Clinical effect of combined ulinastatin and continuous renal replacement therapy on management of severe sepsis with acute kidney injury

Purpose: To explore the effect of a combination of ulinastatin and continuous renal replacement therapy (CRRT) for the treatment of severe sepsis with acute kidney injury (SAKI).Methods: Clinical data for 106 patients diagnosed with SAKI from April 2013 to May 2015 in the intensive care unit (ICU) of Affiliated Hospital of Zhengzhou University, Zhengzhou, China, were collected and randomly assigned into two groups: treatment and control groups. The general information on the two groups were comparable. All the patients received a comprehensive treatment program which included fluid resuscitation, antibiotics, nutritional support and CRRT. The patients in treatment group also received intravenous injection of 300 thousand units/10 mL ulinastatin thrice daily for 5 days. Serum levels of inflammatory cytokines, oxidative stress level, kidney and blood coagulation functions were assayed before and after treatment, using standard methodologies. In addition, adverse reactions and 28-day mortality were recorded.Results: Levels of interleukin-6 (IL-6), tumor necrosis factor α (TNFα), serum C-reactive protein (CRP), procalcitonin (PCT), malondialdehyde (MDA), cystatin, blood urea nitrogen (BUN), prothrombin time (PT), activated partial thromboplastin time (APTT), serum creatinine (SCr) and urinary kidney injury molecule-1 (Kim-1) in the treatment group were significantly lower than those in the control group after ulinastatin treatment (p < 0.05). However, superoxide dismutase (SOD), fibrinogen (Fib) and total antioxidant capacity (T-AOC) in the treatment group were significantly higher in the control group after treatment (p < 0.05). No serious adverse drug reactions were seen in the two groups. In addition, there were no significant differences in 28-day mortality between the two groups.Conclusion: These results suggest that ulinastatin combined with CRRT effectively decreases serum levels of inflammation in SAKI patients through a mechanism involving improvement of antioxidant capacity, reduction of oxidative stress, and enhancement of renal and coagulation functions.Keywords: Ulinastatin, Continuous renal replacement therapy, Sepsis, Acute kidney injury, Inflammatory cytokine

A fleet arithmetic on overlay capacity of multi-aircraft cooperative detect base on transformed chameleon

In allusion to the particularity of Multi-Fighter Cooperative Detection, this paper analyzes the influence of different formation modes of the aircraft.. The framework of basic formation modes is established, moreover, the solutions of these models are also introduced. There is some disadvantage of gridding-method on real-time performance. A transformed chameleon method is used to divide up the big formation and cluster it into the basic ones. The rules-less formations’ detect an overlay area and divided into basic ones, can be figured out on the ground of dividing results. In this way, we can reduce the fighter formations to calculate the overlay capacity fleetly. The simulation results indicate that the method meet the real-time needs with error permissibility

The Effect of Mindfulness Training on Proactive and Reactive Cognitive Control

Previous studies have demonstrated that mindfulness practice can improve general cognitive control. However, little research has examined whether mindfulness practices affect different cognitive control strategies. According to the dual mechanisms of control (DMC) model, different cognitive control strategies may play distinct roles in individuals’ lives. Proactive control allows people to maintain and prepare for goals, whereas reactive control allows them to respond flexibly to a changing environment. Thus, this study investigates the influences of mindfulness training on proactive and reactive control measured by the AX version of the Continuous Performance Test (AX-CPT). Thirty participants completed AX-CPT and the Five Facet Mindfulness Questionnaire (FFMQ) before and after random assignment to either an 8-week mindfulness training group or a control group. The results showed no interaction between group and test time for AY or BX trial type, but the training group had fewer post-test errors on the BX trial and a higher Behavior Shift Index (BSI) of reaction time (RT) compared with the control group. This finding indicates enhanced trend of proactive control with mindfulness training. A positive correlation between the BSI of RT and observing scores on the FFMQ confirmed the connection between attentional components in mindfulness and proactive control. Errors on the AY trial in the post-test decreased in both groups, reflecting reactive control that did not differ between groups. The 8-week mindfulness training demonstrates a potential improvement effect on proactive control and could be helpful in overcoming interference

