Abstract Objectives This meta-analysis summarized the risks that reintubation impose on ventilator-associated pneumonia (VAP) and mortality. Background Extubation failure increases the probability of ...poor clinical outcomes pertaining to mechanical ventilation. Methods Literature published during a 15-year period was retrieved from PubMed, Web of Knowledge databases, the Embase (Excerpa Medica database), and the Cochrane Library. Data involving reintubation, VAP, and mortality were extracted for a meta-analysis. Results Forty-one studies involving 29,923 patients were enrolled for the analysis. The summary odds ratio (OR) between VAP and reintubation was 7.57 (95% confidence interval CI = 3.63–15.81). The merged ORs for mortality in hospital and intensive care unit were 3.33 (95% CI = 2.02–5.49) and 7.50 (95% CI = 4.60–12.21), respectively. Conclusions Reintubation can represent a threat to survival and increase the risk of VAP. The risk of mortality after reintubation differs between planned and unplanned extubation. Extubation failure is associated with a higher risk of VAP in the cardiac surgery population than in the general population.
We report a new strategy to construct fluorescence switches by taking advantage of the
E
–
Z
isomerization of the hydrazone group. The switch, synthesized by linking pyridyl-2-aldehydehydrazone to a ...BODIPY fluorophore, was able to exist in three forms:
E-BODIPY
,
Z-BODIPY
and
protonated BODIPY
with different photophysical properties. Reversible ON/OFF fluorescence switching among them was realized by multiple stimuli such as irradiation and addition of acid/base.
Display omitted
•A product-imprinted polymer based organocatalyst was developed.•The organocatalyst is amphiphilic and photoswitchable.•The catalyst catalyzes aldol reaction with good conversion and ...low catalyst loading.•The catalyzed aldol reaction performs well in a mixed solvent of DMSO and water.
A series of amphiphilic molecularly imprinted polymers (MIP1, MIP2, MIP3, MIP4, MIP5, and MIP6) containing hydrophobic photoresponsive sites and hydrophilic catalytically active sites were fabricated using bifunctional monomers. These polymers were characterized by scanning electron microscopy, N2 adsorption–desorption analysis, Fourier Transform infrared spectroscopy, thermal gravimetric analysis, and ultraviolet–visible spectroscopy. The catalytic activity of the amphiphilic molecularly imprinted polymer was investigated towards the aldol reaction between p-nitroaldehyde and acetone (a molecular enlargement reaction) in a mixed solvent of DMSO and water at room temperature. The polymer catalyst MIP3 performs best, and displayed good conversions with low catalyst loading (5mol% of l-hydroxyproline with respect to the aldehyde) and photoswitching properties (photo-regulated conversion difference of 20%). Compared with the corresponding non-imprinted polymer, a higher binding capacity, higher conversion, and better photoswitching properties were obtained when the molecularly imprinted polymer was used as the catalyst, illustrating the importance of the specific cavities in the molecularly imprinted polymer.
Submicron particulate matter (PM1.0) samples were collected at a suburban site in Wuhan from Sept., 2012 to Aug., 2013. Concentration, composition, potential sources and acidity of the PM1.0 were ...investigated. The results indicated that the annual average concentration of PM1.0 was 81.7μg/m3, with the highest and lowest values occurring in winter and summer, respectively. Inorganic water soluble ions constituted 48.9% of the PM1.0, and dominated by secondary species in the form of NH4NO3 and NH4HSO4. The high concentration of Pb (128.4ng/m3) and greatly enriched Pb, Cd and Se in PM1.0 indicated contribution of coal combustion to PM1.0. Ratios of SO42−/NO3− (1.3) and Cl−/Na+ (2.7) revealed the dominant stationary emissions, further confirming the coal combustion source in Wuhan. According to the chemical and meteorological analyses, biomass burning and stagnant weather were proposed to be the main causes to the haze episodes in autumn and winter, respectively.
•PM1.0 is a pollutant of regional concern in Central China.•Water-soluble inorganic ion, carbonaceous fractions, and element species in PM1.0 were measured.•Chemical species/ratios and enrichment factors were used to identify potential source.•Two typical haze episodes were recorded during the sampling campaign.
PIN2/TRF1-interacting telomerase inhibitor 1 (PinX1) is a novel cloned gene which has been identified as a major haploinsufficient tumor suppressor essential for maintaining telomerase activity, the ...length of telomerase and chromosome stability. This study explored the clinical significance and biological function of PinX1 in human clear cell renal cell carcinoma (ccRCC). The clinical relevance of PinX1 in ccRCC was evaluated using tissue microarray and immunohistochemical staining in two independent human ccRCC cohorts. Our data demonstrated that PinX1 expression was dramatically decreased in ccRCC tissues compared with normal renal tissues and paired adjacent non-tumor tissues. Low PinX1 expression was significantly correlated with depth of invasion, lymph node metastasis and advanced TNM stage in patients, as well as with worse overall and disease-specific survival. Cox regression analysis revealed that PinX1 expression was an independent prognostic factor for ccRCC patients. Moreover, PinX1 inhibited the migration and invasion of ccRCC by suppressing MMP-2 expression and activity via NF-κB-dependent transcription in vitro. In vivo studies confirmed that PinX1 negatively regulated ccRCC metastasis and the expression of MMP-2 and NF-κB-p65. These findings indicate that PinX1 suppresses ccRCC metastasis and may serve as a ccRCC candidate clinical prognostic marker and a potential therapeutic target.
