Objective:The neurotoxicity of carbon monoxide(CO)to the central nervous system is a key pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Our previous study found that retinoic acid...Objective:The neurotoxicity of carbon monoxide(CO)to the central nervous system is a key pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Our previous study found that retinoic acid(RA)can suppress the neurotoxic effects of CO.This study further explores,in vivo and in vitro,the molecular mechanisms by which RA alleviates CO-induced central nervous system damage.Methods:A cytotoxic model was established using the mouse hippocampal neuronal cell line HT22 and primary oligodendrocytes exposed to CO,and a DEACMP animal model was established in adult Kunming mice.Cell viability and apoptosis of hippocampal neurons and oligodendrocytes were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay and Annexin V/propidium iodide(PI)double staining.The transcriptional and protein expression of each gene was detected using real time fluorescence quantitative PCR(RT-qPCR)and Western blotting.Long noncoding RNA(lncRNA)SNHG15 and LINGO-1 were knocked down or overexpressed to observe changes in neurons and oligodendrocytes.In DEACMP mice,SNHG15 or LINGO-1 were knocked down to assess changes in central nervous tissue and downstream protein expression.Results:RA at 10 and 20μmol/L significantly reversed CO-induced apoptosis of hippocampal neurons and oligodendrocytes,downregulation of SNHG15 and LINGO-1,and upregulation of brain-derived neurotrophic factor(BDNF)and tyrosine kinase receptor B(TrkB)(all P<0.05).Overexpression of SNHG15 or LINGO-1 weakened the protective effect of RA against CO-induced cytotoxicity(all P<0.05).Knockdown of SNHG15 or LINGO-1 alleviated CO-induced apoptosis of hippocampal neurons and oligodendrocytes and upregulated BDNF and TrkB expression levels(all P<0.05).Experiments in DEACMP model mice showed that knockdown of SNHG15 or LINGO-1 mitigated central nervous system injury in DEACMP(all P<0.05).Conclusion:RA alleviates CO-induced apoptosis of hippocampal neurons and oligodendrocytes,thereby reducing central nervous system injury and exerting neuroprotective effects.LncRNA SNHG15 and LINGO-1 are key molecules mediating RA induced inhibition of neuronal apoptosis and are associated with the BDNF/TrkB pathway.These findings provide a theoretical framework for optimizing the clinical treatment of DEACMP and lay an experimental foundation for elucidating its molecular mechanisms.展开更多
BACKGROUND Organophosphate(OP)poisoning is common in sub-Saharan Africa.It is asso-ciated with high mortality and morbidity.Affected individuals often exhibit cho-linergic symptoms and respiratory distress.Moreover,ot...BACKGROUND Organophosphate(OP)poisoning is common in sub-Saharan Africa.It is asso-ciated with high mortality and morbidity.Affected individuals often exhibit cho-linergic symptoms and respiratory distress.Moreover,other complications,such as pancreatitis,arrhythmias,and hepatic dysfunction,have been reported.How-ever,paralytic ileus is an exceedingly rare complication.CASE SUMMARY We report a case of a 5-year-old boy who presented with altered sensorium and abdominal distension following suspected OP exposure.Physical examination and imaging revealed features of intestinal obstruction and neurological deficits.He was managed with atropine,pralidoxime,and other supportive measures and had a successful recovery.Paralytic ileus is an atypical complication of acute OP poisoning.The resultant intestinal obstruction manifests as cholinergic overac-tivity,leading to bowel dysmotility.This case emphasizes the need for awareness and prompt management of such atypical presentations,especially in the pe-diatric population.CONCLUSION Timely recognition and multidisciplinary management of atypical presentations,such as paralytic ileus,are crucial in improving outcomes in pediatric OP poi-soning.展开更多
Imidacloprid,a neonicotinoid insecticide,is widelyused in agriculture as a safer alternative to highly toxicorganophosphates.It targets nicotinic acetylcholinereceptors in pests and is generally low in toxicity tohuma...Imidacloprid,a neonicotinoid insecticide,is widelyused in agriculture as a safer alternative to highly toxicorganophosphates.It targets nicotinic acetylcholinereceptors in pests and is generally low in toxicity tohumans.However,large ingestions can cause severe,life-threatening complications,with no establishedtreatment protocols.Though rarely fatal,imidaclopridpoisoning is increasingly reported in agricultural regions,particularly in Southeast Asia,with most cases involvingsuicide attempts.展开更多
Chlorfenapyr poisoning is associated with high mortality due to the absence of evidence-based treatment strategies or specific antidotes.[1,2]Chlorfenapyr is a novel N-substituted halogenated pyrrole pro-insecticide.T...Chlorfenapyr poisoning is associated with high mortality due to the absence of evidence-based treatment strategies or specific antidotes.[1,2]Chlorfenapyr is a novel N-substituted halogenated pyrrole pro-insecticide.The active metabolite of tralopyril(a metabolite of chlorfenapyr)can uncouple oxidative phosphorylation and impair adenosine triphosphate(ATP)production.[3]Blood purification techniques,including hemoperfusion(HP),may facilitate tralopyril clearance.[4,5]Here,we present a case of severe chlorfenapyr poisoning that was treated with intensive HP.H owever,during follow-up,we unexpectedly found a ventricular aneurysm in the left ventricle that was not fully explained by coronary artery lesions.展开更多
Investigating highly effective electrocatalysts for high-temperature proton exchange membrane fuel cells(HT-PEMFC)requires the resistance to phosphate acid(PA)poisoning at cathodic oxygen reduction reaction(ORR).Recen...Investigating highly effective electrocatalysts for high-temperature proton exchange membrane fuel cells(HT-PEMFC)requires the resistance to phosphate acid(PA)poisoning at cathodic oxygen reduction reaction(ORR).Recent advancements in catalysts have focused on alleviating phosphoric anion adsorption on Pt-based catalysts with modified electronic structure or catalytic interface and developing Fe-N-C based catalysts with immunity of PA poisoning.Fe-N-C-based catalysts have emerged as promising alternatives to Pt-based catalysts,offering significant potential to overcome the characteristic adsorption of phosphate anion on Pt.An overview of these developments provides insights into catalytic mechanisms and facilitates the design of more efficient catalysts.This review begins with an exploration of basic poisoning principles,followed by a critical summary of characterization techniques employed to identified the underlying mechanism of poisoning effect.Attention is then directed to endeavors aimed at enhancing the HT-PEMFC performance by well-designed catalysts.Finally,the opportunities and challenges in developing the anti-PA poisoning strategy and practical HT-PEMFC is discussed.Through these discussions,a comprehensive understanding of PA-poisoning bottlenecks and inspire future research directions is aim to provided.展开更多
