Jugular venous catheter-associated thrombosis and fatal pulmonary embolism: A case report

INTRODUCTION

Central venous catheters related thrombosis (CRT) insertion has been shown to increase the risk of venous thromboembolism, particularly pulmonary embolism (PE). Nevertheless, deaths cased due to PE have been rarely reported.

PATIENT CONCERNS

A central venous catheter was introduced through the right jugular vein during the operation due to severe septic shock from a 57-year-old male patient. Two days after surgery, the hemodynamics was stable. On the 7th day, and low molecular weight heparin calcium (4100 units, once a day) was added for anticoagulation to prevent venous thromboembolism. On the 15th day, during the process of central venous catheter removal, the patient suddenly lost consciousness, suffered cardiac arrest, and received emergency cardiopulmonary resuscitation.

DIAGNOSIS

Jugular venous catheter-associated thrombosis and fatal PE. An acute bedside ultrasound showed a thrombus drifting with the blood stream in the right jugular vein. The lower section of the xiphoid process by echocardiography showed decreased systolic amplitude of the right atrium and right ventricle, widened and fixed inferior vena cava, and no variation with respiration. Para-sternal left ventricular long axis section showed that the right ventricular outflow tract was significantly extended, and the contraction amplitude of the anterior and posterior walls of the left ventricle decreased. Left ventricular short axis section indicated a right ventricle enlargement and ventricular septum deviation of left ventricle, showing "D" sign. Apical 4-chamber view showed that the right ventricular ratio increased and the contractile capacity decreased.

INTERVENTIONS

One and a half million units of urokinase were immediately given trough intravenous drip.

OUTCOMES

Twenty minutes after thrombolysis, the patient's autonomic heart rhythm was recovered, but continued to suffer from hypotension and coma, followed by multiple organ failure, and died 50 hours later.

CONCLUSION

Recent clinical practice guidelines recommend against the routine use of any anticoagulant thromboprophylaxis in patients with central venous catheters, but for patients at particularly high risk for CRT, consideration can be given to using higher doses of anticoagulant as prophylaxis, although there are virtually no data to support this approach.

SLC12A5 interacts and enhances SOX18 activity to promote bladder urothelial carcinoma progression via upregulating MMP7

Solute carrier family 12 member 5 (SLC12A5) has an oncogenic role in bladder urothelial carcinoma. The present study aimed to characterize the molecular mechanisms of SLC12A5 in bladder urothelial carcinoma pathogenesis. Functional assays identified that in bladder urothelial carcinoma SLC12A5 interacts with and stabilizes SOX18, and then upregulates matrix metalloproteinase 7 (MMP7). In vivo and in vitro assays were performed to confirm the effect of SLC12A5’s interaction with SOX18 on MMP7‐mediated bladder urothelial carcinoma progression. SLC12A5 was upregulated in human bladder tumors, and correlated with the poor survival of patients with bladder urothelial carcinoma tumor invasion and metastasis, promoted by SLC12A5 overexpression. We demonstrated that SLC12A5 interacted with SOX18, and then upregulated MMP7, thus enhancing tumor progression. Importantly, SLC12A5 expression correlated positively with SOX18 and MMP7 expression in bladder urothelial carcinoma. Furthermore, SLC12A5 expression was suppressed by miR‐133a‐3p. Ectopic expression of SLC12A5 partly abolished miR‐133a‐3p‐mediated suppression of cell migration. SLC12A5‐SOX18 complex‐mediated upregulation on MMP7 was important in bladder urothelial carcinoma progression. The miR‐133a‐3p/SLC12A5/SOX18/MMP7 signaling axis was critical for progression, and provided an effective therapeutic approach against bladder urothelial carcinoma.

Clinical manifestations and genetic analysis of 4 children with chronic granulomatous disease

Pediatricians are unfamiliar with chronic granulomatous disease (CGD) because of its rarity and paucity of available data, potentially leading to misdiagnosis, late treatments, and mortality. The main purpose of this study was to summarize the clinical manifestations and auxiliary examination findings of four children with CGD confirmed by genetic testing.This was a case series study of children hospitalized at the Pediatric Respiratory Department of Shandong Provincial Hospital. The clinical, laboratory, treatment, and prognosis data were analyzed.All 4 children were boys. Two were brothers. The children's age was from 34 days to 3 years and 2 months at disease onset. The manifestations were repeated pulmonary infection, lymphadenitis, skin infection, and granuloma formation. Pulmonary infections were common. Abnormal responses were common after BCG vaccination. Thoracic computed tomography (CT) mainly showed nodules and masses, while the consolidation area in CT images reduced slowly. No abnormalities in cellular immune functions and immunoglobulin were found. The disease in all four children was confirmed by genetic testing. Long-term antibiotics and anti-fungal drugs were needed to prevent bacterial and fungal infections.CGD should be considered in children with repeated severe bacterial and fungal infections. Abnormal responses after BCG vaccination and nodular or mass-shaped consolidation in thoracic CT images should hint toward CGD. Gene sequencing could provide molecular evidence for diagnosis. The treatments of CGD include the prevention and treatment of infections and complications. Immunologic reconstitution treatment is currently the only curative treatment for CGD.

