Manifestations and Outcomes of Intracerebral Hemorrhage During the COVID-19 Pandemic in China: Multicenter, Longitudinal Cohort Study.

BACKGROUND: The COVID-19 pandemic has inevitably affected the distribution of medical resources, and epidemic lockdowns have had a significant impact on the nursing and treatment of patients with other acute diseases, including intracerebral hemorrhage (ICH). OBJECTIVE: This study aimed to investigate how the COVID-19 pandemic affected the manifestations and outcomes of patients with ICH. METHODS: Patients with acute ICH before (December 1, 2018-November 30, 2019) and during (December 1, 2019-November 30, 2020) the COVID-19 pandemic at 31 centers in China from the Chinese Cerebral Hemorrhage: Mechanism and Intervention (CHEERY) study were entered into the analysis. Demographic information and clinical manifestations and outcomes were collected and compared between the 2 groups. RESULTS: From December 1, 2018, to November 30, 2020, a total of 3460 patients with ICH from the CHEERY study were enrolled and eventually analyzed. The results showed that during the COVID-19 pandemic, patients with ICH were more likely to be older (P<.001) with a history of ischemic stroke (P=.04), shorter time from onset to admission (P<.001), higher blood pressure (P<.001), higher fasting blood glucose (P=.003), larger hematoma volume (P<.001), and more common deep ICH (P=.01) and intraventricular hemorrhage (P=.02). These patients required more intensive care unit treatment (P<.001) and preferred to go to the hospital directly rather than call an ambulance (P<.001). In addition, the COVID-19 pandemic was associated with an increased risk of pulmonary infection during hospitalization (adjusted risk ratio [RRadjusted] 1.267, 95% CI 1.065-1.509), lower probability of a 3-month good outcome (RRadjusted 0.975, 95% CI 0.956-0.995), and a higher probability of in-hospital (RRadjusted 3.103, 95% CI 2.156-4.465), 1-month (RRadjusted 1.064, 95% CI 1.042-1.087), and 3-month (RRadjusted 1.069, 95% CI 1.045-1.093) mortality. CONCLUSIONS: Our study indicated that the cloud of COVID-19 has adversely impacted the presentation and outcomes of ICH. Medical workers may pay more attention to patients with ICH, while the public should pay more attention to hypertension control and ICH prevention. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900020872; https://www.chictr.org.cn/showprojEN.html?proj=33817.

Diabetic and stress-induced hyperglycemia in spontaneous intracerebral hemorrhage: A multicenter prospective cohort (CHEERY) study.

INTRODUCTION: Admission hyperglycemia is a common finding after spontaneous intracerebral hemorrhage (ICH) secondary to pre-existing diabetes mellitus (DM) or stress-induced hyperglycemia (SIH). Studies of the causal relationship between SIH and ICH outcomes are rare. AIM: We aimed to identify whether SIH or pre-existing DM was the cause of admission hyperglycemia associated with ICH outcomes. METHODS: Admission glycosylated hemoglobin (HbA1c), glucose levels, and comorbidity data from the prospective, multicenter cohort, Chinese Cerebral Hemorrhage: Mechanisms and Intervention Study (CHEERY), were collected and analyzed. According to different admission blood glucose and HbA1c levels, patients were divided into nondiabetic normoglycemia (NDN), diabetic normoglycemia (DN), diabetic hyperglycemia (DH), and SIH groups. Modified Poisson regression models were used to analyze ICH outcomes in the different groups. RESULTS: In total, 1372 patients were included: 388 patients with admission hyperglycemia, 239 with DH, and 149 with SIH. In patients with hyperglycemia, SIH was associated with a higher risk of pulmonary infection [risk ratios (RR): 1.477, 95% confidence interval (CI): 1.004-2.172], 30-day (RR: 1.068, 95% CI: 1.009-1.130) and 90-day mortality after ICH (RR: 1.060, 95% CI: 1.000-1.124). CONCLUSIONS: Admission hyperglycemia is a common finding after ICH, and SIH is a sensitive predictor of the risk of pulmonary infection and all-cause death after ICH.

Periodate-based molecular perovskites as promising energetic biocidal agents.

