Binary blends of normal corn starch and cow cockle starch for the slow-thickening behavior upon pasting.

Corn starch with slow thickening property may facilitate more efficient heat transfer and safety of corn starch-thickened foods. Partial substitution of normal corn starch (NCS) with slow-pasting behavior of cow cockle starch (CCS) was hypothesized to impart binary starch blend with slow-thickening effect during hydrothermal heating. To test hypothesis, a series of starch blend dispersions (with weight ratios of CCS to NCS = 75:25, 50:50, 25:75) were prepared at various starch concentrations (6 %, 8 %, 10 %, and 12 %) and subjected to the Rapid Viscosity Analysis (RVA). RVA viscographs of starch blends were compared with that of NCS, suggesting that nearly all starch blends at various concentrations showed longer time span of pasting and lower pasting rate. Although CCS and NCS blend gels exhibited lower Young's modulus and hardness based on textural profile analysis, the sensory panels revealed that 6 % and 8 % starch blend gels (with weight ratio of CCS to NCS = 25:75) showed the mouthfeel analogous to NCS gel. These findings highlight a viable non-chemical modification strategy that enables binary blends of CCS and NCS as a novel gelling agent with slow-pasting property and may aid in safety and high-quality processing of hydrogel foods.

Comparison of Outcomes Between Early and Late Tracheostomy.

BACKGROUND: The timing of tracheostomy in ventilated patients remains controversial. This study aimed to compare the effect of early tracheostomy (≤7 d) with late tracheostomy (>7 d) on the prognosis of patients requiring prolonged mechanical ventilation. METHODS: This was a retrospective observational cohort study. The data of 175 patients who received tracheostomy at the ICU between January 1, 2015-July 31, 2022, were collected. Patients were excluded from the study if medical records were incomplete or they underwent tracheostomy as part of a planned operation procedure. One-to-one propensity score matching was used to correct the baseline characteristics between the early and late tracheostomy groups. The treatment process and outcomes were compared between the two groups. The primary outcome was the incidence of ventilator-associated pneumonia (VAP) between groups. RESULTS: After propensity score matching, 88 subjects were included in the analysis. Compared with the late tracheostomy group, the incidence of VAP, hospital length of stay, sedation-free days, ventilator-free days, and ICU-free days were longer in the early tracheostomy group. There were no significant differences in the 90-d mortality between the two groups. CONCLUSIONS;: Early tracheostomy can reduce the occurrence of complications for ICU patients.

SPI1-mediated autophagy of peripheral blood monocyte cells as a mechanism for sepsis based on single-cell RNA sequencing.

Autophagy has been documented to participate in immune responses and inflammatory diseases, but the mechanistic actions of monocyte autophagy in sepsis remain largely unknown. This study intends to analyze the mechanism of autophagy of peripheral blood monocyte cells (PBMCs) in sepsis based on single-cell RNA sequencing (scRNA-seq). The scRNA-seq data of PBMC samples from sepsis patients were downloaded from the GEO database, followed by identification of cell marker genes, key pathways and key genes. The bioinformatics analysis showed that the PBMC samples of sepsis patients mainly contained 9 immune cell types, among which three types of monocytes showed significant changes in cell numbers in sepsis patients. Of note, the highest autophagy score was found in the intermediate monocytes. The Annexin signaling pathway was a key pathway for the communication between monocytes and other cells. More importantly, SPI1 was predicted as a key gene in the autophagy phenotype of intermediate monocytes, and SPI1 might suppress ANXA1 transcription. The high expression of SPI1 in sepsis was confirmed by RT-qPCR and Western blot analysis. Dual luciferase reporter gene assay verified that SPI1 could bind to the promoter region of ANXA1. Furthermore, it was found that SPI1 might affect monocyte autophagy in the mouse model of sepsis through regulation of ANXA1. In conclusion, we provide insight into the mechanism underlying the septic potential of SPI1, which enhances monocyte autophagy by inhibiting the transcription of ANXA1 in sepsis.

