Recurrent malignant hyperthermia after scoliosis correction surgery

Malignant hyperthermia(MH)is a genetic disorder of skeletal muscle cells that affects muscle cytoplasmic calcium homeostasis,with high mortality and low morbidity.Generally,it presents with non-specific signs of a hypermetabolic response,including high fever,tachycardia,and elevated end-tidal carbon dioxide(ETCO_(2)).The successful treatment lies in the timely recognition and early use of dantrolene.[1]As an inhibitor of Ca2+release through ryanodine receptor(RYR)channels,the skeletal muscle relaxant dantrolene has proven to be both a valuable experimental probe of intracellular Ca2+signaling and a lifesaving treatment for MH.[2]Dominant mutations in the skeletal muscle RYR1 gene are well-recognized causes of both malignant hyperthermia susceptibility(MHS)and central core disease(CCD).

The effects of microRNA-34a regulating Notch-1/NF-κB signaling pathway on lipopolysaccharide-induced human umbilical vein endothelial cells

BACKGROUND: Notch-1/NF-κB signaling plays a key role in the cecal ligation and puncture(CLP)-induced sepsis. This study aims to investigate the intervention effects of microRNA-34a(miR-34a) lentivirus regulating Notch-1/NF-κB signaling pathway on lipopolysaccharide(LPS)-induced human umbilical vein endothelial cells(HUVEC).METHODS: HUVEC were divided into four groups as the following: they were infected with negative control lentivirus(NC group) or miR-34a lentivirus(OE group); LPS(1 g/mL) was added on the third day on the basis of NC group and OE group for 24 hours(NC+LPS group or OE+LPS group). The levels of TNF-α, IL-1β, IL-6, and IL-10 in the cell supernatants, and the mRNA and protein expression of Notch-1 and NF-κB in the HUVEC were evaluated.RESULTS: After 24 hours, the levels of TNF-α, IL-1β, IL-6 in the cell supernatants and the protein expression of NF-κB from NC+LPS group were significantly higher than those of NC group, but IL-10 level and the protein expression of Notch-1 in NC+LPS group were the opposite. After intervention of miR-34a lentivirus, the cell supernatants TNF-α and the protein expression of NF-κB in OE+LPS group after 24 hours markedly decreased compared to NC+LPS group. While the cell supernatants IL-1β and IL-6 and the mRNA expression of NF-κB slightly decreased in OE+LPS group, IL-10 and the mRNA and protein expression of Notch-1 were the opposite.CONCLUSION: miR-34a regulating Notch-1/NF-κB signaling pathway can reduce the HUVEC damage caused by LPS stimulation.

Method for visualizing the shear process of rock joints using 3D laser scanning and 3D printing techniques

This study presents a visualized approach for tracking joint surface morphology.Three-dimensional laser scanning(3DLS)and 3D printing(3DP)techniques are adopted to record progressive failure during rock joint shearing.The 3DP resin is used to create transparent specimens to reproduce the surface morphology of a natural joint precisely.The freezing method is employed to enhance the mechanical properties of the 3DP specimens to reproduce the properties of hard rock more accurately.A video camera containing a charge-coupled device(CCD)camera is utilized to record the evolution of damaged area of joint surface during the direct shear test.The optimal shooting distance and shooting angle are recommended to be 800 mm and 40?,respectively.The images captured by the CCD camera are corrected to quantitatively describe the damaged area on the joint surface.Verification indicates that this method can accurately describe the total sheared areas at different shear stages.These findings may contribute to elucidating the shear behavior of rock joints.

N-doped carbon nanotubes formed in a wide range of temperature and ramping rate for fast sodium storage

Herein,nickel@nitrogen-doped carbon nanotubes(Ni@NCNTs)are prepared by a simple and reliable method with Ni-based complex as single-source precursor.Significantly,the formation of CNTs is not susceptible to the calcination temperature and ramping rate and Ni@NCNTs can be attained from 430 to 900℃in an inert atmosphere.Then they are the first time to be applied as the anode material for sodium-ion batteries.The presence of Ni nanoparticles(NPs)facilitates the solid electrolyte interface film over the anode surface and improves the capacity retention of the host material,especially at the high rates.Furthermore,Na+diffusion is reinforced after the introduction of Ni NPs.Ni@NCNTs obtained at 500℃(Ni@NCNTs-500)exhibit the best capacity retention and rate capability.Kinetics analyses demonstrate the faster electron transportation and ion diffusion than others prepared at other temperatures.The surficial capacitance storage favors the fast electrochemistry kinetics.It delivers a high specific capacity(192 mA h g^−1 at 0.5 A g^−1),excellent cycling stability(103 mA h g^−1 after 10,000 cycles at 10 A g^−1),and outstanding high-rate capability up to 20 A g^−1(118 mA h g^−1).The related full cells confirm a high energy density of 140 Wh kg^−1 at 38.16 W kg^−1 and 44.27 W h kg^−1 at 762 W kg^−1.

