Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its...Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its reliabil- ity and accuracy are dependent upon the mathematical model. In this work, an integrated mathematical model for the microchannel in the crimped ribbon flame attesters was set up; the fluid flow behavior and the sensitiv- ities of four chemical kinetics mechanisms of propane-air on the accuracy were analysed. It is shown that turbu- lence is predominant in the microchannel of the crimped ribbon flame arresters under the defiagration and detonation conditions, and a new quenching criterion for the numerical simulation is proposed. The kinetics mechanism of Mansouri et al. among the four ones is the most accurate due to the best agreement of the pre- dicted outlet temperature at the experimental flameproof velocity with the autoignition temperature of propane-air. The species mass fraction profiles and the temperature distribution, which are too difficult to mea- sure due to the tiny dimension of the microchannel in experiments, are captured. The fundamental insights into chemical reactions and heat loss are well portrayed. It can be concluded that the integrated mathematical model established in this work can be used as a reliable tool for modeling, selecting and designing such type of crimped ribbon flame attesters with the propane-air medium in the future.展开更多
In this paper, controlling chaos when chaotic ferroresonant oscillations occur in a voltage transformer with nonlin- ear core loss model is performed. The effect of a parallel metal oxide surge arrester on the ferrore...In this paper, controlling chaos when chaotic ferroresonant oscillations occur in a voltage transformer with nonlin- ear core loss model is performed. The effect of a parallel metal oxide surge arrester on the ferroresonance oscillations of voltage transformers is studied. The metal oxide arrester (MOA) is found to be effective in reducing ferroresonance chaotic oscillations. Also the multiple scales method is used to analyze the chaotic behavior and different types of fixed points in ferroresonance of voltage transformers considering core loss. This phenomenon has nonlinear chaotic dynamics and includes sub-harmonic, quasi-periodic, and also chaotic oscillations. In this paper, the chaotic behavior and various ferroresonant oscillation modes of the voltage transformer is studied. This phenomenon consists of different types of bifur- cations such as period doubling bifurcation (PDB), saddle node bifurcation (SNB), Hopf bifurcation (HB), and chaos. The dynamic analysis of ferroresonant circuit is based on bifurcation theory. The bifurcation and phase plane diagrams are il- lustrated using a continuous method and linear and nonlinear models of core loss. To analyze ferroresonance phenomenon, the Lyapunov exponents are calculated via the multiple scales method to obtain Feigenbaum numbers. The bifurcation diagrams illustrate the variation of the control parameter. Therefore, the chaos is created and increased in the system.展开更多
Rogowski coils(RCs)are widely used to measure power or high frequency currents based on their design.In this paper,two types of RCs that are circular(traditional)and cylindrical shapes wound using wire covered by varn...Rogowski coils(RCs)are widely used to measure power or high frequency currents based on their design.In this paper,two types of RCs that are circular(traditional)and cylindrical shapes wound using wire covered by varnish are constructed.This construction is carried out to be suitable for monitoring the discharge current of the surge arrester installed in the distribution system.Concerning high frequency RC modeling for both types considering transfer function is introduced.Self-integrating for both types is attained.Therefore,the experimental tests using function generator for both coils are carried out to identify the parameters of the transfer function representing the introduced model.The measured signals for current and induced voltages are denoised for the parameter identification process.The denoised process is achieved using the MATLAB code‘wdenoise’while the parameters are estimated using the system identification toolbox.Verification of the proposed model is achieved using experimental results for the two coils.The sensitivity of the two coils is investigated based on the induced output voltage.The application concerning the two coils for monitoring the discharge current of the surge arrester is done.The results confirm the accuracy of the introduced RC model,as well as the performance of the cylindrical shape,is better than the traditional one.The simulation is carried out using MATLAB and ATPDraw programs.展开更多
Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. Thi...Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. This paper presents the electrical performance of ZnO SAs in 22 kV distribution systems using thermal image camera under the power frequency AC operating voltages. When ZnO surge arresters are installation takes a long time in distribution system over more than 5 years. For the experimental study, as ZnO installation takes a long time over 6 years the leakage current is 63.9 mA, temperature differences were measured over a period of time over 14 degree Celsius. This data will be useful as a guideline for solving problems and reducing power loss from leakage current. Moreover, it will be useful in predicting lifetime of ZnO SAs.展开更多
Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wa...Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wall bushings and disconnecting switches for power transmission & distribution systems. In fact, SEPW is展开更多
Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective de...Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective devices. The study was testing performance of arresters on low voltage system. The activity was testing of arresters using steady state and impulse voltages. The arresters consisted of gas tube, zener diode, varistor and spark gap arresters, then it was made a cascade circuit between the varistor and spark gap arresters with a decoupling element. The decoupling elements were used air, iron and ferrite. The test yielded data of current and voltage on the tables and oscilloscope waveforms. The arresters had cut voltages early different from each other, namely the gas tube, zener diode, spark gap and varistor arresters were at the voltages of 500 V, 250 V, 1,000 V and 565 V respectively. The iron core decoupling element cascade circuit had the least oscillation among remaining cores.展开更多