Epidemics caused by pathogens in recent years have created an urgent need for energetic biocidal agents with the capacity of detonation and releasing bactericides. Herein we present a new type of energetic biocidal agents based on a series of iodine-rich molecular perovskites, (H2dabco)M(IO4)3 (dabco = 1,4-diazabicyclo[2.2.2]octane, M = Na+/K+/Rb+/NH4 + for DAI-1/2/3/4) and (H2dabco)Na(H4IO6)3 (DAI-X1). These compounds possess a cubic perovskite structure, and notably have not only high iodine contents (49-54 wt%), but also high performance in detonation velocity (6.331-6.558 km s-1) and detonation pressure (30.69-30.88 GPa). In particular, DAI-4 has a very high iodine content of 54.0 wt% and simultaneously an exceptional detonation velocity up to 6.558 km s-1. As disclosed by laser scanning confocal microscopy observation and a standard micro-broth dilution method, the detonation products of DAI-4 exhibit a broad-spectrum bactericidal effect against bacteria (E. coli, S. aureus, and P. aeruginosa). The advantages of easy scale-up synthesis, low cost, high detonation performance, and high iodine contents enable these periodate-based molecular perovskites to be highly promising candidates for energetic biocidal agents. Electronic Supplementary Material: Supplementary material is available in the online version of this article at 10.1007/s40843-022-2257-6.

ADVISING score: a reliable grading scale based on injury and response for intracerebral haemorrhage.

BACKGROUND: Intracerebral haemorrhage (ICH) is the most devastating form of stroke causing high morbidity and mortality. We aimed to develop a novel clinical score incorporating multisystem markers to predict functional dependence at 90 days after ICH. METHODS: We analysed data from Chinese Cerebral Hemorrhage: Mechanism and Intervention study. Multivariable logistic regression analysis was used to identify the factors associated with 90-day functional dependency (the modified Rankin Scale ≥3) after ICH and develop the ADVISING scoring system. To test the scoring system, a total of 2111 patients from Hubei province were included as the training cohort, and 733 patients from other three provinces in China were included as an external validation cohort. RESULTS: We found nine variables to be significantly associated with functional dependency and included in the ADVISING score system: age, deep location of haematoma, volume of haematoma, National Institutes of Health Stroke Scale, aspartate transaminase, international normalised ratio, neutrophil-lymphocyte ratio, fasting blood glucose and glomerular filtration rate. Individuals were divided into 12 different categories by using these nine potential predictors. The proportion of patients who were functionally dependent increased with higher ADVISING scores, which showed good discrimination and calibration in both the training cohort (C-statistic, 0.866; p value of Hosmer-Lemeshow test, 0.195) and validation cohort (C-statistic, 0.884; p value of Hosmer-Lemeshow test, 0.853). The ADVISING score also showed better discriminative performance compared with the other five existing ICH scores (p<0.001). CONCLUSIONS: ADVISING score is a reliable tool to predict functional dependency at 90 days after ICH.

Experimental Study on the Mechanism of Cinnamaldehyde Ameliorate Proteinuria Induced by Adriamycin.

Objective: Cinnamaldehyde (CA) is the main active component of Guizhi (Cinnamomi ramulus) to ameliorate adriamycin- (ADR-) induced proteinuria in rats. However, the underlying mechanism of CA against proteinuria remains unclear. The aim of this study was to investigate the action mechanisms of CA to treat proteinuria. Methods: 13 rats were randomly selected from 78 SD rats as control group, and the other rats were injected with ADR (3 mg/kg/time) twice through tail vein on day 1 and day 8 for modeling. After modeling, the rats were randomly divided into 5 groups as follows: ADR group, ADR+CA low-dose group, ADR+CA middle-dose group, ADR+CA high-dose group and Benazepril group with 13 rats in each group. The urine of SD rats was collected for 24 h, urine protein, creatinine and urea nitrogen were detected, renal index was calculated, and HE staining and western blot were performed. Results: The 24 h urine volume and urine protein, renal function, and renal histopathology got worse significantly in the ADR group. To western blot, CA downregulated the protein expression of ACE and Ang-2 and upregulated the protein expression of ACE2 in RAS signaling pathway. Conclusion: The underlying action mechanism of CA to treat NS might mainly be achieved by regulating RAS signaling pathway.

Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score.

