Bifurcation of Excited-State Population Leads to Anti-Kasha Luminescence in a Disulfide-Decorated Organometallic Rhenium Photosensitizer.

We report a rhenium diimine photosensitizer equipped with a peripheral disulfide unit on one of the bipyridine ligands, [Re(CO)3(bpy)(S-Sbpy4,4)]+ (1+, bpy = 2,2'-bipyridine, S-Sbpy4,4 = [1,2]dithiino[3,4-c:6,5-c']dipyridine), showing anti-Kasha luminescence. Steady-state and ultrafast time-resolved spectroscopies complemented by nonadiabatic dynamics simulations are used to disclose its excited-state dynamics. The calculations show that after intersystem crossing the complex evolves to two different triplet minima: a (S-Sbpy4,4)-ligand-centered excited state (3LC) lying at lower energy and a metal-to-(bpy)-ligand charge transfer (3MLCT) state at higher energy, with relative yields of 90% and 10%, respectively. The 3LC state involves local excitation of the disulfide group into the antibonding σ* orbital, leading to significant elongation of the S-S bond. Intriguingly, it is the higher-lying 3MLCT state, which is assigned to display luminescence with a lifetime of 270 ns: a signature of anti-Kasha behavior. This assignment is consistent with an energy barrier ≥ 0.6 eV or negligible electronic coupling, preventing reaction toward the 3LC state after the population is trapped in the 3MLCT state. This study represents a striking example on how elusive excited-state dynamics of transition-metal photosensitizers can be deciphered by synergistic experiments and state-of-the-art calculations. Disulfide functionalization lays the foundation of a new design strategy toward harnessing excess energy in a system for possible bimolecular electron or energy transfer reactivity.

A Multiplex Recombinase-Aided qPCR Assay for Highly Sensitive and Rapid Detection of khe, blaKPC -2, and blaNDM -1 Genes in Klebsiella pneumoniae.

OBJECTIVE: This study aimed to establish a highly sensitive and rapid single-tube, two-stage, multiplex recombinase-aided qPCR (mRAP) assay to specifically detect the khe, blaKPC-2, and blaNDM-1 genes in Klebsiella pneumoniae. METHODS: mRAP was carried out in a qPCR instrument within 1 h. The analytical sensitivities of mRAP for khe, blaKPC-2, and blaNDM-1 genes were tested using recombinant plasmids and dilutions of reference strains. A total of 137 clinical isolates and 86 sputum samples were used to validate the clinical performance of mRAP. RESULTS: mRAP achieved the sensitivities of 10, 8, and 14 copies/reaction for khe, blaKPC-2, and blaNDM-1 genes, respectively, superior to qPCR. The Kappa value of qPCR and mRAP for detecting khe, blaKPC-2, and blaNDM-1 genes was 1, 0.855, and 1, respectively (p < 0.05). CONCLUSION: mRAP is a rapid and highly sensitive assay for potential clinical identification of khe, blaKPC-2, and blaNDM-1 genes in K. pneumoniae.

Luminescent Iridium Complexes with a Sulfurated Bipyridine Ligand: PCET Thermochemistry of the Disulfide Unit and Photophysical Properties.