This paper systematically studies the flashover probability of wind turbine blade lightning arrester and the impact of strong electromagnetic pulses on the local and surrounding wind turbines during lightning strikes....This paper systematically studies the flashover probability of wind turbine blade lightning arrester and the impact of strong electromagnetic pulses on the local and surrounding wind turbines during lightning strikes.The research results indicate that the flashover probability of direct lightning strikes by the wind turbine blade lightning arrester is almost negligible,and the strong electromagnetic pulse of wind turbine blade during lightning strikes has a serious impact on the electronic equipment of the machine,while the impact on the surrounding wind turbine is relatively small.At the same time,the calculation formula for the reflection of lightning current on the carbon brush between the wind turbine hub and the engine compartment during the flashing of the wind turbine blades is provided,and the calculation method for calculating the spatial gradient distribution of electromagnetic field intensity using Biot-Savart Law theorem is applied.The limitations of using wind turbine blades for lightning protection are pointed out,and a technical route for achieving wind turbine lightning safety is proposed,which can be used as a reference for wind turbine lightning protection technicians.展开更多
The surge arrester with excellent protection characteristics would decrease the overvoltage level ap- plied on the power apparatus to reduce their insulation levels and manufacturing bottleneck. The arrester for the 1...The surge arrester with excellent protection characteristics would decrease the overvoltage level ap- plied on the power apparatus to reduce their insulation levels and manufacturing bottleneck. The arrester for the 1000-kV ultra-high voltage ac power transmission system is designed as tank-type structure. The field-circuit combination numerical method combining the three-dimensional finite element method with circuit is proposed to analyze the potential distribution of GIS arrester. By comparing several design schemes, the most effective method to improve the potential distribution along the varistor column is to increase the voltage gradient of the ZnO varistor. Synthesizing several influential factors, the suitable voltage gradient of ZnO varistor should be controlled to 435 V/mm, and the resulted nonuniform degree of the potential distribution along the varistor column inside the GIS arrester would be controlled smaller than 10%. The result in this paper provides the fundamental technical index for the study of the high voltage gradient ZnO varistors.展开更多
Mutations in the microrchidia CW-type zinc finger protein 2(MORC2)gene are the causative agent of Charcot-Marie-Tooth disease type 2Z(CMT2Z),and the hotspot mutation p.S87L is associated with a more seve re spinal mus...Mutations in the microrchidia CW-type zinc finger protein 2(MORC2)gene are the causative agent of Charcot-Marie-Tooth disease type 2Z(CMT2Z),and the hotspot mutation p.S87L is associated with a more seve re spinal muscular atrophy-like clinical phenotype.The aims of this study were to determine the mechanism of the severe phenotype caused by the MORC2 p.S87L mutation and to explore potential treatment strategies.Epithelial cells were isolated from urine samples from a spinal muscular atrophy(SMA)-like patient[MORC2 p.S87L),a CMT2Z patient[MORC2 p.Q400R),and a healthy control and induced to generate pluripotent stem cells,which were then differentiated into motor neuron precursor cells.Next-generation RNA sequencing followed by KEGG pathway enrichment analysis revealed that differentially expressed genes involved in the PI3K/Akt and MAP K/ERK signaling pathways were enriched in the p.S87L SMA-like patient group and were significantly downregulated in induced pluripotent stem cells.Reduced proliferation was observed in the induced pluripotent stem cells and motor neuron precursor cells derived from the p.S87L SMA-like patient group compared with the CMT2Z patient group and the healthy control.G0/G1 phase cell cycle arrest was observed in induced pluripotent stem cells derived from the p.S87L SMA-like patient.MORC2 p.S87Lspecific antisense oligonucleotides(p.S87L-ASO-targeting)showed significant efficacy in improving cell prolife ration and activating the PI3K/Akt and MAP K/ERK pathways in induced pluripotent stem cells.Howeve r,p.S87L-ASO-ta rgeting did not rescue prolife ration of motor neuron precursor cells.These findings suggest that downregulation of the PI3K/Akt and MAP K/ERK signaling pathways leading to reduced cell proliferation and G0/G1 phase cell cycle arrest in induced pluripotent stem cells might be the underlying mechanism of the severe p.S87L SMA-like phenotype.p.S87L-ASO-targeting treatment can alleviate disordered cell proliferation in the early stage of pluripotent stem cell induction.展开更多
BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogrammingrelated parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the ...BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogrammingrelated parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC).METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Aflliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82) and a survival group(n=38).Healthy adult volunteers(n=40) of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogrammingrelated parameters(lactate dehydrogenase [LDH],lactate and pyruvate),neuron-specific enolase(NSE) and interleukin 6(IL-6) were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation II(APACHE II) score and Sequential Organ Failure Assessment(SOFA) score were calculated.The Cerebral Performance Category(CPC) score was recorded on day 28 after ROSC.RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1) significantly increased and were higher in the non-survivors than in the survivors on admission(all P<0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE II score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P<0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC) of 0.904 [95% confidence interval [95% CI]:0.851–0.957]) with 96.8% specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95% CI:0.911–0.989) with 94.7% specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested.CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive eflcacy of LDH during the first week was superior to others.展开更多