The Senescence-Related Signature Predicts Prognosis and Characterization of Tumor Microenvironment Infiltration in Pancreatic Cancer.

Background: Senescence is thought to be an imperative effect on the development of cancer. However, few studies pay an attention to the senescence-associated genes in pancreatic cancer (PC). The prognostic value of senescence-related genes (SRGs) and their involvement in tumor microenvironment (TME) in the PC remain obscure. The aim of this research was to investigate the prognostic role of senescence-associated genes and their affection in TME in PC. Methods: The transcriptome and clinical information of PC patients were obtained from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) databases. Two SRG-mediated molecular clusters were comprehensively identified. In total, data from the 285 PC patients were randomly used to develop a senescence-associated gene signature in the training set and verified in the validation set. Immune microenvironment analysis pertained to senescence-related genes was performed. Results: A SRG_score including five senescence-associated genes was established to separate PC patients into two risk groups. High-risk patients had worse overall survival than low-risk patients. The result of the multivariate Cox regression analysis identified the risk score and stage as independent prognostic factors for PC patients. Receiver operating characteristic curve (ROC) analysis confirmed the credible predictive ability of the nomogram. The area under time-dependent ROC curve (AUC) reached 0.746 at 1 year, 0.781 at 3 years, and 0.868 at 5 years in the training set and 0.653 at 1 year, 0.755 at 3 years, and 0.785 at 5 years in the validation set. Moreover, the SRG_score was associated with TME, tumor mutation burden (TMB), and chemotherapeutic drug sensitivity. Conclusions: This study found that the novel SRG_score could be an independent prognostic target for PC patients. Senescence-associated genes had a vital impact on the immune microenvironment and the treatment of PC patients.

Predictive value of neutrophil-to-lymphocyte and platelet ratio in in-hospital mortality in septic patients.

Background: Among critically ill patients in the intensive care unit (ICU), sepsis is an urgent global public health problem due to its high incidence, high mortality rate and complex pathogenesis. Objective: This study was to evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR), and neutrophil-to-lymphocyte and platelet ratio (NLPR) in-hospital mortality in septic patients on days 1, 3 and 5 in ICU. Methods: The data of septic patients admitted to the ICU of the Sixth Affiliated Hospital of Sun Yat-sen University from March, 2018 to July, 2019 were collected. NLR and NLPR were calculated and multivariate logistic regression analysis was performed to identify the relationship between them and in-hospital mortality, respectively. Receiver operating characteristic curve (ROC) was used to determine the efficacy and optimal cutoff value of diagnostic tests. Results: A total of 173 septic patients were included in this analysis, including 108 cases in the survival group and 65 in the death group, with a total mortality rate of 37.6%. A multivariate logistic regression analysis showed that NLR on day 5 was independently correlated with in-hospital mortality rate (OR 1.041, 95% CI: 1.008-1.074), and Day 5 NLPR was also independently associated with in-hospital mortality rate (OR 1.020, 95% CI: 1.001-1.040). The areas under the receiver operating characteristic curve (AUC) of the NLR on days 1 and 3 was 0.513 and 0.542 respectively, and the optimal cutoff value were 23.16 and 15.48, and the AUC of the NLR on day 5 was 0.589, and the best cutoff value was 15.85. The AUC of NLPR on day 1 and 3 was 0.517 and 0.547, respectively, and the optimal cutoff value was 10.25 and 18.47. The AUC of NLPR on day 5 was the largest, 0.654, and the optimal cutoff value was 8.22. After combined NLPR on day 5 with age and sequential organ failure assessment (SOFA) scores, the AUC increase to 0.718. Among the joint predictors, the optimal cutoff value for NLPR on day 5 was 9.31. Conclusion: We found that Day 5 NLPR and NLR were independently correlated with in-hospital mortality. Day 5 NLPR Combined with age and SOFA scores may be help predict mortality in ICU septic hospitalized patients.

