Antegrade and retrograde approaches with a mechanical thrombectomy device for the treatment of acute lower limb deep vein thrombosis.

OBJECTIVE: To examine the efficacy of antegrade and retrograde approaches with the AngioJet thrombectomy device for the treatment of acute lower limb deep vein thrombosis (DVT) and to evaluate the necessity of filter placement. METHODS: The clinical data of patients with acute lower limb DVT treated with the AngioJet device from January 2021 to June 2023 were retrospectively analyzed. The patients were divided into the antegrade and retrograde treatment groups according to the surgical approach and the direction of valve opening. The thrombosis interception rate of the filter, incidence of pulmonary embolism (PE), thrombectomy effectiveness, venous obstruction rate, and thrombosis recurrence rate of each treatment group were evaluated. In addition, factors affecting patency were analyzed. RESULTS: AngioJet was employed for 84 patients with acute lower limb DVT, treating a total of 88 limbs. The thrombosis interception rate of the filter was 35.7% (30 patients). The incidence of new PE or PE exacerbation was 6.0% (5 patients), and a filter retrieval rate of 97.6% (82 patients) was detected. Thrombus removal of grade III occurred in 35 (64.8%) of the 54 limbs (61.4%) in the antegrade treatment group, versus 13 (38.2%) of the 34 limbs (38.6%) in the retrograde treatment group (P<0.05). At 3 months, venous patency and bleeding events involved 52 (96.3%) and 4 (7.4%) limbs in the antegrade treatment group, respectively, versus 29 (85.3%) and 2 (5.9%) in the retrograde treatment group, respectively (P>0.05). Regression analysis was performed to determine factors that may affect 3-month patency in both groups. Statistically significant linear relationships were found between 3-month patency and thrombus removal rate [OR=0.546 (0.326, 0.916)], thrombus formation time [OR=1.018 (1.002, 1.036)], and preoperative thrombosis score [OR=1.012 (1.002, 1.022)] in the antegrade treatment group, as well as thrombus removal rate [0.473 (0.229, 0.977)] in the retrograde treatment group. In regression analysis of factors affecting patency in both groups and VCSS/Villalta score, a statistically significant linear relationship was found between thrombus formation time and VCSS score in the antegrade treatment group [0.576 (0.467, 0.710)]. CONCLUSION: Both antegrade and retrograde approaches are safe and effective for the treatment of acute lower limb DVT. There are no differences in 3-month deep vein patency and post-thrombotic syndrome (PTS) incidence rates. Individuals with acute lower limb DVT are at high risk of thrombus shedding after treatment with AngioJet thrombectomy, and placement of a vena cava filter (VCF) is recommended for effective interception.

High pressure Raman study of isobutyramide.

Isobutyramide (IBA) has attracted considerable attention due to its expansive prospects for practical applications in the synthesis of drugs, dyes and other organic compounds. Herein we perform the high-pressure studies of IBA crystal by Raman spectral measurements at room temperature from ambient pressure to 30 GPa by using diamond anvil cells (DACs) to gain comprehensive insights into its structure and stability. Raman vibrational modes of IBA crystal at ambient pressure are resolved based on the experimental results and the first-principles theoretical calculations. High-pressure Raman scattering results show the Raman bands splitting, emergence/disappearance of the Raman bands and discontinuous wavenumber shifts at 1, 2 and 10 GPa, which indicate that IBA crystal undergoes three structural phase transitions at corresponding pressure. In addition, softening of the C = O and N-H stretching vibrational modes of IBA with increasing pressure can be interpreted by the reorganization of the hydrogen bond network of IBA molecules due to phase transition.

Molecular modelling of shockwave-mediated delivery of paclitaxel aggregates across the neuronal plasma membrane.

