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Serum procalcitonin levels are associated with rhabdomyolysis following exertional heatstroke: an over 10-year intensive care survey

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World Journal of Emergency Medicine 2024年第1期15卷 23-27页

作者： li zhong Feifei Shuai Conglin Wang lipeng Han Zhifeng liu ming Wu Department of Traditional Chinese Medicine the First Affi liated HospitalGuizhou University of Chinese MedicineGuiyang 550001China Department of Medical Critical Care Medicine General Hospital of Southern Theatre Command of People’s Liberation ArmyGuangzhou 510010China Department of Infection and Critical Care Medicine Shenzhen Second People’s Hospital&First Affi liated Hospital of Shenzhen UniversityHealth Science CenterShenzhen 518035China Department of Nosocomial Infection Prevention and Control Shenzhen Second People’s HospitalShenzhen 518035China Key Laboratory of Hot Zone Trauma Care and Tissue Repair of People's liberation Army General Hospital of Southern Theatre Command of People's Liberation ArmyGuangzhou 510010China

BACKGROUND:Heatstroke has become a common emergency event in hospitals.Procalcitonin(PCT)is used as a biomarker of infection in the emergency department(ED),but its role in rhabdomyolysis(RM)following exertional heatstroke(EHS)remains unclear.METHODS:A retrospective cohort study enrolled patients with EHS from the intensive care unit(ICU).We collected RM biomarkers,inflammation markers,critical disease scores at admission,24 h,48 h,and discharge,and 90-day mortality.Correlation analysis,linear regression and curve fi tting were used to identify the relationship between PCT and RM.RESULTS:A total of 162 patients were recruited and divided into RM(n=56)and non-RM(n=106)groups.PCT was positively correlated with myoglobin(Mb),acute hepatic injury,disseminated intravascular coagulation(DIC),Sequential Organ Failure Assessment(SOFA)score,and Acute Physiology and Chronic Health Evaluation II(APACHE II)score,with correlation coefficients of 0.214,0.237,0.285,0.454,and 0.368,respectively(all Plinear relationship between PCT and RM,and a two-piecewise linear regression model showed that PCT was related to RM with an odds ratio of 1.3 and a cut-off oflity compared to non-RM cases(P=0.0093).CONCLUSION:High serum PCT concentrations are associated with RM after EHS in critically ill patients.Elevated PCT concentrations should be interpreted cautiously in patients with EHS in the ED.

关键词： Procalcitonin Myoglobin Rhabdomyolysis Exertional heatstroke

Risk factors for brain injury in patients with exertional heatstroke:A 5-year experience

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Chinese Journal of Traumatology 2024年第2期27卷 91-96页

作者： li zhong ming Wu Zhe-Ying liu Yan liu Zhi-Feng liu Department of Traditional Chinese Medicine The First Affiliated HospitalGuizhou University of Chinese MedicineGuiyang550001China Department of Infection and Critical Care Medicine The Second People's Hospital of Shenzhen&First Affiliated Hospital of Shenzhen UniversityHealth Science CenterShenzhenGuangdong province518035China Department of Medical Critical Care Medicine General Hospital of Southem Theatre Command of PLA.Guangzhou510010China Guangdong Branch Center National Clinical Research Center for Geriatric Diseases(Chinese PLA General Hospital)Guangzhou510010China

