Expression profile of polyunsaturated fatty acids in colorectal cancer

AIM:To investigate the relationship between the metabolism of polyunsaturated fatty acids(PUFAs)andtumor-associated factors for predicting the outcome of colorectal carcinoma(CRC)in Chinese patients.METHODS:Fresh-frozen malignant and normal tissues from 82 Chinese patients with CRC were analyzed for PUFA composition using gas-liquid chromatography.The levels of vascular endothelial growth factor(VEGF),cyclooxygenase-2(COX-2),prostaglandin E2 and platelet-derived growth factor(PDGF)were measured by enzyme-linked immunosorbent assay,and the levels of VEGF,p53 and Ki-67 were measured by immunohistochemistry.RESULTS:In malignant tissue,compared with normal tissue,the levels of totalω-6 PUFAs(24.64%±3.41%vs 26.77%±3.37%,P=0.00)and linoleic acid(LA)(15.46%±3.51%vs 18.30%±2.83%,P<0.01)were lower,whereas the levels of totalω-3 PUFAs(1.58%±0.74%vs 1.35%±0.60%,P<0.01)and dihomo-gamma-linolenic acid(DGLA)(1.32%±0.69%vs 0.85%±0.29%,P<0.01)were significantly higher.The ratios of arachidonic acid(AA)/LA(0.53±0.22 vs0.42±0.19,P<0.01)and AA/totalω-6 PUFAs(0.31±0.09 vs 0.27±0.10,P<0.01)were also significantly higher in malignant tissue.The levels of PDGF(353.10±148.85 pg/m L vs 286.09±104.91 pg/m L,P<0.01),COX-2(125.21±70.29 ng/m L vs 67.06±42.22 ng/m L,P<0.01)and VEGF(357.11±128.76 pg/m L vs211.38±99.47 pg/m L,P<0.01)were also higher in malignant tissue compared to normal tissue.COX-2was inversely correlated with LA(R=-0.3244,P<0.05)and positively correlated with AA/totalω-6 PUFAs(R=0.3083,P<0.05)and AA/LA(R=0.3001,P<0.05).The tissue level of LA was highest in poorly differentiated tumors(19.9%±6.3%,P<0.05),while the ratio of AA/ω-3 PUFAs was lowest in these tumors(10.8±2.6,P<0.05).In VEGF-positive tumors,the level of LA was higher(16.2%±3.7%vs 13.9%±2.7%,P<0.01),while the AA/ω-3PUFA,AA/ω-6 PUFA,and AA/LA ratios were lower than in VEGF-negativetumors(5.0±1.8 vs 6.7±3.3,0.30±0.09 vs 0.34±0.09,0.50±0.21 vs 0.61±0.21,P<0.01).CONCLUSION:The metabolism of PUFAs may playan important role in the evolution of inflammationdriven tumorigenesis in CRC and may be considered apotential marker for prognosis.

SARS-CoV抗体检测在发热鉴别诊断中的可靠性探讨

目的探讨是否可以通过检测SARS-CoVIgM、IgG抗体来协助早期鉴别诊断发热患者。方法利用SARS-CoVELISA试剂盒检测正常人群、普通发热患者、临床SARS疑似患者和临床SARS确诊患者新鲜血浆标本中的IgM和IgG抗体。结果正常人群中SARS-CoV抗体阳性率为0%(0/25);疑似患者中SARS-CoV抗体阳性率为40%(4/10);确诊患者中SARS-CoV抗体阳性率为95%(60/63)。结论利用SARS-CoVELISA检测中晚期SARS患者血浆中的相应抗体较可靠,但在普通发热患者中会出现较高的假阳性率。

Hyperbaric Oxygen Treatment Improves Hearing Level via Attenuating TLR4/NF-κB Mediated Inflammation in Sudden Sensorineural Hearing Loss Patients

