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The effect of steroids used in the treatment of coronavirus disease 2019 on infections in intensive care. 用于治疗 2019 年冠状病毒病的类固醇对重症监护中感染的影响。
IF 0.9 Pub Date : 2022-04-13 eCollection Date: 2022-01-01 DOI: 10.14744/nci.2022.43827
Ahmet Sari, Mesut Aslan, Osman Ekinci

Objective: Cytokine storm in coronavirus disease 2019 (COVID-19) patients causes lung damage and acute respiratory distress syndrome (ARDS). Immunomodulators such as steroids are widely used to control this situation. This study investigates the effectiveness of steroids used in COVID-19 patients, and their effects on secondary infections, morbidity, and mortality.

Methods: Data were obtained by retrospectively scanning the files of patients in our hospital's intensive care unit clinic during the three peak periods.

Results: Between the steroid and non-steroid groups, there was no statistically significant difference in reproductive rates. These rates were 49.7% and 43.2%, respectively. Reproductive rates among steroid types were determined as 25 (56.8%) in the Methylprednisolone group, 18 (69.2%) (Highest) in the Dexamethasone + Methylprednisolone group, and 54 (43.2%) (Lowest) in the Dexamethasone group. Steroid treatment duration was effective on reproduction. Steroids cause more infections, especially after invasive procedures (Tracheal intubation, central venous catheter, etc.). In the groups with and without tracheal aspirate steroids, the growth rates were 71 (76.3%) and 32 (54.2%) respectively. There was no difference in mortality between the groups.

Conclusion: Cytokine storm causes lung damage and ARDS. Steroids can be useful in controlling this hyper-inflammatory situation. However, increased secondary infections, an important side effect of steroids, increase mortality. Steroids more often cause these infections, especially in patients undergoing invasive Strict adherence to infection control measures during steroid treatment will reduce this risk. In conclusion, while steroids reduce mortality by controlling the hyper-inflammatory picture, they also increase mortality with increased secondary infections. Preventing infections enables success with steroids.

目的:冠状病毒病 2019(COVID-19)患者的细胞因子风暴会导致肺损伤和急性呼吸窘迫综合征(ARDS)。类固醇等免疫调节剂被广泛用于控制这种情况。本研究调查了在COVID-19患者中使用类固醇的效果及其对继发感染、发病率和死亡率的影响:方法:通过回顾性扫描本院重症监护室门诊在三个高峰期的患者档案获得数据:结果:类固醇组和非类固醇组之间的生殖率差异无统计学意义。这两组的生殖率分别为 49.7% 和 43.2%。类固醇治疗组的繁殖率分别为:甲泼尼龙组 25 例(56.8%)、地塞米松+甲泼尼龙组 18 例(69.2%)(最高)和地塞米松组 54 例(43.2%)(最低)。类固醇治疗持续时间对繁殖有效。类固醇会导致更多的感染,尤其是在侵入性操作(气管插管、中心静脉导管等)之后。在使用和未使用气管抽吸类固醇的组别中,生长率分别为 71(76.3%)和 32(54.2%)。结论:细胞因子风暴会导致肺部损伤:结论:细胞因子风暴会导致肺损伤和 ARDS。结论:细胞因子风暴会导致肺损伤和 ARDS,类固醇可以有效控制这种高炎症状态。然而,类固醇的一个重要副作用--继发感染的增加会增加死亡率。类固醇更常导致这些感染,尤其是在接受侵入性治疗的患者中。总之,类固醇虽然可以通过控制炎症反应来降低死亡率,但也会因继发感染的增加而增加死亡率。预防感染是类固醇治疗成功的关键。
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引用次数: 0
Inhibition of HIV replication through siRNA carried by CXCR4-targeted chimeric nanobody. 通过 CXCR4 靶向嵌合纳米抗体携带的 siRNA 抑制 HIV 复制。
IF 8 Pub Date : 2020-07-01 Epub Date: 2019-10-22 DOI: 10.1007/s00018-019-03334-8
Catarina Cunha-Santos, Pedro Ricardo Lucas Perdigao, Francisco Martin, Joana Gomes Oliveira, Miguel Cardoso, Ana Manuel, Nuno Taveira, Joao Goncalves

Small interfering RNA (siRNA) application in therapy still faces a major challenge with the lack of an efficient and specific delivery system. Current vehicles are often responsible for poor efficacy, safety concerns, and burden costs of siRNA-based therapeutics. Here, we describe a novel strategy for targeted delivery of siRNA molecules to inhibit human immunodeficiency virus (HIV) infection. Specific membrane translocation of siRNA inhibitor was addressed by an engineered nanobody targeting the HIV co-receptor CXCR4 (NbCXCR4) in fusion with a single-chain variable fragment (4M5.3) that carried the FITC-conjugated siRNA. 4M5.3-NbCXCR4 conjugate (4M5.3X4) efficiently targeted CXCR4+ T lymphocytes, specifically translocating siRNA by receptor-mediated endocytosis. Targeted delivery of siRNA directed to the mRNA of HIV transactivator tat silenced Tat-driven viral transcription and inhibited the replication of distinct virus clades. In summary, we have shown that the engineered nanobody chimera developed in this study constitutes an efficient and specific delivery method of siRNAs through CXCR4 receptor.

