In deaerated 0.05 M,0.1 M,0.2 M and 0.5 M K_(2)HPO_(4) solutions with pH 9.5,AZ31 magnesium(Mg)alloy was subjected to potentiostatic polarization at−0.8 VSCE to deposit a phosphate conversion coating.The morphology,st...In deaerated 0.05 M,0.1 M,0.2 M and 0.5 M K_(2)HPO_(4) solutions with pH 9.5,AZ31 magnesium(Mg)alloy was subjected to potentiostatic polarization at−0.8 VSCE to deposit a phosphate conversion coating.The morphology,structure,chemical composition,and protective performance of the conversion coating during the formation process were characterized.The results showed that amorphous Mg(OH)_(2) and MgHPO_(4) and crystallized KMgPO_(4)·6H2O(struvite-K)were successively deposited on the surface of AZ31 Mg alloy in the four solutions.MgHPO_(4) was converted from Mg(OH)_(2),while struvite-K was transformed from MgHPO_(4).The distribution of Mg(OH)_(2),MgHPO_(4) and struvite-K along the thickness of the coating difers with K_(2)HPO_(4) concentration.As the concentration of K_(2)HPO_(4) increased,the coating time was gradually shortened,and the coating was gradually thinned.Meanwhile,the ratio of the nucleation rate to the growth rate of struvite-K crystal nuclei increased,resulting in a decrease in the size of struvite-K crystal.When the concentration of K_(2)HPO_(4) increased from 0.05 to 0.1 M,the content of struvite-K increased,and the protective performance of the coating was enhanced.However,as the concentration of K_(2)HPO_(4) continued to increase to 0.5 M,the content of struvite-K and the protective performance of the coating decreased.展开更多
Objective Focused cardiac ultrasound(FCU)and lung ultrasound(LU)are increasingly being used in critically ill patients.This study aimed to investigate the effect of FCU in combination with LU on these patients and to ...Objective Focused cardiac ultrasound(FCU)and lung ultrasound(LU)are increasingly being used in critically ill patients.This study aimed to investigate the effect of FCU in combination with LU on these patients and to determine if the timing of ultrasound examination was associated with treatment change.Methods This is a multicenter cross-sectional observational study.Consecutive patients admitted to the intensive care unit(ICU)were screened for enrollment.FCU and LU were performed within the first 24 h,and treatment change was proposed by the performer based on the ultrasound results and other clinical conditions.Results Among the 992 patients included,502 were examined within 6 h of ICU admission(early phase group),and 490 were examined after 6 h of admission(later phase group).The early phase group and the later phase group had similar proportions of treatment change(48.8%vs.49.0%,χ^(2)=0.003,P=0.956).In the multivariable analysis,admission for respiratory failure was an independent variable associated with treatment change,with an odds ratio(OR)of 2.357[95%confidence interval(CI):1.284-4.326,P=0.006];the timing of examination was not associated with treatment change(OR=0.725,95%CI:0.407-1.291,P=0.275).Conclusions FCU in combination with LU,whether performed during the early phase or later phase,had a significant impact on the treatment of critically ill patients.Patients with respiratory failure were more likely to experience treatment change after the ultrasound examination.展开更多
[Objectives] This study was conducted to optimize the ethanol extraction technology of monoester alkaloids from Radix Aconiti Preparata. [Methods]On the basis of defined extraction times,ethanol concentration,ethanol ...[Objectives] This study was conducted to optimize the ethanol extraction technology of monoester alkaloids from Radix Aconiti Preparata. [Methods]On the basis of defined extraction times,ethanol concentration,ethanol times and extraction time were investigated by HPLC-MS combined with orthogonal test to optimize extraction process using the content of monoester alkaloids( the sum of benzoyl neoaconitine,benzoyl hypoaconitine and benzoyl aconitine) as an index.[Results]The optimum ethanol extraction technology was as follows: 75% ethanol,ethanol amount 25 times of the medicinal material,and each extraction for 1. 5 h.[Conclusions] The optimal extraction technology is simple,feasible,stable and reliable. It can provide reference for the industrial production and quality control of monoester alkaloids from Radix Aconiti Preparata.展开更多
