Unveiling the heightened susceptibility: Exploring early hypophosphatemia in critically ill trauma patients.

BACKGROUND: Phosphorus is a vital mineral crucial for various physiological functions. Critically ill trauma patients frequently experience hypophosphatemia during the immediate post-traumatic phase, potentially impacting outcomes. This study aims to investigate the incidence of early hypophosphatemia in critically major trauma patients. METHODS: In this prospective observational study, trauma patients admitted to the intensive care unit (ICU) within one day were enrolled. These patients were categorized into Hypo-P groups and Non-hypo groups based on the development of new-onset hypophosphatemia within 72 h after feeding. The primary outcome assessed was the incidence of new-onset hypophosphatemia. The secondary outcomes included ICU and hospital stay, ventilation duration, and mortality. RESULTS: 76.1% of patients developed a new onset of hypophosphatemia within 72 h after feeding. The Hypo-P group had significantly longer ICU stays (8.1 days ± 5.5 vs. 4.4 days ± 3.1; p = 0.0251) and trends towards extended hospital stay, ventilation duration, and higher mortality. Additionally, they demonstrated significantly higher urine fractional excretion of phosphate (FEPO4) on the first ICU day (29.2% ± 14.23 vs. 19.5% ± 8.39; p = 0.0242). CONCLUSION: Critically ill trauma patients exhibited a significantly higher incidence of early hypophosphatemia than typical ICU rates, indicating their heightened vulnerability. The significantly high urine FEPO4 underscores the crucial role of renal loss in disrupting phosphate metabolism in this early acute phase after trauma. A significant correlation was observed between hypophosphatemia and longer ICU stays. Monitoring and managing phosphate levels may influence outcomes, warranting further investigation.

Clinical significance of WT1 in the evaluation of therapeutic effect and prognosis of non-M3 acute myeloid leukemia.

To explore the clinical significance and prognosis of acute myeloid leukemia (AML) patients with WT1 mutations.In total, the clinical data of 269 adult patients with non-M3 AML were considered retrospectively. From these patients, 153 carried WT1 mutation whereas 116 were negative. WT1 mutation positive patients were further divided into WT1 low expression and high expression groups base on the expression level of WT1 by qPCR at diagnosis (cut off: 170500). Survival and therapeutic effect analysis were performed for the above patients with different interfering factors such as co-mutations, the extent of WT1 log reduction and the chemotherapy regimens. Patients with high WT1 expression have higher rate of relapse. We can accurately identify patients with inferior outcomes when we take the following factors into consideration: the WT1 expression level at diagnosis; different prognostic factors including co-mutations (especially NPM1 and FLT3-ITD); the log reduction of WT1 after induction therapy and the risk of stratification. Idarubicin + Cytarabine (IA) regimen could reduce the expression level of WT1 after treatment, and Allo-HSCT played an important role in improving the prognosis of patients with WT1 high expression and patients with WT1 negativity. Among the relapsed patients, there existed a rising trend of WT1-MRD in advance than MFC-MRD and that of patients with continuous complete remission (CR). Different clinical background should be taken into consideration when we judge the prognosis and therapeutic effect of patients with WT1 mutations. In addition, WT1 may be an optional MRD marker, which needs regular monitoring.

Design, Synthesis, and Antifungal Activity of Some Novel Phenylthiazole Derivatives Containing an Acylhydrazone Moiety.

Crop fungal diseases pose a serious threat to global crop production and quality. Developing new and efficient fungicides is an important measure to control crop diseases. Phenylthiazole was found to be an excellent antifungal skeleton based on our previous study on the structural optimization and biological activity of the natural product thiasporine A. To find new fungicides, 45 phenylthiazole derivatives containing an acylhydrazone moiety were designed and synthesized by the principle of active substructure splicing. Forty-two of the forty-five compounds are novel, except for compounds E1, E14, and E33. Their structures were structurally characterized by 1H NMR, 13C NMR, and HRMS. The antifungal activities of the target compounds against Magnaporthe oryzae Colletotrichum camelliaet, Bipolaris maydis, and Sclerotinia sclerotiorum were evaluated at 25 µg/mL. The bioassay results revealed that most of these compounds exhibited excellent antifungal activities against M. oryzae and C. camelliaet at 25 µg/mL. In particular, compounds E4, E10, E14, E17, E23, E26, and E27 showed the inhibition rate of more than 80% against M. oryzae, with EC50 values of 1.66, 2.01, 2.26, 1.45, 1.50, 1.29, and 2.65 µg/mL, respectively, which were superior to that of the commercial fungicides Isoprothiolane (EC50 = 3.22 µg/mL) and Phenazine-1-carboxylic acid (EC50 = 27.87 µg/mL). The preliminary structure-activity relationship (SAR) results suggested that introducing methyl, halogen, or methoxy at the ortho-position of R1 and the para-position of R2 can endow the final structure with excellent antifungal activity against M. oryzae. The current results provide useful data for developing phenylthiazole derivatives as new fungicides for controlling rice blast caused by M. oryzae.

