Artificial intelligence-driven computer aided diagnosis system provides similar diagnosis value compared with doctors' evaluation in lung cancer screening.

OBJECTIVE: To evaluate the consistency between doctors and artificial intelligence (AI) software in analysing and diagnosing pulmonary nodules, and assess whether the characteristics of pulmonary nodules derived from the two methods are consistent for the interpretation of carcinomatous nodules. MATERIALS AND METHODS: This retrospective study analysed participants aged 40-74 in the local area from 2011 to 2013. Pulmonary nodules were examined radiologically using a low-dose chest CT scan, evaluated by an expert panel of doctors in radiology, oncology, and thoracic departments, as well as a computer-aided diagnostic(CAD) system based on the three-dimensional(3D) convolutional neural network (CNN) with DenseNet architecture(InferRead CT Lung, IRCL). Consistency tests were employed to assess the uniformity of the radiological characteristics of the pulmonary nodules. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy. Logistic regression analysis is utilized to determine whether the two methods yield the same predictive factors for cancerous nodules. RESULTS: A total of 570 subjects were included in this retrospective study. The AI software demonstrated high consistency with the panel's evaluation in determining the position and diameter of the pulmonary nodules (kappa = 0.883, concordance correlation coefficient (CCC) = 0.809, p = 0.000). The comparison of the solid nodules' attenuation characteristics also showed acceptable consistency (kappa = 0.503). In patients diagnosed with lung cancer, the area under the curve (AUC) for the panel and AI were 0.873 (95%CI: 0.829-0.909) and 0.921 (95%CI: 0.884-0.949), respectively. However, there was no significant difference (p = 0.0950). The maximum diameter, solid nodules, subsolid nodules were the crucial factors for interpreting carcinomatous nodules in the analysis of expert panel and IRCL pulmonary nodule characteristics. CONCLUSION: AI software can assist doctors in diagnosing nodules and is consistent with doctors' evaluations and diagnosis of pulmonary nodules.

Impact of paravertebral block on perioperative neurocognitive disorder: a systematic review and meta-analysis of randomized controlled trials.

Objective: To investigate whether paravertebral block reduces postoperative delirium (POD)/delayed neurocognitive recovery (DNR) in adults after major surgery with general anesthesia. Methods: For this systematic review and meta-analysis, we searched online databases PubMed, EMBASE, CENTRAL, and Web of Science till March 19th, 2023 to examine studies which use paravertebral block (PVB) for perioperative neurocognitive disorder. Primary and secondary outcomes were identified for the incidence of perioperative neurocognitive disorder. We did not restrict the follow-up duration of the included studies. Statistical analysis was performed to calculate mean difference (MD), Odd ratios (OR) and CI between RCTs. The quality of the evidence was assessed with the Cochrane risk of bias tool. The registration number of the study in PROSPERO is CRD42023409502. PROSPERO is an international database of prospectively registered systematic reviews. Registration provides transparency in the review process and it helps counter publication bias. Results: Total 1,225 patients from 9 RCTs were analyzed. The incidence of POD [Odds Ratio (OR) = 0.48, 95% CI 0.32, 0.72; p = 0.0004; I2 = 0%] and DNR [OR = 0.32, 95% CI 0.13, 0.80; p = 0.01; I2 = 0%] were significantly reduced in PVB group. The analysis showed no significant differences in postoperative MMSE scores [MD = 0.50, 95% CI -2.14, 3.15; p = 0.71; I2 = 98%]. Paravertebral block analgesia reduces pain scores and/or opioid use after surgery. Additionally, blood pressure was significantly lower in the PVB group, intraoperatively [MD = -15.50, 95% CI -20.71, -10.28; p < 0.001; I2 = 12%] and postoperatively [MD = -5.34, 95% CI -10.65, -0.03 p = 0.05; I2 = 36%]. Finally, PVB group had significantly shorter hospital stays [MD = -0.86, 95% CI -1.13, -0.59; p < 0.001; I2 = 0%]. Conclusion: Paravertebral block analgesia may prevent perioperative POD/DNR in patients undergoing major surgery. Further research with large sample sizes is required to confirm its effectiveness.

