AngioJet thrombectomy with extracorporeal membrane oxygenation support for an acute large-scale pulmonary embolism with bilateral atrial thrombosis: a case report of catastrophic antiphospholipid syndrome.

Background: Catastrophic Antiphospholipid Syndrome (CAPS), a severe systemic autoimmune disorder, predominantly causes life-threatening multi-organ failure, with a high mortality rate. It primarily affects small vessels, seldom impacting large vessels. Notably, acute massive pulmonary embolism (PE) with bilateral atrial thrombosis is an exceptional occurrence in CAPS. Acute pulmonary embolism (PE) is a common cardiovascular disease that progresses rapidly and has a high mortality rate. Acute massive PE combined with bilateral atrial thrombosis has an even higher mortality rate. PE treatments primarily include pharmaceuticals, catheter interventions, and surgical measures, with integrated treatment strategies demonstrating promising outcomes in clinical practice. Extracorporeal membrane oxygenation (ECMO) can provide cardiopulmonary support for the treatment of high-risk PE patients and is a proven therapeutic measure. Methods: This report presents the case of a 52-year-old male admitted due to fever and sudden onset of impaired consciousness, with cardiac ultrasound and pulmonary artery CT angiography revealing an acute large-scale pulmonary embolism accompanied by bilateral atrial thrombosis, with the condition rapidly worsening and manifesting severe respiratory and circulatory failure. With ECMO support, the patient underwent a thrombectomy using an AngioJet intervention. The diagnosis of CAPS was confirmed through clinical presentation and laboratory examination, and treatment was adjusted accordingly. Results: The patient made a successful recovery and was subsequently discharged from the hospital. Conclusion: In CAPS patients, the rare instance of acute massive PE accompanied by bilateral atrial thrombosis significantly risks severe respiratory and circulatory failure, adversely affecting prognosis. Early initiation of ECMO therapy is crucial, offering a vital opportunity to address the root cause. In this case report the patient was successfully treated with an AngioJet thrombectomy supported by ECMO.

[Cognition function and its influencing factors among people aged 55 and above in 4 provinces of China from 2018 to 2019].

OBJECTIVE: To analyze the current situation of cognition function of people aged 55 and above in 4 provinces of China, and to explore its influencing factors of demographic characteristics. METHODS: Using the baseline data of the "Community-based Cohort Study on Nervous System Diseases", middle-aged and older populations aged ≥55 years with completed data on demographic and economic factors and the cognitive function scale were selected as study subjects. A total of 5103 subjects were included in the study(male 2294, female 2809, 55-64 years old 1875, 65-74 years old 2197, 75-94 years old 1031). Multi-stage stratified cluster random sampling was adopted, and survey subjects were selected from a total of 32 communities in Hebei, Zhejiang, Shaanxi and Hunan provinces. The baseline data obtained from a face-to-face questionnaire survey was entered using electronic tablets on the spot. Montreal cognitive assessment(MoCA) and activities of daily living scale(ADL) were used to determine mild cognitive impairment(MCI) and its subtypes. Multiple linear regression and multiple Logistic regression model were used to analyze the influencing factors of cognitive function in populations. RESULTS: Among middle-aged and elderly Chinese populations, the score of overall cognitive function and its sub-domains were 21. 79±6. 17, 11. 20±4. 18(memory), 8. 81±3. 31(execution), 5. 33±1. 76(visual-spatial ability), 4. 53±1. 40(language), 13. 32±3. 98(attention) and 5. 54±0. 95(orientation). The prevalence of MCI and its subtypes were 35. 86%, 4. 57%(amnestic MCI single domain, aMCI-SD), 3. 64%(nonamnestic MCI single domain, naMCI-SD), 6. 68%(amnestic MCI multiple domains, aMCI-MD) and 3. 94%(nonamnestic MCI multiple domains, naMCI-MD). Subjects aged ≥55 years, living in rural areas, or with per capita monthly household income less than 1000 yuan had lower score of overall cognitive function and its sub-domains(P<0. 05), and also had lower prevalence of MCI and its subtypes. The OR of MCI, naMCI-SD, aMCI-MD and naMCI-MD was 2. 38(95% CI 1. 98-2. 86), 1. 54(95% CI 1. 01-2. 34), 2. 30(95% CI 1. 65-3. 20) and 3. 11(95% CI 2. 07-4. 69) respectively in subjects aged ≥75 years versus those aged 55-64 years, and of MCI, naMCI-SD and aMCI-MD was 3. 02(95%CI 2. 48-3. 66), 4. 30(95%CI 2. 69-6. 88) and 2. 62(95%CI 1. 81-3. 79) respectively in those living in rural areas versus those living in city areas. Subjects with higher per capita monthly household income had lower ORs of MCI and its subtypes. CONCLUSION: The prevalence rate of MCI among people aged 55 and above in four provinces in China is at a relatively high level. In the studied 4 provinces of China, about 35% of Chinese middle-aged and elderly populations are affected by MCI. The status of overall cognitive function and its sub-domains of subjects aged 75 years and above, living rural areas and with lower per capita monthly household income are poor, and they may have a higher risk of MCI and its subtypes.

