[Timing of starting veno-venous extracorporeal membrane oxygenation].

Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is mainly used for reversible acute respiratory failure that is difficult to correct with mechanical ventilation and other conventional measures or preparation of lung transplantation. Acute respiratory distress syndrome (ARDS) is a typical clinical syndrome of acute respiratory failure. The timing of starting VV-ECMO in severe ARDS still face many controversies and challenges. This paper we discuss the current feasible assessment methods of when to start VV-ECMO in ARDS, such as, optimization of mechanical ventilation parameters, monitoring of respiratory dynamics and hemodynamics, assessment of lung recruitability and electrical impedance tomography (EIT) real-time monitoring, etc.

A new diphosphate Ba2LiGa(P2O7)2: synthesis, crystal structure and Eu3+-activated fluorescence performance.

Finding new luminescent materials is always a meaningful goal in the field of photoelectricity studies. Herein, a new diphosphate compound Ba2LiGa(P2O7)2 (BLGP) was prepared using a high-temperature flux method. It displays an anionic chain structure of [LiGa(P2O7)2]∞, constructed from P2O7, LiO5 and GaO6 polyhedra. The Ba2+ ions are distributed in the voids between the [LiGa(P2O7)2]∞ chains, bonding them and maintaining charge balance. To test its potential as a luminescent host, Eu3+ doped phosphors BLGP:xEu3+ (x = 0.05, 0.10, 0.15, 0.20, 0.25 and 0.30) were synthesized and studied in detail. Upon 394 nm light irradiation, BLGP:xEu3+ showed bright orange emission with a dominant peak at 595 nm due to the 5D0 → 7F1 transition of Eu3+. The optimal doping amount of Eu3+ is 0.20, and the internal quantum efficiency of the phosphor B1.8LGP:0.2Eu3+ was determined to be 67%. The temperature quenching behavior of B1.8LGP:0.2Eu3+ was studied, suggesting that the photoluminescence (PL) intensity decreased to about 50% at 450 K due to thermal quenching. All these features show that this compound is a good luminescent host material for Eu3+ activators.

CCL3 participates in the development of rheumatoid arthritis by activating AKT.

OBJECTIVE: To investigate whether CC chemokine 3 (CCL3) could exert a certain effect on rheumatoid arthritis (RA) by regulating inflammatory responses and provide a new direction for the treatment of RA. PATIENTS AND METHODS: Totally 47 RA patients (10 males and 37 females) with complete clinical data were included. Meanwhile, 27 healthy volunteers with same age and gender were recruited as healthy controls. The mRNA and protein level of CCL3 in the peripheral blood mononuclear cells (PBMCs) of RA patients and normal controls were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) and Western blot, respectively. The inflammatory infiltration of synovial tissue was observed by hematoxylin and eosin (HE) staining. Immune fluorescence was used to further analyze the level of CCL3 in T and B cells of synovial tissue in RA patients. Simultaneously, real-time flow cytometry was applied to detect the level of CCL3 in T and B cells of PBMCs in the normal control group and the RA group. Western blot was used to detect the level of pAKT in RA-FLS treated with different concentrations of recombinant human CCL3. Besides, enzyme-linked immunosorbent assay (ELISA) was applied to detect the levels of interleukin-1ß (IL-1ß), tumor necrosis factor-α (TNF-α) and receptor activator of nuclear factor kappa-B ligand (RANKL) in the culture supernatant of RA-FLS stimulated by different doses of recombinant human CCL3. RESULTS: The level of CCL3 in peripheral blood and synovial fluid of RA patients was markedly higher than that of normal controls. Inflammatory cells were infiltrated in synovial tissue of RA patients. Meanwhile, CCL3 was mainly expressed in CD4+ T cells. CCL3 treatment in rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS) could activate the PI3K/AKT signaling pathway to different degrees and increase the expression of cytokines including interleukin-6 (IL-6), IL-1ß, TNF-α, and RANKL. These results indicated that CCL3 might participate in the progression of RA by activating AKT. CONCLUSIONS: We showed that CCL3 enhanced the expression level of pro-inflammatory cytokines such as IL-6, IL-1ß, TNF-α, and RANKL by activating the PI3K/AKT signaling pathway. Besides, CCL3 could up-regulate CD4+T cells to mediate the inflammatory response of RA. These findings might provide new directions for the prevention of RA.