Epidemiology and Association Rules Analysis for Pulmonary Tuberculosis Cases with Extrapulmonary Tuberculosis from Age and Gender Perspective: A Large-Scale Retrospective Multicenter Observational Study in China.

Background: Tuberculosis (TB), a multisystemic disease with protean presentation, remains a major global health problem. Although concurrent pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) cases are commonly observed clinically, knowledge regarding concurrent PTB-EPTB is limited. Here, a large-scale multicenter observational study conducted in China aimed to study the epidemiology of concurrent PTB-EPTB cases by diagnostically defining TB types and then implementing association rules analysis. Methods: The retrospective study was conducted at 21 hospitals in 15 provinces in China and included all inpatients with confirmed TB diagnoses admitted from Jan 2011 to Dec 2017. Association rules analysis was conducted for cases with concurrent PTB and various types of EPTB using the Apriori algorithm. Results: Evaluation of 438,979TB inpatients indicated PTB was the most commonly diagnosed (82.05%) followed by tuberculous pleurisy (23.62%). Concurrent PTB-EPTB was found in 129,422 cases (29.48%) of which tuberculous pleurisy was the most common concurrent EPTB type observed. The multivariable logistic regression models demonstrated that odds ratios of concurrent PTB-EPTB cases varied by gender and age group. For PTB cases with concurrent EPTB, the strongest association was found between PTB and concurrent bronchial tuberculosis (lift = 1.09). For EPTB cases with concurrent PTB, the strongest association was found between pharyngeal/laryngeal tuberculosis and concurrent PTB (lift = 1.11). Confidence and lift values of concurrent PTB-EPTB cases varied with gender and age. Conclusions: Numerous concurrent PTB-EPTB case types were observed, with confidence and lift values varying with gender and age. Clinicians should screen for concurrent PTB-EPTB in order to improve treatment outcomes.

Risk factors for delayed neurocognitive recovery in elderly patients undergoing thoracic surgery.

BACKGROUND: To investigate the risk factors for delayed neurocognitive recovery in elderly patients undergoing thoracic surgery. METHODS: A total of 215 elderly patients who underwent thoracic surgery between May 2022 and October 2022 were recruited in this prospective observational study. Cognitive function was tested by MoCA tests that were performed by the same trained physician before surgery, on postoperative day 4 (POD4), and on postoperative day 30 (POD30). Univariate and multivariate logistic regression models were used to analyze the risk factors for DNR. RESULTS: A total of 154 patients (55.8% men) with an average age of 67.99 ± 3.88 years were finally included. Patients had an average preoperative MoCA score of 24.68 ± 2.75. On the 30th day after surgery, 26 (16.88%) patients had delayed postoperative cognitive recovery, and 128 (83.12%) had postoperative cognitive function recovery. Diabetes mellitus (OR = 6.508 [2.049-20.664], P = 0.001), perioperative inadvertent hypothermia (< 35℃) (OR = 5.688 [1.693-19.109], P = 0.005), history of cerebrovascular events (OR = 10.211 [2.842-36.688], P < 0.001), and VICA (sevoflurane combined with propofol anesthesia) (OR = 5.306 [1.272-22.138], P = 0.022) resulted as independent risk factors of delayed neurocognitive recovery. On the POD4, DNR was found in 61 cases (39.6%), and age ≥ 70 years (OR = 2.311 [1.096-4.876], P = 0.028) and preoperative NLR ≥ 2.5 (OR = 0.428 [0.188-0.975], P = 0.043) were identified as independent risk factors. CONCLUSIONS: The risk factors for delayed neurocognitive recovery in elderly patients undergoing thoracic surgery include diabetes, perioperative inadvertent hypothermia (< 35℃), VICA (sevoflurane combined with propofol anesthesia), and history of cerebrovascular events.

Advances of supramolecular interaction systems for improved oil recovery (IOR).

