Association between isolated hypothyroxinaemia in early pregnancy and perinatal outcomes

Background: The effect of isolated maternal hypothyroxinaemia (IMH) on pregnancy complications and neonatal outcomes in human beings is still controversial. Methods: This was a retrospective cohort study based on the electronic medical register system. The records of women with a singleton pregnancy who sought antenatal examination between January 2014 and December 2015 at Shanghai First Maternity and Infant Hospital were extracted from the electronic medical records system. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and anti-thyroperoxidase autoantibody (TPO-Ab) was measured before 20 gestational weeks, and a multiple logistic regression model was used to estimate the odds ratios of pregnancy complications and neonatal outcomes between euthyroid women and those with isolated hypothyroxinaemia. Results: A total of 8173 women were included in this study, of whom 34 2 (4.18%) were diagnosed with IMH. Regression analysis showed that IMH diagnosed in the second trimester (13–20 weeks) was associated with an increased risk of hypertensive disorders of pregnancy (OR = 2.66, 95% CI: 1.38–5.10) and placenta abruption (OR = 3.64, 95% CI: 1.07–12.41), but not with preterm delivery (OR = 1.09, 95% CI: 0.50–2.40), small or large gestational age of infant (OR = 0.91, 95% CI: 0.39–2.12; OR = 1.16, 95% CI: 0.72–1.86), macrosomia (OR = 1.71, 95% CI: 0.95–3.07), gestational diabetes mellitus (OR = 1.36, 95% CI: 0.86–2.15) and placenta previa (OR = 1.62, 95% CI: 0.39–7.37). Conclusion: IMH could be a risk factor for hypertensive disorders of pregnancy

Traditional Chinese medicine improves myasthenia gravis by regulating the symbiotic homeostasis of the intestinal microbiota and host

Myasthenia gravis (MG) is an autoimmune disease caused by autoantibodies that is dependent on T-cell immunity and complement participation and mainly involves neuromuscular junctions. In this study, 30 patients with myasthenia gravis were selected and divided into pretreatment (Case group) and posttreatment (Treatment group) and 30 healthy volunteers (CON group) were included. Among them, the treatment group was treated with Modified Buzhong Yiqi Decoction (MBZYQD), and the levels of antibodies such as AChR, Musk and Titin in blood and intestinal microbiota were compared before treatment (Case group), after treatment (Treatment group) and in healthy volunteers (CON group). The results showed that after treatment with MBZYQD, the antibody levels of AChR, MuSK, and Titin and the inflammatory factor level of IL-6, IL-1β, and IL-22 in MG patients decreased significantly and nearly returned to a healthy level. In addition, after treatment with MBZYQD, the diversity, structure and function of intestinal microorganisms in MG patients also recovered to a healthy level. At the phylum level, the relative abundance of Proteobacteria in the Case group increased significantly, accompanied by a significant decrease in the relative abundance of Bacteroides compared with that in the CON group, the relative abundance of Proteobacteria and Bacteroides in the Treatment group was similar to that in the CON group. At the genus level, the relative abundance of Shigella in the Case group was significantly increased, accompanied by a significant decrease in the relative abundance of Prevotella, and the relative abundance of Shigella and Prevotella in Treatment group was similar to that in the CON group. Moreover, the fluorobenzoate degradation pathway (KO00364) was significantly increased in the Case group, while this pathway was significantly decreased in the Treatment group. In conclusion, MBZYQD can improve the immune function of the host by regulating the diversity, structure and function of the intestinal microbiota to treat myasthenia gravis

A study on the correlation between hemoglobin concentration and the storage quality of suspended red blood cells prepared from the whole blood of Tibetan male residents

BackgroundPrevious studies reported that the blood of Tibetans living at different altitudes may vary slightly. There is evidence that the harsh environmental conditions at high altitudes, such as low pressure and hypoxia, may affect the morphology and hemorheology of red blood cells (RBCs). Hypoxia would increase the levels of hemoglobin ([Hb]) and hematocrit (Hct), potentially increasing blood hyperviscosity and compromising blood collection and transfusions. Therefore, it is critical to investigate the in vitro storage quality of Tibetan RBCs.ObjectivesIn this study, the in vitro quality of suspended RBCs (SRBCs) prepared from whole blood (WB) of Tibetan residents with varying Hb concentrations ([Hb]) was measured during storage, and the relationship between the major factors in RBC storage and [Hb] was studied.Materials and methodsThe WB of Tibetan men was divided into three groups based on [Hb] levels (group A: 120 < Hb ≤ 185 g/L; group B: 185 < Hb ≤ 210 g/L; group C: Hb > 210 g/L). The SRBCs prepared from WB were examined aseptically on days 1, 14, 21, and 35 after storage.Results[Hb] was not correlated with mean corpuscular volume (MCV), adenosine triphosphate (ATP), pH, P50, and hemolysis. There was a moderate or strong negative association between platelets (PLT) and [Hb] from days 1 to 35, and the PLT number of group C was lower than group A during storage. Group C had the highest change rates of electrolytes, glucose, and lactate, and there were moderate or strong positive correlations between lactate and [Hb] (r = 0.3772, p = 0.0045), glucose and [Hb] (r = 0.5845, p < 0.0001), Na+ and [Hb] (r = 0.3966, p = 0.0027), and K+ and [Hb] (r = 0.4885, p = 0.0002). Group B had the highest change rates of 2,3-DPG on day 35, and there was a negative correlation between 2,3-DPG and [Hb] (r = −0.4933, p = 0.0001).ConclusionsThese new data on the [Hb] could have implications for researchers wishing to study the storage quality of Tibetan SRBCs, particularly in the context of erythrocyte metabolism, and we propose finding a new, suitable alternative solution for plateau SRBCs, particularly the blood with [Hb] greater than 185 g/L. Our results could have important implications for researchers wishing to study the potential framework of high-altitude-induced SRBC storage lesions

