A retrospective analysis of mortality in a Beijing hospital Emergency Department.

OBJECTIVE: The aim of this study was to analyze the epidemiological characteristics of mortality in the emergency department of Beijing Tongren Hospital from 2014 to 2019. METHODS: A total of 781 cases in the hospital's emergency department that resulted in mortality were retrospectively screened, and epidemiological and analytical methods were used to analyze the epidemiological characteristics and the trend of adult mortality in the emergency department of our hospital. RESULTS: Of the 781 selected cases, 448 were male, and 333 were female. Mortality rates were highest in patients aged 80-89 years, and most of the patients were retired (71.57%). Infection disease was associated with the highest mortality rate (44%), followed by cardiovascular disease and malignant tumors. CONCLUSION: Infectious diseases, cardiovascular diseases, and malignant tumors are the major threats to the lives of patients in the hospital's emergency department. The cause of death differs depending on the patient's age. KEY WORDS: Death, Emergency department, Epidemiological characteristics, Etiology, Retrospective analysis.

Protective effect of extracorporeal membrane pulmonary oxygenation combined with cardiopulmonary resuscitation on post-resuscitation lung injury.

BACKGROUND: Cardiac arrest (CA) is a critical condition that is a concern to healthcare workers. Comparative studies on extracorporeal cardiopulmonary resuscitation (ECPR) and conventional cardiopulmonary resuscitation (CCPR) technologies have shown that ECPR is superior to CCPR. However, there is a lack of studies that compare the protective effects of these two resuscitative methods on organs. Therefore, we aim to perform experiments in swine models of ventricular fibrillation-induced CA to study whether the early application of ECPR has advantages over CCPR in the lung injury and to explore the protective mechanism of ECPR on the post-resuscitation pulmonary injury. METHODS: Sixteen male swine were randomized to CCPR (CCPR; n=8; CCPR alone) and ECPR (ECPR; n=8; extracorporeal membrane oxygenation with CCPR) groups, with the restoration of spontaneous circulation at 6 hours as an endpoint. RESULTS: For the two groups, the survival rates between the two groups were not statistically significant (P>0.05), the blood and lung biomarkers were statistically significant (P<0.05), and the extravascular lung water and pulmonary vascular permeability index were statistically significant (P<0.01). Compared with the ECPR group, electron microscopy revealed mostly vacuolated intracellular alveolar type II lamellar bodies and a fuzzy lamellar structure with widening and blurring of the blood-gas barrier in the CCPR group. CONCLUSIONS: ECPR may have pulmonary protective effects, possibly related to the regulation of alveolar surface-active proteins and mitigated oxidative stress response post-resuscitation.

Synthesis and cytotoxic activity of chalcone analogues containing a thieno[2,3-d]pyrimidin-2-yl group as the A-ring or B-ring.

Many natural or synthetic chalcones have potential anti-tumor activity. Here, we synthesized two series of chalcone analogues containing a thieno[2,3-d]pyrimidin-2-yl group and evaluated for their cytotoxic activity towards cultured human lung cancer A549 and colorectal HCT-116 cells. Among them, compound 8d was the most cytotoxic against HCT-116 cells, with an IC50 value of 2.65 µM. Analyses of the phenotypic changes induced by this compound found a dose-dependent accumulation of HCT-116 cells in sub-G1 phase, indicating that compound 8d might induce apoptosis. Furthermore, we found that 8d triggered mitochondrial membrane potential depolarization, promoted reactive oxygen species formation in HCT-116 cells, and increased the percentage of early and late apoptotic cells. Finally, immunoblotting indicated that 8d increased PARP-1 and caspases 3, 7 and 9 cleavage. These data suggest that compound 8d induces apoptosis via the mitochondrial death pathway.

ECMO attenuates inflammation response and increases ATPase activity in brain of swine model with cardiac arrest compared with CCPR.

