Newly formed dust within the circumstellar environment of SN Ia-CSM 2018evt.

Dust associated with various stellar sources in galaxies at all cosmic epochs remains a controversial topic, particularly whether supernovae play an important role in dust production. We report evidence of dust formation in the cold, dense shell behind the ejecta-circumstellar medium (CSM) interaction in the Type Ia-CSM supernova (SN) 2018evt three years after the explosion, characterized by a rise in mid-infrared emission accompanied by an accelerated decline in the optical radiation of the SN. Such a dust-formation picture is also corroborated by the concurrent evolution of the profiles of the Hα emission line. Our model suggests enhanced CSM dust concentration at increasing distances from the SN as compared to what can be expected from the density profile of the mass loss from a steady stellar wind. By the time of the last mid-infrared observations at day +1,041, a total amount of 1.2 ± 0.2 × 10-2 M⊙ of new dust has been formed by SN 2018evt, making SN 2018evt one of the most prolific dust factories among supernovae with evidence of dust formation. The unprecedented witness of the intense production procedure of dust may shed light on the perceptions of dust formation in cosmic history.

A nomogram for predicting osteoarthritis based on serum biomarkers of bone turnover in middle age: A cross-sectional study of PTH and ß-CTx.

The objective of this study was to investigate the diagnostic model of osteoarthritis by bone turnover markers in Chinese middle-aged subjects. The study was designed as a cross-sectional investigation with 305 participants aged 45 to 64. Radiographs of tibiofemoral knee joints were used for diagnose osteoarthritis. Radiographic grading, evaluated using the Kellgren and Lawrence grading scale (K-L), was scored by 2 experienced observers who were blinded to the source of subjects. An optimal model was developed by logistic regression. And the prognostic performance of the selected model was assessed by the area under the receiver operating characteristic curve. The prevalence of osteoarthritis was 52.29% (n = 137/262) in middle age. ß-CTx levels tended to increase according to the K-L grades, whereas PTH levels significantly decrease. levels of 25(OH)D, ß-CTx, and PTH were each significantly associated with osteoarthritis risk (P < .05). Based on the estimated parameters of the optimal model, a nomogram was constructed for predicting osteoarthritis. These data suggest that the combination of PTH and ß-CTx could significantly improve the prognosis of osteoarthritis in middle age, and that the nomogram can assist primary physicians in the identification of high-risk men.

Ultra-stable perovskite quantum dot composites encapsulated with mesoporous SiO2 and PbBr(OH) for white light-emitting diodes.

Lead halide perovskite quantum dots (QDs) with high fluorescence efficiency and high color purity have a broad application prospect in the field of backlight display, but poor stability has been a key factor limiting their commercialization. Herein, we successfully synthesized CsPbBr3 QDs-KIT-6 (CsPbBr3 -K6) composite by using KIT-6 molecular sieve as the limited template with a simple high temperature solid-phase method. Further, the semi-protected CsPbBr3 QDs in KIT-6 frame will spontaneously hydrolyze when encountering water, and finally the double-encapsulated CsPbBr3 QDs-KIT-6@PbBr(OH) (CsPbBr3 -K6@PbBr(OH)) composite are obtained. CsPbBr3 -K6@PbBr(OH) composite shows excellent green emission properties, including a photoluminescence quantum yield (PLQY) (~73%) and a narrow emission linewidth of 25 nm. It is interesting that, the composite has excellent stability, including water stability without attenuation of fluorescence intensity after soaking in water for 60 days, thermal stability of 120°C heating-cooling cycle, and excellent optical stability without attenuation under continuous ultraviolet irradiation.

Exploration of the effects of Yang's pricking-cupping therapy on eczema-induced pruritus based on rs-fMRI. / 基于rs-fMRI探讨杨氏絮刺火罐对湿疹瘙痒的影响.

