Discrimination and screening of volatile metabolites in atractylodis rhizoma from different varieties using headspace solid-phase microextraction-gas chromatography-mass spectrometry and headspace gas chromatography-ion mobility spectrometry, and ultra-fast gas chromatography electronic nose.

Atractylodis rhizoma is a common bulk medicinal material with multiple species. Although different varieties of atractylodis rhizoma exhibit variations in their chemical constituents and pharmacological activities, they have not been adequately distinguished due to their similar morphological features. Hence, the purpose of this research is to analyze and characterize the volatile organic compounds (VOCs) in samples of atractylodis rhizoma using multiple techniques and to identify the key differential VOCs among different varieties of atractylodis rhizoma for effective discrimination. The identification of VOCs was carried out using headspace solid-phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) and headspace gas chromatography-ion mobility spectrometry (HS-GC-IMS), resulting in the identification of 60 and 53 VOCs, respectively. The orthogonal partial least squares discriminant analysis (OPLS-DA) model was employed to screen potential biomarkers and based on the variable importance in projection (VIP ≥ 1.2), 24 VOCs were identified as critical differential compounds. Random forest (RF), K-nearest neighbor (KNN) and back propagation neural network based on genetic algorithm (GA-BPNN) models based on potential volatile markers realized the greater than 90 % discriminant accuracies, which indicates that the obtained key differential VOCs are reliable. At the same time, the aroma characteristics of atractylodis rhizoma were also analyzed by ultra-fast gas chromatography electronic nose (Ultra-fast GC E-nose). This study indicated that the integration of HS-SPME-GC-MS, HS-GC-IMS and ultra-fast GC E-nose with chemometrics can comprehensively reflect the differences of VOCs in atractylodis rhizoma samples from different varieties, which will be a prospective tool for variety discrimination of atractylodis rhizoma.

Visualization of Multiphase Reactive Flow and Mass Transfer in Functionalized Microfluidic Porous Media.

Multiphase reactive flow in porous media is an important research topic in many natural and industrial processes. In the present work, photolithography is adopted to fabricate multicomponent mineral porous media in a microchannel, microfluidics experiments are conducted to capture the multiphase reactive flow, methyl violet 2B is employed to visualize the real-time concentration field of the acid solution and a sophisticated image processing method is developed to obtain the quantitative results of the distribution of different phases. With the advanced methods, experiments are conducted with different acid concentration and inlet velocity in different porous structures with different phenomena captured. Under a low acid concentration, the reaction will be single phase. In the gaseous cases with higher acid concentration, preferential flow paths with faster flow and reaction are formed by the multiphase hydrodynamic instabilities. In the experiments with different inlet velocities, it is observed that a higher inlet velocity will lead to a faster reaction but less gas bubbles generated. In contrast, more gas bubbles would be generated and block the flow and reaction under a lower inlet velocity. Finally, in heterogeneous structures, fractures or cavities would significantly redirect the flow and promote the formation of preferential flow path nearby.

[Adsorption Performance and Mechanism of Oxytetracycline in Water by KOH Modified Biochar Derived from Corn Straw].

The pollution control of tetracycline antibiotics in the environment has become a hot topic, and biochar adsorption has become an important technology to remove organic pollutants. Pyrolytic biochars (BC400, BC500, and BC600) were prepared from corn straw and then were modified by KOH to obtain KBC400, KBC500, and KBC600. Among them, KBC400 was selected for secondary pyrolysis activation at 400-600℃ to obtain AKBC400, AKBC500, and AKBC600. The structure characteristics and surface properties of AKBC were also characterized. The adsorption kinetics and thermodynamic characteristics of oxytetracycline hydrochloride (OTC) in the solution by AKBC were investigated using batch experiments. Compared to that of BC400, the specific surface area and pore structure of AKBC were significantly improved, and the aromaticity was also enhanced, resulting in the notable enhancement of the adsorption capacities for OTC. The pseudo-second-order kinetics model could better fit the adsorption process, and AKBC500 had the largest adsorption rate constant and capacity. Both the intraparticle diffusion and film diffusion were the rate-limiting steps. The Langmuir, Freundlich, and Temkin models could fit the adsorption isotherms perfectly. The adsorption of OTC on AKBC was a spontaneous, endothermic, and entropy-increasing process by both physisorption and chemisorption. The pH values in the range of 3.0-7.0 were favorable for the adsorption of OTC by AKBC. The adsorption capacity decreased with the humic acid concentration over 10 mg·L-1. The adsorption mechanism of OTC by AKBC involved pore filling, hydrogen bonding, π-π conjugation, cation-π bond, and strong electrostatic effect. AKBC still had good reusability for OTC removal after five times of regeneration. The obtained AKBC is a potential adsorbent for OTC removal from water due to the good pore structure, high adsorption capacity, and stable adsorption effect.