Molecular systems combining light harvesting and charge storage are receiving great attention in the context of, for example, artificial photosynthesis and solar fuel generation. As part of ongoing efforts to develop new concepts for photoinduced proton-coupled electron transfer (PCET) reactivities, we report a cyclometallated iridium(III) complex [Ir(ppy)2(S-Sbpy)](PF6) ([1]PF6) equipped with our previously developed sulfurated bipyridine ligand S-Sbpy. A new one-step synthetic protocol for S-Sbpy is developed, starting from commercially available 2,2'-bipyridine, which significantly facilitates the use of this ligand. [1]+ features a two-electron reduction with potential inversion (|E1| > |E2|) at moderate potentials (E1 = -1.12, E2 = -1.11 V versus. Fc+/0 at 253 K), leading to a dithiolate species [1]-. Protonation with weak acids allows for determination of pKa = 23.5 in MeCN for the S-H···S- unit of [1H]. The driving forces for both the H atom and the hydride transfer are calculated to be ∼60 kcal mol-1 and verified experimentally by reaction with a suitable H atom and a hydride acceptor, demonstrating the ability of [1]+ to serve as a versatile PCET reagent, albeit with limited thermal stability. In MeCN solution, an orange emission for [1]PF6 from a triplet-excited state was found. Density functional calculations and ultrafast absorption spectroscopy are used to give insight into the excited-state dynamics of the complex and suggest a significantly stretched S-S bond for the lowest triplet-state T1. The structural responsiveness of the disulfide unit is proposed to open an effective relaxation channel toward the ground state, explaining the unexpectedly short lifetime of [1]+. These insights as well as the quantitative ground-state thermochemistry data provide valuable information for the use of S-Sbpy-functionalized complexes and their disulfide-/dithiol-directed PCET reactivity.

Predicting risk of severe neonatal outcomes in preterm infants born from mother with prelabor rupture of membranes.

BACKGROUND: Perinatal complications are common burdens for neonates born from mother with pPROM. Physicians and parents sometimes need to make critical decisions about neonatal care with short- and long-term implications on infant's health and families and it is important to predict severe neonatal outcomes with high accuracy. METHODS: The study was based on our prospective study on 1001 preterm infants born from mother with pPROM from August 1, 2017, to March 31, 2018 in three hospitals in China. Multivariable logistic regression analysis was applied to build a predicting model incorporating obstetric and neonatal characteristics available within the first day of NICU admission. We used enhanced bootstrap resampling for internal validation. RESULTS: One thousand one-hundred pregnancies with PROM at preterm with a single fetus were included in our study. SNO was diagnosed in 180 (17.98%) neonates. On multivariate analysis of the primary cohort, independent factors for SNO were respiratory support on the first day,, surfactant on day 1, and birth weight, which were selected into the nomogram. The model displayed good discrimination with a C-index of 0.838 (95%CI, 0.802-0.874) and good calibration performance. High C-index value of 0.835 could still be reached in the internal validation and the calibration curve showed good agreement. Decision curve analysis showed if the threshold is > 15%, using our model would achieve higher net benefit than model with birthweight as the only one predictor. CONCLUSION: Variables available on the first day in NICU including respiratory support on the first day, the use of surfactant on the first day and birthweight could be used to predict the risk of SNO in infants born from mother with pPROM with good discrimination and calibration performance.

A Bioinspired Disulfide/Dithiol Redox Switch in a Rhenium Complex as Proton, H Atom, and Hydride Transfer Reagent.

The transfer of multiple electrons and protons is of crucial importance in many reactions relevant in biology and chemistry. Natural redox-active cofactors are capable of storing and releasing electrons and protons under relatively mild conditions and thus serve as blueprints for synthetic proton-coupled electron transfer (PCET) reagents. Inspired by the prominence of the 2e-/2H+ disulfide/dithiol couple in biology, we investigate herein the diverse PCET reactivity of a Re complex equipped with a bipyridine ligand featuring a unique SH···-S moiety in the backbone. The disulfide bond in fac-[Re(S-Sbpy)(CO)3Cl] (1, S-Sbpy = [1,2]dithiino[4,3-b:5,6-b']dipyridine) undergoes two successive reductions at equal potentials of -1.16 V vs Fc+|0 at room temperature forming [Re(S2bpy)(CO)3Cl]2- (12-, S2bpy = [2,2'-bipyridine]-3,3'-bis(thiolate)). 12- has two adjacent thiolate functions at the bpy periphery, which can be protonated forming the S-H···-S unit, 1H-. The disulfide/dithiol switch exhibits a rich PCET reactivity and can release a proton (ΔG°H+ = 34 kcal mol-1, pKa = 24.7), an H atom (ΔG°H• = 59 kcal mol-1), or a hydride ion (ΔG°H- = 60 kcal mol-1) as demonstrated in the reactivity with various organic test substrates.

