Purinergic P2X7 receptor involves in anti-retinal photodamage effects of berberine.

Berberine (BBR) is a Chinese herb with antioxidant and anti-inflammatory properties. In a previous study, we found that BBR had a protective effect against light-induced retinal degeneration in BALB/c mice. The purinergic P2X7 receptor (P2X7R) plays a key role in retinal degeneration via inducing oxidative stress, inflammatory changes, and cell death. The aim of this study was to investigate whether BBR can induce protective effects in light damage experiments and whether P2X7R can get involved in these effects. C57BL/6 J mice and P2X7 knockout (KO) mice on the C57BL/6 J background were used. We found that BBR preserved the outer nuclear layer (ONL) thickness and retinal ganglion cells following light stimulation. Furthermore, BBR significantly suppressed photoreceptor apoptosis, pro-apoptotic c-fos expression, pro-inflammatory responses of Mϋller cells, and inflammatory factors (TNF-α, IL-1ß). In addition, protein levels of P2X7R were downregulated in BBR-treated mice. Double immunofluorescence showed that BBR reduced overexpression of P2X7R in retinal ganglion cells and Mϋller cells. Furthermore, BBR combined with the P2X7R agonist BzATP blocked the effects of BBR on retinal morphology and photoreceptor apoptosis. However, in P2X7 KO mice, BBR had an additive effect resulting in thicker ONL and more photoreceptors. The data suggest that the P2X7 receptor is involved in retinal light damage, and BBR inhibits this process by reducing histological impairment, cell death, and inflammatory responses.

Median effective dose of spinal ropivacaine in combined spinal and epidural anesthesia for emergency cesarean delivery following failed vaginal delivery with epidural labor analgesia: a single-blind, sequential dose-finding study.

PURPOSE: This study aimed to estimate the median effective dose of intrathecal isobaric ropivacaine without opioid required for adequate cesarean delivery anesthesia after epidural labor analgesia. METHODS: Patients aged 20-40 years with American Society of Anesthesiology scores of I-II, body mass index ≤ 36, who underwent emergency cesarean delivery after failed vaginal delivery with epidural analgesia of a duration ≤ 6 h were included in the study. After removal of the epidural used for labor analgesia, a new combined spinal epidural was performed, and a dose of intrathecal isobaric ropivacaine without opioid was administered. The dose was determined using up-down methodology, with the starting patient's dose set to 12 mg. Adequate anesthesia, defined as a pinprick level no lower than T6 at 5 min after ropivacaine administration, resulted in the next patient receiving a dose of ropivacaine 1 mg higher, and inadequate anesthesia 1 mg lower. The primary outcome was the median (95% confidence interval (CI)) dose of spinal ropivacaine required for adequate cesarean delivery anesthesia. RESULTS: Of the 46 patients included in the study, 40 were analyzed. The median spinal ropivacaine dose was 8.11 mg (95% CI 7.29-8.93 mg) by the Dixon and Mood method and 8.06 mg (95% CI 6.93-9.00 mg) by isotonic regression. Two patients had high spinal anesthesia. CONCLUSION: Our findings suggest that for 50% of patients undergoing cesarean delivery after failed vaginal delivery with epidural analgesia, an 8-mg spinal dose of isobaric ropivacaine without opioid provides an anesthesia level no lower than T6 at 5 min.

Tailoring the p-Band Center of NS Pair for Accelerating High-Performance Lithium-Oxygen Battery.

The local coordination environment of catalytical moieties directly determines the performance of electrochemical energy storage and conversion devices, such as Li-O2 batteries (LOBs) cathode. However, understanding how the coordinative structure affects the performance, especially for non-metal system, is still insufficient. Herein, a strategy that introduces S-anion to tailor the electronic structure of nitrogen-carbon catalyst (SNC) is proposed to improve the LOBs performance. This study unveils that the introduced S-anion effectively manipulates the p-band center of pyridinic-N moiety, substantially reducing the battery overpotential by accelerating the generation and decomposition of intermediate products Li1-3 O4 . The lower adsorption energy of discharging product Li2 O2 on NS pair accounts for the long-term cyclic stability by exposing the high active area under operation condition. This work demonstrates an encouraging strategy to enhance LOBs performance by modulating the p-band center on non-metal active sites.