Verification of Composite Beam Theory with Finite Element Model for Pretensioned Concrete Members with Prestressing FRP Tendons.

Composite beam theory was previously developed to establish an analytical solution for determining the transfer length of prestressed fiber-reinforced polymers (FRP) tendons in pretensioned concrete members. In the present study, a novel finite element (FE) modeling approach is proposed to provide further verification of the developed analytical method. The present FE model takes into account the friction coefficients obtained from pull-out tests on the FRP tendons and prestressed concrete members. Convergence analysis of two numerical simulations with different mesh densities is carried out as well. The results demonstrated that the transfer length predicted by the fine FE model with a friction coefficient of α = 0.3 for high pretension is in good agreement with the measured values and the analytical solutions. The consistency between the analytical solution and FE simulation not only further proves the reliability of composite beam theory but also demonstrates the importance of the bond-slip relationship in predicting the transfer length of pretensioned concrete members prestressed with FRP tendons.

Inhibition of epithelial-to-mesenchymal transition augments antitumor efficacy of nanotherapeutics in pancreatic ductal adenocarcinoma.

Intrinsic drug resistance mechanisms of tumor cells often reduce intracellular drug concentration to suboptimal levels. Epithelial-to-mesenchymal transition (EMT) is a pivotal process in tumor progression and metastasis that confers an aggressive phenotype as well as resistance to chemotherapeutics. Therefore, it is imperative to develop novel strategies and identify new targets to improve the overall efficacy of cancer treatment. We developed SN38 (active metabolite of irinotecan)-assembled glycol chitosan nanoparticles (cSN38) for the treatment of pancreatic ductal adenocarcinoma (PDAC). Furthermore, cSN38 and the TGF-ß1 inhibitor LY364947 formed composite nanoparticles upon self-assembly (cSN38 + LY), which obviated the poor aqueous solubility of LY364947 and enhanced drug sensitivity. The therapeutic efficacy of cSN38 + LY nanotherapeutics was studied in vitro and in vivo using suitable models. The cSN38 nanoparticles exhibited an antitumor effect that was significantly attenuated by TGF-ß-induced EMT. The cellular uptake of SN38 was impeded during EMT, which affected the therapeutic efficacy. The combination of LY364947 and cSN38 markedly enhanced the cellular uptake of SN38, increased cytotoxic effects, and inhibited EMT in PDAC cells in vitro. Furthermore, cSN38 + LY significantly inhibited PDAC xenograft growth in vivo. The cSN38 + LY nanoparticles increased the therapeutic efficacy of cSN38 via repressing the EMT of PDAC cells. Our findings provide a rationale for designing nanoscale therapeutics to combat PDAC.

Is atypical monkeypox a sexually transmitted disease? / 中国热带医学

@# Atypical monkeypox broke out in many non-endemic countries in 2022, and the cumulative number of cases worldwide reached 21 775 on July 11. Although most cases of atypical monkeypox outbreaks were related to sexual behavior, there was no clear consensus on whether monkeypox is a sexually transmitted disease, and the current guidelines issued in China for the diagnosis and treatment of monkeypox do not yet rule out monkeypox as a sexually transmitted disease. This review analyzed the evidence supporting atypical monkeypox as a sexually transmitted disease and other possible explanations from the perspectives of monkeypox case definition/diagnostic criteria, epidemiology, clinical features, laboratory examinations, and public health prevention and control measures, aiming to provide suitable recommendations for the prevention and control of monkeypox outbreaks in China.

-Norm-Based Robust Feature Extraction Method for Fault Detection.