Excited-State Dynamics of [Ru(S-Sbpy)(bpy)2]2+ to Form Long-Lived Localized Triplet States.

The novel photosensitizer [Ru(S-Sbpy)(bpy)2]2+ harbors two distinct sets of excited states in the UV/Vis region of the absorption spectrum located on either bpy or S-Sbpy ligands. Here, we address the question of whether following excitation into these two types of states could lead to the formation of different long-lived excited states from where energy transfer to a reactive species could occur. Femtosecond transient absorption spectroscopy identifies the formation of the final state within 80 fs for both excitation wavelengths. The recorded spectra hint at very similar dynamics following excitation toward either the parent or sulfur-decorated bpy ligands, indicating ultrafast interconversion into a unique excited-state species regardless of the initial state. Non-adiabatic surface hopping dynamics simulations show that ultrafast spin-orbit-mediated mixing of the states within less than 50 fs strongly increases the localization of the excited electron at the S-Sbpy ligand. Extensive structural relaxation within this sulfurated ligand is possible, via S-S bond cleavage that results in triplet state energies that are lower than those in the analogue [Ru(bpy)3]2+. This structural relaxation upon localization of the charge on S-Sbpy is found to be the reason for the formation of a single long-lived species independent of the excitation wavelength.

Electrochemical and Photophysical Properties of Ruthenium(II) Complexes Equipped with Sulfurated Bipyridine Ligands.

The development of new solar-to-fuel scenarios is of great importance, but the construction of molecular systems that convert sunlight into chemical energy represents a challenge. One specific issue is that the molecular systems have to be able to accumulate redox equivalents to mediate the photodriven transformation of relevant small molecules, which mostly involves the orchestrated transfer of multiple electrons and protons. Disulfide/dithiol interconversions are prominent 2e-/2H+ couples and can play an important role for redox control and charge storage. With this background in mind, a new photosensitizer [Ru(S-Sbpy)(bpy)2]2+ (12+) equipped with a disulfide functionalized bpy ligand (S-Sbpy, bpy = 2,2'-bipyridine) was synthesized and has been comprehensively studied, including structural characterization by X-ray diffraction. In-depth electrochemical studies show that the S-Sbpy ligand in 12+ can be reduced twice at moderate potentials (around -1.1 V vs Fc+/0), and simulation of the cyclic voltammetry (CV) traces revealed potential inversion (E2 > E1) and allowed to derive kinetic parameters for the sequential electron-transfer processes. However, reduction at room temperature also triggers the ejection of one sulfur atom from 12+, leading to the formation of [Ru(Sbpy)(bpy)2]2+(22+). This chemical reaction can be suppressed by decreasing the temperature from 298 to 248 K. Compared to the archetypical photosensitizer [Ru(bpy)3]2+, 12+ features an additional low energy optical excitation in the MLCT region, originating from charge transfer from the metal center to the S-Sbpy ligand (aka MSCT) according to time-dependent density functional theory (TD-DFT) calculations. Analysis of the excited states of 12+ on the basis of ground-state Wigner sampling and using charge-transfer descriptors has shown that bpy modification with a peripheral disulfide moiety leads to an energy splitting between charge-transfer excitations to the S-Sbpy and the bpy ligands, offering the possibility of selective charge transfer from the metal to either type of ligands. Compound 12+ is photostable and shows an emission from a 3MLCT state in deoxygenated acetonitrile with a lifetime of 109 ns. This work demonstrates a rationally designed system that enables future studies of photoinduced multielectron, multiproton PCET chemistry.

Effect of graphene oxide with different morphological characteristics on properties of immobilized enzyme in the covalent method.

