Prognosis-related classifi cation and dynamic monitoring of immune status in patients with sepsis:A prospective observational study

BACKGROUND:The dynamic monitoring of immune status is crucial to the precise and individualized treatment of sepsis.In this study,we aim to introduce a model to describe and monitor the immune status of sepsis and to explore its prognostic value.METHODS:A prospective observational study was carried out in Zhongshan Hospital,Fudan University,enrolling septic patients admitted between July 2016 and December 2018.Blood samples were collected at days 1 and 3.Serum cytokine levels(e.g.,tumor necrosis factor-α[TNF-α],interleukin-10[IL-10])and CD14+monocyte human leukocyte antigen-D-related(HLA-DR)expression were measured to serve as immune markers.Classifi cation of each immune status,namely systemic inflammatory response syndrome(SIRS),compensatory anti-inflammatory response syndrome(CARS),and mixed antagonistic response syndrome(MARS),was defined based on levels of immune markers.Changes of immune status were classifi ed into four groups which were stabilization(SB),deterioration(DT),remission(RM),and non-remission(NR).RESULTS:A total of 174 septic patients were enrolled including 50 non-survivors.Multivariate analysis discovered that IL-10 and HLA-DR expression levels at day 3 were independent prognostic factors.Patients with MARS had the highest mortality rate.Immune status of 46.1%patients changed from day 1 to day 3.Among four groups of immune status changes,DT had the highest mortality rate,followed by NR,RM,and SB with mortality rates of 64.7%,42.9%,and 11.2%,respectively.CONCLUSIONS:Severe immune disorder defi ned as MARS or deterioration of immune status defi ned as DT lead to the worst outcomes.The preliminary model of the classifi cation and dynamic monitoring of immune status based on immune markers has prognostic values and is worthy of further investigation.

Growth hormone therapy for children with KBG syndrome:A case report and review of literature

BACKGROUND The incidence of short stature in KBG syndrome is relatively high.Data on the therapeutic effects of growth hormone(GH)on children with KBG syndrome accompanied by short stature in the previous literature has not been summarized.CASE SUMMARY Here we studied a girl with KBG syndrome and collected the data of children with KBG syndrome accompanied by short stature from previous studies before and after GH therapy.The girl was referred to our department because of short stature.Physical examination revealed mild dysmorphic features.The peak GH responses to arginine and clonidine were 6.22 and 5.40 ng/mL,respectively.The level of insulin-like growth factor 1(IGF-1)was 42.0 ng/mL.Genetic analysis showed a c.2635 dupG(p.Glu879fs)mutation in the ANKRD11 gene.She received GH therapy.During the first year of GH therapy,her height increased by 0.92 standard deviation score(SDS).Her height increased from-1.95 SDS to-0.70 SDS after two years of GH therapy.There were ten children with KBG syndrome accompanied by short stature who received GH therapy in reported cases.Height SDS was improved in nine(9/10)of them.The mean height SDS in five children with KBG syndrome accompanied by short stature increased from-2.72±0.44 to-1.95±0.57 after the first year of GH therapy(P=0.001).There were no adverse reactions reported after GH treatment.CONCLUSION GH treatment is effective in our girl and most children with KBG syndrome accompanied by short stature during the first year of therapy.

Real-time monitoring of the lithiation process in organic electrode 7,7,8,8-tetracyanoquinodimethane by in situ EPR

