Double plasma molecular adsorption system for Stevens–Johnson syndrome/toxic epidermal necrolysis:A case report

BACKGROUND Stevens–Johnson syndrome and toxic epidermal necrolysis(SJS/TEN)are very serious skin allergies,with an etiology related to infections and medication.Since the coronavirus disease 2019(COVID-19)pandemic,severe acute respiratory syndrome coronavirus-2 has also been considered to cause SJS/TEN.CASE SUMMARY We report the case of a woman in her thirties who took acetaminophen after contracting COVID-19.After 3 d of fever relief,she experienced high fever and presented with SJS/TEN symptoms,accompanied by intrahepatic cholestasis.Three days of corticosteroid treatment did not alleviate the skin damage;therefore,double plasma molecular adsorption system(DPMAS)therapy was initiated,with treatment intervals of 48 h.Her skin symptoms improved gradually and were resolved after seven DPMAS treatments.CONCLUSION DPMAS therapy is beneficial for abrogating SJS/TEN because plasma adsorption and perfusion techniques reduce the inflammatory mediators(e.g.,tumor necrosis factor-alpha and interleukin-10 and-12)speculated to be involved in the pathology of the skin conditions.

Plasma perfusion治疗对HBV相关性肝衰竭患者T淋巴细胞亚群及炎性因子表达水平影响的相关性分析

目的:探讨血浆灌流(PP)治疗对肝衰竭患者循环血中T淋巴细胞亚群及炎性因子水平表达的影响及临床意义。方法:以112例肝衰竭患者作为治疗组,选取同期HBsAg(-)的健康体检者25例为对照组,检测在PP治疗前后循环血中CD4+T、CD8+T及炎性因子中的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-10、γ-干扰素(IFN-γ)的水平表达。结果:治疗组患者在采用PP治疗后,TBIL、ALT、PTA、CRP的表达水平较治疗前明显下降(P<0.05)。治疗组患者采用PP治疗前,CD4+T、CD8+T水平较对照组低表达,CD4+T/CD8+T比值高表达,差异有统计学意义(P<0.05)。治疗组患者在PP治疗后,CD4+T、CD8+T水平较治疗前明显上调,CD4+T/CD8+T比值明显下调,差异有统计学意义(P<0.05);CD4+T、CD8+T水平较对照组明显下调,CD4+T/CD8+T比值明显上调,差异有统计学意义(P<0.05)。治疗组患者在PP治疗前,TNF-α、IFN-γ、IL-6、IL-10水平较对照组明显上调,差异有统计学意义(P<0.05);治疗组患者在PP治疗后TNF-α、IFN-γ、IL-6、IL-10水平较治疗前明显下调,差异有统计学意义(P<0.05);治疗组患者在PP治疗后TNF-α、IFN-γ、IL-6、IL-10水平较对照组明显上调,差异有统计学意义(P<0.05)。结论:PP治疗肝衰竭患者可显著调控循环血中T淋巴细胞亚群的失衡状态,调节紊乱的炎性因子水平,促进肝功能复常,提高肝衰竭患者存活率。

Plasma Modification of Activated Carbon Fibers for Adsorption of SO_2

Viscose-based activated carbon fibers （VACFs） were treated by a dielectric-barrier discharge plasma under the feed gas of N2. The surface functional groups of VACFs were modified to improve the adsorption and catalysis capacity for SO2. The surface properties of the untreated and plasma-treated VACFs were diagnosed by SEM, BET, FTIR, and XPS, and the adsorption capacities of VACFs for SO2 were also compared and discussed. The results show that after the plasma treatment, the external surface of VACFs was etched and became rougher, while the surface area and the total pore volume decreased. FTIR and XPS revealed that nitrogen atoms were introduced onto the VACFs surface and the distribution of functional groups on the VACFs surface was changed remarkably. The adsorption characteristic of SO2 indicates that the plasmatreated VACFs have better adsorption capacity than the original VACFs due to the nitrogen functional groups and new functional groups formed in modification, which is beneficial to the adsorption of SO2.

