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Environmental impacts associated with shale gas exploitation have been historically underestimated due to neglecting to account for the production or the release of end-of-pipe organic pollutants. Here, we assessed the environmental impacts of shale gas production in China and the United States using life cycle assessment. Through data mining, we compiled literature information on organic pollutants in flowback and produced water (FPW), followed by assessments using USEtox to evaluate end-of-pipe risks. Results were incorporated to reveal the life cycle risks associated with shale gas exploitation in both countries. China exhibited higher environmental impacts than the US during the production phase. Substantially different types of organic compounds were observed in the FPW between two countries. Human carcinogenic and ecological toxicity attributed to organics in FPW was 3 orders of magnitude higher than that during the production phase in the US. Conversely, in China, end-of-pipe organics accounted for approximately 52%, 1%, and 47% of the overall human carcinogenic, noncarcinogenic, and ecological impacts, respectively. This may be partially limited by the quantitative data available. While uncertainties exist associated with data availability, our study highlights the significance of integrating impacts from shale gas production to end-of-pipe pollution for comprehensive environmental risk assessments.
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Gás Natural , China , Medição de Risco , Estados Unidos , Humanos , Monitoramento AmbientalRESUMO
Identifying causative toxicants in mixtures is critical, but this task is challenging when mixtures contain multiple chemical classes. Effect-based methods are used to complement chemical analyses to identify toxicants, yet conventional bioassays typically rely on an apical and/or single endpoint, providing limited diagnostic potential to guide chemical prioritization. We proposed an event-driven taxonomy framework for mixture risk assessment that relied on high-throughput screening bioassays and toxicant identification integrated by deep learning. In this work, the framework was evaluated using chemical mixtures in sediments eliciting aryl-hydrocarbon receptor activation and oxidative stress response. Mixture prediction using target analysis explained <10% of observed sediment bioactivity. To identify additional contaminants, two deep learning models were developed to predict fingerprints of a pool of bioactive substances (event driver fingerprint, EDFP) and convert these candidates to MS-readable information (event driver ion, EDION) for nontarget analysis. Two libraries with 121 and 118 fingerprints were established, and 247 bioactive compounds were identified at confidence level 2 or 3 in sediment extract using GC-qToF-MS. Among them, 12 toxicants were analytically confirmed using reference standards. Collectively, we present a "bioactivity-signature-toxicant" strategy to deconvolute mixtures and to connect patchy data sets and guide nontarget analysis for diverse chemicals that elicit the same bioactivity.
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PURPOSE: To investigate the value of CT urography (CTU) indicators in the quantitative differential diagnosis of bladder urothelial carcinoma (BUC) and inverted papilloma of the bladder (IPB). MATERIAL AND METHODS: The clinical and preoperative CTU imaging data of continuous 103 patients with histologically confirmed BUC or IPB were retrospectively analyzed. The imaging data included 6 qualitative indicators and 7 quantitative measures. The recorded clinical information and imaging features were subjected to univariate and multivariate logistic regression analysis to find independent risk factors for BUC, and a combined multi-indicator prediction model was constructed, and the prediction model was visualized using nomogram. ROC curve analysis was used to calculate and compare the predictive efficacy of independent risk factors and nomogram. RESULTS: Junction smoothness, maximum longitudinal diameter, tumor-wall interface and arterial reinforcement rate were independent risk factors for distinguishing BUC from IPB. The AUC of the combined model was 0.934 (sensitivity = 0.808, specificity = 0.920, accuracy = 0.835), and its diagnostic efficiency was higher than that of junction smoothness (AUC=0.667, sensitivity = 0.654, specificity = 0.680, accuracy = 0.660), maximum longitudinal diameter (AUC=0.757, sensitivity = 0.833, specificity = 0.604, accuracy = 0.786), tumor-wall interface (AUC=0.888, sensitivity = 0.755, specificity = 0.808, accuracy = 0.816) and Arterial reinforcement rate (AUC=0.786, sensitivity = 0.936, specificity = 0.640, accuracy = 0.864). CONCLUSION: Above qualitative and quantitative indicators based on CTU and the combination of them may be helpful to the differential diagnosis of BUC and IPB, thus better assisting in clinical decision-making. KEY POINTS: 1. Bladder urothelial carcinoma (BUC) and inverted papilloma of the bladder (IPB) exhibit similar clinical symptoms and imaging presentations. 2. The diagnostic value of CT urography (CTU) in distinguishing between BUC and IPB has not been documented. 3. BUC and IPB differ in lesion size, growth pattern and blood supply. 4. The diagnostic efficiency is optimized by integrating multiple independent risk factors into the prediction model.