OBJECTIVES: To explore the clinical effect of Yang's pricking-cupping therapy and its central mechanism in treatment of eczema-induced pruritus using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: Fifty patients with eczema-induced pruritus were enrolled in the observation group, and 50 healthy subjects were enrolled in the control group. No any intervention was delivered in the control group. Yang's pricking-cupping therapy was operated at Dazhui (GV 14) and bilateral Quchi (LI 11), Xuehai (SP 10) and Sanyinjiao (SP 6), once a week, lasting 6 weeks in the observation group. The scores of the 12-item pruritus severity scale (12-PSS), the eczema area and severity index (EASI), the dermatology life quality index (DLQI), the Pittsburgh sleep quality index (PSQI), and the self-rating anxiety scale (SAS) were compared before and after treatment in the observation group. The rs-fMRI scanning was conducted and the regional homogeneity (ReHo) analysis performed in all of the participants before and after treatment in the observation group, as well as at the time of subject enrollment in the control group. The correlation was analyzed between ReHo values in the different areas of the brain and the scores of the above scales. RESULTS: Compared with those before treatment, the scores of 12-PSS, EASI, DLQI, PSQI, and SAS were reduced after treatment in the observation group (P<0.01, P<0.05). ReHo values were increased in the right caudate nucleus, the right middle temporal gyrus, the right orbitofrontal gyrus, the right thalamus and the left angular gyrus before treatment in the observation group when compared with those in the control group (P<0.001); and ReHo values in the above areas of the brain were decreased after treatment when compared with those before treatment in the observation group (P<0.001). In comparison with the control group, ReHo values were reduced in the left middle temporal gyrus, the left superior parietal lobule and the left supplementary motor area in the observation group before treatment (P<0.001); while when compared with those before treatment, ReHo values in the above areas of the brain were elevated after treatment in the observation group (P<0.001). Before treatment, ReHo value in the left supplementary motor area was positively correlated with 12-PSS score (r=0.432, P=0.004), and the value in the right orbitofrontal gyrus was negatively correlated with PSQI score (r=-0.318, P=0.04) in the observation group. After treatment, ReHo value in the left superior parietal lobule was positively correlated with 12-PSS score (r=0.384, P=0.012) in the observation group. CONCLUSIONS: The abnormal cerebral functional activities are exhibited in multiple areas of the brain involved in stimulus response, emotional regulation, behavior control and attention in the patients with eczema-induced pruritus. Yang's pricking-cupping therapy can effectively relieve the pruritus symptoms and skin lesions of the patients, which may be related to reversing the abnormal cerebral functional activities induced by pruritus.

One-Step Hydrothermal Synthesis of MoO2/MoS2 Nanocomposites as High-Performance Electrode Material for Supercapacitors.

By only changing the ratio of Mo to S source, a distinctive single phase MoO2 or MoS2 and MoO2/MoS2 nanocomposites (NCs) are obtained through a simple one-step hydrothermal method based on CH4N2S as a sulfur source and (NH4)6Mo7O24·4H2O as a source of Mo in oxalic acid. The effect of ratio of Mo to S source on the composition, structure, and electrochemical performance are systematically researched. Due to its unique design, abundant macropores active sites in MoO2/MoS2 NCs induce superior rate property (55.30% capacitance retention to 20 from 1 A g-1) and larger specific capacitance (1667.3 F g-1 at 1 A g-1) and longer cycle life (94.75% after 5000 cycles) as used directly as an electrode. Furthermore, at a power density of 225 W kg-1, a maximal energy density of 21.85 Wh kg-1 is provided by the asymmetric supercapacitor (MoO2/MoS2//AC). The capacitance of asymmetric supercapacitor (ASC) is remarkably enhanced by 129.02% under 5000 cycles at a current density of 1.5 A g-1, demonstrating outstanding cycle property. These results imply the prepared MoO2/MoS2 NCs have promising applications in advanced energy storages. It is important and should be noted that NCs of oxide and sulfide are prepared with only a simple one-step process.