小干扰 RNA(siRNA)在治疗中的应用仍然面临着缺乏高效、特异性传输系统的重大挑战。基于 siRNA 的疗法疗效不佳、安全性堪忧、成本高昂,这些问题往往都是由目前的载体造成的。在这里,我们描述了一种靶向递送 siRNA 分子以抑制人类免疫缺陷病毒(HIV)感染的新策略。siRNA 抑制剂的特异性膜转运是通过一种针对 HIV 共受体 CXCR4(NbCXCR4)的工程纳米抗体与携带 FITC 结合 siRNA 的单链可变片段(4M5.3)融合来实现的。4M5.3-NbCXCR4 共轭物(4M5.3X4)能有效靶向 CXCR4+ T 淋巴细胞,通过受体介导的内吞作用特异性地转运 siRNA。靶向递送指向 HIV 转录激活因子 tat mRNA 的 siRNA 能抑制 Tat 驱动的病毒转录,并抑制不同病毒支系的复制。总之,我们的研究表明,本研究中开发的工程纳米抗体嵌合体是一种通过 CXCR4 受体高效、特异地递送 siRNA 的方法。
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引用次数: 0
Connexin Hemichannel Block Using Orally Delivered Tonabersat Improves Outcomes in Animal Models of Retinal Disease. 利用口服托那伯沙特阻断附件半通道可改善视网膜疾病动物模型的疗效
IF 5.7 Pub Date : 2020-01-01 DOI: 10.1007/s13311-019-00786-5
Mohd Nasir Mat Nor, Ilva D Rupenthal, Colin R Green, Monica L Acosta

Increased Connexin43 hemichannel opening is associated with inflammasome pathway activation and inflammation in a range of pathologies including ocular disorders, such as age-related macular degeneration (AMD) and diabetic retinopathy (DR). In this study, the effect on retinal function and morphology of clinically safe doses of orally delivered tonabersat, a small molecule connexin hemichannel blocker, was investigated in the light-damaged retina animal model of dry AMD and in a spontaneous rat model of DR. Clinical parameters (fundus imaging, optical coherence tomography (OCT), and electroretinography) and inflammatory markers (immunohistochemistry for Iba-1 microglial marker, astrocyte marker glial fibrillary acidic protein, and Connexin43 protein expression) were assessed. Tonabersat treatment reduced inflammation in the retina in parallel with preservation of retinal photoreceptor function when assessed up to 3 months post light damage in the dry AMD model. In the DR model, clinical signs, including the presence of aneurysms confirmed using Evans blue dye perfusion, were reduced after daily tonabersat treatment for 2 weeks. Inflammation was also reduced and retinal electrical function restored. Tonabersat regulates assembly of the inflammasome (NLRP3) through Connexin43 hemichannel block, with the potential to reduce inflammation, restore vascular integrity and improve anatomical along with some functional outcomes in retinal disease.

在包括老年性黄斑变性(AMD)和糖尿病视网膜病变(DR)等眼部疾病在内的一系列病理中,附件蛋白43半通道开放的增加与炎性体通路的激活和炎症有关。在这项研究中,研究人员在干性黄斑变性的光损伤视网膜动物模型和自发性糖尿病视网膜病变大鼠模型中研究了口服临床安全剂量的小分子连接蛋白半通道阻断剂 tonabersat 对视网膜功能和形态的影响。研究人员评估了临床参数(眼底成像、光学相干断层扫描(OCT)和视网膜电图)和炎症标记物(免疫组织化学检测 Iba-1 微胶质细胞标记物、星形胶质细胞标记物胶质纤维酸性蛋白和 Connexin43 蛋白表达)。在干性黄斑变性模型中,光损伤后 3 个月的评估结果显示,托那贝沙治疗可减少视网膜中的炎症,同时保留视网膜感光器的功能。在干性黄斑变性模型中,每天服用托那伯沙特 2 周后,临床症状(包括使用埃文斯蓝染料灌注确认的动脉瘤的存在)有所减轻。炎症也减轻了,视网膜电功能恢复了。托那伯沙特通过阻断Connexin43半通道调节炎性体(NLRP3)的组装,有可能减轻炎症、恢复血管完整性、改善视网膜疾病的解剖和某些功能结果。
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引用次数: 0
Structural analysis of free and liganded forms of the Fab fragment of a high-affinity anti-cocaine antibody, h2E2. 高亲和力抗可卡因抗体 h2E2 的 Fab 片段的游离和配体结构分析。
IF 1.1 Pub Date : 2019-11-01 Epub Date: 2019-11-05 DOI: 10.1107/S2053230X19013608
Kemin Tan, Min Zhou, Angela J Ahrendt, Norma E C Duke, Nassif Tabaja, William J Ball, Terence L Kirley, Andrew B Norman, Andrzej Joachimiak, Marianne Schiffer, Rosemarie Wilton, P Raj Pokkuluri