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Carcinoma de Células de Transição , Papiloma Invertido , Neoplasias da Bexiga Urinária , Humanos , Neoplasias da Bexiga Urinária/cirurgia , Carcinoma de Células de Transição/patologia , Bexiga Urinária/patologia , Papiloma Invertido/patologia , Estudos Retrospectivos , Urografia/métodos , Tomografia Computadorizada por Raios XRESUMO
We theoretically propose a scheme of the nonreciprocal conversion device between photons of two arbitrary frequencies in a hybrid cavity optomechanical system, where two optical cavities and two microwave cavities are coupled to two different mechanical resonators via radiation pressure. Two mechanical resonators are coupled together via the Coulomb interaction. We study the nonreciprocal conversions between both the same and different types of frequency photons. The device is based on multichannel quantum interference to break the time-reversal symmetry. Our results show the perfect nonreciprocity conditions. By adjusting the Coulomb interaction and the phase differences, we find that the nonreciprocity can be modulated and even transformed into reciprocity. These results provide new insight into the design of nonreciprocal devices, including isolators, circulators, and routers in quantum information processing and quantum networks.
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Objective: The objective of this research study was to compare the safety and efficacy of bronchial artery embolization (BAE) using Embospheres alone versus Embospheres combined with gelfoam particles in patients with massive hemoptysis. Methods: A total of 127 patients with tuberculous massive hemoptysis who were scheduled to undergo BAE were recruited and divided into two groups: Embosphere group (E group, n = 57) and Embosphere combined with gelfoam particles group (E + G group, n = 70). Technical and clinical success were assessed after BAE surgery, and mortality, untoward reactions, and risk factors for clinical failure were recorded during follow-up. Results: The technical success rate was 92.99% in the E group and 97.14% in the E + G group (P = .272), with similar 1-year mortality rates of 1.76% and 2.86%, respectively (P = .684). However, the E group exhibited a lower clinical success rate compared to the E + G group (85.96% vs. 97.14%), and this difference was statistically significant (P = .020). The untoward reactions showed no statistically significant difference (all P > .05). Univariate analysis revealed that four factors were statistically significant: age (P = .028), presence of pulmonary cavity (P = .001), diabetes (P = .005), and a single use of Embosphere embolization (P = .020). Multivariate regression analysis demonstrated that embolization with Embosphere alone was a risk factor for clinical treatment failure (P = .025). Conclusion: The combination of Embosphere with gelfoam particles can significantly improve the hemostatic effect of BAE without increasing the incidence of adverse reactions.
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Embolização Terapêutica , Esponja de Gelatina Absorvível , Humanos , Esponja de Gelatina Absorvível/uso terapêutico , Hemoptise/tratamento farmacológico , Hemoptise/etiologia , Artérias Brônquicas , Gelatina/uso terapêutico , Embolização Terapêutica/efeitos adversos , Resultado do Tratamento , Estudos RetrospectivosRESUMO
BACKGROUND: Since December 2019, there has been a global outbreak of COVID-19. As of the end of July 2020, more than 600,000 deaths had been reported globally. The purpose of this paper is to further explore the application of non-invasive ventilation in severe COVID-19 patients. METHODS: A retrospective study was conducted to included 57 confirmed COVID-19 patients, among which 36 cases were severe. According to different oxygen inhalation methods, they were divided into non-invasive ventilator assisted ventilation group with 21 cases (group A) and 15 cases of nasal catheter oxygen inhalation group (group B). The data of respiration (RR), heart rate (HR), partial arterial pressure of oxygen (PaO2), partial arterial pressure of carbon dioxide (PaCO2), and oxygenation index (OI) before the treatment of noninvasive ventilator assisted ventilation or nasal catheter oxygen treatment at 24, 48, and 72 hours of treatment of the 2 groups were collected and analyzed to determine whether the above indicators were statistically different in each time period. RESULTS: After 24 hours of treatment with noninvasive ventilator assisted ventilation in group A, RR gradually decreased, PaO2 and OI were significantly higher than before treatment, while after 24 hours of treatment, PaO2, RR, HR and other indexes in group B showed no significant improvement, and OI increased gradually after 48 hours of treatment, with statistically significant difference compared with that before treatment. CONCLUSIONS: Early adoption of non-invasive ventilation can effectively improve the hypoxic state of patients with severe COVID-19. The combination of underlying diseases will not prolong the use of non-invasive ventilation.
