Magnetic resonance (MR) evaluation of deep venous thrombosis of 338 discharged viral pneumonia patients.

Background: Viral pneumonia (VP) often leads to the development of deep vein thrombosis (DVT) in hospitalized patients. The aim of the study was to investigate the incidence of DVT in discharged patients with VP, and whether new and old DVT differ in transverse relaxation time. Methods: In this prospective cohort study in Wuhan, China, 338 consecutive discharged VP patients from February 2021 to March 2023 who underwent T2 weighted Sampling Perfection with Application Optimized Contrast Evolution (SPACE) were recruited to detect DVT. T2 mapping and T2* mapping were performed for the patients with DVT detected by magnetic resonance imaging (MRI). The minimum, maximum, mean of T2 time and T2* time of DVT were recorded as T2min, T2max, T2mean, T2*min, T2*max, and T2*mean, respectively. Clinical data and laboratory findings were compared between new and old DVT cases, which were defined based on the examination results before and after discharge. A Mann-Whitney test was used to compare transverse relaxation time parameters between new and old DVT. Results: Twelve percent of VP patients (40/338) developed new DVT after discharge. Thirty-three out of 104 DVTs did not resolve after discharge. Compared with patients with new DVT, patients with old DVT were older (67 vs. 59 years, P=0.003); and had a higher proportion of bedridden time >72 hours (72.7% vs. 37.0%, P<0.001). Patients with old DVT had a lower lymphocyte count (0.67×109/L vs. 0.97×109/L, P=0.01), higher C-reactive protein (59 vs. 35 mg/L, P=0.019), and higher levels of D-dimer (6.7 vs. 0.9 µg/mL, P<0.001) than patients with new DVT. Patients with old DVT received more invasive mechanical ventilation (30.3% vs. 7.4%, P<0.001) and had a higher proportion of acute respiratory distress syndrome (75.8% vs. 51.9%, P<0.001), and a higher proportion of cardiac injury (39.4% vs. 14.8%, P=0.033) than patients with new DVT. T2min, T2max, T2mean, and T2*max of new DVT were significantly greater than old DVT (17.6±10.4 vs. 13.2±5.9 ms, 94.9±44.9 vs. 42.3±23.6 ms, 46.8±24.0 vs. 25.0±12.6 ms, 22.5±12.4 vs. 10.7±3.5 ms, P<0.05 for all). There was no significant difference in T2*min or T2*mean between new and old DVT (3.2±0.4 vs. 3.1±0.4 ms, 8.2±4.9 vs. 5.5±1.5 ms, P>0.05 for both). Conclusions: T2 weighted SPACE magnetic resonance (MR) is valuable in the follow-up of thrombosis of discharged VP patients. T2 mapping distinguishes between new and old DVT.

High Ambipolar Mobility and Long-Range Carrier Transport in Violet Phosphorus Nanosheet.

Carrier transport capacity with high mobility and long-range diffusion length holds particular significance for the advancement of modern optoelectronic devices. Herein, we have unveiled the carrier dynamics and transport properties of a pristine violet phosphorus (VP) nanosheet by a transient absorption microscopy. Under the excitation (2.41 eV) above the exciton band, two photoinduced absorption peaks with the energy difference of approximately 520 meV emerge within a broadband transient absorption background which originates from the prompt generation of free carriers and the concomitant formation of excitons (lifetime of 467.21 ps). This observation is consistent with the established band-edge model of VP. Intriguingly, we have determined the ambipolar diffusion coefficient and mobility of VP to be approximately 47.32 cm2·s-1 and 1798 cm2·V-1·s-1, respectively, which further indicate a long-range carrier transport of approximately 2.10 µm. This work unveils the significant carrier transport capacity of VP, highlighting its potential for future optoelectronic and excitonic applications.

Thermal evaporation-driven fabrication of Ru/RuO2 nanoparticles onto nickel foam for efficient overall water splitting.

