Early intravenous administration of tirofiban is recommended in patients with acute ischemic stroke treated with alteplase:a meta-analysis

Background:The occurrence of early neurological deterioration following intravenous thrombolysis(IVT)is considered a particularly ominous clinical event and is strongly correlated with poor outcomes.Initiating tirofiban within 24 h after IVT has been suggested as a better treatment option to achieve long-term functional outcomes.However,the rationality of this remedy is a controversial.The purpose of the study was to evaluate the safety and efficacy of early intravenous tirofiban administration after IVT in patients with acute ischemic stroke(AIS).Methods:Databases including PubMed,EMBASE,Cochrane Library,and Web of Science were searched for clinical trials on early tirofiban implementation after IVT in patients with AIS from inception to September 2022.Odds ratios(ORs)were generated for dichotomous variants via meta-analysis using STATA 17.0 MP.Results:Five clinical trials with 725 patients were eligible.The study outcomes demonstrated that early tirofiban administration after IVT was not associated with symptomatic intracranial hemorrhage(OR,0.78;95%confidence interval(CI),0.22–2.74;P=0.70),asymptomatic intracranial hemorrhage(OR,1.11;95%CI,0.52–2.37;P=0.80),systemic bleeding(OR,0.97;95%CI,0.42–2.23;P=0.94),and death(OR,1.05;95%CI,0.47–2.31;P=0.91),but may reduce the incidence of early neurological deterioration(OR,0.09;95%CI,0.02–0.50;P=0.01),and was significantly associated with 90-day excellent(modified Rankin scale score 0–1)(OR,2.01;95%CI,1.35–3.02;P=0.00)and favorable(modified Rankin scale score 0–2)(OR,2.30;95%CI,1.63–3.23;P=0.00)functional outcomes.Conclusion:The early intravenous administration of tirofiban after IVT in patients with AIS may be a safe and effective treatment strategy that improves long-term neurological functional outcomes without increasing the risk of adverse events.

Severe serous cavity bleeding caused by acquired factor V deficiency associated with lymphatic leakage in a hemodialysis patient: A case report

BACKGROUND Acquired factor V deficiency is a rare secondary hemorrhagic disease,which can lead to a severe bleeding disorder.CASE SUMMARY We report a 47-year-old hemodialysis patient who presented with severe hemorrhagic pleural effusion and hemorrhagic pericardial effusion associated with lymphatic leakage.The laboratory examination revealed decreased factor V activity (2% of population average value).With decreased lymphatic leakage,factor V activity increased (to 46%).Lymph drainage correlated with prothrombin time and active partial thrombin time.The cause of the disease favored an acquired disease.The common causes which trigger factor V inhibitors were excluded.An inhibitor was not detected.It is possible that there was a clotting factor inhibitor leaking with the lymph in the drainage.Inhibitor production may be due to immune dysfunction caused by persistent lymphatic drainage,or that coagulation inhibitors were produced,drained with the lymph,and partly cleared by hemodialysis.CONCLUSION In this case,we have firstly reported factor V deficiency associated with lymphatic leakage in a hemodialysis patient.

An investigation on the dosimetric impact of hip prosthesis in radiotherapy

The objectives of this study are to evaluate the dosimetric impact of hip prosthesis using ELEKTA linac X-rays and compare the dose perturbations of metallic and nonmetallic hip prostheses. The local dose distributions of typical hip prostheses were calculated for 4, 8, and 15 MV beams by Geant4. Three prosthesis materials were selected in calculation to reveal the relation between material type and local dose perturbations of prostheses. Furthermore,the effect of nominal energy on prosthesis perturbation was also discussed and analyzed. Taking the calculated dose to the hip joint as reference, considerable differences were observed between prostheses and hip joints. In the prosthesis shadow region, the relative dose decreasing was up to 36, 21, and 16 % for the Co–Cr–Mo alloy, titanium alloy, and ceramic prostheses, respectively. In backscattering region, the relative dose increasing was about1–7 %. Overall, the results show that the dose perturbation effect of prostheses was mainly determined by material type, nominal energy, and density. Among these typical hip prostheses, ceramic prosthesis introduces the lowest dose perturbations.

