MXene/ZnS/chitosan-cellulose composite with Schottky heterostructure for efficient removal of anionic dyes by synergistic effect of adsorption and photocatalytic degradation.

Nowadays, dye water pollution is becoming increasingly severe. Composite of MXene, ZnS, and chitosan-cellulose material (MX/ZnS/CC) was developed to remove anionic dyes through the synergistic effect of adsorption and photocatalytic degradation. MXene was introduced as the cocatalyst to form Schottky heterostructure with ZnS for improving the separation efficiency of photocarriers and photocatalytic performance. Chitosan-cellulose material mainly served as the dye adsorbent, while also could improve material stability and assist in generation of free radicals for dye degradation. The physics and chemistry properties of MX/ZnS/CC composite were systematically inspected through various characterizations. MX/ZnS/CC composite exhibited good adsorption ability to anionic dyes with adsorption capacity up to 1.29 g/g, and excellent synergistic effects of adsorption and photodegradation with synergistic removal capacity up to 5.63 g/g. MX/ZnS/CC composite performed higher synergistic removal ability and better optical and electrical properties than pure MXene, ZnS, chitosan-cellulose material, and MXene/ZnS. After compounding, the synergistic removal percentage of dyes increased by a maximum of 309 %. MX/ZnS/CC composite mainly adsorbs anionic dyes through electrostatic interactions and catalyzes the generation of •O2-, h+, and •OH to degrade dyes, which has been successfully used to remove anionic dyes from environmental water, achieving a 100 % removal of 50 mg/L dye.

RhIII-Catalyzed Direct Heteroarylation of Unactivated C(sp3)-H with N-Heteroaryl Boronates.

Disclosed herein is a rhodium(III)-catalyzed direct heteroarylation reaction between unactivated aliphatic C(sp3)-H bonds in 2-alkylpyridines and heteroaryl organoboron reagents. This catalytic protocol is compatible with various heterocyclic boronates containing ortho- and meta-pyridine, pyrazoles, furan, and quinoline with strong coordination capability. The achievement of this methodology provides an efficient route to build new C(sp3)-heteroaryl bonds.

Crosstalk between ubiquitin ligases and ncRNAs drives cardiovascular disease progression.

Cardiovascular diseases (CVDs) are multifactorial chronic diseases and have the highest rates of morbidity and mortality worldwide. The ubiquitin-proteasome system (UPS) plays a crucial role in posttranslational modification and quality control of proteins, maintaining intracellular homeostasis via degradation of misfolded, short-lived, or nonfunctional regulatory proteins. Noncoding RNAs (ncRNAs, such as microRNAs, long noncoding RNAs, circular RNAs and small interfering RNAs) serve as epigenetic factors and directly or indirectly participate in various physiological and pathological processes. NcRNAs that regulate ubiquitination or are regulated by the UPS are involved in the execution of target protein stability. The cross-linked relationship between the UPS, ncRNAs and CVDs has drawn researchers' attention. Herein, we provide an update on recent developments and perspectives on how the crosstalk of the UPS and ncRNAs affects the pathological mechanisms of CVDs, particularly myocardial ischemia/reperfusion injury, myocardial infarction, cardiomyopathy, heart failure, atherosclerosis, hypertension, and ischemic stroke. In addition, we further envision that RNA interference or ncRNA mimics or inhibitors targeting the UPS can potentially be used as therapeutic tools and strategies.

Chitosan-alginate sponge with multiple cross-linking networks for adsorption of anionic dyes: Preparation, property evaluation, mechanism exploration, and application.

