Auxin synthesis promotes N metabolism and optimizes root structure enhancing N acquirement in maize (Zea mays L.).

MAIN CONCLUSION: Foliar NAA increases photosynthate supplied by enhancing photosynthesis, to strengthen root activity and provide a large sink for root carbohydrate accumulation, which is beneficial to acquire more nitrogen. The improvement of grain yield is an effective component in the food security. Auxin acts as a well-known plant hormone, plays an important role in maize growth and nutrient uptake. In this study, with maize variety Zhengdan 958 (ZD958) as material, the effects of auxin on nitrogen (N) uptake and assimilation of seedling maize were studied by hydroponic experiments. With water as the control, naphthalene acetic acid (NAA, 0.1 mmol/L) and aminoethoxyvinylglycine (AVG, 0.1 mmol/L, an auxin synthesis inhibitor) were used for foliar spraying. The results showed that NAA significantly improved photosynthetic rate and plant biomass by 58.6% and 91.7%, respectively, while the effect of AVG was opposite to that of NAA. At the same time, key enzymes activities related N assimilation in NAA leaves were significantly increased, and the activities of nitrate reductase (NR), glutamine synthetase (GS) and glutamate synthase (GOGAT) were increased by 32.3%, 22.9%, and 16.2% in new leaves. Furthermore, NAA treatment promoted underground growth. When compared with control, total root length, root surface area, root tip number, branch number and root activity were significantly increased by 37.8%, 22.2%, 35.1%, 28.8% and 21.2%. Root growth is beneficial to N capture in maize. Ultimately, the total N accumulation of NAA treatment was significantly increased by 74.5%, as compared to the control. In conclusion, NAA foliar spraying increased endogenous IAA content, and enhanced the activity of N assimilation-related enzymes and photosynthesis rate, in order to build a large sink for carbohydrate accumulation. In addition, NAA strengthened root activity and regulated root morphology and architecture, which facilitated further N uptake and plant growth.

Association of the TyG index with prognosis in surgical intensive care patients: data from the MIMIC-IV.

BACKGROUND: The triglyceride-glucose (TyG) index, a tool for assessing insulin resistance, is increasingly recognized for its ability to predict cardiovascular and metabolic risks. However, its relationship with trauma and surgical patient prognosis is understudied. This study investigated the correlation between the TyG index and mortality risk in surgical/trauma ICU patients to identify high-risk individuals and improve prognostic strategies. METHODS: This study identified patients requiring trauma/surgical ICU admission from the Medical Information Mart for Intensive Care (MIMIC-IV) database, and divided them into tertiles based on the TyG index. The outcomes included 28-day mortality and 180-day mortality for short-term and long-term prognosis. The associations between the TyG index and clinical outcomes in patients were elucidated using Cox proportional hazards regression analysis and RCS models. RESULTS: A total of 2103 patients were enrolled. The 28-day mortality and 180-day mortality rates reached 18% and 24%, respectively. Multivariate Cox proportional hazards analysis revealed that an elevated TyG index was significantly related to 28-day and 180-day mortality after covariates adjusting. An elevated TyG index was significantly associated with 28-day mortality (adjusted hazard ratio, 1.19; 95% confidence interval 1.04-1.37) and 180-day mortality (adjusted hazard ratio, 1.24; 95% confidence interval 1.11-1.39). RCS models revealed that a progressively increasing risk of mortality was related to an elevated TyG index. According to our subgroup analysis, an elevated TyG index is associated with increased risk of 28-day and 180-day mortality in critically ill patients younger than 60 years old, as well as those with concomitant stroke or cardiovascular diseases. Additionally, in nondiabetic patients, an elevated TyG index is associated with 180-day mortality. CONCLUSION: An increasing risk of mortality was related to an elevated TyG index. In critically ill patients younger than 60 years old, as well as those with concomitant stroke or cardiovascular diseases, an elevated TyG index is associated with adverse short-term and long-term outcomes. Furthermore, in non-diabetic patients, an elevated TyG index is associated with adverse long-term prognosis.

Association of Cardiovascular Health with Cognitive Function in US Older Adults: A Population-Based Cross-Sectional Study.