The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Maj...The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Major manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful resuscitation.Why do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was described.By modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony heart.Community awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term outcomes.Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes.This review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation syndrome.The pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for CPR.Although restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and care.The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.展开更多
Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Over...Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Overall,different types of plasticity,including stem cell-driven genesis of new neurons(adult neurogenesis),cells in arrested maturation(dormant neurons),neuro-glial and synaptic plasticity,can coexist and contribute to grant plastic changes in the brain,from a cellular to system level(Benedetti and Couillard-Despres,2022;Bonfanti et al.,2023).展开更多
Aqueous Zn-ion batteries(AZIBs)have attracted increasing attention in next-generation energy storage systems due to their high safety and economic.Unfortunately,the side reactions,dendrites and hydrogen evolution effe...Aqueous Zn-ion batteries(AZIBs)have attracted increasing attention in next-generation energy storage systems due to their high safety and economic.Unfortunately,the side reactions,dendrites and hydrogen evolution effects at the zinc anode interface in aqueous electrolytes seriously hinder the application of aqueous zinc-ion batteries.Here,we report a critical solvation strategy to achieve reversible zinc electrochemistry by introducing a small polar molecule acetonitrile to form a“catcher”to arrest active molecules(bound water molecules).The stable solvation structure of[Zn(H_(2)O)_(6)]^(2+)is capable of maintaining and completely inhibiting free water molecules.When[Zn(H_(2)O)_(6)]^(2+)is partially desolvated in the Helmholtz outer layer,the separated active molecules will be arrested by the“catcher”formed by the strong hydrogen bond N-H bond,ensuring the stable desolvation of Zn^(2+).The Zn||Zn symmetric battery can stably cycle for 2250 h at 1 mAh cm^(-2),Zn||V_(6)O_(13) full battery achieved a capacity retention rate of 99.2%after 10,000 cycles at 10 A g^(-1).This paper proposes a novel critical solvation strategy that paves the route for the construction of high-performance AZIBs.展开更多
Objective Endometrial carcinoma(EC)is a prevalent gynecological malignancy characterized by increasing incidence and mortality rates.This underscores the critical need for novel therapeutic targets.One such potential ...Objective Endometrial carcinoma(EC)is a prevalent gynecological malignancy characterized by increasing incidence and mortality rates.This underscores the critical need for novel therapeutic targets.One such potential target is cell division cycle 20(CDC20),which has been implicated in oncogenesis.This study investigated the effect of the CDC20 inhibitor Apcin on EC and elucidated the underlying mechanism involved.Methods The effects of Apcin on EC cell proliferation,apoptosis,and the cell cycle were evaluated using CCK8 assays and flow cytometry.RNA sequencing(RNA-seq)was subsequently conducted to explore the underlying molecular mechanism,and Western blotting and coimmunoprecipitation were subsequently performed to validate the results.Animal studies were performed to evaluate the antitumor effects in vivo.Bioinformatics analysis was also conducted to identify CDC20 as a potential therapeutic target in EC.Results Treatment with Apcin inhibited proliferation and induced apoptosis in EC cells,resulting in cell cycle arrest.Pathways associated with apoptosis and the cell cycle were activated following treatment with Apcin.Notably,Apcin treatment led to the upregulation of the cell cycle regulator p21,which was verified to interact with CDC20 and consequently decrease the expression of downstream cyclins in EC cells.In vivo experiments confirmed that Apcin treatment significantly impeded tumor growth.Higher CDC20 expression was observed in EC tissue than in nonmalignant tissue,and increased CDC20 expression in EC patients was associated with shorter overall survival and progress free interval.Conclusion CDC20 is a novel molecular target in EC,and Apcin could be developed as a candidate antitumor drug for EC treatment.展开更多
Objective:To examine the inhibitory effect of Hydrangea serrata extract against hepatocellular carcinoma HepG2 cells and its underlying mechanisms.Methods:The effects of Hydrangea serrata extract on growth inhibition ...Objective:To examine the inhibitory effect of Hydrangea serrata extract against hepatocellular carcinoma HepG2 cells and its underlying mechanisms.Methods:The effects of Hydrangea serrata extract on growth inhibition of tumor cells and spheroids were assessed using MTT and 3D culture assays.Quantitative real-time PCR and Western blot analyses were employed to investigate the changes in mRNA and protein expression levels of molecules related to cell cycle and apoptosis.Results:Hydrangea serrata extract effectively inhibited the growth of both tumor cells and spheroids.The extract also significantly upregulated p27 mRNA expression and downregulated CDK2 mRNA expression,leading to cell cycle arrest.Moreover,increased BAX/Bcl-2 ratio as well as caspase-9 and-3 were observed after treatment with Hydrangea serrata extract,indicating the induction of tumor cell apoptosis.Conclusions:Hydrangea serrata extract has the potential to alleviate tumors by effectively modulating cell-cycle-related gene expressions and inducing apoptosis,thereby inhibiting tumor growth.展开更多
BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysm...BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients’general information,ETCO_(2),and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.展开更多
