RESUMO
Objective: To assess the effects of the clinical nursing pathway (CNP) on blood glucose and urine ketones in patients with diabetic ketoacidosis (DKA). Methods: A total of 60 patients with DKA (20 type I and 40 type II) treated in the Department of Endocrinology at Anhui Second People's Hospital from January 2018 to May 2022 were recruited and randomly assigned to receive routine nursing (control group) or CNP plus routine nursing (observation group), with 30 patients in each group. The observation group received the clinical nursing pathway (CNP) along with routine nursing care. As part of the CNP, low-flow oxygen therapy was administered to the patients. Low-flow oxygen therapy involves the delivery of oxygen at a lower flow rate compared to high-flow oxygen therapy. In this study, a flow rate of 2 L/min was used. The low-flow oxygen was administered to the patients through a nasal cannula or a similar device. Outcome measures included symptom relief and length of hospital stay. Results: The observation group showed a significantly higher decline rate of blood glucose in patients than in the control group. Patients in the observation group had a more rapid disappearance of urine ketones versus those in the control group. CNP plus routine nursing resulted in a significantly shorter length of hospital stay versus routine nursing (RR:0.79, 95% CI (1.078, 4.511), P < .05). Conclusion: CNP plus continuous low-flow oxygen breathing facilitates the decline of blood glucose, removes ketone bodies, mitigates DKA symptoms, and shortens the length of hospital stay.
RESUMO
Cordycepin is the primary active compound of Cordyceps militaris. However, the definitive genetic mechanism governing cordycepin synthesis in fruiting body growth and development remains elusive, necessitating further investigation. This study consists of 64 C. militaris strains collected from northeast China. The high-yielding cordycepin strain CMS19 was selected for the analysis of cordycepin production and the genetic basis of cordycepin anabolism. First, the whole-genome sequencing of CMS19 yielded a final size of 30.96 Mb with 8 contigs and 9781 protein-coding genes. The genome component revealed the presence of four additional secondary metabolite gene clusters compared with other published genomes, suggesting the potential for the production of new natural products. The analyses of evolutionary and genetic differentiation revealed a close relationship between C. militaris and Beauveria bassiana. The population of strains distributed in northeast China exhibited the significant genetic variation. Finally, functional genes associated with cordycepin synthesis were identified using a combination of genomic and transcriptomic analyses. A large number of functional genes associated with energy and purine metabolism were significantly enriched, facilitating the reconstruction of a hypothetical cordycepin metabolic pathway. Therefore, our speculation of the cordycepin metabolism pathway involved 24 genes initiating from the glycolysis and pentose phosphate pathways, progressing through purine metabolism, and culminating in the core region of cordycepin synthesis. These findings could offer fundamental support for scientific utilizations of C. militaris germplasm resources and standardized cultivation for cordycepin production.