A case report of successful rescue using veno-arterial extracorporeal membrane oxygenation: managing cerebral-cardiac syndrome.

Introduction: The presence of cerebral-cardiac syndrome, wherein brain diseases coincide with heart dysfunction, significantly impacts patient prognosis. In severe instances, circulatory failure may ensue, posing a life-threatening scenario necessitating immediate life support measures, particularly effective circulatory support methods. The application of extracorporeal membrane oxygenation (ECMO) is extensively employed as a valuable modality for delivering circulatory and respiratory support in the care of individuals experiencing life-threatening circulatory and respiratory failure. This approach facilitates a critical temporal window for subsequent interventions. Consequently, ECMO has emerged as a potentially effective life support modality for patients experiencing severe circulatory failure in the context of cerebral-cardiac syndrome. However, the existing literature on this field of study remains limited. Case description: In this paper, we present a case study of a patient experiencing a critical cerebral-cardiac syndrome. The individual successfully underwent veno-arterial-ECMO (VA-ECMO) therapy, and the patient not only survived, but also received rehabilitation treatment, demonstrating its efficacy as a life support intervention. Conclusion: VA-ECMO could potentially serve as an efficacious life support modality for individuals experiencing severe circulatory failure attributable to cerebral-cardiac syndrome.

Case Report: Resuscitation of patient with tumor-induced acute pulmonary embolism by venoarterial extracorporeal membrane oxygenation.

Background: Pulmonary embolism is a condition of right cardiac dysfunction due to pulmonary circulation obstruction. Malignant tumor-induced pulmonary embolism, which has a poor therapeutic outcome and a significant impact on hemodynamics, is the cause of sudden death in patients with malignant tumors. Case description: A 38-year-old female patient, who had a medical history of right renal hamartoma, and right renal space-occupying lesion, was admitted to the hospital. During the procedure to resect the right renal malignancy, the blood pressure and end-tidal carbon dioxide level dropped, and a potential pulmonary embolism was considered as a possibility. After inferior vena cava embolectomy, the hemodynamics in the patient remained unstable. The successful establishment of venoarterial extracorporeal membrane oxygenation (VA-ECMO) resulted in the stabilization of her hemodynamics and ventilation. On Day 2 of VA-ECMO support, her respiration and hemodynamics were relatively stable, and ECMO assistance was successfully terminated following the "pump-controlled retrograde trial off (PCRTO)" test on Day 6. The patient improved gradually after the procedure and was discharged from the hospital after 22 days. Conclusion: VA-ECMO can be used as a transitional resuscitation technique for patients with massive pulmonary embolism. It is critical for the perfusion of vital organs and can assist with surgical or interventional treatment, lower right heart pressure, and hemodynamic stability. VA-ECMO has a significant impact on patient prognosis and can reduce the mortality rate.

Does COVID-19 affect sperm quality in males? the answer may be yes, but only temporarily.

BACKGROUND: The Corona Virus Disease 2019 (COVID-19) pandemic has raised concerns regarding its potential impact on male reproductive health. However, the impact of COVID-19 on sperm quality remains uncertain. This retrospective study aimed to investigate the short-term and relatively long-term effects of COVID-19 infection on sperm quality. METHODS: A total of 85 males with fertility requirements, who underwent semen evaluation at Guilin People's Hospital between June 2022 and July 2023, were included in the study. Changes in semen parameters were analyzed across three specific timeframes: within 6 months before COVID-19 infection, within 3 months after COVID-19 infection, and 3-6 months after COVID-19 recovery. RESULTS: The results revealed that the sperm concentration and total sperm number were significantly lower after infection compared to before, while in the recovery period, the sperm concentration, total sperm count, progressive motility, and normal morphology significantly increased. Comparing the three periods, the most significant difference was observed in sperm concentration, which exhibited a significant decrease after infection but returned to normal levels after recovery from COVID-19. CONCLUSIONS: These findings suggest that COVID-19 may exert some impact on sperm quality, particularly evidenced by decreased sperm concentration post-infection. Fortunately, these effects on semen parameters appear to be temporary, with gradual restoration of semen parameters within 3-6 months after recovery. However, further research is needed to explore the underlying mechanisms and long-term implications of these observed changes in semen parameters.