BACKGROUND Simple bone cysts(SBC)are benign tumor-like bone lesions typically identified in children.While SBC may lead to growth disturbances or growth arrest,such cases are uncommon.The mechanisms behind these obser...BACKGROUND Simple bone cysts(SBC)are benign tumor-like bone lesions typically identified in children.While SBC may lead to growth disturbances or growth arrest,such cases are uncommon.The mechanisms behind these observations remain unclear.Additionally,research on the etiology of SBC remains inconclusive,and there has been no consensus on the appropriate timing and methodology for treatment.CASE SUMMARY Here,we present our experience in the successful surgical management of a 10-year-old girl with SBC,who presented with a pathological fracture complicated by malunion of the displaced fracture,varus deformity,and limb length discrepancy.We hypothesized two possible etiologies for the patient’s growth arrest and subsequent humerus varus deformity:(1)Direct disruption of the physis by fluid from the cyst itself;and(2)damage to the epiphysis due to repetitive pathological fractures associated with SBC.In addressing this case,surgical intervention was undertaken to correct the proximal humerus varus deformity.This approach offered the advantages of simultaneously correcting angular abnormalities,achieving mild limb lengthening,providing definitive SBC treatment,and reducing the overall treatment duration.CONCLUSION As per current literature,acute correction of acute angular deformity in proximal humeral SBC is not well comprehended.However,in this specific case,acute correction was considered an optimal solution.展开更多
BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare system.Although there have been advances in treatment modali...BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare system.Although there have been advances in treatment modalities,survival rates for TCA patients remain low.This narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating TCA.METHODS:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,2022.The search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English language.Following the search,943 articles were retrieved,and two independent reviewers conducted a screening process.RESULTS:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable rhythm.There were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital epinephrine.Emergency thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt trauma.Resuscitative endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic shock.When implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality rates.Veno-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,respectively.In the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ECLS.CONCLUSION:TCA remains a signifi cant challenge for emergency medical services due to its high morbidity and mortality rates.Pre-and intra-arrest prognostic factors can help identify patients who are likely to benefit from aggressive and resource-intensive resuscitation measures.Further research is needed to enhance guidelines for the clinical use of established and emerging therapeutic approaches that can help optimize treatment effi cacy and ameliorate survival outcomes.展开更多
Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to impr...Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are unknown.To this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB pathways.Subsequently,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by asphyxia.The results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these effects.To conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.展开更多
BACKGROUND Cardiac arrest(CA)induced by electric shock is a rare occurrence,particularly in cases of prolonged CA.Currently,there is limited literature on similar incidents,and we present a relevant case report.CASE S...BACKGROUND Cardiac arrest(CA)induced by electric shock is a rare occurrence,particularly in cases of prolonged CA.Currently,there is limited literature on similar incidents,and we present a relevant case report.CASE SUMMARY A 27-year-old Asian male man,experiencing respiratory CA due to electric shock,was successfully restored to sinus rhythm after 50 min of cardiopulmonary resuscitation and 8 electrical defibrillation sessions.In the subsequent stages,the patient received multiple organ function protection measures,leading to a successful recovery and eventual discharge from the hospital.CONCLUSION Prolonging resuscitation time can enhance the chances of survival for patients,this study provide valuable insights into the management of electric shock-induced CA.展开更多
基金Supported by the National Key Research and Development Program of China(2016YFB0301701)the National Natural Science Foundation of China(21706268+4 种基金9143411421376254)the Postdoctoral Science Foundation of Qingdao Municipal Government(Y7330419DM)the Instrument Developing Project of the Chinese Academy of Sciences(YZ201641)State Key Laboratory of Safety and Control for Chemicals of China
文摘Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its reliabil- ity and accuracy are dependent upon the mathematical model. In this work, an integrated mathematical model for the microchannel in the crimped ribbon flame attesters was set up; the fluid flow behavior and the sensitiv- ities of four chemical kinetics mechanisms of propane-air on the accuracy were analysed. It is shown that turbu- lence is predominant in the microchannel of the crimped ribbon flame arresters under the defiagration and detonation conditions, and a new quenching criterion for the numerical simulation is proposed. The kinetics mechanism of Mansouri et al. among the four ones is the most accurate due to the best agreement of the pre- dicted outlet temperature at the experimental flameproof velocity with the autoignition temperature of propane-air. The species mass fraction profiles and the temperature distribution, which are too difficult to mea- sure due to the tiny dimension of the microchannel in experiments, are captured. The fundamental insights into chemical reactions and heat loss are well portrayed. It can be concluded that the integrated mathematical model established in this work can be used as a reliable tool for modeling, selecting and designing such type of crimped ribbon flame attesters with the propane-air medium in the future.
