Construction and regulation of high active sites in montmorillonite composite catalyst for the removal of ofloxacin via persulfate activation.

In this study, ionic liquids (ILs) were used as organic modifiers by introducing montmorillonite nanolayers containing potential C and N active sites between the montmorillonite nanolayers. Organically modified montmorillonite (ILs-Mt-p) was further prepared by high-temperature pyrolysis under N2 and used for the removal of ofloxacin (OFL) by activated peroxymonosulfate (PMS). Combined with XPS and other characterization analyses, it was found that the catalyst materials prepared from different organic modifiers had similar surface functional groups and graphitized structures, but contained differences in the types and numbers of C and N active sites. The catalyst (3CPC-Mt-p) obtained after pyrolysis of montmorillonite modified with cetylpyridinium chloride (CPC) had optimal catalytic performance, in which graphitic C, graphitic N, and carbonyl group (C[bond, double bond]O) could synergistically promote the activation of PMS by electron transfer, and 77.3 % of OFL could be removed within 60 min. The effects of OFL concentration, initial pH, and anions on the effects of OFL removal by the 3CPC-Mt-p/PMS system were further investigated. Satisfactory degradation results were obtained over a wide pH range. Cl- promoted the system to degrade OFL, while the presence of SO42-, H2PO4- and HA showed some inhibition, but overall the 3CPC-Mt-p catalysts had a strong anti-interference ability, showing good application prospects. The quenching experiments and EPR tests showed that O2-- and 1O2 in the 3CPC-Mt-p/PMS system were the main reactive oxygen species for the degradation of OFL, and •OH was also involved in the reaction. This study provides ideas for the construction and modulation of active sites in mineral materials such as montmorillonite and broadens the application of montmorillonite composite catalysts in advanced oxidation processes for the treatment of antibiotic wastewater.

Measuring the quality of transitional care based on elderly patients' experiences with the partners at care transitions measure: a cross-sectional survey.

BACKGROUND: The quality of transitional care is closely related to the health outcomes of patients, and understanding the status of transitional care for patients is crucial to improving the health outcomes of patients. Therefore, this study aims to investigate the quality of transitional care in elderly patients with chronic diseases and analyze its influencing factors, to provide a basis for improving transitional care services. METHODS: This is a cross-sectional study. We used the Chinese version of the Partners at Care Transitions Measure (PACT-M) to survey patients with chronic diseases aged 60 years and older who were about to be discharged from five tertiary hospitals in Henan and Shanxi provinces. We used the mean ± standard deviation to describe the quality of transitional care, t-test or one-way ANOVA, and regression analysis to explore the factors affecting the quality of transitional care for patients. RESULTS: 182 elderly patients with chronic diseases aged ≥ 60 years completed the PACT-M survey. The scores of PACT-M1 and PACT-M2 were (30.69 ± 7.87) and (25.59 ± 7.14) points, respectively. The results of the t-test or one-way ANOVA showed that the patient's marital status, ethnicity, religion, educational level, preretirement occupation, residence, household income per month, and living situation had an impact on the quality of transitional care for elderly patients with chronic diseases (P < 0.05). The results of regression analyses showed that patients' preretirement occupation, social support, and health status were the main influences on the quality of transitional care for elderly patients with chronic diseases (P < 0.05), and they explained 63.1% of the total variance. CONCLUSIONS: The quality of transitional care for older patients with chronic illnesses during the transition from hospital to home needs further improvement. Factors affecting the quality of transitional care included patients' pre-retirement occupation, social support, and health status. We can improve the hospital-community-family tertiary linkage service to provide coordinated and continuous transitional care for patients based on their occupation, health status, and social support to enhance the quality of transitional care and the patient's health.

Clinical value of ultrasound in adult Wilms' tumor patient with uremia: A case report and literature review.

RATIONALE: Wilms' tumor (WT) is the most common pediatric kidney malignancy and is rarely found in adults. Nonspecific clinical symptoms and imaging features often lead to delayed diagnosis or misdiagnosis of adult WT, resulting in poor clinical outcomes. Ultrasound (US), as an efficient and noninvasive examination method, has been widely used in clinical diagnosis and treatment. Therefore, various US evidence is meaningful to improve understanding of adult WT characteristics in ultrasound. PATIENT CONCERNS: A 45-year-old female patient with uremia (regular hemodialysis for 13 years) with painless gross hematuria was diagnosed with a right kidney tumor penetrating to the lung. Preoperatively, B-mode ultrasonography showed an ill-defined hyperechoic mass in the right kidney, which revealed an unclear border, uneven internal echoes, and calcification. Besides, the internal blood flow signal of the tumor was detected. Contrast-enhanced ultrasound (CEUS) showed an uneven hyper-enhancement in the tumor ("fast in and slow out"). Contrast-enhanced computed tomography of the kidney indicated a similar result as the CEUS. Moreover, the chest CT identified multiple pulmonary metastatic nodules. DIAGNOSES: An ultrasound-guided percutaneous core needle biopsy of the tumor proceeded to make a definite diagnosis of adult WT (epithelial type). INTERVENTIONS: The patient was treated with tislelizumab. OUTCOMES: No progress was found to date. LESSONS: We report the first case in which CEUS was performed in an adult WT patient with uremia and multiple pulmonary metastases. The features obtained by the US can help in the diagnosis of adult WT and direct further diagnostic procedures.

Metal-Based Electrocatalysts for Selective Electrochemical Nitrogen Reduction to Ammonia.

