Incidence and risk factors for pulmonary hemorrhage after percutaneous CT-guided pulmonary nodule biopsy: an observational study.

To evaluate the current incidence of pulmonary hemorrhage and the potential factors contributing to its increased risk after percutaneous CT-guided pulmonary nodule biopsy and to summarize the technical recommendations for its treatment. In this observational study, patient data were collected from ten medical centers from April 2021 to April 2022. The incidence of pulmonary hemorrhage was as follows: grade 0, 36.1% (214/593); grade 1, 36.8% (218/593); grade 2, 18.9% (112/593); grade 3, 3.5% (21/593); and grade 4, 4.7% (28/593). High-grade hemorrhage (HGH) occurred in 27.2% (161/593) of the patients. The use of preoperative breathing exercises (PBE, p =0.000), semiautomatic cutting needles (SCN, p = 0.004), immediate contrast enhancement (ICE, p =0.021), and the coaxial technique (CoT, p = 0.000) were found to be protective factors for HGH. A greater length of puncture (p =0.021), the presence of hilar nodules (p = 0.001), the presence of intermediate nodules (p = 0.026), a main pulmonary artery diameter (mPAD) larger than 29 mm (p = 0.015), and a small nodule size (p = 0.014) were risk factors for high-grade hemorrhage. The area under the curve (AUC) was 0.783. These findings contribute to a deeper understanding of the risks associated with percutaneous CT-guided pulmonary nodule biopsy and provide valuable insights for developing strategies to minimize pulmonary hemorrhage.

Pneumothorax after percutaneous CT-guided lung nodule biopsy: a prospective, multicenter study.

Background: Pneumothorax is a common complication induced by computed tomography (CT)-guided percutaneous needle biopsy, with a frequency of 17-40.4%. It remains debatable how to predict and prevent the occurrence of post-biopsy pneumothorax. In a real-world setting, we investigated the characteristics associated with pneumothorax in primary lung nodule biopsy. Methods: This clinical registry cohort study recorded patients with newly diagnosed pulmonary nodules from 10 medical centers from April 2021 to April 2022, and the data were input into the electronic data capture (EDC) system. The eligibility criteria for participants included being within the age range of 18 to 80 years and expressing a willingness to undergo percutaneous puncture biopsy, among other requirements. Conversely, the exclusion criteria included an inability to cooperate throughout the biopsy process and the emergence of new health issues during the study duration resulting in attendance delays, among other factors. This study collected data from 924 patients, out of which 593 were included after exclusion. The essential characteristics, imaging features of pulmonary nodules, and technical factors associated with percutaneous biopsy were recorded. T-tests or one-way analysis of variance (ANOVA) were performed for continuous variables and Pearson's χ2 test, likelihood ratio, or Fisher's exact test were applied for categorical variables for comparison as appropriate, followed by multivariate logistic regression. Results: The overall incidence of pneumothorax was 13.0% (77/593), among which timely pneumothorax was 10.3% (61/593), delayed pneumothorax was 2.7% (16/593), and the rate of chest tube placement was 3.4% (20/593). There was no significant difference in the incidence of pneumothorax in a needle size range of 16-19 G (P=0.129), but the incidence of pneumothorax was lower with 17 G needles than with 18 G. An increased morbidity of pneumothorax was correlated with age (P=0.003), emphysema (P=0.006), and operation time (P=0.002). There was no significant increase in the incidence of pneumothorax between 1 or 2 passes through the pleura (P=0.062). However, multiple pleural passes (3 times) increased the chances of pneumothorax significantly (P=0.022). These risk factors have a certain clinical value in predicting the incidence of post-biopsy pneumothorax, and the area under the curve (AUC) was 0.749. Conclusions: The most common post-biopsy complication, pneumothorax, was managed conservatively in most cases. A maximum of two pleural passes does not increase the incidence of pneumothorax, and the 17 G needle is more suitable for percutaneous biopsy of pulmonary nodules in the real world.

Carmichaeline A: a new C20-diterpenoid alkaloid from Aconitum carmichaeli.

The roots of Aconitum carmichaeli Debx. are known for their medicinal value. A new C20-diterpenoid alkaloid designated as carmichaeline A (1) has been isolated, along with eight known diterpenoid alkaloids from the roots of the plant. Their structures were elucidated on the basis of spectroscopic data interpretation.

Ultrasound-assisted oxidative desulfurization of bunker-C oil using tert-butyl hydroperoxide.

This work investigated the ultrasonic assisted oxidative desulfurization of bunker-C oil with TBHP/MoO3 system. The operational parameters for the desulfurization procedure such as ultrasonic irradiation time, ultrasonic wave amplitude, catalyst initial concentration and oxidation agent initial concentration were studied. The experimental results show that the present oxidation system was very efficient for the desulfurization of bunker-C oil and ~35% sulfur was removed which was dependent on operational parameters. The application of ultrasonic irradiation allowed sulfur removal in a shorter time. The stronger the solvent polarity is, the higher the sulfur removal rate, but the recovery rate of oil is lower. The sulfur compounds in bunker-C oil reacted with TBHP to produce corresponding sulfoxide, and further oxidation produced the corresponding sulfone.

Improving the performance of membrane bioreactors by adding a metabolic uncoupler, 4-nitrophenol.

Effects of 4-nitrophenol (4NP) on the overall performance of membrane bioreactors (MBRs) were investigated in two bench-scale submerged MBRs. Positive impacts of 4NP on activated sludge production and membrane fouling were demonstrated over 45 days of stable operational period. After addition of 4-nitrophenol, the sludge production could be reduced effectively, but only a slight reduction in chemical oxygen demand removal was obtained. The effluent NH4(+)-N concentrations were almost the same in two MBRs. The transmembrane pressures (TMPs) and resistance R increased with increasing mixed liquor suspended solid concentration at each MBR. The average daily TMP increase rates in the control MBR reactor remained at about 0.23 kPa day(-1) and dropped to about 0.12 kPa day(-1) in the 4NP-MBR. Compared with the control MBR, a wider dispersion and lower peak of floc size, a lower zeta potential, and a lower extracellular polymeric substance concentration were observed in the 4NP-MBR.

(1ß,2α,3α,7α,11α,13ß)-1,3,7,11-Tetra-acet-oxy-2,13-bis-(benz-yloxy)-21-methyl-19,21-secohetisan-19-al hemi-hydrate.

In the crystal structure of the title compound, C(43)H(46)NO(13)·0.5H(2)O, the mol-ecule assumes a U-shaped conformation, the terminal benzene rings being approximately parallel and partially overlapped with each other. The mol-ecule contains eight alicyclic and heterocyclic rings. The cyclo-hexane rings adopt chair conformations, the other three six-membered carbocyclic rings form a bicyclo-[2.2.2]octane system with a boat conformation for each six-membered ring, the six-membered heterocyclic ring has a chair conformation and both of the five-membered rings have envelope conformations. The solvent water mol-ecule links with the organic mol-ecule via classic O-H⋯O and weak C-H⋯O hydrogen bonding in the crystal structure.