Extracorporeal membrane oxygenation (ECMO) could increase survival rate and neurological outcomes of cardiac arrest (CA) patients compared with conventional cardiopulmonary resuscitation (CCPR). Currently, the underlying mechanisms how ECMO improves neurological outcomes of CA patients compared with CCPR have not been revealed. A pig model of CA was established by ventricular fibrillation induction and then underwent CCPR or ECMO. Survival and hemodynamics during the 6 h after return of spontaneous circulation (ROSC) were compared. The levels of inflammatory cytokines and Ca2+-ATPase and NA+-K+-ATPase activities were detected. Brain tissues histology and ultra-microstructure in CCPR and ECMO groups were also examined. Results suggested that ECMO significantly improved the survival of pigs compared with CCPR. Heart rate (HR) decreased while cardiac output (CO) increased along with the time after ROSC in both ECMO and CCPR groups. At each time point, HR in ECMO groups was lower than that in CCPR group while CO and mean arterial pressure in ECMO group was higher than CCPR group. In ECMO group, lower levels of IL-1, IL-1ß, IL-6, TNFα, and TGFß, especially IL-1, IL-6, TNFα, and TGFß, were found compared that in CCPR group while no difference of IL-10 between the two groups was observed. Similar with the results from enzyme-linked immunosorbent assay, decreased expressions of IL-6 and TGFß were also identified by Western blotting. And Ca2+-ATPase and NA+-K+-ATPase activities were increased by ECMO compared with CCPR. Hematoxylin and eosin staining and ultra-microstructure examination also revealed an improved inflammation situation in ECMO group compared with CCPR group.

Synthesis and evaluation of chalcone analogues containing a 4-oxoquinazolin-2-yl group as potential anti-tumor agents.

The chalcone motif can be found in many molecules that contribute to essential biological processes, and many chalcone-containing compounds exhibit potent anti-cancer activity. Here, we synthesized two series of chalcone analogues (3a-s and 6a-s) based on substituting the chalcone B-ring or A-ring with a 4-oxoquinazolin-2-yl group, and then evaluated them for cytotoxic activity in human colorectal HCT-116 and breast cancer MCF-7 cell lines. Compounds 3a-s (in which a 4-oxoquinazolin-2-yl group functioned as the B-ring) were markedly more cytotoxic than compounds 6a-s (in which 4-oxoquinazolin-2-yl group functioned as the A-ring), based on their IC50 values to inhibit proliferation. Compound 3f was found as the most potent among 38 analogues and the mechanism of its cytotoxicity was investigated. Flow cytometry indicated that HCT-116 cells treated with compound 3f resulted in a dose-dependent accumulation of cells in the sub-G1 phase, which is representative of apoptotic cells. Subsequent assays (including Annexin V-FITC/PI, AO-EB, MitoSOX™ Red and JC-1 staining) confirmed that 3f exposure induced apoptosis in HCT-116 cells. Immunoblotting analysis indicated that cellular exposure to 3f increased the cleavage of PARP1 and caspases 3, 7, and 9. Taken together, this novel chalcone analogue has a cytotoxic effect on cultured cancer cell-lines that is likely mediated by inducing apoptosis via the mitochondrial death pathway.

Extracorporeal Membrane Oxygenation Improving Survival and Alleviating Kidney Injury in a Swine Model of Cardiac Arrest Compared to Conventional Cardiopulmonary Resuscitation.

