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Introduction: Immune checkpoint inhibitors can cause immune-related adverse events in various organ systems, with myocarditis being the most serious and life-threatening. This article reports three cases of immune myocarditis induced by camrelizumab, detailing the diagnostic and treatment process. Case Report: Three cases of immune-related myocarditis caused by the use of camrelizumab are reported. Three patients (case 1, male, 44 years old; case 2, male, 69 years old; and case 3, male, 53 years old) were treated with the immune checkpoint inhibitor, camrelizumab 200 mg, intravenously for nasopharyngeal and esophageal cancers. In case 1, 18 days after the 3rd cycle of immunotherapy, the patient's troponin levels were elevated. In case 2, 1 day after the 1st cycle of treatment, troponin levels were elevated. The electrocardiogram showed right bundle branch block with left anterior branch block and abnormal ST-T segments in the lower wall, and the echocardiogram showed segmental ventricular dyskinesia and thickening of the myocardium of the left and right ventricles. In case 3, 12 days after the 3rd cycle of treatment, the patient developed chest tightness and breathlessness, and cardiac biomarkers were elevated. The electrocardiogram showed borderline QT interval prolongation and extensive ST-T segment changes, and cardiac ultrasound showed thinning of the myocardium in the middle and lower left ventricular anterior and lower posterior walls and loss of motility. All 3 patients were diagnosed with immune-associated cardiomyositis induced by camrelizumab, and camrelizumab was discontinued. In case 1, methylprednisolone succinate was administered as an intravenous infusion of 500 mg once a day for 4 days, and the patient's troponin levels gradually decreased. In case 2, following the administration of intravenous methylprednisolone succinate sodium (500 mg) once daily for 5 consecutive days, the patient experienced gastrointestinal bleeding. The hormone dose was then reduced, and intravenous immune globulin (IVIG) 10 g/day was added. Treatment continued for 3 days after the patient's death due to immune myocarditis and heart failure combined with gastrointestinal bleeding. Case 3 underwent a tracheotomy and received methylprednisolone sodium succinate (240 mg) intravenous drip daily for 7 days. Camrelizumab was discontinued. Although troponin and NT-proBNP levels remained elevated with an upward trend 7 days after starting treatment, they decreased after adding IVIG 20 g/day for 3 days. Treatment continued for another 3 days after improvement in cardiac biomarkers. After gradually reducing the hormone dose over 5 days following the stabilization of the patient's condition, he was discharged from the hospital. The patient's follow-up status is good. Conclusion: Emphasizing the importance of baseline assessment, early detection and timely intervention, standardized use of glucocorticosteroids, and the addition of immunosuppressants where necessary, these measures can be effective in reducing mortality and ultimately improving prognosis.
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Heterostructure interfacial engineering between photocatalyst and co-catalyst to obtain an optimized electronic structure is a promising approach to improving their performance in the photocatalytic hydrogen evolution reaction (HER). In this work, two-dimensional nanopetal-like ZnIn2S4 (ZIS) with an adequately exposed active (110) edge facet-decorated Ni cluster heterostructure was prepared via chemical bath deposition, followed by photodeposition. In the catalyst preparation, the ZIS microstructure was modulated to sufficiently expose the active sites of the (110) edge for the HER, on which spontaneous interfacial engineering with an additional Ni cluster co-catalyst would be triggered via photodeposition in situ. The hydrogen production rate of the composite photocatalyst was excellent, at up to 26.80 mmol g-1 h-1 under simulated sunlight, which was 15.4 times greater than that of pristine ZIS. The optimized photocatalyst achieved a state-of-the-art apparent quantum yield of 61.68% at a single wavelength of 420 nm. Combined with systematic experimental characterization and density functional theory calculation, it was demonstrated that the separation and migration of charge carriers were significantly enhanced via the Ni cluster-induced interfacial electron redistribution, which contributed to the near-zero Gibbs free energy barrier and favored intermediate (*H) adsorption and desorption behavior, resulting in the superior photocatalytic performance. In summary, this work enables tuning of the interfacial electronic properties via spontaneous photodeposition of metallic cluster co-catalyst on the edge active sites, through which the separation of photogenerated charge carriers and surface redox reactions can be synergistically facilitated.
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Exploration of artificial aggregation-induced emission luminogens (AIEgens) has garnered extensive interest in the past two decades. In particular, AIEgens possessing natural characteristics (BioAIEgens) have received more attention recently due to the advantages of biocompatibility, sustainability and renewability. However, the extremely limited number of BioAIEgens extracted from natural sources have retarded their development. Herein, a new class of BioAIEgens based on the natural scaffold of chromene have been facilely synthesized via green reactions in a water system. These compounds show regiostructure-, polymorphism- and substituent-dependent fluorescence, which clearly illustrates the close relationship between the macroscopic properties and hierarchical structure of aggregates. Due to the superior biocompatibility of the natural scaffold, chromene-based BioAIEgens can specifically target the endoplasmic reticulum (ER) via the introduction of tosyl amide. This work has provided a new chromene scaffold for functional BioAIEgens on the basis of green and sustainable 'in-water' synthesis, applicable regiostructure-dependent fluorescence, and effective ER-specific imaging.