Response of Soil Fauna to the Shift in a Riparian Landscape along an Urban-Rural Habitat Gradient.

Urbanization is accelerating worldwide, resulting in drastic alterations of natural riverbanks, which seriously affects the ecological functions and services of riparian landscapes. Our understanding of how anthropogenic activities influence soil animal communities within riparian zones is scarce. The soil fauna represents an important biotic component of the soil ecosystem and greatly contributes to soil structure and fertility formation. We investigated the richness, abundance, diversity, and distribution of soil animal groups, including macro- and mesofauna, in different riparian landscapes along an urban-rural habitat gradient. In natural riparian zones with permeable revetments, the soil fauna was richest and most abundant, mainly because of the low levels of human disturbance and the more suitable habitat conditions. Different soil animal groups responded differently to revetment type and distance from the water flow. The hygrophilous soil mesofauna, requiring a more humid environment, was more sensitive to shifts in revetment types, the location on the riverbank, and the seasons. In summer, when precipitation in the study area was highest, the abundance of the hygrophilous soil mesofauna was significantly higher than in autumn. Distance from the water flow significantly affected the abundance of the hygrophilous soil mesofauna. Our results demonstrated that hygrophilous soil mesofauna can serve as a good indicator in riparian zones, reflecting the hydrological conditions. We also observed interactions between revetment type and distance from the water flow; the distance effect was stronger in the natural riparian zone with a permeable revetment type. Our results highlight the importance of anthropogenic effects on soil ecosystem processes and functions in riparian landscapes, and the necessity of protecting and retaining the natural riverbank and native vegetation patches in riparian landscape planning and construction.

Intraperitoneally Delivered Mesenchymal Stem Cells Alleviate Experimental Colitis Through THBS1-Mediated Induction of IL-10-Competent Regulatory B Cells.

Mesenchymal stem cells (MSCs) show promising therapeutic potential in treating inflammatory bowel disease (IBD), and intraperitoneal delivery of MSCs have become a more effective route for IBD treatment. However, the underlying mechanisms are still poorly understood. Here, we found that intraperitoneally delivered MSCs significantly alleviated experimental colitis. Depletion of peritoneal B cells, but not macrophages, clearly impaired the therapeutic effects of MSCs. Intraperitoneally delivered MSCs improved IBD likely by boosting the IL-10-producing B cells in the peritoneal cavity, and a single intraperitoneal injection of MSCs could significantly prevent disease severity in a recurrent mouse colitis model, with lower proinflammation cytokines and high level of IL-10. The gene expression profile revealed that thrombospondin-1 (THBS1) was dramatically upregulated in MSCs after coculture with peritoneal lavage fluid from colitis mice. Knockout of THBS1 expression in MSCs abolished their therapeutic effects in colitis and the induction of IL-10-producing B cells. Mechanistically, THBS1 modulates the activation of transforming growth factor-ß (TGF-ß), which combines with TGF-ß receptors on B cells and contributes to IL-10 production. Blocking the interaction between THBS1 and latent TGF-ß or inhibiting TGF-ß receptors (TGF-ßR) significantly reversed the THBS1-mediated induction of IL-10-producing B cells and the therapeutic effects on colitis. Collectively, our study revealed that intraperitoneally delivered MSCs secreted THBS1 to boost IL-10+Bregs and control the progression and recurrence of colitis, providing new insight for the prevention and treatment of IBD.

Effects of Terlipressin on Management of Hypotensive Brain-Dead Patients Who are Potential Organ Donors: A Retrospective Study.

