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The intrinsic volumetric stress during cycling is the main obstacle for developing Si-based materials as high-energy-density lithium-ion battery anodes. Elastic binders have been demonstrated as an efficient approach to alleviate the stress of Si. Herein, we design a tough 3D hard/soft polymeric network (LPTS) using lithiated poly(acrylic acid), silk sericin, and highly branched tannic acid. Covalent cross-linking provides a robust mechanical strength to endure the large stress. The formed multiple hydrogen bonds with bonding energies between 3.46 and 25 kcal mol-1 can effectively dissipate the stress through sequential hydrogen bond disassociation. The multifunctional LPTS binder maintains the integrity of the Si-based electrodes during repeated discharging/charging. Additionally, Li+ can be transferred via a Li-conducting group (-COOLi), thereby enhancing the ionic conductivity of electrodes. Consequently, the Si/LPTS electrode exhibits an improved initial Coulombic efficiency and excellent durability over 400 cycles. Meanwhile, this binder is also suitable for Si-C anodes, enabling stable cycling at a high areal capacity >3.6 mAh cm-2 and delivering 72.2% capacity retention for the LFP||Si-C/LPTS full cell after 200 cycles. This study provides insight into developing efficient Si-based binders that are facile and low-cost for next-generation high-energy-density systems.
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Over the last few decades, there has been a growing discourse surrounding environmental and health issues stemming from drinking water and the discharge of effluents into the environment. The rapid advancement of various sewage treatment methodologies has prompted a thorough exploration of promising materials to capitalize on their benefits. Metal-organic frameworks (MOFs), as porous materials, have garnered considerable attention from researchers in recent years. These materials boast exceptional properties: unparalleled porosity, expansive specific surface areas, unique electronic characteristics including semi-conductivity, and a versatile affinity for organic molecules. These attributes have fueled a spike in research activity. This paper reviews the current MOF-based wastewater removal technologies, including separation, catalysis, and related pollutant monitoring methods, and briefly introduces the basic mechanism of some methods. The scale production problems faced by MOF in water treatment applications are evaluated, and two pioneering methods for MOF mass production are highlighted. In closing, we propose targeted recommendations and future perspectives to navigate the challenges of MOF implementation in water purification, enhancing the efficiency of material synthesis for environmental stewardship.
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Background: The systemic immuno-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are widely used and have been shown to be predictive indicators of various diseases. Diabetic nephropathy (DN), retinopathy (DR), and peripheral neuropathy (DPN) are the most prominent and common microvascular complications, which have seriously negative impacts on patients, families, and society. Exploring the associations with these three indicators and diabetic microvascular complications are the main purpose. Methods: There were 1058 individuals with type 2 diabetes mellitus (T2DM) in this retrospective cross-sectional study. SII, NLR, and PLR were calculated. The diseases were diagnosed by endocrinologists. Logistic regression and subgroup analysis were applied to evaluate the association between SII, NLP, and PLR and diabetic microvascular complications. Results: SII, NLR, and PLR were significantly associated with the risk of DN [odds ratios (ORs): 1.52, 1.71, and 1.60, respectively] and DR [ORs: 1.57, 1.79, and 1.55, respectively] by multivariate logistic regression. When NLR ≥2.66, the OR was significantly higher for the risk of DPN (OR: 1.985, 95% confidence interval: 1.29-3.05). Subgroup analysis showed no significant positive associations across different demographics and comorbidities, including sex, age, hypertension, HbA1c (glycated hemoglobin), and dyslipidemia. Conclusion: This study found a positive relationship between NLR and DN, DR, and DPN. In contrast, SII and PLR were found to be only associated with DN and DR. Therefore, for the diagnosis of diabetic microvascular complications, SII, NLR and PLR are highly valuable.