Observation of a comb of squeezed states with a strong squeezing factor by a bichromatic local oscillator

We demonstrate the experimental detection of an optical squeezing covering several higher resonances of the optical parametric amplifier (OPA) by adopting a bichromatic local oscillator (BLO). The BLO is generated from a waveguide electro-optic phase modulator (WGM) and subsequent optical mode cleaner (OMC), without the need of additional power balance and phase control. The WGM is used for generating the frequency-shifted sideband beams with equal power and certain phase difference, and the OMC is used for filtering the unwanted optical modes. Among a measurement frequency range from 0 to 16.64 GHz, the maximum squeezing factors are superior to 10 dB below the shot noise limit for the first three discrete odd-order resonances of the OPA.

circ-MYBL2 Serves As A Sponge For miR-361-3p Promoting Cervical Cancer Cells Proliferation And Invasion

Background

Circular RNAs (circRNAs) have been considered as a key regulator in tumor carcinogenesis. However, the roles and underlying mechanisms of circRNAs in cervical cancer (CC) remain largely unknown. In this study, we explored the effects of circ-MYBL2 (hsa_circ_0060467) on CC progression.

Methods

Levels of circ-MYBL2 and miR-361-3p were examined by qRT-PCR. CCK-8 assay, colony formation assay and transwell invasion assay were used to determine the roles of circ-MYBL2 in CC. Dual-luciferase reporter and RNA pull down assays were employed to verify the relationship between circ-MYBL2 and miR-361-3p.

Results

We showed that the expression of circ-MYBL2 was significantly upregulated and positively associated with advanced FIGO stage, larger tumor size, lymph node metastasis, and poor prognosis in CC patients. Function assays revealed that circ-MYBL2 inhibition suppressed CC cells’ proliferation, invasion and epithelial–mesenchymal transition (EMT) processes. In mechanism, miR-361-3p was identified as a direct target of circ-MYBL2, rescue assays showed that miR-361-3p suppression reversed the effects of si-circ-MYBL2 on CC cells’ progression.

Conclusion

Our findings suggested that circ-MYBL2 promoted CC progression by regulating miR-361-3p expression, which provided a novel therapeutic target for the treatment of CC patients.

An adhesive locomotion model for the rock-climbing fish, Beaufortia kweichowensis

The rock-climbing fish (Beaufortia kweichowensis) adheres to slippery, fouled surfaces and crawls both forward and backward in torrential streams. During locomotion, two suckers can be distinguished. Here, the general skeletal structure of the rock-climbing fish was determined using microtomography. Friction and adhesion were positively correlated, as were friction and fin ray angle. The unique adhesive locomotion system used by the rock-climbing fish was observed with a high speed camera. This system comprised two anisotropic suckers bearing two paired fins and two girdle muscles. A locomotion model was established based on these results. In this model, the fin states controlled the direction of motion using anisotropic friction, and alternate contractions of the girdle muscles provided propulsion during bidirectional crawling. This adhesive locomotion system was compared with other biological locomotion mechanisms. Based on these comparisons, we hypothesized that this novel system might represent an energy-saving solution for undulatory underwater vertical movement without detaching from the substrate.

Plastic-like Hydrogels with Reversible Conversion of Elasticity and Plasticity and Tunable Mechanical Properties

The development of hydrogels with excellent mechanical properties is highly desirable in both fundamental studies and practical applications. But it is difficult to construct hydrogels that are both tough and stiff at the same time as these properties often contradict each other. Here, we report a facile and efficient method for producing ultrastiff and tough poly(N-isopropylacrylamide) (PNIPAM)/clay plastic-like hydrogels (PHs) by immersing PNIPAM/clay hydrogel into NaCl aqueous solution. The optimized PH-2-6 presented superior strength, modulus, and toughness (4.1 ± 0.2 MPa, 41.6 ± 8 MPa, and 15.85 ± 0.8 MJ m^-3, respectively). The unique mechanical properties are attributed to the synergistic effect of the osmotic pressure and the strong affinity between Na⁺ ion and the PNIPAM chain, which lead to a high degree of PNIPAM chain entanglement and fixing. Note that the PHs were molded into any required shape under an applied force, and retained permanently their shapes even if the load was removed, thus displaying typical plasticity. However, the deformed PHs could return to their original size and softness of hydrogel when immersed in pure water, which is a kind of shape-memory effect. The reversible conversion of elasticity and plasticity and shape memory arise from a kind of dynamic physical across-linking of Na⁺ and PNIPAM molecular chains, which could exist in the salt aqueous and disintegrate in water reversibly. Moreover, the mechanical properties of hydrogel can be tuned by adjusting the salt concentration and immersion time. The facile strategy may provide further avenue in developing hydrogels with such versatile dynamic behaviors to expand their applications.

