Comparative efficacy and safety of Chinese patent medicines of iron deficiency anemia during pregnancy:A network meta-analysis

BACKGROUND Iron deficiency anemia(IDA)is a prevalent nutritional disorder during pregnancy.Clinical studies indicate that incorporating Chinese patent medicines(CPMs)with oral iron(OI)in treating IDA in pregnancy can reduce adverse effects and improve clinical outcomes.Nonetheless,the comparative efficacy of different CPMs remains unclear.AIM To assess the safety and effectiveness of different CPMs for treating IDA during pregnancy using network meta-analysis.METHODS We conducted a search for randomized controlled trials(RCTs)that combined CPM and OI for IDA treatment in pregnancy,spanning from 2013 to the present.Data analysis was performed using Rev Man 5.3 and Stata 14.0 on literature that satisfied the quality criteria.RESULTS The analysis included 45 RCTs,encompassing 4422 pregnant patients with IDA.Six CPMs were examined,including Shengxuebao Mixture,Shengxuening Tablets(SXN),Yiqi Weixue CPMs(YQWX),Jianpi Shengxue CPMs(JPSX),Yiqi Buxue Tablets,and Compound Hongyi Buxue Oral Liquid(FFHY).Findings indicated that FFHY+OI significantly improved the clinical effective rate.SXN+OI was most effective in boosting red blood cells counts and hemoglobin levels.YQWX+OI showed superior results in improving serum ferritin,and SXN+OI was most effective in increasing serum iron levels.JPSX+OI was optimal in reducing adverse pregnancy outcomes,while YQBX+OI effectively minimized adverse events.A cluster analysis suggested that SXN+OI could be the potentially optimal therapeutic regimen for IDA in pregnancy.CONCLUSION This study demonstrates that the combination of OI with CPMs offers better outcomes than OI alone.Based on clinical efficacy and other measured outcomes,SXN+OI emerges as the most effective treatment modality for improving the health of pregnant patients with IDA.

Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients

Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C.

Immune mechanisms of Concanavalin A model of autoimmune hepatitis

As a chronic inflammatory disease of the liver,the pathogenic mechanisms of autoimmune hepatitis (AIH) have not yet been elucidated,with prognosis and diagnosis remaining unsatisfied.Currently the only viable treatments of AIH are immunosuppressant application and liver transplantation.It is considered that lack of good animal AIH models is the main reason for the shortage of a simple and efficient cure.The Concanavalin A (Con A) model is a typical and well established model for investigating T-cell and macrophage dependent liver injury in mice,which closely mimics the pathogenesis mechanisms and pathological changes of patients,and is regarded as the best experimental model for AIH research so far.In this paper we eluci-dated the pathogenic mechanisms of AIH and the evolution of relative animal models.We go on to further focus on Con A-induced liver injury from the point of immunological mechanisms and the change of cytokine levels.Finally,we manifested the clinical significance of the AIH animal models and the challenges they would meet during their future development.

Study on gold concentrate leaching by iodine-iodide

Gold extraction by iodine-iodide solution is an effective and environment-friendly method. In this study, the method using iodine-iodide for gold leaching is proved feasible through thermodynamic calculation. At the same time, experiments on flotation gold concentrates were carried out and encouraging results were obtained. Through optimizing the technological conditions, the attained high gold leaching rate is more than 85%. The optimum process conditions at 25℃ are shown as follows： the initial iodine concentration is 1.0%, the iodine-to-iodide mole ratio is 1：8, the solution pH value is 7, the liquid-to-solid mass ratio is 4：1, the leaching time is 4 h, the stirring intensity is 200 r/mim, and the hydrogen peroxide consumption is 1%.