Detection of serum procalcitonin and hypersensitive C-reactive protein in patients with pneumonia and sepsis.

Sepsis, a systemic inflammatory response syndrome induced by infection, has high rates of morbidity and mortality. Pneumonia is a major cause for sepsis; however, pneumonia complicated by sepsis is a difficult clinical diagnosis. To assess the clinical relevance of serum procalcitonin (PCT) and hypersensitive C-reactive protein (hs-CRP) in early diagnosis of pneumonia complicated by sepsis, 220 patients with pneumonia who were admitted to hospital from July 2015 to July 2016 were enrolled in this study. The patients were divided into non-sepsis (N=82), mild sepsis (N=97), severe sepsis (N=23), and septic shock (N=18) groups. The patients were also divided into a survival group (N=186) and a death group (N=34) according to their prognosis at 2 weeks. The PCT and hs-CRP levels and Acute Physiology and Chronic Health Evaluation-II (APACHE-II) scores of the two groups were evaluated. The PCT level and APACHE-II score showed a progressively increasing tendency in the non-sepsis, mild sepsis, severe sepsis, and septic shock group; the differences between all pairs of groups were significant (P less than 0.05). The hs-CRP level was significantly lower in the non-sepsis group than in the other groups (P less than 0.05), but differences among the other groups were not significant (P>0.05). The areas under the receiver operating characteristic curves of PCT and hs-CRP for diagnosis of pneumonia complicated by mild and severe sepsis were 0.841 and 0.817, respectively. The optimal cut-off points for pneumonia and sepsis were ≥0.5 ng/mL and ≥55 mg/L, respectively; the sensitivity and specificity were 71.42% and 82.13%, and 75.04% and 53.61%, respectively. The sensitivity and specificity of diagnosis based on PCT and hs-CRP were 89.32% and 85.68%, respectively. PCT and hs-CRP are used to assess the severity of pneumonia in combination with sepsis in new-borns, but PCT is more strongly related to the severity of sepsis than is hs-CRP. Detection of PCT in combination with hs-CRP facilitates the early diagnosis of pneumonia and sepsis in new-borns, as well as monitoring of the treatment response and prediction of the prognosis.

[Effects of crystalline silica with different exposure patterns on lung fibrosis in rats].

Objective: To investigate the effects of crystalline silica with different exposure patterns on lung fibrosis in rats. Methods: A total of 20 adult male Wistar rats were randomly divided into 4 groups consisting of five animals each and received intratracheal instillation of sterile saline or silica suspension in different patterns: saline once at day 0, saline once/week, crystalline silica 50 mg at day 0, crystalline silica 6.25 mg/week. The rats were sacrificed at 8 weeks. The lung tissues were collected for pathological analyses, and determining mRNA and protein levels of related fibrogenic molecules. Results: The collagen deposition induced by crystalline silica in lung tissues were increased. The mRNA levels of IL-1ß and Col I in group c were significantly elevated than those in group saline once at day 0 (all P<0.05). Compared with group saline once/week, the mRNA levels of IL-1ß, TGF-ß, Col I, Col III and CTGF were significantly increased in group crystalline silica 6.25 mg/week (P<0.05) . The mRNA levels of Col I and CTGF were significantly increased in group crystalline silica 6.25 mg/week in comparison with those in group crystalline silica 50 mg at day 0 (P<0.05) . Conclusion: Given the same cumulative dose of crystalline silica, multiple exposures were likely to induce more severe lung fibrosis.

[Effect of Gas6 in silica-induced inflammation on differentiated human acute monocytic leukemia (THP-1) macrophages].

