W Comae has significant variability in multi-wavelengthes, from radio to gamma-ray bands. A bright outburst in optical and X-ray bands was observed in 1998, and most recently, a strong TeV flare was detected by VERITA...W Comae has significant variability in multi-wavelengthes, from radio to gamma-ray bands. A bright outburst in optical and X-ray bands was observed in 1998, and most recently, a strong TeV flare was detected by VERITAS in 2008. It is the first TeV intermediate-frequency-peaked BL Lacertae source. I find that both the broadband spectral energy distributions （SEDs） which were quasi-simultaneously obtained during the TeV flare and during the optical/X-ray outburst are well fit by using a single-zone synchrotron ＋ synchrotron-self-Compton model. The satisfactory fitting requires a large beaming factor, i.e., δ- 25 and δ- 20 for the TeV flare and the optical/X-ray outburst, respectively, suggesting that both the optical/X-ray outburst and the TeV flare are from a relativistic jet. The size of the emission region of the TeV flare is three times larger than that of the optical/X-ray outburst, and the strength of the magnetic field for the TeV flare is - 14 times smaller than that of the X-ray/optical outburst, likely indicating that the region of the TeV flare is more distant from the core than that of the X-ray/optical outburst. The inverse Compton component of the TeV flare peaks around 1.3 GeV, but it is around 20 MeV for the X-ray/optical outburst, lower than that for the TeV flare by two orders of magnitude. The model predicts that the optical/X-ray outburst might be accompanied by a strong MeV/GeV emission, but the TeV flare may be not associated with the X-ray/optical outburst. The GeV emission is critical for characterizing the SEDs of the optical/X-ray outburst and the TeV flare. The predicted GeV flux is above the sensitivity of Fermi/LAT, and it could be verified with the observations by Fermi/LAT in the near future.展开更多
Objective To explore the relationship between serum chloride levels and prognosis in patients with hepatic coma in the intensive care unit(ICU).Methods We analyzed 545 patients with hepatic coma in the ICU from the Me...Objective To explore the relationship between serum chloride levels and prognosis in patients with hepatic coma in the intensive care unit(ICU).Methods We analyzed 545 patients with hepatic coma in the ICU from the Medical Information Mart for Intensive Care IV(MIMIC-IV)database.Associations between serum chloride levels and 28-day and 1-year mortality rates were assessed using restricted cubic splines(RCSs),Kaplan-Meier(KM)curves,and Cox regression.Subgroup analyses,external validation,and mechanistic studies were also performed.Results A total of 545 patients were included in the study.RCS analysis revealed a U-shaped association between serum chloride levels and mortality in patients with hepatic coma.The KM curves indicated lower survival rates among patients with low chloride levels(<103 mmol/L).Low chloride levels were independently linked to increased 28-day and 1-year all-cause mortality rates.In the multivariate models,the hazard ratio(HR)for 28-day mortality in the low-chloride group was 1.424(95%confidence interval[CI]:1.041–1.949),while the adjusted hazard ratio for 1-year mortality was 1.313(95%CI:1.026–1.679).Subgroup analyses and external validation supported these findings.Cytological experiments suggested that low chloride levels may activate the phosphorylation of the NF-κB signaling pathway,promote the expression of pro-inflammatory cytokines,and reduce neuronal cell viability.Conclusion Low serum chloride levels are independently associated with increased mortality in patients with hepatic coma.展开更多