文摘In this paper, controlling chaos when chaotic ferroresonant oscillations occur in a voltage transformer with nonlin- ear core loss model is performed. The effect of a parallel metal oxide surge arrester on the ferroresonance oscillations of voltage transformers is studied. The metal oxide arrester (MOA) is found to be effective in reducing ferroresonance chaotic oscillations. Also the multiple scales method is used to analyze the chaotic behavior and different types of fixed points in ferroresonance of voltage transformers considering core loss. This phenomenon has nonlinear chaotic dynamics and includes sub-harmonic, quasi-periodic, and also chaotic oscillations. In this paper, the chaotic behavior and various ferroresonant oscillation modes of the voltage transformer is studied. This phenomenon consists of different types of bifur- cations such as period doubling bifurcation (PDB), saddle node bifurcation (SNB), Hopf bifurcation (HB), and chaos. The dynamic analysis of ferroresonant circuit is based on bifurcation theory. The bifurcation and phase plane diagrams are il- lustrated using a continuous method and linear and nonlinear models of core loss. To analyze ferroresonance phenomenon, the Lyapunov exponents are calculated via the multiple scales method to obtain Feigenbaum numbers. The bifurcation diagrams illustrate the variation of the control parameter. Therefore, the chaos is created and increased in the system.
基金funded from Taif University Researchers Supporting Project number(TURSP-2020/264),Taif University,Taif,Saudi Arabia.
文摘Rogowski coils(RCs)are widely used to measure power or high frequency currents based on their design.In this paper,two types of RCs that are circular(traditional)and cylindrical shapes wound using wire covered by varnish are constructed.This construction is carried out to be suitable for monitoring the discharge current of the surge arrester installed in the distribution system.Concerning high frequency RC modeling for both types considering transfer function is introduced.Self-integrating for both types is attained.Therefore,the experimental tests using function generator for both coils are carried out to identify the parameters of the transfer function representing the introduced model.The measured signals for current and induced voltages are denoised for the parameter identification process.The denoised process is achieved using the MATLAB code‘wdenoise’while the parameters are estimated using the system identification toolbox.Verification of the proposed model is achieved using experimental results for the two coils.The sensitivity of the two coils is investigated based on the induced output voltage.The application concerning the two coils for monitoring the discharge current of the surge arrester is done.The results confirm the accuracy of the introduced RC model,as well as the performance of the cylindrical shape,is better than the traditional one.The simulation is carried out using MATLAB and ATPDraw programs.
文摘Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. This paper presents the electrical performance of ZnO SAs in 22 kV distribution systems using thermal image camera under the power frequency AC operating voltages. When ZnO surge arresters are installation takes a long time in distribution system over more than 5 years. For the experimental study, as ZnO installation takes a long time over 6 years the leakage current is 63.9 mA, temperature differences were measured over a period of time over 14 degree Celsius. This data will be useful as a guideline for solving problems and reducing power loss from leakage current. Moreover, it will be useful in predicting lifetime of ZnO SAs.
文摘Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wall bushings and disconnecting switches for power transmission & distribution systems. In fact, SEPW is
文摘Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective devices. The study was testing performance of arresters on low voltage system. The activity was testing of arresters using steady state and impulse voltages. The arresters consisted of gas tube, zener diode, varistor and spark gap arresters, then it was made a cascade circuit between the varistor and spark gap arresters with a decoupling element. The decoupling elements were used air, iron and ferrite. The test yielded data of current and voltage on the tables and oscilloscope waveforms. The arresters had cut voltages early different from each other, namely the gas tube, zener diode, spark gap and varistor arresters were at the voltages of 500 V, 250 V, 1,000 V and 565 V respectively. The iron core decoupling element cascade circuit had the least oscillation among remaining cores.