Improved oil recovery (IOR) includes enhanced oil recovery (EOR) and other technologies (i.e. fracturing, water injection optimization, etc.), have become important methods to increase the oil/gas production in petroleum industry. However, conventional flooding systems always encounter the problems of low efficiency, high cost and complicated synthetic procedures for harsh reservoirs conditions. In recent decades, the supramolecular interactions are introduced into IOR processes to simplify the synthetic procedures, alter their structures and properties with bespoke functionalities and responsiveness suitable for different conditions. Herein, we primarily review the fundamentals of several supramolecular interactions, including hydrophobic association, hydrogen bond, electrostatic interaction, host-guest recognition, metal-ligand coordination and dynamic covalent bond from intrinsic principles and extrinsic functions. Then, the descriptions of supramolecular interactions in IOR processes from categories and advances are focused on the following variables: polymer, surfactant, surfactant/polymer (SP) complex for EOR and viscoelasticity surfactant (VES) for clean hydraulic fracturing aspects. Finally, the field applications, challenges and prospects for supramolecular interactions in IOR processes are involved and systematically addressed. The development of supramolecular interactions can open the way toward adaptive and evolutive IOR technology, a further step towards the cost-effective production of petroleum industry.

Epidemiology of concurrent extrapulmonary tuberculosis in inpatients with extrapulmonary tuberculosis lesions in China: a large-scale observational multi-centre investigation.

AIMS: A high proportion of all patients with tuberculosis (TB) present with extrapulmonary TB (EPTB), including concurrent EPTB involving more than one extrapulmonary lesion site. However, previous reports only characterized lesions of single-site EPTB cases. This study aimed to investigate epidemiological characteristics and association rules of concurrent EPTB cases in China. METHODS: An observational multi-centre study of 208,214 patients with EPTB lesions was undertaken in China from January 2011 to December 2017. Multi-variable logistic regression analysis was used to identify associations between gender and concurrent EPTB, and age and concurrent EPTB. Association rules were analysed for significance using the Apriori algorithm. RESULTS: The most common EPTB lesion was tuberculous pleurisy (49.8%), followed by bronchial TB (14.8%) and tuberculous meningitis (7.6%). The most common type of concurrent EPTB was tuberculous pleurisy concurrent with tuberculous peritonitis (1.80%). In total, 22 association rules, including 20 strong association rules, were identified; among these, the highest confidence rates were found for tuberculous myelitis concurrent with tuberculous meningitis, and sacral TB concurrent with lumbar vertebral TB. The association rules of EPTB concurrent with other EPTB types were found to vary with gender and age. The confidence rate of tuberculous myelitis concurrent with tuberculous meningitis was higher in females (83.67%) than males, and was highest in patients aged 25-34 years (87.50%). CONCLUSIONS: Many types of concurrent EPTB were found. Greater awareness of concurrent EPTB disease characteristics is needed to ensure timely clinical diagnosis and treatment of this disease.

On the effects of organic-acids isomers on temperature-responsiveness in wormlike micelles (WLMs) systems.

Responsive wormlike micelles (WLMs) consisted of cationic surfactants and organic-acids are fascinating due to their reversible molecular recognition properties. However, it is unknown how the structure of organic-acids alters the stimuli-responsiveness of WLMs systems. Herein, the peculiar nature of temperature-responsive behaviors in three WLMs systems were systematically investigated. These were manufactured by combining N-erucamidopropyl-N,N-dimethylamine (UC22AMPM) with isomers of organic-acids: o-phthalic acid (o-PA), m-phthalic acid (m-PA) and p-phthalic acid (p-PA) at molar ratio of 2:1 (named as o-EAPA, m-EAPA and p-EAPA respectively). The phase behaviors, macro- and micro-rheology, as well as the mechanism of temperature-responsiveness were explored by visual inspection, rheological and optical methods. The results showed that the three systems exhibited different responsiveness with increase of temperature. Among them, the viscosity and viscoelasticity of o-EAPA were gradually decreased with temperature increase from 30 °C to 90 °C. On the other hand, those of p-EAPA were firstly increased and subsequently decreased, exhibiting the highest viscosity during the heating process. This peculiar phenomenon was attributed to the hydrophilic difference of organic-acids isomers, leading to variations of micelle transitions upon temperature increase. This study is the first report of aromatic-acids isomers inducing different on temperature-responsiveness, and finding beneficial for the development of responsive WLMs for different applications.

Advances of microemulsion and its applications for improved oil recovery.

