Advanced tubal pregnancy at 34 weeks with eclampsia and HELLP syndrome: a case report and literature re.

BACKGROUND: Tubal ectopic pregnancies in the late stages of pregnancy are uncommon, and reports on their complications are scarce. We present the case of a woman who had a tubal ectopic pregnancy at around 34 weeks and developed severe pre-eclampsia complications. CASE: A 27-year-old woman presented to our hospital several times with vomiting and convulsions. A physical exam revealed hypertension, scattered ecchymosis, and a large abdominal mass. A computed tomography (CT) scan performed in an emergency revealed an empty uterus, a stillbirth baby in the abdominal cavity, and a crescent-shaped placenta. Blood tests revealed that the patient had a low platelet count and clotting dysfunction. Laparotomy confirmed advanced right fallopian tube pregnancy without rupture, and salpingectomy was performed. Pathological examination revealed a significantly thickened tubal wall, adhesion of the placenta, and poor placental perfusion. CONCLUSION: The unusually thickened muscular layer of the tube may be one of the reasons for tubal pregnancy progressing to an advanced stage. Placenta adhesion and the special site to which it is attached reduce the risk of rupture. The detection of a crescent-shaped placenta on imaging may aid in the accurate diagnosis, distinguishing between abdominal and tubal pregnancy. Women with advanced ectopic pregnancy are more likely to develop pre-eclampsia and have poorer maternal-fetal outcomes. These negative outcomes may be influenced by abnormal artery remodeling, villous dysplasia, and placental infarction.

Findings on agricultural cleaner production in the three Gorges Reservoir Area.

The 'rural revitalization strategy' is important to achieve sustainable development in the Three Gorges Reservoir Area (TGRA), the largest reservoir in China, located in the poverty alleviation region of the Qinling-Daba mountains, and characterized as mountainous and hilly dominated by backwards resettlements. Pig farming around the reservoir area is a key industry, accounting for 0.90% of the arable land area in the country, while the annual pig market represents a 1.37% share of the national figure. Here, 12 study sites were investigated on-site for understanding agricultural green development in the TGRA. We found two main prevailing models: one of ecological circulation (EC), based on animal husbandry and recycling. Of the 12 site, six cases of the ecological circulation model relied on pig husbandry, combined with cropping (grains/fruits/vegetables) by eco-industrial chains, such as pig-biogas-fruit (grain/vegetables), to prevent environmental pollution, while promoting agricultural economic growth by recycling fecal residues and wastewater (FSW) from pig-husbandry facilities to the fields. Our analysis predicted that a farm holding 10,000 pigs may save inorganic nitrogen and phosphorus fertilizers by as much as 74.36 and 11.15 ton·a-1, respectively. On the other hand, five cases of ecological models oriented towards agritourism provided tourists with high-quality ecological products while coordinating environment protection with economic development. In addition, 11 research points applied water and fertilizer integration system for the purpose of saving water. However, lack of sufficient supporting arable land made intensive pig farming a risk of ecological degradation. Green control technologies are rarely used leading to an increase in the type and amount of pesticides. Our study has theoretical and practical significance for decision-makers to promote agricultural cleaner production (ACP).

Case report: Acute ischemic stroke caused by intracranial artery dissection in a patient with skull fractures.

The intracranial artery dissection (IAD) is an uncommon but life-threatening disease. The IAD would develop a significant cerebral infarction due to unrecognized contrecoup brain injury. We report a 53-year-old man fell to develop blunt cerebrovascular injuries (BCVIs) more than 2 months ago. During his rehabilitation, he often had a transient left headache and underwent short-term right limb weakness twice, but he did not care. He was hospitalized again because of suffering right limb weakness for more than 4 h. The brain computed tomography angiography (CTA) showed subtotal occlusion of the left middle cerebral artery M1 segment, and the vascular morphology displayed the IAD. The patient was then treated with balloon dilation and a self-expanding stent. This case highlights that IAD may show delayed onset with no initial typical symptom. By early detecting of abnormal signs and symptoms, serious traumatic brain injury may be avoided.

