Safety and effectiveness of tunneled peripherally inserted central catheters versus conventional PICC in adult cancer patients.

OBJECTIVES: This study aimed to compare the safety and effectiveness of tunneled peripherally inserted central catheters (T-PICC) vs. conventional PICCs (C-PICC) in adult cancer patients. METHODS: A multicentre randomized controlled trial was conducted between April 2021 and January 2022 in seven hospitals in China. 564 participants were randomly assigned to T-PICC or C-PICC. These data were collected and compared: the baseline characteristics and catheterization-related characteristics, periprocedural complications, and long-term complications. RESULTS: Five-hundred fifty-three participants (aged, 52.6 ± 12.3 years; female, 39.1%) were ultimately analyzed. No significant differences in periprocedural complications were found between the T-PICC and C-PICC groups (all p > 0.05). Compared with C-PICC, T-PICC significantly reduced the incidence of long-term complications (26.4% vs. 39.9%, p < 0.001). Specifically, reduced complications were found in central line-associated bloodstream infection (1.8% vs. 5.1%, p = 0.04), thrombosis (1.1% vs. 4.0%, p = 0.03), catheter dislodgement (4.7% vs. 10.1%, p = 0.01), non-infectious oozing (17.3% vs. 28.6%, p = 0.002), local infection (3.6% vs. 7.6%, p = 0.04), skin irritation (6.1% vs. 10.9%, p = 0.046), and reduced unplanned catheter removal (2.2% vs. 7.2%, p = 0.005). No significant differences were found between T-PICC and C-PICC regarding catheter occlusion (6.5% vs. 5.8%, p = 0.73) or skin damage (2.2% vs. 2.9%, p = 0.58). CONCLUSION: T-PICC is safe and effectively reduces long-term complications. CLINICAL RELEVANCE STATEMENT: The tunneled technique is effective in reducing PICC-related long-term complications. Thus, it is recommended for cancer patients at high risk of PICC-related complications. TRIAL REGISTRATION: The registration number on https://www.chictr.org.cn/ is ChiCTR2100044632. The name of the trial registry is "A multicenter randomized controlled study of clinical use of tunneled vs. non-tunneled PICC". KEY POINTS: Cather-related complications are associated with the technique of catheterization. Compared with conventional PICC, tunneled PICC reduced catheter-related long-term complications. Tunneled PICC placement provides an alternative catheterization method for cancer patients.

A bibliometric analysis on the health behaviors related to mild cognitive impairment.

Background: Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI. Methods: The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index sub-databases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, co-keywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain. Results: The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatrics-related journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials. Conclusion: This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies.

Impurities in Polymer-Lined Autoclaves Affect Zeolite Synthesis and Si Incorporation Behavior.

Polymer-lined autoclaves are commonly believed to be highly durable and inert in hydrothermal reactions. Herein, we use the hydrothermal synthesis of AlPO-18 zeolite as a case study to demonstrate that the choice of autoclave materials (polytetrafluoroethylene or para-polyphenylene) does significantly affect the product of zeolite synthesis. A small amount of glass fiber in the PPL-lined autoclave unexpectedly functions as a source of silicon and yields SAPO-34 instead of AlPO-18 as the product. The outcomes of 19 successive experiments conducted with a single PPL-lined autoclave exhibit significant variations, further highlighting that the impurities arising from the autoclaves should be considered during the hydrothermal synthesis procedure. In contrast to SAPO-34 synthesized by the conventional method, which displays only Si(4Al) at a low Si/Al ratio, SAPO-34 synthesized in the PPL-lined autoclave exhibits multiple silicon coordination environments. This outcome provides new physical insights into the silicon incorporation mechanism and proposes a viable strategy for regulating the silicon coordination environment at low Si/Al ratios.

Hemostatic and antibacterial calcium-copper zeolite gauze for infected wound healing.

