BACKGROUND Sepsis is a common disease in intensive care units,with high morbidity and mortality.Intestinal microecology plays a vital part in the development and progression of this disease,possibly because sepsis and...BACKGROUND Sepsis is a common disease in intensive care units,with high morbidity and mortality.Intestinal microecology plays a vital part in the development and progression of this disease,possibly because sepsis and its treatment cause specific changes in the composition of the intestinal flora.AIM To investigate the characteristics of intestinal flora disturbance in sepsis patients treated with antibiotics.METHODS In this prospective comparative study,we enrolled ten patients with sepsis(sepsis group),hospitalized in the Department of Critical Care Medicine of the General Hospital,Ningxia Medical University,China(a class IIIa general hospital)from February 2017 to June 2017;ten patients without sepsis hospitalized in the same period(non-sepsis group)and ten healthy individuals(control group)were also enrolled.Fecal samples collected from the three groups were subjected to 16S rRNA gene sequencing and the intestinal flora diversity,structure,and composition were determined.Additionally,the dynamics of the intestinal flora diversity,structure,and composition in sepsis patients were investigated via 16S rRNA gene sequencing of samples collected 0 d,3 d,and 7 d after admittance to the intensive care unit.Correlations between the serum levels of procalcitonin,endotoxin,diamine oxidase,and D-lactic acid and the intestinal flora composition of sepsis patients were also investigated.RESULTS Compared with the healthy control group,sepsis and non-sepsis patients showed reduced intestinal floraα-diversity and a distinct flora structure,with Firmicutes as the dominant phylum,and significantly decreased proportions of Bacteroidetes,as well as Prevotella and Lachnospira,among other genera.Of note,the proportion of Enterococcus was significantly increased in the intestinal tract of sepsis patients.Interestingly,theα-diversity in the sepsis group decreased gradually,from days 1 to 7 of treatment.However,pairwise comparisons showed that both the diversity and structure of the intestinal flora were not significantly different considering the three different time points studied.Curiously,the serum levels of procalcitonin,endotoxin,diamine oxidase,and D-lactic acid in sepsis patients correlated with the prevalence of various bacterial genera.For example,the prevalence of Ruminococcus was positively correlated with serum procalcitonin,endotoxins,and diamine oxidase;similarly,the prevalence of Roseburia was positively correlated with serum procalcitonin,endotoxins,and D-lactic acid.CONCLUSION Sepsis patients in intensive care units show dysbiosis,lasting for at least 1 wk.展开更多
BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the opti...BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal microecology.METHODS Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three groups.RESULTS In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P<0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P<0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P<0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.展开更多
BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically ...BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.展开更多
Intermolecular hydrogen bonding among urea units grants prominent mechanical strength to polyurea elastomer materials.However,such interactions can cause significant solubility problems when synthesizing oligourea mac...Intermolecular hydrogen bonding among urea units grants prominent mechanical strength to polyurea elastomer materials.However,such interactions can cause significant solubility problems when synthesizing oligourea macrocycles with a large number of urea units,and it remains unknown for macrocycles containing more than six urea units.Here,we demonstrate a two-step,modular strategy for making a new class of tetraurea and octaurea macrocycles using commercially available building blocks.Intramolecular hydrogen bonding within the fundamental o-phenylene bis(urea)unit is the key to overcoming intermolecular hydrogen bonding to form favorable conformations for ring-closure reactions.The size and monomer sequences can be controlled by varying the flexibility of the spacers.Rigid diphenyl methylene and diphenyl ether linkers selectively afford tetraurea macrocycles,whereas the flexible hexylene linker produces octaurea macrocycles.Macrocycles encoded with two different spacers were also made.All these macrocycles are confirmed by X-ray diffraction structural analysis of the complexed forms with sulfate anions.Interestingly,a unique“figure-eight”structure is observed for the complex of MUH octaurea macrocycle with two encapsulated sulfate anions.Our study shows a paradigm of making large oligourea macrocycles with designer properties in a programable manner with tunable monomer sequences.展开更多
A biphenyl-bridged bis-tris(urea)ligand L was rationally designed with a favorable angle to construct a hexagon-shaped A_(6)L_(6)(A=anion)complex upon assembly with phosphate anions(PO_(4)^(3−))via anioncoordination-d...A biphenyl-bridged bis-tris(urea)ligand L was rationally designed with a favorable angle to construct a hexagon-shaped A_(6)L_(6)(A=anion)complex upon assembly with phosphate anions(PO_(4)^(3−))via anioncoordination-driven assembly(ACDA).Due to the moderate flexibility of L,another well-defined discrete architecture,a square-like A_(4)L_(4) complex,has also been obtained from ligand L and PO_(4)^(3−).Interconversion between these two self-assemblies can be readily realized by solvent regulation.In addition,the two anionic architectures display different binding abilities for selected cationic guest molecules,enabling the uptake of a desired guest from amixture of guests.展开更多
基金the National Key Research and Development Program of China,No.2016YFD0400605.
