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RNA interference technology is a powerful tool with substantially clinical prospects for carcinoma therapy, in which efficiency and specificity of delivery of dsRNA remains a critical issue. Herein, aiming at delivery of dsRNA in efficient and safe way, we constructed targeting delivery platform (CTL-PEG-FA) by grafting curdlan with trilysine through click reaction, then modifying with PEG linked folic acid. The CTL-PEG-FA vector exhibited excellent gene binding capacity to condense siRNA and dramatically reduced cytotoxicity. Increased cell uptake of CTL-PEG-FA/Bcl-2 siRNA was achieved by the synergism of folate mediated endocytosis and charge interaction, and further causing severe HepG2 cells injury through apoptosis mechanism after down-regulation of Bcl-2 protein. In vivo experiments, CTL-PEG-FA/Bcl-2 siRNA complex distinctly accumulated in tumor site and significantly inhibited the growth of tumor, while no obvious toxicity was observed. Therefore, well-performed CTL-PEG-FA with excellent biocompatibility, has the potential to be the candidate of gene therapy for clinical applications.

Nurse staffing impacts patient outcomes, but little is known about the relationship between nurse staffing and outcomes for lung cancer patients undergoing pulmonary lobectomy.

To examine the association between nurse staffing and outcomes following lobectomy for lung cancer.

Patients (N=16,994) with lung cancer between who underwent lobectomy between 2008-2011 were identified in the National Inpatient Sample. Nurse staffing was quantified using registered nurse full-time equivalents per adjusted patient days. Multivariable models were used to estimate the effect of RN FTEs on mortality, length of stay, and costs, controlling for covariates.

Patients treated at hospitals using 5.6 or more RN FTEs had shorter hospitals stays by 0.37 days (p=0.008), had 36% lower odds of mortality (OR=0.64, p=0.014), but incurred $4,388 (p<0.0001) in additional costs.

Hospital administrators face a troubling trade-off between costs and outcomes in decisions about nurse staffing mix for pulmonary lobectomy.

Hospital administrators face a troubling trade-off between costs and outcomes in decisions about nurse staffing mix for pulmonary lobectomy.COVID-19 is a relatively new and rapidly emerging disease. Given current knowledge of the disease process, it is of the utmost importance to gain further insight into its different clinical manifestations. In this report we describe three cases involving Hispanic males with COVID-19 all of whom developed pneumomediastinum during their hospital course. We want to emphasize the importance of this adverse event despite their non-smoking history and the exclusion of positive pressure ventilation. Frequent chest radiographs help with early recognition of this disease process. Early detection of pneumomediastinum is important as this could lead to worse morbidity if left unrecognized despite its usually benign nature.With the goal of zero-liquid discharge and green energy harvest, extraction of abundant green energy from saline water via pressure retarded osmosis (PRO) technology is a promising but challenging issue for water treatment technologies to achieve water and energy sustainability. Development of high performance PRO membranes has received increased concerns yet still under controversy in practical applications. In this review, a comprehensive and up-to-date discussion of some key historical developments is first introduced covering the major advances of PRO engineering applications and novel membranes especially made in recent years. Then the critical performance indicators of PRO membranes including water flux and power density are briefly discussed. Subsequently, sufficient discussion on four performance limiting factors in PRO membrane and process is presented including concentration polarization, reverse solute diffusion, membrane fouling and mechanical stability. To fully address these issues, an updated insight is provided into recent major progresses on advanced fabrication and modification techniques of novel PRO membranes featuring enhanced performance with different configurations and materials, which are also reviewed in detail based on the viewpoint of design rationales. Afterwards, antifouling strategies and engineering applications are critically introduced. Finally, conclusions and future perspective of PRO membrane for practical operation are briefly discussed.

Some studies have reported that long-term prognosis after pneumonia is poor. Our aim was to determine predictors of long-term outcomes with special attention to community-acquired pneumonia (CAP) etiology.

We studied 1930 patients who were hospitalized with CAP from January 2002 through November 2017at Saitama Cardiovascular and Respiratory Center and were discharged alive. We conducted a retrospective study for calculation of survival rate using the Kaplan-Meier method and analysis of prognostic factors by multivariate analysis using a Cox proportional hazard model.

The median follow-up period was 442.5 (range 1-5514) days. During this period, 321 patients died. Median survival time was 11.9 years, and 1-year and 5-year survival rates were 93.8% and 74.0%, respectively. Among the patients' demographics factors, old age, poor performance status (PS) score, pneumococcal vaccination history, some underlying respiratory diseases, and chronic heart failure were significant independent factors of poor prognosis. selleck chemical Among pathogens, Streptococcus pneumoniae (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.03, 3.07, P=0.038) and Pseudomonas aeruginosa (HR 1.68, 95% CI 1.07, 2.64, P=0.024) were significant independent factors of poor prognosis, whereas influenza virus tended to predict a good prognosis (HR 0.60, 95% CI 0.36, 1.02, P=0.058). Respiratory disease accounted for 59% of all causes of death after CAP, and the rate of death from pneumonia was the largest at 22%.

Not only age, general condition, and comorbidities but also specific pathogens were predictors of long-term prognosis after hospital discharge for CAP.

Not only age, general condition, and comorbidities but also specific pathogens were predictors of long-term prognosis after hospital discharge for CAP.

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