Relationship of sleep disturbance and postoperative delirium: a systematic review and meta-analysis.

Background: Studies have investigated the relationship between sleep disturbance and postoperative delirium (PD) but have controversial results. A systematic review and meta-analysis have a high level of evidence to comprehensively evaluate the effect of sleep disturbance on PD. Our study aims to provide available evidence regarding the effect of sleep disturbance on PD. Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant studies from database inception to April 28, 2021. The eligible studies were identified according to the "PICOS" principles. Odds ratio (OR) was used to indicate the effect index, and 95% confidence interval (CI) was applied to express the effect size. The heterogeneity was tested. Subgroup analyses, meta-regression, and sensitivity analysis were also applied. Begg's test was used to test potential publication bias. The modified Newcastle-Ottawa Scale (NOS) was used to evaluate the literature quality. Results: Totally, 18 articles including 2,714 patients were enrolled, with most of the included literature being of moderate to high quality. The results of systematic and meta-analysis suggested that sleep disturbance was associated with an increased risk of PD (OR: 3.731; 95% CI: 2.338 to 5.956). Subgroup analysis results demonstrated that sleep disturbance in patients aged <65 years (OR: 6.072; 95% CI: 3.054 to 12.071), aged ≥65 years (OR: 2.904; 95% CI: 1.487 to 5.671), and undergoing cardiac (OR: 3.390; 95% CI: 1.359 to 8.453), orthopedic (OR: 3.943; 95% CI: 2.219 to 7.008), or other surgeries (OR: 4.963; 95% CI: 2.156 to 11.420) increased the risk of PD (all P<0.005). Moreover, increased risk of PD was found for both preoperative (OR: 2.804; 95% CI: 1.517 to 5.184) and postoperative (OR: 6.302; 95% CI: 3.794 to 10.467) sleep disturbance (all P<0.005). No associations between obstructive sleep apnea (OSA; OR: 2.008; 95% CI: 0.753 to 5.354; P=0.164), insomnia (OR: 4.005; 95% CI: 0.636 to 25.203; P=0.139) and risk of PD were observed. Conclusions: Our study indicated the relationship between sleep disturbance and the risk of PD. Patients undergoing surgical treatments should pay attention to their sleep quality. However, more research is needed to confirm its relationship.

Effects of organic matter on interaction forces between polystyrene microplastics: An experimental study.

The aggregation and deposition processes of marine microplastics are extremely important in marine ecosystems. The main effect of these two physical processes is the transfer of surface microplastics to the deep sea, and the underlying kinetics can be significantly affected by the organic matter in the ocean. The morphology of and interaction force on 20-µm polystyrene microplastics in the presence of organic matter were studied by using environmental scanning electron microscopy (ESEM) and atomic force microscopy (AFM), respectively. Experiments were performed using organic matter of various concentrations, and the results showed that humic acid formed a translucent organic film around polystyrene microplastics. With increasing total organic content (TOC), the average overall size of the microplastic coated with biofilm increased up to 11 % (at a TOC of 50 mg/L) and then decreased slightly. The biofilm formed by humic acid decreases the repulsion force between two particles and thus could promote the aggregation process significantly. A modified formulation of eXtended Derjaguin-Landau-Verwey-Overbeek (XDLVO) theory, describing the interaction force of microplastics with the influences of biofilms was proposed based on the measured results.

Continuous Renal Replacement Therapy in Pediatric Patients With Acute Kidney Injury After Liver Transplantation.

