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The soluble fraction of atmospheric transition metals is particularly associated with health effects such as reactive oxygen species compared to total metals. However, direct measurements of the soluble fraction are restricted to sampling and detection units in sequence burdened with a compromise between time resolution and system bulkiness. Here, we propose the concept of aerosol-into-liquid capture and detection, which allowed one-step particle capture and detection via the Janus-membrane electrode at the gas-liquid interface, enabling active enrichment and enhanced mass transport of metal ions. The integrated aerodynamic/electrochemical system was capable of capturing airborne particles with a cutoff size down to 50 nm and detecting Pb(II) with a limit of detection of 95.7 ng. The proposed concept can pave the way for cost-effective and miniaturized systems, for the capture and detection of airborne soluble metals in air quality monitoring, especially for abrupt air pollution events with high airborne metal concentrations (e.g., wildfires and fireworks).
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Steel fiber textile, which is composed of steel fibers and glass fibers, has a support layer impregnated with hot melt adhesive (HMA). During long-term service, the bonding force between the steel fiber/HMA system interfaces is poor. In order to improve the bond strength and durability of the interface, this paper introduced sandblasting, acid-etching, and phosphating treatments on the surface of the steel fibers. Also, the effects of these three pretreatment methods on the bond strength of the steel fiber/HMA interface were investigated. The results indicate that the interfacial bond strength of composites made from steel fibers is improved via surface treatment. Under a hydrothermal and simulated concrete pore solution environment, the durability of the steel fiber/HMA interface after sandblasting and acid-etching pretreatment is not as good as that after phosphating pretreatment. The mechanical properties of the phosphating/HMA composite were maintained at 4.56 and 2.24 times compared to those of the untreated/HMA composite, respectively. This is because the pinning effect formed by the phosphating film on the surface of steel fibers at the interface of steel fiber/HMA can serve as a physical barrier against corrosion, preventing the invasion of chloride ions and water vapor and improving the durability of the interface.
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Human-infecting pathogens that transmit through the air pose a significant threat to public health. As a prominent instance, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that caused the COVID-19 pandemic has affected the world in an unprecedented manner over the past few years. Despite the dissipating pandemic gloom, the lessons we have learned in dealing with pathogen-laden aerosols should be thoroughly reviewed because the airborne transmission risk may have been grossly underestimated. From a bioanalytical chemistry perspective, on-site airborne pathogen detection can be an effective non-pharmaceutic intervention (NPI) strategy, with on-site airborne pathogen detection and early-stage infection risk evaluation reducing the spread of disease and enabling life-saving decisions to be made. In light of this, we summarize the recent advances in highly efficient pathogen-laden aerosol sampling approaches, bioanalytical sensing technologies, and the prospects for airborne pathogen exposure measurement and evidence-based transmission interventions. We also discuss open challenges facing general bioaerosols detection, such as handling complex aerosol samples, improving sensitivity for airborne pathogen quantification, and establishing a risk assessment system with high spatiotemporal resolution for mitigating airborne transmission risks. This review provides a multidisciplinary outlook for future opportunities to improve the on-site airborne pathogen detection techniques, thereby enhancing the preparedness for more on-site bioaerosols measurement scenarios, such as monitoring high-risk pathogens on airplanes, weaponized pathogen aerosols, influenza variants at the workplace, and pollutant correlated with sick building syndromes.
