Acquired methemoglobinemia in a third trimester puerpera and her premature infant with sodium nitrite poisoning:A case report

BACKGROUND The common cause of sodium nitrite poisoning has shifted from previous accidental intoxication by exposure or ingestion of contaminated water and food to recent alarming intentional intoxication as an employed method of suicide/exit.The subsequent formation of methemoglobin(MetHb)restricts oxygen transport and utilization in the body,resulting in functional hypoxia at the tissue level.In clinical practice,a mismatch of cyanotic appearance and oxygen partial pressure usually contributes to the identification of methemoglobinemia.Prompt recognition of characteristic mismatch and accurate diagnosis of sodium nitrite poisoning are prerequisites for the implementation of standardized systemic interventions.CASE SUMMARY A pregnant woman was admitted to the Department of Critical Care Medicine at the First Affiliated Hospital of Harbin Medical University due to consciousness disorders and drowsiness 2 h before admission.Subsequently,she developed vomiting and cyanotic skin.The woman underwent orotracheal intubation,invasive mechanical ventilation(IMV),and correction of internal environment disturbance in the ICU.Her premature infant was born with a higher-than-normal MetHb level of 3.3%,and received detoxification with methylene blue and vitamin C,supplemental vitamin K1,an infusion of fresh frozen plasma,as well as respiratory support via orotracheal intubation and IMV.On day 3 after admission,the puerpera regained consciousness,evacuated the IMV,and resumed enteral nutrition.She was then transferred to the maternity ward 24 h later.On day 7 after admission,the woman recovered and was discharged without any sequelae.CONCLUSION MetHb can cross through the placental barrier.Level of MetHb both reflects severity of the sodium nitrite poisoning and serves as feedback on therapeutic effectiveness.

网络游戏助力中华文明对外传播路径探析——以《原神》为例

互联网诞生以来,网络游戏以其互动性、趣味性吸引了一大波受众,同时网络游戏本身具有承载信息、讲述故事并进一步传播文化的功能,如何实现其正向传播价值值得我们关注。本文从网络游戏角度出发,研究其对于中华文明传播的价值与具体路径,在对当前网络游戏传播中华文明问题现状进行分析的基础上,以网游《原神》为例,探析其在游戏视听、情节设计等方面对中国浅层形象与深层观念的传播效果,最终从技术升级、文创开发、政策推进、产品多元化四个方面提出建议,以期为国产网络游戏对中华文明、中华传统文化的创造性转化与传播提供一定的思路。

人口信息人像比对系统评测方法研究与实践

由于受技术发展和资金投入等多方面因素的制约,人口管理工作中存在的一些重大问题始终难以解决,如虚假身份、多重户口、一人多证、漂白身份等问题。本文对人脸图像数据库的设计和创建、人脸识别系统的指标评测两方面问题开展研究,通过完善技术手段,加强户籍管理。

Procalcitionin as a diagnostic marker to distinguish upper and lower gastrointestinal perforation

AIM To assess the accuracy of serum procalcitionin(PCT)as a diagnostic marker in verifying upper and lower gastrointestinal perforation(GIP).METHODS This retrospective study included 46 patients from the surgical intensive care unit(ICU)of the Second Affiliated Hospital of Harbin Medical University who were confirmed to have GIP between June 2013 and December 2016.Demographic and clinical patient data were recorded on admission to ICU.Patients were divided into upper(n=19)and lower(n=27)GIP groups according to the perforation site(above or below Treitz ligament).PCT and WBC count was obtained before laparotomy and then compared between groups.Meanwhile,the diagnostic accuracy of PCT was analyzed.RESULTS Patients with lower GIP exhibited significantly higher APACHE II score,SOFA score and serum PCT level than patients with upper GIP(P=0.017,0.004,and0.001,respectively).There was a significant positive correlation between serum PCT level and APACHE II score or SOFA score(r=0.715 and r=0.611,respectively),while there was a significant negative correlation between serum PCT level and prognosis(r=-0.414).WBC count was not significantly different between the two groups,and WBC count showed no significant correlation with serum PCT level,APACHE II score,SOFA score or prognosis.The area under the receiver operating characteristic curve of PCT level to distinguish upper or lower GIP was 0.778.Patients with a serum PCT level above 17.94 ng/d L had a high likelihood of lower GIP,with a sensitivity of 100%and a specificity of 42.1%.CONCLUSION Serum PCT level is a reliable and accurate diagnostic marker in identifying upper or lower GIP before laparotomy.