Although graphene oxide (GO) has great potential in the field of immobilized enzyme catalysts, the detailed effects of GO with different morphological structures on immobilized enzyme are not well understood. GOs were prepared from 8000 mesh and nanoscale graphite at different reaction temperatures, and used as carriers to immobilize alpha-amylase by cross-linking method. The properties of GOs were characterized through Atomic force microscope, Fourier-transformed infrared, X-ray photoelectron spectroscopy, Raman and UV-Vis. Furthermore, the dosage of cross-linking agent, cross-linking time, optimum temperature/pH, thermal/pH/storage stability, reusability and kinetic parameters of immobilized enzymes were investigated. The results showed that the loading of alpha-amylase on GOs was 162.3-274.2 mg g-1. The reusability experiments revealed high activity maintenance of immobilized alpha-amylase even after seven reaction cycles. Moreover, the storage stability of immobilized enzyme improved via immobilization in comparison with free one and it maintained over 70% of their initial activity after 20 days storage at 4 °C.

Electron Delocalization of Mixed-Valence Diiron Sites Mediated by Group†10 Metal Ions in Heterotrimetallic Fe-M-Fe (M=Ni, Pd, and Pt) Chain Complexes.

The heterotrimetallic complexes [FeMFe(dpa)4 Cl2 ] (M=Ni (1), Pd (2), and Pt (3); dpa- =dipyridylamido) featuring two high-spin iron centers linked by Group 10 metals were synthesized and their physical properties were investigated. Oxidation of 1-3 with suitable oxidants in CH2 Cl2 solution yielded the mixed-valent species [1]+/2+ -[3]+/2+ . The solution properties of [1]0/+/2+ -[3]0/+/2+ were characterized by 1 H NMR and UV/Vis/NIR spectroscopy as well as spectroelectrochemisty. The mixed-valent states of [1]+ -[3]+ obtained by electrochemical or chemical oxidation are classified as class II valence delocalization. The solid-state structures of 1-3, [1]+ , [3]+ , and [1]2+ were determined by single-crystal X-ray diffraction analysis, exhibiting a linear metal framework with an approximate D4 symmetry. The spin states and magnetic properties were studied by using SQUID magnetometry, EPR and Mössbauer spectroscopy, and DFT calculations. Antiferromagnetic interactions between terminal high-spin iron centers are present within [1]0/+/2+ -[3]0/+/2+ and the |J| values increase with the central metal ion changing from Ni to Pt. The DFT calculations reproduce the antiferromagnetic coupling and ascribe it to a σ-type exchange pathway. The substitution of the central metal not only influences the spin-spin interactions but also the degree of electronic delocalization between the terminal iron sites along the Fe-M-Fe chains.

The first heteropentanuclear extended metal-atom chain: [Ni⁺-Ru25⁺-Ni²âº-Ni²âº (tripyridyldiamido)4(NCS)2].

This study develops the first heteropentametal extended metal atom chain (EMAC) in which a string of nickel cores is incorporated with a diruthenium unit to tune the molecular properties. Spectroscopic, crystallographic, and magnetic characterizations show the formation of a fully delocalized Ru2(5+) unit. This [Ru2]-containing EMAC exhibits single-molecule conductance four-fold superior to that of the pentanickel complex and results in features of negative differential resistance (NDR), which are unobserved in analogues of pentanickel and pentaruthenium EMACs. A plausible mechanism for the NDR behavior is proposed for this diruthenium-modulated EMAC.

The cytoplasmic domain of rat synaptotagmin I enhances synaptic transmission.

Synaptotagmin, an integral membrane protein of synaptic vesicles, functions as a calcium sensor in the temporal control of neurotransmitter release. Although synaptotagmin facilitates lipid membrane fusion in biochemical experiments, overexpression of synaptotagmin inhibits neurotransmission. A facilitatory effect of synaptotagmin on synaptic transmission was never observed. To determine whether synaptotagmin may accelerate synaptic transmission in vivo, we injected the cytoplasmic domain of rat synaptotagmin I (CD-syt) into crayfish motor axons and tested the effect of CD-syt on synaptic response. We confirmed that CD-syt accelerates neuromuscular transmission. The injected preparation had larger synaptic potentials with shorter rise time. Experiments with varying calcium concentrations showed that CD-syt increased the maximum synaptic response of the neuromuscular synapses. Further tests on short-term plasticity of neuromuscular synapses revealed that CD-syt increases the release probability of the release-ready vesicles.