Robust S-doped TiO_(2)@N,S-codoped carbon nanotube arrays as free-binder anodes for efficient sodium storage

Titanium dioxide(TiO_2) has been investigated broadly as a stable,safe,and cheap anode material for sodium-ion batteries in recent years.However,the poor electronic conductivity and inherent sluggish sodium ion diffusion hinder its practical applications.Herein,a self-template and in situ vulcanization strategy is developed to synthesize self-supported hybrid nanotube arrays composed of nitrogen/sulfur-codoped carbon coated sulfur-doped TiO_2 nanotubes(S-TiO_2@NS-C) starting from H_2 Ti_2 O_5-H_2 O nanoarrays.The S-TiO_2@NS-C composite with one-dimensional nano-sized subunits integrates several merits.Specifically,sulfur doping strongly improves the Na~+ storage ability of TiO_2@C-N nanotubes by narrowing the bandgap of original TiO_2.Originating from the nanoarrays structures built from hollow nanotubes,carbon layer and sulfur doping,the sluggish Na~+ insertion/extraction kinetics is effectively improved and the volume variation of the electrode material is significantly alleviated.As a result,the S-TiO_2@NS-C nanoarrays present efficient sodium storage properties.The greatly improved sodium storage performances of S-TiO_2@NS-C nanoarrays confirm the importance of rational engineering and synthesis of hollow array architectures with higher complexity.

Use of veno-arterial extracorporeal membrane oxygenation in the fi rst successful combined lung-liver transplantation patient in China

Dear editor,Extracorporeal membrane oxygenation(ECMO)is a modality of extracorporeal life support that allows for temporary support in pulmonary and/or cardiac failure refractory to conventional therapy.[1]ECMO use has been exponentially increasing over the last decade and is now considered a mainstream lifesaving treatment modality in critical care medicine.Many studies report ECMO use in patients with acute respiratory distress syndrome refractory to conventional clinical support,in-hospital cardiac arrest,and cardiogenic refractory shock.[1-3]Herein,we report the use of veno-arterial ECMO(VA-ECMO)in the first successful combined lung-liver transplantation(CLLT)patient in China.

Rare autonomic nervous system dysfunction: Alternating bilateral mydriasis

Dear editor,Pupillary abnormalities, i.e., mydriasis, pupillary arefl exia, and/or anisocoria, may indicate the occurrence of acute clinical events in intensive care units (ICUs),which are particularly seen in severe patients with brain and/or cervical spinal cord injury. The pathophysiology of benign episodic mydriasis is still not completely clear. We present a patient with severe burns presented with temporary alternating bilateral pupil enlargement accompanied by paroxysmal increases in respiration,heart rate, and blood pressure.

菜籽油和亚麻籽油对粒毛盘菌生物量和代谢产物的影响

本文主要研究了不同浓度的菜籽油和亚麻籽油对粒毛盘菌YM406生物量和代谢产物的影响。向培养基中分别添加0.5%、1%、2%、3%和4%的菜籽油和亚麻籽油进行发酵10天,发现当菜籽油浓度为1%,亚麻籽油浓度为2%时,生物量与未添加油脂的平均生物量(4.29 g/L)差距不大,分别是4.26 g/L和4.27 g/L,而其他浓度都会不同程度地抑制生物量。但同一油脂不同浓度间生物量没有显著性差异。不同浓度的菜籽油和亚麻籽油对胞外多糖(LEP)产量均有明显的抑制作用。选择添加1%菜籽油和添加2%亚麻籽油的发酵液,采用液相色谱-质谱联用技术(LC-MS),分别检测了经氯仿、乙酸乙酯萃取及未萃取的发酵液中代谢产物,检测结果显示添加1%菜籽油发酵液共检测出27种物质,添加2%亚麻籽油发酵液共检测出20种物质,添加这两种油脂的发酵液中检测出的物质只有4种相同,这说明不同类型的油脂对代谢产物类型有显著影响。添加1%菜籽油发酵液经两种萃取剂萃取后只有3种相同物质,而添加2%亚麻籽油后只有4种,说明不同萃取剂萃取后发酵液的检测结果差异明显。本研究结果表明,不同类型的油脂对粒毛盘菌YM406生物量和多糖产量具有抑制作用,并且不同浓度的油脂抑制作用不同;不同类型的油脂会影响粒毛盘菌YM406代谢产物种类。

