The prediction of outcomes in convulsive status epilepticus (CSE) remains a constant challenge. The Encephalitis-Nonconvulsive Status Epilepticus-Diazepam Resistance-Image Abnormalities-Tracheal ...Intubation (END-IT) score was a useful tool for predicting the functional outcomes of CSE patients, excluding cerebral hypoxia patients. With further understanding of CSE, and in view of the deficiencies of END-IT itself, we consider it necessary to modify the prediction tool.
The prediction model was designed from a cohort of CSE patients from Xijing Hospital (China), between 2008 and 2020. The enrolled subjects were randomly divided into training cohort and validation cohort as a ratio of 2:1. The logistic regression analysis was performed to identify the predictors and construct the nomogram. The performance of the nomogram was assessed by calculating the concordance index, and creating calibration plots to check the consistency between the predicted probabilities of poor prognosis and the actual outcomes of CSE.
The training cohort included 131 patients and validation cohort included 66 patients. Variables included in the nomogram were age, etiology of CSE, non-convulsive SE, mechanical ventilation, abnormal albumin level at CSE onset. The concordance index of the nomogram in the training and validation cohorts was 0.853 (95% CI, 0.787-0.920) and 0.806 (95% CI, 0.683-0.923), respectively. The calibration plots showed an adequate consistency between the reported and predicted unfavorable outcomes of patients with CSE at 3 months after discharge.
A nomogram for predicting the individualized risks of poor functional outcomes in CSE was constructed and validated, which has been an important modification of END-IT score.
•We set up a method for determination of low levels of 16 PAHs in soil.•Analyses were performed by HPLC with fluorescence and diode-array detectors.•The analytical performance of the proposed method ...were demonstrated.
Risk assessment of polycyclic aromatic hydrocarbons (PAHs) contaminated soil and source apportionment require accurate analysis of the concentration of each PAH congener in the soil. However, determination of low level PAH congeners in soil is difficult because of similarity in the chemical properties of 16 PAHs and severe matrix interferences due to complex composition of soils. It is therefore imperative to develop a sensitive and accurate method for determination of low level PAHs in soil. In this work, high performance liquid chromatography equipped with fluorescence and diode-array detectors (HPLC–FLD–DAD) was used to determine the concentration of 16 PAHs in soil. The separation of the 16 PAHs was achieved by optimization of the mobile phase gradient elution program and FLD wavelength switching program. Qualitative analysis of the 16 PAHs was based on the retention time (RT) and each PAH specific spectrum obtained from DAD. In contrast, the quantitative analysis of individual PAH congeners was based on the peak areas at the specific wavelength with DAD and FLD. Under optimal conditions the detection limit was in the range 1.0–9.5μgL−1 for 16 PAHs with DAD and 0.01–0.1μgL−1 for 15 PAHs with FLD, and the RSD of PAHs was less than 5% with DAD and 3% with FLD. The spiked recoveries were in the range 61–96%, with the exception of NaP (<40%). The results show that HPLC–FLD–DAD can provide more accurate and reliable analysis of low level PAH congeners in soil samples.
The vast majority of control schemes related to the sequential probability ratio test (SPRT) are designed for the purpose of monitoring only the process mean. Nonetheless, most manufacturing ...processes are vulnerable to external factors that cause the process mean and variability to change simultaneously. It is, therefore, crucial to consider a joint scheme for monitoring both the location and scale parameters of a production process. In this article, we develop a scheme that combines both mean and variance information in a single SPRT, known as the omnibus SPRT (OSPRT) chart. Expressions for the run-length properties of the OSPRT chart are derived by means of the Markov chain approach. We also propose optimal designs for the OSPRT chart based on two different metrics, i.e. by minimising the average time to signal and the average extra quadratic loss. Through a comprehensive analysis, this article reveals that the optimal OSPRT chart outperforms the classical
$ \bar{X} $
X
¯
-S, weighted-loss cumulative sum, absolute-value SPRT, and two maximum weighted-moving-average-type charts. The optimal OSPRT chart also has the advantage of collecting a small number of samples on average before producing a decision. Finally, the implementation of the OSPRT chart is presented with a wire bonding industrial dataset.