Chest pain caused by left coronary artery spasm in a patient with anomalous origin of right coronary artery. / å³å† çŠ¶åŠ¨è„‰èµ·æºå¼‚å¸¸æ‚£è€ å‘ç”Ÿå·¦å† çŠ¶åŠ¨è„‰ç—‰æŒ›è‡´èƒ¸ç—›1例.

Anomalous origin of coronary artery is rare and important reason of chest pain, syncope, and sudden death in young and middle-aged patients. This case reported a patient with interarterial anomalous right coronary artery and chest pain, which was confirmed to be the result of severe vasospasm of the proximal left anterior descending artery. The patient had reoccurred spontaneous chest pain and the dynamic ST segment and T wave changes at anterior walls. Coronary angiography confirmed left coronary artery spasm. Chest pain was controlled by diltiazem and isosorbide mononitrate. During 3 months of follow-up after discharge, the patient did not have chest pain anymore.

NiWO4 Microflowers on Multi-Walled Carbon Nanotubes for High-Performance NH3 Detection.

NiWO4 microflowers with a large surface area up to 79.77 m2·g-1 are synthesized in situ via a facile coprecipitation method. The NiWO4 microflowers are further decorated with multi-walled carbon nanotubes (MWCNTs) and assembled to form composites for NH3 detection. The as-fabricated composite exhibits an excellent NH3 sensing response/recovery time (53 s/177 s) at a temperature of 460 °C, which is a 10-fold enhancement compared to that of pristine NiWO4. It also demonstrates a low detection limit of 50 ppm; the improved sensing performance is attributed to the porous structure of the material, the large specific surface area, and the p-n heterojunction formed between the MWNTs and NiWO4. The gas sensitivity of the sensor based on daisy-like NiWO4/MWCNTs shows that the sensor based on 10 mol % (MWN10) has the best gas sensitivity, with a sensitivity of 13.07 to 50 ppm NH3 at room temperature and a detection lower limit of 20 ppm. NH3, CO2, NO2, SO2, CO, and CH4 are used as typical target gases to construct the NiWO4/MWCNTs gas-sensitive material and study the research method combining density functional theory calculations and experiments. By calculating the morphology and structure of the gas-sensitive material NiWO4(110), the MWCNT load samples, the vacancy defects, and the influence law and internal mechanism of gas sensitivity were described.

[Value of a new predictive model in evaluating short-term prognosis of patients with hepatitis B virus related acute-on-chronic liver failure].

