Platelet-to-Lymphocyte Ratio (PLR), Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), and Eosinophil-to-Lymphocyte Ratio (ELR) as Biomarkers in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD).

Purpose: The study comprehensively evaluated the prognostic roles of the platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), basophil-to-lymphocyte ratio (BLR), and eosinophil-to-lymphocyte ratio (ELR) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Patients and Methods: Six hundred and nineteen patients with AECOPD and 300 healthy volunteers were retrospectively included into the study. The clinical characteristics of the patients with AECOPD and the complete blood counts (CBCs) of the healthy volunteers were collected. The associations of PLR, NLR, MLR, BLR, and ELR with airflow limitation, hospital length of stay (LOS), C-reactive protein (CRP), and in-hospital mortality in patients with AECOPD were analyzed. Results: Compared with the healthy volunteers, PLR, NLR, MLR, BLR, and ELR were all elevated in COPD patients under stable condition. PLR, NLR, MLR, and BLR were further elevated while ELR was lowered during exacerbation. In the patients with AECOPD, PLR, NLR, and MLR were positively correlated with hospital LOS as well as CRP. In contrast, ELR was negatively correlated with hospital LOS as well as CRP. Elevated PLR, NLR, and MLR were all associated with more severe airflow limitation in AECOPD. Elevated PLR, NLR, and MLR were all associated with increased in-hospital mortality while elevated ELR was associated with decreased in-hospital mortality. Binary logistic regression analysis showed that smoking history, FEV1% predicted, pneumonia, pulmonary heart disease (PHD), uric acid (UA), albumin, and MLR were significant independent predictors ofin-hospital mortality. These predictors along with ELR were used to construct a nomogram for predicting in-hospital mortality in AECOPD. The nomogram had a C-index of 0.850 (95% CI: 0.799-0.901), and the calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) further demonstrated its good predictive value and clinical applicability. Conclusion: In summary, PLR, NLR, MLR, and ELR served as useful biomarkers in patients with AECOPD.

Lanthanide Single-molecule Magnets: Synthetic Strategy, Structures, Properties and Recent Advances.

Single-molecule magnets (SMMs) show wide potential applications in the field of ultrahigh-density storage materials, quantum computing, spintronics, and so on. Lanthanide (Ln) SMMs, as an important category of SMMs, open up a promising prospect due to their large magnetic moments and huge magnetic anisotropy. However, the construction of high performance for Ln SMMs remains an enormous challenge. Although remarkable advances are focused on the topic of Ln SMMs, the research on Ln SMMs with different nuclear numbers is still deficient. Therefore, this review summarizes the design strategies for the construction of Ln SMMs, as well as the metal skeleton types. Furthermore, we collect reported Ln SMMs with mononuclearity, dinuclearity, and multinuclearity (three or more Ln spin centers) and the SMM properties including energy barrier (Ueff ) and pre-exponential factor (τ0 ) are described. Finally, Ln SMMs with low-nuclearity SMMs, especially for single-ion magnets (SIMs), are highlighted to understand the correlations between structures and magnetic behavior of the detail SMM properties are described. We expect the review can shed light on the future developments of high-performance Ln SMMs.

Long-Term Prognostic Factors in Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A 15-Year Multicenter Retrospective Study.

Background: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a multisystem autoimmune disease with small-vessel involvement. In AAV, microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) are major clinicopathologic variants. In addition, myeloperoxidase (MPO) and proteinase 3 (PR3) are major target antigens. The objective of the study was to explore the predictive factors for long-term survival in AAV patients. Materials and Methods: A multicenter retrospective study was carried out on 407 patients between 2005 and 2020. Clinical parameters were obtained from laboratory tests including the ANCA types, antinuclear antibody (ANA), extractable nuclear antigen (ENA), anti-streptolysin O (ASO), glomerular filtration rate (GFR), and the laboratory examinations for the blood routine, liver function, renal function, and immunity, etc. The data for clinical parameters were collected from electronic medical records (EMRs), and the data for patient survival were acquired through regular follow-up. The association of clinical parameters with overall survival (OS) along with 3-year and 5-year survival rates was analyzed, and the nomogram as a predictive model was established according to the analysis results. Results: In the present study, 336 (82.6%) patients and 46 (11.3%) patients were diagnosed with MPA and GPA, respectively. The mean and median OS for all the patients were 2,285 and 2,290 days, respectively. The 1-year, 3-year, 5-year, and 10-year cumulative survival rates for all the patients were 84.2%, 76.3%, 57.2%, and 32.4%, respectively. Univariate and multivariate survival analyses indicated that the independent prognostic factors included age, pathological categories (MPA, GPA, and other types), serum ANCA types (negative or positive for MPO and/or PR3), ANA, ASO, GFR, lymphocyte, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP), and these clinical parameters except for ASO were used to construct a nomogram. The nomogram for 3-year and 5-year survival rates had a C-index of 0.721 (95% CI 0.676-0.766). The calibration curves showed that the predicted values of the nomogram for 3-year and 5-year survival rates were generally consistent with practical observed values, and decision curve analysis (DCA) further demonstrated the practicability and accuracy of the predictive model. Conclusion: Laboratory tests at diagnosis have great significance in the prediction of long-term survival in AAV patients.