Objective Hyperbaric oxygen treatment(HBOT)has demonstrated efficacy in improving hearing levels of patients with idiopathic sudden sensorineural hearing loss(ISSHL);however,the underlying mechanisms are not well understood.HBOT alleviates the inflammatory response,which is mediated by Toll-like receptor(TLR)4 and nuclear factor(NF)-κB.In this study we investigated whether HBOT attenuates inflammation in ISHHL patients via alteration of TLR4 and NF-κB expression.Methods ISHHL patients(n=120)and healthy control subjects(n=20)were enrolled in this study.Patients were randomly divided into medicine group treated with medicine only(n=60)and HBO group receiving both HBOT and medicine(n=60).Audiometric testing was performed pre-and posttreatment.TLR4,NF-кB,and TNF-αexpression in peripheral blood of ISSHL patients and healthy control subjects was assessed by ELISA before and after treatment.Results TLR4,NF-κB,and TNF-αlevels were upregulated in ISSHL patients relative to healthy control subjects;the levels were decreased following treatment and were lower in the HBO group than that in the medicine group post-treatment(P<0.05 and P<0.01).Conclusion HBOT alleviates hearing loss in ISSHL patients by suppressing the inflammatory response induced by TLR4 and NF-κB signaling.

Quality metrics and outcomes among critically ill patients in China:results of the national clinical quality control indicators for critical care medicine survey 2015-2019

Background:It is crucial to improve the quality of care provided to ICU patient,therefore a national survey of the medical quality of intensive care units(ICUs)was conducted to analyze adherence to quality metrics and outcomes among critically ill patients in China from 2015 to 2019.Methods:This was an ICU-level study based on a 15-indicator online survey conducted in China.Considering that ICU care quality may vary between secondary and tertiary hospitals,direct standardization was adopted to compare the rates of ICU quality indicators among provinces/regions.Multivariate analysis was performed to identify potential factors for in-hospital mortality and factors related to ventilator-associated pneumonia(VAP),catheter-related bloodstream infections(CRBSIs),and catheter-associated urinary tract infections(CAUTIs).Results:From the survey,the proportions of structural indicators were 1.83%for the number of ICU inpatients relative to the total number of inpatients,1.44%for ICU bed occupancy relative to the total inpatient bed occupancy,and 51.08%for inpatients with Acute Physiology and Chronic Health Evaluation II scores≥15.The proportions of procedural indicators were 74.37%and 76.60%for 3-hour and 6-hour surviving sepsis campaign bundle compliance,respectively,62.93%for microbiology detection,58.24%for deep vein thrombosis prophylaxis,1.49%for unplanned endotracheal extubations,1.99%for extubated inpatients reintubated within 48 hours,6.38%for unplanned transfer to the ICU,and 1.20%for 48-hour ICU readmission.The proportions of outcome indicators were 1.28‰for VAP,3.06‰for CRBSI,3.65‰for CAUTI,and 10.19%for in-hospital mortality.Although the indicators varied greatly across provinces and regions,the treatment level of ICUs in China has been stable and improved based on various quality control indicators in the past 5 years.The overall mortality rate has dropped from 10.19%to approximately 8%.Conclusions:The quality indicators of medical care in China’s ICUs are heterogeneous,which is reflected in geographic disparities and grades of hospitals.This study is of great significance for improving the homogeneity of ICUs in China.

Evaluation of ICUs and weight of quality control indicators:an exploratory study based on Chinese ICU quality data from 2015 to 2020

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit(ICU)patients in Chinese mainland over six years(2015–2020).The data for this study were from 31 provincial and municipal hospitals(3425 hospital ICUs)and included 2110685 ICU patients,for a total of 27607376 ICU hospitalization days.We found that 15 initially established quality control indicators were good predictors of patient prognosis,including percentage of ICU patients out of all inpatients(%),percentage of ICU bed occupancy of total inpatient bed occupancy(%),percentage of all ICU inpatients with an APACHE II score≥15(%),three-hour(surviving sepsis campaign)SSC bundle compliance(%),six-hour SSC bundle compliance(%),rate of microbe detection before antibiotics(%),percentage of drug deep venous thrombosis(DVT)prophylaxis(%),percentage of unplanned endotracheal extubations(%),percentage of patients reintubated within 48 hours(%),unplanned transfers to the ICU(%),48-h ICU readmission rate(%),ventilator associated pneumonia(VAP)(per 1000 ventilator days),catheter related blood stream infection(CRBSI)(per 1000 catheter days),catheter-associated urinary tract infections(CAUTI)(per 1000 catheter days),in-hospital mortality(%).When exploratory factor analysis was applied,the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation:nosocomial infection management(21.35%),compliance with the Surviving Sepsis Campaign guidelines(17.97%),ICU resources(17.46%),airway management(15.53%),prevention of deep-vein thrombosis(14.07%),and severity of patient condition(13.61%).Based on the different weights of the core elements associated with the 15 indicators,we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management+17.97%xcompliance with SSC guidelines+17.46%×ICU resources+15.53%×airway management+14.07%×DVT prevention+13.61%×severity of patient condition.This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.