INTRODUCTION: Promoting cardiovascular health (CVH) by Life's Simple 7 is associated with better cognitive function. In 2022, the American Heart Association (AHA) prompted Life's Essential 8 (LE8) to strengthen CVH assessment. This study investigated the association between the new CVH metrics assessed by LE8 and cognitive function, thus providing evidence for implementing LE8 in the primordial prevention of cognitive impairment. METHODS: 2,050 participants aged 60 and older from National Health and Nutrition Examination Survey 2011-2014 were included. Cognitive function was measured by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). The overall and domain-specific cognitive function z-score was created. CVH score was calculated following AHA's advisory. The multivariable linear regression model estimated the associations. RESULTS: The CVH score assessed by LE8 was independently, positively, and linearly associated with the overall cognitive function. A per-10 point increase in CVH was associated with higher overall cognitive z-scores (ß, 0.06; 95% confidence interval [CI], 0.03, 0.09), and participants with moderate (ß, -0.14; 95% CI, -0.22, -0.05) and low CVH (ß, -0.27; 95% CI, -0.37, -0.16) had lower overall cognitive z-scores compared to participants with high CVH. Similar patterns of associations were observed between CVH of AFT and DSST. Components of CVH were further associated with different domain-specific cognitive functions. CONCLUSION: Maintaining an ideal CVH improves cognitive function in older adults. Ideal adherence to individual components of LE8 was associated with improved overall and domain-specific cognitive functions. Therefore, promoting CVH according to LE8 might benefit cognitive function in the elderly.

Nausea and vomiting in pregnancy (NVP) in Chinese pregnant women: a cross-sectional study.

BACKGROUND: This study addresses the scarcity of research on nausea and vomiting in pregnancy (NVP) in China. It aims to explore the current NVP status in the country using validated questionnaires, analyze associated factors, and provide a useful reference for future research. The study also compares results from different assessment tools. METHODS: Online questionnaires were utilized to gather data from 535 pregnant women across 24 provinces. Demographic, pregnancy, and NVP-related information were collected. NVP severity was assessed using Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) and the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) scales. Ordinal logistic regression identified factors linked to NVP severity. Differences between PUQE and RINVR assessments were compared. RESULTS: NVP prevalence exceeded 90%, with 96.1% assessed by PUQE and 90.8% by RINVR. Incidence decreased from nausea to retching and vomiting. Severe NVP correlated with reduced gestational weight gain, younger age, fewer gestational weeks, and living in North (all P values < 0.05). There was moderate consistency between PUQE and RINVR assessments. The NVP prevalence assessed by the PUQE is higher than that assessed by the RINVR in the same population. However, the proportion of NVP levels above moderate assessed by RINVR is greater than that assessed by PUQE. CONCLUSIONS: NVP is highly prevalent among Chinese pregnant women, with nausea being predominant. RINVR assessments may be better able to identify severe NVP, thereby improving the low treatment rates for severe NVP.

Sodium, potassium intake, and all-cause mortality: confusion and new findings.

BACKGROUND: The World Health Organization (WHO) has established recommended daily intakes for sodium and potassium. However, there is currently some controversy regarding the association between sodium intake, potassium intake, the sodium-to-potassium ratio, and overall mortality. To assess the correlations between sodium intake, potassium intake, the sodium-to-potassium ratio, and overall mortality, as well as the potential differences in sodium and potassium intake thresholds among different population groups, we analyzed data from NHANES 2003-2018. METHODS: NHANES is an observational cohort study that estimates sodium and potassium intake through one or two 24-h dietary recalls. Hazard ratios (HR) for overall mortality were calculated using multivariable adjusted Cox models accounting for sampling design. A total of 13855 out of 26288 participants were included in the final analysis. Restricted cubic spline analyses were used to examine the relationship between sodium intake, potassium intake, and overall mortality. If non-linearity was detected, we employed a recursive algorithm to calculate inflection points. RESULTS: Based on one or two 24-h dietary recalls, the sample consisted of 13,855 participants, representing a non-institutionalized population aged 40-80 years, totaling 11,348,771 person-months of mean follow-up 99.395 months. Daily sodium intake and daily potassium intake were inversely associated with all-cause mortality. Restrictive cubic spline analysis showed non-linear relationships between daily sodium intake, potassium intake, sodium-potassium ratio, and total mortality. The inflection point for daily sodium intake was 3133 mg/d, and the inflection point for daily potassium intake was 3501 mg/d, and the inflection point for daily sodium-potassium ratio intake was 1.203 mg/mg/d. In subgroup analyses, a significant interaction was found between age and high sodium intake, which was further confirmed by the smooth curves that showed a U-shaped relationship between sodium intake and all-cause mortality in the elderly population, with a inflection point of 3634 mg/d. CONCLUSION: Nonlinear associations of daily sodium intake, daily potassium intake and daily sodium-potassium ratio intake with all-cause mortality were observed in American individuals. The inflection point for daily sodium intake was 3133 mg/d. And the inflection point for daily sodium intake was 3634 mg/d in elderly population. The inflection point for daily potassium intake was 3501 mg/d. The inflection point for daily sodium-potassium ratio intake was 1.203 mg/mg/d, respectively, A healthy diet should be based on reasonable sodium intake and include an appropriate sodium-to-potassium ratio.