Background Intracerebral hemorrhage is the most disabling and lethal form of stroke. We aimed to develop a novel clinical score for neurological deterioration during hospitalization after intracerebral hemorrhage. Methods and Results We analyzed data from the CHERRY (Chinese Cerebral Hemorrhage: Mechanism and Intervention) study. Two-thirds of eligible patients were randomly allocated into the training cohort (n=1027) and one-third into the validation cohort (n=515). Multivariable logistic regression was used to identify factors associated with neurological deterioration (an increase in National Institutes of Health Stroke Scale of ≥4 or death) within 15 days after symptom onset. A prediction score was developed based on regression coefficients derived from the logistic model. The site, size, gender, National Institutes of Health Stroke Scale, age, leukocyte, sugar (SIGNALS) score was developed as a sum of individual points (0-8) based on site (1 point for infratentorial location), size (3 points for >20 mL of supratentorial hematoma volume or 2 points for >10 mL of infratentorial hematoma volume), sex (1 point for male sex), National Institutes of Health Stroke Scale score (1 point for >10), age (1 point for ≥70 years), white blood cell (1 point for>9.0×109/L), and fasting blood glucose (1 point>7.0 mmol/L). The proportion of patients who suffered from neurological deterioration increased with higher SIGNALS score, showing good discrimination and good calibration in the training cohort (C statistic, 0.821; Hosmer-Lemeshow test, P=0.687) and in the validation cohort (C statistic, 0.848; Hosmer-Lemeshow test, P=0.592), respectively. Conclusions The SIGNALS score reliably predicts the risk of in-hospital neurological deterioration of patients with intracerebral hemorrhage.

PDA modification and properties of α-AlH3.

We present a novel surface coating to resolve the stability of α-AlH3. Inspired by the strong chemical adhesion of mussels, the polymerization of dopamine was first introduced to coat α-AlH3 through simple situ polymerization. The α-AlH3 was used as a substrate. In-depth characterizations confirmed the formation of polydopamine (PDA) on the α-AlH3 surface. The coated α-AlH3 sample was characterized by X-ray diffraction X-ray photoelectron spectrometry and Scanning Electron Microscope. The results show that a strong PDA film is formed on the surface of α-AlH3, and PDA@α-AlH3 retains its primary morphology. The crystal form of α-AlH3 does not change after coating with PDA. The XPS analysis results show that N1 s appears on the material after coating with PDA, indicating that polydopamine is formed on the surface of α-AlH3. The moisture absorption tests show that the moisture absorption rate of α-AlH3 is greatly reduced after being coated with PDA. The excellent intact ability of PDA prevents α-AlH3 from reacting with water in air. The thermal stability of α-AlH3 before and after coating was analyzed by DSC. This work demonstrates the successful applications of dopamine chemistry to α-AlH3, thereby providing a potential method for metastable materials.

Clinical and Prognostic Characteristics of Recurrent Intracerebral Hemorrhage: A Contrast to First-Ever ICH.

This study aimed to compare clinical and prognostic characteristics between recurrent and first-ever ICH. Four thousand twelve patients entered the study, and 64% of them were male. The median age is 62 years (interquartile range, 55-71). Among them, 3,750 (93.5%) patients had no experience of previous ICH, and 262 (6.5%) patients were considered as recurrent ICH. We compared demographic data, baseline clinical characteristics, imaging information, hematological parameters, and clinical outcomes between recurrent and first-ever ICH. We found that recurrent ICH was significantly associated with older age, more frequent history of ischemic heart disease, ischemic stroke, hypertension, and hyperlipidemia, while patients with recurrent ICH had previously received more antihypertensive therapy, and showed lower admission blood pressure (median, 160 vs. 167 mmHg) and higher baseline of National Institute of Health stroke scale (NIHSS) score (median, 10 vs. 9). We also demonstrated that recurrent ICH was an independent risk factor of 3-month function dependence after adjusting for many potentially competitive risk factors.

Spatial Analysis on the Role of Multi-Dimensional Urbanizations in Carbon Emissions: Evidence from China.

