Predictive value of CD86 for the occurrence of sepsis (Sepsis-3) in patients with infection

This prospective observational study explored the predictive value of CD86 in the early diagnosis of sepsis in the emergency department. The primary endpoint was the factors associated with a diagnosis of sepsis. The secondary endpoint was the factors associated with mortality among patients with sepsis. It enrolled inpatients with infection or high clinical suspicion of infection in the emergency department of a tertiary Hospital between September 2019 and June 2021. The patients were divided into the sepsis and non-sepsis groups according to the Sepsis-3 standard. The non-sepsis group included 56 patients, and the sepsis group included 65 patients (19 of whom ultimately died). The multivariable analysis showed that CD86% (odds ratio [OR] = 1.22, 95% confidence interval [CI]: 1.04-1.44, P = 0.015), platelet count (OR = 0.99, 95%CI: 0.986-0.997, P = 0.001), interleukin-10 (OR = 1.01, 95%CI: 1.004-1.025, P = 0.009), and procalcitonin (OR = 1.17, 95%CI: 1.01-1.37, P = 0.043) were independent risk factors for sepsis, while human leukocyte antigen (HLA%) (OR = 0.96, 05%CI: 0.935-0.995, P = 0.022), respiratory rate (OR = 1.16, 95%CI: 1.03-1.30, P = 0.014), and platelet count (OR = 1.01, 95%CI: 1.002-1.016, P = 0.016) were independent risk factors for death in patients with sepsis. The model for sepsis (CD86%, platelets, interleukin-10, and procalcitonin) and the model for death (HLA%, respiratory rate, and platelets) had an area under the curve (AUC) of 0.870 and 0.843, respectively. CD86% in the first 24 h after admission for acute infection was independently associated with the occurrence of sepsis in the emergency department.

Expansin SlExp1 and endoglucanase SlCel2 synergistically promote fruit softening and cell wall disassembly in tomato

Fruit softening, an irreversible process that occurs during fruit ripening, can lead to losses and waste during postharvest transportation and storage. Cell wall disassembly is the main factor leading to loss of fruit firmness, and several ripening-associated cell wall genes have been targeted for genetic modification, particularly pectin modifiers. However, individual knockdown of most cell wall-related genes has had minimal influence on cell wall integrity and fruit firmness, with the notable exception of pectate lyase. Compared to pectin disassembly, studies of the cell wall matrix, the xyloglucan-cellulose framework, and underlying mechanisms during fruit softening are limited. Here, a tomato (Solanum lycopersicum) fruit ripening-associated α-expansin (SlExpansin1/SlExp1) and an endoglucanase (SlCellulase2/SlCel2), which function in the cell wall matrix, were knocked out individually and together using clustered regularly interspaced short palindromic repeat (CRISPR)/CRISPR-associated nuclease 9-mediated genome editing. Simultaneous knockout of SlExp1 and SlCel2 enhanced fruit firmness, reduced depolymerization of homogalacturonan-type pectin and xyloglucan, and increased cell adhesion. In contrast, single knockouts of either SlExp1 or SlCel2 did not substantially change fruit firmness, while simultaneous overexpression of SlExp1 and SlCel2 promoted early fruit softening. Collectively, our results demonstrate that SlExp1 and SlCel2 synergistically regulate cell wall disassembly and fruit softening in tomato.

Enhancing the dielectric and thermal properties of polytetrafluoroethylene-based composites through designing and constructing a novel interfacial structure

Polytetrafluoroethylene (PTFE) is widely used as a fundamental core material for high-frequency and high-speed signal transmission fields due to its excellent dielectric properties. However, the high coefficient of thermal expansion (CTE) characteristic of PTFE severely limits its practical application. The CTE of PTFE can be reduced by filling with SiO2, which is always accompanied by a rapid deterioration of dielectric properties due to the poor interfacial compatibility between SiO2 and PTFE matrix. In this paper, the challenge of synergistic regulation of dielectric and CTE properties for PTFE-based composites is overcome by constructing an interfacial structure with physical interactions. Micro-mesoporous SiO2 (mSiO2) is prepared and introduced as a filler, compared with smooth surface SiO2 (sSiO2), the presence of micro-mesoporous in mSiO2 allows PTFE molecular chains to be adsorbed on the surface or in the pore channels of mSiO2, which improves the interfacial combination of the mSiO2/PTFE composites through the physical interaction between mSiO2 and PTFE. The results show that mSiO2/PTFE composite exhibits a lower CTE (58 ppm °C-1) while maintaining a lower dielectric constant (εr, 2.29, 30 GHz) with dielectric loss (tan δ, 2.31 × 10-3, 30 GHz) at a filler addition of 30 vol%, as compared with that of the sSiO2/PTFE composites. This work provides a new strategy for fabricating PTFE-based composites with low CTE as well as low εr and tan δ.

Carboxymethyl chitosan and polycaprolactone-based rapid in-situ packaging for fruit preservation by solution blow spinning

Nanofiber packaging has not yet gained practical application in fruit preservation because of some limitations, such as low production rate and utilization, and failure due to poor adhesion to the fruit. Herein, to solve this issue, a novel fruit packaging method based on solution blow spinning (SBS), called in-situ packaging, was pioneered. Specifically, carboxymethyl chitosan (CMCH) and polycaprolactone (PCL) were chosen as substrate materials and cherry tomatoes were selected as demonstration subjects. CMCH/PCL nanofibers were deposited directly onto the surface of cherry tomatoes by SBS, forming a tightly adherent and stable fiber coating in 8 min. Also, this in-situ packaging could be easily peeled off by hand. The in-situ packaging was an excellent carrier for active substances and was effective in inhibiting gray mold on cherry tomatoes. The in-situ packaging film formed a barrier on the surface of cherry tomatoes to limit moisture penetration, resulting in reduced respiration of fruits, which led to reduced weight and firmness loss. In addition, metabolomics and color analysis revealed that the in-situ packaging delayed ripening of cherry tomatoes after harvest. Overall, the in-situ packaging method developed in the present work provides a new solution for post-harvest fruit preservation.

Mechanisms of the response of apple fruit to postharvest compression damage analyzed by integrated transcriptome and metabolome

Apple fruit is susceptible to compression damage within the postharvest supply chain given its thin peels and brittle texture, which can result in decay and deterioration and have a substantial impact on its marketability and competitiveness. Thorough bioinformatics investigations are lacking on postharvest compression damage stress-induced alterations in genes and metabolic regulatory networks in fruits. In the present study, a comprehensive analysis of both the transcriptome and metabolome was conducted on 'Red Fuji' apples experiencing compression-induced damage. During the storage after damage has occurred, the gene expression of MdOFUT19, MdWRKY48, MdCBP60E, MdCYP450 and MdSM-like of the damaged apples was consistently higher than that of the control group. The damaged apples also had higher contents of some metabolites such as procyanidin A1, Dl-2-Aminooctanoic acid, 5-O-p-Coumaroyl shikimic acid and 5,7-Dihydroxy-3',4',5'-trimethoxyflavone. Analysis of genes and metabolites with distinct expressions on the common annotation pathway suggested that the fruit may respond to compression stress by promoting volatile ester and lignin synthesis. The above results can deepen the comprehension of the response mechanisms in apple fruits undergoing compression-induced damage.

Comprehensive metabolome and transcriptome analyses demonstrate divergent anthocyanin and carotenoid accumulation in fruits of wild and cultivated loquats

Eriobotrya is an evergreen fruit tree native to South-West China and adjacent countries. There are more than 26 loquat species known in this genus, while E. japonica is the only species yet domesticated to produce fresh fruits from late spring to early summer. Fruits of cultivated loquat are usually orange colored, in contrast to the red color of fruits of wild E. henryi (EH). However, the mechanisms of fruit pigment formation during loquat evolution are yet to be elucidated. To understand these, targeted carotenoid and anthocyanin metabolomics as well as transcriptomics analyses were carried out in this study. The results showed that β-carotene, violaxanthin palmitate and rubixanthin laurate, totally accounted for over 60% of the colored carotenoids, were the major carotenoids in peel of the orange colored 'Jiefangzhong' (JFZ) fruits. Total carotenoids content in JFZ is about 10 times to that of EH, and the expression levels of PSY, ZDS and ZEP in JFZ were 10.69 to 23.26 folds to that in EH at ripen stage. Cyanidin-3-O-galactoside and pelargonidin-3-O-galactoside were the predominant anthocyanins enriched in EH peel. On the contrary, both of them were almost undetectable in JFZ, and the transcript levels of F3H, F3'H, ANS, CHS and CHI in EH were 4.39 to 73.12 folds higher than that in JFZ during fruit pigmentation. In summary, abundant carotenoid deposition in JFZ peel is well correlated with the strong expression of PSY, ZDS and ZEP, while the accumulation of anthocyanin metabolites in EH peel is tightly associated with the notably upregulated expressions of F3H, F3'H, ANS, CHS and CHI. This study was the first to demonstrate the metabolic background of how fruit pigmentations evolved from wild to cultivated loquat species, and provided gene targets for further breeding of more colorful loquat fruits via manipulation of carotenoids and anthocyanin biosynthesis.

