Hemoglobin Levels and Weaning Outcome of Mechanical Ventilation in Difficult-To-Wean Patients: A Retrospective Cohort Study

Introduction

The effect of hemoglobin levels on the weaning outcomes of mechanically ventilated patients remains under debate, particularly for the patients with difficult weaning. This study aims to evaluate the effect of hemoglobin levels on weaning outcomes in difficult-to-wean patients.

Methods

This retrospective cohort study was conducted in a university-affiliated teaching hospital in Taiwan. Patients who fulfilled the criteria of difficult weaning were enrolled. Medical records were reviewed to obtain data on hemograms, biochemistry tests, transfusion records, comorbidities and weaning outcome. The association between hemoglobin levels and 30-day weaning outcomes was evaluated using a logistic regression model.

Results

A total of 751 patients received mechanical ventilation during the study period, 138 of whom fulfilled the criteria of difficult weaning. Compared with the patients whose hemoglobin was <8 g/dL, those with higher hemoglobin levels were more likely to be successfully weaned (odds ratio [OR], 3.69; 95% CI, 1.22–11.15 for hemoglobin 8–10 g/dL and OR, 4.16, 95% CI, 1.30–13.29 for hemoglobin >10 g/dL). Multivariate analysis showed that the odds ratio for weaning success remained significant for hemoglobin levels of 8–10 g/dL (adjusted OR, 3.3; 95% CI, 1.07–10.15) with borderline significance for hemoglobin level > 10 g/dL (adjusted OR, 2.95, 95% CI, 0.88–9.96).

Conclusions

Hemoglobin level is independently associated with weaning outcome in difficult-to-wean patients. Further studies are needed to evaluate whether a restrictive transfusion trigger for acute critical illness is also appropriate for such patients.     

Electroacupuncture Ameliorates Cognitive Impairment Through the Inhibition of NLRP3 Inflammasome Activation by Regulating Melatonin-Mediated Mitophagy in Stroke Rats

Neurochemical Research - Previous studies found that electroacupuncture (EA) at the Shenting (DU24) and Baihui (DU20) acupoints alleviates cognitive impairment in cerebral...     

Rapid and sensitive assay for the phytotoxin rhizobitoxine.

Rhizobitoxine is a phytotoxin synthesized by some strains of the legume symbiont genus Bradyrhizobium and the plant pathogen Pseudomonas andropogonis. We demonstrate here a new enzymatic assay which is 100-fold more sensitive than previous assays and can detect as little as 1.0 pmol of rhizobitoxine. The assay is based on the inhibition of Salmonella typhimurium beta-cystathionase by rhizobitoxine. Interestingly, beta-cystathionase from Bradyrhizobium japonicum is insensitive to rhizobitoxine at concentrations lower than 75 microM.     

Supramolecular aggregation/disaggregation-based molecular sensing: a review focused on investigations from China

Supramolecular aggregation and disaggregation induced by external stimuli can impact the optical or electrical signals of the aggregates/constituting units (receptors). Therefore, manipulating supramolecular aggregation/disaggregation has recently been employed to construct novel and promising photoluminescence (PL)‐based sensing and recognition systems. The sensing systems were capable of substantially enhancing the sensitivity, relying on cooperative interactions occurring in the assembly/disassembly processes (mostly operating in emission turned‐on or emission‐enhanced mode). This review focuses mainly on recent advances in the new emerging PL‐based sensing platforms, based on manipulating the behaviours of supramolecular aggregation/disaggregation, including aggregation‐induced emission (AIE), metallophilic interactions‐related sensing (metallophilic interactions‐induced aggregation/disaggregation), metal coordination polymers‐related sensing, and other sensing systems involving supramolecular aggregation/disaggregation. In particular, those sensing systems developed by scientists in China are summarized and highlighted. Copyright © 2011 John Wiley & Sons, Ltd.     

pH-induced conformational changes in the soluble manganese-stabilizing protein of photosystem II

In this paper, we analyzed the pH-induced changes in the conformational states of the manganese-stabilizing protein (MSP) of photosystem II. Distinct conformational states of MSP were identified using fluorescence spectra, far-UV circular dichroism, and pressure-induced unfolding at varying suspension pH values, and four different conformational states of MSP were clearly distinguished using the center of fluorescence spectra mass when suspension pH was altered from 2 to 12. MSP was completely unfolded at a suspension pH above 11 and partly unfolded below a pH of 3. Analysis of the center of fluorescence spectral mass showed that the MSP structure appears stably folded around pH 6 and 4. The conformational state of MSP at pH 4 seems more stable than that at pH 6. Studies of peak positions of tryptophan fluorescence and MSP-bound 1-anilinonaphthalene-8-sulfonic acid fluorescence spectra supported this observation. A decrease in the suspension pH to 2 resulted in significant alterations in the MSP structure possibly because of protonation of unprotonated residues at lower pH, suggesting the existence of a large number of unprotonated amino acid residues at neutral pH possibly useful for proton transport in oxygen evolution. The acidic pH-induced conformational changes of MSP were reversible upon increase of pH to neutral pH; however, N-bromosuccinimide modification of tryptophan (Trp241) blocks the recovery of pH-induced conformational changes in MSP, implying that Trp241 is a key residue for the unfolded protein to form a functional structure. Thus, pH-induced structural changes of stable MSP (pH 6-4) may be utilized to analyze its functionality as a cofactor for oxygen evolution.     