Inhibition of neutrophil extracellular trap formation attenuates NLRP1-dependent neuronal pyroptosis via STING/IRE1α pathway after traumatic brain injury in mice

IntroductionIncreased neutrophil extracellular trap (NET) formation has been reported to be associated with cerebrovascular dysfunction and neurological deficits in traumatic brain injury (TBI). However, the biological function and underlying mechanisms of NETs in TBI-induced neuronal cell death are not yet fully understood.MethodsFirst, brain tissue and peripheral blood samples of TBI patients were collected, and NETs infiltration in TBI patients was detected by immunofluorescence staining and Western blot. Then, a controlled cortical impact device was used to model brain trauma in mice, and Anti-Ly6G, DNase, and CL-amidine were given to reduce the formation of neutrophilic or NETs in TBI mice to evaluate neuronal death and neurological function. Finally, the pathway changes of neuronal pyroptosis induced by NETs after TBI were investigated by administration of peptidylarginine deiminase 4 (a key enzyme of NET formation) adenovirus and inositol-requiring enzyme-1 alpha (IRE1α) inhibitors in TBI mice.ResultsWe detected that both peripheral circulating biomarkers of NETs and local NETs infiltration in the brain tissue were significantly increased and had positive correlations with worse intracranial pressure (ICP) and neurological dysfunction in TBI patients. Furthermore, the depletion of neutrophils effectively reduced the formation of NET in mice subjected to TBI. we found that degradation of NETs or inhibition of NET formation significantly inhibited nucleotide-binding oligomerization domain (NOD)-like receptor pyrin domain containing 1 (NLRP1) inflammasome-mediated neuronal pyroptosis after TBI, whereas these inhibitory effects were abolished by cyclic GMP-AMP (cGAMP), an activator of stimulating Interferon genes (STING). Moreover, overexpression of PAD4 in the cortex by adenoviruses could aggravate NLRP1-mediated neuronal pyroptosis and neurological deficits after TBI, whereas these pro-pyroptotic effects were rescued in mice also receiving STING antagonists. Finally, IRE1α activation was significantly upregulated after TBI, and NET formation or STING activation was found to promote this process. Notably, IRE1α inhibitor administration significantly abrogated NETs-induced NLRP1 inflammasome-mediated neuronal pyroptosis in TBI mice.DiscussionOur findings indicated that NETs could contribute to TBI-induced neurological deficits and neuronal death by promoting NLRP1-mediated neuronal pyroptosis. Suppression of the STING/ IRE1α signaling pathway can ameliorate NETs-induced neuronal pyroptotic death after TBI

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Electrochemical impedance spectroscopy and surface properties characterization of anion exchange membrane fouled by sodium dodecyl sulfate

In this study, the fouling of anion exchange membrane (AEM) in electrodialysis was investigated using sodium dodecyl sulfate (SDS) as a model foulant, and the effect of membrane cleaning on the properties of the fouled AEMs was examined further. Results showed that the severer fouling of AEM was caused by the higher concentration of SDS in the feed solution, and a dense SDS fouling layer was formed on the ARM surface, causing the obvious increase of electrical resistance and the deterioration of desalination performance. Electrochemical impedance spectroscopy (EIS) indicated the SDS fouling layer on the AEM could hinder, even restrict completely the transmembrane migration of the ions, especially at high concentration of SDS. The cleaning experiment showed the cleaning effect of ultra -pure water was similar to that of Ha solution, but was better than that of NaOH solution, in which most SDS on the fouled AEM could be removed effectively by cleaned in ultra-pure water. EIS of the fouled AEMs before and after cleaned indicated that the remaining SDS on the cleaned AEM had almost no influence on the transmembrane migration of the ions through AEM.</p

Effect of plasma treatment on the surface properties and antifouling performance of homogeneous anion exchange membrane

A homogeneous anion exchange membrane (AEM) with quaternary ammonium group was treated by low temperature plasma using different feed gases to improve the antifouling performance of AEMs in electrodialysis (ED). X-ray photoelectron spectroscopy analysis indicated that nitrogen-and oxygen-containing functionalities were incorporated, respectively, on the membrane surface after N-2 and O-2 plasma treatments. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) analyses indicated that the surface morphology and surface roughness of the plasma-treated AEMs exhibited various changes because of the different etching effects of the two gases. Contact angle and zeta potential measurement confirmed that the surface hydrophilicity and negative charge density of the plasma-treated AEMs improved significantly and variously, which were related to the difference of the feed gases. No obvious changes occurred in the electrical resistance and ED performance of the plasma-treated AEMs, compared with the pristine AEM. The antifouling performance of the plasma-treated AEMs for sodium dodecylbenzenesulfonate (SDBS) improved significantly. Moreover, the O-2-treated AEM exhibited better antifouling property than the N-2-treated AEM. Results indicated that the high surface negative charge of the O-2-treated AEM was crucial to the improvement of the antifouling performance for SDBS.</p