OBJECTIVE: To establish a predictive model and investigate its value in evaluating short-term prognosis of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF). METHODS: Patients with HBV-ACLF admitted to Tianjin Second People's Hospital and Beijing Youan Hospital, Capital Medical University from May 2015 to October 2018 were enrolled. The data of gender, age, laboratory markers at admission, model for end-stage liver disease (MELD) score and clinical complications were collected for analysis. According to the prognosis on 12-week, patients were divided into survival group and death group. Univariate analysis and binary Logistic regression analysis were used to test the risk factors for short-term prognosis of the patients with HBV-ACLF, and a prediction model was established. The accuracy of each index and the established model were verified by the receiver operating characteristic (ROC) curve. RESULTS: A total of 148 patients with HBV-ACLF were enrolled in the study, 91 cases survived while 57 cases died during the 12-week period. The age, total bilirubin (TBIL), neutrophil percentage (NEUT%), hepatitis B surface antigen (HBsAg), MELD score of death group were higher than those of survival group [age (years old): 50.00 (44.50, 55.00) vs. 43.00 (34.00, 53.00), TBIL (µmol/L): 310.30 (240.70, 405.70) vs. 266.40 (184.20, 360.20), NEUT%: (74.52±13.05)% vs. (66.64±12.35)%, lgHBsAg (kU/L): 3.72 (3.29, 3.92) vs. 2.97 (2.49, 3.78), MELD score: 24.27 (19.71, 27.40) vs. 21.88 (18.83, 24.38), all P < 0.05], while albumin (ALB), total cholesterol (CHO), prothrombin activity (PTA) and alpha-fetoprotein (AFP) were lower than those of survival group [ALB (g/L): 29.80 (27.05, 31.05) vs. 30.80 (28.00, 33.90), CHO (mmol/L): 1.98 (1.50, 2.38) vs. 2.49 (2.05, 3.01), PTA: (30.37±7.09)% vs. (32.94±6.03)%, AFP (µg/L): 21.54 (9.28, 51.54) vs. 66.16 (24.50, 152.80), all P < 0.05]. Logistic regression analysis showed that NEUT%, HBsAg and AFP were independent risk factors for short-term prognosis of patients with HBV-ACLF [odds ratio (OR) was 77.843, 1.439, 0.995, respectively, all P < 0.05]. According to the results of regression analysis, the NHA-ACLF model (NEUT%+HBsAg+AFP) was established. The formula was logit (NHA-ACLF) = -5.441+5.688×NEUT%+0.430×lgHBsAg-0.005×AFP. The area under the ROC curve (AUC) of the NHA-ACLF model for pred HBV-ACLF patients was 0.790, which was better than NEUT% (AUC = 0.696), lgHBsAg (AUC = 0.670), AFP (AUC = 0.703) and MELD score (AUC = 0.640). When the cut-off value of NHA-ACLF model score was 0.459, the sensitivity was 73.7%, and the specificity was 79.1%. CONCLUSIONS: NEUT%, HBsAg and AFP are independent predictive indicator for short-term prognosis in patients with HBV-ACLF. Compared with MELD score, the risk assessment model NHA-ACLF has a greater value in predicting the short-term prognosis of patients with HBV-ACLF.

Effect of Jinhua Qinggan granules on novel coronavirus pneumonia in patients.

OBJECTIVE: To evaluate the effectiveness and safety of Jinhua Qinggan granules in the treatment of patients with novel coronavirus pneumonia (COVID-19). METHODS: Eighty cases of COVID-19 diagnosed from January 24 to February 17, 2020 in Beijing YouAn Hospital Affiliated to Capital Medical University were retrospectively analyzed. All 80 patients received symptomatic and supportive treatment. Among them, 44 patients took Jinhua Qinggan granules (treatment group) within 24 h of admission, and the remaining 36 patients either did not take Jinhua Qinggan granules or took the granules for less than 2 d (control group). In this study, we compared the duration of viral nucleic acid detection and of pneumonia absorption improvement between the two groups. RESULTS: Among the 80 cases, 37 were male (46%) and 43 were female (54%) with age ranging from 15 to 86 years, with an average age of 51.19 years. The average duration of viral nucleic acid detection was (7 ± 4) d in the Jinhua Qinggan administration group and (10 ± 4) d for the control group (P = 0.010), following which, nucleic acid tests were negative. Of the two groups, 56.82% in the Jinhua Qinggan treatment group and 27.78% in the control group demonstrated negative nucleic acid tests within 7 d or less. The 7-day viral clearance rate was significantly higher in the Jinhua Qinggan group compared with the control group (P = 0.009). Furthermore, the pneumonia recovery time indicated by chest CT was (8 ± 4) d in the Jinhua Qinggan group, which was significantly shorter than the control group, at (10 ± 5) d (P = 0.021). No adverse reactions were found in the treatment group after taking this medicine. CONCLUSION: In patients with COVID-19, Jinhua Qinggan granules can effectively shorten the duration of nucleic acid detection and promote the absorption of pneumonia inflammatory exudate without obvious adverse reactions.

Organophosphate flame retardants in total suspended particulates from an urban area of zhengzhou, China: Temporal variations, potential affecting factors, and health risk assessment.