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Plaquetas , Diabetes Mellitus Tipo 2 , Angiopatías Diabéticas , Linfocitos , Neutrófilos , Humanos , Masculino , Femenino , Persona de Mediana Edad , Neutrófilos/patología , Estudios Retrospectivos , Estudios Transversales , Linfocitos/patología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/sangre , Angiopatías Diabéticas/sangre , Angiopatías Diabéticas/diagnóstico , Angiopatías Diabéticas/inmunología , Angiopatías Diabéticas/patología , Plaquetas/patología , Anciano , Inflamación/sangre , Inflamación/patología , Neuropatías Diabéticas/sangre , Neuropatías Diabéticas/patología , Neuropatías Diabéticas/etiología , Neuropatías Diabéticas/diagnóstico , Retinopatía Diabética/sangre , Retinopatía Diabética/diagnóstico , Retinopatía Diabética/inmunología , Nefropatías Diabéticas/sangre , Nefropatías Diabéticas/patología , Nefropatías Diabéticas/diagnóstico , Recuento de Linfocitos , Recuento de Plaquetas , AdultoRESUMEN
Purpose: The purpose of this study is to assess the effect of glucocorticoid prescription feedback intervention in complex primary care institutions for regulating its inappropriate use. Design Setting and Interventions: A six-month cluster randomized cross-over controlled trial was conducted in primary care institutions. A total of 347 physicians from 69 participating institutions were randomly allocated to either group A or group B. Both groups were given feedback interventions or serve as control. The feedback intervention comprised two components: a real-time pop-up warning of inappropriate glucocorticoid prescriptions based on the Hospital Information System and a high-proportion prescription feedback intervention warning system. Outcome Measures: The primary outcome measure was the 10-day inappropriate glucocorticoid prescription rate, while the 10-day glucocorticoid prescription rate served as secondary outcome measure. Results: At baseline, the 10-day inappropriate glucocorticoid prescription rates were 66.63% and 66.57% in group A and group B, respectively, showing no significant difference (p = 0.140). Following the intervention, group A exhibited a significant reduction in 10-day inappropriate glucocorticoid prescription rate at the crossing point by 13.69% (p < 0.001). In contrast, group B, which served as the control group, experienced an increase of 5.93% (p = 0.037) at the same crossover point. After the crossover point, there was a decrease in 10-day inappropriate glucocorticoid prescription rate for both groups. Group B as the intervention group demonstrated a reduction of 28.22% compared to the crossing point (p < 0.001), whereas group A showed a decrease of 12.20% (p = 0.339). The characteristics of physicians did not significantly influence the inappropriate glucocorticoid prescription rate. Conclusion: The real-time pop-up warning of inappropriate glucocorticoid prescriptions based on the Hospital Information System and high-proportion prescription feedback intervention warning system can effectively regulate the inappropriate glucocorticoid prescribing behavior of physicians. Trial Registration: ISRCTN11747547.
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BACKGROUND: In this study, we retrospectively analysed macrophage infiltration and podocyte injury in three patients with diffuse proliferative lupus nephritis (LN) who underwent repeated renal biopsy. CASE SUMMARY: Clinical data of three diffuse proliferative LN patients with different pathological characteristics (case 1 was LN IV-G (A), case 2 was LN IV-G (A) + V, and case 3 was LN IV-G (A) + thrombotic microangiopathy) were reviewed. All patients underwent repeated renal biopsies 6 mo later, and renal biopsy specimens were studied. Macrophage infiltration was assessed by CD68 expression detected by immunohistochemical staining, and an immunofluorescence assay was used to detect podocin expression to assess podocyte damage. After treatment, Case 1 changed to LN III-(A), Case 2 remained as type V LN lesions, and Case 3, which changed to LN IV-S (A), had the worst prognosis. We observed reduced macrophage infiltration after therapy. However, two of the patients with active lesions after treatment still showed macrophage infiltration in the renal interstitium. Before treatment, the three patients showed discontinuous expression of podocin. Notably, the integrity of podocin was restored after treatment in Case 1. CONCLUSION: It may be possible to reverse podocyte damage and decrease the infiltrating macrophages in LN patients through effective treatment.