Objective: To investigate the modulation role of Gas6 in silica-induced inflammatory effect on human macrophages. Methods: Differentiated THP-1 macrophages were exposed to different concentrations of silica for 6 h and 24 h. Additionally, silica-activated macrophages were treated with different concentrations of recombine human Gas6 and Gas6 antibody respectively. Cell viabilities were determined by CCK-8 kit. Expression levels of Gas6 and inflammatory cytokines (TNF-α, IL-1ß and IL-6) were measured by ELISA assay kits. Results: Silica particles induced clear dose-dependent decreases of cell viability and Gas6 expression at both 6 h and 24 h. The cell viability of 24 h is lower than 6 h at the same concentration of silica (P<0.05). Furthermore, silica activated macrophages treated with Gas6 antibody induced significant decreases of Gas6 both at 6 h and 24 h (P<0.05). After pretreated with various concentrations of Gas6 antibody, silica induced higher expressions of inflammatory cytokines (TNF-α, IL-1ß, IL-6) in dose-dependent manners at two time points. Addition of exoge-nous Gas6 significantly suppressed silica-induced inflammatory cytokines concentrations mentioned above in the cell culture supernatants in clear dose-dependent manners. Conclusion: Exogenous Gas6 could inhibit the secre-tion of inflammatory cytokines in macrophages, while the block of Gas6 might enhance this inflammation.

[Association between personal exposure to metals in fine particulate matter and urinary metals: baseline results from a panel study].

OBJECTIVE: To investigate the associations between 21 metals in fine particulate matter (PM2.5) and their corresponding concentrations in urine in the general population. METHODS: Between April and May 2011, this panel study enrolled 120 residents using random sampling approach in Wuhan communities which contained 3 035 subjects. Participants were aged 18 to 80 years and had lived in the sampling buildings for at least 5 years. Data from basic questionnaires, physical examinations, and morning blood and urine samples under fasting conditions were collected. Participants with missing data were excluded. Finally, 83 particpants included. Participants were instructed to use personal air samplers to continuously monitor PM2.5 for 24 h. The following 21 metals were measured in PM2.5 and urine by inductively coupled plasma mass spectrometry: aluminum, titanium, vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, selenium, rubidium, strontium, molybdenum, cadmium, tin, antimony, barium, tungsten, thallium and lead. The associations between PM2.5 metals and urinary metals were investigated using generalized linear regression models. RESULTS: The age of the study population was (51.5±6.3)years. After adjusting for age, sex, smoking status, BMI, education and income, elevated urinary chromium was significantly associated with increased chromium concentrations in personal PM2.5. The least square means (standard deviation) of urinary chromium in participants classified as having low exposure (<12.491 ng/m(3)), intermediate exposure (12.491-32.388 ng/m(3)) and high exposure (>32.388 ng/m(3)) were (-1.334±0.756), (-1.114±0.813) and (-0.718±0.645) µg/mmol creatinine, respectively (P=0.009). However, the association between urinary and personal PM chromium was not observed after additionally adjusting for false discovery rate (P>0.05). Furthermore, the results demonstrated that other metals in PM2.5 were not related to their corresponding concentrations in urine of subjects. CONCLUSION: Urinary concentrations of metals did not reflect human exposure to metals in air, and may not be appropriate as an index to assess personal exposure to metals in particulate matter.

[Association of urinary metals and lung function in general Chinese population of Wuhan].