[Treatment of multi-segment fracture of complex femoral shaft with instrument-assisted reduction combined with intramedullary interlocking nail fixation].

OBJECTIVE: To investigate the effect of minimally invasive mini-incision and instrumented reduction combined with interlocking intramedullary nailing in the treatment of patients with multi-segment fracture of complex femoral shaft. METHODS: From January 2013 to January 2016, 32 patients with multiple fractures segments of femoral shaft were treated with instrumentation-assisted reduction combined with interlocking intramedullary nailing, including 22 males and 10 females with an average age of 45 years old ranging 17 to 68 years old. The time from injured to operation was 5 to 10 days with an average of 7 days. After admission, routine tibial tubercle or supracondylar bone traction was performed. The patient's general condition was evaluated, the operation time and intraoperative blood loss were recorded. According to Thorsen femoral fracture morphology evaluation criteria and Hohl knee function evaluation of postoperative efficacy, postoperative fracture healing, complications and postoperative recovery of limb function were observed. RESULTS: All patients were followed up for 6 to 24 months with an average of 12 months. The operative time ranged from 48 to 76 minutes with an average of 67 min. The intraoperative blood loss was 150 to 400 ml with an average of 220 ml. The surgical incisions all achieved grade A healing. The fractures reached the clinical standard of healing. The fracture healing time ranged from 4.2 to 10.8 months with an average of 5.7 months. There were no nonunion, incision infection and internal fixation fracture, failure and other complications. According to Thorsen femoral fracture morphology evaluation criteria, the result was excellent in 28 cases, good in 3 cases, fair in 1 case. According to Hohl knee function evaluation criteria, the result was excellent in 30 cases, good in 2 cases. CONCLUSIONS: Instrument-assisted reduction combined with interlocking intramedullary nail fixation is a safe and effective method for the treatment of complex femoral shaft fractures. It has advantages of small trauma, fixed fixation, quick recovery, early postoperative functional exercise.

Crystal structure of poly[bis-(µ-2-amino-4,5-di-cyano-imidazolato-κ(2) N (1):N (3))-trans-bis-(N,N'-di-methyl-formamide-κO)cadmium].

In the title structure, [Cd(C5H2N5)2(C3H7NO)2] n or [Cd(adci)2(DMF)2] n , the Cd(2+) ion is located on a twofold rotation axis and is six-coordinated in a CdN4O2 manner by four imidazole N atoms of four symmetry-related 2-amino-4,5-di-cyano-imidazolate (adci) anions in the equatorial plane and by two O atoms of symmetry-related N,N-di-methyl-formamide (DMF) ligands in axial positions. The adci(-) anions bridge adjacent Cd(2+) ions [shortest Cd⋯Cd separation = 6.733 (3) Å] into a layered coordination polymer extending parallel to (001). The primary amino group and the non-coordinating cyano groups of adci(-) anions are involved in hydrogen-bonding inter-actions with DMF ligands to stabilize the crystal structure.

Two new flavonoids from Morus notabilis.

Phytochemical investigation of the twigs of Morus notabilis led to the isolation and characterization of two new flavonoids, notabilisin F (1) and notabilisin G (2). Their structures were elucidated on the basis of extensive spectroscopic analysis.

[Analgesic and sedative effects of multimodal analgesia in stage of emergence after general anesthesia for cleft lip and/or palate prosthesis].

OBJECTIVE: To investigate the effects of multimodal analgesia on analgesia and sedation during emergence of general anesthesia for cleft lip and/or palate surgery pediatric patients. METHODS: Fifty-four pediatric patients with ASA I and II cleft lip and/or palate, aged 2-7, undergoing prosthesis were randomly allocated into 2 groups: control group (Group C, n=28) inhaling nitrous oxide/oxygen (50%:50%) and sevoflurane(5%) for general anesthesia, and multimodal group (Group M, n=26), injected intravenously with fentanyl and atracurium in addition to inhalation of nitrous oxide/oxygen (50%:50%) and sevoflurane (5%). Ventilation was controlled with PCV modal to maintain end-tidal CO2 to 35-45 mmHg. Local anesthesia at the surgical site was facilitated by the surgeon before the beginning of surgery. After intubation, rectal paracetamol was used for Group M (120 mg for 2-4 year-olds and 325 mg for 5-7 year-olds) and fentanyl 0.5 microg/kg was injected for postoperative analgesia 10 min before the end of surgery. An observer who was blinded to the protocol recorded the time from the discontinuation of sevoflurane and nitrous oxide to tracheal extubation, accessed the sedation and pain scale, recorded the time ready for discharge from post-anesthesia care unit (PACU) and the incidence of adverse effects. RESULTS: The time ready for discharge from PACU of Group M was (25+/-4) min, significantly shorter than that of Group C [(32+/-3) min, t=7.426, P<0.01]. The analgesia satisfaction rate of Group M was 69.2% (18/26), significantly higher than that of Group C [25.0%, 7/28, P<0.05]. The severe pain rate of Group M was 7.7%, significantly lower than that of Group C (35.7%, F=5.333, P=0.021). The agitation rate of Group M was 11.5%, significantly lower than that of Group C (39.3%, F=4.571, P=0.033). CONCLUSION: Multimodal analgesic regimen of infiltration of local anesthetic at surgical site and rectal paracetamol and intravenous fentanyl provides sufficient analgesia, minimizes the incidence of agitation after general anesthesia in cleft lip and/or palate surgery for children, increases the speed of referring patients in PACU, and ensures the safety of the postanaesthetic patients.