Two-step high-pressure high-temperature synthesis of nanodiamonds from naphthalene

Nanodiamonds have outstanding mechanical properties,chemical inertness,and biocompatibility,which give them potential in various applications.Current methods for preparing nanodiamonds often lead to products with impurities and uneven morphologies.We report a two-step high-pressure high-temperature(HPHT) method to synthesize nanodiamonds using naphthalene as the precursor without metal catalysts.The grain size of the diamonds decreases with increasing carbonization time(at constant pressure and temperature of 11.5 GPa and 700℃,respectively).This is discussed in terms of the different crystallinities of the carbon intermediates.The probability of secondary anvil cracking during the HPHT process is also reduced.These results indicate that the two-step method is efficient for synthesizing nanodiamonds,and that it is applicable to other organic precursors.

Cationic engineered nanodiamonds for efficient antibacterial surface with strong wear resistance

The spread of diseases caused by bacterial adhesion and immobilization in public places constitutes a serious threat to public health.Prevention of bacteria spread by the construction of an antibacterial surface takes precedence over post-infection treatment.Herein,we demonstrate an effective antibacterial surface with strong wear resistance by constructing cationic engineered nanodiamonds(C-NDs).The C-NDs with positive surface potentials interact effectively with bacteria through electrostatic interactions,where the C-NDs act on the phospholipid bilayer and lead to bacterial membrane collapse and rupture through hydrogen bonding and residual surface oxygen-containing reactive groups.In this case,bactericidal rate of 99.99%and bacterial biofilm inhibition rate of more than 80%can be achieved with the C-NDs concentration of 1 mg/mL.In addition,the C-NDs show outstanding antibacterial stability,retaining over 87%of the antibacterial effect after stimulation by adverse environments of heat,acid,and external abrasion.Therefore,an antibacterial surface with high wear resistance obtained by integrating C-NDs with commercial plastics has been demonstrated.The antibacterial surface with a mass fraction of 1 wt.%C-NDs improved abrasion resistance by 3981 times,with 99%killing of adherent bacteria.This work provides an effective strategy for highly efficient antibacterial wear-resistant surface,showing great practical applications in public health environments.

Remote Ischemic Postconditioning for Ischemic Stroke： A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background：Remote ischemic postconditioning （RIPostC） appears to protect distant organs from ischemia-reperfusion injury （IRI）. However, cerebral protection results have remained inconclusive. In the present study, a meta-analysis was performed to compare stroke patients with and without RIPostC.Methods：CNKI, WanFang, VIP, CBM, PubMed, and Cochrane Library databases were searched up to July 2016. Data were analyzed using both fixed-effects and random-effects models by Review Manager. For each outcome, risk ratio （RR） and mean difference （MD） with 95% confidence interval （CI） were calculated.Results：A total of 13 randomized controlled trials that enrolled a total of 794 study participants who suffered from or are at risk for brain IRI were selected. Compared with controls, RIPostC significantly reduced the recurrence of stroke or transient ischemic attacks （RR = 0.37; 95% CI： 0.26–0.55; P 〈 0.00001）. Moreover, it can reduce the levels of the National Institutes of Health Stroke Scale score （MD： 1.96; 95% CI： 2.18–1.75; P 〈 0.00001）, modified Rankin Scale score （MD： 0.73; 95% CI： 1.20–0.25; P = 0.00300）, and high-sensitivity C-reactive protein （MD： 4.17; 95% CI： 4.71–3.62; P 〈 0.00001） between the two groups. There was no side effect of RIPostC using tourniquet cuff around the limb on ischemic stroke treating based on different intervention duration.Conclusion：The present meta-analysis suggests that RIPostC might offer cerebral protection for stroke patients suffering from or are at risk of brain IRI.

