Laminar Composite Solid Electrolyte with Poly(Ethylene Oxide)-Threaded Metal-Organic Framework Nanosheets for High-Performance All-Solid-State Lithium Battery

Developing laminar composite solid electrolyte with ultrathin thickness and continuous conduction channels in vertical direction holds great promise for all-solid-state lithium batteries.Herein,a thin,laminar solid electrolyte is synthesized by filtrating–NH 2 functionalized metal-organic framework nanosheets and then being threaded with poly(ethylene oxide)chains induced by the hydrogen-bonding interaction from–NH_(2) groups.It is demonstrated that the threaded poly(ethylene oxide)chains lock the adjacent metal-organic framework nanosheets,giving highly enhanced structural stability(Young’s modulus,1.3 GPa)to 7.5-μm-thick laminar composite solid electrolyte.Importantly,these poly(ethylene oxide)chains with stretching structure serve as continuous conduction pathways along the chains in pores.It makes the non-conduction laminar metal-organic framework electrolyte highly conductive:3.97×10^(−5) S cm^(−1) at 25℃,which is even over 25 times higher than that of pure poly(ethylene oxide)electrolyte.The assembled lithium cell,thus,acquires superior cycling stability,initial discharge capacity(148 mAh g^(−1) at 0.5 C and 60℃),and retention(94% after 150 cycles).Besides,the pore size of nanosheet is tailored(24.5–40.9˚A)to evaluate the mechanisms of chain conformation and ion transport in confined space.It shows that the confined pore only with proper size could facilitate the stretching of poly(ethylene oxide)chains,and meanwhile inhibit their disorder degree.Specifically,the pore size of 33.8˚A shows optimized confinement effect with trans-poly(ethylene oxide)and cis-poly(ethylene oxide)conformation,which offers great significance in ion conduction.Our design of poly(ethylene oxide)-threaded architecture provides a platform and paves a way to the rational design of next-generation high-performance porous electrolytes.

康替唑胺与利奈唑胺对70岁以上重症院内获得性肺炎患者的疗效比较

背景康替唑胺作为抗革兰阳性菌的新型药物,其疗效不劣于利奈唑胺,且不良反应的发生情况较利奈唑胺更低,但其在医院获得性肺炎(hospital acquired pneumonia,HAP)领域应用尚少。目的比较康替唑胺治疗利奈唑胺对高龄重症院内获得性肺炎(severe hospital acquired pneumonia,SHAP)患者的疗效及不良反应。方法回顾性分析解放军总医院第二医学中心2021年1月1日—2023年2月15日发生SHAP、年龄≥70岁且在院内接受康替唑胺(800 mg,口服,1次/12 h)或利奈唑胺(600 mg,静滴或口服,1次/12 h)治疗患者的一般资料和临床资料,比较两组临床疗效及不良反应。结果共纳入358例患者。康替唑胺组111例,年龄(92.91±6.93)岁,男性占88.3%(98/111);利奈唑胺组247例,年龄(92.19±6.92)岁,男性占91.9%(227/247)。两组差异无统计学意义(P>0.05)。康替唑胺组与利奈唑胺的临床有效率分别为55.0%(61/111)和61.1%(151/247),差异无统计学意义(P>0.05)。对一般及临床基线指标进行倾向性评分匹配后,康替唑胺组与利奈唑胺组各36例患者,两组间临床有效率(61.1%vs 69.4%,P=0.458)、微生物清除率(22.2%vs 27.8%,P=0.296)差异均无统计学意义。康替唑胺组血小板下降的发生率显著低于利奈唑胺组(50.0%vs 80.6%,P=0.006);康替唑胺组和利奈唑胺组血红蛋白下降发生率分别为41.7%和61.1%,红细胞下降发生率分别为50.0%和61.1%,乳酸升高的发生率分别为44.1%和54.3%,乳酸酸中毒发生率分别为29.4%和34.3%,两组差异均无统计学意义(P>0.05)。结论康替唑胺治疗高龄SHAP的疗效与利奈唑胺相当,但其引起的血小板下降发生率显著低于利奈唑胺。

Lower extremity peripherally inserted central catheter placement ectopic to the ascending lumbar vein:A case report

BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.