Shock-assisted paclitaxel (PTX) transport across the blood-brain barrier offers a promising treatment strategy for brain tumors. Here, based on a realistically complex human brain plasma membrane (PM) model, we investigated the dynamic transmembrane behavior of a PTX cluster by shock induced bubble collapse, focusing on the effect of impulse (I), bubble diameter (D) and arrays. The results show that all three factors can control the transport depth (ΔDPM) of PTX. For a fixed D, the ΔDPM grows exponentially with I, ΔDPM ∼ exp (I), and eventually reaches a critical depth. But the depth, ΔDPM, can be adjusted linearly in a wider range of D. This mainly depends on the size of jets from bubble collapse. For bubble arrays, the bubbles in series can transport PTX deeper than a single bubble, while the parallel does the opposite. In addition, only PTX clusters in the range of jet action can be successfully transported. Finally, the absorption of PTX clusters was examined via recovery simulation. Not all PTX clusters across the membrane can be effectively absorbed by cells. The shallow PTX clusters are quickly attracted by the membrane and embedded into it. The critical depth at which PTX clusters can be effectively absorbed is about 20 nm. These molecular-level mechanisms and dynamic processes of PTX clusters crossing the PM membrane may be helpful in optimizing the application of shock-induced bubble collapse for the delivery of PTX to tumor cells.

Creep mechanical tests and shear rheological model of the anchorage rock mass under water‒rock coupling.

The development of deep geotechnical engineering is restricted by the complex geological conditions of deep rock masses and the unknown creep mechanism of rock in water-rich environments. To study the shear creep deformation law of the anchoring rock mass under different water content conditions, marble was used as the bedrock to make anchoring specimens, and shear creep tests of the anchoring rock mass under different water contents were carried out. The influence of water content on rock rheological characteristics is explored by analysing the related mechanical properties of the anchorage rock mass. The coupling model of the anchorage rock mass can be obtained by connecting the nonlinear rheological element and the coupling model of the anchorage rock mass in series. Related studies show that (1) shear creep curves of anchorage rock masses under different water contents have typical creep characteristics, including decay, stability and acceleration stages. The creep deformation of the specimens can be improved with increasing moisture content. (2) The long-term strength of the anchorage rock mass shows an opposite change law with increasing water content. The creep rate of the curve increases gradually with increasing water content. The creep rate curve shows a U-shaped change under high stress. (3) The nonlinear rheological element can explain the creep deformation law of rock in the acceleration stage. By connecting the nonlinear rheological element with the coupled model of anchoring rock mass in series, the coupled model of water‒rock under water cut conditions can be obtained. The model can be used to study and analyse the whole process of shear creep of an anchored rock mass under different water contents. This study can provide theoretical support for the stability analysis of anchor support tunnel engineering under water cut conditions.

Drug discovery by targeting the protein-protein interactions involved in autophagy

Autophagy is a cellular process in which proteins and organelles are engulfed in autophagosomal vesicles and transported to the lysosome/vacuole for degradation. Protein-protein interactions (PPIs) play a crucial role at many stages of autophagy, which present formidable but attainable targets for autophagy regulation. Moreover, selective regulation of PPIs tends to have a lower risk in causing undesired off-target effects in the context of a complicated biological network. Thus, small-molecule regulators, including peptides and peptidomimetics, targeting the critical PPIs involved in autophagy provide a new opportunity for innovative drug discovery. This article provides general background knowledge of the critical PPIs involved in autophagy and reviews a range of successful attempts on discovering regulators targeting those PPIs. Successful strategies and existing limitations in this field are also discussed.

Lactate regulators contribute to tumor microenvironment and predict prognosis in lung adenocarcinoma.

