SIRT4 promotes neuronal apoptosis in models of Alzheimer's disease via the STAT2-SIRT4-mTOR pathway.

Alzheimer's disease (AD) is the leading cause of dementia and presents a considerable disease burden. Its pathology involves substantial neuronal loss, primarily attributed to neuronal apoptosis. Although sirtuin 4 (SIRT4) has been implicated in regulating apoptosis in various diseases, the role of SIRT4 in AD pathology remains unclear. The study used APP/PS1 mice as an animal model of AD and amyloid-ß (Aß)1-42-treated HT-22 cells as an AD cell model. SIRT4 expression was determined by quantitative real-time polymerase chain reaction, Western blot, and immunofluorescence. A Sirt4 knockdown model was established by intracranial injection of lentivirus-packaged sh-SIRT4 and cellular lentivirus transfection. Immunohistochemistry and flow cytometry were used to examine Aß deposition in mice and apoptosis, respectively. Protein expression was assessed by Western blot analysis. The UCSC and JASPAR databases were used to predict upstream transcription factors of Sirt4. Subsequently, the binding of transcription factors to Sirt4 was analyzed using a dual-luciferase assay and chromatin immunoprecipitation. SIRT4 expression was upregulated in both APP/PS1 mice and Aß-treated HT-22 cells compared with their respective control groups. Sirt4 knockdown in animal and cellular models of AD resulted in reduced apoptosis, decreased Aß deposition, and amelioration of learning and memory impairments in mice. Mechanistically, SIRT4 modulates apoptosis via the mTOR pathway and is negatively regulated by the transcription factor signal transducer and activator of transcription 2 (STAT2). Our study findings suggest that targeting the STAT2-SIRT4-mTOR axis may offer a new treatment approach for AD.NEW & NOTEWORTHY The study reveals that in Alzheimer's disease models, SIRT4 expression increases, contributing to neuronal apoptosis and amyloid-ß deposition. Reducing SIRT4 lessens apoptosis and amyloid-ß accumulation, improving memory in mice. This process involves the mTOR pathway, regulated by STAT2 transcription factor. These findings suggest targeting the STAT2-SIRT4-mTOR axis as a potential Alzheimer's treatment strategy.

Tf2O as a CF3 Source for the Synthesis of Trifluoromethoxylation Reagent nC4F9SO3CF3.

Described herein is the convenient synthesis of an efficient trifluoromethoxylation reagent, nC4F9SO3CF3, by using cheap and widely available reagents and without the need of any tedious column chromatography purification procedure.

Characteristics of lymphocyte subsets and cytokine profiles of patients with COVID-19.

BACKGROUND: Abnormalities of lymphocyte subsets and cytokine profiles have been observed in most patients with coronavirus disease (COVID-19). Here, we explore the role of lymphocyte subsets and cytokines on hospital admission in predicting the severity of COVID-19. METHODS: This study included 214 patients with COVID-19 who were treated at Chongqing University Three Gorges Hospital from January 19, 2020 to April 30, 2020. Any mutants were not detected in the studied patients. Patients were divided into non-intensive care unit (ICU) (mild/moderate) group and ICU (severe/critical) group, according to the severity of the disease. Clinical and laboratory data, including peripheral lymphocyte subsets and cytokines, were analyzed and compared. Logistic regression was used to analyze the predictive factors for ICU admission. Receiver operating characteristic (ROC) curves were drawn to evaluate the predictive value of selected indicators for the severity of COVID-19. RESULTS: Of the 214 patients enrolled, 161 were non-ICU patients and 53 were ICU patients. Lymphopenia was observed in nearly all of ICU patients (96.2%) and 84.5% of non-ICU patients on hospital admission. The absolute number of lymphocytes, CD3+ T cells, CD4+ T cells, CD8+ T cells, CD19+ B cells, and natural killer (NK) cells were lower in ICU group (659.00 × 106/L, 417.00 × 106/L, 261.00 × 106/L, 140.00 × 106/L, 109.00 × 106/L, 102.00 × 106/L, respectively) than in non-ICU group (1063.00 × 109/L, 717.00 × 106/L, 432.00 × 106/L, 271.00 × 106/L, 133.00 × 106/L, 143.00 × 106/L, respectively). Interleukin (IL)-6 was significantly higher in ICU patients than in non-ICU patients (18.08 pg/mL vs. 3.13 pg/mL, P < 0.001). Multivariate logistic regression analysis showed that age (odds ratio: 1.067 [1.034-1.101]), diabetes mellitus (odds ratio: 9.154 [2.710-30.926]), CD3+ T cells (odds ratio: 0.996 [0.994-0.997]), and IL-6 (odds ratio: 1.006 [1.000-1.013]) were independent predictors for the development of severe disease. ROC curve analysis showed that the area under the ROC curve (AUC) of CD3+ T cells and IL-6 was 0.806 (0.737-0.874) and 0.785 (0.705-0.864), respectively, and the cutoff values were 510.50 × 106/L (sensitivity, 71.7%; specificity, 79.5%) and 6.58 pg/mL (77.4%, 74.5%), respectively. There were no statistical differences among all tested indicators of lymphocyte subsets and cytokines between severe group (n = 38) and critical group (n = 15) on hospital admission or ICU admission, respectively. CONCLUSIONS: The levels of lymphocyte subsets decreased and the level of IL-6 increased significantly in ICU COVID-19 patients compared with non-ICU COVID-19 patients. Therefore, the number of CD3+ T cells and the level of IL-6 on hospital admission may serve as predictive factors for identifying patients with wild-type virus infection who will have severe disease.

