Bio-capped and green synthesis of ZnO/g-C_(3)N_(4) nanocomposites and its improved antibiotic and photocatalytic activities: An exceptional approach towards environmental remediation

In this research study, we have synthesized the bio-capped ZnO/g-C_(3)N_(4) nanocomposites by employing lemon juice(Citrus limon) as a stabilizer and mediator. Fruitfully, lemon juice which contains various acidic functional groups and citric acid has the capability to block the surface of g-C_(3)N_(4) from chemical reactivity and activated the surface of g-C_(3)N_(4) for various reactions. Consequently, the agglomeration behavior and controlled shape of g-C_(3)N_(4) has also been achieved. Our experimental results i.e. XRD,TEM, HRTEM, PL, FS, XPS, and PEC have confirmed that the lemon juice mediated and green g-C_(3)N_(4)(L-CN) have good performances and remarkable visible light photocatalytic activities as compared to the chemically synthesized g-C_(3)N_(4)(CN). Furthermore, the small surface area and low charge separation of g-C_(3)N_(4) is upgraded by coupling with Zn O nanoparticles. It is proved that the coupling of Zn O worked as a facilitator and photoelectron modulator to enhance the charge separation of g-C_(3)N_(4). Compared to pristine lemon-mediated green g-C_(3)N_(4)(L-CN), the most active sample 5Zn O/L-CN showed ~ 5-fold improvement in activities for ciprofloxacin(CIP) and methylene blue(MB) degradation. More specifically,the mineralization process and degradation pathways, and the mineralization process of ciprofloxacin(CIP) and methylene blue(MB) are suggested. Finally, our present novel research work will provide new access to synthesize the eco-friendly and bio-caped green g-C_(3)N_(4)nanomaterials and their employment for pollutants degradation and environmental purification.

In situ formed cross-linked polymer networks as dual-functional layers for high-stable lithium metal batteries

Lithium-metal anodes(LMAs)have been recognized as the ultimate anodes for next-generation batteries with high energy density,but stringent assembly-environment conditions derived from the poor moisture stability dramatically hinder the transformation of LMAs from laboratory to industry.Herein,an in situ formed cross-linked polymer layer on LMAs is designed and constructed by a facile thiol-acrylate click chemistry reaction between poly(ethylene glycol)diacrylate(PEGDA)and the crosslinker containing multi thiol groups under UV irradiation.Owing to the hydrophobic nature of the layer,the treated LMAs demonstrate remarkable humid stability for more than 3 h in ambient air(70%relative humidity).The coating humid-resistant protective layer also possesses a dual-functional characterization as solid polymer electrolytes by introducing lithium bis(trifluoromethanesulfonyl)imide in the system in advance.The intimate contact between the polymer layer and LMAs reduces interfacial resistance in the assembled Li/LiFePO_(4)or Li/LiNi_(0.8)Co_(0.1)Mn_(0.1)O_(2)full cell effectively,and endows the cell with an outstanding cycle performance.

Correlation of diffusion tensor imaging and cognitive function in patients with leukoaraiosis

Conventional imaging technology does not measure white matter lesions of the brain or cognitive impairment. Diffusion tensor imaging is able to detect changes in the microstructure of white matter, and correlating vascular risk factors with cognitive dysfunction seems feasible using this technique. A total of 60 leukoaraiosis patients and 30 healthy elderly controls received diffusion tensor imaging examination to detect the average diffusion coefficient and fractional anisotropy of leukoaraiosis lesion and normal white matter. Leukoaraiosis severity positively correlated with average diffusion coefficient but negatively correlated with fraction anisotropy. Neuropsychology tests （mini-mental state examination） were related to average diffusion coefficient and fraction anisotropy of normal white matter in leukoaraiosis patients, especially in the anterior horn and centrum semiovale. The average diffusion coefficient and fraction anisotropy of leukoaraiosis displayed characteristic changes. Therefore, diffusion tensor imaging can detect the macrostructural changes in white matter with normal magnetic resonance imaging, and these changes are related to cognitive function. Application of diffusion tensor imaging techniques to analyze the correlation between vascular risk factors and cognitive dysfunction is feasible.