内镜下不同方式治疗难治性腐蚀性食管狭窄的临床研究(附3例报告)

目的探讨内镜下不同方式治疗难治性腐蚀性食管狭窄的临床疗效。方法回顾性分析3例分别行内镜探条扩张术、支架植入术及内镜下推进式放射状切开术(EPRD)治疗难治性腐蚀性食管狭窄患者的临床资料。结果经反复内镜治疗后,3例患者均获得良好的治疗效果,术中及术后均未出现大出血和穿孔等严重并发症,并且随着治疗次数增多,狭窄缓解时间越长,吞咽困难改善也越明显。3种治疗方式中,支架植入术对吞咽困难的改善效果最明显。结论内镜探条扩张术、支架植入术及EPRD治疗难治性食管狭窄均是安全可行且有效的方法。

Trans-umbilical endoscopic cholecystectomy with a water-jet hybrid-knife:A pilot animal study

AIM:To investigate the feasibility and safety of Natural orifice trans-umbilical endoscopic cholecystectomy with a water-jet hybrid-knife in a non-survival porcine model.METHODS:Pure natural orifice transluminal endoscopic surgery(NOTES) cholecystectomy was performed on three non-survival pigs,by transumbilical approach,using a water-jet hybrid-knife. Under general anesthesia,the following steps detailed the procedure:(1) incision of the umbilicus followed by the passage of a double-channel flexible endsocope through an overtube into the peritoneal cavity;(2) establishment of pneumoperitoneum;(3) abdominal exploration;(4)endoscopic cholecystectomy:dissection of the gallbladder performed using water jet equipment,ligation of the cystic artery and duct conducted using nylon loops;and(5) necropsy with macroscopic evaluation.RESULTS:Transumbilical endoscopic cholecystectomy was successfully completed in the first and third pig,with minor bleedings. The dissection times were 137and 42 min,respectively. The total operation times were 167 and 69 min,respectively. And the lengths of resected specimen were 6.5 and 6.1 cm,respectively.Instillation of the fluid into the gallbladder bed produced edematous,distended tissue making separation safe and easy. Reliable ligation using double nylon loops insured the safety of cutting between the loops.There were no intraoperative complications or hemodynamic instability. Uncontrolled introperative bleeding occurred in the second case,leading to the operation failure.CONCLUSION:Pure NOTES trans-umbilical cholecystectomy with a water-jet hybrid-knife appears to be feasible and safe. Further investigation of this technique with long-term follow-up in animals is needed to confirm the preliminary observation.

Successful opening in-stent chronic total occlusion lesion of coronary artery by excimer laser coronary angioplasty

In percutaneous coronary intervention (PCI), chronic total occlusion (CTO) coronary artery disease still remains difficult to treat. One of the reasons for the failure is the hard of the CTO lesions that balloon is difficult to pass through or expand. Previous methods to deal with CTO lesions that cannot be passed by balloon, include selecting reinforced catheter (such as 5 in 6 guiding catheter, Guidzilla catheter, or Tornus microcatheter), guidewire extrusion or rotary grinding technology. In recent years, excimer laser coronary angioplasty (ELCA) has been gradually applied to CTO lesions. Using inert halide as the laser medium, ELCA emits a 308 nm high-intensity unidirectional light wave with absorption depth of only 50 μmL, resulting in less thermal effect and less damage to non-target lesions. In this paper, we will describe a successful PCI case of an in-stent CTO lesion using ELCA with long term coronary angiography follow-up.

Acute choroidal involvement in lupus nephritis: A case report and review of literature

BACKGROUND Systemic lupus erythematosus(SLE),characterized by the production of autoantibodies and widespread deposition of immune complexes,predominantly affects women of childbearing age.More than one-third of SLE patients present ocular manifestations.Choroidal disease is currently not completely understood,and its precise differentiation from central serous chorioretinopathy is rarely achieved.To date,no more than 60 patients with choroidal involvement have been reported.CASE SUMMARY A 37-year-old Chinese woman experienced decreased visual acuity bilaterally,accompanied by increasing periorbital swelling and severe conjunctival chemosis.Decreased breath sounds in both bases were detected via auscultation,as well as pitting edema in both ankles.SLE and lupus nephritis were diagnosed based on serositis,renal disorder,leukopenia and positive anti-Smith and anti-nuclear antibodies.Lupus choroidopathy was diagnosed based on ocular presentation and imaging. The patient was treated with systemic corticosteroids, spironolactone, hydroxychloroquine(HCQ), mycophenolate mofetil (MMF), and intravenous immunoglobulin. After 4 wkof hospitalization, the patient was discharged. Indocyanine green angiography showed no leakagefrom choroidal vessels, and ocular coherence tomography detected low amounts of subretinalfluid right before discharge. The patient was prescribed oral methylprednisolone, HCQ, and MMF.Two months after the first visit, ophthalmological examination revealed a visual acuity of 20/20bilaterally, and SLE disease activity was well controlled;her symptoms disappeared completely.CONCLUSIONHere we presented a case of lupus choroidopathy, successfully treated with systemic corticosteroids,and discussed previously reported cases, focusing on differential diagnosis with a centralserous chorioretinopathy.

