The Chinese Society of Critical Care Medicine (CSCCM) has developed the clinical practice guidelines of nutrition assessment and monitoring for patients in adult intensive care unit (ICU) of China. This guideline focuses on nutrition assessment and metabolic monitoring to achieve the optimal and individualized nutrition therapy for critical ill patients. This guideline was made by experts in critical care medicine and evidence-based medicine methodology and was developed after a thorough system review and summary of relevant trials or studies published from 2000 to July 2023. A total of 18 recommendations were formed and consensus was reached through discussions and review by expert groups in critical care medicine, parenteral and enteral nutrition, and surgery. The recommendations are based on the currently available evidence and cover several key fields, including nutrition risk screening and assessment, evaluation and assessment of enteral feeding intolerance, metabolic and nutritional measurement and monitoring during nutrition therapy, and organ function evaluation related to nutrition supply. Each question was analyzed according to the PICO principle. In addition, interpretations were provided for four questions that did not reach a consensus but may have potential clinical and research value. The plan is to update this nutrition assessment and monitoring guideline using the international guideline update method within 3 to 5 years.
Adult ; Humans ; China ; Critical Care ; Critical Illness/therapy* ; Intensive Care Units ; Nutrition Assessment ; Nutritional Support/methods*

Studies have shown that spatial attention remarkably affects the trial-to-trial response variability shared between neurons. Difficulty in the attentional task adjusts how much concentration we maintain on what is currently important and what is filtered as irrelevant sensory information. However, how task difficulty mediates the interactions between neurons with separated receptive fields (RFs) that are attended to or attended away is still not clear. We examined spike count correlations between single-unit activities recorded simultaneously in the primary visual cortex (V1) while monkeys performed a spatial attention task with two levels of difficulty. Moreover, the RFs of the two neurons recorded were non-overlapping to allow us to study fluctuations in the correlated responses between competing visual inputs when the focus of attention was allocated to the RF of one neuron. While increasing difficulty in the spatial attention task, spike count correlations were either decreased to become negative between neuronal pairs, implying competition among them, with one neuron (or none) exhibiting attentional enhancement of firing rate, or increased to become positive, suggesting inter-neuronal cooperation, with one of the pair showing attentional suppression of spiking responses. Besides, the modulation of spike count correlations by task difficulty was independent of the attended locations. These findings provide evidence that task difficulty affects the functional interactions between different neuronal pools in V1 when selective attention resolves the spatial competition.
Animals ; Attention/physiology* ; Macaca mulatta ; Neurons/physiology* ; Photic Stimulation ; Primary Visual Cortex ; Visual Cortex/physiology*

Humans ; COVID-19 ; Consensus ; SARS-CoV-2 ; China

Objective:To investigate the changes in liver function and peripheral regulatory lymphocytes before and after treatment in patients with occupational medicamentosa-like dermatitis due to trichloroethylene (OMDT) .Methods:In December 2019, 16 patients with OMDT (8 patients with erythema multiforme and 8 with erythema multiforme major) who were admitted from February 2017 to February 2019 were enrolled as subjects. Liver function parameters and percentages of peripheral regulatory lymphocytes were measured before and after treatment, and the changes in liver function and peripheral regulatory T and B lymphocytes and their correlation were analyzed.Results:Before treatment, compared with the healthy control group, the experimental group had significantly higher levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , total bilirubin (TBIL) , direct bilirubin (DBIL) and gamma-glutamyl transpeptidase (GGT) and significantly lower levels of total protein (TP) , albumin (ALB) and cholinesterase (CHE) ( P<0.05) . Compared with the healthy control group, the experimental group had significantly lower percentages of lymphocytes, CD4 + T cells, CD4 +CD25 + Tregs, CD19 +CD24 +CD27 + Bregs and CD4 +/CD8 + ratio, as well as a significantly higher percentage of CD8 + T cells ( P<0.05) . Before treatment, the levels of ALT, AST, GGT and DBIL were negatively correlated with the percentages of CD4 +CD25 + Tregs, CD19 +CD24 +CD27 + Bregs, CD4 + T cells and CD4 +/CD8 + ratio ( r=-0.386 to -0.809, P<0.05) and was positively correlated with the percentage of CD8 + T cells (except DBIL) ( r=0.503-0.568, P<0.05) . The levels of TP and ALB were positively correlated with the percentages of CD4 +CD25 + Tregs, CD19 +CD24 +CD27 +Bregs and CD4 + T cells ( r= 0.351-0.784, P<0.05) , ALB was negatively correlated with the percentage of CD8 + T cells ( r=-0.315, P<0.05) . CHE was positively correlated with the percentages of CD4 +CD25 + Tregs, CD19 +CD24 +CD27 +Bregs and CD4 +/CD8 + ratio ( r=0.390-0.527, P<0.05) . Conclusion:Immune dysfunction is observed in patients with OMDT, which may be caused by the imbalance of regulatory lymphocytes. And liver injury may be associated with the increase of CD8 + T cells and the reductions of percentages of CD4 + T cells, CD4 +CD25 + Tregs, CD19 +CD24 +CD27 +Bregs and CD4 +/CD8 + ratio.

