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.     

Rapid response to changing environments during biological invasions: DNA methylation perspectives

Dissecting complex interactions between species and their environments has long been a research hot spot in the fields of ecology and evolutionary biology. The well‐recognized Darwinian evolution has well‐explained long‐term adaptation scenarios; however, “rapid” processes of biological responses to environmental changes remain largely unexplored, particularly molecular mechanisms such as DNA methylation that have recently been proposed to play crucial roles in rapid environmental adaptation. Invasive species, which have capacities to successfully survive rapidly changing environments during biological invasions, provide great opportunities to study molecular mechanisms of rapid environmental adaptation. Here, we used the methylation‐sensitive amplified polymorphism (MSAP) technique in an invasive model ascidian, Ciona savignyi, to investigate how species interact with rapidly changing environments at the whole‐genome level. We detected quite rapid DNA methylation response: significant changes of DNA methylation frequency and epigenetic differentiation between treatment and control groups occurred only after 1 hr of high‐temperature exposure or after 3 hr of low‐salinity challenge. In addition, we detected time‐dependent hemimethylation changes and increased intragroup epigenetic divergence induced by environmental stresses. Interestingly, we found evidence of DNA methylation resilience, as most stress‐induced DNA methylation variation maintained shortly (~48 hr) and quickly returned back to the control levels. Our findings clearly showed that invasive species could rapidly respond to acute environmental changes through DNA methylation modifications, and rapid environmental changes left significant epigenetic signatures at the whole‐genome level. All these results provide fundamental background to deeply investigate the contribution of DNA methylation mechanisms to rapid contemporary environmental adaptation.     

Nicotinic acids: liver-targeted SCD inhibitors with preclinical anti-diabetic efficacy

An in vitro screening protocol was used to transform a systemically-distributed SCD inhibitor into a liver-targeted compound. Incorporation of a key nicotinic acid moiety enables molecular recognition by OATP transporters, as demonstrated by uptake studies in transfected cell lines, and likely serves as a critical component of the observed liver-targeted tissue distribution profile. Preclinical anti-diabetic oGTT efficacy is demonstrated with nicotinic acid-based, liver-targeting SCD inhibitor 10, and studies with a close-structural analog devoid of SCD1 activity, suggest this efficacy is a result of on-target activity.     

Bidirectional regulation of dendritic voltage-gated potassium channels by the fragile X mental retardation protein

How transmitter receptors modulate neuronal signaling by regulating voltage-gated ion channel expression remains an open question. Here we report dendritic localization of mRNA of Kv4.2 voltage-gated potassium channel, which regulates synaptic plasticity, and its local translational regulation by fragile X mental retardation protein (FMRP) linked to fragile X syndrome (FXS), the most common heritable mental retardation. FMRP suppression of Kv4.2 is revealed by elevation of Kv4.2 in neurons from fmr1 knockout (KO) mice and in neurons expressing Kv4.2-3'UTR that binds FMRP. Moreover, treating hippocampal slices from fmr1 KO mice with Kv4 channel blocker restores long-term potentiation induced by moderate stimuli. Surprisingly, recovery of Kv4.2 after N-methyl-D-aspartate receptor (NMDAR)-induced degradation also requires FMRP, likely due to NMDAR-induced FMRP dephosphorylation, which turns off FMRP suppression of Kv4.2. Our study of FMRP regulation of Kv4.2 deepens our knowledge of NMDAR signaling and reveals a FMRP target of potential relevance to FXS.     

Fertilization and cytogenetic examination of interspecific reciprocal hybridization between the scallops, Chlamys farreri and Mimachlamys nobilis