Industrial data are in general corrupted by noises and outliers, which do not meet the application assumptions in feature extraction. Many existing feature extraction algorithms are not robust, overly consider the less important features of the data, and cannot capture the key features of the data. To this end, the two-level feature extraction method (TFEM) based on -norm is proposed in this study. Compared with single-projection feature extraction algorithms, TFEM consists of two projections: the nonreduced and reduced dimensionality projections. The nonreduced dimensionality projection can remove the parts of less important features that are unrelated to the key features of the data. The reduced dimensionality projection can reduce the dimensionality of the data and further extract the features of the data. In addition, -norm is used to make the algorithm more robust. Finally, the convergence of the proposed algorithm is analyzed. Extensive experiments have been conducted on the Tennessee Eastman and Penicillin Fermentation processes to demonstrate that the proposed method is more effective than other state-of-the-art fault detection methods.

Exosomal CD44 Transmits Lymph Node Metastatic Capacity Between Gastric Cancer Cells via YAP-CPT1A-Mediated FAO Reprogramming.

Background: Lymph node metastasis (LNM) commonly occurs in gastric cancer (GC) and is tightly associated with poor prognosis. Exosome-mediated lymphangiogenesis has been considered an important driver of LNM. Whether exosomes directly transmit the LNM phenotype between GC cells and its mechanisms remain elusive. Methods: A highly lymphatic metastatic GC cell line (HGC-27-L) was established by serial passage of parental HGC-27 cells in BALB/c nude mice. The capacities of migration, invasion and LNM; fatty acid oxidation (FAO) levels; and the role of exosome-transferred LNM phenotype were compared among HGC-27-L, HGC-27 and primary GC cell line AGS. Exosomes derived from GC cells and sera were separately isolated using ultracentrifugation and ExoQuick exosome precipitation solution, and were characterized by transmission electron microscopy, Nanosight and western blotting. Transwell assay and LNM models were conducted to evaluate the capacities of migration, invasion and LNM of GC cells in vitro and in vivo. ß-oxidation rate and CPT1 activity were measured to assess FAO. CPT1A inhibitor etomoxir was used to determine the role of FAO. Label-free LC-MS/MS proteome analysis screened the differential protein profiling between HGC-27-exosomes and AGS-exosomes. Small interference RNAs and YAP inhibitor verteporfin were used to elucidate the role and mechanism of exosomal CD44. TCGA data analysis, immunochemistry staining and ELISA were performed to analyze the expression correlation and clinical significance of CD44/YAP/CPT1A. Results: FAO was increased in lymphatic metastatic GC cells and indispensable for sustaining LNM capacity. Lymphatic metastatic GC cell-exosomes conferred LNM capacity on primary GC cells in an FAO-dependent way. Mechanistically, CD44 was identified to be enriched in HGC-27-exosomes and was a critical cargo protein regulating exosome-mediated transmission, possibly by modulating the RhoA/YAP/Prox1/CPT1A signaling axis. Abnormal expression of CD44/YAP/CPT1A in GC tissues was correlated with each other and associated with LNM status, stages, invasion and poor survival. Serum exosomal CD44 concentration was positively correlated with tumor burden in lymph nodes. Conclusions: We uncovered a novel mechanism: exosomal CD44 transmits LNM capacity between GC cells via YAP-CPT1A-mediated FAO reprogramming from the perspective of exosomes-transferred LNM phenotype. This provides potential therapeutic targets and a non-invasive biomarker for GC patients with LNM.

Analysis on clinical features of 17 death cases of imported malaria in China / 中国热带医学

@#Abstract: Objective　China was certified by World Health Organization as a malaria-free country in 2021. Malaria has become a rare infectious disease, and preventing the re-transmission of imported malaria and reducing deaths are the main challenges facing China after elimination of malaria. To analyze and clarify the characteristics of imported malaria deaths, and to provide prevention and treatment recommendations for overseas workers and health care workers. Methods　The data of 17 imported malaria deaths in the analysis of malaria deaths from 2016 to 2020 by the National Severe Malaria Treatment Expert Group were collected, and the relevant clinical epidemiological data and disease course records were analyzed. Results　The 17 malaria deaths were all imported from Africa with Plasmodium falciparum infection (malarial cerebral type), with no obvious regularity in the month of onset. Among them, 16 were male patients, 5 cases with underlying diseases such as diabetes mellitus, and 10 patients were first diagnosed in a second-level or lower hospital. Excluding patients who died of respiratory cardiac arrest in ambulances, the mean time difference between first onset and malaria diagnosis in 16 patients was 6.8 days (median 5.5 days), and the mean time between first onset and antimalarial treatment was 7.4 days (median 6 days), the mean time difference from initial onset to death was 10.3 days (median 8.5 days). Excluding cases with onset abroad and unknown time of return, all 14 patients developed the disease within 30 days after returning to China. Conclusion　All the fatal cases were infected with Plasmodium falciparum imported from Africa. The patients' awareness of actively seeking medical treatment is weak, and the delay in seeking medical treatment caused by the insufficient diagnosis and treatment capacity of health institutions at the township level and below is the main reason for the deaths. It is recommended to strengthen the self-protection awareness of staff in malaria-endemic areas overseas and raise their awareness of malaria. For returnees from areas with high malaria risk, primary medical institutions should pay attention to the patient's travel history in Africa, improve the awareness of malaria diagnosis, malaria diagnosis and treatment capabilities.

