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Mitochondria are the center of cellular energy metabolism, and their functions are tightly regulated by the nuclear and mitochondria genomes.Potential mechanisms responsible for age-related mitochondrial dysfunction include the accumulation of mitochondrial DNA (mtDNA) damage caused by replication errors or oxidative damage, and the epigenetic changes in mtDNA (mitoepigenetics). These mechanisms are essential for the development and progression of age-related macular degeneration (AMD). Age-related mtDNA damage disrupts energy metabolism and cellular function in the retinal pigment epithelium (RPE) and neuroretinal cells, which further mediates oxidative stress, lysosomal dysfunction and pyroptosis, resulting in RPE degeneration, drusen deposition and retinal inflammation.Mitochondrial genome protection, such as humanin administration, may be a promising preventive or therapeutic target in the early stages of AMD.This review focused on the research progress of the mitochondrial genetic mechanism in AMD pathogenesis and provided new ideas for exploring the prevention and treatment strategies of AMD.
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OBJECTIVE@#To investigate the correlation between early-stage blood pressure indexes and prognosis in sepsis patients.@*METHODS@#A retrospective cohort study was conducted on the medical records of patients diagnosed with sepsis from 2001 to 2012 in the Medical Information Mart for Intensive Care-III (MIMIC-III) database. Patients were divided into survival group and death group according to the 28-day prognosis. General data of patients and heart rate (HR) and blood pressure at admission to ICU and within 24 hours after admission were collected. The blood pressure indexes including the maximum, median and mean value of systolic index, diastolic index and mean arterial pressure (MAP) index were calculated. The data were randomly divided into training set and validation set (4 : 1). Univariate Logistic regression analysis was used to screen covariates, and multivariate Logistic stepwise regression models were further developed. Model 1 (including HR, blood pressure, and blood pressure index related variables with P < 0.1 and other variables with P < 0.05) and Model 2 (including HR, blood pressure, and blood pressure index related variables with P < 0.1) were developed respectively. The receiver operator characteristic curve (ROC curve), precision recall curve (PRC) and decision curve analysis (DCA) curve were used to evaluate the quality of the two models, and the influencing factors of the prognosis of sepsis patients were analyzed. Finally, nomogram model was developed according to the better model and effectiveness of it was evaluated.@*RESULTS@#A total of 11 559 sepsis patients were included in the study, with 10 012 patients in the survival group and 1 547 patients in the death group. There were significant differences in age, survival time, Elixhauser comorbidity score and other 46 variables between the two groups (all P < 0.05). Thirty-seven variables were preliminarily screened by univariate Logistic regression analysis. After multivariate Logistic stepwise regression model screening, among the indicators related to HR, blood pressure and blood pressure index, the HR at admission to ICU [odds ratio (OR) = 0.992, 95% confidence interval (95%CI) was 0.988-0.997] and the maximum HR (OR = 1.006, 95%CI was 1.001-1.011), maximum MAP index (OR = 1.620, 95%CI was 1.244-2.126), mean diastolic index (OR = 0.283, 95%CI was 0.091-0.856), median systolic index (OR = 2.149, 95%CI was 0.805-4.461), median diastolic index (OR = 3.986, 95%CI was 1.376-11.758) were selected (all P < 0.1). There were 14 other variables with P < 0.05, including age, Elixhauser comorbidity score, continuous renal replacement therapy (CRRT), use of ventilator, sedation and analgesia, norepinephrine, norepinephrine, highest serum creatinine (SCr), maximum blood urea nitrogen (BUN), highest prothrombin time (PT), highest activated partial thromboplastin time (APTT), lowest platelet count (PLT), highest white blood cell count (WBC), minimum hemoglobin (Hb). The ROC curve showed that the area under the curve (AUC) of Model 1 and Model 2 were 0.769 and 0.637, respectively, indicating that model 1 had higher prediction accuracy. The PRC curve showed that the AUC of Model 1 and Model 2 were 0.381 and 0.240, respectively, indicating that Model 1 had a better effect. The DCA curve showed that when the threshold was 0-0.8 (the probability of death was 0-80%), the net benefit rate of Model 1 was higher than that of Model 2. The calibration curve showed that the prediction effect of the nomogram model developed according to Model 1 was in good agreement with the actual outcome. The Bootstrap verification results showed that the nomogram model was consistent with the above results and had good prediction effects.@*CONCLUSIONS@#The nomogram model constructed has good prediction effects on the 28-day prognosis in sepsis patients, and the blood pressure indexes are important predictors in the model.