Effects of alpha-lipoic acid on sperm quality in patients with varicocele-related male infertility: study protocol for a randomized controlled clinical trial.

BACKGROUND: Varicocele is a high incidence and is considered to be the most common and correctable cause of male infertility. Oxidative stress (OS) plays a central role in the pathogenesis of varicocele-related male infertility. In addition to varicocelectomy, antioxidant supplementation seems to be an effective scheme for the treatment of varicocele-related male infertility, but it is still controversial. The purpose of this study is to determine the effects of alpha-lipoic acid (ALA) supplementation on sperm quality in patients with varicocele-related male infertility. METHODS: In this randomized controlled clinical trial, we will randomize 80 patients with varicocele-related male infertility from Guilin People's Hospital. The non-surgical observation group (n = 20) will receive ALA, the non-surgical control group (n = 20) will receive vitamin E, the surgical observation group (n = 20) will receive ALA after the operation, and the surgical control group (n = 20) will receive vitamin E after the operation. The course of treatment will be 3 months. The results will compare the changes in semen parameters, sex hormones, testicular volume, sperm DNA fragment index (DFI), seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC) between the groups at baseline and after 3 months of antioxidant supplementation. DISCUSSION: Whether it is necessary to use antioxidants in varicocele-related male infertility, how potent antioxidants should be used, postoperative application or non-surgical independent application still needs to be explored. This study attempts to compare the effects of two antioxidants (ALA and vitamin E) on sperm quality in patients with varicocele-related male infertility (surgical or non-surgical) and attempted to answer the above questions. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR) ChiCTR2100054958. Registered on 29 December 2021.

The effect of screening and treatment of Ureaplasma urealyticum infection on semen parameters in asymptomatic leukocytospermia: a case-control study.

BACKGROUND: Ureaplasma urealyticum (UU) infection, as well as asymptomatic leukocytospermia, whether it has effect on semen parameters and whether it needs screening and treatment is still a confusing and controversial topic for clinicians. METHODS: Among 1530 adult males who visited Guilin People's Hospital due to infertility, 295 were diagnosed with asymptomatic leukocytospermia, and 95 were further screened for UU-positive. 81 UU-positive asymptomatic leukocytospermia patients received 7-day or 14-day treatment plan with doxycycline, and 70 cases were cured. The semen parameters of non-leukocytospermia, leukocytospermia, UU-positive leukocytospermia and UU-negative leukocytospermia groups were compared, and the differences between the two treatment plans and the semen parameters before UU treatment and 1 month after UU-cured were compared. RESULTS: Compared with non-leukocytospermia patients, the sperm concentration, progressive motility (PR), and normal morphology of patients with leukocytospermia decreased, while those with UU-positive leukocytospermia performed more significantly. The PR, total motility, and normal morphology of UU-positive leukocytospermia patients were significantly lower than those of UU-negative leukocytospermia patients (all p < 0.001). The UU cure rates of the 7-day and 14-day treatment plan with doxycycline was 84.62% and 89.66% (p = 0.738), respectively, and the sperm concentration, PR, total motility, and normal morphology of the cured UU-positive leukocytospermia patients were all increased after 1 month (p = 0.001, p = 0.022, p = 0.004 and p = 0.008, respectively). CONCLUSIONS: It is significant to screen and treat UU infection in asymptomatic leukocytospermia for improving sperm quality. Where appropriate, the 7-day treatment plan with doxycycline may be a good choice.

Mechanism and effect of γ-butyrolactone solvent vapor post-annealing on the performance of a mesoporous perovskite solar cell.