Ten-year retrospective analysis of multiple trauma complicated by pulmonary contusion

Background: This study reports a 10-year retrospective analysis of multiple trauma complicated by pulmonary contusion. The purpose of this study is to ascertain the risk factors for mortality due to trauma in patients with pulmonary contusion, the impact of various treatment options for prognosis, and the risk factors for concurrent Acute Respiratory Distress Syndrome(ARDS). Methods: We retrospectively analyzed 252 trauma patients with lung contusion admitted to the General Hospital of Guangzhou Military Command from January 2000 to June 2011 by using the statistical processing system SPSS 17.0 for Windows. Results: We included 252 patients in our study, including 214 males and 38 females. The average age was 37.1±14.9 years. There were 110 cases admitted to the ICU, of which 26 cases with ARDS. Nine of the 252 patients died. We compared those who survived with those who died by gender and age, the difference was not statistically significant(P=0.199, P=0.200). Separate univariate analysis of those who died and those who survived found that shock on admission(P=0.000), coagulation disorders(P=0.000), gastrointestinal bleeding(P=0.02), the need for emergency surgery on admission(P=0.000), pre-hospital intubation(P=0.000), blood transfusion within 24 hours(P=0.006), the use of mechanical ventilation(P=0.000), and concurrent ARDS(P=0.000) are poor prognosis risk factors. Further logistic analysis, including the admission GCS score(OR=0.708, 95%CI 0.516-0.971, P=0.032), ISS score(OR 1.135, 95%CI 1.006-1.280, P=0.039), and concurrent ARDS(OR=15.814, 95%CI 1.819-137.480, P=0.012), identified the GCS score, ISS score and concurrent ARDS as independent risk factors of poor prognosis. Shock(OR=9.121, 95%CI 0.857-97.060, P=0.067) was also related to poor prognosis. Patients with injury factors such as road accident, falling injury, blunt injury and crush injury, et al.(P=0.039), infection(P=0.005), shock(P=0.004), coagulation disorders(P=0.006), emergency surgery(P=0.01), pre-hospital intubation(P=0.000), chest tube insertion(P=0.004), blood transfusion(P=0.000), usage of hormones(P=0.002), phlegm(P=0.000), ventilation(P=0.000) were at a significantly increased risk for ARDS complications. Conclusions: Those patients with multiple trauma and pulmonary contusion admitted to the hospital with shock, coagulopathy, a need for emergency surgery, pre-hospital intubation, and a need for mechanical ventilation could have a significantly increased risk of mortality and ARDS incidence. A risk for poor prognosis was associated with gastrointestinal bleeding. A high ISS score, high APACHE Ⅱ, and low GCS score were independent risk factors for poor prognosis. If patients developed an infection or were given drainage, hormones, and phlegm treatment, they were at higher risk of ARDS. Pre-hospital intubation and drainage were independent risk factors for ARDS. In patients with ARDS, the ICU stay, total length of stay, and hospital costs might increase significantly. A GCS score<5.5, APACHE Ⅱ score>16.5, and ISS score>20.5 could be considered indicators of poor prognosis for patients with multiple trauma and lung contusion.

超乳联合房角分离或小梁切除对PACG合并白内障患者血流动力学的影响

目的:探究超声乳化白内障吸除联合房角分离术或小梁切除术对原发性闭角型青光眼(PACG)合并白内障患者血流动力学的影响。方法:随机数字表格法将巴中市中心医院2015-01/2017-06收治的94例94眼PACG合并白内障患者分为超声乳化白内障吸除联合房角分离术(观察组)与超声乳化白内障吸除联合小梁切除术(对照组),每组47例,比较两组疗效指标。结果:观察组术后1、3mo收缩期峰值流速(PSV)、舒张末期流速(EDV)均显著大于对照组,术后3mo阻力指数(RI)明显小于对照组以及前房深度、房角开放程度显著大于对照组(P<0.05)。结论:房角分离或小梁切除联合超声乳化均能有效降低眼压,促进患者视力恢复,但房角分离术相对能更好地促进房角开放,改善血流动力学。

