Experimental investigation of influence of amide polymer on loess for subgrade.

The effects of moisture and drying shrinkage can lead to uneven settlement, cracking, and other diseases in loess subgrade. The objective of this study was to investigate the effects of amide polymer (AP) on the permeability, mechanical properties and crack resistance of loess by orthogonal experiments. The basic properties of AP and the permeability, mechanical properties, and dry-wet variation properties of polymer-modified loess were tested, and a scale model verification and simulation analysis were conducted. In this paper, water migration in subgrade is regulated by improving the water sensitivity of loess. By reducing the variation range of subgrade water content, the stress accumulation in subgrade caused by water is weakened. The results show that the curing time and mechanical properties of AP are directly affected by the oxidant and reducing agent, and the mechanical properties of AP are compatible with the characteristics of loess. AP filled the grain gap and reduced the permeability of loess by 34.05-280.83%. The ductility of polymer-modified loess is significantly increased, and the strain of peak strength is increased by 17.21-126.36%. AP can regulate moisture change, reduce the surface tension between particles, and reduce stress concentration. The strength loss rate was reduced by 19.98-51.21% by enhancing the cracking resistance and weakening the strength loss caused by dry and wet cycling. The increase of upper layer moisture content in the scale model of polymer-modified loess subgrade is reduced by 31.38-36.11%.

Medicating the coast in a metropolitan city: Enantiomeric profiles and joint probabilistic risk assessment of antidepressants and antihistamines.

Pharmaceuticals are receiving increasing attention as emerging contaminants in the aquatic environment. Herein, we investigated the occurrence of 11 antidepressants, 6 antihistamines and 4 metabolites in treated wastewater effluents, rivers, stormwater, and seawater in Hong Kong, with special focus on chirality. The average levels of ∑pharmaceuticals ranged from 0.525 to 1070 ng/L in all samples and the total annual mass load of target pharmaceuticals in the marine environment of Hong Kong was 756 kg/y. Antihistamines accounted for >80 % of ∑pharmaceuticals, with diphenhydramine and fexofenadine being predominant. The occurrence and enantiomeric profiles of brompheniramine and promethazine sulfoxide were reported in global natural waters for the first time. Among chiral pharmaceuticals, mirtazapine and fexofenadine exhibited R-preference, while others mostly exhibited S-preference, implying that the ecological risks derived from achiral data for chiral pharmaceuticals may be biased. The joint probabilistic risk assessment of fluoxetine revealed that R-fluoxetine and rac-fluoxetine presented different ecological risks from that of S-fluoxetine; Such assessment also revealed that target pharmaceuticals posed only minimal to low risks, except that diphenhydramine posed an intermediate risk. As estimated, 10 % aquatic species will be affected when the environmental level of diphenhydramine exceeds 7.40 ng/L, which was seen in 46.9 % samples. Collectively, this study highlights further investigations on the enantioselectivity of chiral pharmaceuticals, particularly on environmental behavior and ecotoxicity using local aquatic species as target organisms.

[Research Status and Trend of Devices for Treating Advanced Heart Failure].

Heart failure (HF),a chronic progressive disease,is a global health problem and the leading cause of deaths in the global population.The pathophysiological abnormalities of HF mainly include abnormal cardiac structure (myocardium and valves),disturbance of electrophysiological activities,and weakened myocardial contractility.In addition to drug therapy and heart transplantation,interventional therapies can be employed for advanced-stage HF,including transcatheter interventions and mechanical circulatory assist devices.This article introduces the devices used for advanced HF that have been marketed or certified as innovative or breakthrough devices around the world and summarizes the research status and prospects the trend in this field.As diversified combinations of HF devices are used for the treatment of advanced HF,considerations regarding individualized HF therapy,risk-benefit evaluation on device design,medical insurance payment,post-market supervision system,and protection of intellectual property rights of high-end technology are needed,which will boost the development of the technology and industry and benefit the patients.

Middle mediastinal paraganglioma: A case report and review of the literature.

