Mussel-inspired hydrogels for fast fabrication of flexible SERS tape for point-of-care testing of ß-blockers.

The flexible surface-enhanced Raman scattering (SERS) platform has ceaselessly propelled the development of point-of-care testing (POCT) in diverse fields. Herein, we report a facile strategy for the SERS-chemometric analysis of four ß-blockers (bisoprolol, metoprolol, acebutolol and esmolol) based on a super-sticky mussel-inspired hydrogel SERS tape. The surface morphology and mechanical properties of the hydrogel tape can be easily controlled by adjusting the compositional ratio. The optimized tape with excellent toughness and adhesiveness allows efficient collection of analytes through a simple "paste and peel off" approach, further by spraying with silver nanoparticles using a household sprayer to instantly assemble a flexible SERS substrate, the analytes can then detected by a portable Raman spectrometer. This POCT strategy enables the identification and discrimination of four similar ß-blockers with high sensitivity and accuracy in combination with the statistical algorithms. The developed SERS tape is finally utilized for the recognition of ß-blockers in simulated urine solution, which realizes a limit of detection of 1.0 ng mL-1, revealing a promising potential of this SERS-based POCT for the clinical detection of doping abuse.

Lower long-term mortality in obese patients with community-acquired pneumonia: possible role of CRP.

OBJECTIVE: The present study aimed to investigate the relationship between obesity and mortality in patients with community-acquired pneumonia (CAP) in China. METHODS: In total, 909 patients with CAP were recruited for this study from January 2010 to June 2015. All patients were selected and divided into 4 groups according to their body mass index (BMI) values. All patients' clinical information was recorded. The associations among mortality; BMI; the 30-day, 6-month and 1-year survival rates for different BMI classes; the etiology of pneumonia in each BMI group; and the risk factors for 1-year mortality in CAP patients were analyzed. RESULT: With the exception of the level of C-reactive protein (CRP), no other clinical indexes showed significant differences among the different BMI groups. No significant differences were observed among all groups in terms of the 30-d and 6-month mortality rates (p>0.05). There was a significantly lower risk of 1-year mortality in the obese group than in the nonobese group, (p<0.05). Logistic regression analysis showed that there were seven independent risk factors for 1-year mortality in CAP patients, namely, age, cardiovascular disease, cerebrovascular disease, obesity, APACHE II score, level of CRP and CAP severity. CONCLUSION: Compared with nonobese patients with CAP, obese CAP patients may have a lower mortality rate, especially with regard to 1-year mortality, and CRP may be associated with the lower mortality rate in obese individuals than in nonobese individuals.

Lower long-term mortality in obese patients with community-acquired pneumonia: possible role of CRP

OBJECTIVE: The present study aimed to investigate the relationship between obesity and mortality in patients with community-acquired pneumonia (CAP) in China. METHODS: In total, 909 patients with CAP were recruited for this study from January 2010 to June 2015. All patients were selected and divided into 4 groups according to their body mass index (BMI) values. All patients' clinical information was recorded. The associations among mortality; BMI; the 30-day, 6-month and 1-year survival rates for different BMI classes; the etiology of pneumonia in each BMI group; and the risk factors for 1-year mortality in CAP patients were analyzed. RESULT: With the exception of the level of C-reactive protein (CRP), no other clinical indexes showed significant differences among the different BMI groups. No significant differences were observed among all groups in terms of the 30-d and 6-month mortality rates (p>0.05). There was a significantly lower risk of 1-year mortality in the obese group than in the nonobese group, (p<0.05). Logistic regression analysis showed that there were seven independent risk factors for 1-year mortality in CAP patients, namely, age, cardiovascular disease, cerebrovascular disease, obesity, APACHE II score, level of CRP and CAP severity. CONCLUSION: Compared with nonobese patients with CAP, obese CAP patients may have a lower mortality rate, especially with regard to 1-year mortality, and CRP may be associated with the lower mortality rate in obese individuals than in nonobese individuals.

Therapeutic efficacy of intensified walk training under the electrocardiogram telemetry in stroke induced lower limb dysfunction patients with heart failure.