神经内镜技术在桥小脑角区部分脑神经疾病中的临床应用

目的探讨神经内镜技术在桥小脑角区(cerebellopontine angle area,CPA)脑神经疾病中的临床应用。方法回顾性分析57例CPA区脑神经疾病病例资料,采用全神经内镜技术或神经内镜联合显微镜技术,明确责任血管或责任灶来源。结果术后随访6~36个月。25例原发性面肌痉挛症状完全缓解,3例Cohen和Albert分级由术前Ⅲ级转变为Ⅰ级。19例原发性三叉神经痛症状完全缓解,2例疼痛BRS分级由术前Ⅴ级转变为Ⅱ级。6例CPA区继发性三叉神经痛症状基本缓解,2例症状明显减轻。本组病例无继发性面瘫及听力损伤,无脑脊液漏,无复发及死亡。结论神经内镜技术在治疗CPA区脑神经疾病中,能清晰无死角显示术区解剖结构,有利于发现责任病灶及直观观察减压后效果,术后随访疗效确切,无严重并发症。

43例复发脑胶质瘤病理进展的影响因素分析

目的分析低级别脑胶质瘤患者复发术后病理进展为高级别胶质瘤的影响因素。方法收集我院43例复发脑胶质瘤患者的临床资料。利用单因素分析和多因素Logistic回归分析方法分析首发癫痫症状、术前KPS评分、肿瘤IDH类型等因素对复发脑胶质瘤患者术后病理进展的影响。结果43例复发脑胶质瘤患者中,二次手术病理为高级别胶质瘤有9例(20.9%),而无进展者有34例(79.1%)。经单因素分析和多因素Logistic回归分析发现,首发癫痫症状、术后放化疗为影响复发脑胶质瘤患者术后病理进展为高级别胶质瘤的保护性因素(P<0.05)。结论首发癫痫症状和术后放化疗是复发脑胶质瘤病理进展的保护因素。对于非癫痫首发症状或术后未接受放化疗的低级别胶质瘤患者,需密切跟进随访,及早接受合适的临床试验。

A New Aging Treatment Way for Near α High Temperature Titanium Alloys

Two near α titanium alloys, Ti-5.6Al-4.8Sn-2.0Zr-1Mo-0.35Si （1#） and Ti-6.0AI-4.8Sn-2.0Zr-1Mo-0.35Si （2#）, were solution-treated in the upper α＋β phase fields, and the duplex mixture microstructures consisting of the less volume fraction primary α phase （αp） and the transformed β phase （βt） were obtained. The aging treatments were carried out at 700℃ for 1# alloy and 760℃ for 2# alloy under varied terms, respectively. It guaranteed α2 ordered phase to precipitate only in αp but not in βt for the two alloys. The slower precipitation and growth of the α2 ordered phase and silicide was observed in 1# alloy in comparison with 2# alloy. The mechanical properties including tensile strength and ductility, the creep and lasting properties at 600℃ were investigated. Prolonging aging time did not predominantly change the tensile strength and ductility for the two alloys. The 600℃/100 h thermal exposure caused a notable decrease of tensile ductility in 2# alloy though no distinct decrease could be observed in 1# alloy after the thermal exposure. The lasting property of i# alloy was increased with prolonging aging time and finally was equal to or even better than that of 2# alloy. Nevertheless, no evident increase emerged in 2# alloy with prolonging aging time. Similarly, the creep property of 1# alloy monotonously increased with increasing aging time and finally was equal to or even better than that of 2# alloy. No evident increase could be observed for 2# alloy. It can be deduced that the overgrowth of α2 ordered phase and silicide is unable to enhance hot strength properties but cause an unacceptable damage to tensile ductility. The optimum equilibrium of the comprehensive properties depending on the proper control of α2 ordered phase and silicide can be achieved by properly selecting aging temperature and time.