RATIONAL: Paragangliomas are rare and can occur in many places throughout the body, but mediastinal paragangliomas are even rarer, accounting for less than 0.3% of mediastinal masses. Extremely susceptible to misdiagnosis and mistreatment, which may lead to the death of the patient. PATIENT CONCERNS: We report a case of a giant paraganglioma of the middle mediastinum. A 40-year-old woman was admitted to the hospital with a rib fracture and a chest computed tomography suggesting a giant occupying tumor in the middle mediastinum. DIAGNOSIS: Immunohistochemistry revealed positive for S100 fraction and Syn, focally positive for CgA, while negative for CKp and succinate dehydrogenase complex iron sulfur subunit B gene, and Ki67index ≈ 5%. The imaging and immunohistochemical features suggested a final diagnosis of Paragangliomas. INTERVENTIONS: This patient underwent lateral open heart surgery to remove a mediastinal mass. OUTCOMES: One month after being discharged, the patient was contacted by phone for a follow-up visit and reported feeling OK. Unfortunately, as of the date of submission, the patient did not come to our hospital for review. LESSONS: Mediastinal paraganglioma as a rare and potentially malignant tumor susceptible to misdiagnosis and mistreatment. Organ pathology examination is the gold standard for diagnosis, and surgery is an important treatment method. A clear diagnosis and thorough preoperative examination are important guarantees for the success of surgery.

New Perspective to Understand and Prioritize the Ecological Impacts of Organophosphate Esters and Transformation Products in Urban Stormwater and Sewage Effluents.

Due to their prevalence in urban contaminated water, the driving factors of organophosphate esters (OPEs) need to be well examined, and their related ecological impacts should include that of their transformation products (TPs). Additionally, a robust framework needs to be developed to integrate multiple variables related to ecological impacts for improving the ecological health assessment. Therefore, OPEs and TPs in urban stormwater and wastewater in Hong Kong were analyzed to fill these gaps. The results revealed that the total concentrations of OPEs in stormwater were positively correlated with the area of transportation land. Individual TP concentrations and the mass ratios of individual TPs/OPEs were somewhat higher in sewage effluents than that in stormwater. OPEs generally showed relatively higher risk quotients than TPs; however, the total risk quotients increased by approximately 38% when TPs were factored in. Moreover, the molecular docking results suggested that the investigated TPs might cause similar endocrine disruption in marine organisms as their parent OPEs. This study employed the Toxicological-Priority-Index scheme to successfully integrate the ecological risks and endocrine-disrupting effects to refine the ecological health assessment of the exposure to OPEs and their TPs, which can better inform the authority on the prioritization for regulating these contaminants of emerging concern in urban built environments.

Microplastic occurrence and ecological risk assessment in the eight outlets of the Pearl River Estuary, a new insight into the riverine microplastic input to the northern South China Sea.

Estuaries are unique transition zones connecting terrestrial and coastal environments and are recognized as primary conveyors for land-derived plastics to open oceans. Riverine microplastics (MPs) have been commonly investigated using sequential sampling which might not effectively reflect the actual load. In this study, sampling at eight outlets was performed during a complete tidal cycle to estimate the MP flux to the Pearl River Estuarine (PRE) using a concurrent sampling strategy. The MP abundances ranged from 2.90 ± 0.57-5.9 ± 2.27 particles/L. A remarkable difference between tides in MP abundances suggests tidal effect should not be overlooked in assessment. The MP load through the eight outlets was estimated at 304 trillion particles or 1102 tons into the PRE annually. Additionally, similar potential ecological risk assessment among eight rivers implied that environmental threats posed by less urbanized and populated rural areas on the western side have been under-evaluating for decades.

Significant riverine inputs of typical plastic additives-phthalate esters from the Pearl River Delta to the northern South China Sea.

Phthalate esters (PAEs) are representative additives used extensively in plastics. In this study, 15 PAEs were investigated at the eight riverine outlets of the Pearl River Delta (PRD). The total concentrations of Σ15PAEs, including both the dissolved and particulate phases, ranged from 562 to 1460 ng/L and 679 ng/L-2830 ng/L in the surface and bottom layers, respectively. Dibutyl phthalate (DBP) and di(2-ethylhexyl) phthalate (DEHP) dominated in the dissolved and suspended particulate matter (SPM) phases, respectively, accounting for >50 % and > 80 % of Σ15PAEs. Riverine input of wastewater from the PRD was possibly the primary source of the contamination. Higher levels of PAEs occurred at the eastern outlets than at the western ones. The dissolved and particulate PAEs varied seasonally, with significantly higher concentrations observed in the dry season than in the wet season. However, no significant differences of PAE levels in both phases were observed among low, medium, and high tides. The partitioning results demonstrated that SPM is important in the transportation of pollutants in estuaries, where more hydrophobic DEHP was predominantly transported by the SPM phase, while those more hydrophilic ones were regularly transported by the dissolved phase. The total annual flux of Σ15PAEs through the eight outlets to the SCS reached 1390 tons.

