Cerebral Infarction as the Primary Presentation of Acute Aortic Dissection.

Background: The aim of this study was to determine the clinical characteristics and outcome of patients with aortic dissection (AD) who present with an initial manifestation of cerebral infarction. Methods: We retrospectively analyzed patients who were diagnosed with AD and admitted to the emergency department from May 1, 2017 to May 1, 2022. Data was collected for variables including age, sex, clinical manifestation, past medical history, and laboratory test results. Results: Twenty-five patients (2.61%, 22 type A and 3 type B) showed cerebral infarction as the primary presentation for acute AD, while another 933 AD patients (471 type A and 462 type B) who presented with other symptoms served as the control group. Eighteen of the 25 patients (72%) were initially diagnosed with stroke, and the diagnosis of AD was missed. However, patients with a missed diagnosis of AD did not have significantly different mortality to those in whom AD was diagnosed (chi-square test, p > 0.9999). Patients with cerebral infarction as the first presentation had a higher incidence of type A AD than the control patients (p = 0.0002), while their mortality rate was also higher than the control group of AD patients (p < 0.0001). Furthermore, patients with cerebral infarction as the first presentation were more likely to have multiple organ dysfunction. Conclusions: AD with an initial presentation of cerebral infarction is a rare condition with high mortality. However, the initial failure to diagnose AD does not further increase patient mortality.

Roles of Amides on the Formation of Atmospheric HONO and the Nucleation of Nitric Acid Hydrates.

Nitrous acid (HONO) is hazardous to the human respiratory system, and the hydrolysis of NO2 is the source of HONO. Hence, the investigation on the removal and transformation of HONO is urgently established. The effects of amide on the mechanism and kinetics of the formation of HONO with acetamide, formamide, methylformamide, urea, and its clusters of the catalyst were studied theoretically. The results show that amide and its small clusters reduce the energy barrier, the substituent improves the catalytic efficiency, and the catalytic effect order is dimer > monohydrate > monomer. Meanwhile, the clusters composed of nitric acid (HNO3), amides, and 1-6 water molecules were investigated in the amide-assisted nitrogen dioxide (NO2) hydrolysis reaction after HONO decomposes by combining the system sampling technique and density functional theory. The study on thermodynamics, intermolecular forces, optics properties of the clusters, as well as the influence of humidity, temperature, atmospheric pressure, and altitude shows that amide molecules promote the clustering and enhance the optical properties. The substituent facilitates the clustering of amide and nitric acid hydrate and lowers the humidity sensitivity of the clusters. The findings will help to control the atmospheric aerosol particle and then reduce the harm of poisonous organic chemicals on human health.

Release of Leu-Pro-Pro from corn gluten meal by fermentation with a Lactobacillus helveticus strain.

BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitory peptides are potential alternatives to the synthetic ACE inhibitory drugs, but the in vivo antihypertensive effects of most of them have not been confirmed. The tripeptide Leu-Pro-Pro (LPP) is one of the few peptides that have been proved clinically effective in reducing the blood pressure of hypertensive patients and casein is currently its major source. LPP is contained in multiple fractions of zein, and corn gluten meal (CGM) is hence a potential new source of LPP. For this purpose, CGM was fermented with a Lactobacillus helveticus strain and the medium composition was optimized; the decoloration of the resultant hydrolysate was investigated as well. RESULTS: LPP could be successfully released from CGM by fermentation with the strain Lactobacillus helveticus CICC 22536. The highest LPP content and protein recovery of 561 mg kg-1 and 14.92% occurred in the medium containing 20 g L-1 glucose, 15 g L-1 beef extract, 60 g L-1 CGM, 10 g L-1 CaCO3 , 0.5 g L-1 NaCl, and inoculation amount 6%. The supplementation of Flavourzyme® further improved the two parameters to 662 mg kg-1 and 36.94%, respectively. The permeate of the hydrolysate after ultrafiltration through a 5 kDa membrane could be effectively decolored by the macroporous resin XAD-16 without notable protein loss, and its LPP content was further boosted to 743 mg kg-1 . CONCLUSION: CGM is a potential new source of LPP and its ultrafiltered and decolored hydrolysate could be used to develop new antihypertensive functional foods. © 2021 Society of Chemical Industry.

