The novel Mechanical Ventilator Milano for the COVID-19 pandemic

This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.

MDM2 inhibition improves cisplatin-induced renal injury in mice via inactivation of Notch/hes1 signaling pathway

OBJECTIVE

To explore the potential function of MDM2-mediated Notch/hes1 signaling pathway in cisplatin-induced renal injury.

METHODS

The acute renal injury models of mice after intraperitoneal injection of cisplatin in vivo, and the apoptotic models of human renal tubular epithelial (HK-2) cells induced by cisplatin in vitro, were conducted respectively. The renal function-related parameters were measured. The renal tissue pathological changes and apoptosis were observed by PAS staining and TUNEL staining, respectively. Cell viability and apoptosis were detected by MTT and flow cytometry. Notch/hes1 pathway-related proteins were tested by Western blotting.

RESULTS

After mice injected by cisplatin, the levels of Cr, BUN, urine cystatin C, urine NGAL and urine ACR were increased and GFR was decreased with the elevation of renal tubular injury scores, the upregulation of the expressions of MDM2, N1ICD, Hes1 and Cleaved caspase-3, as well as the enhancement of cell apoptosis accompanying decreased ratio of Bcl-2/Bax. However, these cisplatin-induced renal injuries of mice have been improved by MDM2 inhibition. Besides, the declined viability, increased cytotoxicity, and enhanced apoptosis were observed in cisplatin-induced HK-2 cells, with the activated Notch/hes1 pathway. Notably, the phenomenon was alleviated in cisplatin-induced HK-2 cells transfected with MDM2 shRNA, but was severer in those co-treated with AdMDM2. Moreover, Notch1 siRNA can reverse the injury of AdMDM2 on HK-2 cells.

CONCLUSION

Inhibiting MDM2 could reduce cell apoptosis through blocking Notch/hes1 signaling pathway, thus alleviating the acute renal injury caused by cisplatin.

Low plasma miR-25 expression is a favorite prognosis factor in non-small cell lung cancer

OBJECTIVE

Circulating microRNAs (miRNAs) are promising biomarkers for the diagnosis and prognosis prediction of cancer. In the study, we aimed to investigate the potential clinical significance of the plasma miR-25 in non-small cell lung carcinoma (NSCLC).

PATIENTS AND METHODS

We first compared the miRNAs expression pattern between NSCLC tissues and adjacent normal tissues then, bioinformatic analysis of the downstream targets of miR-25 was performed. The diagnostic and prognostic value of the plasma miR-25 in NSCLC was then evaluated.

RESULTS

The expression level of miR-25 was increased in NSCLC tissues compared to the adjacent normal tissues. In addition, bioinformatic analysis of the downstream-targeted genes of miR-25 revealed that many gene ontology functions and pathways were associated with cancer progression. The levels of plasma miR-25 were significantly upregulated in NSCLC patients compared to normal controls. In addition, the plasma miR-25 levels were especially higher in NSCLC patients with positive lymph node metastasis, poorly differentiation or advanced clinical stage. Subsequently, we found that the plasma miR-25 expression levels were dramatically decreased in 45 NSCLC patients after receiving surgical treatment. The receiver operating characteristic (ROC) curve analysis indicated that the plasma miR-25 exhibited high diagnostic sensitivity and specificity to discriminate NSCLC cases from healthy subjects. More interestingly, the combination of the plasma miR-25 and carcinoembryonic antigen (CEA) could effectively enhance the accuracy for distinguishing NSCLC patients from normal controls. Moreover, the plasma miR-25 overexpression was closely correlated with aggressive clinical characteristics and poor survival. Finally, the plasma miR-25 was identified as an independent prognostic marker for the overall survival of NSCLC.

CONCLUSIONS

Collectively, our findings demonstrated that the plasma miR-25 might serve as a novel promising biomarker in the diagnosis and prognosis prediction of NSCLC.

[Epidemiological characteristics of COVID-19 monitoring cases in Yinzhou district based on health big data platform]

Objective: To understand the epidemiological characteristics of COVID-19 monitoring cases in Yinzhou district based on health big data platform to provide evidence for the construction of COVID-19 monitoring system. Methods: Data on Yinzhou COVID-19 daily surveillance were collected. Information on patients' population classification, epidemiological history, COVID-19 nucleic acid detection rate, positive detection rate and confirmed cases monitoring detection rate were analyzed. Results: Among the 1 595 COVID-19 monitoring cases, 79.94% were community population and 20.06% were key population. The verification rate of monitoring cases was 100.00%. The total percentage of epidemiological history related to Wuhan city or Hubei province was 6.27% in total, and was 2.12% in community population and 22.81% in key population (P<0.001). The total COVID-19 nucleic acid detection rate was 18.24% (291/1 595), and 53.00% in those with epidemiological history and 15.92% in those without (P<0.001).The total positive detection rate was 1.72% (5/291) and the confirmed cases monitoring detection rate was 0.31% (5/1 595). The time interval from the first visit to the first nucleic acid detection of the confirmed monitoring cases and other confirmed cases was statistically insignificant (P>0.05). Conclusions: The monitoring system of COVID-19 based on the health big data platform was working well but the confirmed cases monitoring detection rate need to be improved.

[Selection of the cutoff value on tuberculin skin test in diagnosing tuberculosis infection: a population-based cross-sectional study in Eastern China]

Objective: To confirm the cutoff induration diameter of tuberculin skin test (TST) so as to decrease the false positive of the TST. Methods: Fasting blood glucose test, TST and Quanti FERON-TB (QFT) Gold In-Tube test were administered to recruit participants at the baseline stage. QFT was used as the gold standard to determine the cutoff of the TST test. Results: Overall, 5 405 participants were enrolled in this study, of whom 1 104 (20.4%) were QFT positive. Among all the 5 405 participants that without stratification, diagnostic value reached the highest when the induration diameter was 10.25 mm with sensitivity and specificity as 0.731 and 0.727, respectively. When the participants were divided into groups as nondiabetics, confirmed diabetics, undiagnosed diabetics, the sensitivities and specificities appeared as 0.701, 0.837, 0.824 and 0.805, 0.821, 0.778 with induration diameters as 11.25 mm, 10.25 mm and 11.25 mm, respectively. Conclusions: Findings of this study confirmed that the specificity of tuberculin test could be significantly improved by using 10-12 mm as the cutoff value for diagnosing the latent tuberculosis infection.