Background: Administration of terlipressin can reverse hypotension in potential organ donors with norepinephrine-resistance. The aim of this study was to determine the effects of terlipressin on the hemodynamics, liver function, and renal function of hypotensive brain-dead patients who were potential organ donors. Methods: A retrospective study was conducted by using the ICU database of one hospital. 18 patients in a total of 294 brain-dead cases were enrolled and administered terlipressin intravenously. All physiological parameters of recruited patients were obtained at baseline, 24 and 72 h after administration, and immediately before organ procurement. Results: Terlipressin induced significant increases in mean arterial pressure (MAP) from 69.56 ± 10.68 mm Hg (baseline) to 101.82 ± 19.27 mm Hg (immediately before organ procurement) and systolic blood pressure (SBP) from 89.78 ± 8.53 mm Hg (baseline) to 133.42 ± 26.11 mm Hg (immediately before organ procurement) in all patients. The increases in MAP were accompanied by significant decreases in heart rate (HR) from 113.56 ± 28.43 bpm (baseline) to 83.89 ± 11.70 bpm (immediately before organ procurement), which resulted in the decrease of norepinephrine dose over time from 0.8 ± 0.2 µg/kg/min (baseline) to 0.09 ± 0.02 µg/kg/min (immediately before organ procurement). There were no changes in central venous pressure, liver function including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and bilirubin. Renal function, assessed by serum creatinine (SCr), urine output (UOP), creatinine clearance rate (CCr), and estimated glomerular filtration rate (eGFR), improved significantly. Conclusion: Our analysis of brain-dead patients with hypotension indicates that administration of terlipressin can significantly increases MAP, SBP, UOP, CCr, and eGFR, while decreases HR and Scr. Terlipressin appears to help maintain hemodynamic stability, reduce vasoactive support, and improve renal function.

[Characteristics of soil animal community with different garden plants and various planting periods in Wenjiang District, Chengdu, China]. / æˆéƒ½å¸‚æ¸©æ±ŸåŒºä¸åŒæ ½æ¤å¹´é™å›­æž—æ¤ç‰©åœŸå£¤åŠ¨ç‰©ç¾¤è½ç‰¹å¾.

In order to provide scientific guidance for soil quality evaluation and optimum management of flower and seedling industry, we investigated the characteristics of soil animal community with different garden plants and various planting periods in Wenjiang District, Chengdu. A total of 10258 soil animals belonging to 26 orders and 78 families were captured in four sampling times. There were significant differences in the taxonomic richness in the plots with different garden plants, generally highest in plots with Loropetalum chinense var. rubrum or Ginkgo biloba and lowest in plot with Zoysia japonica. The taxonomic richness was lower in the plots with different garden plants than the control. Taxonomic richness and abundance of soil fauna in Osmanthus fragrans plot did not change across sampling seasons. The abundance but not taxonomic richness of soil fauna in other plots had obvious seasonal variations. Different garden plants and various planting periods significantly influenced soil faunal diversity indices. Density-group index (DG) and Margalef richness index (D) in G. biloba plot, as well as Shannon diversity index (H) and D index in Z. japonica plot decreased significantly with the increases of planting period. The DG and D indices of soil animals in O. fragrans plot increased significantly with increasing planting period. The indices of soil animal diversity in L. chinense var. rubrum plot did not change regularly with planting period. The DG, D, and H indices were lowest in O. fragrans plot with different planting periods. Results of hierarchical clustering and canonical correlation analyse (CCA) indicated that garden plant species had stronger effects on the habitat than planting period. Responses of soil fauna to various habitats were different, with available P and soil pH having stronger effects on soil fauna. Our results indicated that soil animal community shifted with the changes of garden plant and planting period as well as management and cultivation methods. Excessive human interference and monoculture had negative effects on soil animal community and caused soil degradation.

MiRNA-133a aggravates inflammatory responses in sepsis by targeting SIRT1.