The role of the microenvironment on the fate of adult stem cells

Adult stem cells(SCs) exist in all tissues that promote tissue growth, regeneration, and healing throughout life. The SC niche in which they reside provides signals that direct them to proliferate, differentiate, or remain dormant; these factors include neighboring cells, the extracellular matrix, soluble molecules, and physical stimuli. In disease and aging states, stable or transitory changes in the microenvironment can directly cause SC activation or inhibition in tissue healing as well as functional regulation. Here, we discuss the microenvironmental regulation of the behavior of SC and focus on plasticity approaches by which various environmental factors can enhance the function of SCs and more effectively direct the fate of SCs.

Predictions of mortality related to four major cancers in China,2020 to 2030

Background:Cancer has become a global health problem,and assessments of cancer mortality are important for effective public health policy-making and adequate resource allocation.In this study,we aimed to predict the mortality rates and numbers of deaths related to four common cancers(lung,liver,stomach,and esophagus)in China from 2020 to 2030 and to estimate the corresponding cancer burden caused by population aging and tobacco smoking.Methods:Cancer mortality data(2004-2017)were extracted from China’s death surveillance datasets,and China’s population figures(2020-2030)were obtained from the United Nations population projections.Smoking prevalence data were retrieved from a World Health Organization global report,and relative risks of smoking and cancers were derived from large-scale Asian studies.We predicted the deaths related to the four major cancers and age-standardized mortality rates using joinpoint regression and linear regression models.The tobacco smoking related burden of these four major cancers was estimated using the population attributable fraction.Results:Unlike lung cancer mortality which was predicted to continue to increase,the age-standardized mortality rates for digestive cancers(liver,stomach,and esophageal cancers)are predicted to decline over the next decade.The number of deaths caused by the four major cancers is predicted to increase from 1,490,304 in 2020 to 1,823,960 in 2030.The age-specific mortality rates of the four major cancers are predicted to increase with age after 40-45 years,peaking in the age groups of 80-84 and ≥85 years.In 2030,the combined number of deaths from the four examined cancers among adults aged ≥65 years is predicted to be 1,167,153,accounting for 64% of all deaths from these cancers.Tobacco smoking is predicted to contribute to nearly 29% of deaths fromthese cancers,corresponding to 527,577 deaths.Conclusions:The overall trend in the combined total mortality from four major cancers is predicted to decline over the next decade;however,the corresponding death toll is expected to surge,in the context of China’s population aging and high smoking prevalence.These estimates provide data-driven evidence for China to implement effective cancer control measures in the future.

Analysis of factors influencing 3-and 6-h compliance with the surviving sepsis campaign guidelines based on medical-quality intensive care unit data from China

To the Editor:In the past decades,there were at least 31.5 million sepsis patients worldwide.Of these patients,5.3 million sepsis patients face death every year.[1]Studies have shown the mortality from sepsis can be reduced by compliance with the surviving sepsis campaign guidelines(C_(ssc)).[2]Compliance with guidelines depends on the execution of the medical team.We assume that the medical quality of the intensive care unit(Q_(ICU))will have an important impact on the C_(ssc).