Objective: This study aimed to explore the clinical application of continuous renal replacement therapy (CRRT) in pediatric patients with acute kidney injury (AKI) after liver transplantation. Methods: Pediatric patients who underwent liver transplantation were retrospectively investigated. Those who developed AKI within 1 year after the surgery were included and divided into a CRRT group and a non-CRRT group. The perioperative conditions and postoperative complications of the two groups were compared along with the prognoses of the groups to analyze the high-risk factors of the postoperative CRRT. Results: 189 (36.91%) patients developed AKI within 1 year after the liver transplantation surgery. There were 18 patients in the CRRT group and 171 in the non-CRRT group. The differences in the preoperative conditions were not statistically significant between the two groups. Compared with the non-CRRT group, patients in the CRRT group had significantly longer transplantation times, higher volumes of intraoperative hemorrhage, and increased incidence of postoperative unscheduled surgery, postoperative primary nonfunction of the transplanted liver, secondary liver transplantation, hepatic artery occlusion, and intestinal fistula (P < 0.05). Moreover, the proportion of patients in AKI stage 3 is higher in the CRRT group (83.33%) than that in the non-CRRT group (11.11%), P < 0.001. The median time to initiate CRRT was 10 days postoperatively, the median number of CRRT treatments per patient was 2 times, the average duration of each CRRT treatment was 10.1 h, and the average rate of the decrease in blood creatinine per treatment was 25.6%. Results of multivariate logistic regression analysis showed that AKI stage 3 [OR=40.000, 95%CI (10.598, 150.969), P = 0.016], postoperative unscheduled surgery [OR=6.269, 95%CI (3.051, 26.379), P = 0.007], and hepatic artery occlusion [OR = 17.682, 95%CI (1.707, 40.843), P = 0.001] were recognized as risk factors for postoperative AKI with CRRT therapy. The one- and two-year survival rates were 72.22% and 72.22% in the CRRT group, respectively; and 97.08% and 96.49% in the non-CRRT group, accordingly. There were statistically significant differences in the one- and two-year survival rates between the two groups (P < 0.001). Conclusion: The incidence of AKI after liver transplantation in pediatric patients was high. Patients with AKI stage 3, hepatic artery occlusion, and underwent unscheduled surgery postoperatively were with a high likelihood of receiving CRRT, which was related to a lower one- and two-year survival rates. CRRT effectively improved the one- and two-year survival rates.

[Application of continuous renal replacement therapy in infants with acute kidney injury after liver transplantation].

OBJECTIVE: To investigate the clinical application of continuous renal replacement therapy (CRRT) in infants with acute kidney injury (AKI) after liver transplantation. METHODS: A retrospective study was conducted on infants with AKI after liver transplantation in Tianjin First Center Hospital from January 1, 2019 to June 1, 2021. Infants with AKI within 1 year after liver transplantation were divided into CRRT group and non-CRRT group according to whether CRRT was performed. The preoperative and intraoperative condition, the postoperative complications were compared, the risk factors of CRRT for AKI infants, the clinical characteristics of CRRT were analyzed, and the prognosis between CRRT group and non-CRRT group were compared. RESULTS: (1) A total of 512 cases of pediatric liver transplantation were performed. A total of 189 cases (36.9%) developed AKI within 1 year after surgery, including 18 cases in CRRT group and 171 cases in non-CRRT group. (2) There was no significant difference in preoperative conditions between the two groups. The duration of liver transplantation (hours: 8.8±1.5 vs. 7.5±1.3) and intraoperative blood loss [mL: 370 (220-800) vs. 310 (200-400)] in CRRT group were significantly higher than those in non-CRRT group. CRRT group had significantly higher incidence of postoperative complication [unplanned operation: 8 cases (44.4%) vs. 14 cases (8.2%), primary nonfunction: 1 case (5.6%) vs. 0 case (0%), retransplantation: 3 cases (16.7%) vs. 0 case (0%), hepatic artery thrombosis: 3 cases (16.7%) vs. 4 cases (2.3%), intestinal fistula: 2 cases (11.1%) vs. 2 cases (1.2%)] than non-CRRT group (all P < 0.05). (3) The average start time of CRRT was 10 (1-240) days. The per capita frequency of CRRT treatment was 3.3 (1.0-14.0) times. The average duration of each CRRT treatment was 10.1 (6.0-19.3) hours, the average reduction rate of serum creatinine (SCr) was 25.6% (13.5%-45.0%) after CRRT. (4) In CRRT group, 5 patients died, the 1-year and 2-year survival rates were both 72.22%. In non-CRRT group, 6 patients died, the 1-year and 2-year survival rates were 97.1% and 96.5%, respectively. There were significant differences in 1-year and 2-year survival rates between the two groups (both P < 0.01). CONCLUSIONS: The incidence of AKI after pediatric liver transplantation was high, and most infants treated with CRRT were associated with serious surgical complications. CRRT was a powerful means to remove inflammatory factors and maintain the stability of circulation and internal environment, which could improve the multi-organ dysfunction effectively.