A systematic study of microplastic occurrence in urban water networks of a metropolis.

The release of microplastics from sewage treatment works (STWs) into the oceans around coastal cities is well documented. However, there are fewer studies on the microplastic abundance in stormwater drains and their emissions into the coastal marine environment via sewage and stormwater drainage networks. Here, we comprehensively investigated microplastic abundance in 66 sewage and 18 sludge samples collected from different process stages at three typical STWs and 36 water samples taken from six major stormwater drains during the dry and wet seasons in Hong Kong, which is a metropolitan city in south China. The results showed that microplastics were detected in all the sewage and stormwater samples, with the abundance ranging from 0.07 to 91.9 and from 0.4 to 36.48 particles/L, respectively, and in all the sludge samples with the abundance ranging from 167 to 936 particles/g (d. w.). There were no significant seasonal variations in the microplastic abundance across all samples of sewage, sludge, and stormwater. For both waterborne sample types, a smaller size (0.02-0.3 mm) and fiber shape were the dominant characteristics of the microplastics. Polyethylene terephthalate (PET) and polypropylene (PP) were the most abundant polymer types in the sewage samples, while polyethylene (PE), PET, PP, and PE-PP copolymer were the most abundant polymer types in the stormwater samples. The estimated range of total daily microplastic loads in the effluent from STWs in Hong Kong is estimated to be 4.48 × 109 - 2.68 × 1010 particles/day, demonstrating that STWs are major pathways of microplastics in coastal environments despite the high removal percentage of microplastics in sewage treatment processes examined. This is the first comprehensive study on microplastics in the urban waters of a coastal metropolis. However, further studies on other coastal cities will enable an accurate estimation of the microplastic contribution of stormwater drains to the world's oceans.

The beneficial cutoffs of vitamin D for metabolic syndrome varies by sex among the elderly Chinese population: A cross-sectional study.

Metabolic syndrome (MetS) is a risk factor for various diseases with a high prevalence globally. We aimed to investigate the association of serum vitamin D levels with MetS, and we hypothesized that the beneficial cutoffs of vitamin D for MetS might vary by sex among urban people aged ≥60 years in Tianjin, China. This community-based cross-sectional study was conducted in 2 community health centers. We collected lifestyle and anthropometric information and measured serum 25(OH)D3 concentrations by high-performance liquid chromatography. MetS was diagnosed based on the 2009 International Diabetes Federation/American Heart Association/National Heart, Lung, and Blood Institute criterion. Binary logistic regression and stratification analysis were performed to determine the association between MetS and 25(OH)D3 levels. Among 840 eligible participants (347 males and 493 females), 439 (52.3%) were diagnosed with MetS. The prevalence rates of MetS in men and women were 52.7% and 51.9%, respectively (P = .82). In the whole population, no significant association was found between 25(OH)D3 and MetS, regardless of which 25(OH)D3 cutoff was used. After stratification by sex, men with serum 25(OH)D3 ≥40 ng/mL had a significantly lower risk of MetS before and after adjustment, with odds ratios (ORs) and 95% confidence intervals (CIs) of 0.55 (0.31-0.98) and 0.53 (0.29-0.96), respectively. For women, serum 25(OH)D3 ≥20 ng/mL was associated with a lower MetS risk, with unadjusted and adjusted ORs (95% CI) of 0.64 (0.43-0.95) and 0.61 (0.41-0.91), respectively. This association was more significant among females with respect to diastolic pressure and triglycerides. The beneficial cutoffs of serum 25(OH)D3 levels for MetS among men and women might be different.

Association between Early Oral ß-Blocker Therapy and Risk for In-Hospital Major Bleeding after Percutaneous Coronary Intervention for Acute Coronary Syndrome: Findings from CCC-ACS Project.