Rapid Detection of Acetylbritannilactone from Inula britannica in Plasma of Rats by Online Sweeping-Micellar Electrokinetic Chromatography

Objective To establish a rapid method for detecting acetylbritannilactone(ABL)by online sweeping-micellar electrokinetic chromatography(MEKC)and to elevate the sensitivity of the detection.Methods The combination of online sweeping technique with MEKC was used to determine the content of ABL in the extract of Inula britannica in plasma of rats.Results ABL was completely separated within 15 min in running buffer and sample buffer.The optimal conditions were as follows:on uncoated fused quartz silica capillary,with separation voltage of 23 kV,capillary temperature of 25 oC,and detection wavelength of 195 nm.The regression equations revealed good linear relationships between the peak area and concentration of ABL(r=0.998),with the detection limits of 0.005–0.15 mg/mL.The relative standard deviations of migration time and peak areas for intra-and inter-batch were<2.45%and<2.26%,respectively.The recovery rate of this method was 96.3%–97.2%.Conclusion This method provides some advantages in separation speed,testing sensitivity,and operating convenience,with low sample and reagent consumption.The online sweeping-MEKC is an effective method for pharmacokinetic study and analysis on tracing biological samples.

Neurovascular unit in diabetic retinopathy:pathophysiological roles and potential therapeutical targets

Diabetic retinopathy(DR),one of the common complications of diabetes,is the leading cause of visual loss in working-age individuals in many industrialized countries.It has been traditionally regarded as a purely microvascular disease in the retina.However,an increasing number of studies have shown that DR is a complex neurovascular disorder that affects not only vascular structure but also neural tissue of the retina.Deterioration of neural retina could precede microvascular abnormalities in the DR,leading to microvascular changes.Furthermore,disruption of interactions among neurons,vascular cells,glia and local immune cells,which collectively form the neurovascular unit,is considered to be associated with the progression of DR early on in the disease.Therefore,it makes sense to develop new therapeutic strategies to prevent or reverse retinal neurodegeneration,neuroinflammation and impaired cell-cell interactions of the neurovascular unit in early stage DR.Here,we present current perspectives on the pathophysiology of DR as a neurovascular disease,especially at the early stage.Potential novel treatments for preventing or reversing neurovascular injuries in DR are discussed as well.

Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality improvement action(EQIA)study:a national cohort study in China from 2017 to 2019

This cohort study was performed to explore the influence of intensive care unit(ICU)quality on in-hospital mortality of veno-venous(V-V)extracorporeal membrane oxygenation(ECMO)-supported patients in China.The study involved all V-V ECMO-supported patients in 318 of 1700 tertiary hospitals from 2017 to 2019,using data from the National Clinical Improvement System and China National Critical Care Quality Control Center.ICU quality was assessed by quality control indicators and capacity parameters.Among the 2563 V-V ECMO-supported patients in 318 hospitals,a significant correlation was found between ECMO-related complications and prognosis.The reintubation rate within 48 hours after extubation and the total ICU mortality rate were independent risk factors for higher in-hospital mortality of V-V ECMO-supported patients(cutoff:1.5%and 7.0%;95%confidence interval:1.05–1.48 and 1.04–1.45;odds ratios:1.25 and 1.23;P=0.012 and P=0.015,respectively).Meanwhile,the V-V ECMO center volume was a protective factor(cutoff of≥50 cases within the 3-year study period;95%confidence interval:0.57–0.83,odds ratio:0.69,P=0.0001).The subgroup analysis of 864 patients in 11 high-volume centers further strengthened these findings.Thus,ICU quality may play an important role in improving the prognosis of V-V ECMO-supported patients.

Neurovascular unit in diabetic retinopathy:pathophysiological roles and potential therapeutical targets

Diabetic retinopathy(DR),one of the common complications of diabetes,is the leading cause of visual loss in working-age individuals in many industrialized countries.It has been traditionally regarded as a purely microvascular disease in the retina.However,an increasing number of studies have shown that DR is a complex neurovascular disorder that affects not only vascular structure but also neural tissue of the retina.Deterioration of neural retina could precede microvascular abnormalities in the DR,leading to microvascular changes.Furthermore,disruption of interactions among neurons,vascular cells,glia and local immune cells,which collectively form the neurovascular unit,is considered to be associated with the progression of DR early on in the disease.Therefore,it makes sense to develop new therapeutic strategies to prevent or reverse retinal neurodegeneration,neuroinflammation and impaired cell-cell interactions of the neurovascular unit in early stage DR.Here,we present current perspectives on the pathophysiology of DR as a neurovascular disease,especially at the early stage.Potential novel treatments for preventing or reversing neurovascular injuries in DR are discussed as well.