The causes of chronic heart failure (CHF) and its progression are likely to be due to complex genetic factors. Adenosine receptors A2A and A2B (ADORA2A and ADORA2B, respectively) play an important ...role in cardio-protection. Therefore, polymorphisms in the genes encoding those receptors may affect the risk and severity of CHF. This study was a case-control comparative investigation of 300 northern Chinese Han CHF patients and 400 ethnicity-matched healthy controls. Four common single-nucleotide polymorphisms (SNPs) of ADORA2A (rs2236625, rs2236624, rs4822489, and rs5751876) and one SNP of ADORA2B (rs7208480) were genotyped and an association between SNPs and clinical outcomes was evaluated. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association. The rs4822489 was significantly associated with the severity of CHF after adjustment for traditional cardiovascular risk factors (p = 0.040, OR = 1.912, 95% CI = 1.029-3.550). However, the five SNPs as well as the haplotypes were not found to be associated with CHF susceptibility. The findings of this study suggest that rs4822489 may contribute to the severity of CHF in the northern Chinese. However, further studies performed in larger populations and aimed at better defining the role of this gene are required.
Aims/hypothesis
More than 90% of Chinese familial early-onset type 2 diabetes mellitus is genetically unexplained. To investigate the molecular aetiology, we identified and characterised whether ...mutations in the
KCNJ11
gene are responsible for these families.
Methods
KCNJ11
mutations were screened for 96 familial early-onset type 2 diabetic probands and their families. Functional significance of the identified mutations was confirmed by physiological analysis, molecular modelling and population survey.
Results
Three novel
KCNJ11
mutations, R27H, R192H and S116F117del, were identified in three families with early-onset type 2 diabetes mellitus. Mutated
KCNJ11
with R27H or R192H markedly reduced ATP sensitivity (E23K>R27H>C42R>R192H>R201H), but no ATP-sensitive potassium channel currents were detected in the loss-of-function S116F117del channel in vitro. Molecular modelling indicated that R192H had a larger effect on the channel ATP-binding pocket than R27H, which may qualitatively explain why the ATP sensitivity of the R192H mutation is seven times less than R27H. The shape of the S116F117del channel may be compressed, which may explain why the mutated channel had no currents. Discontinuation of insulin and implementation of sulfonylureas for R27H or R192H carriers and continuation/switch to insulin therapy for S116F117del carriers resulted in good glycaemic control.
Conclusions/interpretation
Our results suggest that genetic diagnosis for the
KCNJ11
mutations in familial early-onset type 2 diabetes mellitus may help in understanding the molecular aetiology and in providing more personalised treatment for these specific forms of diabetes in Chinese and other Asian patients.
Objective: To explore the survival status and prognostic factors of patients with pancreatic cancer in Hainan.
Methods: Clinical data of patients who were diagnosed as pancreatic cancer and visited ...the First and Second Affiliated Hospital of Hainan Medical University and Haikou People's Hospital from 2013 to 2017 were collected based on electronic medical records. Basic information was collected by a self-designed questionnaire. Data about admission examinations including blood routine examination, blood biochemistry tests, tumour markers tests, imaging examination and other clinical tests were also collected. The date of follow-up via telephone was 30 June 2018. The survival rate was analyzed by the Kaplan-Meier method and the logrank test. Univariate and multivariate analyses were performed with COX regression model.
Results: A total of 198 patients were included in the study. Kaplan-Meier results showed that the overall survival (OS) in 6 months and 1, 2, 3 and 5 years was 47.4%, 26.8%, 16.4%, 13.2%, and 8.7%, respectively. The median OS was 5.8 months. Log-rank test analysis found that there were significant differences in OS among patients with different age, surgery status, distant metastasis or absolute number of neutrophils, percentage of neutrophils, absolute number of lymphocytes, neutrophil-to-lymphocyte ratio (NLR), CA199 and carcino-embryonic antigen (P<0.1). COX multivariate analysis showed that age, surgical presence, presence or absence of distant metastasis and NLR were significantly associated OS (P<0.05).
Conclusions: Older age, higher NLR and liver or lung metastasis are independent risk factors, while surgical treatment is an independent protective factor for patients with pancreatic cancer.
PDF
