Effect of a multidisciplinary nutrition management model in patients with critical illness: A randomized trial.

BACKGROUND: Managing nutrition in critically ill patients involves many medical fields. However, the nutrition management of critically ill patients has not been comprehensive enough to achieve multidisciplinary team cooperation in China and many other countries. Furthermore, there is no standardized management model or process. AIM: To explore the multidisciplinary cooperative nutrition management model for critically ill patients in the ICUs in China, verify its clinical effect and provide a clinical practice reference for the nutrition management of critically ill patients. STUDY DESIGN: A multidisciplinary cooperative nutrition management team, including ICU doctors, ICU nurses, clinical nutritionists, clinical pharmacists and radiologists, was established for critically ill patients. According to a literature review and domestic guidelines, the standardized process of nutritional management for critically ill patients was constructed through the Delphi expert consultation method. One hundred thirty-two patients in the ICU were randomly divided into an experimental group and a control group. A routine nutrition management mode, which was the nutrition management plan mainly formulated by the ICU doctor in charge only and the ICU nurses responsible for the implementation and monitoring of nutrition support, was implemented in the control group. And a multidisciplinary nutrition management mode, which was the nutrition management implemented by the multidisciplinary teams with the standardized nutrition management process for critically ill patients, was adopted in the experimental group. The early nutritional support rate, nutritional indexes (serum albumin, preprotein, haemoglobin and hs-CPR), mechanical ventilation time, ICU hospitalization days and hospitalization expenses of the two groups were compared. RESULTS: The early nutritional support rates of the experimental group and the control group were 89.39% and 69.7%, respectively (χ2 = .002, p = .031). Serum albumin (35.4 vs. 33.1 g/L), preprotein (153.2 vs. 125.9 mg/L) and haemoglobin (97.5 vs. 90.6 g/L) in the experimental group were significantly higher than in the control group (p = .000, .016, .033). The days of hospitalization in the ICU of the experimental group were shorter than in the control group (5.1 vs. 7.1, p = .039). High-sensitivity C-reactive protein, the days of mechanical ventilation and ICU hospitalization expenses of the experimental group were lower than in the control group; however, the difference was not statistically significant (p = .713, .068, .489). CONCLUSIONS: Because of the severity and complexity of patients' diseases, it is necessary to implement multidisciplinary nutrition management for critically ill patients. Research shows that the multidisciplinary nutrition management standardized process for critically ill patients that was constructed in this study can effectively improve nutritional indexes such as serum albumin, preprotein and haemoglobin, shorten the length of stay in the ICU and promote the rehabilitation of patients, and this process be widely used in the clinic. RELEVANCE TO CLINICAL PRACTICE: Structured multidisciplinary nutrition management operational processes can guide clinical practice. They could be widely used in the clinical nutrition management of critically ill patients in critical care units or other departments.

Adaptive evolution of microorganisms based on industrial environmental perturbations / 生物工程学报

The development of synthetic biology has greatly promoted the construction of microbial cell factories, providing an important strategy for green and efficient chemical production. However, the bottleneck of poor tolerance to harsh industrial environments has become the key factor hampering the productivity of microbial cells. Adaptive evolution is an important method to domesticate microorganisms for a certain period by applying targeted selection pressure to obtain desired phenotypic or physiological properties that are adapted to a specific environment. Recently, with the development of technologies such as microfluidics, biosensors, and omics analysis, adaptive evolution has laid the foundation for efficient productivity of microbial cell factories. Herein, we discuss the key technologies of adaptive evolution and their important applications in improvement of environmental tolerance and production efficiency of microbial cell factories. Moreover, we looked forward to the prospects of adaptive evolution to realize industrial production by microbial cell factories.

Construction and application of microbial cell factories for unnatural amino acids / 生物工程学报

Unnatural amino acids are widely used in medicine, pesticide, material, and other industries and the green and efficient synthesis has attracted a lot of attention. In recent years, with the rapid development of synthetic biology, microbial cell factories have become a promising means for biosynthesis of unnatural amino acids. This study reviewed the construction and application of microbial cell factories for unnatural amino acid, including the synthetic pathway reconstruction, design/modification of key enzymes and their coordinated regulation with precursors, blocking of competitive alternative pathways, and construction of cofactor circulation systems. Meanwhile, on the basis of the new principles for designing the microbial cell factories, new biosynthetic pathways adapted to cells and the production environment, as well as new biomanufacturing system established based on cell adaptive evolution and intelligent fermentation regulation, we looked forward to the further construction and application of microbial cell factories for industrial bio-production.

HPLC phenolic profile and induction of apoptosis by Linum usitatissimum extract in LNCaP cells by caspase3 and Bax pathways.