Subject(s)
Humans , Cohort Studies , Retrospective Studies , Blood Pressure , Intensive Care Units , ROC Curve , Sepsis/diagnosis , Prognosis , Critical Care , NorepinephrineABSTRACT
In acute or chronic lung diseases, inappropriate immune response and abnormal repair process can lead to irreversible damage to lung tissue, which in turn leads to decreased lung function and even respiratory failure or death. Mesenchymal stem cells (MSCs) and their derivatives have shown wide application prospects in cell therapy and acellular therapy of lung diseases and are entering the clinical transformation stage because of their unique physiological functions and characteristics, but the safety and efficacy of MSCs and their derivatives are still controversial. Nebulization therapy provides new opportunities and challenges for the innovative treatment of MSCs and their derivatives in lung diseases. In a number of preclinical studies and clinical trials, there have been evidence that atomization therapy of MSCs and their derivatives is safe and effective. This method could be an optimal solution for the treatment of various complex lung diseases. However, extensive research should be carried out on various strategies and their compatibility with different nebulizers before this method can be used in clinical setting. In this paper, we review the research progress of MSCs and their derivatives by nebulization in the treatment of pulmonary diseases.
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Photoreceptor cells are special retinal neurons with photo-transformation ability. Loss of photoreceptors in age-related macular degeneration (AMD) is secondary to RPE loss, leakage of serum components from the neovascularization and scar formation, which is one of the main mechanisms of irreversible visual impairment in patients with AMD. Many studies have shown that inflammatory environment is involved in the process of photoreceptor cell death. Aging, photooxidation injury and other factors affects the retinal microenvironment through different levels of mechanisms such as retinal pigment epithelial cells, retinal glial cells, hematogenous macrophages and inflammatory factors, which results in photoreceptor injuries and participates in the progression of AMD by drusen formation and neovascularization. This study reviews the research status and progress of inflammation and photoreceptor cell death, and provides new ideas for exploring the blinding mechanism and treatment strategies of AMD.
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Thoracic and abdominal aortic aneurysm repair has always been a challenging procedure in cardiovascular surgery due to its high mortality and complication rate. At present, there are traditional open surgery, hybrid surgery and intracavitary repair for thoracic and abdominal aortic aneurysms. The main postoperative complication of spinal cord ischemia injury is paraplegia, which seriously affects the long-term survival rate and quality of life of patients. This paper summarized and considered the pathogenesis, risk factors and prevention measures of spinal cord ischemia injury after thoracic and abdominal aortic aneurysm repair.
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Objective To investigate the clinical effect of total hip replacement in patients with hip fusion .Methods 31cases (43 hips) with hip fusion underwent total hip replacement from January 2006 to December 2012 ,To retro-spective analysis on clinical curative effect and operation related issues .Results The mean time of follow-up was 14 .2 months(12 to 72 months) in 26 cases (37 hips) .All patients had good relief postoperative on hip pain ,knee pain and low back pain ,and the gait was closed to normal ,and the activities of daily living improved in part of cases ,including 16 cases went back to work .The assessment of X-ray showed that had not found any complications ,such as dislocation ,Osteolysis and loosening ,the excellent rate was 89 .19% .Conclusion For pa-tients with hip fusion ,Total hip replacement can improve the function of the hip fusion and relieve pain .
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An automatic detection of Electrocardiogram (ECG) using Quantum Neural Networks (QNN) with multiresolution analysis is given in the paper. QNN originates from exploiting BP neural networks. With the quantum neurons, QNN can model the levels of uncertainty arising from complex classification problems. Its potential advantage over conventional methods is based on the argument for reliability. The fuzzy feature is expected to enhance the reliability of the network, which is critical for improving desirable diagnosis accuracy. And wavelet transform with multiresolution analysis is adopted in ECG pretreatment for reducing the numbers of neurons. So it can improve convergence speed of the network. The results of simulation confirmed the feasibility of the proposed approach.