Heterogeneous Fe-Co dual-atom catalyst outdistances the homogeneous counterpart for peroxymonosulfate-assisted water decontamination: New surface collision oxidation path and diatomic synergy

Heterogeneous catalysts lag far behind their homogeneous counterparts in activating peroxymonosulfate (PMS) for water decontamination due to the low site intrinsic activity and sluggish mass transfer. The single-atom catalyst can bridge the gap between heterogeneous and homogeneous catalysts, but the difficulty to break scaling relations originating from the site monotony restricts further efficiency upgradation. Herein through modulating the crystallinity of NH₂-UIO-66, a porous carbon support with ultrahigh surface area (1721.71 m² g^-1) is obtained to anchor the dual-atom FeCoN₆ site, which exhibits superior turnover frequency over single-atom FeN₄ and CoN₄ sites (13.07 versus 9.97, 9.07 min^-1). The as-synthesized composite thus outperforms the homogeneous catalytic system (Fe³⁺+Co²⁺) for sulfamethoxazole (SMZ) degradation, and the catalyst-dose-normalized kinetic rate constant (99.26 L min^-1 g^-1) exceeds reported values by 1∼2 orders of magnitude. Moreover, only 20 mg of the catalyst can run a fluidized-bed reactor to realize continuous zero discharge of SMZ in multiple actual waters for up to 8.33 h. Unlike all reported reaction routes, the catalysis on the diatomic site follows a new surface collision oxidation path, i.e. the dispersed catalyst adsorbs PMS to generate surface-activated PMS with high potential, which collides with surrounding SMZ and directly seizes electron from it to induce pollutant oxidation. Theoretical calculation indicates that the enhanced activity of FeCoN₆ site stems from the diatomic synergy, leading to stronger PMS adsorption, larger near-Fermi-level density of states and optimal global Gibbs free energy evolution. Overall, this work provides an effective strategy of constructing heterogeneous dual-atom catalyst/PMS process to achieve faster pollution control than homogeneous system, and sheds light on the interatomic synergetic mechanism for PMS activation.

Based on P (cv-a) CO2/C (a-cv) O2 and its changes are associated with an early reduction in multiple organ failure in patients with septic hyperlactocidemia

                The study aimed to investigate the relationship between the respiratory quotient (RQ), measured by the central venous-arterial carbon dioxide partial pressure difference/arterial-venous oxygenation difference ratio, and the early remission of multi-organ failure (MOF) in sepsis patients with hyperlactatemia. The study observed 49 septic patients with hyperlactatemia in the ICU, obtaining blood samples before and after resuscitation, and dividing the patients into two groups depending on whether the modified Sequential Organ Failure Assessment score improved after 24 hours of treatment. Results showed that lactate clearance was faster and the rate of change in RQ was higher in the improved group than in the unimproved group. Further analysis showed that an RQ ≤0.198 mmHg/mL/L or a change of ≥30.71% in RQ after 24 hours of resuscitation was associated with early improvement in MOF. In conclusion, changes in RQ were associated with early improvement in MOF in septic patients with hyperlactatemia, suggesting that RQ could be used as a potential marker for predicting early remission and guiding clinical interventions.

Intravenous metronidazole-, levofloxacin-containing triple therapy for treating patients with Helicobacter pylori-related active peptic ulcer complications: A pilot study

OBJECTIVE

The aim of this pilot study was to evaluate the efficacy and safety of intravenous use esomeprazole, metronidazole, and/or levofloxacin in the treatment of Helicobacter pylori (H. pylori)-associated peptic ulcer complications.

METHODS

Inpatients with peptic ulcer complications who were not able to take oral medicine were randomly assigned to three groups: triple therapy (esomeprazole, levofloxacin, metronidazole) and dual therapy (esomeprazole, levofloxacin/metronidazole) for 7 days. After intravenous treatment, all patients received open-label oral esomeprazole 20 mg bid for another 1 month. All subjects were followed up for gastroscopy at the seventh day of intravenous treatment to confirm the ulcer healing and ¹³ C-urea breath test to confirm successful H. pylori eradication 4-6 weeks after completion of oral esomeprazole therapy.

RESULTS

The H. pylori eradication rate of both LEV-dual therapy (33.3%, 95% CI: 9.7%-70.0%) and MTZ-dual therapy (50%, 95% CI: 21.5%-78.5%) was significantly lower than that of triple therapy (95%, 95% CI: 71.1%-97.4%) (p = .003, .016). There were no significant differences in the adverse effects among all treatment groups, and the adverse effects were rare.

CONCLUSIONS

The intravenous triple regimen, consisting of proton-pump inhibitor, metronidazole, and levofloxacin, could be considered in patients of H. pylori-associated peptic ulcer complications if oral medicine cannot be provided.

N-doped porous bowl-like carbon with superhigh external surface area for ultrafast degradation of bisphenol A: Key role of site exposure degree

High-temperature nitrogen (N) doping boosts the activity of biochars for peroxymonosulfate (PMS) activation, but the N heat loss causes the unsatisfactory catalytic efficiency. Improving the surface area for obtaining the high exposure of N sites is a promising solution. Herein, a soft template-KHCO₃ etching strategy is used to synthesize the N-doped porous bowl-like carbon (NPBC) with ultrahigh external surface area (1610.8 m² g^-1). The bowl-like structure eliminates inert bulk interior and allows unobstructed mass transfer of reactants onto both outer and inner surfaces, while the large pore channels by KHCO₃ etching further improves the exposure degree of limited N sites. Although NPBC has only 0.43% N content, 93.1% of bisphenol A (BPA) is removed within 1 min through the electron-transfer pathway by fully utilizing the N active centers, and the kinetic rate constant (k) reaches 5.29 min^-1, exceeding reported values by 2-270 times. Moreover, the NPBC/PMS system possesses excellent applicability for various organics and conditions, effectively mineralizes BPA and reduces effluent biotoxicity. A quantitative index W representing N exposure degree is first proposed and shows high linearity with the k values of BPA degradation (R²=0.992, 0 <W<3750 m² g^-1%^-1), proving the critical role of W in determining catalytic efficiency.

Mapping the research trends and hot topics of ventricular arrhythmia: A bibliometric analysis from 2001 to 2020

BACKGROUND

Studies of ventricular arrhythmia (VA) have drawn much scholarly attention over the past two decades. Our study aimed to assess the current situation and detect the changing research trends of VA quantitatively and qualitatively.

MATERIALS AND METHODS

All the information used in our statistical and bibliometric analysis were collected and summarized from papers retrieved from the Web of Science Core Collection (WoSCC) database on December 22, 2021 using certain criteria. Visual analytics were realized using CiteSpace, VOSviewer, the bibliometrix R package, and the bibliometric online analysis platform.

RESULTS

A total of 6,897 papers (6,711 original articles, 182 proceedings papers, three book chapters, and one data paper) were published in 796 journals that concentrated on the research areas of cardiovascular and critical care medicine. The most productive country and influential institution was the USA and the Mayo Clinic, respectively. Heart Rhythm (551 articles and 8,342 local citations) published the most manuscripts. The keyword co-occurrence and co-citation network of references analyses revealed that the most popular terms were ventricular tachycardia, ventricular fibrillation, catheter ablation, implantable cardioverter defibrillator (ICD), and sudden cardiac death (SCD). Further, the burst detection analysis demonstrated that topics strongly associated with clinical prognosis, such as meta-analysis, long-term outcomes, and impact, were new concerns.

CONCLUSION

Our study offers a comprehensive picture of VA research and provides profound insights into the current research status. Moreover, we show that new topics within the VA research field have focused more on prognosis and evidence-based clinical guidelines.