Home range and habitat use of male Reeves’s pheasant (Syrmaticus reevesii) during winter in Dongzhai National Nature Reserve, Henan Province, China

Home range and habitat use of male Reeves’s pheasant (Syrmaticus reevesii) were studied during winter of 2001∼2002 and 2002∼2003 in the Dongzhai National Nature Reserve, Henan Province. Results from five individuals of Reeves’s pheasant with over 30 relocations, indicated that the average size of home range was 10.03 ± 1.17 hm² by Minimum Convex Polygon method, 8.60 ± 0.35 hm² by 90% Harmonic Mean Transformation method, and 9.50 ± 1.90 hm² by 95% Fixed Kernel method. It was observed that the winter range is smaller than that in the breeding season. The mean core area of the home range was found to be 1.88 ± 0.37 hm². Although the habitat composition of the core area varied greatly for individuals, a large part of the habitats used were composed of confier and broadleaf mixed forests, masson pine forests, fir forests, and shrubs. Habitat use within the study area was non-random, while habitats within home ranges were randomly used. Habitat use was dictated by tree diameter at breast height, shrub height and coverage at 2.0 m. The proximity between forests and shrubs were also found to be important in providing refuge for the birds during winter. Recommendations for conservation management include protecting the existing habitats in Dongzhai National Nature Reserve, increasing suitable habitat for Reeves’s Pheasant through artificial plantations (e.g. firs), and restoring some parts of the large shrub area into forests. __________ Translated from Biodiversity Science, 2005, 13 (5) [译自: 生物多样性, 2005,13(5)]     

Protein kinase A RII-like (R2D2) proteins exhibit differential localization and AKAP interaction

A-kinase anchoring proteins (AKAPs) bind to protein kinase A (PKA) via an amphipathic helix domain that interacts with a dimerization/docking domain on the regulatory (R) subunit of PKA. Four other mammalian proteins (ROPN1, ASP, SP17, and CABYR) also contain a highly conserved RII dimerization/docking (R2D2) domain, suggesting all four proteins may interact with all AKAPs in a manner similar to RII. All four of these proteins were originally detected in the flagellum of mammalian sperm. In this report, we demonstrate that all four R2D2 proteins are expressed in a wide variety of tissues and three of the proteins SP17, CABYR, and ASP are located in motile cilia of human bronchus and fallopian tubes. In addition, we detect SP17 in primary cilia. We also provide evidence that ROPN1 and ASP bind to a variety of AKAPs and this interaction can be disrupted with anchoring inhibitor peptides. The interaction of SP17 and CABYR with AKAPs appears to be much more limited. None of the R2D2 proteins appears to bind cAMP, a fundamental characteristic of the regulatory subunits of PKA. These observations suggest that R2D2 proteins utilize docking interactions with AKAPs to accomplish their function of regulating cilia and flagella. Based on location, affinity for AKAPs and lack of affinity for cAMP, it appears that each R2D2 protein has a unique role in this process.     

金雀异黄素对不同淋巴转移能力的小鼠肝癌细胞株的抑制作用

MTT法检测大豆提取物金雀异黄素（genistein,Gen）对不同淋巴转移能力的腹水型小鼠肝癌细胞株HepA-H和HepA-L的生长抑制作用。应用电镜观察细胞形态和流式细胞术检测细胞凋亡。将HepA-H和HepA-L接种NIH小鼠,制备荷瘤动物模型,Gen腹腔给药后第14天取淋巴结观察,并计算转移率。TUNEL法检测淋巴结凋亡细胞,并计算凋亡指数。实验发现：（1）Gen对两株细胞均具有良好的生长抑制作用,且对HepA-H的抑制优于HepA-L;（2）Gen在体外诱导两株细胞发生凋亡,且HepA-H的凋亡率高于HepA-L,并呈量效关系;（3）Gen抑制荷瘤动物肿瘤生长和肿瘤淋巴转移,且对HepA-H的抑制强于HepA-L,实验组H的凋亡指数（3．87％）也显著高于实验组L（1．69％）。故研究认为Gen显著抑制HepA-H和HepA-L肝癌细胞淋巴转移的作用机制,可能与诱导细胞凋亡有关,对高淋巴转移细胞的抑制作用强于低淋巴转移细胞,提示Gen抗肿瘤作用具有一定的选择性。     

A rare protein fluorescence behavior where the emission is dominated by tyrosine: case of the 33-kDa protein from spinach photosystem II

An abnormal fluorescence emission of protein was observed in the 33-kDa protein which is one component of the three extrinsic proteins in spinach photosystem II particle (PS II). This protein contains one tryptophan and eight tyrosine residues, belonging to a "B type protein". It was found that the 33-kDa protein fluorescence is very different from most B type proteins containing both tryptophan and tyrosine residues. For most B type proteins studied so far, the fluorescence emission is dominated by the tryptophan emission, with the tyrosine emission hardly being detected when excited at 280 nm. However, for the present 33-kDa protein, both tyrosine and tryptophan fluorescence emissions were observed, the fluorescence emission being dominated by the tyrosine residue emission upon a 280 nm excitation. The maximum emission wavelength of the 33-kDa protein tryptophan fluorescence was at 317 nm, indicating that the single tryptophan residue is buried in a very strong hydrophobic region. Such a strong hydrophobic environment is rarely observed in proteins when using tryptophan fluorescence experiments. All parameters of the protein tryptophan fluorescence such as quantum yield, fluorescence decay, and absorption spectrum including the fourth derivative spectrum were explored both in the native and pressure-denatured forms.