基金Research Project on Lightning Protection Technology for 35 kV Collector Lines in Wuxuan Qinglan Wind Farm(SFC/WXY-ZX-FW-23-008)Strong Electromagnetic Pulse Protection(Lightning)Effect in Guangdong Yuedian Zhuhai Biqing Bay Sea Wind Field and Real-time Monitoring Technology Research and Development Project of Grounding ResistanceResearch and Application Demonstration Project of Lightning Protection Technology for Offshore and Island Wind Field of China General Nuclear New Energy South China Branch.
文摘This paper systematically studies the flashover probability of wind turbine blade lightning arrester and the impact of strong electromagnetic pulses on the local and surrounding wind turbines during lightning strikes.The research results indicate that the flashover probability of direct lightning strikes by the wind turbine blade lightning arrester is almost negligible,and the strong electromagnetic pulse of wind turbine blade during lightning strikes has a serious impact on the electronic equipment of the machine,while the impact on the surrounding wind turbine is relatively small.At the same time,the calculation formula for the reflection of lightning current on the carbon brush between the wind turbine hub and the engine compartment during the flashing of the wind turbine blades is provided,and the calculation method for calculating the spatial gradient distribution of electromagnetic field intensity using Biot-Savart Law theorem is applied.The limitations of using wind turbine blades for lightning protection are pointed out,and a technical route for achieving wind turbine lightning safety is proposed,which can be used as a reference for wind turbine lightning protection technicians.
基金Supported by the National Nature Science Foundation of China (Grant Nos.50425721,5073001)the 11th Five-year National S&T Supporting Plan (Grant No.2006BAA02A16)
文摘The surge arrester with excellent protection characteristics would decrease the overvoltage level ap- plied on the power apparatus to reduce their insulation levels and manufacturing bottleneck. The arrester for the 1000-kV ultra-high voltage ac power transmission system is designed as tank-type structure. The field-circuit combination numerical method combining the three-dimensional finite element method with circuit is proposed to analyze the potential distribution of GIS arrester. By comparing several design schemes, the most effective method to improve the potential distribution along the varistor column is to increase the voltage gradient of the ZnO varistor. Synthesizing several influential factors, the suitable voltage gradient of ZnO varistor should be controlled to 435 V/mm, and the resulted nonuniform degree of the potential distribution along the varistor column inside the GIS arrester would be controlled smaller than 10%. The result in this paper provides the fundamental technical index for the study of the high voltage gradient ZnO varistors.
基金supported by the National Natural Science Foundation of China,Nos.82171172(to RZ)and 81771366(to RZ)Fundamental Research Funds for the Central Universities of Central South University,Nos.2021zzts1095(to SZ)and 2022zzts0832(to HY)。
文摘Mutations in the microrchidia CW-type zinc finger protein 2(MORC2)gene are the causative agent of Charcot-Marie-Tooth disease type 2Z(CMT2Z),and the hotspot mutation p.S87L is associated with a more seve re spinal muscular atrophy-like clinical phenotype.The aims of this study were to determine the mechanism of the severe phenotype caused by the MORC2 p.S87L mutation and to explore potential treatment strategies.Epithelial cells were isolated from urine samples from a spinal muscular atrophy(SMA)-like patient[MORC2 p.S87L),a CMT2Z patient[MORC2 p.Q400R),and a healthy control and induced to generate pluripotent stem cells,which were then differentiated into motor neuron precursor cells.Next-generation RNA sequencing followed by KEGG pathway enrichment analysis revealed that differentially expressed genes involved in the PI3K/Akt and MAP K/ERK signaling pathways were enriched in the p.S87L SMA-like patient group and were significantly downregulated in induced pluripotent stem cells.Reduced proliferation was observed in the induced pluripotent stem cells and motor neuron precursor cells derived from the p.S87L SMA-like patient group compared with the CMT2Z patient group and the healthy control.G0/G1 phase cell cycle arrest was observed in induced pluripotent stem cells derived from the p.S87L SMA-like patient.MORC2 p.S87Lspecific antisense oligonucleotides(p.S87L-ASO-targeting)showed significant efficacy in improving cell prolife ration and activating the PI3K/Akt and MAP K/ERK pathways in induced pluripotent stem cells.Howeve r,p.S87L-ASO-ta rgeting did not rescue prolife ration of motor neuron precursor cells.These findings suggest that downregulation of the PI3K/Akt and MAP K/ERK signaling pathways leading to reduced cell proliferation and G0/G1 phase cell cycle arrest in induced pluripotent stem cells might be the underlying mechanism of the severe p.S87L SMA-like phenotype.p.S87L-ASO-targeting treatment can alleviate disordered cell proliferation in the early stage of pluripotent stem cell induction.