Developing high-performance bifunctional electrocatalysts towards the hydrogen evolution reaction/oxygen evolution reaction (HER/OER) holds great significance for efficient water splitting. This work presents a two-stage metal-organic thermal evaporation strategy for the fabrication of Ru-based catalysts (Ru/NF) through growing ruthenium (Ru)/ruthenium dioxide (RuO2) nanoparticles (NPs) on nickel foam (NF). The optimal Ru/NF shows remarkable performance in both the HER (26.1 mV) and the OER (235.4 mV) at 10 mA cm-2 in an alkaline medium. The superior OER performance can be attributed to the synergistic interaction between Ru and RuO2, facilitating fast alkaline water splitting. Density functional theory studies reveal that the resulting Ru/RuO2 with the (110) crystal surface reinforces the adsorption of oxygen on RuO2, while metallic Ru improves water dissociation in alkaline electrolytes. Besides, Ru/NF requires only 1.50 V at 10 mA cm-2 for overall water splitting, surpassing 20 wt% Pt/C/NF||RuO2/NF. This work demonstrates the promising potential of a thermal evaporation approach for designing stable Ru-based nanomaterials loaded onto conductive substrates for high performance overall water splitting.

Protein tyrosine phosphatase 1B contributes to neuropathic pain by aggravating NF-κB and glial cells activation-mediated neuroinflammation via promoting endoplasmic reticulum stress.

BACKGROUND: Neuropathic pain is a prevalent and highly debilitating condition that impacts millions of individuals globally. Neuroinflammation is considered a key factor in the development of neuropathic pain. Accumulating evidence suggests that protein tyrosine phosphatase 1B (PTP1B) plays a crucial role in regulating neuroinflammation. Nevertheless, the specific involvement of PTP1B in neuropathic pain remains largely unknown. This study aims to examine the impact of PTP1B on neuropathic pain and unravel the underlying molecular mechanisms implicated. METHODS: In the current study, we evaluated the paw withdrawal threshold (PWT) of male rats following spared nerve injury (SNI) to assess the presence of neuropathic pain. To elucidate the underlying mechanisms, western blotting, immunofluorescence, and electron microscopy techniques were employed. RESULTS: Our results showed that SNI significantly elevated PTP1B levels, which was accompanied by an increase in the expression of endoplasmic reticulum (ER) stress markers (BIP, p-PERK, p-IRE1α, and ATF6) and phosphorylated NF-κB in the spinal dorsal horn. SNI-induced mechanical allodynia was impaired by the treatment of intrathecal injection of PTP1B siRNA or PTP1B-IN-1, a specific inhibitor of PTP1B. Moreover, the intrathecal administration of PTP1B-IN-1 effectively suppressed the expression of ER stress markers (BIP, p-PERK/p-eIF2α, p-IRE1α, and ATF6), leading to the inhibition of NF-κB, microglia, and astrocytes activation, as well as a decrease in pro-inflammatory cytokines, including TNF-α, IL-6, and IL-1ß. However, these effects were reversed by intrathecal administration of tunicamycin (Tm, an inducer of ER stress). Additionally, intrathecal administration of Tm in healthy rats resulted in the development of mechanical allodynia and the activation of NF-κB-mediated neuroinflammatory signaling. CONCLUSIONS: The upregulation of PTP1B induced by SNI facilitates the activation of NF-κB and glial cells via ER stress in the spinal dorsal horn. This, in turn, leads to an increase in the production of pro-inflammatory cytokines, thereby contributing to the development and maintenance of neuropathic pain. Therefore, targeting PTP1B could be a promising therapeutic strategy for the treatment of neuropathic pain.

Efficacy and safety of patient-controlled intravenous analgesia after APS team standardized postoperative pain management: A 6-year experience of an acute pain service in 107802 Chinese patients.