[Comparison of clinicopathological features for indications of different types of antiviral therapy in chronic hepatitis B]

Objective: To compare and analyze the clinicopathological features and significance for indications of different types of antiviral therapy in chronic hepatitis B (CHB). Methods: Clinical data of 861 CHB cases who received liver biopsy, had hepatitis B virus (HBV) DNA-positive (> 30 IU/ml) and met the indications for antiviral therapy from January 2014 to December 2019 were included. Liver pathological changes and their correlation with clinical characteristics were compared and analyzed. According to different data, t-test, analysis of variance, nonparametric test, χ² test, Ridit and logistic regression analysis were used for statistical analysis. Results: Most of the cases (72.24%) had remarkable pathological damage. The degree of liver fibrosis was higher in the normal than the abnormal group (P<0.001). 17.54% cases had hepatic steatosis. The vast majority of cases (97.33%) had positive hepatitis B surface antigen (HBsAg), while only 50.87% had positive hepatitis B core antigen (HBcAg). The positive correlation factors affecting the severity of liver histopathology were alkaline phosphatase level, while the negative correlation factors were positive HBcAg staining, albumin and platelet level. The degree of liver inflammation and fibrosis had statistically significant differences with different HBcAg staining levels (χ²=44.142 and 102.386, respectively; P<0.001), and the severity was more apparent in the negative group. Conclusion: There exist differences in clinicopathological features for indications of different types of antiviral therapy in patients with CHB. Liver function test range is inconsistent with degrees of hepatic histological severity. The positive and intensity of liver tissue HBcAg staining, and albumin and alanine aminotransferase levels have negative correlation with disease severity.

EFFECTS OF SHENFU INJECTION ON SUBLINGUAL MICROCIRCULATION IN SEPTIC SHOCK PATIENTS: A RANDOMIZED CONTROLLED TRIAL

ABSTRACT

Background and Objective: The optimization of macrocirculatory hemodynamics is recommended by current sepsis guidelines. However, microcirculatory dysfunction is considered the cause of severe sepsis. In the present study, we designed to verify whether the application of Shenfu injection (SFI) restores microcirculation, thereby improving tissue perfusion and inhibiting organ dysfunction, resulting in improved outcomes. Design: We conducted a prospective, single-center, randomized, double-blind, placebo-controlled clinical trial. Intervention: Patients were randomly assigned to group receiving SFI (n = 20) or placebo (n = 20) for 5 days. We administered SFI or glucose injection for 5 days and blinded the investigators and clinical staff by applying light-proof infusion equipment that concealed therapy allocation. Measurements and Results: We measured the systemic dynamics and lactate levels, biomarkers of endothelial dysfunction, and inflammatory cytokines in the plasma. The parameters of sublingual microcirculation were assessed using side-stream dark-field imaging. Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) score, total dose, and duration of vasopressor use, emergency intensive care unit (EICU) stay, and 28-day mortality were evaluated. After treatment with SFI, the disturbance of the sublingual microcirculation was considerably alleviated, as indicated by the significant increase in total vessel density, perfused vessel density, and microvascular flow index. Moreover, the plasma biomarker levels of endothelial dysfunction, including Ang-2, Syn-1, and ET-1, were reversed after SFI treatment. Importantly, the SFI group had a more favorable prognosis than the control group in terms of the APACHE-II score, SOFA score, duration of vasopressor administration, and length of EICU stay. However, the difference in mortality at day 28 was not statistically different between the SFI (15%, 3/20) and placebo (25%, 5/20) groups ( P = 0.693). Conclusions : Shenfu injection provided apparent effects in improving sublingual microcirculatory perfusion in patients with septic shock, and this protection may be related with the inhibition of endothelial dysfunction and vasodilatory effects.

Sulfide-modified zero-valent iron activated periodate for sulfadiazine removal: Performance and dominant routine of reactive species production

In this work, sulfide-modified zero-valent iron (S-Fe⁰) was used to activate periodate (IO₄^-, PI) for sulfadiazine (SDZ) removal. 60 μM SDZ could be completely removed within only 1 min by S-Fe⁰/PI process. Compared with other oxidants including H₂O₂, peroxymonosulfate (PMS), peroxydisulfate (PDS), S-Fe⁰ activated PI exhibited better performance for SDZ removal but with lower Fe leaching. Compared with Fe⁰/PI process, S-Fe⁰/PI process could reduce more than 80% Fe⁰ and PI dosage. Inorganic ions and nature organic matters had negligible effect on SDZ removal in S-Fe⁰/PI system inducing its good SDZ removal efficiency in natural fresh water. 80.2% SDZ still could be removed within 2 min after 7th run. S-Fe⁰/PI process also exhibited 2.5 - 20.1 folds enhancement for various pollutants removal compared with Fe⁰/PI process. Scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), electrochemical tests, and density functional theory (DFT) calculation were conducted to confirm the presence of sulfurs could enhance the reactivity of S-Fe⁰ thus increased the efficiency of PI activation for antibiotics removal. Electron paramagnetic resonance spectroscopy (EPR) tests, radical quenching experiments, quantitative detection and DFT calculation were performed to illustrate the role of multiple reactive species in SDZ removal and the dominant pathway of multiple reactive species production. IO₃^·, ^·OH, O₂^-·, ¹O₂, Fe^IV, and SO₄^·- all participated in SDZ removal. ^·OH played the major role in SDZ removal and the dominant routine of ^·OH production was IO₄^- → O₂^-· → H₂O₂ → ^·OH. Meanwhile, S-Fe⁰/PI process could efficiently mineralize SDZ and reduce the toxicity. Comparison with other PI activation approaches and SDZ treatment techniques further demonstrated S-Fe⁰ was an efficient catalyst for PI activation and present study process was a promising approach for antibiotics removal.

Effects of Methylprednisolone on Myocardial Function and Microcirculation in Post-resuscitation: A Rat Model

Background

Previous studies have demonstrated that inflammation and impaired microcirculation are key factors in post-resuscitation syndromes. Here, we investigated whether methylprednisolone (MP) could improve myocardial function and microcirculation by suppressing the systemic inflammatory response following cardiopulmonary resuscitation (CPR) in a rat model of cardiac arrest (CA).

Methods

Sprague-Dawley rats were randomly assigned to (1) sham, (2) control, and (3) drug groups. Ventricular fibrillation was induced and then followed by CPR. The rats were infused with either MP or vehicle at the start of CPR. Myocardial function and microcirculation were assessed at baseline and after the restoration of spontaneous circulation. Blood samples were drawn at baseline and 60-min post-resuscitation to assess serum cytokine (TNF-α, IL-1β, and IL-6) levels.

Results

Myocardial function [estimated by the ejection fraction (EF), myocardial performance index (MPI), and cardiac output (CO)] improved post-ROSC in the MP group compared with those in the control group (p &lt; 0.05). MP decreased the levels of the aforementioned pro-inflammatory cytokines and alleviated cerebral, sublingual, and intestinal microcirculation compared with the control (p &lt; 0.05). A negative correlation emerged between the cytokine profile and microcirculatory blood flow.

Conclusion

MP treatment reduced post-resuscitation myocardial dysfunction, inhibited pro-inflammatory cytokines, and improved microcirculation in the initial recovery phase in a CA and resuscitation animal model. Therefore, MP could be a potential clinical target for CA patients in the early phase after CPR to alleviate myocardial dysfunction and improve prognosis.

Protection Against Post-resuscitation Acute Kidney Injury by N-Acetylcysteine via Activation of the Nrf2/HO-1 Pathway

Background and Objective

Acute kidney injury (AKI), the common complication after cardiopulmonary resuscitation (CPR), seriously affects the prognosis of cardiac arrest (CA) patients. However, there are limited studies on post-resuscitation AKI. In addition, it has been demonstrated that N-acetylcysteine (N-AC) as an ROS scavenger, has multiorgan-protective effects on systemic and regional ischaemia-reperfusion injuries. However, no studies have reported its protective effects against post-resuscitation AKI and potential mechanisms. This study aimed to clarify the protective effects of N-AC on post-resuscitation AKI and investigate whether its potential mechanism was mediated by activating Nrf-2/HO-1 pathway in the kidney.

Methods

We established cardiac arrest models in rats. All animals were divided into four groups: the sham, control, N-AC, and ZnPP groups. Animals in each group except for the ZnPP group were assigned into two subgroups based on the survival time: 6 and 48 h. The rats in the control, N-AC, and ZnPP groups underwent induction of ventricular fibrillation (VF), 8 min untreated VF and cardiopulmonary resuscitation. Renal function indicators, were detected using commercial kits. Renal pathologic changes were assessed by haematoxylin–eosin (HE) staining. Oxidative stress and inflammatory responses were measured using the corresponding indicators. Apoptosis was evaluated using terminal uridine nick-end labeling (TUNEL) staining, and expression of proteins associated with apoptosis and the Nrf-2/HO-1 pathway was measured by western blotting.