基金funded by the Shenzhen Science and Technology Program (JCYJ20230807112007014)Shenzhen Key Medical Discipline Construction Fund (SZXK046)。
文摘BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogrammingrelated parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC).METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Aflliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82) and a survival group(n=38).Healthy adult volunteers(n=40) of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogrammingrelated parameters(lactate dehydrogenase [LDH],lactate and pyruvate),neuron-specific enolase(NSE) and interleukin 6(IL-6) were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation II(APACHE II) score and Sequential Organ Failure Assessment(SOFA) score were calculated.The Cerebral Performance Category(CPC) score was recorded on day 28 after ROSC.RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1) significantly increased and were higher in the non-survivors than in the survivors on admission(all P<0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE II score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P<0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC) of 0.904 [95% confidence interval [95% CI]:0.851–0.957]) with 96.8% specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95% CI:0.911–0.989) with 94.7% specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested.CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive eflcacy of LDH during the first week was superior to others.
文摘The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Major manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful resuscitation.Why do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was described.By modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony heart.Community awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term outcomes.Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes.This review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation syndrome.The pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for CPR.Although restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and care.The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.
基金supported by Progetto Trapezio,Compagnia di San Paolo(67935-2021.2174)to LB,Fondazione CRT(Cassa di Risparmio di Torino,RF=2022.0618)to LB。
文摘Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Overall,different types of plasticity,including stem cell-driven genesis of new neurons(adult neurogenesis),cells in arrested maturation(dormant neurons),neuro-glial and synaptic plasticity,can coexist and contribute to grant plastic changes in the brain,from a cellular to system level(Benedetti and Couillard-Despres,2022;Bonfanti et al.,2023).
基金supported by the National Natural Science Foundation of China(No.52272198 and 52002122)the Project funded by China Postdoctoral Science Foundation(No.2021M690947).
文摘Aqueous Zn-ion batteries(AZIBs)have attracted increasing attention in next-generation energy storage systems due to their high safety and economic.Unfortunately,the side reactions,dendrites and hydrogen evolution effects at the zinc anode interface in aqueous electrolytes seriously hinder the application of aqueous zinc-ion batteries.Here,we report a critical solvation strategy to achieve reversible zinc electrochemistry by introducing a small polar molecule acetonitrile to form a“catcher”to arrest active molecules(bound water molecules).The stable solvation structure of[Zn(H_(2)O)_(6)]^(2+)is capable of maintaining and completely inhibiting free water molecules.When[Zn(H_(2)O)_(6)]^(2+)is partially desolvated in the Helmholtz outer layer,the separated active molecules will be arrested by the“catcher”formed by the strong hydrogen bond N-H bond,ensuring the stable desolvation of Zn^(2+).The Zn||Zn symmetric battery can stably cycle for 2250 h at 1 mAh cm^(-2),Zn||V_(6)O_(13) full battery achieved a capacity retention rate of 99.2%after 10,000 cycles at 10 A g^(-1).This paper proposes a novel critical solvation strategy that paves the route for the construction of high-performance AZIBs.
文摘Objective Endometrial carcinoma(EC)is a prevalent gynecological malignancy characterized by increasing incidence and mortality rates.This underscores the critical need for novel therapeutic targets.One such potential target is cell division cycle 20(CDC20),which has been implicated in oncogenesis.This study investigated the effect of the CDC20 inhibitor Apcin on EC and elucidated the underlying mechanism involved.Methods The effects of Apcin on EC cell proliferation,apoptosis,and the cell cycle were evaluated using CCK8 assays and flow cytometry.RNA sequencing(RNA-seq)was subsequently conducted to explore the underlying molecular mechanism,and Western blotting and coimmunoprecipitation were subsequently performed to validate the results.Animal studies were performed to evaluate the antitumor effects in vivo.Bioinformatics analysis was also conducted to identify CDC20 as a potential therapeutic target in EC.Results Treatment with Apcin inhibited proliferation and induced apoptosis in EC cells,resulting in cell cycle arrest.Pathways associated with apoptosis and the cell cycle were activated following treatment with Apcin.Notably,Apcin treatment led to the upregulation of the cell cycle regulator p21,which was verified to interact with CDC20 and consequently decrease the expression of downstream cyclins in EC cells.In vivo experiments confirmed that Apcin treatment significantly impeded tumor growth.Higher CDC20 expression was observed in EC tissue than in nonmalignant tissue,and increased CDC20 expression in EC patients was associated with shorter overall survival and progress free interval.Conclusion CDC20 is a novel molecular target in EC,and Apcin could be developed as a candidate antitumor drug for EC treatment.