[Etiological analysis of 61 286 hospitalized specimens from a tertiary hospital over 5 years]

OBJECTIVE

To investigate the detection and distribution of hospitalized specimens from a tertiary hospital over 5 years.

METHODS

Specimens of sputum, urine, blood, secretions and puncture fluid were collected from patients admitted to the Harrison International Peace Hospital from November 2013 to November 2018. The origin of specimens, the distribution of departments and the distribution of pathogenic bacteria isolated were analyzed retrospectively.

RESULTS

A total of 61 286 specimens were sent for examination during the 5 years. The top 5 specimens were sputum culture (n = 18 302, 29.9%), sputum smear (n = 11 253, 18.4%), blood culture (n = 9 713, 15.8%), urine culture (n = 6 448, 10.5%) and secretion culture (n = 6 133, 10.0%), accounting for 84.6% (51 849/61 286). Sputum specimens accounted for 48.2% (29 555/61 286) with the largest proportion. The number of specimens from medical wards was much higher than that from surgical wards (specimens: 25 468 vs. 10 521), respiratory medicine, department of critical care medicine and emergency intensive care unit (EICU) were important sources of pathogenic specimens in the hospital, accounting for 29.8% (18 243/61 286) in total. The average positive rate of all specimens was 23.5% (14 424/61 286). The positive rates of sputum culture and urine culture were 29.7% (5 428/18 302) and 35.4% (2 281/6 448), respectively, while the positive rate of blood culture was only 6.6% (643/9 713). Escherichia coli was the most common pathogen in all specimens except for sputum culture and fecal culture. Escherichia coli [40.6% (926/2 281)], Klebsiella pneumoniae [9.2% (210/2 281)], Pseudomonas aeruginosa [8.2% (188/2 281)], Enterococcus faecalis (group D) [6.6% (151/2 281)] and Candida albicans [3.2% (73/2 281)] were the most common pathogens in urine culture. Klebsiella pneumoniae [24.1% (1 309/5 428)], Acinetobacter baumannii [21.3% (1 154/5 428)], Pseudomonas aeruginosa [15.1% (818/5 428)], Escherichia coli [6.5% (351/5 428)] and Maltose oligotrophomonas maltose [5.8% (316/5 428)] were the most common pathogens in sputum culture. Escherichia coli [36.5% (235/643)], Klebsiella pneumoniae [10.9% (70/643)], Pseudomonas aeruginosa [4.8% (31/643)], Staphylococcus epidermidis [3.4% (22/643)] and Staphylococcus humanis [3.3% (21/643)] were the most common pathogens in blood culture.

CONCLUSIONS

Specimens sent for examination by inpatients are mainly from internal medicine wards, mainly from sputum, blood and urine, and the detected pathogens are mainly Gram-negative bacteria.

[Clinical analysis of seven cases of myeloid sarcoma]

Objective: To investigate the clinical manifestations, pathological features, diagnosis and treatment of myeloid sarcoma, and to improve the understanding of myeloid sarcoma. Methods: The clinical data, diagnosis and treatment of 7 patients with myeloid sarcoma were retrospectively analyzed. Results: Of the 7 patients with myeloid sarcoma, 1 was male and 6 were female. In most patients, the local compression symptoms caused by painless local masses or masses were the first manifestations. One patient had lesions involving the cervix and vaginal bleeding was the first symptom. The lesions were extensive with 19 sites involved. The positive proportion of immunohistochemical staining was 6/6 for CD43, 6/7 for MPO, 4/5 for CD117, 4/4 for LCA, 3/5 for CD34 and 2/2 for CD99. Lymphocyte markers CD3 and CD20 were negative in all 7 patients. Conclusions: Myeloid sarcoma is a rare hematological malignancy. Early diagnosis and active treatment are the key to improve prognosis. Current treatments include systemic chemotherapy, surgical resection, radiation therapy, and hematopoietic stem cell transplantation.