BACKGROUND The optic nerve sheath diameter(ONSD)measured by ultrasound has emerged as a significant noninvasive method for detecting elevated intracranial pressure(ICP),guiding timely interventions,and monitoring trea...BACKGROUND The optic nerve sheath diameter(ONSD)measured by ultrasound has emerged as a significant noninvasive method for detecting elevated intracranial pressure(ICP),guiding timely interventions,and monitoring treatment response.Previous studies have shown that the baseline ONSD at admission is a prognostic indicator of mortality in adult patients with cerebrovascular events,traumatic brain injury,hepatic encephalopathy,and acute stroke.However,pediatric data on the dynamic changes in ONSD remain limited.AIM To study the association between within-48 hours admission dynamic ONSD changes and mortality in children with clinically relevant elevated ICP.METHODS This single-institution prospective study was performed at a tertiary Children’s Hospital in Vietnam,between November 2023 and August 2024.The primary outcome was in-hospital mortality rate.ONSD data were measured at admission,24 hours,and 48 hours post-admission to pediatric intensive care unit(PICU).Linear mixed-effects models accounting for repeated measures within individuals were used to analyze the association between ONSD changes and in-hospital mortality.RESULTS A total of 69 PICU-admitted children with clinically relevant raised ICP were enrolled and included in the analysis.The median patient age was 6 years(interquartile range:1-12),and males accounted for 54%of all patients.The inhospital mortality rate in children with clinically relevant raised ICP was 23.2%.Traumatic brain injury,sepsisassociated encephalopathy,and septic shock were the main causes of death in this cohort.Linear mixed-effects analysis showed that dynamic variability in ONSD values upon PICU admission and during the first 48 hours later correlated significantly with increased mortality.Nonsurvivors had a 5.3%increase in the mean ONSD at 48 hours compared to baseline levels,while the survivors showed a 5.6%reduction in ONSD.CONCLUSION Serial ultrasound-based ONSD measurements within 48 hours of admission better predicted mortality than baseline data in critically ill children,offering a practical,noninvasive tool for early prognosis in elevated ICP.展开更多
BACKGROUND Traumatic brain injury(TBI)is the second most common presentation of trauma victims.Among the various non-neurological complications after TBI,acute kidney injury(AKI)is not uncommon.AIM To establish the in...BACKGROUND Traumatic brain injury(TBI)is the second most common presentation of trauma victims.Among the various non-neurological complications after TBI,acute kidney injury(AKI)is not uncommon.AIM To establish the incidence,risk factors,and predictors of AKI in TBI victims.The secondary aim was to study the impact of AKI development on the outcomes of patients with TBI.METHODS This was a single-center retrospective cohort study of TBI victims with a Glasgow coma scale(GCS)≤11 in an apex trauma center in a metropolitan city.RESULTS The incidence of AKI after TBI was 11%.The risk factors for AKI after TBI were old age(P<0.001),comorbidities(P=0.023),shock(P<0.001),blood transfusion(P=0.016),consecutive neurosurgical intervention(P=0.029),high intracranial pressure(ICP)(P<0.001),rhabdomyolysis(P<0.001),and diabetes insipidus(P<0.001).The predictors of AKI after TBI were,on point-biserial correlation:Lower GCS(rpb=-0.27,n=331,P<0.001);and on multivariate logistic regression:(1)Shock(odds ratio[OR]:-11.94,P<0.001);(2)Rhabdomyolysis(OR:-7.33,P=0.001);(3)High ICP(OR:-4.39,P=0.018);(4)High Carlson comorbidity index(OR:-1.97,P=0.001);and(5)High acute physiology and chronic health evaluation-2(APACHE-2)score(OR:-1.13,P<0.001).The phenomenon of post-TBI AKI increased the extent of stay in intensive care unit(P=0.008),demand for ventilators(P=0.0170),ventilator days(P<0.001),incidence of brain death(P<0.001),and mortality(P<0.001).CONCLUSION Every tenth TBI victim suffers from AKI.AKI after TBI can be predicted by the patient's underlying comorbidities,on arrival low GCS,high APACHE-2 score,shock,rhabdomyolysis,and high ICP.The occurrence of AKI in TBI victims adversely affects outcome variables;however,this may be a reflection of the severe nature of TBI in the AKI group.New research is needed to understand the effects of AKI on outcome variables.展开更多