The design and development of wound dressings with excellent procoagulant and antibacterial activity to achieve high wound healing effectiveness are highly desirable in clinical applications. In this work, we develop a calcium-copper zeolite gauze (CaCu-ZG) by a two-step process involving calcium and copper ion exchange in a zeolite gauze. The CaCu-ZG exhibits remarkable procoagulant and antibacterial abilities, as well as good biocompatibility. Compared with the medical gauze, the blood clotting time of CaCu-ZG significantly decreases and the antibacterial activity increases in both in vivo and in vitro experiments. The remarkable ability of wound healing has been verified using a mouse dorsal skin-infected wound model, demonstrating its great potential for wound treatment in clinical applications.

Living alone increases the risk of developing type 2 diabetes mellitus: A systematic review and meta-analysis based on longitudinal studies.

BACKGROUND: Living alone is a prevalent psychological issue that has been found to have significant implications for lifestyle and health status. While considerable research has been conducted to explore the relationship between living alone and the risk of developing type 2 diabetes mellitus (T2DM), the majority of studies have been cross-sectional, leaving direct correlations elusive. Therefore, this study aims to analyze data from longitudinal studies to determine whether living alone increases the risk of T2DM. METHODS: A comprehensive search was conducted in the PubMed, Cochrane, and Embase databases to identify studies examining the association between living alone and T2DM risk. The search encompassed studies published until September 2023. Pooled analysis utilized the random-effects model with inverse variance and included adjusted hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs). RESULTS: The meta-analysis comprised a total of 8 studies, which consisted of 5 prospective cohort studies and 3 retrospective cohort studies. The total population under consideration included 11,686,677 individuals without T2DM, of whom 54.3% were female. Among this population, 396,368 individuals developed T2DM. To account for heterogeneity, a random-effects model was employed. Overall, the pooled data demonstrated a significant association between living alone and an increased risk of T2DM when compared to living with others (HR 1.24, 95% CI 1.06-1.46). Subgroup analysis revealed that this risk was not statistically significant for either males (HR 1.28, 95% CI 0.93-1.76) or females (HR 1.06, 95% CI 0.84-1.33), nor in prospective cohort studies (HR 1.26, 95% CI 0.91-1.74) or retrospective cohort studies (HR 1.26, 95% CI 0.91-1.74). CONCLUSION: Individuals living alone faced a significantly higher risk of developing diabetes compared to those who did not live alone. However, no significant difference in this risk was observed between genders and study types. Further high-quality studies are necessary in the future to elucidate this causal association.

Fibroblast Growth Factor 23 Neutralizing Antibody Ameliorates Abnormal Renal Phosphate Handling in Sickle Cell Disease Mice.

We assessed the involvement of fibroblast growth factor 23 (FGF23) in phosphaturia in sickle cell disease (SCD) mice. Control and SCD mice were treated with FGF23 neutralizing antibody (FGF23Ab) for 24 hours. Serum ferritin was significantly increased in SCD mice and was significantly reduced in female but not male SCD mice by FGF23Ab. FGF23Ab significantly reduced increased erythropoietin in SCD kidneys. Serum intact FGF23 was significantly increased in SCD female mice and was markedly increased in SCD male mice; however, FGF23Ab significantly reduced serum intact FGF23 in both genotypes and sexes. Serum carboxy-terminal-fragment FGF23 (cFGF23) was significantly reduced in SCD IgG male mice and was markedly but not significantly reduced in SCD IgG female mice. FGF23Ab significantly increased cFGF23 in both sexes and genotypes. Serum 1,25-dihydroxyvitamin D3 was significantly increased in SCD IgG and was further significantly increased by FGF23Ab in both sexes and genotypes. Significantly increased blood urea nitrogen in SCD was not reduced by FGF23Ab. The urine phosphate (Pi)/creatinine ratio was significantly increased in SCD in both sexes and was significantly reduced by FGF23Ab. Increased SCD kidney damage marker kidney injury molecule 1 was rescued, but sclerotic glomeruli, increased macrophages, and lymphocytes were not rescued by short-term FGF23Ab. FGF23Ab significantly reduced increased phospho-fibroblast growth factor receptor 1, αKlotho, phosphorylated extracellular signal-regulated kinase, phosphorylated serum/glucocorticoid-regulated kinase 1, phosphorylated sodium-hydrogen exchanger regulatory factor-1, phosphorylated janus kinase 3, and phosphorylated transducer and activator of transcription-3 in SCD kidneys. The type II sodium Pi cotransporter (NPT2a) and sodium-dependent Pi transporter PiT-2 proteins were significantly reduced in SCD kidneys and were increased by FGF23Ab. We conclude that increased FGF23/FGF receptor 1/αKlotho signaling promotes Pi wasting in SCD by downregulating NPT2a and PIT2 via modulation of multiple signaling pathways that could be rescued by FGF23Ab.