BACKGROUND: Acute kidney injury (AKI) frequently occurs in cardiopulmonary resuscitation patients. Studies comparing the effects of extracorporeal membrane oxygenation (ECMO) with conventional cardiopulmonary resuscitation (CCPR) on AKI were rare. This study aimed to compare the effects of ECMO with those of CCPR on survival rate and AKI and explore the underlying mechanisms in a swine model of cardiac arrest (CA). METHODS: Sixteen male pigs were treated with ventricular fibrillation to establish CA model and then underwent CCPR (CCPR group, n = 8) or ECMO during cardiopulmonary resuscitation (ECPR group, n = 8). The study endpoints were 6 h after return of spontaneous circulation (ROSC) or death. Serum and urine samples were collected at baseline and during the 6 h after ROSC. The biomarkers of AKI were detected by enzyme-linked immunosorbent assay. The apoptosis of renal tubular epithelial cells was discovered by transmission electron microscope (TEM) and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Apoptosis-related genes were detected by immune-staining and Western blotting. Data were compared by Student's t-test. RESULTS: All pigs in ECPR group were successfully resuscitated with a higher 6-h survival rate (8/8) compared to CCPR group (6/8). The expressions of AKI biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), tissue inhibitor of metalloproteinase2 (TIMP2), insulin-like growth factor-binding protein 7 (IGFBP7), liver fatty acid-binding protein (LFABP), and kidney injury molecule1 (Kim-1) were all increased along with the time after ROSC in both groups and lower in ECPR group compared with CCPR group. Especially, products of urinary TIMP and IGFBP levels (TIMP*IGFBP) were significantly lower at ROSC4 (0.58 ± 0.10 ng2/ml2 vs. 1.18 ± 0.38 ng2/ml2, t = 4.33, P = 0.003) and ROSC6 (1.79 ± 0.45 ng2/ml2 vs. 3.00 ± 0.44 ng2/ml2, t = 5.49, P < 0.001); urinary LFABP was significantly lower at ROSC6 (0.74 ± 0.06 pg/ml vs. 0.85 ± 0.11 pg/ml, t = 2.41, P = 0.033); and urinary Kim-1 was significantly lower at ROSC4 (0.66 ± 0.09 pg/ml vs. 0.83 ± 0.06 pg/ml, t = 3.99, P = 0.002) and ROSC6 (0.73 ± 0.12 pg/ml vs. 0.89 ± 0.08 pg/ml, t = 2.82, P = 0.016). Under light microscope and TEM, the morphological injures in renal tissues were found to be improved in ECPR group. Moreover, apoptosis was also alleviated in ECPR group. CONCLUSIONS: Compared with CCPR, ECMO improves survival rate and alleviates AKI in a swine model of CA. The mechanism of which might be via downregulating AKI biomarkers and apoptosis in kidney.

[As2O3 Up-Regulates the Proportion of CD4+CD25+CD127low Tregs in Peripheral Blood of Patients with Severe Aplastic Anemia].

OBJECTIVE: To investigate the effect of ATO on the proportion of Treg in the peripheral blood of patients with severe aplastic anemia (SAA) in vitro. METHODS: The peripheral blood of 20 newlydiagnosed patients were collected, and the peripheral blood monomuclear cells (PBMNC) were extracted. After the PBMNC were treated with ATO of different concentrotions (0, 1, 2.5 and 5 µmol/L) for 96 hours, the proportion of CD44+ CD25+CD127low regulatatory T cells (Treg) were detected by flow cytometry. The expression levels of Foxp3 mRNA were detected by RT-PCR, and the levels of IFN-γ,IL-4,IL-17 and TGF-ß1 were detected by ELTSA to verify the results of flow cytomery. RESULTS: ATO significantly increased the proportion of Treg (P<0.01) at the concentration of 2.5 and 5 µmol/L, and the rising degree of Treg proportion improved with the increasing ATO concentration(r= 0.524). Treg proportion increased at a concentration of 1 µmol/L, but without statistical significance (P>0.05). At 1(P<0.05), 2.5(P<0.01) and 5 µmol/L(P<0.01), ATO significantly up-regulated the expression of Foxp3 mRNA, and the increase of Foxp3 mRNA positively and linearly correlated with the increase of Treg cell-frequency(r=0.523). ATO significantly reduced the levels of IFN-γ (at ATO 1,2.5 and 5 µmol/L, P<0.01), IL-4 (at ATO 2.5 µmol/L, P<0.01; at ATO 5 µmol/L, P<0.01) and IL-17(at ATO 2.5 µmol/L, P<0.05; at ATO 5 µmol/L, P<0.01). ATO had no significant effect on TGF-ß1 at 1(P>0.05) and 2.5 µmol/L (P>0.05), but significantly reduced TGF-ß1 level at 5 µmol/L (P<0.05). CONCLUSION: ATO can mediate the immune regulation through up-regulating the proportion of Treg in peripheral blood of patients with SAA and reducing the levels of IFN-γ, IL-4 and IL-17.