基金funded by the GRRC Program of Gyeonggi province[GRRC-KyungHee2023(B01)],Republic of Korea.
文摘Objective:To examine the inhibitory effect of Hydrangea serrata extract against hepatocellular carcinoma HepG2 cells and its underlying mechanisms.Methods:The effects of Hydrangea serrata extract on growth inhibition of tumor cells and spheroids were assessed using MTT and 3D culture assays.Quantitative real-time PCR and Western blot analyses were employed to investigate the changes in mRNA and protein expression levels of molecules related to cell cycle and apoptosis.Results:Hydrangea serrata extract effectively inhibited the growth of both tumor cells and spheroids.The extract also significantly upregulated p27 mRNA expression and downregulated CDK2 mRNA expression,leading to cell cycle arrest.Moreover,increased BAX/Bcl-2 ratio as well as caspase-9 and-3 were observed after treatment with Hydrangea serrata extract,indicating the induction of tumor cell apoptosis.Conclusions:Hydrangea serrata extract has the potential to alleviate tumors by effectively modulating cell-cycle-related gene expressions and inducing apoptosis,thereby inhibiting tumor growth.
基金supported by National Natural Science Foundation of China General Program (82172179)Mathematics Tianyuan Fund (12126604)Central High-level Hospital Clinical Research Project (2022-PUMCH-B-110)
文摘BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients’general information,ETCO_(2),and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.
文摘BACKGROUND Simple bone cysts(SBC)are benign tumor-like bone lesions typically identified in children.While SBC may lead to growth disturbances or growth arrest,such cases are uncommon.The mechanisms behind these observations remain unclear.Additionally,research on the etiology of SBC remains inconclusive,and there has been no consensus on the appropriate timing and methodology for treatment.CASE SUMMARY Here,we present our experience in the successful surgical management of a 10-year-old girl with SBC,who presented with a pathological fracture complicated by malunion of the displaced fracture,varus deformity,and limb length discrepancy.We hypothesized two possible etiologies for the patient’s growth arrest and subsequent humerus varus deformity:(1)Direct disruption of the physis by fluid from the cyst itself;and(2)damage to the epiphysis due to repetitive pathological fractures associated with SBC.In addressing this case,surgical intervention was undertaken to correct the proximal humerus varus deformity.This approach offered the advantages of simultaneously correcting angular abnormalities,achieving mild limb lengthening,providing definitive SBC treatment,and reducing the overall treatment duration.CONCLUSION As per current literature,acute correction of acute angular deformity in proximal humeral SBC is not well comprehended.However,in this specific case,acute correction was considered an optimal solution.
文摘BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare system.Although there have been advances in treatment modalities,survival rates for TCA patients remain low.This narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating TCA.METHODS:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,2022.The search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English language.Following the search,943 articles were retrieved,and two independent reviewers conducted a screening process.RESULTS:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable rhythm.There were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital epinephrine.Emergency thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt trauma.Resuscitative endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic shock.When implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality rates.Veno-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,respectively.In the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ECLS.CONCLUSION:TCA remains a signifi cant challenge for emergency medical services due to its high morbidity and mortality rates.Pre-and intra-arrest prognostic factors can help identify patients who are likely to benefit from aggressive and resource-intensive resuscitation measures.Further research is needed to enhance guidelines for the clinical use of established and emerging therapeutic approaches that can help optimize treatment effi cacy and ameliorate survival outcomes.
基金supported by the Natural Science Fund of Fujian Province,No.2020J011058(to JK)the Project of Fujian Provincial Hospital for High-level Hospital Construction,No.2020HSJJ12(to JK)+1 种基金the Fujian Provincial Finance Department Special Fund,No.(2021)848(to FC)the Fujian Provincial Major Scientific and Technological Special Projects on Health,No.2022ZD01008(to FC).
文摘Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are unknown.To this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB pathways.Subsequently,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by asphyxia.The results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these effects.To conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.
文摘BACKGROUND Cardiac arrest(CA)induced by electric shock is a rare occurrence,particularly in cases of prolonged CA.Currently,there is limited literature on similar incidents,and we present a relevant case report.CASE SUMMARY A 27-year-old Asian male man,experiencing respiratory CA due to electric shock,was successfully restored to sinus rhythm after 50 min of cardiopulmonary resuscitation and 8 electrical defibrillation sessions.In the subsequent stages,the patient received multiple organ function protection measures,leading to a successful recovery and eventual discharge from the hospital.CONCLUSION Prolonging resuscitation time can enhance the chances of survival for patients,this study provide valuable insights into the management of electric shock-induced CA.