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Aqueous electrolytes have become a research hotspot because of their high safety and low cost, while the inevitable ionization phenomenon of water in aqueous solution leads to the existence of competitive ions (H+) except the active ions. In this article, we take aqueous Na base electrolyte as an example to clear the ion competition behavior by modeling, simulating together with experimental verification. First, the reaction tendency of the two ions (Na+ and H+) is obtained by calculating the Gibbs energy change of the reaction. Furthermore, the properties of electrolytes with different concentrations including transportation are obtained by modeling. After that, relevant experiments are also proceeded to verify the simulation results. Then, the ion competition behavior is analyzed by in situ observation by controlling the constant concentration of Na+: the high concentration of Na+ can reduce the proportion of H+ and reduce the competitiveness of H+; a high concentration of Na+ causes the increased viscosity and reduces the ion diffusion. Based on this, the correlation between ion competitiveness and ion ratio is also confirmed by keeping the concentration of Na+ unchanged and adjusting the concentration of H+ (adjusting pH). The influence of the ion competition phenomenon (Na+ and H+) is the reaction characteristics of the substance itself and the ratio of ion concentration. Finally, the electrochemical performance is further verified in 3,4,9,10-perylene tetracarboxylic dianhydride (PTCDI) symmetric cells and in full-cells with vanadium phosphate sodium (NVP) as the cathode and PTCDI as the anode.
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BACKGROUND: Several treatment modalities are used for the treatment of periorbital rejuvenation with variable results. Recent studies showed that fractional radiofrequency may be an effective treatment modality for periorbital aging. This study aims to determine the efficacy and safety of negative pressure fractional microneedle radiofrequency (NPFMR) as a treatment for periorbital aging. METHODS: Twenty-five patients with periorbital aging were involved in this study. They were treated two times with an interval of 1 month. The patients were evaluated before treatment and 1, 3, and 6 months after the final treatment. RESULTS: The research findings suggest that periorbital wrinkles of the patients were significantly improved by VISIA system (p < 0.05). Physiological indicators detected by MPA10 system showed that compared with before treatment, the hydration increased (p < 0.05) and trans epidermal water loss (TEWL) decreased (p < 0.05) at 3 and 6 months after treatment. The glossiness increased at 1 month after treatment compared to pre-treatment (p < 0.05) and returned to the baseline level at 3 and 6 months after treatment. There was no significant change in melanin content (p > 0.05). Periorbital dermal thickness of the patients significantly increased at 1, 3, and 6 months after treatment according to skin ultrasound (p < 0.05). A periorbital skin biopsy revealed that the collagen fibers in the dermis were significantly thicker and more orderly after treatment, and the expression of type I collagen fibers and elastic fibers was increased compared with that before treatment. One patient developed post-inflammatory hyperpigmentation (PIH) at 1 month after the first treatment, which improved after active treatment. No other adverse reactions were observed. CONCLUSIONS: NPMFR could be an effective and safe treatment modality for the treatment of periorbital aging.
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Satisfacción del Paciente , Envejecimiento de la Piel , Humanos , Resultado del Tratamiento , Piel/diagnóstico por imagen , Rejuvenecimiento , EnvejecimientoRESUMEN
The application of metal batteries is seriously affected by active ions transport and deposition stability during operation. This article takes water-based Zn metal electrodes as an example to analyze the factors that affect ion distribution and the impact of ion distribution on electrodeposition morphology through electrochemical model simulation calculation, in situ observation and electrochemical experiment: 1) high concentration will reduce the concentration polarization and the overpotential; 2) The passage of active ions through channels are facilitated by small anion (Cl-) rather than bigger one (SO4 2-), which means small deposition overpotential; 3) The transportability-reaction properties of cations (Zn2+, Li+, Na+ and H+) depends on their concentration, solvent coordination structure, and the energy changes during redox reactions. Based on the diffusion and reaction properties, a Li+ coupled Zn2+ electrolyte is designed to achieve the rapid transportation of doped ions to cover uneven growth sites and maintain a stable interface for the steady deposition of active Zn2+, guiding the interface design for high stability metal batteries in addition to the traditional addition of organic solvents.