Poly (Acrylamide-co-Acrylic Acid) Hydrogel Induced by Glow-Discharge Electrolysis Plasma and Its Adsorption Properties for Cationic Dyes

In this paper, poly （acrylamide-co-acrylic acid） （P（AM-co-AA）） hydrogel was pre- pared in an aqueous solution by using glow-discharge electrolysis plasma （GDEP） induced copoly- merization of acrylamide （AM） and acrylic acid （AA）, in which N,N＇-methylenebisacrylamide （MBA） was used as a crosslinker. A mechanism for the synthesis of P（AM-co-AA） hydrogel was proposed. To optimize the synthesis condition, the following parameters were examined in detail： the discharge voltage, discharge time, the content of the crosslinker, and the mass ratio of AM to AA. The results showed that the optimum pH range for cationic dyes removal was found to be 5.0-10.0. The P（AM-co-AA） hydrogel exhibits a very high adsorption potential and the ex- perimental adsorption capacities for Crystal violet （CV） and Methylene blue （MB） were 2974.3 mg/g and 2303.6 mg/g, respectively. The adsorption process follows a pseudo-second-order kinetic model. In addition, the adsorption mechanism of P（AM-co-AA） hydrogel for cationic dyes was also discussed.

Plasma graft of poly(ethylene glycol) methyl ether methacrylate (PEGMA) on RGP lens surface for reducing protein adsorption

Poly（ethylene glycol） methyl ether methacrylate（PEGMA） was grafted on fluorosilicone acrylate rigid gas permissible contact lens surface by means of argon plasma induced polymerization to improve surface hydrophilicity and reduce protein adsorption.The surface properties were characterized by contact angle measurement,x-ray photoelectron spectroscopy（XPS） and atomic force microscopy respectively.The surface protein adsorption was evaluated by lysozyme solution immersion and XPS analysis.The results indicated that a thin layer of PEGMA was successfully grafted.The surface hydrophilicity was bettered and surface free energy increased.The lysozyme adsorption on the lens surface was reduced greatly.

Clinical effects investigation of continuous plasma filtration with adsorption and continuous hematodialysis on improving the immune level of patients with sepsis in ICU

Objective:To investigate the clinical effects of continuous plasma filtration with adsorption and continuous hematodialysis on improving the immune level of patients with sepsis in ICU. Methods:A total of 80 patients with sepsis were randomly divided into study group and control group, 40 patients in each group. All the patients were treated by routine treatment. Patients in study group were treated by continuous plasma filtration with adsorption and patients in control group were treated by continuous hematodialysis. The blood samples were collected before and after treatment. The immune cell level, inflammatory factors level, APACHEⅡ score and death rate were compared between two groups.Results:All immune cell indexes were significantly improved in both groups. All immune cell indexes in study group were significantly better than those in control group, after treatment. All inflammatory factors were significantly decreased in both groups. All inflammatory factors in study group were significantly better than those in control group, after treatment. The APACHEⅡ in study group was significantly better than that in control group, after treatment. The death rate in study group was significantly less than that in control group.Conclusion:Continuous plasma filtration with adsorption has a great clinical efficacy on patients with sepsis in ICU, which can improve the immune level and prognosis, makes it worth for clinical application.

Determination of trace amounts of morphine in human plasma by anodic adsorptive stripping differential pulse voltammetry

New adsorptive anodic differential pulse stripping voltammetry method for the direct determination of morphine at trace levels in human plasma of addicts is proposed.The procedure involves an adsorptive accumulation of morphine on a HMDE,followed by oxidation of adsorbed morphine by voltammetry scan using differential pulse modulation.The optimum conditions for the analysis of morphine are pH 10.5,Eacc of -100 mV（vs.Ag/AgCl）,and tacc of 120 s.The peak current is proportional to the concentration of morphine,and a Linear calibration graph is obtained at 0.01-3.10μg mL^-1.A relative standard deviation of 1.06%（n=5）was obtained,and the limit of detection was 3 ng mL^-1.The capabiLity of the method for the analysis of real samples was evaluated by the determination of morphine in spiked human plasma and addicts human plasma with satisfactory results.