AIMS: Information regarding ß-blocker use and bleeding risk in patients on antithrombotic therapy in contemporary practice is limited. We examined the association between early (within the first 24 hours) oral ß-blocker therapy and major in-hospital bleeds among acute coronary syndrome (ACS) patients treated with percutaneous coronary intervention (PCI). METHODS AND RESULTS: In the Improving Care for Cardiovascular Disease in China-ACS project, among patients without contraindications to ß-blocker, we examined the association between early oral ß-blocker exposure [users/non-users, dosing, and type (metoprolol vs. bisoprolol)] and major in-hospital bleeds. Of the 43,640 eligible patients, 36.0% patients received early oral ß-blocker and 637 major bleeds were recorded. Compared with non-users, early oral ß-blocker was associated reduced risks for major bleeds [odds ratio (OR): 0.48; 95% confidence interval (CI): 0.38-0.61] and in-hospital mortality (OR: 0.47; 95%CI: 0.34-0.64) in multivariable-adjusted logistic regression models. Early oral ß-blocker use associated reduction in major bleeding was evident both in high-dose (defined by metoprolol-equivalent dose ≥50 mg/day) users (OR: 0.47; 95%CI: 0.33-0.68) and in low-dose users (metoprolol-equivalent dose <50 mg/day; OR: 0.61; 95%CI: 0.47-0.79). No significant difference was observed between metoprolol and bisoprolol in terms of reductions in major bleeding and mortality. Analyses based on inverse-probability-of-treatment-weighted regression adjustment and propensity-score matching yielded consistent findings. CONCLUSION: In this retrospective study based on the nationwide ACS registry, among patients treated by PCI, in addition to a reduction in in-hospital mortality, oral ß-blocker therapy initiated within the first 24 hours was associated with a reduced risk for major in-hospital bleeds. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02306616.

Spatiotemporal occurrence of phthalate esters in stormwater drains of Hong Kong, China: Mass loading and source identification.

Urban stormwater is an important pathway for transporting anthropogenic pollutants to water bodies. Phthalate esters (PAEs) are endocrine disruptors owing to their estrogenic activity and potential carcinogenicity and their ubiquitous presence has garnered global interest. However, their transportation by urban stormwater has been largely overlooked. This study, for the first time, investigated 15 PAEs in stormwater from six major stormwater drains in the highly urbanized Hong Kong, a major metropolitan city in China. The results showed that PAEs were ubiquitous in the stormwater of Hong Kong, with total concentrations (∑15PAEs) spanning from 195 to 80,500 ng/L. Bis(2-n-butoxyethyl) phthalate (DBEP), diisopentyl phthalate (DiPP), dicyclohexyl phthalate (DCHP) and di-n-pentyl phthalate (DnPP) were detected in stormwater for the first time. Spatial variations in PAEs were observed among different stormwater drains, possibly due to the different land use patterns and intensities of human activities in their respective catchments. The highest and lowest levels of ∑15PAEs were found in Kwai Chung (3860 ± 1960 ng/L) and the Ng Tung River (672 ± 557 ng/L), respectively. Additionally, significantly higher concentrations of ∑15PAEs in stormwater were found in the wet season (2520 ± 2050 ng/L) than in the dry season (947 ± 904 ng/L). Principal component analysis classified domestic and industrial origins as two important sources of PAEs in the stormwater of Hong Kong. Stormwater played a crucial role in transporting PAEs, with an estimated annual flux of 0.705-29.4 kg. Thus, possible stormwater management measures were proposed to protect the receiving environment and local ecosystems from stormwater.

The Impact of Age on Statin-Related Glycemia: A Propensity Score-Matched Cohort Study in Korea.

The aim of this study was to investigate the influence of statin on glycemic control in different age groups. Patients admitted for suspected or confirmed coronary artery disease between January 2005 and December 2013 in Seoul, Korea were initially enrolled. After propensity score matching, 2654 patients (1:1 statin users and non-users) were selected out of total 5041 patients, including 1477 "young" patients (≤60 y) and 1177 elderly patients (>60 y). HbA1c was decreased by 0.04% (±0.86%) in statin non-users. On the contrary, a slight increment of 0.05% (±0.71%) was found in statin users (p < 0.001). The change patterns of HbA1c were constant in both young and elderly patient groups. Furthermore, elderly statin users demonstrated significantly worse glycemic control in serum insulin and homeostatic model assessment­insulin resistance (HOMA-IR) index. In elderly patients, statin users were found to have a 2.61 ± 8.34 µU/mL increment in serum insulin, whereas it was 2.35 ± 6.72 µU/mL for non-users (p = 0.012). Statin users had a 0.78 ± 3.28 increment in HOMA-IR, in contrast to the 0.67 ± 2.51 increment in statin non-users (p = 0.008). In conclusion, statin treatment was associated with adverse glycemic control in the elderly population.