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OBJECTIVE: To explore the surgical techniques, advantages, and disadvantages of neuroendoscopic telovelar approach in the treatment of brainstem and fourth ventricle lesions. METHODS: The clinical data of 5 patients treated by neuroendoscopic telovelar approach from March 2020 to March 2022 were analyzed retrospectively. RESULTS: Among the 5 patients, there were 3 cavernous hemangiomas in pontine arm and 2 tumors in brainstem and fourth ventricle. All patients could successfully complete the operation, and 4 patients recovered well, other 1 patient discharged automatically for serious complications of other systems after the operation. CONCLUSION: The telovelar approach has gained popularity as a safe and effective strategy for lesions in fourth ventricular and brainstem. However, without removing the posterior arch of the atlas, it is difficult to enter the upper part of the fourth ventricle under a microscope. Transcranial neuroendoscopy can effectively compensate for the shortcomings of microscopy, whether used as an auxiliary measure for microsurgery or alone with proficient endoscopic techniques, it will provide greater application in minimally invasive surgery for fourth ventricle and brainstem lesions. By utilizing the excellent degree of freedom of transcranial neuroendoscopy, there is no need to open the posterior arch of the atlas, making the surgery more minimally invasive. However, the sample size of this study is small, and it was completed under the very mature neuroendoscopic technology of our team. Its general safety and practicality still require extensive clinical research validation.
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Neuroendoscopía , Humanos , Neuroendoscopía/métodos , Cuarto Ventrículo/cirugía , Procedimientos Neuroquirúrgicos/efectos adversos , Estudios Retrospectivos , Tronco Encefálico/cirugíaRESUMEN
The commercial application of lithium-sulfur (Li-S) batteries has faced obstacles, including challenges related to low sulfur utilization, structural degradation resulting from electrode volume expansion, and migration of polysulfide lithium (LiPSs). Herein, Co1-xS/3D-Ti3C2Tx composites with three-dimensional (3D) multilayered structures are used as separator modification materials for Li-S batteries to solve these problems. The multilevel layered structure of Co1-xS/3D-Ti3C2Tx establishes an efficient electron and Li+ transfer path, alleviates the volume change during the battery charge-discharge process, and enhances the stability of the structure. In addition, the battery assembled with the modified separator shows excellent discharge capacity and cycle stability at 0.5 C and could maintain a high discharge capacity after 500 cycles. This work provides a method for designing highly dispersed metal sulfide nanoparticles on MXenes and extends the application of MXenes-based composites in electrochemical energy storage.
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Purpose: The purpose of this study was to investigate the prescribing patterns and usage trends of systemic glucocorticoids in primary care institutions located in Southwest China from 2018 to 2021. Materials and Methods: A retrospective cross-sectional analysis of systemic glucocorticoids prescriptions was conducted in 32 primary care institutions located in Southwest China between 2018 and 2021. Prescriptions of systemic glucocorticoids were classified as appropriate or inappropriate use. Inappropriate use was further classified into (1) inappropriate indications and (2) inappropriate selection of glucocorticoids. Generalized estimation equations were employed to investigate the factors associated with inappropriate utilization of systemic glucocorticoids. The seasonal autoregressive integrated moving average (SARIMA) model was employed to predict the rate of inappropriate glucocorticoids prescriptions. Results: A total of 203,846 (92.89%) prescriptions were included, both the number of systemic glucocorticoids prescriptions and inappropriate prescriptions increased in winter. Diseases of the respiratory system (68.90%) were the most frequent targets of systemic glucocorticoids use. Of all prescriptions, 73.18% exhibited inappropriate indications, while 0.05% demonstrated inappropriate selection. The utilization of systemic glucocorticoids was deemed inappropriate for diseases of the respiratory system (94.19%), followed by diseases of the digestive system (87.75%). Physicians, who were female or younger than 33 years old, possess lower levels of education and professional titles and exhibit a higher likelihood of inappropriately prescribing systemic glucocorticoids. The phenomenon of inappropriate glucocorticoids use was commoner among male patients aged 65 years and older. After conducting model verification, it was determined that the SARIMA model could be used to predict the monthly rate of inappropriate systemic glucocorticoids prescriptions in primary care institutions in southwest China. Conclusion: The inappropriate use of systemic glucocorticoids remains a significant concern in primary care institutions. In this regard, continuing education and professional knowledge training of physicians should be strengthened in the future.