Targeted imaging of the lysosome and endoplasmic reticulum and their pH monitoring with surface regulated carbon dots.

Organelles play crucial roles in cellular activities and the functions of organelles are related greatly to the pH values, therefore, the bio-imaging of targeted organelles and their related pH sensing is of great importance in biological assays. Herein we report the fluorescence imaging of specific organelles, i.e., lysosomes and endoplasmic reticulum, and their pH sensing with surface regulated carbon dots (CDs). Carbon dots functionalized with amine groups (ACDs) are first prepared by hydrothermal treatment of citric acid and urea, and then laurylamine functionalized CDs (LCDs) are obtained via the conjugation of laurylamine with ACDs. The as-prepared ACDs and LCDs provide clear and bright imaging results for the lysosome and endoplasmic reticulum, respectively. The subcellular targeting features of the two CDs are attributed to their surface chemistries and cellular uptake pathways. Moreover, both the CDs are pH responsive within a certain pH range, i.e., 4.0-5.4 for ACDs and 6.2-7.2 for LCDs. The ACDs and LCDs are thus successfully applied to visualize the pH fluctuations of the lysosome and endoplasmic reticulum in MCF-7 cells.

Association of serum biomarkers with outcomes of cardiac arrest patients undergoing ECMO.

BACKGROUND: Recently, a series of studies have been conducted to investigate the association of the common biochemical biomarkers, such as serum lactate and creatinine, with clinical outcomes in cardiac arrest patients treated with extracorporeal membrane oxygenation (ECMO), however, the results were not consistent and the sample size of primary studies is limited. In the present study, we performed a systematic review and meta-analysis to summarize the associations. METHODS: Relevant studies in English databases (PubMed, ISI web of science, and Embase) and Chinese databases (Wanfang and CNKI) up to January 2018 were systematically searched. Crude ORs or HRs from the included studies were extracted and pooled to summarize the associations of lactate and creatinine with clinical outcomes including survival and neurological outcomes in ECMO treated cardiac arrest patients. RESULTS: 17 papers containing 903 cases were included in the present meta-analysis study. After pooling all the eligible studies, we identified the significant associations of high lactate level with poor survival (N=13, OR=1.335, 95%CI=1.167-1.527, P<0.001) and poor neurological outcome (N=2, HR=1.058, 95%CI=1.020-1.098, P=0.002) in CA patients treated with ECMO and a slight significant association of high creatinine with poor survival was also found (N=7, OR=1.010, 95%CI=1.002-1.018, P=0.015). CONCLUSIONS: High serum lactate level was associated with poor survival and poor neurological outcome in CA patients treated with ECMO. Further well-designed studies with larger sample size should be conducted to confirm the results.

Application and comparison in biosynthesis and biodegradation by Fusarium solani and Aspergillus fumigatus cutinases.

In this study, two synthesized cutinase genes from Fusarium solani and Aspergillus fumigatus were expressed in Pichia pastoris X33. The characteristics of these two cutinases were investigated and compared. The results indicated that F. solani and A. fumigatus cutinases hydrolyzed p-nitrophenyl substrates with different carbon chain lengths. A. fumigatus cutinase predominately hydrolyzed p-nitrophenyl butyrate, but F. solani cutinase preferred p-nitrophenyl decanoate. The abilities of polymer synthesis and bioplastic degradation were tested and compared between F. solani and A. fumigatus cutinases. The results showed that F. solani cutinase had degradation ability on poly(ε-caprolactone) (PCL) and synthesized polymer with a molecular weight (MW) of 2300 in organic solvent. However, A. fumigatus cutinase completely degraded PCL and synthesized molecules with a MW of 25,000, suggesting that A. fumigatus cutinase has more promising applications.

[Study on the diagnostic value of lung biopsy in hematologic patients with lung infection].