Investigation and Analysis of the Colonization and Prevalence of Carbapenem-Resistant Enterobacteriaceae in Pediatric Liver Transplant Recipients.

OBJECTIVE: This study aimed to investigate the colonization and prevalence of carbapenem-resistant Enterobacteriaceae (CRE) in pediatric liver transplant recipients and analyze the high-risk factors and prognosis of CRE infection. METHODS: A prospective study involving 152 pediatric patients undergoing liver transplantation was carried out. Anal swab bacteria cultures were collected when the patients entered the intensive care unit (ICU) and when they left in order to screen for intestinal CRE colonization. The results were grouped according to the occurrence of CRE infection following surgery, and the patients were divided into two groups: a CRE infection group and a non-CRE infection group. Univariate analysis and multiple logistic regression analysis were conducted to determine the independent risk factors of CRE infection and analyze the survival rate. RESULTS: Of the 152 pediatric liver transplant recipients enrolled in the study, there were 13 cases of postoperative CRE infection and 139 cases of non-CRE infection. The incidence of preoperative CRE infection, preoperative cytomegalovirus (CMV) infection, and preoperative sepsis in the CRE infection group was significantly higher than in the non-CRE infection group (P < 0.005). Intraoperative bleeding volume and operation times in the CRE infection group were also significantly higher than in the non-CRE infection group (P < 0.05). Furthermore, postoperative ICU treatment time, postoperative occurrence of unplanned surgery, postoperative mechanical ventilation of more than 24 hours, and the incidence of pre-ICU CRE colonization in the CRE infection group were significantly higher than in the non-CRE infection group (P < 0.05). Finally, the difference between the CRE infection group and the non-CRE infection group in six-month survival rate following surgery was significant (P < 0.001). CONCLUSION: The independent risk factors of CRE infection following pediatric liver transplantation include preoperative CRE infection and pre-ICU CRE colonization. CRE infection progresses quickly, with a poor prognosis and a high mortality rate. The CRE screening of anal swabs is crucial for the early detection of CRE infection.

A prediction model of delayed graft function in deceased donor for renal transplant: a multi-center study from China.

BACKGROUND: Kidneys obtained from deceased donors increase the incidence of delayed graft function (DGF) after renal transplantation. Here we investigated the influence of the risk factors of donors with DGF, and developed a donor risk scoring system for DGF prediction. METHODS: This retrospective study was conducted in 1807 deceased kidney donors and 3599 recipients who received donor kidneys via transplants in 29 centers in China. We quantified DGF associations with donor clinical characteristics. A donor risk scoring system was developed and validated using an independent sample set. RESULTS: The incidence of DGF from donors was 19.0%. Six of the donor characteristics analyzed, i.e., age, cause of death, history of hypertension, terminal serum creatinine, persistence of hypotension, and cardiopulmonary resuscitation (CPR) time were risk factors for DGF. A 49-point scoring system of donor risk was established for DGF prediction and exhibited a superior degree of discrimination. External validation of DGF prediction revealed area under the receiver-operating characteristic (AUC) curves of 0.7552. CONCLUSIONS: Our study determined the deceased donor risk factors related to DGF after renal transplantation pertinent to the Chinese cohort. The scoring system developed here had superior diagnostic significance and consistency and can be used by clinicians to make evidence-based decisions on the quality of kidneys from deceased donors and guide renal transplantation therapy.