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COVID-19 , Humanos , Respiração Artificial , Estudos Retrospectivos , SARS-CoV-2 , Ventiladores MecânicosRESUMO
The main objective of the current study was to investigate the chemical composition of the essential oil of Artemisia asiatica together with investigating the antibacterial effects it exerts on several common respiratory infection causing bacteria including Haemophilus influenzae. Its mechanism of action was studied using various state-of-the-art assays like scanning electron microscopy, DNA, RNA and protein leakage assays, growth curve assays etc. The essential oil was extracted from the leaves of A. asiatica by supercritical CO2 fluid extraction technology. Chemical composition of essential oils was analyzed by gas chromatography-mass-spectrometry (GC-MS). The antibacterial activity was evaluated against 6 bacteria by the paper disc diffusion method. The minimum inhibitory concentration (MIC) and minimum bactericide concentration (MBC) values of the essential oil were estimated by agar dilution method. The antibacterial mechanism was evaluated by growth curve, the integrity of cell membrane and scanning electronmicroscope (SEM). Gas chromatographic analysis of the A. asiatica essential oil led to the identification of 16 chemical constituents accounting for 97.2% of the total oil composition. The major components were found to be Piperitone, (z)-davanone, p-cymene and 1, 8-cineole. The essential oil showed maximum growth inhibition against Haemophilus influenzae with a zone of inhibition of 24.5 mm and MIC/MBC values of 1.9/4.5 mg/mL respectively. Bacteria treated with the essential oil led to a rapid decrease in the number of viable cells. On adding the essential oil of A. asiatica to the bacterial culture, the constituents of the bacterial cell got released into the medium and this cell constituent release increased with increasing doses of the essential oil. SEM showed that the bacterial cells treated with the essential oil showed damaged cell wall, deformed cell morphology and shrunken cells.
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Antibacterianos/farmacologia , Artemisia/química , Bactérias/efeitos dos fármacos , Haemophilus influenzae/efeitos dos fármacos , Óleos Voláteis/farmacologia , Extratos Vegetais/farmacologia , Infecções Respiratórias/microbiologia , Membrana Celular/efeitos dos fármacos , China , Monoterpenos Cicloexânicos , Cicloexanóis , Cimenos , Relação Dose-Resposta a Droga , Eucaliptol , Cromatografia Gasosa-Espectrometria de Massas , Testes de Sensibilidade Microbiana , Microscopia Eletrônica de Varredura , Monoterpenos , Óleos Voláteis/química , Óleos de Plantas/química , Óleos de Plantas/farmacologia , SesquiterpenosRESUMO
Due to the restrictions on quantum measurement imposed by relativistic causality, it is not easy to perform a nonlocal measurement on spacelike separated systems instantaneously. Here we design an experiment in an optical system to perform the nonlocal measurement of a product observable on a two-qubit system, where a maximally-entangled two-qubit state, acting as an ancillary meter, and three identical Kerr media are used to couple the system under consideration and the target meter. It is shown that the nonlocal measurement of the product observable, σzAâσzB, which has two degenerate eigenvalues, could be implemented in a deterministic way without violating relativistic causality.
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By slightly vibrating the mirrors in an interferometer at different frequencies, the photons' trajectory information is stored in the light beam. To read out this information, we record the centroid location of the intensity distribution of output beam and Fourier analyze its time evolution. It is shown that every vibrating mirror contributes a peak in the Fourier spectrum. In other words, we can reveal the trajectory of the photons by figuring out the vibrating mirrors which ever interact with the light beam based on the Fourier spectrum. This techniques is not limited by the vibration amplitude of the mirrors.