Treatment of osteoporotic intertrochanteric fractures by zoledronic acid injection combined with proximal femoral nail anti-rotation

观察在 osteoporotic intertrochanteric 的处理与 zoledronic 酸注射相结合的近似大腿骨的钉子反旋转(PFNA ) 的临床的结果的目的断裂在老。有 osteoporotic intertrochanteric 破裂的 60 个老病人用一台双精力 X 光检查骨头密度仪器被诊断的方法。病人们随机被划分成治疗或控制组(在每个组的 30 个盒子) 。在两个组的病人被关上 / 打开的减小和内部固定用 PFNA 对待。在治疗组，病人们收到了一 zoledronic 5 mg/100 ml 经由的磷的酸注射静脉内滴下，除了 Caltrate D (qd ) 和 alpha 骨化酒精(qd ) 的 0.25 g 的 600 mg。控制组收到了 Caltrate D (qd ) 和 alpha 骨化酒精(qd ) 的 0.25 g 的 600 mg。口头的药被管理 12 个月。骨头疼痛地势在骨头矿物质密度(BMD ) 被观察，并且变化腰部并且健康方面臀部被记录。临床的结果被评估用视觉类似物规模(管) ，哈里斯关节功能分数，和生活优秀的骨质疏松症可伸缩(OQOLS ) 。结果与控制组，相比，骨头疼痛症状显著地被减轻(p 1-4 , 大腿骨的颈和 trochanter (p p = 0.04 ) 。在处理组的盒子在控制组比那些更快速愈合了[(13 景漠瑳潥潰潲楴? 湩整瑲潲档湡整楲? 牦捡畴敲 ? 祢稠汯摥潲楮 ? 捡摩椠橮' 虡 N 湯挠浯楢敮 ? 楷桴瀠潲楸慭? 敦潭慲? 慮汩愠瑮 ?

A network security entity recognition method based on feature template and CNN-BiLSTM-CRF

By network security threat intelligence analysis based on a security knowledge graph(SKG), multi-source threat intelligence data can be analyzed in a fine-grained manner. This has received extensive attention. It is difficult for traditional named entity recognition methods to identify mixed security entities in Chinese and English in the field of network security, and there are difficulties in accurately identifying network security entities because of insufficient features extracted. In this paper, we propose a novel FT-CNN-BiLSTM-CRF security entity recognition method based on a neural network CNN-BiLSTM-CRF model combined with a feature template(FT). The feature template is used to extract local context features, and a neural network model is used to automatically extract character features and text global features. Experimental results showed that our method can achieve an F-score of 86% on a large-scale network security dataset and outperforms other methods.

Heart Rate Variability in Patients with Acute Ischemic Stroke at Different Stages of Renal Dysfunction： A Cross-sectional Observational Study

Background： Renal function is associated with mortality and functional disabilities in stroke patients, and impaired autonomic function is common in stroke, but little is known regarding its effects on stroke patients with renal dysfunction. This study sought to evaluate the association between autonomic function and stroke in patients with renal dysfunction. Methods： This study comprised 232 patients with acute ischemic stroke consecutively enrolled from February 2013 to November 2014 at Guangdong Provincial Hospital of Chinese Medicine in China. All patients recruited underwent laboratory evaluation and 24 h Holter electrocardiography （ECG）. Autonomic function was measured based on the heart rate variability （HRV） using 24 h Holter ECG. Renal damage was assessed through the estimated glomerular filtration rate （eGFR）, and stroke severity was rated according to the National Institutes of Health Stroke Scale （NIHSS）. The Barthel index and modifed Rankin score were also determined following admission. All the clinical covariates that could potentially affect autonomic outcome variables were adjusted with linear regression. Results： In the patients with a mild or moderate decreased eGFR, the values for the standard deviation of the averaged normal-to-normal RR interval （SDANN） index （P = 0.022L very low frequency （VLF） （P = 0.043）, low frequency （LF） （P= 0.023）, and ratio of low-to-high frequency power （LF/HF） （P = 0.001 ） were significantly lower than those in the patients with a normal eGFR. A lnultinomial linear regression indicated that eGFR （t - 2.47, P - 0.014）, gender （t - -3.60, P 〈0.001）, and a history of hypertension （t = -2.65, P = 0.008） were the risk factors of LF/HF; the NIHSS score （SDANN index： t = -3.83, P 〈 0.001 ; VLF： t = -3.07, P = 0.002： LF： t = -2.79, P = 0.006） and a history of diabetes （SDANN index： t = -3.58, P 〈 0.001; VLF： t = -2.54, P = 0.012; LF： t = -2.87, P = 0.004） were independent factors Ibr the SDANN index, VLF, and LF; the Oxfordshire Community Stroke Project （t = -2.38, P = 0.018） was related to the SDANN index. Conclusions： Autonomic dysfunction is aggravated with the progression ofeGFR stage in patients with acute ischemic stroke; the eGFR is an independent factor of LF/HF in the adjusted models. Stroke severity and a history of diabetes are more significantly associated with HRV in patients with acute ischemic stroke at different stages of renal dysfnnction.