China's First Demonstration of Cobalt-rich Manganese Crust Thickness Measurement in the Western Pacific with a Parametric Acoustic Probe.

Cobalt-rich manganese crusts (CRCs) are important as a potential mineral source that could occur throughout the Pacific on seamounts, ridges, and plateaus. We built a prototype parametric acoustic probe to complete the task of in-situ thickness measurements to estimate the volumetric distribution of deep-sea mineral. The prototype is designed with dual-channels for receiving the primary and secondary signal, which lays a foundation for improving the thickness extraction algorithm. Considering that the signal quality is degraded by the system interference and ambient noise, some improvements to the algorithm are proposed by including the wavelet-based envelope extraction method and the adaptive estimation strategy based on the dual-channel information. Additionally, wavelet regression is applied to reduce the measuring noise assuming that the CRCs have local thickness invariability. The algorithm is suitable for the CRCs with the structure of the multilayers at the top surface and one single layer at the bottom surface. A laboratory experiment is performed to validate the effectiveness of the algorithm. The experiments carried out on the China Ocean 51th voyage in the Western Pacific Ocean on Aug 30, 2018, are described and the data obtained by using the sit-on-bottom stationary measurement are processed to validate the design of the prototype.

Treatment of superficial infantile hemangiomas with timolol: Evaluation of short-term efficacy and safety in infants.

Timolol has been demonstrated to be efficacious in the topical treatment of superficial infantile hemangiomas (IHs). We conducted a prospective study to evaluate the short-term efficacy and safety of timolol in the treatment of superficial IH in Chinese infants. From March to November 2012, 124 patients with superficial IHs were included in the prospective study. The patients were divided into two groups: treatment (101 patients, the timolol drops were administered on the surface of the lesions three times daily, and erythromycin ointment was applied around the lesions) and observation (23 patients, without treatment). The results were categorized into three grades: class 1 (ineffective), class 2 (controlled growth) and class 3 (promoted regression). Within one week of the initiation of timolol treatment, a number of the lesions became softer and lighter in color. Four months following the initiation of timolol treatment, the overall response was class 1 in eight patients (7.9%), class 2 in 36 patients (35.6%) and class 3 in 57 patients (56.4%). Complete tumor regression was observed in 12 patients. No adverse effects were recorded during the treatment period. Among the patients in the observation group, there were 15 class 1 patients (65.2%), seven class 2 patients (30.4%) and only one class 3 patient (4.3%). In conclusion, timolol is an effective and safe treatment for superficial IH. In addition, it may be used in the treatment of proliferative superficial IH, particularly in infants within 6 months of age.

Microfiltration process by inorganic membranes for clarification of TongBi liquor.

