The rapid development of metagenomics,metabolomics,and metatranscriptomics provides novel insights into the intestinal microbiota factors linked to inflammatory bowel disease(IBD).Multiple microorganisms play a role i...The rapid development of metagenomics,metabolomics,and metatranscriptomics provides novel insights into the intestinal microbiota factors linked to inflammatory bowel disease(IBD).Multiple microorganisms play a role in intestinal health;these include bacteria,fungi,and viruses that exist in a dynamic balance to maintain mucosal homeostasis.Perturbations in the intestinal microbiota disrupt mucosal homeostasis and are closely related to IBD in humans and colitis in mice.Therefore,preventing or correcting the imbalance of microbiota may serve as a novel prevention or treatment strategy for IBD.We review the most recent evidence for direct or indirect interventions targeting intestinal microbiota for treatment of IBD in order to overcome the current limitations of IBD therapies and shed light on personalized treatment options.展开更多
Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN m...Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes.In the past two decades,several markers and predictive tools have been proposed and evaluated for this purpose.Conventional biomarkers like C-reactive protein,procalcitonin,lymphocyte count,interleukin-6,and interleukin-8,and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN.On the other hand,scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested,and the results showed that they may provide better accuracy.For early prevention of IPN,several new therapies were tested,including early enteral nutrition,anti-biotics,probiotics,immune enhancement,etc.,but the results varied.Taken together,several evidence-supported predictive markers and scoring systems are readily available for predicting IPN.However,effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition.In this editorial,we summarize evidence concerning early prediction and prevention of IPN,providing insights into future practice and study design.A more homo-geneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN,thereby achieving individualized treatment.展开更多
Thermal steam plasma jet is promising for applications in environmental industries due to its distinctive characteristics of high enthalpy and high chemical reactivity. However, the performance of the steam plasma tor...Thermal steam plasma jet is promising for applications in environmental industries due to its distinctive characteristics of high enthalpy and high chemical reactivity. However, the performance of the steam plasma torch for its generation is limited by the problems of the large arc voltage fluctuation and serious erosion of the electrodes. In this study, a gas-stabilized steam plasma torch which can operate continuously and stably was designed. Experiments were conducted to reveal the effect of the different working parameters, including the anode diameter, the cooling water temperature, the arc current and the steam flow rate, on its Volt-Ampere characteristics, arc voltage fluctuation, thermal efficiency, jet characteristics and electrodes erosion. Results showed that the use of hot water to cool the electrodes can effectively prevent the condensation of steam on the inner wall of the electrodes, thus significantly reducing the arc voltage fluctuations and electrodes erosion. This is crucial for increasing the working life of the electrodes and ensuring long-term stability of the steam plasma torch. In addition, suitable anode diameter can greatly reduce the arc voltage fluctuation of the steam plasma torch and effectively improve the stability of the steam plasma jet. Furthermore, high arc current can effectively reduce the fluctuations of the arc voltage and increase the length and the volume of the steam plasma jet. Finally, using steam as the plasma forming gas can achieve higher thermal efficiency compared to air. An ideal thermal efficiency can be achieved by properly reducing the arc current and increasing the steam flow rate.展开更多