Purpose:Minimal data exist on brain injury in patients with exertional heatstroke(EHS)in developing country.In this study,we explored the risk factors for brain injury induced by EHS 90-day after onset.Methods:A retrospective cohort study of patients with EHS was conducted in the intensive care unit of the General Hospital of Southern Theater Command of PLA in China from April 2014 to June 2019.Patients were divided into non-brain injury(fully recovered)and brain injury groups(comprising deceased patients or those with neurological sequelae).The brain injury group was further subdivided into a death group and a sequela group for detailed analysis.General information,neurological performance and information on important organ injuries in the acute stage were recorded and analysed.Multivariable logistic regression was used to identify risk factors for brain injury after EHS and mortality risk factors for brain injury,and Kaplan-Meier survival curve was used to evaluate the effect of the neurological dysfunction on survival.Results:Out of the 147 EHS patients,117 were enrolled,of which 96(82.1%)recovered,13(11.1%)died,and 8(6.8%)experienced neurological sequelae.Statistically significant differences were found between non-brain injury and brain injury groups in age,hypotension,duration of consciousness disorders,time to drop core body temperature below 38.5℃,lymphocyte counts,platelet counts,procalcitonin,alanine aminotransferase,aspartate aminotransferase,creatinine,cystatin C,coagulation parameters,international normalized ratio,acute physiology and chronic health evaluation II scores,sequential organ failure assessment(SOFA)scores,and Glasgow coma scale scores(all p<0.05).Multivariate logistic regression showed that age(OR=1.090,95%CI:1.02-1.17,p=0.008),time to drop core temperature(OR=8.223,95%CI:2.30-29.40,p=0.001),and SOFA scores(OR=1.676,95%CI:1.29-2.18,p<0.001)are independent risk factors for brain injury induced by EHS.The Kaplan-Meier curves suggest significantly prolonged survival(p<0.001)in patients with

关键词： Exertional heatstroke Brain injury Sequela Risk factors Disorders of consciousness

Computed tomography radiomic features and clinical factors predicting the response to first transarterial chemoembolization in intermediate-stage hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 361-369页

作者： zhong-Xing Shi Chang-Fu li li-Feng Zhao zhong-Qi Sun li-ming Cui Yan-Jie Xin Dong-Qing Wang Tan-Rong Kang Hui-Jie Jiang Department of Interventional Radiology the Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086China Department of Digestive Medicine Daqing Longnan HospitalDaqing 163453China Department of Radiology Daqing Longnan HospitalDaqing 163453China Department of Radiology the Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086China

Background:According to clinical practice guidelines,transarterial chemoembolization(TACE)is the standard treatment modality for patients with intermediate-stage hepatocellular carcinoma(HCC).Early prediction of treatment response can help patients choose a reasonable treatment plan.This study aimed to investigate the value of the radiomic-clinical model in predicting the efficacy of the first TACE treatment for HCC to prolong patient survival.Methods:A total of 164 patients with HCC who underwent the first TACE from January 2017 to September 2021 were analyzed.The tumor response was assessed by modified response evaluation criteria in solid tumors(mRECIST),and the response of the first TACE to each session and its correlation with overall survival were evaluated.The radiomic signatures associated with the treatment response were identified by the least absolute shrinkage and selection operator(LASSO),and four machine learning models were built with different types of regions of interest(ROIs)(tumor and corresponding tissues)and the model with the best performance was selected.The predictive performance was assessed with receiver operating characteristic(ROC)curves and calibration curves.Results:Of all the models,the random forest(RF)model with peritumor(+10 mm)radiomic signatures had the best performance[area under ROC curve(AUC)=0.964 in the training cohort,AUC=0.949 in the validation cohort].The RF model was used to calculate the radiomic score(Rad-score),and the optimal cutoff value(0.34)was calculated according to the Youden’s index.Patients were then divided into a high-risk group(Rad-score>0.34)and a low-risk group(Rad-score≤0.34),and a nomogram model was successfully established to predict treatment response.The predicted treatment response also allowed for significant discrimination of Kaplan-Meier curves.Multivariate Cox regression identified six independent prognostic factors for overall survival,including male[hazard ratio(HR)=0.500,95%confidence interval(CI):0.260–0.962,P=0.038],alpha-fetoprotein(HR=

关键词： Hepatocellular carcinoma Transarterial chemoembolization Radiomics Treatment response Prediction

Nano polystyrene microplastics could accumulate in Nile tilapia(Oreochromis niloticus):Negatively impacts on the intestinal and liver health through water exposure