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A diversity of contaminants of emerging concern (CECs) are present in wastewater effluent, posing potential threats to receiving waters. It is urgent for a holistic assessment of the occurrence and risk of CECs related to wastewater treatment plants (WWTP) on national and regional scales. A data mining-based risk prioritization method was developed to collect the reported contaminants and their respective concentrations in municipal and industrial WWTPs and their receiving waters across China over the past 20 years. A total of 10,781 chemicals were reported in 8336 publications, of which 1037 contaminants were reported with environmental concentrations. While contaminant categories varied across WWTP types (municipal vs. industrial) and regions, pharmaceuticals and cyclic hydrocarbons were the most studied CECs. Contaminant composition in receiving water was closer to that in municipal than industrial WWTPs. Publications on legacy pesticides and polycyclic aromatic hydrocarbons in WWTP decreased recently compared to the past, while pharmaceuticals and perfluorochemicals have received increasing attention, showing a changing concern over time. Detection frequency, concentration, removal efficiency, and toxicity data were integrated for assessing potential risks and prioritizing CECs on national and regional scales using an environmental health prioritization index (EHPi) approach. Among 666 contaminants in municipal WWTP effluent, trichlorfon and perfluorooctanesulfonic acid were with the highest EHPi scores, while 17É-ethinylestradiol and bisphenol A had the highest EHPi scores among 304 contaminants in industrial WWTPs. The prioritized contaminants varied across regions, suggesting a need for tailoring regional measures of wastewater treatment and control.
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The severity evaluation of Parkinson's disease (PD) is of great significance for the treatment of PD. However, existing methods either have limitations based on prior knowledge or are invasive methods. To propose a more generalized severity evaluation model, this paper proposes an explainable 3D multi-head attention residual convolution network. First, we introduce the 3D attention-based convolution layer to extract video features. Second, features will be fed into LSTM and residual backbone networks, which can be used to capture the contextual information of the video. Finally, we design a feature compression module to condense the learned contextual features. We develop some interpretable experiments to better explain this black-box model so that it can be better generalized. Experiments show that our model can achieve state-of-the-art diagnosis performance. The proposed lightweight but effective model is expected to serve as a suitable end-to-end deep learning baseline in future research on PD video-based severity evaluation and has the potential for large-scale application in PD telemedicine. The source code is available at https://github.com/JackAILab/MARNet.
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Compressão de Dados , Doença de Parkinson , Telemedicina , Humanos , Doença de Parkinson/diagnóstico , SoftwareRESUMO
Indoor exposome is a growing concern, including a mixture of legacy and emerging contaminants. Recent studies suggest that indoor pollutants may accumulate in pet hair, a part of indoor exposome, increasing health risks to pet owners; however, the source and hazards of pollutants associated with pet hair are largely unknown. Here, we found that hydrophobic pollutants often had higher indoor concentrations than hydrophilic ones, and polycyclic aromatic hydrocarbons (PAHs) were the most dominant fractions (61.1%) in indoor air exposome while polycyclic musks (PCMs) had the highest concentrations among all contaminant classes in indoor dust (1559 ± 1598 ng g-1 dw) and pet hair (2831 ± 2458 ng g-1 dw). The levels of hygiene-related contaminants (PCMs, current-use pesticides (CUPs), and antibiotics) were higher in pet hair than dust due to direct contact during applications. Health risk assessment using toxicity thresholds from high-throughput screening data showed that human health risks from the five classes of indoor contaminants (PAHs, PCMs, organophosphate esters, CUPs, and antibiotics) via inhalation, ingestion, and dermal contact were within acceptable limits, but the children may be exposed to a higher risk than the adults. The thresholds estimated from the ToxCast data using endpoint sensitivity distribution make the exposome risk assessment feasible in the absence of benchmarks, which is beneficial for including a mixture of emerging pollutants in risk assessment.