Organophosphate esters (OPEs) are widely used as flame retardants and plasticizers in industry and daily life, but the partition of OPEs to particles is still unclear because of the wide range of their physicochemical properties. In this study, six target OPEs with different vapor pressures (log PL) were measured from 30 total suspended particulate (TSP) samples collected from an urban area of Zhengzhou from June to November in 2018. The total concentration of OPEs ranged from 0.30 to 3.46 ng/m3, with average concentration of 1.04 ng/m3. Tris (chloroethyl) phosphate (TCEP), tris(2-chloroisopropyl) phosphate (TCPP), and tributyl phosphate (TnBP) were most abundant in TSP, accounting for approximately 86.0% to the total OPEs. The temporal variations showed a specific trend that OPE concentrations in TSP were much higher in autumn than those of summer. Significant positive correlations were observed between TSP concentration in air and the total concentration of OPEs in TSP, with r up to 0.596. Particle concentrations caused major changes on OPE concentrations in TSP with octanol-air partition coefficient (log KOA) between 7.7 and 10 but had no significant influence on the OPEs with log KOA higher than 12. Temperature had significant influence on the total and individual OPEs with high vapor pressures (log PL > -4.0), indicating that log KOA and log PL had significant influence on the OPE concentrations in TSP and may be one of the key factors on their temporal variations. Temperature had significant influence on OPE concentrations in TSP due to the strong temperature dependency of log KOA and log PL. No significant relationships were found between the wind speed and OPE concentrations in TSP, suggesting that OPEs detected in TSP might be emitted from the local sources. The hazards quotient (HQ) values were 6-8 orders of magnitude lower than 1, indicating that there was a low risk to local residents from the exposure to OPEs in TSP. This study preliminarily illuminates the potential affecting factors on the temporal variations of OPEs in TSP. It would be helpful for investigating the gas-particle partitioning behaviors and human health risks of OPEs in air.

Qingchangligan formula alleviates acute liver injury by attenuating extracellular histone-associated inflammation.

Qingchangligan formula (QCLGF) is a traditional Chinese medicine that has exhibited remarkable clinical efficacy for patients with acute-on-chronic liver failure (ACLF). However, the hepatoprotective mechanisms of QCLGF are not completely understood. Extracellular histones were recently identified as the novel inflammatory mediators involved in the pathogenesis of acute liver injury. This study aimed to investigate whether QCLGF provides hepatoprotection by targeting extracellular histones. We showed that QCLGF significantly improved the survival rate of the ConA-treated mice, ameliorated hepatotoxicity, and markedly decreased the levels of extracellular histones and the associated cytokines. We further demonstrated that QCLGF attenuated systemic inflammation by inhibiting the mitogen-activated protein kinase (MAPK) signaling pathway. In addition, exogenous histones induced a significant HL-7702 cell damage, which could be prevented by administration of QCLGF. Lastly, we observed that extracellular histones and the associated cytokines were consistently lower in ACLF patients receiving conventional medical therapy plus QCLGF than in patients receiving only conventional medical therapy. Collectively, these results provide evidence that QCLGF has therapeutic potentials for treating ACLF, which may be due to its ability to interfere with extracellular histone-mediated cellular damage and systemic inflammation.

Value-added conversion of waste cooking oil and post-consumer PET bottles into biodiesel and polyurethane foams.

A sustainable process of value-added utilization of wastes including waste cooking oil (WCO) and post-consumer PET bottles for the production of biodiesel and polyurethane (PU) foams was developed. WCO collected from campus cafeteria was firstly converted into biodiesel, which can be used as vehicle fuel. Then crude glycerol (CG), a byproduct of the above biodiesel process, was incorporated into the glycolysis process of post-consumer PET bottles collected from campus to produce polyols. Thirdly, PU foams were synthesized through the reaction of the above produced polyols with isocyanate in the presence of catalysts and other additives. The characterization of the produced biodiesel demonstrated that its properties meet the specification of biodiesel standard. The effect of crude glycerol loading on the properties of polyols and PU foams were investigated. All the polyols showed satisfactory properties for the production of rigid PU foams which had performance comparable to those of some petroleum-based analogs. A mass balance and a cost analysis for the conversion of WCO and waste PET into biodiesel and PU foams were also discussed. This study demonstrated the potential of WCO and PET waste for the production of value-added products.