The use of immobilised bacteria cross-linked within magnetic alginate beads enhances the treatment of benzophenone-type UV filter chemicals by the SBR system.

Benzophenone-n compounds (BPs) are applied in a broad spectrum of commercial products, one of which is sunscreen. These chemicals are frequently detected in a variety of environmental matrices worldwide, especially water bodies. BPs are defined as emerging contaminants as well as endocrine-disrupting contaminants; thus, it has become necessary to develop aggressive and green treatments to remove BPs. In this study, we used immobilised BP-biodegrading bacteria linked to reusable magnetic alginate beads (MABs). The MABs were added to a sequencing batch reactor (SBR) system to enhance the removal of 2,4-dihydroxybenzophenone (BP-1) and oxybenzone (BP-3) from sewage. The BP-1 and BP-3 biodegrading bacteria in the MABs consisted of strains from up to three genera to allow for efficient biodegradation. The strains used were Pseudomonas spp., Gordonia sp., and Rhodococcus sp. The optimal composition of the MABs consisted of 3% (w/v) alginate and 10% (w/v) magnetite. The MABs resulted in 60.8%-81.7% recovery by weight after 28 days, and there was a continuous release of bacteria. Moreover, the biological treatment of the BPs sewage improved after adding 100 g of BP1-MABs (1:27) and also 100 g BP3-MABs (1:27) into the SBR system at a hydraulic retention time (HRT) of 8 h. Compared with the SBR system without MABs, the removal rates of BP-1 and BP-3 increased from 64.2% to 71.5% and from 78.1% to 84.1%, respectively. Furthermore, the COD removal increased from 36.1% to 42.1%, and total nitrogen increased from 30.5% to 33.2%. Total phosphorus remained constant at 29%. The bacterial community analysis showed that the Pseudomonas population was <2% before the MAB addition, but increased to 56.1% by day 14. In contrast, the Gordonia sp. And Rhodococcus sp. Populations (<2%) remained unchanged throughout the 14-day treatment period.

An immune risk score predicts survival of patients with diffuse large B-cell lymphoma.

PURPOSE: Providing accurate prognostic models is necessary for diffuse large B-cell lymphoma, but there are still many uncertainties. So far, none of the models include immune cells. Therefore, an immune risk score was constructed to predict the survival of patients. METHODS: CIBERSORTx was chosen to estimate the proportion of 22 human immune cell subsets from public datasets and generate an immune risk score to predict patients' survival in a training cohort using the least absolute shrinkage and selection operator (LASSO) Cox regression model. RESULTS: The prognostic model had high predictive ability in the training and validation cohorts. Subjects in the training cohort with high scores had a worse prognosis compared with subjects with low scores. The same result was also found in the three validation cohorts. Multivariable analysis suggested that the immune risk score was an independent prognostic factor. The merged score, including the immune risk score and the international prognostic index (IPI) risk category, had better predictive accuracy. CONCLUSIONS: Our immune risk score promises to be a complement to current prognostic models.

The Risk Factors for Cervical Cytological Abnormalities Among Women Infected With Non-16/18 High-Risk Human Papillomavirus: Cross-sectional Study.