In this paper, γ-butyrolactone (GBL) solvent vapor post-annealing (SVPA) on CH3NH3PbI3 thin films is reported, aiming to improve the complete transformation of PbI2 and increase the grain size of the CH3NH3PbI3 crystal, thus boosting the performance of mesoporous CH3NH3PbI3 perovskite solar cells (PSCs). The influence of GBL SVPA on the microstructure of perovskite layers and performance of PSCs was studied. The short circuit current density (J sc) of the devices significantly increased, yielding a high efficiency of 16.58%, which was 27.05% higher than that of thermally annealed films. A model was derived to explain the effect of GBL SVPA on PSCs. The perovskite films prepared by this method present several advantages such as complete transformation of PbI2 to CH3NH3PbI3, high crystallinity, large grain size, and fewer grain boundaries than those prepared without GBL SVPA. This improvement is beneficial for charge dissociation and transport in hybrid photovoltaic devices.

Contrast Dose and Radiation Dose Reduction in Abdominal Enhanced Computerized Tomography Scans with Single-phase Dual-energy Spectral Computerized Tomography Mode for Children with Solid Tumors.

BACKGROUND: Contrast dose and radiation dose reduction in computerized tomography (CT) scan for adult has been explored successfully, but there have been few studies on the application of low-concentration contrast in pediatric abdominal CT examinations. This was a feasibility study on the use of dual-energy spectral imaging and adaptive statistical iterative reconstruction (ASiR) for the reduction of radiation dose and iodine contrast dose in pediatric abdominal CT patients with solid tumors. METHODS: Forty-five patients with solid tumors who had initial CT (Group B) and follow-up CT (Group A) after chemotherapy were enrolled. The initial diagnostic CT scan (Group B) was performed using the standard two-phase enhanced CT with 320 mgI/ml concentration contrast, and the follow-up scan (Group A) was performed using a single-phase enhanced CT at 45 s after the beginning of the 270 mgI/ml contrast injection using spectral mode. Forty percent ASiR was used for the images in Group B and monochromatic images with energy levels ≥60 keV in Group A. In addition, filtered back-projection (FBP) reconstruction was used for monochromatic images <60 keV in Group A. The total radiation dose, total iodine load, contrast injection speed, and maximum injection pressure were compared between the two groups. The 40 keV and 60 keV spectral CT images of Group A were compared with the images of Group B to evaluate overall image quality. RESULTS: The total radiation dose, total iodine load, injection speed, and maximum injection pressure for Group A were decreased by 19%, 15%, 34.4%, and 18.3%, respectively. The optimal energy level in spectral CT for displaying the abdominal vessels was 40 keV. At this level, the CT values in the abdominal aorta and its three branches, the portal vein and its two branches, and the inferior vena cava were all greater than 340 hounsfield unit (HU). The abdominal organs of Groups A and B had similar degrees of absolute and relative enhancement (t = 0.36 and -1.716 for liver, -0.153 and -1.546 for pancreas, and 2.427 and 0.866 for renal cortex, all P> 0.05). Signal-to-noise ratio of the abdominal organs was significantly lower in Group A than in Group B (t = -8.11 for liver, -7.83 for pancreas, and -5.38 for renal cortex, all P< 0.05). However, the subjective scores for the 40 keV (FBP) and 60 keV (40% ASiR) spectral CT images determined by two radiologists were all> 3, indicating clinically acceptable image quality. CONCLUSIONS: Single-phase, dual-energy spectral CT used for children with solid abdominal tumors can reduce contrast dose and radiation dose and can also maintain clinically acceptable image quality.

[Treatment of trigger finger with located needle knife].