Therapeutical plasma exchange for thrombotic thrombocytopenic purpura in the emergency department: A single center experience.

INTRODUCTION: Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening and easily misdiagnosed thrombotic microangiopathy disease. Few studies have reported the use of therapeutic plasma exchange (TPE) for TTP in emergency departments in China. The present study was a retrospective analysis of patients with TTP who were treated with TPE in our emergency intensive care unit (EICU). METHODS: This study retrospectively analyzed patients with TTP who received TPE management from July 1, 2014 to February 1, 2020. The following clinical data of these patients were collected: laboratory results, first symptoms, ADAMTS13 levels, glucocorticoid levels, TPE times and outcomes. RESULTS: The study included 19 patients (9 male and 10 female) with 20 clinical episodes, and 1 female patient had two episodes. TPE was used in 17 patients, and TPE was performed once every 2-3 days in patients. The volume for each TPE treatment was 2000 ml. In total, 4 male patients died, and 15 patients survived. One female experienced a relapse. No significant differences in age, RBC, HGB, PLT, ALT, AST, BUN, Cr, LDH, or bilirubin were noted between the survival and death groups. The mortality rate of male patients was significantly higher than that of female patients(p = 0.0325, p < 0.05), and the mean age of deceased patients was 64.25 ± 4.78 years, which was older than the mean age of survivors (47.38 ± 4.30). However, no significant difference was noted (p = 0.0787). CONCLUSION: TPE had satisfactory results for TTP patients although it was not performed every day. Older male TTP patients exhibited a relatively increased risk of death.

Antibacterial activity of lysozyme after association with carboxymethyl konjac glucomannan.

The unique high isoelectric point of lysozyme (LYZ) restricts its application in composite antibacterial coating due to the unfavorable liability to electrostatic interaction with other components. In this work, the antibacterial activity of a dispersible LYZ-carboxymethyl konjac glucomannan (CMKGM) polyelectrolyte complex was evaluated. Kinetic analysis revealed that, compared with free LYZ, the complexed enzyme exhibited decreased affinity (Km) but markedly increased Vmax against Micrococcus lysodeikticus, and QCM and dynamic light scattering analysis confirmed that the complex could bind with the substrate but in a much lower ratio. The complexation with CMKGM did not alter the antibacterial spectrum of LYZ, and the complex exerted antibacterial function by delaying the logarithmic growth phase and impairing the cell integrity of Staphylococcus aureus. Since the LYZ-CMKGM complex is dispersible in water and could be assembled easily, it has great potential as an edible coating in food preservation.

Spray drying the Pickering emulsions stabilized by chitosan/ovalbumin polyelectrolyte complexes for the production of oxidation stable tuna oil microcapsules.

The microencapsulation of polysaturated fatty acids by spray drying remains a challenge due to their susceptibility to oxidation. In this work, antioxidant Pickering emulsions were attempted as feeds to produce oxidation stable tuna oil microcapsules. The results indicated that the association between chitosan (CS) and ovalbumin (OVA) was a feasible way to fabricate antioxidant and wettable complexes and a high CS percentage favored these properties. The particles could yield tuna oil Pickering emulsions with enhanced oxidation stability through high-pressure homogenization, which were successfully spray dried to produce microcapsules with surface oil content of 8.84 % and microencapsulation efficiency of 76.65 %. The microcapsules exhibited significantly improved oxidation stability and their optimum peroxide values after storage at 50 °C, 85 % relative humidity, or natural light for 15 d were 48.67 %, 60.07 %, and 39.69 % respectively lower than the powder derived from the OVA-stabilized emulsion. Hence, Pickering emulsions stabilized by the CS/OVA polyelectrolyte complexes are potential in the production of oxidation stable polyunsaturated fatty acid microcapsules by spray drying.

Early enhanced external counter pulsation improves neurological recovery after the return of spontaneous circulation in a mongrel dog cardiac arrest model*.

