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B型利钠肽、白细胞介素6及APACHEⅡ评分对老年重症肺炎合并心力衰竭患者预后的评估价值 被引量:4
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作者 苗利辉 李京 +1 位作者 王明虎 岑强 《中华心力衰竭和心肌病杂志(中英文)》 2023年第1期11-16,共6页
目的探讨老年重症肺炎合并心力衰竭患者血浆B型利钠肽(BNP)、白细胞介素6(IL-6)及急性生理和慢性健康状况(APACHEⅡ)评分对预后的评估价值。方法回顾性分析首都医科大学附属复兴医院急诊留观室及急诊监护室2020年1月至2022年6月期间共12... 目的探讨老年重症肺炎合并心力衰竭患者血浆B型利钠肽(BNP)、白细胞介素6(IL-6)及急性生理和慢性健康状况(APACHEⅡ)评分对预后的评估价值。方法回顾性分析首都医科大学附属复兴医院急诊留观室及急诊监护室2020年1月至2022年6月期间共124例年龄≥60岁老年重症肺炎合并心力衰竭患者资料。根据患者28天转归,分为死亡组(n=39)和存活组(n=85),比较两组患者基线人口学特征、超声心动图指标,以及入院后24h实验室化验、APACHEⅡ评分结果的差异,应用多因素logistic回归分析探究影响老年重症肺炎合并心力衰竭患者不良预后的危险因素,并进行受试者工作特征(ROC)曲线分析入院24h的BNP、IL-6及APACHEⅡ评分对老年重症肺炎合并心力衰竭患者预后的评估价值。结果死亡组患者基线年龄、谷丙转氨酶、C反应蛋白、降钙素原、IL-6、BNP及APACHEⅡ评分均显著高于对照组(P均<0.05),收缩压及左心室射血分数显著低于对照组(P<0.05)。多因素logistic回归分析显示,入院24h内BNP、IL-6、APACHEⅡ评分是老年重症肺炎合并心力衰竭患者不良预后的独立危险因素。患者入院24h内BNP、IL-6、APACHEⅡ评分的ROC曲线下面积分别为0.814(敏感度76.9%、特异度78.8%)、0.875(敏感度74.4%、特异度89.4%)和0.917(敏感度100%、特异度71.8%)。结论患者入院24h内血清BNP、IL-6及APACHEⅡ评分对老年重症肺炎合并心力衰竭患者的短期预后具有预测价值。 展开更多
关键词 心力衰竭 重症肺炎 老年 预后
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Cell-free synthesis system-assisted pathway bottleneck diagnosis and engineering in Bacillus subtilis 被引量:2
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作者 Rongzhen Tian minghu wang +8 位作者 Jintian Shi Xiaolong Qin Haoyu Guo Xuanjie Jia Jianghua Li Long Liu Guocheng Du Jian Chen Yanfeng Liu 《Synthetic and Systems Biotechnology》 SCIE 2020年第3期131-136,共6页
Metabolic engineering is a key technology for cell factories construction by rewiring cellular resources to achieve efficient production of target chemicals.However,the existence of bottlenecks in synthetic pathway ca... Metabolic engineering is a key technology for cell factories construction by rewiring cellular resources to achieve efficient production of target chemicals.However,the existence of bottlenecks in synthetic pathway can seriously affect production efficiency,which is also one of the core issues for metabolic engineers to solve.Therefore,developing an approach for diagnosing potential metabolic bottlenecks in a faster and simpler manner is of great significance to accelerate cell factories construction.The cell-free reaction system based on cell lysates can transfer metabolic reactions from in vivo to in vitro,providing a flexible access to directly change protein and metabolite variables,thus provides a potential solution for rapid identification of bottlenecks.Here,bottleneck diagnosis of the N-acetylneuraminic acid(NeuAc)biosynthesis pathway in industrially important chassis microorganism Bacillus subtilis was performed using cell-free synthesis system.Specifically,a highly efficient B.subtilis cell-free system for NeuAc de novo synthesis was firstly constructed,which had a 305-fold NeuAc synthesis rate than that in vivo and enabled fast pathway dynamics analysis.Next,through the addition of all potential key intermediates in combination with substrate glucose respectively,it was found that insufficient phosphoenolpyruvate supply was one of the NeuAc pathway bottlenecks.Rational in vivo metabolic engineering of NeuAc-producing B.subtilis was further performed to eliminate the bottleneck.By down-regulating the expression level of pyruvate kinase throughout the growth phase or only in the stationary phase using inhibitory Nterminal coding sequences(NCSs)and growth-dependent regulatory NCSs respectively,the maximal NeuAc titer increased 2.0-fold.Our study provides a rapid method for bottleneck diagnosis,which may help to accelerate the cycle of design,build,test and learn cycle for metabolic engineering. 展开更多
关键词 Pathway bottleneck diagnosis Cell-free synthesis system Bacillus subtilis
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