Air contamination caused by the ammonia slip phenomenon has gradually captured the researcher’s extensive attention.An effective strategy for controlling fugitive NH_(2)is critical to improving the air quality and li...Air contamination caused by the ammonia slip phenomenon has gradually captured the researcher’s extensive attention.An effective strategy for controlling fugitive NH_(2)is critical to improving the air quality and living environment.In the present work,CuO_(x)/La_(2)Ce_(2)O_(7)composite as a potential candidate catalyst is synthesized through the electrostatic adsorption method for the selective catalytic oxidation(SCO_(2))of NH_(2)to N.The 5%Cu Ox/La_(2)Ce_(2)O_(7)exhibits the best catalytic activity(T=243℃)and ammonia conversion efficiency.The improvement of performance is mainly attributed to the superficial connection of[Ce-O-Cu],which enhances the capturing ability of ammonia molecule and accelerates the dissociating efficiency of N–H bonding for Nevolution,simultaneously.This work provides a facile method to synthesis pyrochlore-like composite catalyst of NH_(2)-SCO_(2) for solving the problem of ammonia slip pollution in the future.展开更多
Topologically protected states are important in realizing robust optical behaviors that are quite insensitive to local defects or perturbations,which provide a promising solution for robust photonic integrations.Here,...Topologically protected states are important in realizing robust optical behaviors that are quite insensitive to local defects or perturbations,which provide a promising solution for robust photonic integrations.Here,we propose to implement fast topological beam splitters and routers via the adiabatic passage of edge and interface states in the cross-linking configuration of Su-Schrieffer-Heeger(SSH)chains with interface defects.The channel state does not immerse into the band continuum during the adiabatic cycle,making the adiabatic restriction less stringent and the transport process more efficient.Based on the accelerated topological pumping,the beam splitters and routers exhibit improved robustness against losses of the system yet degraded resilience to fluctuation of coupling strengths and on-site energies compared with the conventional topological splitting and routing schemes.In addition,we confirm that the model demonstrates good scalability when the system size is varied.The simulation results of topological beam splitting in coupled waveguide arrays are in good consistency with theoretical analysis.This topological design provides a robust way to control photons,which may suggest further application of topological devices with unique properties and functionalities for integrated photonics.展开更多
新型冠状病毒肺炎(COVID-19,简称“新冠肺炎”)疫情在全球范围内蔓延,对人类健康造成巨大威胁.目前已有疫苗问世,但仍没有可靠的治愈办法.中医药的临床应用在国内疫情防控中发挥了重要作用,并已涌现出若干临床研究,其中中医药治疗新冠...新型冠状病毒肺炎(COVID-19,简称“新冠肺炎”)疫情在全球范围内蔓延,对人类健康造成巨大威胁.目前已有疫苗问世,但仍没有可靠的治愈办法.中医药的临床应用在国内疫情防控中发挥了重要作用,并已涌现出若干临床研究,其中中医药治疗新冠肺炎的临床研究文献信息、治疗现状及规律值得系统归纳与解读,为未来的临床与科研提供基础.检索2020年1月1日至2021年3月1日期间PubMed、Embase、Web of Science、medRxiv、中国知网、万方数据库及中国生物医学文献数据库,纳入中医药治疗COVID-19的临床研究文献,获取文献的基本信息及治疗内容信息,评价文献质量,进行文献计量学分析.共纳入47篇文献,绝大多数以中文发表(42篇,占全部文献的89.36%);从临床试验注册的文献量(12篇)、被引量(单篇最高被引62次)及相关质量评价量表(改良Chalmers评分平均61.40分)的结果来看,整体研究质量仍有待提高.共涉及中药复方66个,其中苦杏仁、甘草、石膏、麻黄、茯苓、藿香等中药使用频次较高.结局指标中临床症状(发热、咳嗽、乏力等)缓解率、普通型转为重型率,实验室指标中的白细胞总数、淋巴细胞总数及C反应蛋白、肺CT影像学变化及不良反应受到关注.目前中医药治疗新冠肺炎的临床研究质量亟待提高,未来需进一步规范中医药临床循证研究的设计与实施.中医药主流治法为清热解表化湿,麻杏石甘汤为最常用的经典祖方,“三药三方”在临床得到广泛应用.经中医药治疗后临床症状显著缓解,常见实验室指标、肺部影像学改善明显,安全性良好.中医药通过多机制、多途径防治COVID-19,其规律值得进一步探讨.展开更多
Mesoporous LiFePO4/C microspheres consisting of LiFePO4 nanoparticles are successfully fabricated by an eco-friendly hydrothermal approach combined with high-temperature calcinations using cost-effective LiOH and Fe3...Mesoporous LiFePO4/C microspheres consisting of LiFePO4 nanoparticles are successfully fabricated by an eco-friendly hydrothermal approach combined with high-temperature calcinations using cost-effective LiOH and Fe3＋ salts as raw materials.In this strategy,pure mesoporous LiFePO4 microspheres,which are composed of LiFePO4 nanoparticles,were uniformly coated with carbon（1.5nm）.Benefiting from this unique architecture,these mesoporous LiFePO4/C microspheres can be closely packed,having high tap density.The initial discharge capacity of LiFePO4/C microspheres as positive-electrode materials for lithium-ion batteries could reach 165.3 mAh/g at 0.1 C rate,which is notably close to the theoretical capacity of LiFePO4 due to the large BET surface area,which provides for a large electrochemically available surface for the active material and electrolyte.The material also exhibits high rate capability（100 mAh/g at 8 C） and good cycling stability（capacity retention of 92.2%after 400 cycles at 8 C rate）.展开更多