Unsaturated Fatty Acid Liposomes Selectively Regulate Glutathione Peroxidase 4 to Exacerbate Lipid Peroxidation as an Adaptable Liposome Platform for Anti-Tumor Therapy.

Regulating non-apoptotic cell death of cancer cells provides a promising strategy to overcome apoptosis resistance during cancer treatment. Lipids are essential components to exacerbate several non-apoptotic cell death pathways. In the present study, unsaturated fatty acid (UFA) liposomes prepared with linoleic acid, oleic acid, or α-linolenic acid have the potential to affect lipid metabolism. Notably, UFA liposomes markedly increased cellular reactive oxygen species (ROS) and down-regulated the expression of glutathione peroxidase 4 (GPX4) in tumor cells, resulting in lipid peroxidation, which in turn caused rapid membrane rupture and induced non-apoptotic cell death of tumor cells. Concomitantly, UFA liposomes induced ROS-mediated tumor-associated macrophages toward a tumoricidal phenotype to reverse the immunosuppressive tumor microenvironment. Consequently, UFA liposomes substantially inhibited tumor growth in a melanoma model by promoting lipid peroxidation, inducing non-apoptotic cell death of tumor cells, and increasing infiltration of anti-tumor immune cells at tumor sites. Therefore, UFA liposomes regulate GXP4 to exacerbate lipid peroxidation and provide a versatile liposome platform for enhancing anti-tumor therapy which could be readily extended to the delivery of anticancer agents.

High-efficiency mode-locked erbium-doped ZBLAN fiber laser around 2.8 µm by directly depositing Bi2S3 particles onto a cavity mirror.

Mid-infrared (MIR) pulsed lasers near a 3 µm waveband show great potential for the high absorption of water molecules and many important gas molecules. A passively Q-switched mode-locked (QSML) E r 3+-doped fluoride fiber laser with a low laser threshold and high slope efficiency around a 2.8 µm waveband is reported. The improvement is achieved by depositing bismuth sulfide (B i 2 S 3) particles onto the cavity mirror directly as a saturable absorber and using the cleaved end of the fluoride fiber as output directly. -QSML pulses begin to appear with the pump power of 280 mW. The repetition rate of the QSML pulses reaches a maximum of 33.59 kHz with the pump power of 540 mW. When the pump power is further increased, the output of the fiber laser switches from the QSML to the continuous-wave mode-locked operation with the repetition rate of 28.64 MHz and the slope efficiency of 12.2%. The results indicate that B i 2 S 3 is a promising modulator for the pulsed lasers near a 3 µm waveband, which paves the way for further development of various applications in MIR wavebands, including material processing, MIR frequency combs, and modern healthcare.

MG53 alleviates hypoxia/reoxygenation-induced cardiomyocyte injury by succinylation and ubiquitination modification.

BACKGROUND: Mitsugumin 53 (MG53) is a membrane repair factor that is associated with acute myocardial infarction. This study aimed to investigate the effects of MG53 on cardiomyocyte injury and the posttranslational modification of MG53. METHODS: Cardiomyocyte injury was evaluated by enzyme-linked immunosorbent assay and flow cytometry. The succinylation and ubiquitination levels of MG53 were examined by immunoprecipitation (IP) and western blot. The relationship between MG53 and KAT3B or SIRT7 was assessed by co-IP and immunofluorescence. RESULTS: The results showed that overexpression of MG53 inhibited inflammation response and apoptosis of cardiomyocytes induced by hypoxia/reoxygenation (H/R). Succinylation and protein levels of MG53 were downregulated in H/R-induced cells, which was inhibited by SIRT7 and promoted by KAT3B. SIRT7 aggravated and KAT3B alleviated MG53-mediated cardiomyocyte injury. Moreover, MG53 was succinylated and ubiquitinated at K130. CONCLUSION: SIRT7 inhibited/KAT3B promoted succinylation of MG53 at K130 sites, which suppressed ubiquitination of MG53 and upregulated its protein levels, thereby alleviating H/R-induced cardiomyocyte injury. The findings suggested that MG53 may be a potential therapy for myocardial infarction.

2†µm sub-GHz harmonic mode-locked soliton generation based on a Bi2S3 saturable absorber.