OBJECTIVES: The aim of this study was to investigate whether early enhanced external counter pulsation therapy after cardiopulmonary resuscitation improved neurological outcome in a mongrel dog cardiac arrest model. DESIGN: Randomized, animal study. SETTING: Assisted circulation laboratory. SUBJECTS: Twenty-four healthy male adult dogs (12-14 kg). INTERVENTIONS: After minutes of untreated ventricular fibrillation followed by 2 minutes of cardiopulmonary resuscitation, the dogs were randomized to receive 4 hours of enhanced external counter pulsation therapy, to receive 4 hours of hypertension with over 140 mm Hg or to be a control. MEASUREMENTS: Blood pressure and left ventricular ejection fraction were recorded. Cerebral flow was assessed using magnetic resonance imaging. Arterial blood gases and endothelium-derived vasoactive substances were assessed before cardiac arrest and 4 hours after the return of spontaneous circulation. Neurological outcome was assessed by the neurologic deficit score and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining. RESULTS: Enhanced external counter pulsation significantly improved the left ventricular ejection fraction and increased common carotid artery blood flow and shear stress. Enhanced external counter pulsation increased both relative cerebral blood volume (RCBV, p = 0.043) and relative cerebral blood flow (RCBF, p = 0.012) in animals 4 hours after return of spontaneous circulation. Enhanced external counter pulsation therapy promoted the production of nitric oxide and tissue plasminogen activator and decreased the release of endothelin-1 (p = 0.013) after return of spontaneous circulation. Treatment with norepinephrine in the high mean artery pressure also increased common carotid artery blood flow and shear stress. However, no effects on the left ventricular ejection fraction, the production of nitric oxide and tissue plasminogen activator, or the release of endothelin-1 were found. The neurologic deficit scores of the animals were significantly lower at 24, 48, 72, and 96 hours in the enhanced external counter pulsation group, as well as at 24, 72, and 96 hours compared with animals in the control group after return of spontaneous circulation. Fewer apoptotic neurons were observed in the animals in the enhanced external counter pulsation group compared with the animals in the control and hypertension groups. CONCLUSIONS: These data indicated that the treatment of early enhanced external counter pulsation improved neurological outcome by both increasing cerebral blood flow and improving the recovery of microcirculation after return of spontaneous circulation. The treatment of early enhanced external counter pulsation can be a good option for protecting the brain after return of spontaneous circulation.

Interfacial adsorption behavior of the Aspergillus oryzae lipase-chitosan complex and stability evaluation of the resultant Pickering emulsion.

To prompt the application of the chitosan (CS)-Aspergillus oryzae lipase (AOL) complex in the construction of novel biphasic catalysis medium, its Pickering emulsion stabilization ability as well as adsorption behavior in the oil-water interface were investigated and the stability of resultant emulsion was evaluated. The results indicated that the CS-AOL complex assembled in mass ratio 1:5 was an effective Pickering stabilizer and up to 90 % AOL could be retained in the emulsion interface. Quartz crystal microbalance with dissipation monitoring suggested that the CS-AOL complex spontaneously absorbed to oil-water interface; absorption dynamics analysis revealed that the adsorption was driven by diffusion accompanied by rapid structural rearrangement; while interfacial dilatational rheology demonstrated the formation of an elastic film in the oil-water interface. The Pickering emulsions were pseudoplastic and that in oil fraction 0.6 exhibited the elastic behavior in contrast to the viscous behavior in oil fractions 0.2 and 0.4. The Pickering emulsion exhibited excellent stability against storage for up to 28 d, pHs 2.0-12.0, heating at 25-90 °C, and up to 500 mmol/L NaCl, and the corresponding interfacial AOL retentions exceeded 80 % during exposure to these conditions. Hence, the CS-AOL complex could be used as a stabilizer to construct Pickering emulsion-based biphasic catalysis systems.

Hydrogen-rich saline reverses oxidative stress, cognitive impairment, and mortality in rats submitted to sepsis by cecal ligation and puncture.