Effects of Alloying Elements on the Volume Fraction of Ordered α_2 Phase Precipitated in Ti-Al-Sn-Zr Alloys

An ideal method has been established for calculating the precipitation of α2 ordered phase in near-α titanium alloys based on the theory on the critical electron concentration for the precipitation of α2 ordered phase in near-α titanium alloys. With complete precipitation of α2 phase in near-α titanium alloys, the alloys can be considered to be composed of two parts： （1） the α2 ordered phase with the stoichiometric atomic ratio of Ti3X; （2） the disorder solid solution with the critical composition in which the α2 ordered phase is just unable to precipitate. By using this method, the volume fractions of α2 ordered phase precipitated in Ti-Al, Ti-Sn, Ti-Al-Sn-Zr alloys with various AI, Sn and/or Zr contents have been calculated. The influences of AI and Sn on the precipitation of α2 ordered phase are discussed. The calculating results show substantial agreement with the experimental ones.

Effects of Landau damping and collision on stimulated Raman scattering with various phase-space distributions

Stimulated Raman scattering(SRS)is one of the main instabilities affecting success of fusion ignition.Here,we study the relationship between Raman growth and Landau damping with various distribution functions combining the analytic formulas and Vlasov simulations.The Landau damping obtained by Vlasov-Poisson simulation and Raman growth rate obtained by Vlasov-Maxwell simulation are anti-correlated,which is consistent with our theoretical analysis quantitatively.Maxwellian distribution,flattened distribution,and bi-Maxwellian distribution are studied in detail,which represent three typical stages of SRS.We also demonstrate the effects of plateau width,hot-electron fraction,hot-to-cold electron temperature ratio,and collisional damping on the Landau damping and growth rate.They gives us a deep understanding of SRS and possible ways to mitigate SRS through manipulating distribution functions to a high Landau damping regime.

IL-17 sustains the plasma cell response via p38-mediated Bcl-xL RNA stability in lupus pathogenesis

Recent studies have demonstrated a central role for plasma cells in the development of autoimmune diseases,such as systemic lupus erythematosus(SLE).Currently,both the phenotypic features and functional regulation of autoreactive plasma cells during SLE pathogenesis remain largely unclear.In this study,we first found that a major subset of IL-17 receptor-expressing plasma cells potently produced anti-dsDNA IgG upon IL-17A(IL-17)stimulation in SLE patients and lupus mice.Using a humanized lupus mouse model,we showed that the transfer of Th17 cell-depleted PBMCs from lupus patients resulted in a significantly reduced plasma cell response and attenuated renal damage in recipient mice compared to the transfer of total SLE PBMCs.Moreover,long-term BrdU incorporation in lupus mice detected highly enriched long-lived BrdU+subsets among IL-17 receptor-expressing plasma cells.Lupus mice deficient in IL-17 or IL-17 receptor C(IL-17RC)exhibited a diminished plasma cell response and reduced autoantibody production with attenuated renal damage,while the adoptive transfer of Th17 cells triggered the plasma cell response and renal damage in IL-17-deficient lupus mice.In reconstituted chimeric mice,IL-17RC deficiency resulted in severely impaired plasma cell generation but showed no obvious effect on germinal center B cells.Further mechanistic studies revealed that IL-17 significantly promoted plasma cell survival via p38-mediated Bcl-xL transcript stabilization.Together,our findings identified a novel function of IL-17 in enhancing plasma cell survival for autoantibody production in lupus pathogenesis,which may provide new therapeutic strategies for the treatment of SLE.