Irinotecan(CPT11)chemotherapy-induced diarrhea affects a substantial cancer population due to b-glucuronidase(Gus)converting 10-O-glucuronyl-7-ethyl-10-hydroxycamptothecin(SN38G)to toxic 7-ethyl-10-hydroxycamptothecin...Irinotecan(CPT11)chemotherapy-induced diarrhea affects a substantial cancer population due to b-glucuronidase(Gus)converting 10-O-glucuronyl-7-ethyl-10-hydroxycamptothecin(SN38G)to toxic 7-ethyl-10-hydroxycamptothecin(SN38).Existing interventions primarily address inflammation and Gus enzyme inhibition,neglecting epithelial repair and Gus-expressing bacteria.Herein,we discov-ered that dehydrodiisoeugenol(DDIE),isolated from nutmeg,alleviates CPT11-induced intestinal muco-sitis alongside a synergistic antitumor effect with CPT11 by improving weight loss,colon shortening,epithelial barrier dysfunction,goblet cells and intestinal stem cells(ISCs)loss,and wound-healing.The anti-mucositis effect of DDIE is gut microbiota-dependent.Analysis of microbiome profiling data from clinical patients and CPT11-induced mucositis mice reveals a strong correlation between CPT11 chemotoxicity and Gus-expressing bacteria,particularly Enterococcus faecalis(E.faecalis).DDIE coun-ters CPT11-induced augmentation of E.faecalis,leading to decreased intestinal Gus and SN38 levels.The Partial Least Squares Path Model(PLS-PM)algorithm initially links E.faecalis to dysregulated epithelial renovation.This is further validated in a 3D intestinal organoid model,in which both SN38 and E.faecalis hinder the formation and differentiation of organoids.Interestingly,colonization of E.fae-calis exacerbates CPT11-induced mucositis and disturbs epithelial differentiation.Our study unveils a microbiota-driven,epithelial reconstruction-mediated action of DDIE against mucositis,proposing the‘Gus bacteriaehosteirinotecan axis’as a promising target for mitigating CPT11 chemotoxicity.展开更多
Background:There is controversy over the optimal early protein delivery in critically ill patients with acute kidney injury(AKI).This study aims to evaluate whether the association between early protein delivery and 2...Background:There is controversy over the optimal early protein delivery in critically ill patients with acute kidney injury(AKI).This study aims to evaluate whether the association between early protein delivery and 28-day mortality was impacted by the presence of AKI in critically ill patients.Methods:This is a post hoc analysis of data from a multicenter cluster-randomised controlled trial enrolling newly admitted critically ill patients(n=2772).Participants without chronic kidney disease and with complete data concerning baseline renal function were included in this study.The primary outcome was 28-day mortality.Cox proportional hazards models were used to analyze the association between early protein delivery,reflected by mean protein delivery from day 3-5 after enrollment,28-day mortality and whether baseline AKI stages interacted with this association.Results:Overall,2552 patients were included,among whom 567(22.2%)had AKI at enrollment(111 stageⅠ,87 stageⅡ,369 stageⅢ).Mean early protein delivery was 0.60±0.38 g/kg/day among the study patients.In the overall study cohort,each 0.1 g/kg/day increase in protein delivery was associated with a 5%reduction in 28-day mortality[hazard ratio(HR)=0.95;95%confidence interval(CI)0.92-0.98,p<0.001].The association between early protein delivery and 28-day mortality significantly interacted with baseline AKI stages(adjusted interaction p=0.028).Each 0.1 g/kg/day increase in early protein delivery was associated with a 4%reduction in 28-day mortality(HR=0.96;95%CI 0.92-0.99,p=0.011)among patients without AKI and 9%(HR=0.91;95%CI 0.84-0.99,p=0.021)among those with AKI stageⅢ.However,such associations cannot be observed among patients with AKI stagesⅠandⅡ.Conclusions:Increased early protein delivery(up to close to the guideline recommendation)was associated with reduced 28-day mortality in critically ill patients without AKI and with AKI stageⅢ,but not in those with AKI stageⅠorⅡ.展开更多
基金Supported by National Natural Science Foundation of China,No.81273572 and No.81530096the Natural Science Foundation of Shanghai,No.17ZR1427800.