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Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluentes Ambientais , Praguicidas , Hidrocarbonetos Policíclicos Aromáticos , Criança , Adulto , Humanos , Monitoramento Ambiental , Poluição do Ar em Ambientes Fechados/análise , Medição de Risco , Hidrocarbonetos Policíclicos Aromáticos/análise , Poeira/análise , Antibacterianos , Cabelo/química , Poluentes Atmosféricos/análiseRESUMO
OBJECTIVE: To explore the application rules and effects of "Four Elements, One Peptide, and Two Transplantations" in the bundle treatment of the patients with coronavirus disease 2019 (COVID-19), so as to provide a scientific evidence for effective treatment and prevention of severe type. METHODS: A retrospective comparative study method was used to analyze the clinical data of COVID-19 patients admitted to Wuxi Fifth People's Hospital from January 2020 to March 2022, including demographic information, underlying diseases, clinical classification, length of hospital stay, treatment cost, clinical symptoms, laboratory tests and other key indicators, and evaluate the application rules and effect of "Four Elements, One Peptide, and Two Transplantations" in the bundle treatment of the patients with COVID-19. RESULTS: The L-type new coronavirus strain was predominant in 2020, the Delta variant in 2021, and the Omicron variant in 2022. The proportion of mild cases was highest in 2022, with the highest proportion of > 65 years old patients developing severe and critical. Among the 150 patients, the proportion of interferon use (100.0%) was the highest in the bundle treatment regimen of "Four Elements, One Peptide, and Two Transplantation". The combined use of vitamin C, interferon and thymopeptide was highest in 2022. More than 75.0% of the age > 65 years old group had underlying diseases, which was also the age group with the highest proportion of "Four Elements, One Peptide, and Two transplantations". Compared with mild cases, the age, length of hospital stay, and hospitalization cost of patients with COVID-19 increased significantly with severity. Mild, ordinary, severe, and critically ill patients all had low lymphocyte counts, with 40.0% of severe patients having the lowest lymphocyte counts within 3 days of admission. The lymphocyte count of critically ill patients was reduced or continuously reduced after admission, and the use of the "Four Elements, One Peptide, and Two transplantations" method to regulate immunity can effectively save the lives of critically ill patients. Of all cases of COVID-19 infection, 51.3% were asymptomatic, followed by respiratory symptoms (48.7%) and lung lesions (38.0%). Patients with renal dysfunction received this bundle therapy was highest, followed abnormal coagulation and abnormal liver function. This bundle therapy promoted a significant increase in CD4+ T lymphocytes and B lymphocytes in various cases. After treatment, as the virus turns negative, the proportion of M1 type macrophages increased, and the proportion of regulatory T cell (Treg cells) that suppress immunity and the infection related C-C chemokine receptor type (CCR10+) Treg cells decreased. Mild adult cases showed a great change and declined rapidly. CONCLUSIONS: Advanced age with underlying diseases is a risk factor for severe disease of COVID-19, the "Four Elements, One Peptide, and Two transplantations" bundle fine treatment of COVID-19 can improve the proportion of lymphocyte composition and organ function, which can control the occurrence and development of severe diseases. In addition to the proportion of CD4+ T cells, the changes of the M1 macrophage, total Treg cell, and CCR10+ Treg cell proportions can be used to determine disease changes of adult patients.
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COVID-19 , Humanos , Adulto , Idoso , SARS-CoV-2 , Estado Terminal , Estudos Retrospectivos , Antivirais , Peptídeos , InterferonsRESUMO
BACKGROUND: Scientists have been facing numerous challenges in the development of an effective therapeutic strategy for the treatment of COVID-19 pneumonia. Several studies have suggested that improving patient immunity and reducing lung injury induced by SARS-CoV-2 may be effective for treating patients with COVID-19. METHODS: A pilot trial of nebulization therapy with exosomes of mesenchymal stem cells (MSCs) was performed on seven patients with COVID-19 pneumonia. Exosomes secreted from MSCs were collected and purified using multiple ultrafiltration steps. All patients were treated with nebulization of MSC-derived exosomes, and primary safety and efficacy outcomes were evaluated. RESULTS: Our clinical study demonstrated that nebulization of MSC-derived exosomes is a novel method that might be utilized in the treatment of COVID-19 pneumonia. Nebulization of MSC-derived exosomes did not induce acute allergic or secondary allergic reactions but did promote the absorption of pulmonary lesions and reduce the duration of hospitalization for mild cases of COVID-19 pneumonia. CONCLUSIONS: Nebulization of MSC-derived exosomes is a safe, effective, and simple method, and their application at the beginning of treatment may be more beneficial. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000030261. Registered on 26 February 2020.