Silencing PFKP restrains the stemness of hepatocellular carcinoma cells.

BACKGROUND: Glycolysis reprogramming is deeply involved in the progression of hepatocellular carcinoma (HCC), in which HCC cells with stemness traits play important roles as well. Thus, whether platelet isoform of phosphofructokinase 1 (PFKP), a rate-limiting enzyme in glycolysis, contributes to the maintenance of stemness of HCC cells is worth investigation. METHODS: PFKP levels were compared between human hepatocellular carcinoma and adjacent normal tissues by Western blotting and immunohistochemistry. The relationship between PFKP expression and clinic pathological features was also analyzed. Furthermore, the colony formation capabilities and the levels of stemness markers (ALDH1, CD44, CD133, Sox-2) as well as ß-catenin were compared between HCC cells either undergoing PFKP silencing or overexpression. RESULTS: PFKP levels were higher in HCC as compared to normal hepatic tissues. Silencing PFKP decreased HCC proliferation, colony formation capabilities, and levels of stemness markers and ß-catenin; whereas overexpressing PFKP demonstrated the opposite effects. CONCLUSION: PFKP promoted HCC proliferation and contributed to the maintenance of HCC stemness. Silencing PFKP could restrain the stemness of HCC, suggesting that PFKP may be a potential therapeutic target for HCC treatment.

Lymph node metastasis-derived gastric cancer cells educate bone marrow-derived mesenchymal stem cells via YAP signaling activation by exosomal Wnt5a.

Lymph node metastasis (LNM), a common metastatic gastric-cancer (GC) route, is closely related to poor prognosis in GC patients. Bone marrow-derived mesenchymal stem cells (BM-MSCs) preferentially engraft at metastatic lesions. Whether BM-MSCs are specifically reprogrammed by LNM-derived GC cells (LNM-GCs) and incorporated into metastatic LN microenvironment to prompt GC malignant progression remains unknown. Herein, we found that LNM-GCs specifically educated BM-MSCs via secretory exosomes. Exosomal Wnt5a was identified as key protein mediating LNM-GCs education of BM-MSCs, which was verified by analysis of serum exosomes collected from GC patients with LNM. Wnt5a-enriched exosomes induced YAP dephosphorylation in BM-MSCs, whereas Wnt5a-deficient exosomes exerted the opposite effect. Inhibition of YAP signaling by verteporfin blocked LNM-GC exosome- and serum exosome-mediated reprogramming in BM-MSCs. Analysis of MSC-like cells obtained from metastatic LN tissues of GC patients (GLN-MSCs) confirmed that BM-MSCs incorporated into metastatic LN microenvironment, and that YAP activation participated in maintaining their tumor-promoting phenotype and function. Collectively, our results show that LNM-GCs specifically educated BM-MSCs via exosomal Wnt5a-elicited activation of YAP signaling. This study provides new insights into the mechanisms of LNM in GC and BM-MSC reprogramming, and will provide potential therapeutic targets and detection indicators for GC patients with LNM.

Fluorescent hydrogen sulfide probes based on azonia-cyanine dyes and their imaging applications in organelles.

Three hydrogen sulfide (H2S) probes based on an azonia-cyanine skeleton were successfully designed and prepared. Probe 1a, containing 4-chloro-7-nitro-1,2,3-benzoxadiazole connected to the cyanine dye, had an emission at 660 nm that was enhanced 4.5-fold by the reduced photoinduced electron transfer process when reacting with H2S. Probes 1b and 1c were constructed from cyanine dyes with electron withdrawing 2,4-dinitrophenyl and 7-nitrobenzo[c] [1,2,5]oxadiazol-4-yl groups, respectively. Probes 1b and 1c gave off-on type responses with 169- and 17-fold fluorescent enhancements at 639 nm with H2S. Their emission properties were influenced by intramolecular hydrogen bonds and intramolecular charge transfer processes. The detection limits of probes 1a-1c were calculated at 178, 121, and 9.6 nM, respectively. The intracellular imaging experiments with HeLa cells indicated probe 1a was a mitochondria-targeting H2S probe, while probes 1b and 1c were lysosome-targeting H2S probes.