MiR–20a-5p promotes radio-resistance by targeting Rab27B in nasopharyngeal cancer cells

Additional file 3: Figure S2. The protein level of PARP and caspase3 detected by western in NCM, 5PM, NCA, 5PA, si-NC and si-Rab27B transfected CNE-2 and CNE-1 cells respectively

Disability transitions and health expectancies among elderly people aged 65 years and over in China: A nationwide longitudinal study

Disability has become a critical issue among elderly populations, yet limited large-scale research related to this issue has been conducted in China, an aging society. This study explored sex and urban-rural differences in disability transitions and life expectancies among older adults in China. Data were collected from the Chinese Longitudinal Health Longevity Survey (CLHLS), which enrolled people aged 65 and older and was conducted in randomly selected counties and cities across 22 provinces in China. Disability was diagnosed based on basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). Several individual characteristics were assessed, including sociodemographic factors (age, sex and region, etc.) and health behaviors (currently smoking, currently drinking, etc.). Multistate models were applied to analyze the transition rates among 4 states: no disability, mild disability, severe disability and death. The transition rates from disabled states to the no-disability state were found to decrease markedly with age. The rates of recovery from mild disability in rural areas were higher than those in urban areas. Rural elderly individuals lived shorter lives than their urban counterparts, but they tended to live with better functional status, spending a larger fraction of their remaining life with less severe disability. Based on these findings, devoting more attention and resources to rural areas may help less severely disabled people recuperate and prevent severe disability. The study provides insights into health plan strategies to help guide the allocation of limited resources

Impact of cigarette smoking on the relationship between body mass index and coronary heart disease: a pooled analysis of 3264 stroke and 2706 CHD events in 378579 individuals in the Asia Pacific region

BACKGROUND: Elevated levels of body mass index (BMI) and smoking are well established lifestyle risk factors for coronary heart disease (CHD) and stroke. If these two risk factors have a synergistic relationship, rigorous lifestyle modification may contribute to greater reduction in cardiovascular burden than previously expected. METHODS: A pooled analysis of individual participant data from 38 cohorts, involving 378,579 participants. Hazards ratios (HRs) and 95% confidence intervals (CIs) for BMI by cigarette smoking status were estimated using Cox proportional hazard models. RESULTS: During a mean follow-up of 3.8 years, 2706 CHD and 3264 strokes were recorded. There was a log-linear, positive relationship of BMI with CHD and stroke in both smokers and non-smokers with evidence of a synergistic effect of smoking on the association between BMI and CHD only: HRs (95% CIs) associated with a 2 kg/m2 higher BMI were 1.13 (1.10-1.17) in current smokers and 1.09 (1.06-1.11) in non-smokers (p-value for interaction=0.04). CONCLUSION: Smoking amplifies the positive association between BMI and CHD but not stroke. If confirmed, these results suggest that effective strategies that target smoking cessation and weight loss are likely to have a greater impact than anticipated on reducing the burden of CHD.published_or_final_versio

Optical and molecular diversity of dissolved organic matter in sediments of the Daning and Shennong tributaries of the Three Gorges Reservoir

Introduction: Damming significantly modifies the function of natural river networks and influences sediment dynamics with a reservoir’s operation. The dissolved organic matter (DOM) in reservoir sediments severely affects carbon flow from land to sea. However, the properties of DOM (e.g., quantity and quality) in reservoir sediments and their relationship with carbon cycling remain unclear as complex reservoir construction interrupts the environmental processes.Methods: This study characterizes the optical and molecular properties of sediment water-extractable organic matter (WEOM) in the Daning and Shennong tributaries of the world’s largest reservoir—the Three Gorges Reservoir (TGR)—by applying optical techniques and ultrahigh-resolution Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS).Results and Discussion: We first assessed the link between light-absorbing components and the individual molecules in WEOM, which were significantly different than DOM in water and indicated that there might be an intrinsic variation between DOM in sediment and in water. Then, with the unique optical–molecular property linkage assessed, multiple sources (autochthonous and terrestrial) were identified, and a declining trend of terrestrial and recalcitrant WEOM was revealed from the tributaries upstream to downstream. Finally, through covariance analysis of the properties between WEOM and sediment particles, we demonstrated that the WEOM dynamic was most likely regulated by hydrologic sorting-induced particle size and mineral composition variations of sediment. Moreover, assessment between lability and WEOM molecular properties suggested that the WEOM dynamic likely contributes to carbon burial in the reservoir. This study emphasizes the influence of dam construction on organic matter accumulation and riverine carbon cycling