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BACKGROUND: Astrocytes have been demonstrated to undergo conversion into functional neurons, presenting a promising approach for stroke treatment. However, the development of small molecules capable of effectively inducing this cellular reprogramming remains a critical challenge. METHODS: Initially, we introduced a glial cell marker gene, GFaABC1D, as the promoter within an adeno-associated virus vector overexpressing miR-124 into the motor cortex of an ischemia-reperfusion model in rats. Additionally, we administered NeuroD1 as a positive control. Lentiviral vectors overexpressing miR-124 were constructed and transfected into primary rat astrocytes. We assessed the cellular distribution of GFAP, DCX, and NeuN on days 7, 14, and 28, respectively. RESULTS: In rats with ischemic stroke, miR-124-transduced glial cells exhibited positive staining for the immature neuron marker doublecortin (DCX) and the mature neuron marker NeuN after 4 weeks. In contrast, NeuroD1-overexpressing model rats only expressed NeuN, and the positive percentage was higher in co-transfection with miR-124 and NeuroD1. Overexpression of miR-124 effectively ameliorated neurological deficits and motor functional impairment in the model rats. In primary rat astrocytes transduced with miR-124, DCX was not observed after 7 days of transfection, but it appeared at 14 days, with the percentage further increasing to 44.6% at 28 days. Simultaneously, 15.1% of miR-124-transduced cells exhibited NeuN positivity, which was not detected at 7 and 14 days. In vitro, double fluorescence assays revealed that miR-124 targeted Dll4, and in vivo experiments confirmed that miR-124 inhibited the expression of Notch1 and DLL4. CONCLUSIONS: The overexpression of miR-124 in astrocytes demonstrates significant potential for improving neurological deficits following ischemic stroke by inhibiting DLL4 expression, and it may facilitate astrocyte-to-neuronal transformation.
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Isquemia Encefálica , Accidente Cerebrovascular Isquémico , MicroARNs , Accidente Cerebrovascular , Ratas , Animales , Astrocitos/metabolismo , Accidente Cerebrovascular Isquémico/genética , Accidente Cerebrovascular Isquémico/metabolismo , Neuronas/metabolismo , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/genética , Accidente Cerebrovascular/metabolismo , MicroARNs/genética , MicroARNs/metabolismo , Isquemia Encefálica/metabolismoRESUMEN
CAR-T targeting CD19 have achieved significant effects in the treatment of B-line leukemia and lymphoma. However, the treated patients frequently relapsed and could not achieve complete remission. Therefore, improving the proliferation and cytotoxicity of CAR-T cells, reducing exhaustion and enhancing infiltration capacity are still issues to be solved. The IL-7 has been shown to enhance the memory characteristics of CAR-T cells, but the specific mechanism has yet to be elaborated. miRNAs play an important role in T cell activity. However, whether miRNA is involved in the activation of CAR-T cells by IL-7 has not yet been reported. Our previous study had established the 3rd generation CAR-T cells. The present study further found that IL-7 significantly increased the proliferation of anti-CD19 CAR-T cells, the ratio of CD4 + CAR + cells and the S phase of cell cycle. In vivo study NAMALWA xenograft model showed that IL-7-stimulated CAR-T cells possessed stronger tumoricidal efficiency. Further we validated that IL-7 induced CAR-T cells had low expression of CDKN1A and high expression of miRNA-98-5p. Additionally, CDKN1A was associated with miRNA-98-5p. Our results, for the first time, suggested IL-7 could conspicuously enhance the proliferation of CAR-T cells through miRNA-98-5p targeting CDKN1A expression, which should be applied to CAR-T production.