Microemulsion, because of its excellent interfacial tension reduction and solubilization properties, has wide range of applications in the petroleum industry, especially in improved oil recovery (IOR). Herein, the concept, types and formation mechanism of microemulsion were primarily introduced. Then, the preparation and characterization methods were illustrated. Additionally, several effect factors were elaborated specifically based on the composition of microemulsion. Finally, the application of microemulsion in IOR was addressed, including IOR mechanism analysis based on sweep efficiency and displacement efficiency, injection method (microemulsion flooding, in-situ microemulsion formation) and field tests. Furthermore, the current challenges and prospects of microemulsion on IOR were analyzed.

A review of wettability alteration using surfactants in carbonate reservoirs.

The wettability of carbonate rocks is often oil-wet or mixed wet. A large fraction of oil is still remained in carbonate reservoirs, it is therefore of particular significance to implement effective methods to improve oil recovery from carbonate reservoirs. Altering wettability from oil-wet to more favorable water-wet has been proven successful to achieve this goal. Surfactants are widely investigated and served as wettability modifiers in this process. Yet a comprehensive review of altering wettability of carbonate reservoirs with surfactants is ignored in literature. This study begins with illustration of wettability evolution process in carbonate reservoirs. Techniques to evaluate wettability alteration extent or to reveal behind mechanisms are also presented. Several surfactant systems are analyzed in terms of their wettability alteration mechanisms, influential factors of performance, applicable conditions, and limitations. Mixture of different types of surfactants could obtain synergic effects, where applicable conditions are extended, and final performance is improved. Gemini surfactants have many desirable properties, which warrants further investigation for understanding their wettability alteration mechanisms and performance. At the end, this review discusses strategies related with surfactant cost, surfactant adsorption, and challenges at high temperature, high salinity reservoirs conditions. Also, some unclear issues are discussed.

An Advanced Material with Synergistic Viscoelasticity Enhancement of Hydrophobically Associated Water-Soluble Polymer and Surfactant.

In order to prepare materials with controllable properties, changeable microstructure, and high viscoelasticity solution with low polymer and surfactant concentration, a composite is constituted by adding surfactant (sodium dodecyl sulfate, SDS) to hydrophobically associated water-soluble polymer (abbreviated as PAAC) solution. The viscoelasticity, aggregate microstructure, and interaction mechanism of the composite are investigated by rheometery, Cryo-transmission electron microscopy (Cryo-TEM), and fluorescence spectrum. The results show that when the mass ratio of polymer to surfactant is 15:1, the viscosity of the composite reaches the maximum. The viscosity of the composite system increases hundredfold. The viscosity plateau under dynamic shear is generated. The composite has the properties of high viscoelasticity, strong shear thinning behavior, and good salt tolerance, and temperature resistance. The maximum viscosity of the composite is shown at the salinity of 20000 mg L-1 . In addition, there is no phase separation in the composite with the increase of polymer and surfactant concentration, which indicates the good stability of the system. It is proposed a method to obtain a high viscoelasticity solution by adding surfactants without wormlike micelles to a hydrophobically associated water-soluble polymer solution.

Factors associated with differential T cell responses to antigens ESAT-6 and CFP-10 in pulmonary tuberculosis patients.

ABSTRACT: The T-SPOT.TB assay detects cellular immune responses to 2 core Mycobacterium tuberculosis antigens, early secreted antigenic target of 6-kDa protein (ESAT-6) and culture filtrate protein-10 (CFP-10). T-SPOT.TB has been recently used for auxiliary diagnosis of active pulmonary tuberculosis (PTB). However, testing can produce inconsistent results due to differential PTB patient immune responses to these antigens, prompting us to identify factors underlying inconsistent results.Data were retrospectively analyzed from 1225 confirmed PTB patients who underwent T-SPOT.TB testing at 5 specialized tuberculosis hospitals in China between December 2012 and November 2015. Numbers of spot-forming cells (SFCs) reflecting T cell responses to ESAT-6 and CFP-10 antigens were recorded then analyzed via multivariable logistic regression to reveal factors underlying discordant T cell responses to these antigens.The agreement rate of 84.98% (82.85%-86.94%) between PTB patient ESAT-6 and CFP-10 responses demonstrated high concordance. Additionally, positivity rates were higher for ESAT-6 than for CFP-10 (84.8% vs 80.7%, P < .001), with ESAT-6 and CFP-10 microwell SFC numbers for each single positive group not differing significantly (P > .99), while spot numbers of the single positive group were lower than numbers for the double positive group (P < .001). Elderly patients (aged ≥66 years) and patients receiving retreatment were most likely to have discordance results.ESAT-6 promoted significantly more positive T-SPOT.TB results than did CFP-10 in PTB patients. Advanced age and retreatment status were correlated with discordant ESAT-6 and CFP-10 results. Assessment of factors underlying discordance may lead to improved PTB diagnosis using T-SPOT.TB.

