The effect of prophylactic antibiotics in acute upper gastrointestinal bleeding patients in the emergency department

BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group(6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins(P=0.045) and endotracheal intubation(P=0.005) in the prophylactic antibiotic group, and endoscopic treatment(P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.

Zokor activity promotes soil water infiltration in the Mu Us sandy land of northern Shaanxi,China

Zokors are common subterranean rodents that inhabit agricultural fields, shrublands, and grasslands in the arid and semi-arid regions of China. Zokor burrowing activities can alter soil structure and affect soil hydrological processes;however, there are few studies regarding their effects on soil preferential flow in the Mu Us sandy land. An evaluation of the effects of zokor disturbance on their habitat and soil water is important for understanding the ecological role of zokors in the soil ecosystem of the Mu Us sandy land. A field dye-tracing experiment was conducted in the Gechougou watershed on the southeastern edge of the Mu Us sandy land to investigate the effect of zokor burrowing activity on soil preferential flow characteristics. Our results showed that the density of zokor tunnels was the highest(0.40–0.46 m m^(-2)) under 30%–50% vegetation coverage and that the tunnels were approximately 3 cm from the surface.Both stained area ratio and stained path number were higher at sites with zokors than without zokors. Stained path widths were 10–80 and > 80 mm at zokor-harboring sites exhibiting homogeneous flow and heterogeneous finger flow, respectively. In the absence of zokors, homogeneous flow and highly interacted macropore flow were predominant. Soil water content below the zokor tunnels was higher than that above the tunnels. Moderate disturbance of soil structure by zokor activity facilitated soil water infiltration. These results enabled a better understanding of the effect of soil fauna on soil structure and hydrological processes and provided recommendations for ecological construction and renovation in arid and semi-arid regions.

A slippery hydrogel coating with durable oil-repellent property and self-regeneration capacity

Traditional lubricant impregnated surfaces usually required fluorinated lubricants to achieve slippery oil repellency, but the lubricants infused were expensive and toxic and also suffered from limited stability because of their migrating, evaporating, and leaking during use. Herein, to address this issue, we fabricated a durably fluorine-free slippery oil-repellent hydrogel coating using water as the lubricant. Due to its enhanced water-binding affinity, water could wet the hydrogel completely and form a hydrated-water layer on the surface. The hydrated water layer could act as a lubricant to repel foreign oils, which allowed the hydrogel to display slippery oil-repellency in air, exhibit superoleophobicity underwater, and resist oil fouling upon oil immersion.The hydrogel kept its oil-repellent properties after mechanical tests as well as thermal and freezing treatments,demonstrating its durability. Thanks to its moisture absorption, the water lubricant layer could self-regenerate upon the lubricated water layer depletion through exposure to a humid environment. Exploiting it is water-attracting and oil repellency, the hydrogel coating was demonstrated as a versatile platform for oil/water separation, polymer/water separation, drag-reduction, and antifogging.