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MicroARNs , Receptores Quiméricos de Antígenos , Humanos , Receptores Quiméricos de Antígenos/metabolismo , Inmunoterapia Adoptiva/métodos , Interleucina-7/genética , Interleucina-7/metabolismo , MicroARNs/genética , Proliferación Celular , Antígenos CD19/genética , Antígenos CD19/metabolismo , Inhibidor p21 de las Quinasas Dependientes de la Ciclina/metabolismoRESUMEN
Despite the significant reduction in atmospheric pollutant levels during the COVID-19 lockdown, the presence of haze in the North China Plain remained a frequent occurrence owing to the enhanced formation of secondary inorganic aerosols under ammonia-rich conditions. Quantifying the increase or decrease in atmospheric ammonia (NH3) emissions is a key step in exploring the causes of the COVID-19 haze. Historic activity levels of anthropogenic NH3 emissions were collected through various yearbooks and studies, an anthropogenic NH3 emission inventory for Henan Province for 2020 was established, and the variations in NH3 emissions from different sources between COVID-19 and non-COVID-19 years were investigated. The validity of the NH3 emission inventory was further evaluated through comparison with previous studies and uncertainty analysis from Monte Carlo simulations. Results showed that the total NH3 emissions gradually increased from north-west to south-east, totalling 751.80 kt in 2020. Compared to the non-COVID-19 year of 2019, the total NH3 emissions were reduced by approximately 4 %, with traffic sources, waste disposal and biomass burning serving as the sources with the top three largest reductions, approximately 33 %, 9.97 % and 6.19 %, respectively. Emissions from humans and fuel combustion slightly increased. Meanwhile, livestock waste emissions decreased by only 3.72 %, and other agricultural emissions experienced insignificant change. Non-agricultural sources were more severely influenced by the COVID-19 lockdown than agricultural sources; nevertheless, agricultural activities contributed 84.35 % of the total NH3 emissions in 2020. These results show that haze treatment should be focused on reducing NH3, particularly controlling agricultural NH3 emissions.
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Contaminantes Atmosféricos , COVID-19 , Humanos , Amoníaco/análisis , Contaminantes Atmosféricos/análisis , Pandemias , COVID-19/epidemiología , Control de Enfermedades Transmisibles , Aerosoles y Gotitas Respiratorias , China/epidemiología , Monitoreo del AmbienteRESUMEN
SiOx-based material is a promising candidate for lithium-ion batteries (LIBs) owing to its high theoretical capacity. The inherent disadvantages of poor electronic conductivity and large volume variation can be solved by constructing the outermost carbon layer and reserving internal voids. However, the practical application of SiOx/C composites remains a great challenge due to the unsatisfactory energy density. Herein, we propose a facile synthetic approach for fabricating SNG/H-SiOx@C composites, which are constructed by amorphous carbon, hollow SiOx (H-SiOx), and spherical natural graphite (SNG). H-SiOx alleviates volume expansion, while amorphous carbon promotes Li+ migration and stable solid electrolyte interphase (SEI) formation. The as-prepared SNG/H-SiOx@C demonstrates a high reversible capacity (465 mAh g-1), excellent durability (93% capacity retention at 0.5C after 500 cycles), lower average delithiation potential than SNG (0.143 V after 500 cycles), and a 14% gravimetric energy density improvement at a loading level of 4.5 mg cm-2. Even at a compacted density of 1.5 g cm-3, the SNG/H-SiOx@C anode presents a modest volume deformation of 14.3% after 100 cycles at 0.1C.
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Purpose: To explore the prescription patterns and usage trends of antibiotics within primary care institutions located in underdeveloped regions of China from 2017 to 2022. Methods: A retrospective analysis of antibiotic prescriptions was conducted from 25 primary care institutions in Guizhou Province during the period of 2017-2022. Antibiotic prescriptions were categorized into appropriate and inappropriate use. Appropriate use is further categorized into preferred medication, and antibiotics can be used or substituted. Inappropriate use is further categorized into unnecessary use, incorrect spectrum of antibiotics and combined use of antibiotics. Factors associated with inappropriate use were investigated using generalized estimation equations. Holt-Winters and SARIMA models were employed to predict the number of inappropriate antibiotic prescriptions as the alternative model. Results: A total of 941,924 prescriptions were included, revealing a decreasing trend in both the number and inappropriate rates of antibiotic prescriptions from 2017 to 2022. Diseases of the respiratory system (70.66%) was the most frequent target of antibiotic use, with acute upper respiratory infections of multiple and unspecified sites representing 52.04% of these cases. The most commonly used antibiotics were penicillins (64.44%). Among all prescriptions, inappropriate antibiotic prescriptions reached 66.19%. Physicians aged over 35, holding the title of associate chief physician and possessing more than 11 years of experience were more likely to prescribe antibiotics inappropriately. The phenomenon of inappropriate antibiotic use was commoner among children aged five or younger. By comparing model parameters, it was determined that the SARIMA model outperforms the Holt-Winters model in predicting the number of inappropriate antibiotic prescriptions among primary care institutions. Conclusion: The number and inappropriate rates of antibiotic prescriptions in southwest China exhibited a downward trend from 2017 to 2022, but inappropriate prescription remains a serious problem in primary care institutions. Therefore, future efforts should focus on strengthening physician education, training, and clinical practice. Additionally, physicians' awareness of common misconceptions about inappropriate antibiotic use must be improved, and the prescribing behavior of physicians who fulfill patients' expectations by prescribing antibiotics needs to be modified.
