Study on different isolation technology on the performance of blue micro-LEDs array applications.

In this study, a 3 × 3 blue micro-LED array with a pixel size of 10 × 10 µm2 and a pitch of 15 µm was fabricated on an epilayer grown on a sapphire substrate using metalorganic chemical vapor deposition technology. The fabrication process involved photolithography, wet and dry etching, E-beam evaporation, and ion implantation technology. Arsenic multi-energy implantation was utilized to replace the mesa etching for electrical isolation, where the implantation depth increased with the average energy. Different ion depth profiles had varying effects on electrical properties, such as forward current and leakage currents, potentially causing damage to the n-GaN layer and increasing the series resistance of the LEDs. As the implantation depth increased, the light output power and peak external quantum efficiency of the LEDs also increased, improving from 5.33 to 9.82%. However, the efficiency droop also increased from 46.3 to 48.6%.

Clinical characteristics and risk factors of 267 patients having severe fever with thrombocytopenia syndrome-new epidemiological characteristics of fever with thrombocytopenia syndrome: Epidemiological characteristics of SFTS.

OBJECTIVE: To analyze the epidemiological distribution, clinical characteristics, and prognostic risk factors of patients having severe fever with thrombocytopenia syndrome (SFTS). METHODS: We enrolled 790 patients with SFTS divided into the ordinary group and the severe group, analyzed the clinical characteristics, and screened the risk factors of severious patients by univariate logistic regression analysis. RESULTS: Most of the 790 patients (SFTS) are farmers (84.56%). The proportion of patients with fieldwork history was 72.41%, of which 21.27% had a clear history of a tick bite and 98.61% were sporadic cases. The annual peak season is from April to November. 16.33% patients were not accompanied by fever. The incidence of severe thrombocytopenia was 47.59%. They were statistically significant between the 2 groups in indicators such as age, hypertension, coronary heart disease, diabetes mellitus, bunyavirus nucleic acid load and mean platelet count (P < .05). Multivariate non conditional Logistic regression analysis showed that the risk factors of the mild patients deteriorating severe disease were age (OR = 1.985, P  ≤ .003), diabetes mellitus (OR = 1.702, P  ≤ .001), coronary heart disease (OR = 1.381, P ≤ .003), platelet count (OR = 2.592, P  ≤ .001), viral nucleic acid loading (OR = 3.908, P  ≤ .001). CONCLUSION: The incidence population and seasonal distribution characteristics of patients with SFTS are obvious. The risk factors for poor prognosis of severe patients are old age, multiple basic medical histories, high viral load, a serious decrease of mean platelet count, and delay of treatment time.

Effect of procalcitonin on the severity and prognostic value of elderly patients with a severe infection of oral and maxillofacial space.

This study aimed to investigate the effect on the severity and prognostic value of serum procalcitonin for elderly patients with oral and maxillofacial infections. We divided 163 elderly patients with severe oral and maxillofacial infection into survival and death groups according to the prognosis between June 2015 and May 2021, measured serum procalcitonin by enzyme-linked immunosorbent assay on the 1st, 2nd, 3rd, 5th, and 7th day after admission for the dynamic changes of serum procalcitonin level, collected the general physiological and biochemical indexes for the scores of acute physiology and general chronic condition, compared the correlation between serum procalcitonin, mean platelet count and APACHE score, analyzed the prognostic value of serum procalcitonin levels at different time after admission by ROC curve. The serum procalcitonin level increased significantly in both groups after admission, sharply increased at first and then rapidly decreased in the survival group, and continued to rise or declined slowly with fluctuation of high level in the death group. There was a negative correlation between serum procalcitonin level and mean platelet count (r = -0.698, P < .05) and a positive correlation between serum procalcitonin and APACHE II (R = 0.803, P < .05). The ROC curve showed that the serum procalcitonin level had little value on the first day and great value on the third day in predicting the prognosis of elderly patients with severe oral and maxillofacial infection (PCT1d = 0.539, PCT3d = 0.875, P < .05). The serum procalcitonin level is correlated with the severity of the disease in elderly patients with severe oral and maxillofacial space infection. Dynamic observation of it is helpful for the prognosis judgment of patients. After admission, serum procalcitonin level on the third day has a great value for the prognosis judgment of elderly patients with severe oral and maxillofacial space infection.

Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin's adjunct role.

How to identify the optimum switch point of sequential invasive and noninvasive ventilation is the focus of clinical attention on the patients suffering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by acute respiratory failure (ARF). This study aims to explore the clinical significance of taking the change rate of procalcitonin (PCT) as identifying the timing of weaning on the mechanical ventilation for the patients of AECOPD followed by ARF as a complication. There were altogether 140 patients of AECOPD complicated with ARF, who were randomly selected and divided into a study group and a control group respectively. A change rate of serum PCT level exceeding 50% was taken as the switch point selection of tracheal intubation removal for the patients of the study group, while the 'pulmonary infection control (PIC) window' was done for those in the control group. With CRP, IL-6, TNF-a, PaCO2, PaO2, and Lac having been detected before and after treatment to them all, clinical indexes were obtained and compared between these two groups. The CRP, TNF-a, and IL-6 levels of the patients in the study group after treatment (p < 0.05) were lower than those in the control group. There was no significant difference in PaCO2, PaO2, and Lac between these two groups before and after treatment (p > 0.05). Even so, some other indexes available for the study group of patients were found to be lower than those for the control group (p < 0.05) in the following aspects: duration of invasive ventilation support, total time of mechanical ventilation support, incidence rate of ventilator-associated pneumonia, 48-hour reintubation rate, incidence rate of upper gastrointestinal bleeding, hospitalization time of critical respiratory illness, total hospitalization time, RICU treatment cost, total treatment cost, and mortality. It is preferable to take the change rate of PCT level exceeding 50% as the switch point of weaning time in sequential mechanical ventilation rather than the PIC window. AbbreviationsAECOPD: acute exacerbation of chronic obstructive pulmonary disease; ARF: acute respiratory failure; PCT: procalcitonin; PaO2: the oxygen partial pressure; PaCO2: the partial pressure of carbon dioxide; TNF-a: serum tumor necrosis factor-a; IL-6: interleukin-6; CRP: serum C-reactive protein; PIC window: pulmonary infection control window; RICU: respiration and intensive care unit.

Prognostic values of procalcitonin and platelet in the patient with urosepsis.

BACKGROUND: The patient suffering from urinary sepsis is often accompanied by elevated serum procalcitonin (PCT) levels and a decline in the average platelet count (PLT), which could result in a poor prognosis. This study aimed to evaluate the value of PCT and PLT in determining the severity of urinary sepsis. METHODS: A total of 120 urosepsis patients enrolled were divided into a survival group and a death group, respectively, according to their status within 14 days after admission. Changes in PCT and PLT levels between the 2 groups were compared at different time points. A receiver operating characteristic (ROC) curve was eventually obtained to predict the prognostic value of PCT and PLT. RESULTS: The PCT levels in the survival group declined gradually after admission, and the PLT decreased at first but increased rapidly in subsequence. The PCT level in the death group, however, declined in a flat-slope trend or was hardly noticeable together with the number of PLT reduced significantly. In particular, it is on the 3rd day that PCT tended to positively correlate with acute physiological and chronic health score II (APACHE II) score (r = 0.730, P < .05), but negatively with PLT (r = 0.472, P < .05). The APACHE II score and PLT (r = 0.612, P < .05) were also negatively correlated with each other. As indicated by the ROC curve, the PCT level on the 3rd day after admission was of great value for the clinical mortality prognosis, and the area under the curve was 0.858. Moreover, PLT also has a high predictive value for prognosis. Area under the curve is 0.951. When the PLT was more than 51 × 109 /L, the sensitivity was up to 90%, and the specificity was 90%. CONCLUSION: PLT and PCT levels are closely related to the APACHE II score, which could indicate the severity of urosepsis in patients. The contribution of this study was to confirm that dynamic monitoring of the changes in PCT and PLT helps determine the prognosis of urosepsis patients.