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COVID-19 , Exossomos , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , COVID-19/terapia , Humanos , Transplante de Células-Tronco Mesenquimais/métodos , Projetos Piloto , SARS-CoV-2 , Cordão UmbilicalRESUMO
OBJECTIVE: To explore the diagnostic value of carcinoembryonic antigen (CEA) and cytokeratin-19-fragment (CYFRA21-1) in lung cancer patients. METHODS: The levels of serum CEA and CYFRA21-1 were measured in 102 patients with lung cancer, 45 patients with benign lung disease and 36 health controls by electrochemiluminescence. RESULTS: The level of serum CEA and positive rate [(25.77 ± 15.34) ng/ml, 47.1%] were significantly higher in the lung cancer group than that in the benign lung disease group [(4.67 ± 2.21) ml, 7.7%; P < 0.05] and controls [(3.98 ± 3.00) ng/ml, 3.8%; P < 0.05], The level of serum CYFRA21-1 and positive rate [(14.08 ± 8.34) ng/ml, 62.7%] were also significantly higher in the lung cancer group than that in the benign lung disease group [(3.27 ± 2.87) ml, 7.7%; P < 0.05] and controls [(2.69 ± 2.02 ng/ml, 3.8%; P < 0.05]. The difference of level of CEA and CYFRA21-1 between the benign lung disease group and controls was statistically not significant (P > 0.05). Both tumor markers were increased to a different degree in the lung cancer patients at various TNM stages [(CEA: stage II (17.78 ± 8.71) ng/ml, stage III (25.84 ± 7.34) ng/ml, stage IV (34.85 ± 6.99) ng/ml; and CYFRA21-1: stage II (10.05 ± 6.76) ng/ml, stage III (15.93 ± 6.66) ng/ml, stage IV (22.78 ± 4.12) ng/ml]. Combined use of both makers showed a significant higher sensitivity (77.5% vs. 47.1%, 62.8%), but reduced specificity (86.8% vs. 94.0%, 95.6%), and not significantly changed accuracy (83.5% vs. 77.1%, 83.8%) in the diagnosis of lung cancer. CONCLUSIONS: CEA and CYFRA21-1 employed separately are helpful in the diagnosis of lung cancer. Combined detection of these two tumor markers can improve the positivity for diagnosis of lung cancer.
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Antígenos de Neoplasias/sangue , Antígeno Carcinoembrionário/sangue , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Queratina-19/sangue , Neoplasias Pulmonares/diagnóstico , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Carcinoma Pulmonar de Células não Pequenas/sangue , Carcinoma Pulmonar de Células não Pequenas/patologia , Estudos de Casos e Controles , Feminino , Humanos , Pneumopatias Obstrutivas/sangue , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Pneumonia/sangue , Carcinoma de Pequenas Células do Pulmão/sangue , Carcinoma de Pequenas Células do Pulmão/patologia , Tuberculose Pulmonar/sangueRESUMO
OBJECTIVE: To analyze the immunotherapy and clinical characteristics of coronavirus disease 2019 (COVID-19) patients, and focus on exploring the effects of immunotherapy and mesenchymal stem cells (MSC) transplantation in the critically ill patients' treatment. METHODS: Fity-five COVID-19 patients were admitted to the Fifth People's Hospital of Wuxi from January 23rd to March 31st, 2020 as the research object. The demographic characteristics of the cases and the methods of immunotherapy were analyzed, focusing on the immunized indicators, positivity of pathogens and clinical indicators of critically ill COVID-19 patient, and the effects of immunotherapy and stem cell transplantation were evaluated. RESULTS: Aged, male and people with comorbidities were the main risk factors in the development of severe and critical COVID-19. All of confirmed COVID-19 cases (n = 55) had been treated with interferon-α (IFN-α), of which 81.8% (n = 45, mild and ordinary) of the patients were recovered, 14.6% (n = 8) of the patients were converted to severe, 3.6% (n = 2) of the patients were converted to critical, and some severe patients were treated with gamma globulin and albumin as adjuvant treatment. Critically ill patients were not only treated with IFN-α, gamma globulin and albumin, but also treated with convalescent plasma and MSC transplantation. Due to pulmonary hemorrhage and persistently low blood oxygen saturation, terminal lung transplantation therapy was implemented. The total number of lymphocytes, CD4+, CD8+ T lymphocytes, natural killer (NK) cells and B cells in peripheral blood of the two critical COVID-19 patients were significantly reduced, and the functions of lung, liver, and kidney were severely damaged on admission, manifested as significant increase of the levels of blood C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and blood urea nitrogen (BUN), etc. and decrease of blood oxygen saturation, and type I respiratory failure, and the noninvasive assisted ventilation was needed to improve. After adjuvant immunotherapy such as gamma globulin, the nucleic acid of 2019 novel