Background: Lactic acid, as a product of glycolysis, increases tumor cell migration and the invasion of tumor cells in the tumor microenvironment. Besides this, lactic acid promotes the expression of programmed death-1 expression (PD-1) in regulatory T cells, which could cause the failure of PD-1 blockade therapy. However, the implications of lactic acid in the tumor microenvironment of lung adenocarcinoma (LUAD) remain largely unclear. Methods: We performed unsupervised consensus clustering to identify lactic-associated subtypes using expression profile of lactate regulators in LUAD. Differentially expressed genes (DEGs) associated with lactic-associated subtypes was used to construct lactate signature (LaSig) using LASSO regression algorithm. Immune infiltration analysis was conducted by ESTIMATER and drug sensitivity was estimated by R package called "pRRophetic". The difference between two groups was calculated using Wilcox rank sum test and correlation analysis was calculated using Pearson correlation coefficient. Results: In this study, we evaluated DNA methylation and the mutation frequency of lactate regulators and found lactate regulators showed low mutation frequency in the TCGA-LUAD cohort, except TP53. At the RNA level, the expression level of lactate regulators was significantly associated with the immune cell component. In particular, expression of LDHA was positively correlated with CD4 T cell, CD8 T cell, M1 macrophages, and the enrichment score of multiple immune pathways. Two clusters were defined using the gene expression level of lactate regulators, and LDHA was significantly upregulated in cluster 1 with poor overall survival. A lactate signature (LaSig) had a robust performance in predicting the survival rate and immunotherapy response of LUAD patients. Moreover, patients in the high LaSig group may be more likely to benefit from these drugs (Cisplatin, Erlotinib, Gemcitabine, and Vinblastine) than those in the low LaSig group. Conclusion: In summary, our study explores the role of lactate regulators in guiding the clinical treatment of lung adenocarcinoma and provides additional help to supplement traditional molecular subtypes.

Giant broad ligament leiomyoma with postoperative infection diagnosed with contrast-enhanced ultrasound: Case report and literature review.

A 33-year-old woman of giant broad ligament leiomyoma with myxoid degeneration was misdiagnosed as ovarian tumor. The patient underwent a transabdominal myomectomy and developed a pelvic infection after operation diagnosed with contrast-enhanced ultrasound. She was cured and ultimately discharged after symptomatic treatment. Only 21 cases of giant broad ligament leiomyomas with a diameter larger than 12 cm were included. The present systematic review aimed to increase awareness of the clinical characteristics and treatment methods of giant broad ligament leiomyoma, and reduce the rates of misdiagnosis and postoperative complications.

Evaluation of methodological and reporting quality of domestic clinical guidelines for hyperuricemia / 中国中药杂志

This study aims to evaluate the methodological and reporting quality of diagnosis and treatment guidelines for hyperuricemia as well as the expert consensuses and promote the understanding and application of the diagnosis and treatment guidelines for hyperuricemia. With "hyperuricemia" "guidelines" "consensus" "recommendations" as the key words in titles, the authors searched for the published clinical guidelines on hyperuricemia in Chinese against CNKI, Wanfang, VIP, Medlive and the official website of the industry association. The retrieval time limit was until May 31, 2021. The appraisal of guidelines for research and evaluation Ⅱ(AGREEⅡ) and the reporting items for practice guidelines in health care(RIGHT) were employed to evaluate the methodological quality and reporting quality of 14 guidelines/consensuses included. The average scores of the guidelines/consensuses were 80.85%(48.61%-98.61%) for the domain of scope and purpose, 34.52%(0-69.44%) for the domain of stakeholder involvement, 35.53%(6.25%-92.19%) for the domain of rigor of development, 55.85%(23.61%-86.11%) for the domain of clarity of presentation, 26.19%(0-76.04%) for the domain of applicability, and 21.42%(0-50.00%) for the domain of editorial independence. Nine guidelines/consensuses were of medium overall quality with grade B recommendation, and five guidelines/consensuses were of poor quality with grade C recommendation. The RIGHT classified the fourteen guidelines/consensuses into one of high reporting quality, three of medium reporting quality, and ten of low reporting quality. The results of this study indicate that the standardization and rigor of the methodological quality and the reporting quality of the clinical guidelines/consensuses for hyperuricemia in China remain to be strengthened.

Dysideanones F-G and dysiherbols D-E, unusual sesquiterpene quinones with rearranged skeletons from the marine sponge Dysidea avara / 中国天然药物

Four new sesquiterpene quinone meroterpenoids, dysideanones F-G (1-2) and dysiherbols D-E (3-4), were isolated from the marine sponge Dysidea avara collected from the South China Sea. The new structures were elucidated by extensive analysis of spectroscopic data including HR-MS and 1D and 2D NMR spectra, and their absolute configurations were assigned by single-crystal X-ray diffraction and ECD calculations. Anti-inflammatory evaluation showed that dysiherbols D-E (3-4) exhibited moderate inhibitory activity on TNF-α-induced NF-κB activation in human HEK-293T cells with IC50 values of 10.2 and 8.6 μmol·L-1, respectively.