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COVID-19 , Pandemias , Humanos , Pandemias/prevenção & controle , Aerossóis e Gotículas Respiratórios , COVID-19/diagnóstico , COVID-19/prevenção & controle , SARS-CoV-2RESUMO
A consensus has not been reached on the association of metabolic syndrome (MetS) with adverse outcomes in patients with stable coronary artery disease (CAD). The purpose of this systematic review and meta-analysis was to summarize the prognostic implication of MetS in patients with stable CAD. We comprehensively searched articles indexing in PubMed and Embase databases until August 14, 2022. Original studies investigating the association of MetS with adverse outcomes in patients with stable CAD were included. Seven studies including 32 736 patients with stable CAD were identified. Depending on the definition of MetS, the reported prevalence of MetS ranged from 23.4% to 63%. Meta-analysis showed that patients with MetS conferred an increased risk of all-cause mortality [risk ratio (RR) 1.22; 95% confidence intervals (CI) 1.15-1.19], cardiovascular mortality (RR 1.49; 95% CI 1.16-1.92), and MACEs defined by death, myocardial infarction, revascularization, cardiac arrest, or angina admission (RR 1.47; 95% CI 1.20-1.79), respectively. Leave-one-out sensitivity analysis indicated the robustness of the value of MetS in prediction of all-cause mortality. MetS may be an independently predictor of adverse outcomes in patients with stable CAD. However, future studies are required to consolidate the current evidence due to the small number of studies included.
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Doença da Artéria Coronariana , Síndrome Metabólica , Infarto do Miocárdio , Humanos , Doença da Artéria Coronariana/complicações , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Fatores de Risco , PrognósticoRESUMO
Ambient air pollution of fine particulate matter with diameters less than 2.5 µm (PM2.5) is associated with millions of premature deaths per year, recognized as a leading global health concern. The dose-response relation between ambient PM2.5 exposure and mortality risk is the most fundamental information for assessments of the health effects of PM2.5. The existing dose-response relations were generally developed based on the assumption of equal contribution to toxicity from various sources. However, the sources of PM2.5 may significantly influence health effects. In this study, we conducted an ecological study to investigate the global long-term correlation between source-specific PM2.5 exposure and cause-specific mortality risk (SPECM) based on the regional aggregate data of the publically available official health databases from 528 regions worldwide with a total registered population of 3.2 billion. The results provided preliminary epidemiological evidence for differing chronic health effects across various sources. The relative mortality risks of lung cancer and circulatory diseases were closely correlated with the primary emissions from industrial and residential combustion sources. Chronic lower respiratory diseases were mostly associated with the mass concentration of particulate matter.
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Poluentes Atmosféricos , Poluição do Ar , Material Particulado/análise , Poluentes Atmosféricos/análise , Saúde Global , Poluição do Ar/análise , Bases de Dados Factuais , Exposição AmbientalRESUMO
BACKGROUND: Herein, we aimed to analyse the effects of body mass index (BMI) on the treatment outcomes of in vitro fertilisation (IVF) in a cohort of women undergoing their first IVF cycle. METHODS: A total of 2311 cycles from 986 women undergoing their first IVF/intracytoplasmic sperm injection cycle with fresh/frozen embryo transfer between January 2018 and December 2021 at the Center of Reproductive Medicine, Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine, were considered in this retrospective cohort study. First, the included patients were classified into four groups based on their BMI: underweight (BMI < 18.5 kg/m2, 78 patients), normal weight (18.5 ≤ BMI < 24 kg/m2, 721patients), overweight (24 ≤ BMI < 28 kg/m2, 147 patients), and obese (BMI ≥ 28 kg/m2, 40 patients). The IVF outcomes included the Gn medication days; Gn dosage; number of retrieved oocytes, mature oocytes, fertilized oocytes, cleavages, and available embryos and high-quality embryos; implantation rate; clinical pregnancy rate and live birth rate. Next, all the obtained data were segregated into three different subgroups according to the patient age: < 30 years, 30-38 years and > 38 years; the IVF pregnancy outcomes were compared among the groups. RESULTS: Compared with the other three groups, the underweight group had a higher number of fertilized oocytes, cleavage and available embryos and a smaller Gn medication days and required a lower Gn dosage. There was no difference in the number of retrieved oocytes and mature oocytes among the groups. Moreover, compared with the women aged 30-38 years in the overweight group, those in the normal weight group had a significantly higher implantation rate, clinical pregnancy rate and live birth rate (p = 0.013 OR 1.75, p = 0.033 OR 1.735, p = 0.020 OR 1.252 respectively). The clinical pregnancy rate was also significantly higher in those aged 30-38 years in the normal weight group than in the obese group (p = 0.036 OR 4.236). CONCLUSIONS: Although the BMI can greatly affect the pregnancy outcomes of women aged 30-38 years, it has almost no effects on the outcomes of younger or older women.