Saturable absorber (SA) based harmonic mode-locking (HML) techniques at 2 µm waveband are much less reported than those at 1.5 µm waveband, the maximum repetition rate of the harmonic pulse generated by such techniques at 2 µm waveband is also much lower than those generated at 1.5 µm waveband. In this paper, the 39th harmonic with the repetition rate of 908.6 MHz is realized in a Bi2S3-based thulium-doped fiber laser. The fundamental mode-locked pulse has a central wavelength of 1954.2 nm and a 3-dB bandwidth of 5.1 nm. The repetition rate is 23.27 MHz and the pulse width is 902 fs. The characteristics of the material and harmonic mode-locked pulse are investigated. To the best of our knowledge, this is the highest and the closest resonance frequency to GHz among the reported SA-based harmonic mode-locked fiber lasers operating at 2 µm waveband.

Constructing an experiential education model in undergraduate radiology education by the utilization of the picture archiving and communication system (PACS).

BACKGROUND: Medical education in China is in a transitional period, from passive learning models to experiential education. We modified an experiential education method for radiology education. The aim of this study is to evaluate the effect of this method on undergraduate radiology education. METHOD: With the help of the picture archiving and communication system (PACS) and RadiAnt DICOM Viewer, we modified an experiential education method that simulates similar working conditions for undergraduate medical students to formulate radiology diagnosis similar to clinical radiologists. A total of 101 students were allocated into either the experiential education group or the control group. The final examination scores and a 5-point Likert scale self-assessment questionnaire of radiologic skills were collected from all the students as an objective assessment and a subjective assessment respectively. A questionnaire was also used to assess the satisfaction with the experiential model in the experiential education group. Mann-Whitney U test was used to compare the ranked data, and t-tests were used to compare the numeric data. RESULTS: The experiential education group demonstrated significantly higher scores (7.4 ± 1.3) compared to the control group (6.7 ± 1.5, p < 0.05) in the question type "description and diagnosis". The self-assessment questionnaire indicated that the experiential education was related to increased familiarity with the diagnosis thinking principle and the sequences and reconstruction methods of computer tomography (CT) imaging, which also strengthen participants' self-confidence to perform future clinical work (p < 0.05). The self-assessment questionnaire in the experiential education group showed that the majority of students were satisfied with the organization (82.5%), interactivity (85%) and quality (85%) of the learning activity. Most students found this model of learning to be helpful for studying radiology (85%) and for understanding anatomy (90%). CONCLUSION: Compared with the traditional radiology education approach, the experiential education method showed greater efficacy in improving students' analysis and diagnostic skills and their self-confidence.

Expression of recombinant human acetylcholinesterase and its application in screening its inhibitors.

This study is designed to obtain recombinant human acetylcholinesterase (rhAChE) and apply it in screening acetylcholinesterase inhibitors. The rhAChE was overexpressed in HEK293 cells transfected by plasmid of pCMV-AChE with the cationic liposome and rhAChE was found to be secreted into cell culture medium. AChE activity was assayed according to modified Ellman method to obtain kinetic parameters. IC so50 values for donepezil compounds of rhAChE were calculated to determine their activities of inhibition. The results showed that Km value was 151.9 micromol.L-1 donepezil inhibited rhAChE in a mixed competitive-noncompetitive way (Ki= 16.03 nmol.L-1, Ki = 18.36 nmol.L-1) and that most new compounds tested exhibited high activities of inhibition on rhAChE. The study suggests that rhAChE is available to be applied in screening AChE inhibitors in vitro.

The relationship between psychological capital and self-directed learning ability among undergraduate nursing students-a cross-sectional study.

Background: Psychological capital has become a prominent focus in positive psychology, highlighting the positive influence of higher psychological capital on individuals. Self-directed learning ability is a fundamental skill for students, vital for enhancing academic performance and professional development, and is integral to the continuous learning process of nursing students. Recognizing the relationship between psychological capital and self-directed learning ability is crucial for the progress and development of undergraduate nursing students. Objective: This study aims to investigate the correlation between psychological capital and self-directed learning ability in undergraduate nursing students, as well as to explore the factors that influence these variables. Methods: A cross-sectional survey was conducted with 667 full-time undergraduate nursing students from a nursing school in Taizhou, China. Psychological capital and self-directed learning ability were assessed using the Psychological Capital Questionnaire and Self-Directed Learning Scale, respectively. Correlation and stepwise multiple regression analyses were then carried out to evaluate the relationship between psychological capital and self-directed learning ability among the participants. Results: The study revealed that the psychological capital score averaged at 103.24 ± 15.51, while the self-directed learning scale score averaged at 230.67 ± 27.66. Variations in psychological capital scores were noted based on factors including grade level, being an only child, growth environment, monthly living expenses, parental education level, voluntary selection of nursing major, and club experience. Similarly, differences in self-directed learning scores were associated with factors such as grade level, gender, parental education level, and voluntary selection of nursing major. Moreover, a positive correlation was identified between the overall psychological capital scores and the total self-directed learning ability scores among nursing students. Notably, the multiple regression analysis highlighted that optimism and resilience played significant roles as predictors of self-directed learning ability. Conclusion: Psychological capital is positively correlated with the self-directed learning ability of nursing students, with optimism and resilience identified as crucial predictors. Nursing educators can utilize strategies rooted in positive psychology and perseverance to improve the self-directed learning ability of nursing students.