BACKGROUND: High-risk human papillomavirus (hrHPV) infection is a necessary cause of almost all cervical cancers. Relative to hrHPV 16/18 infection, non-16/18 hrHPV infection is of less concern. However, the increasing prevalence of non-16/18 hrHPV infections has become an important public health issue. The early identification and treatment of cervical cytological abnormalities in women infected with non-16/18 hrHPV reduces the incidence of cervical cancer. To date, no study has examined the risk factors for cytological abnormalities in this high-risk population. OBJECTIVE: This population-based, cross-sectional study aimed to identify the risk factors for cervical cytological abnormalities in women infected with non-16/18 hrHPV. METHODS: A total of 314,587 women from the general population were recruited for cervical cancer screening at 136 primary care hospitals in Xiangyang, China. Of these, 311,604 women underwent HPV genotyping, and 17,523 non-16/18 hrHPV-positive women were referred for cytological screening according to the screening program. A logistic regression model was used to assess the risk factors for cytological abnormalities among these non-16/18 hrHPV-positive women. A separate analysis was performed to determine the factors influencing high-grade cytological abnormalities. RESULTS: The non-16/18 hrHPV infection rate was 5.88% (18,323/311,604), which was 3-fold higher than that of hrHPV 16/18 (6068/311,604, 1.95%). Among the non-16/18 hrHPV-positive women who underwent ThinPrep cytologic test, the overall prevalence rates of cervical cytological abnormalities and high-grade cytological abnormalities were 13.46% (2359/17,523) and 1.18% (206/17,523), respectively. Multivariate logistic regression analysis revealed that women with middle or high school educational attainment were at a higher risk of having cytological abnormalities than those who received primary education (odds ratio [OR] 1.31, 95% CI 1.17-1.45; P<.001, and OR 1.32, 95% CI 1.14-1.53; P<.001, respectively). Living in rural areas (OR 2.58, 95% CI 2.29-2.90; P<.001), gravidity ≥3 (OR 2.77, 95% CI 1.19-6.45; P=.02), cervix abnormalities detected in pelvic examination (OR 1.22, 95% CI 1.11-1.34; P<.001), and having a cervical cancer screening 3 years ago (OR 0.79, 95% CI 0.62-1.00; P=.048) were associated with cytological abnormalities. The risk factors for high-grade cytological abnormalities included middle school education (OR 1.45, 95% CI 1.07-1.98; P=.02), living in rural regions (OR 1.52, 95% CI 1.10-2.10; P=.01), and cervix abnormality (OR 1.72, 95% CI 1.30-2.26; P<.001). CONCLUSIONS: The dominant epidemic of non-16/18 hrHPV infection is revealed in Chinese women. Multiple risk factors for cervical cytological abnormalities have been identified in women infected with non-16/18 hrHPV. These findings can provide important information for clinically actionable decisions for the screening, early diagnosis, intervention, and prevention of cervical cancer in non-16/18 hrHPV-positive women.

Applying the Student Response System in the Online Dermatologic Video Curriculum on Medical Students' Interaction and Learning Outcomes during the COVID-19 Pandemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic impacted medical education worldwide. Online lecture is increasingly prevalent in higher education, but students' completion rate is quite low. Aims: This study aimed to determine the effectiveness of the student response system (SRS) in the online dermatologic video curriculum on medical students. Methods: A prospective study was conducted on 176 undergraduate fourth-year medical students. The online video lecture was integrated with SRS. Results: A total of 173 students completed the pre-test, and the attendance rate (pre-test/total) was 98.3%. A total of 142 students completed the post-test, and the completion rate (post-test/pre-test) was 82.8%. The post-test score (83.69 ± 4.34) was found to be significantly higher than that of the pre-test (62.69 ± 6.08, P =0.0002). A total of 138 students completed the questionnaire, and 92% of students opined that SRS was easy to operate. 86% of students agreed with the fact that the use of SRS could increase their learning performance by interacting with teachers. In the open-ended question, students stated that SRS offered opportunities for student-faculty interaction, allowed them to get immediate feedback, and promote active participation. Conclusions: These results highlight that the integration of SRS in the online video curriculum increases students' completion rates and learning outcomes. Moreover, the SRS is easy to operate for the students and enhances student-faculty interaction. The SRS may be adopted in online learning during this challenging time.

Degradation of Decabromodiphenyl Ether in an Aerobic Clay Slurry Microcosm Using a Novel Immobilization Technique.

A novel chitosan immobilization technique that entraps photocatalyst and microbes was developed and applied to decompose decabromodiphenyl ether (BDE-209) in a clay slurry microcosm. The optimized conditions for immobilization were obtained by mixing 1.2% (w/v) chitosan dissolved in 1% (v/v) acetic acid with nano-TiO2 particles and the BDE-209-degrading bacterial mixed culture. This aqueous mixture was injected into 1% (w/v) water solution containing sodium tripolyphosphate to form spherical immobilized beads. The surface of the immobilized beads was reinforced by 0.25% (v/v) glutaraldehyde cross-linking. These beads had enough mechanical strength during BDE-209 degradation to maintain their shape in the system at a stirring rate of 200-rpm, while undergoing continuous 365 nm UVA irradiation. This novel TiO2-Yi-Li immobilized chitosan beads system allowed a successful simultaneous integration of photolysis, photocatalysis and biodegradation to remove BDE-209. The remaining percentage of BDE-209 was 41% after 70 days of degradation using this system. The dominant bacteria in the BDE-209-degrading bacterial mixed culture during remediation were Chitinophaga spp., Methyloversatilis spp., Terrimonas spp. and Pseudomonas spp. These bacteria tolerated the long-term UVA irradiation and high-level free radicals present, while utilizing BDE-209 as their primary carbon resource. This new method has great potential for the treatment of a range of pollutants.