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Journal of Environmental Sciences 2024年第3期137卷 604-614页

作者： Di Wu Xing Lu li-Xue Dong Juan Tian Jin Deng Lei Wei Hua Wen Shan zhong ming Jiang School of Basic Medical Sciences Wuhan UniversityWuhan 430071China Key Laboratory of Freshwater Biodiversity Conservation Ministry of Agriculture and Rural AffairsYangtze River Fisheries Research InstituteChinese Academy of Fishery SciencesWuhan 430223China Hubei Province Key Laboratory of Allergy and Immunology Wuhan 430071China

Microplastics(MPs)have become a significant concern for their potential toxicity.However,the correlation between the size of plastic particles and their toxicity remains inconclusive.Here,we investigate the toxic effects of different sizes(80 nm,800 nm,8μm and 80μm)polystyrene MPs(PS-MPs)on the model organism Nile tilapia(Oreochromis niloticus).The results of bioluminescent imaging indicate that the 80 nm PS-MPs are more likely to invade the body.H&E staining shows severe damage on the intestinal villi and distinct hepatic steatosis in the 80 nm group.Ed U labeling shows that the proliferation activity of intestinal and liver cells reduces significantly in the 80 nm group.The gut microbiome analysis shows a severe imbalance of gut microbiota homeostasis in the 80 nm group.The analysis of liver transcriptomics and metabolomics shows that the liver lipid metabolism is disordered in the 80 nm group.In conclusion,this study confirms that the 80 nm PS-MPs are more likely to induce intestinal and liver toxicity.All the above lay the foundation for further study on the pathological damage of MPs to other organisms.

关键词： Microplastics(MPs) Intestinal toxicity liver toxicity Gut microbiome lipid metabolism

An Electrochemical Perspective of Aqueous Zinc Metal Anode

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Nano-Micro Letters 2024年第1期16卷 274-312页

作者： Huibo Yan Songmei li Jinyan zhong Bin li School of Materials Science and Engineering Beihang UniversityBeijing 100191People’s Republic of China

Based on the attributes of nonflammability,environmental benignity,and cost-effectiveness of aqueous electrolytes,as well as the favorable compatibility of zinc metal with them,aqueous zinc ions batteries(AZIBs)become the leading energy storage candidate to meet the requirements of safety and low cost.Yet,aqueous electrolytes,acting as a double-edged sword,also play a negative role by directly or indirectly causing various parasitic reactions at the zinc anode side.These reactions include hydrogen evolution reaction,passivation,and dendrites,resulting in poor Coulombic efficiency and short lifespan of AZIBs.A comprehensive review of aqueous electrolytes chemistry,zinc chemistry,mechanism and chemistry of parasitic reactions,and their relationship is lacking.Moreover,the understanding of strategies for suppressing parasitic reactions from an electrochemical perspective is not profound enough.In this review,firstly,the chemistry of electrolytes,zinc anodes,and parasitic reactions and their relationship in AZIBs are deeply disclosed.Subsequently,the strategies for suppressing parasitic reactions from the perspective of enhancing the inherent thermodynamic stability of electrolytes and anodes,and lowering the dynamics of parasitic reactions at Zn/electrolyte interfaces are reviewed.Lastly,the perspectives on the future development direction of aqueous electrolytes,zinc anodes,and Zn/electrolyte interfaces are presented.

关键词： Aqueous zinc ions batteries Parasitic reactions Aqueous electrolyte Zinc anode

C_(Ar)-Br bond cleavage via cooperative EnT/NHC catalysis: mild access to indolines

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Science China Chemistry 2024年第3期67卷 922-927页

作者： Yi-Xiong Dong Cao-Bo li ming-Lei Jin zhong-Hua Gao Song Ye Beijing National Laboratory for Molecular Sciences CAS Key Laboratory of Molecular Recognition and FunctionCAS Research/Education Center for Excellence in Molecular SciencesInstitute of ChemistryChinese Academy of SciencesBeijing 100190China University of Chinese Academy of Sciences Beijing 100049China