RNA interference-mediated gene silencing of vascular endothelial growth factor in colon cancer cells

AIM： TO inhibit the expression of vascular endothelial growth factor （VEGF） in colon cancer cell line by RNA interference （RNAi）.METHODS： Followed the service of E-RNAi, we designed and constructed two kinds of shRNA expression vectors aiming at the VEGF gene, then transfected them into colon cancer HT29 cells by lipofectamineTM 2000. The level of VEGF mRNA was investigated by RT-PCR and Northern blotting. The protein expression of VEGF was observed by immunofluoresence staining and Western blotting.RESULTS： We got two kinds of VEGF specific shRNA expression vectors which could efficiently inhibit the expression of VEGF in HT29 cells. RT-PCR, Northern blotting, immunofluoresence staining and Western blotting showed that inhibition rate for VEGF expression was up to 42%, 89%, 73% and 82%, respectively.CONCLUSION： The expression of VEGF can be inhibited by RNA interference in HT29 cells.

Brain-derived neurotrophic factor inhibits glucose intolerance after cerebral ischemia

Brain-derived neurotrophic factor is associated with the insulin signaling pathway and glucose me- tabolism. We hypothesized that expression of brain-derived neurotrophic factor and its receptor may be involved in glucose intolerance following ischemic stress. To verify this hypothesis, this study aimed to observe the changes in brain-derived neurotrophic factor and tyrosine kinase B receptor expression in glucose metabolism-associated regions following cerebral ischemic stress in mice. At day 1 after middle cerebral artery occlusion, the expression levels of brain-derived neurotrophic factor were significantly decreased in the ischemic cortex, hypothalamus, liver, skeletal muscle, and pancreas. The expression levels of tyrosine kinase B receptor were decreased in the hypothalamus and liver, and increased in the skeletal muscle and pancreas, but remained unchanged in the cortex Intrahypothalamic administration of brain-derived neurotrophic factor （40 ng） suppressed the de- crease in insulin receptor and tyrosine-phosphorylated insulin receptor expression in the liver and skeletal muscle, and inhibited the overexpression of gluconeogenesis-associated phosphoenolpy- ruvate carboxykinase and glucose-6-phosphatase in the liver of cerebral ischemic mice. However, serum insulin levels remained unchanged. Our experimental findings indicate that brain-derived neurotrophic factor can promote glucose metabolism, reduce gluconeogenesis, and decrease blood glucose levels after cerebral ischemic stress. The low expression of brain-derived neurotrophic factor following cerebral ischemia may be involved in the development of glucose intolerance.

Comparison of demographic features and laboratory parameters between COVID-19 deceased patients and surviving severe and critically ill cases