New insights into the functions of MDSCs in autoimmune pathogenesis

Myeloid-derived suppressor cells(MDSCs)are a heterogeneous population of immature myeloid cells with immunosuppressive effects that are expanded under pathological conditions.In the past decade,MDSCs have generated significant research interest and increased attention.Recently,clinical observations and animal model studies have shown that MDSCs accumulate during the development of various autoimmune diseases,including primary Sjogren's syndrome(psS).psS is a common systemic autoimmune disease characterized by lymphocyte infiltration and tissue inflammation in the salivary glands(SG)and lacrimal glands,resulting in dry mouth and dry eyes.Here,we review the latest evidence and provide new insights into the roles of MDSCs in the pathogenesis of autoimmune diseases,focusing on the functional changes in MDSCs and their therapeutic potential in autoimmune diseases.

Rab20 is critical for bacterial lipoprotein tolerization-enhanced bactericidal activity in macrophages during bacterial infection

Bacterial cell wall component-induced tolerance represents an important protective mechanism during microbial infection.Tolerance induced by the TLR2 agonist bacterial lipoprotein(BLP)has been shown to attenuate the inflammatory response,and simultaneously to augment antimicrobial function,thereby conferring its protection against microbial sepsis.However,the underlying mechanism by which BLP tolerance augments bactericidal activity has not been fully elucidated.Here,we reported that the induction of BLP tolerance in murine macrophages upregulated the expression of Rab20,a membrane trafficking regulator,at both the mRNA and protein levels upon bacterial infection.The knockdown of Rab20 with Rab20 specific siRNA(siRab20)did not affect the phagocytosis of Escherichia coli(E.coli),but substantially impaired the intracellular killing of the ingested E.coli in BLP-tolerized macrophages.Furthermore,Rab20 was associated with GFP-E.coli containing phagosomes,and BLP tolerization resulted in the enhanced maturation of GFP-E.coli-containing phagosomes associated with Rab20 and strong lysosomal acidification.The knockdown of Rab20 substantially diminished lysosome acidification and disturbed the fusion of GFP-E.coli containing phagosomes with lysosomes in BLP-tolerized macrophages.These results demonstrate that Rab20 plays a critical role in BLP tolerization-induced augmentation of bactericidal activity via promoting phagosome maturation and the fusion of bacteria containing phagosomes with lysosomes.

Aryl hydrocarbon receptor activation drives polymorphonuclear myeloid-derived suppressor cell response and efficiently attenuates experimental Sjögren’s syndrome

Myeloid-derived suppressor cells(MDSCs)comprise heterogeneous myeloid cell populations with immunosuppressive capacity that contribute to immune regulation and tolerance induction.We previously reported impaired MDSC function in patients with primary Sjögren’s syndrome(pSS)and mice with experimental SS(ESS).However,the molecular mechanisms underlying MDSC dysfunction remain largely unclear.In this study,we first found that aryl hydrocarbon receptor(AhR)was highly expressed by human and murine polymorphonuclear MDSCs(PMN-MDSCs).Indole-3-propionic acid(IPA),a natural AhR ligand produced from dietary tryptophan,significantly promoted PMN-MDSC differentiation and suppressive function on CD4^(+)T cells.In contrast,feeding a tryptophan-free diet resulted in a decreased PMN-MDSC response,a phenotype that could be reversed by IPA supplementation.The functional importance of PMN-MDSCs was demonstrated in ESS mice by using a cell-depletion approach.Notably,AhR expression was reduced in PMN-MDSCs during ESS development,while AhR antagonism resulted in exacerbated ESS pathology and dysregulated T effector cells,which could be phenocopied by a tryptophan-free diet.Interferon regulatory factor 4(IRF4),a repressive transcription factor,was upregulated in PMN-MDSCs during ESS progression.Chromatin immunoprecipitation analysis revealed that IRF4 could bind to the promoter region of AhR,while IRF4 deficiency markedly enhanced AhR-mediated PMN-MDSC responses.Furthermore,dietary supplementation with IPA markedly ameliorated salivary glandular pathology in ESS mice with restored MDSC immunosuppressive function.Together,our results identify a novel function of AhR in modulating the PMN-MDSC response and demonstrate the therapeutic potential of targeting AhR for the treatment of pSS.