BACKGROUND: Sepsis is a systemic inflammatory response syndrome. MicroRNA (miRNA) plays an important role in immune cell activation, inflammatory cytokine release and immune response. However, the mechanism of miR-133a in sepsis remains largely unknown. METHODS: Sepsis mice models were established by applying the cecal ligation and puncture (CLP) method. Quantitative real-time polymerase chain reaction (qRT-PCR) assay was performed to detect the relative expression of miR-133a and inflammatory cytokines. Hematoxylin and eosin (H&E) staining and enzyme-linked immunosorbent assay (Elisa) were used to evaluate organ injury and inflammatory response. Besides, lipopolysaccharide (LPS)-induced RAW264.7 macrophages were used to construct sepsis cell models. Further, dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay were carried out to confirm the relationship between miR-133a and sirtuin-1 (SIRT1). In addition, western blot (WB) assay was performed to measure the relative SIRT1 protein level. RESULTS: MiR-133a was highly expressed in sepsis patients and CLP mice models. Knockdown of miR-133a inhibited sepsis-induced lung, liver and kidney injuries and inflammatory response in CLP mice models. Besides, miR-133a inhibitor also alleviated the inflammatory response of RAW264.7 macrophages induced by LPS. SIRT1 was a target of miR-133a, and silenced SIRT1 could reverse the anti-inflammatory effect of miR-133a inhibitor on LPS-induced sepsis cell models. CONCLUSION: MiR-133a promoted the inflammatory response of sepsis by inhibiting the expression of SIRT1, which might provide a new therapeutic strategy for sepsis.

Silencing of long non-coding RNA MALAT1 suppresses inflammation in septic mice: role of microRNA-23a in the down-regulation of MCEMP1 expression.

OBJECTIVE: Sepsis is a life-threatening disease without ideal biomarkers. Some long non-coding RNAs (lncRNAs) are found to be implicated in sepsis. Thus, we investigated the effects of lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) on inflammation in septic mice and the potential mechanisms of the MALAT1/microRNA-23a (miR-23a)/MCEMP1 axis. METHODS: The sepsis mice model was generated by cecal ligation and puncture (CLP). Then the expressions of lncRNA MALAT1, mast cell-expressed membrane protein 1 (MCEMP1), and miR-23a in septic mice were determined. The interaction between lncRNA MALAT1, miR-23a and MCEMP1 was confirmed. Loss- and gain-of-function approaches were used to verify the roles of the lncRNA MALAT1, miR-23a, and MCEMP1 in inflammation, cell proliferation and apoptosis in septic mice. RESULTS AND CONCLUSION: The myeloperoxidase (MPO) activity and the expression of interleukin 6 (IL-6), IL-1ß, IL-10, and tumor necrosis factor-α (TNF-α) were detected. High expression of the lncRNA MALAT1 and MCEMP1, as well as low expression of miR-23a, was observed in septic mice. LncRNA MALAT1 competitively bound to miR-23a, and miR-23a targeted MCEMP1. Moreover, the down-regulation of lncRNA MALAT1 repressed the expression of MPO, IL-6, IL-10, TNF-α, and IL-1ß. Silencing of lncRNA MALAT1 or overexpression of miR-23a reduced inflammation, inhibited cell proliferation, and promoted cell apoptosis in septic mice. Taken together, MALAT1 promotes the inflammation in septic mice by binding to miR-23a to up-regulate MCEMP1. Therefore, silencing of lncRNA MALAT1 might provide a novel therapeutic target for sepsis.

The Accuracy of Urinary TIMP-2 and IGFBP7 for the Diagnosis of Cardiac Surgery-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis.