Systemic juvenile xanthogranuloma: A systematic review.

OBJECTIVE: To perform a systematic review to investigate the available literature regarding systemic juvenile xanthogranuloma (SJXG) and report the population characteristics, clinical manifestation, therapy, and outcome. REVIEW METHODS: A search of PubMed, Embase, and Cochrane Library for all articles published between 1981 and 2022 was performed with variations and combinations of the following search terms: extracutaneous, visceral, systemic, and juvenile xanthogranuloma (JXG). Data extracted included demographics, organ involvement, treatment, outcome, and permanent sequelae. RESULTS: A total of 103 articles encompassing 159 patients met the inclusion criteria. The median onset age was 9 months, with a male predominance (61%). The distribution of major involved organs varied by age, and younger onset age was associated with more organ involvement. The most commonly involved site was the central nervous system (CNS) (40.9%), followed by the liver (31.4%), the lung (18.9%), and the eye (18.2%). At the termination of follow-up, 93 patients (58.5%) were alive with no disease, 56 (35.2%) were alive with disease, and 10 (6.3%) were dead of disease. There was a significant difference in outcome between patients with and without spleen involvement (p = .0003), and patients with spleen involvement suffered a higher risk of death. Permanent sequelae mainly comprised CNS symptoms and ocular manifestations. CONCLUSIONS: SJXG can involve varying numbers and combinations of extracutaneous sites. There is no standard therapy for SJXG and clinicians should choose individualized therapy modalities.

CXCR4 and TYROBP mediate the development of atrial fibrillation via inflammation.

Atrial fibrillation (AF) is a rapid supraventricular arrhythmia. However, the pathogenesis of atrial fibrillation remains controversial. We obtained transcriptome expression profiles GSE41177, GSE115574 and GSE79768 from GEO database. WGCNA was performed, DEGs were screened, PPI network was constructed using STRING database. CTD database was used to identify the reference score of hub genes associated with cardiovascular diseases. Prediction of miRNAs of hub genes was performed by TargetScan. DIANA-miRPath v3.0 was applied to make functional annotation of miRNA. The animal model of atrial fibrillation was constructed, RT-PCR was used to verify the expression of hub genes. Immunofluorescence assay for THBS2 and VCAN was made to identify molecular. Design of BP neural network was made to explore the prediction relationship of CXCR4 and TYROBP on AF. The merged datasets contained 104 up-regulated and 34 down-regulated genes. GO and KEGG enrichment analysis results of DEGs showed they were mainly enriched in 'regulation of release of sequestered calcium ion into cytosol', 'actin cytoskeleton organization' and 'focal adhesion'. The hub genes were CXCR4, SNAI2, S100A4, IGFBP3, CSNK2A1, CHGB, VCAN, APOE, C1QC and TYROBP, which were up-regulated expression in the AF compared with control tissues. There was strong correlation among the CXCR4, TYROBP and AF based on the BP neural network. Through training, best training performance is 9.6474e-05 at epoch 14, and the relativity was 0.99998. CXCR4 and TYROBP might be involved in the development of atrial fibrillation by affecting inflammation-related signalling pathways and may serve as targets for early diagnosis and preventive treatment.

Hyperuricemia induces lipid disturbances by upregulating the CXCL-13 pathway.

The molecular mechanism underlying hyperuricemia-induced lipid metabolism disorders is not clear. The purpose of the current study was to investigate the mechanism of lipid disturbances in a hyperuricemia mice model. RNA-Seq showed that differentially expressed genes (DEGs) in the fatty acid synthesis signaling pathway were mainly enriched and CXCL-13 was significantly enriched in protein-protein interaction networks. Western blotting, Q-PCR, and immunofluorescence results further showed that hyperuricemia upregulated CXCL-13 and disturbed lipid metabolism in vivo and in vitro. Furthermore, CXCL-13 alone also promoted the accumulation of lipid droplets and upregulated the expression of FAS and SREBP1, blocking AMPK signaling and activating the PKC and P38 signaling pathways. Silencing CXCL-13 reversed uric-acid-induced lipid droplet accumulation, which further downregulated FAS and SREBP1 expression, inhibited the p38 and PKC signaling, and activated AMPK signaling. In conclusion, hyperuricemia induces lipid metabolism disorders via the CXCL-13 pathway, making CXCL-13 a key regulatory factor linking hyperuricemia and lipid metabolism disorders. These results may provide novel insights for the treatment of hyperuricemia.NEW & NOTEWORTHY The underlying molecular mechanism of hyperuricemia-induced lipid metabolism disorders is still unclear. The study aimed to investigate the mechanism of lipid disturbance in hyperuricemia mice model. To our knowledge, we proposed for the first time that CXCL-13 may be a key regulator of hyperuricemia and lipid metabolism disorders. These results may provide new insights for the clinical treatment of hyperuricemia.