Using the panel data of 30 provinces in China from 1997 to 2015, this paper studies the impacts of urbanization on carbon emission. We use the entropy weight method to measure the weight of the indicator to evaluate four-dimensional urbanizations, including population, economic, consumption and living urbanization. In addition, we investigated the spatial correlation of carbon emissions, taking the spatial differences into consideration. The spatial Durbin model is finally selected to analyze the impacts of urbanizations on carbon emission. The conclusions are: Firstly, from the results of the panel data model, the four dimensions of urbanization all play a significant role in promoting carbon emissions in the whole regions. However, in eastern China, central China and western China, four dimensions of urbanization have different impacts on carbon emissions. Secondly, from Moran's I of carbon emissions from 1997 to 2015 in China, we conclude that carbon emissions in China present a significant spatial aggregation. Thirdly, from the results of spatial econometrics model, population urbanization only promotes local carbon emissions. Economic urbanization and consumption urbanization promote local carbon emissions and reduce carbon emissions in its neighboring provinces. Living urbanization promotes both local carbon emissions and its neighboring provinces' carbon emissions. This paper proposes some recommendations for the carbon emission decreasing during urbanization. First, establishment and improvement of coordination mechanisms and information sharing mechanisms across regions should also be considered. Second, control population growth reasonably and optimize population structure in order to achieve an orderly flow and rational distribution of the population. Third, the assessment mechanism of the local government should include not only economic indicators but also other indicators.

Facile synthesis and superior properties of a nitrogen-rich energetic Zn-MOF with a 2D azide-bridged bilayer structure.

Exploring the facile synthesis of Pb-free energetic metal-organic frameworks (EMOFs) with both high nitrogen content and high thermostability is a significant but challenging task in the field of MOF-based green energetic materials. Herein, a new EMOF, [Zn2(atz)3(N3)]n (atz = 5-amino-1H-tetrazole), has been synthesized by simply using a commercial ligand (atz) under mild conditions. A probable mechanism for the formation of azide groups in the product has been proposed, in which the fraction of C-N and N-N bonds in atz is the key. The X-ray single crystal structure analysis reveals the EMOF's unique graphene-like and azide-group-bridged 2D bilayer structure with gourd-type micropores. More impressively, the EMOF shows a high nitrogen content of 59.33% and superior thermostability of up to 362 °C, both among the best of existing EMOFs. In addition, detonation property calculations and sensitivity tests have been carried out, which demonstrate its high-energy and low-sensitivity features. Moreover, [Zn2(atz)3(N3)]n shows the ability to accelerate the thermal decomposition of ammonium perchlorate (AP) and hexanitrohexaazaisowurtzitane (CL-20), making it a potential combustion promoter for green and insensitive propellants.

Association Between Preonset Anti-hypertensive Treatment and Intracerebral Hemorrhage Mortality: A Cohort Study From CHEERY.

Introduction: Hypertension is the most prevalent risk factor for intracerebral hemorrhage (ICH). In this study, we investigated whether preonset anti-hypertensive therapy could affect the outcomes of ICH. Methods: This was a retrospective cohort study. A total of 3,460 consecutive patients with acute first-ever ICH from 31 recruitment sites were enrolled into the Chinese cerebral hemorrhage: mechanism and intervention (CHERRY) study from December 1, 2018 to November 30, 2020, and 2,140 (61.8%) with hypertension history were entered into the analysis. Results: Only 586 patients (27.4%) with hypertension history currently received anti-hypertensive therapy, and which was associated with lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) on admission (SBP, p = 0.008; DBP, p = 0.017), less hematoma volume (9.8 vs. 11%, p = 0.006), and lower all-cause mortality at 3 months (15.3 vs. 19.8%, OR = 0.728, p = 0.016). In multivariable analysis, adjusting for age, gender, residence, ischemic stroke history, admission SBP and DBP, and current use of antihypertension were significantly associated with lower adjusted hazard ratios (HRs) for all-cause mortality at discharge (adjusted HR, 0.497, p = 0.012), 30 days (adjusted HR, 0.712, p = 0.015), and 90 days (adjusted HR, 0.766, p = 0.030). However, after adjusting the variable of hematoma volume, the mortality between the two groups was not significantly different. Conclusions: Preonset anti-hypertensive therapy was associated with lower mortality of ICH, which somewhat depended on hematoma volume.

Silver(I)-Based Molecular Perovskite Energetic Compounds with Exceptional Thermal Stability and Energetic Performance.