Procalcitonin, C-reactive protein, PaCO2, and noninvasive mechanical ventilation failure in chronic obstructive pulmonary disease exacerbation

It is unclear whether procalcitonin (PCT) is correlated with noninvasive ventilation (NIV) failure. This retrospective case-control study aimed to compare PCT levels, C-reactive protein (CRP) levels, and PaCO2 in patients (05/2014-03/2015 at the Harrison International Peace Hospital, China) with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and NIV failure/success.This was a retrospective case-control study of patients with AECOPD who required NIV between May 2014 and March 2015. All consecutive patients with AECOPD admitted at the Department of Critical Care Medicine and transferred from the general ward were included in the study. Hemogram, PCT, erythrocyte sedimentation rate (ESR), arterial blood gas (ABG), and CRP levels were measured ≤1 hour before NIV was used. NIV was considered to have failed if at least one of the following criteria was met: cardiac arrest or severe hemodynamic instability; respiratory arrest or gasping; mask intolerance; difficulty in clearing bronchial secretions; or worsening of ABGs or sensorium level during NIV. The factors associated with NIV failure were determined.A total of 376 patients were included: 286 with successful NIV and 90 wither NIV failure. The multivariate analysis showed that PCT (OR = 2.0, 95%CI: 1.2-3.2, P = .006), CRP (OR = 1.2, 95%CI: 1.1-1.3, P < .001), and PaCO2 (OR = 1.1, 95%CI: 1.1-1.2, P < .001) ≤1 hour before NIV were independently associated with NIV failure. The optimal cutoff were 0.31 ng/mL for PCT (sensitivity, 83.3%; specificity, 83.7%), 15.0 mg/mL for CRP (sensitivity, 75.6%; specificity, 93.0%), and 73.5 mm Hg for PaCO2 (sensitivity, 71.1%; specificity, 100%). The area under the curve (AUC) was 0.854 for PCT, 0.849 for CRP, and 0.828 for PaCO2. PCT, CRP, and PaCO2 were used to obtain a combined prediction factor, which achieved an AUC of 0.978 (95%CI: 0.961-0.995).High serum PCT, CRP, and PaCO2 levels predict NIV failure for patients with AECOPD. The combination of these three parameters might enable even more accurate prediction.

The dynamics of body composition and body energy content in broilers

Body composition (BC) analysis is important because the modern broiler is one of the most efficient animals in producing protein for human consumption, and a proper nutrition could potentiate this meat production. BC by chemical analysis was analyzed in 151 broilers from 1to 60 d of age. Birds were fed mash feeds ad libitum in four phases (starter 1 to 14d, grower 15 to 28 d, finisher 29 to 42 d, and withdrawal 43 to 60 d). Gompertz 3P model, multiple linear regression, and CRD with ANOVA analysis were used in the experimental design using JMP pro 2015. The growth in terms of body weight, protein, fat, minerals (Ca and P) followed a Gompertz 3P model with similar growth rates of about 4.9% per day and the maximum growth was obtained at about 34 d of age. Body weight ranged from 56 to 4184 g, water from 683 to 751 g/kg, protein from 154 to 182 g/kg, fat from 53 to 101 g/kg, minerals (ash) from 17.9 to 22.5 g/kg (AS IS basis). Broiler protein ranged from 563 to 613 g/kg, fat 197 to 317 g/kg, minerals 65.2 to 86.6 g/kg, calcium 11.7 to 18.9 g/kg, and phosphorus 10.3 to 15.3 g/kg dry matter (DM) basis. The calorific coefficients for protein and fat were determined by multiple regressions and resulted in 5.45 ± 0.09 kcal/g for protein and 8.95 ± 0.16 kcal/g for fat. These two coefficients can be used to predict the body energy content or energy of gain. The protein: fat ratio was the highest at day 1 and decreased gradually until day 60. The BC in terms of water, protein, and fat changes with age, water being reduced and protein and fat increased towards d60. Mineral composition remained constant at the end of growth but some fluctuations occurred during the grower period. The understanding of the dynamics of BC will bring new opportunities to study and change feed strategies and increase the feed efficiency for meat in the modern broiler.

[The study of using cordyceps-astragalus-salvia miltiorrhiza to treat acute lung injury induced by paraquat poisoning in rats]