Numerical simulation of tritium behavior under a postulated accident condition for CFETR TEP system

China Fusion Engineering Test Reactor(CFETR)is China's self-designed and ongoing next-generation fusion reactor project.Tritium confinement systems in CFETR guarantee that the radiation level remains below the safety limit during tritium handling and operation in the fuel cycle system.Our tritium technology team is responsible for studying tritium transport behavior in the CFETR tritium safety confinement systems of the National Key R&D Program of China launched in 2017,and we are conducting CFETR tritium plant safety analysis by using CFD software.In this paper,the tritium migration and removal behavior were studied under a postulated accident condition for the Tokamak Exhaust Processing system of CFETR.The quantitative results of the transport behavior of tritium in the process room and glove box during the whole accident sequence(e.g.,tritium release,alarm,isolation,and tritium removal)have been presented.The results support the detailed design and engineering demonstration-related research of CFETR tritium plant.

Malignant proliferative ependymoma of the neck with lymph node metastasis:A case report

BACKGROUND Malignant proliferating trichilemmal tumor(MPTT)is an infrequent malignant neoplasm originating from cutaneous appendages,with only a handful of documented cases.This report delineates a unique instance of MPTT situated in the neck,accompanied by lymph node metastasis.A comprehensive exposition of its clinical trajectory and imaging manifestation is presented,aiming to enhance comprehension and management of this atypical ailment.CASE SUMMARY Patient concerns:A 79-year-old male presented with a longstanding right neck mass persisting for over six decades,exhibiting recent enlargement over the past year.Diagnoses:Enhanced magnetic resonance imaging of the neck unveiled an elliptical mass on the right neck side,characterized by an ill-defined border and a heterogeneous signal pattern.The mass exhibited subdued signal intensity on T1-weighted imaging(T1WI)and a heterogeneous high signal on T2-weighted imaging(T2WI),interspersed with a lengthy T1 and T2 cystic signal motif.Close anatomical association with the submandibular gland joint was noted,and intravenous gadolinium diethylene triamine pentaacetic acid administration facilitated conspicuous enhancement.Substantial enhancement of the solid segment prompted an initial preoperative diagnosis of malignant nerve sheath tumor.However,post-surgery histopathological and immunohistochemical analysis conclusively confirmed the diagnosis as malignant hyperplastic external hair root sheath tumor.Intervention:Complete excision of the tumor was successfully executed.Outcomes:The patient experienced a favorable postoperative recovery.CONCLUSION Malignant proliferative trichilemmal tumor external hair root sheath tumor is a cystic-solid lesion,appearing as low signal on T1WI images or high signal on T2WI with enhancement of the solid component.Suspicions of malignancy are heightened when the tumor border is indistinct,tissue planes are breached,or when linear or patchy high signals are observed in the subcutaneous tissue on T1 liver acquisition with volume acceleration enhanced images along with intermediate signal on T2WI and restricted diffusion on diffusion-weighted imaging images.Strong consideration for malignancy should arise if there are signs of compromised adjacent tissue relationships or direct invasion evident on imaging.We have incorporated the above-mentioned content into the entire manuscript.

