Risk factors and predicting nomogram for the clinical deterioration of non-severe community-acquired pneumonia.

BACKGROUND: Currently, there remains insufficient focus on non-severe community-acquired pneumonia (CAP) patients who are at risk of clinical deterioration, and there is also a dearth of research on the related risk factors. Early recognition of hospitalized patients at risk of clinical deterioration will be beneficial for their clinical management. METHOD: A retrospective study was conducted in The First Affiliated Hospital of Wenzhou Medical University, China, spanning from January 1, 2018 to April 30, 2022, and involving a total of 1,632 non-severe CAP patients. Based on whether their condition worsened within 72 h of admission, patients were divided into a clinical deterioration group and a non-clinical deterioration group. Additionally, all patients were randomly assigned to a training set containing 75% of patients and a validation set containing 25% of patients. In the training set, risk factors for clinical deterioration in patients with non-severe CAP were identified by using LASSO regression analysis and multivariate logistic regression analysis. A nomogram was developed based on identified risk factors. The effectiveness of the nomogram in both the training and validation sets was assessed using Receiver Operating Characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). RESULTS: Age, body mass index (BMI), body temperature, cardiovascular comorbidity, respiratory rate, LDH level, lymphocyte count and D-dimer level were identified as risk factors associated with the clinical deterioration of non-severe CAP within 72 h of admission. The area under curve (AUC) value of the nomogram was 0.78 (95% CI: 0.74-0.82) in the training set and 0.75 (95% CI: 0.67-0.83) in the validation set. Furthermore, the calibration curves for both the training and validation sets indicated that the predicted probability of clinical deterioration aligned with the actual probability. Additionally, DCA revealed clinical utility for the nomogram at a specific threshold probability. CONCLUSION: The study successfully identified the risk factors linked to the clinical deterioration of non-severe CAP and constructed a nomogram for predicting the probability of deterioration. The nomogram demonstrated favorable predictive performance and has the potential to aid in the early identification and management of non-severe CAP patients at elevated risk of deterioration.

Dauricine alleviates cognitive impairment in Alzheimer's disease mice induced by D-galactose and AlCl3 via the Ca2+/CaM pathway.

Alzheimer's disease (AD) is a common neurodegenerative disease in the elderly. Dysregulation of intracellular Ca2+ homeostasis plays a critical role in the pathological development of AD. Dauricine (DAU) is a bisbenzylisoquinoline alkaloid isolated from Menispermum dauricum DC., which can prevent the influx of extracellular Ca2+ and inhibit the release of Ca2+ from the endoplasmic reticulum. DAU has a potential for anti-AD. However, it is unclear whether DAU can exert its anti-AD effect in vivo by regulating the Ca2+ related signaling pathways. Here, we investigated the effect and mechanism of DAU on D-galactose and AlCl3 combined-induced AD mice based on the Ca2+/CaM pathway. The results showed that DAU (1 mg/kg and 10 mg/kg for 30 days) treatment attenuated learning and memory deficits and improved the nesting ability of AD mice. The HE staining assay showed that DAU could inhibit the histopathological alterations and attenuate neuronal damage in the hippocampus and cortex of AD mice. Studies on the mechanism indicated that DAU decreased the phosphorylation of CaMKII and Tau and reduced the formation of NFTs in the hippocampus and cortex. DAU treatment also reduced the abnormally high expression of APP, BACE1, and Aß1-42, which inhibited the deposition of Aß plaques. Moreover, DAU could decrease Ca2+ levels and inhibit elevated CaM protein expression in the hippocampus and cortex of AD mice. The molecular docking results showed that DAU may have a high affinity with CaM or BACE1. DAU has a beneficial impact on pathological changes in AD mice induced by D-galactose and AlCl3 and may act by negative regulation of the Ca2+/CaM pathway and its downstream molecules such as CaMKII and BACE1.

Total alkaloids from the seed embryo of Nelumbo nucifera Gaertn. improve cognitive impairment in APP/PS1 mice and protect Aß-damaged PC12 cells.