Intestinal barrier dysfunction following traumatic brain injury.

Traumatic brain injury (TBI) can cause non-neurological injuries to other organs such as the intestine. Newer studies have shown that paracellular hyperpermeability is the basis of intestinal barrier dysfunction following TBI. Ischemia-reperfusion injury, inflammatory response, abnormal release of neurotransmitters and hormones, and malnutrition contribute to TBI-induced intestinal barrier dysfunction. Several interventions that may protect intestinal barrier function and promote the recovery of TBI have been proposed, but relevant studies are still limited. This review is to clarify the established mechanisms of intestinal barrier dysfunction following TBI and to describe the possible strategies to reduce or prevent intestinal barrier dysfunction.

Effect of incubation with lipopolysaccharide and interferon-γ on reactive astrogliosis.

Sepsis associated encephalopathy is a common complication of sepsis, but its pathogenesis of sepsis-associated encephalopathy remains unclear. Astrocytes are the most abundant brain glial cells, and reactive astrogliosis, a pathological response to central nervous system diseases, has a clear disease and disease-stage specificity. Functional changes of astrocytes are of great significance for the detection and prognosis of sepsis-associated encephalopathy. The pathogenesis of sepsis-associated encephalopathy was explored at the cellular level by examining astrogliosis in an in vitro model of sepsis-associated encephalopathy. Astrocytes of Wistar neonatal rats were incubated with different concentrations of lipopolysaccharide combined with interferon-γ. Cell viability was assessed by levels of tumor necrosis factor-α, interleukin-6, nitric oxide, reactive oxygen species, glial fibrillary acidic protein, changes of astrocyte morphology, and prevalence of apoptosis and necrosis. Compared with the control group, the cell viability of treated groups was decreased. The levels of tumor necrosis factor-α, interleukin-6, nitric oxide, reactive oxygen species, and glial fibrillary acidic protein were increased, hypertrophy of astrocytes was observed, and apoptosis was increased. The pathogenic outcomes of astrogliosis in sepsis-associated encephalopathy is discussed and a new tool provided to explore the pathogenesis of sepsis-associated encephalopathy at the cellular level.

Ultraviolet Photoluminescence of Carbon Nanospheres and its Surface Plasmon-Induced Enhancement.

Ultraviolet (UV) light can be used in versatile applications ranging from photoelectronic devices to biomedical imaging. In the development of new UV light sources, in this study, stable UV emission at ≈350 nm is unprecedentedly obtained from carbon nanospheres (CNSs). The origin of the UV fluorescence is comprehensively investigated via various characterization methods, including Raman and Fourier transform infrared analyses, with comparison to the visible emission of carbon nanodots. Based on the density functional calculations, the UV fluorescence is assigned to the carbon nanostructures bonded to bridging O atoms and dangling -OH groups. Moreover, a twofold enhancement in the UV emission is acquired for Au-carbon core-shell nanospheres (Au-CNSs). This remarkable modification of the UV emission is primarily ascribed to charge transfer between the CNSs and the Au surface.