Near-infrared carbon nanodots for effective identification and inactivation of Gram-positive bacteria

An unacceptable increase in antibacterial resistance has arisen due to the abuse of multiple classes of broad-spectrum antibiotics.Therefore,it is significant to develop new antibacterial agents,especially those that can accurately identify and kill specific bacteria.Herein,we demonstrate a kind of perilla-derived carbon nanodots(CNDs),integrating intrinsic advantages of luminescence and photodynamic,providing the opportunity to accurately identify and kill specific bacteria.The CNDs have an exotic-doped andπ-conjugated core,vitalizing them near-infrared(NIR)absorption and emission properties with photoluminescence quantum yield of 21.1%;hydrophobic chains onto the surface of the CNDs make them to selectively stain Gram-positive bacteria by insertion into their membranes.Due to the strong absorption in NIR region,reactive oxygen species are in situ generated by the CNDs onto bacterial membranes under 660 nm irradiation,and 99.99%inactivation efficiency against Gram-positive bacteria within 5 min can be achieved.In vivo results demonstrate that the CNDs with photodynamic antibacterial property can eliminate the inflammation of the area affected by methicillin-resistant Staphylococcus aureus(MRSA),and enabling the wound to be cured quickly.

Self-exothermic reaction driven large-scale synthesis ofphosphorescent carbon nanodots

Phosphorescent carbon nanodots(CNDs)have various attractive properties and potential applications,but it remains a formidable challenge to achieve large-scale phosphorescent CNDs limited by current methods.Herein,a large-scale synthesis method for phosphorescent CNDs has been demonstrated via precursors’self-exothermic reaction at room temperature.The as-prepared CNDs show fluorescence and phosphorescence property,which are comparable with that synthesized by solvothermal and microwave method.Experimental and computational studies indicate that exotic atom doped sp^(2) hybridized carbon core works as an emissive center,which facilities the intersystem crossing from singlet state to triplet state.The CNDs show phosphorescence with tunable lifetimes from 193 ms to 1.13 s at different temperatures.The demonstration of large-scale synthesis of phosphorescent CNDs at room temperature opens up a new window for room temperature fabrication phosphorescent CNDs.

Ultraviolet phosphorescent carbon nanodots

Phosphorescent carbon nanodots(CNDs)have generated enormous interest recently,and the CND phosphorescence is usually located in the visible region,while ultraviolet(UV)phosphorescent CNDs have not been reported thus far.Herein,the UV phosphorescence of CNDs was achieved by decreasing conjugation size and in-situ spatial confinement in a NaCNO crystal.The electron transition from the P_(x) to the sp^(2) orbit of the N atoms within the CNDs can generate one-unit orbital angular momentum,providing a driving force for the triplet excitons population of the CNDs.The confinement caused by the NaCNO crystal reduces the energy dissipation paths of the generated triplet excitons.By further tailoring the size of the CNDs,the phosphorescence wavelength can be tuned to 348 nm,and the room temperature lifetime of the CNDs can reach 15.8 ms.As a demonstration,the UV phosphorescent CNDs were used for inactivating gram-negative and gram-positive bacteria through the emission of their high-energy photons over a long duration,and the resulting antibacterial efficiency reached over 99.9%.This work provides a rational design strategy for UV phosphorescent CNDs and demonstrates their novel antibacterial applications.