The seed embryo of Nelumbo nucifera Gaertn. is a famous traditional Chinese medicine and food which is considered conducive to the prevention of Alzheimer's disease (AD). In this study, the effect and mechanism of TASENN (total alkaloids from the seed embryo of Nelumbo nucifera Gaertn.) on AD mice and amyloid-ß (Aß) injured PC12 cells were evaluated. HPLC-UV analysis showed that the extracted TASENN (purity = 95.6%) mainly contains Liensinine, Isoliensinine, and Neferine (purity was 23.01, 28.02, and 44.57%, respectively). In vivo, oral treatment with TASENN (50 mg/kg/day for 28 days) improved the learning and memory functions of APP/PS1 transgenic mice, ameliorated the histopathological changes of cortical and hippocampal neurons, and inhibited neuronal apoptosis. We found that TASENN reduced the phosphorylation of Tau and the formation of neurofibrillary tangles (NFTs) in APP/PS1 mouse brain. Moreover, TASENN down-regulated the expression of APP and BACE1, ameliorated Aß deposition, and inhibited microglial proliferation and aggregation. The elevated protein expression of CaM and p-CaMKII in APP/PS1 mouse brain was also reduced by TASENN. In vitro, TASENN inhibited the apoptosis of PC12 cells injured by Aß25-35 and increased the cell viability. Aß25-35-induced increase of cytosolic free Ca2+ level and high expression of CaM, p-CaMKII, and p-Tau were decreased by TASENN. Our findings indicate that TASENN has a potential therapeutic effect on AD mice and a protective effect on PC12 cells. The anti-AD activity of TASENN may be closely related to its negative regulation of the CaM pathway.

Protective effects of Liensinine, Isoliensinine, and Neferine on PC12 cells injured by amyloid-ß.

Excessive accumulation of amyloid-ß (Aß) is the leading cause of Alzheimer's disease (AD). Liensinine, Isoliensinine, and Neferine are main alkaloids in lotus seed embryos. In this paper, the protective effects of Liensinine, Isoliensinine, and Neferine on Aß25-35 -injured PC12 cells were studied. It was found that Liensinine, Isoliensinine, and Neferine could improve the viability and reduce the apoptosis of PC12 cell induced by Aß25-35 . These three alkaloids could also reduce the level of intracellular free Ca2+ and CaM expression in Aß25-35 -treated cells, thereby inhibiting the phosphorylation of CaMKII and tau. In addition, these three compounds can inhibit the production of ROS in PC12 cells injured by Aß25-35 . Our results suggest for the first time that Liensinine, Isoliensinine, and Neferine can inhibit hyperphosphorylation of tau protein by inhibiting the Ca2+ -CaM/CaMKII pathway, thereby reducing the apoptosis and death of PC12 cells damaged by Aß25-35 . PRACTICAL APPLICATIONS: This study highlighted the protective effects and mechanisms of three main active ingredients (Liensinine, Isoliensinine, and Neferine) in the lotus embryo on a typical cell model of Alzheimer's disease (AD). The results revealed that three alkaloids in this healthy food might exert therapeutic potential for AD.

An Improved Sensing Method of a Robotic Ultrasound System for Real-Time Force and Angle Calibration.

An ultrasonic examination is a clinically universal and safe examination method, and with the development of telemedicine and precision medicine, the robotic ultrasound system (RUS) integrated with a robotic arm and ultrasound imaging system receives increasing attention. As the RUS requires precision and reproducibility, it is important to monitor the real-time calibration of the RUS during examination, especially the angle of the probe for image detection and its force on the surface. Additionally, to speed up the integration of the RUS and the current medical ultrasound system (US), the current RUSs mostly use a self-designed fixture to connect the probe to the arm. If the fixture has inconsistencies, it may cause an operating error. In order to improve its resilience, this study proposed an improved sensing method for real-time force and angle calibration. Based on multichannel pressure sensors, an inertial measurement unit (IMU), and a novel sensing structure, the ultrasonic probe and robotic arm could be simply and rapidly combined, which rendered real-time force and angle calibration at a low cost. The experimental results show that the average success rate of the downforce position identification achieved was 88.2%. The phantom experiment indicated that the method could assist the RUS in the real-time calibration of both force and angle during an examination.

[Health assessment on aquatic ecosystem in Liaohe River of Liaoning Province].

Based on the investigation of the hydrology, water quality, periphytic algae, and habitat conditions of 20 hydrologic sections in the Tieling, Shenyang, and Panjin reaches of Liaohe River from June to August 2009, the indicators and their weights for the health assessment of aquatic ecosystem in the River were screened and determined by the method of principal component analysis, and the River's health assessment indicator system and health assessment standard system were constructed. The modified gray correlative degree method was also used to evaluate the aquatic ecosystem health condition at six sections of the River. Among the sections evaluated, three of them had a fair health level, two were worse or worst, and only one reached sub-health degree, suggesting that the aquatic ecosystem in the River was seriously degraded. Special attention should be paid to the ecological recovery of the river system, and comprehensive measures should be taken to control the River' s water pollution.