Progress of polymer gels for conformance control in oilfield.

For the past decades, long-term water flooding processes have led to water channeling in mature reservoirs, which is a severe problem in oilfields. The development of better plugging ability and cost-effective polymer gel is a key aspect for the control of excess water production. Research on polymer gel applicable in a heterogeneous reservoir to plug high permeable channels has been growing significantly as revealed by numerous published scientific papers. This review intends to discuss the polymer gel techniques from innovations to applications. The related difficulties and future prospects of polymer gels are also covered. Developments of polymer gels to resist temperature, early gel formation, synergistic mechanisms and influence of pH, high salinity are systematically emphasized. The review provides a basis to develop polymer gels for future applications in oilfields to meet harsh reservoir conditions. It will assist the researchers to further develop polymer gels to improve the oil recovery from mature reservoirs under economic conditions to meet the requirements of future oilfields.

The prevalence and risks of major comorbidities among inpatients with pulmonary tuberculosis in China from a gender and age perspective: a large-scale multicenter observational study.

In clinical practice, PTB patients have concurrent many types of comorbidities such as pneumonia, liver disorder, diabetes mellitus, hematological disorder, and malnutrition. Detecting and treating specific comorbidities and preventing their development are important for PTB patients. However, the prevalence of most comorbid conditions in patients with PTB is not well described. We conducted a large-scale, multicenter, observational study to elucidate and illustrate the prevalence rates of major comorbidities in inpatients at 21 hospitals in China. The 19 specific comorbidities were selected for analysis in this patient cohort, and stratified the inpatient cohort according to age and gender. A total of 355,929 PTB inpatients were included, with a male:female ratio of 1.98 and the proportion of ≥ 65 years PTB inpatients was the most. Approximately 70% of PTB inpatients had at least one defined type of comorbidity. The prevalence of 19 specific comorbidities in inpatients with PTB was analyzed, with pneumonia being the most common comorbidity. The prevalence of most comorbidities was higher in males with PTB except thyroid disorders, mental health disorders, etc. The prevalence of defined most comorbidities in patients with PTB tended to increase with increasing age, although some specific comorbidities tended to increase initially then decrease with increasing age. Our study describes multiple clinically important comorbidities among PTB inpatients, and their prevalence between different gender and age groups. The results will enhance the clinical aptitude of physicians who treat patients with PTB to recognize, diagnose, and treat PTB comorbidities early.

pH-Responsive aggregates transition from spherical micelles to WLMs induced by hydrotropes based on the dynamic imine bond.

In recent years, the use of dynamic chemical bonds to construct stimulus-responsive micelle systems has received increasing attention. However, current reports focus on the construction of dynamic covalent bond surfactants using dynamic chemical bonds, and the method of applying dynamic covalent bonds to hydrotropes has not been reported yet. In this study, a novel pH-responsive worm-like micelle system was constructed by mixing cetyltrimethylammonium bromide (CTAB), 4-hydroxybenzaldehyde (HB) and p-toluidine (MB) at the molar ratio of 60 mM : 40 mM : 40 mM. The formation mechanism of the dynamic covalent bond hydrotropes and the rheological behavior of the micelles were investigated via rheology, 1H-NMR spectroscopy and Cryo-TEM. The results show that as the pH increases, the viscosity of the solution first decreases and then increases rapidly. The microscopic aggregates in the solution transition from spherical micelles to worm-like micelles (WLMs), and the solution changes from a water-like fluid without viscosity to a gel system that can withstand its own weight. The transformation of the aggregates and their rheology can be attributed to the formation of MB-HB-, which is a type of hydrotrope with dynamic covalent bonds. Moreover, the transition from spherical micelles to worm-like micelles in this system is reversible.