Adsorption of Human Serum Albumin onto PVA-coated Affinity Microporous PTFE Capillary

Affinity dye-ligand Cibacron Blue F3GA（CB F3GA） was covalently coupled with poly（vinyl alcohol）（PVA） coated on the inner surface of microporous poly（tetra-fluoroethylene）（MPTFE） membranous capillary. The PVA-coated PTFE capillary surface was characterized by XPS and FESEM. The grafting degree of PVA and the amount of CB F3GA immobilized onto the membranous capillary were 23.5 mg/g and 89.6 pmol/g, respectively. These dyed membranous capillaries were chemically and mechanically stable, and could be reproducibly prepared. Human serum albumin（HSA） was selected as model protein. The saturation adsorbance of the dye attached membranous capillary was 85.3 mg HSA/g, while the capacity of non-specific adsorption for HSA was less than 0.3 mg/g.

Amine-containing film deposited in pulsed dielectric barrier discharge at a high pressure and its cell adsorption behaviours

With monomer allylamine, amine-containing functional films were prepared in alternative current pulsed dielectric barrier discharge （DBD） at a high pressure. This paper analyses in detail the film properties and structures, such as hydrophilicity, compounds and microstructures as well as amine density by the water contact angle, Fourier transform infrared spectroscopy, atomic force microscopy, and ultraviolet-visible measurement. The influence of discharge param- eters, in particular applied power, on amine density was investigated. As an application the cell adsorption behaviours on plasma polymerization films was performed in-vitro. The results show that at a high pressure pulsed DBD plasma can polymerize films with sufficient amine group on surface, through which the very efficient cell adsorption behaviours was demonstrated, and the high rate of cell proliferation was visualized.

Value of Intrauterine Autologous Platelet-Rich Plasma Therapy on Endometrial Receptivity:A Literature Review

Endometrial receptivity is an important factor that influences embryo implantation.Thus,it is important to identify an applicable approach to improve endometrial receptivity in women undergoing assisted reproductive technology.Recently,growing evidence has indicated that intrauterine platelet-rich plasma(PRP)infusion is an effective method to obtain a satisfactory reproductive outcome by increasing endometrial thickness and improving endometrial receptivity.Therefore,the present review aims to outline the possible mechanisms of PRP on endometrial receptivity and summarize the present literature on the effects of PRP therapy in improving endometrial receptivity.

宫腔灌注富血小板血浆对反复种植失败患者妊娠结局影响的Meta分析

目的评估宫腔灌注富血小板血浆(PRP)对反复种植失败(RIF)妇女妊娠结局的影响。方法使用PubMed、Embase、Scopus、Web of Science、CochraneLibrary、中国知识基础设施工程、维普数据库、万方数据库,检索PRP宫腔灌注治疗RIF患者的临床研究。提取数据后使用固定效应模型或随机效应模型进行Meta分析。结果共纳入7项研究。接受PRP宫腔灌注女性的生化妊娠率[OR=2.18,95%CI:[1.34,3.52],P<0.05]、临床妊娠率(OR=2.47,95%CI:[1.66,3.68],P<0.05)、活产率(OR=5.00,95%CI:[1.09,22.99],P<0.05)和胚胎种植率(OR=1.99,95%CI:[1.36,2.93],P<0.05)高于对照组,流产率低于对照组(OR=0.28,95%CI:[0.10,0.77],P<0.05)。亚组分析显示宫腔灌注0.5 mL PRP组的临床妊娠率高于宫腔灌注1.0 mL PRP组(P<0.05),流产率低于宫腔灌注1.0 mL PRP组(P<0.05)。结论宫腔灌注PRP可提高RIF患者的胚胎种植率、活产率、生化妊娠率和临床妊娠率,且显著降低流产的风险,宫腔灌注0.5 mL PRP具有更好的临床效果。

