血清miR-133a在脓毒症并发ARDS中表达及预后的关系

目的分析血清微小核糖核酸(miR)-133a在脓毒症并发急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)患者中的表达及与预后的关系。 方法选取2019年6月至2021年5月我院收治的65例脓毒症患者,根据是否并发ARDS,分为并发ARDS 35例和无ARDS 30例。随访28 d,统计脓毒症并发ARDS者预后,检测患者入住ICU第1天、第2天、第3天血清miR-133a水平,比较存活者和死亡者临床特征,采用Logistic回归分析判定影响脓毒症并发ARDS预后的因素,采用受试者工作曲线(ROC)分析血清miR-133a水平预测脓毒症并发ARDS者预后的价值。 结果并发ARDS入住ICU第1天、第2天、第3天血清miR-133a水平均高于无ARDS者(P<0.05);随访28 d,脓毒症并发ARDS者病死率为40.00%;死亡者入住ICU第1天、第2天、第3天血清miR-133a水平均高于存活者(P<0.05);死亡者序贯器官衰竭(SOFA)评分、血管外肺水指数、第1天血清miR-133a水平与存活者比较,差异均有统计学意义(P<0.05);Logistic多因素回归分析显示SOFA评分、第1天血清miR-133a水平均是影响脓毒症并发ARDS者死亡的危险因素(P<0.05);ROC分析显示,第1天血清miR-133a水平预测脓毒症并发ARDS者死亡的最佳截断点为1.47,灵敏度为85.71%,特异度为90.48%,AUC为0.857。 结论脓毒症并发ARDS者血清miR-133a水平升高,血清miR-133a水平是影响脓毒症并发ARDS者死亡的危险因素,监测血清miR-133a水平变化,作为预测患者预后的指标。     

气道恶性肿瘤患者光动力治疗24例临床分析

目的回顾性分析经电子支气管镜腔内激光光动力疗法(photodynamic therapy, PDT)治疗的气道恶性肿瘤患者临床资料,探讨PDT治疗的规律性。 方法选择2019年2月至2021年3月由我院呼吸与危重症医学科进行PDT治疗的气道恶性肿瘤患者24例,分别对一般临床资料、PDT治疗情况和治疗后随访,以及治疗后存活患者和死亡患者的特征进行分析。 结果截止2021年8月7日,PDT治疗后获益最大的患者随访时长达13.2个月,远远大于PDT治疗后获益较小患者的随访时长总生存期(overall survival, OS)4.7个月(P＝0.02)。前者以管腔壁型为主(80%),而后者以管腔内型为主(50%)(P＝0.034)。前者腔内病变短于后者(中位数分别是3 cm和5 cm,P＝0.03)。前者年轻、病程短、以腺样囊性癌为主,而后者年龄大、病程长、以鳞癌为主(P>0.05)。 结论管腔壁型、气道腔内病变短,以及年轻、病程短和肺腺样囊性癌的气道恶性肿瘤患者可能在PDT治疗中获益较多;相反,管腔内型、气道腔内病变长,以及年老、病程长和非肺腺样囊性癌的气道恶性肿瘤患者可能在PDT治疗中获益较少。     

间隔附近起源心动过速鉴别诊断一例

35岁女性因室上性心动过速行电生理检查和射频消融。术中诱发宽QRS心动过速,尝试心室超速起搏后变为窄QRS波,起搏后间期－心动过速周长为125 ms。仔细分析可发现两种心动过速周长和VA间期相同,希氏束呈现顺向夺获,校正后的起搏后间期－心动过速周长为75 ms。考虑顺向型房室折返性心动过速,于二尖瓣环左后间隔处消融成功。     

Pharmacokinetics of propafenone hydrochloride sustained-release capsules in male beagle dogs