Objective: To study the therapy of cordyceps-astragalus-salvia miltiorrhiza in treating acute lung injury and pulmonary interstitial fibrosis induced by paraquat poisoning. Methods: All 120 adult Wister male rats were randomly assigned to three groups, the paraquat poisoning group (rats were intragastric administration paraquat 50 mg/kg body weight once at the beginning) , the cordyceps-astragalus-salvia miltiorrhiza therapy group (rats were given cordyceps-astragalus-salvia miltiorrhiza 90 mg/kg body weight intragastric administration half an hour after paraquat was given, then the same dose was given once a day) ; control group (rats were intragastric administration with physiological saline) . At 7th, 14th, 21st, and 28th day rats were sacrificed postanesthetic respectively after paraquat exposure, sample of lung tissue, bronchoalveolar lavage (BAL) , and venous blood were collected. GSH, SOD, TNF-α, TGF-β1, and HYP in plasma, bronchoalveolar lavage (BAL) , and the lung homogenates were determined. Optical microscope was performed to examine pathological changes in lung. Results: Each experimental time point paraquat group and the treatment group rats serum SOD content significantly lower than the control group (P<0.05) . Each experimental time point the treatment group rats serum SOD levels increased significantly than that of paraquat group (P<0.05) . Each experimental time point paraquat group rats serum GSH content significantly lower than that of the control group (P<0.05) . Treatment group rats 7 days time GSH content significantly lower than that of the control group (P<0.05) . Treatment group 21 days, 28 days GSH content was increased significantly than that of the paraquat group (P<0.05) . Each experimental time point paraquat group rats alveolar lavage SOD content was significantly lower than that of the control group (P<0.05) . Treatment group 7 days, 14 days time SOD content was significantly lower than that of the control group (P<0.05) , Treatment group 21 days, 28 days SOD content was increased significantly than that of the paraquat group (P<0.05) . Each experimental time point paraquat group and the treatment group rats alveolar lavage GSH content significantly were lower than that of the control group (P<0.05) . Treatment group days 14 and 21 days, 28 days GSH content was increased significantly than that of the paraquat group (P<0.05) . Each experimental time point paraquat group rats alveolar lavage TNF α levels was higher than that of the control group (P<0.05) . Treatment group 7 days, 14 days the rat alveolar lavage TNF α levels was higher than that of the control group (P<0.05) . Treatment group 21 days, 28 days TNF α content significantly was decreased than that of paraquat group (P<0.05) . Paraquat group days 14 and 21 days, 28 days HYP content was significantly higher than that of control group (P<0.05) . Treatment group 21 days HYP content was significantly higher than that of control group (P<0.05) . Treatment group 28 days time HYP content in lung tissue of rats was significantly decreased than that of the paraquat group (P<0.05) . Each experimental time point paraquat group rat lung tissue (tissue homogenate) TGF-β1 content was higher than that of the control group, the difference was statistically significant (P<0.05) . Under optical microscope, the tissue damage of lung was aggravated, and reduced after cordyceps-astragalus-salvia miltiorrhiza was administrated. Conclusion: Cordyceps-astragalus-salvia miltiorrhiza can reduce inflammation factor releasing, and relieve lung injury. It has therapeutic effect on lung injury induced by paraquat poisoning.

[Xanthogranulonatous pyelonephritis: report of 5 cases]

Xanthogranulomatous pyelonephritis (XGP) is an unusual form of chronic pyelonephritis in which the renal parenchyma is destroyed and replaced by lipid-laden foamy macrophages. It usually affects middle-aged women with a history of recurrent urinary tract infection, diabetes, or kidney stones. The inflammatory process is usually diffuse and can extend beyond the kidney. The rare focal forms may simulate primary renal tumours. The preoperative imaging diagnosis may be difficult. We reported five cases of XGP, The findings of ours were recorded including kidney size, shape, contour, the echogenecity of the renal parenchyma, the internal echoes of the dilate collecting system, the presence of perinephric fluid accumulation and obstruction. One of the 5 cases was a male patient, and the other four were female, with a mean age of 53 years. He affected kidneys of the 5 cases swelled in different degrees, and one of them was found with line-like anechoic fluid. Among the 5 cases, one kidney appeared as diffusely reducing of the parenchyma echogenicity, multiple hypoechoic areas, disappearance of corticomedullary differentiation and multiple hyperecho with shadow. A round cystic anechoic lesion was found in one kidney, with internal punctate echo and peripheral fluid. Ultrasonographic finding of 1 case was extremely hypoechoic lesion on the left kidney, protruding from the outline of the kidney, with the partial renal capsule discontinuous, the less clear boundary, and a little blood flow in it. Ultrasonographic demonstration of 2 cases was mild dilatation of the collecting system with irregular wall thickening and internal hypoechogenicity, and 1 case was solid lesion with less clear boundary to the pelvic wall and a small amount of blood flow signal, the another 1 case was showed floccule without internal blood flow. Three cases were caused by chronic obstruction verified by operation, of which one was staghorn calculi, one was poorly differentiated squamous cell carcinoma in the middle part of the ureter, and one was inflammatory stricture of upper ureteral. Through analysis of the above five cases and review of related literature, we explored diagnoses and management of the patients with XGP. Xanthogranulomatous pyelonephritis (XGP) is a rare chronic variant of pyelonephritis characterized by destruction of the renal parenchyma. Combining ultrasonographic features of XGP with clinical recurrent urinary infection and chronic obstruction, XGP can be included in the differentiation. The diagnosis of XGP suspected by ultrasound can be clarified by CT, MRI, contrast-enhanced ultrasound.