Objective:This study aimed to evaluate the prognostic impact of citicoline sodium capsules on patients with traumatic brain injury(TBI)and its safety.Methods:This study is a multicenter,single-arm,prospective,observat...Objective:This study aimed to evaluate the prognostic impact of citicoline sodium capsules on patients with traumatic brain injury(TBI)and its safety.Methods:This study is a multicenter,single-arm,prospective,observational study of brain trauma patients who met the inclusion criteria between March 2023 and June 2024 and who could be treated with citicoline sodium capsules after being evaluated by the investigator.The Glasgow Coma Scale(GCS)and Mini-Mental State Examination(MMSE),the incidence of adverse drug reactions/adverse events during treatment,and the abnormalities of safety tests with clinical evaluation significance were observed at 1 month and 2 months after treatment.Results:A total of 2806 patients,63.1%of whom were male,with an average age of 58.85 years old.The GCS and MMSE scores of the patients at 1 month and 2 months after treatment were significantly improved and were statistically significant,indicating that citicoline sodium had a significant effect on improving the state of consciousness and cognitive function of patients with TBI.Only 8 adverse reactions were reported in the study,all of which were mild gastrointestinal reactions and anaphylaxis,and did not lead to treatment interruption or serious consequences.Conclusion:Citicoline sodium has a significant therapeutic effect on patients with TBI and has good safety.展开更多
西方的科学研究成果大多来源于英语的语言文化环境,把西方的科学研究成果介绍到中国,必须重视英语的语言文化环境和汉语的语言文化环境的不同,这样才能使国人准确、方便地应用西方的科学研究成果,西学东渐。格拉斯哥昏迷评分(Glasgow co...西方的科学研究成果大多来源于英语的语言文化环境,把西方的科学研究成果介绍到中国,必须重视英语的语言文化环境和汉语的语言文化环境的不同,这样才能使国人准确、方便地应用西方的科学研究成果,西学东渐。格拉斯哥昏迷评分(Glasgow coma scale)被翻译、介绍到国内已有数十年,但汉语版的"Glasgow coma scale"多种多样,容易造成初学者和使用者的迷惑。本文复习有关"Glasgow coma scale"的原始英式英文文献、美式英语英文文献和以往的几个主要的汉语翻译版。结合英式英语、美式英语和汉语的语言文化特点,新译了"Glasgow coma scale",以方便医护人员使用。展开更多
基于Gaia Data Release 2 (Gaia-DR2)星表,采用数据挖掘技术中的DBSCAN(Density-Based Spatial Clustering of Applications with Noise)算法进行邻近疏散星团成员检测.从Gaia-DR2中选取了594284颗恒星(距离太阳<100 pc)作为样本,使...基于Gaia Data Release 2 (Gaia-DR2)星表,采用数据挖掘技术中的DBSCAN(Density-Based Spatial Clustering of Applications with Noise)算法进行邻近疏散星团成员检测.从Gaia-DR2中选取了594284颗恒星(距离太阳<100 pc)作为样本,使用恒星的五维数据(三维空间位置和两维自行)进行聚类分析.在数据预处理阶段,将每一维数据标准化到[0, 1]区间内,避免了单位不一致对聚类效果的影响.然后,利用k-dist图确定了DBSCAN算法的输入参数(Eps, MinPts).最终,使用DBSCAN算法获取了133颗成员星,它们在五维相空间中可以被分成两组,分别对应于疏散星团Hyades和Coma.分析结果表明得到的成员星是可靠的.根据两个星团的成员星, Hyades和Coma的距离分别确定为(46.5±0.3) pc和(84.9±0.4) pc.展开更多
基金supported by the National Natural Science Foundation of China under grants 10533050the National Basic Research Program ("973" Program) of China under Grant 2009CB824800
文摘W Comae has significant variability in multi-wavelengthes, from radio to gamma-ray bands. A bright outburst in optical and X-ray bands was observed in 1998, and most recently, a strong TeV flare was detected by VERITAS in 2008. It is the first TeV intermediate-frequency-peaked BL Lacertae source. I find that both the broadband spectral energy distributions （SEDs） which were quasi-simultaneously obtained during the TeV flare and during the optical/X-ray outburst are well fit by using a single-zone synchrotron ＋ synchrotron-self-Compton model. The satisfactory fitting requires a large beaming factor, i.e., δ- 25 and δ- 20 for the TeV flare and the optical/X-ray outburst, respectively, suggesting that both the optical/X-ray outburst and the TeV flare are from a relativistic jet. The size of the emission region of the TeV flare is three times larger than that of the optical/X-ray outburst, and the strength of the magnetic field for the TeV flare is - 14 times smaller than that of the X-ray/optical outburst, likely indicating that the region of the TeV flare is more distant from the core than that of the X-ray/optical outburst. The inverse Compton component of the TeV flare peaks around 1.3 GeV, but it is around 20 MeV for the X-ray/optical outburst, lower than that for the TeV flare by two orders of magnitude. The model predicts that the optical/X-ray outburst might be accompanied by a strong MeV/GeV emission, but the TeV flare may be not associated with the X-ray/optical outburst. The GeV emission is critical for characterizing the SEDs of the optical/X-ray outburst and the TeV flare. The predicted GeV flux is above the sensitivity of Fermi/LAT, and it could be verified with the observations by Fermi/LAT in the near future.