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OBJECTIVE: To explore factors affecting postoperative rebleeding in patients with spontaneous supratentorial intracerebral hemorrhage (SSICH). METHODS: We retrospectively analyzed data from 724 patients with SSICH treated at Renmin Hospital of Wuhan University from December 2018 to October 2021. Finally, 294 people were eligible to be included in this study. Hematoma locations were classified as basal ganglia, thalamus, subcortex, or intraventricular. Surgery was categorized as neuroendoscopic surgery, burr hole (stereotactic drilling and drainage), or open craniotomy. Postoperative rebleeding was recorded. The incidence, risk factors, and prognosis of postoperative rebleeding were evaluated. RESULTS: All procedures were successfully completed. Postoperative rebleeding occurred in 57 patients (19.83%, 57/294). Univariate logistic regression analysis identified these risk factors for rebleeding: admission Glasgow Coma Scale (GCS) score, irregular hematoma morphology by preoperative Computed Tomography (CT), postoperative hypertension, hematoma location, surgical method (P<0.05), and preoperative hematoma volume (P<0.1). Multivariate logistic regression analysis confirmed admission GCS score, irregular hematoma morphology by preoperative CT, postoperative hypertension, hematoma location, and surgical method as significant risk factors (P<0.05). Burr hole surgery and basal ganglia hematomas were associated with increased odds of rebleeding, and the mortality rates in patients with rebleeding versus no rebleeding were 7.02% versus 0.84%. CONCLUSIONS: Neuroendoscopic surgery, craniotomy, and burr hole are all effective for treating SSICH, but burr hole surgery was an important risk factor for rebleeding and an adverse outcome. Admission GCS score, irregular hematoma morphology, blood pressure control, hematoma location, and surgical method are affected the risk of postoperative rebleeding. 3D Slicer-assisted neuroendoscopic surgery may be the most effective treatment for many patients with SSICH.
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With the rapid reduction of anthropogenic SO2 emissions, the critical driver of haze in China has shifted from being dominated by sulfate to alternating sulfate and nitrate. Haze induced by different driver species may differ in the chemical forms of water-soluble inorganic ions (WSIIs). The unique topography and high-emission industrial agglomeration of the Loess Plateau determine its severe local PM2.5 pollution and influence global weather patterns through the outward export of pollutants. PM2.5 samples were conducted in Pingyao, on the eastern Loess Plateau of China, in autumn and winter. The average mass of PM2.5 was 88.82 ± 57.37 µg/m3; sulfate, nitrate, and ammonium were the dominant component. The chemical form of the ion was dominated by (NH4)2SO4, NH4NO3, NaNO3 and KNO3 during the nitrate-driven (ND) haze, while (NH4)2SO4, NH4HSO4, NH4NO3, NaNO3 and KNO3 were predominant species during the sulfate-driven (SD) haze. Heterogeneous oxidation reactions dominated the mechanism of sulfate formation. Primary sulfate emissions or other generation pathways contributed to sulfate formation during the SD haze. The gas-phase homogeneous reaction of NO2 and NH3 dominates the nitrate generation during the ND haze. The heterogeneous reactions also played an essential role during the SD haze. Nitrate aerosol (42.30%) and coal and biomass combustion (23.23%) were the dominant sources of WSIIs during the ND haze. In comparison, nitrate aerosol (31.80%) and sulfate aerosol (25.08%) were considered the primary control direction during the SD haze. The chemical characteristics and sources of aerosols under various types of haze differ significantly, and knowledge gained from this investigation provides insight into the causes of heavy haze.