A novel recombinant RANKL vaccine prepared by incorporation of an unnatural amino acid into RANKL and its preventive effect in a murine model of collagen-induced arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammatory synovitis, bone atrophy, and subsequent progressive destruction of articular tissue. Targeted inhibition of receptor activator of NF-kB ligand (RANKL) has been highly successful in preventing RA-mediated bone erosion in animal models and patients, suggesting that development of a RANKL vaccine might be of therapeutic value. Our previous study has shown that the recombinant RANKL vaccine Y234pNO2Phe, generated by replacement of a single tyrosine residue (Tyr234) in murine RANKL (mRANKL) with p-nitrophenylalanine (pNO2Phe), induces a high titer antibody response and prevents ovariectomy (OVX)-induced bone loss in mice. This aim of this study was to further evaluate the vaccine's preventive effects in a murine model of collagen-induced arthritis. The results of this study showed that Y234pNO2Phe not only induced a high titer antibody response and inhibited osteoclastogenesis but also significantly prevented bone erosion and ameliorated the severity of a collagen-induced arthritis (CIA) model in mice. Moreover, use of the vaccine improved the clinical situations of the CIA mice. These results suggest a potential application of an anti-RANKL vaccine in the treatment of RA-induced bone erosion.

[Comparison of neurologic outcome between active abdominal compression-decompression cardiopulmonary resuscitation and standard cardiopulmonary resuscitation in asphyxia cardiac arrest].

OBJECTIVE: To compare the neurologic outcome after the active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) and chest compression cardiopulmonary resuscitation (STD-CPR) in asphyxia cardiac arrest (CA). METHODS: A prospective multicenter randomized controlled trial (RCT) was conducted. Adult patients with CA because of asphyxia such as drowning, airway obstruction admitted to Zhengzhou People's Hospital and Sanmenxia Central Hospital from June 2014 to December 2017 were enrolled. With the informed consent of patients' families, patients were divided into AACD-CPR group and STD-CPR group according to random number table method. The blood from median cubital vein or basilic vein were extracted at 1, 6, 12, 24 and 48 hours after the return of spontaneous circulation (ROSC), and the levels of S100B protein and neuron-specific enolase (NSE) were detected by enzyme linked immunosorbent assay. Neurological outcome was classified according to cerebral performance classification (CPC) after 3 months. RESULTS: A total of 183 patients were selected, including 78 ROSC patients after CPR. Patients with CA > 8 minutes and rescue time > 1 hour were excluded, 69 ROSC patients (36 in STD-CPR group and 33 in AACD-CPR group) were finally included. After ROSC, the levels of S100B protein and NSE in blood of two groups were increased gradually, reaching the peak at 6 hours, and then decreased gradually. The levels of S100B protein and NSE in AACD-CPR group at different time points after ROSC were significantly lower than those in STD-CPR group [S100B protein (µg/L): 1.62±0.52 vs. 1.88±0.46 at 1 hour, 1.71±0.41 vs. 2.02±0.58 at 6 hours, 1.24±0.37 vs. 1.52±0.59 at 12 hours, 1.05±0.23 vs. 1.28±0.37 at 24 hours, 0.82±0.29 vs. 1.05±0.36 at 48 hours; NSE (µg/L): 24.76±3.02 vs. 26.78±4.29 at 1 hour, 58.78±5.58 vs. 61.68±5.44 at 6 hours, 53.87±4.84 vs. 56.78±5.68 at 12 hours, 40.96±3.52 vs. 43.13±4.50 at 24 hours, 33.23±2.89 vs. 35.54±3.44 at 48 hours; all P < 0.05]. 3 months after ROSC, the CPC classification of AACD-CPR group was lower than that of the STD-CPR group (average rank: 28.86 vs. 42.46, Z = -3.375, P < 0.001). CONCLUSIONS: After suffering asphyxia CA, patients who accepted AACD-CPR had better neurologic outcome than STD-CPR.

A new vaccine targeting RANKL, prepared by incorporation of an unnatural Amino acid into RANKL, prevents OVX-induced bone loss in mice.

