The effectiveness of the sarcopenia index in predicting septic shock and death in elderly patients with community-acquired pneumonia.

BACKGROUND: Community-acquired pneumonia (CAP) causes high morbidity and mortality in all age groups worldwide. Lower muscle radiodensity was associated with worse clinical outcomes (including shock) and higher in-hospital mortality. Prompt detection of sarcopenia in older adults with CAP is important. The measurement of muscle mass often involves specialized and expensive techniques. A relatively simple and inexpensive method such as the sarcopenia index (SI) to measure muscle mass would be helpful. Therefore, we performed a retrospective cohort study to assess the association between SI and septic shock risk and mortality in older patients with CAP. STUDY DESIGN: In this retrospective cohort study, information on hospitalized CAP patients, including general information and septic shock, were obtained from the medical record database of the Southwest Medical University Zigong Affiliated Hospital, China. Data on patient survival and mortality (all-cause) were acquired from government authorities and telephonic follow-up. Serum creatinine (Cr) and cystatin-C (CysC) levels on admission were included in the database. The SI was determined as the serum Cr/CysC ratio × 100 and the participants were assigned to low and high SI groups. The association between SI and septic shock was evaluated by logistic regression, and that between SI and mortality by Cox regression analysis. RESULTS: In total, 769 older adults (≥ 60 years) with CAP were included, of which 480(62.4%) were male and 289(37.6%)were female. We found that the total prevalence of septic shock in older adults with CAP was 16.0%. In the female group, septic shock was more prevalent in the low SI group than in the high SI group (low SI vs. high SI, 22.22% vs. 11.52%, p = 0.024). Following adjustment for confounders, there was a significant association between high SI and a lower risk of septic shock in female patients (OR = 0.38, 95%CI: 0.16-0.94; p < 0.05). The total death toll of older adults with CAP was 332(43.2%). Irrespective of sex, there was a higher risk of mortality in the low SI group (total group: low SI vs. high SI, 63.02% vs. 36.57%, p < 0.001; male group: low SI vs. high SI, 63.03% vs. 39.34%, p < 0.001; female group: low SI vs. high SI, 73.61% vs. 28.57%, p < 0.001) and, after adjustment for confounding factors and irrespective of sex, high SI was a protective factor for mortality in older adults with CAP (total group: HR = 0.64, 95%CI: 0.48-0.84; p < 0.05; male: HR = 0.69, 95%CI: 0.49-0.97; p < 0.05; female: HR = 0.39, 95%CI: 0.24-0.62; p < 0.05). CONCLUSION: While the SI effectively predicts mortality in older adults with CAP, it was only found to be associated with septic shock in older females.

Cysteine-Rich Receptor-Like Kinase Gene Family Identification in the Phaseolus Genome and Comparative Analysis of Their Expression Profiles Specific to Mycorrhizal and Rhizobial Symbiosis.

Receptor-like kinases (RLKs) are conserved upstream signaling molecules that regulate several biological processes, including plant development and stress adaptation. Cysteine (C)-rich receptor-like kinases (CRKs) are an important class of RLK that play vital roles in disease resistance and cell death in plants. Genome-wide analyses of CRK genes have been carried out in Arabidopsis and rice, while functional characterization of some CRKs has been carried out in wheat and tomato in addition to Arabidopsis. A comprehensive analysis of the CRK gene family in leguminous crops has not yet been conducted, and our understanding of their roles in symbiosis is rather limited. Here, we report the comprehensive analysis of the PhaseolusCRK gene family, including identification, sequence similarity, phylogeny, chromosomal localization, gene structures, transcript expression profiles, and in silico promoter analysis. Forty-six CRK homologs were identified and phylogenetically clustered into five groups. Expression analysis suggests that PvCRK genes are differentially expressed in both vegetative and reproductive tissues. Further, transcriptomic analysis revealed that shared and unique CRK genes were upregulated during arbuscular mycorrhizal and rhizobial symbiosis. Overall, the systematic analysis of the PvCRK gene family provides valuable information for further studies on the biological roles of CRKs in various Phaseolus tissues during diverse biological processes, including Phaseolus-mycorrhiza/rhizobia symbiosis.

