Microplastic is a new kind of pollutant.It exists widely in the aquatic environment and seriously endangers the aquatic ecosystem.In this study,the coagulating sedimentation method was used to remove microplastics in ...Microplastic is a new kind of pollutant.It exists widely in the aquatic environment and seriously endangers the aquatic ecosystem.In this study,the coagulating sedimentation method was used to remove microplastics in water.Polyethylene(PE)was selected as the representative of microplastics,polyferric sulfate(PFS),polyaluminum chloride(PAC)and aluminum sulfate(AS)were used as coagulant,and polyacrylamide(PAM)was used as coagulant aid to study the effects of pH,coagulant concentration and sedimentation time on the removal of PE by single and composite coagulant.The results showed that when the dosage of PFS was 0.5 g/L and pH was 5.0,the removal rate could reach 82.14%,which was better than PAC and AS,indicating that PFS had better coagulation and sedimentation performance for PE;the composite coagulant of PFS+PAC+AS(1 g/L+0.2 g/L+0.2 g/L,pH was 5.0)had the highest removal rate of PE,reaching 96.06%;the removal rate of PE increased with the increase in sedimentation time,but considering that the longer sedimentation time has less contribution to the improvement of removal rate,it is recommended that 4 h is appropriate.展开更多
Graft copolymers of MMA （methyl methacrylate） with NRL （natural rubber latex） referred to as NR-g-PMMA have been prepared using CHP （cumene hydroperoxide）/TEPA （tetraetbylenepentamine） redox initiator. 1H NMR ...Graft copolymers of MMA （methyl methacrylate） with NRL （natural rubber latex） referred to as NR-g-PMMA have been prepared using CHP （cumene hydroperoxide）/TEPA （tetraetbylenepentamine） redox initiator. 1H NMR （proton nuclear magnetic resonance） and FTIR （Fourier transform infrared） analysis have confirmed the occurrence of graft copolymerisations of MMA onto NR that containing 30% and 50% of MMA monomer. The influence of coagulating agents such as formic acid, sulfuric acid and boiling water on the coagulation of NR-g-PMMA latices were investigated. These types of coagulating agent formed compact coagulum and the effect of NR-g-PMMA compounds on cure characteristics, physical properties and appearances were reported.展开更多
PU dispersion was chosen as an impregnating agent to produce leather-like sheet on spun-laced nonwoven.Three typical coagulating processes were studied.It was found that the best coagulating process for the chosen PUd...PU dispersion was chosen as an impregnating agent to produce leather-like sheet on spun-laced nonwoven.Three typical coagulating processes were studied.It was found that the best coagulating process for the chosen PUdispersion to get the leather-like sheet was coagulation in a sodium chloride solution.The detailed study of coagu-lating processes in sodium chloride solution was carriedout and optimal condition was obtained.Some experi-mental results were elucidated.Keywords:PU dispersion,coagulating, impregnating,ar-tificial leather,spun-laced nonwoven.展开更多
This review describes the mechanisms of natural coagulants.It provides a good understanding of the two key processes of coagulation-flocculation:adsorption and charge neutralization,as well as adsorption and bridging....This review describes the mechanisms of natural coagulants.It provides a good understanding of the two key processes of coagulation-flocculation:adsorption and charge neutralization,as well as adsorption and bridging.Various factors have influence the coagulation/flocculation process,including the effect of pH,coagulant dosage,coagulant type,temperature,initial turbidity,coagulation speed,flocculation speed,coagulation and flocculation time,settling time,colloidal particles,zeta potential,the effects of humic acids,and extraction density are explained.The bio-coagulants derived from plants are outlined.The impact of organic coagulants on water quality,focusing on their effects on the physicochemical parameters of water,heavy metals removal,and bacteriological water quality,is examined.The methods of extraction and purification of plant-based coagulants,highlighting techniques such as solvent extraction and ultrasonic extraction,are discussed.It also examines the parameters that influence these processes.The methods and principles of purification of coagulating agents,including dialysis,freeze-drying,ion exchange,electrophoresis,filtration,and centrifugation,are listed.Finally,it evaluates the sustainability of natural coagulants,focusing on the environmental,technical,and economic aspects of their use.At the end of this review,the readers should have a comprehensive understanding of the mechanisms,selection,extraction,purification,and sustainability of plant-based natural coagulants in water treatment.展开更多