Value-added processing of crude glycerol into chemicals and polymers.

Crude glycerol is a low-value byproduct which is primarily obtained from the biodiesel production process. Its composition is significantly different from that of pure glycerol. Crude glycerol usually contains various impurities, such as water, methanol, soap, fatty acids, and fatty acid methyl esters. Considerable efforts have been devoted to finding applications for converting crude glycerol into high-value products, such as biofuels, chemicals, polymers, and animal feed, to improve the economic viability of the biodiesel industry and overcome environmental challenges associated with crude glycerol disposal. This article reviews recent advances of biological and chemical technologies for value-added processing of crude glycerol into chemicals and polymers, and provides strategies for addressing production challenges.

Polyols and polyurethanes from the liquefaction of lignocellulosic biomass.

Polyurethanes (PUs), produced from the condensation polymerizations between polyols and isocyanates, are one of the most versatile polymer families. Currently, both polyols and isocyanates are largely petroleum derived. Recently, there have been extensive research interests in developing bio-based polyols and PUs from renewable resources. As the world's most abundant renewable biomass, lignocellulosic biomass is rich in hydroxyl groups and has potential as a feedstock to produce bio-based polyols and PUs. Lignocellulosic biomass can be converted to liquid polyols for PU applications through acid- or base-catalyzed atmospheric liquefaction processes using polyhydric alcohols as liquefaction solvents. Biomass liquefaction-derived polyols can be used to prepare various PU products, such as foams, films and adhesives. The properties of biomass liquefaction-derived polyols and PUs depend on various factors, such as feedstock characteristics, liquefaction conditions, and PU formulations.

Thermochemical conversion of crude glycerol to biopolyols for the production of polyurethane foams.

This study aimed to produce biopolyols from crude glycerol via a novel thermochemical conversion process. The effect of operational parameters, including sulfuric acid loading and reaction temperature and time, on the properties of the produced biopolyols was investigated. Biopolyols produced under preferred reaction conditions of 200°C, 90 min, and 3% sulfuric acid loading showed a hydroxyl number of around 481 mg KOH/g, an acid number of around 5mg KOH/g, and a viscosity of around 25.0 Pas. The resulting polyurethane (PU) foams showed a compressive strength of around 184.5 kPa and a density of around 43.0 kg/m(3), comparable to those of some petroleum-based analogs. Characterization of the biopolyols via pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS), gas chromatography (GC), and thermogravimetrical analysis (TGA) showed that the major reactions of this process were the formation of monoglycerides and diglycerides through the esterification and transesterification of different components in crude glycerol.

Characterization of crude glycerol from biodiesel plants.

Characterization of crude glycerol is very important to its value-added conversion. In this study, the physical and chemical properties of five biodiesel-derived crude glycerol samples were determined. Three methods, including iodometric-periodic acid method, high performance liquid chromatography (HPLC), and gas chromatography (GC), were shown to be suitable for the determination of glycerol content in crude glycerol. The compositional analysis of crude glycerol was successfully achieved by crude glycerol fractionation and characterization of the obtained fractions (aqueous and organic) using titrimetric, HPLC, and GC analyses. The aqueous fraction consisted mainly of glycerol, methanol, and water, while the organic fraction contained fatty acid methyl esters (FAMEs), free fatty acids (FFAs), and glycerides. Despite the wide variations in the proportion of their components, all raw crude glycerol samples were shown to contain glycerol, soap, methanol, FAMEs, water, glycerides, FFAs, and ash.

