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Intensivists’response to hyperoxemia in mechanical ventilation patients:The status quo and related factors

World Journal of Emergency Medicine 2021年第3期12卷 202-206页

作者： zi-wei ke Yue Jiang Ya-ping Bao Ye-qin Yang Xiao-mei Zong Min Liu Xiang-yun Guan Zhong-qiu Lu Department of Emergency Medicine the First Affi liated Hospital of Wenzhou Medical UniversityWenzhou 325000China Department of Nursing Taizhou Hospital of Zhejiang ProvinceTaizhou 317000China Operating Room the First Affi liated Hospital of Wenzhou Medical UniversityWenzhou 325000China Faculty of Nursing Wenzhou Medical UniversityWenzhou 325000China Yiwu Hospital Affi liated to Wenzhou Medical University Yiwu 322000China

BACKGROUND:Due to the still sparse literature in China,the investigation of hyperoxemia management is required.Thus,we aim to conduct a retrospective study to provide more information about hyperoxemia management in intensive care unit(ICU)patients.METHODS:We retrospectively screened the medical records of adult patients(age≥18 years)who required mechanical ventilation(MV)≥24 hours from January 1,2018,to December 31,2018.All arterial blood gas(ABG)tested during MV was retrieved,and MV settings were recorded.The median arterial partial pressure of oxygen(PaO2)>120 mmHg(1 mmHg=0.133 kPa)was defined as mild to moderate hyperoxemia,and PaO2>300 mmHg as extreme hyperoxemia.Intensivists’response to hyperoxemia was assessed based on the reduction of fraction of inspired oxygen(FiO2)within one hour after hyperoxemia was recorded.Multivariable logistic regression analysis was performed to determine the independent factors associated with the intensivists’response to hyperoxemia.RESULTS:A total of 592 patients were fi nally analyzed.The median Acute Physiology and Chronic Health Evaluation II(APACHE II)score was 21(15-26).The PaO2,arterial oxygen saturation(SaO2),FiO2,and positive end expiratory pressure(PEEP)were 96.4(74.0-126.0)mmHg,97.8%(95.2%-99.1%),0.4(0.4-0.5),and 5(3-6)cmH2O,respectively.Totally 174(29.39%)patients had PaO2>120 mmHg,and 19(3.21%)patients had extreme hyperoxemia at PaO2>300 mmHg.In cases of mild to moderate hyperoxemia with FiO2≤0.4,only 13(2.20%)patients had a decrease in FiO2 within one hour.The multivariable logistic regression analysis showed that a positive response was independently associated with FiO2(odds ratio[OR]1.09,95%confi dence interval[CI]1.06-1.12,Pkely to be decreased.Patients

关键词： Mechanical ventilation Hyperoxemia Fraction of inspired oxygen Arterial blood gas Intensive care unit

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Early prediction and prevention of infected pancreatic necrosis

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World Journal of Gastroenterology 2024年第9期30卷 1005-1010页

作者： Cheng Lv zi-Xiong Zhang Lu ke Department of Critical Care Medicine Jinling HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210000Jiangsu ProvinceChina Research Institute of Critical Care Medicine and Emergency Rescue Nanjing UniversityNanjing 210000Jiangsu ProvinceChina

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.

关键词： Acute pancreatitis Infected pancreatic necrosis Biomarker Scoring system Nutrition therapy Selective digestive decontamination Probiotics Antibiotics Immune enhancement therapy

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SnO2/metal organic complex composite derived from low-temperature activated metal organic complex for advanced lithium storage

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Rare Metals 2024年第7期43卷 3032-3043页

作者： Gui-Long Liu zi-Han Zhao Jin-ke Shen zi-Bo Zhao Nai-Teng Wu Dong-Lei Guo wei-wei Yuan Yong Liu Ye-Hua Su Xian-Ming Liu Luoyang key Laboratory of Green Energy Materials College of Chemistry and Chemical EngineeringLuoyang Normal University School of Materials Science and Engineering Henan University of Science and Technology Inner Mongolia Shijie Chemical Co. Ltd.