文摘The rapid development of metagenomics,metabolomics,and metatranscriptomics provides novel insights into the intestinal microbiota factors linked to inflammatory bowel disease(IBD).Multiple microorganisms play a role in intestinal health;these include bacteria,fungi,and viruses that exist in a dynamic balance to maintain mucosal homeostasis.Perturbations in the intestinal microbiota disrupt mucosal homeostasis and are closely related to IBD in humans and colitis in mice.Therefore,preventing or correcting the imbalance of microbiota may serve as a novel prevention or treatment strategy for IBD.We review the most recent evidence for direct or indirect interventions targeting intestinal microbiota for treatment of IBD in order to overcome the current limitations of IBD therapies and shed light on personalized treatment options.
文摘Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes.In the past two decades,several markers and predictive tools have been proposed and evaluated for this purpose.Conventional biomarkers like C-reactive protein,procalcitonin,lymphocyte count,interleukin-6,and interleukin-8,and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN.On the other hand,scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested,and the results showed that they may provide better accuracy.For early prevention of IPN,several new therapies were tested,including early enteral nutrition,anti-biotics,probiotics,immune enhancement,etc.,but the results varied.Taken together,several evidence-supported predictive markers and scoring systems are readily available for predicting IPN.However,effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition.In this editorial,we summarize evidence concerning early prediction and prevention of IPN,providing insights into future practice and study design.A more homo-geneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN,thereby achieving individualized treatment.
基金the support of the Key Research Program of the Sichuan Provincial Science and Technology Department,China(No.2017GZ0096)
文摘Thermal steam plasma jet is promising for applications in environmental industries due to its distinctive characteristics of high enthalpy and high chemical reactivity. However, the performance of the steam plasma torch for its generation is limited by the problems of the large arc voltage fluctuation and serious erosion of the electrodes. In this study, a gas-stabilized steam plasma torch which can operate continuously and stably was designed. Experiments were conducted to reveal the effect of the different working parameters, including the anode diameter, the cooling water temperature, the arc current and the steam flow rate, on its Volt-Ampere characteristics, arc voltage fluctuation, thermal efficiency, jet characteristics and electrodes erosion. Results showed that the use of hot water to cool the electrodes can effectively prevent the condensation of steam on the inner wall of the electrodes, thus significantly reducing the arc voltage fluctuations and electrodes erosion. This is crucial for increasing the working life of the electrodes and ensuring long-term stability of the steam plasma torch. In addition, suitable anode diameter can greatly reduce the arc voltage fluctuation of the steam plasma torch and effectively improve the stability of the steam plasma jet. Furthermore, high arc current can effectively reduce the fluctuations of the arc voltage and increase the length and the volume of the steam plasma jet. Finally, using steam as the plasma forming gas can achieve higher thermal efficiency compared to air. An ideal thermal efficiency can be achieved by properly reducing the arc current and increasing the steam flow rate.
基金financially supported by the National Natural Science Foundation of China(No.51771131)the Postdoctoral Research Foundation of China(No.2020M670676)+4 种基金the National Engineering Laboratory for Mobile Source Emission Control Technology(No.NELMS2019B01)the CATARC(Tianjin)Automotive Engineering Research Institute Youth Innovation Fund Project(No.S1921506)the Science and Technology Directorate Project of Tianjin City(No.19YFZCSF00960)CATARC(Tianjin)Central Guide Project(No.21243409)CATARC(Tianjin)Youth Science and Technology Talents Project(No.21226303)。
文摘Air contamination caused by the ammonia slip phenomenon has gradually captured the researcher’s extensive attention.An effective strategy for controlling fugitive NH_(2)is critical to improving the air quality and living environment.In the present work,CuO_(x)/La_(2)Ce_(2)O_(7)composite as a potential candidate catalyst is synthesized through the electrostatic adsorption method for the selective catalytic oxidation(SCO_(2))of NH_(2)to N.The 5%Cu Ox/La_(2)Ce_(2)O_(7)exhibits the best catalytic activity(T=243℃)and ammonia conversion efficiency.The improvement of performance is mainly attributed to the superficial connection of[Ce-O-Cu],which enhances the capturing ability of ammonia molecule and accelerates the dissociating efficiency of N–H bonding for Nevolution,simultaneously.This work provides a facile method to synthesis pyrochlore-like composite catalyst of NH_(2)-SCO_(2) for solving the problem of ammonia slip pollution in the future.
