Textured Asymmetric Membrane Electrode Assemblies of Piezoelectric Phosphorene and Ti_(3)C_(2)T_(x)MXene Heterostructures for Enhanced Electrochemical Stability and Kinetics in LIBs

Black phosphorus with a superior theoretical capacity(2596 mAh g^(-1))and high conductivity is regarded as one of the powerful candidates for lithium-ion battery(LIB)anode materials,whereas the severe volume expansion and sluggish kinetics still impede its applications in LIBs.By contrast,the exfoliated two-dimensional phosphorene owns negligible volume variation,and its intrinsic piezoelectricity is considered to be beneficial to the Li-ion transfer kinetics,while its positive influence has not been discussed yet.Herein,a phosphorene/MXene heterostructure-textured nanopiezocomposite is proposed with even phosphorene distribution and enhanced piezo-electrochemical coupling as an applicable free-standing asymmetric membrane electrode beyond the skin effect for enhanced Li-ion storage.The experimental and simulation analysis reveals that the embedded phosphorene nanosheets not only provide abundant active sites for Li-ions,but also endow the nanocomposite with favorable piezoelectricity,thus promoting the Li-ion transfer kinetics by generating the piezoelectric field serving as an extra accelerator.By waltzing with the MXene framework,the optimized electrode exhibits enhanced kinetics and stability,achieving stable cycling performances for 1,000 cycles at 2 A g^(-1),and delivering a high reversible capacity of 524 m Ah g^(-1)at-20℃,indicating the positive influence of the structural merits of self-assembled nanopiezocomposites on promoting stability and kinetics.

Impact of Sedation Protocols on Elderly Patients Undergoing Mechanical Ventilation and Off-Line Weaning

The proportion of elderly patients in intensive care is increasing, and a significant proportion of them require mechanical ventilation. How to implement safe and effective mechanical ventilation for elderly patients, and when appropriate off-line is an important issue in the field of critical care medicine. Appropriate sedation can improve patient outcomes, but excessive sedation may lead to prolonged mechanical ventilation and increase the risk of complications. Elderly patients should be closely monitored and evaluated on an individual basis while offline, and the sedation regimen should be dynamically adjusted. This requires the healthcare team to consider the patient’s sedation needs, disease status, and pharmacodynamics and pharmacokinetics of the drug to arrive at the best strategy. Although the current research has provided valuable insights and strategies for sedation and off-line management, there are still many problems to be further explored and solved.

Tuning the product selectivity of dimethyl oxalate hydrogenation over WO_(x) modified Cu/SiO_(2) catalysts

Product selectivity and reaction pathway are highly dependent on surface structure of heterogeneous catalysts.For vapor-phase hydrogenation of dimethyl oxalate(DMO),"EG route"(DMO→methyl glycolate(MG)ethylene glycol(EG)→ethanol(ET))and"MA route"(DMO→MG→methyl acetate(MA))were proposed over traditional Cu based catalysts and Mo-based or Fe-based catalysts,respectively.Herein,tunable yield of ET(93.7%)and MA(72.1%)were obtained through different reaction routes over WO_(x) modified Cu/SiO_(2) catalysts,and the corresponding reaction route was further proved by kinetic study and in-situ DRIFTS technology.Mechanistic studies demonstrated that H_(2) activation ability,acid density and Cu-WO_(x) interaction on the catalysts were tuned by regulating the surface W density,which resulted in the different reaction pathway and product selectivity.What's more,high yield of MA produced from DMO hydrogenation was firstly reported with the H_(2) pressure as low as 0.5 MPa.

The Performance of Extracorporeal Membrane Oxygenation in Various Viral Pneumonia Pandemics: A Meta-Analysis and Systematic Review

Objective: To compare the effects of extracorporeal membrane oxygenation (ECMO) and routine mechanical ventilation on mortality and the risk of associated adverse events in patients with severe viral pneumonia. Methods: PubMed, the Cochrane Library, Embase, Web of Science, and other databases were searched to collect case-control or cohort studies on prognoses associated with ECMO treatment for viral pneumonia. Search terms included extracorporeal membrane oxygenation, ECMO, viral pneumonia, COVID-19, influenza, MERS, and others. According to the PICOS principle, two evaluators independently screened the literature, extracted the data, cross-checked the data, and extracted the data again. Two researchers evaluated the risk of bias in the included studies according to the Newcastle-Ottawa Scale (NOS) and cross-checked the results. Meta-analysis was performed using RevMan 5.3 software. Results: Nine studies were included for analysis, encompassing a total of 4,330 patients, which were categorized into ECMO and CMV groups. There were no significant differences between the two groups in most baseline data;however, the ECMO group had a lower oxygenation index, and some studies reported higher SOFA scores in the ECMO group compared to the CMV group. There was no significant difference in in-hospital mortality between the two groups. The length of ICU stay, total hospital stay, and total mechanical ventilation time were longer in the ECMO group than in the CMV group. In terms of adverse events, there was no significant difference in the occurrence of kidney injury between the two groups. Bleeding events were reported in two studies, with more bleeding events occurring in the ECMO group. According to the subgroup analysis of different virus types, there were no statistical differences in the above aspects among patients with swine flu, novel coronavirus, and MERS. Conclusion: ECMO has a certain degree of positive significance in the treatment of severe viral pneumonia, but there is no significant difference in the treatment outcome of ECMO across different epidemic periods. The timing of ECMO treatment, patient management, and withdrawal evaluation still need further research.