[Tongxinluo improves vascular endothelial function in patients with type 2 diabetes].

OBJECTIVE: To investigate the effects of Tongxinluo on vascular endothelial function in patients with type 2 diabetes. METHODS: A total of 80 patients with type 2 diabetes were recruited and divided into two groups: Tongxinluo therapy group (n = 40) and conventional therapy group (n = 40). Plasma levels of NO, ET, 6-keto-PGF1alpha and TXB2 and diastolic functions of humeral arteries (measured by high-resolution ultrasound) were measured at baseline and 4 weeks later. RESULTS: The flow-mediated dilation was significantly increased from (8.19 +/- 0.71)% to (12.47 +/- 0.98)% (P < 0.05) in Tongxinluo therapy group after 4 weeks therapy compare to baseline level. Their plasma NO was significantly increased [(47.65 +/- 4.38) pg/ml to (52.91 +/- 4.83) pg/ml, P < 0.001] and plasma ET significantly reduced [(31.23 +/- 2.46) pg/ml to (24.34 +/- 2.46) pg/ml, P < 0.001] post 4 week Tongxinluo therapy. Parameters remained unchanged in the placebo group (P > 0.05) at baseline and 4 weeks later. Non-flow-mediated dilation was unaffected by Tongxinluo therapy. CONCLUSIONS: Tongxinluo improved the vascular endothelial dependent diastolic function in patients with type 2 diabetes by regulating the balance of plasma NO/ET.

[Efficacy and safety of Fufang Biejia Ruangan tablet in patients with chronic hepatitis B complicated with hepatic fibrosis].

OBJECTIVE: To study the clinical therapeutic effects and safety of Fufang Biejia Ruangan tablet (FBRt) in patients with chronic hepatitis B complicated with hepatic fibrosis. METHODS: Totally 420 patients were randomly divided into two groups, FBRt group (300 cases) were treated with Fufang Biejia Ruangan tablets and control group (120 cases) were treated with He Luo Shu Gan capsule, the patients in both groups were treated for 6 months. RESULTS: The cure rate and total effective rate of FBRt group were significantly higher than those of control group (55.67 percent and 81.67 percent vs. 15.8 percent and 60.00 percent, P less than 0.01). CONCLUSION: Fufang Biejia Ruangan tablet could alleviate clinical symptoms and hepatic fibrosis. Fufang Biejia Ruangan tablet is effective and safe in treatment of patients with chronic hepatitis B complicated with liver fibrosis.

[The impact of elevated serum creatinine on the prognosis of acute myocardial infarction].

OBJECTIVE: To evaluate the clinical features and outcomes in patients suffering from acute myocardial infarction combined with elevated serum creatinine. METHODS: We enrolled 340 consecutive patients suffering from acute myocardial infarction admitted into our hospital from 2003.2.1 - 2004.8.31. The patients were divided into the following 2 groups, 269 patients in a group with normal serum creatinine and 71 patients in a group with elevated serum creatinine, according to the normal limit of serum creatinine in our hospital. Outcomes during hospitalization were available in all the patients and one year follow-up data were also available in all the patients. The influence of baseline demographic and clinical variables on mortality at day 30 and one year during the follow-up period was evaluated by Cox proportional hazard regression to determine the independent predictors of late adverse events. RESULTS: Elevated creatinine at baseline was present in 71 of the 340 patients. Compared with patients with normal creatinine, patients with elevated creatinine were older and more likely to have old myocardial infarction and to present with cardiac shock, heart failure, ventricular fibrillation and complete AVB. Mortality was markedly increased in patients with baseline elevated creatinine as compared with these without at day 30 (32.39% versus 4.83%, P = 0.000), during hospitalization (35.21% versus 5.20%, P = 0.000) and at 1 year (43.66% versus 11.15%, P = 0.000). By Cox regression analysis, elevated creatinine was a powerful independent hazard predictor of 30-day survival (odds ratio 4.591, 95% confidence interval 2.149 to 9.808, P = 0.000) and remained to be associated with reduced survival at 1 year (odds ratio 3.936, 95% confidence interval 2.264 to 6.845, P = 0.000). CONCLUSIONS: Baseline elevated creatinine is associated with a markedly increased risk of 30-day death, death during hospitalization and mortality at one year in patients suffering from acute myocardial infarction and may be an independent risk factor of prognosis of acute myocardial infarction.