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Sobrepeso , Magreza , Masculino , Gravidez , Feminino , Humanos , Índice de Massa Corporal , Estudos Retrospectivos , Sobrepeso/complicações , Magreza/complicações , Magreza/epidemiologia , Indução da Ovulação , Sêmen , China/epidemiologia , Fertilização in vitro , Taxa de Gravidez , Obesidade/complicaçõesRESUMO
Objective: This study aims to investigate the clinical efficacy of stereotactic puncture for intracerebral hematoma removal, combined with postoperative individualized health education and rehabilitation training concerning hypertensive cerebral hemorrhage. We also assessed its impact on rebleeding prevention and neurological function recovery. Methods: A retrospective study was conducted, including 90 patients diagnosed with hypertensive cerebral hemorrhage in our hospital between March 2020 and June 2022. The inclusion criteria were patients with an episcleral hematoma volume exceeding 30 ml. The control group underwent minimally invasive removal using neuroendoscopy (45 patients), while the observation group received stereotactic puncture for intracerebral hematoma removal (45 patients). After surgery, both groups received individualized health education and rehabilitation training. The assessment included: (1) determination of clinical efficacy, (2) monitoring for rebleeding within 72 hours after surgery, (3) evaluation of daily living ability using the Barthel index, (4) assessment of motor function using the Fugl-Meyer Assessment (FMA) scale, and (5) monitoring for adverse reactions. Results: The observation group, which underwent stereotactic puncture for intracerebral hematoma removal combined with postoperative individualized health education and rehabilitation training, exhibited significantly better clinical efficacy, Barthel index scores, and FMA scores compared to the control group that underwent neuroendoscopic minimally invasive removal (P < .05). Notably, no complications were observed in either group, and there was no significant difference in the postoperative bleeding rate within 72 hours. Conclusions: The combined treatment approach of stereotactic puncture for intracerebral hematoma removal and postoperative individualized health education and rehabilitation training demonstrates promising therapeutic effects in managing hypertensive cerebral hemorrhage. This approach also contributes significantly to the rehabilitation of patients with hypertensive cerebral hemorrhage, warranting widespread clinical adoption.
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Economic growth and globalization have led to a surge in civil aviation transportation demand. Among the major economies in the world, China has experienced a 12-fold increase in terms of total passenger aviation traffic volume since 2000 and is expected to be the largest aviation market soon. To better understand the environmental impacts of China's aviation sector, this study developed a real-world flight trajectory-based emission inventory, which enabled the fine-grained characterization of four-dimensional (time, longitude, latitude, and altitude) emissions of various flight stages. Our results indicated that fuel consumption and CO2 emissions showed two peaks in altitude distribution: below 1,000 m and between 8,000 and 12,000 m. Various pollutants depicted different vertical distributions; for example, nitrogen oxides (NOX) had a higher fraction during the high-altitude cruise stage due to the thermal NOX mechanism, while hydrocarbons had a dominant fraction at the low-altitude stages due to the incomplete combustion under low-load conditions. This improved aviation emission inventory approach identified that total emissions of CO2 and air pollutants from short-distance domestic flights would be significantly underestimated by the conventional great-circle-based approach due to underrepresented calculation parameters (particularly, flight distance, duration, and cruise altitude). Therefore, we suggest that more real-world aviation flight information, especially actual trajectory records, should be utilized to improve assessments of the environmental impacts of aviation.
