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Potentially fatal electrolyte imbalance caused by severe hydrofluoric acid burns combined with inhalation injury: A case report

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World Journal of Clinical Cases 2019年第20期7卷 3341-3346页

作者： He Fang Guang-Yi Wang Xun Wang Fang He Jian-Dong Su Department of Burn Surgery Changhai Hospital Affiliated to the Naval Medical UniversityShanghai 200433China Department of Burn and Plastic Surgery Suzhou Hospital Affiliated to Nanjing Medical UniversitySuzhou 215002Jiangsu ProvinceChina

BACKGROUND Hydrofluoric acid(HF)is one of the most common causes of chemical burns.HF burns can cause wounds that deepen and progress aggressively.As a result,HF burns are often severe even if they involve a small area of the skin.Published cases of HF burns have mostly reported small HF burn areas.Few cases of HF inhalation injury have been reported to date.CASE SUMMARY A 24-year-old man suffered from extensive hydrofluoric acid burns covering 60%of the total body surface area(TBSA),including deep second degree burns on 47%and third degree burns on 13%of the TBSA,after he fell into a pickling pool containing 15%HF.Comprehensive treatments were carried out after the patient was admitted.Ventricular fibrillation occurred 9 times within the first 2 h,and the lowest serum Ca2+concentration was 0.192 mmol/L.A dose of calcium gluconate(37 g)was intravenously supplied during the first 24 h,and the total amount of calcium gluconate supplementation was 343 g.Extracorporeal membrane oxygenation(ECMO)was applied for 8 d to handle the acute respiratory distress syndrome(ARDS)induced by the HF inhalation injury.The patient was discharged after 99 d of comprehensive treatment,including skin grafting.CONCLUSION Extensive HF burns combined with an inhalation injury led to a potentially fatal electrolyte imbalance and ARDS.Adequate and timely calcium supplementation and ECMO application were the keys to successful treatment of the patient.

关键词： Hydrofluoric acid burn Inhalation injury Hypocalcemia Acute respiratory distress syndrome Extracorporeal membrane oxygenation Case report

Effects of the prone position on arterial blood gas analysis and respiratory parameters of acute respiratory distress syndrome patients:An observational retrospective study

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Journal of Acute Disease 2023年第3期12卷 107-113页

作者： Furkan Tontu Baris Yildiz Sinan Asar Gulsum Oya Hergunsel Zafer Cukurova Intensive Care Unit Basaksehir City HospitalIstanbulTurkey Intensive Care Unit Bakırköy Dr.Sadi Konuk Training and Research HospitalIstanbulTurkey

Objective:To investigate the effect of the first prone position on arterial blood gas analysis and respiratory parameters of acute respiratory distress syndrome(ARDS)patients with and without COVID.Methods:This study was conducted retrospectively with 22 COVID-ARDS and 22 non-COVID ARDS patients,who were placed in a prone position for at least 16 hours on the first day at the intensive care unit admission,and arterial blood gas analysis was taken in the pre-prone,prone and post-prone periods.Results:PaO2 were significantly increased in the pre-prone vs.prone comparison in both groups,but the increase in the PaO2/FiO2 ratio was not significant.In comparing the pre-prone vs.post-prone PaO2/FiO2 ratios,there was a significant difference only in the non-COVID ARDS group.Conclusions:The improved oxygenation provided by prone positioning is more permanent with the“post-prone effect”in non-COVID ARDS patients.This can be attributed to the differences in the pathogenesis of the two ARDS types.

关键词： Respiratory distress syndrome Prone position Intensive Care Units Respiration Ventilation oxygenation

Euxinia as a dominant process during OAEla(Early Aptian)on the Eastern Russian Platform and during OAElb(Early Albian)in the Middle Caspian

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Science China Earth Sciences 2017年第1期60卷 58-70页

作者： Svetlana O. ZORINA Oksana V. PAVLOVA Bulat M. GALIULL1N Vladimir P. MOROZOV Alexey A. ESKIN Institute of Geology and Petroleum Technologies Kazan Federal University 4/5 Kremlyovskaya street Kazan 420008 Russian Federation