BACKGROUND: Tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP7) are recent promising markers for identification of cardiac surgery-associated acute kidney injury (CSA-AKI). The aim of this study was systematically and quantitatively to evaluate the accuracy of urinary TIMP-2 and IGFBP7 for the diagnosis of CSA-AKI. METHODS: Three databases including PubMed, ISI web of knowledge, and Embase were systematically searched from inception to March 2018. Two investigators conducted the processes of literature search study selection, data extraction, and quality evaluation independently. Meta-DiSc and STATA were used for all statistical analyses. RESULTS: A total of 8 studies comprising 552 patients were included in this meta-analysis. Pooled sensitivity and specificity with corresponding 95% confidence intervals (CIs) were 0.79 (95% CI, 0.71-0.86, I 2 = 74.2%) and 0.76 (95% CI, 0.72-0.80, I 2 = 80.8%), respectively. Pooled positive likelihood ratio (LR), negative LR, and diagnostic odds ratio were 3.49 (95% CI, 2.44-5.00, I 2 = 61.5%), 0.31(95% CI, 0.19-0.51, I 2 = 51.8%), and 14.89 (95% CI, 7.31-30.32, I 2 = 27.9%), respectively. The area under curve estimated by summary receiver operating characteristic was 0.868 (standard error [SE] 0.032) with a Q* value of 0.799 (SE 0.032). Sensitivity analysis demonstrated that one study notably affected the stability of pooled results. One of the subgroups investigated-AKI threshold-could account for partial heterogeneity. CONCLUSION: Urinary TIMP-2 and IGFBP7 is a helpful biomarker for early diagnosis of CSA-AKI. And, the potential of this biomarker with a broader spectrum of clinical settings may be the focus of future studies.

Higher vs. Lower DP for Ventilated Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis.

OBJECTIVES: Driving pressure (DP) has recently become a promising mediator for the identification of the effects of mechanical ventilation on outcomes in acute respiratory distress syndrome (ARDS). The aim of this study was to systematically and quantitatively update and assess the association between DP and mortality among ventilated patients with ARDS. METHODS: PubMed, the Cochrane Library, ISI Web of Knowledge, and Embase were systematically searched from inception to June 2018. Two investigators conducted the literature search study selection, data extraction, and quality evaluation independently. RevMan 5.3 software was used for all statistical analyses. RESULTS: A total of seven studies comprising 8010 patients were included in this meta-analysis. Higher DP showed a significant association with higher mortality (pooled risk ratio, 1.10; 95% [CI], 1.05-1.16; I 2 =58%). Sensitivity analysis indicated that one study significantly affected the stability of pooled results. One of the subgroups investigated, ARDS severity, could account for the heterogeneity. An exploratory post hoc subgroup analysis and higher DP significantly increased mortality in the mild to severe ARDS subgroup (RR 1.28; 95% [CI], 1.14-1.43; I 2 =0), but not in the moderate to severe ARDS subgroup (RR 1.18; 95% [CI], 0.95-1.46; I 2 =52%). CONCLUSION: Higher DP was significantly associated with an increased risk of death among ventilated patients with ARDS. But it did not seem to predict prognosis to moderate to severe ARDS. Future prospective randomized clinical trials are needed to verify the results of this meta-analysis and address the unresolved questions about optimum cutoff values for DP. TRIAL REGISTRATION: This trial is registered with PROSPERO (CRD42018102146), on 11 August 2018.

Early extubation after thymectomy is good for the patients with myasthenia gravis.

OBJECTIVES: Patients with myasthenia gravis (MG) often benefit from thymectomy, but the optimal timing of extubation following thymectomy in these patients remains unknown. This study of MG patients compared the effect of early and late extubation following thymectomy on clinical outcome. METHODS: We performed a study of data from 96 patients with MG who received thymectomy procedures, followed by early (< 6 h) or late (> 6 h) extubation, at our institution between October 2011 and November 2017. Patient clinical and demographic characteristics, preoperative data, and postoperative clinical outcomes were analyzed. Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. RESULTS: The patients in the early extubation group (n = 53) and late extubation group (n = 43) had similar preoperative clinical and demographic characteristics. However, the early extubation group had a significantly longer duration of MG (24 months vs. 12 months, P < 0.013) and a lower incidence of reintubation (11.3% vs. 37.2%, P = 0.003). Postoperative pulmonary infection was significantly more common in the late extubation group (39.5% vs. 11.3%, P = 0.001; adjusted odds ratio = 6.94, 95% CI 1.24-38.97). Also, patients in the late extubation group had a longer duration of ICU stay (6.4 ± 4.0 h vs. 4.3 ± 1.8 h; P = 0.003) and had a longer adjusted duration of ICU stay by 0.93 days (95% CI 0.02-1.85). CONCLUSIONS: Our analysis of patients with MG who received thymectomy procedures indicated that early extubation was associated with improved clinical outcomes, in particular with reduced risk of postoperative pulmonary infection and reduced ICU stay.