There are few studies on the impact of postoperative pain management (such as Acute Pain Service, APS) on the prognosis of patients, especially the research on large samples, even less data on Chinese patients. It is reported that only 25.12 % of hospitals in China have established APS or similar teams, and less than 10 % of them are responsible for the whole process of postoperative analgesia services. Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology has established a professional APS team led by anesthesiologists (TJ-APS), and has a standardized workflow and management system. Based on the TJ-APS standardized postoperative pain management, the incidence and adverse effects of postoperative pain in different types of surgical patients were analyzed. In total, 107,802 patients receiving intravenous PCA from the Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology were selected between January 2016 and December 2021, which were under TJ-APS standardized postoperative analgesia process, postoperative analgesia strategy based on the principle of "low opioid, multimodal, specialization and individualization", as well as regular ward rounds and 24-h on call on-duty system. We assessed the incidence and adverse effects of postoperative pain in different types of surgical patients. Based on the TJ-APS standardized postoperative pain management, the incidence of poor postoperative analgesia in patients with intravenous PCA is significantly lower than that reported in the current literature (20 %), and mainly occurs in biliary-pancreatic surgery, extrahepatic surgery and gastrointestinal surgery. The overall incidence of adverse effects was 5.52 %, of which nausea and vomiting was the highest, especially among gynecological tumors and gynecological patients, which were 10.75 % and 8.68 % respectively, but both were lower than the level reported in the current literature (20 %). This APS multimodal management and analgesia process can provide reference and guidance for PCA management of postoperative acute pain.

MRI-based radiomics features uncover the micro-change of dorsal root ganglia lesion for patients with post-herpetic neuralgia.

Objective: To create and authenticate MRI-based radiomic signatures to identify dorsal root ganglia (DRG) lesions in post-herpetic neuralgia (PHN) patients generalizable and interpretable. Method: This prospective diagnostic study was conducted between January 2021 and February 2022. Lesioned DRG in patients with PHN and normal DRG in age-, sex-, height-, and weight-matched healthy controls were selected for assessment and divided into two groups (8:2) randomly: training and testing sets. The least absolute shrinkage and selection operator algorithm was employed to generate feature signatures and construct a model, followed by the assessment of model efficacy using the area under the curve (AUC) of the receiver operating characteristic (ROC), as well as sensitivity and specificity metrics. Results: The present investigation involved 30 patients diagnosed with postherpetic neuralgia (PHN), consisting of 18 males and 12 females (mean age 60.70 ± 10.18 years), as well as 30 healthy controls, comprising 18 males and 12 females (mean age 58.13 ± 10.54 years). A total of 98 DRG were randomly divided into two groups (8:2), namely a training set (n = 78) and a testing set (n = 20). Five radiomic features were chosen to construct the models. In the training dataset, the area under the curve (AUC) was 0.847, while the sensitivity and specificity were 71.79 and 97.44%, respectively. In the test dataset, the AUC was 0.87, and the sensitivity and specificity were 80.00 and 100.00%, respectively. Conclusion: An MRI-based radiomic signatures model has the capacity to uncover the micro-change of damaged DRG in individuals afflicted with postherpetic neuralgia.

NTRK1-mediated protection against manganese-induced neurotoxicity and cell apoptosis via IGF2 in SH-SY5Y cells.