High-efficiently utilizing micro-nano ozone bubbles to enhance electro-peroxone process for rapid removal of trace pharmaceutical contaminants from hospital wastewater.

The electro-peroxone (EP) process encounters two inherent challenges in wastewater treatment: sluggish O2/O3 transfer and substantial ozone waste. To overcome these limitations, we introduced micro-nano bubbles (MNBs) aeration to enhance O2/O3 dissolution and diffusion, ultimately aiming to improve the removal of trace pharmaceutical contaminants from hospital wastewater. In the MNBs aeration system, the ozone transfer coefficient ranging from 0.536 to 0.265 min-1, significantly surpassing that of conventional aeration (0.220 to 0.090 min-1) by approximately 2 to 4.5 times. Consequently, the EP process under MNBs aeration significantly enhanced ozone-resistant ibuprofen (IBU) removal, achieving a removal rate of 98.4 ± 1.5 %, far exceeding the 47.3 ± 4.7 % observed with conventional aeration. This significant improvement was attributed to the heightened production of hydroxyl radicals (•OH), reaching 0.97 × 10-9 M s, compared to only 0.28 × 10-9 M s in conventional aeration. The mechanism behind the enhanced •OH production in the MNBs-EP process relied primarily on two factors: improved O2/O3 dissolution due to high internal pressure/large surface and enhanced O3/H2O2 activation from high collapse energy. These factors together contributed to the robust oxidation capability of the MNBs-EP system. As a result, over 97 % removal efficiency was achieved for five representative pharmaceutical pollutants (sulfamethoxazole, ribavirin, norfloxacin, tetracycline and ampicillin) in just 1 min. Furthermore, when applied to real hospital wastewater, the MNBs-O3-E treatment system reduced all 15 detected trace pharmaceutical compounds to below 10 ng L-1 and achieved 14 types of pollutants with removal rates of over 85 % within 15 min, resulting in an ultrahigh total removal rate of 98.6 %, from an initial total concentration of 2108 ng L-1 to less than 30 ng L-1. Thus, micro-nano aeration endowed the EP process as a promising advanced oxidation system for rapid and highly-effective removal of trace pharmaceutical contaminants from hospital wastewater.

Comparison of Different Head Tilt Angles in Tomotherapy and Volumetric Modulated Arc Therapy for Hippocampal-Avoidance Whole-Brain Radiotherapy.

PURPOSE: Hippocampal-avoidance whole-brain radiotherapy (HA-WBRT) planning can present challenges. This study examines the influence of head tilt angles on the dosimetric characteristics of target and organs at risk (OARs), aiming to identify the optimal tilt angle that yields optimal dosimetric outcomes using tomotherapy (TOMO). METHODS: Eight patients diagnosed with brain metastases underwent CT scans at five tilt angles: [0°, 10°), [10°, 20°), [20°, 30°), [30°, 40°), and [40°, 45°]. Treatment plans were generated using TOMO and volumetric modulated arc therapy (VMAT). Dosimetric parameters including conformity index (CI), homogeneity index (HI), D2cc, D98%, and Dmean of PTV, as well as Dmax, and Dmean of OARs were analyzed. Furthermore, a comparison was made between the dosimetric parameters of TOMO and VMAT plans. Finally, delivery efficiency of TOMO plans were assessed. RESULTS: For the PTV, [40°, 45°] tilt angle demonstrated significantly better conformity, homogeneity, lower D2cc, and lower Dmean for the PTV. Regarding the OARs, the [40°, 45°] head tilt angle demonstrated significantly lower Dmax and Dmean in hippocampus, eyes, optic chiasm, and optic nerves. The [40°, 45°] tilt angle also showed significantly lower Dmax for brainstem and cochleas, as well as a lower Dmean for lens. In the [40°,45°] tilt angle for HA-WBRT, TOMO showed superior performance over VMAT for the PTV. TOMO achieved lower Dmax for brainstem, cochleas, optic nerves, and optic chiasm, as well as a lower Dmean for hippocampus. Furthermore, a significant correlation was found between delivery time and the PTV projection length in the sagittal plane. CONCLUSION: The TOMO plan utilizing a tilt angle range of [40°, 45°] demonstrated superior PTV conformity and uniformity, along with enhanced OARs sparing. Furthermore, it exhibited a dosimetric advantage over VMAT for PTV and most OARs at the same angle range.