Neuroprotective effect of high-dose hyperbaric oxygenation on rats with acute cerebral infarction in super-early stage:Curative comparison between 9-hour and 18-hour therapeutic protocols

BACKGROUND： Previously, only single short-time low-dose hyperbaric oxygenation （HBO） protocol was administrated to treat acute ischemic stroke in early stage and the conflicting results were obtained. There are few studies to report the outcome of administering long-time （can cover all the natural pathologic progression period） high-dose HBO to treat the disease. OBJECTIVE： To evaluate the therapeutic effect between two kinds of high-dose hyperbaric oxygenation on super-early stage of acute permanent middle cerebral artery occlusion （MCAO） in rats. DESIGN： A randomized controlled experimental study. SETTING： Beijing Tiantan Hospital, Capital Medical University; Beijing Research Institute of Neurosurgery. MATERIALS： Seventy-four male SD rats, aged 2.5 months old, weighing （ 280 ＋ 20） g, were provided by the Animal Institute, Chinese Academy of Medical Sciences. Hyperbaric oxygenation device was hyperbaric air cabin in which there was a self-made pure oxygen animal experimental cabin （made in China）. METHODS： This experiment was carried out in the municipal laboratory of Beijing Tiantan Hospital affiliated to Capital Medical University and Beijing Research Institute of Neurosurgery. ① Experimental intervention： All the rats were developed into models of permanent MCAO by suture embolism. Then, they were randomly divided into two HBO groups （9 hours and 18 hours） and control group, with 24 rats in each as well as 3-hour ultrastructure control group, with 2 rats. After being modeled for 3 hours, rats in the two HBO groups stayed in the hyperbaric cabin for 9 hours and 18 hours, separately. Rats in the 9-hour HBO group inhaled pure oxygen at hours 1, 3, 5, 7 and 9, and hyperbaric air at hours 2, 4, 6 and 8. Rats in the 18-hour HBO group inhaled pure oxygen at hours l, 3, 5, 7, 9, 11, 13, 15 and 17, and hyperbaric air at hours 2, 4, 6, 8, l0 12, 14, 16 and 18. After being created into models, rats in the control group and 3-hour ultrastructure control group breathed room air. ② Experimental evaluation： Neurologic functions of rat models in the 9-hour and 18-hour HBO groups as well as control group were scored by Bederson and Garica two neurological grading systems at hours 14 and 28 and on day 5; Infarct volume of rat models in the two HBO groups and control group was measured at hour 24 and on day 5 with NIH image processing software Image J; The pathological changes of brain tissue in the brain infarct region and its opposite region of rat models in the two HBO groups and 3-hour ultrastructure control group were observed with a Philips EM 208S transmission electron microscope. MAIN OUTCOME MEASURES： ① Neurobehavioral outcome. ② Rat brain infarct volume. ③ Ultrastructure of brain tissue in the ischemic penumbra of infarct models at the different time points RESULTS： ① Neurobehavioral outcome： After treatment, Garica score in the 9-hour and 18-hour HBO groups was significantly higher than that in the control group （P 〈 0.01）. Bederson score on day 5 after modeling in the 9-hour and 18-hour HBO groups was significantly lower than that in the control group （P 〈 0.01）. ② Cerebral infarct volume： Cerebral infarct volume in the 9-hour and 18-hour HBO groups was significantly smaller than that in the control group at hour 24 and on day 5 after modeling （P 〈 0.01）. In the 18-hour HBO group, infarct volume on day 5 after modeling was significantly larger than that at hour 24 after modeling （P 〈 0.05）. ③In the 3-hour ultrastructure control group, astrocyte edema and neuron damage around the capillary in the infarct cerebral tissue significantly relieved in the rats which were subjected to HBO. CONCLUSION： High dose of HBO is highly efficient in reducing infarct volume and improving neurobehavioral outcome of rats with acute cerebral infarction, and also has an important role in inhibiting the pathological progression of ischemic brain tissue after cerebral infarction.

Effect of 3D anchorage attachment on the alleviating tipping/extrusion of premolars for en-mass distalization of maxillary molars with clear aligners:A finite element study

