BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other characteristics.Pati...BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other characteristics.Patients with delirium in the intensive care unit(ICU)are often missed or misdiagnosed and do not receive adequate attention.AIM To analyze the risk factors for delirium in ICU patients and explore the applica-tion of emotional nursing with pain nursing in the management of delirium.METHODS General data of 301 critically ill patients were retrospectively collected,including histories(cardiovascular and cerebrovascular diseases,hypertension,smoking,alcoholism,and diabetes),age,sex,diagnosis,whether surgery was performed,and patient origin(emergency/clinic).Additionally,the duration of sedation,Richmond Agitation Sedation Scale score,combined emotional and pain care,ven-tilator use duration,vasoactive drug use,drainage tube retention,ICU stay du-ration,C-reactive protein,procalcitonin,white blood cell count,body tempe-rature,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment score were recorded within 24 h after ICU admission.Patients were assessed for delirium according to confusion assessment method for the ICU,and univariate and multivariate logistic regre-ssion analyses were performed to identify the risk factors for delirium in the patients.RESULTS Univariate logistic regression analysis was performed on the 24 potential risk factors associated with delirium in ICU patients.The results showed that 16 risk factors were closely related to delirium,including combined emotional and pain care,history of diabetes,and patient origin.Multivariate logistic regression analysis revealed that no combined emotional and pain care,history of diabetes,emergency source,surgery,long stay in the ICU,smoking history,and high APACHE II score were independent risk factors for de-lirium in ICU patients.CONCLUSION Patients with diabetes and/or smoking history,postoperative patients,patients with a high APACHE II score,and those with emergency ICU admission need emotional and pain care,flexible visiting modes,and early intervention to reduce delirium incidence.展开更多
BACKGROUND Tuberculosis is a chronic infectious disease and an important public health pro-blem.Despite progress in controlling tuberculosis,the incidence of tuberculosis in China is still very high,with 895000 new ca...BACKGROUND Tuberculosis is a chronic infectious disease and an important public health pro-blem.Despite progress in controlling tuberculosis,the incidence of tuberculosis in China is still very high,with 895000 new cases annually.This case report des-cribes the investigation of a case of severe disseminated tuberculosis in a young adult with normal immune function,conducted to ascertain why a Mycobacterium tuberculosis(M.tuberculosis)strain caused such severe disease.CASE SUMMARY A previously healthy 28-year-old woman presented to our hospital with a 1-mo-nth history of fever and fatigue.She was diagnosed with severe disseminated pulmonary tuberculosis,spinal tuberculosis with paravertebral abscesses,and tuberculous meningitis.M.tuberculosis was isolated from bronchoal-veolar lavage fluid.She was treated with standard antituberculous therapy and underwent debridement,bone graft,and internal fixation surgery for spinal tuberculosis.She responded to therapy and regained her ability to walk following the surgery.We analysed the whole-genome sequence of the strain and designated it BLM-A21.Additional M.tuberculosis genomes were selected from the Virulence Factor Database(http://www.mgc.ac.cn/cgi-bin/VFs/genus.cgi?Genus=Mycobacterium)for comparison.An evolutionary tree of the BLM-A21 strain was built using PhyML maximum likelihood software.Further gene analysis revealed that,except for the pks1 gene,BLM-A21 had similar virulence genes to the CDC 1551 and H37Rv strains,which have lower dissemination.CONCLUSION We speculate that the pks1 virulence gene in BLM-A21 may be the key virulence gene responsible for the wide-spread dissemination of M.tuberculosis infection in this previously healthy adult with normal immune function.展开更多
In the last few years, photochemical and electrochemical CO2 transformations have attracted increasing attention in response to topical interest in renewable energy and green chemistry. The present minireview offers a...In the last few years, photochemical and electrochemical CO2 transformations have attracted increasing attention in response to topical interest in renewable energy and green chemistry. The present minireview offers an overview about the current approaches for the photochemical and electrochemical carbon dioxide fixation with organic compounds. Valuable products, including carboxylic acids and heterocyclic compounds, are accessible through carboxylation and carboxylative cyclization, respectively. In photochemical and electrochemical processes, photo- or electro-induced radical ions or other high-energy organic compounds are considered as key intermediates to react with CO2. Besides, activation of CO2 to produce radical anion has also been reported.展开更多