Water-induced MAPbBr_(3)@PbBr(OH) with enhanced luminescence and stability

Poor stability has long been one of the key issues that hinder the practical applications of lead-based halide perovskites.In this paper,the photoluminescence(PL)quantum yield(QY)of bromide-based perovskites can be increased from 2.5% to 71.54% by introducing water,and the PL QY of a sample in aqueous solution decreases minimally over 1 year.The enhanced stability and PL QY can be attributed to the water-induced methylamino lead bromide perovskite(MAPbBr_(3))@PbBr(OH).We note that this strategy is universal to MAPbBr_(3),formamidine lead bromide perovskite(FAPbBr_(3)),inorganic lead bromide perovskite(CsPbBr_(3)),etc.Light-emitting devices(LEDs)are fabricated by using the as-prepared perovskite as phosphors on a 365 nm UV chip.The luminance intensity of the LED is 9549 cd/m^(2) when the driven current is 200 mA,and blemishes on the surface of glass are clearly observed under the illumination of the LEDs.This work provides a new strategy for highly stable and efficient perovskites.

Multi-stage dual replica bit-line delay technique for process-variation-robust timing of low voltage SRAM sense amplifier

目的:为克服高动态弱信号环境下信号的积分峰值受比特符号翻转和频率误差的影响,提出一种基于离散chirp-Fourier变换块补零方法。创新点:与传统闭环捕获和跟踪的接收机结构相比,该方法适用于开环捕获。该方法结合了离散chirp-Fourier变换和块补零思想,能够使后相关信号在剥离比特符号后进行相干积累并同时进行高动态参数精准预测。同时,对所提方法的检测性能进行分析推导捕获概率和虚警概率表达式。方法:首先,后相关信号通过块补零处理被分为一些块,然后这些块通过离散chirp-Fourier变换处理。以这种方式比特翻转对积分峰值的影响可以被削弱,同时后相关信号可以进行相干积累。最后通过阈值检测积分峰值来完成高动态参数的预测,这个阈值是通过设定的虚警概率得出的。仿真结果表明当接收信号长度一定时,本文方法较BASIC方法能在更低的信噪比下检测到高动态参数。结论:本文结合离散chirp-Fourier变换和块补零思想,在弱信号高动态环境下提出基于离散chirp-Fourier变换的块补零方法。仿真结果表明本文方法较BASIC方法在更低的信噪比下预测高动态参数。与利用传统接收机结构的闭环捕获和跟踪方法的相比,这种方法是一种开环捕获的方法,非常适合软件无线电接收机。

高动态弱信号环境下针对L1信号参数估计的基于离散chirp-Fourier变换块补零方法（英文）

目的:为克服高动态弱信号环境下信号的积分峰值受比特符号翻转和频率误差的影响,提出一种基于离散chirp-Fourier变换块补零方法。创新点:与传统闭环捕获和跟踪的接收机结构相比,该方法适用于开环捕获。该方法结合了离散chirp-Fourier变换和块补零思想,能够使后相关信号在剥离比特符号后进行相干积累并同时进行高动态参数精准预测。同时,对所提方法的检测性能进行分析推导捕获概率和虚警概率表达式。方法:首先,后相关信号通过块补零处理被分为一些块,然后这些块通过离散chirp-Fourier变换处理。以这种方式比特翻转对积分峰值的影响可以被削弱,同时后相关信号可以进行相干积累。最后通过阈值检测积分峰值来完成高动态参数的预测,这个阈值是通过设定的虚警概率得出的。仿真结果表明当接收信号长度一定时,本文方法较BASIC方法能在更低的信噪比下检测到高动态参数。结论:本文结合离散chirp-Fourier变换和块补零思想,在弱信号高动态环境下提出基于离散chirp-Fourier变换的块补零方法。仿真结果表明本文方法较BASIC方法在更低的信噪比下预测高动态参数。与利用传统接收机结构的闭环捕获和跟踪方法的相比,这种方法是一种开环捕获的方法,非常适合软件无线电接收机。