A chitosan-alginate sponge (CAS) with multiple cross-linking networks was developed using chitosan, sodium alginate, polyvinyl alcohol, and glutaraldehyde to adsorb and enrich the anionic dyes form the food samples. The multiple networks in CAS refer to the electrostatic cross-linking network, hydrogen bonding cross-linking network, and covalent cross-linking network. Compared with pure chitosan and alginate sponges, the CAS showed better three-dimensional network structure, mechanical behavior, and stability, which is benefit by multiple cross-linking networks. The physical and chemical properties of CAS were systematically studied by a series of characterizations. The adsorption performance of CAS on anionic dyes was inspected with different dye concentration, time, temperature, and pH conditions. CAS exhibited a good and stable adsorption property to amaranth, carmine, and sunset yellow with the saturation adsorption capacity of 94.34, 111.5, and 80.05 mg∙g-1, respectively. Furthermore, CAS performed outstanding selectivity to anionic dyes with the selectivity factor up to 16.99. Through electrostatic potential analysis, it is inferred that CAS mainly adsorbs anionic dyes through electrostatic interactions. CAS showed satisfactory reusability, maintaining 97 %-99 % of adsorption performance after six cycles of recycling. Finally, CAS was combined with high-performance liquid chromatography for the enrichment and detection of anionic dyes in candy and cocktail samples, achieving the enrichment factor up to 84.77.

ZnS/CuFe2O4/MXene ternary heterostructure photocatalyst for efficient adsorption and photocatalytic degradation of azo dyes under visible light: Synergistic effect, mechanism, and application.

ZnS/CuFe2O4/MXene (ZSCFOM) composite with ternary heterostructures was prepared by solvothermal methods for the first time to effectively adsorb and photodegrade the azo dyes. ZSCFOM mainly adsorbed azo dyes through the hydrogen bonding and electrostatic interactions, with saturated adsorption capacities of 377 mg g-1 for direct brown M and 390 mg g-1 for direct black RN. ZSCFOM exhibited both characteristics of Schott heterostructure and p-n heterostructure, but it is not a simple superposition of the two heterostructures, but rather achieves better photocatalytic property. ZSCFOM performed a higher separation efficiency of electrons and holes than pure CuFe2O4 and pure ZnS. Under visible light, ZSCFOM was more effective in removing the azo dyes than MXene, CuFe2O4, ZnS, CuFe2O4/MXene, ZnS/MXene, and ZnS/CuFe2O4. The migration pathways of photogenerated carriers in ZSCFOM were inferred as that the electrons were concentrated in MXene and conduction band of ZnS, and holes were gathered in valence band of CuFe2O4. MXene served as a cocatalyst to accelerate the separation of electrons and holes. ZSCFOM mainly degraded DBM and DBRN by catalyzing the generation of holes, superoxide radicals, and hydroxyl radicals. The 100% of 0.05 g L-1 azo dyes were removed by ZSCFOM within 30 min from the environmental water systems.

A review of cardiovascular effects and underlying mechanisms of legacy and emerging per- and polyfluoroalkyl substances (PFAS).

Cardiovascular disease (CVD) poses the leading threats to human health and life, and their occurrence and severity are associated with exposure to environmental pollutants. Per- and polyfluoroalkyl substances (PFAS), a group of widely used industrial chemicals, are characterized by persistence, long-distance migration, bioaccumulation, and toxicity. Some PFAS, particularly perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA) and perfluorohexanesulfonic acid (PFHxS), have been banned, leaving only legacy exposure to the environment and human body, while a number of novel PFAS alternatives have emerged and raised concerns, such as polyfluoroalkyl ether sulfonic and carboxylic acid (PFESA and PFECA) and sodium p-perfluorous nonenoxybenzene sulfonate (OBS). Overall, this review systematically elucidated the adverse cardiovascular (CV) effects of legacy and emerging PFAS, emphasized the dose/concentration-dependent, time-dependent, carbon chain length-dependent, sex-specific, and coexposure effects, and discussed the underlying mechanisms and possible prevention and treatment. Extensive epidemiological and laboratory evidence suggests that accumulated serum levels of legacy PFAS possibly contribute to an increased risk of CVD and its subclinical course, such as cardiac toxicity, vascular disorder, hypertension, and dyslipidemia. The underlying biological mechanisms may include oxidative stress, signaling pathway disturbance, lipid metabolism disturbance, and so on. Various emerging alternatives to PFAS also play increasingly prominent toxic roles in CV outcomes that are milder, similar to, or more severe than legacy PFAS. Future research is recommended to conduct more in-depth CV toxicity assessments of legacy and emerging PFAS and explore more effective surveillance, prevention, and treatment strategies, accordingly.

