BACKGROUND:To evaluate the accuracy of National Early Warning Score (NEWS) in predicting clinical outcomes (28-day mortality, intensive care unit [ICU] admission, and mechanical ventilation use) for septic patients with community-acquired pneumonia (CAP) compared with other commonly used severity scores (CURB65, Pneumonia Severity Index [PSI], Sequential Organ Failure Assessment [SOFA], quick SOFA [qSOFA], and Mortality in Emergency Department Sepsis [MEDS]) and admission lactate level. METHODS: Adult patients diagnosed with CAP admitted between January 2017 and May 2019 with admission SOFA ≥2 from baseline were enrolled. Demographic characteristics were collected. The primary outcome was the 28-day mortality after admission, and the secondary outcome included ICU admission and mechanical ventilation use. Outcome prediction value of parameters above was compared using receiver operating characteristics (ROC) curves. Cox regression analyses were carried out to determine the risk factors for the 28-day mortality. Kaplan-Meier survival curves were plotted and compared using optimal cut-off values of qSOFA and NEWS. RESULTS: Among the 340 enrolled patients, 90 patients were dead after a 28-day follow-up, 62 patients were admitted to ICU, and 84 patients underwent mechanical ventilation. Among single predictors, NEWS achieved the largest area under the receiver operating characteristic (AUROC) curve in predicting the 28-day mortality (0.861), ICU admission (0.895), and use of mechanical ventilation (0.873). NEWS+lactate, similar to MEDS+lactate, outperformed other combinations of severity score and admission lactate in predicting the 28-day mortality (AUROC 0.866) and ICU admission (AUROC 0.905), while NEWS+lactate did not outperform other combinations in predicting mechanical ventilation (AUROC 0.886). Admission lactate only improved the predicting performance of CURB65 and qSOFA in predicting the 28-day mortality and ICU admission. CONCLUSIONS: NEWS could be a valuable predictor in septic patients with CAP in emergency departments. Admission lactate did not predict well the outcomes or improve the severity scores. A qSOFA ≥2 and a NEWS ≥9 were strongly associated with the 28-day mortality, ICU admission, and mechanical ventilation of septic patients with CAP in the emergency departments.

It is well documented that vascular tone is the key determinant of blood vessel resistance and blood flow. But vascular tone could be regulated by modulating the activity of potassium channel directly. Potassium channel openers promote vasodilation by inhibiting the activity of voltage dependent calcium channels and reducing Ca 2+ influx. In this case, inhibition results from membrane hyperpolarisation, which arises due to the stimulation of K + efflux through smooth muscle K + channels. While K + channels are blocked, vasoconstriction could be observed as a result of membrane depolarization, which opens voltage dependent calcium channels. The influx of Ca 2+ can promote smooth muscle contraction by making myosin light chain phosphorylation and arising thick myofilament and thin myofilament relative movements. In this article, the gene structure, current character, Pharmacological and physiological effects of the four subtypes potassium channels are reviewed.

Humans ; Spleen ; injuries ; physiology ; surgery ; Splenectomy

Abstract?AIM: To characterize the effects of sodium iodate on mouse retinal morphology and function.?METHODS: Sodium iodate at 35mg/kg ( body weight) was administered by tail vein injection into adult 6-8wk C57BL/6J mice. Morphological and functional changes of the retina were assessed at 6h, 1, 3, 5 and 8d after injections by fundus imaging, optical coherence tomography (OCT), ERG and histology. Mice in control group were give tail vein injection of equivalent dose of normal saline. All the eyeballs were removed for paraffin section and H-E staining.?RESULTS: The fundus photographs images at 6h after injection showed obvious changes, which were light red in retina and showed retinal blood vessels radial arranged. At 6h after injection, off-white drusen-like change was found at fundus. While there were no observable changes in OCT image and ERG. At 1d after injection, the fundus lesion aggravated and the drusen increased gradually. There were retinal pigment epithelial ( RPE) disorders, photoreceptors and outer nuclear layer (ONL) damage through OCT. At 3d after injection, the retina lesion aggravated further and the retina became edema. At 5d after injection, the retina edema cleared away, the optic nerve became white and the fundus lesions increased. At 8d after injection, the RPE layer, photoreceptors and ONL were destroyed obviously. In the process, ERG showed the amplitudes of a- and b-wave decreased in a time-dependent manner. H-E staining showed that cells in retina of mice in control group were neatly arranged and well- distributed. The outer layer retina of sodium iodate injection group was wave-like, the normal structure of RPE disappeared and black round sediment could be seen which increased with time. At 8d after injection, there were any normal RPE.?CONCLUSION: The tail vein injection of sodium iodate can well simulate the pathogenesis of age - related macular degeneration which can provide a good animal model for AMD.