The effect of β-mannanase on nutrient utilization and blood parameters in chicks fed diets containing soybean meal and guar gum

The present study was conducted to determine whether the addition of β-mannanase in broiler feed changes hormonal profiles in the blood and broiler performance and nutrient availability. Five hundred and four Cobb male chickens were studied during d 7 to 21. Three corn-soybean meal (SBM) based diets 1) Low SBM (18% SBM); 2) High SBM (31% SBM); and 3) High SBM+GG (31% SBM + Guar Gum (GG) 0.5%) with 3 levels of β-mannanase (0, 200, and 400 ppm) were mixed to produce 9 diets. A factorial design 3 × 3 was performed with JMP pro 13 (SAS, 2017). Analysis of variance and contrast analysis were used to test significance level at P < 0.05. Glucose (190 and 188 mg/dL) was increased with 200 and 400 ppm of β-mannanase, respectively, compared to control (182 mg/dL) in the fasted state (P < 0.037). Glucose was higher in chicks fed with the High SBM and High SBM + GG diets but lower in the fasted re-fed state (P < 0.01). Insulin was higher with 200 and 400 ppm added β-mannanase in the fed state (P < 0.021). Insulin-like growth factor-1 was higher with 400 ppm added to High SBM+GG. β-mannanase improved feed conversion ratio (FCR) 9 points with 400 ppm in High SBM diet (P < 0.01) and 16 and 18 points with 200 and 400 ppm, respectively, added to the High SBM+GG diet (P < 0.01). Viscosity decreased from 19.2 to 7 cps with both enzyme doses in the High SBM + GG diet (P < 0.01). Digestible energy was +152 kcal/kg with 400 ppm β-mannanase in the High SBM diet and +200 kcal/kg with both levels of enzyme in High SBM+GG diet. Digestibility of amino acids was improved from 0.8 to 3.6% with β-mannanase in High SBM+GG diet (P < 0.05). In conclusion, chicks fed with High SBM and High SBM+GG diets with added β-mannanase significantly improved blood glucose and anabolic hormone homeostasis, FCR, digestible energy, and digestible amino acids compared to chicks fed with same diets without β-mannanase.

MicroRNA-124 inhibits cell proliferation, invasion and migration by targeting CAV1 in bladder cancer

MicroRNAs (miRs) may have promotive or suppressive roles in various human cancers types, but the molecular mechanisms underlying the role of miR-124 in bladder cancer (BC) progression have remained largely elusive. In the present study, it was observed that miR-124 was significantly downregulated in BC tissues compared with that in adjacent non-neoplastic tissues. Furthermore, its expression was also reduced in several human BC cell lines (T24, HT-1376 and 5637) compared with that in the normal bladder epithelial SV-HUC-1 cell line. A low expression of miR-124 in BC patients was significantly associated with advanced malignancy and a poor prognosis. Caveolin 1 (CAV1) was identified as a novel target gene of miR-124, and the expression of CAV1 was negatively regulated by miR-124 in T24 cells. Furthermore, CAV1 was identified to be significantly upregulated in BC tissues and cell lines, and a negative correlation was observed between the expression of miR-124 and CAV1 in BC tissues. Furthermore, restoration of miR-124 expression significantly inhibited the proliferation, migration and invasion of T24 cells, and these effects were impaired following overexpression of CAV1. Taken together, the present results demonstrate that miR-124 has a suppressive role in the proliferation, migration and invasion of BC cells by targeting CAV1, which suggests that miR-124 is a potential therapeutic candidate for BC.

Mimicking a Dog's Nose: Scrolling Graphene Nanosheets

Inspired by the densely covered capillary structure inside a dog's nose, we report an artificial nanostructure, i. e., poly(sodium p-styrenesulfonate)-functionalized reduced graphene oxide nanoscrolls (PGNS), with high structural perfection and efficient gas sensing applications. A facile supramolecular assembly is introduced to functionalize graphene with the functional polymer, combined with the lyophilization technique to massively transform the planar graphene-based nanosheets to nanoscrolls. Detailed characterizations reveal that the bioinspired nanoscrolls exhibit a wide-open tubular morphology with uniform dimensions that is structurally distinct from the previously reported ones. The detailed morphologies of the graphene-based nanosheets in each scrolling stage during lyophilization are monitored by cryo-SEM. This unravels an asymmetric polymer-induced graphene scrolling mechanism including the corresponding scrolling process, which is directly presented by molecular dynamics simulations. The fabricated PGNS sensors exhibit superior gas sensing performance with reliable repeatability, excellent linear sensibility, and, especially, an ultrahigh response ( R_a/ R_g = 5.39, 10 ppm) toward NO₂. The supramolecular assembly combined with the lyophilization technique to fabricate PGNS provides a strategy to design biomimetic materials for gas sensors and chemical trace detectors.

Conducting-Polymer-Based Materials for Electrochemical Energy Conversion and Storage

To alleviate the current energy crisis and environmental pollution, sustainable and ecofriendly energy conversion and storage systems are urgently needed. Due to their high conductivity, promising catalytic activity, and excellent electrochemical properties, conducting polymers have been attracting intense attention for use in electrochemical energy conversion and storage. Here, the latest advances regarding the utilization of conducting polymers for fuel cells and supercapacitors are introduced. The strategies employed to improve the electrocatalytic and electrochemical performances of conducting-polymer-based materials are presented. In addition, future research endeavors and possible directions for further progress in this field are outlined.

