[An early warning model for sepsis complicated with acute respiratory distress syndrome based on synthetic minority oversampling technique algorithm].

OBJECTIVE: To explore the independent risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis, establish an early warning model, and verify the predictive value of the model based on synthetic minority oversampling technique (SMOTE) algorithm. METHODS: A retrospective case-control study was conducted. 566 patients with sepsis who were admitted to Jinan People's Hospital from October 2016 to October 2022 were enrolled. General information, underlying diseases, infection sites, initial cause, severity scores, blood and arterial blood gas analysis indicators at admission, treatment measures, complications, and prognosis indicators of patients were collected. The patients were grouped according to whether ARDS occurred during hospitalization, and the clinical data between the two groups were observed and compared. Univariate and binary multivariate Logistic regression analysis were used to select the independent risk factors of ARDS during hospitalization in septic patients, and regression equation was established to construct the early warning model. Simultaneously, the dataset was improved using the SMOTE algorithm to build an enhanced warning model. Receiver operator characteristic curve (ROC curve) was drawn to validate the prediction efficiency of the model. RESULTS: 566 patients with sepsis were included in the final analysis, of which 163 developed ARDS during hospitalization and 403 did not. Univariate analysis showed that there were statistically significant differences in age, body mass index (BMI), malignant tumor, blood transfusion history, pancreas and peripancreatic infection, gastrointestinal tract infection, pulmonary infection as the initial etiology, acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, albumin (Alb), blood urea nitrogen (BUN), mechanical ventilation therapy, septic shock and length of intensive care unit (ICU) stay between the two groups. Binary multivariate Logistic regression analysis showed that age [odds ratio (OR) = 3.449, 95% confidence interval (95%CI) was 2.197-5.414, P = 0.000], pulmonary infection as the initial etiology (OR = 2.309, 95%CI was 1.427-3.737, P = 0.001), pancreas and peripancreatic infection (OR = 1.937, 95%CI was 1.236-3.035, P = 0.004), septic shock (OR = 3.381, 95%CI was 1.890-6.047, P = 0.000), SOFA score (OR = 9.311, 95%CI was 5.831-14.867, P = 0.000) were independent influencing factors of ARDS during hospitalization in septic patients. An early warning model was established based on the above risk factors: P1 = -4.558+1.238×age+0.837×pulmonary infection as the initial etiology+0.661×pancreas and peripancreatic infection+1.218×septic shock+2.231×SOFA score. ROC curve analysis showed that the area under the ROC curve (AUC) of the model for ARDS during hospitalization in septic patients was 0.882 (95%CI was 0.851-0.914) with sensitivity of 79.8% and specificity of 83.4%. The dataset was improved based on the SMOTE algorithm, and the early warning model was rebuilt: P2 = -3.279+1.288×age+0.763×pulmonary infection as the initial etiology+0.635×pancreas and peripancreatic infection+1.068×septic shock+2.201×SOFA score. ROC curve analysis showed that the AUC of the model for ARDS during hospitalization in septic patients was 0.890 (95%CI was 0.867-0.913) with sensitivity of 85.3% and specificity of 79.1%. This result further confirmed that the early warning model constructed by the independent risk factors mentioned above had high predictive performance. CONCLUSIONS: Risk factors for the occurrence of ARDS during hospitalization in patients with sepsis include age, pulmonary infection as the initial etiology, pancreatic and peripancreatic infection, septic shock, and SOFA score. Clinically, the probability of ARDS in patients with sepsis can be assessed based on the warning model established using these risk factors, allowing for early intervention and improvement of prognosis.

Effect of transverse colostomy versus ileostomy in colorectal anastomosis on post-operative wound complications: A meta-analysis.

A meta-analysis was conducted to evaluate the effect of colostomy or ileostomy on post-operative wound complications. The research was tested using Embase, PubMed and Cochrane Library databases. Included were randomized, controlled clinical trials (RCTs). A sensitivity analysis and a meta-analysis were carried out. The results indicated that there were no statistically significant differences in the reduction of wound infection between LC and LI. Out of 268 related studies, 5 publications were chosen and examined for compliance. Literature quality was evaluated throughout the trial. Studies with poor literature were excluded. The data were analysed with RevMan 5.3, and a decision was taken to analyse the data with either a stochastic or a fixed-effects model. There were no significant differences in the incidence of post-operative infection in patients with LC (OR, 0.79; 95% CI, 0.34, 1.81; p = 0.57), and the incidence of post-operative anastomotic fistulae (OR, 0.98; 95% CI, 0.30, 3.15; p = 0.97) was not significantly different from that with LI. These meta-analyses indicate that no significant reduction in the incidence of post-operative infections or anastomotic fistulae was observed by either LC or LI.

Chlamydia Trachomatis Infection: Their potential implication in the Etiology of Cervical Cancer.