文摘Objective To explore the relationship between serum chloride levels and prognosis in patients with hepatic coma in the intensive care unit(ICU).Methods We analyzed 545 patients with hepatic coma in the ICU from the Medical Information Mart for Intensive Care IV(MIMIC-IV)database.Associations between serum chloride levels and 28-day and 1-year mortality rates were assessed using restricted cubic splines(RCSs),Kaplan-Meier(KM)curves,and Cox regression.Subgroup analyses,external validation,and mechanistic studies were also performed.Results A total of 545 patients were included in the study.RCS analysis revealed a U-shaped association between serum chloride levels and mortality in patients with hepatic coma.The KM curves indicated lower survival rates among patients with low chloride levels(<103 mmol/L).Low chloride levels were independently linked to increased 28-day and 1-year all-cause mortality rates.In the multivariate models,the hazard ratio(HR)for 28-day mortality in the low-chloride group was 1.424(95%confidence interval[CI]:1.041–1.949),while the adjusted hazard ratio for 1-year mortality was 1.313(95%CI:1.026–1.679).Subgroup analyses and external validation supported these findings.Cytological experiments suggested that low chloride levels may activate the phosphorylation of the NF-κB signaling pathway,promote the expression of pro-inflammatory cytokines,and reduce neuronal cell viability.Conclusion Low serum chloride levels are independently associated with increased mortality in patients with hepatic coma.
文摘BACKGROUND The optic nerve sheath diameter(ONSD)measured by ultrasound has emerged as a significant noninvasive method for detecting elevated intracranial pressure(ICP),guiding timely interventions,and monitoring treatment response.Previous studies have shown that the baseline ONSD at admission is a prognostic indicator of mortality in adult patients with cerebrovascular events,traumatic brain injury,hepatic encephalopathy,and acute stroke.However,pediatric data on the dynamic changes in ONSD remain limited.AIM To study the association between within-48 hours admission dynamic ONSD changes and mortality in children with clinically relevant elevated ICP.METHODS This single-institution prospective study was performed at a tertiary Children’s Hospital in Vietnam,between November 2023 and August 2024.The primary outcome was in-hospital mortality rate.ONSD data were measured at admission,24 hours,and 48 hours post-admission to pediatric intensive care unit(PICU).Linear mixed-effects models accounting for repeated measures within individuals were used to analyze the association between ONSD changes and in-hospital mortality.RESULTS A total of 69 PICU-admitted children with clinically relevant raised ICP were enrolled and included in the analysis.The median patient age was 6 years(interquartile range:1-12),and males accounted for 54%of all patients.The inhospital mortality rate in children with clinically relevant raised ICP was 23.2%.Traumatic brain injury,sepsisassociated encephalopathy,and septic shock were the main causes of death in this cohort.Linear mixed-effects analysis showed that dynamic variability in ONSD values upon PICU admission and during the first 48 hours later correlated significantly with increased mortality.Nonsurvivors had a 5.3%increase in the mean ONSD at 48 hours compared to baseline levels,while the survivors showed a 5.6%reduction in ONSD.CONCLUSION Serial ultrasound-based ONSD measurements within 48 hours of admission better predicted mortality than baseline data in critically ill children,offering a practical,noninvasive tool for early prognosis in elevated ICP.
