Bifunctional WC-Supported RuO2 Nanoparticles for Robust Water Splitting in Acidic Media.

We report the strong catalyst-support interaction in WC-supported RuO2 nanoparticles (RuO2 -WC NPs) anchored on carbon nanosheets with low loading of Ru (4.11 wt.%), which significantly promotes the oxygen evolution reaction activity with a η10 of 347 mV and a mass activity of 1430 A gRu -1 , eight-fold higher than that of commercial RuO2 (176 A gRu -1 ). Theoretical calculations demonstrate that the strong catalyst-support interaction between RuO2 and the WC support could optimize the surrounding electronic structure of Ru sites to reduce the reaction barrier. Considering the likewise excellent catalytic ability for hydrogen production, an acidic overall water splitting (OWS) electrolyzer with a good stability constructed by bifunctional RuO2 -WC NPs only requires a cell voltage of 1.66 V to afford 10 mA cm-2 . The unique 0D/2D nanoarchitectures rationally combining a WC support with precious metal oxides provides a promising strategy to tradeoff the high catalytic activity and low cost for acidic OWS applications.

Efficacy and safety of microsphere transarterid chemoembolization combined with radiotherapy versus microsphere transarterial chemoembolization alone in treatment of patients with unresectable liver cancer / 临床肝胆病杂志

@#ObjectiveTo investigate the efficacy and safety of microsphere transarterial chemoembolization (TACE) combined with radiotherapy in the treatment of patients with unresectable liver cancer. MethodsA total of 68 patients with unresectable liver cancer were enrolled in Shantou central hospital from January 2016 to October 2018, among whom there were 65 male and 3 female patients, with a median age of 55 years (range 36-75 years). These patients were randomly divided into microsphere TACE group with 34 patients and microsphere TACE combined with radiotherapy group (combined group with 34 patients). The two groups were compared in terms of short-term response rate, progression-free survival (PFS) rate, overall survival (OS) rate, and adverse events to evaluate safety. The chi-square test was used for comparison of categorical data between groups, and the Kaplan-Meier method and the log-rank test were used for comparison of PFS and OS rates. ResultsUp to the last follow-up on April 30, 2019, all patients completed treatment as planned and the median follow-up time was 15.2 months. A total of 25 deaths were observed. The objective response rate was 50.0% in the microsphere TACE group and 76.5% in the combined group, and the combined group had a significantly better short-term response than the microsphere TACE group (χ2=7.995, P=0046). For the microsphere TACE group, the 6-, 12-, 18-, and 24-month OS and PFS rates were 94.1%/76.5%, 69.0%/47.1%, 51.3%/23.9%, and 30.9%/9.6%, respectively, and for the combined group, the 6-, 12-, 18-, and 24-month OS and PFS rates were 100%/93.7%, 87.8%/81.1%, 75.1%/52.9%, and 58.2%/44.1%, respectively; the combined group had significantly better PFS and OS time than the microsphere TACE group (χ2=9.027 and 4.288, P=0.002 7 and 0.038). There was a low incidence rate of adverse events in the two groups, and no treatment-related death was observed. ConclusionCompared with microsphere TACE alone, microsphere TACE combined with radiotherapy significantly improves short-term response and long-term survival in patients with unresectable liver cancer and thus provides a more effective and safer treatment for such patients.

Cold tolerance and silencing of three cold-tolerance genes of overwintering Chinese white pine larvae.

The values of physiological indices and the enzymes activities involved in the overwintering stage were studied in D. armandi larvae in each month from October 2014 to March 2015. The sorbitol, trehalose and glycerol values initially tended to increase as the ambient temperature decreased, before declining until the end of the winter. The activities of four enzymes (SOD, CAT, LDH and AchE) decreased, whereas POD, PK and MDH showed opposite trends in activity. Other enzyme activities (those of TPS, SDH and GLK) were low during the overwintering period and later increased and stabilized during spring. In this study, a polymerase chain reaction (PCR) genes of SDH, TPS and GLK was utilized to identify DarmSDH, DarmTPS and DarmGLK in D. armandi. They were found to be abundantly expressed during the overwintering stage by quantitative real-time PCR (qRT-PCR) analyses; by contrast, these three genes showed higher expression levels in December 2014 than in May 2015. The qRT-PCR results demonstrated that the reduction of mRNA expression levels was significant in DarmSDH-, DarmTPS- and DarmGLK-dsRNA-treated D. armandi compared with water-injected and non-injected controls. The mortality responses at low temperature were also increased in the dsRNA-treated D. armandi compared with the controls.