The digital divide impacts on mental health during the COVID-19 pandemic.

One of the most daunting unintended consequences of the digital revolution is the digital divide (DD), a pervasive social and information inequality. It negatively affects all sectors of society, and exerts compounding influences on other social inequities. To further complicate the situation, the COVID-19 pandemic has been intensifying the scale of DD and deepening the scope of DD barriers with the increasing but imbalanced applications of digital technologies. For instance, while digital technologies can provide support to fulfill people's mental health needs, recurring evidence shows that DD-prone people are more likely to be excluded from critical services, activities, and resources to support their health concerns and challenges. So far, studies about the mental health consequences of DD amid COVID-19 are limited. Available evidence suggests that the general mental health impacts of COVID-19 include anxiety, depression, and suicidal behaviors, while the mental health consequences of DD due to COVID-19 are mainly stress, distress, and anxiety. To shed light on the research gap, based on the social inequality roots of DD and the nexus between DD barriers and factors of social inequalities, this study highlights the alarming overlap between DD-prone communities and vulnerable populations. Furthermore, we underscore the future research directions that could help society better serve both underserved communities.

Transcriptome analysis of the transdifferentiation of canine BMSCs into insulin producing cells.

BACKGROUND: Bone marrow mesenchymal stem cells are a potential resource for the clinical therapy of certain diseases. Canine, as a companion animal, living in the same space with human, is an ideal new model for human diseases research. Because of the high prevalence of diabetes, alternative transplantation islets resource (i.e. insulin producing cells) for diabetes treatment will be in urgent need, which makes our research on the transdifferentiation of Bone marrow mesenchymal stem cells into insulin producing cells become more important. RESULT: In this study, we completed the transdifferentiation process and achieved the transcriptome profiling of five samples with two biological duplicates, namely, "BMSCs", "islets", "stage 1", "stage 2" and "stage 3", and the latter three samples were achieved on the second, fifth and eighth day of induction. A total of 11,530 differentially expressed transcripts were revealed in the profiling data. The enrichment analysis of differentially expressed genes revealed several signaling pathways that are essential for regulating proliferation and transdifferentiation, including focal adhesion, ECM-receptor interaction, tight junction, protein digestion and absorption, and the Rap1 signaling pathway. Meanwhile, the obtained protein-protein interaction network and functional identification indicating involvement of three genes, SSTR2, RPS6KA6, and VIP could act as a foundation for further research. CONCLUSION: In conclusion, to the best of our knowledge, this is the first survey of the transdifferentiation of canine BMSCs into insulin-producing cells according with the timeline using next-generation sequencing technology. The three key genes we pick out may regulate decisive genes during the development of transdifferentiation of insulin producing cells.

A current collect-free Li1.2Ni0.13Co0.13Mn0.54O2flexible film for high-performance lithium-ion batteries.

Due to the high demand for more convenient flexible devices, there are more requirements for higher performance of flexible batteries. The layered lithium-rich manganese-based Li1.2Ni0.13Co0.13Mn0.54O2cathode material has the advantages of higher energy density, higher discharge capacity and environmentally friendly, so it can be used for high-performance flexible electrode cathode material. Its theoretical capacity can reach more than 250 mAh g-1, which is higher than most cathode materials currently used in commercialization. Here we synthesize Li1.2Ni0.13Co0.13Mn0.54O2(LNCM) cathode, and then use a simple method to make a current collect-free LNCM flexible film. This film has excellent flexibility and electrochemical performance. At 25 mA g-1, its initial discharge capacity reaches 314.0 mAh g-1. After 200 cycles of 500 mA g-1, its capacity retention rate is 82.1%, the attenuation is about 0.08% per cycle. Moreover, by bending at any position of the flexible film, it can still remain intact, and the soft-packaged battery made by the flexible film can still be used under the bending condition and keep the brightness of the LED lamp unchanged. This shows that using Li1.2Ni0.13Co0.13Mn0.54O2to make high-performance flexible electrodes is a simple and effective method, which is expected to be practically applied to flexible electronic devices.