Predictive Factors of Postoperative Peritumoral Brain Edema after Meningioma Resection.

BACKGROUND: Postoperative peritumoral brain edema (PTBE) is the progressively exacerbating cerebral edema following meningiomas resection. OBJECTIVE: The study aims to identify the predictive factors of postoperative PTBE. MATERIALS AND METHODS: A retrospective study was conducted on the 117 cases of patients who underwent meningioma. The histopathological features of the tumors were re-assessed according to WHO 2016 classification. Clinical and pathohistological features were analyzed. RESULTS: Thirteen patients (11.1%) were diagnosed having postoperative PTBE. Preoperative seizure (odds ratio [OR] = 6.125, P = 0.039) and histological prominent nucleoli (OR = 3.943, P = 0.039) were the independent risk factors for postoperative PTBE. Meningiomas with a parietal localization were more likely to develop postoperative PTBE (OR = 3.576, P = 0.054). Brain invasion and large tumor volume did not increase complication rate. Preoperative edema index was significantly higher in brain invasive meningiomas (3.0 ± 2.2 versus 1.8 ± 1.7, P = 0.001). Patients having moderate preoperative PTBE were prone to the complication (21.4% versus 7.9%, P = 0.100). CONCLUSIONS: Preoperative seizure were the predictive factors for postoperative PTBE. Careful venous protection during the operation may be helpful, especially for tumors locating in the parietal lobe. Prominent nucleoli observed in postoperative pathology should warrant surgeons' attention. Comprehensive perioperative management is essential for these patients.

Shifting subdural fluid collection and hydrocephalus after foramen magnum decompression for basilar invagination.

Background: Postoperative hydrocephalus and subdural fluid collection (SFC) have been reported as the rare complications following foramen magnum decompression in patients with Chiari malformation.Case Description: The paper reports the case of a 63-year-old female patient who underwent foramen magnum decompression for basilar invagination. The patient developed a shifting, bilateral SFC and subsequent acute hydrocephalus. A ventriculoperitoneal shunting was performed and the clinical symptom resolved. The dramatic change in CSF distribution supported the diagnosis of external hydrocephalus, which was associated with a postoperative cervical pseudomeningocele.Conclusions: Postoperative SFC in patients underwent foramen magnum decompression may harbor different mechanisms. Subdural drainage for patients having external hydrocephalus may have a higher recurrence rate.

Views on Discharge Criteria and Stratified Management of Admission for COVID-19: A Case Report.

We report a case of atypical clinical manifestation of pneumonia infected by 2019-novel coronavirus, which is helpful to improve the understanding of the clinical characteristics of pneumonia caused by the virus. At the same time, some suggestions on the discharge criteria and hierarchical management of admission of 2019-nCoV pneumonia are put forward. The results are constructive for effective prevention and control of 2019-nCoV pneumonia and optimizing patient process management in China.

Impact of Surgeon Experience on Postoperative Rehemorrhage in Spontaneous Basal Ganglia Intracerebral Hemorrhage.

BACKGROUND: Spontaneous intracerebral hemorrhage (SICH) is of high mortality and morbidity. SICH in the basal ganglia is usually attributed to chronic hypertension. Postoperative rehemorrhage is a severe complication, and it is relative to surgical techniques. METHODS: A retrospective survey was conducted on 123 patients with basal ganglia SICH who received surgery from January 2015 to January 2019. Postoperative rehemorrhage within 24 hours was recorded. Preoperative clinical parameters, surgeon experience (<10 and >20 years), operation time, surgical approach, and hemostasis technique were recorded and analyzed. RESULTS: The total postoperative rehemorrhage rate was 12.2% (15/123). The univariable analysis showed general surgeons had a higher postoperative rehemorrhage rate than experienced surgeons (30.4% vs. 8.6%, respectively; P = 0.068). The operation time (minutes) in experienced surgeons was significantly longer (164.9 ± 53.5 vs. 137.7 ± 30.8, P = 0.016), but they had a higher chance to locate the responsible vessel (74.2% vs. 40.0%, P = 0.001), respectively. Logistic analysis indicated that experienced surgeons significantly reduced the risk of rehemorrhage (odds ratio [OR], 0.242; P = 0.021). Transsylvian approach was a protective factor for postoperative rehemorrhage (OR, 0.291; P = 0.045). CONCLUSIONS: Surgeons' experience plays the most important role in postoperative rehemorrhage. Surgeons with rich experience were willing to spend more time to achieve definitive hemostasis in operation. The use of a transsylvian approach can significantly reduce the rehemorrhage rate. Packing hemostasis with gelatin sponge may increase complications.