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Poluentes Atmosféricos , Aviação , Poluentes Atmosféricos/análise , Dióxido de Carbono , Desenvolvimento Econômico , Óxidos de Nitrogênio/análiseRESUMO
BACKGROUND: Subspine impingement (SSI) does not have effective diagnostic criteria, especially in patients who also have femoroacetabular impingement (FAI). The classification of anterior inferior iliac spine (AIIS) morphology via three-dimensional CT is controversial. PURPOSE: To propose a method for ultrasound-guided AIIS injection as a way to diagnose SSI and evaluate the accuracy of radiography methods, including 3-D CT and MRI, as well as intraoperative findings. METHODS: Patients diagnosed with FAI between September 2020 and December 2021 were evaluated in this prospective study. Those who met the criteria were included in the ultrasound-guided AIIS injection test. Whether the pain was relieved after injection was recorded in the radiology report. Patients who experienced significant relief of the anterior groin pain (more than 50%) after the AIIS injection were considered positive responders. Among these patients, radiography materials, including AIIS morphology as measured by 3-D CT as well as superior capsular oedema on MRI, were compared. The presence of congestion or bruising on the capsule side of the labrum corresponding to the AIIS during hip arthroscopy was recorded. RESULTS: A total of 73 patients with FAI underwent the ultrasound-guided AIIS injection test. Prevalence rates of 13.70% (10/73), 58.90% (43/73), 23.29% (17/73) and 4.11% (3/73) were recorded for Type I, Type IIA, Type IIB and Type III AIISs, respectively. Thirty-six patients had positive responses to injection, and 37 patients had negative responses to injection. None of the patients with Type I, 23 (53.49%) patients with Type IIA, 11 (64.71%) patients with Type IIB and 2 (66.7%) patients with Type III AIISs had positive responses to the injection. A total of 57.14% of patients with Type II or Type III AIIS had positive responses to the injection. The proportions of patients with superior capsular oedema on MRI in the Type I, Type IIA, Type IIB, and Type III AIIS groups was 0, 30.23, 29.41 and 0%, respectively. Among non-Type I AIIS patients, those who reported positive responses to the injection had a higher incidence of superior capsular oedema (38.89% vs. 14.81%, P = 0.036), but they had no significant differences in the proportion of congestion or bruising of the labrum (47.22% vs. 37.04%, P = 0.419). The results showed that no pairs of methods-ultrasound-guided injection, MRI, and intraoperative findings-achieved good consistency (κ = 0.222, κ = 0.098 and κ = - 0.116). CONCLUSIONS: Radiographic methods including 3-D CT and MRI as well as the intraoperative findings of the labrum cannot be considered an accurate and reliable basis for the diagnosis and treatment of SSI in FAI patients. It is suggested that ultrasound-guided AIIS injections be combined with radiography to better diagnose SSI. LEVEL OF EVIDENCE: IV, case series.
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Impacto Femoroacetabular , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Impacto Femoroacetabular/cirurgia , Radiografia , Artroscopia/métodos , Dor , Articulação do Quadril/cirurgiaRESUMO
Soil heavy metal pollution is widespread around the world. Compared with hyperaccumulation plants, non-hyperaccumulator plant communities have many advantages in the remediation of heavy metals pollution in soil. The application of nitrogen (N) and phosphorus (P) is inexpensive and convenient, which can promote the growth of plant. N and P fertilizer might increase plant community remediation of heavy metal polluted soils. In our study, the effects of N and P fertilizer on remediation of soil Cd, Cu, Pb pollution by plant community were studied through a greenhouse experiment. Our results indicated that addition of N, P and N + P fertilizer increased plant community aboveground biomass. Simultaneously, addition of N and P fertilizer increased the accumulation of heavy metals in aboveground of the plant community and accelerated plants absorption soil heavy metals. Among them, N fertilizer had the best effect. Our results provide an inexpensive method for remediation heavy metal pollution of contaminated farmland, abandoned land and mine tailings, etc.