In-air self-reduction synthesis and luminescence properties from Mg21 Ca4 Na4 (PO4 )18 :Eu2+ -Eu3+ excited using ultraviolet light.

A series of Mg21 Ca4 Na4 (PO4 )18 :Eu2+ -Eu3+ phosphors was successfully synthesized using a high-temperature solid-state method in an air atmosphere. The phase structures and luminescence properties of the samples were studied in detail. The phosphors exhibited strong visible light emission under different wavelengths of ultraviolet light excitation. By harmonizing the doping concentration of Eu3+ to adjust the relative luminescence intensity of Eu2+ and Eu3+ , a colourful emission of phosphors could be achieved. In addition, the colour coordinates of the International Commission on lighting indicated that Mg21 Ca4 Na4 (PO)18 :Eu2+ -Eu3+ could be considered as a potential blue, orange and red phosphor for white light-emitting diode applications.

Self-reduction synthesis and luminescence properties of Eu, Dy co-doped SrMg2 (PO4 )2 phosphor.

A series of SrMg2 (PO4 )2 :Eu2+ -Eu3+ ,Dy3+ phosphors was synthesized successfully using a high-temperature solid-state method in an air atmosphere. The structures were studied in detail using X-ray diffraction (XRD) and the luminescence properties of the samples. SrMg2 (PO4 )2 :Eu2+ -Eu3+ samples can emit adjustable blue-violet light by controlling the proportion of dopant concentration of europium and dysprosium under 340 nm excitation. Dy3+ exhibits typical blue and yellow emission under 350 nm excitation. The energy transferred from Eu3+ to Dy3+ in Dy and Eu co-doped system was determined by comparing the fluorescence spectra of single-doped system. In addition, the colour coordinates of the International Commission on lighting (CIE) indicated that SrMg2 (PO4 )2 :Eu2+ -Eu3+ ,Dy3+ could be considered as a potential blue-purple phosphor for white light-emitting diode applications.

In-air self-reduction synthesis and colour tunable luminescence from SrBPO5 :Eu2+ -Eu3+ excited using ultraviolet light.

SrBPO5 :Eu2+ -Eu3+ phosphors were synthesized using a conventional solid self-reduction reaction in an air atmosphere. Samples were characterized using thermogravimetry analysis (TGA), differential scanning calorimetry (DSC), X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectra, fluorescence spectra and Commission International de l'Eclairage (CIE) data. The results of TGA and DSC showed that the raw materials could completely react at 1000°C. FTIR spectra and XRD results displayed that europium ions of different concentrations do not effect the structure of the hosts. Fluorescence spectra displayed that europium ions exist in bivalent and trivalent forms, and that the emission peak at 403 nm was attributed to the typical 5d-4f transition for Eu2+ ; 597 nm and 620 nm emissions were assigned to the characteristic transitions of 5 D0 -7F1, 2 for Eu3+ . CIE results depicted that the colour tone of the phosphors could be macro-controlled from blue to purple by controlling the doping amount of Eu3+ .Therefore, relative luminescence intensity between Eu2+ and Eu3+ could be adjusted by controlling the doping concentration of europium to tune the luminescence colour of SrBPO5 .

Eu3+ -Eu2+ -doped xAl2 O3 -ySiO2 and xAl2 O3 -zMgO composites phosphors.

In this paper, the Eu3+ -Eu2+ (4%, molar ratio)-doped xAl2 O3 -ySiO2 (x = 0-2.5, y = 1-5) and xAl2 O3 -zMgO (x = 0-1.5, z = 0-3) composites phosphors with different Al2 O3 to SiO2 (A/S) and Al2 O3 to MgO (A/M) ratios were prepared using a high-temperature solid-state reaction under air atmosphere. The effects of the A/S and A/M on luminescence properties, crystal structure, electron spin resonance, and Commission Internationale de l'Eclairage chromaticity coordinates of the samples were systematically analyzed. These results indicated that the different A/S and A/M ratios in the matrix effectively affected the crystal phase, degrees of self-reduction of Eu3+ , and led the relative emission intensity of Eu2+ /Eu3+ to change and adjust.