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OBJECTIVES: To study the expression of V-domain Ig suppressor of T cell activation (VISTA) in peripheral blood of children with juvenile idiopathic arthritis (JIA) and its role in the pathogenesis of JIA. METHODS: In this prospective study, peripheral blood was collected from 47 children with different subtypes of JIA and 10 healthy children. Flow cytometry was used to measure the expression levels of VISTA, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α) on CD14+ mononuclear cells, CD4+ T lymphocytes, and CD8+ T lymphocytes. RESULTS: The children with JIA had a significantly lower expression level of VISTA than the healthy children (P<0.05). There was a significant difference in the expression of VISTA between the children with different subtypes of JIA, with the lowest expression level in those with systemic JIA (P<0.05). There was also a significant difference in the expression of VISTA between different immune cells, with a significantly higher expression level on the surface of monocytes (P<0.05). Correlation analysis showed that VISTA was negatively correlated with the expression of IFN-γ and TNF-α on CD4+ T cells (r=-0.436 and -0.382 respectively, P<0.05), CD8+ T cells (r=-0.348 and -0.487 respectively, P<0.05), and CD14+ mononuclear cells (r=-0.582 and -0.603 respectively, P<0.05). CONCLUSIONS: The insufficient expression of VISTA may be associated with the pathogenesis of JIA, and enhancing the immunomodulatory effect of VISTA might be one option for the treatment of JIA in the future.

High-throughput synthesis of AlPO and SAPO zeolites by ink jet printing.

Ink jet printing is for the first time introduced into the synthesis of aluminophosphate (AlPO) and silicoaluminophosphate (SAPO) zeolite. As a high-throughput technique, 256 zeolite precursors with multiple formulations could be obtained within 2 h, while the product phase was regulated relative to the variant compositions.

Preparation of CaMgAl-calcined layered double hydroxides and application on the removal of phosphates.

A calcined CaMgAl-layered double hydroxide nanocomposite, CaMgAl-LDH (CCMA-0.83-600), was prepared by introducing Mg on the basis of CaAl-LDHs for the removal of phosphate from wastewater. The structure of the as-synthesized CCMA-0.83-600 was confirmed by XRD and SEM analyses. Parameters affecting the adsorption process of phosphate adsorbed by CCMA-0.83-600 were thoroughly explored, such as initial pH, adsorbent dosage and co-existing anions. The adsorption kinetic study suggested that the adsorption process accorded with the pseudo-second-order kinetic model and the adsorption rate was controlled by both the liquid film diffusion and intra-particle diffusion. The adsorption isotherm study indicated the adsorption process followed by the Langmuir isotherm model. Thermodynamic analysis suggested that the adsorption of phosphate was spontaneous and exothermic. The obtained results indicated that CCMA-0.83-600 is a suitable candidate for the removal of phosphate from wastewater.

A cysteine enzyme hemostat for efficient heparin-tolerant blood coagulation.

It is challenging to stop bleeding effectively in patients treated with heparin which leads to enhanced risk of uncontrolled bleeding during operation. Herein, we report an easy-to-use and heparin-tolerant hemostatic agent based on a thrombin-like cysteine enzyme (papain), which catalyzes the hydrolysis of fibrinogen and cross-linking of fibrin clots. A papain-based hemostat with increased procoagulant activity is developed through immobilizing papain on the cellulose carrier, which displays short clotting time in both normal and heparinized plasmas. The excellent hemostatic performance of the papain-based hemostat is further confirmed with reduced hemostatic time and limited blood loss in a mouse tail amputation model, rabbit auricular artery injury model and rat liver injury model, in which a natural coagulation system fails to function on account of heparin. This bio-hemostat has great potential to reverse the effect of heparin and stop topical hemorrhage rapidly in surgical procedures.