coronavirus (2019-nCoV) turned into negative. The CRP of one critically ill patient was significantly lower than the value at admission (minimum of 21 mg/L). But the lung inflammation progressed rapidly, and the pathological results of the lung tissue from the lung transplantation showed hemorrhage and irreversible fibrosis. The ability to secrete immunoglobulin A (IgA) was significantly reduced. Liver function had been significantly improved and stabilized after treatment with convalescent plasma during the recovery period. MSC transplantation treatment reduced the BUN level by > 50% compared with the previous period, and the total number of lymphocytes in the patient increased by more than 2 times (rose from 0.23×109/L to 0.57×109/L), but the total amount of lymphocytes was still lower than the normal reference value (< 1.1×109/L). The lung inflammation lesions were obviously absorbed, and the vital signs were stable. CONCLUSIONS: In addition to IFN, gamma globulin, antiserum and MSC transplantation therapy can help clear the virus and reduce inflammation. Although MSC transplantation fail to completely change the immunecompromised state of critically ill patients, it controlled the progression of inflammation in the liver and kidneys.
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COVID-19 , Células-Tronco Mesenquimais , Idoso , COVID-19/terapia , Estado Terminal , Humanos , Imunização Passiva , Imunoterapia , Masculino , SARS-CoV-2 , Soroterapia para COVID-19RESUMO
ABSTRACT: Since the first infected case of Coronavirus Disease 2019 (COVID-19) was reported in Wuhan, China in December 2019, the virus has spread swiftly, inflicting upon millions of people around the globe. The objective of the study is to investigate and analyze the clinical characteristics and outcomes of patients infected with COVID-19 in Wuxi, China.Cross-sectional study.The Fifth People's Hospital of Wuxi, China.A total of 48 COVID-19 patients were enrolled in the study from 23 January 2020 to 8 March 2020, and the clinical data of these subjects were collected.Epidemiological, clinical, laboratory, and radiologic characteristics, as well as treatment and outcome data, were collected and analyzed.Of these 48 patients with confirmed COVID-19, 3 were mild cases (6.3%), 44 were moderate cases (91.7%), 1 was severe case (2.1%). The median age of the subjects was 45 years (interquartile range [IQR], 24-59; range, 5-75 years). Twenty-five of the patients (52.1%) were male and 23 (47.9%) were female. Twenty-eight cases (58.3%) returned to Wuxi, Jiangsu Province. Thirty-four (70.8%) cases were infected due to clustering epidemic and 29 cases (85.3%) were attributable to family-clustering epidemic. No obvious clinical symptoms were observed in the cohort of patients, except for 3 mild cases. The most common symptoms include fever (41 [85.4%]), cough (28 [58.3%]), asthenia (13 [27.1%]), expectoration (11 [22.9%]), diarrhea (10 [20.8%]), and dyspnea (5 [10.4%]). Seventeen (35.4%) patients had lower lymphocyte values than baseline, 31 patients (64.6%) had higher d-dimers to exceed the normal range. The distribution of high-resolution computed tomography (HRCT)-positive lesions were as follows: left lung in 5 cases (10.4%), right lung in 9 cases (18.8%), and bilateral lungs in 31 cases (64.6%). In terms of density of lesions: 28 cases (58.3%) showed ground glass shadows in the lung, 7 cases (14.6%) showed solid density shadows, and 10 cases (20.8%) showed mixed density shadows. Extrapulmonary manifestations found that mediastinal lymph nodes were enlarged in 2 cases (4.2%) and that pleural effusion was present in 1 case (2.1%). All patients underwent treatment in quarantine. Forty-five (93.8%) patients received antiviral treatments, 22 (45.8%) patients received antibacterial treatments, 6 (12.5%) patients received glucocorticoid treatments, 2 (4.2%) patients received high flow oxygen inhalation treatments, and 6 (12.5%) patients received noninvasive ventilation treatments. As of 8 March 2020, all 48 patients included in this study were cured. The average time of hospitalization of the 48 patients was 18â±â6 (meanâ±âSD) days, the average time of the lesion resorption was 11â±â4 days, and the average time taken to achieve negativity in the result of nucleic acid examination was (10â±â4) days.The epidemiological characteristics of 48 COVID-19 patients in Wuxi were mainly imported cases and clustered cases. The clinical manifestations of these patients were mainly fever and cough. Laboratory results showed that the lymphocytopenia and increased d-dimer are positively correlated with disease severity. Pulmonary imaging showed unilateral or bilateral ground glass infiltration. Most of the patients entered clinical recovery stage within 15 days after hospitalization.