Background:While central venous pressure(CVP)measurement is used to guide fluid management for high-risk surgical patients during the perioperative period,its relationship to patient prognosis is unknown.Methods:This ...Background:While central venous pressure(CVP)measurement is used to guide fluid management for high-risk surgical patients during the perioperative period,its relationship to patient prognosis is unknown.Methods:This single-center,retrospective observational study enrolled patients undergoing high-risk surgery from February 1,2014 to November 31,2020,who were admitted to the surgical intensive care unit(ICU)directly after surgery.Patients were divided into the following three groups according to the first CVP measurement(CVP1)after admission to the ICU:low,CVP1<8 mmHg;moderate,8 mmHg≤CVP1≤12 mmHg;and high,CVP1>12 mmHg.Perioperative fluid balance,28-day mortality,length of stay in the ICU,and hospitalization and surgical complications were compared across groups.Results:Of the 775 high-risk surgical patients enrolled in the study,228 were included in the analysis.Median(interquartile range)positive fluid balance during surgery was lowest in the low CVP1 group and highest in the high CVP1 group(low CVP1:770[410,1205]mL;moderate CVP1:1070[685,1500]mL;high CVP1:1570[1008,2000]mL;all P<0.001).The volume of positive fluid balance during the perioperative period was correlated with CVP1(r=0.336,P<0.001).The partial arterial pressure of oxygen(PaO 2)/fraction of inspired oxygen(FiO 2)ratio was significantly lower in the high CVP1 group than in the low and moderate CVP1 groups(low CVP1:400.0[299.5,443.3]mmHg;moderate CVP1:362.5[330.0,434.9]mmHg;high CVP1:335.3[254.0,363.5]mmHg;all P<0.001).The incidence of postoperative acute kidney injury(AKI)was lowest in the moderate CVP1 group(low CVP1:9.2%;moderate CVP1:2.7%;high CVP1:16.0%;P=0.007).The proportion of patients receiving renal replacement therapy was highest in the high CVP1 group(low CVP1:1.5%;moderate CVP1:0.9%;high CVP1:10.0%;P=0.014).Logistic regression analysis showed that intraoperative hypotension and CVP1>12 mmHg were risk factors for AKI within 72 h after surgery(adjusted odds ratio[aOR]=3.875,95%confidence interval[CI]:1.378–10.900,P=0.010 and aOR=1.147,95%CI:1.006–1.309,P=0.041).Conclusions:CVP that is either too high or too low increases the incidence of postoperative AKI.Sequential fluid therapy based on CVP after patients are transferred to the ICU post-surgery does not reduce the risk of organ dysfunction caused by an excessive amount of intraoperative fluid.However,CVP can be used as a safety limit indicator for perioperative fluid management in high-risk surgical patients.展开更多
Introduction Coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2),is highly contagious[1]and has developed into a global pan-demic.Up to July 1,2022,COVID-...Introduction Coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2),is highly contagious[1]and has developed into a global pan-demic.Up to July 1,2022,COVID-19 has affected>200 coun-tries and regions across the globe and caused 545,226,550 con-firmed cases and 6334,728 deaths,[2]seriously compromising human life,public properties.展开更多
This consensus focuses on severe and critical coronavi-rus disease 2019(COVID-19)mainly based on the consideration that mortality of severe and critical cases is higher than mild and mo derate cases of COVID-19.Severe...This consensus focuses on severe and critical coronavi-rus disease 2019(COVID-19)mainly based on the consideration that mortality of severe and critical cases is higher than mild and mo derate cases of COVID-19.Severe patients usually developed dyspnea and/or hypoxemia in a short period of time,and in some cases progressively developed respiratory failure,septic shock,coagulation disorders,and multi-organ dysfunction.展开更多
Background:The outbreak of coronavirus disease 2019(COVID-19)has posed a huge threat to human health.However,little is known regarding the risk factors associated with COVID-19 severity.We aimed to explore early-stage...Background:The outbreak of coronavirus disease 2019(COVID-19)has posed a huge threat to human health.However,little is known regarding the risk factors associated with COVID-19 severity.We aimed to explore early-stage disease risk factors associated with eventual disease severity.Methods:This study enrolled 486 hospitalized,non-intensive care unit(ICU)-admitted adult patients with COVID-19(age≥18 years)treated at Wuhan Jinyintan Hospital,who were divided into three groups according to disease severity.The demographic,clinical,and laboratory data at admission and clinical outcomes were compared among severity groups,and the risk factors for disease severity were identified by multiple regression analysis.Results:Of 486 patients with COVID-19,405(83.33%)were discharged,33(6.71%)died outside of the ICU,and 48(7.20%)were still being treated in the ICU by the time the study period ended.Significant differences in age,lymphocyte counts,and the levels of procalcitonin,aspartate aminotransferase,and D-dimer(P<0.001 for all)among the three groups.Further analysis showed that older age,decreased lymphocyte counts,and increased procalcitonin,aspartate aminotransferase,and D-dimer levels were significantly associated with disease progression.Conclusion:Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)may impair the immune system,the blood coagulation system,and hepatic and cardiac function.Some clinical characteristics and laboratory findings can help identify patients with a high risk of disease severity,which can be significant for appropriate resource allocation during the COVID-19 pandemic.展开更多
基金financially supported by the National Natural Science Foundation of China(No.52373322).