BACKGROUND: Excessive manganese (Mn) exposure has been linked to neurotoxicity, cognitive impairments. Neurotrophic Receptor Kinase 1 (NTRK1) encodes Tropomyosin kinase A (TrkA), a neurotrophic receptor, as a mediator of neuron differentiation and survival. Insulin-like growth factor 2 (IGF2), a pivotal member of the insulin gene family, plays a crucial role in brain development and neuroprotection. Despite this knowledge, the precise mechanisms through which NTRK1 and IGF2 influence cell responses to Mn-induced neuronal damage remain elusive. METHODS: Cell apoptosis was assessed using CCK8, TUNEL staining, and Western blot analysis of cleaved Caspase-3. Lentiviral vectors facilitated NTRK1 overexpression, while small interfering RNAs (siRNAs) facilitated IGF2 knockdown. Real-time Quantitative PCR (qPCR) determined gene expression levels, while Western blotting measured protein expression. RESULTS: The study reveals that NTRK1 inhibits MnCl2-induced apoptosis in SH-SY5Y cells. NTRK1 overexpression significantly upregulated IGF2 expression, and subsequent siRNA-IGF2 experiments confirmed IGF2's pivotal role in NTRK1-mediated neuroprotection. Notably, the study identifies that NTRK1 regulates the expression of IGF2 in the neuroprotective mechanism with the involvement of ER stress pathways. DISCUSSION: The study reveals NTRK1's neuroprotective role via IGF2 against Mn-induced neurotoxicity and ER stress modulation in SH-SY5Y cells. These findings offer insights into potential therapies for neurodegenerative disorders related to Mn exposure and NTRK1 dysfunction, driving future research in this domain.

Alterations of the gut microbiota in patients with postherpetic neuralgia.

Postherpetic neuralgia (PHN) is a prevalent, intricate, and intractable form of neuropathic pain. The available evidence indicates that alterations in the gut microbiota are significant environmental determinants in the development of chronic neuropathic pain. Nevertheless, the correlation between the gut microbiota and PHN remains elusive. A cross-sectional study was performed on a cohort of 27 patients diagnosed with PHN and 27 matched healthy controls. Fecal samples were collected and subjected to microbiota analysis using 16S ribosomal RNA gene sequencing. Comparable levels of bacterial richness and diversity were observed in the gut microbiota of PHN patients and healthy controls. A significant difference was observed in 37 genera between the two groups. Furthermore, the LEfSe method revealed that the abundance levels of Escherichia-Shigella, Streptococcus, Ligilactobacillus, and Clostridia_UCG-014_unclassified were elevated in PHN patients, while Eubacterium_hallii_group, Butyricicoccus, Tyzzerella, Dorea, Parasutterella, Romboutsia, Megamonas, and Agathobacter genera were reduced in comparison to healthy controls. Significantly, the discriminant model utilizing the predominant microbiota exhibited efficacy in distinguishing PHN patients from healthy controls, with an area under the curve value of 0.824. Moreover, Spearman correlation analysis demonstrated noteworthy correlations between various gut microbiota and clinical symptoms, including disease course, anxiety state, sleep quality, heat pain, pain intensity, and itching intensity. Gut microbiota dysbiosis exists in PHN patients, microbiome differences could be used to distinguish PHN patients from normal healthy individuals with high sensitivity and specificity, and altered gut microbiota are related to clinical manifestations, suggesting potentially novel prevention and therapeutic directions of PHN.

Navigating the Landscape of MANF Research: A Scientometric Journey with CiteSpace Analysis.

This study employs bibliometric analysis through CiteSpace to comprehensively evaluate the status and trends of MANF (mesencephalic astrocyte-derived neurotrophic factor) research spanning 25 years (1997-2022). It aims to fill the gap in objective and comprehensive reviews of MANF research. MANF-related studies were extracted from the Web of Science database. MANF publications were quantitatively and qualitatively analyzed for various factors by CiteSpace, including publication volume, journals, countries/regions, institutions, and authors. Keywords and references were visually analyzed to unveil research evolution and hotspot. Analysis of 353 MANF-related articles revealed escalating annual publications, indicating growing recognition of MANF's importance. High-impact journals such as the International Journal of Molecular Sciences and Journal of Biological Chemistry underscored MANF's interdisciplinary significance. Collaborative networks highlighted China and the USA's pivotal roles, while influential figures and partnerships drove understanding of MANF's mechanisms. Co-word analysis of MANF-related keywords exposed key evolutionary hotspots, encompassing neurotrophic effects, cytoprotective roles, MANF-related diseases, and the CDNF/MANF family. This progression from basic understanding to clinical potential showcased MANF's versatility from cellular protection to therapy. Bibliometric analysis reveals MANF's diverse research trends and pathways, from basics to clinical applications, driving medical progress. This comprehensive assessment enriches understanding and empowers researchers for dynamic evolution, advancing innovation, and benefiting patients. Bibliometric analysis of MANF research. The graphical abstract depicts the bibliometric analysis of MANF research, highlighting its aims, methods, and key results.