Hemostatic Effects of Bio-Zeolite Gauze and QuikClot Combat Gauze on Major Bleeding in Rabbits Acutely Exposed to High Altitude.

Objective: Hemostatic gauze application is an effective way to control major bleeding, which is the most common cause of death in trauma in both civilian and military settings. Coagulation derangement after acute exposure to high altitude might alter the effects of hemostatic gauzes. The present study aimed to observe the hemostatic effects of bio-zeolite gauze (BZG) and QuikClot Combat Gauze® (QCG) on major bleeding in rabbits acutely exposed to high altitude.Methods: Sixty rabbits were randomly and evenly divided into six groups. Animal models of simulated blast- and fragment-induced inguinal major bleeding were prepared in lower altitude and high-altitude areas, and BZG, QCG, and ordinary gauze without hemostatic material were used to control bleeding. The primary outcomes included immediate hemostasis rate, blood loss, and survival rate, while the secondary outcomes included hemodynamic parameters, laboratory examinations, and coagulation-relevant markers.Results: The overall effects of BZG and QCG were better than those of ordinary gauze, with a higher immediate hemostatic rate, less blood loss, and higher survival rate at 90 min after gauze application and higher red blood cell and platelet counts and lower creatinine level at 30 min after gauze application in lower altitude. The concentrations of coagulation factor XII and factor X in rabbits acutely exposed to high altitude were significantly lower than those in lower altitude. At high altitude, the hemostatic effects of BZG did not decrease significantly compared to those in the lower altitude, whereas those of ordinary gauze and QCG decreased significantly at high altitude compared to those in the lower altitude.Conclusions: Coagulation derangement after acute exposure to high altitude has negative effects on ordinary gauze and QCG but has no significant negative hemostatic effects on BZG.

Vanillin attenuates the ethanol withdrawal syndrome and ethanol withdrawal induced anxiety by regulating the neurochemical balance.

Ethanol abuse is a major public issue globally and withdrawal of ethanol after chronic exposure contributes to the development of behavioural changes. The present study evaluates vanillin effect against the ethanol withdrawal syndrome (EWS) and the associated anxiety. Rats were exposed to ethanol for 21 days at 7.2% concentration maximum with drinking water in a modified liquid diet. Vanillin at doses of 100 and 200 mg/kg were administered 30 min prior to ethanol withdrawal, and behavioural changes were observed at 1st, 2nd, 4th, 6th and 12th h of ethanol withdrawal. Moreover, the locomotor activity was assessed using the astrophotometer and level of anxiety by the elevated plus maze. The level of neurotransmitters and mRNA expression of corticotropin-releasing factor (CRF) and corticotropin releasing factor receptor 1 (CRFR1) were estimated in brain tissue of vanillin treated EWS rats. There was a significant improvement in the ethanol withdrawal behaviour in the vanillin treated group compared to EWS rats. The locomotor activity and level of anxiety was observed to be reduced significantly (p < 0.01) in the vanillin treated group compared to EWS rats. Treatment with vanillin ameliorates the altered level of g-aminobutyric acid (GABA), dopamine and glutamate and level of corticosterone in ethanol withdrawal rats. mRNA expression of CRF and CRFR1 was reduced significantly (p < 0.01) in brain tissue of the vanillin treated group compared to the EWS group of rats. In conclusion, data reveal that treatment with vanillin shows a beneficial effect against EWS and ethanol withdrawal associated anxiety by regulating CRF/CRFR1 expression.

Bone loss is ameliorated by fecal microbiota transplantation through SCFA/GPR41/ IGF1 pathway in sickle cell disease mice.

