Objective To investigate the protective effect and mechanism of Daucosterol on H2O2-induced oxidative stress in hu-man renal duct epithelial cells(HK-2 cells).Methods HK-2 cells were cultured in vitro,and treated with different concentrations of H2O2(1 μmol/L,5μmol/L,10μmol/L,50μmol/L and 100pmol/L)for 24h in H2O2 treatment group;In Daucosterol intervention group,HK-2 cells were pretreated with 50μmol/L Daucosterol for 2h and then treated with different concentrations of H2O2.CCK-8 assay was used to detect cell viability in each group.Hochest33342/PI fluorescence staining and caspase-3 immunofluorescence assay were used to analyze cell apoptosis.The levels of reactive oxygen species(ROS)were analyzed using DCFH-DA fluorescent probe stai-ning.Western blot assay was used to analyze the expression levels of Bax,Bcl-2 and NOX4.Results The inhibition rates in 50μmol/L and 100μmol/L H2O2 treatment groups were 20.74％±3.32％and 53.90％±2.37％;the inhibition rates in Daucosterol intervention group were 10.29％±1.69％(t=4.859,P=0.008)and 37.38％±3.95％(t=6.212,P=0.003),respectively,and the differ-ences were statistically significant.The results of Hochest33342/PI fluorescence staining showed significantly more Hochest33342 fluores-cence signal aggregation and PI fluorescence positive cells in H2O2 treatment group than in Daucosterol intervention group.Immunofluores-cence assay showed that the expression level of caspase-3 in H2O2 treatment group was significantly higher than that in Daucosterol inter-vention group.ROS level in Daucosterol intervention group was significantly attenuated compared with H2O2 treatment group.The results of Western blot showed that the expression level of NOX4 protein in H2O2 treatment group was higher than that in the control group,but significantly decreased in Daucosterol intervention group;The expression level of Bax protein also decreased in Daucosterol intervention group,compared with H2O2 treatment group.Conclusion Daucosterol intervention can alleviate H2O2-induced oxidative stress in HK-2 cells and reduce apoptosis to exert a protective effect.

Objective:To evaluate the predictive value of sequential organ failure assessment (SOFA) for 28-day mortality in patients with post-cardiac arrest syndrome (PCAS).Methods:Retrospective analysis of 125 patients with PCAS who were treated in Emergency Intensive Care Unit (EICU) of Wenzhou People's Hospital from July 2016 to July 2021. Clinical data were collected, including age, gender, underlying diseases, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), SOFA score on admission to EICU and 28-day mortality. Univariate and multivariate Logistic regression model was constructed to analyze the influencing factors of PCAS patients, which was used to examine the independent correlation between SOFA score and 28-day mortality. Receiver operator characteristic curve (ROC curve) was used to determine the best predictive value of SOFA score and 28-day mortality in PCAS patients.Results:Among the 125 PCAS patients, there were 91 males and 34 females with an average age of (58.7±15.1) years old, and 97 died and 28 survived within 28 days. The overall SOFA score ranged from 7 to 15 points, with an average of 10.9 (10.0, 12.0) points. The SOFA score of non-survival group was significantly higher than that of the survival group [points: 11.0 (10.0, 12.0) vs. 9.5 (9.0, 10.0), P < 0.05]. This difference between SOFA score mainly caused by the neurological and cardiovascular systems. After excluding neurological factors, the SOFA score of the non-survival group was still significantly higher than that of the survival group [points: 8.0 (6.0, 8.0) vs. 6.5 (6.0, 7.0), P < 0.05]. SOFA score was found to be an independent risk factor for 28-day mortality in PCAS patients by multifactorial Logistic regression analysis [odds ratio ( OR) = 1.97, 95% confidence interval (95% CI) was 1.24-3.04]. The correlation between neurological score and mortality was the highest in subgroups ( OR = 3.47, 95% CI was 1.04-11.52). The area under the ROC curve (AUC) predicted by SOFA score was 0.81 (95% CI was 0.73-0.89). When SOFA score cut-off value was 10.5 points (10 or 11 points), the sensitivity and specificity of SOFA score for predicting 28-day mortality in patients with PCAS were 67.0% and 82.1%, respectively. Conclusions:The SOFA score is quite accurate in predicting 28-day mortality in patients with PCAS.

Objective:To explore the optimal pulse oxygen saturation (SpO 2) range during hospitalization for patients with sepsis. Methods:A case-control study design was employed. Demographic information, vital signs, comorbidities, laboratory parameters, critical illness scores, clinical treatment information, and clinical outcomes of sepsis patients were extracted from the Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ). A generalized additive model (GAM) combined with a Loess smoothing function was employed to analyze and visualize the nonlinear relationship between SpO 2 levels during hospitalization and in-hospital all-cause mortality. The optimal range of SpO 2 was determined, and Logistic regression model along with Kaplan-Meier curve were utilized to validate the association between the determined range of SpO 2 and in-hospital all-cause mortality. Results:A total of 5?937 patients met the inclusion criteria, among whom 1?191 (20.1%) died during hospitalization. GAM analysis revealed a nonlinear and U-shaped relationship between SpO 2 levels and in-hospital all-cause mortality among sepsis patients during hospitalization. Multivariable Logistic regression analysis further confirmed that patients with SpO 2 levels between 0.96 and 0.98 during hospitalization had a decreased mortality compared to those with SpO 2 < 0.96 [hypoxia group; odds ratio ( OR) = 2.659, 95% confidence interval (95% CI) was 2.190-3.229, P < 0.001] and SpO 2 > 0.98 (hyperoxia group; OR = 1.594, 95% CI was 1.337-1.900, P < 0.001). Kaplan-Meier survival curve showed that patients with SpO 2 between 0.96 and 0.98 during hospitalization had a higher probability of survival than those patient with SpO 2 < 0.96 and SpO 2 > 0.98 (Log-Rank test: χ2 = 113.400, P < 0.001). Sensitivity analyses demonstrated that, with the exception of subgroups with smaller sample sizes, across the strata of age, gender, body mass index (BMI), admission type, race, heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate, body temperature, myocardial infarction, congestive heart failure, cerebrovascular disease, chronic liver disease, diabetes mellitus, sequential organ failure assessment (SOFA), simplified acute physiology score Ⅱ (SAPSⅡ), systemic inflammatory response syndrome score (SIRS), and Glasgow coma score (GCS), the mortality of patients with SpO 2 between 0.96 and 0.98 was significantly lower than those of patients with SpO 2 < 0.96 and SpO 2 > 0.98. Conclusions:During hospitalization, the level of SpO 2 among sepsis patients exhibits a U-shaped relationship with in-hospital all-cause mortality, indicating that heightened and diminished oxygen levels are both associated with increased mortality risk. The optimal SpO 2 range is determined to be between 0.96 and 0.98.