Linum usitatissimum is a candidate as a remedy to treat prostate problems in some folklore medicines. In this study, we have reported the phenolic and flavonoid constituents, antioxidant activity, and potential of the plant extract against prostate cancer cells. The phenolic and flavonoid compound profile of the extract were established using HPLC analysis. While the total phenolic and flavonoid content (TPC and TFC) were analyzed using classic methods. The antioxidant activity of the extract was also evaluated. MTT assay and flow cytometry technique was used to evaluate antiproliferation activity and induction apoptosis of the plant extract on prostate cancer cells of LNCaP. We also evaluated the gene expression of Bax and caspase-3 using the real-time qPCR assay. HPLC result revealed that L. usitatissimum extract (LUE) was rich in phenolic acids such as gallic, ferulic, and vanillic acid with the amount of 3.56, 2.12, 1.24 µg/g extract respectively. 383.4 mg GAE/g and 47.1 mgRuE/g were calculated for total phenolic and flavonoid content. LUE exhibited radical scavenging activity with IC50 = 19.3 ± 1.1 µg/mL. LUE chelated ferrous ions with IC50 = 121.1 ± 1.3 µg/mL. LUE showed anti-proliferative activity on LNCaP cells with the IC50 values of 8.3, 6.3, and 5.4 µg/mL after 24, 48, and 72 h treatment. LUE also increased cell mortality by inducing apoptosis (15.3-29.8%). The real-time qPCR results exhibited an increase in gene expression of Bax and caspase-3. Our in vitro study demonstrates that L. usitatissimum can be considered as an effective agent to inhibit the growth and invasion the human prostate cancer cells.

Rapid Development of Neutralizing and Diagnostic SARS-COV-2 Mouse Monoclonal Antibodies

The need for high-affinity, SARS-CoV-2-specific monoclonal antibodies (mAbs) is critical in the face of the global COVID-19 pandemic, as such reagents can have important diagnostic, research, and therapeutic applications. Of greatest interest is the ~300 amino acid receptor binding domain (RBD) within the S1 subunit of the spike protein because of its key interaction with the human angiotensin converting enzyme 2 (hACE2) receptor present on many cell types, especially lung epithelial cells. We report here the development and functional characterization of 29 nanomolar-affinity mouse SARS-CoV-2 mAbs created by an accelerated immunization and hybridoma screening process. Differing functions, including binding of diverse protein epitopes, viral neutralization, impact on RBD-hACE2 binding, and immunohistochemical staining of infected lung tissue, were correlated with variable gene usage and sequence.

High-throughput quantitation of SARS-CoV-2 antibodies in a single-dilution homogeneous assay

SARS-CoV-2 emerged in late 2019 and has since spread around the world, causing a pandemic of the respiratory disease COVID-19. Detecting antibodies against the virus is an essential tool for tracking infections and developing vaccines. Such tests, primarily utilizing the enzyme-linked immunosorbent assay (ELISA) principle, can be either qualitative (reporting positive/negative results) or quantitative (reporting a value representing the quantity of specific antibodies). Quantitation is vital for determining stability or decline of antibody titers in convalescence, efficacy of different vaccination regimens, and detection of asymptomatic infections. Quantitation typically requires two-step ELISA testing, in which samples are first screened in a qualitative assay and positive samples are subsequently analyzed as a dilution series. To overcome the throughput limitations of this approach, we developed a simpler and faster system that is highly automatable and achieves quantitation in a single-dilution screening format with sensitivity and specificity comparable to those of ELISA.

Literature analysis of researches on interview before transferring to ICU in China / 中国实用护理杂志

Objective To analyze the current research status and problem of ICU visiting before patient transfer in.To supply the reference for the future research in the field. Methods China National Knowledge Infrastructure,Wanfang database and VIP database were searched for literatures on the field. Note Express and Excel 2007 were used to statistical analysis the tendency of the literature publication trend, distribution,region, article type and research topic. Results Totally 86 articles were retrieved. The first was published in 2004,the related articles increased gradually yearly.18 articles were published in core journals and 16 kinds of nursing journals.There were 6 funds-supported articles,3 degree papers. The top three provinces where the first author came from were Jiangsu,Hubei and Shanghai.The primary study types(74.42%) were experimental study and quasi-experimental study. The primary study topic (90.7%)were intervention comparing and problem resolving. Conclusions Research on ICU pre-visiting is focused by the domestic researchers.However,the object of the pre-visiting,visiting content and form should be improved. The tool of visiting should be structured. The research method and topic should be increased.