Microplastics: A major source of phthalate esters in aquatic environments.

Phthalate esters (PAEs) are predominant additives in plastics, their widespread contamination in aquatic environments has raised global concern. Here, twelve plastic products were prepared as microplastics to investigate their release behaviors of PAEs. Six out of 15 PAEs were quantified after 14 days of incubation in water. The leaching potentials were plastic type-specific, where the pencil case (polyvinyl chloride, PVC) represented the highest migrations with total ∑15 PAEs concentration of 6660 ± 513 ng/g, followed by the cleaning brush-1 (polyamide, PA, ~1830 ng/g) and rubber glove (1390 ± 57.5 ng/g). Conversely, the straw (polypropylene, PP), cleaning brush-2 (polyethylene terephthalate, PET) and shampoo bottle (PET) released the lowest amounts of PAEs, with 50.3 ± 8.21, 93.9 ± 91.8 and 104.35 ng/g, respectively. The release patterns of PAE congeners were polymer type-related, where di-n-butyl phthalate (DBP) dominated the leaching from PA, PP and PET microplastics (47-84%), diethyl phthalate leached the most from PVC and rubber microplastics (45-92%), while diisobutyl phthalate and DBP dominated the leaching from PE microplastics (68-94%). Water chemical properties could affect PAEs migration and the kinetic leaching process was well fitted with the pseudo-first-order model. Approximately 57.8-16,100 kg/year of PAEs were estimated to be released into oceans from microplastics.

Microplastic occurrence in the northern South China Sea, A case for Pre and Post cyclone analysis.

Microplastics (MPs) have become a great concern owing to their persistence and ecotoxicity in various environmental compartments. MPs can be transported from land to oceans via the aquatic system, and the oceans are believed to be the final sink for MPs. To resolve the lack of data concerning MP contamination in the northern South China Sea (NSCS), coastal seawater and sediments were investigated. The sample sites included the coastal area from Hong Kong to western Guangdong Province, which provided a representative coverage of variable distance to the shore. MP particles were observed in all samples, suggesting a widespread MP pollution in NSCS. The average MP abundance was relatively high in South China Sea, but it was lower than that in other Chinese coastal areas. In all samples, the dominant MP polymer was polyethylene terephthalate fibers. No statistically significant correlation was found between the abundances of MPs in seawater and sediment. The MP distribution in surface water affected by the monsoon exhibited high abundance in the east and low in the west, and MPs were more abundant near the shore than away from it. The tropical cyclone had no obvious effect on the overall MP abundance except in the Hong Kong west marine water (R4), which may attribute to proximity to Hong Kong and other islands.

The effects of insulin therapy on mortality in diabetic patients undergoing percutaneous coronary intervention.