文摘In deaerated 0.05 M,0.1 M,0.2 M and 0.5 M K_(2)HPO_(4) solutions with pH 9.5,AZ31 magnesium(Mg)alloy was subjected to potentiostatic polarization at−0.8 VSCE to deposit a phosphate conversion coating.The morphology,structure,chemical composition,and protective performance of the conversion coating during the formation process were characterized.The results showed that amorphous Mg(OH)_(2) and MgHPO_(4) and crystallized KMgPO_(4)·6H2O(struvite-K)were successively deposited on the surface of AZ31 Mg alloy in the four solutions.MgHPO_(4) was converted from Mg(OH)_(2),while struvite-K was transformed from MgHPO_(4).The distribution of Mg(OH)_(2),MgHPO_(4) and struvite-K along the thickness of the coating difers with K_(2)HPO_(4) concentration.As the concentration of K_(2)HPO_(4) increased,the coating time was gradually shortened,and the coating was gradually thinned.Meanwhile,the ratio of the nucleation rate to the growth rate of struvite-K crystal nuclei increased,resulting in a decrease in the size of struvite-K crystal.When the concentration of K_(2)HPO_(4) increased from 0.05 to 0.1 M,the content of struvite-K increased,and the protective performance of the coating was enhanced.However,as the concentration of K_(2)HPO_(4) continued to increase to 0.5 M,the content of struvite-K and the protective performance of the coating decreased.
文摘Objective Focused cardiac ultrasound(FCU)and lung ultrasound(LU)are increasingly being used in critically ill patients.This study aimed to investigate the effect of FCU in combination with LU on these patients and to determine if the timing of ultrasound examination was associated with treatment change.Methods This is a multicenter cross-sectional observational study.Consecutive patients admitted to the intensive care unit(ICU)were screened for enrollment.FCU and LU were performed within the first 24 h,and treatment change was proposed by the performer based on the ultrasound results and other clinical conditions.Results Among the 992 patients included,502 were examined within 6 h of ICU admission(early phase group),and 490 were examined after 6 h of admission(later phase group).The early phase group and the later phase group had similar proportions of treatment change(48.8%vs.49.0%,χ^(2)=0.003,P=0.956).In the multivariable analysis,admission for respiratory failure was an independent variable associated with treatment change,with an odds ratio(OR)of 2.357[95%confidence interval(CI):1.284-4.326,P=0.006];the timing of examination was not associated with treatment change(OR=0.725,95%CI:0.407-1.291,P=0.275).Conclusions FCU in combination with LU,whether performed during the early phase or later phase,had a significant impact on the treatment of critically ill patients.Patients with respiratory failure were more likely to experience treatment change after the ultrasound examination.
基金Supported by Traditional Chinese Medicine Science and Technology Development Program of Shandong Province (2017-1982019-0400)Major Science and Technology Innovation Project of Shandong Province (2018CXGC1304)。
文摘[Objectives] This study was conducted to optimize the ethanol extraction technology of monoester alkaloids from Radix Aconiti Preparata. [Methods]On the basis of defined extraction times,ethanol concentration,ethanol times and extraction time were investigated by HPLC-MS combined with orthogonal test to optimize extraction process using the content of monoester alkaloids( the sum of benzoyl neoaconitine,benzoyl hypoaconitine and benzoyl aconitine) as an index.[Results]The optimum ethanol extraction technology was as follows: 75% ethanol,ethanol amount 25 times of the medicinal material,and each extraction for 1. 5 h.[Conclusions] The optimal extraction technology is simple,feasible,stable and reliable. It can provide reference for the industrial production and quality control of monoester alkaloids from Radix Aconiti Preparata.
基金supported by high-level hospital foster grants from Fujian Provincial Hospital,Fujian Province,China[Grant number:(2020)HSJJ14].