Relationship between cytotoxic T-lymphocyte antigen 4 -318C/T (rs5742909) gene polymorphism and the risk of acute rejection in renal transplantation.

Results on the relationship between CTLA4 -318C/T (rs5742909) gene polymorphism and risk of acute rejection in renal transplantation are still conflicting. This meta-analysis was performed to update the association between CTLA4 -318C/T and risk of acute rejection in renal transplantation. The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. Twelve reports were included in this meta-analysis for the association of CTLA4 -318C/T gene polymorphism with acute rejection risk in renal transplantation, consisting of 728 acute rejection patients and 1628 non-acute rejection controls. The association between CTLA4 -318C/T gene polymorphism and acute rejection risk in renal transplantation for overall populations was not found in this meta-analysis (T allele: OR=0.96, 95% CI: 0.60-1.54, P=.88; TT genotype: OR=0.90, 95% CI: 0.47-1.71, P=.74; CC genotype: OR=1.00, 95% CI: 0.62-1.59, P=.98). Interestingly, T allele was associated with the risk of acute rejection in renal transplantation in African population. In conclusion, CTLA4 -318C/T gene polymorphism is not associated with the risk of acute rejection in renal transplantation in overall populations.

Association of cytotoxic T-lymphocyte antigen 4 +49A/G gene polymorphism with acute rejection risk in renal transplantation.

The conclusions on the association between cytotoxic T-lymphocyte antigen 4 (CTLA4) +49A/G gene polymorphism and acute rejection risk in renal transplantation are still debated. This meta-analysis was performed to update the association between CTLA4 +49A/G and acute rejection risk in renal transplantation. The association investigations were identified from PubMed and Cochrane Library, and eligible studies were included and synthesized using meta-analysis method. Fourteen reports were included into this meta-analysis for the association of CTLA4 A/G gene polymorphism and acute rejection risk in renal transplantation, consisting of 962 acute rejection patients and 2084 non-acute rejection controls. The association between CTLA4 G allele/GG genotype and acute rejection risk in renal transplantation was found in this meta-analysis (G allele: OR=1.21, 95% CI: 1.03-1.44, P=.02; GG genotype: OR=1.37, 95% CI: 1.10-1.69, P=.004). However, the AA genotype was not associated with acute rejection risk in renal transplantation. In conclusion, CTLA4 G allele/GG genotype is associated with the acute rejection risk in renal transplantation.

[Intensive care unit survey of cognition status of donation after brain death].

OBJECTIVE: To explore the development approach of donation after brain death through analyzing the cognition status of donation after brain death among medical staff and potential donor (PD) family members of intensive care unit (ICU). METHODS: Analysis was conducted for the cognition of donation after brain death among 149 ICU professionals and 879 PD family members at 89 hospitals from July 2011 to April 2013. RESULTS: Medical staff: 100% (149/149) recognized the significance of donation after brain death, 96.6% (144/149) approved of donation after brain death, 85.9% (128/149) knew about brain death criteria, 94.0% (140/149) accepted the equivalence of brain death as death. Awareness of standard of potential donor: 13.4% (20/149) were aware of donation age, 40.9% (61/149) familiar with the donation criteria of liver and kidney function and 44.3% (66/149) knew the hepatitis B donation criteria. Necessity of brain death legislation: 79.2% (118/149) considered it necessary, 14.8% (22/149) unimportant and 6.0% (9/149) not necessary. How to manage donation after brain death: 43.6% (65/149) did not know how, 79.2% (118/149) were afraid and 30.9% (46/149) never considered. Family members: 0/879 knew about brain death, 98.6% (867/879) accepted the equivalence of brain death as death, 99.5% (875/879) approved the significance of donation after brain death and 47.0% (413/879) agreed with donation after brain death. The reasons for approving the significance of donation after brain death but not agreeing with donation: 80.5% (372/462) required a full corpse after death and 19.5% (90/462) for other reasons. Reasons for agreeing with donation but refuse: 50.1% (207/413) were opposed by other family members, 11.4% (47/413) beware of neighbors' chat about their organ trading, 9.2% (38/413) hoped to be paid and 8.0% (33/413) for the others. CONCLUSIONS: The cognitive deficits of donation after brain death for medical staff and family members, medical staff's worries about brain death legislation and traditional thoughts of family members are the main reasons for a low conversion rate of PD. A professional transplant coordinating team should be built for national organ donation knowledge education.

