Background Sepsis is a common critical condition caused by the body’s overwhelming response to certain infective agents. Many biomarkers, including the serum lactate level, have been used for sepsis diagnosis and guiding treatment. Recently, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) recommended the Sequential Organ Failure Assessment (SOFA) and the quick SOFA (qSOFA) rather than lactate for screening sepsis and assess prognosis. Here, we aim to explore and compare the prognostic accuracy of the lactate level, the SOFA score and the qSOFA score for mortality in septic patients using the public Medical Information Mart for Intensive Care III database (MIMIC III). Methods The baseline characteristics, laboratory test results and outcomes for sepsis patients were retrieved from MIMIC III. Survival was analysed by the Kaplan-Meier method. Univariate and multivariate analysis was performed to identify predictors of prognosis. Receiver operating characteristic curve (ROC) analysis was conducted to compare lactate with SOFA and qSOFA scores. Results A total of 3713 cases were initially identified. The analysis cohort included 1865 patients. The 24-h average lactate levels and the worst scores during the first 24 h of ICU admission were collected. Patients in the higher lactate group had higher mortality than those in the lower lactate group. Lactate was an independent predictor of sepsis prognosis. The AUROC of lactate (AUROC, 0.664 [95% CI, 0.639–0.689]) was significantly higher than that of qSOFA (AUROC, 0.547 [95% CI, 0.521–0.574]), and it was similar to the AUROC of SOFA (AUROC, 0.686 [95% CI, 0.661–0.710]). But the timing of lactate relative to SOFA and qSOFA scores was inconsistent. Conclusion Lactate is an independent prognostic predictor of mortality for patients with sepsis. It has superior discriminative power to qSOFA, and shows discriminative ability similar to that of SOFA. Electronic supplementary material The online version of this article (10.1186/s13049-019-0609-3) contains supplementary material, which is available to authorized users.
Materials for photosensitized oxygen activation are extremely important for a suite of photodynamic applications in biomedical, analytical, and energy sectors. Carbon-based photosensitizers are attractive for their low cost and high stability, but most of them such as fullerene and graphene quantum dots suffer from low efficiency, and the rational design of carbon-based photosensitizers remains a challenge. Given the similar chemical origin of phosphorescence and photosensitization, we herein synthesized a series of nitrogen-doped carbon dots (C-dots) and confirmed that their photo-oxidation activity correlated with their phosphorescence quantum yields, providing a direction for the rational designing of such materials. Compared to other carbon nanomaterials and molecular photosensitizers, these C-dots have the highest activity, and they can finish oxidation reactions in a few seconds. The excellent photosensitized oxygen activation makes these water-soluble C-dots a promising oxidase-mimicking nanozyme for photodynamic antimicrobial chemotherapy and other applications.
Glioma groups, including lower-grade glioma (LGG) and glioblastoma multiforme (GBM), are the most common primary brain tumor. Malignant gliomas, especially glioblastomas, are associated with a dismal prognosis. Hypoxia is a driver of the malignant phenotype in glioma groups; it triggers a cascade of immunosuppressive processes and malignant cellular responses (tumor progression, anti-apoptosis, and resistance to chemoradiotherapy), which result in disease progression and poor prognosis. However, approaches to determine the extent of hypoxia in the tumor microenvironment are still unclear. Here, we downloaded 575 LGG patients and 354 GBM patients from Chinese Glioma Genome Atlas (GGGA), and 530 LGG patients and 167 GBM patients from The Cancer Genome Atlas (TCGA) with RNA sequence and clinicopathological data. We developed a hypoxia risk model to reflect the immune microenvironment in glioma and predict prognosis. High hypoxia risk score was associated with poor prognosis and indicated an immunosuppressive microenvironment. Hypoxia signature significantly correlated with clinical and molecular features and could serve as an independent prognostic factor for glioma patients. Moreover, Gene Set Enrichment Analysis showed that gene sets associated with the high-risk group were involved in carcinogenesis and immunosuppression signaling. In conclusion, we developed and validated a hypoxia risk model, which served as an independent prognostic indicator and reflected overall immune response intensity in the glioma microenvironment.
A long-standing challenge in nanozyme catalysis is low activity at physiological pH, especially for oxidase- and peroxidase-mimicking nanozymes. We herein communicate that Mn(II) can promote catalysis at neutral pH for carbon dots (C-dots) as a photo-oxidase nanozyme. The C-dots produce singlet oxygen upon light irradiation to oxidize Mn(II) to Mn(III), which is confirmed by a suite of spectroscopic evidence. The in situ produced Mn(III) acts as a mediator, analogous to mediators in electrochemistry to enhance electron transfer. None of the other divalent metal ions show such an effect, allowing the selective detection of Mn(II) down to 5 nM. EDTA further enhances the activity by stabilizing the highly active Mn(III), producing an intense blue color by oxidizing 3,3′,5,5′-tetramethylbenzidine (TMB) in just 10 s. Finally, this reaction was used to evaluate antioxidants. With this method, more analytical and biomedical applications of nanozymes can be exploited at neutral pH, and it may inspire other strategies to overcome the pH limitation in nanozyme catalysis.
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