Background:Hemodialysis(HD) per se is a risk factor for thrombosis.Considering the growing body of evidence on blood-flow restriction(BFR) exercise in HD patients,identification of possible risk factors related to the...Background:Hemodialysis(HD) per se is a risk factor for thrombosis.Considering the growing body of evidence on blood-flow restriction(BFR) exercise in HD patients,identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model.The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise(RE) with BFR on this molecule.Methods:Two hundred and six HD patients volunteered for this study(all with a glomerular filtration rate of <15 mL/min/1.73 m2).The RE+BFR session consisted of 50% arterial occlusion pressure during 50 min sessions of HD(intradialytic exercise).RE repetitions included concentric and eccentric lifting phases(each lasting 2 s) and were supervised by a strength and conditioning specialist.Results:Several variables were associated with elevated levels of D-dimer,including higher blood glucose,citrate use,recent cardiovascular events,recent intercurrents,higher inflammatory status,catheter as vascular access,older patients(>70 years old),and HD vintage.Furthermore,RE+BFR significantly increases D-dimer after 4 h.Patients with borderline baseline D-dimer levels(400-490 ng/mL) displayed increased risk of elevating D-dimer over the normal range(≥500 ng/mL).Conclusion:These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE+BFR.D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE+BFR.展开更多
The coagulation process is a widely applied technology in water and wastewater treatment.Novel composite polyferric mag-nesium-silicate-sulfate(PFMS)coagulants were synthesized using Na_(2)SiO_(3)·9H_(2)O,Fe_(2)(...The coagulation process is a widely applied technology in water and wastewater treatment.Novel composite polyferric mag-nesium-silicate-sulfate(PFMS)coagulants were synthesized using Na_(2)SiO_(3)·9H_(2)O,Fe_(2)(SO_(4))_(3),and MgSO_(4) as raw materials in this paper.The effects of aging time,Fe:Si:Mg,and OH:M molar ratios(M represents the metal ions)on the coagulation performance of the as-pre-pared PFMS were systematically investigated to obtain optimum coagulants.The results showed that PFMS coagulant exhibited good co-agulation properties in the treatment of simulated humic acid-kaolin surface water and reactive dye wastewater.When the molar ratio was controlled at Fe:Si:Mg=2:2:1 and OH:M=0.32,the obtained PFMS presented excellent stability and a high coagulation efficiency.The removal efficiency of ultraviolet UV254 was 99.81%,and the residual turbidity of the surface water reached 0.56 NTU at a dosage of 30 mg·L^(-1).After standing the coagulant for 120 d in the laboratory,the removal efficiency of UV254 and residual turbidity of the surface wa-ter were 88.12%and 0.68 NTU,respectively,which accord with the surface water treatment requirements.In addition,the coagulation performance in the treatment of reactive dye wastewater was greatly improved by combining the advantages of magnesium and iron salts.Compared with polyferric silicate-sulfate(PFS)and polymagnesium silicate-sulfate(PMS),the PFMS coagulant played a better decolor-ization role within the pH range of 7-13.展开更多
Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of ...Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.展开更多
BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-assoc...BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P<0.05).On day 1,the SIC score with a cut-off value>3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.展开更多