OBJECTIVE: To evaluate the diagnostic value and safety of percutaneous lung biopsy in hematologic patients with lung infection. METHODS: 28 cases hematologic patients received CT-guided percutaneous lung biopsy when they developed a fever associated with pulmonary nodules or lumps in CT scan whose clinical diagnosis were unclear during or after chemotherapy. Sample of each lesion were drawn twice. The lung tissue was re-scanned after lung biopsy to check up in order to discover bleeding and pneumothorax. Biopsy tissue was examined by bacteria culture, acid-fast staining and pathology. Pathological examination contained HE staining, acid-fast stain, PAS stain, TB-DNA, methenamine silver and others. RESULTS: 28 cases contain 24 males and 4 females. Median age was 40 15 - 77 years old. Blood tests were as follows: 3 cases with HGB > 110 g/L, 9 with HGB 90 - 110 g/L, 12 with HGB 60 - 89 g/L, 4 with HGB < 60 g/L. 8 with WBC > 10×10(9)/L, 6 with WBC (4 - 10)×10(9)/L, 13 with WBC < 4×10(9)/L, 1 with WBC < 2×10(9)/L; 14 with PLT > 100×10(9)/L, 5 with PLT (50 - 100)×10(9)/L, 5 with PLT < 50×10(9)/L, 4 with PLT < 30×10(9)/L. 4 cases had mild extended PT, 3 mild extended APTT, 3 FIB lower than normal. Lung CT scans were as follows: 4 cases with simply lesion in right lung, 4 with simply lesion in left lung, 20 with lesions in bilateral lung. 8 cases were diagnosed as fungal infection, 3 as tuberculosis infection, 1 as lung cancer, 1 as pulmonary infiltration of lymphoma, 1 as pulmonary infiltration of leukemia, and 14 as inflammatory changes with no specific diagnosis. 4 cases came with pneumothorax during lung biopsy, mild to moderate in 3 cases and severe in 1 case. Severe patient turned better after CT-guided suction. 3 cases with mild hemoptysis turned better after treatment. CONCLUSION: When hematopathy patients are with pulmonary nodules or lumps in CT scan whose clinical diagnosis is unclear, CT-guided percutaneous lung biopsy is safe and conducive to early diagnosis and conducive to early rehabilitation of patients if the coagulation function is basically normal and platelet count is not too low.

[Clinical outcomes of different regimens for non-Hodgkin's lymphoma with bone marrow involvement: analysis of 148 cases].

OBJECTIVE: To investigate the effects of different treatment protocols on non-Hodgkin's lymphoma (NHL) with bone marrow involvement (BMI). METHODS: The clinical data of 148 patients of NHL with BMI, 108 undergoing CHOP regimen, 51 undergoing dose-intensive CHOP regimens, 13 undergoing CHOP regimen + rituximab, and 27 undergoing hemopoietic stem cell transplantation (HSCT) after CHOP protocol with remission. The curative effects were retrospectively analyzed. RESULTS: (1) The response rate (RR) for the whole group was 80.4%, with a complete remission (CR) rate of 60.7%. The response rate of the patients treated with the dose-intensive regimens (dose-intensive group) was 84.3%, significantly higher than that of the patients treated with standard CHOP regimen (64.1%, P < 0.05). (2) The 3- and 5-year overall survival (OS) rates and progress-free survival (PFS) of the B-cell NHL patients who underwent HSCT + Rituximab treatment (Rituximab combined with chemotherapy) were significantly higher than those of the dose-intensive group and CHOP group, and the 3- and 5-year OS rates and PFS of the dose-intensive group were all significantly higher than those of the CHOP group (all P < 0.05). (3) The 3- and 5-year OS rates, and PFS of the T-cell NHL patients who underwent HSCT group and dose-intensive CHOP were all significantly higher than those patients who underwent CHOP regimen (all P < 0.05). CONCLUSION: Superior survival may benefit from Dose-intensive regimens and HSCT, may be good choices for the patients with NHLBMI, a group of heterogeneous malignancies with poor prognosis. And combined chemotherapy with Rituximab treatment remarkably raises the effect for CD20(+) B-cell NHLBMI.

Self-assembly and cathodoluminescence of microbelts from Cu-doped boron nitride nanotubes.