Assuntos
COVID-19 , Tosse , Febre , Hospitalização/estatística & dados numéricos , Assistência ao Paciente , SARS-CoV-2/isolamento & purificação , Avaliação de Sintomas/estatística & dados numéricos , COVID-19/sangue , COVID-19/epidemiologia , COVID-19/fisiopatologia , COVID-19/terapia , China/epidemiologia , Análise por Conglomerados , Tosse/diagnóstico , Tosse/etiologia , Saúde da Família/estatística & dados numéricos , Feminino , Febre/diagnóstico , Febre/etiologia , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Humanos , Linfopenia/diagnóstico , Linfopenia/etiologia , Masculino , Pessoa de Meia-Idade , Assistência ao Paciente/métodos , Assistência ao Paciente/estatística & dados numéricos , Radiografia Torácica/estatística & dados numéricos , Tomografia Computadorizada por Raios X/métodosRESUMO
ABSTRACT: The aim of this study was to retrospectively analyze the clinical data of COVID-19 patients with different severity during February 2020 in Wuxi, China.The present retrospective study included a total of 60 cases who were diagnosed as COVID-19 patients and hospitalized in the Wuxi Fifth People's Hospital during February 2020 to March 2020. Among all patients 14 cases were asymptomatic, 25 cases were with mild stage, 13 cases were with moderate stage, and 8 cases were with severe stage. Basic clinical data as well as clinical characteristics, including temperature, respiratory rate, heart rate, blood gas analysis data, whole blood test data, and the prognosis condition, were collected and analyzed. Statistical analysis was conducted in different severity stage patients.Among the patients, the median temperature gradually increased from the asymptomatic to the severe patients and the median age increased from the mild to the severe patients with statistical difference. The hospitalization duration was the highest in severe patients. Higher heart rate, as well as lower oxygen partial pressure and oxygenation index were observed in severe patients than the other groups. Besides, higher CRP and globulin levels after admission were found in severe patients, and were gradually increased from the asymptomatic patients to the severe patients. On the contrary, the lymphocyte ratio and count was significant lower in severe patients. We also observed higher D-Dimer levels in the severe patients and the difference was statistical. Among all patients, 2 cases (3.33%) died and other patients were all cured after treatment.Statistical difference was mainly found mainly in age, hospitalization duration, temperature, CRP levels, O2 partial pressure and oxygenation index, globulin, lymphocyte ratio, and D-Dimer in patients with different severity. The higher CRP levels, lower O2 partial pressure and oxygenation index, higher globulin, lower lymphocyte ratio, and higher D-Dimer might be associated with the patients' severity.
Assuntos
COVID-19/patologia , Adolescente , Adulto , Idoso , Infecções Assintomáticas/epidemiologia , COVID-19/epidemiologia , COVID-19/terapia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto JovemRESUMO
We propose and simulate a new kind of compact polarizing beam splitter (PBS) based on a photonic crystal ring resonator (PCRR) with complete photonic bandgaps. The two polarized states are separated far enough by resonant and nonresonant coupling between the waveguide modes and the microring modes. Some defect holes are utilized to control the beam propagation. The simulated results obtained by the finite-difference time-domain method show that high transmission (over 95%) is obtained and the polarization separation is realized with a length as short as 3.1 microm. The design of the proposed PBS can be flexible, thanks to the advantages of PCRRs.