Testing functional anchor groups for the efficient immobilization of molecular catalysts on silver surfaces.

Modifications of complexes by attachment of anchor groups are widely used to control molecule-surface interactions. This is of importance for the fabrication of (catalytically active) hybrid systems, viz. of surface immobilized molecular catalysts. In this study, the complex fac-Re(S-Sbpy)(CO)3Cl (S-Sbpy = 3,3'-disulfide-2,2'-bipyridine), a sulfurated derivative of the prominent Re(bpy)(CO)3Cl class of CO2 reduction catalysts, was deposited onto the clean Ag(001) surface at room temperature. The complex is thermostable upon sublimation as supported by infrared absorption and nuclear magnetic resonance spectroscopy. Its anchoring process has been analyzed using scanning tunneling microscopy (STM) and density functional theory (DFT) calculations. The growth behavior was directly contrasted to the one of the parent complex fac-Re(bpy)(CO)3Cl (bpy = 2,2'-bipyridine). The sulfurated complex nucleates as single molecule at different surface sites and at molecule clusters. In contrast, for the parent complex nucleation only occurs in clusters of several molecules at specifically oriented surface steps. While this shows that surface immobilization of the sulfurated complex is more efficient as compared to the parent, symmetry analysis of the STM topographic data supported by DFT calculations indicates that more than 90% of the complexes adsorb in a geometric configuration very similar to the one of the parent complex.

Establishment of a Multiplex Detection Method for Common Bacteria in Blood Based on Human Mannan-Binding Lectin Protein-Conjugated Magnetic Bead Enrichment Combined with Recombinase-Aided PCR Technology.

Objective: Recombinase-aided polymerase chain reaction (RAP) is a sensitive, single-tube, two-stage nucleic acid amplification method. This study aimed to develop an assay that can be used for the early diagnosis of three types of bacteremia caused by Staphylococcus aureus (SA), Pseudomonas aeruginosa (PA), and Acinetobacter baumannii (AB) in the bloodstream based on recombinant human mannan-binding lectin protein (M1 protein)-conjugated magnetic bead (M1 bead) enrichment of pathogens combined with RAP. Methods: Recombinant plasmids were used to evaluate the assay sensitivity. Common blood influenza bacteria were used for the specific detection. Simulated and clinical plasma samples were enriched with M1 beads and then subjected to multiple recombinase-aided PCR (M-RAP) and quantitative PCR (qPCR) assays. Kappa analysis was used to evaluate the consistency between the two assays. Results: The M-RAP method had sensitivity rates of 1, 10, and 1 copies/µL for the detection of SA, PA, and AB plasmids, respectively, without cross-reaction to other bacterial species. The M-RAP assay obtained results for < 10 CFU/mL pathogens in the blood within 4 h, with higher sensitivity than qPCR. M-RAP and qPCR for SA, PA, and AB yielded Kappa values of 0.839, 0.815, and 0.856, respectively ( P < 0.05). Conclusion: An M-RAP assay for SA, PA, and AB in blood samples utilizing M1 bead enrichment has been developed and can be potentially used for the early detection of bacteremia.

[Types and risk factors of arrhythmia on young patients with acute coronary syndrome in Henan province].