A feasibility study of jaw thrust as an indicator assessing adequate depth of anesthesia for insertion of supraglottic airway device in morbidly obese patients

Background:Jaw thrust has been proven as a useful test determining adequate depth of anesthesia for successful insertion of supraglottic airway device (SAD) in normal adults and children receiving intra-venous or inhalational anesthesia induction.This prospective observational study aimed to determine the feasibility and validity of this test when using as an indicator assessing adequate depth of anesthesia for successful insertion of SAD in spontaneously breathing morbidly obese patients receiving sevoflurane inhalational induction.Methods:Thirty morbidly obese patients with a body mass index 40 to 73 kg/m2 undergoing bariatric surgery in Beijing Friendship Hospital from October 2018 to January 2019 were included in this study.After adequate pre-oxygenation,5% sevoflurane was inhaled and inhalational concentration of sevoflurane was increased by 1% every 2 min.After motor responses to jaw thrust disappeared,a SAD was inserted and insertion conditions were graded.The anatomic position of SAD was assessed using a fiberoptic bronchoscope.Results:The SAD was successfully inserted at the first attempt in all patients.Insertion conditions of SAD were excellent in nine patients (30%) and good in 21 patients (70%),respectively.The fiberoptic views of SAD position were adequate in 28 patients (93%).Conclusions:Jaw thrust test is a reliable indicator determining adequate anesthesia depth of sevoflurane inhalational induction for successful insertion of SAD in spontaneously breathing morbidly obese patients.

Bacterial degradation of anthraquinone dyes

Anthraquinone dyes,which contain anthraquinone chromophore groups,are the second largest class of dyes after azo dyes and are used extensively in textile industries.The majority of these dyes are resistant to degradation because of their complex and stable structures;consequently,a large number of anthraquinone dyes find their way into the environment causing serious pollution.At present,the microbiological approach to treating printing and dyeing wastewater is considered to be an economical and feasible method,and reports regarding the bacterial degradation of anthraquinone dyes are increasing.This paper reviews the classification and structures of anthraquinone dyes,summarizes the types of degradative bacteria,and explores the possible mechanisms and influencing factors of bacterial anthraquinone dye degradation.Present research progress and existing problems are further discussed.Finally,future research directions and key points are presented.

The Case of Using Multiple Streams in Streaming

Off-chip replacement （capacity and conflict） and coherent read misses in a distributed shared memory system cause execution to stall for hundreds of cycles. These off-chip replacement and coherent read misses are recurring and forming sequences of two or more misses called streams. Prior streaming techniques ignored reordering of misses and not-recently-accessed streams while streaming data. In this paper, we present stream prefetcher design that can deal with both problems. Our stream prefetcher design utilizes stream waiting rooms to store not-recently-accessed streams. Stream waiting rooms help remove more off-chip misses. Using trace based simulation% our stream prefetcher design can remove 8% to 66% （on average 40%） and 17% to 63% （on average 39%） replacement and coherent read misses, respectively. Using cycle-accurate full-system simulation, our design gives speedups from 1.00 to 1.17 of princeton application repository for shared-memory computers （PARSEC） workloads running on a distributed shared memory system with the exception of dedup and swaptions workloads.

One-pot solvothermal synthesis of ZnTe/RGO nanocomposites and enhanced visible-light photocatalysis

Zinc telluride/reduced graphene oxide （ZnTe/RGO） nanocomposites are synthesized by a one-pot, facile, solvothermal process using hydrazine hydrate as the reducing agent. Hydrazine hydrate not only promoted the formation ofZnTe nanoparticles but also reduced GO to RGO. The formation of ZnTe/RGO is demonstrated by different techniques. In addition, the experimental results suggest a possible formation mechanism of these nanocomposites. Finally, due to the transfer of the photo-generated electrons between ZnTe and RGO resulting in low electrons/holes recombination, the as-prepared nanocomposites of ZnTe/RGO exhibited strongly enhanced photocatalytic activity for the bleaching of methyl blue （MB） dye under visible light irradiation.

A safe strategy for anesthesia induction and airway management in morbidly obese patients

To the Editor:Morbidly obese patients are known to be difficult for facemask ventilation and tracheal intubation,leading to an increased risk for a "cannot intubate cannot ventilate" situation.Awake tracheal intubation is often considered as one of the safest strategies for anesthesia induction and airway management in patients with known or predicted difficult airways,but the technique itself is an uncomfortable procedure.