In recent years, molecular perovskite energetic materials have attracted more attention because of their simple synthesis processes, high thermal stabilities, excellent performances, and great significance as a design platform for energetic materials. To explore the possibility of the application of molecular perovskite energetic materials in heat-resistant explosives, four silver(I)-based molecular perovskite energetic compounds, (H2A)[Ag(ClO4)3], where H2A = piperazine-1,4-diium (H2pz2+) for PAP-5, 1-methyl-piperazine-1,4-diium (H2mpz2+) for PAP-M5, homopiperazine-1,4-diium (H2hpz2+) for PAP-H5, and 1,4-diazabicyclo[2.2.2]octane-1,4-diium (H2dabco2+) for DAP-5, were synthesized by a one-pot self-assembly strategy and structurally characterized. The single-crystal structures indicated that PAP-5, PAP-M5, and DAP-5 possess cubic perovskite structures while PAP-H5 possesses a hexagonal perovskite structure. Differential thermal analyses showed that their onset decomposition temperatures are >308.3 °C. For PAP-5 and DAP-5, they have not only exceptional calculated detonation parameters (D values of 8.961 and 8.534 km s-1 and P values of 42.4 and 37.9 GPa, respectively) but also the proper mechanical sensitivity (impact sensitivities of ≤10 J for PAP-5 and 3 J for DAP-5 and friction sensitivities of ≤5N for both PAP-5 and DAP-5) and thus are of interest as potential heat-resistant primary explosive components.

Comparative Thermal Research on Energetic Molecular Perovskite Structures.

Molecular perovskites are promising practicable energetic materials with easy access and outstanding performances. Herein, we reported the first comparative thermal research on energetic molecular perovskite structures of (C6H14N2)[NH4(ClO4)3], (C6H14N2)[Na(ClO4)3], and (C6H14ON2)[NH4(ClO4)3] through both calculation and experimental methods with different heating rates such as 2, 5, 10, and 20 °C/min. The peak temperature of thermal decompositions of (C6H14ON2)[NH4(ClO4)3] and (C6H14N2) [Na(ClO4)3] were 384 and 354 °C at the heating rate of 10 °C/min, which are lower than that of (C6H14N2)[NH4(ClO4)3] (401 °C). The choice of organic component with larger molecular volume, as well as the replacement of ammonium cation by alkali cation weakened the cubic cage skeletons; meanwhile, corresponding kinetic parameters were calculated with thermokinetics software. The synergistic catalysis thermal decomposition mechanisms of the molecular perovskites were also investigated based on condensed-phase thermolysis/Fourier-transform infrared spectroscopy method and DSC-TG-FTIR-MS quadruple technology at different temperatures.

An Integration of Network Pharmacology and Experimental Verification to Investigate the Mechanism of Guizhi to Treat Nephrotic Syndrome.

Background: Guizhi has the pharmacological activity of anti-inflammatory. However, the effect mechanism of Guizhi against nephrotic syndrome (NS) remains unclear. A network pharmacological approach with experimental verification in vitro and in vivo was performed to investigate the potential mechanisms of Guizhi to treat NS. Methods: Active compounds and potential targets of Guizhi, as well as the related targets of NS were obtained from the public databases. The intersecting targets of Guizhi and NS were obtained through Venny 2.1.0. The key targets and signaling pathways were determined by protein-protein interaction (PPI), genes ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) analysis. And the overall network was constructed with Cytoscape. Molecular docking verification was carried out by AutoDock Vina. Finally, in vitro and in vivo experiments were performed to verify the mechanism of Guizhi to treat NS. Results: 63 intersecting targets were obtained, and the top five key targets mainly involed in NF- Kappa B and MAPK signaling pathway. In the overall network, cinnamaldehyde (CA) was the top one active compound with the highest degree value. The molecular docking showed that the top five key targets were of good binding activity with the active components of Guizhi. To in vitro experiment, CA, the main active component of Guizhi, inhibited the secretion of IL-1ß, IL-6, TNF-α in LPS challenged RAW264.7 cells, and down regulated the protein expression of p-NF-κB p65 and p-p38 MAPK in LPS challenged RAW264.7 cells. In vitro experiment showed that, 24 urinary protein and renal function were increased in ADR group. To western blot, CA down regulated the protein expression of p-p38 MAPK in rats of adriamycin-induced nephropathy. Conclusion: CA might be the main active component of Guizhi to treat NS, and the underlying mechanism might mainly be achieved by inhibiting MAPK signaling pathway.

Research on the Mechanism of Guizhi to Treat Nephrotic Syndrome Based on Network Pharmacology and Molecular Docking Technology.

