatia Diabética/fisiopatologia , Fluormetolona/administração & dosagem , Humanos , Substâncias Protetoras/administração & dosagem
16.
Molecules ; 27(5)2022 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-35268655

RESUMO

In this paper, we report the design, synthesis and biological evaluation of a novel S-allyl-l-cysteine (SAC) and gallic acid conjugate S-(4-fluorobenzyl)-N-(3,4,5-trimethoxybenzoyl)-l-cysteinate (MTC). We evaluate the effects on ischemia-reperfusion-induced PC12 cells, primary neurons in neonatal rats, and cerebral ischemic neuronal damage in rats, and the results showed that MTC increased SOD, CAT, GPx activity and decreased LDH release. PI3K and p-AKT protein levels were significantly increased by activating PI3K/AKT pathway. Mitochondrial pro-apoptotic proteins Bax and Bim levels were reduced while anti-apoptotic protein Bcl-2 levels were increased. The levels of cleaved caspase-9 and cleaved caspase-3 were also reduced in the plasma. The endoplasmic reticulum stress (ERS) was decreased, which in turns the survival rate of nerve cells was increased, so that the ischemic injury of neurons was protected accordingly. MTC activated the MEK-ERK signaling pathway and promoted axonal regeneration in primary neurons of the neonatal rat. The pretreatment of MEK-ERK pathway inhibitor PD98059 and PI3K/AKT pathway inhibitor LY294002 partially attenuated the protective effect of MTC. Using a MCAO rat model indicated that MTC could reduce cerebral ischemia-reperfusion injury and decrease the expression of proinflammatory factors. The neuroprotective effect of MTC may be due to inhibition of the over-activation of the TREK-1 channel and reduction of the current density of the TREK1 channel. These results suggested that MTC has a protective effect on neuronal injury induced by ischemia reperfusion, so it may have the potential to become a new type of neuro-ischemic drug candidate.


Assuntos
Fosfatidilinositol 3-Quinases
17.
Nutrients ; 14(3)2022 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-35276925

RESUMO

(1) Background: Acute muscle inflammation leads to increased sonographic echodensity. We developed a technique to characterize the echodensity of the gastric antrum wall and assess its feasibility in evaluating the severity of acute gastrointestinal injury (AGI); (2) Methods: The B-mode images of the gastric antrum of each enrolled patient were obtained daily by point-of-care ultrasound (POCUS). The 50th percentile, 85th percentile, and mean value of the grayscale distribution according to histogram analysis (ED50, ED85, and EDmean, respectively) were used to characterize the gastric antrum echodensity. Consistency and correlation analyses were performed to evaluate the feasibility and reproducibility of gastric antrum echodensity measurement. The association of gastric antrum echodensity with the severity of AGI and its ability to predict feeding intolerance (FI) were analyzed; (3) Results: In total, 206 POCUS images of 43 patients were analyzed. The gastric antrum echodensity measurements had sufficient intra- and inter-investigator reliabilities (intraclass correlation coefficient >0.9 for all parameters). The ED50 showed a significant upward trend as AGI severity increased, as well as ED85 and EDmean (p for trend <0.001, respectively). Patients who experienced FI had a higher ED50 (67.8 vs. 56.1, p = 0.02), ED85 (85.6 vs. 71.2, p = 0.01), and EDmean (70.3 vs. 57.6, p = 0.01) upon enteral feeding initiation; (4) Conclusions: Measurement of gastric antrum echodensity was technically feasible and reproducible in ventilated patients. Increased gastric antrum echodensity was associated with greater severity of AGI. Patients with higher gastric antrum echodensity upon enteral nutrition initiation via a nasogastric tube were more likely to develop FI.


Assuntos
Estado Terminal , Antro Pilórico , Nutrição Enteral/métodos , Humanos , Recém-Nascido , Antro Pilórico/diagnóstico por imagem , Reprodutibilidade dos Testes , Ultrassonografia
18.
Biomacromolecules ; 23(3): 1443-1452, 2022 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-35143725

RESUMO

Starch biosynthesis is controlled by multiple enzymes, including granule-bound starch synthase I (GBSSI), soluble starch synthases (SSs), branching enzymes (BEs), and debranching enzymes (DBEs). Although the role of individual isoforms has been primarily elucidated, the precise information about how they work together in the synthesis of specific amylose and amylopectin chains is still unclear. In this study, starch molecular chain-length distributions (CLDs) of five rice varieties with different amylose contents were measured by fluorophore-assisted carbohydrate electrophoresis and size-exclusion chromatography and fitted with two mathematical models, and the protein abundance of 11 starch synthesis-related enzymes was measured by western blotting. The correlation between model fitting parameters of amylose and amylopectin CLDs demonstrated that amylose and amylopectin syntheses are closely dependent. GBSSI could interact with BEI, BEIIb, SSIIa, SSIVb, ISA1, PUL, and PHO1 to synthesize the amylopectin intermediate and long chains as well as amylose chains. In addition, the interaction among SSIVb and SSI, SSIIa, BEI, BEIIb, ISA1, and PUL possibly suggests that SSIVb assists them to synthesize the amylopectin chains. The results can help understand the mechanisms about the functional interaction of different enzyme isoforms in starch biosynthesis.