Exosomal noncoding RNAs in central nervous system diseases: biological functions and potential clinical applications.

Central nervous system (CNS) disease is a general term for a series of complex and diverse diseases, including Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), CNS tumors, stroke, epilepsy, and amyotrophic lateral sclerosis (ALS). Interneuron and neuron-glia cells communicate with each other through their homeostatic microenvironment. Exosomes in the microenvironment have crucial impacts on interneuron and neuron-glia cells by transferring their contents, such as proteins, lipids, and ncRNAs, constituting a novel form of cell-to-cell interaction and communication. Exosomal noncoding RNAs (ncRNAs), including microRNAs (miRNAs), long noncoding RNAs (lncRNAs), circular RNAs (circRNAs), and PIWI-interacting RNAs (piRNAs), regulate physiological functions and maintain CNS homeostasis. Exosomes are regarded as extracellular messengers that transfer ncRNAs between neurons and body fluids due to their ability to cross the blood-brain barrier. This review aims to summarize the current understanding of exosomal ncRNAs in CNS diseases, including prospective diagnostic biomarkers, pathological regulators, therapeutic strategies and clinical applications. We also provide an all-sided discussion of the comparison with some similar CNS diseases and the main limitations and challenges for exosomal ncRNAs in clinical applications.

One-Pot Construction of Heteroarylation/Esterification Products of Acrylic Acids via Iridium(III)-Catalyzed C-H Activation.

A carboxylate-assisted iridium(III)-catalyzed regioselective C(sp2)-H heteroarylation/esterification reaction of acrylic acid is disclosed herein for the first time. This catalytic protocol tolerates various α-substituted, ß-substituted, and α, ß-disubstituted acrylic acids as well as heteroaromatic boronates well. The resulting 3,4-dihydro-2H-pyran-6-carboxylic acid derivative 3r highlighted the AIE-active luminophore with multiple emission signal properties and a high quantum yield of 28%, exhibiting the potential application of this methodology for the synthesis of nitrogen-containing organic functional materials.

Molecularly imprinted polymers based on magnetic metal-organic frameworks for surface-assisted laser desorption/ionization time-of-flight mass spectrometry analysis and simultaneous luteolin enrichment.

UiO-66(NH2), a metal-organic framework, exhibits excellent UV absorption and energy transfer performance and can be used as a substrate for surface-assisted laser desorption/ionization (SALDI) analysis of small molecules. Molecularly imprinted polymers (MIPs) exhibit outstanding selectivity toward certain targets. The complexes of UiO-66(NH2) and MIPs can be applied as both an adsorbent and substrate for SALDI-time-of-flight mass spectrometry (SALDI-TOF MS) analysis of small molecules. Herein, magnetic UiO-66(NH2)-molecularly imprinted polymers (MUMIPs) were prepared for the selective enrichment and detection of luteolin via SALDI-TOF MS. The amino group on UiO-66(NH2) were used as functional monomer to prepare MIPs that interact with luteolin via hydrogen bonding. The surface functional monomer can effectively control the coating thickness of the MIPs to avoid embedding template molecules and enhance adsorption performance. In addition, Fe3O4 particles were introduced for rapid magnetic separation. The physicochemical properties of the MUMIPs were characterized via scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, thermal gravimetric analysis, vibrating sample magnetometry, Brunauer-Emmett-Teller analysis, and X-ray photoelectron spectroscopy. Adsorption experiments and selectivity studies indicated that MUMIPs exhibited good adsorption capacity, fast adsorption rates, and excellent luteolin selectivity. MUMIPs are efficient substrates for the SALDI analysis of luteolin and its structural analogs. In addition, the MUMIPs-SALDI-TOF MS method successfully detected luteolin in rat plasma and urine after administration of oral Chrysanthemum morifolium Ramat extracts. This method possessed high sensitivity with a limit of detection of 0.5 ng/mL. The traditional precipitation method combined with high-performance liquid chromatography-mass spectrometry was also used to analyze luteolin in biological samples. Compared with the traditional method, the novel MUMIP-SALDI-TOF MS method can more effectively detect the target compounds in complex samples. Ultimately, the MUMIP-SALDI-TOF MS method was applied to detect luteolin and its metabolites in rat liver after oral luteolin treatment. Three luteolin metabolites (apigenin, chrysoeriol, and diosmetin) were analyzed using the newly developed MUMIP-SALDI-TOF MS method.