We aimed to explore the therapeutic effect of Bifidobacterium lactis on food allergy by investigating the percentage of Treg and Th17 cells in Chinese children and related molecular mechanisms. A ...total of 256 children with food allergy were evenly assigned into two groups: BG, the children received 10 ml B. lactis (1 × 106/ml) daily, and CG, the children received the solution without B. lactis daily for three months. Allergic symptoms, serum IgE, and food antigen-specific IgE were measured. A mouse allergy model was established by using shrimp tropomyosin and treated with B. lactis. Relative mRNA levels of Treg- and Th17-associated cytokines were measured by using quantitative PCR. The percentage of Treg and Th17 cells in spleen were measured by using flow cytometry. After 3-month therapy, the allergic symptoms of the BG were remarkably reduced when compared with the CG (P<0.05). Serum levels of IgE and food antigen-specific IgE were decreased too (P<0.05). Similar results were also found in a mouse allergy model. After B. lactis treatment, the relative mRNA level of FoxP3 was significantly enhanced in the B. lactis therapy group when compared to positive controls. In addition, relative mRNA levels of FoxP3 and TGF-β associated with Treg cells were increased, whereas relative mRNA levels of IL-17A and IL-23 associated with Th17 were reduced. B. lactis treatment significantly increased the ratio of Treg and Th17 cells in a mouse allergy model (P<0.05). B. lactis effectively alleviates allergic symptoms by increasing the ratio of Treg and Th17 cells.
Varicocele is one of the most important causes of male infertility, as this condition leads to a decline in sperm quality. It is generally believed that the presence of varicocele induces an increase ...in reactive oxygen species levels, leading to oxidative stress and sperm apoptosis; however, the specific pathogenic mechanisms affecting spermatogenesis remain elusive. Prokineticin 2 (PK2), a secretory protein, is associated with multiple biological processes, including cell migration, proliferation, and apoptosis. In the testis, PK2 is expressed in spermatocytes under normal physiological conditions. To investigate the role of PK2 in varicocele, a rat varicocele model was established to locate and quantify the expression of PK2 and its receptor, prokineticin receptor 1 (PKR1), by immunohistochemistry and quantitative real-time PCR assays (qPCR). Moreover, H2O2 was applied to mimic the oxidative stress state of varicocele through coculturing with a spermatocyte-derived cell line (GC-2) in vitro, and the apoptosis rate was detected by flow cytometry. Here, we illustrated that the expression levels of PK2 and PKR1 were upregulated in the spermatocytes of the rat model. Administration of H2O2 stimulated the overexpression of PK2 in GC-2. Transfection of recombinant pCMV-HA-PK2 into GC-2 cells promoted apoptosis by upregulating cleaved-caspase-3, caspase-8, and B cell lymphoma 2-associated X; downregulating B cell lymphoma 2; and promoting the accumulation of intracellular calcium. Overall, we revealed that the varicocele-induced oxidative stress stimulated the overexpression of PK2, leading to apoptosis of spermatocytes. Our study provides new insight into the mechanisms underlying oxidative stress-associated male infertility and suggests a novel therapeutic target for male infertility.
Ischemia–reperfusion injury occurs after reperfusion treatment for patients suffering myocardial infarction, however the underlying mechanisms are incompletely understood and effective ...pharmacological interventions are limited. Here, we report the identification and characterization of the FDA-approved drug disulfiram (DSF) as a cardioprotective compound. By applying high-throughput chemical screening, we found that DSF decreased H
2
O
2
-induced cardiomyocyte death by inhibiting Gasdermin D, but not ALDH1, in cardiomyocytes. Oral gavage of DSF decreased myocardial infarct size and improved heart function after myocardial ischemia–reperfusion injury in rats. Therefore, this work reveals DSF as a potential therapeutic compound for the treatment of ischemic heart disease.