[Effect of Acupuncture on Prognosis and Immune Function of Sepsis Patients].

OBJECTIVE: To study the effect of acupuncture on the immune function of sepsis patients. METHODS: Ninety sepsis patients were assigned to the control group, the thymosin a1 group, and the acupuncture treatment group according to random digit table, 30 patients in each group. Patients in the control group were treated according to the guideline of Surviving Sepsis Campaign (SSC). Patients in the control group received routine treatment. Those in the thymosin alpha1 group additionally received subdermal injection of thymosin alpha1 (1.6 mg), once per day for 6 successive days. Needling at related points such as Zusanli (ST36), Yanglingquan (GB34), Neiguan (PC6), Guanyuan (RN4), and so on, was performed in patients of the acupuncture treatment group, once per day for 6 successive days. T cell subgroups (CD3+, CD4+, CD8+, CD4+ /CD8+) and immunoglobulin levels (IgG, IgA, IgM) were detected. The length of ICU hospital stay, hospital readmission rate, and 28-day mortality were compared among the three groups. RESULTS: After six days of treatment, CD3+, CD4+, CD8+, IgG, IgA, IgM, and CD4+ /CD8+ ratio of three groups were all significantly increased (P < 0.01). Of them, CD3+, CD4+, CD8+, IgG, IgA, and IgM increased more significantly in the thymosin alpha1 group and the acupuncture treatment group (P < 0.01). Compared with the control group, the ICU hospitalization length was significantly shortened, the hospital readmission rate and the 28-day mortality were lower in the thymosin alpha1 group and the acupuncture treatment group (P < 0.05, P < 0.01). There was no statistical difference in each index between the thymosin alpha1 group and the acupuncture treatment group (P > 0.05). CONCLUSION: Acupuncture could adjust the immune function of sepsis patients, improve their immunological indicators and prognoses.

[Effect of acupuncture on acute left heart failure by PiCCO technique].

OBJECTIVE: To observe the clinical effect of acupuncture on acute heart failure (AHF) patients. METHODS: Totally 60 patients who were diagnosed as AHF were assigned to the acupuncture group and the control group, 30 in each group. Those in the control group received inotropic agents, preload and afterload reducing therapy, anti-infection and so on. Besides, those in the acupuncture group received needling at relative points, once daily for 5 consecutive days. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SI), left ventricle working index (LCWI) were monitored by thermodilution pulse-indicated continuous cardiac output (PiCCO) technique. Changes of the aforesaid data were compared between before and after treatment. The ICU length of stay, readmission rate,and the 28-day mortality were also compared between the two groups. RESULTS: After 5 days of the treatment, CI, SI, and LCWI increased more obviously (P < 0.01), HR and MAP decreased significantly (P < 0.05). Of them, CI, SI, and LCWI increased more obviously in the acupuncture group (P < 0.05).There was no obvious difference in HR or MAP between the two groups (P > 0.05). Compared with the first day of admission in the same group, CI, SI, and LCWI obviously increased in the acupuncture group from the second day (P < 0.05). HR started to decrease since the fourth day (P < 0.05), and MAP began to decrease until the fifth day (P < 0.05). CI, SI, and LCWI started to increase in the control group from the third day (P < 0.05); HR and MAP both began to decrease since the fifth day (P < 0.05). Compared with the control group, the ICU length of stay was obviously shortened in the acupuncture group (P < 0.05). The readmission rate and the 28-day mortality rate were lower than those of the control group (P < 0.05). CONCLUSION: The combination of acupuncture and Western medical therapy might strengthen acute heart failure patients' heart functions, elevate the therapeutic effect, and improve the prognosis.