BACKGROUND Coronavirus disease 2019(COVID-19) has been far more devastating than expected, showing no signs of slowing down at present. Heilongjiang Province is the most northeastern province of China, and has cold weather for nearly half a year and an annual temperature difference of more than 60℃, which increases the underlying morbidity associated with pulmonary diseases, and thus leads to lung dysfunction. The demographic features and laboratory parameters of COVID-19 deceased patients in Heilongjiang Province, China with such climatic characteristics are still not clearly illustrated.AIM To illustrate the demographic features and laboratory parameters of COVID-19 deceased patients in Heilongjiang Province by comparing with those of surviving severe and critically ill cases.METHODS COVID-19 deceased patients from different hospitals in Heilongjiang Province were included in this retrospective study and compared their characteristics with those of surviving severe and critically ill cases in the COVID-19 treatment center of the First Affiliated Hospital of Harbin Medical University. The surviving patients were divided into severe group and critically ill group according to the Diagnosis and Treatment of New Coronavirus Pneumonia(the seventh edition).Demographic data were collected and recorded upon admission. Laboratory parameters were obtained from the medical records, and then compared among the groups.RESULTS Twelve COVID-19 deceased patients, 27 severe cases and 26 critically ill cases were enrolled in this retrospective study. No differences in age, gender, and number of comorbidities between groups were found. Neutrophil percentage(NEUT%), platelet(PLT), C-reactive protein(CRP), creatine kinase isoenzyme(CK-MB), serum troponin I(TNI) and brain natriuretic peptides(BNP) showed significant differences among the groups(P = 0.020, P = 0.001, P < 0.001, P = 0.001, P < 0.001, P <0.001, respectively). The increase of CRP, D-dimer and NEUT% levels, as well as the decrease of lymphocyte count(LYMPH) and PLT counts, showed significant correlation with death of COVID-19 patients(P = 0.023, P = 0.008, P = 0.045, P = 0.020, P = 0.015, respectively).CONCLUSION Compared with surviving severe and critically ill cases, no special demographic features of COVID-19 deceased patients were observed, while some laboratory parameters including NEUT%, PLT, CRP, CK-MB, TNI and BNP showed significant differences. COVID-19 deceased patients had higher CRP, D-dimer and NEUT% levels and lower LYMPH and PLT counts.

Remote nursing training model combined with proceduralization in the intensive care unit dealing with patients with COVID-19

The shortage of personal protective equipment and lack of proper nursing training have been endangering health care workers dealing with coronavirus disease 2019(COVID-19).In our treatment center,the implementation of a holistic care model of time-sharing management for severe and critical COVID-19 patients has further aggravated the shortage of intensive care unit(ICU)professional nurses.Therefore,we developed a short-term specialized and targeted nursing training program to help ICU nurses to cope with stress and become more efficient,thus reducing the number of nurses required in the ICU.In order to avoid possible human-to-human spread,small teaching classes and remote training were applied.The procedural training mode included four steps:preparation,plan,implementation,and evaluation.An evaluation was conducted throughout the process of nursing training.In this study,we documented and shared experiences in transitioning from traditional face-to-face programs to remote combined with proceduralization nursing training mode from our daily work experiences during the COVID-19 pandemic,which has shown to be helpful for nurses working in the ICU.

Exploration of transmission chain and prevention of the recurrence of coronavirus disease 2019 in Heilongjiang Province due to inhospital transmission

The coronavirus disease 2019(COVID-19)epidemic is a major public health emergency characterized by fast spread,a wide range of infections,and enormous control difficulty.Since the end of December 2019,Wuhan has become the first core infection area of China's COVID-19 outbreak.Since March 2020,the domestic worst-hit areas have moved to the Heilongjiang Province due to the increased number of imported COVID-19 cases.Herein,we reported the major COVID-19 outbreak,which caused a rebound of the epidemic in Harbin,China.After the rebound,different levels of causes for the recurrence of COVID-19,including citylevel,hospital-level,and medical staff-level cause,were investigated.Meanwhile,corresponding countermeasures to prevent the recurrence of the epidemic were also carried out on the city level,hospital level,and medical staff level,which eventually showed the effect of infection control function in a pandemic.In this study,we described the complete transmission chain,analyzed the causes of the outbreak,and proposed corresponding countermeasures from our practical clinical experience,which can be used as a valuable reference for COVID-19 control.

Pembrolizumab-induced Stevens-Johnson syndrome in advanced squamous cell carcinoma of the lung:A case report and review of literature

BACKGROUND For advanced lung squamous cell carcinoma,immune checkpoint inhibitors(ICIs)have been regarded as one of the optimal therapies.While immune-related adverse events(ir AEs)are common in ICI treatment,cutaneous toxicities are among the most common ir AEs.Most immune-related skin toxicity grades are low,and the prognosis is good.However,Stevens-Johnson syndrome(SJS)is a rare but extremely severe cutaneous adverse drug reaction with high mortality.CASE SUMMARY We report a rare case of SJS induced by pembrolizumab.The case involved a 68-year-old female who was diagnosed with advanced squamous cell carcinoma of the lung.SJS appeared after one cycle of immunotherapy combined with chemotherapy.After treatment with prednisone hormone symptoms,antiinfection,gamma globulin,and antipruritic agents,the skin toxicity of the patients gradually decreased and eventually disappeared.Although the antitumor treatment was stopped due to serious adverse reactions,the tumor of the patient remained stable for nearly half a year after one cycle of immune therapy combined with chemotherapy,which also corroborates the delayed effect of immunotherapy.CONCLUSION We believe our report can provide some references for the treatment of SJS and the treatment of immune-related adverse reactions.