Complications in Staged Late Titanium Cranioplasty and Ventriculoperitoneal Shunting for Patients with Traumatic Brain Injury.

BACKGROUND: Hydrocephalus is a common complication following decompressive craniectomy. Ventriculoperitoneal shunt (VPS) is required for some patients before receiving a cranioplasty (CP). The presence of a VPS is regarded as a risk factor for overall CP complications. METHODS: A retrospective survey was conducted on 176 patients with traumatic brain injury who underwent late (>3 months) titanium CP (Ti-CP) in our hospital from April 2014 to July 2018. Thirteen patients (7.4%) had preoperative VPS. Propensity score matching was performed for these 13 patients with a ratio of 1:5. A total of 78 patients were selected. Preoperative clinical parameters and postoperative complications were analyzed. The period of postoperative follow-up ranged from 3 to 63 months (mean 21.3 ± 17.0 months). RESULTS: The overall complication rate was greater in the VPS group (P = 0.010). These patients were more likely to develop a sunken skin flap (P < 0.001). The rate of postoperative cerebral hemorrhage was greater in the VPS group. Logistic analysis showed that preoperative VPS was an independent risk factor for postoperative extradural collection (odds ratio 17.714, P < 0.001). VPS was not related to postoperative infection and seizure. Postoperative drainage duration longer than 2.5 days significantly increased the risk of postoperative infection (odds ratio 7.715, P = 0.023). CONCLUSIONS: The presence of a VPS significantly increased the risk of extradural collection in patients with traumatic brain injury who underwent late Ti-CP. It also was related to postoperative hemorrhage. The sunken skin flap in patients with VPS increased surgical difficulty and the likelihood of extradural accumulation. Preoperative VPS was not related to postoperative infection and seizure in Ti-CP.

Excessive Hemostasis on the Scalp Increases Superficial Surgical Site Infection Rate in Cranioplasty.

BACKGROUND: Cranioplasty is a routine procedure, but it carries a significantly higher complication rate over standard clean cranial surgery. Surgical site infection is the most common but severe complication. Risk factors for surgical site infection are still debated. METHODS: A retrospective survey of 155 patients (≥16 years old) who exclusively underwent customized titanium cranioplasty from April 2014 to January 2017 was performed. Preoperative clinical parameters, surgeon's hemostasis technique, temporalis dissection, operative time, intraoperative blood loss, postoperative catheter duration and drainage, postoperative hemorrhage and extradural fluid collection (EDFC), and prophylactic antibiotics were recorded and compared between patients with superficial surgical site infection (sSSI) and patients with non-sSSI. RESULTS: Overall sSSI rate was 10.3%. Binary logistic analysis showed excessive hemostasis on scalp (odds ratio = 10.302, P = 0.000), presence of postoperative EDFC (odds ratio = 12.740, P = 0.003), and postoperative drainage >277 mL (odds ratio = 10.302, P = 0.000) were independent risk factors for sSSI. Patients who received excessive hemostasis had a longer operative time (P = 0.000). A flaccid cranial defect was a protective factor for postoperative EDFC (odds ratio = 0.130, P = 0.044), whereas presence of ventriculoperitoneal shunt could induce EDFC formation (odds ratio = 9.598, P = 0.020). Postoperative subgaleal drainage was correlated to the size of cranial defect (standardized ß = 0.347, P = 0.000). Timing of cranioplasty and use of prophylactic antibiotics were not related to sSSI. CONCLUSIONS: Surgeons should lower the hemostasis standard for cranioplasty, as this would promote wound healing and reduce operative time, which subsequently decreases SSI rate.