Sn-based metal organic complexes with coordination bonds,multi-active sites,and high theoretical capacity have attracted much attention as promising anodes for lithium ion batteries.However,the low electrical conductivity and huge volume changes restricted their electrochemical stability and practical utilization.Herein,Snbased anode with superior electrochemical performance,including a high reversible capacity of 1050.1 mAh·g-1at 2 A·g-1and a stable capacity of 1105.5 mAh·g-1after 500 cycles at 1 A·g-1,was fabricated via a low-temperature calcination strategy from Sn metal organic complexes.The low-temperature calcination process regulates Sn-O bond and prevents the agglomeration of SnO2,generating highly dispersed SnO2decorated metal organic complexes and providing sufficient active sites for ion storage.Ex situ characterizations expound that the undecomposed Sn-based metal organic complexes could be transformed into SnO2during lithiation and delithiation,which enhances the electrical conductivity and induces a strong pseudo-capacitive behavior,accelerating the electrochemical kinetics;the multiple solid electrolyte interface with inflexible LiF and flexible ROCO2Li buffers the volume variation of the electrode,resulting in its high electrochemical stability.This work provides a simple strategy for preparing excellent Sn-based anodes from metal organic complexes and reveals the lithium storage mechanism of the prepared Snbased anode.

关键词： Metal organic complex Lithium ion battery Electrochemical activation Low-temperature activation Partial decomposition

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SOLVING SYSTEMS OF PHASELESS EQUATIONS VIA RIEMANNIAN OPTIMIZATION WITH OPTIMAL SAMPLING COMPLEXITY

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Journal of Computational Mathematics 2024年第3期42卷 755-783页

作者： Jianfeng Cai ke wei Department of Mathematics Hong Kong University of Science and TechnologyClear Water BayKowloonHong Kong SARChina School of Data Science Fudan UniversityShanghaiChina

A Riemannian gradient descent algorithm and a truncated variant are presented to solve systems of phaseless equations|Ax|^(2)=y.The algorithms are developed by exploiting the inherent low rank structure of the problem based on the embedded manifold of rank-1 positive semidefinite matrices.Theoretical recovery guarantee has been established for the truncated variant,showing that the algorithm is able to achieve successful recovery when the number of equations is proportional to the number of unknowns.Two key ingredients in the analysis are the restricted well conditioned property and the restricted weak correlation property of the associated truncated linear operator.Empirical evaluations show that our algorithms are competitive with other state-of-the-art first order nonconvex approaches with provable guarantees.

关键词： Phaseless equations Riemannian gradient descent Manifold of rank-1 and positive semidefinite matrices Optimal sampling complexity

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Emergence mechanisms of group consensus in social networks

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Frontiers of Engineering Management 2024年第2期11卷 362-368页

作者： Min WANG zi-ke ZHANG College of Media and International Culture Zhejiang UniversityHangzhou 310058China Research Center for Digital Communication Zhejiang UniversityHangzhou 310058China

Reaching consensus within larger social network groups has emerged as a pivotal concern in the digital age of connectivity.This article redefines group consensus as the emergence of collective intelligence resulting from self-organizing actions and interactions of individuals within a social network group.In our exploration of extant research on group consensus,we illuminate two frequently underestimated,yet noteworthy facets:Dynamism and emergence.In contrast to the conventional perspective of consensus as a mere outcome,we perceive it as an ongoing,dynamic process.This process encompasses self-organized communication and interaction among group members,collectively guiding the group towards cognitive convergence and viewpoint integration.Consequently,it is imperative to redirect our focus from the outcomes of group interactions to an examination of the relationships and processes underpinning consensus formation,thus elucidating the mechanisms responsible for the generation of group consensus.The amalgamation of cognitive contexts and accurate simplification of real-world scenarios for simulation and experimental analysis offers a pragmatic operational approach.This study contributes novel theoretical underpinnings and quantitative insights for establishing and sustaining group consensus within the realm of engineering management practices.Concurrently,it holds substantial importance for advancing the broader research landscape pertaining to social consensus.