Gender-specific associations between abdominal adipose mass and bone mineral density in the middle-aged US population.

OBJECTIVES: The relationship between abdominal adipose tissue and osteoporosis is poorly understood. The purpose of this study was to examine the associations of abdominal adipose tissue with bone mineral density (BMD) among a nationally representative sample of US middle-aged adults. MATERIAL AND METHODS: This study included 1498 participants from the National Health and Nutrition Examination Survey 2013-2014 and 2017-2018. Dual-energy x-ray absorptiometry was used to measure BMD at the lumbar spine and femoral neck, as well as to assess abdominal adipose mass by categorizing total adipose tissue (TAT) into visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). Linear regression was used to assess the relationship between abdominal adipose tissue and BMD, and logistic regression and generalized additive model were used to assess the associations of abdominal adipose tissue with the development of low BMD. RESULTS: In our study, men accounted for 51.3%, and the mean age and body mass index for men and women were 49.3 and 49.6 years, and 23.9 and 28.3 kg/m2, respectively. In the univariate model, we found that abdominal adipose mass was positively associated with BMD at femoral neck and spine in both genders. In the multivariate model, among men, a negative correlation was observed between TAT and SAT and BMD at the femoral neck. Additionally, higher masses of TAT, SAT, and VAT were found to significantly increase the risk of low BMD at both the femoral neck and lumbar spine. In contrast, there was no significant association between abdominal adipose mass and BMD in middle-aged women, regardless of menopausal status. CONCLUSIONS: Our finding suggested that abdominal adipose tissue, regardless of its location (SAT or VAT), may have a negative impact on BMD in middle-aged men independently of body weight, but this relationship was not observed in women. Further research is needed to confirm these findings and investigate potential mechanisms underlying these associations.

Evaluation of the correlation of dorsal root ganglia and spinal nerves with clinical symptoms in patients with postherpetic neuralgia using magnetic resonance neurography.

Purpose: To assess changes of dorsal root ganglia (DRG) and spinal nerves in patients with postherpetic neuralgia (PHN), and investigate the correlation between DRG morphology and clinical symptoms in PHN patients using magnetic resonance neurography (MRN). Methods: In this case-control study, forty-nine lesioned DRG in 30 patients and 49 normal DRG in 30 well-matched (age, sex, height, weight) healthy controls were assessed. Clinical symptoms of patients (pain, allodynia, itching, and numbness) were assessed. MRN features (DRG volume (VDRG), the largest diameter (Dmax) of spinal nerves, signal intensity of DRG and spinal nerves (M-value)) were measured in all participants. Multilinear regression analysis was used to evaluate the relationship between the DRG morphology and clinical symptoms in patients. Results: The volume and relative M-value of lesioned DRG in patients were significantly higher than those on the same side of healthy controls (p = 0.013, p < 0.001, respectively). The mean Dmax and relative M-value of spinal nerves on the lesioned side were significantly higher than those on the contralateral and same side of healthy controls (p < 0.0001, p = 0.0001, p = 0.0011, p = 0.0053, respectively). No difference was found between the mean VDRG of the lesioned and contralateral sides. Multiple linear regression analysis revealed that disease duration was independent risk factor for the maximum rate of VDRG differences (p = 0.013). Conclusions: DRG and spinal nerves on the lesioned side are swollen during PHN. Disease duration is an independent risk factor for morphological differences in the lesioned DRG of PHN patients. This study provides important guidance for individualized treatments of PHN.

Reversible Single-Crystal-to-Single-Crystal Transformations between Nanoscale 2D Nanosheets and 3D Metal-Organic Frameworks.