BACKGROUND Ethylene glycol(EG)poisoning is often caused by the accidental ingestion of antifreeze.EG is metabolized into glycolate and oxalate and may cause metabolic acidaemia,neurotoxicity,acute kidney injury,and de...BACKGROUND Ethylene glycol(EG)poisoning is often caused by the accidental ingestion of antifreeze.EG is metabolized into glycolate and oxalate and may cause metabolic acidaemia,neurotoxicity,acute kidney injury,and death.A variety of EG poisoning case reports have been published,and we wrote this case report and literature review to summarize the clinical experience of patients who survived EG poisoning.CASE SUMMARY In this case report,a 55-year-old man developed EG poisoning after ingesting antifreeze by accident and experienced acute kidney injury,nervous system dysfunction and inhalation pneumonia.The timely use of ethanol for detoxification,initiation of haemodialysis,and protection of organ function are effective treatment methods for patients with antifreeze poisoning.The patient was discharged in the 3rd week after admission.When discharged,the patient did not report any discomfort,had stable vital signs,did not have fever or diarrhoea,and had improved liver and kidney functions.CONCLUSION A timely diagnosis,haemodialysis,and organ protection are the keys to the successful treatment of poisoned patients.展开更多
Botulinum toxin,a protein exotoxin secreted by Clostridium botulinum,binds to peripheral nerve terminals,inhibits acetylcholine release,and leads to flaccid muscle paralysis.[1]Botox(onabotulinum toxin A)was approved ...Botulinum toxin,a protein exotoxin secreted by Clostridium botulinum,binds to peripheral nerve terminals,inhibits acetylcholine release,and leads to flaccid muscle paralysis.[1]Botox(onabotulinum toxin A)was approved by the Food and Drug Administration(FDA)for cosmetic and therapeutic indications in 2002,and its global use has increased substantially.[2]However,some unlicensed botulinum toxin products may cause iatrogenic botulism.[3]Early diagnosis remains challenging owing to non-specific clinical features and the lack of diagnostic biomarkers,often delaying the timely administration of antitoxin.[4]This study reviewed recent cases of botulism in our center and summarized their clinical presentations,symptoms,and outcomes.展开更多
BACKGROUND:In recent years,with the ban on paraquat,the use of diquat (DQ) as a substitute has significantly increased,leading to a corresponding increase in DQ poisoning cases.This study aimed to identify relevant ri...BACKGROUND:In recent years,with the ban on paraquat,the use of diquat (DQ) as a substitute has significantly increased,leading to a corresponding increase in DQ poisoning cases.This study aimed to identify relevant risk factors affecting patient prognosis and provide a basis for the assessment of patient prognosis.METHODS:Patients with DQ poisoning were included from September 2020 to December2023,and data were extracted from their electronic medical records on the first day of hospitalization.Least Absolute Shrinkage and Selection Operator (LASSO) regression and binary multivariate logistic regression analyses were performed on the collected clinical data to identify risk factors.RESULTS:A total of 117 patients with acute DQ poisoning were included,and were categorized into two groups based on their 28-day outcomes:survival group (n=67) and non-survival group (n=50).There were no statistically significant differences between the two groups in terms of sex,lymphocyte count,platelet-to-lymphocyte ratio,or blood purification rate (P>0.05).The analysis revealed that age (odds ratio[OR]1.094,95%confidence interval[95%CI]1.022–1.171),blood drug concentration (OR 3.659,95%CI1.846–7.252),lactate (OR 1.686,95%CI 1.062–2.678),neutrophil-to-lymphocyte ratio (NLR)(OR 1.101,95%CI 1.017–1.192),albumin (OR 1.275,95%CI 1.107–1.468),and aspartate aminotransferase (AST)(OR 1.027,95%CI 1.005–1.051) were the risk factors for mortality.CONCLUSION:This study identified key risk factors for 28-day mortality in patients with acute DQ poisoning,which may provide valuable guidance for clinical treatment,particularly for emergency physicians.展开更多
Hydrocarbons(HCs)exert toxic effects on the activity of Cu-based zeolite catalysts for NH_(3)-SCR on diesel vehicles.This study inve stigated the hydrocarbon resistance of both fresh and hydrothermally aged high-silic...Hydrocarbons(HCs)exert toxic effects on the activity of Cu-based zeolite catalysts for NH_(3)-SCR on diesel vehicles.This study inve stigated the hydrocarbon resistance of both fresh and hydrothermally aged high-silica Cu-SSZ-16 catalysts.It was found that low-temperature activity of Cu-SSZ-16 catalyst decreased after C_(3)H_(6) poisoning,which was mainly due to the blockage of pore channels and the coverage of Cu active sites as well as acid sites by the formation of carbon deposits.Additionally,[Cu(OH)]^(+)-Z was proposed to be more easily affected by C_(3)H_(6) poisoning than Cu^(2+)-2Z.Hydrothermally aged Cu-SSZ-16 presented better C_(3)H_(6) resistance than the fresh catalyst since less carbon deposits were accumulated and[Cu(OH)]^(+)-Z species were partially transformed to more-stable Cu^(2+)-2Z in the aged sample.This was probably because of the reduction of acid sites and the formation of CuO_(x),which enhanced the oxidation of C_(3)H_(6),thereby inhibiting the formation of carbon deposits.In addition,the coverage of the active Cu species also influenced the adsorption and oxidation of NO,causing a decrease in low-temperature activity.Thus,the low-temperature activity could be fully recovered by hydrothermal treatment at 500℃due to the removal of carbon deposits and recovery of Cu active sites as well as acid sites.In summary,high-silica CuSSZ-16,with high resistance to HCs and excellent hydrothermal stability,is a competitive candidate as a catalyst for the NH_(3)-SCR reaction in practical application.展开更多
Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency departme...Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency department between January 2022 and January 2024 were randomly divided into two groups using a random number table. The observation group (30 cases) received ultra-early HP treatment, while the reference group (30 cases) received conventional HP treatment initiated 6 hours post-poisoning. The groups were compared in terms of overall emergency efficacy, clinical indicators, serological markers, inflammatory factors, and complication rates. Results: The observation group had a higher total efficacy rate than the reference group, superior clinical indicators, and a lower complication rate (P < 0.05). After 24 hours of emergency treatment, serological markers and inflammatory factor levels in the observation group were lower than those in the reference group (P < 0.05). Conclusion: Ultra-early HP treatment provides better emergency outcomes for SOPP patients by shortening treatment time, improving serological markers and inflammatory factor levels, and offering higher safety. It demonstrates significant advantages in emergency care.展开更多