Detecting Internal Defects in FRP-Reinforced Concrete Structures through the Integration of Infrared Thermography and Deep Learning.

This study represents a significant advancement in structural health monitoring by integrating infrared thermography (IRT) with cutting-edge deep learning techniques, specifically through the use of the Mask R-CNN neural network. This approach targets the precise detection and segmentation of hidden defects within the interfacial layers of Fiber-Reinforced Polymer (FRP)-reinforced concrete structures. Employing a dual RGB and thermal camera setup, we captured and meticulously aligned image data, which were then annotated for semantic segmentation to train the deep learning model. The fusion of the RGB and thermal imaging significantly enhanced the model's capabilities, achieving an average accuracy of 96.28% across a 5-fold cross-validation. The model demonstrated robust performance, consistently identifying true negatives with an average specificity of 96.78% and maintaining high precision at 96.42% in accurately delineating damaged areas. It also showed a high recall rate of 96.91%, effectively recognizing almost all actual cases of damage, which is crucial for the maintenance of structural integrity. The balanced precision and recall culminated in an average F1-score of 96.78%, highlighting the model's effectiveness in comprehensive damage assessment. Overall, this synergistic approach of combining IRT and deep learning provides a powerful tool for the automated inspection and preservation of critical infrastructure components.

Prognostic evaluation of the norepinephrine equivalent score and the vasoactive-inotropic score in patients with sepsis and septic shock: a retrospective cohort study.

Background: This study investigated the association between vasoactive medication exposure and mortality risk in patients with sepsis using the norepinephrine equivalent (NEE) score and vasoactive-inotropic score (VIS). Methods: This retrospective cohort study included adult patients with sepsis requiring vasoactive agents. The data were extracted from the Medical Information Mart for Intensive Care IV database. The primary outcome was 28-day mortality. Multivariate Cox regression was used to elucidate the relationship between vasoactive medication exposure and 28-day mortality, as quantified by the VIS and NEE score. Hazard ratios with 95% confidence intervals (CI) for 28-day mortality were generated, and forest plots were constructed to present the results of univariate and multivariate analyses. The Kaplan-Meier method was used to analyze the cumulative incidence of 28-day mortality. A nomogram was constructed to predict the prognosis of patients with sepsis. Results: The present study encompassed 9,032 patients diagnosed with sepsis who received vasoactive therapy, of which 4,229 patients were further analyzed at the second hour after the onset of sepsis. Distinct variations in demographic data were observed between survivors (n = 3,265, 77.21%) and non-survivors (n = 964, 22.79%). Multivariate analysis indicated that several factors, including VIS >15.04 (p = 0.001), NEE >0.10 (p < 0.001), heart rate (p = 0.045), mean arterial pressure (p = 0.009), respiratory rate (p < 0.001), oxygen saturation (p < 0.001), blood urea nitrogen (BUN) (p = 0.001), and the Acute Physiology and Chronic Health Evaluation II (p < 0.001), were significantly associated with 28-day mortality in the patients with sepsis. The NEE score, respiratory rate, oxygen saturation, and BUN were incorporated into the nomogram model with a concordance index of 0.779 and an area under the curve of 0.802 (95% CI 0.787-0.818). Conclusion: We found that the VIS and NEE score had favorable values for predicting mortality risk in patients with sepsis in the intensive care units. The VIS and NEE score in the second hour after sepsis onset were independently associated with 28-day mortality in patients with sepsis.

The therapeutic effect of levosimendan in patients with prolonged ventilator weaning and cardiac dysfunction.