Crossbreeding is a powerful tool for improving productivity and profitability in aquaculture. We conducted a pilot study of an artificial cross between two important cultivated scallops in China, Chlamys farreri and Mimachlamys nobilis, to test the feasibility of interspecific hybridization. Reciprocal hybridization experiments were performed using a single-pair mating strategy (M. nobilis ♀ × C. farreri ♂ and C. farreri ♀ × M. nobilis ♂). The fertilization of each pair was tracked using fluorescence staining of the gametes, and the chromosomes of the F1 hybrid larvae were examined via conventional karyotyping and genomic in situ hybridization (GISH). We observed moderate fertilization success in both interspecific crosses, although the overall fertilization was generally less rapid than that of intraspecific crosses. Conventional karyotyping showed that 70.4% of the viable F1 larvae in M. nobilis ♀ × C. farreri ♂ and 55.4% in C. farreri ♀ × M. nobilis ♂ comprised hybrid karyotypes (2n = 35 = 6m+5sm+11st+13t), and the results were further confirmed by GISH. Interestingly, we detected a few F1 from the M. nobilis ♀ × C. farreri ♂ cross that appeared to have developed gynogenetically. In addition, chromosome fragmentations, aneuploids and allopolyploids were observed in some F1 individuals. Our study presents evidence that the artificial cross between M. nobilis and C. farreri is experimentally possible. Further investigations of the potential heterosis of the viable F1 offspring at various developmental stages should be conducted to obtain a comprehensive evaluation of the feasibility of crossbreeding between these two scallop species.     

用平截末端使大豆根瘤菌苹果酸脱氨酶基因插入失活及电激法转化

本实验用平截末端连接法把卡那霉素抗性基因插入到大豆根瘤菌（Ｂｒａｈｙｒｈ;ｚｏｂｉｕｍｊａｐｏｎｉｃｕｍ）１１０的苹果酸脱氢酶（ｍｄｈ）基因中,致使ｍｄｈ基因失活,再通过电激法把这一重组基因转入大豆根瘤菌（Ｂｒａｈｙｒｈｉｚｏｂｉｕｍｊａｐｏｎｉｃｕｍ）２１４３中,进而探讨ｍｄｈ基因失活对大豆固氮作用的影响。     

糖皮质激素快速抑制高钾离子诱导嗜铬细胞瘤细胞内游离钙浓度升高 …

本研究应用钙离子特异光指示剂Ｆｕｒａ－２／ＡＭ,使用Ｍｉｒａｃａｌ影像系统检测了糖皮质激素对高钾离子升高嗜铬细胞瘤细胞（ＰＣ１２细胞）内游离钙浓度（［Ｃａ＾＋］ｉ）作用的影响。结果表明：（１）皮质酮抑制高钾离子诱导ＰＣ１２细胞［Ｃａ＾２＋］ｉ升高与其预处理细胞时间的长短有关,预处理３ｍｉｎ时,皮质酮开始产生抑制作用;预处理５ｍｉｎ时,其呈现的抑制作用最;预处理２５ｍｉｎ时,抑制作用基本消失。（２）     

异种血清诱发肝纤维化模型中ECM变化的研究

为了观察异种血清诱发肝纤维化过程中细胞外基质（ECM）及其生成细胞的变化规律,经腹腔注射猪血清建立大鼠肝纤维化模型,以免疫组织化学方法显示肝内胶原（Col）Ⅰ、Ⅲ、Ⅳ、Ⅴ型和纤连蛋白（Fn）及其生成细胞。结果：①Fn最早在汇管区、小叶间隔内沉积,ColⅢ、Ⅳ、Ⅴ随之增多,停止血清注射后它们都明显减弱或消失;ColⅠ沉积出现最迟,但阳性迅速增强,停止注射后仍较强;②结蛋白（Dm）阳性的肝星状细胞（HSC,原称Ito细胞）其分布和数量变化与Fn和ColⅡ基本同步,而位于汇管区及细胞间隔的原始间叶细胞（PMC）Dm（-）。提示ECM生成细胞可能来自细胞骨架表型不同的PMC和HSC,本模型由于能清晰地显示ECM及其生成细胞而更适用于肝纤维化机制及防治的研究。     

桂西壮族手皮纹的分析

本文对广西西部500例健康壮族大、中学生的手皮纹进行了观察分析,计算出各型指纹频率、指纹脊线总数、指纹频度指数、atd角度、a-b脊线数、τ距比、主线横向指数、皮纹花样出现率、掌褶纹出现率共九项基本参数,并将这些数值与汉族作了比较,桂西壮族的手纹与汉族既有相似之处,又有本民族的特点。