[Analysis of drug resistance of Acinetobacter baumannii and its related factors in ICU].

OBJECTIVE: To investigate drug resistance of Acinetobacter baumannii and its related factors in intensive care unit (ICU), and to provide clinical basis for prevention and treatment. METHODS: A retrospective analysis was conducted. Clinical data was collected from 1 050 patients in ICU of Foshan Hospital of Traditional Chinese Medicine from January 2011 to June 2013. The risk factors of nosocomial infection were analyzed with univariate analysis. The independent risk factor was sieved from the risk factors with P<0.05 with unconditional logistic regression analysis to analyze the related factors and drug resistance of Acinetobacter baumannii in ICU. RESULTS: One hundred and thirteen patients suffering from nosocomial infection of Acinetobacter baumannii were found, and its incidence rate was 10.76%. There were 96 cases of infection of multi-drug resistant, extensive-drug resistant and pan-drug resistant Acinetobacter baumannii, accounting for 84.96%. Acinetobacter baumannii detection rate was 79.65% in sputum, 10.62% in urine, 4.42% in wound secretion, 3.54% in blood, and 1.77% in other drainage discharges, respectively. Univariate analysis showed that mechanical ventilation, ICU stay time≥7 days, coma [Glasgow coma score (GCS)<8], usage of broad-spectrum antibiotics were risk factors of nosocomial infection of Acinetobacter baumannii. Multivariate logistic analysis showed that the independent risk factors of nosocomial infection caused by Acinetobacter baumannii in ICU were mechanical ventilation [odds ratio (OR)= 2.957, 95%confidence interval (95%CI) 1.106-6.253, P=0.023], ICU stay time≥7 days (OR=2.991, 95%CI 1.135-6.544, P=0.022), coma (GCS<8,OR=2.894, 95%CI 1.803-7.462, P=0.010), and usage of broad-spectrum antibiotics (OR=3.054, 95%CI 1.009-6.550, P=0.004). Rate of resistance to polymyxin B was the lowest (6.19%), and it was followed by tobramycin and tigecycline, 11.50% and 28.32%, respectively. CONCLUSIONS: Acinetobacter baumannii in ICU was conditional pathogenic bacteria with high infection rate, and the lower respiratory tract was the main site of infestation. The related factors include mechanical ventilation, ICU stay time, coma, usage of broad-spectrum antibiotics. Its antimicrobial resistance rate was high. Comprehensive measures, including environmental isolation, strict bed unit disinfection, enforcement of hand disinfection, strengthening the effort to shorten the duration of mechanical ventilation, reduction of ICU length of stay, enhancement of drainage of mucus, excretions, and other body fluids, and rational use of antibiotics should be encouraged in order to reduce Acinetobacter baumannii in ICU.

[Immune and inflammation confusion in severe sepsis and effects of bi-immunomodulation therapy: a prospective, randomized, controlled clinical trial].