Bone loss is common in sickle cell disease (SCD), but the molecular mechanisms is unclear. Serum insulin-like growth factor 1 (IGF1) was low in SCD subjects and SCD mice. To determine if decreased IGF1 associated with low bone mass in SCD is due to reduced SCFA production by gut microbiota, we performed reciprocal fecal microbiota transplantation (FMT) between healthy control (Ctrl) and SCD mice. uCT and histomorphometry analysis of femur showed decreased bone volume/total volume (BV/TV), trabecular number (Tb.N), osteoblast surface/bone surface (Ob.S/BS), mineralizing surface/ bone surface (MS/BS), inter-label thickness (Ir.L.Th) in SCD mice were significantly improved after receiving Ctrl feces. Bone formation genes Alp, Col1, Runx2, and Dmp1 from SCD mice were significantly decreased and were rescued after FMT from Ctrl feces. Transplantation of Ctrl feces increased the butyrate, valerate, and propionate levels in cecal content of SCD mice. Decreased G-coupled protein receptors 41 and 43 (GPR41 and GPR43) mRNA in tibia and lower IGF1 in bone and serum of SCD mice were partially restored after FMT from Ctrl feces. These data indicate that the healthy gut microbiota of Ctrl mice is protective for SCD bone loss through regulating IGF1 in response to impaired bacterial metabolites SCFAs.

Non-radical synthesis of amide chitosan with p-coumaric acid and caffeic acid and its application in pork preservation.

p-Coumaric acid and caffeic acid were grafted onto chitosan through a non-radical synthesis method to improve the properties of chitosan and expand its application in food industry. Structural characterization demonstrated that the -COOH of the two phenolic acids were bonded to the -NH2 of the chitosan and formed an acylamino. The grafting ratios of p-coumaric acid-modified chitosan (Cm-CTS) and caffeic acid-modified chitosan (Cf-CTS) reached 10.30 % and 9.78 %, respectively. After modification, the water solubility of the chitosan greatly improved from 9.33 % (native chitosan, Nt-CTS) to 77.33 % (Cm-CTS) and 100 % (Cf-CTS). Besides, the involvement of phenolic acid and caffeic acid endowed the chitosan with strengthened antioxidation and antibacterial activities against Escherichia coli and Staphylococcus aureus. Nt-CTS and the modified chitosans were coated on the pork surface. The results indicated that Nt-CTS effectively inhibited pork spoilage and the modified chitosans could further prolong the shelf life of pork.

FGF receptor inhibitor BGJ398 partially rescues osteoarthritis-like phenotype in older high molecular weight FGF2 transgenic mice via multiple mechanisms.

We have used Basic Fibroblast Growth Factor (FGF2) transgenic mice as experimental models for human X-linked hypophosphatemia (XLH)-related degenerative osteoarthritis (OA) to investigate the pathogenesis of the disease and to test potential pharmacotherapies for treatment. This study tested the efficacy of BJG398, a small molecule fibroblast growth factor receptor tyrosine kinase (FGFRTK) inhibitor, to rescue the knee joint osteoarthritis phenotype in High Molecular Weight fibroblast growth factor 2 transgenic (HMWTgFGF2) mice. BJG398 was administered in vivo to 8-month-old female HMWTgFGF2 mice for six weeks. Histomorphometry, immunohistochemistry and micro-CT were used to examine the knee joints in BGJ398-treated and control mice. We assessed: Fibroblast Growth Factor 23 (FGF23) expression and FGFR1 activity; Matrix metalloproteinase 13 (MMP13) and Aggrecanase2 (ADAMTS5) expression; then signaling by SMAD1/5/8-pSMAD6, pERK1/2 and Runt-related transcription factor 2 (RUNX2). Using PrimePCR arrays, we identified a contributing role for major target genes in the TGFB/BMP2 signaling pathway that were regulated by BGJ398. BGJ398 inhibited HMWFGF2/FGF23-induced increase in bone morphogenic protein receptor-1, bone morphogenic protein-2 and 4 and Serine peptidase inhibitor, clade E, member 1. The results from Micro-CT and histology show BGJ398 treatment rescued the OA changes in subchondral bone and knee articular cartilage of HMWTgFGF2 mice. The gene expression and signal transduction results provide convincing evidence that HMWFGF2 generates OA through FGFRTK with characteristic downstream signaling that defines OA, namely: increased FGF23-FGFR1 activity with BMP-BMPR, activation of pSMAD1/5/8-RUNX2 and pERK signaling pathways, then upregulation of MMP13 and ADAMTS5 to degrade matrix. BGJ398 treatment effectively reversed these OA molecular phenotypes, providing further evidence that the OA generated by HMWFGF2 in the transgenic mice is FGFR-mediated and phenocopies the OA found in the Hyp mouse homolog of XLH with a spontaneous mutation in the Phex (phosphate regulating endopeptidase on the X chromosome) gene and human XLH-OA. Overall, the results obtained here explain how the pleotropic effects of FGF2 emanate from the different functions of HMW protein isoforms for cartilage and bone homeostasis, and the pathogenesis of XLH-degenerative osteoarthropathy. BGJ398 inhibits HMWFGF2-induced osteoarthritis via multiple mechanisms. These results provided important scientific evidence for the potential application of BGJ398 as a therapeutic agent for osteoarthritis in XLH.