低置换量血浆置换术联合双重血浆分子吸附术治疗慢加急性肝衰竭患者短期预后的结果

目的探讨低置换量血浆置换术(LPE)+双重血浆分子吸附术(DPMAS)联合治疗慢加急性肝衰竭(ACLF)患者的效果,及对患者肝功能、炎症细胞因子及短期预后的影响。方法使用信封法将100例ACLF患者随机分为观察组和对照组,各50例。两组均常规予以护肝、退黄、降酶、抗病毒、预防出血等治疗。对照组在常规治疗基础上,予以血浆置换(PE)治疗;观察组在常规治疗基础上,予以LPE+DP⁃MAS联合治疗。比较两组患者治疗后肝功能、凝血功能、炎症细胞因子水平、不良反应发生率及90 d生存率。结果治疗后,观察组患者肝功能、凝血功能及炎症细胞因子水平均优于对照组(P<0.05)。两组患者90 d生存率和不良反应总发生率比较,差异无统计学意义(P>0.05)。结论LPE+DPMAS联合治疗ACLF患者,可有效改善肝功能及凝血功能,降低炎症因子水平,安全性高。

Novel interface engineering of LDH-based materials on Mg alloy for efficient photocatalytic systems considering the geometrical linearity of condensed phosphates

This study presents a facile and rapid method for synthesizing novel Layered Double Hydroxide(LDH)nanoflakes,exploring their application as a photocatalyst,and investigating the influence of condensed phosphates'geometric linearity on their photocatalytic properties.Herein,the Mg O film,obtained by plasma electrolysis of AZ31 Mg alloys,was modified by growing an LDH film,which was further functionalized using cyclic sodium hexametaphosphate(CP)and linear sodium tripolyphosphate(LP).CP acted as an enhancer for flake spacing within the LDH structure,while LP changed flake dispersion and orientation.Consequently,CP@LDH demonstrated exceptional efficiency in heterogeneous photocatalysis,effectively degrading organic dyes like Methylene blue(MB),Congo red(CR),and Methyl orange(MO).The unique cyclic structure of CP likely enhances surface reactions and improves the catalyst's interaction with dye molecules.Furthermore,the condensed phosphate structure contributes to a higher surface area and reactivity in CP@LDH,leading to its superior photocatalytic performance compared to LP@LDH.Specifically,LP@LDH demonstrated notable degradation efficiencies of 93.02%,92.89%,and 88.81%for MB,MO,and CR respectively,over a 40 min duration.The highest degradation efficiencies were observed in the case of the CP@LDH sample,reporting 99.99%for MB,98.88%for CR,and 99.70%for MO.This underscores the potential of CP@LDH as a highly effective photocatalyst for organic dye degradation,offering promising prospects for environmental remediation and water detoxification applications.

DPMAS治疗药物性肝损伤伴严重高胆红素血症患者临床疗效研究

目的分析双重血浆分子吸附系统(double plasma molecular adsorption system,DPMAS)治疗药物性肝损伤(drug-induced liver injury,DILI)伴严重高胆红素血症患者的临床疗效。方法收集2021年4月至2022年4月我院诊治的DILI伴严重高胆红素血症患者60例,随机分为观察组30例和对照组30例。对照组给予传统内科治疗,观察组在传统内科治疗基础上行DPMAS治疗。比较两组治疗前后临床症状、实验室指标的变化情况,观察两组治疗有效率及疗效差异。结果引起肝损伤的主要药物包括中药、解热镇痛药、化疗药物等;DILI损伤类型包括肝细胞损伤型、胆汁淤积型、混合型;治疗后,观察组和对照组AST、ALT、ALP、TBA、TBIL、DBIL较两组治疗前显著降低(P<0.05);观察组PT和INR较治疗前降低,而ALB和PTA较治疗前升高(P<0.05);两组治疗后肝肾功能和凝血功能比较,差异无统计学意义(P>0.05)。治疗后,两组有效率比较,差异无统计学意义(P>0.05)。观察组TBIL下降率达30%、50%和70%所需的治疗时间均显著短于对照组(P<0.05),同时观察组TBIL和DBIL总下降率显著高于对照组(P<0.05)。结论DPMAS治疗DILI伴严重高胆红素血症患者的临床疗效显著,可以快速降低胆红素并缩短病程。