Studies show that Graph Neural Networks(GNNs)are susceptible to minor perturbations.Therefore,analyzing adversarial attacks on GNNs is crucial in current research.Previous studies used Generative Adversarial Networks ...Studies show that Graph Neural Networks(GNNs)are susceptible to minor perturbations.Therefore,analyzing adversarial attacks on GNNs is crucial in current research.Previous studies used Generative Adversarial Networks to generate a set of fake nodes,injecting them into a clean GNNs to poison the graph structure and evaluate the robustness of GNNs.In the attack process,the computation of new node connections and the attack loss are independent,which affects the attack on the GNN.To improve this,a Fake Node Camouflage Attack based on Mutual Information(FNCAMI)algorithm is proposed.By incorporating Mutual Information(MI)loss,the distribution of nodes injected into the GNNs become more similar to the original nodes,achieving better attack results.Since the loss ratios of GNNs and MI affect performance,we also design an adaptive weighting method.By adjusting the loss weights in real-time through rate changes,larger loss values are obtained,eliminating local optima.The feasibility,effectiveness,and stealthiness of this algorithm are validated on four real datasets.Additionally,we use both global and targeted attacks to test the algorithm’s performance.Comparisons with baseline attack algorithms and ablation experiments demonstrate the efficiency of the FNCAMI algorithm.展开更多
Ammonia selective catalytic reduction(NH_(3)-SCR)is the most widely used technology in thefield of industrialflue gas denitrification.However,the presence of heavy metals influe gas can seriously affect the performance of...Ammonia selective catalytic reduction(NH_(3)-SCR)is the most widely used technology in thefield of industrialflue gas denitrification.However,the presence of heavy metals influe gas can seriously affect the performance of SCR catalysts,leading to their deactivation or even failure.Therefore,it is of great significance to deeply study the poisoning mechanism of SCR catalysts under the action of heavy metals and how to enhance their resistance to poisoning.This article reviews the reaction mechanism of NH_(3)-SCR technology,compares the impact of heavy metals on the activity of different SCR catalysts,and then discusses in detail the poisoning mechanism of SCR catalysts by heavy metals,including pore blockage,reduction of specific surface area,and destruction of active centers caused by heavy metal deposition,all of which jointly lead to the physical or chemical poisoning of the catalyst.Meanwhile,the mechanism of action when multiple toxicants coexist was analyzed.To effectively address these challenges,the article further summarizes various methods to improve the catalyst's resistance to heavy metal poisoning,such as element doping,structural optimization,and carrier addition,which significantly enhance the heavy metal resistance of the catalyst.Finally,the article provides a prospective analysis of the challenges faced by NH_(3)-SCR catalysts in anti-heavy metal poisoning technology,emphasizing the necessity of in-depth research on the poisoning mechanism,exploration of the mechanism of synergistic action of multiple pollutants,development of comprehensive anti-poisoning strategies,and research on catalyst regeneration technology,in order to promote the development of efficient anti-heavy metal poisoning NH_(3)-SCR catalysts.展开更多
BACKGROUND This case report emphasizes the potential pulmonary toxicity of demulsifier gas,which is a widely used chemical.To our knowledge,this is the first documented instance of acute respiratory distress syndrome(...BACKGROUND This case report emphasizes the potential pulmonary toxicity of demulsifier gas,which is a widely used chemical.To our knowledge,this is the first documented instance of acute respiratory distress syndrome(ARDS)induced by inhalation of demulsifier gas.This report underscores the need for increased workplace safety and awareness regarding health risks associated with demulsifiers,particularly in industrial settings.Timely diagnosis and management of ARDS are crucial for improving patient outcomes,thus making this report significant for clinical practice and occupational health literature.CASE SUMMARY We present a rare case of acute demulsifier poisoning leading to ARDS in a previously healthy 69-year-old man.He presented with chest discomfort,short-ness of breath,and dyspnea following a 30-minute exposure to demulsifier fumes in a poorly ventilated area.Chest computed tomography revealed bilateral diffuse infiltrative shadows.Based on his exposure history and clinical findings,a diag-nosis of ARDS due to demulsifier poisoning was confirmed.The patient required high-flow oxygen and intravenous norepinephrine upon admission and was subsequently intubated for mechanical ventilation.Following timely and effective multidisciplinary treatment interventions including emergency care,intensive care,and respiratory medicine,he achieved positive outcomes and was ultimately discharged.CONCLUSION This case underscores the critical importance of recognizing chemical exposure risks and their potential to cause severe respiratory complications.展开更多
BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms...BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr poisoning.DATA RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October 2023.The inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment strategies.The references in the included studies were also examined to identify additional sources.RESULTS:We included 57 studies in this review.Chlorfenapyr can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine triphosphate.High fever and altered mental status are characteristic clinical presentations of chlorfenapyr poisoning.Once it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and death.Chlorfenapyr poisoning is diflcult to treat,and there is no specific antidote.CONCLUSION:Chlorfenapyr is a new pyrrole pesticide.Although it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely high.There is no specific antidote for chlorfenapyr poisoning.Therefore,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease.展开更多
BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clini...BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.展开更多