BACKGROUND: Sepsis is associated with high morbidity and mortality, and survivors can present with cognitive dysfunction. The present study was performed to investigate the effects of hydrogen-rich saline (HRS) on oxidative stress in the brain, cognitive dysfunction, and mortality in a rat model of sepsis. METHODS: A rat model of sepsis was induced by cecal ligation and puncture. Physiologic saline or HRS was administered intraperitoneally (2.5 mL/kg or 10 mL/kg) 10 min before the operation. The survival rate was recorded, and cognitive function was tested using the Morris water maze. The reactive oxygen species and malondialdehyde levels and superoxide dismutase activity in the hippocampus were observed to evaluate the oxidative stress levels. The caspase 3 levels were measured to detect apoptosis. The histopathologic changes in the hippocampus were evaluated by hematoxylin-eosin staining and the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay. RESULTS: Cecal ligation and puncture resulted in a poor survival rate, evidence of brain injury, and cognitive dysfunction. The hippocampal reactive oxygen species and malondialdehyde levels increased significantly, and superoxide dismutase activity decreased significantly. HRS reversed these changes in a dose-dependent manner. CONCLUSIONS: These findings indicate that HRS could attenuate the consequences of sepsis induced by cecal ligation and puncture in rats, at least in part, by the inhibition of oxidative stress.

Preparation of powdered oil by spray drying the Pickering emulsion stabilized by ovalbumin - Gum Arabic polyelectrolyte complex.

The suitability of the perilla seed oil Pickering emulsion stabilized by the ovalbumin (OVA) - gum Arabic (GA) polyelectrolyte complex for spray drying was investigated and the resultant powder was characterized. The OVA - GA complex conferred enhanced stability to the emulsion than OVA, GA, and their mixture. The viscosity of the Pickering emulsion was highly sensitive to stabilizer concentration and that fabricated by 2% OVA - GA complex showed acceptable viscosity and powder yield. The Pickering emulsion was more effective in preventing oil leakage during spray drying than the OVA-stabilized emulsion and the resultant powder possessed an oil content of up to 77.7%. Besides, the spray-dried Pickering emulsion powder showed greater rehydration and better flowability than that of the OVA-stabilized emulsion powder. Hence, the Pickering emulsion stabilized by the OVA - GA polyelectrolyte complex is promising as a novel feed for the production of oil powders by spray drying.

Addition of Chelators Increased the Stability of Black Rice Anthocyanins against the Metallic Ions in Tap Water and Improved the Coloration of Steamed Cold Noodles.

The anthocyanins in black rice extract (BRA) are sensitive to metallic ions, which restrict its application in the coloration of steamed cold noodles in China that uses tap water as the solvent. Food-grade chelators were added to check if they could increase the stability of BRA. The results indicated that the color decay of BRA in tap water was mainly caused by Fe3+, Cu2+, and Fe2+, and the addition of chelators could effectively antagonize this effect. Coloration with the BRA solution containing the optimized chelator formulation of 0.01% ethylenediaminetetraacetic acid disodium, 0.08% sodium hexametaphosphate, and 0.064% sodium tartrate conferred comparable appearance and chromatic attributes with those of the noodle colored by deionized water-dissolved BRA. The steamed cold noodles colored by the chelators-containing BRA exhibited increased springiness and decreased starch retrogradation, and possessed potential health functions due to its slightly increased resistant starch content and markedly enhanced antioxidant capacity. Hence, the addition of chelators is a feasible way to increase the color stability of BRA in tap water, and the chelators-supplemented BRA could be used to produce steamed cold noodles with attractive color and health benefits.

Risk Factors and Outcome Variables of Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients.