Carbon chain elongation characterizations of electrode-biofilm microbes in electro-fermentation.

The higher efficiency of electro-fermentation in synthesizing medium-chain fatty acids (MCFAs) compared to traditional fermentation has been acknowledged. However, the functional mechanisms of electrode-biofilm enhancing MCFAs synthesis remain research gaps. To address this, this study proposed a continuous flow electrode-biofilm reactor for chain elongation (CE). After 225 days of operation, stable electrode-biofilms formed and notably improved caproate yield by more than 38 %. The electrode-biofilm was enriched with more CE microorganisms and electroactive bacteria compared to the suspended sludge microorganisms, including Caproicibacterium, Oscillibacter and Pseudoramibacter. Besides, the upregulated CE pathways were evaluated by metagenomic analysis, and the results indicated that the pathways such as acetyl-CoA and malonyl-[acp] formation, reverse beta-oxidation, and fatty acid biosynthesis pathway were all markedly enhanced in cathodic biofilm, more than anodic biofilm and suspended microorganisms. Moreover, microbial community regulated processes like bacterial chemotaxis, flagellar assembly and quorum sensing, crucial for electrode-biofilm formation. Electron transfer, energy metabolism, and microbial interactions were found to be prominently upregulated in the cathodic biofilm, surpassing levels observed in anodic biofilm and suspended sludge microorganisms, which further enhanced CE efficiency. In addition, the statistical analyses further highlighted key microbial functions and interactions within the cathodic biofilm. Oscillospiraceae_bacterium was identified to be the most active microbe, alongside pivotal roles played by Caproiciproducens_sp._NJN-50, Clostridiales_bacterium, Prevotella_sp. and Pseudoclavibacter_caeni. Eventually, the proposed microbial collaboration mechanisms of cathodic biofilm were ascertained. Overall, this study uncovered the biological effects of the electrode-biofilm on MCFAs electrosynthesis, thereby advancing biochemicals production and filling the knowledge gaps in CE electroactive biofilm reactors.

Silencing of CircTRIM25/miR-138-5p/CREB1 axis promotes chondrogenesis in osteoarthritis.

BACKGROUND: Dysregulated circular RNAs (circRNAs) are involved in osteoarthritis (OA) progression. OBJECTIVE: We aimed to explore the effect of hsa_circ_0044719 (circTRIM25) on the ferroptosis of chondrocytes. METHODS: Chondrocytes were treated with interleukin (IL)-1ß to generate cell model. Cellular behaviours were measured using cell counting kit-8, enzyme-linked immunosorbent assay, relevant kits, propidium iodide staining, and immunofluorescence assay. Quantitative real-time polymerase chain reaction was performed to examine the expression of circTRIM25, miR-138-5p, and cAMP responsive element binding protein 1 (CREB1), and their interactions were assessed using luciferase reporter analysis and RNA pull-down assay. RESULTS: CircTRIM25 was upregulated in OA tissues and IL-1ß-stimulated chondrocytes. Knockdown of circTRIM25 facilitated the viability and suppressed ferroptosis and inflammation of IL-1ß-induced cells. CircTRIM25 served as a sponge of miR-138-5p, which directly targets CREB1. Downregulation of miR-138-5p abrogated the effect induced by knockdown of circTRIM25. Furthermore, enforced CREB1 reversed the miR-138-5p induced effect. Moreover, knockdown of circTRIM25 attenuated cartilage injury in vivo. CONCLUSION: Silencing of circTRIM25 inhibited ferroptosis of chondrocytes via the miR-138-5p/CREB axis and thus attenuated OA progression.