Objective:To investigate the changes in liver function and peripheral regulatory lymphocytes before and after treatment in patients with occupational medicamentosa-like dermatitis due to trichloroethylene (OMDT) .Methods:In December 2019, 16 patients with OMDT (8 patients with erythema multiforme and 8 with erythema multiforme major) who were admitted from February 2017 to February 2019 were enrolled as subjects. Liver function parameters and percentages of peripheral regulatory lymphocytes were measured before and after treatment, and the changes in liver function and peripheral regulatory T and B lymphocytes and their correlation were analyzed.Results:Before treatment, compared with the healthy control group, the experimental group had significantly higher levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , total bilirubin (TBIL) , direct bilirubin (DBIL) and gamma-glutamyl transpeptidase (GGT) and significantly lower levels of total protein (TP) , albumin (ALB) and cholinesterase (CHE) ( P<0.05) . Compared with the healthy control group, the experimental group had significantly lower percentages of lymphocytes, CD4 + T cells, CD4 +CD25 + Tregs, CD19 +CD24 +CD27 + Bregs and CD4 +/CD8 + ratio, as well as a significantly higher percentage of CD8 + T cells ( P<0.05) . Before treatment, the levels of ALT, AST, GGT and DBIL were negatively correlated with the percentages of CD4 +CD25 + Tregs, CD19 +CD24 +CD27 + Bregs, CD4 + T cells and CD4 +/CD8 + ratio ( r=-0.386 to -0.809, P<0.05) and was positively correlated with the percentage of CD8 + T cells (except DBIL) ( r=0.503-0.568, P<0.05) . The levels of TP and ALB were positively correlated with the percentages of CD4 +CD25 + Tregs, CD19 +CD24 +CD27 +Bregs and CD4 + T cells ( r= 0.351-0.784, P<0.05) , ALB was negatively correlated with the percentage of CD8 + T cells ( r=-0.315, P<0.05) . CHE was positively correlated with the percentages of CD4 +CD25 + Tregs, CD19 +CD24 +CD27 +Bregs and CD4 +/CD8 + ratio ( r=0.390-0.527, P<0.05) . Conclusion:Immune dysfunction is observed in patients with OMDT, which may be caused by the imbalance of regulatory lymphocytes. And liver injury may be associated with the increase of CD8 + T cells and the reductions of percentages of CD4 + T cells, CD4 +CD25 + Tregs, CD19 +CD24 +CD27 +Bregs and CD4 +/CD8 + ratio.

Objective To investigate the effects of cyclopamine (CYP) on endometrial carcinoma (HEC-1A) cell survival and on induction of cell apoptosis .Methods HEC-1A cells were treated with various doses of CYP (0, 5,10, 20 and 40 μmol/L) for 24 h respectively .Then,the inverted microscope was used to observe cell morphology .Cell proliferation and apoptosis were tested by CCK-8 assay and AO/EB bi-labelling assay.The apoptosis rate of HEC-1A was analyzed using flow cytometric analysis , and the key gene expression of Bax and Bcl-2 was detected by quantitative PCR .Results The HEC-1A cells exhibited dramatic morphological changes after treatment with CYP and in a dose-dependent manner .CYP significantly inhibited HEC-1A cell proliferation using CCK8 assays(P<0.05), and induced cell death by AO/EB bi-labelling assay.Moreover,flow cytometry analysis showed that CYP treatment resulted in HEC-1A cell apoptosis, and that a higher concentration of CYP induced severer cell apoptosis (P<0.05).Meanwhile, CYP treated HEC-1A cells exhibited up-regulated expression of Bax and down-regulated expression of Bcl-2 according to Q-PCR.Conclusion Our findings indicatee that CYP can inhibit HEC-1A cell proliferation and induce cell apoptosis .