文摘BACKGROUND Sepsis is a common disease in intensive care units,with high morbidity and mortality.Intestinal microecology plays a vital part in the development and progression of this disease,possibly because sepsis and its treatment cause specific changes in the composition of the intestinal flora.AIM To investigate the characteristics of intestinal flora disturbance in sepsis patients treated with antibiotics.METHODS In this prospective comparative study,we enrolled ten patients with sepsis(sepsis group),hospitalized in the Department of Critical Care Medicine of the General Hospital,Ningxia Medical University,China(a class IIIa general hospital)from February 2017 to June 2017;ten patients without sepsis hospitalized in the same period(non-sepsis group)and ten healthy individuals(control group)were also enrolled.Fecal samples collected from the three groups were subjected to 16S rRNA gene sequencing and the intestinal flora diversity,structure,and composition were determined.Additionally,the dynamics of the intestinal flora diversity,structure,and composition in sepsis patients were investigated via 16S rRNA gene sequencing of samples collected 0 d,3 d,and 7 d after admittance to the intensive care unit.Correlations between the serum levels of procalcitonin,endotoxin,diamine oxidase,and D-lactic acid and the intestinal flora composition of sepsis patients were also investigated.RESULTS Compared with the healthy control group,sepsis and non-sepsis patients showed reduced intestinal floraα-diversity and a distinct flora structure,with Firmicutes as the dominant phylum,and significantly decreased proportions of Bacteroidetes,as well as Prevotella and Lachnospira,among other genera.Of note,the proportion of Enterococcus was significantly increased in the intestinal tract of sepsis patients.Interestingly,theα-diversity in the sepsis group decreased gradually,from days 1 to 7 of treatment.However,pairwise comparisons showed that both the diversity and structure of the intestinal flora were not significantly different considering the three different time points studied.Curiously,the serum levels of procalcitonin,endotoxin,diamine oxidase,and D-lactic acid in sepsis patients correlated with the prevalence of various bacterial genera.For example,the prevalence of Ruminococcus was positively correlated with serum procalcitonin,endotoxins,and diamine oxidase;similarly,the prevalence of Roseburia was positively correlated with serum procalcitonin,endotoxins,and D-lactic acid.CONCLUSION Sepsis patients in intensive care units show dysbiosis,lasting for at least 1 wk.
基金Supported by Ningxia Natural Science Foundation Project,No.2022AAC03488the National Key Research and Development Program of China,No.2016YFD0400605.
文摘BACKGROUND Sepsis exacerbates intestinal microecological disorders leading to poor prognosis.Proper modalities of nutritional support can improve nutrition,immunity,and intestinal microecology.AIM To identify the optimal modality of early nutritional support for patients with sepsis from the perspective of intestinal microecology.METHODS Thirty patients with sepsis admitted to the intensive care unit of the General Hospital of Ningxia Medical University,China,between 2019 and 2021 with indications for nutritional support,were randomly assigned to one of three different modalities of nutritional support for a total of 5 d:Total enteral nutrition(TEN group),total parenteral nutrition(TPN group),and supplemental parenteral nutrition(SPN group).Blood and stool specimens were collected before and after nutritional support,and changes in gut microbiota,short-chain fatty acids(SCFAs),and immune and nutritional indicators were detected and compared among the three groups.RESULTS In comparison with before nutritional support,the three groups after nutritional support presented:(1)Differences in the gut bacteria(Enterococcus increased in the TEN group,Campylobacter decreased in the TPN group,and Dialister decreased in the SPN group;all P<0.05);(2)different trends in SCFAs(the TEN group showed improvement except for Caproic acid,the TPN group showed improvement only for acetic and propionic acid,and the SPN group showed a decreasing trend);(3)significant improvement of the nutritional and immunological indicators in the TEN and SPN groups,while only immunoglobulin G improved in the TPN group(all P<0.05);and(4)a significant correlation was found between the gut bacteria,SCFAs,and nutritional and immunological indicators(all P<0.05).CONCLUSION TEN is recommended as the preferred mode of early nutritional support in sepsis based on clinical nutritional and immunological indicators,as well as changes in intestinal microecology.
