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Exercise intolerance is a major manifestation of pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). We aimed to investigate the characteristics of exercise intolerance in different subgroups of PAH-CHD.We retrospectively enrolled 171 adult patients with PAH-CHD and 30 age and sex-matched healthy subjects and performed cardiopulmonary exercise testing. Gas exchange parameters, including peak oxygen uptake (peak V̇oThe median age of patients at enrollment was 27.8 years, and 131 (76.6%) were female. Peak V̇oExercise capacity was severely reduced in patients with PAH-CHD. Among the four subgroups, patients with Eisenmenger syndrome had the worst exercise capacity and ventilatory efficiency.

Neovascularization is critical to improve the diabetic microenvironment, deliver abundant nutrients to the wound and promote wound closure. However, the excess of oxidative stress impedes the healing process. Herein, a self-adaptive multifunctional hydrogel with self-healing property and injectability is fabricated through a boronic ester-based reaction between the phenylboronic acid groups of the 3-carboxyl-4-fluorophenylboronic acid -grafted quaternized chitosan and the hydroxyl groups of the polyvinyl alcohol, in which pro-angiogenic drug of desferrioxamine (DFO) is loaded in the form of gelatin microspheres (DFO@G). The boronic ester bonds of the hydrogel can self-adaptively react with hyperglycemic and hydrogen peroxide to alleviate oxidative stress and release DFO@G in the early phase of wound healing. A sustained release of DFO is then realized by responding to overexpressed matrix metalloproteinases. In a full-thickness diabetic wound model, the DFO@G loaded hydrogel accelerates angiogenesis by upregulating expression of hypoxia-inducible factor-1 and angiogenic growth factors, resulting in collagen deposition and rapid wound closure. This multifunctional hydrogel can not only self-adaptively change the microenvironment to a pro-healing state by decreasing oxidative stress, but also respond to matrix metalloproteinases to release DFO. The self-adaptive multifunctional hydrogel has a potential for treating diabetic wounds.

To determine whether the stress-induced hyperglycemia ratio (SHR) is independently associated with in-hospital mortality in critically ill patients in nonresuscitation ICUs.In this retrospective cohort study, clinical- and laboratory-related data from patients first admitted to nonresuscitation ICUs were extracted from an open-access database of50,000 ICU admissions. Patients were assigned to one of two groups according to an SHR threshold of 1.1. The primary end point of this study was the in-hospital mortality rate. The associations between SHR and length of stay in the ICU and hospital, duration of mechanical ventilation use, and vasopressor use were secondary end points. Logistic regression models were established in the analysis of in-hospital mortality risk, and areas under the receiver operating characteristic curve (AUC) were analyzed to investigate the association between the primary end point and SHR used alone or together with the Simplified Acute Physiology Scale (SAPS) II score. The Youden index, specificity, and sensitivity of SHR and SAPS-II were also assessed.In this study, 1859 patients were included, 187 of whom (10.06%) died during hospitalization. The group with an SHR of ≥1.1 had a greater in-hospital mortality rate (13.7% vs 7.4%; P0.001), longer length of stay both in the ICU and in the hospital, a longer duration of mechanical ventilation use, and a greater rate of vasopressor use. On adjustment for multivariate risk, a 0.1-point increment in SHR was significantly associated with in-hospital mortality (OR = 1.08; 95% CI, 1.00-1.16; P = 0.036). The AUC of the association between risk and the SAPS-II score was significantly greater than that with SHR (0.797 [95% CI, 0.576-0.664] vs 0.620 [95% CI, 0.764-0.830]; P0.001). The AUC with SAPS-II + SHR was significantly greater than that with SAPS-II used alone (0.802 [95% CI, 0.770-0.835] vs 0.797 [95% CI, 0.764-0.830]; P = 0.023). The Youden index, specificity, and sensitivity of SAPS-II + SHR were 0.473, 0.703, and 0.770, respectively.Stress-induced hyperglycemia, as evaluated using the SHR, was associated with increased in-hospital mortality and worse clinical outcomes in these critically ill patients in nonresuscitation ICUs. SHR was an independent risk factor for in-hospital mortality, and when used together with the SAPS-II, added to the capacity to predict mortality in these patients in nonresuscitation ICUs. Prospective data are needed to validate the capacity of SHR in predicting in-hospital mortality in patients in the nonresuscitation ICU.

Singapore grouper iridovirus (SGIV) is a highly pathogenic double-stranded DNA virus, and the fatality rate of SGIV-infected grouper is more than 90%. Up to now, there is no effective methods to control the disease. Long non-coding RNAs (lncRNAs) might play an important role in individual growth and development, immune regulation and other life processes. In this study, lncRNAs were identified in Epinephelus coioides, an important economic aquaculture marine fish in China and Southeast Asia, and the regulatory relationships of lncRNAs and mRNA response to SGIV infection were analyzed. A total of 11,678 lncRNAs were identified and classified from the spleen and GS (grouper spleen) cells. 105 differentially expressed lncRNAs (DElncRNAs) were detected during SGIV infection. The lncRNAs and the regulated mRNAs were analyzed using co-expression network, lncRNA target gene annotation and GO enrichment. At 24 and 48 h after SGIV infection, 118 and 339 lncRNA-mRNA pairs in GS cells were detected, and 728 and 688 differentially expressed lncRNA-mRNA pairs in spleen were obtained, respectively. GO and KEGG were used to predict the DE lncRNAs' target genes, and deduce the DE lncRNAs-affected signaling pathways. In GS cells, lncRNAs might participate in cell part, binding and catalytic activity; and lncRNAs might be involved in immune system process and transcription factor activity in spleen. These data demonstrated that lncRNAs could regulate the expression of immune-related genes response to viral infection, and providing a new insight into understanding the complexity of immune regulatory networks mediated by lncRNAs during viral infection in teleost fish.