AIM: To observe the effect of curcumin on the retinal structure and the expressions of interleukin-23 (IL-23) and interleukin-17(IL-17) in the rat retina after retinal ischemia-reperfusion injury (RIRI).METHODS:A total of 60 male Sprague-Dawley(SD) rats were randomly divided into normal control group(NCG),model group(MG),low-dose curcumin group (LDCG) and high-dose curcumin group (HDCG) (n=15 per group).RIRI was generated by anterior chamber perfusion of normal saline to the right eye.Rats in LDCG and HDCG received an intraperitoneal injection of 20mg/kg/d and 100mg/kg/d curcumin respectively,at 30min before RIRI and once daily after RIRI.Retinal structure and inflammation were evaluated after hematoxylin and eosin-stained (HE) staining.Western-blot and enzyme-linked immunosorbent assay (ELISA) were used to measure the level of IL-23 and IL-17 expressions after RIRI.RESULTS: The retinal structure of NCG was normal.Retinal edema,empty spaces or loosely packed cells and inflammatory cell infiltration were observed in MG and LDCG groups,whereas the morphological changes in HDCG group were improved as compared to MG and LDCG groups.Western-blot assay and ELISA showed that IL-23 and IL-17 expressions increased significantly after RIRI (vs NCG,P<0.01).Moreover,curcumin reduced IL-23 and IL-17 expressions significantly (vs MG,P<0.01).CONCLUSION: Curcumin can inhibit leukocytes infiltration and improve the retinal pathologic changes.Furthermore,curcumin can reduce retinal IL-23 and IL-17 expressions significantly in a dose-dependent manner.

Child ; Humans ; Intestinal Polyps ; genetics ; Molecular Biology

Adolescent ; Alopecia ; diagnosis ; therapy ; Bone and Bones ; abnormalities ; Denture, Complete, Upper ; Diarrhea ; diagnosis ; therapy ; Female ; Humans ; Spasm ; diagnosis ; therapy

Objective: To investigate chemical constituents from Isodon coetsa distributed in Guizhou. Methods: Chemical constituents were isolated and purified by chromatography with silica gel, Sephadex LH-20, and semi-preparative HPLC, and their structures were identified by analysis of spectroscopic evidences and physicochemical properties as well as relevant references. Results: A total of 19 compounds were isolated from plant material extracted with 95% aqueous methanol, which were elucidated as β-sitosterol (1), stigmasterol (2), β-daucosterol (3), methyl linolenat (4), 9,12-octadecadienoic acid-2-hydroxy-1,3-propanedinyl ester (5), ursolic acid (6), oleanoic acid (7), 3β-hydroxy-urs-20-en-28-oic acid (8), betulinic acid (9), kurarinone (10), maslinic acid (11), 2α-hydroxy ursolic acid (12), 2α,3α-dihydroxy-urs-12-en-28-oic acid (13), 2α,3α,24-trihydrxyolean-12-en-28-oic acid (14), 2α,3β,24- trihydroxyolean-12-en-28-oic acid (15), formononetin (16), emodin (17), uracil (18), and sucrose (19). Conclusion: Compounds 2, 4, 5, 9, 11, 13-19 are isolated from this plant for first time, and compounds 11, 17, 19 are isolated from the genus of Isodon for the first time.

The connotation and position of learning and examination resources center in library were elaborated. How to perfect the service system for readers was proposed by introducing the IC ideas and model into library con-struction.The characteristic, cooperative, sharing and developmental principles were pointed out, which should be followed in construction of the learning and examination resources center.The new model for learning together and innovative service should be established by integrating the characteristic databases ,constructing communication plat-forms,strengthening librarian literacy,and bringing the functions of library resources,spaces and manpower into full play.

A kind of magnesium potassium phosphate cement developed for bone repair was cleared by FDA in 2009 and has been presently in clinical use in America.The biomaterial has the powerful adhesive capability to bind bone,ligament,and tendon to bone,as well as possessing good biocompatiblity,appropriate biodegradability and osteogenicity; to data,it is the only material which possesses the combination of adhesivity and osteogenicity among bone repair biomaterials.The clinical application of the innovative biomaterial will unprecedentedly alter the treatment in orthopedic surgery and related disciplines.To provide a comprehensive appreciation of the innovative biomaterial,this article summaries its development,characteristics of composition and preparation,formation mechanism,application study and superiority.