This study aimed to explore the optimal invisible orthodontic force system during the en-mass distalization of two maxillary molars to minimize the side effect of anchorage loss by changing the direction of the application of the orthodontic force system.A high bio-fidelity 3D finite element model including maxilla,periodontal ligament,dentition,clear aligner,3D anchorage attachment and mini-implant was established.Different lengths of lateral hooks of 3D-printed anchorage attachments and mini-implant positions into the palatal alveolus were considered.A 200 g distal force was applied to the lateral hooks of different horizontal lengths(3.26 mm,6.52 mm and 9.78 mm)with the mini-implant as the application point.Using ABAQUS software,orthodontic tooth movements under 12 different clinical treatment designs were analyzed and calculated.The 3D anchorage attachment enhanced the anchorage of anterior teeth and alleviated the tipping/extrusion of premolars.In contrast to without clear aligners,length of the lateral hook had a negligible effect on both mesial tipping and buccal tipping with clear aligners,which could then be ignored.The change in mesial tipping was less and nearly remained constant despite of the different heights of the mini-implant.The 3D anchorage attachment assisted clear aligner can avoid the side effects of anterior tooth proclination caused by insufficient anchorage.The length of the lateral hook,and height of the mini-implant in this invisible orthodontic force system hardly affects the tooth movement of anchorage units.Clear aligners can effectively control the rotation and tipping of anchorage units caused by 3D anchorage attachment.

Rationale and design of a randomised double-blind 2×2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischaemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis(INSPIRES)

Background It remains unclear if intensive antiplatelet and statin treatments begun within 24-72 hours of cerebral ischaemic events from intracranial or extracranial atherosclerosis is effective or safe.Methods The Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis(INSPIRES)trial is a randomised,double-blind,placebo-controlled,multicentre and 2×2 factorial trial.6100 individuals between the ages of 35 and 80 who have experienced a mild ischaemic stroke or high-risk transient ischaemic attack(TIA)within the previous 72 hours that is attributed to≥50%atherosclerotic stenosis of a major intracranial or extracranial artery or multiple infarctions of atherosclerotic origin will be enrolled in the trial.Eligible subjects will be randomised 1:1:1:1 to one of four groups:(1)intensive antiplatelet therapy(combined clopidogrel and aspirin for days 1-21,then aspirin placebo and clopidogrel for days 22-90)plus immediate intensive statin therapy(atorvastatin at a dose of 80 mg daily for the first 21 days,then 40 mg daily for days 22-90);(2)intensive antiplatelet therapy plus delayed intensive statin therapy(atorvastatin placebo for days 1-3,followed by 40 mg per day of atorvastatin for days 4-90);(3)standard antiplatelet therapy(combination of clopidogrel placebo with aspirin for 90 days)plus immediate intensive statin therapy and(4)standard antiplatelet therapy plus delayed intensive statin therapy.The primary efficacy endpoint is any new stroke(ischaemic or haemorrhagic)within 90 days after randomisation.The primary safety endpoint is moderate to severe bleeding at 90 days.Conclusion The INSPIRES trial will assess the efficacy and safety of intensive antiplatelet therapy and immediate intensive statin therapy begun within 72 hours of onset in decreasing the recurrent stroke at 90 days in patients with acute mild ischaemic stroke or high-risk TIA of intracranial or extracranial atherosclerosis origin.

Design,synthesis,and insecticidal activity of novel terpenoid ester compounds containing bicyclo[2.2.1]heptane against Aphis gossypii Glover

To discover novel and efficient compounds against Aphis gossypii Glover,a series of novel terpene ester derivatives containing the structure of bicyclo[2.2.1]heptane were designed and synthesized using tschimganin as the lead compound.Bioactivity assays showed that most tschimganin analogs exhibited moderate to outstanding insecticidal activity against A.gossypii.In particular,compound 56(LC_(50)=0.28μg mL^(-1)),identified as(1S,2S,4R)-1,7,7-trimethylbicyclo[2.2.1]heptan-2-yl nicotinate,exhibited the best activity,which was significantly superior to that of imidacloprid(LC_(50)=0.54μg mL^(-1))and sulfoxaflor(LC_(50)=0.70μg mL^(-1)).The precise and dependable 3D-QSAR model suggests a promising direction for further design of more active tschimganin-based insecticides.Metabolomics showed that compound 56 disrupted detoxification,amino acid biosynthesis,and energy metabolism and may affect the central nervous system of A.gossypii.The results of this study indicated that tschimganin analogs are a potential new class of green insecticides that can be used for the integrated management of A.gossypii.