Relationship between Serum BNP and Heart Failure in Patients undergoing Maintenance Peritoneal Dialysis / 现代医院

Objective To investigate the relationship between Serum BNP and heart failure in patients un-dergoing maintenance peritoneal dialysis ( MPD) .Methods 80 uremia patients who underwent MPD and 40 healthy volunteers were enrolled in the study.In the morning of treatment, we assessed their cardiac function according to in-terrogation, physical examination, chest X-ray and echocardiography while detecting BNP, Scr, BUN levels in the fasting venous serum of upper extremity.Results 80 MPD patients were divided into 2 groups:a heart failure group (Group A, n=42) and a normal cardiac function group (Group B, n=38).40 healthy volunteers served as a con-trol group ( Group C ) .There were no significant differences in age, weight and sex ratio among 3 groups ( P>0.05).The time period of maintenance peritoneal dialysis in Group A and B was similar (P>0.05).Compared with Group C, the levels of Serum BNP, Scr and BUN were significantly higher in Group A and B( P0.05) .The level of Serum BNP was signifi-cantly higher in Group A than that in Group B (P<0.05).Conclusion The level of Serum BNP may be closely re-lated to the cardiac function and it may be used as a predictor for heart failure in MPD patients.

Comparison of the sedation of dexmedetomidine versus midazolam on mechanically ventilated patients / 临床麻醉学杂志

Objective To investigate sedation of dexmedetomidine versus midazolam on me-chanically ventilated patients.Methods Seventy-six mechanically ventilated patients were randomly divided into midazolam group (group M)and dexmedetomidine group (group D).The loading dose and maintenance dose of midazolam was 0.06 mg/kg and 0.04-0.2 mg·kg-1 ·h-1 ,and 1 μg/kg and 0.2-0.7 μg·kg-1 ·h-1 for dexmedetomidine.The drug dose was adjusted according to Ramsay score scale.Time when Ramsay reach 2-4 score,the length of ICU stay,mechanical ventilation time,drug adverse reactions,the levels of inflammation factors were recorded and compared between two groups.Results The length of ICU stay and arousing time in group D was significantly lower than that of group M (P <0.05).The levels of TNF-α,hs-CRP in group D were lower after 24 hr treat-ment than that of group M(P <0.05).The levels of hs-CRP in group D were lower after 48 hr treat-ment than that of group M (P <0.01).Conclusion Dexmedetomidine treatment reduced the lengh of ICU stay and levels of inflammatory factors of mechanical ventilated patients.

Evaluation for clinical application of UniCel DxH 800 hematology analyzer / 中华检验医学杂志

ObjectiveTo evaluate the improvement on test performance of UniCel DxH 800 automated hematology analyzer for complete blood count (CBC) by detecting its performance indicators and comparing the differences of the results with LH 750 hematology analyzer and ADVIA 2120 hematology analyzer.MethodsThe precision,carryover and linearity of UniCel DxH 800 in measurement of CBC were evaluated by using fresh blood samples and instrument quality control of products.To evaluate the accuracy of leukocyte differential count and reticulocyte count with the microscopic method as the “gold standard”.To calculate the bias and correlation between the results measured by LH 750,ADVIA 2120 and UniCel DxH 800 hematology analyzers and compare these three instruments on the validity of the alarm in abnormal cells.ResultsIntra-precision:The coefficient of variation (CV) of the results of RBC,Hb and MCV were less than 0.5％,the CV of WBC and PLT results were less than 1.5％.Inter-precision:the CV of the parameters above were less than 2.5％.The carryover rate of WBC,RBC,Hb,MCV and PLT were less than 0.51％.In the concentration range covered by clinical samples,the correlation coefficients between the measured values and theoretical value in testing WBC,RBC,Hb and PLT were greater than 0.999 ( P ＜0.01 ).The measurement results of WBC,RBC,Hb,MCV and PLT hy UniCel DxH 800,ADV1A 2120 and LH 750 hematology analyzers have good correlation (r ＞ 0.973,P ＜ 0.01 ).Correlation of reticulocyte count between the UniCel DxH 800 hematology analyzer and microscolpic method was significant (r =0.920,P ＜0.01 ).Correlation of leukocyte differential count about the grauulocytes, lymphocytes and eosinophils between the UniCel DxH 800 hematology analyzer and microscopic method was good (r =0.914,0.900 and 0.725,P ＜0.01 ),followed by monocytes ( r =0.612,P ＜0.01 ),which were better than the LH 750 with similar detection principle.The UniCel DxH 800 hematology analyzer demonstrated higher sensitivity (96.6％ ) for the alarm of abnormal cells and achieved a lower false-negative rate (2.5％ ).Meanwhile,the sensitivity of the neutrophil nuclei left shift was higher (90.5％ ) and the false-negative rate (5.0％) was lower.ConclusionsThe UniCel DxH 800 hematology analyzer for complete blood count shows advantages of high precision,low carryover rate and wide linear range.The results detected by the UniCel DxH 800 hematology analyzer have good correlation with the LH 750 and ADVIA 2120.

Prediction of the enantioselectivity of lipases and esterases by molecular docking method with modified force field parameters.