RNA Interference-Mediated Gene Silencing of Vascular Endothelial Growth Factor

OBJECTIVE To inhibit the expression of the vascular endothelial growth factor (VEGF) by RNA interference, and to observe the effect in different cells line. METHODS Using the services of E-RNAi, we designed and constructed two kinds of shRNAs expression vectors which were aimed at the VEGF gene. These vectors were then transfected into HEK293, colon cancer HT29, Hela and HepG2 cells by LipofectamineTM 2000. The level of VEGF mRNA was determined by RT-PCR and Northern blotting and the VEGF expression was examined by immunofluoresence staining. RESULTS The two kinds of VEGF specific shRNAs expression vectors were found to efficiently inhibit the expression of VEGF in HEK293 and HT29 cells by RT-PCR analysis, with inhibition rates of 72% and 42%, respectively; but the inhibition rates were reduced to 28% in Hela cells and 13% in HepG2 cells. Northern blotting showed that the inhibition rates of VEGF mRNA expression were 88% and 89% in HEK293 and HT29 cells, respectively. The inhibition rate of VEGF protein expression in HT29 cells was 73% based on immunofluoresence staining. CONCLUSION The expression of VEGF was inhibited by RNA interference, but differed with various cells lines, showing that RNA interference was cell-line dependent.

Key Radar Signal Sorting and Recognition Method Based on Clustering Combined with PRI Transform Algorithm

In this paper,we investigate the problem of key radar signal sorting and recognition in electronic intelligence(ELINT).Our major contribution is the development of a combined approach based on clustering and pulse repetition interval(PRI)transform algorithm,to solve the problem that the traditional methods based on pulse description word(PDW)were not exclusively targeted at tiny particular signals and were less time-efficient.We achieve this in three steps:firstly,PDW presorting is carried out by the DBSCAN(Density-Based Spatial Clustering of Applications with Noise)clustering algorithm,and then PRI estimates of each cluster are obtained by the PRI transform algorithm.Finally,by judging the matching between various PRI estimates and key targets,it is determined whether the current signal contains key target signals or not.Simulation results show that the proposed method should improve the time efficiency of key signal recognition and deal with the complex signal environment with noise interference and overlapping signals.

Identification of tRNA-derived Fragments and Their Potential Roles in Atherosclerosis

Objective Atherosclerosis(AS),a chronic inflammatory disease,is the basis of cardiovascular disease(CVD).Although the treatment has been greatly improved,AS still imposes a large burden on human health and the medical system,and we still need to further study its pathogenesis.As a novel biomolecule,transfer RNA-derived fragments(tRFs)play a key role in the progression of various disease.However,whether tRFs contribute to atherosclerosis pathogenesis remains unexplored.Methods With deep sequencing technology,the change of tRFs expression profiles in patients with AS compared to healthy control group was identified.The accuracy of the sequencing data was validated using RT qPCR.Subsequently,we predicted the potential target genes of tRFs by online miRNA target prediction algorithms.The potential functions of tRFs were evaluated with Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses.Results There were 13 tRFs differentially expressed between patients with AS and healthy controls,of which 2 were up-regulated and 11 were down-regulated.Validation by RT-qPCR analysis confirmed the sequencing results,and tRF-Gly-GCC-009 was highly up-regulated in the AS group based on the results of sequencing which was confirmed by RT-qPCR analysis.Furthermore,GO enrichment and KEGG pathway analyses indicated that 10 signaling pathways were related to tRF-Gly-GCC-009.These pathways might be physiopathological fundamentals of AS,mainly involving in Apelin signaling,Notch signaling and calcium signaling.Conclusion The results of our study provide important novel insight into the underlying pathogenesis and demonstrate that tRFs might be potential biomarkers and therapeutic targets for AS in the future.