The Third China National Stroke Registry (CNSR-Ⅲ) for patients with acute ischaemic stroke or transient ischaemic attack: design, rationale and baseline patient characteristics

Background and purpose Stroke is the leading cause of mortality and disability in China.Precise aetiological classification,imaging and biological markers may predict the prognosis of stroke.The Third China National Stroke Registry(CNSR-Ⅲ),a nationwide registry of ischaemic stroke or transient ischaemic attack(TIA)in China based on aetiology,imaging and biology markers,will be considered to clarify the pathogenesis and prognostic factors of ischaemic stroke.Methods Between August 2015 and March 2018,the CNSR-Ⅲrecruited consecutive patients with ischaemic stroke or TIA from 201 hospitals that cover 22 provinces and four municipalities in China.Clinical data were collected prospectively using an electronic data capture system by face-to-face interviews.Patients were followed for clinical outcomes at 3 months,6 months and 1-5 year annually.Brain imaging,including brain MRI and CT,were completed at baseline.Blood samples were collected and biomarkers were tested at baseline.Results A total of 15166 stroke patients were enrolled,among which 31.7%patients were women with the average age of 62.2±11.3 years.Ischaemic stroke was predominant(93.3%,n=14146)and 1020(6.7%)TIAs were enrolled.Conclusions CNSR-Ⅲis a large scale nationwide registry in China.Data from this prospective registry may provide opportunity to evaluate imaging and biomarker prognostic determinants of stroke.

Chinese Stroke Center Alliance:a national effort to improve healthcare quality for acute stroke and transient ischaemic attack:rationale,design and preliminary findings

Background In June 2015,the Chinese Stroke Association(CSA)initiated the Chinese Stroke Center Alliance(CSCA)to establish the national hospital-based stroke care quality assessment and improvement platform.This article outlines its objectives,operational structure,patient population,quality improvement(QI)intervention tools,data elements,data collection methodology and current patient and hospital data.Methods The CSCA is a national,hospital-based,multicentre,voluntary,multifaceted intervention and continuous QI initiative.This multifaceted intervention includes stroke centre development,written care protocols,workshops and a monitoring/feedback system of evidencebased performance measures.The data coordinating centre of the CSCA resides at the China National Clinical Research Center for Neurological Diseases,Beijing Tiantan Hospital.results As of July 2017,1576 hospitals in China have contributed detailed clinical information to serve as a benchmark for the stroke care quality of 433264 patients with acute stroke/transient ischaemic attacks(TIA),including 352572(81.38%)acute ischaemic stroke,30362(7.01%)TIA,42080(9.71%)spontaneous intracranial haemorrhage,5505(1.27%)subarachnoid haemorrhage and 2745(0.63%)not specified stroke.Conclusion The CSCA programme is designed to establish a continuous national stroke registry and help healthcare providers develop stroke centres and treat patients in a consistent manner in accordance with accepted national guidelines and,ultimately,improve patient outcomes.It supports the CSA mission to reduce stroke burden in China.

Endovascular therapy for Acute ischemic Stroke Trial (EAST): study protocol for a prospective, multicentre control trial in China

Background and purpose:5 recent trials have shown the benefit of endovascular treatment for acute ischaemic stroke(AIS)due to large vessel occlusion of the anterior circulation.This study aims to evaluate the safety and efficacy of Solitaire thrombectomy in patients with moderate-to-severe stroke in the Chinese population,which has a high prevalence of intracranial atherosclerosis.Methods and analysis:This multicentre prospective control study will involve 17 stroke centres in China,and plans to recruit 150 patients in the intervention group,and 150 patients in the medical group,in which patients meet enrolment criteria but refuse intervention.Patients with AIS due to large vessel occlusion indicated for treatment with Solitaire stent retriever within 12 hours of symptom onset,and who meet the inclusion and exclusion criteria,will be enrolled in this study.The primary efficacy endpoint is functional independence as defined by a modified Rankin Scale(mRS)score≤2 at 90 days or by functional improvement as defined by mRS,using shift analysis.The procedural efficacy endpoint is arterial recanalisation of the occluded target vessel measured by a modified Thrombolysis in Cerebral Infarction(mTICI)score equal or superior to 2b right following the use of the study device.The primary safety endpoint is symptomatic intracranial haemorrhage(sICH)within 24±3 hours postprocedure.Ethics and dissemination:The protocol was approved by the Ethics Committee at the coordinating centre and by the local Institutional Review Board of each participating centre.Trial registration number:NCT02350283.