文摘Background:While central venous pressure(CVP)measurement is used to guide fluid management for high-risk surgical patients during the perioperative period,its relationship to patient prognosis is unknown.Methods:This single-center,retrospective observational study enrolled patients undergoing high-risk surgery from February 1,2014 to November 31,2020,who were admitted to the surgical intensive care unit(ICU)directly after surgery.Patients were divided into the following three groups according to the first CVP measurement(CVP1)after admission to the ICU:low,CVP1<8 mmHg;moderate,8 mmHg≤CVP1≤12 mmHg;and high,CVP1>12 mmHg.Perioperative fluid balance,28-day mortality,length of stay in the ICU,and hospitalization and surgical complications were compared across groups.Results:Of the 775 high-risk surgical patients enrolled in the study,228 were included in the analysis.Median(interquartile range)positive fluid balance during surgery was lowest in the low CVP1 group and highest in the high CVP1 group(low CVP1:770[410,1205]mL;moderate CVP1:1070[685,1500]mL;high CVP1:1570[1008,2000]mL;all P<0.001).The volume of positive fluid balance during the perioperative period was correlated with CVP1(r=0.336,P<0.001).The partial arterial pressure of oxygen(PaO 2)/fraction of inspired oxygen(FiO 2)ratio was significantly lower in the high CVP1 group than in the low and moderate CVP1 groups(low CVP1:400.0[299.5,443.3]mmHg;moderate CVP1:362.5[330.0,434.9]mmHg;high CVP1:335.3[254.0,363.5]mmHg;all P<0.001).The incidence of postoperative acute kidney injury(AKI)was lowest in the moderate CVP1 group(low CVP1:9.2%;moderate CVP1:2.7%;high CVP1:16.0%;P=0.007).The proportion of patients receiving renal replacement therapy was highest in the high CVP1 group(low CVP1:1.5%;moderate CVP1:0.9%;high CVP1:10.0%;P=0.014).Logistic regression analysis showed that intraoperative hypotension and CVP1>12 mmHg were risk factors for AKI within 72 h after surgery(adjusted odds ratio[aOR]=3.875,95%confidence interval[CI]:1.378–10.900,P=0.010 and aOR=1.147,95%CI:1.006–1.309,P=0.041).Conclusions:CVP that is either too high or too low increases the incidence of postoperative AKI.Sequential fluid therapy based on CVP after patients are transferred to the ICU post-surgery does not reduce the risk of organ dysfunction caused by an excessive amount of intraoperative fluid.However,CVP can be used as a safety limit indicator for perioperative fluid management in high-risk surgical patients.
基金supported by the Shanghai Science and Technology Commission(Grant No.20DZ2200500).
文摘Introduction Coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2),is highly contagious[1]and has developed into a global pan-demic.Up to July 1,2022,COVID-19 has affected>200 coun-tries and regions across the globe and caused 545,226,550 con-firmed cases and 6334,728 deaths,[2]seriously compromising human life,public properties.
基金supported by a grant from the Shanghai Science and Technology Commission(No.20DZ2200500).
文摘This consensus focuses on severe and critical coronavi-rus disease 2019(COVID-19)mainly based on the consideration that mortality of severe and critical cases is higher than mild and mo derate cases of COVID-19.Severe patients usually developed dyspnea and/or hypoxemia in a short period of time,and in some cases progressively developed respiratory failure,septic shock,coagulation disorders,and multi-organ dysfunction.
基金supported by the Fujian Provincial Intensive Medical Center Construction Project[2017-510].
文摘Background:The outbreak of coronavirus disease 2019(COVID-19)has posed a huge threat to human health.However,little is known regarding the risk factors associated with COVID-19 severity.We aimed to explore early-stage disease risk factors associated with eventual disease severity.Methods:This study enrolled 486 hospitalized,non-intensive care unit(ICU)-admitted adult patients with COVID-19(age≥18 years)treated at Wuhan Jinyintan Hospital,who were divided into three groups according to disease severity.The demographic,clinical,and laboratory data at admission and clinical outcomes were compared among severity groups,and the risk factors for disease severity were identified by multiple regression analysis.Results:Of 486 patients with COVID-19,405(83.33%)were discharged,33(6.71%)died outside of the ICU,and 48(7.20%)were still being treated in the ICU by the time the study period ended.Significant differences in age,lymphocyte counts,and the levels of procalcitonin,aspartate aminotransferase,and D-dimer(P<0.001 for all)among the three groups.Further analysis showed that older age,decreased lymphocyte counts,and increased procalcitonin,aspartate aminotransferase,and D-dimer levels were significantly associated with disease progression.Conclusion:Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)may impair the immune system,the blood coagulation system,and hepatic and cardiac function.Some clinical characteristics and laboratory findings can help identify patients with a high risk of disease severity,which can be significant for appropriate resource allocation during the COVID-19 pandemic.