Atomic-scale imaging of CH3NH3PbI3 structure and its decomposition pathway.

Understanding the atomic structure and structural instability of organic-inorganic hybrid perovskites is the key to appreciate their remarkable photoelectric properties and understand failure mechanism. Here, using low-dose imaging technique by direct-detection electron-counting camera in a transmission electron microscope, we investigate the atomic structure and decomposition pathway of CH3NH3PbI3 (MAPbI3) at the atomic scale. We successfully image the atomic structure of perovskite in real space under ultra-low electron dose condition, and observe a two-step decomposition process, i.e., initial loss of MA+ followed by the collapse of perovskite structure into 6H-PbI2 with their critical threshold doses also determined. Interestingly, an intermediate phase (MA0.5PbI3) with locally ordered vacancies can robustly exist before perovskite collapses, enlightening strategies for prevention and recovery of perovskite structure during the degradation. Associated with the structure evolution, the bandgap gradually increases from ~1.6 eV to ~2.1 eV. In addition, it is found that C-N bonds can be readily destroyed under irradiation, releasing NH3 and HI and leaving hydrocarbons. These findings enhance our understanding of the photoelectric properties and failure mechanism of MAPbI3, providing potential strategies into material optimization.

Clinical analysis of ultrasound negative pressure suction with percutaneous nephroscope in the treatment of perirenal abscess / 中华泌尿外科杂志

Objective:To evaluate the clinical efficacy and safety of ultrasound negative pressure suction with percutaneous nephroscope in the treatment of perirenal abscess.Methods:The clinical data of 11 patients with perirenal abscess admitted to Zhejiang Provincial People's Hospital from January 2013 to February 2021 were retrospectively analyzed. There were 4 males and 7 females. The average age was 59(51-76) years. The abscess was located on the left side in 4 cases and on the right side in 7 cases. The average diameter of abscess was 11.2(8.1-19.2) cm. All patients had fever, low back pain and abdominal mass, accompanied by bladder irritation in 6 cases, gross hematuria in 5 cases, abdominal distension, nausea and anorexia in 3 cases. There were 7 cases with type 2 diabetes, 2 cases with rheumatoid arthritis and 6 cases with ipsilateral kidney and ureter stone. Among the 11 patients, 6 had a history of urinary tract infection, 1 had a history of upper respiratory tract infection, 1 had secondary infection of perirenal hematoma after traumatic renal rupture, and 3 had secondary infection of perirenal hematoma after percutaneous nephroscopy. All patients were treated with ultrasound negative pressure suction with percutaneous nephroscope under local anesthesia by single operator. The operation time, intraoperative blood loss, drainage volume, drainage tube indwelling time, postoperative body temperature returned to normal time, postoperative hospital stay, therapeutic effect and complications were analyzed.Results:All operation procedures of 11 patients were successfully completed, including 8 cases of single channel, 2 cases of double channels and 1 case of three channels. The average operation time was 44(20-74)min, the average amount of blood loss was 15(10-20)ml, the average amount of pus was 325(200-500)ml, the average indwelling time of drainage tube was 8(6-12)d, the average time of body temperature returned to normal was 0.9(0.5-2.0)d, and the average hospitalization time was 9.6(7.0-14.0)d. Before discharge, CT reexamination showed that the perirenal abscess disappeared. There were no serious complications during and after operation. The average follow-up time was 4.4(3-8) months. There was no recurrence in all patients.Conclusions:Ultrasound negative pressure suction with percutaneous nephroscope is one of the safe and effective surgical methods for the treatment of perirenal abscess. It has the advantages of small trauma, quick recovery, complete drainage, exact effect and fewer complications.