The epidemiology of extrapulmonary tuberculosis in China: A large-scale multi-center observational study.

Tuberculosis (TB) remains a serious global public health problem in the present. TB also affects other sites (extrapulmonary tuberculosis, EPTB), and accounts for a significant proportion of tuberculosis cases worldwide. In order to comprehensively understand epidemiology of EBTB in China, and improve early diagnosis and treatment, we conducted a large-scale multi-center observational study to assess the demographic data and the prevalence of common EPTB inpatients, and further evaluate the prevalence of EPTB concurrent with Pulmonary tuberculosis (PTB) and the associations between multiple EPTB types and gender-age group in China. All consecutive age≥15yr inpatients with a confirmed diagnosis of EPTB during the period from January 2011 to December 2017 were included in the study. The descriptive statistical analysis included median and quartile measurements for continuous variables, and frequencies and proportions with 95% confidence intervals (CIs) for categorical variables. Multinomial logistic regression analysis was used to compare the association of multiple EPTB types between age group and gender. The results showed that the proportion of 15-24 years and 25-34 years in EPTB inpatients were the most and the ratio of male: female was 1.51. Approximately 70% of EPTB inpatients were concurrent with PTB or other types of EPTB. The most common of EPTB was tuberculous pleurisy (50.15%), followed by bronchial tuberculosis (14.96%), tuberculous lymphadenitis of the neck (7.24%), tuberculous meningitis (7.23%), etc. It was found that many EPTB inpatients concurrent with PTB. The highest prevalence of EPTB concurrent with PTB was pharyngeal/laryngeal tuberculosis (91.31%), followed by bronchial tuberculosis (89.52%), tuberculosis of hilar lymph nodes (79.52%), tuberculosis of mediastinal lymph nodes (79.13%), intestinal tuberculosis (72.04%), tuberculous pleurisy (65.31%) and tuberculous meningitis (62.64%), etc. The results from EPTB concurrent with PTB suggested that females EPTB inpatients were less likely to be at higher risk of concurrent PTB (aOR = 0.819, 95%CI:0.803-0.835) after adjusted by age. As age increasing, the trend risk of concurrent PTB decreased (aOR = 0.994, 95%CI: 0.989-0.999) after adjusted by gender. Our study demonstrated that the common EPTB were tuberculous pleurisy, bronchial tuberculosis, tuberculous lymphadenitis of the neck, tuberculous meningitis, etc. A majority of patients with pharyngeal/laryngeal tuberculosis, bronchial tuberculosis, tuberculosis of hilar/mediastinal lymph nodes, intestinal tuberculosis, tuberculous pleurisy, tuberculous meningitis, etc. were concurrent with PTB. Female EPTB inpatients were less likely to be at higher risk of concurrent PTB, and as age increasing, the trend risk of concurrent PTB decreased. The clinicians should be alert to the presence of concurrent tuberculosis in EPTB, and all suspected cases of EPTB should be assessed for concomitant PTB to determine whether the case is infectious and to help for early diagnosis and treatment.

Prediction model for death in patients with pulmonary tuberculosis accompanied by respiratory failure in ICU: retrospective study.

BACKGROUND: The mortality rate of pulmonary tuberculosis (TB) patients with respiratory failure remains high. This study aimed to identify factors contributing to death in these patients, and develop a mortality prediction model for pulmonary TB patients with respiratory failure. METHODS: A retrospective study of patients admitted consecutively to the medical ICU of Beijing Chest Hospital, (Beijing, China), Chaoyang Fourth Hospital (Liaoning, China) and Hebi Third People's Hospital (Henan, China) from May 2018 to May 2019 was conducted. 153 patients with pulmonary TB accompanied by respiratory failure were enrolled. A multivariate analysis was performed to identify risk factors for death. A predictive fatality score was determined. The utility of the score for predicting death was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: The patients' median age was 57.82±19.42 years (17.0-87.0 years) and there were 106 males (69.28%). The mortality rate was 39.22% (60 of 153). Independent predictive factors of mortality included the PaO2 (hazard ratio 0.928, 95% CI: 0.882 - 0.976, P=0.004), Albumin (hazard ratio 0.881, 95% CI: 0.792- 0.980, P=0.019), Apache II score (hazard ratio 1.120, 95% CI: 1.017-1.234, P=0.022) and C-reactive protein (hazard ratio 1.012, 95% CI: 1.004-1.019, P=0.003). Establishing a logistic model of the death risk grade of pulmonary TB with respiratory failure was Y=1.710 - 0.068*PaO2-0.163* albumin + 0.215* Apache II +0.012* C-reactive protein. The value was Y=-0.494. If the Y value was greater than or equal to -0.494, the patients belonged to the deceased group, and if less than -0.494 the patients belonged to the survival group. AUC=0.818, The sensitivity was 83.3%; specificity was 73.1%. CONCLUSIONS: Pulmonary TB patients with respiratory failure have a high mortality rate and poor prognosis, particularly those with high Apache II scores, high C-reactive protein levels, low PaO2 admission to ICU and low albumin level. The prediction model will help assess the risk of death in patients with TB and respiratory failure.