In the work, molecular docking method was applied to extensively predict the enantioselectivity of lipases and esterases. A ligand library consisted of 69 chiral substrates was docked to four lipases and two esterases to set up the prediction model. During the docking process, necessary modification was carried out on van de Waals and hydrogen bond parameters of enzyme/substrate pair so that the ligands were able to adopt productive geometry in the enzymes. The docking results correctly indicated the enantiopreference for 91% (63/69) of docking pairs and the docking energy difference between substrate enantiomers (Delta Delta G(docking)) was significantly (correlation coefficient = 0.72, P < 0.05) correlated with the activation free energy difference (Delta Delta G( not equal)) that was quantitatively correlated with enantioselectivity of the enzymes. The prediction method was further validated by docking with another 12 enzyme/substrate pairs. Moreover, the prediction error was susceptible to the size of groups bonded to substrate's chiral center and expected Delta Delta G( not equal) values but was not related to the substrate type and reaction medium. The possible reasons of observed error were discussed. It is demonstrated that the docking method has great application potential in high performance prediction of enzyme enantioselectivity.

Hospital Infection in Diabetic Nephropathy: Analysis of Clinical Characteristics / 中华医院感染学杂志

OBJECTIVE To explore the clinical characteristics of hospital infection in diabetic nephropathy(DN). METHODS To retrospectively analyze the incidence rate of hospital infection,the infection sites,pathogenic bacteria,and predisposing factors in 348 cases with diabetic nephropathy,and to compare the index above with the homeochronous 466 diabetic patients without DN. RESULTS Sixty two cases occurred hospital infection from 348 cases with DN,the infection rate was 17.82%,the infection sites were most frequently in respiratory tract(37.10%),then urinary tract(24.19%) and digestive tract(19.35%),the major predisposing factors were out of control of blood glucose,renal sufficiency,advanced age,and longer stay in hospital. CONCLUSIONS The incidence rate of hospital infection is higher,the valid measures to control the hospital infection are to control the blood glucose effectively,to improve the renal function and timely to use the method of anti-infection with forcefulness.

The clinical analysis of hospital acquired acute renal failure / 中国基层医药

Objective To expolre the clinical characteristic of hospital acquired acute renal failure(HA-ARF).Methods To retrospectively analyse the clinical datas of 103 patients who were suffered from acute renal failure in the duration of hospital stay within 5 years,which was compared with the homeochronous community-acquired acute renal failure(CA-ARF).Results In the 103 cases of HA-ARF,the incidence rate was 32.04% in the major age range from 60 to 74 years old,infection was the most important factor(33.01%),then other factors were cardial and cerebrovascular diseases(17.48%),acute hypovolemia(14.56%) and operation(9.71%);The complicating other organ nonfunction(34.95%),and the mortality rate was 39.80%,all the factors in HA-ARF were higher than that in CA-ARF.Conclusion The main factors of origin in HA-ARF are infection,cardial and cerebrovascular disease,acute hypovolemia and operation.The mortality rate of this disease is higher.Etilogical treatment promptly and dialysis regimen are the main means to rescue these patients.

Effect of Prostaglandin E1 Lipid Drug-loaded Microcapsules on Early Diabetic Nephropathy / 中国药房

OBJECTIVE: To explore the therapeutic effect of prostaglandin E1 lipid drug-loaded microcapsules(Lipo PGE1) on the earlier diabetic nephropathy (DN). METHODS: 72 cases with early DN were randomly divided into treatment group and control group. The control group were assigned to receive routine hypoglycemic agent,blood pressure controlling, and symptomatic treatment, while the treatment group were given another drip infusion of Lipo PGE1 20ug plus NS100ml q.d besides the routine therapy as in the control group. Both groups received 3 weeks’ course of treatment. The changes of urinary albumin excretion rate(UAER), urinary transferrin(TRF), urinary microglobulin(?1MG)and so on in the 24h urine of the 2 groups before and after treatment were observed.RESULTS: There was great decrease in UAER, TRF and ?1MG in the 24h urine in the treatment group after treatment(P

Therapeutic effects of mycophenolate mofetil in treating 16 cases of refractory idiopathic thrombocytopenic purpura / 中国实用内科杂志

Objective To study the therapeutic effects of mycophenolate mofetil(MMF) in the treatment of refractory idiopathic thrombocytopenic purpura(ITP).Methods 16 refractory ITP patients were treated with MMF (1.0～1.5g/d),which were given in divided doses for three months as one course;the patients with significant therapeutic effect were given the dose for another three months and reduced by degree.Results Very effective results were obtained in 4 cases,striking improvement in 7,partial response in 1 and no response in 4.The total efficacy was 68.75%.The main side effect was observed as light digestive malaise.Conclusion MMF has striking therapeutic effect in treating refractory ITP with little side effect and can be used as an effective way of treatment.