Objective. Rhizoma Coptidis is an herb that has been frequently used in many traditional formulas for the treatment of diabetic mellitus (DM) over thousands of years. Berberine, the main active ...component of Rhizoma Coptidis, has been demonstrated to have the potential effect of hypoglycemia. To determine the potential advantages of berberine for diabetic care, we conducted this systematic review and meta-analysis to examine the efficacy and safety of berberine in the treatment of patients with type 2 DM. Methods. Eight databases including PubMed, Embase, Web of Science, the Cochrane library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Database (SinoMed), Wanfang Database, and Chinese VIP Information was searched for randomized controlled trials (RCTs) reporting clinical data regarding the use of berberine for the treatment of DM. Publication qualities were also considered to augment the credibility of the evidence. Glycemic metabolisms were the main factors studied, including glycosylated hemoglobin (HbA1c), fasting plasm glucose (FPG), and 2-hour postprandial blood glucose (2hPG). Insulin resistance was estimated by fasting blood insulin (FINS), homeostasis model assessment-insulin resistance (HOMA-IR), and body mass index (BMI). Lipid profiles were also assessed, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL), along with inflammation factors such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Serum creatinine (Scr), blood urea nitrogen (BUN), and adverse events were applied to evaluate the safety of berberine. Results. Forty-six trials were assessed. Analysis of berberine applied alone or with standard diabetic therapies versus the control group revealed significant reductions in HbA1c (MD=−0.73; 95% CI (−0.97, −0.51)), FPG (MD=−0.86, 95% CI (−1.10, −0.62)), and 2hPG (MD=−1.26, 95% CI (−1.64, −0.89)). Improved insulin resistance was assessed by lowering FINS (MD=−2.05, 95% CI (−2.62, −1.48)), HOMA-IR (MD=−0.71, 95% CI (−1.03, −0.39)), and BMI (MD=−1.07, 95% CI (−1.76, −0.37)). Lipid metabolisms were also ameliorated via the reduction of TG (MD=−0.5, 95% CI (−0.61, −0.39)), TC (MD=0.64, 95% CI (−0.78, −0.49)), and LDL (MD=0.86, 95% CI (−1.06, −0.65)) and the upregulation of HDL (MD=0.17, 95% CI (0.09, 0.25)). Additionally, berberine improved the inflammation factor. Conclusion. There is strong evidence supporting the clinical efficacy and safety of berberine in the treatment of DM, especially as an adjunctive therapy. In the future, this may be used to guide targeted clinical use of berberine and the development of medications seeking to treat patients with T2DM and dyslipidemia.
To make clear what role the Urban and Rural Residents Basic Medical Insurance (URRBMI) plays in the inequality in health and healthcare, this article combines the time-varying DID method with the ...concentration index to conduct an empirical study. We find that the URRBMI improves health but expands health inequality among different income groups, with its contribution growing over time. Besides, the URRBMI significantly promotes healthcare utilization, reduces the medical burden, and narrows the gap among different income groups, though this effect is generally downward. These findings help clarify what deserves more attention to enlarge benefits and reduce inequality in this medical reform and provide policy implications for policymakers. Increasing investment in medical resources and constructing the hierarchical medical system and medical treatment combination may make a difference.
Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been accepted as a rapid, accurate, and less labor-intensive method in the identification of ...microorganisms in clinical laboratories. However, there is limited data on systematic evaluation of its effectiveness in the identification of phylogenetically closely-related yeast species. In this study, we evaluated two commercially available MALDI-TOF systems, Autof MS 1000 and Vitek MS, for the identification of yeasts within closely-related species complexes. A total of 1,228 yeast isolates, representing 14 different species of five species complexes, including 479 of
complex, 323 of
complex, 95 of
complex, 16 of
complex (including two
), and 315 of
complex, collected under the National China Hospital Invasive Fungal Surveillance Net (CHIF-NET) program, were studied. Autof MS 1000 and Vitek MS systems correctly identified 99.2% and 89.2% of the isolates, with major error rate of 0.4% versus 1.6%, and minor error rate of 0.1% versus 3.5%, respectively. The proportion of isolates accurately identified by Autof MS 1000 and Vitek MS per each yeast complex, respectively, was as follows;
complex, 99.4% vs 96.3%;
complex, 99.0% vs 79.1%;
complex, 98.9% vs 94.7%;
complex, 100% vs 93.8%; and
, 99.4% vs 95.2%. Overall, Autof MS 1000 exhibited good capacity in yeast identification while Vitek MS had lower identification accuracy, especially in the identification of less common species within phylogenetically closely-related species complexes.
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