Results

N-AC inhibited post-resuscitation AKI. We observed that N-AC reduced the levels of biomarkers of renal function derangement; improved renal pathological changes; and suppressed apoptosis, oxidative stress, and inflammatory response. Additionally, the production of ROS in the kidneys markedly decreased by N-AC. More importantly, compared with the control group, N-AC further upregulated the expression of nuclear Nrf2 and endogenous HO-1 in N-AC group. However, N-AC-determined protective effects on post-resuscitation AKI were markedly reversed after pretreatment of the HO-1 inhibitor zinc protoporphyrin (ZnPP).

Conclusions

N-AC alleviated renal dysfunction and prolonged survival in animal models of CA. N-AC partially exerts beneficial renal protection via activation of the Nrf-2/HO-1 pathway. Altogether, all these findings indicated that N-AC as a common clinical agent, may have the potentially clinical utility to improve patients the outcomes in cardiac arrest.

Facile one-step fabrication of Cu-doped carbon dots as a dual-selective biosensor for detection of pyrophosphate ions and measurement of pH

High-performance determination of pyrophosphate ions (PPi) and pH is an important goal in biological systems. In this work, Cu-doped carbon dots (Cu-CDs) were synthesized rapidly and simply via a one-pot hydrothermal method. The as-obtained Cu-CDs, with an average size of 2.55 nm, exhibit an excitation-independent fluorescence emission and possess desirable functional groups of carboxyl and amine, which can be served as fluorescence nanoprobes for detection of PPi based on surface passivation. Under the optimal condition, the linear range for detection of PPi was 0.05-20 µM, and the corresponding limit of detection (LOD) was 0.013 µM, indicative of a promising assay for the PPi. Moreover, the fluorescent intensity of the Cu-CDs is linear against pH value from 6 to 8.7 in buffer solution, suggesting the feasibility as a pH sensor. The synthesized Cu-CDs coated fluorescent paper indeed can monitor pH in urine with satisfaction by naked eyes through ultraviolet irradiation. The successful detection of PPi and the visual detection of pH value suggest a highly promising application of Cu-CDs in the field of biosensing.

Signal amplification of SiO2 nanoparticle loaded horseradish peroxidase for colorimetric detection of lead ions in water

In this work, we developed an aptamer-based optical assay for the analysis of Pb²⁺, a hazardous heavy metal that may be present in the food chain and harmful to human health. An aptamer targeted against Pb²⁺ was immobilized onto the microplate as the capture probe. SiO₂ nanoparticles (NPs) were synthesized and used as carriers of the signaling horseradish peroxidase (HRP) to achieve amplification of the optical signal. Complementary DNA (cDNA) of the aptamer was also linked to the above mentioned SiO₂ nanoparticle (NPs) as the signal probe. The aptamers were found to be able to capture Pb²⁺, and the unbound aptamers were subsequently hybridized with cDNA-HRP-SiO₂ conjugates. As a result, the addition of TMB-H₂O₂ promoted the formation of blue products in the catalytic system. The assay adopting SiO₂ NPs as an enhancer resulted in higher sensitivity with an LOD of 2.5 nM compared to normal procedures. The feasibility of the aptamer-based colorimetric assay was verified by successful detection of Pb²⁺ in water samples with recoveries in the range of 97.4-103.52%.

MrTPS3 and MrTPS20 Are Responsible for β-Caryophyllene and α-Pinene Production, Respectively, in Red Bayberry (Morella rubra)

Red bayberry is a sweet, tart fruit native to China and grown widely in the south. The key organic compounds forming the distinctive aroma in red bayberry, are terpenoids, mainly β-caryophyllene and α-pinene. However, the key genes responsible for different terpenoids are still unknown. Here, transcriptome analysis on samples from four cultivars, during fruit development, with different terpenoid production, provided candidate genes for volatile organic compound (VOC) production. Terpene synthases (TPS) are key enzymes regulating terpenoid biosynthesis, and 34 TPS family members were identified in the red bayberry genome. MrTPS3 in chromosome 2 and MrTPS20 in chromosome 7 were identified as key genes regulating β-caryophyllene and α-pinene synthesis, respectively, by qRT-PCR. Subcellular localization and enzyme activity assay showed that MrTPS3 was responsible for β-caryophyllene (sesquiterpenes) production and MrTPS20 for α-pinene (monoterpenes). Notably, one amino acid substitution between dark color cultivars and light color cultivars resulted in the loss of function of MrTPS3, causing the different β-caryophyllene production. Our results lay the foundation to study volatile organic compounds (VOCs) in red bayberry and provide potential genes for molecular breeding.

Role of the tomato fruit ripening regulator MADS-RIN in resistance to Botrytis cinerea infection

Tomato MADS-RIN (RIN) transcription factor has been shown to be a master activator regulating fruit ripening. Recent studies have revealed that in addition to activating many other cell wall genes, it also represses expression of XTH5, XTH8, and MAN4a, which are positively related to excess flesh softening and cell wall degradation, which might indicate it has a potential role in pathogen resistance of ripening fruit. In this study, both wild-type (WT) and RIN-knockout (RIN-KO) mutant tomato fruit were infected with Botrytis cinerea to investigate the function of RIN in defense against pathogen infection during ripening. The results showed that RIN-KO fruit were much more sensitive to B. cinerea infection with larger lesion sizes. Transcriptome data and qRT-PCR assay indicate genes of phenylalanine ammonialyase (PAL) and chitinase (CHI) in RIN-KO fruit were reduced and their corresponding enzyme activities were decreased. Transcripts of genes encoding pathogenesis-related proteins (PRs), including PR1a, PRSTH2, and APETALA2/Ethylene Response Factor (AP2/ERF) including ERF.A1, Pti5, Pti6, ERF.A4, were reduced in RIN-KO fruit compared to WT fruit. Moreover, in the absence of RIN the expression of genes encoding cell wall-modifying enzymes XTH5, XTH8, MAN4a has been reported to be elevated, which is potentially correlated with cell wall properties. When present, RIN represses transcription of XTH5 by activating ERF.F4, a class II (repressor class) ERF gene family member, and ERF.F5. These results support the conclusion that RIN enhances ripening-related resistance to gray mold infection by upregulating pathogen-resistance genes and defense enzyme activities as well as reducing accumulation of transcripts encoding some cell wall enzymes.

One-step hydrothermal synthesis of nitrogen-doped carbon dots as a super selective and sensitive probe for sensing metronidazole in multiple samples

A reliable, super selective and sensitive nitrogen-doped carbon dots (N-CDs) nanoprobe that can quantitatively and quickly detect the concentration of metronidazole (MTZ) in multiple samples was built. We first prepared the N-CDs using N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride (EDC·HCl) as the precursor via a green, facile one-step hydrothermal method. The as-synthesized N-CDs were characterized by a variety of analytical and spectroscopic techniques, which revealed excitation-dependent fluorescence behavior with the maximum excitation and emission wavelengths being 335 and 370 nm, respectively. Significantly, the fluorescence emission of N-CDs underwent initial quenching upon the addition of MTZ via the inner filter effect (IFE), indicating a prospective detection method for MTZ. The linear range for MTZ detection was 0.1-250 μM, and the corresponding limit of detection (LOD) and limit of quantification (LOQ) were calculated to be only 70 nM and 233.33 nM, respectively. Moreover, due to the negligible cytotoxicity and superior biocompatibility, the fabricated N-CDs show a promising prospect for detecting MTZ in living cells. In general, our proposed N-CDs-based fluorescence sensing platform possesses super low LOD and LOQ values, wide linear range, and satisfactory selectivity, and can be applied to the detection of MTZ in multiple real samples.