A low prevalence of H pylori and endoscopic findings in HIV-positive Chinese patients with gastrointestinal symptoms.

AIM: To compare the prevalence of H pylori infection, peptic ulcer, cytomegalovirus (CMV) infection and Candida esophagitis in human immunodeficiency virus (HIV)-positive and HIV-negative patients, and evaluate the impact of CD4 lymphocyte on H pylori and opportunistic infections. METHODS: A total of 151 patients (122 HIV-positive and 29 HIV-negative) with gastrointestinal symptoms were examined by upper endoscopy and biopsy. Samples were assessed to determine the prevalence of H pylori infection, CMV, candida esophagitis and histologic chronic gastritis. RESULTS: The prevalence of H pylori was less common in HIV-positive patients (22.1%) than in HIV-negative controls (44.8%; P < 0.05), and the prevalence of H pylori displayed a direct correlation with CD4 count stratification in HIV-positive patients. In comparison with HIV-negative group, HIV-positive patients had a lower incidence of peptic ulcer (20.7% vs 4.1%; P < 0.01), but a higher prevalence of chronic atrophy gastritis (6.9% vs 24.6%; P < 0.05)ìCandida esophagitis and CMV infection. Unlike HIV-negative group, H pylori infection had a close relationship to chronic active gastritis (P < 0.05). In HIV-positive patients, chronic active gastritis was not significantly different between those with H pylori infection and those without. CONCLUSION: The lower prevalence of H pylori infection and peptic ulcer in HIV-positive patients with gastrointestinal symptoms suggests a different mechanism of peptic ulcerogenesis and a different role of H pylori infection in chronic active gastritis and peptic ulcer. The pathogen of chronic active gastritis in HIV-positive patients may be different from the general population that is closely related to H pylori infection.

A zwitterion of 1,5-bis(2-hydroxybenzamido)-3-azapentane: a two-dimensional hydrogen-bonding network involving dimers.

The title compound, 2-{N-[2-(2-hydroxybenzamido)ethylammonioethyl]aminocarbonyl}phenolate, C18H21N3O4, crystallizes in a zwitterionic form as a result of intermolecular proton transfer and possesses a negatively charged phenolate group and a protonated amino group. The 2-hydroxybenzamide and 2-(aminocarbonyl)phenolate moieties attached to the two ends of the C-C-N-C-C backbone adopt a cis conformation in relation to this backbone. All N- and O-bound H atoms are involved in hydrogen-bond formation; the zwitterions are first linked into head-to-tail dimers, which are further organized into a two-dimensional network parallel to the crystallographic bc plane.

[Clinical analysis of arrthythmogenic right ventricular cardiomyopathy].

OBJECTIVE: To investigate the clinical features of arrthythmogenic right ventricular cardiomyopathy (ARVC), and to evaluate the diagnosis of ARVC. METHODS: Twenty-three cases of ARVC underwent ECG, chest x-ray, Holter, transesophageal atrial pacing (TEAP) and intracardiac electrophysiological examination. RESULTS: A syncope attack occurred; the percentage of frequent ventricular premature beats was 95.7%, salvos of the right ventricular originated ventricular tachycardia (VT) was 87%, and the right bundle branch block (RBBB) demonstrated by ECG was 87%; UCG showed that the enlarged right ventricular diametric was (50.1 +/- 8.83) mm, and the right atrium diametric was (48 +/- 8.79) mm; the ratio of right ventricular diametric to left ventricular diametric in the end-diastolic period was 1.09. The right ventricular function [ejection fraction: (0.325 +/- 0.0902)] decreased, which was confirmed by echocardiogram. CONCLUSION: The diagnosis of ARVE can be established on the basis of the repeated syncope attack; RBBB, frequent ventricular premature beats, VT of LBBB patterms, an enlarged right heart and decreased right ventricular function can be found, the ratio of right ventricular dimaetric to left ventricular diametric increases in the end-diastolic period.