Feedback of chain elongation microorganisms on iron-based conductive materials: Enhanced microbial functions and biotoxicity adaptation mechanisms.

Despite the increased research efforts aimed at understanding iron-based conductive materials (CMs) for facilitating chain elongation (CE) to produce medium chain fatty acids (MCFAs), the impact of these materials on microbial community functions and the adaptation mechanisms to their biotoxicity remain unclear. This study found that the supply of zero-valent iron (ZVI) and magnetite enhanced the MCFAs carbon-flow distribution by 26 % and 52 %, respectively. Metagenomic analysis revealed the upregulation of fatty acid metabolism, pyruvate metabolism and ABC transporters with ZVI and magnetite. The predominant functional microorganisms were Massilibacterium and Tidjanibacter with ZVI, and were Petrimonas and Candidatus_Microthrix with magnetite. Furthermore, it was demonstrated that CE microorganisms respond and adapt to the biotoxicity of iron-based CMs by adjusting Two-component system and Quorum sensing for the first time. In summary, this study provided a new deep-insight on the feedback mechanisms of CE microorganisms on iron-based CMs.

Copper ions-photo dual-crosslinked alginate hydrogel for angiogenesis and osteogenesis.

Early healing of bone defects is still a clinical challenge. Many bone-filling materials have been studied, among which photocrosslinked alginate has received significant attention due to its good biocompatibility and morphological plasticity. Although it has been confirmed that photocrosslinked alginate can be used as an extracellular matrix for 3D cell culture, it lacks osteogenesis-related biological functions. This study constructed a copper ions-photo dual-crosslinked alginate hydrogel scaffold by controlling the copper ion concentration. The scaffolds were shaped by photocrosslinking and then endowed with biological functions by copper ions crosslinking. According to in vitro research, the dual-crosslinked hydrogel increased the compressive strength and favored copper dose-dependent osteoblast differentiation and cell surface adherence of rat bone marrow mesenchymal stem cells and the expression of type I collagen (Col1), runt-related transcription factor 2 (Runx2), osteocalcin (OCN), vascular endothelial growth factor (VEGF). In addition, hydrogel scaffolds were implanted into rat skull defects, and more angiogenesis and osteogenesis could be observed in in vivo studies. The above results show that the copper-photo-crosslinked hydrogel scaffold has excellent osseointegration properties and can potentially promote angiogenesis and early healing of bone defects, providing a reference solution for bone tissue engineering materials.

Visual ratiometric optical thermometer with high sensitivity and excellent signal discriminability based on LiScSiO4:Ce3+, Tb3+ thermochromic phosphor.

Developing optical thermometer phosphors with high sensitivity, high signal discriminability and strong fluorescence intensity is ongoing. A dual-emitting thermochromic phosphor, LiScSiO4:Ce3+, Tb3+, was successfully synthesized via solid-state reaction method. The crystal structure, electronic structure, luminescent performance and thermal luminescence behaviors as well as the luminescence mechanism of LiScSiO4:Ce3+, Tb3+ were systematically investigated. Due to the energy transfer and different thermoluminescence behaviors between Ce3+ and Tb3+, high relative sensitivity (2.2 % K-1@473 K), excellent signal discriminability (5747 cm-1), outstanding temperature resolution (0.067 K) and good repeatability, as well as efficient emission at high temperatures were achieved based on the fluorescence intensity ratio of Ce3+ and Tb3+, indicating its potential in ratiometric optical thermometer. Moreover, the excellent visualizing thermochromic enable LiScSiO4:Ce3+, Tb3+ to be used as safety sign in variable temperature environment to monitor temperature distribution.

Urinary microalbumin/creatinine ratio is a predictor of the occurrence and severity of leukoaraiosis.