Expression of miR-31, miR-125b-5p, and miR-326 in the adipogenic differentiation process of adipose-derived stem cells.

MicroRNAs (miRNAs) are small single-stranded RNAs of 19-22 nucleotides (nt) and are important posttranscriptional regulation of genes. A link between miRNA function and cancer was researched by the miRNAs microarray technology recently. However, during adipogenic differentiation of ADSCs process, this technology was less used to study adipogenic differentiation mechanism of ADSCs. In this study, miRNA microarray technology was used to examine the expression of miRNA that were differences between induced group and noninduced group of ADSC adipogenic differentiation. Real-time quantitative PCR (real-time qPCR) was used to quantify the miRNA expression. The TargetScan 5.0 software was used to find their target genes. Our results showed that the expression of rno-miR-31, rno-miR-125b-5p, and rno-miR-326 were downregulation in the adipogenic differentiation process. By the statistic analysis, this study showed that the expression of rno-miR-31 and rno-miR-326 were significantly deregulation. In addition, the target genes of rno-miR-31 and rno-miR-326 were correlated with the adipogenic differentiation. Our study suggested that the expression of rno-miR-31 and rno-miR-326 were involved in the adipogenic differentiation process.

Penta-carbonyl-1κC,2κC-(ferrocenyl-diphenyl-phosphine-1κP)[µ-2-(4-methyl-phen-yl)-2-aza-propane-1,3-dithiol-ato-1:2κS,S':S,S']diiron(I)(Fe-Fe).

The title compound, [Fe(2)(C(9)H(11)NS(2)){Fe(C(5)H(5))(C(17)H(14)P)}(CO)(5)], was prepared as an aza-dithiol-ato-iron model for the iron-only hydrogenase active site. The Fe(2)S(2) unit exhibits a butterfly conformation and the ferrocenyldiphenyl-phosphine ligand is trans to the Fe-Fe bond. The Fe-Fe distance of 2.5160 (8) Šis longer than found in related model structures. Intra-molecular C-H⋯S and inter-molecular C-H⋯O hydrogen bonds are observed.

[Identification of official rhubarb samples based on IR spectra and neural networks].

The Fourier transform infrared (IR) spectrometry and neural networks have been used to identification of official and un-official rhubarb samples in the present work. The IR spectra were compressed by using wavelet transform and then were normalized prior to network training. Spectra with 700 data points were compressed to 44 variables, therefore, the training process of neural networks were speed up. 52 rhubarb samples in which 25 official and 27 unofficial rhubarb samples are included have been used to network modeling. The effects of neuron number in hidden layer and momentum parameter on classification have been investigated. Results showed that about 98% rhubarb samples could be identified correctly when optimized parameters were used. This method can be useful for quality control in rhubarb-contained Chinese medicine production.

[Identification of rhubarb samples based on IR spectra by using Takagi-Sugeno fuzzy systems].

Takagi-Sugeno fuzzy system is composed of several back-propagation neural networks (BP-NNs), and has some fuzzy logic properties. In this paper, the Takagi-Sugeno fuzzy logic system is applied to identifying official and unofficial rhubarb samples based on their infrared spectra. The effects of the number of hidden neurons and the momentum parameters on the prediction were investigated. The results obtained by using Takagi-Sugeno fuzzy system were better than those by commonly used BP-networks. With a proper network training parameter, 100% correctness can be obtained by using Takagi-Sugeno fuzzy system. This method is more accurate than the common methods, and is more scientific than traditional methods. So it is applied to identifying rhubarb easily and rapidly.

[Identification of official rhubarb samples based on NIR spectra and neural networks].

Rhubarb is one of the most widely used Chinese medicinal herbs in China. Fast and accurate identification of official and unofficial rhubarb samples is most critical for quality control of Chinese medicine production. In the present paper near-infrared reflectance spectrometry (NIRS) and artificial neural network (ANN) were combined to develop classification models for identifying 52 official and unofficial rhubarb samples. The measured spectra were compressed by wavelet transformation (WT) and then the ANN classification models were trained with the reduced-variables spectral data. The rate of correct classification was over 96%. The effects of neurons in hidden layer and the momentum were also discussed. Owing to its fast and nondestructive properties, NIRS is a promising approach to identifying Chinese medicinal herbs.