A detailed study of the mineral composition and microstructure of the black shales associated with OAEla(Eastern Russian Platform),OAElb(Middle Caspian),and the host rocks has been carried out using X-ray diffraction,scanning electron microscopic,and microprobe analyses.The results provide important constraints for depositional environments in the sedimentary basins.Black shales with pyrite framboids imply euxinic(sulfidic)conditions with increased organic matter preservation.Disintegrating framboids suggest partial or complete dissolution of the organic matter inside the framboids due to increasing water oxygenation.OAEla on the Eastern Russian Platform is heterogeneous as it includes thin interbeds of concretionary coccolith limestones within the interval of bituminous shales,and correlates with the Lower Aptian Rhagodiscus angustus nannofossil zone.The coccolith limestones indicate short intermittent episodes of interrupted stagnation,rapid oxygenation,and restoration of normal marine conditions.The presence of montmorillonite,albite,microcline,and diopside in the bituminous siltstones and in the host siltstones of OAEla on the Eastern Russian Platform,as well as a high content of titanium in the black siltstones correlated with OAElb in the Middle Caspian allow proposing significant input of pyroclastic material into the extant sea.

关键词： OAE1a OAE1b Black shales Pyrite framboids Euxinia oxygenation Eastern Russian Platform Middle Caspian Cretaceous

Cobalt(II) Salen Complex with Two Aza-crown Pendants and Its Analogues as Synthetic Oxygen Carriers

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Chinese Journal of Chemistry 2004年第6期22卷 558-562,501页

作者：魏星跃李建章毛治华周波秦圣英 Department of Chemistry Sichuan University Chengdu Sichuan 610064 China Analytical and Testing Center Sichuan University Chengdu Sichuan 610064 China

Salen with two aza-crown ether pendants H2L1 and its analogues H2L2--H2L4 were successfully synthesized starting from benzo-10-aza-15-crown-5 (BN15C5) or morpholine. Their structures were characterized by IR, MS, H-1 NMR and elemental analysis, and were confirmed by X-ray diffraction analysis of H2L1. Moreover, the saturated oxygen uptake of their cobalt(II) complexes CoL1-CoL4 in diethyleneglycol dimethyl ether was determined at different temperature. The oxygenation contants ( K-O2) and thermodynamic parameters (DeltaHdegrees and DeltaSdegrees) were calculated. The modulation of O-2-binding capabilities by pendant substituents were investigated as compared with the parent Schiff base complex CoL5 (CoSalen). The results indicate that the dioxygen affinities of CoL have been much more enhanced by aza-crown pendants than that by morpholino pendants, and the O-2-binding capabilities of CoL1 and CoL2 with aza-crown pendants would also be enhanced by adding alkali metal cations.

关键词： benzo-10-aza-15-crown-5 bis-Schiff base transition-metal complex synthesis oxygenation alkali metal ion

Synthesis of N-(4-Salicylideneiminoaryl)monoaza Crown Ethers and Dioxygen Affinities of Their Cobalt(II) Complexes

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Chinese Journal of Chemistry 2003年第5期21卷 510-514页

作者：曾伟李鸿波向瑞礼魏星耀秦圣英 Department of Chemistry Sichuan University Chengdu Sichuan 610064 China Analytical and Testing Center Sichuan University Chengdu Sichuan 610064 China

The Schiff base containing pendant monoaza crown ether HL 1, HL 2, HL 3 and HL 4 have been synthesized by condensation of salicylaldehyde with N (4 aminoaryl)monoaza crown ethers, which were prepared conveniently from 4 nitro N,N di(hydroxyethyl)aniline or 4 nitrobenzyl chloride via cyclization or condensation and reduction. The structures of HL 1—HL 4 were verified by 1H NMR, IR spectra, MS and elemental analysis. Moreover, the oxygenation constants ( K O 2 ) and thermodynamic parameters (Δ H 0 and Δ S 0) of their cobalt(II) complexes were determined in the range of -5 ℃ to 25 ℃, and the effect of crown ring bonded to a Schiff base on the dioxygen affinities of cobalt(II) complexes was also observed as compared to the uncrowned analogue (CoL 5 2).