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Metais Pesados , Poluentes do Solo , Poluentes do Solo/análise , Fertilizantes , Fósforo/farmacologia , Nitrogênio/farmacologia , Biodegradação Ambiental , Metais Pesados/análise , Solo , PlantasRESUMO
BACKGROUND: A comprehensive understanding of the transmission routes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of great importance to effectively control the spread of coronavirus disease 2019 (COVID-19). However, the fundamental dose-response relation is missing for evaluation of the infection risk. METHODS: We developed a simple framework to integrate the a priori dose-response relation for SARS-CoV-2 based on mice experiments, the recent data on infection risk from a meta-analysis, and respiratory virus shedding in exhaled breath to shed light on the dose-response relation for humans. The aerosol transmission infection risk was evaluated based on the dose-response model for a typical indoor environment. RESULTS: The developed dose-response relation is an exponential function with a constant k in the range of about 6.4 × 104 to 9.8 × 105 virus copies, which means that the infection risk caused by 1 virus copy in viral shedding is on the order of 10-6 to 10-5. The median infection risk via aerosol transmission with 1-hour exposure (10-6 to 10-4) was significantly lower than the risk caused by close contact (10-1) in a room with an area of 10 to 400 m2 with 1 infected individual in it and with a typical ventilation rate of 1 air change per hour. CONCLUSIONS: The infection risk caused by aerosol transmission was significantly lower than the risk caused by close contact. It is still necessary to be cautious for the potential aerosol transmission risk in small rooms with prolonged exposure duration.
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COVID-19 , Coronavírus da Síndrome Respiratória do Oriente Médio , Aerossóis , Animais , Humanos , Camundongos , Medição de Risco , SARS-CoV-2RESUMO
BACKGROUND: Diminished ovarian reserve (DOR) refers to a decrease in the number and quality of oocytes in the ovary, which results in a lack of sex hormones and a decline of fertility in women. DOR can potentially progress to premature ovarian failure (POF), which has a negative impact on women's quality of life and is a major cause of female infertility. Oxidative stress is a major contributor to fertility decrease in DOR patients, affecting the follicular microenvironment, oocyte maturation, fertilization, and embryo development. Understanding intracellular signal transduction can be achieved by defining specific oxidized lipid components in follicular fluid (FF) of DOR infertile patients. METHODS: The oxylipins metabolic signatures in the FF of DOR patients and females with normal ovarian reserve (NOR) enrolled for the in vitro fertilization (IVF) cycle were analyzed using UHPLC-MS-MS technology. Principal component analysis (PCA) and orthogonal projections to latent structure discriminant analysis (OPLS-DA) were used to analyze the derived metabolomic profiles. Pathway enrichment analysis was carried out using the Kyoto Encyclopedia of Genes and Genomes (KEGG) and MetaboAnalyst databases. Furthermore, the Spearman rank correlation coefficient was used to determine the correlation between age, FSH, AMH, AFC, oocytes retrieved, MII oocytes, fertilization, high-quality embryos, and the concentration of differential oxidized lipid metabolites in FF. RESULTS: Fifteen oxylipins metabolites were found to be lower in the FF of DOR patients than those in the NOR group, including ±20-HDoHE, ±5-iso PGF2α-VI, 12S-HHTrE, 15-deoxy-Δ12,14-PGJ2, 1a,1b-dihomo PGE2, 1a,1b-dihomo PGF2α, 20-COOH-AA, 20-HETE, 8S,15S-DiHETE, PGA2, PGD2, PGE1, PGF1α, PGF2α, and PGJ2. The pathway enrichment analysis revealed that the 15 differentially oxidized lipid metabolites were closely related to the arachidonic acid metabolic pathway. Correlation analysis revealed that the concentration of 8 different oxidized lipid metabolites in FF was negatively correlated to FSH and positively correlated with AFC. AMH, the number of oocytes retrieved, MII oocytes and fertilization, were all positively correlated with 9 different oxidized lipid metabolites, but only one metabolite was positively correlated with the number of high-quality embryos. CONCLUSIONS: Metabolomic analysis of FF revealed that oxylipins metabolism disorders were closely related to ovarian reserve function. Among these oxylipins metabolites, arachidonic acid metabolism undergoes significant changes that may be related to oocyte development, resulting in decreased fertility in DOR patients. TRIAL REGISTRATION: ChiCTR, ChiCTR2000038182 , Registered 12 September 2020-Retrospectively registered.