Single-crystal-to-single-crystal (SCSC) transformations provide more possibilities for phase transitions, which have attracted great attention in crystal engineering. In this paper, we report a series of reversible SCSC transformations between nanoscale two-dimensional layered double hydroxide (LDH) crystals and three-dimensional metal-organic framework crystals. They can proceed not only in solution systems but also on the surface of solid-state polyacrylonitrile films and fibers. Specifically, reversible SCSC transformations can be carried out between nanoscale ZIF-67 and Co-LDH. The Co-LDH nanomaterials displayed excellent oxygen evolution reaction performance. This work has good universality and scalability, which provides a novel avenue for the synthesis of crystal materials and is of great significance for the recycling of resources.

Broadband All-Optical THz Modulator Based on Bi2Te3/Si Heterostructure Driven by UV-Visible Light.

All-optical terahertz (THz) modulators have received tremendous attention due to their significant role in developing future sixth-generation technology and all-optical networks. Herein, the THz modulation performance of the Bi2Te3/Si heterostructure is investigated via THz time-domain spectroscopy under the control of continuous wave lasers at 532 nm and 405 nm. Broadband-sensitive modulation is observed at 532 nm and 405 nm within the experimental frequency range from 0.8 to 2.4 THz. The modulation depth reaches 80% under the 532 nm laser illumination with a maximum power of 250 mW and 96% under 405 nm illumination with a high power of 550 mW. The mechanism of the largely enhanced modulation depth is attributed to the construction of a type-II Bi2Te3/Si heterostructure, which could promote photogenerated electron and hole separation and increase carrier density dramatically. This work proves that a high photon energy laser can also achieve high-efficiency modulation based on the Bi2Te3/Si heterostructure, and the UV-Visible control laser may be more suitable for designing advanced all-optical THz modulators with micro-level sizes.

Transcriptomics reveals the effects of NTRK1 on endoplasmic reticulum stress response-associated genes in human neuronal cell lines.

Background: NTRK1 gene, encoding TrkA, is essential for the nervous system and drives a variety of biological processes, including pain. Given the unsatisfied analgesic effects of some new drugs targeting NTRK1 in clinic, a deeper understanding for the mechanism of NTRK1 in neurons is crucial. Methods: We assessed the transcriptional responses in SH-SY5Y cells with NTRK1 overexpression using bioinformatics analysis. GO and KEGG analyses were performed, PPI networks were constructed, and the functional modules and top 10 genes were screened. Subsequently, hub genes were validated using RT-qPCR. Results: A total of 419 DEGs were identified, including 193 upregulated and 226 downregulated genes. GO showed that upregulated genes were mainly enriched in response to endoplasmic reticulum (ER) stress, protein folding in ER, etc., and downregulated genes were highly enriched in a series of cellular parts and cellular processes. KEGG showed DEGs were enriched in protein processing in ER and pathways associated with cell proliferation and migration. The finest module was dramatically enriched in the ER stress response-related biological process. The verified seven hub genes consisted of five upregulated genes (COL1A1, P4HB, HSPA5, THBS1, and XBP1) and two downregulated genes (CCND1 and COL3A1), and almost all were correlated with response to ER stress. Conclusion: Our data demonstrated that NTRK1 significantly influenced the gene transcription of ER stress response in SH-SY5Y cells. It indicated that ER stress response could contribute to various functions of NTRK1-dependent neurons, and therefore, ER stress response-associated genes need further study for neurological dysfunction implicated in NTRK1.

Novel mutation in exon11 of PRKCG (SCA14): A case report.