[The study of the risk factors of fungal infection after liver transplantation].

OBJECTIVE: To explore the risk factors of fungal infection so as to provide rationales for the prevention of fungal infection after liver transplantation. METHODS: The clinical data of 94 cases of fungal infections after liver transplantation from January 1, 2003 to November 30, 2010 at our hospital were collected as the infective group. A total of 603 liver transplant patients without fungal infections during the same period were selected as the control group. χ(2) test and t test were utilized for the analysis of possible risk factors for fungal infection. RESULTS: Fungal infection rate was 13.5% (94/697) after liver transplantation and mortality rate of fungal infection 86.2% (81/94). Candida albicans was the majority infective fungi. And the main site of infection was the lungs. The postoperative acute physiology and chronic health evaluation III (APACHE III) score of the infective group was significantly higher than that of the control group (26.0 ± 5.4 vs 21.5 ± 4.7, P < 0.01). The number of patients with primary liver cancer was lower than that of the control group (26.6% vs 45.8%, P < 0.01). The number of decompensated HBV cirrhosis and diabetics in the infective group was higher than that of the control group at pre-operation (23.4% vs 11.6%, 9.6% vs 2.8%, both P < 0.01). The number of patients with postoperative mechanical ventilation over 10 days, postoperative antibiotics over 14 days, postoperative cardiopulmonary dysfunction and liver function recovery time over 7 days, parenteral nutrition over 12 days and hyperglycemia over 7 days in the infective group were significantly higher than that in the control group (all P < 0.01). CONCLUSION: Preoperative primary disease, postoperative disease severity, postoperative organ dysfunction, long-term mechanical ventilation, antibiotics and hyperglycemia, etc. may be the important risk factors of fungal infection after liver transplantation.

Fungal infection in patients after liver transplantation in years 2003 to 2012.

BACKGROUND: Fungal infections after liver transplantation have received considerable interests because of their association with substantial morbidity and mortality. This study investigated risk factors of fungal infection after liver transplantation. MATERIAL/METHODS: Retrospective analysis was performed based on clinical data from 120 patients with fungal infection after liver transplantation from January 1, 2003 to May 30, 2012. χ2 test was used to analyze risk factors for fungal infections. RESULTS: The fungal infection rate after liver transplantation is 13.5% (120/886) and the case fatality rate reaches 70.8%; most are infected by Candida albicans (67.5%), with infection located in the lung (73.3%). Acute physiology and chronic health evaluation scores of the infected group are higher than those of the control group 24 hours after the surgery (27.1±5.2 vs. 21.9±5.0). The percentage of primary liver cancer patients in the infected group was lower than in the control group (26.7% vs. 45.8%). Compared to the control group, the infected group had a higher percentage of patients with HBV, gestational diabetes mellitus, and multiple organ dysfunction syndrome. Percentages of patients with long continuous parenteral nutrition time, poorly controlled high blood sugar, long-term mechanical ventilation, and antibiotics use were higher in the infected group than in the control group. CONCLUSIONS: Preoperative original attack, postoperative critical condition, chronically high blood sugar, long-term use of antibiotics, and mechanical ventilation are probably vital risk factors for fungal infection after liver transplantation.