Incidence, mortality, and predictive factors associated with acute respiratory distress syndrome in multiple trauma patients living in high-altitude areas: a retrospective study in Shigatse.

Background: Acute respiratory distress syndrome (ARDS) is a severe complication that can lead to fatalities in multiple trauma patients. Nevertheless, the incidence rate and early prediction of ARDS among multiple trauma patients residing in high-altitude areas remain unknown. Methods: This study included a total of 168 multiple trauma patients who received treatment at Shigatse People's Hospital Intensive Care Unit (ICU) between January 1, 2019 and December 31, 2021. The clinical characteristics of the patients and the incidence rate of ARDS were assessed. Univariable and multivariable logistic regression models were employed to identify potential risk factors for ARDS, and the predictive effects of these risk factors were analyzed. Results: In the high-altitude area, the incidence of ARDS among multiple trauma patients was 37.5% (63/168), with a hospital mortality rate of 16.1% (27/168). Injury Severity Score (ISS) and thoracic injuries were identified as significant predictors for ARDS using the logistic regression model, with an area under the curve (AUC) of 0.75 and 0.75, respectively. Furthermore, a novel predictive risk score combining ISS and thoracic injuries demonstrated improved predictive ability, achieving an AUC of 0.82. Conclusions: This study presents the incidence of ARDS in multiple trauma patients residing in the Tibetan region, and identifies two critical predictive factors along with a risk score for early prediction of ARDS. These findings have the potential to enhance clinicians' ability to accurately assess the risk of ARDS and proactively prevent its onset.

Breathable Dual-Mode Leather-Like Nanotextile for Efficient Daytime Radiative Cooling and Heating.

Incorporating passive radiative cooling and heating into personal thermal management has attracted tremendous attention. However, most current thermal management materials are usually monofunctional with a narrow temperature regulation range, and lack breathability, softness, and stretchability, resulting in a poor wearer experience and limited application scenarios. Herein, a breathable dual-mode leather-like nanotextile (LNT) with asymmetrical wrinkle photonic microstructures and Janus wettability for highly efficient personal thermal management is developed via a one-step electrospinning technique. The LNT is synthesized by self-bonding a hydrophilic cooling layer with welding fiber networks onto a hydrophobic photothermal layer, constructing bilayer wrinkle structures that offer remarkable optical properties, a wetting gradient, and unique textures. The resultant LNT exhibits efficient cooling capacity (22.0 °C) and heating capacity (22.1 °C) under sunlight, expanding the thermal management zone (28.3 °C wider than typical textiles). Additionally, it possesses favorable breathability, softness, stretchability, and sweat-wicking capability. Actual wearing tests demonstrate that the LNT can provide a comfortable microenvironment for the human body (1.6-8.0 °C cooler and 1.0-7.1 °C warmer than typical textiles) in changing weather conditions. Such a wearable dual-mode LNT presents great potential for personal thermal comfort and opens up new possibilities for all-weather smart clothing.

A Trilayered Composite Fabric with Directional Water Transport and Resistance to Blood Penetration for Medical Protective Clothing.

Functional textiles with enhanced moisture management can facilitate sweat transport away from the skin to improve personal comfort. However, porous materials exhibit low capability of preventing the intrusion of external liquids, becoming a bottleneck in the design of medical protective clothing. Herein, a trilayered composite fabric based on a gradient wettability structure is demonstrated for directional water transport and resistance to blood penetration. The proposed fabric shows distinct advantages, including a high water breakthrough pressure of 2.43 kPa from the external side, an outstanding positive water transport index (1522%), and an antiblood penetration resistance of 2.71 kPa. Moreover, the fabric shows improved comfort with a high moisture transmission (320 g m-2 h-1) and desired water evaporation rate (0.36 g h-1). This work addressed the concern of directional water transport and resistance to blood penetration while providing a comfortable wearing microenvironment, leading to a promising research direction for multifunctional medical textiles.

Integration of Janus Wettability and Heat Conduction in Hierarchically Designed Textiles for All-Day Personal Radiative Cooling.

Personal cooling textiles are a promising energy-free pathway for confronting serious heat-related public health threats and improving industrial worker productivity. Current cooling strategies mainly focus on passive daytime radiation, and there is a lack of research on all-day cooling methods which utilize synergistic radiative, conductive, and evaporative heat dissipation. Herein, we demonstrate a hierarchical polyurethane/silicon nitride fibrous membrane with Janus wettability fabricated via a scalable electrospinning method followed by single-side hydrophilic plasma treatment. High angular-dependent solar reflectance (91%) and human body infrared emittance (93%) allow for a temperature drop of ∼21.9 °C under direct sunlight and ∼2.8 °C at night compared with traditional cotton. The innovative integration of Janus wettability and heat conduction in hierarchically designed textiles ensures a minimum sweat consumption of 0.5 mL h-1, avoiding harmfully excessive perspiration. The excellent all-day cooling performance of this hierarchical textile presents great advantages for smart textile, energy-saving, and personal cooling applications.

Anti-inflammatory labdane diterpenoids from Leonurus japonicus Houtt.