OBJECTIVE: The types and risk factors of arrhythmia were analyzed on acute coronary syndrome (ACS) patients under the age of 44 years who were hospitalized in Henan province between September 2009 to June 2012. METHODS: Medical records of eligible patients were obtained from the information system of the First Affiliated Hospital of Zhengzhou University teleconsultation information center. Middle aged and elderly ACS patients who were hospitalized at the same period served as controls. Data on arrhythmia types, blood pressure, thyroid disease, respiratory sleep apnea syndrome, smoking history, history of alcohol consumption, eating habits, family history of early-onset arrhythmia, laboratory tests were analyzed. RESULTS: (1) Arrhythmia was detected in 110 out of young ACS patients (55%), which was significantly lower than that in the elderly ACS patients (71.05%, P < 0.01). (2) The top three arrhythmias in young ACS patients were: sinus tachycardia (30.50%), the premature ventricular contractions (19.00%), atrial flutter/atrial fibrillation (16.50%). Incidence of sinus tachycardia, atrial flutter/atrial fibrillation were significantly higher while incidence of ventricular tachycardia, ventricular fibrillation, paroxysmal supraventricular tachycardia were significantly lower in young ACS patients than in middle-aged ACS patients (all P < 0.05). The incidence of sinus tachycardia was higher while incidence of ventricular premature accelerated ventricular spontaneous cardiac rhythm, ventricular tachycardia, ventricular fibrillation, non-paroxysmal supraventricular tachycardia, atrial flutter/atrial fibrillation, paroxysmal supraventricular tachycardia, sinus bradycardia, nodal escape, atrioventricular block were significantly lower in young ACS patients than in elderly ACS patients (all P < 0.05). (3) Body mass index, incidence of smoking, coronary three-vessel disease, drinking, eating salty foods, thyroid dysfunction, sleep apnea were significantly higher in youth ACS patients with arrhythmia than in young ACS patients without arrhythmia (all P < 0. 05). (4) Logistic regression analysis found that number of diseased coronary vessels (OR = 24.293), smoking (OR = 1.112) and alcohol consumption (OR = 1.039) were independent risk factor for developing arrhythmia in young ACS patients from Henan province. CONCLUSIONS: The main types of arrhythmia are sinus tachycardia, premature ventricular contractions, atrial flutter/atrial fibrillation and the major risk factors related to the arrhythmia are number of diseased coronary vessels, smoking and alcohol consumption in young ACS patients from Henan province.

[Population characteristics and impact on heart rate variability, heart rate and blood pressure of passive smoking].

OBJECTIVE: To investigate the basic characteristics of passive smoking population, and the impact of passive smoking on heart rate variability, heart rate and blood pressure. METHODS: Eighty-six passive smokers [mean age: (52.4 ± 7.6) years] were recruited from patients and their relatives who visited cardiovascular outpatient department and excluded structural heart disease between June 2010 and June 2012, 80 normal subjects who were not exposed to smoking served as controls. Questionnaire survey, 24 hours ambulatory electrocardiogram examination and blood pressure measurement were performed in all recruited subjects. RESULTS: (1) Non-marriage rate [18.60% (16/86) vs. 3.75% (3/80), P < 0.01] was significantly higher while education level were significantly lower in passive smoking group than in control group. Passive smokers were more likely service industry workers [29.07% (25/86) vs. 15.00% (12/80), P < 0.05] and had longer daily working time [(7.56 ± 1.24) h vs. (6.02 ± 0.96) h, P < 0.01], and were less likely to be professional technology industry employers [20.93% (18/86) vs. 36.25% (29/80), P < 0.05] and managers [13.95% (12/86) vs. 38.75% (31/80), P < 0.01] compared to controls. The main place of passive smoking was workplace (67.44%, 58/86), entertainment venues (63.95%,55/86), restaurants (48.84%, 42/86). (2) Standard of the normal sinus RR intervals (SDNN), the normal consecutive sinus RR interval difference between the root-mean-square (rMSSD) and adjacent the difference between the RR interval>50 ms the number of share the percentage (PNN50) were significantly lower in passive smoking group than in the control group (all P < 0.05). Every 5 min average of the standard deviation of sinus RR cycle (SDNN index) and 24 h every 5 min sinus RR interval mean standard deviation (SDANN) were similar between the 2 groups (all P > 0.05). Ultra-low-frequency power (VLF), low frequency power (LF), high frequency power (HF) and LF/HF were significantly lower in passive smoking group than in the control group (all P < 0.01). (3) Heart rate and diastolic blood pressure were significantly higher in passive smoking group than in control group (all P < 0.05) while systolic blood pressure was similar between the 2 groups (P > 0.05). CONCLUSIONS: Marriage status, education level, profession and daily working time are independent determinants for passive smoking. Passive smoking mainly occurred in the workplace, entertainment venues and restaurants. Passive smoking is linked with reduced heart rate variability, increased 24 h average heart rate and diastolic blood pressure.