In this work,the protic ionic liquid[DBUH][Im](1,8-diazabicyclo[5.4.0]-7-undeceniumimidazolide)was developed as an efficient catalyst for the transesterification of ethylene carbonate with methanol to produce dimethyl...In this work,the protic ionic liquid[DBUH][Im](1,8-diazabicyclo[5.4.0]-7-undeceniumimidazolide)was developed as an efficient catalyst for the transesterification of ethylene carbonate with methanol to produce dimethyl carbonate.At 70℃,up to 97%conversion of ethylene carbonate and 91%yield of dimethyl ca rbonate were obtained with 1 mol%[DBUH][Im](relative to ethylene carbonate)as catalyst in 2 h.Even at room temperature,the conversion of ethylene carbonate can reach 94%and the yield of dimethyl carbonate can approach 81%for 6 h.Catalytic mechanism investigation showed the high catalytic efficiency of this ionic liquid results from the synergistic activation effect,wherein the cation can activate ethylene carbonate and the anion can activate methanol through hydrogen bond formatio n.Although the reusability of the ionic liquid need to be further improved,high efficiency and comme rcial availability of[DBUH][Im]render it a promising catalyst for the preparation of dimethyl carbonate.展开更多
Nowadays,the massive consumption of fossil fuels and the resulting excessive emission of carbon dioxide(CO_(2))have broken the original carbon balance of nature,resulting in global warming and the consequent detriment...Nowadays,the massive consumption of fossil fuels and the resulting excessive emission of carbon dioxide(CO_(2))have broken the original carbon balance of nature,resulting in global warming and the consequent detrimental environmental impacts.To address these issues,various initiatives have been proposed,among which CO_(2) cap-ture and utilization(CCU)is considered as the direct way to mitigate the accumulation of CO_(2) in the atmosphere.Although a plethora of CO_(2) capture reagents and utilization routes have been developed,the cost of CO_(2) capture reagents as well as the amount of CO_(2) utilization still encounters limitations.Recently,CCU with solid wastes have attracted sustained attention due to its ability to synchronize CO_(2) fixation with solid wastes utilization.Especially,the huge amount and low cost of the solid wastes can promote the economic fixation of CO_(2) and thus contribute significantly to the carbon sink.Given the tremendous utility of this strategy,this review article summarizes the state-of-the-art of CO_(2) capture and utilization with solid wastes such as steel slag,concrete waste,fly ash,red mud,calcium carbide residue,and biomass etc.And three parts including CO_(2) mineralization,solid waste-based catalyst promoted CO_(2) transformation,and collaborative transformation of CO_(2) and solid waste are introduced according to the roles of solid waste in CO_(2) utilization.We hope this review can arouse broad concern and spur further development in this field.展开更多
A series of diatomite supported Cu/Ni bimetallic catalysts were prepared using the co-impregnation method to improve the efficiency and selectivity toward methyl 12-hydroxystearate in the hydrogenation of methyl ricin...A series of diatomite supported Cu/Ni bimetallic catalysts were prepared using the co-impregnation method to improve the efficiency and selectivity toward methyl 12-hydroxystearate in the hydrogenation of methyl ricinoleate.The catalysts were characterized using X-ray diffraction(XRD),transmission electron microscopy(TEM),scanning electron microscopy and energy dispersive X-ray spectroscopy(SEM-EDS),X-ray photoelectron spectroscopy(XPS)and temperature programmed reduction(H2-TPR).All the characterization results verified the formation of highly dispersed Cu/Ni alloy on support.Moreover,by subtly regulating the Ni/Cu molar ratio as well as the reaction parameters,the hydrogenation of methyl ricinoleate to methyl 12-hydroxystearate proceeded efficiently and selectively,affording 97%yield of methyl 12-hydroxystearate and nearly equivalent conversion of methyl ricinoleate under 2 MPa H2 pressure and at 130 C in 4 h with only 1 wt%of the catalyst Ni7Cu1/diatomite(based on methyl ricinoleate).Besides,the supported Cu–Ni bimetallic catalyst is stable during recycle and reuse.After five cycles of reuse,much catalytic activity is still preserved.Therefore,this low-cost and stable bimetallic catalyst would be promising for the hydrogenation of methyl ricinoleate to methyl 12-hydroxystearate,representing an example of green catalysis for efficiently conversion of biomass to value-added chemicals and materials.展开更多
Background： Talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immu...Background： Talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus （HIV）. The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. Methods： This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Results： Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HlV-negative patients （n 7; median： 60 days, range： 14-365 days） than for HIV-positive patients （n = 19; median： 30 days, range： 3-90 days, Mann-Whitney U= 31.50, P = 0.041）. HIV-negative patients were more likely to have dyspnea （57.1% vs. 5.3%, Z： = 8.86, P = 0.010）, low neutrophil count （Mann-Whitney U = 27.00, P = 0.029）, high CD4 count （Mann-Whitney U= 0.00, P 0.009）, and high lymphocyte count （Mann-Whitney U = 21.00, P = 0.009）. There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HlV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, l died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. Conclusions： HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective.展开更多