Introduction: PRKCG mutations have been implicated in the pathogenesis of spinocerebellar ataxia type 14 (SCA14), which is a rare autosomal dominant disease marked by cerebellar degeneration, dysarthria, and nystagmus. Until now, there has never been a report of patients with mutations of c.1232G>C worldwide. Case description: We report a case of a 30-year-old Chinese man with episodic dystaxia, speech disorder, and cognitive impairment; however, his father exclusively exhibited a speech disorder regardless of the same mutation. Whole-exome sequencing revealed a heterozygous c.1232G>C (p.G411A) variant of PRKCG. Conclusion: This case presents an extended genotype and phenotype of SCA14, and emphasizes the importance of gene sequencing in patients with spinocerebellar ataxia.

CoSe2 nanoparticles anchored on dual 1D carbon nanotubes/N-doped carbon nanofibers as high-performance anodes for sodium-ion storage.

Transition metal chalcogenides (TMCs) have been widely explored and utilized in sodium-ion battery (SIB) anodes owing to their unique advantages, such as high theoretical specific capacity and low cost. However, their inherent defects, such as low electronic conductivity and severe volume expansion, seriously limit the further development of TMC-based anodes. Here, a novel composite material of CoSe2 nanoparticles (NPs) encapsulated in a dual one-dimensional (1D) carbon composite structure (CoSe2@CNTs/N-CNFs) was designed deliberately. Carbon nanotubes (CNTs) were grown in situ on the surface of carbon nanofibers (CNFs) with eco-friendly ethanol as the carbon source, while electrospun polyacrylonitrile (PAN) fibers were pyrolyzed to form nitrogen-doped nanofibers. It is noted that the wrapping with the composite carbon structure greatly improved the stability of CoSe2 NPs and solved its inherent defects as an anode material. When assembled into a half-cell, the CoSe2@CNTs/N-CNFs electrode exhibited outstanding sodium storage performance with a reversible specific capacity of 442 mA h g-1 after 100 cycles at 0.1 A g-1, as well as excellent rate performance, and the discharge specific capacity still reached 265 mA h g-1 even after 2000 cycles at a high current density of 5 A g-1. This study shows a new way to build a novel carbon substrate and TMC composite sodium storage material with low cost.

General synthesis of CoCeMOx trimetallic oxides via a cation exchange reaction for the oxygen evolution reaction.

Cobalt-based spinel oxides are considered potential candidates for the oxygen evolution reaction (OER) due to their abundant valence changes and promising electrochemical activity, but their low intrinsic activity hinders their practical applications. Herein, we synthesize a series of CoCeMOx (M = Zn, Ni, Ru, Er, Mg, Mn, Sn) derived from CoCeM coordination-driven self-assembled aggregates (CDSAAs) using a general ion exchange and subsequent calcination method. Interestingly, CoCeMOx exhibit different morphologies from porous nanospheres, particle-stacked nanospheres, to hollow nanospheres as the third metal element is altered. Markedly, CoCeZnOx porous nanospheres (PNs) exhibit the best OER performance. The XPS results reveal that the existence of CeO2 and Zn2+ ions significantly increased the Co2+/Co3+ ratio and the content of oxygen vacancies in Co3O4. Furthermore, Co2+ can be used as highly reactive sites to form CoOOH and the high content of oxygen vacancies can optimize the oxygen-containing intermediate adsorption energy, both of which can effectively improve the OER performance. Therefore, well-designed CoCeZnOx PNs demonstrate high OER activity with a lower overpotential (η = 333 mV) than that of commercial RuO2 (344 mV) in 10 mA cm-2, a Tafel slope of 98 mV dec-1, and a long-term durability of 45 h. This work may provide some inspiration for the design of trimetallic oxide nanomaterials.

Hyperkalemic cardiac arrest induced by mannitol administration during craniotomy: A case report and review of the literature.