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Líquido Folicular/metabolismo , Infertilidade Feminina/metabolismo , Doenças Ovarianas/metabolismo , Reserva Ovariana/fisiologia , Oxilipinas/metabolismo , Adulto , Estudos de Casos e Controles , Cromatografia Líquida de Alta Pressão , Feminino , Líquido Folicular/química , Humanos , Infertilidade Feminina/etiologia , Infertilidade Feminina/patologia , Metaboloma/fisiologia , Metabolômica , Doenças Ovarianas/complicações , Doenças Ovarianas/patologia , Oxilipinas/análise , Gravidez , Espectrometria de Massas em Tandem , Adulto JovemRESUMO
The Corona Virus Disease 2019 (COVID-19) is rapidly spreading throughout the world. Aerosol is a potential transmission route. We conducted the quantitative microbial risk assessment (QMRA) to evaluate the aerosol transmission risk by using the South China Seafood Market as an example. The key processes were integrated, including viral shedding, dispersion, deposition in air, biologic decay, lung deposition, and the infection risk based on the dose-response model. The available hospital bed for COVID-19 treatment per capita (1.17 × 10-3) in Wuhan was adopted as a reference for manageable risk. The median risk of a customer to acquire SARS-CoV-2 infection via the aerosol route after 1 h of exposure in the market with one infected shopkeeper was about 2.23 × 10-5 (95% confidence interval: 1.90 × 10-6 to 2.34 × 10-4). The upper bound could increase and become close to the manageable risk with multiple infected shopkeepers. More detailed risk assessment should be conducted in poorly ventilated markets with multiple infected cases. The uncertainties were mainly due to the limited information on the dose-response relation and the viral shedding which need further studies. The risk rapidly decreased outside the market due to the dilution by ambient air and became below 10-6 at 5 m away from the exit.
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Tratamento Farmacológico da COVID-19 , Aerossóis , China/epidemiologia , Humanos , Medição de Risco , SARS-CoV-2 , Alimentos MarinhosRESUMO
In addition to the much-publicized environmental impact of CO2 emission by air traffic, aviation particulate emission also deserves attention. The abundant ultrafine particles in the aviation exhaust with diameters less than 100 nm may penetrate deep into the human respiratory system and cause adverse health effects. Here, we quantified the detailed aviation particle number emission from Zurich Airport and evaluated its influences on the annual mean particle number concentrations in the surrounding communities. The actual flight trajectory data were utilized for the first time to develop an emission inventory with high spatial resolution. The estimated total particle number emission was in the magnitude of 1024 particles per year. The annual mean particle mass concentrations in the nearby communities were increased by about 0.1 µg m-3 due to the aviation emission, equivalent to about 1% of the background concentration. However, the particle number concentration could be increased by a factor of 2-10 of the background level (104 cm-3) for nearby communities. Further studies are required to investigate the health effects of the increased particle number concentration and to evaluate whether the regulation based on the mass concentration is still sufficient for the air quality near airports.