Intensive care unit-acquired weakness: Recent insights

Intensive care unit-acquired weakness(ICU-AW)is a common complication in critically ill patients and is associated with a variety of adverse outcomes.These include the need for prolonged mechanical ventilation and ICU stay;higher ICU,in-hospital,and 1-year mortality;and increased in-hospital costs.ICU-AW is associated with multiple risk factors including age,underlying disease,severity of illness,organ failure,sepsis,immobilization,receipt of mechanical ventilation,and other factors related to critical care.The pathological mechanism of ICUAW remains unclear and may be considerably varied.This review aimed to evaluate recent insights into ICU-AW from several aspects including risk factors,pathophysiology,diagnosis,and treatment strategies;this provides new perspectives for future research.

高毒力碳青霉烯耐药肺炎克雷伯菌的院内播散与分子进化

高毒力碳青霉烯耐药肺炎克雷伯菌(Hv-CRKP)已成为全球公共卫生领域的重大挑战.该研究报告了2017年至2022年浙江一家三甲医院Hv-CRKP分离株的定植和传播情况.对来自72名患者的90个不同的CRKP菌株进行测序分析,发现院内感染Hv-CRKP的流行主要依赖于ST11-K64克隆传播.对11个代表性分离株进行了全基因组测序,得到了31个完整的质粒基因序列,其中包括12个携带KPC-2耐药基因的质粒和10个携带rmpA毒力基因的质粒.除了二元质粒外,还发现了两种可介导rmpA和KPC-2共同传播的融合质粒.研究人员通过捕获其祖先质粒,提出了该融合质粒的形成机制.此外,发现了五种rmpA启动子变异体(P9T到P13T),其活力与地理分布存在差异.通过CRISPR/Cas9基因编辑技术,证实活跃的“P11T-rmpA”调控子是“高风险”ST11-K64/CRKP克隆群的生物标志物.该研究拓展了对ST11-K64/Hv-CRKP流行性克隆的播散和临床演进的认知.

在NaCl非水离子液体中制备类石墨烯状氮硫共掺杂生物质碳材料来提高锂硫电池的动力学研究（英文）

本论文通过结构设计利用简单方法成功制备了一种二维N,S共掺杂类石墨烯纳米片复合结构,即利用NaCl非水离子液体的剥离作用使生物质剥离得到二维片层类石墨烯结构.这种新的非水离子液体剥离技术较其他的碳材料剥离技术具有环境友好性、低成本、安全无毒性等优势,有利于实现量化制备锂硫电池电极材料.该材料采用大自然中广泛存在的紫菜作为原料,其内部富含的氨基酸为原位掺杂N,S元素提供了可能性.二维结构的纳米片能够提供有效的导电性和电解液浸润性的网络结构,同时还能够有效地降低电池在充放电循环过程中导致的体积膨胀效应,最终实现一种高机械性能、优异电化学活性的电极在锂硫电池储能领域中的应用.

High N-doped hierarchical porous carbon networks with expanded interlayers for efficient sodium storage

Sodium-ion batteries (SIBs) have been attracting considerable attention as a promising candidate for large-scale energy storage because of the abundance and low-cost of sodium resources. However, lack of appropriate anode materials impedes further applications. Herein, a novel self-template strategy is designed to synthesize uniform flowerlike N-doped hierarchical porous carbon networks (NHPCN) with high content of N (15.31 at.%) assembled by ultrathin nanosheets via a self-synthesized single precursor and subsequent thermal annealing. Relying on the synergetic coordination of benzimidazole and 2-methylimidazole with metal ions to produce a flowerlike network, a self-formed single precursor can be harvested. Due to the structural and compositional advantages, including the high N doping, the expanded interlayer spacing, the ultrathin two-dimensional nano-sized subunits, and the three-dimensional porous network structure, these unique NHPCN flowers deliver ultrahigh reversible capacities of 453.7 mAh·g^−1 at 0.1 A·g^−1 and 242.5 mAh·g^−1 at 1 A·g^−1 for 2,500 cycles with exceptional rate capability of 5 A·g^−1 with reversible capacities of 201.2 mAh·g^−1. The greatly improved sodium storage performance of NHPCN confirms the importance of reasonable engineering and synthesis of hierarchical carbon with unique structures.

