Combined use of non-biological artif icial liver treatments for patients with acute liver failure complicated by multiple organ dysfunction syndrome

BACKGROUND:Acute liver failure(ALF) caused by viral and non-viral hepatitis is often accompanied with severe metabolic disorders,the accumulation of toxic substances and continuous release and accumulation of a large number of endogenous toxins and inflammatory mediators. The present study aimed to investigate the effects of various combined non-biological artif icial liver treatments for patients with acute liver failure(ALF) complicated by multiple organ dysfunction syndrome(MODS).METHODS:Thirty-one patients with mid- or late-stage liver failure complicated by MODS(score 4) were randomly divided into three treatment groups:plasmapheresis(PE) combined with hemoperfusion(HP) and continuous venovenous hemodiafiltration(CVVHDF),PE+CVVHDF,and HP+CVVHDF,respectively. Heart rate(HR) before and after treatment,mean arterial pressure(MAP),respiratory index(PaO2/FiO2),hepatic function,platelet count,and blood coagulation were determined.RESULTS:Signifi cant improvement was observed in HR,MAP,PaO2/FiO2,total bilirubin(TBIL) and alanine aminotransferase(ALT) levels after treatment(P<0.05). TBIL and ALT decreased more signifi cantly after treatment in the PE+CVVHDF and PE+HP+CVVHDF groups(P<0.01). Prothrombin time(PT) and albumin were signifi cantly improved only in the PE+CVVHDF and PE+HP+CVVHDF groups(P<0.05). TBIL decreased more significantly in the PE+HP+CVVHDF group than in the HP+CVVHDF and PE+CVVHDF groups(P<0.05). The survival rate of the patients was 58.1%(18/31),viral survival rate 36.4%(4/11),and non-viral survival rate 70%(14/20).CONCLUSION:Liver function was relatively improved after treatment,but PE+HP+CVVHDF was more efficient for the removal of toxic metabolites,especially bilirubin. The survival rate was signifi cantly higher in the patients with non-viral liver failure than in those with viral liver failure.

Estimation of cancer burden in Guangdong Province,China in 2009

Background:Surveying regional cancer incidence and mortality provides significant data that can assist in making health policy for local areas;however,the province- and region-based cancer burden in China is seldom reported.In this study,we estimated cancer incidence and mortality in Guangdong Province,China and presented basic information for making policies related to health resource allocation and disease control.Methods:A log-linear model was used to calculate the sex-,age-,and registry-specific ratios of incidence to mortality(l/M) based on cancer registry data from Guangzhou,Zhongshan,and Sihui between 2004 and 2008.The cancer incidences in 2009 were then estimated according to representative l/M ratios and the mortality records from eight death surveillance sites in Guangdong Province.The cancer incidences in each city were estimated by the corresponding sex- and age-specific incidences from cancer registries or death surveillance sites in each area.Finally,the total and region-based cancer incidences and mortalities for the entire population of Guangdong Province were summarized.Results:The estimated l/M ratios in Guangzhou(3.658),Zhongshan(2.153),and Sihui(1.527) were significantly different(P < 0.001),with an average l/M ratio of 2.446.Significant differences in the estimated l/M ratios were observed between distinct age groups and the three cancer registries.The estimated l/M ratio in females was significantly higher than that in males(2.864 vs.2.027,P < 0.001).It was estimated that there were 163,376 new cancer cases(99,689 males and 63,687 females) in 2009;it was further estimated that 115,049 people(75,054 males and 39,995females) died from cancer in Guangdong Province in 2009.The estimated crude and age-standardized rate of incidences(ASRI) in Guangdong Province were 231.34 and 246.87 per 100,000 males,respectively,and 156.98 and 163.57 per 100,000 females,respectively.The estimated crude and age-standardized rate of mortalities(ASRM) in Guangdong Province were 174.17 and 187.46 per 100,000 males,respectively,and 98.59 and 102.00 per 100,000 females,respectively.In comparison with the western area and the northern mountain area,higher ASRI and ASRM were recorded in the Pearl River Delta area and the eastern area in both males and females.Conclusions:Cancer imposes a heavy disease burden,and cancer patterns are unevenly distributed throughout Guangdong Province.More health resources should be allocated to cancer control,especially in the western and northern mountain areas.

Direct Observation of Electron-Vibration Coupling at MXene-Solvent Interface

MXenes,a new family of two-dimensional(2D)materials,have received extensive interest due to their fascinating physicochemical properties,such as outstandinglight-to-heat conversion efficiency.However,the photothermal conversion mechanism of MXenes is still poorly understood.Here,by using femtosecond visible and mid-infrared transient absorption spectroscopy,the electronic energy dissipation dynamics of MXene(Ti_(3)C_(2)T_(x))nanosheets dispersed in various solvents are carefully studied.Our results indicate that the lifetime of photoexcited MXene is strongly dependent on the surrounding environment.Especially,the interfacial electron-vibration coupling between the MXene nanosheets and the adjacent solvent molecules is directly observed following the ultrafast photoexcitation of MXene.It suggests that the interfacial interactions at the MXene-solvent interface play a critical role in the ultrafast energy transport dynamics of MXene,which offers a potentially feasible route for tailoring the light conversion properties of 2D systems.