Intra-abdominal vas deferens cyst in a laboratory rhesus macaque (Macaca mulatta).

A 21-year-old male rhesus macaque presented with abdominal enlargement. The clinical, magnetic resonance imaging, and computerized tomography findings confirmed a large mass occupying the entire abdomen. The mass was surgically removed, and histopathology confirmed a vas deferens cyst. The macaque recovered uneventfully. The veterinarians should be aware of the possibility of an intra-abdominal vas deferens cyst and that, as our case shows, could be treated with surgical removal.

Magnetic porous cellulose surface-imprinted polymers synthetized with assistance of deep eutectic solvent for specific recognition and purification of bisphenols.

Magnetic porous cellulose molecularly imprinted polymers-based bisphenols have been developed using Fe3O4 as the magnetic material, a deep eutectic solvent as the assisted solvent, and N-isopropylacrylamide as the functional monomer. The resulting magnetic porous cellulose molecularly imprinted polymers were characterized using scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, vibrating sample magnetometry, thermal gravimetric analysis, and Brunauer-Emmett-Teller analysis. Moreover, the adsorption properties of the magnetic porous cellulose molecularly imprinted polymers toward bisphenol A, bisphenol F, and bisphenol AF were investigated using static, dynamic, and selective adsorption experiments. The introduction of porous cellulose materials significantly improves the capabilities of the material. The adsorption capacity, mass transfer efficiency, and selectivity of the magnetic porous cellulose molecularly imprinted polymers toward bisphenol A were 5.9, 4.0, and 4.4 times those of traditional molecularly imprinted polymers. Moreover, the adsorption stability of the magnetic porous cellulose molecularly imprinted polymers was investigated under different temperature and pH conditions. The adsorption characteristics of the magnetic porous cellulose molecularly imprinted polymers toward the target molecules were investigated using adsorption isotherm, kinetic, and thermodynamic models. Hydrogen bonding is the main interaction formed between the magnetic porous cellulose molecularly imprinted polymers and the target molecules. Magnetic porous cellulose molecularly imprinted polymers have great application value with excellent stability and reusability. Finally, the combination of the magnetic porous cellulose molecularly imprinted polymers and high-performance liquid chromatography or ultra-performance liquid chromatography-mass spectrometry was successfully used for the purification and detection of bisphenols in milk (1.349 ng/mL bisphenol F and 3.014 ng/mL bisphenol AF), canned fruits (1129 ng/mL bisphenol A, 10.11 ng/mL bisphenol F, and 91.87 ng/mL bisphenol AF), and fish (11.91 ng/mL bisphenol AF) samples. Furthermore, the magnetic porous cellulose molecularly imprinted polymer method is more selective, sensitive, and accurate than the traditional precipitation method.

Adverse cardiovascular effects and potential molecular mechanisms of DEHP and its metabolites-A review.