关键词： synthesis monoaza crown ether cobalt(II) Schiff base complex oxygenation

Efficacy of early prone or lateral positioning in patients with severe COVID-19:a single-center prospective cohort

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Precision Clinical Medicine 2020年第4期3卷 260-271页

作者： Zhong Ni Kaige Wang Ting Wang Yuenan Ni Wei Huang Ping Zhu Tao Fan Ye Wang Bo Wang Jun Deng Zhicheng Qian Jiasheng Liu Wenhao Cai Shanling Xu Yu Du Gang Wang Zongan Liang Weimin Li Jianfei Luo Fengming Luo Dan Liu Department of Respiratory and Critical Care Medicine Clinical Research Center for Respiratory DiseaseWest China HospitalSichuan UniversityChengdu 610041China Department of Integrated Traditional Chinese and Western Medicine West China HospitalSichuan UniversityChengdu 610041China Department of Respiratory and Critical Care Medicine The Affiliated Hospital of Southwest Medical UniversityLuzhou 646000China Intensive Care Unit the Affiliated Hospital of North Sichuan Medical CollegeNanchong 637000China Department of Gastrointestinal Surgery Renmin Hospital of Wuhan UniversityWuhan 430060China Critical Care Medicine Department Sichuan Cancer HospitalAffiliated Cancer Hospital to University of Electronic Science and Technology of ChinaChengdu 610041China Department of Emergency and Critical Care Medicine West China School of Public HealthWest China Fourth HospitalSichuan UniversityChengdu 610041China

Background:Position intervention has been shown to improve oxygenation,but its role in non-invasively ventilated patients with severe COVID-19 has not been assessed.The objective of this study was to investigate the efficacy of early position intervention on non-invasively ventilated patients with severe COVID-19.Methods:This was a single-center,prospective observational study in consecutive patients with severe COVID-19 managed in a provisional ICU at Renmin Hospital of Wuhan University from 31 January to 15 February 2020.Patients with chest CT showing exudation or consolidation in bilateral peripheral and posterior parts of the lungs were included.Early position intervention(prone or lateral)was commenced for>4 hours daily for 10 days in these patients,while others received standard care.Results:The baseline parameters were comparable between the position intervention group(n=17)and the standard care group(n=35).Position intervention was well-tolerated and increased cumulative adjusted mean difference of SpO_(2)/FiO_(2)(409,95%CI 86 to 733)and ROX index(26,95%CI 9 to 43)with decreased Borg scale(−9,95%CI−15 to−3)during the first 7 days.It also facilitated absorption of lung lesions and reduced the proportion of patients with high National Early Warning Score 2(≥7)on days 7 and 14,with a trend toward faster clinical improvement.Virus shedding and length of hospital stay were comparable between the two groups.Conclusions:This study provides the first evidence for improved oxygenation and lung lesion absorption using early position intervention in non-invasively ventilated patients with severe COVID-19,and warrants further randomized trials.

关键词： COVID-19 early position intervention oxygenation ROX index Borg scale

Oxygen Requirements for the Cambrian Explosion

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Journal of Earth Science 2016年第2期27卷 187-195页

作者： Xingliang Zhang Linhao Cui Early Life Institute and State Key Laboratory of Continental Dynamics Department of Geology Northwest University

Hypoxic tolerance experiments may be helpful to constrain the oxygen requirement for animal evolution. Based on literature review, available data demonstrate that fishes are more sensitive to hypoxia than crustaceans and echinoderms, which in turn are more sensitive than annelids, whilst mollusks are the least sensitive. Mortalities occur where O_2 concentrations are below 2.0 mg/L, equivalent to saturation with oxygen content about 25% PAL（present atmospheric level）. Therefore, the minimal oxygen requirement for maintaining animal diversity since Cambrian is determined as 25% PAL. The traditional view is that a rise in atmospheric oxygen concentrations led to the oxygenation of the ocean, thus triggering the evolution of animals. Geological and geochemical studies suggest a constant increase of the oxygen level and a contraction of anoxic oceans during Ediacaran-Cambrian transition when the world oceans experienced a rapid diversification of metazoan lineages. However, fossil first appearances of animal phyla are obviously asynchronous and episodic, showing a sequence as： basal metazoans〉lophotrochozoans〉ecdysozoans and deuterostomes. According to hitherto known data of fossil record and hypoxic sensitivity of animals, the appearance sequence of different animals is broadly consistent with their hypoxic sensitivity： animals like molluscs and annelids that are less sensitive to hypoxia appeared earlier, while animals like echinoderms and fishes that are more sensitive to hypoxia came later. Therefore, it is very likely that the appearance order of animals is corresponding to the increasing oxygen level and/or the contraction of anoxic oceans during Ediacaran-Cambrian transition.