The cooperative visible-light mediated and NHC-catalyzed dearomative arylation-acylation of N-(2-bromobenzoyl)indoles with aldehydes was developed, affording the corresponding highly functionalized polycyclic indolines in moderate to good yields with exclusive diastereoselectivities. Mechanism investigations support the activation of CAr-Br bond via visible-light mediated energy transfer(EnT) and the following single-electron-transfer(SET) with Breslow intermediate under NHC catalysis to give key aryl radical and ketyl radical. This protocol demonstrates the cleavage of CAr-Br bond under mild cooperative EnT/NHC catalysis.

关键词： energy transfer N-heterocyclic carbenes photocatalysis aryl radicals indolines

Hot versus cold subduction initiation

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National Science Review 2024年第2期11卷 101-102页

作者： zhong-Hai li Key Laboratory of Computational Geodynamics College of Earth and Planetary SciencesUniversity of Chinese Academy of Sciences

In the framework of plate tectonics, subduction initiation(SI) indicates the birth of a plate convergent boundary, which is a key point of plate tectonics and Wilson's cycle; however, its dynamic process is not well c... 详细信息

关键词： DRIVEN CRUST

Early diagnosis and management of neonatal sepsis:a perspective

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World Journal of Pediatrics 2024年第4期20卷 303-306页

作者： li‑zhong Du Neonatal Intensive Care Unit Children’s Hospital Zhejiang University School of MedicineNational Clinical Research Center for Child Health3333 Binsheng RoadHangzhou 310052China

Neonatal sepsis is an illness caused by bloodstream bacteria or fungal infections that affect newborn infants under 28 days of age.It stands as a significant contributor to morbidity and mortality in neonatal intensive care units(NICUs).With the improved survival rates of very low-birth-weight or extremely premature infants,a growing number of these vulnerable infants are receiving intensive care and undergoing invasive procedures,making nosocomial infections a persistent challenge in NICUs.The mortality rate associated with neonatal sepsis varies depending on factors such as birth weight,gestational age,and other co-morbidities.It can also lead to a range of long-term health consequences,including neurodevelopmental disabilities like cerebral palsy,visual or hearing impairments,and cognitive problems.Furthermore,neonatal sepsis is linked to various adverse outcomes,including respiratory complications,bronchopulmonary dysplasia,nutritional and growth issues,and immunological dysfunction[1].Due to its atypical clinical presentation and the low rate of specific diagnostic indicators,such as a positive blood culture,accurately diagnosing neonatal sepsis is challenging.Consequently,the appropriateness of antibiotic treatment is often a matter of controversy.

关键词： neonatal mortality diagnosis

Specialization and Coordination: New Paradigm, Theory, and Path for Regional Development

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China Economist 2024年第1期19卷 76-85页

作者： Lu ming Xiang Kuanhu li Pengfei li Jiewei zhong Yuejun Antai College of Economics&Management Shanghai Jiao Tong UniversityShanghaiChina School of Economics Shanghai UniversityShanghai School of Economics and Management Shanghai Maritime UniversityShanghai Faculty of Economics and Management East China Normal UniversityShanghai

In its new development stage,China seeks to derive new dynamism from reform and opening up at a higher level to boost consumption and services.This process coincides with a further differentiation of comparative advantages across regions.Economic activity and population will continue to concentrate in clusters in coastal and central cities amid a continuous outflow of population from remote areas.Development expansion from coastal to interior regions and from central cities to the periphery will promote a new regional development paradigm of“dual centers and periphery”.Therefore,China’s regional development strategy should follow the new theory of seeking relative equilibrium amid development,identify regions of population inflow and outflow,and explore a new development path of regional specialization and coordination.By deepening market reforms and increasing central government coordination,the country is poised to improve the spatial allocation of resources and unleash institutional dividends in the process of developing a unified national market.

关键词： Regional development “dual centers-periphery” comparative advantage population migration