关键词： group consensus social network collective intelligence

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Computed tomography radiogenomics:A potential tool for prediction of molecular subtypes in gastric stromal tumor

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1296-1308页

作者： Xiao-Nan Yin zi-Hao Wang Li Zou Cai-wei Yang Chao-Yong Shen Bai-ke Liu Yuan Yin Xi-Jiao Liu Bo Zhang Gastric Cancer Research Center West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Paediatric Surgery West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Radiology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Gastrointestinal Surgery Sichuan University West China HospitalChengdu 610041Sichuan ProvinceChina

BACKGROUND Preoperative knowledge of mutational status of gastrointestinal stromal tumors(GISTs)is essential to guide the individualized precision therapy.AIM To develop a combined model that integrates clinical and contrast-enhanced computed tomography(CE-CT)features to predict gastric GISTs with specific genetic mutations,namely KIT exon 11 mutations or KIT exon 11 codons 557-558 deletions.METHODS A total of 231 GIST patients with definitive genetic phenotypes were divided into a training dataset and a validation dataset in a 7:3 ratio.The models were constructed using selected clinical features,conventional CT features,and radiomics features extracted from abdominal CE-CT images.Three models were developed:ModelCT sign,modelCT sign+rad,and model CTsign+rad+clinic.The diagnostic performance of these models was evaluated using receiver operating characteristic(ROC)curve analysis and the Delong test.RESULTS The ROC analyses revealed that in the training cohort,the area under the curve(AUC)values for model_(CT sign),model_(CT sign+rad),and modelCT_(sign+rad+clinic)for predicting KIT exon 11 mutation were 0.743,0.818,and 0.915,respectively.In the validation cohort,the AUC values for the same models were 0.670,0.781,and 0.811,respectively.For predicting KIT exon 11 codons 557-558 deletions,the AUC values in the training cohort were 0.667,0.842,and 0.720 for model_(CT sign),model_(CT sign+rad),and modelCT_(sign+rad+clinic),respectively.In the validation cohort,the AUC values for the same models were 0.610,0.782,and 0.795,respectively.Based on the decision curve analysis,it was determined that the model_(CT sign+rad+clinic)had clinical significance and utility.CONCLUSION Our findings demonstrate that the combined modelCT_(sign+rad+clinic)effectively distinguishes GISTs with KIT exon 11 mutation and KIT exon 11 codons 557-558 deletions.This combined model has the potential to be valuable in assessing the genotype of GISTs.

关键词： Gastrointestinal stromal tumor Radiomics Gene mutation Computed tomography Model

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Antitumor Effect of Apcin on Endometrial Carcinoma via p21-Mediated Cell Cycle Arrest and Apoptosis

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Current Medical Science 2024年第3期44卷 623-632页

作者： ke NI zi-li LI Zhi-yong HU Li HONG Department of Obstetrics and Gynecology Renmin Hospital of Wuhan UniversityWuhan430060China Institute of Reproductive Health Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Objective Endometrial carcinoma(EC)is a prevalent gynecological malignancy characterized by increasing incidence and mortality rates.This underscores the critical need for novel therapeutic targets.One such potential target is cell division cycle 20(CDC20),which has been implicated in oncogenesis.This study investigated the effect of the CDC20 inhibitor Apcin on EC and elucidated the underlying mechanism involved.Methods The effects of Apcin on EC cell proliferation,apoptosis,and the cell cycle were evaluated using CCK8 assays and flow cytometry.RNA sequencing(RNA-seq)was subsequently conducted to explore the underlying molecular mechanism,and Western blotting and coimmunoprecipitation were subsequently performed to validate the results.Animal studies were performed to evaluate the antitumor effects in vivo.Bioinformatics analysis was also conducted to identify CDC20 as a potential therapeutic target in EC.Results Treatment with Apcin inhibited proliferation and induced apoptosis in EC cells,resulting in cell cycle arrest.Pathways associated with apoptosis and the cell cycle were activated following treatment with Apcin.Notably,Apcin treatment led to the upregulation of the cell cycle regulator p21,which was verified to interact with CDC20 and consequently decrease the expression of downstream cyclins in EC cells.In vivo experiments confirmed that Apcin treatment significantly impeded tumor growth.Higher CDC20 expression was observed in EC tissue than in nonmalignant tissue,and increased CDC20 expression in EC patients was associated with shorter overall survival and progress free interval.Conclusion CDC20 is a novel molecular target in EC,and Apcin could be developed as a candidate antitumor drug for EC treatment.