Bone homeostasis is maintained by a dynamic balance between osteoblastic bone formation and osteoclastic bone resorption. The receptor activator of nuclear-κB ligand (RANKL) is essential for the function of the bone-resorbing osteoclasts, and targeting RANKL has been proved highly successful in osteoporosis patients. This study aimed to design a novel vaccine targeting RANKL and evaluate its therapeutic effects in OVX-induced bone loss model. Anti-RANKL vaccine was generated by incorporating the unnatural amino acid p-nitrophenylalanine (pNO2Phe) into selected sites in the murine RANKL (mRANKL) molecule. Specifically, mutation of a single tyrosine residue Tyr234 (Y234) or Tyr240 (Y240) of mRANKL to pNO2Phe (thereafter named as Y234pNO2Phe or Y240pNO2Phe) induced a high titer antibody response in mice, whereas no significant antibody response was observed for the wild type mRANKL (WT mRANKL). The antiserum induced by Y234pNO2Phe or Y240pNO2Phe could efficiently prevent osteoclastogenesis in vitro. Moreover, immunization with Y234pNO2Phe or Y240pNO2Phe could also prevent OVX-induced bone loss in mice, suggesting that selected pNO2Phe-substituted mRANKL may pave the way for creating a novel vaccine to treat osteoporosis.

[Predictive value of partial pressure of end-tidal carbon dioxide on the effect of active abdominal compression-decompression cardiopulmonary resuscitation and serum S100B protein on cerebral function].

OBJECTIVE: To explore the predictive value of partial pressure of end-tidal carbon dioxide (PETCO2) on the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) and serum S100B protein on cerebral function. METHODS: 142 adult patients with in-hospital cardiac arrest (IHCA) AACD-CPR in Zhengzhou People's Hospital, Affiliated Southern Medical University from September 2014 to December 2017 were enrolled. Patients were divided into successful group and failure group according to restoration of spontaneous circulation (ROSC) or not; and then according to Glasgow-Pittsburgh cerebral performance categories (CPC) one month after ROSC, the successful group was divided into good prognosis group (CPC 1-2) and poor prognosis group (CPC 3-5) further. The variations of hemodynamic, arterial blood gas index, PETCO2 and serum S100B protein level (25 healthy subjects as normal S100B protein level reference value) during the recovery were analyzed. The predictive value of PETCO2 on the effect of AACD-CPR and serum S100B protein on cerebral function of successful resuscitation patients were analyzed by receiver operating characteristic curve (ROC). RESULTS: (1) According to the traditional qualitative indexes, such as pulsation of the large artery, redness of lips and extremities, spontaneous fluctuation of chest, narrowing of pupil, existence of shallow reflex, etc, 54 in 142 patients with IHCA were successfully resuscitated; 57 cases were successfully resuscitated through the guidance of PETCO2, there was no significant difference between the two groups (χ2 = 0.133, P = 0.715). With the AACD-CPR, 142 CA patients' arterial partial pressure of oxygen (PaO2), arterial blood carbon dioxide partial pressure (PaCO2) were all improved with different degrees; heart rate (HR), mean arterial pressure (MAP), PaO2 and PaCO2 were further improved at 20 minutes after ROSC. At beginning of AACD-CPR, PETCO2 of both groups were about 10 mmHg (1 mmHg = 0.133 kPa). PETCO2 was gradually rising to above 20 mmHg in successful group during AACD-CPR process; the failed group increased slightly within 2-5 minutes, then gradually decreased to below 20 mmHg, there was a significant difference in PETCO2 between the two groups at each time. The area under the ROC (AUC) of PETCO2 at CPR 20 minutes in predicting the outcome of the resuscitation was 0.969, 95% confidence interval (95%CI) was 0.943-0.995 (P = 0.000), when the cut-off value of PETCO2 was 24.25 mmHg, the sensitivity was 90.7%, and the specificity was 96.6%. (2) The level of serum S100B protein at 0.5 hour after ROSC in the good prognosis group and the poor prognosis group were significant higher than that of the normal control group; there was no significant difference between poor prognosis group and good prognosis group. S100B protein concentration of the poor prognosis group reached the peak within 3-6 hours, then gradually decreased, and was higher than that of the normal control group at ROSC 72 hours; the good prognosis was gradually decreased and recovered to normal control group within ROSC 72 hours. The AUC of S100B at 3 hours after ROSC on cerebral function prognosis prediction was 0.925, 95%CI was 0.867-0.984 (P = 0.000), when the cut-off value of S100B protein was 1.215 µg/L, the sensitivity was 85.2%, and the specificity was 85.5%. CONCLUSIONS: The variation of PETCO2 can be used as an objective index to predict the success of AACD-CPR, and serum S100B protein can be used as an objective clinical index to predict cerebral function after AACD-CPR, both of which have some reference and guiding significance for clinical treatment.