BACKGROUND:Poisoned patients often suffer damage to multiple systems,and those experiencing central nervous system disorders present more severe conditions,prolonged hospital stays,and increased mortality rates.We aim...BACKGROUND:Poisoned patients often suffer damage to multiple systems,and those experiencing central nervous system disorders present more severe conditions,prolonged hospital stays,and increased mortality rates.We aimed to assess the efficacy of rehabilitation interventions for patients with toxic encephalopathy.METHODS:This retrospective,observational,comparative cohort study was performed at the teaching hospital affiliated of Nanjing Medical University,from October 2020 to December 2022.Patients who met the diagnostic criteria for toxic encephalopathy and exclusion criteria were included,and patients were divided into three subgroups according to Glasgow Coma Scale(GCS).Demographic and clinical characteristics were collected.The effect of the rehabilitation intervention on patients were assessed in the improvement of consciousness status(Glasgow Coma Scale[GCS]score),muscle strength and movement and swallowing function(Fugl-Meyer Assessment[FMA]scale,Water Swallow Test[WST],and Standardized Swallowing Assessment[SSA]).Subgroup analysis was based on different toxic species.RESULTS:Out of the 464 patients with toxic encephalopathy,184 cases received rehabilitation treatments.For the severe toxic encephalopathy patients,patients without rehabilitation intervention have a 2.21 times higher risk of death compared to patients with rehabilitation intervention(Hazard ratio[HR]=2.21).Subgroup analysis revealed that rehabilitation intervention significantly increased the survival rate of patients with pesticide poisoning(P=0.02),while no significant improvement was observed in patients with drug/biological agent poisoning(P=0.44).After rehabilitation intervention,significant improvement in GCS and FMA were observed in severe patients with toxic encephalopathy(P<0.01).CONCLUSION:Active rehabilitation intervention for patients exposed to poisons that can potentially cause toxic encephalopathy may improve the prognosis and reduce the mortality rate in clinical practice.展开更多
Commercial V_(2)O_(5)-based catalysts have been successfully applied in NH_(3) selective catalytic reduction(NH_(3)-SCR)of NO_(x) from power stations,but their poor alkali-resistance restrains the wider application in...Commercial V_(2)O_(5)-based catalysts have been successfully applied in NH_(3) selective catalytic reduction(NH_(3)-SCR)of NO_(x) from power stations,but their poor alkali-resistance restrains the wider application in nonelectrical industries.In this study,NO_(x) reduction against alkali poisoning over V_(2)O_(5)/TiO_(2) is greatly improved via Ce(SO_(4))_(2) modification.It has been originally demonstrated that Ce^(4+)-SO_(4)^(2−)pair sites play crucial roles in improving NO_(x) reduction against alkali poisoning over V_(2)O_(5)/TiO_(2) catalysts.The strong interaction between V species and Ce sites of Ce^(4+)-SO_(4)^(2−)pairs triggers the reaction between NH_(4)^(+) species and gaseous NO via Eley-Rideal(E-R)reaction pathway.After K-poisoning,the SO_(4)^(2−)sites of Ce^(4+)-SO_(4)^(2−)pairs as protective sites strongly bond with K and thus maintain the high reaction efficiency via the E-R reaction pathway.This work demonstrates an effective strategy to enhance NO_(x) reduction against alkali poisoning over catalysts via constructing Ce^(4+)-SO_(4)^(2−)pair sites,contributing to developing alkali-resistant SCR catalysts for practical application in nonelectrical industries.展开更多
BACKGROUND Aconitine poisoning is highly prone to causing malignant arrhythmias.The elimination of aconitine from the body takes a considerable amount of time,and during this period,patients are at a significant risk ...BACKGROUND Aconitine poisoning is highly prone to causing malignant arrhythmias.The elimination of aconitine from the body takes a considerable amount of time,and during this period,patients are at a significant risk of death due to malignant arrhythmias associated with aconitine poisoning.CASE SUMMARY A 30-year-old male patient was admitted due to accidental ingestion of aconitinecontaining drugs.Upon arrival at the emergency department,the patient intermittently experienced malignant arrhythmias including ventricular tachycardia,ventricular fibrillation,ventricular premature beats,and cardiac arrest.Emergency interventions such as cardiopulmonary resuscitation and defibrillation were promptly administered.Additionally,veno-arterial extracorporeal membrane oxygenation(VA-ECMO)therapy was initiated.Successful resuscitation was achieved before ECMO placement,but upon initiation of ECMO,the patient experienced recurrent malignant arrhythmias.ECMO was utilized to maintain hemodynamics and respiration,while continuous blood purification therapy for toxin clearance,mechanical ventilation,and hypothermic brain protection therapy were concurrently administered.On the third day of VA-ECMO support,the patient’s respiratory and hemodynamic status stabilized,with only frequent ventricular premature beats observed on electrocardiographic monitoring,and echocardiography indicated recovery of cardiac contractile function.On the fourth day,a significant reduction in toxin levels was observed,along with stable hemodynamic and respiratory functions.Following a successful pump-controlled retrograde trial occlusion test,ECMO assistance was terminated.The patient gradually improved postoperatively and achieved recovery.He was discharged 11 days later.CONCLUSION VA-ECMO can serve as a bridging resuscitation technique for patients with reversible malignant arrhythmias.展开更多
Pesticide poisoning is one of the most common diseases in the emergency department, characterized by rapid changes in condition, a high misdiagnosis rate, and a poor prognosis. Measures for early removal of poisons ar...Pesticide poisoning is one of the most common diseases in the emergency department, characterized by rapid changes in condition, a high misdiagnosis rate, and a poor prognosis. Measures for early removal of poisons are crucial, and gastric lavage is one of the important measures. Regarding the post-gastric lavage effect, abdominal CT scanning has an important application value in the assessment of the gastric lavage effect after pesticide poisoning.展开更多
The development of Intelligent Railway Transportation Systems necessitates incorporating privacy-preserving mechanisms into AI models to protect sensitive information and enhance system efficiency.Federated learning o...The development of Intelligent Railway Transportation Systems necessitates incorporating privacy-preserving mechanisms into AI models to protect sensitive information and enhance system efficiency.Federated learning offers a promising solution by allowing multiple clients to train models collaboratively without sharing private data.However,despite its privacy benefits,federated learning systems are vulnerable to poisoning attacks,where adversaries alter local model parameters on compromised clients and send malicious updates to the server,potentially compromising the global model’s accuracy.In this study,we introduce PMM(Perturbation coefficient Multiplied by Maximum value),a new poisoning attack method that perturbs model updates layer by layer,demonstrating the threat of poisoning attacks faced by federated learning.Extensive experiments across three distinct datasets have demonstrated PMM’s ability to significantly reduce the global model’s accuracy.Additionally,we propose an effective defense method,namely CLBL(Cluster Layer By Layer).Experiment results on three datasets have confirmed CLBL’s effectiveness.展开更多