Fluorescence 'turn-on' probe for Al3+ detection in water based on ZnS/ZnO quantum dots with excellent selectivity and stability.

In this work, an efficient and stable fluorescent probe for Al3+was established. The fluorescent probe based on the fluorescence 'turn-on' mode of zinc sulfide crystal composite zinc oxide quantum dots (ZnS/ZnO QDs). The ZnS/ZnO QDs were synthesized via two-step method using L-Cysteine (L-Cys) as a sulfur source and stabilizer. In the synthesis of ZnS/ZnO QDs, the fluorescence of zinc oxide quantum dots (ZnO QDs) decreased and its stability increased in aqueous solution after the addition of L-Cys. In addition, the as-synthesized ZnS/ZnO QDs shows fluorescent enhancement to Al3+. The ZnS/ZnO QDs based fluorescence 'turn-on' probe presented wide linear ranges (1 nM-8µM and 8-100µM). The availability of as-established sensing probe was also estimated by real water sample tests. Furthermore, the fluorescent enhancing mechanism was carried out by recording the fluorescent lifetime of samples, which might be related to the QDs dispersion and charge transfer weaken.

Human locomotion-control brain networks detected with independent component analysis.

Walking is a fundamental movement skill in humans. However, how the brain controls walking is not fully understood. In this functional magnetic resonance imaging study, the rhythmic, bilaterally alternating ankle movements were used as paradigm to simulate walking. In addition to the resting state, several motor tasks with different speeds were tested. Independent component analysis was performed to detect four components shared by all task conditions and the resting state. According to the distributed brain regions, these independent components were the cerebellum, primary auditory cortex-secondary somatosensory cortex-inferior parietal cortex-presupplementary motor area, medial primary sensorimotor cortex-supplementary area-premotor cortex-superior parietal lobule, and lateral primary somatosensory cortex-superior parietal lobule-dorsal premotor cortex networks, which coordinated limb movements, controlled the rhythm, differentiated speed, and performed a function as a basic actor network, respectively. These brain networks may be used as biomarkers of the neural control of normal human walking and as targets for neural modulation to improve different aspects of walking, such as rhythm and speed.

Prevention of non-response to cardiac resynchronization therapy: points to remember.

Cardiac resynchronization therapy (CRT) is an important and effective therapy for end-stage heart failure. Non-response to CRT is one of the main obstacles to its application in clinical practice. There is no uniform consensus or definition of CRT "response." Clinical symptoms, ventricular remodeling indices, and cardiovascular events have been reported to be associated with non-responders. To prevent non-response to CRT, three aspects should be thoroughly considered: preoperative patient selection, electrode implantation, and postoperative management. Preoperative selection of appropriate patients for CRT treatment is an important step in preventing non-response. Currently, the CRT inclusion criteria are mainly based on the morphology of QRS waves in deciding ventricular dyssynchrony. Echocardiography and cardiac magnetic resonance are being explored to predict nonresponse to CRT. The location of left ventricular electrode implantation is a current hot spot of research; it is important to identify the location of the latest exciting ventricular segment and avoid scars. Cardiac magnetic resonance and ultrasonic spot tracking are being progressively developed in this field. Some new techniques such as His Bundle pacing, endocardial electrodes, and novel sensors are also being investigated. Postoperative management of patients is another essential step towards preventing non-response; it mainly focuses on the treatment of the disease itself and CRT program control optimization. CRT treatment is just one part of the overall treatment of heart failure, and multidisciplinary efforts are needed to improve the overall outcome.

Thioglycolic acid-capped ZnSe quantum dots as nanoprobe for cobalt(II) and iron(III) via measurement of grey level, UV-vis spectra and dynamic light scattering.