Correlation between serum cystatin C content and renal function in aged patients with benign prostatic hyperplasia / 心血管康复医学杂志

Objective:To explore the correlation between serum cystatin C (Cys C)content and renal function in aged patients with benign prostatic hyperplasia (BPH).Methods:Clinical data of 237 aged BPH patients were retro-spectively analyzed.According to international prostate symptom score (IPSS),they were divided into mild group (n=25),moderate group (n=67)and severe group (n= 145);another 110 patients without prostatic hyperplasia were enrolled as normal control group in the same period.Levels of serum Cys C,blood urea nitrogen (BUN),ser-um creatinine (Scr),fasting blood glucose (FBG),blood lipids and prostate-specific antigen (PSA)were measured in all groups,and prostate volume (PV)was calculated.Results:Compared with normal control group,PV signifi-cantly rose [(18.94±4.62)ml vs.(40.09±12.72)ml],maximum urinary flow rate (Qmax)significantly reduced [(18.67±4.60)ml/s vs.(9.93±3.54)ml/s],and serum Cys C level significantly increased [(1.03±0.23)mg/L vs.(1.53±0.61)mg/L]in BPH group,P <0.01 all.Subgroup analysis indicated that serum Cys C levels in mild, moderate and severe group [(1.32±0.45)mg/L,(1.42±0.32)mg/L,(1.61 ±0.64)mg/L]were significantly higher than that of normal control group,P <0.01 all;and that of severe group was significantly higher than those of mild group and moderate group (P <0.01 or P <0.05).Pearson correlation analysis indicated that serum Cys C level was positively correlated with of age,SBP,DBP,FBG,BUN,Scr,PV and IPSS (r=0.179~0.580,P <0.05 or P <0.01),and inversely correlated with Qmax (r=-0.243,P <0.05)in BPH patients.Conclusion:Serum Cys C level significantly rise,and related with BPH degree,correlated with renal function in aged BPH patients,which can be used to predict renal function of these patients.

Assessment of the estimations of glomerular filtration rate in Chinese diabetic patients / 中华检验医学杂志

Objective To assess the applicability of the Modification of Diet in Renal Disease (MDRD)formula to kidney function impaired Chinese diabetic patients.Methods Glomerular filtration rates(GFRs)in 463 Chinese diabetic patients(219 female,244 male,aged 14 to 88)were estimated by measuring ~(99m)Tc-DTPA clearance and with equations based on serum creatinine(Scr)and cystatin C(Cys C)concentrations.GFRs derived from various equations were compared with the ~(99m)Tc-DTPA clearance GFRs and their relative accuracies were assessed with ROC analysis.All the Scr measurements were performed with both the Roche enzymatic assay and the Beckman LX20 kinetic alkaline picrate assay,and Cys C with immunonephelometric and immunoturbidimetric assays.Results The reciprocals of Cys C and Scr were linearly correlated with ~(99m)Tc-DTPA clearance GFRs(r=0.830 and 0.690,repectively).The correlation of GFR with Scr could be expressed by an adjusted MDRD equation:GFR [ ml?(min?1.73 m~2)~(-1)]=175?(Scr)~(-1.154)?(age)~(-0.203)?0.742(female)?0.827,where 0.827 was a coefficient for Chinese.The adjusted equation showed a better accuracy than the MDRD equation(areas under the ROC curve 0.818 vs 0.644).The adjusted equation was also more accurate than equations obtained in previous Chinese studies.GFRs were also estimated by using Cys(in mg/L)with the following equation:GFR [ ml?(min?1.73 m~2)~(-1)] = 63.24?(Cys C)~(-0.3378).The accuracy of the Cys equation was similar to the Scr equation,or better in patients aged 60 and above.The Roche enzymatic results which were traceable to the isotope dilution mass spectrometry(IDMS)methods were significantly lower than Beckman LX20 results,but the results were closely correlated with each other(Y = 0.94X-0.02).When non-traceable Scr results were used,the coefficient needed to be adjusted.Conclusions GFRs can be estimated with equations based on either Scr or Cys C.GFR estimation should use standardized Scr results and take into account ethnic effects.