Capsaicin Attenuates Lipopolysaccharide-Induced Inflammation and Barrier Dysfunction in Intestinal Porcine Epithelial Cell Line-J2

Capsaicin is a spicy, highly pungent, colorless, vanilloid compound found in chili peppers with anti-inflammatory, antioxidant, anti-cancer, and analgesic properties. However, the protective effects of capsaicin on the pig intestine during inflammation are yet to be explored. This study investigated the effects of capsaicin on the gut inflammatory response, intestinal epithelial integrity, and gene expression level of nutrient transporters in a model of lipopolysaccharide (LPS)-induced inflammation in non-differentiated intestinal porcine epithelial cell line-J2 (IPEC-J2). The results showed that the pre-treatment of cells with capsaicin (100 μM) significantly decreased the gene expression and secretion of proinflammatory cytokines induced by LPS through Toll-like receptor 4 (TLR4)/NF-κB signaling pathway. In addition, pre-treatment of cells with capsaicin also increased both gene and protein abundance of tight junction proteins. Furthermore, pre-treatment cells with capsaicin significantly increased trans-epithelial electrical resistance (TEER) and decreased permeability of fluorescein isothiocyanate-dextran (FD4) from the apical side to the basolateral side compared with the control (P < 0.05). Additionally, pre-treatment of cells with capsaicin upregulated the mRNA abundance of nutrients transporters such as Na⁺/glucose cotransporter 1 (SGLT1). These results suggested that capsaicin could attenuate LPS-induced inflammation response through TLR4/NF-κB pathway and improve barrier integrity and glucose absorption.

[Clinicopathological analysis in patients with chronic hepatitis B virus infection in immune tolerant phase]

Objective: To analyze the liver pathology, clinical characteristics and influence factors in patients with chronic hepatitis B virus (HBV) infection in immune tolerant phase (IT). Methods: The clinical data of 273 patients in IT phase who underwent liver biopsy from January 2015 to December 2019 were included in this study. The correlation between liver pathological changes and clinical features was analyzed. Results: There were 43 cases (15.75%) with liver histologic activity ≥ G2, 30 cases (10.99%) with liver fibrosis ≥ S2, and 55 cases (20.15%) with liver pathology ≥ G2 and/or ≥ S2. A total of 17.95% patients had liver steatosis. The majority (98.17%) of tissue samples were positive for HBsAg staining, while only 79.49% were positive for HBcAg. The characteristics of liver pathology were comparable in men from women patients. The differences of G and S were not statistically significant according to different HBsAg positivity, while those were statistically significant according to different HBcAg positivity. By univariate and multivariate analysis, the independent risk factors of pathological severity were HBcAg intensity, HBeAg level, and age. However, the differences of liver histologic activity and fibrosis were not statistically significant between those younger than 30 years old group from those older than 30 years old, neither between those younger or older than 40. Although the diagnostic value of liver inflammation and fibrosis 5 (LIF-5) was better than that of aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis 4 score (FIB-4), three diagnostic models for predicting the pathological severity were not strong enough (all area under the curves<0.8). Only the specificity of LIF-5 for predicting≥ G2, ≥ G2 and/or ≥ S2 was over 80%. Conclusions: Approximately 20% patients with chronic HBV infection in IT phase have progressive liver inflammation or fibrosis. The intensity of liver HBcAg and HBeAg level are negatively correlated with the severity of disease. The diagnostic models or most clinical indicators have low predictive effect for chronic HBV infections in IT phase.

Levosimendan in rats decreases acute kidney injury after cardiopulmonary resuscitation by improving mitochondrial dysfunction

Background

Acute kidney injury (AKI), the most common complication after cardiac resuscitation, is highly prevalent and harmful. There is increasing evidence that levosimendan can improve cardiac output, increase renal blood flow, and prevent AKI. As a novel calcium sensitizer, levosimendan may exert its protective effect via mitochondria.

Methods

Rat models of asphyxia-induced cardiac arrest and cardiopulmonary resuscitation (CPR) were set up. Thirty healthy adult male SD rats were randomly divided into CPR group (CPR group, n=10), levosimendan-treated group (levo group, n=10), and sham-operated group (sham group, n=10). Twelve hours after CPR, serum renal function indicators were measured, the kidney injury and mitochondrial morphological changes were observed. Oxygen uptake of the mitochondria, mitochondrial adenosine triphosphate (ATP) and mitochondrial free Ca²⁺ concentration were measured. Oxidative stress-related indicator levels in rat kidney tissues were further detected to analyze the differences in apoptosis rates among these three groups. Mitochondrial optic atrophy 1 (Opa1), dynamin-related protein 1 (Drp1), and apoptosis-related proteins were detected using Western blotting.

Results

Compared with the sham group, the CPR group had a significant increase in renal tissue damage. PAS staining and HE stains confirmed that CPR led to renal histopathological damage and destruction of the mitochondrial structure. Levosimendan improved the histopathological and ultrastructural damages of kidneys. Further analysis revealed that mitochondrial ATP content, NADH dehydrogenase, succinate dehydrogenase/cytochrome C oxidase, superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (CSH-Px) decreased. Free Ca²⁺ concentration and malondialdehyde (MDA) significantly increased (all P<0.05) in the kidney tissues of rats in the CPR group. However, mitochondrial ATP content, NADH dehydrogenase, succinate dehydrogenase/cytochrome C oxidase, SOD, CAT, and CSH-Px increased, whereas free Ca²⁺ concentration and MDA decreased (all P<0.05) in the levo group. The apoptosis rate increased in the CPR group. There were significantly increased levels of Drp1 protein levels, and significantly decreased Opa1 expression (all P<0.05). However, the levo group showed the opposite effects (all P<0.05).

Conclusions

Levosimendan can alleviate AKI following CPR, which may be achieved by improving mitochondrial dysfunction and suppressing the mitochondrial apoptosis pathway.

Nitrogen and copper-doped carbon quantum dots with intrinsic peroxidase-like activity for double-signal detection of phenol

Herein, a simple and facile one-step hydrothermal carbonization synthesis procedure for the fabrication of N, Cu-doped carbon quantum dots (N, Cu-CQDs) as a peroxidase-mimicking enzyme was reported. The peroxidase-like performance of N, Cu-CQDs was assessed based on the oxidative coupling reaction of phenol with 4-aminoantipyrine (4-AAP) in the presence of hydrogen peroxide (H2O2). The N, Cu-CQDs/4-AAP/H2O2 system was applied to sensing phenol based on double signals of absorption spectra (or colorimetric visualization) as well as fluorescence spectra. The obtained limits of detection (LODs) were as low as 0.12 μM and 0.02 μM, respectively. Moreover, the proposed method was successfully applied to the determination of phenol in sewage with satisfactory recovery. Our results demonstrate that the N, Cu-CQDs/4-AAP/H2O2/phenol sensing system has a great potential prospect for applications in environmental chemistry and biotechnology.

Renoprotective effects of levosimendan on acute kidney injury following cardiac arrest via anti-inflammation, anti-apoptosis, and ERK activation

ATP‐sensitive potassium channels (KATPs) have protective effects in ischemia–reperfusion‐induced injuries and can be activated by levosimendan. This study investigated the effects of levosimendan on renal injury, inflammation, apoptosis, and survival in a rat model of acute kidney injury (AKI) following cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). Rats underwent a 5‐min asphyxia‐based CA and resuscitation. The rats were treated with levosimendan after successful resuscitation. Renal functions, histological changes, inflammatory responses, and apoptosis were examined. NRK‐52E cells treated by hypoxia/reoxygenation (H/R) were used to establish an in vitro CA‐CPR model. Rats in the CA‐induced AKI group had a low survival rate and increased levels of creatinine, blood urea nitrogen, and proinflammatory cytokines, as well as increased tubular injury. These results were significantly reversed after treatment with levosimendan. Levosimendan downregulated the expression of the apoptosis‐related proteins Bax, cleaved caspase‐3, and cleaved caspase‐9, as well as upregulated Bcl‐2 and p‐ERK expression in vivo and in vitro. Thus, our data suggest that levosimendan reduces mortality and AKI following CA and CPR via suppression of inflammation and apoptosis, and activation of ERK signaling.

Clinical characteristics and risk factors for mortality in patients with coronavirus disease 2019 in intensive care unit: a single- center, retrospective, observational study in China

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a potentially life-threatening contagious disease which has spread all over the world. Risk factors associated with the clinical outcomes of COVID-19 pneumonia in intensive care unit (ICU) have not yet been well determined.

METHODS

This was a retrospective, single-centered, observational study, in which 47 patients with confirmed COVID-19 were consecutively enrolled from February 24 to April 5, 2020. The patients were registered from the ICU of Leishenshan Hospital in Wuhan, China. Clinical characteristics and outcomes were collected and compared between survivors and non-survivors. Multivariable logistic regression was performed to analyze the risk factors of death in patients with COVID-19.