Rif1 Maintains Telomere Length Homeostasis of ESCs by Mediating Heterochromatin Silencing

SummaryTelomere length homeostasis is essential for genomic stability and unlimited self-renewal of embryonic stem cells (ESCs). We show that telomere-associated protein Rif1 is required to maintain telomere length homeostasis by negatively regulating Zscan4 expression, a critical factor for telomere elongation by recombination. Depletion of Rif1 results in terminal hyperrecombination, telomere length heterogeneity, and chromosomal fusions. Reduction of Zscan4 by shRNA significantly rescues telomere recombination defects of Rif1-depleted ESCs and associated embryonic lethality. Further, Rif1 negatively modulates Zscan4 expression by maintaining H3K9me3 levels at subtelomeric regions. Mechanistically, Rif1 interacts and stabilizes H3K9 methylation complex. Thus, Rif1 regulates telomere length homeostasis of ESCs by mediating heterochromatic silencing

Variation of cataract surgery costs in four different graded providers of China

<p>Abstract</p> <p>Background</p> <p>China has the largest population of cataract patients in the world. However, the cataract surgery rate per million remains low in China. We carried out a survey on costs of cataract surgery from four different graded providers in China and analyzed differences in cost among these clinics.</p> <p>Methods</p> <p>1,189 patients were recruited for the study in four eye clinics, located in two provinces, Guangdong province in southern China and Hubei province in central China. The average cost of each cataract surgery episode was calculated including cost of intraocular lens, cost of drugs and facility cost. We also collected information on reimbursement and disposable annual income of local residents.</p> <p>Results</p> <p>Mean total cost per cataract intervention of four different providers varied considerably, ranging from US$1,293 in Union Hospital to US$ 536 in Jingshan County Hospital. In all providers, except for Jingshan County Hospital, the cost exceeded annual disposable income of local rural residents. As to the proportion of patients with reimbursement, the figure for Union Hospital was only 36%, while for other three clinics it was more than 60%. There was a significant difference between mean reimbursement ratios, with the highest ratio in Zhongshan Ophthalmic Center being 71%.</p> <p>Conclusions</p> <p>Significant differences in costs of cataract surgery were found among the 4 different graded providers. A part of the cost was borne by patients. Proportion of patients with reimbursement and mean reimbursement ratios were higher in economically developed regions than in economically developing regions. Much more financial support should be directed into the rural New Cooperative Medical Scheme to raise the reimbursement ratio in rural China.</p

Direct and indirect effects of climate on richness drive the latitudinal diversity gradient in forest trees

Data accessibility statement: Full census data are available upon reasonable request from the ForestGEO data portal, http://ctfs.si.edu/datarequest/ We thank Margie Mayfield, three anonymous reviewers and Jacob Weiner for constructive comments on the manuscript. This study was financially supported by the National Key R&D Program of China (2017YFC0506100), the National Natural Science Foundation of China (31622014 and 31570426), and the Fundamental Research Funds for the Central Universities (17lgzd24) to CC. XW was supported by the Strategic Priority Research Program of the Chinese Academy of Sciences (XDB3103). DS was supported by the Czech Science Foundation (grant no. 16-26369S). Yves Rosseel provided us valuable suggestions on using the lavaan package conducting SEM analyses. Funding and citation information for each forest plot is available in the Supplementary Information Text 1.Peer reviewedPostprin