双重血浆分子吸附系统序贯半量血浆置换改善乙肝相关慢加急性肝衰竭患者的短期预后

目的探讨双重血浆分子吸附系统序贯半量血浆置换(DPMAS+HPE)治疗对乙肝相关慢加急性肝衰竭(HBV-ACLF)患者短期生存率的影响。方法回顾性收集2015年1月1日至2022年12月31日在本院住院治疗的HBV-ACLF病例资料,按照治疗方式的不同分为内科综合治疗组和DPMAS+HPE组,倾向得分匹配消除组间混杂偏差,比较2组基线资料及治疗后实验室指标改善情况,Logistic回归分析HBV-ACLF患者死亡相关危险因素,Kaplan-Meier生存分析比较2组30 d和90 d累计生存率。结果本研究共纳入373例HBV-ACLF病例,其中治疗组136例在内科综合治疗基础上接受1次DPMAS+HPE。237例单纯接受内科综合治疗,经倾向得分匹配(PSM)后纳入136例患者作为对照组。治疗组治疗前后丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总蛋白(TP)下降幅度(446.5 vs 159.0、317.0 vs 92.0、5.2 vs 0.3)显著大于对照组,差异具统计学意义(P<0.05);DPMAS+HPE治疗是HBV-ACLF患者30 d和90 d死亡独立保护因素(30 d:OR=0.497,P<0.05;90 d:OR=0.436,P<0.05);治疗组30 d和90 d累计生存率显著高于对照组(30 d:50.71%vs 44.12%,P<0.05;90 d:30.15%vs 22.79%,P<0.05)。结论DPMAS+HPE能改善HBV-ACLF患者肝功能和短期生存率,可作为1种有效治疗HBV-ACLF患者的人工肝模式。

血浆炎性因子吸附在脓毒症治疗中的应用研究进展

脓毒症和脓毒性休克是重症监护室常见病种,全球每年有超过1 800万严重脓毒症病例。国外流行病学调查显示,脓毒症的病死率已经超过心肌梗死,成为重症监护室非心脏病人的死亡主要原因。医学的进步带来越来越多治疗脓毒症的创新治疗方式,连续血液净化逐渐成为脓毒症患者早期治疗的重要手段,同时体外血液吸附在脓毒症患者中的治疗价值也逐渐受到重视。本文旨在总结近些年血浆炎性因子吸附在脓毒症治疗中应用的研究进展,对现有研究报道或已在临床应用的常见的几种体外血液吸附技术及其相关研究进展进行总结,以期为更好认识其在临床治疗中的运用价值及对预后的改善提供参考,从而为脓毒症及脓毒症休克患者治疗提供帮助。

不同模式人工肝治疗对肝衰竭患者肝肾功能及凝血功能的影响

目的:分析对肝衰竭患者开展不同模式的人工肝治疗的影响。方法:选取2022年1—9月九江市第一人民医院收治的75例肝衰竭患者,经随机数字表法划分成A组、B组、C组,各25例,A组进行双重血浆分子吸附(DPMAS)+血浆置换(PE),B组进行血浆透析滤过(PDF),C组开展PE,比较三组症状改善效果、实验室指标、终末期肝病模型(MELD)评分的变化,并统计不良反应发生情况。结果:三组治疗后的有效率、不良反应发生率基本一致(P>0.05)。三组治疗前血清总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、肌酐(Cr)、白蛋白(ALB)、国际标准化比值(INR)、凝血酶原活动度(PTA)、MELD评分差异均无统计学意义(P>0.05);治疗后,三组TBIL、ALT、AST、Cr、INR、MELD评分较治疗前均降低,C组ALB、PTA较治疗前均升高,A、B组ALB、PTA较治疗前均降低(P<0.05);三组间治疗后的TBIL、ALT、AST、Cr、INR、MELD评分比较,差异均无统计学意义(P>0.05),C组ALB、PTA均高于A、B组(P<0.05)。结论:肝衰竭患者中,将DPMAS+PE、PDF、PE进行灵活应用的疗效良好,无明显优劣,对临床症状的改善均有着较为理想的应用价值。