OBJECTIVE: To explore the therapeutic effect of levosimendan in patients with prolonged ventilator weaning and cardiac dysfunction. METHOD: Patients with prolonged ventilator weaning and cardiac dysfunction were randomly allocated to receive conventional treatment (control group) or intravenous infusion of levosimendan for 24 h based on conventional treatment (levosimendan group). Weaning success rates were then compared between the two groups. The study was retrospectively registered with Research Registry (ID No. researchregistry10304). RESULTS: A total of 40 patients were included (20 per group). Within 3 days after initiation of treatment, significantly more cases were successfully weaned in the levosimendan group versus control group (eight versus four cases, respectively). Among the eight patients who underwent pulse indicator continuous cardiac output monitoring in the levosimendan group, the global ejection fraction increased 24 h after treatment, and the cardiac function index and cardiac index increased 72 h after treatment. CONCLUSION: For patients requiring prolonged mechanical ventilation who have concomitant cardiac dysfunction, levosimendan may be considered to increase the probability of weaning success.

Efficacy and safety of 3 mg pegylated recombinant human granulocyte colony-stimulating factor as support to chemotherapy for lung cancer.

BACKGROUND: NCCN guidelines recommend a dose of 100 µg/kg or a fixed dose of 6 mg pegylated recombinant human granulocyte colony-stimulating factor (PEG rhG-CSF) for chemotherapy-induced neutropenia. However, a single dose of 60 µg/kg or 100 µg/kg produced a similar neutrophil response among patients with chemotherapy-induced neutropenia (CIN). Thus, this prospective randomized study was designed to investigate the efficacy of 3 mg PEG rhG-CSF in preventing acute lower respiratory tract infection (ALRTI) after chemotherapy. METHODS: Patients with stage IIIB/IVA lung cancer who underwent chemotherapy were randomly divided into a (i) control group, and (ii) treatment group subject to 3 mg PEG rhG-CSF after chemotherapy. Patients in the control group were administered rhG-CSF (5 µg/kg) when decreased absolute neutrophil count (ANC) reached grade 3 of adverse events. The primary outcome was incidence of ALRTI, and the secondary outcomes included ANC, febrile neutropenia (FN), incidence of delayed chemotherapy, infection-related medical expenses and adverse reactions. RESULTS: Compared with the control group, there was a significant decrease in the incidence of ALRTI (9.6% vs. 24.6%, p < 0.01), FN (1.7% vs. 7.3%, p < 0.001) and neutropenia (8.3% vs. 23.3%, p < 0.01) in the PEG-rhG-CSF group. The incidence of ALRTI was significantly correlated with the grade of CTCAE on ANC. The main adverse reactions of PEG-rhG-CSF were pain and fatigue, among which three cases showed pain of ≥ grade 3. The cost of infection-associated medical expenditure in the treatment group was greatly reduced compared with the control group (p < 0.001). CONCLUSIONS: ALRTI could well be prevented after prophylactic application of PEG-rhG-CSF (3 mg), and was related to the reduced neutropenia.

Design of a self-centring drill bit for orthopaedic surgery: A systematic comparison of the drilling performance.

Bone drilling is an indispensable and demanding operation among many orthopaedic operations. A dedicated drill bit that can achieve low-trauma and self-centring drilling is in urgent need. In this study, a three-step orthopaedic low-traumatic drill bit design was proposed. In order to evaluate the drilling performance of the proposed drill, comprehensive comparison tests were carried out with various commercial medical drills in terms of skiving force, thrust force, temperature rise, and surface quality. The experimental results show that the proposed three-step drill design with the optimal point angle, a small chisel edge, transition arc and web thinning can obtain lower and more stable thrust force, slighter bending force, smaller temperature rise, and higher hole quality compared with the commercial drill bits. The proposed drill shows satisfactory drilling performance and has great application potential in clinical surgery.

Intrapleural treatment in patients with non-small cell lung cancer with malignant pleural effusions in the real world.