RESULTS

The study cohort included 47 adult patients with an average age of 70.55±12.52 years, and 30 (63.8%) patients were men. Totally 15 (31.9%) patients died. When compared to survivors, nonsurvivors showed a higher proportion of septic shock [6 (40%) patients vs. 3 (9.4%) patients], disseminated intravascular coagulation [3 (21.4%) vs. 0], and had higher score of APACHE II (25.07±8.03 vs. 15.56±5.95), CURB-65 {3 [2-4] vs. 2 [1-3]}, Sequential Organ Failure Assessment (SOFA) {7 [5-9] vs. 3 [1-6]}, higher level of D-dimer {5.74 [2.32-18] vs 2.05 [1.09-4.00]} and neutrophil count {9.4 [7.68-14.54] vs. 5.32 [3.85-9.34]}. SOFA score (OR 1.47; 95% CI: 1.01-2.13; P=0.0042) and the lymphocyte count (OR 0.02; 95% CI: 0.00-0.86; P=0.042) on admission were independently risk factors for mortality. Patients with higher lymphocyte count (>0.63×109 /L) and lower SOFA score (≤4) on admission had a significantly better prognosis than those with lower lymphocyte count (≤0.63×109 /L) and higher SOFA score (>4) in overall survival.

CONCLUSIONS

Higher SOFA score and lower lymphocyte count at admission were connected with poor prognosis of patients with COVID-19 in ICU. Lymphocyte count may serve as a promising prognostic biomarker.

Joint Image Encryption and Screen-Cam Robust Two Watermarking Scheme

This paper proposes a joint encryption and screen-cam robust watermarking scheme. This method combines the advantages of smartphone, encryption and watermarking technologies, thereby achieving watermark extraction with a smartphone, partial decryption and tracking leakage from sneak shots. We design a dual watermarking algorithm to achieve watermark detection from both encrypted and decrypted images. First, a watermark is embedded in the discrete Fourier transform (DFT) domain to enable leakage tracking. Then, a second watermark is generated based on QR (Quick response) code encoding and inverse DFT to achieve high watermark capacity and error correction ability, where the secret key for decryption is included in the watermark message. By hiding this message carrying the watermark for the encrypted image in the changes caused by embedding the first watermark, we can improve imperceptibility and will not affect the effectiveness of the proposed scheme. Finally, to enhance the robustness of watermark after encryption, a chaotic mapping-based segment encryption algorithm is proposed. In the process of watermark detection, to cope with perspective correction, a frame locating based algorithm is employed to achieve watermark synchronization from a recaptured picture of the encrypted image. Considering the severe quality degradation, we use a noise component and local statistic feature-based method to extract the message bits. The experimental results show that the proposed scheme is secure, and highly robust, to screen-cam the process for both before and after decryption. Additionally, after decryption, the proposed scheme also has high robustness against common image processing attacks.

The Photomorphogenic Transcription Factor PpHY5 Regulates Anthocyanin Accumulation in Response to UVA and UVB Irradiation

Red coloration contributes to fruit quality and is determined by anthocyanin content in peach (Prunus persica). Our previous study illustrated that anthocyanin accumulation is strongly regulated by light, and the effect of induction differs according to light quality. Here we showed that both ultraviolet-A (UVA) and ultraviolet-B (UVB) irradiation promoted anthocyanin biosynthesis in "Hujingmilu" peach fruit, and a combination of UVA and UVB had additional effects. The expression of anthocyanin biosynthesis and light signaling related genes, including transcription factor genes and light signaling elements, were induced following UV irradiation as early as 6 h post-treatment, earlier than apparent change in coloration which occurred at 72 h. To investigate the molecular mechanisms for UVA- and UVB-induced anthocyanin accumulation, the genes encoding ELONGATED HYPOCOTYL 5 (HY5), CONSTITUTIVE PHOTOMORPHOGENIC1 (COP1), Cryptochrome (CRY), and UV RESISTANCE LOCUS 8 (UVR8) in peach were isolated and characterized through functional complementation in corresponding Arabidopsis (Arabidopsis thaliana) mutants. PpHY5 and PpCOP1.1 restored hypocotyl length and anthocyanin content in Arabidopsis mutants under white light; while PpCRY1 and PpUVR8.1 restored AtHY5 expression in Arabidopsis mutants in response to UV irradiation. Arabidopsis PpHY5/hy5 transgenic lines accumulated higher amounts of anthocyanin under UV supplementation (compared with weak white light only), especially when UVA and UVB were applied together. These data indicated that PpHY5, acting as AtHY5 counterpart, was a vital regulator in UVA and UVB signaling pathway. In peach, the expression of PpHY5 was up-regulated by UVA and UVB, and PpHY5 positively regulated both its own transcription by interacting with an E-box in its own promoter, and the transcription of the downstream anthocyanin biosynthetic genes chalcone synthase 1 (PpCHS1), chalcone synthase 2 (PpCHS2), and dihydroflavonol 4-reductase (PpDFR1) as well as the transcription factor gene PpMYB10.1. In summary, functional evidence supports the role of PpHY5 in UVA and UVB light transduction pathway controlling anthocyanin biosynthesis. In peach this is via up-regulation of expression of genes encoding biosynthetic enzymes, as well as the transcription factor PpMYB10.1 and PpHY5 itself.

Yellow emission carbon dots for highly selective and sensitive OFF-ON sensing of ferric and pyrophosphate ions in living cells

A simple "OFF-ON" fluorescent system was proposed for selective and sensitive detection of ferric ion (Fe³⁺) and pyrophosphate (PPi) in living cells. The method was constructed based on the bright yellow emission of carbon dots (y-CDs), which were prepared using o-phenylenediamine (OPD) as the precursor via a facile hydrothermal treatment. The as-obtained y-CDs, with an average size of 2.6 nm, exhibited an excitation-independent emission peak at 574 nm. The fluorescence of y-CDs can be remarkably quenched by Fe³⁺ with high selectivity and sensitivity. Interestingly, the quenched fluorescence can be recovered regularly upon addition of PPi, showing a promising detection for PPi. The linear ranges for Fe³⁺ and PPi detections were 0.05-80 and 0.5-120 μM, respectively, and the corresponding limit of detections (LODs) were 22.1 and 73.9 nM. As we proved the y-CDs have negligible cytotoxicity and excellent biocompatibility, further application to the fluorescence imaging of intracellular Fe³⁺ and PPi were conducted, suggesting the prepared y-CDs can be used to monitor Fe³⁺ and PPi variation in living cells. Overall, our developed y-CDs-based OFF-ON switch fluorescent probe has the advantages of simplicity, agility, high sensitivity and selectivity, which provides a promising platform for environmental and biology applications, and paves a new avenue for monitoring the hydrolysis process of adenosine triphosphate disodium salt (ATP) by detection of PPi in organisms.

Emerging Trends and Hot Topics in Cardiopulmonary Resuscitation Research: A Bibliometric Analysis from 2010 to 2019

Background

Cardiopulmonary resuscitation (CPR) is a topic of great scientific and clinical interest that has received much attention in the past decade. Our study aimed to predict the trends in CPR research activities and evaluate hot topics via bibliometric means, quantitatively and qualitatively.

Material/Methods

All data were collected from a search of the Web of Science Core Collection on May 12, 2020. Retrieved information was investigated with bibliometric analysis by CiteSpace and VOSviewer software and the Online Analysis Platform of Literature Metrology to analyze and predict the trends and hotspots in this field.

Results

Our search returned a total of 9563 articles and reviews on CPR published from 2010 through 2019. The number of original research studies on CPR has been increasing annually. The journal Resuscitation published the greatest number of manuscripts involved CPR, and the leading country and institution with regard to contributions on CPR were the United States and the University of Pennsylvania. Keyword co-occurrence/co-citation-cluster analysis showed that the most popular terms associated with CPR occurred in the manner of cluster labels, such as therapeutic hypothermia and treatment recommendation, among others. In addition, palliative care, sepsis, extracorporeal membrane oxygenation, and brain injury were identified as new foci through burst detection analysis.

Conclusions

Our study showed that the scientific research focus on CPR is switching from traditional therapeutic treatments to a public health practice, with in-depth understanding and development of CPR-related techniques expanding over the past decade. These results demonstrate trends in the CPR research and detected the possible neo-foci for ensuing research.

Klebsiella pneumoniae infection associated septic pulmonary embolism in an emergency department from east China

BACKGROUND

Septic pulmonary embolism (SPE) is attracting more attention as a special pulmonary sign in severe infection. We aimed to describe the clinical and imaging features of Klebsiella pneumoniae (K. pneumonia)-associated SPE in the emergency department.