基金support by the National Natural Science Foundation of China(Grant Nos.62075048 and 12304407)China Postdoctoral Science Foundation(Grant Nos.2023TQ0310 and GZC20232446).
文摘Topologically protected states are important in realizing robust optical behaviors that are quite insensitive to local defects or perturbations,which provide a promising solution for robust photonic integrations.Here,we propose to implement fast topological beam splitters and routers via the adiabatic passage of edge and interface states in the cross-linking configuration of Su-Schrieffer-Heeger(SSH)chains with interface defects.The channel state does not immerse into the band continuum during the adiabatic cycle,making the adiabatic restriction less stringent and the transport process more efficient.Based on the accelerated topological pumping,the beam splitters and routers exhibit improved robustness against losses of the system yet degraded resilience to fluctuation of coupling strengths and on-site energies compared with the conventional topological splitting and routing schemes.In addition,we confirm that the model demonstrates good scalability when the system size is varied.The simulation results of topological beam splitting in coupled waveguide arrays are in good consistency with theoretical analysis.This topological design provides a robust way to control photons,which may suggest further application of topological devices with unique properties and functionalities for integrated photonics.
文摘新型冠状病毒肺炎(COVID-19,简称“新冠肺炎”)疫情在全球范围内蔓延,对人类健康造成巨大威胁.目前已有疫苗问世,但仍没有可靠的治愈办法.中医药的临床应用在国内疫情防控中发挥了重要作用,并已涌现出若干临床研究,其中中医药治疗新冠肺炎的临床研究文献信息、治疗现状及规律值得系统归纳与解读,为未来的临床与科研提供基础.检索2020年1月1日至2021年3月1日期间PubMed、Embase、Web of Science、medRxiv、中国知网、万方数据库及中国生物医学文献数据库,纳入中医药治疗COVID-19的临床研究文献,获取文献的基本信息及治疗内容信息,评价文献质量,进行文献计量学分析.共纳入47篇文献,绝大多数以中文发表(42篇,占全部文献的89.36%);从临床试验注册的文献量(12篇)、被引量(单篇最高被引62次)及相关质量评价量表(改良Chalmers评分平均61.40分)的结果来看,整体研究质量仍有待提高.共涉及中药复方66个,其中苦杏仁、甘草、石膏、麻黄、茯苓、藿香等中药使用频次较高.结局指标中临床症状(发热、咳嗽、乏力等)缓解率、普通型转为重型率,实验室指标中的白细胞总数、淋巴细胞总数及C反应蛋白、肺CT影像学变化及不良反应受到关注.目前中医药治疗新冠肺炎的临床研究质量亟待提高,未来需进一步规范中医药临床循证研究的设计与实施.中医药主流治法为清热解表化湿,麻杏石甘汤为最常用的经典祖方,“三药三方”在临床得到广泛应用.经中医药治疗后临床症状显著缓解,常见实验室指标、肺部影像学改善明显,安全性良好.中医药通过多机制、多途径防治COVID-19,其规律值得进一步探讨.
文摘Mesoporous LiFePO4/C microspheres consisting of LiFePO4 nanoparticles are successfully fabricated by an eco-friendly hydrothermal approach combined with high-temperature calcinations using cost-effective LiOH and Fe3＋ salts as raw materials.In this strategy,pure mesoporous LiFePO4 microspheres,which are composed of LiFePO4 nanoparticles,were uniformly coated with carbon（1.5nm）.Benefiting from this unique architecture,these mesoporous LiFePO4/C microspheres can be closely packed,having high tap density.The initial discharge capacity of LiFePO4/C microspheres as positive-electrode materials for lithium-ion batteries could reach 165.3 mAh/g at 0.1 C rate,which is notably close to the theoretical capacity of LiFePO4 due to the large BET surface area,which provides for a large electrochemically available surface for the active material and electrolyte.The material also exhibits high rate capability（100 mAh/g at 8 C） and good cycling stability（capacity retention of 92.2%after 400 cycles at 8 C rate）.