BACKGROUND: The aim of the study was to assess the efficacy and side-effects of intrapleural treatment in non-small cell lung cancer (NSCLC) patients with malignant pleural effusions (MPEs). METHODS: The medical records of NSCLC patients with MPEs diagnosed in four Chinese hospitals from October 2014 to December 2019 were searched. The Kaplan-Meier method is used to calculate median overall survival (MOS) and subgroup analyses are done. RESULTS: A total of 285 patients were evaluated; 81.1% of patients received intrapleural treatment, and no patients received talc pleurodesis. MOS of the whole cohort was 21 months. Patients were divided into three groups: erythromycin group (EG; intrapleural treatment with drugs and erythromycin); intrathoracic treatment group (ITG; intrapleural treatment with drugs); control group (CG; no drug treatment in the pleural cavity). The MOS of patients in the EG, ITG and CG was 20, 22, and 19 months, respectively. Among patients who received only chemotherapy as systemic therapy, the MOS of intrathoracic administration group (IAG; i.e., EG and ITG) was longer than that of CG (12 vs. 6 months; p = 0.034), and the MOS of patients with a ratio of carcinoembryonic antigen in pleural effusion (PE-CEA): CEA in blood (B-CEA) ≤1 is worse than that of patients with a ratio >1 (4 vs. 12 months, p = 0.021) and that of CG (4 vs. 6 months, p = 0.442). CONCLUSIONS: Intrapleural treatment can prolong the survival of NSCLC patients with MPE who do not receive targeted treatment or who only receive chemotherapy. The PE-CEA: B-CEA ratio can be used to predict the efficacy if intrapleural treatment is indicated.

[Effect of terlipressin on prognosis of adult septic shock patients: a Meta-analysis].

OBJECTIVE: To investigate the effect of terlipressin on prognosis of adult septic shock patients. METHODS: All randomized controlled clinical trials (RCT) of terlipressin in the treatment of adult septic shock patients from January 1980 to December 2019 were retrieved from CNKI, Wanfang, SinoMed, PubMed, Embase, Springer Link, Cochrane Library, Google Scholar, and etc. Patients in the treatment group received terlipressin while patients in the control group received norepinephrine or other vasopressors. Main outcome indicator was mortality. Secondary outcome indicators included the incidence of severe adverse events, limb peripheral ischemic events and renal complications. Literature screening, data extraction and quality evaluation were conducted by two researchers respectively. Meta-analysis was performed with RevMan 5.3 software. Funnel plot was used to analyze the publication bias. RESULTS: A total of 507 related literatures were retrieved. According to the inclusion and exclusion criteria, 8 RCT studies were finally included, with a total of 811 patients. One study was considered to have a lower risk of bias, 6 studies had uncertain risk of bias, and 1 study had a higher risk of bias. The Meta-analysis showed that terlipressin did not significantly improve the mortality of septic shock patients compared with the control group [odds ratio (OR) = 0.89, 95% confidence interval (95%CI) was 0.67-1.19, P = 0.45]; increased the incidence of severe adverse events (OR = 2.98, 95%CI was 1.99-4.45, P < 0.000 01); there was a tendency to increase the incidence of limb peripheral ischemic events, but without statistical difference (OR = 10.81, 95%CI was 0.88-133.19, P = 0.06); and reduced the incidence of renal complications (OR = 0.30, 95%CI was 0.09-0.96, P = 0.04). Funnel plot analysis indicated that there might be publication bias in a study on case fatality and incidence of serious adverse events in the included literature. No significant publication bias was found in studies on the incidence of limb peripheral ischemic events and the incidence of kidney-related complications. CONCLUSIONS: The available evidence suggests that terlipressin could not significantly improve mortality in adult's septic shock patients, but it may reduce the incidence of renal complications. A tendency to increase the incidence of limb peripheral ischemic events in the terlipressin-treated group needs to be emphasized.

[Analgesia in intensive care unit: something truly counts].

OBJECTIVE: Critical patients in the intensive care unit (ICU) are often accompanied with acute pain, which may lead to a series of physiological responses that affect the prognosis of patients. With the continuous advancement of modern medicine, the pain management strategies and analgesics have also greatly developed, and the concept has been continuously updated. In the individualized diagnosis and treatment mode, the pain management is an indispensable component of ICU comprehensive treatment. Multimodal analgesia (MMA) strategies have also shown to be effective in optimizing analgesia in critical patients. However, there are still many shortcomings and differences in pain evaluation and its management. The characteristics and methodologies of related analgesics need to be further summarized and discussed. The current literature about the evaluation of pain, pharmacology and non-pharmacological techniques were reviewed to provide references for the scientific and reasonable implementation of analgesia treatment in ICU.

miR-155 Regulates claudin1 Expression in Humans With Intestinal Mucosa Dysfunction After Brain Injury.