This paper describes the development and validation of a liquid chromatography–mass spectrometric assay for propafenone and its application to a pharmacokinetic study of propafenone administered as a new propafenone hydrochloride sustained-release capsule (SR-test), as an instant-release tablet (IR-reference) and as the market leader sustained-release capsule (Rythmol, SR-reference) in male beagle dogs (n=8). In Study A comparing SR-test with IR-reference in a crossover design T_max and t_1/2 of propafenone for SR-test were significantly higher than those for IR-reference while C_max and AUC were lower demonstrating the sustained release properties of the new formulation. In Study B comparing SR-test with SR-reference the observed C_max and AUC of propafenone for SR-test (124.5±140.0 ng/mL and 612.0±699.2 ng·h/mL, respectively) were higher than for SR-reference (78.52±72.92 ng/mL and 423.6±431.6 ng·h/mL, respectively) although the differences were not significant. Overall, the new formulation has as good if not better sustained release characteristics to the market leader formulation.KEY WORDS: Propafenone, Pharmacokinetics, Sustained-release, Beagle dog, Plasma     

One step synthesis of high-efficiency AgBr–Br–g-C3N4 composite catalysts for photocatalytic H2O2 production via two channel pathway

In this work, a two-component modified AgBr–Br–g-C₃N₄ composite catalyst with outstanding photocatalytic H₂O₂ production ability is synthesized. XRD, UV-Vis, N₂ adsorption, TEM, XPS, EPR and PL were used to characterize the obtained catalysts. The as-prepared AgBr–Br–g-C₃N₄ composite catalyst shows the highest H₂O₂ equilibrium concentration of 3.9 mmol L⁻¹, which is 7.8 and 19.5 times higher than that of GCN and AgBr. A “two channel pathway” is proposed for this reaction system which causes the remarkably promoted H₂O₂ production ability. In addition, compared with another two-component modified catalyst, Ag–AgBr–g-C₃N₄, AgBr–Br–g-C₃N₄ composite catalyst displays the higher photocatalytic H₂O₂ production ability and stability.

In this work, a two-component modified AgBr–Br–g-C₃N₄ composite catalyst with outstanding photocatalytic H₂O₂ production ability is synthesized.     

Mechanism of adsorption of humic acid by modified aged refuse

In the present study, aged refuse (AR) was modified to be applied as an adsorbent to remove humic acid from water. The efficiency of humic acid removal by modified aged refuse (MAR) under different preparation conditions (calcination temperature, dose of aged refuse for calcination and holding time) was systematically investigated. Results showed that the optimum preparation conditions are calcination temperature = 700 °C, AR dose for calcination = 25 g, and holding time = 2.0 h. The characteristics of the modified aged refuse obtained under different calcination conditions were determined by Fourier transform infrared, X-ray diffraction and X-ray photoelectron spectroscopy analysis. In addition, the effects of modified aged refuse dose and initial solution pH on adsorption performance were studied. The removal of humic acid increased with higher doses of modified aged refuse, and weak alkaline (initial pH = 8.0) conditions were favorable for humic acid removal. A pseudo-second order model fitted the experimental data well. Moreover, the adsorption isotherms were well described by the Langmuir isotherm model, in which the monolayer surface loading was calculated to be approximately 37 mg g⁻¹. During the adsorption process, the molecular weight, degree of condensation and aromaticity of humic acid were considerably decreased, according to 3D-EEM analysis. MAR as a new type of adsorbent thus provides a potential adsorption method for humic acid.

In the present study, aged refuse (AR) was modified to be applied as an adsorbent to remove humic acid from water.     