Management and Analysis of Sports Health Level of the Elderly Based on Deep Learning.

With the accelerating rate of population aging in China, the health of the elderly has received more and more attention and has become one of the most important issues in the elderly care industry. Because of insufficient research on the personal health of the elderly, the value of medical examination data cannot be fully exploited, many physical indicators have a certain impact on overall health or heart health, and there are few studies on heart health assessment. This paper proposes a deep learning-based elderly management analysis method of human exercise health level, using the exercise health management model to evaluate the heart health level of the elderly. Firstly, the indicators to measure heart health are proposed through traditional expert knowledge and personal health index to analyze heart health. Through dynamic assessment, predict the heart health status at the next time point, analyze possible heart diseases, and provide corresponding methods for the health of the elderly, which helps improve the physical health of the elderly. Quality of life provides assistance to meet the needs of improving the health of older adults.

Oxidative Stress Can Be Attenuated by 4-PBA Caused by High-Fat or Ammonia Nitrogen in Cultured Spotted Seabass: The Mechanism Is Related to Endoplasmic Reticulum Stress.

Oxidative stress is a common phenomenon in aquaculture, which can be induced by nutritional or environmental factors. Generally, oxidative stress causes poor growth performance, metabolic dysregulation, and even the death of aquatic animals. To identify a nutritional intervention strategy, high-fat diet (HFD) feeding (Experiment I) and acute ammonia nitrogen challenge (Experiment II) tests were carried out. In Experiment I, HFD feeding significantly decreased the growth performance concomitantly with excessive fat deposition in the liver and abdomen. The addition of 4-PBA in the diet improved the excessive fat accumulation. The activities of antioxidative enzymes were suppressed, and the levels of lipid and protein peroxidation were increased, indicating that HFD feeding induced oxidative stress. The endoplasmic reticulum stress (ERs) related genes were downregulated in the HFD group. Under a transmission electron microscope (TEM), more swollen and dilated ER lumen could be observed. These results indicated that the HFD induced ERs activation. Although 4-PBA acted as a potent ERs inhibitor, as evidenced by the alleviated alterations of ERs molecules and the ER ultrastructure, the oxidative stress was also attenuated by 4-PBA. In Experiment II, dietary 4-PBA improved the tolerance to the acute ammonia nitrogen challenge, as lower mortality and serum aminotransferase activity was found. Further results showed that 4-PBA decreased the peroxidation content and attenuated ERs, thus confirming the correlation between oxidative stress and ERs. Our findings showed that dietary 4-PBA supplementation can attenuate oxidative stress induced by a HFD or acute ammonia challenge; the mechanism is related to its potent inhibition effect for ERs.

A Bio-Inorganic Hybrid Hemostatic Gauze for Effective Control of Fatal Emergency Hemorrhage in "Platinum Ten Minutes".