Efficacy of a novel endotoxin adsorber polyvinylidene fluoride fiber immobilized with L-serine ligand on septic pigs

A novel adsorber,polyvinylidene fluoride matrix immobilized with L-serine ligand (PVDF-Ser),was developed in the present study to evaluate its safety and therapeutic efficacy in septic pigs by extracorporeal hemoperfusion.Endotoxin adsorption efficiency (EAE) of the adsorber was firstly measured in vitro.The biocompatibility and hemodynamic changes during extracorporeal circulation were then evaluated.One half of 16 pigs receiving lipopolysaccharide (Escherichia coli O111:B4,5 μg/kg) intravenously in 1 h were consecutively treated by hemoperfusion with the new adsorber for 2 h.The changes of circulating endotoxin and certain cytokines and respiratory function were analyzed.The 72 h-survival rate was assessed eventually.EAE reached 46.3% (100 EU/ml in 80 ml calf serum) after 2 hcirculation.No deleterious effect was observed within the process.The plasma endotoxin,interleukin-6 (IL-6),and tumor necrosis factor-α (TNF-α) levels were decreased during the hemoperfusion.Arterial oxygenation was also improved during and after the process.Furthermore,the survival time was significantly extended (>72 h vs.47.5 h for median survival time).The novel product PVDF-Ser could adsorb endotoxin with high safety and efficacy.Early use of extracorporeal hemoperfusion with the new adsorber could reduce the levels of circulating endotoxin,IL-6,and TNF-α,besides improve respiratory function and consequent 72 h-survival rate of the septic pigs.Endotoxin removal strategy with blood purification using the new adsorber renders a potential promising future in sepsis therapy.

FMO3-TMAO axis modulates the clinical outcome in chronic heart-failure patients with reduced ejection fraction:evidence from an Asian population

The association among plasma trimethylamine-N-oxide(TMAO),FMO3 polymorphisms,and chronic heart failure(CHF)remains to be elucidated.TMAO is a microbiota-dependent metabolite from dietary choline and carnitine.A prospective study was performed including 955 consecutively diagnosed CHF patients with reduced ejection fraction,with the longest follow-up of 7 years.The concentrations of plasma TMAO and its precursors,namely,choline and carnitine,were determined by liquid chromatography-mass spectrometry,and the FMO3 E158K polymorphisms(rs2266782)were genotyped.The top tertile of plasma TMAO was associated with a significant increment in hazard ratio(HR)for the composite outcome of cardiovascular death or heart transplantation(HR=1.47,95%CI=1.13-1.91,P=0.004)compared with the lowest tertile.After adjustments of the potential confounders,higher TMAO could still be used to predict the risk of the primary endpoint(adjusted HR=1.33,95%CI=1.01-1.74,P=0.039).This result was also obtained after further adjustment for carnitine(adjusted HR=1.33,95%CI=1.01-1.74,P=0.039).The FM03 rs2266782 polymorphism was associated with the plasma TMAO concentrations in our cohort,and lower TMAO levels were found in the AA-genotype.Thus,higher plasma TMAO levels indicated increased risk of the composite outcome of cardiovascular death or heart transplantation independent of potential confounders,and the FMO3 AA-genotype in rs2266782 was related to lower plasma TMAO levels.

Bilateral lobar lung transplantation and a single lung transplantation using lungs from a single organ donor during coronavirus disease 2019 pandemic

To the Editor:During the coronavirus disease 2019(COVID-19)pandemic in China,cadaveric organ donation became drastically reduced,which exacerbated the waitlist morbidity and mortality of lung transplant(LTx)patients.We report a case where we were able to maximize the utilization of the lungs from a single cadaveric donor by performing a single left LTx for one recipient using the donor’s left lung,and by bipartitioning the donor’s right lung,we were able to perform bilateral lobar transplantation for another recipient.

Revolution of vitamin E production by starting from microbial fermented farnesene to isophytol

Vitamin E is one of the most widely used vitamins.In the classical commercial synthesis of vitamin E(a-tocopherol),the chemical synthesis of isophytol is the key technical barrier.Here,we establish a new process for isophytol synthesis from microbial fermented farnesene.To achieve an efficient pathway for farnesene production,Saccharomyces cerevisiae was selected as the host strain.First,b-farnesene synthase genes from different sources were screened,and through protein engineering and system metabolic engineering.

Analysis of the flow characteristics of the high-pressure supercritical carbon dioxide jet

The supercritical carbon dioxide(SC-CO2)jet has a wide application prospect for rock breaking and jet fracturing in the development of the unconventional shale energy,due to its special physicochemical properties.To investigate its jet flow characteristics,the high-speed photography is used in experiments and the simulations through a compressible numerical model are carried out.It is shown that the jet flow field can be divided into three typical regions,the mixing layer possesses the same characteristics as a gas/gas turbulent mixing layer,with the divergent angles evidently smaller than those of the incompressible jets.The predicted results by the numerical model are in a good agreement with those of the experimentations.Through the dimensionless analysis,the potential core shows a length of about 9d and an increasing trend with the increase of the inlet pressure while the decay rate shows a decreasing trend,and the radial profiles consistent well with the 41 Ue-η''normalized method.In addition,a significant temperature drop of the SC-CO2 is observed between the nozzle inlet and the exit.A simple and convenient semi-empirical equation for calculating this temperature variation is deduced.Finally,the flow characteristics suggest that the SC-CO2 jet should be treated as a compressible jet.