Clinical Factors Affecting Platelet Growth in the Treatment of Aplastic Anemia by Tonifying Kidney and Generating Blood

Objective:To investigate the influence of kidney-tonifying and blood-generating method on platelet(PLT)growth in the treatment of aplastic anemia(AA)and analyze the characteristics of the clinical factors affecting PLT growth.We enrolled patients treated from September 2018to March 2021 in the China Academy of Traditional Chinese Medicine(TCM)Xiyuan Hospital,China Academy of TCM hospital gate 19sub-center.We enrolled 128 AA patients,for whom the inclusion criteria were:treatment is given priority to with kidney and heart's-blood method,on the basis of western medicine treatment for kidney fill party avoid Fried instant particles,stay for 3 months for a period of treatment,taking two consecutive period of treatment,changes in the PLT were observed,and the clinical characteristics of AA patients,such as PLT growth and recovery from baseline value,were analyzed.Materials and Methods:A total of 128 AA patients from 19 branches of Xiyuan Hospital,China Academy of Chinese Medical Sciences and Guang'anmen Hospital,China Academy of Chinese Medical Sciences treated from September 2018 to March 2021 were enrolled.The treatment was based on the kidney-tonifying and blood-generating method and lasted for 3 months as a course of treatment.The changes in the number of PLT in patients were observed,and the clinical characteristics of AA affecting PLT growth and recovery from baseline value were analyzed.Results:After 6 months of treatment following the kidney-tonifying and blood-generating method,PLT increased from the baseline values in 75 cases,including 21 cases of AA with normal PLT recovery and 54 cases of AA without normal PLT recovery.There were 53 cases of AA in whom PLT did not increase from the baseline.Analysis of the general data showed that patients with lower Karnofsky Performance Status(KPS)score were more likely to experience PLT growth or even return to normal after therapy(P<0.05).The results of routine blood analysis showed that when hemoglobin(HGB)was≥60 g/L and the reticulocyte(RET)proportion was≥0.3%before treatment,PLTs were more likely to increase,even returning to normal in some patients(P<0.05).Analysis of bone puncture results before treatment showed that when the proliferation of nucleated cells was low or extremely low in bone puncture examination,with the proportion of granulocytes<40%,and the proportion of erythroid cells<20%,the treatment method was more effective at increasing PLT count(P<0.05).Analysis of the chromosome karyotype results before treatment showed that when the chromosome karyotype was normal,PLTs were more likely to increase or even return to normal after treatment(P<0.05).Analysis of T-lymphocyte subsets before treatment showed that when CD3+human leukocyte antigen(HLA)-DR+proportion was≥30%,PLTs were more likely to increase or even return to normal(P<0.05).Conclusions:AA patients with a low KPS score,higher HGB≥60 g/L,RET proportion≥0.3%,low or extremely low proliferation of nucleated cells,granulocytes proportion<40%,erythroid proportion<20%,normal chromosome karyotype,CD3+HLA-DR+≥30%,should be treated with a kidney-tonifying and blood-generating method.Such patients are more likely to show PLT growth and the values may even return to normal.

A bismuth(Ⅲ) PVC membrane ion selective electrode based on5-(3,4,5-trimethoxyphenyl)-4-amino-1,2,4-triazole-3-thiol

The construction,performance characteristics and application of a new bismuth（Ⅲ） PVC membrane electrode based on 5-（3,4,5-trimethoxyphenyl）-4-amino-1,2,4-triazole-3-thiol are reported in this paper.The designed sensor exhibited a Nernstian response for Bi^3＋ ion ranging from 5.0×10^-7 mol/L to1.0×10^-2 mol/L with a slope of 19.8 mV/decade.The operational pH range of the sensor is 3.0-6.0.The electrode shows a response time of 6 s and can be used for at least five weeks without any considerable divergence in potentials.It exhibits very good selectivity relative to a wide variety of alkali,alkaline earth,transition and heavy metal ions.The proposed electrode could be used as an indicator electrode in potentiometric titration of Bi^3＋ ions with EDTA and in the determination of Bi^3＋ content in stomach medicine.