Membrane separation is an alternative separation technology to the conventional method of filtration. Hence, it has attracted use in the purification and concentration of Chinese Herbal Medicine Extracts (CHMEs). The purpose of this work was to study the process of microfiltration of Tongbi liquor (TBL), a popular Chinese herbal drink, using ceramic membranes. Zirconium oxide and aluminum oxide membranes with pore mean sizes of 0.2 µm and 0.05 µm, respectively, are used for comparisons in terms of flux, transmittance of the ingredients, physical-chemical parameters, removal of macromolecular materials and fouling resistance. The results show that 0.2 µm zirconium oxide membrane is more suitable. The stable permeate flux reaches 135 L·h(-1)·m(-2), the cumulative transmittance of the indicator is 65.53%. Macromolecular materials, such as starch, protein, tannin, pectin and total solids were largely eliminated in retentate after filtration using 0.2 µm ZrO2 ceramic membrane, resulting in clearer TBL. Moreover, this work also reveals that continuous ultrasound could strengthen membrane process that the permeate flux increases significantly. This work demonstrates that the purification of CHME with ceramic membranes is possible and yielded excellent results.

[Pollution prevention and control of aqueous extract of astragali radix processed with ZrO2 inorganic ceramic membrane micro-filtration].

OBJECTIVE: To study the measures for preventing and controlling the pollution of aqueous extract of Astragali Radix proceeded with inorganic ceramic membrane micro-filtration, in order to find effective measures for preventing and controlling the membrane pollution. METHOD: The resistance distribution, polymer removal and changes in physical and chemical parameters of the zirconium oxide film of different pore diameters were determined to analyze the state or location of pollutants as well as the regularity of formation. Meanwhile, recoil and ultrasonic physical measures were adopted to strengthen the membrane process, in order to explore the methods for preventing and controlling the membrane pollution. RESULT: When 0.2 microm of ZrO2 micro-filtrated aqueous extract of Astragali Radix, the rate of pollution was as high as 44.9%. The hole blocking resistance and the concentration polarization resistance were the main filtration resistances, while the surface deposit resistance decreased with the increase in the membrane's hold diameter; after micro-filtration, the liquid turbidity significantly reduced, with slight changes in both pH and viscosity. The 0.2 microm ZrO2 micro-filtration membrane performed better than the 0.05 microm pore size membrane in terms of conductivity. The 0. 2 microm and 0.05 microm pore diameter membranes showed better performance in the removal of pectin. The ultrasonic measure to strengthen membranes is more suitable to this system, with a flux rate up by 41.7%. CONCLUSION: The membrane optimization process adopts appropriate measures for preventing and controlling the membrane pollution, in order to reduce the membrane pollution, recover membrane performance and increase filtration efficiency.

Development of single-domain recombinant antibodies to reverse transcriptase domain of human hTERT.

This paper describes the development of single-domain recombinant antibodies against human telomerase core protein. A His-tagged hTERT spanning main reverse-transcriptase domain of hTERT was purified from host E. coli and used to immunize BALB/c mice. The VHs (heavy chain variable region genes) were amplified by PCR from total RNA of splenocytes and further induced random mutagenesis by DNA shuffling to enrich the repertoire of VH library. All VHs were cloned into phagemid vectors and displayed to generate 4 x 10(10) phage libraries. The candidates carrying VH domains against hTERT were primarily screened through three times of panning procedure on His-tagged hTERT coated microplates, and specific antibodies were further selected by West-Western blot. Two clones, designated as a3 and b8, were confirmed to interact with the target in the solid-phase assay. DNA sequencing proved their mouse VH origin. The purified single-domain antibody of b8 could not only recognize native hTERT, but also neutralize human telomerase activity on inhibitory assay and b8 showed the stronger suppressive efficacy compared with a3. The data demonstrated that the developed single-domain recombinant antibodies were hTERT-specific with high potential of binding and activity inhibition.