Patients with craniocerebral trauma often have intestinal mucosal dysfunction, and the claudin1 protein plays an important role in intestinal mucosal function. Our previous work has shown that the expression of microRNA-155 (miR-155) in the peripheral blood of patients with craniocerebral trauma is decreased. Animal experiments also suggest that the expression of miR-155 is increased in the intestinal mucosa of mice with brain injury and the expression of claudin1 is decreased. We recruited 56 samples (35 patients with traumatic brain injury [TBI] and 21 patients without history of head trauma) to detect the expression of miR-155 on claudin1 regulation by quantitative polymerase chain reaction, reverse transcriptase polymerase chain reaction, and so on. We also used the receiver operating characteristic curve (ROC) to further evaluate the diagnostic value of the 2 biomarkers. From the results, we found that the expression level of miR-155 and claudin1 in the case group was lower than that in the control group. Human miR-155 (Hsa-miR-155) may positively regulate intestinal mucosal function by inhibiting the expression of claudin1, leading to intestinal mucosal barrier dysfunction. Combining the ROC curve data, the results further prove that miR-155 and claudin1 might be the new clinical diagnostic markers and treatment targets for the intestinal mucosal barrier dysfunction after TBI.

2D Electron Gas and Oxygen Vacancy Induced High Oxygen Evolution Performances for Advanced Co3 O4 /CeO2 Nanohybrids.

The rational design of atomic-scale interfaces in multiphase nanohybrids is an alluring and challenging approach to develop advanced electrocatalysts. Herein, through the selection of two different metal oxides with particular intrinsic features, advanced Co3 O4 /CeO2 nanohybrids (NHs) with CeO2 nanocubes anchored on Co3 O4 nanosheets are developed, which show not only high oxygen vacancy concentration but also remarkable 2D electron gas (2DEG) behavior with ≈0.79 ± 0.1 excess e- /u.c. on the Ce3+ sites at the Co3 O4 -CeO2 interface. Such a 2DEG transport channel leads to a high carrier density of 3.8 × 1014 cm-2 and good conductivity. Consequently, the Co3 O4 /CeO2 NHs demonstrate dramatically enhanced oxygen evolution reaction (OER) performances with a low overpotential of 270 mV at 10 mA cm-2 and a high turnover frequency of 0.25 s-1 when compared to those of pure Co3 O4 and CeO2 counterparts, outperforming commercial IrO2 and some recently reported representative OER catalysts. These results demonstrate the validity of tailoring the electrocatalytic properties of metal oxides by 2DEG engineering, offering a step forward in the design of advanced hybrid nanostructures.

[Effect of high-flow nasal cannula oxygen therapy on improving the atelectasis in adults after cardiac surgeries: a Meta-analysis].

OBJECTIVE: To systematically evaluate the effect of high-flow nasal cannula oxygen (HFNC) on improving the atelectasis and respiratory function in adults after cardiac surgeries. METHODS: All randomized controlled trials (RCTs) about HFNC therapy for adults after cardiac surgeries published from January 2000 to March 2018 were searched through CNKI, CBM, VIP, Wanfang, PubMed, Springer Link, Embase, Web of Science, Cochrane Library. The references from relevant articles were searched. The experimental group was treated with HFNC while the control group treated with conventional oxygen therapy (COT). The outcome measurements included radiological atelectasis score (RAS), endotracheal reintubation rate and the length of intensive care unit (ICU) stay. Two researchers were responsible for literature screening, data extraction and quality evaluation respectively. Meta-analysis was performed with RevMan 5.2 software. Funnel plot was used to analyze the publication bias. RESULTS: A total of 4 RCTs were enrolled and 643 patients were included (325 in experimental group and 318 in control group). Meta-analysis showed that the tracheal reintubation rate in experimental group was lower than that in control group [odds ratio (OR) = 0.26, 95% confidence interval (95%CI) = 0.09-0.74, P = 0.01], but there was no significant difference in RAS [mean difference (MD) = -0.15, 95%CI = -0.50-0.21, P = 0.41] and the length of ICU stay (MD = 0.09, 95%CI = -0.09-0.26, P = 0.33) between experimental group and control group. Sensitivity analysis was performed in two trials with low risk of bias, which demonstrated that there was no significant difference in RAS between the two groups (MD = 0.06, 95%CI = -0.26-0.37, P = 0.73). It was shown by the funnel analysis that there was bias in the study of the length of ICU stay in the literature, while the bias of RAS and tracheal reintubation rate was low. CONCLUSIONS: Compared with COT, HFNC could reduce the rate of tracheal reintubation in adults after cardiac surgeries, but no difference was found in improving atelectasis or reducing the length of ICU stay.