Seven undescribed labdane diterpenoids, japonicones A-G, were isolated from the aerial parts of Leonurus japonicus Houtt. Japonicones C-G contained two keto carbonyl groups in their structures attached to C-3 and C-7, which are rare for labdane diterpenoids. The structures and absolute configurations of japonicones A-G were established by means of spectroscopic analyses (HRESIMS, 1D and 2D NMR, and ECD). Their anti-inflammatory activities were evaluated by measuring their inhibitory effects on PGE2 production in LPS-stimulated RAW264.7 macrophages. Japonicones A-D and G showed inhibition of PGE2 production with IC50 values in the range of 8.62-30.71 µM (the positive control paracetamol showed an IC50 = 5.79 µM).

Two new labdane diterpenoids from aerial parts of Leonurus japonicus and their anti-inflammatory activity.

Two new labdane diterpenoids, Leojaponin E (1) and F (2), together with three known compounds were isolated from the dried herb of Leonurus japonicus Houtt., Lamiaceae. Their structures were determined based on extensive spectroscopic analyses. The absolute configurations of 1 and 2 were elucidated on the basis of experimental and calculated electronic circular dichroism spectra. In addition, compounds 1 and 2 exerted inhibition of LPS-induced PGE2 production in a dose-dependent manner at concentrations ranging from 5 to 20 µM.

[A new aurone with anti-inflammatory activity from Cleistocalyx operculatus flower buds].

A new compound(Z)-6-hydroxy-4-methoxy-5,7-dimethylaurone was isolated from Cleistocalyx operculatus flower buds. Its structure was identified by spectroscopic data including MS, ¹H-NMR, ¹³C-NMR HSQC and HMBC. A known compound, 2',4'-dihydroxy-6'-methoxy-3'5'-dimethylchalcone (DMC), was also isolated and identified,and used as material to synthesize (Z)-6-hydroxy-4-methoxy-5,7-dimethylaurone.Anti-inflammatory activities of the two compounds were tested in vitro. The results showed that (Z)-6-hydroxy-4-methoxy-5,7-dimethylaurone possesses much stronger PGE2 inhibitory activity (IC50 6.12 nmol·L⁻¹) than the positive control ibuprofen （68.66 nmol·L⁻¹ï¼‰.

Relationship between molecular weight, monosaccharide composition and immunobiologic activity of Astragalus polysaccharides.

Four Astragalus polysaccharides (APS1-APS4) were isolated from the water extract of Radix Astragali and purified through ethanol precipitation with 20 %, 40 %, 60 % and 80 % ethanol, respectively. The total sugar content was measured by sulfuric acid-phenol method. Their molecular weight was determined using high performance gel permeation chromatography (HPGPC) and their monosaccharide composition was analyzed by reversed-phase high performance liquid chromatography (HPLC) after pre-column derivatization. Then the immunobiologic activity of APS was evaluated by the experiment of spleen lymphocytes proliferation in vitro. The data suggested that precipitation by different concentration of ethanol will obtain different molecular weight APS, the higher concentration of ethanol the smaller molecular weight for APS. The molecular weights of four APS were 257.7 kDa, 40.1 kDa, 15.3 kDa and 3.2 kDa. Monosaccharide composition analysis indicated that APS1 consisted of glucose only, and APS2 all consisted of arabinose. APS3 consisted of rhamnose, glucose, galactose and arabinose and APS4 consisted of galactose and arabinose, in a molar ratio of 1:10.76:6.55:12 and 3.02:1. The result of immunobiologic activity assay showed that both APS2 and APS3 can effectively stimulate normal spleen lymphocyte proliferation in vitro. Apart from this, the effect of APS2 also showed dose dependent tendency from 6.25 µg/mL to 800 µg/mL. The result of this research indicated that Astragalus polysaccharides, which consist of arabinose and their molecular weight between 15.2 kDa to 40.1 kDa, neither too high nor too low, had significant immune activity.

[Research on Chinese medicine pairs effects of Panax notoginseng and Bletilla striata before and after compatibility on contents of notoginsenosides].

To discuss the synergistic mechanism of compatible use of two medicinal herbs,Panax notoginseng and Bletilla striata, an HPLC was established to determine two ginseng saponins (20S)-ginseng saponin Rg3 and ginseng saponin Rh4 contained in single decoction of Panax notoginseng as well as in compound decoction of Panax notoginseng and Bletillastriata in different compatibility ratio (1∶0.5, 1∶1, 1∶2), followed by analyzing the impact of amount of notoginsenosides after compatibility. As a result, compared with the single decoction of Panax notoginseng, the contents of ginseng saponin Rg3 and ginseng saponin Rh4 in the compound decoction of Panax notoginseng and Bletillastriata were on the rise as the increasement of the amount of Bletillastriata. The contents of the notoginsengsaponin R1, ginseng saponin Rg1 and ginseng saponin Rb1 of Panax notoginseng single decoction were significantly decreased after compatibility. Therefore, after compatibility, it was more easy to produce (20S)-ginseng saponin Rg3 and ginseng saponin Rh4.This study can extend to a method of preparation of (20S)-ginseng saponin Rg3 and ginseng saponin Rh4. Furthermore, after compatibility, two ginseng saponins which had lipase inhibitory effect were both increased significantly, indicating that the compatibility of these two herb medicines may have effect on losing weight.