OBJECTIVE: To investigate the immune and inflammation confusion state in severe sepsis and the effects of two way immunomodulation therapy with continuous blood purification (CBP), thymosin alpha1, and combined therapy of CBP and thymosin alpha(1). METHODS: 91 Patients with severe sepsis aged > 18, with Marshall score>5. were randomly divided into 4 groups: CBP Group (n = 22) undergoing continuous renal replacement therapy (CRRT) or molecular adsorbents recirculating system (MARS) therapy once a day for 3 days in addition to classical Surviving Sepsis Campaign (SSC) therapy, Thymosin alpha(1) Group (n = 23) undergoing subcutaneous injection of thymosin alpha(1) 1.6 mg once a day for 7 days in addition to SSC therapy, Combined Therapy Group (n = 22) undergoing CBP combined with thymosin alpha(1) treatment in addition to SSC therapy, and SSC Group (treatment control group, n = 24) undergoing SSC therapy only. Peripheral blood samples were collected before treatment, and 3 and 7 days after the beginning of treatment (days 4 and 8) to detect the serum interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-alpha. The levels of CD(14)(+) monocyte human leucocyte antigen (HLA)-DR and T lymphocytes were monitored. The mechanical ventilation time, ICU stay length, and mortality within 28 d and mortality within 90 d were observed. Ten healthy persons were used as healthy control group. RESULTS: Thirty-four of the 91 patients died within 28 d with a mortality of 77.4% (Death Group) and other 57 patients were put in Survival Group. The levels of serum IL-6, IL-10, and TNFalpha, and IL-6/IL-10 at different time points of both Death and Survival Groups were all significantly higher, and the HLA-DR level, and CD(3)(+), CD(4)(+), and CD(8)(+) T lymphocyte numbers at different time points of both Death and Survival Groups were all significantly lower than those of the healthy controls (P < 0.05 or < 0.01). The levels of serum IL-6, IL-6/IL-10, TNFalpha, HLA-DR, and CD(3)(+), CD(4)(+), and CD(8)(+) T lymphocyte at different time points of Death Group were all significantly higher than those of Survival Group (P < 0.05 or < 0.01). The CD(3)(+) T lymphocyte number on day 8 of Thymosin Group was significantly higher than that of SSC Group (all P < 0.05). The serum IL-6 and TNFalpha and IL-6/IL-10 were decreased, and HLA-DR, and CD(3)(+), CD(4)(+), and CD(8)(+) were increased significantly on day 8 in CBP and Combined Therapy Groups. The level of TNFalpha decreased, and the numbers of CD(3)(+) and CD(4)(+) T lymphocytes increased significantly on day 4 in Combined Therapy Group (P < 0.05 or P < 0.01). Compared with Thymosin Group, almost all the indexes of CBP and Combined Therapy Groups were improved, only the CD(3)(+) T lymphocyte level on day 4 increased and the IL-6/IL-10 ratio on day 8 was decreased significantly in Combined Therapy Group (both P < 0.05). Compared with those of SSC Group, the mechanical ventilation time, length of ICU stay within 28 days, and 28 days mortality and 90 days mortality of the 3 treatment groups were all decreased, and there were statistical differences in the length of ICU stay of CBP Group and in the mechanical ventilation time and length of ICU stay within 28 days of Combined Therapy Group (both P < 0.05). CONCLUSION: Systemic inflammatory response and immunodepression exist simultaneously in severe sepsis. Thymosin alpha(1) increases the cellular immunity, and CBP bi-modulates the immune turbulence, reduces the inflammatory mediators, and ameliorates the immune homeostasis. These 2 therapies also improve the clinical prognosis and the combination of both would be more effective.

[Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse].

OBJECTIVE: To investigate the feasibility and merits of emergency bedside temporary cardiac pacing through left subclavicular vein guided by pacemaker impulse. METHODS: The left subclavicular vein was punctured with Seldinger technique for insertion of a cannula. After setting the rate of pacemaker at 20 beat/min above the patients' spontaneous heart rate with output current of 5 mA and sensing voltage of 3 mV, the electrode was inserted through the cannula until the electrocardiograph displaying pulsed signal and pacing rhythm. RESULTS: Good pacing was achieved in 18 patients with one having poor pacing, which was improved 2 h later. The pacing was not satisfactory in two cases. No postoperative complications occurred in the 21 patients. CONCLUSION: Emergency bedside temporary cardiac pacing through the left subclavicular vein guided by pacemaker impulse is rapid and ensures high success rate and safety.

[Intensive care and treatment of severe ovarian hyperstimulation syndrome].

OBJECTIVE: To investigate the clinical manifestations, pathogenesis and treatment of severe ovarian hyperstimulation syndrome (OHSS). METHODS: The clinical data of 20 OHSS patients were analyzed retrospectively. RESULTS: Severe OHSS occurred after controlled ovarian hyperstimulation for superovulation. The major manifestations of OHSS included abdominal distension, nausea, ascites, hydrothorax, oliguria, concentrated blood, acid-base and electrolytes, disturbance, azotemia, thrombosis etc., which could be controlled by volume expansion with albumin, low-molecular-weight dextran, 6% Haes, abdominal and thoracic drainages or even early pregnancy termination. CONCLUSION: Preventive measure of OHSS is very important, and the patients must be treated timely and correctly once OHSS occurs.