文摘BACKGROUND Metaplastic breast carcinoma(MBC)is a rare subtype of invasive breast cancer comprising malignant epithelial and mesenchymal cells.Compared with other invasive breast cancers,MBC is not only histologically distinctly heterogeneous but also has a rapid and aggressive growth pattern,which leads to a significant risk of recurrence and mortality.CASE SUMMARY In this study,we report the case of a patient with a large left breast mass diagnosed with bilateral invasive ductal carcinoma in both breasts after a preoperative core needle aspiration biopsy of the bilateral breast mass.The patient received neoadjuvant chemotherapy and underwent bilateral breast modified radical mastectomy.Postoperative pathology suggested carcinosarcoma with predominantly chondrosarcoma in the left breast and invasive ductal carcinoma(luminal B)in the right breast.As the patient did not achieve complete pathological remission after six cycles of neoadjuvant chemotherapy,we administered six months of intensive capecitabine treatment.Then the patient was switched to continuous treatment with endocrine therapy using letrozole+goserelin,and the patient is currently in stable condition.However,as MBC of the breast is concurrently diagnosed with chondrosarcoma differentiation,our case is sporadic.CONCLUSION Given the variety of immunohistochemical types of bilateral breast cancer,achieving effective chemotherapy should be a key research focus.
基金supported by the National Natural Science Foundation of China(grant nos.21772154 and 91856102)the support of the Beijing Institute of Technology Research Fund Program for Young Scholars.
文摘Intermolecular hydrogen bonding among urea units grants prominent mechanical strength to polyurea elastomer materials.However,such interactions can cause significant solubility problems when synthesizing oligourea macrocycles with a large number of urea units,and it remains unknown for macrocycles containing more than six urea units.Here,we demonstrate a two-step,modular strategy for making a new class of tetraurea and octaurea macrocycles using commercially available building blocks.Intramolecular hydrogen bonding within the fundamental o-phenylene bis(urea)unit is the key to overcoming intermolecular hydrogen bonding to form favorable conformations for ring-closure reactions.The size and monomer sequences can be controlled by varying the flexibility of the spacers.Rigid diphenyl methylene and diphenyl ether linkers selectively afford tetraurea macrocycles,whereas the flexible hexylene linker produces octaurea macrocycles.Macrocycles encoded with two different spacers were also made.All these macrocycles are confirmed by X-ray diffraction structural analysis of the complexed forms with sulfate anions.Interestingly,a unique“figure-eight”structure is observed for the complex of MUH octaurea macrocycle with two encapsulated sulfate anions.Our study shows a paradigm of making large oligourea macrocycles with designer properties in a programable manner with tunable monomer sequences.
基金supported by the National Natural Science Foundation of China(nos.21971210,91856102,and 21772154)the Natural Science Foundation of Shaanxi Province(no.2019KJXX-062).
文摘A biphenyl-bridged bis-tris(urea)ligand L was rationally designed with a favorable angle to construct a hexagon-shaped A_(6)L_(6)(A=anion)complex upon assembly with phosphate anions(PO_(4)^(3−))via anioncoordination-driven assembly(ACDA).Due to the moderate flexibility of L,another well-defined discrete architecture,a square-like A_(4)L_(4) complex,has also been obtained from ligand L and PO_(4)^(3−).Interconversion between these two self-assemblies can be readily realized by solvent regulation.In addition,the two anionic architectures display different binding abilities for selected cationic guest molecules,enabling the uptake of a desired guest from amixture of guests.