关键词： oxygenation Cambrian explosion metazoan lineages divergence fossil firstappearance.

ANAGRAM PROBLEM-SOLVING AND LEARNING IN ANTERIOR PREFRONTAL CORTEX

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Journal of Innovative Optical Health Sciences 2008年第2期1卷 157-175页

作者： SHOKO NIOKA JOSEPH I.TRACY SHANE RAINES SCOTT BUNCE BRITTON CHANCE Department of Biochemistry-Biophysics Biostatistics University of PennsylvaniaPAUSA Department of Neurology and Radiology Thomas Jefferson University§Department of PsychologyDrexel University PhiladelphiaPAUSA

We utilized Near-Infrared(NIR)spectroscopy to closely investigate the activation change in anterior prefrontal cortex(aPFC)during verbal anagram problem-solving and learning.We used a parametric design of anagram-solving with three difficulty levels and evaluated anagram skill with two sets of subjects and protocols.The first protocol was a one-time evaluation of untrained subjects(n=10)and the second protocol evaluated subjects over 6 weeks of training(n=6).The untrained subjects in the first protocol demonstrated blood oxygenation corresponding to neuronal activation in the aPFC in response to medium and hard difficulty levels of the stimuli,while the easy anagram task deoxygenated the aPFC bilaterally,corresponding to deactivation.Higher performers have more aPFC activation than lower performers in the medium difficulty level anagram-solving task.Six weeks of training in the second protocol showed that training reduced oxygenation in aPFC.In particular,subjects with lower baseline skill in anagram production showed a larger reduction in oxygenation where true performance gains occurred(medium difficulty)and smaller reduction where the performance gains were limited(hard anagrams).Association of the aPFC activation with the difficulty of the complex task suggests that aPFC is a part of a circuit for execution of task performance.In addition,more use of aPFC by untrained high performers suggests that the role of the aPFC is to increase efficiency of a problem-solving task.Thus,the NIR spectroscopy showed that the aPFC is a key structure in the circuit implementing the development of anagram skill.

关键词： Anagram anterior prefrontal cortex hemoglobin NIR oxygenation training effects difficulty

Monitoring photodynamic therapy of head and neck malignancies with optical spectroscopies

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World Journal of Clinical Cases 2013年第3期1卷 96-105页

作者： Ulas Sunar Department of Cell Stress Biology and Oncology PDT CenterRoswell Park Cancer InstituteBuffaloNew YorkNY 14263United States

In recent years there has been significant developments in photosensitizers(PSs), light sources and light delivery systems that have allowed decreasing the treatment time and skin phototoxicity resulting in more frequent use of photodynamic therapy(PDT) in the clinical settings. Compared to standard treatment approaches such as chemo-radiation and surgery, PDT has much reduced morbidity for head and neck malignancies and is becoming an alternative treatment option. It can be used as an adjunct therapy to other treatment modalities without any additive cumulative side effects. Surface illumination can be an option for pre-malignant and early-stage malignancies while interstitial treatment is for debulking of thick tumors in the head and neck region. PDT can achieve equivalent or greater efficacy in treating head and neck malignancies, suggesting that it may be considered as a first line therapy in the future. Despite progressive development, clinical PDT needs improvement in several topics for wider acceptance including standardization of protocols that involve the same administrated light and PS doses and establishing quantitative tools for PDT dosimetry planning and response monitoring. Quantitative measures such as optical parameters, PS concentration, tissueoxygenation and blood flow are essential for accurate PDT dosimetry as well as PDT response monitoring and assessing therapy outcome. Unlike conventional imaging modalities like magnetic resonance imaging, novel optical imaging techniques can quantify PDT-related parameters without any contrast agent administration and enable real-time assessment during PDT for providing fast feedback to clinicians. Ongoing developments in optical imaging offer the promise of optimization of PDT protocols with improved outcomes.

关键词： Head and neck cancer Photodynamic therapy Monitoring and predicting response Blood flow oxygenation Oxygen metabolism Diffuse optical imaging