Rationale and design of Patient-centered Retrospective Observation of Guideline-Recommended Execution for Stroke Sufferers in China: China PROGRESS

Background In 2009,China launched ambitious healthcare reform plans to provide affordable and equitable basic healthcare for all patients,including the substantial number of patients who had a stroke.However,little is known about the pattern of evidence-based stroke care and outcomes across hospitals,regions and time during the last decade.Aims The Patient-centered Retrospective Observation of Guideline-Recommended Execution for Stroke Sufferers in China(China PROGRESS)Study aims to use findings from a representative sample of Chinese hospitals over the last decade to improve future stroke care for patients hospitalised with ischaemic stroke(IS)or transient ischaemic attack(TIA).Design The China PROGRESS Study will use a two-stage cluster sampling method to identify over 32000 patient records from 208 hospitals across the Eastern,Central and Western geographical regions in China.To assess the temporal trends in patient characteristics,treatment and outcomes,study investigators will select records from 2005,2010 and 2015.A double data reading/entry system will be developed to conduct this assessment.A central coordinating centre will monitor case ascertainment,data abstraction and data management.Analyses will examine patient characteristics,testing patterns,in-hospital treatment and outcomes,and variations across regions and across time.Conclusions The China PROGRESS Study is the first nationally representative study that aims to better understand care quality and outcomes for patients with IS or TIA before and after the national healthcare reform in China.This initiative will translate findings into clinical practices that improve care quality for patients who had a stroke and policy recommendations that allow these changes to be implemented widely.Ethics approval This study has also been approved by the central institutional review board(IRB)at Beijing Tiantan Hospital.

Predictors of dysphagia screening and pneumonia among patients with acute ischaemic stroke in China:findings from the Chinese Stroke Center Alliance(CSCA)

Background and purpose Guidelines recommend dysphagia screening to identify those at high risk of pneumonia.However,little is known about the prevalence and predictors of dysphagia screening and pneumonia among patients with acute ischaemic stroke in China.Methods Using data from the Chinese Stroke Center Alliance,which is a multicentre,prospective,consecutive patient enrolment programme,univariate and multivariate analyses were conducted to identify patient and hospital characteristics associated with dysphagia screening and pneumonia during acute hospitalisation.Results Of 790811 patients admitted to 1476 hospitals,622718(78.7%)underwent dysphagia screening,and 64398(8.1%)developed pneumonia.Patients in stroke units were more likely to be screened for dysphagia than those not in stroke units(OR 1.50;95%CI 1.48 to 1.52),while patients with a past history of stroke were less likely to be screened(OR 0.87;95%CI 0.86 to 0.88).Dysphagia screening(OR 1.46;95%CI 1.30 to 1.65),dysphagia(OR 7.31;95%CI 7.15 to 7.46),and admission to stroke units(OR 1.17;95%CI 1.14 to 1.19)were significantly associated with a greater risk of pneumonia.Conclusions Dysphagia was a critical factor in the development of pneumonia.Nearly one in five patients with acute ischaemic stroke in the Chinese Stroke Center Alliance were not screened for dysphagia.Pneumonia prevention during acute hospitalisation is dependent not only on dysphagia screening but also on the effectiveness of subsequent dysphagia management interventions.Further studies are needed to elucidate the relationship between dysphagia screening,stroke unit care and pneumonia in patients with acute ischaemic stroke.

GRP per capita and hospital characteristics associated with intravenous tissue plasminogen activator adherence rate:evidence from the Chinese Stroke Center Alliance

Background Timely delivery of intravenous tissue plasminogen activator(IV-rt PA)is pivotal to eligible patients who had a stroke while achieving higher rates of IV-rt PA has been problematic.This paper focuses on investigating influential factors associated with the administration of IV-rt PA,primarily per capita gross regional product(GRP)and healthcare system factors.Methods The study included 980 hospitals in the Chinese Stroke Center Alliance where 158003 patients who had an acute ischaemic stroke received IV-rt PA between August 2015 and August 2019.The adherence rate to IV-rt PA within 4.5 hours time window in each hospital was the primary outcome.Influential factors were grouped into two categories:macroeconomic status and hospital characteristics.The outcome was analysed using multivariable linear regression.Results GRP per capita(β=2.37,p<0.001),hospital stroke centre certification(β=3.77,p<0.001),number of neurologists(β=0.12,p<0.001),existence of emergency services for neurological treatment(β=7.43,p=0.014),presence of emergency department(β=10.03,p=0.019)and cooperating with emergency centre(β=4.65,p=0.029)were significantly positively associated with the adherence rate to IV-rt PA.Conclusions Higher GRP per capita,affluent neurological personnel,well-equipped emergency services for neurological treatment and routine cooperation with the emergency centre were important for enhancing the adherence rate to IV-rt PA among patients who had an acute ischaemic stroke in China.