OBJECTIVE: To investigate the association between levels of 23 urinary metals and lung function, and explore their does-response relationships in the general population of Wuhan province, China. METHODS: This was a cross-sectional study that enrolled volunteers from two communities of Wuhan between April and May 2011. All volunteers had resided in Wuhan for at least 5 years. Information from questionnaires and physical examinations were collected and lung function was assessed. Data from 2 540 volunteers were included. Urinary levels of 23 metals were measured by inductively coupled plasma mass spectrometry (ICP-MS). The relationship between urinary metals and lung function was analyzed with single and multiple regression models. RESULTS: The mean age of the study population was 52.8 years. Mean levels of urinary metals, after adjustment for creatinine, including cobalt, copper, zinc, nickel, antimony and barium were 0.02, 0.68, 23.80, 0.20, 0.10, 0.34 and 0.26 µg/g creatinine, respectively. There were significant concentration-response relationships between increases in some urinary metals and reduced lung function. Single-metal regression models demonstrated that for each 1-unit increase in urinary levels of cobalt, lncopper, lnzinc, lnantimony, there was a reduction in forced vital capacity (FVC) of 0.091 L (95%CI: -0.155--0.027), 0.101 L (95%CI: -0.178--0.025), 0.094 L (95%CI: -0.172--0.027) and 0.118 L (95% CI: -0.203--0.033), respectively. Each 1-unit-increase in urinary lncobalt, lnnickel, lnstrontium, lnantimony, lnthallium, lnlead was associated with a reductions in forced expiratory volume in 1 sec (FEV1) of 0.070 L (95%CI: -0.124--0.016), 0.063 L (95%CI: -0.118--0.007), 0.063 L (95%CI: -0.124--0.002), 0.092 L (95%CI: -0.164--0.020), 0.055 L (95%CI: -0.105--0.005), 0.081 L (95%CI: -0.148--0.014), and 0.097 L (95% CI: -0.151--0.042), respectively. With respect to metal co-exposure, FVC was significantly associated with elevated urinary levels of cobalt, Cu and Sb, with reductions of 0.126 L (95%CI: 0.037-0.216) and 0.106 L (95% CI: 0.021-0.192), respectively, while FEV1 was significantly associated with elevated urinary Co, Sb, Ba and Pb, with reductions of 0.067 L (95% CI: -0.129--0.005), 0.142 L (95% CI: -0.247--0.037), 0.073 L (95% CI: -0.142--0.003) and 0.104 L (95% CI: -0.175--0.034), respectively. CONCLUSIONS: Certain urinary metals were potentially associated, in a dose-dependent manner, with reduced lung function in the general population. Co-exposure to metals had stimulative and anti-stimulative effects on lung function.

How important is the {103} plane of stable Ge2 Sb2 Te5 for phase-change memory?

Closely correlating with {200} plane of cubic phase, {103} plane of hexagonal phase of Ge(2)Sb(2)Te(5) plays a crucial role in achieving fast phase change process as well as formation of modulation structures, dislocations and twins in Ge(2)Sb(2)Te(5). The behaviors of {103} plane of hexagonal phase render the phase-change memory process as a nanoscale shape memory.

Toward structural/chemical cotailoring of phase-change Ge-Sb-Te in a transmission electron microscope.

Ge2Sb2Te5, as the prototype material for phase-change memory, can be transformed from amorphous phase into nanoscale rocksalt-type GeTe provided with an electron irradiation assisted by heating to 520°C in a 1250 kV transmission electron microscope. This sheds a new light into structural and chemical cotailoring of materials through coupling of thermal and electrical fields.

Association of de novo human leukocyte antigen and major histocompatibility complex class I chain-related gene-A antibodies and proteinuria with graft survival 5 years after renal transplantation.

BACKGROUND: Association of de novo human leukocyte antigen (HLA) and major histocompatibility complex class I chain-related gene-A (MICA) antibodies and proteinuria with graft survival 5 years after renal transplantation. De novo presence of HLA and MICA antibodies after renal transplantation is associated with poor graft survival. Proteinuria after transplantation is also considered a risk factor for premature graft loss. In this study, we investigated the association of de novo HLA and MICA antibodies on proteinuria after renal transplantation and the association of proteinuria and de novo antibodies with graft survival. METHODS: We enrolled 275 patients without preexisting HLA and MICA antibodies followed for >5 years after renal transplantation. All donor organs were from living-related donors or from an organ donation program. HLA and MICA antibodies were detected by the Luminex method. Patients with proteinuria (>150 mg/d) underwent intermittent 24-hour proteinuria examination. RESULTS: The frequencies of de novo HLA and MICA antibody 5 years after transplantation were 25.8% and 12%, respectively. In total, 26.5% of patients had proteinuria at the 5-year follow-up. De novo HLA antibody was associated with increased proteinuria after transplantation (relative risk, 3.12). HLA antibody and proteinuria were both associated with poor 5-year graft survival (P = .027 and P = .006, respectively). CONCLUSION: De novo HLA and MICA antibodies and proteinuria after renal transplantation are all associated with poor graft survival. De novo HLA antibody is independent risk factor for posttransplant proteinuria, and proteinuria affects the association of de novo antibodies with decreased graft survival after transplantation.