OBJECTIVE: To investigate the correlation between the urinary microalbumin/creatinine ratio (UACR) and the occurrence and severity of leukoaraiosis. METHODS: A total of 323 patients were retrospectively recruited. Demographic, clinical, and laboratory data were collected at the time of admission, and the UACR was calculated based on the levels of urinary microalbumin and creatinine. All patients showed improvement in cranial magnetic resonance imaging (MRI) examination. The subjects were divided into leukoaraiosis and non-leukoaraiosis groups according to the results of the cranial MRI examination. According to the Fazekas standard score, the patients in the leukoaraiosis group were divided into the mild leukoaraiosis group: Fazekas (1-2 points), moderate leukoaraiosis group: Fazekas (3-4points); and severe leukoaraiosis group: Fazekas (5-6 points). RESULTS: A regression analysis was performed to adjust for confounding factors. (1) Compared with the non-leukoaraiosis group, UACR level was higher in the leukoaraiosis group at admission, and the difference between the groups was statistically significant (p < 0.05). (2) In the multivariate logistic regression analysis, UACR was correlated with the occurrence of leukoaraiosis, which may be an independent risk factor. (3) The UACR levels increased gradually in the mild, moderate and severe leukoaraiosis groups, and the difference was statistically significant (p< 0.05). (4) In the ordered multi-category logistic regression analysis, UACR was correlated with the severity of leukoaraiosis, which may be an independent risk factor. CONCLUSION: UACR is associated with the occurrence and severity of leukoaraiosis, and may be an independent risk factor.

Design of a nitridoalumosilicate red phosphor synthesized under mild conditions.

Developing nitridosilicate red phosphors under mild synthesis conditions is important for regulating the emission quality of white light-emitting diodes (WLEDs). Based on the thermodynamic theory and crystal structure chemistry for the synthesis of nitridosilicates, the Gibbs free energy variation of a hybrid system can be made more negative by reducing the proportion of Si3N4 and increasing the proportion of M2N3 and AlN, enabling the formation of new nitridosilicates under mild conditions. Therefore, a general chemical formula MxSiyAlzNk was proposed for the design of nitridosilicate red phosphors prepared under mild conditions, where M is an alkaline earth metal ion; x > y; z ≥ y; 1 ≤ y ≤ 3; x + 2y = 3n + 3; k - z = 2n + 2; and n is a positive integer. Therefore, in this study, we successfully synthesized the nitridoalumosilicate red phosphor Ca4SiAl3N7:Eu2+ at normal pressure and lower temperature (1350 °C). Under excitation with 460 nm blue light, the Ca4SiAl3N7:Eu2+ phosphor efficiently emits red light at 645 nm and exhibits excellent thermal stability. The crystal structure and luminescence properties of Ca4SiAl3N7:Eu2+ were investigated in detail. The results indicate that Ca4SiAl3N7:Eu2+ exhibits strong potential for use in WLEDs. The design of nitridoalumosilicate red phosphors synthesized under mild conditions based on Gibbs free energy variation provides a new idea for the development of new nitride phosphors.

Individualized positive end-expiratory pressure with and without recruitment maneuvers in obese patients during bariatric surgery.

This study aimed to determine whether regular recruitment maneuvers (RMs) are essential for obese patients (OPs) undergoing elective laparoscopic bariatric surgery (LBS) during intraoperative ventilation with individualized positive end-expiratory pressure (PEEP). Patients were randomly assigned to two arms: the RM + PEEP-EIT arm consisted of individualized PEEP titrated by electrical impedance tomography (EIT) with two regular RMs and the PEEP-EIT arm consisted of individualized PEEP titrated by EIT without additional RMs. For these two arms together, EIT-guided PEEP varied among individuals. The partial pressure of oxygen in arterial blood to fractional inspired oxygen (PaO2 /FiO2 ) ratio in the RM + PEEP-EIT arm was higher than that in the PEEP-EIT arm at 1 h after pneumoperitoneum (p = 0.024) and at the end of surgery (p = 0.035). There was no great difference in the PaO2 /FiO2 ratio between these two arms when measured 5 min prior to postanesthesia care unit (PACU) departure and on postoperative day 1. Compared with the PEEP-EIT arm, patients in the RM + PEEP-EIT arm had significantly higher intraoperative dynamic respiratory system compliance (p < 0.001) but consumed more vasopressors (p = 0.036). Postoperative pulmonary complications occurred in 1 of 29 patients in the RM + PEEP-EIT arm compared with 2 of 31 patients in the PEEP-EIT arm. Regular lung RMs can improve intraoperative oxygenation and respiratory system compliance among OPs undergoing LBS with EIT-guided individual PEEP. However, the improvement might disappear before leaving the PACU, and regular RMs resulted in more vasopressor consumption.