OBJECTIVE: To investigate the clinical effects of located needle knife in the treatment of trigger finger. METHODS: The clinical data of 133 patients(145 fingers) with trigger finger underwent treatment with located needle knife from September 2010 to March 2014 were retrospectively analyzed. There were 37 males(40 fingers) and 96 females (105 fingers), aged from 18 to 71 years old with a mean of 51.8 years. Course of disease was from 1 to 19 months with an average of 8.2 months. Affected fingers included 82 thumbs, 12 index fingers, 11 middle fingers, 36 ring fingers, and 4 little fingers. According to the standard of Quinnell grade, 42 fingers were grade III, 92 fingers were grade IV, and 11 fingers were grade V. Firstly the double pipe gab was put into the distal edge of hypertrophic tendon sheath, then small knife needle was used to release the sheath proximally along the tendon line direction. The informations of wound healing and nerve injury, postoperative finger function, finger pain at 6 months were observed. RESULTS: The operation time was from 8 to 25 min with an average of 9.8 min. All the patients were followed up from 6 to 26 months with an average of 12.5 months. No complications such as the wound inflammation and seepage, vascular or nerve injuries were found. According to the standard of Quinnell grade, 123 fingers got excellent results, 15 good, 7 poor. CONCLUSIONS: It's a good choice to treat trigger finger with located needle knife in advantage of minimal invasion, simple safe operation, and it should be promoted in clinic.

[Relationship between upper airway and cranial-facial growth patterns in adolescents with normal occlusion].

PURPOSE: To investigate the relationship between upper airway and cranial-facial growth pattern among teenagers with normal occlusion. METHODS: The study subjects consisted of 52 boys and 64 girls with normal occlusion. Their cephalometric radiographs were obtained. The sagittal diameter of upper airway was analyzed according to gender and different growth pattern. The relationship of upper airway diameter and cranial-facial formation was evaluated by stepwise regression analysis using SPSS 21.0 software package. RESULTS: There was no significant difference between male and female about upper airway diameter in teenagers, also no difference was found among different growth patterns. Regression analysis showed that upper airway was associated with some cranial-facial formation parameters. CONCLUSIONS: Although there is no significant difference in the upper airway diameters among different growth patterns, there is still certain association between cranial-facial formation and upper airway in adolescents.

Optimal enamel conditioning strategy for rebonding orthodontic brackets: a laboratory study.

OBJECTIVE: To compare the conventional etching and primer method (CEP) and the self-etching primer method (SEP) in rebonding brackets. METHODS: Forty human maxillary second premolars extracted for orthodontic purpose were randomly divided into 4 equal groups. Group 1 and Group 2 were bonded using the CEP method; Group 3 and Group 4 using the SEP method. All the brackets were debonded and 40 new brackets were rebonded with four different protocols after surface cleaning: Group 1: CEP + adhesive; Group 2: CEP without etch step + adhesive; Group 3: SEP + adhesive; Group 4: non-acidic primer + adhesive. Then, the shear bond strength (SBS) of each group was tested and the measurements of adhesive remnant index scores (ARI) and SEM examination were performed. RESULTS: The mean SBSs for Group 1, 2, 3 and 4 were 14.18, 6.57, 11.90, 5.91 MPa, respectively. Statistical differences of the SBS existed between Group 1 and 2 (P < 0.05) and between Group 3 and 4 (P < 0.05). No difference was found between Group 1 and 3, or Group 2 and 4. CONCLUSION: Omission of the acid-etching step in rebonding orthodontic brackets may be adequate for the clinical requirement. No differences in SBS and ARI of the rebonded brackets were showed between CEP and SEP methods.

A potential therapeutic method for conductive hearing loss in growing children-orthodontic expansion treatment.

Conductive hearing loss, the second most common type of hearing loss, happens when there is a problem transmitting sound waves into inner ear, which will bring a lot of inconvenience to the patient in life and put the impaired person at a competitive disadvantage. Although conductive hearing loss could be relieved by hearing aids, the inconvenience of using these removable aids or the surgery trauma of the implanted ones should not be overlooked. Transversal maxillary deficiency and high palatal arches are often found in patients with conductive hearing loss. Some researchers have reported that there is close relationship between the maxillary contraction and hearing damage. Luckily, rapid maxillary expansion (RME) has been proved to be an effective treatment method for the transversal maxillary deficiency in clinical orthodontics for more than 40 years. Thus, we hypothesized that RME treatment would be a potential therapeutic method for conductive hearing loss in growing children with maxillary constriction.