PURPOSE: This study's goal was to explore risk factors affecting short-term prognosis of cardiorenal syndrome type 1 (CRS1) in acute myocardial infarction (AMI) patients. METHODS: In this retrospective analysis of CRS1 in AMI patients hospitalized from January 2011 to December 2014, the patients were classified into deceased or survivor groups. Clinical data, including demographics, laboratory results, and 28-day outcomes, were collected. RESULTS: The incidence rate of CRS1 in AMI patients was 15.2% (274 in 1801). Ultimately, 88 patients were enrolled and 25 (28.4%) were classified into the deceased group, while 63 were classified into the survivor group. There were statistically significant differences between the groups for hypertension, mechanical ventilation, KIDGO stage, NT-proBNP, Hb, ALB, PCI, decreased LVEF, 7th-day SCr value, and the highest SCr value recorded within 7 days (all P < 0.05). Multivariate logistic regression showed that the following factors were significantly related to whether a patient died: requiring mechanical ventilation, increased NT-proBNP levels and 7th-day SCr values, and decreased LVEFs. The APACHE II, SOFA, and SASP II scores on the 7th day were significantly higher in the deceased group (all P < 0.05). The accuracy of APACHE II, SOFA, and SASP II scores on the 7th day for predicting death were 84.1%, 78.4% and 79.5%, respectively. The AUC of 7th-day APACHE II, SOFA, and SASP II scores was 0.844, 0.803, and 0.827, respectively, with no statistically significant differences between the three scores (P > 0.05). CONCLUSION: The mortality rate of CRS1 in AMI patients was 28.4% (25 in 88) within 28 days. Mechanical ventilation, increased NT-proBNP levels, the 7th-day SCr value, and decreased LVEF were related to death in AMI patients with CRS1. APACHE II, SOFA, and SAPS II scores on the 7th day were satisfactorily accurate in predicting death within 28 days.

Fabrication of lipase-loaded particles by coacervation with chitosan.

Coacervation of the lipase from Aspergillus oryzae (AOL) with chitosan was a feasible way to fabricate lipase-loaded particles and the optimum conditions were phase separation pH 5.5, chitosan to AOL mass ratio 1:5, and temperature 25 °C in the absence of NaCl, which conferred an AOL loading efficiency of up to 95.48% and activity recovery of 69.60%. The AOL-chitosan coacervates were highly porous and more susceptible to weight loss upon heating. Coacervation with chitosan increased the activity of AOL and shifted its optimum pH from 7.0 to 6.0, but exerted no effect on its optimum temperature (45 °C). Thermal deactivation kinetics analysis revealed that the coacervated AOL was more thermal stable, while the Michaelis-Menten kinetics analysis indicated that coacervation with chitosan increased the Vmax of AOL by 2.4 folds, but decreased its substrate affinity by 3.6 folds. Hence, the AOL-chitosan coacervates are potential in the construction of Pickering emulsion-based lipase catalysis systems.

Clinical Features of Aortic Dissection in the Emergency Department: A Single-center Experience from South China.

OBJECTIVES: Our goal in this study was to determine 1) whether there are any differences in clinical characteristics between Chinese and Western patients with aortic dissection (AD), and 2) the mortality rate of AD patients in the emergency department (ED) and identify the risk predictors for death. METHODS: We retrospectively analyzed patients who were diagnosed with AD and admitted to our ED between September 1, 2017-August 31, 2020. Data on age, gender, clinical manifestation, medical history, routine blood tests, liver and kidney function, coagulation, myocardial enzymology, and mortality were collected. RESULTS: We enrolled 535 AD patients (422 men and 113 women) with a mean age of 54.7±14.1 years. Type A AD constituted 40% of the total number of AD cases, while type B AD constituted 60%. The proportion of those who were females, 10-92 years, with type A AD, and hypertension in the Chinese population was lower than that in the Western population (P <0.05 for all). Type A AD patients had a higher proportion of acute AD clinical manifestations than did patients with type B AD (P = 0.0084, P <0.05). The mortality rate of type A AD patients (10.75%) was higher than that of type B AD patients (1.87%) (P <0.0001) in the ED. Higher values of white blood cells, neutrophils, high-density lipoprotein, activated partial thromboplastin time, and D-dimer level with worsened hepatic and renal function were found in the deceased group, and multivariate logistic regression revealed that blood urea nitrogen (BUN) levels (P = 0.0031, P <0.05) were significantly associated with death. CONCLUSION: In South China, patients with AD had a mean age of 54.7 years, with 78.88% prevalence in males and 66.92% hypertension rate. Type A AD accounted for 40% of all AD cases, and 10.70% of patients with type A AD died in the ED. Elevated BUN levels may be a risk predictor for death in patients with type A AD.