Regional Characteristics of Cloud Radiative Effects before and after the South China Sea Summer Monsoon Onset

The South China Sea summer monsoon(SCSSM)onset is characterized by rapid thermodynamical changes in the atmosphere that are critical to regional weather and climate processes.So far,few studies have focused on the changes in the associated cloud and radiative features.This study investigates spatiotemporal characteristics of topof-atmosphere(TOA)cloud radiative effects(CREs)before and after the SCSSM onset over the South China Sea(SCS)and South China(SC),based on the 2001–2016 Clouds and the Earth’s Radiant Energy System(CERES)Energy Balanced and Filled(EBAF)satellite data and ERA-Interim reanalysis data.Before the SCSSM onset,strong net CRE(NCRE)dominated by its cooling shortwave component occurs over SC,while descending motion and weak NCRE prevail over the SCS.In the SCSSM onset pentad,convection,high clouds,and longwave and shortwave CREs(LWCRE and SWCRE)abruptly increase over the southern and central SCS,and their high-value centers subsequently move northeastward and are strongly affected by the western Pacific subtropical high.The strong offset between LWCRE and SWCRE enables the NCRE intensity(TOA radiation budget)to be quite small(large)between the SCS and the western North Pacific after the SCSSM onset.In contrast,low–middle-level clouds and strong cooling SWCRE remain over SC after the SCSSM onset,but the increasing high clouds and LWCRE weaken(intensify)the regional NCRE(TOA radiation budget)intensity.These marked latitudinal differences in CREs between the SCS and SC primarily arise from their respective dominant cloud types and circulation conditions,which manifest the differences between the tropical SCSSM and subtropical East Asian monsoon processes.The results indicate that regional cloud fractions and CREs before and after the SCSSM onset are strongly modulated by quickly changed largescale circulation over the East Asian monsoon regions,and the spatiotemporal variation of CREs is a response to the monsoonal circulation adjustment to a large extent.

Genetic causal association between gut microbiota and sepsis: Evidence from a two-sample bidirectional Mendelian randomization analysis

Background Sepsis is a severe and potentially life-threatening condition characterized by a dysregulated host response and organ dysfunction.The causal relationship between intestinal microbiota and sepsis is unclear.Methods A two-sample Mendelian randomization(MR)study was performed to proxy the causal association between gut microbiota and sepsis.The genome-wide association study(GWAS)data of sepsis and gut microbiome were collected from the Integrative Epidemiology Unit(IEU)OpenGWAS,with summary-level data obtained from the UK Biobank.Five traditional methods were used to estimate the potential causal relationships between gut microbiota and sepsis,including the inverse-variance weighted method,weighted median method,MR-Egger regression,simple mode,and weighted mode.Reverse MR analysis was performed on the bacteria that were found to be causally associated with sepsis in forward MR analysis.Cochran's Q statistic was used to quantify the heterogeneity of instrumental variables.Results The inverse-variance weighted estimate suggested that class Lentisphaeria(odds ratio[OR]=0.86,95%confidence interval[CI]:0.78 to 0.94,P=0.0017,q=0.1596)and order Victivallales(OR=0.86,95%CI:0.78 to 0.94,P=0.0017,q=0.1596)have a protective effect on sepsis.The genus Eubacterium eligens group(OR=1.34,95%CI:1.11 to 1.63,P=0.0029,q=0.1881)was positively associated with the risk of sepsis.Sepsis may be a significant risk factor for genus Odoribacter(OR=1.18,95%CI:1.10 to 1.39,P=0.0415,q=0.9849)and Phascolarctobacterium(OR=1.21,95%CI:1.00 to 1.46,P=0.0471,q=0.9849),but this effect was not statistically significant after false discovery rate correction.There was a suggestive association between sepsis and Faecalibacterium(OR=0.85,95%CI:0.73 to 0.98,P=0.0278)and Ruminococcus 1(OR=0.85,95%CI:0.73 to 1.00,P=0.0439),which were not significant after false discovery rate correction(q>0.2).Conclusions This study found that class Lentisphaeria,order Victivallales,and genus Eubacterium eligens group may have a causal relationship with the risk of sepsis.