One-step synthesis of highly monodisperse hybrid silica spheres in aqueous solution.

An effective and reproducible method of preparing highly monodisperse organic-inorganic hybrid silica spheres was studied. One process, one precursor (organosilane) and one solvent (water) were used in our experiments. The size of hybrid silica spheres could be adjusted from 360 to 770 nm with relative standard deviation below 2% by controlling the concentration of the organosilane precursor and the ammonia catalyst. The increasing of the precursor concentration increases the particle size while the catalyst concentration has a reverse effect on the particle size. The concept of homogeneous nucleation and growth processes are introduced to explain the formation mechanism and the effect of reaction conditions. The scanning electron microscopy (SEM) images illustrate the copiousness in quantity and the uniformity in size/shape of the particles that could be routinely accomplished in this synthesis. Fourier transform infrared (FT-IR) and (29)Si nuclear magnetic resonance (NMR) spectra confirm the structure of vinyl hybrid silica spheres, where the vinyl group (-CH=CH(2)) exists and connects to the silicon atom. This method has also been extended to design and prepare other organic-inorganic hybrid materials especially in monodisperse surface-modified silica spheres.

[Temporospatial expression of bFGF and IGF-I in growing goats with cranial suture distraction osteogenesis].

OBJECTIVE: To investigate the expression patterns of bFGF and IGF-I in the growing goats with distracted cranial suture. METHODS: Coronal suture distraction was performed to 12 growing goats. The suture was expanded using a custom-made distractor with a rate of 0.4 mm/day for 8 days. Four goats were killed at 0, 2, and 4 weeks after the completion of suture distraction osteogenesis, respectively. The expanded sutures were harvested and processed for immunohistochemistry analysis of bFGF and IGF-I. Two goats without suture distraction were also examined as controls. RESULTS: The coronal sutures were expanded successfully. At 0 and 2 weeks after the completion of suture distraction, collagen fiber bundles were strengthened and aligned in the direction of the distraction. Strong expressions of bFGF and IGF-I were detected in the distracted sutures. Expressions of bFGF appeared in the fibroblast-like cells and the osteoblasts cells. Positive signal of IGF-I was mainly localized to the osteoblasts and the newly formed osteocytes. The strongest expressions of bFGF and IGF-I were found 0-2 weeks after the completion of the suture distraction. CONCLUSION: Distraction stimulates the production of bFGF and IGF-I, which may contribute to the formation and remodeling of new bones.

[Atomic absorption fingerprint and identification studies of Da Huo Luo pill. I. Exploration of inorganic elements fingerprint for establishment of industrial standard].

The fingerprints for most of Chinese medicines based on their organic compositions have been well established. Nevertheless, there are very few known fingerprints which are based on inorganic elements. In order to identify the Da Huo Luo Dan and its efficiency from other Chinese medicines, the authors attempted to set up a fingerprint which could be determined by the measurement of inorganic elements in Da Huo Luo Dan and other Chinese medicines. In the present study, the authors first employed 28 batches of Da Huo Luo Dan produced by Zhang-Shu Pharmatheutical Company in Jiang Xi Province to screen 12 kinds of inorganic elements measured by atomic absorption spectrophotometer and established the atomic absorption fingerprints. Secondly, the authors tried to identify Da Huo Luo Dan and other Chinese medicines by using the similarly analysis of vectors and the statistical analysis of compositional data. The result showed that the methods the authors used here were predictable to tell the efficiency of Da Huo Luo Dan from others. The authors' study also proves that establishment of standard for quality control by analysis of inorganic elements in Chinese medicines is feasible. The present study provides a new idea and a new technique that serve for the establishment of industrial standards for analysis of inorganic elements fingerprint to explore the effects of Chinese medicines.