We report the self-assembly of microbelts from Cu-doped boron nitride nanotubes by chemical vapor deposition using Cu as a catalyst. The BN nanotubes with Cu-encapsulated flat tips have uniform outer diameters of approximately 240 nm, inner diameters of approximately 210 nm, and lengths of approximately 10 microm, and Cu is found to uniformly dope into the nanotubes. Most importantly, the nanotubes are self-assembled to form microbelts with 10 microm in width and tens of micrometers in length. Strong and tunable light emissions from the ultraviolet to visible light range are observed in such Cu-doped microbelts, showing their high potential for applications in lasing, light-emitting diode, and medical diagnosis devices.

Novel boron nitride hollow nanoribbons.

Novel BN hollow nanoribbons (BNHNRs) were fabricated by a simple ZnS nanoribbon templating method. Such BNHNRs have a distinct structure and show unique optical properties, as demonstrated from Raman, Fourier transform infrared spectroscopy, UV-vis spectroscopy, and cathodoluminescence spectroscopy, when compared with other forms of BN nanostructures. With high crystallinity, the BNHNRs exhibit an extraordinary ultraviolet CL emission at 5.33 eV. Such a property is highly advantageous for optoelectronic applications, particularly in the ultraviolet region, such as blue lasing and light emitting diodes. This templating method has also been extended to synthesize other hollow nanostructures such as boron carbonitride. This study represents a new methodology for fabricating hollow nanostructures with defined crystallinity and unique optical properties.

[Retrospective analysis of 54 patients with high risk aggressive T-cell non-Hodgkin lymphomas].

OBJECTIVE: To analyse the clinical characteristics, treatments and prognosis of patients with T-cell non-Hodgkins lymphoma (NHL) in intermediate-high and high risk. METHODS: Fifty-four patients with T-cell NHL classified intermediate-high and high risk were retrospectively analyzed. RESULTS: According to WHO classification criteria, there were 12 cases of T-lymphoblastic lymphoma (TLBL), 31 peripheral T-cell lymphoma unspecified (PTCL-U), and 11 hepatosplenic T-cell lymphoma (HSTCL). The IPI were 12 cases of intermediate-high risk and 42 high risk. Of them, 49 cases were bone marrow affected and 7 CNS affected. The response rate (RR) for the whole group was 86.5%, complete remission (CR) rate 67.3%, and 3-year survival rate 16.0%. The 3-year survival rates for haematopoietic stem cell transplantation and chemotherapy groups were 44.4% and 8.3%, respectively. Multi-factor analysis showed that choice of therapy modality, and achievement of remission were significant factors for overall survival. CONCLUSION: T-NHL is a group of heterogeneous malignancies. The response rate of intermediate-high and high risk T- NHL, especially PTCL-U and LTBL, is not low, but its long-term outcome is poor. New treatment modality needs to be explored for these patients, and autologous HSCT is perhaps a good choice.

Electron beam nanoprocessing of a carbon nanotube film using a variable pressure scanning electron microscope.

We demonstrate a novel method of processing carbon nanotubes using a variable pressure scanning electron microscope. Lines were processed in a nanotube film by electron beam irradiation in oxygen gas and nitrogen gas. The processing mechanism can be explained in terms of gas ion sputtering and chemical reaction. In this experiment, the narrowest line width of 120 nm was achieved in a nitrogen atmosphere.

Cloning and sequence analysis of myostatin promoter in sheep.

To better understand the structure and function of the myostatin's gene promoter region in sheep, we cloned and sequenced a 1.517 kb fragment containing the 5'-regulatory region of the sheep myostatin gene (GenBank accession number is AY918121). The promoter sequence consists of three TATA boxes, one CAAT box, and eight putative E-boxes. Some putative muscle growth response elements for Octamer-binding factor 1(Octamer), Activator protein 1(AP1), Growth factor independence 1 zinc finger protein (Gfi-1B), Myocyte enhancer factor 2 (MEF2), Muscle-specific Mt binding site (MTBF), Glucocorticoid response elements (GRE) and Progesterone receptor binding site (PRE) were detected. Some of the motifs are conserved as compared to with that in the goat, bovine and porcine myostatin promoters. However, some differences were also found.