[Autophagy regulated by JWA influenced sensitivity of esophageal cancer to cisplatin]

Objective: To explore the effect of JWA on cisplatin sensitivity and its potential molecular mechanism in esophageal cancer. Methods: The siRNA was used to inhibit the JWA expression, then cisplatin sensitivity and LC3 (autophagy related protein) expression levels were observed in TE1 cells.Further, the effect of autophagy inhibitor tamoxifen (3-MA) on above process was determined.Cisplatin sensitivity of 20 fresh esophageal cancer samples was evaluated by histoculture drug response assay (HDRA). Result: Silencing JWA gene increased the sensitivity of TE1 cells to cisplatin (P<0.05), and decreased the LC3-Ⅰ and LC3-Ⅱ proteins induced by cisplatin.Furthermore, combined with 3-MA increased the inhibition rate of cisplatin in JWA silencing group (P<0.05). Additionally, the inhibition rate of cisplatin on tissues with low JWA expression were higher than those with high expression (45.6% vs 25.6%, P=0.005). Conclusions: JWA could influence the cisplatin sensitivity by regulating autophagy in esophageal cancer.

Three-Dimensional Crumpled Graphene-Based Nanosheets with Ultrahigh NO2 Gas Sensibility

It is well-established that the structures dominate the properties. Inspired by the highly contorted and crumpled maxilloturbinate inside dog nose, herein an artificial nanostructure, i.e., 3D crumpled graphene-based nanosheets, is reported with the simple fabrication, detailed characterizations, and efficient gas-sensing applications. A facile supramolecular noncovalent assembly is introduced to modify graphene with functional molecules, followed with a lyophilization process to massively transform 2D plane graphene-based nanosheets to 3D crumpled structure. The detailed morphological characterizations reveal that the bioinspired nanosheets exhibit full consistency with maxilloturbinate. The fabricated 3D crumpled graphene-based sensors exhibit ultrahigh response (R_a/R_g = 3.8) toward 10 ppm of NO₂, which is mainly attributed to the specific maxilloturbinate-mimic structure. The sensors also exhibit excellent selectivity and sensing linearity, reliable repeatability, and stability. Interestingly, it is observed that only 4 mg of graphene oxide (GO) raw materials can produce more than 1000 gas sensors, which provides a new insight for developing novel 3D biomimetic materials in large-scale gas sensor production.

ORMDL3 is associated with airway remodeling in asthma via the ERK/MMP-9 pathway

ORMDL sphingolipid biosynthesis regulator 3 (ORMDL3) has been previously implicated in asthma pathogenesis, its effect on airway remodeling remains to be elucidated. The present study examined the expression levels of ORMDL3 in a mouse model of asthma. Mice were divided into three groups: Asthmatic model (n=10), budesonide‑treated (n=10) and a control group (n=8). Asthma was induced by sensitization with ovalbumin (OVA) and aluminum hydroxide on day 1, 7 and 14. Subsequently mice were exposed to OVA three times per week from day 28. In order to investigate the mechanism of airway remodeling 100 µg/kg aerosol budesonide was administered to 6 animals prior to exposure to OVA. The condition of lung tissues was assessed through histology, and the expression levels of ORMDL3, phosphorylated‑extracellular‑signal regulated kinase (p‑ERK) and matrix metallopeptidase‑9 (MMP‑9) were quantified using immunohistochemistry, reverse transcription‑quantitative polymerase chain reaction and western blotting. A severe inflammatory response and airway remodeling were pretreatment with budesonide. Expression levels of ORMDL3, phosphorylated (p)‑ERK and MMP‑9 were significantly greater in the asthma‑model group; however, in the group pretreated with budesonide their expression was reduced. Expression levels of ORMDL3, p‑ERK and MMP‑9 were significantly positively correlated with bronchial wall thickness. ORMDL3 expression was significantly positively correlated with p‑ERK and MMP‑9. Therefore, increased ORMDL3 expression may induce the p‑ERK/MMP‑9 pathway to promote pathological airway remodeling in patients with asthma.

[Analysis of death risk factors for nosocomial infection patients in an ICU: a retrospective review of 864 patients from 2009 to 2015]

OBJECTIVE

To investigate the mortality risk factors of nosocomial infection patients in intensive care unit (ICU), and to guide clinicians to take effective control measures.