[Effects of active abdominal compression-decompression CPR on oxygen metabolism and prognosis in patients with cardiac arrest].

OBJECTIVE: To analyze the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) and standard cardiopulmonary resuscitation (STD-CPR) on oxygen metabolism and prognosis of patient with cardiac arrest (CA), and to evaluate the treatment effect of AACD-CPR. METHODS: Patients with CA, CA time less than 30 minutes, and without STD-CPR and AACD-CPR contraindications admitted to the Zhengzhou People's Hospital from October 1st 2015 to May 31st 2017 were enrolled. The patients were divided into STD-CPR group and AACD-CPR group according to random number table. All patients were given the same rescue measures, if required to give defibrillation; STD-CPR group was operated according to the 2015 American Heart Association (AHA) CPR guidelines; AACD-CPR group was recovered using abdominal lifting and compression cardiopulmonary resuscitation instrument. The oxygen metabolism, hemodynamic, arterial blood gas and prognostic indicators were recorded in the two groups during the resuscitation. RESULTS: A total of 69 cases, with STD-CPR group of 34 cases and AACD-CPR group of 35 cases were enrolled finally. (1) The oxygen metabolism: during the recovery, compared with STD-CPR group, arterial blood oxygen content (CaO2), arterial-venous oxygen content difference (avDO2), the oxygen carrying capacity (DO2), oxygen consumption (VO2) in AACD-CPR group were significantly increased [CaO2 (mL/L): 156±15 vs. 142±19, avDO2 (mL/L): 83±14 vs. 73±13, DO2 (mL/min): 248±51 vs. 208±54, VO2 (mL/min): 134±29 vs. 118±32, all P < 0.05], but there were no significant differences in cardiac output (CO) and mixed venous oxygen content (CvO2). (2) Hemodynamic and arterial blood gas: there were no significant differences in the base values of the heart rate (HR), mean arterial pressure (MAP), pH value, pulse oxygen saturation (SpO2), arterial oxygen pressure (PaO2), arterial partial pressure of carbon dioxide (PaCO2), and blood lactate (Lac) between two groups. In the recovery process, MAP, pH value, SpO2, PaO2 of two groups were increased, while PaCO2 and Lac were decreased. Except MAP of STD-CPR group was slightly higher than AACD-CPR group, the change tendency of AACD-CPR group was more obvious in each index obviously [pH value difference: 0.10±0.15 vs. 0.02±0.13, SpO2 difference: 0.311±0.255 vs. 0.159±0.232, PaO2 difference (mmHg, 1 mmHg = 0.133 kPa): 12.96±21.84 vs. 3.01±13.56, PaCO2 difference (mmHg): -9.91±11.17 vs. -3.52±13.87, Lac value difference (mmol/L): -0.64±0.61 vs. -0.31±0.58, all P < 0.05]. (3) Prognosis: compared with STD-CPR group, the restoration of spontaneous circulation (ROSC) rate in AACD-CPR group was slightly increased (22.9% vs. 8.8%, P > 0.05), but the ROSC time in AACD-CPR group was significantly shortened (minutes: 9.59±2.67 vs. 11.83±3.05, P < 0.01), nerve function defect score (NDS) was significantly decreased at 1, 2 weeks (26.45±6.42 vs. 30.73±7.38, 19.25±6.27 vs. 22.64±5.63, both P < 0.05), and the 2-week survival was slightly increased (17.1% vs. 5.9%, P > 0.05). CONCLUSIONS: AACD-CPR is similar to STD-CPR in improving hemodynamics of CA patients, but has advantage in the blood oxygen supply for tissues and organs, and the neurological function prognosis is better.

[Treatment of Unilateral Neglect using Repetitive Transcranial Magnetic Stimulation (rTMS) and Sensory Cueing (SC) in Stroke Patients].