Currently, cardiovascular disease (CVD) is a health hazard that is associated with progressive deterioration upon exposure to environmental pollutants. Di(2-ethylhexyl) phthalate (DEHP) has been one of the focuses of emerging concern due to its ubiquitous nature and its toxicity to the cardiovascular (CV) system. DEHP has been noted as a causative risk factor or a risk indicator for the initiation and augment of CVDs. DEHP represents a precursor that contributes to the pathogenesis of CVDs through its active metabolites, which mainly include mono (2-ethylhexyl) phthalate (MEHP). Herein, we systematically presented the association between DEHP and its metabolites and adverse CV outcomes and discussed the corresponding effects, underlying mechanisms and possibly interventions. Epidemiological and experimental evidence has suggested that DEHP and its metabolites have significant impacts on processes and factors involved in CVD, such as cardiac developmental toxicity, cardiac injury and apoptosis, cardiac arrhythmogenesis, cardiac metabolic disorders, vascular structural damage, atherogenesis, coronary heart disease and hypertension. DNA methylation, PPAR-related pathways, oxidative stress and inflammation, Ca2+ homeostasis disturbance may pinpoint the relevant mechanisms. The preventive and therapeutic measures are potentially related with P-glycoprotein, heat-shock proteins, some antioxidants, curcumin, apigenin, ß-thujaplicin, glucagon-like peptide-1 receptor agonists and Ang-converting enzyme inhibitors and so on. Promisingly, future investigations should aid in thoroughly assessing the causal relationship and molecular interactions between CVD and DEHP and its metabolites and explore feasible prevention and treatment measures accordingly.

Efficacy evaluation of Lattice Carbon Dioxide Laser Therapy in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence.

OBJECTIVES: To investigate the efficacy and postoperative complications of lattice carbon dioxide laser in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence. METHODS: A total of 30 postmenopausal female patients with mild to moderate stress urinary incontinence, recruited from the Affiliated Hospital of Hebei University from September to November 2019, were selected as the study subjects and treated with lattice carbon dioxide laser therapy. Treatment was given at intervals of one month. The degree of urinary incontinence, the urinary incontinence questionnaire (ICI-Q-SF) score, and the urinary incontinence quality of life scale (I-QOL)) Score, surgical satisfaction, one hour pad test and postoperative complications before treatment and after each treatment of all patients were respectively recorded and compared. RESULTS: Compared with those before treatment, the grade of urinary incontinence and ICI-Q-SF scores of these 30 patients after each treatment were lower, and their I-QOL scores were higher. The difference of one hour urine pad test was statistically significant (P<0.05), but the follow-up data of three months after the third treatment was close to that of one month after the first treatment. The satisfaction rate of these 30 patients was 76.67% (23/30). After treatment, only one patient presented vaginal itching discomfort on the first day after surgery and the symptoms disappeared three days later. No obvious complications occurred in the other 29 patients. CONCLUSION: The treatment of mild and moderate postmenopausal patients with stress urinary incontinence with lattice carbon dioxide laser can effectively reduce the incidence of incontinence and improve the quality of life.

Emerging roles of circRNAs in the pathological process of myocardial infarction.

Myocardial infarction (MI) is defined as cardiomyocyte death in a clinical context consistent with ischemic insult. MI remains one of the leading causes of morbidity and mortality worldwide. Although there are a number of effective clinical methods for the diagnosis and treatment of MI, further investigation of novel biomarkers and molecular therapeutic targets is required. Circular RNAs (circRNAs), novel non-coding RNAs, have been reported to function mainly by acting as microRNA (miRNA) sponges or binding to RNA-binding proteins (RBPs). The circRNA-miRNA-mRNA (protein) regulatory pathway regulates gene expression and affects the pathological mechanisms of various diseases. Undoubtedly, a more comprehensive understanding of the relationship between MI and circRNA will lay the foundation for the development of circRNA-based diagnostic and therapeutic strategies for MI. Therefore, this review summarizes the pathophysiological process of MI and various approaches to measure circRNA levels in MI patients, tissues, and cells; highlights the significance of circRNAs in the regulation MI pathogenesis and development; and provides potential clinical insight for the diagnosis, prognosis, and treatment of MI.

Macao Dementia Policy: Challenges and prospects (innovative practice).

This paper highlights the challenges and prospects of older people with dementia in Macao. Macao Dementia Policy was launched in 2016 as the 27th globally, aligned with World Health Organization Global Action Plan on the Public Health Response to Dementia 2017-2025, includes a 10-year strategic framework to establish dementia friendly communities across the region. Dementia Working Group, cognitive assessment network in Health Centers, Dementia Medical Center, and Dementia Support Center were established subsequently. These initiatives manifest that Macao Government has taken great strides to improve waiting times, diagnosis rates, integrated care, and dementia friendliness through a seamless dementia service network.