Engineering the carrier dynamics of g-C3N4 by rolling up planar sheets into nanotubes via ultrasonic cavitation.

Rolling up 2D atomic layered materials into 1D nanotubes gives rise to fascinating properties due to their lower dimension, higher anisotropy, and strain effects. In this work, the curving of 2D graphitic C3N4 (g-C3N4) sheets into 1D nanotubes is demonstrated for the first time through simple and clean ultrasonic treatments. The steady-state optical transitions are slightly enhanced while the localized trapping of excited carriers is considerably suppressed after rolling up the planar sheets into nanotubes. The mechanical method to modulate the dimension scarcely changes the chemical structures, enabling the pure investigation on shape-induced physical effects. As a proof of principle, this work confirms the dynamics of excited carriers, and the photoelectronic properties of 2D semiconductors can be significantly engineered by a simple morphological evolution.

[Methylene blue in the treatment of vasodilatory shock: a Meta-analysis].

OBJECTIVE: To investigate the clinical efficacy of methylene blue in the treatment of refractory hypotension caused by vascular paralysis during the course of vasodilatory shock. METHODS: The related articles were searched by retrieving the terms using methylene blue, vascular paralysis, hemodynamics, hypotension, vasodilatory shock in CNKI, China Biomedical Literature database, Wanfang database, PubMed, Springer Link, and BIOSIS Previews database. The retrieval time was from January 1994 to June 2017. The randomized clinical trials (RCTs) which using methylene blue as the experimental group, normal saline or catecholamine as the control in the treatment of refractory hypotension caused by vascular paralysis during the course of vasodilatory shock were collected. The primary end points were mean arterial pressure (MAP) immediately or 1 hour after the methylene blue administration, and the mortality at the longest follow-up available; the secondary end point was serum lactic acid (Lac) 1 hour after the methylene blue administration. Literature screening, data extraction and quality evaluation were carried out by two researchers. Meta analysis was performed using RevMan 5.3 software. The sensitivity analysis was performed in two trials with low risk of bias. The funnel plot for MAP was performed in five relative trials to analyze the research and publication bias. RESULTS: Totally 269 relative articles were collected, according to the inclusion and exclusion criteria, finally 6 RCTs with 214 patients were enrolled, 108 in methylene blue group, and 106 in control group. Four of the studies were considered to have mild to moderate risk of bias, two studies of high risk of bias. The Meta-analysis demonstrated that compared with the control group, methylene blue could significantly improve MAP [mean difference (MD) = 4.87, 95% confidence interval (95%CI) = 2.61 to 7.13, P < 0.000 1], reduce the serum Lac levels (MD = -1.06, 95%CI = -1.98 to -0.14, P = 0.02), and the mortality was decreased without statistical difference [odds ratio (OR) = 0.58, 95%CI = 0.25 to 1.31, P = 0.19]. Sensitivity analysis was performed in two trials with low risk of bias, which demonstrated methylene blue could exactly increase MAP (MD = 8.93, 95%CI = 1.55 to 16.32, P = 0.02). Funnel plot for MAP was performed in five relative trials which found no obvious publication bias. CONCLUSIONS: Methylene blue could significantly increase MAP in the patients with refractory hypotension caused by vascular paralysis during the course of vasodilatory shock, decrease the Lac levels, and does not increase the risk of death. Therefore, methylene blue should be a potential and safe vasoconstrictor.