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Poluentes Atmosféricos , Aviação , Poluentes Atmosféricos/análise , Aeroportos , Monitoramento Ambiental , Humanos , Tamanho da Partícula , Material Particulado/análise , Emissões de Veículos/análiseRESUMO
T cell immunoglobulin and ITIM domain (TIGIT) is a novel immune checkpoint receptor and plays critical roles in cancer immunity. Adult acute lymphoblastic leukemia (ALL) remains a treatment challenge despite years of research. In this study, we analyzed the status of TIGIT expression in circulating T cells from patients with adult ALL. Compared to the data in healthy controls, the expression of TIGIT in CD4+CD25- T cells and CD8+ T cells in adult ALL patients presented a small but significant upregulation. Stimulation via the CD3/CD28 route increased TIGIT mRNA expression at 24â¯h, which peaked at 48â¯h and was maintained at 72â¯h post-stimulation. The frequency of TIGIT+ cells, on the other hand, consistently increased over time. ALL protein lysate or Wilms' Tumor 1 peptide could significantly increase the expression of TIGIT in ALL, but not healthy control T cells. Compared to TIGIT- cells, the TIGIT+ cells presented significantly higher PD-1 and Tim-3 expression directly ex vivo, and significantly lower IL-2, IFN-γ, and TNF-α after CD3/CD28 stimulation. The high inhibitory molecule and low cytokine expression signature was especially pronounced in ALL TIGIT+ CD4+CD25- T cells and TIGIT+ CD8+ T cells. Blocking TIGIT alone could minimally increase cytokine expression independent of PD-1 and Tim-3 blocking, whereas blocking TIGIT, PD-1, and Tim-3 altogether was significantly more effective. Together, these data demonstrated that TIGIT regulated T cell function in adult ALL patients, and may serve as a treatment target for ALL.
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Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Receptores Imunológicos/metabolismo , Linfócitos T/imunologia , Linfócitos T/metabolismo , Adulto , Antígenos CD28/metabolismo , Complexo CD3/metabolismo , Linfócitos T CD4-Positivos/metabolismo , Citocinas/metabolismo , Feminino , Receptor Celular 2 do Vírus da Hepatite A/metabolismo , Humanos , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Masculino , Receptor de Morte Celular Programada 1/metabolismo , Regulação para CimaRESUMO
Wilsonian crisis (hemolytic crisis and acute liver failure [ALF] in Wilson's disease) is fatal and almost all patients ultimately need a timely liver transplantation to save their lives. How to safely pass the critical period to liver transplantation is still a big challenge to doctors especially to pediatricians facing more difficult situations in blood purification. Here, we report about a 7-year-old child (weight 21 kg) presenting with severe hemolysis and impending ALF that made a rapid recovery with prompt initiation of plasmapheresis combined with continuous plasma filtration adsorption (CPFA) and chelation therapy. Rapidly efficient removal of copper, bilirubin, and albumin-binding toxins by hybrid blood purification alleviated hemolysis and liver injury and successfully bridged the patient over the critical period to late liver transplantation. Moreover, a review of the literature was performed examining the use of plasmapheresis, molecular adsorbent recirculation system, single-pass albumin dialysis, and continuous veno-venous hemodiafiltration in Wilson disease. The experience of our case points to that plasmapheresis combined with CPFA treatment can improve clinical symptoms and bridge children over through Wilsonian crisis to late live transplantation, and CPFA treatment is feasible and safe in children weighing more than 20 kg.
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Hemofiltração , Degeneração Hepatolenticular/terapia , Falência Hepática Aguda/terapia , Transplante de Fígado , Plasmaferese , Cuidados Pré-Operatórios/métodos , Criança , Feminino , Degeneração Hepatolenticular/complicações , Humanos , Falência Hepática Aguda/etiologiaRESUMO
Multiple myeloma (MM) is an incurable cancer characterized by the development of malignant plasma cells. The CD8 T cell-mediated cytotoxicity is considered a major player in antitumor immunity, but in MM patients, the CD8 T cells displayed senescence markers and were functionally impaired. To investigate whether cytotoxic CD4 T cells could act as a treatment alternative in MM, we examined the frequency and function of naturally occurring cytotoxic CD4 T cells in MM patients. The cytotoxic CD4 T cells were identified as granzyme-A, granzyme B-, and perforin-expressing CD4 T cells, and their frequencies were significantly upregulated in MM patients when compared with healthy controls. The frequencies of cytotoxic CD4 T cells in MM patients were not associated with the frequencies of cytotoxic CD8 T cells, but were negatively associated with disease severity. Interestingly, the expression levels of inhibitory molecules, including PD-1 and CTLA-4, were significantly lower in cytotoxic CD4 T cells than in cytotoxic CD8 T cells. When co-incubated with autologous CD38+CD138+ plasma cells, CD4 T cells were capable of eliminating plasma cells with varying degrees of efficacy. In MM patients, the frequency of circulating plasma cells was negatively correlated with the frequency of cytotoxic CD4 T cells. Therefore, CD4 T cell-mediated cytotoxicity existed naturally in MM patients and could potentially act as an option in antitumor therapies.