Mechanism of venous thrombosis in patients with multiple myeloma / 中国医师杂志

Multiple myeloma is a plasma cell disease with the second highest incidence among hematological malignancies. Its risk of concurrent thrombosis is high, which greatly affects the quality of life and even endangers life of multiple myeloma patients. The pathogenesis of thrombosis in patients with multiple myeloma is complex, which is still unclear. However many mechanisms are considered to be related to hypercoagulable state in patients with multiple myeloma. Currently, there is a lack of thrombosis risk assessment model for multiple myeloma. Therefore, this paper reviews the research and the latest progress of venous thrombosis in patients with multiple myeloma, and provides a theoretical basis for the prevention and treatment of thrombosis.

Analysis of the SARS-CoV-2 specific antibodies and immune function of COVID-19 patients one year after discharge / 中国胸心血管外科临床杂志

@#Objective    To summarize the results of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibody, total antibody and cellular immune function of COVID-19 convalescent patients one year after discharge, and to analyze the correlation between the SARS-CoV-2 antibody and the indexes of immune function. Methods    A total of 41 confirmed COVID-19 patients discharged from Chengdu Public Health Clinical Medical Center from January to April 2020 and followed up one year after discharge were included in the study as the research group, including 18 males and 23 females with an average age of 47.83±12.95 years. The results of SARS-CoV-2 IgG, total antibody and immune function indexes one year after discharge were collected in order to discuss the correlation of SARS-CoV-2 and cellular immune function. A total of 40 healthy employees of the hospital vaccinated against COVID-19 were randomly selected as the vaccine group, including 10 males and 30 females with an average age of 43.90±6.86 years. The SARS-CoV-2 antibodies between the two groups were compared. Results    CD8+T cell count was higher and CD4+T/CD8+T was lower in male patients than those in female patients (all P<0.05). The IgG and total antibodies in patients with re-detectable positive RNA test were both higher than those in patients without re-detectable positive RNA test, but the differences were not statistically significant (P=0.158, 0.060). The positive rate of SARS-CoV-2 IgG in the research group was 80.5% (33/41). SARS-CoV-2 IgG was positively correlated with total antibody (P<0.001). There was a positive correlation between CD4+T cell count and SARS-CoV-2 IgG (r=0.455, P=0.003). The positive rate of SARS-CoV-2 IgG, SARS-CoV-2 IgG amount and total antibody amount in the research group were significantly higher than those in the vaccine group (all P<0.001). Conclusion    SARS-CoV-2 IgG of most COVID-19 patients one year after discharge is positive, and their SARS-CoV-2 total antibody is significantly higher than people vaccinated against COVID-19, which suggests that patients infected with SARS-CoV-2 can obtain lasting protection, but the protection may be gradually weaken over time. The degree of antibody attenuation in patients with re-detectable positive RNA test may be weaker. In the convalescence stage, the dynamics of SARS-CoV-2 IgG may be closely related to cellular immune function.

Peptidomimetic-based antibody surrogate for HER2

Inhibition of human epidermal growth factor receptor 2 mediated cell signaling pathway is an important therapeutic strategy for HER2-positive cancers. Although monoclonal antibodies are currently used as marketed drugs, their large molecular weight, high cost of production and susceptibility to proteolysis could be a hurdle for long-term application. In this study, we reported a strategy for the development of artificial antibody based on

Piezoelectric and pyroelectric effects induced by interface polar symmetry.

Interfaces in heterostructures have been a key point of interest in condensed-matter physics for decades owing to a plethora of distinctive phenomena-such as rectification1, the photovoltaic effect2, the quantum Hall effect3 and high-temperature superconductivity4-and their critical roles in present-day technical devices. However, the symmetry modulation at interfaces and the resultant effects have been largely overlooked. Here we show that a built-in electric field that originates from band bending at heterostructure interfaces induces polar symmetry therein that results in emergent functionalities, including piezoelectricity and pyroelectricity, even though the component materials are centrosymmetric. We study classic interfaces-namely, Schottky junctions-formed by noble metal and centrosymmetric semiconductors, including niobium-doped strontium titanium oxide crystals, niobium-doped titanium dioxide crystals, niobium-doped barium strontium titanium oxide ceramics, and silicon. The built-in electric field in the depletion region induces polar structures in the semiconductors and generates substantial piezoelectric and pyroelectric effects. In particular, the pyroelectric coefficient and figure of merit of the interface are over one order of magnitude larger than those of conventional bulk polar materials. Our study enriches the functionalities of heterostructure interfaces, offering a distinctive approach to realizing energy transduction beyond the conventional limitation imposed by intrinsic symmetry.