METHODS

A retrospectively cohort study was conducted. The relevant information of patients with nosocomial infection treated in ICU of Hengshui Harrison International Peace Hospital Affiliated to Hebei Medical University from June 2009 to December 2015 was analyzed. The patients who admitted to ICU again, with length of ICU stay less than 48 hours, without first etiology of screening within 48 hours of ICU admission, or without complete pathogenic information were excluded. The gender, age, diagnosis, length of ICU stay, invasive operation, nutritional status, acute physiology and chronic health evaluation II (APACHEII) score, sequential organ failure assessment (SOFA) score, distribution and drug resistance of the pathogens, and procalcitonin (PCT) levels at 7 days after nosocomial infection were recorded. The risk factors leading to death in patients with nosocomial infection were analyzed by logistic regression, and the receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of all risk factors on the outcome of patients with nosocomial infection.

RESULTS

In 864 enrolled patients with male of 54.75% and mean age of (63.50±15.80) years, 732 (84.72%) patients survived and 132 (15.28%) died. Compared with survivors, the non-survivors had higher age (years: 65.47±15.32 vs. 58.15±13.27), incidence of urgent trachea intubation (32.58% vs. 22.81%), deep venous catheterization (83.33% vs. 63.25%), and multiple drug-resistant infection (65.91% vs. 33.20%), longer length of ICU stay (days: 13.56±4.29 vs. 10.29±4.32) and duration of coma (days: 7.36±2.46 vs. 5.48±2.14), lower albumin (g/L: 23.64±8.47 vs. 26.36±12.84), higher APACHEII score (19.28±5.16 vs. 17.56±5.62), SOFA score (8.55±1.34 vs. 6.43±2.65), and PCT (μg/L: 3.06±1.36 vs. 2.53±0.87, all P < 0.05). There was no significant difference in gender and urinary tract catheterization between survivors and non-survivors (both P > 0.05). The low respiratory tract was the most common site of infection followed by urinary tract and bloodstream in both groups. It was shown by logistic regression analysis that prolonged ICU stay [odds ratio (OR) = 2.039, 95% confidence interval (95%CI) = 1.231-3.473, P = 0.002], APACHEII score (OR = 1.683, 95%CI = 1.002-9.376, P = 0.000), SOFA score (OR = 2.060, 95%CI = 1.208 -14.309, P = 0.041), PCT (OR = 2.090, 95%CI = 1.706-13.098, P = 0.004), and multi-drug resistant pathogens infection (OR = 5.245, 95%CI = 2.213-35.098, P = 0.027) were independent risk factors for ICU mortality in patients with nosocomial infection. The area under ROC curve (AUC) of length of ICU stay, APACHEII score, SOFA score, and PCT level for predicting death of nosocomial infection patients was 0.854, 0.738, 0.786, and 0.849, respectively, the best cut-off value was 16.50 days, 22.45, 6.37 and 3.38 μg/L, respectively, the sensitivity was 83.6%, 90.0%, 81.1%, and 89.6%, and the specificity was 70.3%, 75.6%, 71.3%, and 85.4%, respectively.

CONCLUSIONS

Prolonged ICU stay, nosocomial infection with secondary sepsis and multiple organ dysfunction syndrome were the leading causes of death for nosocomial infection patients in ICU. Prolonged ICU stay, APACHE II score, SOFA score, and PCT level could effectively predict death risks for nosocomial infection patients.

Early use of noninvasive techniques for clearing respiratory secretions during noninvasive positive-pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease and hypercapnic encephalopathy: A prospective cohort study

Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China.A total of 74 patients received NPPV and 90 patients received CMV. Inclusion criteria included the following: physician-diagnosed AECOPD, spontaneous airway clearance of excessive secretions, arterial blood gas analysis requiring intensive care, moderate-to-severe dyspnea, and a Kelly-Matthay scale score of 3 to 5. Exclusion criteria included the following: preexisting psychiatric/neurological disorders unrelated to HE, upper gastrointestinal bleeding, upper airway obstruction, acute coronary syndromes, preadmission tracheostomy or endotracheal intubation, and urgent endotracheal intubation for cardiovascular, psychomotor agitation, or severe hemodynamic conditions.Intensive care unit participants were managed by NPPV. Participants received standard treatment consisting of controlled oxygen therapy during NPPV-free periods; antibiotics, intravenous doxofylline, corticosteroids (e.g., salbutamol and ambroxol), and subcutaneous low-molecular-weight heparin; and therapy for comorbidities if necessary. Nasogastric tubes were inserted only in participants who developed gastric distension. No pharmacological sedation was administered.The primary and secondary outcome measures included comparative complication rates, durations of ventilation and hospitalization, number of invasive devices/patient, and in-hospital and 1-year mortality rates.Arterial blood gases and sensorium levels improved significantly within 2 hours in the NPPV group with lower hospital mortality, fewer complications and invasive devices/patient, and superior weaning off mechanical ventilation. Mechanical ventilation duration, hospital stay, or 1-year mortality was similar between groups.NPPV combined with a noninvasive strategy to clear secretions during the first 2 hours may offer advantages over CMV in treating AECOPD patients complicated by HE.