Death from massive hemorrhage represents a global problem. It is a challenging task to design hemostatic materials with significant efficacy, good biocompatibility, reliable safety, and high stability. In this study, we demonstrate an effective bio-inorganic hybrid hemostat fabricated by stepwise procedures of on-site growth of zeolite gauze and immobilization of trypsin on the zeolite gauze. The as-synthesized hybrid hemostat catalyzes the transition of prothrombin-to-thrombin and exhibits excellent procoagulant performance in the both normal plasma and FX-deficient plasma. The hemostatic treatment of junctional femoral artery rupture in the porcine model confirms that this hybrid hemostat manifests itself with superior hemostatic performance over commercial hemostatic dressings, in terms of a reduced time to hemostasis and blood loss. The stability of the hybrid hemostat is validated through high temperature and violent shaking evaluation. This bio-inorganic hybrid hemostat displays high procoagulant activity, low cytotoxicity, and extended shelf life which may achieve the "Platinum Ten Minutes" rescue in battlefield and traffic accident medicine.

Acute kidney injury in patients with primary nephrotic syndrome: influencing factors and coping strategies.

BACKGROUND: Acute kidney injury (AKI) is a frequent and serious complication in patients with primary nephrotic syndrome (PNS). We aimed to evaluate the influencing factors of AKI in patients with PNS, to provide implications for the clinical management and nursing care of patients with PNS. METHODS: PNS patients who were treated in the Department of Nephrology in our hospital from January 1, 2020 to July 31, 2021 were included. The clinical characteristics and pathological type of PNS patients were evaluated. Pearson correlation and Logistic regression analysis were performed to analyze the related risk factors of AKI in patients with PNS. RESULTS: A total of 328 patients with PNS were included, the incidence of AKI in PNS patients was 28.05%. Pearson correlation analysis showed that diabetes(r = 0.688), pulmonary infection (r = 0.614), albumin (r = 0.779), serum creatinine (r = 0.617), uric acid (r = 0.522), blood urea nitrogen (r = 0.616), renal tubular casts (r = 0.707) were correlated with AKI in PNS patients (all P < 0.05). Logistic regression analysis indicated that diabetes (OR2.908, 95%CI1.844 ~ 4.231), pulmonary infection(OR3.755, 95%CI2.831 ~ 4.987), albumin ≤ 24 g/L (OR1.923, 95%CI1.214 ~ 2.355), serum creatinine ≥ 90 µmol/L (OR2.517, 95%CI2.074 ~ 3.182), blood urea nitrogen ≥ 6.5 mmol/L (OR1.686, 95%CI1.208 ~ 2.123), uric acid ≥ 390 µmol/L (OR2.755, 95%CI2.131 ~ 3.371), renal tubular casts(OR1.796, 95%CI1.216 ~ 2.208) were the independently influencing factors of AKI in PNS patients (all P < 0.05). CONCLUSIONS: AKI is common in PNS patients. Actively controlling diabetes and pulmonary infection, strengthening nutrition support and renal function monitoring are essential to reduce the occurrence of AKI in PNS patients.

Preparation of biochar from constructed wetland plant and its adsorption performance towards Cu2.

In order to solve problems in the treatment and disposal of huge production of artificial wetland plants and heavy metal pollution, two constructed wetland plants of reed and gladiolus were selected as raw materials to prepare biochar for adsorbing heavy metals from aqueous solutions. The experimental results showed that reed biochar prepared at 600℃ and activated by KOH with an impregnation ratio of 1:3 (KRAC-3) exhibited relatively high adsorption ability towards Cu2+. The optimal results analyzed by Design-Expert software showed that the maximum adsorption rate of KRAC-3 towards Cu2+ was obtained under the optimal conditions of adsorbent dosage of 1.2 g/L, pH of 4.96, and reaction time of 137.43 min. The adsorption of Cu2+ followed pseudo-second-order kinetics and the Langmuir adsorption model. The theoretical maximum adsorption capacity of KRAC-3 calculated from the Langmuir isotherm model was 148.08 mg/g. Microscopic tests with the help of SEM, EDS, and XRD revealed that physical adsorption, ion exchange, electrostatic adsorption, surface complexation, and precipitation were the main adsorption mechanism of Cu2+ loading onto KRAC-3. This study will provide a theoretical basis for the application of biochar prepared from constructed wetland plants and the treatment of heavy metal-containing wastewater.