METHODS

Records of patients with primarily extrapulmonary infection of K. pneumoniae who were admitted to the emergency department between 2014 and 2019 were retrieved. The identifications of K. pneumoniaeassociated SPE were mainly dependent on the clinical manifestations, typical imaging findings, and presence of a primary source of K. pneumoniae infection.

RESULTS

A total of 33 cases were identified as SPE with extrapulmonary K. pneumoniae infection. The main clinical manifestations were a febrile/fragile state (100%), respiratory symptoms (18.2%), and digestive symptoms (33.3%). Eight patients (24.2%) developed septic shock, 2 (6.0%) experienced respiratory failure, and 2 (6.0%) complicated endophthalmitis. The major source of infection was liver abscess (n=26, 78.8%), followed by septicemia (n=8, 24.2%), intestinal infection (n=3, 9.1%), and ascites (n=1, 3.0%). The computed tomography (CT) features included the following: peripheral wedge-shaped opacity (n=12, 36.4%), a feeding vessel sign (n=3, 9.1%), multiple nodular lesions (n=5, 15.2%), multifocal lung ill-infiltrations (n=15, 45.5%), patchy ground-glass opacities (n=6, 18.2%), focal consolidations (n=9, 27.3%), lung abscesses (n=4, 12.1%), and pleural effusion (n=21, 63.6%). Re-examination of lung HRCT conducted in 7 patients demonstrated imaging improvement after treatment.

CONCLUSIONS

K. pneumonia-SPE presented special clinical and imaging characteristics, which bear similarities to the signs of pneumonia, but was potentially catastrophic. Identifying SPE in septic conditions is crucial to improving clinical outcomes.

Regulation of fruit ripening by the brassinosteroid biosynthetic gene SlCYP90B3 via an ethylene-dependent pathway in tomato

The essential role of ethylene in fruit ripening has been thoroughly studied. However, the involvement of brassinosteroids (BRs) in the regulation of fruit ripening and their relationship with the ethylene pathway are poorly understood. In the current study, we found that BRs were actively synthesized during tomato fruit ripening. We then generated transgenic lines overexpressing or silencing SlCYP90B3, which encodes a cytochrome P450 monooxygenase that catalyzes the rate-limiting step of BR synthesis. The expression level of SlCYP90B3 was positively related to the contents of bioactive BRs as well as the ripening process in tomato fruit, including enhanced softening and increased soluble sugar and flavor volatile contents. Both carotenoid accumulation and ethylene production were strongly correlated with the expression level of SlCYP90B3, corroborated by the altered expression of carotenoid biosynthetic genes as well as ethylene pathway genes in transgenic tomato fruits. However, the application of the ethylene perception inhibitor 1-methycyclopropene (1-MCP) abolished the promotion effect of SlCYP90B3 overexpression on carotenoid accumulation. Taken together, these results increase our understanding of the involvement of SlCYP90B3 in bioactive BR biosynthesis as well as fruit ripening in tomato, thus making SlCYP90B3 a target gene for improvement of visual, nutritional and flavor qualities of tomato fruits with no yield penalty.

Functional analysis of PpRHM1 and PpRHM2 involved in UDP-l-rhamnose biosynthesis in Prunus persica

UDP-l-rhamnose (UDP-Rha) is an important sugar donor for glycosylation of various cell molecules in plant. Rhamnosides are widely present in different plant tissues and play important biological roles under different developmental or environmental conditions. However, enzymes involved in UDP-Rha biosynthesis and their encoding genes have been identified in few plants, which limits the functional analysis of plant rhamnosides. Here, two UDP-Rha biosynthesis genes, named PpRHM1 (2028 bp) and PpRHM2 (2016 bp), were isolated and characterized from Prunus persica, which is rich sources of flavonol rhamnosides. Both recombinant RHM proteins can catalyze the transformation from UDP-d-glucose (UDP-Glc) to UDP-Rha, which was confirmed by LC-MS and formation of flavonol rhamnosides. Biochemical analysis showed that both recombinant RHM proteins preferred alkaline conditions in pH range of 8.0-9.0 and had optimal reaction temperature between 25 and 30 °C. PpRHM1 showed the better UDP-Glc substrate affinity with K_m of 360.01 μM. Gene expression analysis showed different transcript levels of both RHMs in all plant tissues tested, indicating the involvement of rhamnosides in various tissues in plant. Such results provide better understanding of UDP-Rha biosynthesis in fruit tree and may be helpful for further investigation of various rhamnose derivatives and their biological functions.

Clinical characteristics and risk factors of catheter-associated urinary tract infections caused by Klebsiella Pneumoniae

BACKGROUND

The clinical characteristics and risk factors of catheter-associated urinary tract infections (CAUTIs) caused by Klebsiella pneumoniae (KP) have not been well investigated.

METHODS

This retrospective study performed at a university teaching hospital in China from January 2012 to November 2017 analyzed data for 227 patients with urinary tract infection (UTI) caused by KP. Patients' demographic characteristics and clinical outcomes were recorded. Risk factors were analyzed using a binary logistic regression model.

RESULTS

Of 227 patients with Klebsiella pneumoniae-related urinary tract Infection (KP-UTI), the infection was catheter-associated in 90 patients. More than half of them were male (60%), over 60 years old, hospitalized in general ward, always acquired in hospital, and got a longer hospitalization more than one month. The Klebsiella pneumoniae-related catheter-associated urinary tract infections (KP-CAUTIs) patients always combined with lots of chronic comorbidities. A high proportion of invasive device, extendedspectrum β-lactamase (ESBL) expression and multidrug resistance (MDR) were found in KP-CAUTIs patients. When taken antimicrobial activity into consideration, KP-CAUTIs patients performed resistance to most antibiotics in varying degrees. Logistic regression analysis revealed that after grouping by ESBL expression and in-hospital mortality among patients with KP-CAUTI, complicated urinary tract infection (cUTI) was an independent risk factor for ESBL positive KP-CAUTIs [odds ratio (OR) 59.256; 95% CI, 3.417-1,027.628; P=0.005], whereas congestive heart failure was identified as an independent risk factor for in-hospital mortality (OR 25.592; 95% CI, 2.376-275.629; P=0.008) in KP-CAUTI patients.

CONCLUSIONS

Patients with KP-CAUTI displayed distinctive characteristics. cUTI and congestive heart failure were independently associated with ESBL expression and in-hospital mortality in patients with KPCAUTI.

Effects of Casein, Chicken, and Pork Proteins on the Regulation of Body Fat and Blood Inflammatory Factors and Metabolite Patterns Are Largely Dependent on the Protein Level and Less Attributable to the Protein Source

The impact of meat protein on metabolic regulation is still disputed and may be influenced by protein level. This study aimed to explore the effects of casein, pork, and chicken proteins at different protein levels (40% E vs 20% E) on body weight regulation, body fat accumulation, serum hormone levels, and inflammatory factors/metabolites in rats maintained on high-fat (45% E fat) diets for 84 d. Increased protein levels resulted in a significant reduction in body fat mass and an increase in the serum levels of the anti-inflammatory cytokine IL-10, independent of protein source. Analysis of blood via untargeted metabolomics analysis identified eight, four, and four metabolites significantly altered by protein level, protein source, and a protein level-source interaction, respectively. Together, the effects of casein, chicken, and pork protein on the regulation of body fat accumulation and blood metabolite profile are largely dependent on protein level and less attributable to the protein source.

Studies on the effects of bone marrow stem cells on mitochondrial function and the alleviation of ARDS

Mesenchymal stem cells (MSCs) can alleviate acute respiratory distress syndrome (ARDS), but the mechanisms involved are unclear, especially about their specific effects on cellular mitochondrial respiratory function. Thirty mice were allocated into the Control, LPS, and LPS + Bone marrow mesenchymal stem cell (BMSC) group (n = 10/group). Mouse alveolar epithelial cells (MLE-12) and macrophage cells (RAW264.7) were divided into the same groups. Pathological variation, inflammation-related factors, reactive oxygen species (ROS), ATP levels, and oxygen consumption rate (OCR) were analyzed. Pathologic features of ARDS were observed in the LPS group and were significantly alleviated by BMSCs. The trend in inflammation-related factors among the three groups was the LPS group > LPS + BMSC group > Control group. In the MLE-12 co-culture system, IL-6 was increased in the LPS group but not significantly reduced in the LPS + BMSC group. In the RAW264.7 co-culture system, IL-1β, TNF-α, and IL-10 levels were all increased in the LPS group, IL-1β and TNF-α levels were reduced by BMSCs, while IL-10 level kept increasing. ROS and ATP levels were increased and decreased respectively in both MLE-12 and RAW264.7 cells in the LPS groups but reversed by BMSCs. Basal OCR, ATP-linked OCR, and maximal OCR were lower in the LPS groups. Impaired basal OCR and ATP-linked OCR in MLE-12 cells were partially restored by BMSCs, while impaired basal OCR and maximal OCR in RAW264.7 cells were restored by BMSCs. BMSCs improved the mitochondrial respiration dysfunction of macrophages and alveolar epithelial cells induced by LPS, alleviated lung tissue injury, and inflammatory response in a mouse model of ARDS.