The advances of organic chromium based polymer gels and their application in improved oil recovery.

In recent years, with the further development of old oilfields, in order to further improve the oil recovery, they must be conformance controlled. Among various types of conformance control methods, polymer gels composed of polymers and crosslinkers have attracted widespread attention because of their efficiency and low costs. Among them, organic chromium gels with their good formation adaptability and high stability have been fully developed in recent decades. This review introduces the different types of polymers and crosslinkers used in the preparation of organic chromium gels, and the mechanisms of affecting their performance are analyzed. On this basis, the organic chromium gels for different formation conditions are introduced, including nanoparticle-reinforced and compound organic chromium gels. At the same time, evaluation methods of organic chromium gels are introduced, while the focus is on the in-situ measurement method (mirco-rheology) of gel formation time developed in recent decades. Based on the currently developed organic chromium gel and the analysis of the development status in oilfields, future directions like the use of supramolecular organic chromium gel and shear organic chromium gel are suggested.

Effects of sodium chloride on rheological behaviour of the gemini-like surfactants.

The gemini-like surfactants have been constructed by compounding N-erucamidopropyl-N,N-dimethylamine (UC22AMPM) and o-phthalic acid (o-PA), m-phthalic acid (m-PA), or p-phthalic acid (p-PA), and are denoted as o-EAPA, m-EAPA, and p-EAPA, respectively. It is well known that inorganic salts have significant effects on surfactant aggregates, and herein the effects of sodium chloride (NaCl) on gemini-like surfactants is explored by rheological and dynamic light scattering measurements, and cryo-TEM. It is found that the viscoelasticity of the EAPA systems first increases and then decreases with an increase of the NaCl concentration. And the optimal NaCl concentrations for these three systems are in the order of o-EAPA < m-EAPA < p-EAPA due to different spacer distances between the two carboxyl groups in the phthalic acid. Similar trends in the N,N-dimethyl oleoaminde-propylamine (DOAPA) and o-PA, m-PA, or p-PA systems were also observed. The results show that an appropriate NaCl concentration will promote gemini-like surfactants to form wormlike micelles (WLMs). Upon further increasing the NaCl concentration, the WLMs transform into vesicles. Excessive NaCl concentration will cause the surfactant systems to reach their cloud point and make the surfactants precipitate out. The mechanism of the effects of NaCl is that Cl- reduces the electrostatic repulsion between the headgroups of the surfactants. This work is helpful in understanding the effects of inorganic salts on the surfactants and this study is useful for exploring the practical applications of gemini-like surfactants.

Advances of spontaneous emulsification and its important applications in enhanced oil recovery process.

Emulsions, including oil-in-water (O/W) and water-in-oil (W/O) emulsions, can play important roles in both controlling reservoir conformance and displacing residual oil for enhanced oil recovery (EOR) projects. However, current methods, like high-shear mixing, high-pressure homogenizing, sonicators and others, often use lots of extra energy to prepare the emulsions with high costs but very low energy efficiency. In recent decades, spontaneous emulsification methods, which allow one to create micro- and nano-droplets with very low or even no mechanical energy input, have been launched as an overall less expensive and more efficient alternatives to current high extra energy methods. Herein, we primarily review the basic concepts on spontaneous emulsification, including mechanisms, methods and influenced parameters, which are relevant for fundamental applications for industrials. The spontaneity of the emulsification process is influenced by the following variables: surfactant structure, concentration and initial location, oil phase composition, addition of co-surfactant and non-aqueous solvent, as well as salinity and temperature. Then, we focus on the description of importance for emulsions in EOR processes from advances and categories to improving oil recovery mechanisms, including both sweep efficiency and displacement efficiency aspects. Finally, we systematically address the applications and outlooks based on the use of spontaneous emulsification in the practical oil reservoirs for EOR processes, in which conventional, heavy, high-temperature, high-salinity and low-permeability oil reservoirs, as well as wastewater treatments after EOR processes are involved.