为关联感设计：面向老年人的交互服务设计探索

在过去的几十年里,我们经历了人类预期寿命的大幅提高,与此同时,人口老龄化也成为了一个世界性的现象,在安全、移动、卫生保健和社会福利等各个领域都带来了严峻的挑战。随着老龄过程中身心健康水平的下降和社交圈的缩小,老年人往往挣扎于维系良好生活质量和社会关系的过程中。与此同时,互联网和相关技术的快速发展却也为研究人员和设计师们带来了新的机遇以改善老年人与他人交流沟通的体验、减少老年群体被社会孤立的风险。随着数字生活和现实生活的逐渐融合,通过实体交互与嵌入现实环境的相关技术来帮助老年人等相对远离数字生活的群体重返大众网络的研究探索展现出新的潜力。在本文中,我们主要介绍三个案例研究,分别着眼于老年人的三个典型情境,旨在提高他们与他人的社会联系。基于这些设计实践中的经验,我们探讨了以支持、改善老年人社交生活为目的的交互设计在老年公寓环境中的潜力和未来可能的方向。

INFLUENCES OF ACID POST-TREATMENT ON THE MORPHOLOGY OF SOAP-FREE P(MMA-EA-MAA)PARTICLES PREPARED BY SEEDED EMULSION POLYMERIZATION

Soap-free poly（methyl methacrylate-ethyl acrylate-methacrylic acid） latex particles with narrow size distribution were synthesized by seeded emulsion polymerization, and the porous particles were created by a stepwise alkali/acid treatment method. Effects of acid treatment conditions on the particle morphology were investigated. Results show that one to three pores were formed inside most of particles after post-treatment. At pH 7.0, when the treatment temperature was lower than 70℃, the size of particles and the volume of pores remained almost unchanged, and these two values increased significantly when the temperature was higher than 70℃. Both the particle size and the pore volume decreased with the increase of initial pH value and treatment time in the acid treatment. As the pH was below 4.0 and the treatment time was longer than 180 min, the particles shrunk in size.

A Software Defined Open Wi-Fi Platform

Wireless local area network(WLAN) is an indivisible part of the next generation wireless system. In this paper, an open Wi-Fi platform is designed and developed with special consideration of real-time signal processing. Such system can help accelerate research and development of future wireless network, especially in the case of cellular/Wi-Fi co-existing networks. This platform is based on the Intel general-purpose processor and the universal software radio peripheral(USRP) radio front end. The design including the physical layer implementations is purely software and is optimized for real-time signal processing on the general purpose processor. In the lab experiment, this platform supports baseband rate up to 700 Mbps with 2 transmitters in 80 MHz bandwidth. A cellular-Wi-Fi signaling interface between the Wi-Fi access point(AP) and the 5G core network is also developed and validated as an example for wireless resource allocation.

Standardization of critical care management of non-critically ill patients with COVID-19

The large global outbreak of coronavirus disease 2019(COVID-19)has seriously endangered the health care system in China and globally.The sudden surge of patients with severe acute respiratory syndrome coronavirus 2 infection has revealed the shortage of critical care medicine resources and intensivists.Currently,the management of non-critically ill patients with COVID-19 is performed mostly by non-intensive care unit(ICU)physicians,who lack the required professional knowledge,training,and practice in critical care medicine,especially in terms of continuous monitoring of the respiratory function,intervention,and feedback on treatment effects.This clinical problem needs an urgent solution.Therefore,here,we propose a series of clinical strategies for non-ICU physicians aimed at the standardization of the management of non-critically ill patients with COVID-19 from the perspective of critical care medicine.Isolation management is performed to facilitate the implementation of hierarchical monitoring and intervention to ensure the reasonable distribution of scarce critical care medical resources and intensivists,highlight the key patients,timely detection of disease progression,and early and appropriate intervention and organ function support,and thus improve the prognosis.Different management objectives are also set based on the high-risk factors and the severity of patients with COVID-19.The approaches suggested herein will facilitate the timely detection of disease progression,and thus ensure the provision of early and appropriate intervention and organ function support,which will eventually improve the prognosis.