关键词： endometrial carcinoma CDC20 apoptosis cell cycle arrest p21 BBC3

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Clinical significance of platelet mononuclear cell aggregates in patients with sepsis and acute respiratory distress syndrome

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World Journal of Clinical Cases 2024年第5期12卷 966-972页

作者： Chong-Min Huang Juan-Juan Li wei-ke wei Department of Intensive Medicine The Second People's Hospital of Haining CityHaining 314419Zhejiang ProvinceChina Department of Integrated Traditional Chinese and Western Medicine Qingyang HospitalHangzhou 310023Zhejiang ProvinceChina

BACKGROUND The diagnosis of sepsis combined with acute respiratory distress syndrome(ARDS)has increased owing to the enhanced awareness among medical profes-sionals and the continuous development of modern medical technologies,while early diagnosis of ARDS still lacks specific biomarkers.One of the main patho-genic mechanisms of sepsis-associated ARDS involves the actions of various pathological injuries and inflammatory factors,such as platelet and white blood cells activation,leading to an increase of surface adhesion molecules.These adhesion molecules further form platelet-white blood cell aggregates,including platelet-mononuclear cell aggregates(PMAs).PMAs has been identified as one of the markers of platelet activation,here we hypothesize that PMAs might play a potential biomarker for the early diagnosis of this complication.METHODS We selected 72 hospitalized patients diagnosed with sepsis as the study population between March 2019 and March 2022.Among them,30 patients with sepsis and ARDS formed the study group,while 42 sepsis patients without ARDS comprised the control group.After diagnosis,venous blood samples were imme-diately collected from all patients.Flow cytometry was employed to analyze the expression of PMAs,platelet neutrophil aggregates(PNAs),and platelet aggregates(PLyAs)in the serum.Additionally,the Acute Physiology and Chronic Health Evaluation(APACHE)II score was calculated for each patient,and receiver operating characteristic curves were generated to assess diagnostic value.RESULTS The study found that the levels of PNAs and PLyAs in the serum of the study group were higher than those in the control group,but the difference was not statistically significant(P>0.05).However,the expression of PMAs in the serum of the study group was significantly upregulated(P<0.05)and positively correlated with the APACHE II score(r=0.671,P<0.05).When using PMAs as a diagnostic indicator,the area under the curve value was 0.957,indicating a high diagnostic value(P<0.05).Furthermore,the optimal cutoff value

关键词： Sepsis Acute respiratory distress syndrome Platelet leukocyte aggregates Platelet mononuclear cell aggregates,Biomarker

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Carbon nanofibers embedded with Fe-Co alloy nanoparticles via electrospinning as lightweight high-performance electromagnetic wave absorbers

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Rare Metals 2024年第6期43卷 2769-2783页

作者： Wen-Jun Cai Jian-Guo Jiang zi-Dong Zhang zi-Xuan Liu Lu-Jie Zhang Zhen-Kun Long ke Bi key Laboratory for Liquid-Solid Structural Evolution and Processing of Materials (Ministry of Education) Shandong University School of Materials Science and Engineering Shandong University Energy Institute Qilu University of Technology (Shandong Academy of Sciences) State key Laboratory of Information Photonics and Optical Communications School of ScienceBeijing University of Posts and Telecommunications