Assuntos
Amilose , Oryza , Amilopectina/química , Amilopectina/metabolismo , Amilose/química , Modelos Teóricos , Oryza/química , Oryza/metabolismo , Amido/química
19.
J Med Virol ; 94(6): 2588-2597, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35170774

RESUMO

Amantadine, an antiviral drug, has been widely used in human anti-influenza treatments. However, several highly pathogenic avian influenza viruses show amantadine-resistance mutations in the viral matrix 2 (M2) protein. Here we analyzed global H5N1 sequencing data and calculate possible correlations between frequencies of key mutations in M2 and the mortality rates. We found that the frequency of L26I/V27A mutation in M2 (isolated from both human and avian hosts) is linearly correlated with the mortality rates of human H5N1 infections. The significant correlation between M2 mutations in avians and the mortality rates in humans suggests that the pre-existence of L26I/V27A in birds may determine patient fatalities after transinfections from avian to human hosts. 100% prevalence of L26I/V27A mutation increased the mortality rates from 51% (95% confidence interval [CI] 37%-65%) to 89% (95% CI 88%-90%). Mutations involving Leu26 or Val27 were identified to be the major mutations emerging from drug selection pressure. Thus the emergence of the super H5N1 virus with a fatality of over 90% may be attributed to the abuse of amantadine in poultry, especially in some southeast Asian countries. A more stringent control to antiviral veterinary drugs is imperative.


Assuntos
Virus da Influenza A Subtipo H5N1 , Influenza Aviária , Influenza Humana , Amantadina/farmacologia , Amantadina/uso terapêutico , Animais , Antivirais/farmacologia , Antivirais/uso terapêutico , Aves , Farmacorresistência Viral/genética , Humanos , Virus da Influenza A Subtipo H5N1/genética , Influenza Aviária/epidemiologia , Influenza Humana/tratamento farmacológico , Influenza Humana/epidemiologia , Filogenia , Aves Domésticas , Proteínas da Matriz Viral/genética
20.
Int J Gen Med ; 15: 451-463, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35046706

RESUMO

PURPOSE: Risk factors and prognostic model of fatal outcomes need to be investigated for the increasing number of immunocompromised hosts (ICHs) who are hospitalized for severe pneumonia with high hospital mortality. PATIENTS AND METHODS: In this single-center, retrospective study, we recruited 1,933 ICHs with severe pneumonia who were admitted to the intensive care unit (ICU) in West China hospital, Sichuan university, China between January, 2012 and December, 2018. Clinical features, laboratory findings, and fatal outcomes were collected from electronic medical records. Patients were randomly separated into a 70% training set (n=1,353) and a 30% testing set (n=580) for the development and validation of a prediction model. All data within 24 hours of ICU admission were compared between survivors and non-survivors. The risk factors were identified through LASSO and multivariate logistic regression analysis, and then used to develop a predicting nomogram. The nomogram for predicting hospital mortality of ICHs with severe pneumonia in the ICU was validated by C-index, AUC (area under the curve), calibration curve, and Decision Curve Analysis (DCA). RESULTS: Eight risk factors, including age, fever, dyspnea, chronic renal disease, platelet counts, neutrophil counts, PaO2/FiO2 ratio, and the requirement for vasopressors, were adopted in a nomogram for predicting hospital mortality. The nomogram had great predicting accuracy with a C-index of 0.819 (95% CI=0.795-0.842) in the training set, and a C-index of 0.819 (95% CI=0.783-0.855) in the testing set for hospital mortality. Additionally, the nomogram had well-fitted calibration curves. DCA demonstrated that the nomogram was clinically beneficial. CONCLUSION: This study developed a novel nomogram for predicting hospital mortality of ICHs with severe pneumonia in the ICU. Validation showed good discriminatory ability and calibration, indicating that the nomogram was expected to be a superior predictive tool for doctors to identify risk factors and predict mortality, and might be generally applied in clinical practice after more external validations.

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