Development and Multicenter Performance Evaluation of The First Fully Automated SARS-CoV-2 IgM and IgG Immunoassays

BACKGROUNDThe outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread globally. The laboratory diagnosis of SARS-CoV-2 infection has relied on nucleic acid tests. However, there are many limitations of nucleic acid tests, including low throughput and high rates of false negatives. More sensitive and accurate tests to effectively identify infected patients are needed. METHODSThis study has developed fully automated chemiluminescent immunoassays (CLIA) to determine IgM and IgG antibodies to SARS-CoV-2 in human serum. The assay performance has been evaluated at 10 hospitals. Clinical specificity was evaluated by measuring 972 hospitalized patients with diseases other than COVID-19, and 586 donors of a normal population. Clinical sensitivity was assessed on 503 confirmed cases of SARS-CoV-2 by RT-PCR and 52 suspected cases. RESULTSThe assays demonstrated satisfied assay precision with coefficient of variation (CV) of less than 4.45%. Inactivation of specimen does not affect assay measurement. SARS-CoV-2 IgM shows clinical specificity of 97.33% and 99.49% for hospitalized patients and normal population respectively. SARS-CoV-2 IgG shows clinical specificity of 97.43% and 99.15% for the hospitalized patients and the normal population respectively. SARS-CoV-2 IgM and IgG show clinical sensitivity of 85.88% and 96.62% respectively for confirmed SARS-Cov-2 infection with RT-PCR, of 73.08% and 86.54% respectively for suspected cases. CONCLUSIONSwe have developed fully automated immunoassays for detecting SARS-CoV-2 IgM and IgG antibodies in human serum. The assays demonstrated high clinical specificity and sensitivity, and add great value to nucleic acid testing in fighting against the global pandemic of the SARS-CoV-2 infection.

Transmission electron microscopy of organic-inorganic hybrid perovskites: myths and truths.

Organic-inorganic hybrid perovskites (OIHPs) have attracted extensive research interest as a promising candidate for efficient and inexpensive solar cells. Transmission electron microscopy (TEM) characterizations that can benefit the fundamental understanding and the degradation mechanism are widely used for these materials. However, their sensitivity to the electron beam illumination and hence structural instabilities usually prevent us from obtaining the intrinsic information or even lead to significant artifacts. Here, we systematically investigate the structural degradation behaviors under different experimental factors to reveal the optimized conditions for TEM characterizations of OIHPs by using low-dose electron diffraction and imaging techniques. We find that a low temperature (-180 °C) does not slow down the beam damage but instead induces a rapid amorphization for OIHPs. Moreover, a less severe damage is observed at a higher accelerating voltage. The beam-sensitivity is found to be facet-dependent that a (1 0 0) exposed CH3NH3PbI3 (MAPbI3) surface is more stable than a (0 0 1) surface. With these guidance, we successfully acquire the atomic structure of pristine MAPbI3 and identify the characterization window that is very narrow. These findings are helpful to guide future electron microscopy characterizations of these beam-sensitive materials, which are also useful for finding strategies to improve the stability and performance of the perovskite solar cells.