Single-Port Percutaneous Nephroscopy combined with GreenLight Laser in Simple Renal Cyst.

OBJECTIVE: To explore the therapeutic effect of percutaneous nephroscopy combined with Green Light laser on simple renal cyst. METHODS: A retrospective analysis was conducted to review the clinical data, surgical procedures, intraoperative bleeding, postoperative adverse reactions, and length of stay of 32 patients who had been admitted to Affiliated Hospital of Hebei University from January 2018 to February 2019. All patients had been diagnosed with simple renal cyst by imaging examination and met the surgical indications for single-port percutaneous nephroscopy combined with GreenLight laser for unroofing and decompression of the renal cyst. Among the 32 patients, there were 18 males and 14 females, with 15 cases on the left and 17 on the right. The patients aged 38 to 62 years old, with an average of 45 years old. Thirteen cases were hospitalized mainly due to complaint of lumbar pain, and 19 cases were admitted after a renal cyst was found by physical examination. The diameter of the cyst ranged from 4.2 to 9.1 cm, with an average of 6.1 cm. A percutaneous nephroscopic channel was established during the surgery. Once a nephroscope was placed into the cyst, GreenLight laser (energy of 80W) was used to remove the free cyst wall 0.3cm from the renal parenchymal margin under direct vision. After the incision margin was observed with no obvious exudation under microscope, the cyst wall was removed through the channel and sent for pathological examination. A drainage catheter was placed near the cyst cavity. RESULTS: All the 32 patients were successfully operated, without transition to laparoscopic and open surgery. The operations took 30 to 62 minutes, with an average of 45 minutes. The intraoperative bleeding ranged from three to 14 ml, with an average of 10 ml. No adverse events such as postoperative infection, fever, or active bleeding occurred. The drainage catheters were removed one to three days after operation, with an average of 1.5 days after operation. The drainage volume was 20 to 55 ml, with an average of 35 ml. No obvious liquid extravasation was seen in all cases. The length of stay after operation ranged from three to five days, with an average of 3.5 days. Postoperative pathological reports all suggested renal cyst wall. The patients were followed up for six months, and no cyst recurred. CONCLUSIONS: Single-port percutaneous nephroscopy combined with Green Light laser could provide significant clinical effect in treating simple renal cyst with minimal trauma.

Experience in the application of laparoscopic anatomical adrenalectomy via the renal cortex surface monolayer.

OBJECTIVE: To discuss the clinical application of laparoscopic anatomical adrenalectomy via the renal cortex surface in the operation of adrenal masses. METHODS: A retrospective analysis was performed on 231 patients with adrenal masses who were received and cured in the urology department of the Affiliated Hospital of Hebei University from July 2016 to January 2019. All patients received retroperitoneal adrenalectomy by means of laparoscopic anatomical adrenalectomy via the renal cortex surface. Operation duration, bleeding volume, postoperative complications, retention time of the drainage tube were measured and analyzed, and postoperative follow-up surveys were administered. RESULTS: All cases were successfully operated. Two cases were converted to open surgery due to the presence of large adrenal tumors, and the patients suffered no significant complications. The mean operation duration, bleeding volume and retention time of the drainage tube were 31 minutes, 20 mL and 1.2±0.6 d, respectively. In terms of the postoperative pathology of adrenal tumors, 183 cases were shown to have adenomas, 34 had pheochromocytomas, nine had schwannomas, 3 had metastases from lung cancer, and two had sarcomas. A total of 174 patients were followed up for three to 18 months. Only one case with sarcoma that relapsed within half a year of the operation. CONCLUSION: In the treatment of adrenal masses, laparoscopic anatomical adrenalectomy via the renal cortex surface has many advantages including the large operation space, clear view of anatomical markers, little bleeding, small trauma, few postoperative complications, simple operational procedures and short learning curves. This technique needs clinical promotion.

Minimally invasive beating heart technique for mitral valve surgery in patients with previous sternotomy and giant left ventricle.