Noninherited Factors in Fetal Congenital Heart Diseases Based on Bayesian Network: A Large Multicenter Study

Background: Current studies have confirmed that fetal congenital heart diseases (CHDs) are caused by various factors. However, the quantitative risk of CHD is not clear given the combined effects of multiple factors. Objective: This cross-sectional study aimed to detect associated factors of fetal CHD using a Bayesian network in a large sample and quantitatively analyze relative risk ratios (RRs). Methods: Pregnant women who underwent fetal echocardiography (N = 16,086 including 3,312 with CHD fetuses) were analyzed. Twenty-six maternal and fetal factors were obtained. A Bayesian network is constructed based on all variables through structural learning and parameter learning methods to find the environmental factors that directly and indirectly associated with outcome, and the probability of fetal CHD in the two groups is predicted through a junction tree reasoning algorithm, so as to obtain RR for fetal CHD under different exposure factor combinations. Taking into account the effect of gestational week on the accuracy of model prediction, we conducted sensitivity analysis on gestational week groups. Results: The single-factor analysis showed that the RRs for the numbers of births, spontaneous abortions, and parental smoking were 1.50, 1.38, and 1.11 (P < 0.001), respectively. The risk gradually increased with the synergistic effect of ranging from one to more environmental factors above. The risk was higher among subjects with five synergistic factors, including the number of births, upper respiratory tract infection during early pregnancy, anemia, and mental stress as well as a history of spontaneous abortions or parental smoking, than in those with less than 5 factors (RR = 2.62 or 2.28, P < 0.001). This result was consistent across the participants grouped by GWs. Conclusion: We identified six factors that were directly associated with fetal CHD. A higher number of these factors led to a higher risk of CHD. These findings suggest that it is important to strengthen healthcare and prenatal counseling for women with these factors.     

Conformational Stability of Poly (N-Isopropylacrylamide) Anchored on the Surface of Gold Nanoparticles

To verify the temperature sensitive failure of poly (N-isopropylacrylamide) (PNIPAM) anchored on the surface of gold nanoparticles (AuNPs), the UV-Vis spectra with temperature variations of the following aqueous solutions respectively containing AuNPs-PNIPAM, Au-PNIPAM/PNIPAM, PNIPAM, in different media (including salt, ethanol, HCl and cetyltrimethylammoniumbromide (CTAB)), were systematically determined. The results indicated that the UV-Vis spectrum of AuNPs-PNIPAM suspension hardly changed even above the Lower Critical Solution Temperature (LCST) of PNIPAM, but that of Au-PNIPAM/PNIPAM sharply increased only in absorbance intensity. A possible mechanism of the failed temperature sensitivity of PNIPAM anchored on the surface of AuNPs was proposed. Being different from free PNIPAM molecules, a strong interaction exists among PNIPAM molecules anchored on the surface of AuNPs, restraining the change in conformation of PNIPAM. The temperature sensitivity of Au-PNIPAM/PNIPAM originates from the free PNIPAM molecules rather than the anchored PNIPAM one. The changing electrostatic interaction could effectively regulate the aggregation behavior of AuNPs-PNIPAM and enhance its sensitivity to temperature.     

Single- Versus Double-Unit Umbilical Cord Blood Transplantation for Hematologic Diseases: A Systematic Review

Controversial results exist regarding the clinical benefits of single- vs double-unit umbilical cord blood transplantation (UCBT) in patients with hematologic diseases. A systematic review was conducted to evaluate this issue. The PubMed, Embase, and Cochrane Library databases were searched up to May 2018. A total of 25 studies including 6571 recipients were identified. Although double-unit UCB contained higher doses of total nucleated cells and CD34⁺ cells, it offered no advantages over single-unit UCB in terms of hematologic recovery, including the rate and speed of neutrophil and platelet engraftment. Double-unit UCBT was associated with higher incidences of grades II-IV acute and extensive chronic graft-vs-host disease, accompanied by a lower relapse incidence, which may be attributed to a graft-vs-graft effect induced by double-unit UCB. However, transplant-related mortality, disease-free survival, and overall survival were comparable between single- and double-unit UCBT. Although double-unit UCBT confers no clinical advantages over single-unit UCBT, certain patients, such as those at high risk of relapse, might benefit from double-unit UCBT, a possibility that needs to be clarified in future randomized trials.