A high-affinity anti-cocaine monoclonal antibody, designated h2E2, is entering phase 1 clinical trials for cocaine abuse therapy. To gain insight into the molecular details of its structure that are important for binding cocaine and cocaine metabolites, the Fab fragment was generated and crystallized with and without ligand. Structures of the unliganded Fab and the Fab fragment bound to benzoylecgonine were determined, and were compared with each other and with other crystallized anti-cocaine antibodies. The affinity of the h2E2 antibody for cocaine is 4 nM, while that of the cocaine metabolite benzoylecgonine is 20 nM. Both are higher than the reported affinity for cocaine of the two previously crystallized anti-cocaine antibodies. Consistent with cocaine fluorescent quenching binding studies for the h2E2 mAb, four aromatic residues in the CDR regions of the Fab (TyrL32, TyrL96, TrpL91 and TrpH33) were found to be involved in ligand binding. The aromatic side chains surround and trap the tropane moiety of the ligand in the complex structure, forming significant van der Waals interactions which may account for the higher affinity observed for the h2E2 antibody. A water molecule mediates hydrogen bonding between the antibody and the carbonyl group of the benzoyl ester. The affinity of binding to h2E2 of benzoylecgonine differs only by a factor of five compared with that of cocaine; therefore, it is suggested that h2E2 would bind cocaine in the same way as observed in the Fab-benzoylecgonine complex, with minor rearrangements of some hypervariable segments of the antibody.

一种名为 h2E2 的高亲和力抗可卡因单克隆抗体正进入用于可卡因滥用治疗的第一阶段临床试验。为了深入了解其结构中对结合可卡因和可卡因代谢物非常重要的分子细节,我们生成了 Fab 片段,并在有配体和无配体的情况下将其结晶化。测定了未加配体的 Fab 和与苯甲酰基可待因结合的 Fab 片段的结构,并将其与其他结晶的抗可卡因抗体进行了比较。h2E2 抗体对可卡因的亲和力为 4 nM,而对可卡因代谢物苯甲酰可待因的亲和力为 20 nM。两者都高于之前报道的两种结晶化抗可卡因抗体对可卡因的亲和力。与对 h2E2 mAb 进行的可卡因荧光淬灭结合研究一致,发现 Fab CDR 区域的四个芳香族残基(TyrL32、TyrL96、TrpL91 和 TrpH33)参与了配体结合。在复合物结构中,芳香族侧链环绕并捕获配体的托烷分子,形成重要的范德华相互作用,这可能是 h2E2 抗体亲和力较高的原因。一个水分子介导了抗体与苯甲酰酯羰基之间的氢键。与可卡因相比,苯甲酰可待因与 h2E2 的亲和力仅相差五倍;因此,有人认为 h2E2 与可卡因的结合方式与在 Fab-苯甲酰可待因复合物中观察到的方式相同,只是对抗体的某些超变异区段进行了微小的重排。
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引用次数: 0
Job dissatisfaction, 'burnout' and alienation of labour: undercurrents in England's NHS. 工作不满、"职业倦怠 "和劳动异化:英格兰国家医疗服务体系中的暗流。
IF 8.8 Pub Date : 2019-09-01 DOI: 10.1177/0141076819855956
Steve Iliffe, Jill Manthorpe
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引用次数: 0
Analysis of Mortality and Survival Rate of Liver Cancer in Zhejiang Province in China: A General Population-Based Study. 中国浙江省肝癌死亡率和生存率分析:基于普通人群的研究
IF 2.7 Pub Date : 2019-07-10 eCollection Date: 2019-01-01 DOI: 10.1155/2019/1074286
Fang-Rong Fei, Ru-Ying Hu, Wei-Wei Gong, Jin Pan, Meng Wang

Background: Few accurate up-to-date studies provide liver cancer mortality and survival information in Zhejiang province. This research aimed to depict the mortality and survival of liver cancer in Zhejiang province in China during 2005-2010.