文摘BACKGROUND Traumatic brain injury(TBI)is the second most common presentation of trauma victims.Among the various non-neurological complications after TBI,acute kidney injury(AKI)is not uncommon.AIM To establish the incidence,risk factors,and predictors of AKI in TBI victims.The secondary aim was to study the impact of AKI development on the outcomes of patients with TBI.METHODS This was a single-center retrospective cohort study of TBI victims with a Glasgow coma scale(GCS)≤11 in an apex trauma center in a metropolitan city.RESULTS The incidence of AKI after TBI was 11%.The risk factors for AKI after TBI were old age(P<0.001),comorbidities(P=0.023),shock(P<0.001),blood transfusion(P=0.016),consecutive neurosurgical intervention(P=0.029),high intracranial pressure(ICP)(P<0.001),rhabdomyolysis(P<0.001),and diabetes insipidus(P<0.001).The predictors of AKI after TBI were,on point-biserial correlation:Lower GCS(rpb=-0.27,n=331,P<0.001);and on multivariate logistic regression:(1)Shock(odds ratio[OR]:-11.94,P<0.001);(2)Rhabdomyolysis(OR:-7.33,P=0.001);(3)High ICP(OR:-4.39,P=0.018);(4)High Carlson comorbidity index(OR:-1.97,P=0.001);and(5)High acute physiology and chronic health evaluation-2(APACHE-2)score(OR:-1.13,P<0.001).The phenomenon of post-TBI AKI increased the extent of stay in intensive care unit(P=0.008),demand for ventilators(P=0.0170),ventilator days(P<0.001),incidence of brain death(P<0.001),and mortality(P<0.001).CONCLUSION Every tenth TBI victim suffers from AKI.AKI after TBI can be predicted by the patient's underlying comorbidities,on arrival low GCS,high APACHE-2 score,shock,rhabdomyolysis,and high ICP.The occurrence of AKI in TBI victims adversely affects outcome variables;however,this may be a reflection of the severe nature of TBI in the AKI group.New research is needed to understand the effects of AKI on outcome variables.
文摘Objective:This study aimed to evaluate the prognostic impact of citicoline sodium capsules on patients with traumatic brain injury(TBI)and its safety.Methods:This study is a multicenter,single-arm,prospective,observational study of brain trauma patients who met the inclusion criteria between March 2023 and June 2024 and who could be treated with citicoline sodium capsules after being evaluated by the investigator.The Glasgow Coma Scale(GCS)and Mini-Mental State Examination(MMSE),the incidence of adverse drug reactions/adverse events during treatment,and the abnormalities of safety tests with clinical evaluation significance were observed at 1 month and 2 months after treatment.Results:A total of 2806 patients,63.1%of whom were male,with an average age of 58.85 years old.The GCS and MMSE scores of the patients at 1 month and 2 months after treatment were significantly improved and were statistically significant,indicating that citicoline sodium had a significant effect on improving the state of consciousness and cognitive function of patients with TBI.Only 8 adverse reactions were reported in the study,all of which were mild gastrointestinal reactions and anaphylaxis,and did not lead to treatment interruption or serious consequences.Conclusion:Citicoline sodium has a significant therapeutic effect on patients with TBI and has good safety.
文摘西方的科学研究成果大多来源于英语的语言文化环境,把西方的科学研究成果介绍到中国,必须重视英语的语言文化环境和汉语的语言文化环境的不同,这样才能使国人准确、方便地应用西方的科学研究成果,西学东渐。格拉斯哥昏迷评分(Glasgow coma scale)被翻译、介绍到国内已有数十年,但汉语版的"Glasgow coma scale"多种多样,容易造成初学者和使用者的迷惑。本文复习有关"Glasgow coma scale"的原始英式英文文献、美式英语英文文献和以往的几个主要的汉语翻译版。结合英式英语、美式英语和汉语的语言文化特点,新译了"Glasgow coma scale",以方便医护人员使用。