Analysis of rs4420638A/G and -317H1/H2 polymorphisms of APOC1 gene among Chinese patients with pre-eclampsia / 中华医学遗传学杂志

OBJECTIVE@#To assess the association of apolipoprotein (apo) C1 (APOC1) gene rs4420638A/G and -317H1/H2 polymorphisms with the risk of pre-eclampsia (PE) and the influence of their genotypes on the clinical and metabolic indexes among Chinese women.@*METHODS@#In total 289 PE patients and 824 women with uncomplicated pregnancies were included. The rs4420638A/G genotype was determined by a Taqman real-time PCR allelic discrimination assay. The -317H1/H2 genotype was measured through PCR and restriction fragment length polymorphism analysis. Serum lipid and apo levels were measured by an enzymatic kit and a PEG-enhanced immunoturbidimetric assay.@*RESULTS@#Allelic and genotypic frequencies of the APOC1 gene rs4420638A/G and -317H1/H2 were not significantly different between the two groups (all P> 0.05). However, patients carrying the G allele of the rs4420638A/G locus had higher serum levels of triglyceride, non-HDL-C and apoB, and a higher apoB/apoA1 ratio compared with those with an AA genotype (all P< 0.05). Patients carrying the H2 allele of the -317H1/H2 polymorphism had smaller delivery gestational weeks compared with those with the H1H1 genotype (P< 0.05).@*CONCLUSION@#Polymorphisms of the APOC1 gene rs4420638 and -317H1/H2 sites may be associated with abnormal lipoprotein metabolism among Chinese patients with PE, though no association was found between variants of the APOC1 gene and the risk of PE among them.

Relationship between asthma and attention deficit hyperactivity disorder in children and their risk factors / 中华实用儿科临床杂志

In recent years, the relationship between children′s chronic diseases and neuropsychiatric diseases and their pathogenesis have become a hot and difficult issue in pediatric research.Bronchial asthma (asthma) is a co-mmon chronic airway inflammatory disease in children.The latest large-scale population-based reports confirmed the close relationship between asthma and attention deficit hyperactivity disorder (ADHD), the most common neurodevelopmental disorder in children.Therefore, the specific relationship between asthma and ADHD, and the latest research progress of their risk factors were reviewed in this article in order to understand the specific relationship between them and its risk factors, so as to facilitate the long-term clinical management of asthmatic children.

Enhanced recovery after surgery improves clinical outcomes of liver transplant recipients / 器官移植

Objective To investigate the rationality and efficacy of enhanced recovery after surgery (ERAS) in liver transplant recipients. Methods Clinical data of 465 liver transplant recipients were retrospectively analyzed. All recipients were divided into the ERAS group (n=163) and control group (n=302) according to whether they received ERAS. The severity of disease in the ERAS group was worse than that in the control group. Operation situations including the operation time, anhepatic phase and intraoperative blood transfusion volume of the liver transplant recipients were observed and recorded. Postoperative recovery conditions including the length of intensive care unit (ICU) stay, total length of hospital stay, total ventilator removal time at postoperative 28 d and postoperative re-intubation rate were recorded. The survival rates at 90 d, 180 d and 1 year after liver transplantation were calculated. The influencing factors of survival rate of liver transplant recipients were analyzed. Results The anhepatic phase in the ERAS group was 45 (39, 53) min, significantly longer than 40 (32, 48) min in the control group (P < 0.05). The volume of erythrocyte infusion in the ERAS group was 10 (7, 13) U, significantly less than 18 (10, 28) U in the control group (P < 0.05). The length of postoperative ICU stay and total length of hospital stay in the ERAS group were 135 (84, 212) h and 24 (18, 33) d, significantly shorter than 154 (103, 253) h and 34 (20, 50) d in the control group (both P < 0.05). Total ventilator removal time at postoperative 28 d was 26 (25, 27) d, significantly longer than 26 (23, 27) d in the control group (P < 0.05). The postoperative re-intubation rate in the ERAS group was 11.0%, significantly lower than 20.8% in the control group (P < 0.05). The 90 d, 180 d and 1-year survival rates in the ERAS group were 92.8%, which were significantly higher than 81.1%, 78.1% and 75.7% in the control group (all P < 0.05). ERAS and operation time were the independent influencing factors of survival rate of liver transplant recipients (both P < 0.05). Conclusions ERAS after liver transplantation can improve the survival rate of recipient, shorten the length of hospital stay, reduce the re-intubation rate and accelerate the rehabilitation after liver transplantation.