基金supported by the Natural Science Foundation of Hunan Province(2021JJ31089)the Scientific Research Project of Health Commission of Hunan Province(202203104548),China。
文摘Objective:The neurotoxicity of carbon monoxide(CO)to the central nervous system is a key pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Our previous study found that retinoic acid(RA)can suppress the neurotoxic effects of CO.This study further explores,in vivo and in vitro,the molecular mechanisms by which RA alleviates CO-induced central nervous system damage.Methods:A cytotoxic model was established using the mouse hippocampal neuronal cell line HT22 and primary oligodendrocytes exposed to CO,and a DEACMP animal model was established in adult Kunming mice.Cell viability and apoptosis of hippocampal neurons and oligodendrocytes were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay and Annexin V/propidium iodide(PI)double staining.The transcriptional and protein expression of each gene was detected using real time fluorescence quantitative PCR(RT-qPCR)and Western blotting.Long noncoding RNA(lncRNA)SNHG15 and LINGO-1 were knocked down or overexpressed to observe changes in neurons and oligodendrocytes.In DEACMP mice,SNHG15 or LINGO-1 were knocked down to assess changes in central nervous tissue and downstream protein expression.Results:RA at 10 and 20μmol/L significantly reversed CO-induced apoptosis of hippocampal neurons and oligodendrocytes,downregulation of SNHG15 and LINGO-1,and upregulation of brain-derived neurotrophic factor(BDNF)and tyrosine kinase receptor B(TrkB)(all P<0.05).Overexpression of SNHG15 or LINGO-1 weakened the protective effect of RA against CO-induced cytotoxicity(all P<0.05).Knockdown of SNHG15 or LINGO-1 alleviated CO-induced apoptosis of hippocampal neurons and oligodendrocytes and upregulated BDNF and TrkB expression levels(all P<0.05).Experiments in DEACMP model mice showed that knockdown of SNHG15 or LINGO-1 mitigated central nervous system injury in DEACMP(all P<0.05).Conclusion:RA alleviates CO-induced apoptosis of hippocampal neurons and oligodendrocytes,thereby reducing central nervous system injury and exerting neuroprotective effects.LncRNA SNHG15 and LINGO-1 are key molecules mediating RA induced inhibition of neuronal apoptosis and are associated with the BDNF/TrkB pathway.These findings provide a theoretical framework for optimizing the clinical treatment of DEACMP and lay an experimental foundation for elucidating its molecular mechanisms.
文摘BACKGROUND Organophosphate(OP)poisoning is common in sub-Saharan Africa.It is asso-ciated with high mortality and morbidity.Affected individuals often exhibit cho-linergic symptoms and respiratory distress.Moreover,other complications,such as pancreatitis,arrhythmias,and hepatic dysfunction,have been reported.How-ever,paralytic ileus is an exceedingly rare complication.CASE SUMMARY We report a case of a 5-year-old boy who presented with altered sensorium and abdominal distension following suspected OP exposure.Physical examination and imaging revealed features of intestinal obstruction and neurological deficits.He was managed with atropine,pralidoxime,and other supportive measures and had a successful recovery.Paralytic ileus is an atypical complication of acute OP poisoning.The resultant intestinal obstruction manifests as cholinergic overac-tivity,leading to bowel dysmotility.This case emphasizes the need for awareness and prompt management of such atypical presentations,especially in the pe-diatric population.CONCLUSION Timely recognition and multidisciplinary management of atypical presentations,such as paralytic ileus,are crucial in improving outcomes in pediatric OP poi-soning.
文摘Imidacloprid,a neonicotinoid insecticide,is widelyused in agriculture as a safer alternative to highly toxicorganophosphates.It targets nicotinic acetylcholinereceptors in pests and is generally low in toxicity tohumans.However,large ingestions can cause severe,life-threatening complications,with no establishedtreatment protocols.Though rarely fatal,imidaclopridpoisoning is increasingly reported in agricultural regions,particularly in Southeast Asia,with most cases involvingsuicide attempts.
基金supported by the National Key Research and Development Program of China(2023YFC3603100 and 2023YFC3603105)"Leading Goose"R&D Program of Zhejiang(2022C03076-4).
文摘Chlorfenapyr poisoning is associated with high mortality due to the absence of evidence-based treatment strategies or specific antidotes.[1,2]Chlorfenapyr is a novel N-substituted halogenated pyrrole pro-insecticide.The active metabolite of tralopyril(a metabolite of chlorfenapyr)can uncouple oxidative phosphorylation and impair adenosine triphosphate(ATP)production.[3]Blood purification techniques,including hemoperfusion(HP),may facilitate tralopyril clearance.[4,5]Here,we present a case of severe chlorfenapyr poisoning that was treated with intensive HP.H owever,during follow-up,we unexpectedly found a ventricular aneurysm in the left ventricle that was not fully explained by coronary artery lesions.
文摘Investigating highly effective electrocatalysts for high-temperature proton exchange membrane fuel cells(HT-PEMFC)requires the resistance to phosphate acid(PA)poisoning at cathodic oxygen reduction reaction(ORR).Recent advancements in catalysts have focused on alleviating phosphoric anion adsorption on Pt-based catalysts with modified electronic structure or catalytic interface and developing Fe-N-C based catalysts with immunity of PA poisoning.Fe-N-C-based catalysts have emerged as promising alternatives to Pt-based catalysts,offering significant potential to overcome the characteristic adsorption of phosphate anion on Pt.An overview of these developments provides insights into catalytic mechanisms and facilitates the design of more efficient catalysts.This review begins with an exploration of basic poisoning principles,followed by a critical summary of characterization techniques employed to identified the underlying mechanism of poisoning effect.Attention is then directed to endeavors aimed at enhancing the HT-PEMFC performance by well-designed catalysts.Finally,the opportunities and challenges in developing the anti-PA poisoning strategy and practical HT-PEMFC is discussed.Through these discussions,a comprehensive understanding of PA-poisoning bottlenecks and inspire future research directions is aim to provided.