OBJECTIVES: To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and sensory cueing (SC) for improving hemi-spatial attention deficits related to unilateral neglect, upper limb function and independence of stroke patients. METHODS: An assessor-blinded randomized controlled trial (RCT) was conducted. Eligible stroke patients were treated with rTMS (n =17) or rTMS combined with SC (n =16) in addition to conventional rehabilitation measures. rTMS was applied with low frequency (1 Hz) over the posterior parietal cortex (P5) of the lefthemisphere, 90% resting motor threshold, 900 pulses each session, one session per day, and 5 d per week for 2 weeks. SC was emitted using a wristwatch device attached to the hemiplegic arm for 2 weeks with a cumulative wear time of 3 h per day. The severity of unilateral neglect [behavioral inattention test conventional subtests (BITC), Catherine Bergego scale (CBS)], activity of daily living [modified Barthel index (MBI)], and upper limb function [Fugl-Meyer assessment (FMA), action research arm test (ARAT)] of the patients were measured pre- and post-interventions (immediately after 2 weeks' treatment) by an occupational therapist. RESULTS: BIT-C was relieved significantly over time in both groups. But rTMS+SC had greater improvement than rTMS alone (P <0.05). No significant differences was found between the two groups in other outcomes (CBS, FMA, ARAT). CONCLUSION: rTMS combined with SC is better than rTMS alone for treating unilateral neglect in stroke patients.

Reversible Absorption and Emission Responses of Nile Blue and Azure A Derivatives in Extreme Acidic and Basic Conditions.

Oxazinium derivatives have recently played an important role in bioanalysis attributing to the distinguished properties, thus a detailed study of the structure-property relationship is especially significant. Herein, pH-sensitive optical properties of Nile Blue (1a), N-monoalkyl-Nile Blue (1b) and Azure A (1c) have been carried out in extreme acid and base conditions. Dyes 1a and 1c showed colorimetric changes by the protonation of nitrogen atom in strong acidic condition (pH < 2.0), and dyes 1a - c exhibited colorimetric changes by equilibrium between amino and imide groups in very strong basic case (pH > 7.6). Besides, their fluorescent properties were closed to ON - OFF and OFF - ON emissions at 640-820 nm under strong acidic and basic conditions. Moreover, the absorption and emission properties were reversible, and there were no remarkable optical intensity changes of dyes 1a - c under subacidic and neutral solutions (pH = 3.0-7.0). The (TD) DFT calculations were used to optimize the most stable structures of their corresponding protonated and deprotonated forms, and their absorption and emission properties were also explained. Their fluorescent properties nearly ON-OFF and OFF - ON in strong acidic and basic conditions at near-infrared region will give the possible application in pH detection for extreme conditions. Graphical abstract ᅟ.

Comparative characterization of stem cells from human exfoliated deciduous teeth and dental pulp stem cells.

OBJECTIVE: This study focused on the characterization of stem cells from human exfoliated deciduous teeth (SHED) in comparison with dental pulp stem cells (DPSCs) to certify SHED as a key element in tissue engineering. METHODS: In the present study, SHED and DPSCs were assayed for their cell surface antigens and proliferation by measuring the cell cycles, growth rates, Ki67-positive efficiencies, and colony-forming units (CFUs). The evaluation of multi-differentiation was performed using alizarin red and oil red O and real-time PCR in vitro. The mineralization capability of the cells was examined in vivo by implanting with ceramic bovine bone (CBB) into subcutaneous of immunocompromised mice for 8weeks. A three-dimensional pellet cultivation system is proposed for SHED and DPSCs to recreate the biological microenvironment that is similar to that of a regenerative milieu. RESULTS: SHED showed a higher proliferation rate and differentiation capability in comparison with DPSCs in vitro, and the results of the in vivo transplantation suggest that SHED have a higher capability of mineralization than the DPSCs. The mRNA expression levels of inflammatory cytokines, including matrix metalloproteinase-1 (MMP1), tissue inhibitors of metalloproteinase-1 (TIMP1), matrix metalloproteinase-2 (MMP2), tissue inhibitors of metalloproteinase-2 (TIMP2) and interleukin-6 (IL-6) were higher in SHED than that in DPSCs. In addition, the expression levels of Col I and proliferating cell nuclear antigen (PCNA) in SHED sheets were significantly higher than those in DPSCs sheets. CONCLUSIONS: This study systematically demonstrated the differences in the growth and differentiation characteristics between SHED and DPSCs. Consequently, SHED may represent a suitable, accessible and potential alternative source for regenerative medicine and therapeutic applications.