Ammonia (NH3) plays a significant role in the manufacture of fertilizers, nitrogen-containing chemical production, and hydrogen storage. The electrochemical nitrogen reduction reaction (e-NRR) is an attractive prospect for achieving clean and sustainable NH3 production, under mild conditions driven by renewable energy. The sluggish cleavage of N≡N bonds and poor selectivity of e-NRR are the primary challenges for e-NRR, over the competitive hydrogen evolution reaction (HER). The rational design of e-NRR electrocatalysts is of vital significance and should be based on a thorough understanding of the structure-activity relationship and mechanism. Among the various explored e-NRR catalysts, metal-based electrocatalysts have drawn increasing attention due to their remarkable performances. This review highlighted the recent progress and developments in metal-based electrocatalysts for e-NRR. Different kinds of metal-based electrocatalysts used in NH3 synthesis (including noble-metal-based catalysts, non-noble-metal-based catalysts, and metal compound catalysts) were introduced. The theoretical screening and the experimental practice of rational metal-based electrocatalyst design with different strategies were systematically summarized. Additionally, the structure-function relationship to improve the NH3 yield was evaluated. Finally, current challenges and perspectives of this burgeoning area were provided. The objective of this review is to provide a comprehensive understanding of metal-based e-NRR electrocatalysts with a focus on enhancing their efficiency in the future.

Assessing the agreement between the partners at care transitions measure and the care transitions measure for elderly patients with chronic diseases.

BACKGROUND: Elderly patients with chronic diseases are very vulnerable during the transition from hospital to home and have a high need for transitional care. The quality of transitional care is closely related to patient health outcomes. Using appropriate scales to evaluate the quality of transitional care is important for efforts aimed at improving it. The study aimed to analyze the consistency between the Chinese version of the Partners at Care Transitions Measure (PACT-M) and the Care Transition Measure (CTM) in assessing the quality of transition care in elderly patients with chronic diseases. METHODS: This is a cross-sectional study, we used a convenience sampling method to investigate patients with chronic diseases aged ≧ 65 years who were about to be discharged from the three affiliated hospitals of Zhengzhou University in Henan Province, from August 2021 to May 2022. The sample consisted of 196 elderly patients with chronic diseases. Data were collected using a demographic survey, PACT-M, and CTM. We used EpiData 3.1 software for systematic logical error checking, SPSS 21.0 to analyze the data, and the Bland-Altman analysis to analyze the consistency of the two scales. RESULTS: The mean total scores for PACT-M and CTM were 65.52 ± 6.23 and 52.07 ± 7.26, respectively. The 95% confidence interval (CI) for the mean difference and ratios were (-31.52, 4.61) and (0.85, 1.72), with 3.57% and 5.10% of the points outside the 95% CI limits, separately. CONCLUSIONS: The difference analysis of Bland-Altman showed a good consistency of the two scales, while the rate analysis did not meet the a priori definition of good consistency, but it is very close to 5%. Therefore, the consistency of the two scales in assessing the quality of transitional care for elderly patients with chronic diseases needs to be further validated.

Variation of Ginsenosides in Ginseng of Different Ages.

Panax ginseng has been used in traditional oriental medicine for thousands of years. Ginsenosides, the major chemical components of the roots, are considered to be responsible for the medicinal properties of ginseng. Ginsenosides increase with the age of ginseng root in general knowledge, and in this study the content of ginsenosides in ginseng of different ages was quantified. Separation and determination of eight main ginsenosides, Rg1, Re, Rb1, Rc, Rg2, Rb2, Rb3 and Rd, was performed by high performance liquid chromatography with UV detection at 203 nm. The content of Rg1, Re, Rb1, Rc, Rg2 and Rd increased from 5 to 16-year-old ginseng and then decreased, while Rb2 and Rb3 increased in the range of 5-12 years, but then slowly decreased. However, the total eight ginsenosides in 16 year old ginseng had a higher content than that in any other from 5-18 years old. As a result, the content of ginsenosides and total ginsenosides was not positively related to age from 5-18 years, which is not in full agreement with the general knowledge of ginseng. Thus, this study suggests that the older wild ginseng may not result in better medicinal ginseng for herbal medicines.

Inflammatory bowel disease: pathogenesis.

Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is characterized by chronic relapsing intestinal inflammation. It has been a worldwide health-care problem with a continually increasing incidence. It is thought that IBD results from an aberrant and continuing immune response to the microbes in the gut, catalyzed by the genetic susceptibility of the individual. Although the etiology of IBD remains largely unknown, it involves a complex interaction between the genetic, environmental or microbial factors and the immune responses. Of the four components of IBD pathogenesis, most rapid progress has been made in the genetic study of gut inflammation. The latest internationally collaborative studies have ascertained 163 susceptibility gene loci for IBD. The genes implicated in childhood-onset and adult-onset IBD overlap, suggesting similar genetic predispositions. However, the fact that genetic factors account for only a portion of overall disease variance indicates that microbial and environmental factors may interact with genetic elements in the pathogenesis of IBD. Meanwhile, the adaptive immune response has been classically considered to play a major role in the pathogenesis of IBD, as new studies in immunology and genetics have clarified that the innate immune response maintains the same importance in inducing gut inflammation. Recent progress in understanding IBD pathogenesis sheds lights on relevant disease mechanisms, including the innate and adaptive immunity, and the interactions between genetic factors and microbial and environmental cues. In this review, we provide an update on the major advances that have occurred in above areas.