Unfavourable treatment outcomes in tuberculosis patients with different vitamin D status and blood glucose levels in a programme setting in China.

OBJECTIVE: Tuberculosis (TB) treatment success rates are high in China, but there are still a considerable number of cases who have unfavourable treatment outcomes (UTO). We aimed to determine the proportion of TB patients with UTO and to assess whether baseline characteristics that included glycaemic status [normal fasting blood glucose (FBG), transient hyperglycaemia and diabetes mellitus (DM)] and vitamin D status were associated with UTO. METHOD: Prospective cohort study conducted between November 2015 and July 2016 at six clinics within routine TB services in Jilin province, where persons with TB were consecutively recruited. Data analysis was performed using the chi-squared test and multivariate logistic regression. RESULTS: Of the 306 recruited TB patients, 96 (31.4%) had smear-positive pulmonary TB, 187 (61.1%) had smear-negative pulmonary TB and 23 (7.5%) had extrapulmonary TB (EPTB). Of these, 95 (31.1%) had normal blood glucose, 83 (27.1%) had transient hyperglycaemia and 128 (41.8%) had DM. 227 (74.2%) patients had vitamin D deficiency/severe deficiency. There were 125 (40.8%) patients with UTO of whom the majority were lost to follow-up (57.6%) or not evaluated (28.8%). UTO was significantly associated with smear-negative pulmonary TB (P = 0.009), EPTB (P < 0.001) and DM (P = 0.007). CONCLUSION: The proportion of TB patients with UTO increased with smear-negative pulmonary TB, EPTB and DM. TB programmes need to pay more attention to these issues and ensure intensive patient support to those at risk and early detection of DM.

OBJECTIF: Les taux de succès du traitement de la tuberculose (TB) sont élevés en Chine, mais il existe encore un nombre considérable de cas avec des résultats de traitement défavorables (RTD). Nous avons cherché à déterminer la proportion de patients TB avec un RTD et d'évaluer si les caractéristiques de base comprenant le statut glycémique [glycémie normale à jeun (GJ), hyperglycémie transitoire et diabète sucré (DS)] et le statut en vitamine D étaient associés à un RTD. MÉTHODE: Etude de cohorte prospective réalisée entre novembre 2015 et juillet 2016 dans six cliniques des services anti-TB de routine de la province de Jilin, où des personnes atteintes de TB ont été recrutées consécutivement. L'analyse des données a été réalisée à l'aide du test du chi carré et de la régression logistique multivariée. RÉSULTATS: Sur 306 patients TB recrutés, 96 (31.4%) avaient une TB pulmonaire à frottis positif, 187 (61.1%) avaient une TB pulmonaire à frottis négatif et 23 (7.5%) avaient une TB extra pulmonaire (TBEP). Parmi ceux-ci, 95 (31.1%) avaient une glycémie normale, 83 (27.1%) avaient une hyperglycémie transitoire et 128 (41.8%) avaient un DS. 227 (74.2%) patients avaient une déficience/déficience sévère en vitamine D. Il y avait 125 (40.8%) patients avec un RTD dont la majorité (57.6%) ont été perdus de vue ou ont été non évalués (28.8%). Le RTD était significativement associé à la TB pulmonaire à frottis négatif (p = 0.009), la TBEP (P < 0.001) et le DS (P = 0.007). CONCLUSION: La proportion de patients TB avec un RTD augmentait avec la TB pulmonaire à frottis négatif, la TBEP et le DS. Les programmes anti-TB devraient accorder plus d'attention à ces problèmes et assurer un soutien intensif au patient pour les personnes à risque et une détection précoce du DS.