OBJECTIVES: This study aimed to explore the therapeutic efficacy of intensified walk training under the electrocardiogram (ECG) telemetry in stroke induced lower limb dysfunction patients with heart failure. MATERIAL AND METHODS: A total of 40 patients with stroke induced lower limb dysfunction and heart failure were randomized into control group and walk training group (n=20 per group). Besides comprehensive rehabilitation, patients in walk training group received intensified walk training under the ECG telemetry and patients in control group received traditional training. After 5-week treatment, the FMA score of lower limbs, ADL score, 6-min walking distance and left ventricular ejection fraction (EF) by heart ultrasonography were determined. RESULTS: There were no marked differences in the demographics between two groups at baseline, and no severe complications were observed during training in the walk training group. In control group, 6 patients developed lung edema which required further therapy. After 5-week training, the FMA score of lower limbs, ADL score and 6-min walk distance were improved to different extents, but the improvement was more obvious in walk training group (P<0.05). The left ventricular EF remained unchanged in both groups. CONCLUSIONS: In patients with stroke induced lower limb dysfunction and heart failure, routine rehabilitation in combination with additional walk training under the ECG telemetry is helpful to increase the training efficiency and training intensity and improve the low limb function and walk distance when the safety is assured.

Clinical treatment of orthostatic hypotension after spinal cord injury with training based on electric uprise bed coupled with remote ECG and BP monitor.

BACKGROUND: The treatment for orthostatic hypotension (OH) after spinal cord injury (SCI) is an important part of rehabilitation in late-stage SCI. Electric uprise bed training is a relatively commonly used method in treating OH, and how to carry out uprise bed training safely and effectively is an urgent problem. In the early stage of SCI, we used a remote monitoring system to monitor the whole process of uprise bed training, and we explored a safe and efficient method of electric uprise bed training. MATERIAL AND METHODS: The experimental group consisted of 36 patients diagnosed with orthostatic hypotension (OH) after SCI and who received training with an electric uprise bed coupled with remote monitoring system, and the control group of 18 subjects who used a traditional training method. RESULTS: There were no differences in baseline data between the 2 groups. There were no severe symptoms during training in the experimental group, but 3 patients had severe symptoms in the control group. Among the 32 enrolled subjects reaching upright training status within 30 days (17 subjects in the experimental group and 15 subjects in the control group), time interval of training from horizontal position to erect position in the experimental group was 18.00±3.12 days and 21.40±4.95 days in the control group. Time interval in the experimental group was significantly less than in the control group. However, among all 36 subjects, by combining results of follow-up, there was no significant difference of time interval of training from horizontal position to erect position between the experimental group and the control group. In the experimental group 90.52% of patients finished training compared to 78.19% in the control group (P<0.01). After training, values of OCs and OCd of the experimental group were lower than in the control group. There was no significant difference between groups in number of re-diagnosed OH. CONCLUSIONS: Implementation of training with electric uprise bed coupled with remote monitoring system is generally safe for patients with OH after SCI. For patients who could reach standing training status within 30 days, implementation can improve efficiency of training by shortening time interval of training from horizontal position to erect position. It can increase orthostatic blood pressure change during position change.

[Prevalence of symptomatic orthostatic hypotension and orthostatic blood pressure changes].

OBJECTIVE: To analyze the prevalence and orthostatic blood pressure changes in subjects with symptomatic orthostatic hypotension (OH), and to observe the relation between symptoms and orthostatic blood pressure change in this population. METHODS: A total of 193 subjects who consulted physicians due to OH related symptoms were selected, and divided into three groups: young (n = 37), middle-aged (n = 66) and elder (n = 90). Height, body weight, waist circumference, hip circumference and resting heart rate were measured. Symptom scores of every subject were obtained. CAVI and ABI were measured. Blood pressure including recumbent position, orthostatic systolic and diastolic blood pressure was measured at the morning and at the afternoon on two separate examination days with at least one week interval. After that, orthostatic changes in systolic blood pressure (OCs) and orthostatic changes in diastolic blood pressure (OCd) were calculated. RESULTS: OH prevalence was 32.6% in this cohort. The prevalence of three groups was similar [young: 32.4%, middle-aged: 25.8%, and elderly: 37.8%, respectively (P > 0.05)]. Only 9 cases (14.29% of confirmed OH cases) reached the OH diagnostic criteria with equal or more than 2 times orthostatic blood pressure measurements. OH was diagnosed in 63 patients during the 4 times orthostatic blood pressure check, of which 19.5% to 57.14% cases were diagnosed with single orthostatic blood pressure check. Age, weight, body mass index, waist-to-hip ratio, smoking, drinking habit, sex, coronary heart disease, hypertension, Parkinson's disease, stroke history, antihypertensive drug use were similar between OH group and non-OH group. Height, waist circumference, hip circumference, and resting heart rate were significantly lower in OH group than in non-OH group (P < 0.05). The values of the factors in OH group were lower. CAVI was 8.45 ± 0.19 in non-OH group and 8.37 ± 0.27 in OH group (P > 0.05), ABI was significantly lower in OH group than in non-OH group (1.004 ± 0.013 vs. 1.051 ± 0.009, P < 0.01). CONCLUSION: The prevalence of OH in people with related symptoms is high. Repeated orthostatic blood pressure measurements can improve OH detection rate.