Gender differences in the predictive effect of depression and aggression on suicide risk among first-year college students.

BACKGROUND: Depression and aggression are related to the risk of suicide. Previous studies have associated different characteristics with depression and aggression in separate gender groups. The main aim of this study was to investigate the gender differences in the predictive effect of depression and aggression on suicide risk among first-year college students. METHODS: A total of 2004 first-year undergraduates (80.5 % female, mean age = 19.4 ± 0.8 years) were surveyed by a battery of questionnaires that contained the Chinese version of the Beck scale for Suicide Ideation, the Chinese version of the 12-item Aggression Questionnaire, and the Center for Epidemiologic Studies Depression scale. RESULTS: (1) Depression severity was significantly associated with the suicidality risk (r = 0.090, p < 0.01). (2) Suicide risk correlated positively with physical aggression, verbal aggression, anger, and hostility in the aggression questionnaire (r = 0.308, 0.227, 0.284, 0.277, p < 0.01). (3) A possible gender difference was noted for suicide risk in that depression degree was a significant risk factor for females but not males (R2 = 0.095, F = 41.554, p < 0.01), whereas anger was a significant predictor of suicide risk for males but not for females (R2 = 0.21, F = 25.75, p < 0.01). CONCLUSIONS: Gender differences exist in the predictive effect of depression and aggression on suicide risk among first-year college students.

[Clinical features of Candida albicans sepsis in preterm infants: an analysis of 13 cases].

OBJECTIVE: To investigate the clinical features of Candida albicans sepsis in preterm infants. METHODS: Retrospective analysis was performed on the clinical data of 13 preterm infants with Candida albicans sepsis, who were born at 28 to 36 weeks of gestational age and who weighed between 1400 and 2815 g. RESULTS: The infants were infected with Candida albicans at the age of 19±11 d, with the main clinical manifestations being apnea, poor response, poor skin perfusion, blood oxygen concentration decrease, dark skin, yellowish skin, heart rate increase in the rest state, copious phlegm and difficulty in weaning from the ventilator. The infants showed significantly decreased platelet and increased C-reactive protein (CRP), platelet distribution width (PDW), alanine transaminase (ALT), creatine kinase isoenzyme-MB (CK-MB), total bilirubin (TBIL), creatine kinase (CK), and lactate dehydrogenase (LDH). CK and LDH were significantly decreased after 2 weeks of antifungal therapy. Only 3 cases developed drug resistance to fluconazole and these showed response when treated with voriconazole instead. Of the 13 cases, 10 were cured, 2 abandoned therapy and 1 died. CONCLUSIONS: The clinical manifestations of Candida albicans sepsis are nonspecific in preterm infants. Infectious diseases are probably caused by Candida albicans in preterm infants 2-3 weeks after birth. Preterm infants show decreased platelet and increased CRP, PDW, ALT, CK-MB, TBIL, CK, and LDH when infected with Candida albicans.

Treatment of neonates with respiratory distress syndrome by proportional assist ventilation plus synchronized intermittent mandatory ventilation: a comparison study.