BACKGROUND: A growing number of studies have reported insulin therapy to be associated with a higher incidence of major adverse cardiac events in diabetic patients with coronary artery disease. However, the relationship between insulin use and the clinical outcomes of patients with diabetes who undergoing percutaneous coronary intervention (PCI) has not been fully clarified. METHODS: A total of 1,069 consecutive patients with diabetes who underwent PCI were enrolled and divided into 2groups: oral hypoglycemic agents (OHA) group (709 patients) and insulin therapy group (360 patients). The primary and secondary endpoints of this study were all-cause death and cardiac death, respectively. RESULTS: At baseline, the maximum creatine kinase-MB (CK-MB), plasma glucose, hemoglobin A1c, high-sensitivity C-reactive protein (CRP), and creatinine levels were higher, while the left ventricular ejection fraction (LVEF) was lower, in the insulin therapy group than in the OHA group. After propensity score matching of baseline characteristics, for patients treated with insulin, the odds ratios of death from any cause in hospital, within 1 year of surgery, and within 2 years of surgery were 12.03 (95% CI: 1.486-97.33, P=0.020), 10.33 (95% CI: 1.21-88.12, P=0.033), and 2.99 (95% CI: 1.22-7.31, P=0.016), respectively, and the odds ratios of cardiac death were 10.33 (95% CI: 1.21-88.12, P=0.033), 6.49 (95% CI: 1.33-31.59, P=0.021), and 5.27 (95% CI: 1.45-19.13, P=0.011), respectively. Generalized estimating equations analysis showed the odds ratios of all-cause death and cardiac death for insulin-treated patients to be 4.77 (95% CI: 1.76-12.95, P=0.002) and 5.38 (95% CI: 1.29-22.96, P=0.023), respectively. CONCLUSIONS: Compared with OHA, insulin therapy significantly increases the risk of in-hospital all-cause and cardiac death in patients with diabetes undergoing PCI, and the risk remains significantly at least 2 years after surgery.

Cetylpyridinium Trichlorostannate: Synthesis, Antimicrobial Properties, and Controlled-Release Properties via Electrical Resistance Tomography.

Cetylpyridinium trichlorostannate (CPC-Sn), comprising cetylpyridinium chloride (CPC) and stannous chloride, was synthesized and characterized via single-crystal X-ray diffraction measurements indicating stoichiometry of C21H38NSnCl3 where the molecules are arranged in a 1:1 ratio with a cetylpyridinium cation and a [SnCl3]- anion. CPC-Sn has shown potential for application as a broad-spectrum antimicrobial agent, to reduce bacteria-generated volatile sulfur compounds and to produce advanced functional materials. In order to investigate its controlled-release properties, electrical resistance tomography was implemented. The results demonstrate that CPC-Sn exhibits extended-release properties in an aqueous environment as opposed to the CPC counterpart.

Epidemiological Features of Glycemic Levels and Relative Determinants at Different Altitudes Among Tibetans in China: A Cross-Sectional Population-Based Study.

Risk factors associated with diabetes mellitus have been widely researched worldwide, but the determinants of glycemic levels among Tibetans in China are currently unclear. We thus aimed to determine the relationship between altitude and glycemic levels and to identify factors associated with glycemic levels among Tibetans in China. In 2011, a total of 1,659 Tibetans (aged ≥18 years) from Changdu, China, were enrolled to this cross-sectional research. Potential factors associated with postprandial glucose (PPG), fasting plasma glucose (FPG), and insulin (INS) levels were assessed. FPG and PPG levels increased with age and total cholesterol (TC) level. In addition, FPG levels were higher among patients with rural residence and hypertension, while PPG levels increased with increasing BMI. INS levels increased with residence, lower education, higher BMI, and higher TG levels and decreased with higher altitude and TC levels. Moreover, risk factors for FPG, PPG, and INS differed in those residing at a higher altitude. These findings identify several important risk factors that affect glycemic levels and may be used to develop effective strategies for metabolic disease prevention among populations in high-altitude areas. Furthermore, these findings suggest that it is necessary to formulate a standard for PPG, FPG, and INS in high-altitude areas.

Effects of atorvastatin combined with bivalirudin on coagulation function, cardiac function, and inflammatory factors of percutaneous coronary intervention in elderly patients with acute myocardial infarction.