[Impact of attack frequency and therapy strategies on outcome of patients with vasovagal syncope].

OBJECTIVE: To analyze the impact of attack frequency as well as therapy strategies on outcome of patients with vasovagal syncope (VVS). METHODS: A total of 159 patients (aged from 15 - 59 years old) with VVS were included in this study. Patients were divided into low frequency (< 3) group (n = 95) and high (≥ 3) frequency group (n = 64) according to the attack frequency in the past 5 years at the primary survey. Patients received one of the three therapies: no treatment, physical therapy, and comprehensive treatment. All cases were followed up with telephone or outpatient visit for 24 months. RESULTS: Incidence of syncope was significantly higher in the high frequency group and in the low frequency group [40.6% (26/64) vs. 11.6% (11/95), P < 0.01]. The overall improvement rate was significantly higher in the low frequency group than that of high frequency group (P < 0.01). Improvement rate was significantly higher in the physical therapy subgroup and the comprehensive treatment subgroup than no treatment subgroup for patients with low attack frequency [81.8% (27/33) vs. 47.1% (8/17), P < 0.05; 82.2% (37/45) vs. 47.1% (8/17), P < 0.05], and in comprehensive treatment subgroup than in physical therapy subgroups observed between and [62.2% (28/45) vs. 31.6% (6/19), P < 0.05] for patients with high attack frequency. CONCLUSION: Outcome is related to previous attack frequency for patients with VVS, physical therapy is effective for reducing the recurrence rate of syncope in VVS patients with low attack frequency while physical therapy combined with pharmacotherapy should be applied for VVS patients with high attack frequency to improve outcome.

[Comparative study of warfarin and aspirin for stroke prevention in elderly patients with atrial fibrillation].

OBJECTIVE: To analyze current stroke prevention measures for elderly patients with atrial fibrillation. METHODS: A retrospective analysis was conducted of the clinical records of elderly patients with atrial fibrillation treated in our hospital within the recent 5 years. The distribution of high risk factors for different age levels was studied, and the incidence of stroke and complications such as hemorrhage were compared between patients treated with warfarin and aspirin therapy. RESULTS: Compared with patients of 65 to 75 years old, the incidence of complications with other high risk factors was increased in advanced age group (over 75 years). Of these patients, 19.0% were treated with warfarin and 73.4% with aspirin. Compared with the aspirin group, stroke incidence was decreased significantly in warfarin group, which had simultaneously increased nonfatal hemorrhage. CONCLUSION: Warfarin can be more effective than aspirin for stroke prevention in elderly patients with atrial fibrillation, but in clinical practice, the usage rate of warfarin still remains low with insufficient monitoring.

[Effects of aging and hypoxia on the proliferation of cultured rat pulmonary arterial smooth muscle cells].

OBJECTIVE: To study the effects of aging and hypoxia on the proliferative behavior of cultured pulmonary arterial smooth muscle cells (PASMCs). METHODS: PASMCs isolated from aged (18-24 months) and young (3-4 months) rats were divided, according to the different treatments the cells were subjected to, into young and aged normoxic groups (groups A and B) and young and aged hypoxic groups (groups C and D) respectively. MTT cell proliferation assay, 3H-TdR incorporation assay, flow cytometriy and immunocytochemical analysis were respectively employed to observe the proliferative behavior. RESULTS: Compared with the cells from young rats, PASMCs from aged rats had a higher proliferation rate, more 3H-TdR incorporation, increased mitotic cell ratio, reduced amount of the total protein, and elevated content of proliferating cell nuclear antigen (PCNA). In comparison with normoxic condition, hypoxia elicited higher proliferation rate of the cells with inhibition of 3H-TdR incorporation that was subsequently increased. Higher percentage of mitotic cells, less total protein amount and increased PCNA were also observed in response to hypoxia. CONCLUSIONS: Aging and hypoxia may directly induce PASMC proliferation, and in aging PASMCs, the proliferation is the most obvious in response to hypoxic stimulation.