去脂血浆净化治疗急性高脂血症性胰腺炎的效果分析

目的:分析去脂血浆净化治疗急性高脂血症性胰腺炎的临床效果。方法:选取2020年1月—2022年9月东台市人民医院收治的急性高脂血症性胰腺炎患者85例,按照随机数字表法分为研究组和对照组,对照组(42例)使用血浆置换治疗,研究组(43例)则采用去脂血浆净化血液灌流治疗,比较两组临床疗效。结果:研究组治疗总有效率、高密度脂蛋白胆固醇(HDL-C)、转化生长因子-β(TGF-β)水平和平均动脉压(MAP)均高于对照组,三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、淀粉酶(AMS)、降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)水平均低于对照组,腹痛消失时间早于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05)。结论:去脂血浆净化应用于血液灌流治疗急性高脂血症性胰腺炎效果显著,能够有效稳定患者血脂水平,同时改善其免疫功能。

氩等离子体改性膨润土及其对亚甲基蓝吸附性能的研究

膨润土是一种硅酸盐黏土矿物,在机械、冶金、化工、环保等行业有重要应用。通过改变放电气体种类,放电时间等参数得到不同性能的改性膨润土样品,通过吸附亚甲基蓝试验确定了最佳改性条件。对改性后的膨润土进行了FTIR、SEM和XRD、TGA、BET等分析表征。结果表明,Ar等离子体改性可以提升膨润土的吸附性能。改性后的样品基本骨架保持不变,但比表面积和孔容增大,电位降低。将10 mg Ar等离子体改性的膨润土置于200 mL,20 mg/L的亚甲基蓝溶液中,吸附量可达183 mg/g,而未改性的膨润土的吸附量只有117 mg/g。

双重血浆分子吸附系统序贯血浆置换治疗HBV感染相关慢加急性肝衰竭疗效及对患者血清内毒素和炎症因子水平的影响

目的:分析双重血浆分子吸附系统(DPMAS)序贯血浆置换(PE)治疗乙型肝炎病毒感染相关慢加急性肝衰竭(HBV-ACLF)疗效及对患者血清内毒素和炎症因子水平的影响。方法:将92例HBV-ACLF患者根据非随机同期对照研究及患者自愿原则分为DPMAS序贯PE组(n=45例)和PE组(n=47例)。PE组接受单纯PE治疗,DPMAS序贯PE组接受DPMAS序贯PE治疗。比较两组患者治疗4周及12周时的好转率及存活率;比较两组治疗前、治疗4周及12周时的血清炎性因子、内毒素水平(ET)及终末期肝病模型(MELD)评分;比较两组并发症发生情况。结果:两组治疗4周好转率比较有统计学差异(P<0.05),治疗12周好转率比较无统计学差异(P>0.05);两组治疗4周及12周存活率比较无统计学差异(均P>0.05);治疗4周及12周时,DPMAS序贯PE组血清C反应蛋白(CRP)、白细胞介素6(IL-6)、中性粒细胞/淋巴细胞比值(NLR)及ET水平低于PE组(均P<0.05);DPMAS序贯PE组治疗4周时的MELD评分低于PE组(P<0.05);两组治疗期间肺部感染、电解质紊乱、肝肾综合征等并发症发生率比较无统计学差异(均P>0.05)。结论:DPMAS序贯PE治疗HBV-ACLF患者,可有效降低血清炎症因子及内毒素水平,应用效果良好。