基金supported by the National Natural Science Foundation of China(No.82274329,82304991,82130115)the China Postdoctoral Science Foundation(No.2023M732336)the Shanghai Science and Technology Committee Sailing Program Foundation(No.23YF1442500,China).
文摘Irinotecan(CPT11)chemotherapy-induced diarrhea affects a substantial cancer population due to b-glucuronidase(Gus)converting 10-O-glucuronyl-7-ethyl-10-hydroxycamptothecin(SN38G)to toxic 7-ethyl-10-hydroxycamptothecin(SN38).Existing interventions primarily address inflammation and Gus enzyme inhibition,neglecting epithelial repair and Gus-expressing bacteria.Herein,we discov-ered that dehydrodiisoeugenol(DDIE),isolated from nutmeg,alleviates CPT11-induced intestinal muco-sitis alongside a synergistic antitumor effect with CPT11 by improving weight loss,colon shortening,epithelial barrier dysfunction,goblet cells and intestinal stem cells(ISCs)loss,and wound-healing.The anti-mucositis effect of DDIE is gut microbiota-dependent.Analysis of microbiome profiling data from clinical patients and CPT11-induced mucositis mice reveals a strong correlation between CPT11 chemotoxicity and Gus-expressing bacteria,particularly Enterococcus faecalis(E.faecalis).DDIE coun-ters CPT11-induced augmentation of E.faecalis,leading to decreased intestinal Gus and SN38 levels.The Partial Least Squares Path Model(PLS-PM)algorithm initially links E.faecalis to dysregulated epithelial renovation.This is further validated in a 3D intestinal organoid model,in which both SN38 and E.faecalis hinder the formation and differentiation of organoids.Interestingly,colonization of E.fae-calis exacerbates CPT11-induced mucositis and disturbs epithelial differentiation.Our study unveils a microbiota-driven,epithelial reconstruction-mediated action of DDIE against mucositis,proposing the‘Gus bacteriaehosteirinotecan axis’as a promising target for mitigating CPT11 chemotoxicity.
文摘Background:There is controversy over the optimal early protein delivery in critically ill patients with acute kidney injury(AKI).This study aims to evaluate whether the association between early protein delivery and 28-day mortality was impacted by the presence of AKI in critically ill patients.Methods:This is a post hoc analysis of data from a multicenter cluster-randomised controlled trial enrolling newly admitted critically ill patients(n=2772).Participants without chronic kidney disease and with complete data concerning baseline renal function were included in this study.The primary outcome was 28-day mortality.Cox proportional hazards models were used to analyze the association between early protein delivery,reflected by mean protein delivery from day 3-5 after enrollment,28-day mortality and whether baseline AKI stages interacted with this association.Results:Overall,2552 patients were included,among whom 567(22.2%)had AKI at enrollment(111 stageⅠ,87 stageⅡ,369 stageⅢ).Mean early protein delivery was 0.60±0.38 g/kg/day among the study patients.In the overall study cohort,each 0.1 g/kg/day increase in protein delivery was associated with a 5%reduction in 28-day mortality[hazard ratio(HR)=0.95;95%confidence interval(CI)0.92-0.98,p<0.001].The association between early protein delivery and 28-day mortality significantly interacted with baseline AKI stages(adjusted interaction p=0.028).Each 0.1 g/kg/day increase in early protein delivery was associated with a 4%reduction in 28-day mortality(HR=0.96;95%CI 0.92-0.99,p=0.011)among patients without AKI and 9%(HR=0.91;95%CI 0.84-0.99,p=0.021)among those with AKI stageⅢ.However,such associations cannot be observed among patients with AKI stagesⅠandⅡ.Conclusions:Increased early protein delivery(up to close to the guideline recommendation)was associated with reduced 28-day mortality in critically ill patients without AKI and with AKI stageⅢ,but not in those with AKI stageⅠorⅡ.