BACKGROUND: The proportion assisted ventilation (PAV) can improve patient-ventilator interaction, reducing the incidence of end-expiratory asynchrony and increasing the time of synchrony. PAV could compensate for the leaks by elastic and resistive unloading and thus is ideal for neonates with uncuffed airways. The aim of this study was to compare the relevant clinical parameters of neonates with respiratory distress syndrome (RDS) who are supported by PAV plus synchronized intermittent mandatory ventilation (SIMV) and SIMV. METHODS: Forty-six neonates diagnosed as RDS who required mechanical ventilation were randomly divided into observer group (support by PAV+SIMV mode, N.=23) and control group (support by SIMV mode, N.=23). The X-ray grading situation, the number of asynchrony-delayed trigger, mean arterial blood pressure (MABP), spontaneous respiratory rate (RR), heart rate (HR), blood gas analysis values and circulation and respiratory parameters at each timepoint after 30 minutes, 12, 24, 48 and 72 hours of mechanical ventilation were observed. RESULTS: The forty-four neonates in two groups have been cured, the other 2 neonates (one in each group) gave up treatment and automatically discharged. There were no statistically significant differences in male, gestational age, body weight, duration of mechanical ventilation, oxygen dependence and hospital stay between the two groups (all P>0.05). There were no statistically significant differences in MABP, HR and ratio of arterial-to-alveolar partial pressure of oxygen (a/APO2) at each time point after mechanical ventilation between the two groups(all P>0.05). The number of asynchrony-delayed trigger in observer group was lower than that in control group, the difference was statistically significant (P<0.05). The number of spontaneous RR in observer group was higher than that in control group. The difference was statistically significant (P<0.05). CONCLUSIONS: The PAV plus SIMV shows a good clinical effect in treatment of neonates with RDS. It could be better to use neonatal spontaneous breathing and might cause less damage to the lung than SIMV mode.

Latency period of PROM at term and the risk of neonatal infectious diseases.

To find the risk of time thresholds of PROM for infectious diseases of term neonates. A multi-center prospective cohort study including pregnancies with PROM at term with a single fetus were conducted. Time thresholds of the duration from PROM to delivery were examined in 2-h increments to assess the rates of infectious neonatal diseases. 7019 pregnancies were included in the study. Neonatal pneumonia and sepsis were most frequent infectious diseases in neonates born from mother with PROM at term. Rates of early-onset pneumonia varied significantly when comparing length of time of PROM greater than 16 h vs. less than 16 h (for EOP in 3 days of life, adjusted OR 1.864, 95% CI 1.159 ~ 2.997, p = 0.010; for EOP in 7 days of life, adjusted OR 1.704, 95% CI 1.104 ~ 2.628, p = 0.016). Neonates born from mother of whom the length of time from PROM to delivery ≥ 16 h were at a higher risk of acquiring EOP.

The expression and prognostic significance of Topo-II and c-erbB-2 in breast cancer.

BACKGROUND: This study aimed to investigate the expression and prognostic significance of topoisomeraseII (Topo-II）and c-erbB-2. METHODS: A total of 92 cases of patients with breast cancer who came to our hospital for treatment from November 2013 to January 2016 were included as the experimental group, and 90 healthy subjects who came to our hospital for physical examination during the same period were selected as the control group. ELISA was used to detect the expression levels of Topo-II and c-erbB-2 in serum of each group. The correlation among expression levels, degree of tumor differentiation and pathological types of Topo-II and c-erbB-2 in serum of patients with breast cancer were observed. RESULTS: The expression levels of Topo-II and c-erbB-2 in the experimental group were higher than those in the control group (P<0.05). The expression levels of Topo-II and c-erbB-2 in serum of patients with different stages increased with the clinical stages. The survival rate of patients with different expression levels of Topo-II and c-erbB-2 was compared, it was found that the survival rate of the low-expression group (80.49%) was significantly higher than that of the high-expression group (50.98%). The ROC curve was used to analyze Topo-II and c-erbB-2, the result showed that the sensitivity, specificity and AUC of Topo-II in the diagnosis of breast cancer was 72.22%, 94.56% and 0.8641, respectively. The sensitivity, specificity and AUC of c-erbB-2 in the diagnosis of breast cancer were 94.45%, 66.30% and 0.8379, respectively. CONCLUSIONS: In conclusion, Topo-II and c-erbB-2 are highly expressed in breast cancer and are closely related to breast cancer. Moreover, the detection of Topo-II and c-erbB-2 in serum can help diagnose gestational diabetes mellitus quickly and effectively.