Objective To study the inhibitory effect of recombinant human interferon α1b (IFN-α1b) on enterovirus 71 (EV71) in vitro and to investigate the antiviral mechanism of IFN-α1b.Methods The cytotoxity of IFN-α1b and the inhibition of IFN-α1b on cytopathic effect before and after EV71 infection were measured in rhabdomyosarcoma (RD) cell line.The in vitro inhibition of IFN-α1b on EV71 RNA and VP1 protein,and the protection of IFN-α1b on EV71 infected cells were also investigated.Then the EV71 invasion prevention of IFN-α1b induced transmembrane protein IFITM3 was evaluated.Results When treated 12h before or 1h after EV71 infection,IFN-α1b presented a IC50 258.53IU/ml and 2113.58IU/ml with SI>16497 and >3271,respectively,suggesting that IFN-α1b had obvious anti EV71 activity,and IFN-α1b treatment before EV71 infection was more effective.This study also showed that IFN-α1b significantly inhibited EV71 RNA replication and protein synthesis,and delayed the progeny virus release,which might prevent EV71 invasion by inducing IFITM3 expression.Conclusion IFN-α1b has anti EV71 activity and can act as an antiviral agent by influencing the viral life cycle including invasion,replication,assembly and release.

Objective To detect the expression of metastasis sappressor 1(MTSS1) gene in cervical cancer tissue and to clarify its association with cervical cancer.Methods Totally 103 cases of cervical tissue were collected between Dec 2011 and Dec 2014 and classified according to biopsy and stage .Q-PCR and Western blotting were used to detect the expression of MTSS1 in normal cervical tissue and in different clinical stages of cervical cancer tissue .Results The expression of MTSS1 inⅡB-Ⅳstages of cervical cancer tissue was significantly higher than that of normal tissue or Ⅰ-ⅡA stages through q-PCR (P=0.000).Western blotting results showed that MTSS1 was positively expressed in normal cervical tissue at a rate of 23.3% or 53.3% in cervical cancer tissue.Moreover, the expression of MTSS1 was poorly correlated with age, tumor differentiation and lymphnode metastasis in cervical cancer tissue (P>0.05).The protein level of MTSS1 expressed in ⅡB-Ⅳ stages was significantly higher than that ofⅠ-ⅡA stages(P=0.005).Conclusion The expression of MTSS1 indicates the clinical stage of cervical cancer , suggesting that MTSS1 may play an important role in the development of cervical cancer .

OBJECTIVE To study the molecular mechanism of cisplatin(DDP)by which HeLa cell growth and proliferation are inhibited. METHODS Cultured HeLa cells were treated with DDP 0.02-75 μmol · L-1 for 24 or 48 h. CCK-8 assay was used to determine the cell proliferation. The wound scratch assay was used to detect the cell migration and invasion. Flow cytometry was used to detect the cell cycle arresting. q-PCR was used to test the expression of metastasis suppressor gene 1 (MTSS1)mRNA. Western blot was used to determine protein levels of MTSS1,phosphorylated-extra?cellular signal-regulated kinase(p-ERK) and phosphorylated-serine-threonine kinase(p-AKT). RESULTS Following the treatment with DDP for 24 or 48 h,the proliferation of HeLa cells was inhibited significantly (P<0.05),the value of the half inhibitory concentration (IC50) of cells was 4.14 and 11.82 μmol · L-1. Migration and invasion activity of HeLa cells were reduced according to the wound scratch assay(P<0.05). Flow cytometry results showed that the cell cycle was arrested at S phase. q-PCR results showed that MTSS1 mRNA expression changed with DDP in a concentration-dependent manner (r24 h=-0.965,P<0.01;r48 h=-0.953,P<0.01). Western blot showed that the protein levels of MTSS1,p-ERK and p-AKT expression declined significantly with the increase in DDP concentrations(p-ERK:r24 h=-0.875,P<0.01;r48 h=-0.966,P<0.01. p-AKT:r24 h=-0.831,P<0.01;r48 h=-0.863,P<0.01. MTSS1:r24 h=-0.969,P<0.01;r48 h=-0.988,P<0.01). CONCLUSION DDP treatment inhibits HeLa growth and proliferation by interfering with the MTSS1 expression and disturbing the activation of ERK and AKT signaling pathways.

Objective To investigate whether myeloid-derived suppressor cells (MDSCs) have a protective effect in septic mice. Methods The model of caecal ligation and puncture (CLP) was performed to induce polymicrobial sepsis in mice. The changes of MDSCs in spleens at different times after operation were studied. In order to observe the influence of MDSCs on the inflammatory factors and survival of septic mice, MDSCs were injected into the peritoneal cavities of mice after CLP. Results MDSCs accumulated in spleens of septic mice progressively. MDSCs could increase anti-inflammatory cytokine production, decrease the level of inflammatory factors, and improve the survival rate of mice with sepsis. Conclusion MDSCs can attenuate the inflammation and improve the survival rate of mice with sepsis, suggesting that intraperitoneal injection of MDSCs may provide a new direction for the treatment of sepsis.