Thioglycolic acid-functionalized ZnSe quantum dots (QDs) as a colorimetric nanoprobe were prepared and applied to the determination of cobalt(II) and iron(III). Test strips were obtained by a dipping-drying process. On exposure to Co(II), they undergo a color change from white to brown, and on exposure to Fe(III) from white to pink. The limits of detection (LOD) are 2.6 mg L-1 for Co(II) and 2.2 mg L-1 for Fe(III). Test strips introduce a low-cost, portable, rapid and convenient tool for determination of Co(II) and Fe(III). In addition, two other analytical methods have been studied for detection of Co(II) and Fe(III) at low concentration. The first is UV-vis spectrometry which has a LOD as low as 0.14 mg L-1 for Co(II) (at 412 nm) and 0.12 mg L-1 for Fe(III) (at 400 nm). The second is dynamic light scattering (DLS) with a LOD of 3.0 µg L-1 for Co(II) and 2.5 µg L-1 for Fe(III). Graphical abstract Thioglycolic acid-functionalized ZnSe quantum dots (TGA-ZnSe QDs) show high sensitivity and low detection limits for Co2+ and Fe3+.

Investigations of Different Ion Intercalations on the Performance of FBG Hydrogen Sensors Based on Pt/MoO3.

α-MoO3 has been used as a hydrogen sensing material due to its excellent properties and unique crystalline layer structure. However, the low repeatability of α-MoO3 based hydrogen sensor restricts its practical application. In this paper, the effect of intercalated ion species and the amount in α-MoO3 is experimentally investigated and discussed. It is concluded that the repeatability of the sensor depends on the radius of intercalated ions and amount of ionic bonds. The optimal ion species is Na+ and the optimal amount of precursor is 1 mmol.

[Influence of Critical Care Ultrasound Oriented Fluid Management in Different Stages of Shock to the Outcome].

OBJECTIVE: To investigate the relationship between fluid management oriented by critical care ultrasound and prognosis in patients with shock. METHODS: We analyzed the data of a randomized controlled trial called Critical Care Ultrasound Oriented Shock Treatment (CCUSOST) in the Department of Critical Care Medicine, West China Hospital retrospectively. 77 patients in the critical care ultrasound oriented treatment group (experimental group) and 70 patients in the conventionally treated group as control were included in the statistics, to evaluate the relationship between fluid intake and prognosis. Univariate and multivariate logistic regression analyses were used to analyze risk factors for ICU mortality. RESULTS: The baseline indexes of the patients in the experimental group and the control group were consistent. The ICU mortality of the experimental group was significantly lower than that of the control group (P < 0.05).The fluid intake in the stabilization and de-escalation phases was less than the the control group (P < 0.05). We divided these shock patients into survival group (92 cases) and non-survival (55 cases) according to whether they died in ICU, and the univariate analysis for ICU mortality showed that acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, SOFA score, Lac, hourly urine output, total fluid intake, fluid intake in the salvage and optimization stages, fluid intake in the stabilization and de-escalation stages were significantly different (P < 0.05) between survivers and non-survivers. Multivariete analysis showed that the fluid intake during the salvage and optimization phases, fluid intake in the stabilization and de-escalation phases were independent risk factors for ICU mortality. CONCLUSION: Critical care ultrasound oriented shock fluid management could reduce fluid intake of stabilization and de-escalation phases, and improved adverse outcome; whether the fluid intake during stabilization and de-escalation phases, or the fluid intake during the salvage and optimization phases, both were associated with patient prognosis.

[The Clinical Value of the Pathophysiology Oriented Critical Care Ultrasound Exam (POCCUE) Protocol in Acute Respiratory and Circulatory Compromise of Critically Ill Patients].

OBJECTIVE: The aim of this study is to explore the diagnostic and therapeutic accuracy of pathophysiology and clinic oriented critical care ultrasound exam (POCCUE) protocol in acute respiratory and circulatory compromise of critically ill patients. METHODS: Prospectively included patients with acute respiratory and circulatory compromise from ICU of West China Hospital of Sichuan University from March to April 2018. The POCCUE protocol designed according to the pathophysiological changes of acute respiratory and circulatory disorders includes: the first part is the acquiring an ultrasound section and measuring corresponding indicators including pulmonary and echocardiographic indicators; the second part is a comprehensive analysis according to the former examination which evaluates the pathophysiological changes of acute respiratory and circulatory disorders, and then establish the initial etiology diagnosis and start treatment. The clinical value of the POCCUE protocol, including the accuracy of diagnosis, and the differences in treatment was verified by comparing the clinical outcome with the traditional treatment group. RESULTS: A total of 82 subjects were used for statistics. Compare with the traditional group, POCCUE can notably increase the diagnostic and therapeutic accuracy of clinic and pathophysiology (diagnostic accuracy: 93.90% vs. 68.29%, P < 0.01; therapeutic accuracy: 93.90% vs. 62.20%, P < 0.01). CONCLUSION: The POCCUE has a higher accuracy of diagnosis and treatment for patients with acute respiratory and circulatory compromise.