Organic electrodes are advantageous for rechargeable lithium-ion batteries owing to their high theoretical capacities, diverse functionalities, and environmental compatibility. Understanding the working mechanism of organic electrodes is vital to strategic materials design. However, due to lack of suitable characterization tools, it has been challenging to probe the reaction processes of organic electrodes in real-time. Here, non-destructive in situ electron paramagnetic resonance(EPR) was performed on a model organic electrode, 7,7,8,8-tetracyanoquinodimethane(TCNQ) used in rechargeable lithium-ion batteries,to directly follow the redox reactions in real-time. In order to minimize interfering signals from other parts of the batteries than the TCNQ electrode of interest, two sets of batteries are fabricated and studied with in situ EPR:(1) a Li CoO_(2)//Li_(4)Ti_5O_(12) full-cell battery to determine the EPR signal evolution of additives and electrolytes;(2) a Li CoO_(2)//TCNQ battery, and the difference in the observed EPR signals reflects purely the redox reactions of TCNQ upon lithiation and delithiation. A two-electron reversible redox reaction is delineated for TCNQ. TCNQ dimers form during the first electron injection upon lithiation and followed by the break-down of the dimers and associated electron coupling to produce massive delocalized electrons, resulting in increased EPR signal during the 2 nd electron injection. Reversible trends are observed during electron ejection upon delithiation. In situ EPR is very sensitive to electron activities,thus is a powerful tool to follow redox reactions of organic electrodes, allowing for improved fundamental understanding of how organic electrodes work and for informed design of high-performance organic materials for energy storage.

An alphavirus replicon particle delivering prefusion-stabilized spike protein provides potent immunoprotection against SARS-CoV-2 Omicron variant

Dear Editor,The prolonged outbreak and spread of coronavirus disease 2019(COVID-19),caused by SARS-CoV-2 poses a great threat to global economic and public health.The protective efficacy of the vaccines based on the spike protein(S)of SARS-CoV-2 has been compromised by the emergence of variants of concern(VOC).

Flexible electrical stimulation device with Chitosan-Vaseline®dressing accelerates wound healing in diabetes

The healing process of diabetic wounds is typically disordered and prolonged and requires both angiogenesis and epithelialization.Disruptions of the endogenous electric fields(EFs)may lead to disordered cell migration.Electrical stimulation(ES)that mimics endogenous EFs is a promising method in treating diabetic wounds;however,a microenvironment that facilitates cell migration and a convenient means that can be used to apply ES are also required.Chitosan-Vaseline■gauze(CVG)has been identified to facilitate wound healing;it also promotes moisture retention and immune regulation and has antibacterial activity.For this study,we created a wound dressing using CVG together with a flexible ES device and further evaluated its potential as a treatment for diabetic wounds.We found that high voltage monophasic pulsed current(HVMPC)promoted healing of diabetic wounds in vivo.In studies carried out in vitro,we found that HVMPC promoted the proliferation and migration of human umbilical vein endothelial cells(HUVECs)by activating PI3K/Akt and ERK1/2 signaling.Overall,we determined that the flexible ES-chitosan dressing may promoted healing of diabetic wounds by accelerating angiogenesis,enhancing epithelialization,and inhibiting scar formation.These findings provide support for the ongoing development of this multidisciplinary product for the care and treatment of diabetic wounds.

Luminescence property and magnetic resonance imaging of Gd_(2)O_(3):Tb^(3+) nanocrystals doped with Zn^(2+),Li^(+)

Gd_(2)O_(3):Tb^(3+) nanocrystal co-doped with Zn^(2+)and Li^(+) was prepared by the combination of polyol and solid-phase methods.The synthesized nanoparticles were characterized by X-ray diffraction(XRD),field emission scanning electron microscopy(FESEM),transmission electron microscopy(TEM),photoluminescence(PL)spectra and magnetic resonance imaging(MRI).The results revealed that both Gd_(2)O_(3):Tb^(3+)/Zn^(2+) and Gd_(2)O_(3):Tb^(3+)/Li^(+) had cubic unit structures with a spherical shape,and the fluorescence intensity of the nanoparticles reached a maximum at a doping concentration of0.050 mmol%for Zn^(2+) and 2 mol%for Li^(+),respectively.In addition,the T_(1)/T_(2)(longitudinal/transverse relaxation time)-weighted MRI signals got enhanced due to the increased longitudinal relaxivity(r1)and transverse relaxivity(r2)after the doping by metal ions.Therefore,the materials reported here can be used for fluorescence and MR bimodal imaging,as tracers and for fluorescence detections.