文摘BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other characteristics.Patients with delirium in the intensive care unit(ICU)are often missed or misdiagnosed and do not receive adequate attention.AIM To analyze the risk factors for delirium in ICU patients and explore the applica-tion of emotional nursing with pain nursing in the management of delirium.METHODS General data of 301 critically ill patients were retrospectively collected,including histories(cardiovascular and cerebrovascular diseases,hypertension,smoking,alcoholism,and diabetes),age,sex,diagnosis,whether surgery was performed,and patient origin(emergency/clinic).Additionally,the duration of sedation,Richmond Agitation Sedation Scale score,combined emotional and pain care,ven-tilator use duration,vasoactive drug use,drainage tube retention,ICU stay du-ration,C-reactive protein,procalcitonin,white blood cell count,body tempe-rature,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment score were recorded within 24 h after ICU admission.Patients were assessed for delirium according to confusion assessment method for the ICU,and univariate and multivariate logistic regre-ssion analyses were performed to identify the risk factors for delirium in the patients.RESULTS Univariate logistic regression analysis was performed on the 24 potential risk factors associated with delirium in ICU patients.The results showed that 16 risk factors were closely related to delirium,including combined emotional and pain care,history of diabetes,and patient origin.Multivariate logistic regression analysis revealed that no combined emotional and pain care,history of diabetes,emergency source,surgery,long stay in the ICU,smoking history,and high APACHE II score were independent risk factors for de-lirium in ICU patients.CONCLUSION Patients with diabetes and/or smoking history,postoperative patients,patients with a high APACHE II score,and those with emergency ICU admission need emotional and pain care,flexible visiting modes,and early intervention to reduce delirium incidence.
基金Supported by the Research on Intelligent Recommendation Decision Model of Geriatrics Based on Big Data,No.2021CX01010136.
文摘BACKGROUND Tuberculosis is a chronic infectious disease and an important public health pro-blem.Despite progress in controlling tuberculosis,the incidence of tuberculosis in China is still very high,with 895000 new cases annually.This case report des-cribes the investigation of a case of severe disseminated tuberculosis in a young adult with normal immune function,conducted to ascertain why a Mycobacterium tuberculosis(M.tuberculosis)strain caused such severe disease.CASE SUMMARY A previously healthy 28-year-old woman presented to our hospital with a 1-mo-nth history of fever and fatigue.She was diagnosed with severe disseminated pulmonary tuberculosis,spinal tuberculosis with paravertebral abscesses,and tuberculous meningitis.M.tuberculosis was isolated from bronchoal-veolar lavage fluid.She was treated with standard antituberculous therapy and underwent debridement,bone graft,and internal fixation surgery for spinal tuberculosis.She responded to therapy and regained her ability to walk following the surgery.We analysed the whole-genome sequence of the strain and designated it BLM-A21.Additional M.tuberculosis genomes were selected from the Virulence Factor Database(http://www.mgc.ac.cn/cgi-bin/VFs/genus.cgi?Genus=Mycobacterium)for comparison.An evolutionary tree of the BLM-A21 strain was built using PhyML maximum likelihood software.Further gene analysis revealed that,except for the pks1 gene,BLM-A21 had similar virulence genes to the CDC 1551 and H37Rv strains,which have lower dissemination.CONCLUSION We speculate that the pks1 virulence gene in BLM-A21 may be the key virulence gene responsible for the wide-spread dissemination of M.tuberculosis infection in this previously healthy adult with normal immune function.
基金This work was financially supported by the National Natural Science Foundation of China （Nos. 21472103, 21672119, 21421001）, the National Key Research and Development Program （No. 2016YFA0602900）, the Natural Science Foundation of Tianjin （No. 16JCZDJC39900）, and the ＂12th Five-Year＂ National Science and Technology Support Plan （No. 2015BAD15B07）.
文摘In the last few years, photochemical and electrochemical CO2 transformations have attracted increasing attention in response to topical interest in renewable energy and green chemistry. The present minireview offers an overview about the current approaches for the photochemical and electrochemical carbon dioxide fixation with organic compounds. Valuable products, including carboxylic acids and heterocyclic compounds, are accessible through carboxylation and carboxylative cyclization, respectively. In photochemical and electrochemical processes, photo- or electro-induced radical ions or other high-energy organic compounds are considered as key intermediates to react with CO2. Besides, activation of CO2 to produce radical anion has also been reported.