三代后的新一代EGFR-TKIs研究进展

肺癌是全球死亡率最高的癌种。第一、二代表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors,EGFR-TKIs)的出现,在一定程度上极大地提高了非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的生存期及生活质量,但大多数患者在经过一段时间的无进展生存期后会产生耐药性,其中以T790M突变为主要耐药机制。针对此耐药突变出现的是以奥希替尼为代表的第三代EGFR-TKIs,其效果显著,然而仍不可避免的出现耐药性,如:C797S突变、间质表皮转化(mesenchymal-epithelial transition,MET)、RAS突变、BRAF突变、小细胞肺癌(small cell lung cancer,SCLC)转化、上皮间质细胞转化(epithelial mesenchymal transition,EMT)等。但是目前第三代EGFR-TKIs耐药后并没有标准有效的治疗方案。故本文主要阐述三代后的新一代EGFRTKIs的研究进展,为后续的研究及治疗提供一定的参考。

Nonradical-dominated peroxymonosulfate activation through bimetallic Fe/Mn-loaded hydroxyl-rich biochar for efficient degradation of tetracycline

Biochar-based transition metal catalysts have been identified as excellent peroxymonosulfate(PMS)activators for producing radicals used to degrade organic pollutants.However,the radical-dominated pathways for PMS activation severely limit their practical applications in the degradation of organic pollutants from wastewater due to side reactions between radicals and the coexisting anions.Herein,bimetallic Fe/Mn-loaded hydroxyl-rich biochar(FeMn-OH-BC)is synthesized to activate PMS through nonradical-dominated pathways.The as-prepared FeMn-OH-BC exhibits excellent catalytic activity for degrading tetracycline at broad pH conditions ranging from 5 to 9,and about 85.0%of tetracycline is removed in 40 min.Experiments on studying the influences of various anions(HCO_(3)^(−),NO_(3)^(−),and H_(2)PO_(4)^(−))show that the inhibiting effect is negligible,suggesting that the FeMn-OHBC based PMS activation is dominated by nonradical pathways.Electron paramagnetic resonance measurements and quenching tests provide direct evidence to confirm that 1O2 is the major reactive oxygen species generated from FeMn-OH-BC based PMS activation.Theoretical calculations further reveal that the FeMn-OH sites in FeMn-OH-BC are dominant active sites for PMS activation,which have higher adsorption energy and stronger oxidative activity towards PMS than OH-BC sites.This work provides a new route for driving PMS activation by biochar-based transition metal catalysts through nonradical pathways.

A mixed-cation lead iodide MA_(1-x)EA_xPbI_3 absorber for perovskite solar cells

The mixed-cation lead halide perovskites have emerged as a new class of promising light harvesting materials for solar cells. The formamidinium（FA）, methylammonium（MA） and Cs cations are widely studied in the field of mixed-cation perovskites. Here, we have investigated ethylammonium（EA） as an alternative cation to fabricate a mixed-cation perovskite of MA_（1-x）EA_xPbI_3. We have characterized the materials using the X-ray diffraction（XRD）, scanning electron microscope（SEM）, and UV–vis spectrum. Our results have confirmed the successful incorporation of EA cations into MAPbI_3. Interestingly, the optimal amount of EA to achieve the best performance is quite low. This is different from the FA–MA mixed-cation perovskites although EA and FA have similar radii. In short, the EA–MA mixed-cation perovskite has some material and device properties highly distinguishable from the FA–MA one.

Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease(2020 edition)

In recent years,as living standards have continued to improve,the number of diabetes patients in China,along with the incidence of complications associated with the disease,has been increasing.Among these complications,diabetic foot disease is one of the main causes of disability and death in diabetic patients.Due to the differences in economy,culture,religion and level of medical care available across different regions,preventive and treatment methods and curative results for diabetic foot vary greatly.In multidisciplinary models built around diabetic foot,the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology.In 2019,under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society,the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease(2020 edition)was established with the participation of scholars from the specialist areas of endocrinology,burn injury,vascular surgery,orthopedics,foot and ankle surgery and cardiology.Drawing lessons from diabetic foot guidelines from other countries,this guide analyses clinical practices for diabetic foot,queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China.This paper begins with assessments and diagnoses of diabetic foot,then describes treatments for diabetic foot in detail,and ends with protections for high-risk feet and the prevention of ulcers.This manuscript covers the disciplines of internal medicine,surgical,nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot.

1,4-吡啶硫内鎓盐在有机合成中的研究与应用

1,4-吡啶硫内鎓盐是一类重要的氮硫杂合成子,其中的吡啶片段既可以作为离去基团,也可以作为亲电反应位点参与反应,构建多种类型的氮硫杂骨架.因此,近年来1,4-吡啶硫内鎓盐在含氮、含硫杂环化合物的合成应用中受到了极大的关注.基于此,系统综述了1,4-吡啶硫内鎓盐在两种反应模式([3+m]和[5+m]环合反应)下构建氮硫杂环的研究进展,总结了其在环合反应及杂环化学中的应用,并对该领域的研究前景进行了展望.