文摘BACKGROUND Ethylene glycol(EG)poisoning is often caused by the accidental ingestion of antifreeze.EG is metabolized into glycolate and oxalate and may cause metabolic acidaemia,neurotoxicity,acute kidney injury,and death.A variety of EG poisoning case reports have been published,and we wrote this case report and literature review to summarize the clinical experience of patients who survived EG poisoning.CASE SUMMARY In this case report,a 55-year-old man developed EG poisoning after ingesting antifreeze by accident and experienced acute kidney injury,nervous system dysfunction and inhalation pneumonia.The timely use of ethanol for detoxification,initiation of haemodialysis,and protection of organ function are effective treatment methods for patients with antifreeze poisoning.The patient was discharged in the 3rd week after admission.When discharged,the patient did not report any discomfort,had stable vital signs,did not have fever or diarrhoea,and had improved liver and kidney functions.CONCLUSION A timely diagnosis,haemodialysis,and organ protection are the keys to the successful treatment of poisoned patients.
文摘Botulinum toxin,a protein exotoxin secreted by Clostridium botulinum,binds to peripheral nerve terminals,inhibits acetylcholine release,and leads to flaccid muscle paralysis.[1]Botox(onabotulinum toxin A)was approved by the Food and Drug Administration(FDA)for cosmetic and therapeutic indications in 2002,and its global use has increased substantially.[2]However,some unlicensed botulinum toxin products may cause iatrogenic botulism.[3]Early diagnosis remains challenging owing to non-specific clinical features and the lack of diagnostic biomarkers,often delaying the timely administration of antitoxin.[4]This study reviewed recent cases of botulism in our center and summarized their clinical presentations,symptoms,and outcomes.
基金supported by Tianjin Municipal Medical Key Construction Project Funding (TJYXZDXK-007A)the Beijing Union Medical Foundation-Rui E Emergency Medicine Research Funding (PUMF01010010-2024-18)。
文摘BACKGROUND:In recent years,with the ban on paraquat,the use of diquat (DQ) as a substitute has significantly increased,leading to a corresponding increase in DQ poisoning cases.This study aimed to identify relevant risk factors affecting patient prognosis and provide a basis for the assessment of patient prognosis.METHODS:Patients with DQ poisoning were included from September 2020 to December2023,and data were extracted from their electronic medical records on the first day of hospitalization.Least Absolute Shrinkage and Selection Operator (LASSO) regression and binary multivariate logistic regression analyses were performed on the collected clinical data to identify risk factors.RESULTS:A total of 117 patients with acute DQ poisoning were included,and were categorized into two groups based on their 28-day outcomes:survival group (n=67) and non-survival group (n=50).There were no statistically significant differences between the two groups in terms of sex,lymphocyte count,platelet-to-lymphocyte ratio,or blood purification rate (P>0.05).The analysis revealed that age (odds ratio[OR]1.094,95%confidence interval[95%CI]1.022–1.171),blood drug concentration (OR 3.659,95%CI1.846–7.252),lactate (OR 1.686,95%CI 1.062–2.678),neutrophil-to-lymphocyte ratio (NLR)(OR 1.101,95%CI 1.017–1.192),albumin (OR 1.275,95%CI 1.107–1.468),and aspartate aminotransferase (AST)(OR 1.027,95%CI 1.005–1.051) were the risk factors for mortality.CONCLUSION:This study identified key risk factors for 28-day mortality in patients with acute DQ poisoning,which may provide valuable guidance for clinical treatment,particularly for emergency physicians.
基金supported by the National Natural Science Foundation of China(Nos.52225004,22402220,and 52200136)the National Key R&D Program of China(Nos.2022YFC3704400 and 2022YFC3701804)the Construction Project of National New Material Production and Application Demonstration Platform(No.TC220H06N)。
文摘Hydrocarbons(HCs)exert toxic effects on the activity of Cu-based zeolite catalysts for NH_(3)-SCR on diesel vehicles.This study inve stigated the hydrocarbon resistance of both fresh and hydrothermally aged high-silica Cu-SSZ-16 catalysts.It was found that low-temperature activity of Cu-SSZ-16 catalyst decreased after C_(3)H_(6) poisoning,which was mainly due to the blockage of pore channels and the coverage of Cu active sites as well as acid sites by the formation of carbon deposits.Additionally,[Cu(OH)]^(+)-Z was proposed to be more easily affected by C_(3)H_(6) poisoning than Cu^(2+)-2Z.Hydrothermally aged Cu-SSZ-16 presented better C_(3)H_(6) resistance than the fresh catalyst since less carbon deposits were accumulated and[Cu(OH)]^(+)-Z species were partially transformed to more-stable Cu^(2+)-2Z in the aged sample.This was probably because of the reduction of acid sites and the formation of CuO_(x),which enhanced the oxidation of C_(3)H_(6),thereby inhibiting the formation of carbon deposits.In addition,the coverage of the active Cu species also influenced the adsorption and oxidation of NO,causing a decrease in low-temperature activity.Thus,the low-temperature activity could be fully recovered by hydrothermal treatment at 500℃due to the removal of carbon deposits and recovery of Cu active sites as well as acid sites.In summary,high-silica CuSSZ-16,with high resistance to HCs and excellent hydrothermal stability,is a competitive candidate as a catalyst for the NH_(3)-SCR reaction in practical application.
文摘Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency department between January 2022 and January 2024 were randomly divided into two groups using a random number table. The observation group (30 cases) received ultra-early HP treatment, while the reference group (30 cases) received conventional HP treatment initiated 6 hours post-poisoning. The groups were compared in terms of overall emergency efficacy, clinical indicators, serological markers, inflammatory factors, and complication rates. Results: The observation group had a higher total efficacy rate than the reference group, superior clinical indicators, and a lower complication rate (P < 0.05). After 24 hours of emergency treatment, serological markers and inflammatory factor levels in the observation group were lower than those in the reference group (P < 0.05). Conclusion: Ultra-early HP treatment provides better emergency outcomes for SOPP patients by shortening treatment time, improving serological markers and inflammatory factor levels, and offering higher safety. It demonstrates significant advantages in emergency care.
基金supported by the Natural Science Basic Research Plan in Shaanxi Province of China(Program No.2022JM-381,2017JQ6070)National Natural Science Foundation of China(Grant No.61703256),Foundation of State Key Laboratory of Public Big Data(No.PBD2022-08)the Fundamental Research Funds for the Central Universities,China(Program No.GK202201014,GK202202003,GK201803020).