基金the Ministry of Science and Technology of China(National Key Research and Development Program,No.2016YFA0602900)the National Natural Science Foundation of China(No.21672119)for financial support。
文摘In this work,the protic ionic liquid[DBUH][Im](1,8-diazabicyclo[5.4.0]-7-undeceniumimidazolide)was developed as an efficient catalyst for the transesterification of ethylene carbonate with methanol to produce dimethyl carbonate.At 70℃,up to 97%conversion of ethylene carbonate and 91%yield of dimethyl ca rbonate were obtained with 1 mol%[DBUH][Im](relative to ethylene carbonate)as catalyst in 2 h.Even at room temperature,the conversion of ethylene carbonate can reach 94%and the yield of dimethyl carbonate can approach 81%for 6 h.Catalytic mechanism investigation showed the high catalytic efficiency of this ionic liquid results from the synergistic activation effect,wherein the cation can activate ethylene carbonate and the anion can activate methanol through hydrogen bond formatio n.Although the reusability of the ionic liquid need to be further improved,high efficiency and comme rcial availability of[DBUH][Im]render it a promising catalyst for the preparation of dimethyl carbonate.
基金This work was financially supported by National Natural Science Foundation of China(21975135,22171149)the Fundamental Research Funds for the Central Universities,Nankai University。
文摘Nowadays,the massive consumption of fossil fuels and the resulting excessive emission of carbon dioxide(CO_(2))have broken the original carbon balance of nature,resulting in global warming and the consequent detrimental environmental impacts.To address these issues,various initiatives have been proposed,among which CO_(2) cap-ture and utilization(CCU)is considered as the direct way to mitigate the accumulation of CO_(2) in the atmosphere.Although a plethora of CO_(2) capture reagents and utilization routes have been developed,the cost of CO_(2) capture reagents as well as the amount of CO_(2) utilization still encounters limitations.Recently,CCU with solid wastes have attracted sustained attention due to its ability to synchronize CO_(2) fixation with solid wastes utilization.Especially,the huge amount and low cost of the solid wastes can promote the economic fixation of CO_(2) and thus contribute significantly to the carbon sink.Given the tremendous utility of this strategy,this review article summarizes the state-of-the-art of CO_(2) capture and utilization with solid wastes such as steel slag,concrete waste,fly ash,red mud,calcium carbide residue,and biomass etc.And three parts including CO_(2) mineralization,solid waste-based catalyst promoted CO_(2) transformation,and collaborative transformation of CO_(2) and solid waste are introduced according to the roles of solid waste in CO_(2) utilization.We hope this review can arouse broad concern and spur further development in this field.
基金supported by the National Program on Key Research Project(2016YFA0602900)Nankai University Engineering Research Center for Castor and also supported by"the Fundamental Research Funds for the Central Universities",Nankai University(000082).
文摘A series of diatomite supported Cu/Ni bimetallic catalysts were prepared using the co-impregnation method to improve the efficiency and selectivity toward methyl 12-hydroxystearate in the hydrogenation of methyl ricinoleate.The catalysts were characterized using X-ray diffraction(XRD),transmission electron microscopy(TEM),scanning electron microscopy and energy dispersive X-ray spectroscopy(SEM-EDS),X-ray photoelectron spectroscopy(XPS)and temperature programmed reduction(H2-TPR).All the characterization results verified the formation of highly dispersed Cu/Ni alloy on support.Moreover,by subtly regulating the Ni/Cu molar ratio as well as the reaction parameters,the hydrogenation of methyl ricinoleate to methyl 12-hydroxystearate proceeded efficiently and selectively,affording 97%yield of methyl 12-hydroxystearate and nearly equivalent conversion of methyl ricinoleate under 2 MPa H2 pressure and at 130 C in 4 h with only 1 wt%of the catalyst Ni7Cu1/diatomite(based on methyl ricinoleate).Besides,the supported Cu–Ni bimetallic catalyst is stable during recycle and reuse.After five cycles of reuse,much catalytic activity is still preserved.Therefore,this low-cost and stable bimetallic catalyst would be promising for the hydrogenation of methyl ricinoleate to methyl 12-hydroxystearate,representing an example of green catalysis for efficiently conversion of biomass to value-added chemicals and materials.
文摘Background： Talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus （HIV）. The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. Methods： This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Results： Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HlV-negative patients （n 7; median： 60 days, range： 14-365 days） than for HIV-positive patients （n = 19; median： 30 days, range： 3-90 days, Mann-Whitney U= 31.50, P = 0.041）. HIV-negative patients were more likely to have dyspnea （57.1% vs. 5.3%, Z： = 8.86, P = 0.010）, low neutrophil count （Mann-Whitney U = 27.00, P = 0.029）, high CD4 count （Mann-Whitney U= 0.00, P 0.009）, and high lymphocyte count （Mann-Whitney U = 21.00, P = 0.009）. There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HlV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, l died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. Conclusions： HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective.