As a lot of electromagnetic pollution and interference issues have emerged,to overcome electromagnetic interference,prevent electromagnetic hazards,and develop new high-performance electromagnetic wave(EMW) absorbers have become a significant task in the field of materials science.In this paper,a three-dimensional(3D) carbon nanofibers network with core-shell structure,embedded with varied molar ratios of iron and cobalt(4:0,3:1,2:2,1:3,0:4),was effectively synthesized(Fe/Co@C-CNFs) via electrospinning.The phase,microstructure,magnetic and EMW absorption properties were studied.It is discovered that Fe/Co@C-CNFs doped with iron:cobalt=1:1 have excellent EMW absorption capacity.When the matching thickness is 1.08 mm,the minimum reflection loss(RL) value is-18.66 dB,while the maximum effective absorption bandwidth(EAB) reaches 4.2 GHz(13.9-18 GHz) at a thickness of 1.22 mm.This is owing to the absorbers' superior impedance matching and multiple reflections as well as the conductivity,dielectric,and magnetic losses of carbon nanofibers embedded with Fe-Co alloy particles.In addition,the radar cross section(RCS) of the absorbers has been calculated by CST Studio Suite,showing that the absorbing coating can effectively reduce the RCS at various angles,especially for Fe/Co@C-CNFs doped with iron:cobalt=1:1.These findings not only provide new insights for the preparation of light-weight and high-performance electromagnetic wave absorbers,but also contribute to energy storage and conversion.

关键词： Electromagnetic wave (EMW) absorbers Fe/Co@C-CNFs Core–shell structure EMW absorbing mechanism Radar cross section (RCS)

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Chain Dynamics Heterogeneity in Plasticized Poly(vinyl butyral)(PVB) as Elucidated by Solid-State NMR

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Chinese Journal of Polymer Science 2024年第1期42卷 113-124,I0010页

作者： Jing Lv Xu Chen zi-Shuo Wu Ya-Hui Li wei Chen National Synchrotron Radiation Laboratory Anhui Provincial Engineering Laboratory of Advanced Functional Polymer FilmCAS Key Laboratory of Soft Matter ChemistryUniversity of Scienceand Technology of ChinaHefei 230026China

The chain dynamics heterogeneity of the poly(vinyl butyral)(PVB) plasticized by triethylene glycol bis(2-ethylhexa noate)(TEG-EH) was investigated by various solid-state NMR techniques.The plasticized PVB shows two domains in distinct molecular dynamics differences,namely,rigid and soft domains,where the latter is the plasticizer-rich domain.The time domain low field NMR was first used to investigate the dynamics heterogeneity of the plasticized PVB,and the results show the decreasing activated energy of components in the soft domain of plasticized PVB(E_a=20.2 kJ/mol) as compared with that of the pristine one(E_a=24.3 kJ/mol).Detailed dynamics heterogeneity was obtained by high-field NMR with site-specific features.The quadrupole-echo ~2H-NMR was adopted to elucidate the dynamics heterogeneity of the vinyl alcohol(VA) units,where only the hydroxyl group of VA is deuterated.The ~1H-^(13)C WISE NMR spectra show that there is not much difference in the mobility of the VB unit in PVB with and without plasticizer,whereas the glass transition temperature differed by approximately 53℃.This is further supported by Torchia's T_1 relaxation measurements.The origin of such an unusual phenomenon is attributed to the critical role of the remaining VA(~22%) in the soft domain,where the VA units locally aggregate through hydrogen bonding.Also,the existence of a mobility gradient in the VB unit has been demonstrated.Moreover,the mobility difference for VB with different stereo-geometry(meso or racemic conformation) is observed for the first time.This indicates the importance of modulating the ratio of meso over racemic VB for controlling the macroscopic perfo rmance of PVB.

关键词： Poly(vinyl butyral) Dynamics heterogeneity Plasticizer Solid state NMR

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