OBJECTIVE: Nephrotic syndrome (NS) is a common glomerular disease caused by a variety of causes and is the second most common kidney disease. Guizhi is the key drug of Wulingsan in the treatment of NS. However, the action mechanism remains unclear. In this study, network pharmacology and molecular docking were used to explore the underlying molecular mechanism of Guizhi in treating NS. METHODS: The active components and targets of Guizhi were screened by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), Hitpick, SEA, and Swiss Target Prediction database. The targets related to NS were obtained from the DisGeNET, GeneCards, and OMIM database, and the intersected targets were obtained by Venny2.1.0. Then, active component-target network was constructed using Cytoscape software. And the protein-protein interaction (PPI) network was drawn through the String database and Cytoscape software. Next, Gene Ontology (GO) and pathway enrichment analyses of Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed by DAVID database. And overall network was constructed through Cytoscape. Finally, molecular docking was conducted using Autodock Vina. RESULTS: According to the screening criteria, a total of 8 active compounds and 317 potential targets of Guizhi were chosen. Through the online database, 2125 NS-related targets were identified, and 93 overlapping targets were obtained. In active component-target network, beta-sitosterol, sitosterol, cinnamaldehyde, and peroxyergosterol were the important active components. In PPI network, VEGFA, MAPK3, SRC, PTGS2, and MAPK8 were the core targets. GO and KEGG analyses showed that the main pathways of Guizhi in treating NS involved VEGF, Toll-like receptor, and MAPK signaling pathway. In molecular docking, the active compounds of Guizhi had good affinity with the core targets. CONCLUSIONS: In this study, we preliminarily predicted the main active components, targets, and signaling pathways of Guizhi to treat NS, which could provide new ideas for further research on the protective mechanism and clinical application of Guizhi against NS.

Influence of respiratory function training under the mode of mutual-assisted patients on postoperative pulmonary infection and immune function on lung cancer.

OBJECTIVE: This study explored the effect of respiratory function training under the mode of mutual-help of patients to the postoperative pulmonary infection and immune function on lung cancer. METHODS: 116 lung cancer patients who received surgical treatment from June 2018 to June 2019 were enrolled as the object. Patients were categorized into a control or observation group, according to the admission time of patients. Each group contained 58 subjects. The control-group was given regular nursing intervention, and the observation-group received respiratory function training under the mode of mutual assist between patients. Subsequently, the postoperative pulmonary infection, pulmonary function, and the changes of immune function before and after surgery were compared between the two groups. RESULT: The pulmonary infection rate of the group for observation was much lower than that of the control-group. The difference was statistically significant (5.17%, 17.24%, = 0.0394). The postoperative pulmonary function indexes in the observation-group were conspicuously better than those in control-group, the difference was statistically conspicuous (P<0.05). After nursing intervention, the cellular immune factors TNF-α, IL-8, and IL-6 of the two groups were conspicuously lower than those before the nursing intervention, and the decrease in the observation-group was remarkably greater than that in control-group, with the difference of statistical significance (P<0.05). In addition, the T cell subsets CD4+ and CD4+/CD8+ in the observation-group were conspicuously higher than those in the control-group. CD8+ in the observation-group was conspicuously lower than that in the group of control, with statistical significance (P<0.05). CONCLUSION: The respiratory function training under the mode of mutual-assist of patients can effectively reduce the incidence of postoperative pulmonary infection, improve the postoperative pulmonary function index, and improve the immune function, which is worthy of clinical promotion.

The predictive accuracy of satellite sign for hematoma expansion in intracerebral hemorrhage: A meta-analysis.

BACKGROUND AND PURPOSE: Satellite sign is a novel neuroimaging marker for predicting hematoma expansion (HE), which is closely related to unfavorable prognosis in patients with spontaneous intracerebral hemorrhage (ICH). However, the predictive value of satellite sign varied according to previous studies. Thus, we conduct this meta-analysis to systematically review the application value of satellite sign in related studies. METHODS: We searched the literature in PubMed, Embase, and Web of Science from inception to April 10, 2020. Effect values, including sensitivity, specificity, and positive and negative likelihood ratio were pooled to assess the diagnostic value of satellite sign for HE in patients with ICH. RESULTS: The meta-analysis included five studies with a total of 1493 patients. Results showed that the pooled diagnostic sensitivity and specificity were 0.50 (95 % CI, 0.31-0.70) and 0.71 (95 % CI, 0.56-0.83), respectively. In addition, the pooled positive and negative likelihood ratios were 1.7 (95 % CI, 1.5-2.1) and 0.70 (95 % CI, 0.54-0.89), respectively. No significant publication bias was found. CONCLUSION: Satellite sign exhibited moderate sensitivity and specificity for predicting HE in patients with ICH. Further studies are needed to explore its value in clinical application.

