Pediatric Wilson disease presenting as acute liver failure:Prognostic indices

BACKGROUND Acute liver failure(ALF)can be a primary presentation of Wilson disease(WD).Mortality rates are high in WD with ALF(WDALF).Predictions of mortality in WDALF vary by model and are sometimes contradictory,perhaps because few patients are studied or WD diagnoses are questionable.AIM To determine the outcomes among well-documented WDALF patients and assess mortality model performance in this cohort.METHODS We reviewed the medical records of our pediatric WDALF patients(n=41 over 6-years-old,single-center retrospective study)and compared seven prognostic models(King’s College Hospital Criteria,model for end-stage liver disease/pediatric end-stage liver disease scoring systems,Liver Injury Unit[LIU]using prothrombin time[PT]or international normalized ratio[INR],admission LIU using PT or INR,and Devarbhavi model)with one another.RESULTS Among the 41 Han Chinese patients with ALF,WD was established by demonstrating ATP7B variants in 36.In 5 others,Kayser-Fleischer rings and Coombs-negative hemolytic anemia permitted diagnosis.Three died during hospitalization and three underwent liver transplantation(LT)within 1 mo of presentation and survived(7.3%each);35(85.4%)survived without LT when given enteral D-penicillamine and zinc-salt therapy with or without urgent plasmapheresis.Parameters significantly correlated with mortality included encephalopathy,coagulopathy,and gamma-glutamyl transpeptidase activity,bilirubin,ammonia,and serum sodium levels.Area under the receiver operating curves varied among seven prognostic models from 0.981 to 0.748 with positive predictive values from 0.214 to 0.429.CONCLUSION WDALF children can survive and recover without LT when given D-penicillamine and Zn with or without plasmapheresis,even after enlisting for LT.

Fe–Al Phase Formation Studied by Internal Friction during Heating Process

We systematically investigate the internal friction properties of a Fe-(43 at.%)Al powder mixture compact during the heating process with the expectation to understand the phase formation and transition process.Three internal friction peaks are successively observed during the heating process from room temperature to 750℃,but almost completely disappear in the subsequent cooling process.Three internal friction peaks exhibit obvious measuring frequency dependence,which increases with decreasing the frequency.The first internal friction peak originates from the micro-sliding of weak bonding interface between Al particles corresponding to a recr.ystallization process of deformed Al particles.The second internal friction peak is attributed to a phase formation process associated with the formation of the intermediate phase Fe2Al5.The third internal friction peak is considered to result from the formation of the FeAl intermetallic compound owing to the reaction of Fe2Al5 and residual Fe initiated by a dramatic thermal explosion reaction.

Synthesis and properties of potassium 5,5'-azobis(1-nitraminotetrazolate)：A green primary explosive with superior initiation power

Potassium 5,5＇-azobis（1-nitraminotetrazolate）,（K2ABNAT）, a new green primary explosive, was synthesized via a safe and convenient synthetic procedure based on methylcarbazate and cyanogen azide. The compound was characterized by single-crystal X-ray diffraction, IR spectroscopy, Raman spectroscopy, multinuclear NMR spectroscopy, elemental analysis, and differential scanning calorimetry（DSC）. With the calculated（CBS-4M） heat of formation（617.0 kJ/mol） and the room temperature X-ray density（2.11 g/cm^3）, impressive values for the detonation parameters such as detonation velocity（8367 m/s） and pressure（31.5 GPa） were computed using the EXPLO5 program. The superior calculated energetic performance show it could serve as a green replacement for the widely used primary explosive,lead（II） azide, which contains toxic ingredient.