Holistic care model of time-sharing management for severe and critical COVID-19 patients

The rapid global outbreak of coronavirus disease 2019(COVID-19)and the surge of infected patients have led to the verge of exhaustion of critical care medicine resources worldwide,especially with regard to critical care staff.A holistic care model on time-sharing management for severe and critical COVID-19 patients is proposed,which includes formulation of individualized care objectives and plans,identification of care tasks in each shift and making detailed checklist,and management of quality of care.This study was conducted in the COVID-19 treatment center of Harbin,Heilongjiang Province.The data collected from the treatment center were recorded and analyzed.From the results we can deduce that it is especially suitable for non-intensive care unit(non-ICU)nurses to adapt care management mode of ICU as soon as possible and ensure the quality and efficiency of care during the epidemic.The holistic care model on time-sharing management for severe and critical cases with COVID-19 proposed based on our daily work experiences can assist in improving the quality and efficiency of care,thus reducing the mortality rate of patients in ICU.

COVID-19 patient with an incubation period of 27 d:A case report

BACKGROUND As a highly contagious disease,coronavirus disease 2019(COVID-19)is wreaking havoc around the world due to continuous spread among close contacts mainly via droplets,aerosols,contaminated hands or surfaces.Therefore,centralized isolation of close contacts and suspected patients is an important measure to prevent the transmission of COVID-19.At present,the quarantine duration in most countries is 14 d due to the fact that the incubation period of severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2)is usually identified as 1-14 d with median estimate of 4-7.5 d.Since COVID-19 patients in the incubation period are also contagious,cases with an incubation period of more than 14 d need to be evaluated.CASE SUMMARY A 70-year-old male patient was admitted to the Department of Respiratory Medicine of The First Affiliated Hospital of Harbin Medical University on April 5 due to a cough with sputum and shortness of breath.On April 10,the patient was transferred to the Fever Clinic for further treatment due to close contact to one confirmed COVID-19 patient in the same room.During the period from April 10 to May 6,nucleic acid and antibodies to SARS-CoV-2 were tested 7 and 4 times,respectively,all of which were negative.On May 7,the patient developed fever with a maximum temperature of 39℃,and his respiratory difficulties had deteriorated.The results of nucleic acid and antibody detection of SARS-CoV-2 were positive.On May 8,the nucleic acid and antibody detection of SARS-CoV-2 by Heilongjiang Provincial Center for Disease Control were also positive,and the patient was diagnosed with COVID-19 and reported to the Chinese Center for Disease Control and Prevention.CONCLUSION This case highlights the importance of the SARS-CoV-2 incubation period.Further epidemiological investigations and clinical observations are urgently needed to identify the optimal incubation period of SARS-CoV-2 and formulate rational and evidence-based quarantine policies for COVID-19 accordingly.

Clinical Efficacy of Mixing Natural Teeth and Implant Supported Denture Sleeve

Objective:To analyze the clinical efficacy of Mixing natural teeth and implant supported denture sleeve,and provide reference for clinical treatment.Methods:46 patients with Molarless in hospital from December 2010-December 2014 were selected,patients were randomly divided into observer group and control group,two groups of patients were designed and planted natural teeth fixed bridge and natural teeth and implants mixed support sleeve denture,regular follow patients and the surrounding alveolar bone height changes,5-year cumulative retention rate,clinical efficiency and other indicators.Results:During clinical observation,patients with no obvious symptoms,the use of feel good,no loose superstructure situation.Two groups of patients were 2 cases of patients with implant loosening occurs,the amount of bone resorption annual observation group(0.22±0.10)mm less than the control group(0.24±0.08)mm,but no significant difference(P>0.05),clinical observation group efficiency(100%)was significantly higher(72.3%)(P<0.05),the observation group study implants 5-year cumulative retention rate was 94.4%.Conclusion:Mixing natural teeth and implant-supported telescopic denture success rate of 100%was observed during the clinical results were satisfactory,with use value.