Clinical values of gene alterations as marker of minimal residual disease in non-M3 acute myeloid leukemia.

Acute myeloid leukemia (AML) is a malignant disease of the hematopoietic system. Residual leukemic cells after treatment are associated with relapse. Thus, detecting minimal residual disease (MRD) is significant. Major techniques for MRD assessment include multiparameter flow cytometry (MFC), polymerase chain reaction (PCR), and next-generation sequencing (NGS). At a molecular level, AML is the consequence of collaboration of several gene alterations. Some of these gene alterations can also be used as MRD markers to evaluate the level of residual leukemic cells by PCR and NGS. However, when as MRD markers, different gene alterations have different clinical values. This paper aims to summarize the characteristics of various MRD markers, so as to better predict the clinical outcome of AML patients and guide the treatment.

Effect of electrically stimulating acupoint, Zusanli (ST 36), on patient's recovery after laparoscopic colorectal cancer resection: a randomized controlled trial.

OBJECTIVE: To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on enhanced recovery after surgery (ERAS) in laparoscopic colorectal cancer resection and its clinical significance. METHODS: Sixty-four patients undergoing laparoscopic colorectal resection were randomly divided into two groups, the control group (group A) and the TEAS group (group B). Patients in the TEAS group received electroacupuncture stimulation of bilateral Zusanli (ST 36) at 30 min before anesthesia to the end of surgery. The patients in the control group were not given the stimulation. Perioperative anesthesia management of the two groups were performed according to the ERAS guidelines, and postoperative patient-controlled intravenous analgesia (PCIA) was used. The amount of remifentanil used in the two groups was observed and recorded, and the visual analogue scale (VAS) of the 4, 12, 24 and 48 h after surgery in the two groups was recorded. Moreover, postoperative anal exhaust time, postoperative feeding time, postoperative first ambulation time and postoperative hospital stay length were compared between the two groups. RESULTS: Compared with group A, the VAS score of group B decreased significantly at 48 h after operation (P < 0.05). The postoperative anal exhaust time in group B was significantly shorter than that of group A (P < 0.05). There was no significant difference between the two groups with regards to remifentanil consumption, postoperative feeding time, postoperative first ambulation time and postoperative hospital stay (all P > 0.05). CONCLUSION: TEAS can promote the recovery of postoperative gastrointestinal function and reduce the pain intensity 48 h after surgery, thus satisfying the need of early postoperative analgesia.

[Application of Transcutaneous Electrical Acupoint Stimulation Combined with Transversus Abdominis Plane Block to Enhanced Recovery After Surgery in Patients Undergoing Laparoscopic Colorectal Cancer Resection: A Randomized Controlled Clinical Trial].

OBJECTIVE: To explore the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with transversus abdominis plane (TAP) block in the enhanced recovery after surgery (ERAS) in patients undergoing laparoscopic colorectal cancer resection (LCCR). METHODS: A total of 101 patients undergoing LCCR were randomly divided into three groups: control (n＝34), TAP (n＝35) and TEAS＋TAP (n＝32). Conventional perioperative anesthesia management of the 3 groups was performed according to the ERAS guidelines. All the patients experienced patient controlled epidural analgesia (PCEA), and those of the TAP and TEAS＋TAP groups received TAP block by injection of 0.3% Roperca hydrochloride (15 mL) into the space between the internal oblique and the transverse abdominis after induction of anesthesia. For patients of the TEAS＋TAP group, TEAS (2 Hz/10 Hz, an endurable stimulation strength) was applied to bilateral Zusanli (ST 36) from 30 min before anesthesia to the end of the surgery. The blood glucose value and dosage of Remifentanil used were recorded. The pain severity was assessed at 4, 12, 24 and 48 h after surgery by using visual analogue scale (VAS). Moreover, postoperative anal exhaust time, postoperative oral feeding time, postoperative first ambulation time and postoperative hospital stay length were recorded. RESULTS: The total dosages of Remifentanil used during surgery, and the blood glucose levels were significantly lower in the TAP and TEAS＋TAP groups than in the control group (P<0.05), but had no significant differences between the TAP and TEAS＋TAP groups (P>0.05). The VAS scores of the TAP and TEAS＋TAP groups were considerably lower than those of the control group at 4, 12, 24 and 48 h after surgery (P<0.05, except 48 h of TAP group). Of the 34, 35 and 32 cases in the control, TAP and TEAS＋TAP groups, 5(14.7%), 3(8.6%) and 1(3.1%) on the 1st day post-surgery, and 2(5.9%), 0(0) and 0(0) on the 2nd day after surgery experienced nausea and vomiting. The postoperative anal exhaust time and postoperative oral feeding time were significantly earlier in both TAP and TEAS＋TAP groups than in the control group (P<0.05), and the exhaust time of the TEAS＋TAP group was even earlier than that of the TAP group (P<0.05). No significant differences were found among the 3 groups in the postoperative ambulation time and postoperative hospitalization time (P>0.05). CONCLUSION: TEAS combined with TAP block analgesia is superior to simple TAP block analgesia in relieving postoperative pain, shortening the recovery time of gastrointestinal function and promoting postoperative rehabilitation in patients undergoing LCCR.