Carbonate-enhanced catalytic activity and stability of Co3O4 nanowires for 1O2-driven bisphenol A degradation via peroxymonosulfate activation: Critical roles of electron and proton acceptors

Transition-metal catalysts (TMCs) for peroxymonosulfate (PMS) activation suffer from low stability (i.e. severe metal leakage and poor reusability) when maintaining high activity in water decontamination. An innovative carbonate (CO₃^2-)-mediated method to synchronously enhance the catalytic activity and stability of TMCs was developed herein. In a model PMS/Co₃O₄ nanowire system for bisphenol A (BPA) degradation, the first-order kinetic constant and total organic carbon removal ratio were increased by 202.27% and 71.32% upon adding CO₃^2-, respectively. Meanwhile, the cobalt release amount was significantly reduced from 4.90 to 0.03 mg/L, and the number of reuse with high efficiency (>90% of BPA removal within 10 min) was augmented from 1 to 3 times. The CO₃^2- buffered pH decline to repress metal leakage, and promoted Co(III) reduction into Co(II) to avoid the over-oxidation of catalyst. Under the driving of CO₃^2-, the dominated reactive species were switched from •OH/SO₄^•- to ¹O₂ accompanying the migration of catalytic center from Co(II) to Co(III). The Co(III) and CO₃^2-/OH^- acted as electron and proton acceptors, respectively, to accelerate PMS decomposition into SO₅^•- and subsequent generation of vast ¹O₂. This work proposes a green way to construct novel ¹O₂-based catalytic systems with excellent activity and stability for pollution remediation.

STAPLAg: a convenient early warning score for use in infected patients in the intensive care unit

Sepsis is a life-threatening disease in the intensive care unit (ICU). The current diagnostic criteria for sequential organ failure assessment (SOFA) scores do not reflect the current understanding of sepsis. We developed a novel and convenient score to aid early prognosis.Retrospective multivariable regression analysis of 185 infected emergency ICU (EICU) patients was conducted to identify independent variables associated with death, to develop the new "STAPLAg" score; STAPLAg was then validated in an internal cohort (n = 106) and an external cohort (n = 78) and its predictive efficacy was compared with that of the initial SOFA score.Age, and initial serum albumin, sodium, PLR, troponin, and lactate tests in the emergency department were independent predictors of death in infected EICU patients, and were used to establish the STAPLAg score (area under the curve [AUC] 0.865). The initial SOFA score on admission was predictive of death (AUC 0.782). Applying the above categories to the derivation cohort yielded mortality risks of 7.7% for grade I, 56.3% for grade II, and 75.0% for grade III. Internal (AUC 0.884) and external (AUC 0.918) cohort validation indicated that the score had good predictive power.The STAPLAg score can be determined early in infected EICU patients, and exhibited better prognostic capacity than the initial SOFA score on admission in both internal and external cohorts. STAPLAg constitutes a new resource for use in the clinical diagnosis of sepsis and can also predict mortality in infected EICU patients. REGISTRATION NUMBER:: ChinCTR-PNC-16010288.

Enhanced synergistic removal of Cr(VI) and Cd(II) with bi-functional biomass-based composites

Cr(VI) and Cd(II) are typical heavy metal ions and their co-removal is significant. Nitrogen-doped, bi-functional, and biomass-based composites (CP-BA) were successfully applied for efficient and synergistic removal of Cr(VI) and Cd(II). The mutual promotion ratios of adsorption capacity by Cr(VI) and Cd(II) were 161.32 % and 14.13 %, respectively. In addition, all coexisting inorganic anions could extremely promote the removal of Cd(II) with the best promotion ratio upon phosphate ions as high as 80.00 %. The following co-removal mechanisms were deeply revealed: (1) Cr(VI) combined with protonated imine groups could weaken the electrostatic repulsion between CP-BA and Cd(II) by electrostatic shielding, and further promoted the coordination of Cd(II) with hydroxyl, carboxyl and neutral imine groups. (2) Cd(II) which were coordinated to neutral imine groups could form cation bridges, and thus promoted the interaction with Cr(VI) because of the electrostatic attraction. Moreover, the removal capacity for Cr(VI) and Cd(II) did not display obvious reduction even after four cycles. Therefore, CP-BA showed a great potential in the co-removal of inorganic anion-cation complexes from wastewater.

Low-Fe(III) driven UV/Air process for enhanced recovery of heavy metals from EDTA complexed system

The efficient recovery of heavy metals from complexed wastewater is an essential but challenging task. In this study, a novel low-Fe(III) driven UV/Air process (LFUA) was developed to break the strong complexation between ethylenediamine tetracetic acid (EDTA) and heavy metal ions (HMIs) and enable the enhanced recovery of HMIs via chelating resin adsorption (CRA). The inside mechanism of the LFUA process includes: 1) displacement of HMIs from HMI-EDTA complexes by Fe(III); 2) direct photolysis of Fe(III)-EDTA through a ligand-to-metal charge transition reaction (LMCT) and indirect photolysis of EDTA by HO₂·/O₂·^-. The iron dosage was orders of magnitude lower than that previously reported, due to the Fe(II)/Fe(III) redox cycle in the LFUA process. Fe(II) formed during the LMCT reaction of Fe(III)-EDTA was oxidized back to Fe(III) by O₂ and HO₂·, and the reformed Fe(III) was then recombined with EDTA to sustains the LMCT reaction. EDTA was completely removed in 20 min at a molar ratio of Fe(III)/EDTA = 0.05. In addition, following the LFUA process, the adsorption amounts of various HMIs onto D463 resin were at least two orders of magnitude higher than those reported using the direct adsorption process. Employing the integrated technique of LFUA + CRA enabled the efficient removal of up to 64.5 mg/L of Cu(II) from inlet wastewater, and residual Cu(II) was below 0.5 mg/L. The results of desorption experiments showed that over 90% of Cu(II) was recovered, and the desorption solution had a Cu concentration of 2.1 g/L and purity of 99%. Furthermore, the economic and practical feasibility of using the combined process of LFUA + CRA was analyzed to substantiate that the technique is highly efficient and clean (produces no harmful sludge). Therefore, it is an appropriate and practical process in removing HMIs-EDTA complexes and recovering HMIs from wastewater.

Developing Single Nucleotide Polymorphisms for Identification of Cod Products by RAD-Seq

The increase in the rate of seafood fraud, particularly in the expensive fishes, forces us to verify the identity of marine products. Meanwhile, the definition of cod lacks consistency at the international level, as few standards and effective application methods are capable of accurately detecting cod species. Genetic fingerprinting is important for both certifying authenticity and traceability of fish species. In this study, we developed a method that combines DNA barcoding and the restriction-site associated DNA sequencing (RAD-Seq) approach for the identification of cod products. We first obtained 6941 high-quality single nucleotide polymorphism (SNP)s from 65.6 gigabases (Gb) of RAD-Seq raw data, and two sequences that contain SNPs were finally used to successfully identify three different cod product species, which are Atlantic cod (Gadus morhua), Greenland turbot (Reinhardtius hippoglossoides), and Patagonian toothfish (Dissostichus eleginoides). This SNP-based method will help us to identify the products, which are sold under the name of "Xue Yu" (Cod) in China, and works in parallel with existing fish identification techniques to establish an efficient framework to detect and prevent fraud at all points of the seafood supply chain.

Absolute x-ray calibration of an Amersham imaging plate scanner

The absolute response of the GE Amersham Typhoon^tm imaging plate scanner is studied in this paper. The sensitivity function of the scanner with different photomultiplier tube voltages was obtained by using a pre-calibrated Cu Kα x-ray tube. The results showed that the sensitivity function decreases exponentially with higher voltage and is also affected by the scanning pixel size. The spatial resolution and the fading effect of the imaging plate system on x rays were also investigated and compared with the previous scanner models.