PURPOSE: To analyze the efficacy of minimally invasive beating heart technique for mitral valve surgery in the cardiac patients with previous sternotomy and giant left ventricle. METHODS: Eighty cardiac patients with previous sternotomy and giant left ventricle according to the diagnostic criteria that left ventricular end diastolic diameter (LVEDD) was ≥70 mm, who underwent mitral valve surgery at our center from January 2006 to January 2019 were analyzed. We divided all patients into minimally invasive beating heart technique group (n = 30) and conventional median resternotomy arrested heart technique group (n = 50) according to the surgical methods. Preoperative, intraoperative, and postoperative variables were compared between two groups. RESULTS: Minimally invasive beating heart technique compared to the conventional median resternotomy arrested heart technique for mitral valve surgery in the cardiac patients with previous sternotomy and giant left ventricle had significant differences in operation time(P = 0.002), cardiopulmonary bypass (CPB) time(P < 0.001), intraoperative blood loss(P < 0.001), postoperative transfusion ratio(P = 0.01), postoperative transfusion amount(P < 0.001), postoperative drainage volume(P = 0.001), extubation time(P = 0.04), intensive care unit (ICU) stay time(P = 0.04) and postoperative hospital stay time(P < 0.001), but no significant differences in re-exploration for bleeding, postoperative 30-day mortality, postoperative complications and 6 months postoperative echocardiographic parameters. CONCLUSIONS: Using the method of minimally invasive beating heart technique for mitral valve surgery in the cardiac patients with previous sternotomy and giant left ventricle is effective and reliable, meanwhile reduce the operation time and CPB time, decrease the transfusion ratio and transfusion amount, shorten postoperative ICU stay and hospital stay time, promote the early extubation so that accelerate the patients' early recovery. All of these show a benefit of minimally invasive beating heart technique compared to conventional median resternotomy arrested heart technique.

Outbreak of macrolide-resistant mycoplasma pneumoniae in a primary school in Beijing, China in 2018.

BACKGROUND: On 7th June, 2018, a primary school in Beijing, China notified Shunyi CDC of an outbreak of acute respiratory disease characterized by fever and cough among students and resulting in nine hospitalization cases during the preceding 2 weeks. We started an investigation to identify the etiologic agent, find additional cases, develop and implement control measures. METHODS: We defined probable cases as students, teachers and other staffs in the school developed fever (T ≥ 37.5 °C) with cough or sore throat; or a diagnosis of pneumonia during May 1-June 31, 2018. Confirmed cases were probable cases with Mycoplasma pneumoniae detected in oropharyngeal (OP) swabs by quantitative real-time polymerase chain reaction (qPCR). We searched case by reviewing school absenteeism records and interviewing students, teachers and staff in this school. Oropharyngeal swabs were collected from symptomatic students. Two qPCR) assay, a duplex qPCR assay, and sequencing were performed to determine the pathogen, genotype and macrolide resistance at the gene level, respectively. RESULTS: From May 1st to June 31st, 2018, we identified 55 cases (36 probable and 19 confirmed), of whom 25 (45%) were hospitalized for complications. All cases were students, none of the teachers and other staffs in the school were with similar symptoms. The attack rate (AR) was 3.9% (55/1398) for all students. The cases were mainly male (58%), with an age range of 7-8 years (median: 7 years). 72% (18/25) of inpatients had radiograph findings consistent with pneumonia, and some cases were hospitalized for up to 4 weeks. Pathogen detection results indicated that Mycoplasma pneumonia (M. pneumoniae) P1 type 1 was the causative agent in this outbreak, and the strain harbored one point mutation of A to G at position 2063. CONCLUSIONS: The infections by macrolide-resistant M. pneumoniae are not always mild and pneumonia was common and M. pneumoniae could causes serious complications which require long-term hospitalization. In the future infectious disease prevention and control practice, M. pneumoniae should be paid more attention. It is necessary to establish and improve the pathogen and drug resistance surveillance system in order to prevent and control such mutated strains of M. pneumoniae from causing future outbreaks or epidemics in China.