Methods: The data were collected from the Zhejiang Chronic Disease Surveillance Information and Management System, and the mortality rates of liver cancer were calculated by gender, age, and areas. Chinese population census in 2000 and Segi's world population were used for age-standardized mortality rate. The observed and relative survival rates of liver cancer patients were analyzed.

Results: The crude mortality rate of liver cancer was 32.11/105. The age-standardized mortality rate was 17.39/105 and 23.07/105 by Chinese population (ASIRC) and Segi's world population (ASIRW), respectively. The crude liver cancer mortality rate and age-standardized rate in urban areas were lower than those of rural areas. The overall 1-, 3-, and 5-year observed survival (OS) rates of liver cancer patients were 38.61%, 21.65%, and 16.83%, respectively. The 1-, 3-, and 5-year relative survival (RS) rates of liver cancer patients were 39.49%, 23.27%, and 19.09%, respectively. Survival rate decreased obviously within 1 to 5 years and then leveled off. It was shown that the male overall survival rate was higher than the female one and the difference was statistically significant (P<0.05).

Conclusions: Both lower mortality and better survival rates were observed in urban areas, compared to rural areas. Relevant parties including government, public resource, and propaganda department should devote enough attention to rural areas.

背景:很少有准确的最新研究提供浙江省肝癌死亡率和生存率的信息。本研究旨在描述 2005-2010 年浙江省肝癌的死亡率和生存率:方法:数据来自浙江省慢性病监测信息管理系统,按性别、年龄和地区计算肝癌死亡率。年龄标准化死亡率采用 2000 年中国人口普查数据和 Segi 的世界人口数据。对肝癌患者的观察生存率和相对生存率进行了分析:结果:肝癌的粗死亡率为 32.11/105。结果:肝癌粗死亡率为 32.11/105,按中国人口(ASIRC)和 Segi's 世界人口(ASIRW)计算的年龄标准化死亡率分别为 17.39/105 和 23.07/105。城市地区的粗肝癌死亡率和年龄标准化死亡率均低于农村地区。肝癌患者的1年、3年和5年总观察生存率(OS)分别为38.61%、21.65%和16.83%。肝癌患者的 1 年、3 年和 5 年相对生存率(RS)分别为 39.49%、23.27% 和 19.09%。生存率在1至5年内明显下降,随后趋于平稳。结果显示,男性总生存率高于女性,且差异具有统计学意义(PConclusions:与农村地区相比,城市地区的死亡率更低,存活率更高。包括政府、公共资源和宣传部门在内的有关方面应给予农村地区足够的重视。
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引用次数: 0
Liquid Crystals 液晶
Pub Date : 2019-06-30 DOI: 10.1017/9781108595308.014
P. Biscari
Since the beginning of the 1970’s the term soft matter has been established to describe the complex behavior of a large variety of materials that share some common features, mainly related to the nontrivial interaction between the microand the macroscopic degrees of freedom. Liquid crystals, colloids, polymers, granular materials and biological tissues are only a few among the many soft materials that challenge today’s research.
自20世纪70年代初以来,“软物质”一词被用来描述具有一些共同特征的大量材料的复杂行为,这些特征主要与微观自由度和宏观自由度之间的非平凡相互作用有关。液晶、胶体、聚合物、颗粒材料和生物组织只是挑战当今研究的许多软材料中的一小部分。
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引用次数: 0
Lubricants 润滑剂
Pub Date : 2019-06-30 DOI: 10.1017/9781108595308.009
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引用次数: 9
Nanochemistry
Pub Date : 2019-06-30 DOI: 10.1002/9780470740880.ch15
Ashutosh Sharma, G. Oza
{"title":"Nanochemistry","authors":"Ashutosh Sharma, G. Oza","doi":"10.1002/9780470740880.ch15","DOIUrl":"https://doi.org/10.1002/9780470740880.ch15","url":null,"abstract":"","PeriodicalId":50368,"journal":{"name":"Industrial and Engineering Chemistry","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88268174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
Chemistry of Carbon and Hydrogen 碳和氢化学
Pub Date : 2019-06-30 DOI: 10.1017/9781108595308.028
{"title":"Chemistry of Carbon and Hydrogen","authors":"","doi":"10.1017/9781108595308.028","DOIUrl":"https://doi.org/10.1017/9781108595308.028","url":null,"abstract":"","PeriodicalId":50368,"journal":{"name":"Industrial and Engineering Chemistry","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79537087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Industrial and Engineering Chemistry
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