The structure and luminescence properties of Mn2+ /Eu2+ /Er3+ -doped MgO-Ga2 O3 -SiO2 glasses and glass-ceramics.

The MgO-Ga2 O3 -SiO2 glasses and glass-ceramics samples doped with Eu2+ /Mn2+ /Er3+ and heated in reductive atmosphere were prepared by the sol-gel method. The structure, morphology and the luminescence properties were studied using X-ray diffraction, high-resolution transmission electron microscope, fluorescence spectra, and up-conversion emission. The luminescence characteristics of doped ions could be influenced by temperature and matrix component. The characteristic emission of Mn2+ , Eu2+ and Er3+ were seen and the energy transfer efficiency from Eu2+ to Mn2+ was enhanced as Mn2+ concentration was increased. In addition, the two-photon process was determined for the Er3+ -doped samples.

Effects of statin therapy on mean platelet volume in patients with risk of cardiovascular diseases: a systematic review and meta-analysis.

Many studies have demonstrated the effects of statin therapy on platelet, but it is controversial that whether statin could reduce mean platelet volume (MPV) in patients with the risk of cardiovascular diseases. To further improve the clinical significance of MPV in those patients and explore new function of statin, we conducted this research. Relevant studies were selected by searching electronic databases (PubMed, Embase and Cochrane Library) and reference lists of related articles by hand. Two reviewers independently assessed eligibility and quality of the studies. Eventually, we included ten studies, a total of 1189 patients with the risk of cardiovascular diseases. Consolidating relevant data and comparing the changes of MPV before and after statin treatment, we found that statin could decrease MPV [standard mean difference (SMD) = -0.47 (-0.71-0.23)], which was statistically significant (P=0.0001). Subgroup analysis suggested that when ≥55 years, this decrease did not occur [SMD = -0.06 (-0.18, 0.06)]. Drug type, sample size, ethnicity, mean age and quality of included article were sources of heterogeneity. Therefore, statin therapy could reduce MPV significantly and exhibited antiplatelet activity, which is of great importance in clarifying the clinical significance of MPV in cardiovascular events and the prevention of cardiovascular events.

[A twenty-year review of clinical liver transplantation].