文摘Studies show that Graph Neural Networks(GNNs)are susceptible to minor perturbations.Therefore,analyzing adversarial attacks on GNNs is crucial in current research.Previous studies used Generative Adversarial Networks to generate a set of fake nodes,injecting them into a clean GNNs to poison the graph structure and evaluate the robustness of GNNs.In the attack process,the computation of new node connections and the attack loss are independent,which affects the attack on the GNN.To improve this,a Fake Node Camouflage Attack based on Mutual Information(FNCAMI)algorithm is proposed.By incorporating Mutual Information(MI)loss,the distribution of nodes injected into the GNNs become more similar to the original nodes,achieving better attack results.Since the loss ratios of GNNs and MI affect performance,we also design an adaptive weighting method.By adjusting the loss weights in real-time through rate changes,larger loss values are obtained,eliminating local optima.The feasibility,effectiveness,and stealthiness of this algorithm are validated on four real datasets.Additionally,we use both global and targeted attacks to test the algorithm’s performance.Comparisons with baseline attack algorithms and ablation experiments demonstrate the efficiency of the FNCAMI algorithm.
基金supported by National Natural Science Foundation of China(U20A20130)Fundamental Research Funds for the Central Universities(FRF-EYIT-23-07).
文摘Ammonia selective catalytic reduction(NH_(3)-SCR)is the most widely used technology in thefield of industrialflue gas denitrification.However,the presence of heavy metals influe gas can seriously affect the performance of SCR catalysts,leading to their deactivation or even failure.Therefore,it is of great significance to deeply study the poisoning mechanism of SCR catalysts under the action of heavy metals and how to enhance their resistance to poisoning.This article reviews the reaction mechanism of NH_(3)-SCR technology,compares the impact of heavy metals on the activity of different SCR catalysts,and then discusses in detail the poisoning mechanism of SCR catalysts by heavy metals,including pore blockage,reduction of specific surface area,and destruction of active centers caused by heavy metal deposition,all of which jointly lead to the physical or chemical poisoning of the catalyst.Meanwhile,the mechanism of action when multiple toxicants coexist was analyzed.To effectively address these challenges,the article further summarizes various methods to improve the catalyst's resistance to heavy metal poisoning,such as element doping,structural optimization,and carrier addition,which significantly enhance the heavy metal resistance of the catalyst.Finally,the article provides a prospective analysis of the challenges faced by NH_(3)-SCR catalysts in anti-heavy metal poisoning technology,emphasizing the necessity of in-depth research on the poisoning mechanism,exploration of the mechanism of synergistic action of multiple pollutants,development of comprehensive anti-poisoning strategies,and research on catalyst regeneration technology,in order to promote the development of efficient anti-heavy metal poisoning NH_(3)-SCR catalysts.
文摘BACKGROUND This case report emphasizes the potential pulmonary toxicity of demulsifier gas,which is a widely used chemical.To our knowledge,this is the first documented instance of acute respiratory distress syndrome(ARDS)induced by inhalation of demulsifier gas.This report underscores the need for increased workplace safety and awareness regarding health risks associated with demulsifiers,particularly in industrial settings.Timely diagnosis and management of ARDS are crucial for improving patient outcomes,thus making this report significant for clinical practice and occupational health literature.CASE SUMMARY We present a rare case of acute demulsifier poisoning leading to ARDS in a previously healthy 69-year-old man.He presented with chest discomfort,short-ness of breath,and dyspnea following a 30-minute exposure to demulsifier fumes in a poorly ventilated area.Chest computed tomography revealed bilateral diffuse infiltrative shadows.Based on his exposure history and clinical findings,a diag-nosis of ARDS due to demulsifier poisoning was confirmed.The patient required high-flow oxygen and intravenous norepinephrine upon admission and was subsequently intubated for mechanical ventilation.Following timely and effective multidisciplinary treatment interventions including emergency care,intensive care,and respiratory medicine,he achieved positive outcomes and was ultimately discharged.CONCLUSION This case underscores the critical importance of recognizing chemical exposure risks and their potential to cause severe respiratory complications.
基金supported by the Research Foundation of Ningbo No.2 Hospital (2023HMKY49)Ningbo Key Support Medical Discipline (2022-F16)。
文摘BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr poisoning.DATA RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October 2023.The inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment strategies.The references in the included studies were also examined to identify additional sources.RESULTS:We included 57 studies in this review.Chlorfenapyr can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine triphosphate.High fever and altered mental status are characteristic clinical presentations of chlorfenapyr poisoning.Once it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and death.Chlorfenapyr poisoning is diflcult to treat,and there is no specific antidote.CONCLUSION:Chlorfenapyr is a new pyrrole pesticide.Although it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely high.There is no specific antidote for chlorfenapyr poisoning.Therefore,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease.
基金supported by National Natural Science Foundation of China(82172184)。
文摘BACKGROUND:In clinical practice,some patients might not be able or unwilling to provide a thorough history of medication and poison exposure.The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.METHODS:This was a retrospective and descriptive study from an institute of poisoning.Patient registration information and test reports spanning the period from April 1,2020 to March 31,2022,were obtained.Patients with uncertain exposure histories and who underwent toxicological analysis were included.Clinical manifestations and categories of toxics were analyzed.RESULTS:Among the 195 patients with positive toxicological analysis results,the main causes of uncertain exposure history was disturbance of consciousness(62.6%),unawareness(23.6%)and unwillingness or lack of cooperation(13.8%).The predominant clinical manifestations were disturbed consciousness(62.6%),followed by vomiting and nausea(14.4%)and liver function abnormalities(8.7%).A comparison of clinical manifestations between patients with positive and negative(n=99)toxicological analyses results revealed significantly different proportions of disturbances in consciousness(63%vs.21%),dizziness(1.5%vs.5.1%),multi-organ failure(1.5%vs.7.1%),and local pain(0 vs 4%).The main categories of substances involved were psychiatric medications(23.1%),sedatives(20.5%),insecticides(13.8%),and herbicides(12.8%).CONCLUSION:The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific,and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.
基金funded by the National Natural Science Foundation of China(82372214).