Soy-derived isoflavones inhibit HeLa cell growth by inducing apoptosis.

Isoflavones are among the major bioactive compounds found in a wide variety of plant-derived foods, especially in soybeans and soy-based foods. In this study, the effect of a soy-derived isoflavone mixture (designated as SI-I, containing 71% daidzein, 14.3% genistein and 14.7% glycitein) on HeLa cells and its mechanism were investigated. SI-I in concentration range 5-80 µg/ml significantly reduced the survival rate of HeLa cells by MTT assay, whereas showed no side effect on that of L929 cells. After HeLa cells were exposed to 10, 20 and 40 µg/ml SI-I for 4 days, typical apoptotic morphological changes, including nuclear fragmentation, cytoplasm shrinkage and decrease of cell volume, were observed by fluorescence microscope and CLSM, respectively. FCM analysis revealed that the percentages of early apoptotic cells with lost Δψm increased by 2.27, 2.74 and 4.05 folds respectively, compared with control. The results showed that SI-I inhibited HeLa cell growth through inducing apoptosis via the mitochondrial pathway and comparisons with reported data indicated that synergistic effect existed between the isoflavone species contained in SI-I. It is proposed that natural soy-derived isoflavones are potential candidates as chemotherapeutic agents against human cervical cancer.

Corrigendum: Social Innovation for Food Security and Tourism Poverty Alleviation: Some Examples From China.

[This corrects the article DOI: 10.3389/fpsyg.2021.614469.].

Social Innovation for Food Security and Tourism Poverty Alleviation: Some Examples From China.

The COVID-19 pandemic has brought hunger to millions of people around the world. Social distancing measures coupled with national lockdowns have reduced work opportunities and the overall household incomes. Moreover, the disruption in agricultural production and supply routes is expected to continue into 2021, which may leave millions without access to food. Coincidentally, those who suffer the most are poor people. As such, food security and tourism poverty alleviation are interlinked when discussing social problems and development. While the corporate interest in tourism poverty alleviation is as old as the industrial revolution, little research has been conducted to show how social innovation can be leveraged to reinforce food security and alleviate poverty. Thus, this case study examines the food industry in rural China to establish how it conducts social innovation in food production and distribution to facilitate social development and mitigate poverty.

Carboxymethyl konjac glucomannan coating on multilayered emulsions for improved bioavailability and targeted delivery of curcumin.

Curcumin was entrapped in multilayered emulsions to increase its stability and bioavailability. Curcumin emulsion stabilized by whey protein isolate (WPI) was coated with chitosan (CHI) or carboxymethyl konjac glucomannan (CMKGM) alone to form secondary emulsions and their combination in sequence to form the tertiary emulsion, in which, the polyelectrolyte concentrations were 1.0% WPI for the primary emulsion, 0.4% CMKGM for the secondary emulsion -CMKGM, 0.2% CHI for the secondary emulsion -CHI, and 0.1% CMKGM for the tertiary emulsion. The characteristics of the emulsions, including their particle size, ζ potential, microstructure, creaming stability, and biopolymer distribution, were investigated and their colon-targeted delivery potential was evaluated through both in vitro and in vivo studies as well. The curcumin-loaded secondary and tertiary emulsions were stable with a narrow size distribution and were generated by layer-by-layer assembly according to confocal laser scanning microscope observation. When CMKGM was located at the outermost layer, the corresponding secondary and tertiary emulsions showed a greatly reduced release of curcumin in the simulated gastric fluid, but exhibited increased release in the ß-mannanase-containing simulated colonic fluid. In vivo evaluation in mice demonstrated that the bioavailability of curcumin in the CMKGM-coated secondary and tertiary emulsions was increased by about 4 folds compared with that of free curcumin and curcumin could be released in a sustainable manner. These results demonstrated that multilayered emulsions coated with CMKGM could promote curcumin absorption in the gastrointestinal tract and hence is a promising colon-targeted delivery system for curcumin.