A colorimetric assay for vanillin detection by determination of the luminescence of o-toluidine condensates.

Vanillin (4-hydroxy-3-methoxybenzaldehyde), a food additive with rich milk flavor, is commonly used in the food, beverage and cosmetic industries. However, excessive consumption of vanillin may cause liver and kidney damage. Therefore, methods for detecting and controlling the level of vanillin in food, especially in infant powder, have important practical significance. In this study, we established a colorimetric assay for vanillin detection. The detection was performed under high-temperature and acidic conditions, which can induce the reaction of the aldehyde group of vanillin with the amino group of o-toluidine. The resulting product had a maximum absorption at 363 nm, which was quantified by a UV spectrophotometer. This assay had a limit of detection (LOD) of 1 pg mL-1 and a linear range between 1 µg mL-1 and 100 µg mL-1. The average recoveries at three spiked levels were in the range from 91.1% to 101.6% with a relative standard deviation (RSD) of 4.62% ~ 7.27%.

A simple in vitro tumor chemosensitivity assay based on cell penetrating peptide tagged luciferase.

The analysis of intracellular ATP can reveal the response of cells to different treatments and is important for individualized medicine. In the present study, we developed a cell penetrating peptides (CPPs) tagged luciferase (TAT-LUC) for tumor chemosensitivity assay. The activity of recombinant TAT-LUC was evaluated using ATP standard solution and tumor cells. This recombinant TAT-LUC was then used for the analysis of sensitivity index (SI) of four strains of tumor cells. The results showed that TAT-LUC could detect less than 10 nM extracellular ATP with a strong correlation between the luminescence intensity and the ATP content (R2 = 0.994). Without cell lysis, the detection limit for intracellular ATP analysis was 40 tumor cells. Furthermore, chemosensitivity of four strains of tumor cells (Skov-3/DDP, A549/DDP, MDA-MB-231, Huh-7) was determined by this assay successfully. The cell penetration ability of TAT-LUC enables the assay not only to reflect drug resistance of tumor cells real-timely but also to minimize the test time, which can be a valuable aid for personalized cancer chemotherapy.

Nanopolymeric micelle effect on the transdermal permeability, the bioavailability and gene expression of plasmid.

This study attempts to investigate the transdermal permeability, the bioavailability and gene expression of plasmid formulated with nonionic poly(ethylene oxide)-poly(propylene oxide)-poly(ethylene oxide) (PEO-PPO-PEO) polymeric micelles (PM). Dynamic light scattering (DLS) and atomic force microscopy (AFM) were used to analyze the PM formulated pCMV-Lac Z (P/PM) containing the gene for ß-galactosidase (ß-Gal) driven by cytomegalovirus early promoter. Franz diffusion cell was used for in vitro transdermal permeability analysis. Real-time PCR was used to quantify the permeated plasmid in vitro and in vivo. ß-Gal activity assay was performed to evaluate transgene expression in vivo. The size of P/PM was ~50 nm with round shape. PM significantly enhanced the in vitro transdermal permeability of plasmid in a direction- and temperature-dependent manner. Following transdermal application of P/PM, higher area under the curve (AUC(P/PM): 98.34 h·ng/mL) and longer half-life of plasmid were detected compared with that of plasmid alone (AUC(P): 10.12 h·ng/mL). Additionally, the ß-Gal activity was significantly increased in skin, stomach, brain and spinal cord at both 48 and 72 h after P/PM application and in testis and spleen at 72 h postapplication. In conclusion, PM formulation enhanced the permeation of plasmid through skin into blood circulation, increasing its absorption and the transgene expression in various tissues.