文摘BACKGROUND:Poisoned patients often suffer damage to multiple systems,and those experiencing central nervous system disorders present more severe conditions,prolonged hospital stays,and increased mortality rates.We aimed to assess the efficacy of rehabilitation interventions for patients with toxic encephalopathy.METHODS:This retrospective,observational,comparative cohort study was performed at the teaching hospital affiliated of Nanjing Medical University,from October 2020 to December 2022.Patients who met the diagnostic criteria for toxic encephalopathy and exclusion criteria were included,and patients were divided into three subgroups according to Glasgow Coma Scale(GCS).Demographic and clinical characteristics were collected.The effect of the rehabilitation intervention on patients were assessed in the improvement of consciousness status(Glasgow Coma Scale[GCS]score),muscle strength and movement and swallowing function(Fugl-Meyer Assessment[FMA]scale,Water Swallow Test[WST],and Standardized Swallowing Assessment[SSA]).Subgroup analysis was based on different toxic species.RESULTS:Out of the 464 patients with toxic encephalopathy,184 cases received rehabilitation treatments.For the severe toxic encephalopathy patients,patients without rehabilitation intervention have a 2.21 times higher risk of death compared to patients with rehabilitation intervention(Hazard ratio[HR]=2.21).Subgroup analysis revealed that rehabilitation intervention significantly increased the survival rate of patients with pesticide poisoning(P=0.02),while no significant improvement was observed in patients with drug/biological agent poisoning(P=0.44).After rehabilitation intervention,significant improvement in GCS and FMA were observed in severe patients with toxic encephalopathy(P<0.01).CONCLUSION:Active rehabilitation intervention for patients exposed to poisons that can potentially cause toxic encephalopathy may improve the prognosis and reduce the mortality rate in clinical practice.
基金the National Natural Science Foundation of China(Nos.22125604,22106100,21976117)Shanghai Rising-Star Program(No.22QA1403700)+1 种基金Chenguang Program supported by Shanghai Education Development FoundationShanghai Municipal Education Commission(No.22Z00354).
文摘Commercial V_(2)O_(5)-based catalysts have been successfully applied in NH_(3) selective catalytic reduction(NH_(3)-SCR)of NO_(x) from power stations,but their poor alkali-resistance restrains the wider application in nonelectrical industries.In this study,NO_(x) reduction against alkali poisoning over V_(2)O_(5)/TiO_(2) is greatly improved via Ce(SO_(4))_(2) modification.It has been originally demonstrated that Ce^(4+)-SO_(4)^(2−)pair sites play crucial roles in improving NO_(x) reduction against alkali poisoning over V_(2)O_(5)/TiO_(2) catalysts.The strong interaction between V species and Ce sites of Ce^(4+)-SO_(4)^(2−)pairs triggers the reaction between NH_(4)^(+) species and gaseous NO via Eley-Rideal(E-R)reaction pathway.After K-poisoning,the SO_(4)^(2−)sites of Ce^(4+)-SO_(4)^(2−)pairs as protective sites strongly bond with K and thus maintain the high reaction efficiency via the E-R reaction pathway.This work demonstrates an effective strategy to enhance NO_(x) reduction against alkali poisoning over catalysts via constructing Ce^(4+)-SO_(4)^(2−)pair sites,contributing to developing alkali-resistant SCR catalysts for practical application in nonelectrical industries.
文摘BACKGROUND Aconitine poisoning is highly prone to causing malignant arrhythmias.The elimination of aconitine from the body takes a considerable amount of time,and during this period,patients are at a significant risk of death due to malignant arrhythmias associated with aconitine poisoning.CASE SUMMARY A 30-year-old male patient was admitted due to accidental ingestion of aconitinecontaining drugs.Upon arrival at the emergency department,the patient intermittently experienced malignant arrhythmias including ventricular tachycardia,ventricular fibrillation,ventricular premature beats,and cardiac arrest.Emergency interventions such as cardiopulmonary resuscitation and defibrillation were promptly administered.Additionally,veno-arterial extracorporeal membrane oxygenation(VA-ECMO)therapy was initiated.Successful resuscitation was achieved before ECMO placement,but upon initiation of ECMO,the patient experienced recurrent malignant arrhythmias.ECMO was utilized to maintain hemodynamics and respiration,while continuous blood purification therapy for toxin clearance,mechanical ventilation,and hypothermic brain protection therapy were concurrently administered.On the third day of VA-ECMO support,the patient’s respiratory and hemodynamic status stabilized,with only frequent ventricular premature beats observed on electrocardiographic monitoring,and echocardiography indicated recovery of cardiac contractile function.On the fourth day,a significant reduction in toxin levels was observed,along with stable hemodynamic and respiratory functions.Following a successful pump-controlled retrograde trial occlusion test,ECMO assistance was terminated.The patient gradually improved postoperatively and achieved recovery.He was discharged 11 days later.CONCLUSION VA-ECMO can serve as a bridging resuscitation technique for patients with reversible malignant arrhythmias.
文摘Pesticide poisoning is one of the most common diseases in the emergency department, characterized by rapid changes in condition, a high misdiagnosis rate, and a poor prognosis. Measures for early removal of poisons are crucial, and gastric lavage is one of the important measures. Regarding the post-gastric lavage effect, abdominal CT scanning has an important application value in the assessment of the gastric lavage effect after pesticide poisoning.
基金supported by Systematic Major Project of China State Railway Group Corporation Limited(Grant Number:P2023W002).
文摘The development of Intelligent Railway Transportation Systems necessitates incorporating privacy-preserving mechanisms into AI models to protect sensitive information and enhance system efficiency.Federated learning offers a promising solution by allowing multiple clients to train models collaboratively without sharing private data.However,despite its privacy benefits,federated learning systems are vulnerable to poisoning attacks,where adversaries alter local model parameters on compromised clients and send malicious updates to the server,potentially compromising the global model’s accuracy.In this study,we introduce PMM(Perturbation coefficient Multiplied by Maximum value),a new poisoning attack method that perturbs model updates layer by layer,demonstrating the threat of poisoning attacks faced by federated learning.Extensive experiments across three distinct datasets have demonstrated PMM’s ability to significantly reduce the global model’s accuracy.Additionally,we propose an effective defense method,namely CLBL(Cluster Layer By Layer).Experiment results on three datasets have confirmed CLBL’s effectiveness.