Pathogenic bacterial strains can alter the normal function of cells and induce different levels of inflammatory responses that are connected to the development of different diseases, such as tuberculosis, diarrhea, cancer etc. Chlamydia trachomatis (C. trachomatis) is an intracellular obligate gram-negative bacterium which has been connected with the cervical cancer etiology. Nevertheless, establishment of causality and the underlying mechanisms of carcinogenesis of cervical cancer associated with C. trachomatis remain unclear. Studies reveal the existence of C. trachomatis in cervical cancer patients. The DNA repair pathways including mismatch repair, nucleotide excision, and base excision are vital in the abatement of accumulated mutations that can direct to the process of carcinogenesis. C. trachomatis recruits DDR proteins away from sites of DNA damage and, in this way, impedes the DDR. Therefore, by disturbing host cell-cycle control, chromatin and DDR repair, C. trachomatis makes a situation favorable for malignant transformation. Inflammation originated due to infection directs over production of reactive oxygen species (ROS) and consequent oxidative DNA damage. This review may aid our current understanding of the etiology of cervical cancer in C. trachomatis-infected patients.

Photothermal and adsorption effects of silver selenide nanoparticles modified by different surfactants in nursing care of cancer patients.

Silver selenide nanoparticles have advantages of low cytotoxicity, desirable near-infrared light response characteristics, and easy surface modification, which attract increasing attention in chemo-photothermal therapy and nursing care of cancer patients. In this contribution, we synthesized Ag2Se nanoparticles modified by the surfactant of cetyltrimethylammonium bromide (CTAB) using a ligand exchange strategy. Their microstructure and composition were characterized by transmission electron microscopy, X-ray diffraction, X-ray Photo-electronic Spectroscopy, and Fourier transform infrared spectroscopy. The CTAB modified Ag2Se nanoparticles exhibited a uniform diameter distribution centered at ~12 nm. In order to investigate the photothermal and adsorption effects of CTAB-Ag2Se nanocomposites, we also prepared sodium dodecyl benzene sulfonate (SDBS) modified Ag2Se nanoparticles to make a comparison. The CTAB-Ag2Se nanoparticles showed high photothermal properties, a photothermal conversion efficiency of 20.1% and a high drug adsorption performance of 48.2 µg/mg. Importantly, the CTAB-Ag2Se-DOX presented an MCF-7 cell activity of only 27.3% under near-infrared radiation. The results revealed that the surface-modified Ag2Se nanoparticles with CTAB had stronger antitumor ability.

MADS-box transcription factor Mcm1 controls cell cycle, fungal development, cell integrity and virulence in the filamentous insect pathogenic fungus Beauveria bassiana.

MADS-box transcription factor Mcm1 plays crucial roles in regulating mating processes and pathogenesis in some fungi. However, its roles are varied in fungal species, and its function remains unclear in entomopathogenic fungi. Here, Mcm1 orthologue, Bbmcm1, was characterized in a filamentous entomopathogenic fungus, Beauveria bassiana. Disruption of Bbmcm1 resulted in a distinct reduction in growth with abnormal conidiogenesis, and a significant decrease in conidial viability with abnormal germination. ΔBbmcm1 displayed impaired cell integrity, with distorted cell wall structure and altered cell wall component. Abnormal cell cycle was detected in ΔBbmcm1 with longer G2 /M phase but shorter G1 /G0 and S phases in unicellular blastospores, and sparser septa in multicellular hyphae, which might be responsible for defects in development and differentiation due to the regulation of cell cycle-involved genes, as well as the corresponding cellular events-associated genes. Dramatically decreased virulence was examined in ΔBbmcm1, with impaired ability to escape haemocyte encapsulation, which was consistent with markedly reduced cuticle-degrading enzyme production by repressing their coding genes, and downregulated fungal effector protein-coding genes, suggesting a novel role of Mcm1 in interaction with host insect. These data indicate that Mcm1 is a crucial regulator of development, cell integrity, cell cycle and virulence in insect fungal pathogens.

Homocysteine injures vascular endothelial cells by inhibiting mitochondrial activity.

The aim of the present study was to investigate the role of homocysteine (Hcy) in the pathogenesis of pulmonary embolism (PE) and the associated molecular mechanisms in human umbilical vein endothelial cells (HUVECs). Hcy contents were detected with high-performance liquid chromatography. Apoptosis was detected by flow cytometry using Annexin-V staining. Cytochrome c oxidase (COX) activity was assessed with an enzyme activity assay, and the expression levels of COX 17 were determined by western blot analysis. Intracellular reactive oxygen species levels were measured using a microplate reader with a fluorescence probe. The results demonstrated that, compared with the control group, the serum Hcy levels were significantly elevated in the PE group, suggesting that Hcy may be an indicator for PE. Following treatment with Hcy, the apoptosis rate was markedly elevated in HUVECs. Moreover, Hcy decreased COX activity and downregulated the expression of COX 17 in HUVECs. Furthermore, Hcy increased the ROS levels in these endothelial cells. However, all the above-mentioned physiopathological changes induced by Hcy in HUVECs could be restored by folic acid. In conclusion, the results of the present study demonstrated that Hcy inhibited COX activity, downregulated COX 17 expression, increased intracellular ROS levels and enhanced apoptosis in endothelial cells.