Introduction: Mannitol is the most widely used hyperosmolar agent during neurosurgical procedures. However, its use can lead to serious hyperkalemia with altered cardiac conduction. Case presentation: Here we report a case in which a 40-min cardiac arrest was caused by mannitol-induced hyperkalemia during craniotomy. In addition, we conducted a literature review through a PubMed (MEDLINE) search of the relevant literature published so far. Details of all cases are presented and discussed. The results suggest that male patients or patients with uncontrolled diabetes might be at higher risk to develop this phenomenon. The results also suggest that the high dose and rapid rate of infusion of mannitol might contribute to mannitol-induced hyperkalemia. Conclusion: Physicians should be aware of the existence of mannitol-induced hyperkalemia. Although the mechanism of this complication is not well established, it is prudent to administer mannitol cautiously, especially in patients with uncontrolled diabetes. Continuous electrocardiogram monitoring and frequent measurements of serum electrolytes can help to detect and treat possible life-threatening events induced by mannitol-induced hyperkalemia early.

Refractory postherpetic neuralgia in a multiple myeloma patient with lenalidomide maintenance therapy: a case report.

Herpes zoster is not common in multiple myeloma (MM) patients treated with lenalidomide-based regimens. We report an MM patient in his late 60s who received lenalidomide as maintenance treatment and whose condition was complicated with refractory postherpetic neuralgia. The patient received antiviral treatment and analgesia immediately after the diagnosis of herpes zoster. Two months later, the patient received acupuncture, radiofrequency treatment, and even spinal cord stimulation, which failed to relieve the pain. Consequently, we performed high-resolution magnetic resonance imaging of the cervical and thoracic nerves. Then, stellate ganglion block, left C5/C6/C7/C8 nerve root block, and left thoracic 1, 2 paravertebral nerve block were performed with the assistance of real-time ultrasound. The pain was immediately relieved after treatment; however, the symptoms reappeared 2 days later. At 5 months after treatment, the patient still experienced severe pain. We suggest that MM patients complicated with postherpetic neuralgia are refractory to treatment. Starting nerve block therapy, pulsed radiofrequency, and other interventional therapies as early as possible could be a more optimal treatment plan for these patients.

Short-Term Effects of Low-Level Ambient Air NO2 on the Risk of Incident Stroke in Enshi City, China.

Previous studies found that exposure to ambient nitrogen dioxide (NO2) was associated with an increased risk of incident stroke, but few studies have been conducted for relatively low NO2 pollution areas. In this study, the short-term effects of NO2 on the risk of incident stroke in a relatively low-pollution area, Enshi city of Hubei Province, China, were investigated through time-series analysis. Daily air-pollution data, meteorological data, and stroke incidence data of residents in Enshi city from 1 January 2015 to 31 December 2018 were collected. A time-series analysis using a generalised additive model (GAM) based on Poisson distribution was applied to explore the short-term effects of low-level NO2 exposure on the risk of incident stroke and stroke subtypes, as well as possible age, sex, and seasonal differences behind the effects. In the GAM model, potential confounding factors, such as public holidays, day of the week, long-term trends, and meteorological factors (temperature and relative humidity), were controlled. A total of 9122 stroke incident cases were included during the study period. We found that NO2 had statistically significant effects on the incidence of stroke and ischemic stroke, estimated by excess risk (ER) of 0.37% (95% CI: 0.04-0.70%) and 0.58% (95% CI: 0.18-0.98%), respectively. For the cumulative lag effects, the NO2 still had a statistically significant effect on incident ischemic stroke, estimated by ER of 0.61% (95% CI: 0.01-1.21%). The two-pollutant model showed that the effects of NO2 on incident total stroke were still statistically significant after adjusting for other air pollutants (PM2.5, PM10, SO2, CO, and O3). In addition, the effects of NO2 exposure on incident stroke were statistically significant in elderly (ER = 0.75%; 95% CI: 0.11-1.40%), males (ER = 0.47%; 95% CI: 0.05-0.89%) and cold season (ER = 0.83%; 95% CI: 0.15-1.51%) subgroups. Our study showed that, as commonly observed in high-pollution areas, short-term exposure to low-level NO2 was associated with an increased risk of incident stroke, including ischemic stroke. Males and elderly people were more vulnerable to the effects of NO2, and the adverse effects might be promoted in the cold season.