OBJECTIVE: To review the development of adult and pediatric liver transplantation in Tianjin First Center Hospital, and to enhance academic exchanges, improve technological innovation, and jointly promote the progress and maturity in the field of liver transplantation. METHODS: The development of liver transplantation in Tianjin First Center Hospital was analyzed. The clinical data of adult and pediatric liver transplantation from September 1998 to September 2018 were collected. The important events and technological innovation achievements of liver transplantation during the 20 years were summarized. RESULTS: The first clinical liver transplantation was attempted in Tianjin First Central Hospital in April 1980. The first long-term survival adult liver transplantation in China was completed in 1994 (11 years survival after the operation). The specialized team of liver transplantation was formally established in September 1998. The 20-year clinical exploration and progress reflected the characteristics of era changes and technological innovation during the rapid development of liver transplantation in China. Our center performed liver re-transplantation in January 1999, reduced-size pediatric liver transplantation in August 2000. In May 2001, we organized the formulation for the preventive and treatment plan for hepatitis B recurrence after liver transplantation. We performed combined liver and kidney transplantation in July 2002, split liver transplantation (SLT) in April 2004, the first domino liver transplantation (DLT) in August 2005. Pediatric living donor liver transplantation (LDLT) was initiated in October 2006, adult LDLT was carried out in August 2007. In September 2007, the first living donor combined liver and kidney transplantation from the same donor in Asia was performed. The first domino+living donor double grafts liver transplantation in the world was performed in January 2009. In March 2011, we performed laparoscopically assisted right hepatic lobe liver transplantation (LDLT) with middle hepatic vein. In May 2014, living donor laparoscopic left lateral lobe procurement was successfully established. In April 2016, simultaneous liver, pancreas and kidney multi-organ transplantation was completed. Domino donor-auxiliary liver transplantation was performed in February 2017. In December 2017, extracorporeal membrane oxygenation (ECMO)-supported liver transplantation in a patient with severe pulmonary hypertension was successfully completed. Liver transplantation combined with partial splenectomy was established in April 2018. Cross-domino liver transplantation (hypersensitive kidney transplantation with auxiliary liver transplantation+pediatric liver transplantation) was performed in May 2018. During the 20 years, the team has performed or assisted other centers in Beijing, Shanghai, Guangzhou and Shenzhen to carry out more than 10 000 cases of liver transplantations. A total of 7 043 cases of various types of liver transplantation were performed in the single center of the hospital (6 005 adult liver transplantations and 1 038 pediatric liver transplantations). Concerning adult liver transplantation, the cumulative 1-year, 3-year and 5-year survival rate from September 1998 to March 2003 were 83.1%, 73.0% and 69.0%, from April 2003 to March 2009 were 85.3%, 76.2% and 72.1% and from April 2009 to September 2018 were 87.5%, 79.2% and 75.1%, respectively. The cumulative 1-year, 3-year and 5-year survival rate for pediatric liver transplantation were 93.5%, 92.2% and 90.2%, respectively. The nucleoside (acid) analogue combined with low dose hepatitis B immunoglobulin (HBIG) was developed to prevent the recurrence of hepatitis B after liver transplantation, this plan has reduced the recurrence rate of hepatitis B and the 5-year re-infection rate of hepatitis B virus (HBV) after liver transplantation significantly. The risk assessment system for tumor recurrence after liver transplantation was established and individual treatment method was established based on this assessment system. Continuous exploration and improvement of liver transplantation for liver cancer, liver re-transplantation, liver transplantation with portal vein thrombosis, SLT, DLT and multi-organ combined transplantation have significantly improved the clinical efficacy of patients and the post-operative survival rate. CONCLUSIONS: The liver transplantation team of Tianjin First Center Hospital has carried out a scientific and technological exploration on the key problems and technical difficulties of clinical liver transplantation. This work strongly has initiated and promoted the rapid development of liver transplantation in China. The restrictive barrier of hepatitis B recurrence after liver transplantation has been overcome. The risk prevention and control system of tumor recurrence after liver transplantation has been established. A series of innovative achievements that can be popularized have been achieved in the field of complex liver transplantation and expansion of donor liver source. The iterative progress and sustainable development of liver transplantation have been realized.

[Successful management of hyperammonemia syndrome in a patient after skin transplantation: a case report and a literature review on 41 patients].

OBJECTIVE: Hyperammonemia syndrome (HS) is a comparatively rare but often fatal clinical syndrome characterized by progressive respiratory alkalosis and abrupt mental status alteration associated with markedly elevated plasma ammonium levels. Although the exact mechanism of HS remains unclear, infection with urease producing microbes is proposed as the main etiology of HS recently. A patient with HS after repeated autologous skin transplantation was admitted to Tianjin First Center Hospital in March 2018, presented with fever, coma and epilepsy. The infection of Mycoplasma hominis was confirmed in blood sample by high throughput gene detection. The patient was survived after multimodal management including antimicrobial treatment, aggressive ammonia removal by continuous renal replacement therapy in combination with lactulose, and mechanical ventilation. She was successfully discharged from intensive care unit (ICU) with clear consciousness, normal temperature and smooth breath. In view of the experience of the case treatment, a review of literature was conducted to discuss the epidemiology and clinical characteristics, possible etiologies and mechanisms, and outcomes with emphasis on treatment strategies of HS and to promote more clinicians to recognize this rare disease.