Buzhongyiqi Decoction Protects Against Loperamide-Induced Constipation by Regulating the Arachidonic Acid Pathway in Rats.

Constipation is a common gastrointestinal disorder without effective treatment approach. Buzhongyiqi decoction (BZYQD) is a classical formula that has been commonly used for gastrointestinal disorders for nearly 1,000 years. In this study, we aimed to investigate the protective effect of BZYQD against loperamide-induced constipation and its potential mechanism. Rats with loperamide-induced constipation were orally administered BZYQD. BZYQD treatment obviously increased the small intestinal transit rate and alleviated colon tissue pathological damage. Subsequently, serum metabolomics study was performed to identify the metabolites affected by BZYQD. Metabolomics identified that the levels of 17 serum metabolites, including prostaglandin E2 (PGE2), arachidonic acid (AA), and inositol, were significantly changed in BZYQD-treated group compared with those in the loperamide-induced group. Pathway analysis revealed that those metabolites were mainly associated with arachidonic acid metabolism, biosynthesis of unsaturated fatty acids, ascorbate and aldarate metabolism, inositol phosphate metabolism. Additionally, BZYQD treatment down-regulated the cyclooxygenase-2 expression and decrease production of the proinflammatory mediator PGE2. Further study revealed that BZYQD administration decreased serum levels of the inflammatory factors IL-1ß and TNF-α, inhibited phosphorylation of the nuclear transcription factor NF-κB, and down-regulated expression of the inflammatory factors IL-1ß and IL-6 in the constipated rat colon. Moreover, BZYQD treatment also increased serum levels of inositol, motilin and gastrin, and promoted gastrointestinal motility. In conclusion, the present study suggested that BZYQD exerted a protective effect against loperamide-induced constipation, which may be associated with its role in regulation of multiple metabolic pathways.

Knowledge, attitude, and practice regarding atrial fibrillation among neurologists in central China: A cross-sectional study.

BACKGROUND: Physicians' knowledge and practice of atrial fibrillation (AF) are determinants of the efficacy of thromboprophylaxis. HYPOTHESIS: This study aimed to investigate physicians' knowledge, attitude, and practice toward AF, to analyze the influencing factors, and to provide data to support departments that develop health policies. METHODS: A cross-sectional study was carried out from October 1, 2016, to March 31, 2018. A standard-structured anonymous questionnaire was completed by each participant through face-to-face interviews. RESULTS: A total of 611 doctors from 38 hospitals were responded to this survey. The mean of the total score of the questionnaire was 21.59 ± 3.559 (total score of the questionnaire was 36), and the mean scores of knowledge, attitude, and practice were 6.86 ± 1.70, 6.13 ± 1.35, and 8.59 ± 2.21, respectively. The doctor' s knowledge, practice scores, and total scores were positively correlated with the education level and the workplace. The influencing factors that affect doctors' knowledge, attitudes, and practice scores including education level, professional title, working years, hospital grade, and hospital location. CONCLUSIONS: There was still a big gap in neurologists' knowledge and practice about AF. It is necessary to strengthen the continuous improvement of doctor training to improve the management of AF.

High activity of NiCo2O4 promoted Pt on three-dimensional graphene-like carbon for glycerol electrooxidation in an alkaline medium.

Spinel oxide NiCo2O4 supported on a three-dimensional hierarchically porous graphene-like carbon (3D HPG) material has been firstly used to enhance the activity of Pt for glycerol electrooxidation. The addition of NiCo2O4 into the Pt/HPG catalyst can significantly improve the catalytic performance for glycerol oxidation. When NiCo2O4 is added to the Pt/HPG catalyst, the onset potential is 25 mV more negative than that on the Pt/HPG catalyst without NiCo2O4. The current density at -0.3 V on the Pt-NiCo2O4 (wt 10 : 1)/HPG electrode is 1.3 times higher than that on the Pt (30 wt%)/HPG electrode. The Pt-NiCo2O4 electrode presented in this work shows great potential as an electrocatalyst for glycerol electrooxidation in an alkaline medium.