BACKGROUND: Acute myocardial infarction (AMI) occurs when atherosclerotic lesions which present in the coronary arteries cause the intravascular plate to rupture and with the result of myocardial ischemia, hypoxia, and infarct. The preferred treatment for AMI is currently percutaneous coronary intervention (PCI), for which the key to the success is the choice of anticoagulant and thrombolytic drugs during surgery. Here, we aim to explore the effects of atorvastatin combined with bivalirudin on coagulation function, cardiac function, and inflammatory factors in elderly patients with AMI who underwent PCI. METHODS: The clinical data of 86 AMI patients who were admitted to our hospital between February 2016 and May 2018 were retrospectively analyzed. Based on different treatments, the patients were divided into the control group and the observation group, with 43 patients in each group. The control group patients were treated with bivalirudin, and the observation group was treated with bivalirudin plus atorvastatin. Both groups of patients underwent PCI and the clinical efficacy, coagulation function, cardiac function, inflammatory factor levels and cardiovascular events (MACE), and other clinical data were compared between the groups. RESULTS: The total clinical effective rate in the observation group was significantly higher than that in the control group (90.90% vs. 72.09%) (P<0.05). Fibrinogen (Fg) and D-dimer (D-D) levels were significantly decreased after treatment in both groups but were significantly lower in the observation group than in the control group. The prothrombin time (PT) was significantly prolonged after treatment in both groups but was significantly longer in the observation group than in the control group after treatment (P<0.05). Meanwhile, the left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were significantly reduced after treatment in both groups but were significantly lower in the observation group than in the control group, whereas the left ventricular ejection fraction (LVEF) was significantly higher in the observation group compared with the control group after treatment (P<0.05). After treatment, serum levels of transforming growth factor-ß1 (TGF-ß1), tumor necrosis factor-α (TNF-α), and IL-6 were significantly reduced in both groups but the levels were significantly lower in the observation group than in the control group (P<0.05). The overall incidence of MACE in the observation group was significantly lower than that in the control group (9.30% vs. 30.23%) (P<0.05). CONCLUSIONS: Atorvastatin combined with bivalirudin can improve the efficiency of clinical treatment in elderly AMI patients who undergo PCI, while simultaneously improving blood coagulation function and reducing the occurrence of bleeding, compared with bivalrudin alone. It can also decrease the level of inflammatory factors, promote vascular recanalization, and improve myocardial ischemia, thereby reducing the incidence of MACE and improving patient prognosis.

Synthesis, Characterization, and Investigation of the Antimicrobial Activity of Cetylpyridinium Tetrachlorozincate.

Cetylpyridinium tetrachlorozincate (referred to herein as (CP)2ZnCl4) was synthesized and its solid-state structure was elucidated via single-crystal X-ray diffraction (SC-XRD), revealing a stoichiometry of C42H76Cl4N2Zn with two cetylpyridinium (CP) cations per [ZnCl4]2- tetrahedra. Crystal structures at 100 and 298 K exhibited a zig-zag pattern with alternating alkyl chains and zinc units. The material showed potential for application as a broad-spectrum antimicrobial agent, to reduce volatile sulfur compounds (VSCs) generated by bacteria, and in the fabrication of advanced functional materials. Minimum inhibitory concentration (MIC) of (CP)2ZnCl4 was 60, 6, and 6 µg mL-1 for Salmonella enterica, Staphylococcus aureus, and Streptococcus mutans, respectively. The MIC values of (CP)2ZnCl4 were comparable to that of pure cetylpyridinium chloride (CPC), despite the fact that approximately 16% of the bactericidal CPC is replaced with bacteriostatic ZnCl2 in the structure. A modified layer-by-layer deposition technique was implemented to synthesize mesoporous silica (i.e., SBA-15) loaded with approximately 9.0 wt % CPC and 8.9 wt % Zn.

Site-Directed Mutagenesis Reveals Crucial Residues in Escherichia coli Resistance-Nodulation-Division Efflux Pump OqxB.

Resistance-nodulation-division (RND) efflux pumps are important determinants of multidrug resistance in Gram-negative bacteria. As one of the typical members of the RND superfamily, Escherichia coli OqxAB multidrug efflux pump confers resistance to antimicrobial agents, such as olaquindox and fluoroquinolone. In the present study, site-directed mutagenesis and antimicrobial susceptibility measurement assay were applied to identify the crucial residues within OqxB, the transporter component of the OqxAB efflux pump system. It was found that alanine substitution of proton translocation pathway residues D410, D411, and R976 resulted in a complete loss of the transport function. Further studies revealed that the charge property of these residues is important for proper function of OqxB. Alanine replacement of residues involved in substrate-binding domains, including V141, F180, Y330, and F626, exhibited different responses toward different antimicrobial agents. Conservative replacement of Y330, F626, and F180 with amino acids having similar aromatic ring structure resulted in full or partial recovery of the efflux function. Molecular docking analysis demonstrated that olaquindox may form hydrogen bonds with F626, Y330, and V141, whereas only Y330 and F180 may interact with ciprofloxacin, implicating the different roles played by these residues when transporting different kinds of substrates. Graphical Abstract [Figure: see text].