[Exploration of quality control of inorganic elements in Chinese herbal medicines for stimulating blood circulation and relaxing muscles and joints by atomic absorption spectrophotometry].

Researches have shown the close relationships between inorganic elements and curative efficiencies of various Chinese herbal medicines. Yet, in studies of chemical composition and quality control of Chinese herbal medicines for stimulating blood circulation and relaxing muscles and joints, inorganic substances are often overlooked. In order to improve and reestablish the standard of quality control of Chinese herbal medicines, the authors attempted a method that would incorporate the composition of inorganic elements as part of the quality control. In the present study, the authors used atomic absorption spectrophotometry to measure the contents of fifteen inorganic elements, namely, Cu, Ca, Fe, K, Mg, Mo, Ni, Sr, V, Mn, Zn, Na, Cr, Cd, and Hg, in several Chinese herbal medicines, including Da Huo Luo Wan. The authors then discussed the relationship between these inorganic elements and curative efficiencies of these Chinese herbal medicines. By comparing the levels of inorganic elements found in Da Huo Luo Wan with those found in other Chinese herbal medicines used in the study, it was revealed that trace elements, Fe, Cu, Mn, and Zn, contribute to the curative efficiency of Da Huo Luo Wan. The authors' results showed that the amounts of trace elements Fe, Cu, Mn and Zn found in Chinese herbal medicine Da Huo Luo Wan are related to the following curative effects of Da Huo Luo Wan: relieving rheumatism, rectifying breathing and alleviating phlegm, stimulating blood circulation and relaxing muscles and joints. The measurement and analysis of inorganic elements in Da Huo Luo Wan will also provide evidences and references for the fingerprint establishment of Da Huo Luo Wan in the future.

[Determination of V, Mo, Ni, g in Chinese traditional cardiovascular medicine by AAS].

Aimed at curing life-threatening cardiovascular diseases, many new drugs containing Chinese medicines have been developed for commercial use. It is critical that the contents of these drugs are well monitored and controlled. In the last five decades, understanding the effects of trace elements on treating cardiovascular diseases has drawn more and more attention of researchers. In the present study, AAS was used to measure the amounts of V, Mo, Ni and Hg in several Chinese medicines treating cardiovascular diseases, such as Di Ao Xinxue Kang capsule etc. The results revealed that all Chinese medicines under study are rich in trace elements. Furthermore, the authors' data exhibit the potential therapeutic effects of V, Mo and Ni in treating cardiovascular diseases. By providing the measurements and fingerprints of trace elements found in Chinese medicines treating cardiovascular diseases, the authors' report offers theoretical support to the potential effectiveness of trace elements in combating cardiovascular diseases.

[Study on trace elements in wuji baifeng wan and its preparation].

We studied the amount of trace elements in the traditional Chinese medicine Wuji Baifeng Wan by cluster analysis, and found that the clustering results of the trace elements in Twelve Wuji Baifeng Wan (the southern preparation) and Wuji Baifeng Wan (the northern preparation) were not in the same group. In this paper, AAS was used for the determination of trace elements in Wuji Baifeng Wan and its preparation. The results showed that there were great differences between Twelve Wuji Baifeng Wan and Wuji Baifeng Wan , while the difference between Chinese Taihe Chicken and Native Chicken was slight. So we drew a conclusion that the great differences between Twelve Wuji Baifeng Wan and Wuji Baifeng Wan were caused by other medicine, not in its preparation.

[Determination of trace elements in shenrong heixi wan].

Shenrong Heixi Wan is a pure traditional Jiangxi medicine which has been mainly used to cure coma in clinic as its main function is resuscitation. In this paper, four trace elements in Shenrong Heixi Wan and other five traditional Chinese medicines have been determined and contrasted by AAS. The results show that there are abundant benificial trace elements in Shenrong Heixi Wan while pernicious trace elements such as Hg, Cd etc. are low. So the medicine is safe to take.