Bilateral External Ventricular Drains Increase Ventriculostomy-Associated Cerebrospinal Fluid Infection in Low Modified Graeb Score Intraventricular Hemorrhage.

BACKGROUND: Ventriculostomy-associated cerebrospinal fluid infection (VAI) is a major complication limiting the use of an external ventricular drain (EVD) in treating patients with intraventricular hemorrhage (IVH). Risk factors of VAI are still under wide discussion. METHODS: We performed a retrospective review of 84 patients with IVH who underwent EVD at our center between January 2012 and January 2017. Preoperative clinical parameters, surgeon status, number of catheters and catheter-days, subgaleal tunneling distance, frequency of urokinase flush, and prophylactic antibiotics were compared between the infective and noninfective groups. RESULTS: The overall rate of VAI was 31.0%. Univariate analysis showed a higher modified Graeb Score (mGS), higher proportion of bilateral catheters, and longer hospital stay in patients with VAI. Binary logistic analysis of all clinical factors identified high mGS (≥16) as an independent risk factor for VAI (odds ratio, 3.242; P = 0.026). Among operative and postoperative factors, the use of bilateral catheters significantly contributed to VAI (odds ratio, 4.211; P = 0.031), but a subgroup comparison showed an increased VAI rate only in the low mGS group (mGS <15). No VAI occurred in patients with a single EVD in the low mGS group. Catheter-days and multiple urokinase flushes were not related to VAI. CONCLUSIONS: Patients with a high mGS are vulnerable to VAI. Bilateral EVD may be an appropriate treatment option for patients with a high mGS, but might increase the risk of infection in those with a low mGS.

Intraparenchymal papillary meningioma of brainstem: case report and literature review.

Both intraparenchymal papillary meningioma and papillary meningioma with cyst formation of brainstem have never been reported. The authors present an extremely rare case of patient with intraparenchymal papillary meningioma of brainstem. A 23-year-old Chinese male presented with a 4-month history of progressive left upper limb and facial nerve palsy. Magnetic resonance imaging revealed a cystic-solid, heterogeneously enhancing mass in pons and right cerebral peduncle with no dural attachment. The tumor was totally removed via subtemporal approach. During surgery, the lesion was found to be completely intraparenchymal. Histological and immunohistochemical examinations were compatible with the diagnosis of papillary meningioma. The lesion recurred nine months after primary surgery, a second surgery followed by radiotherapy was performed. Till to now (nearly 2 years after the treatment), the patient is tumor free survival. Intraparenchymal meningioma of brainstem with cystic formation is very rare, however, it should be considered as a differential diagnosis of a brainstem neoplasm. The present case strongly recommended that postoperative radiotherapy was essential for the patients with papillary meningiomas.

[Expression of chemokine receptor CXCR3 mRNA in patients with atopic dermatitis].

OBJECTIVE: To investigate the role of chemokine receptor CXCR3 in patients with atopic dermatitis. METHODS: The expression of CXCR3 mRNA was measured by fluorescent quantitative polymerase chain reaction, and the relationship between CXCR3 mRNA expression and the disease severity (graded according to SCORAD index system) was assessed by correlation analysis. RESULTS: CXCR3 mRNA expression was significantly higher in patients with atopic dermatitis than in healthy control subjects (P7lt;0.01), and showed obvious positive correlation with SCORAD index system. CONCLUSION: These data suggest an important role of CXCR3 in the development and progression of atopic dermatitis.

[Traumatic nasal cerebrospinal fluid fistula: report of 86 cases].

The clinical record of 86 cases of traumatic nasal cerebrospinal fluid (CSF) fistula treated either surgically or conservatively between 1997 and 2001 was retrieved and analyzed. The fistula completely healed in 15 surgically treated patients (17.4%) and 71 conservatively treated patients (82.6%), and in the follow-up observation, recurrence was identified in none of the cases. Our experience approves the importance of head position, lowering intracranial pressure and application of antibiotics in the conservative therapy, and for surgical treatment, water-tight closure of the dura fistula should be performed.