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Linfócitos T CD4-Positivos/fisiologia , Citotoxicidade Imunológica/imunologia , Mieloma Múltiplo/imunologia , Idoso , Apoptose , Linfócitos T CD4-Positivos/imunologia , Antígeno CTLA-4/análise , Antígeno CTLA-4/imunologia , Proliferação de Células , China , Feminino , Granzimas , Humanos , Imunidade Celular , Masculino , Perforina , Receptor de Morte Celular Programada 1/análise , Receptor de Morte Celular Programada 1/imunologia , Linfócitos T Citotóxicos/imunologiaRESUMO
BACKGROUND: Platelet (PLT) storage at cold temperatures (4°C) can reduce bacterial contamination and lower the risk of transfusion-related complications. We compared the effects of 22 and 4°C storage conditions for PLTs to further explore the efficiency of hemostasis in acute bleeding and extended PLT shelf life. STUDY DESIGN AND METHODS: Manually prepared PLTs (PLT concentrates in plasma, not PLT additive solution) were stored at 4 and 22°C. The PLT counts, scanning electronic microscope observations, blood gas indices, biochemical indices, PLT aggregative function, and surface CD62P expression were monitored and compared between the groups. RESULTS: There was no obvious change in PLT counts between Day 21 at 4°C and Day 5 at 22°C. PLTs stored at 4°C for 10 to 14 days were dramatically activated, had rough surfaces, and showed a significant degree of long pseudopodia formation. The pH of the PLTs on Day 5 was lower at 22°C than at 4°C, while the lactate dehydrogenase and lactic acid levels in the former group were significantly higher (p < 0.005). The maximum aggregation rates induced by collagen and arachidonic acid in the PLTs stored at 4°C for 5 days remained higher than 80%, while the rates induced by four inducers in the PLTs stored at 22°C were less than 5%. PLTs stored at 4°C for 10 to 14 days showed higher surface expression of PAC-1 and CD62P. CONCLUSION: PLT counts, cellular morphologies, PLT membranes, cytoplasmic structures, aggregation rates, and hemostatic PLT function stored at 4°C for 10 to 14 days were better than those stored at 22°C for 5 days.
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Plaquetas/metabolismo , Preservação de Sangue/métodos , Temperatura Baixa , Temperatura Alta , Humanos , Concentração de Íons de Hidrogênio , L-Lactato Desidrogenase/metabolismo , Ácido Láctico/metabolismo , Fatores de TempoRESUMO
This report demonstrated the first study on the use of a new 2D nanomaterial (Mxene) for enhancing membrane performance of intermediate temperature (>100 °C) polymer electrolyte membrane fuel cells (ITPEMFCs). In this study, a typical Ti3C2T x -MXene was synthesized and incorporated into polybenzimidazole (PBI)-based membranes by using a solution blending method. The composite membrane with 3 wt% Ti3C2T x -MXene showed the proton conductivity more than 2 times higher than that of pristine PBI membrane at the temperature range of 100 °C-170 °C, and led to substantial increase in maximum power density of fuel cells by â¼30% tested at 150 °C. The addition of Ti3C2T x -MXene also improved the mechanical properties and thermal stability of PBI membranes. At 3 wt% Ti3C2T x -MXene, the elongation at break of phosphoric acid doped PBI remained unaffected at 150 °C, and the tensile strength and Young's modulus was increased by â¼150% and â¼160%, respectively. This study pointed out promising application of MXene in ITPEMFCs.