BACKGROUND Ischemic stroke is a rare event associated with an elevated risk of blood clot formation owing to an underlying malignancy.Herein,we present a case of ovarian carcinoma that led to cerebral infarction.CASE ...BACKGROUND Ischemic stroke is a rare event associated with an elevated risk of blood clot formation owing to an underlying malignancy.Herein,we present a case of ovarian carcinoma that led to cerebral infarction.CASE SUMMARY A 43-year-old woman experienced sudden onset right-sided paralysis and difficulty speaking two days after discovery of a large ovarian tumor measuring approximately 14 cm,which was suspected to be malignant.Further examination revealed left middle cerebral artery infarction.The patient had a history of hypertension and adenomyosis.Following stabilization with heparin treatment and vital signs management,the patient underwent debulking surgery,including total hysterectomy,bilateral salpingo-oophorectomy,omentectomy,and bilateral pelvic and para-aortic lymph node dissection.The final diagnosis was clear cell carcinoma of the right ovary(stage IA).Subsequently,the patient completed six rounds of adjuvant chemotherapy while simultaneously undergoing rehabilitation.Presently,the patient is able to walk independently,although she still experiences aphasia.CONCLUSION Prompt medical intervention and interdisciplinary care are crucial in the setting of incidental findings such as a large ovarian tumor.展开更多
BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for ...BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.展开更多
BACKGROUND Gastrointestinal(GI)bleeding accounts for over half a million admissions annually and is the most common GI diagnosis requiring hospitalization in the United States.Bipolar electrocoagulation devices are us...BACKGROUND Gastrointestinal(GI)bleeding accounts for over half a million admissions annually and is the most common GI diagnosis requiring hospitalization in the United States.Bipolar electrocoagulation devices are used for the management of gastrointestinal bleeding.There is no data on device-related adverse events for gold probe(GP)and injection gold probe(IGP).AIM To analyze this using the Food and Drug Administration(FDA’s)Manufacturer and User Facility Device Experience(MAUDE)database from 2013 to 2023.METHODS We examined post-marketing surveillance data on GP and IGP from the FDA MAUDE database to report devicerelated and patient-related adverse events between 2013-2023.The MAUDE database is a publicly available resource providing over 4 million records relating to medical device safety.Statistical analyses were performed using IBM SPSS Statistics V.27.0(IBM Corp.,Armonk,NY,United States).RESULTS Our search elicited 140 reports for GP and 202 reports for IGP,respec-tively,during the study period from January 2013 to August 2023.Malfunctions reportedly occurred in 130 cases for GP,and actual patient injury or event occurred in 10 patients.A total of 149 patients(74%)reported with Injection GP events suffered no significant consequences due to the device failure,but 53 patients(26%)were affected by an event.CONCLUSION GP and IGP are critical in managing gastrointestinal bleeding.This study of the FDA MAUDE database revealed the type,number,and trends of reported device-related adverse events.The endoscopist and support staff must be aware of these device-related events and be equipped to manage them if they occur.展开更多
Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage ...Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.展开更多
Fluid catalytic cracking (FCC) salty wastewaters, containing quaternary ammonium compounds (QACs), are very difficult to treat by biochemical process. Anoxic/oxic (A/O) biochemical system, based on nitrification and d...Fluid catalytic cracking (FCC) salty wastewaters, containing quaternary ammonium compounds (QACs), are very difficult to treat by biochemical process. Anoxic/oxic (A/O) biochemical system, based on nitrification and denitrification reactions, was used to assess their possible biodegradation. Because of the negative effects of high salt concentration (3%), heavy metals and toxic organic matter on microorganisms’ activities, some techniques consisting of dilution, coagulation and flocculation, and ozonation pretreatments, were gradually tested to evaluate chemical oxygen demand (COD), ammonia-nitrogen (ammonia-N) and total nitrogen (TN) removal rates. In this process of FCC wastewater, starting with university-domesticated sludge, the ammonia-N and TN removal rates were worst. However, when using domesticated SBR’s sludge and operating with five-fold daily diluted influent (thus reducing salt concentration), the ammonia-N removal reached about 57% while the TN removal rate was less than 37% meaning an amelioration of the nitrification process. However, by reducing the dilution factors, these results were inflected after some days of operation, with ammonia-N removal decreasing and TN barely removed meaning a poor nitrification. Even by reducing heavy metals concentration with coagulation/flocculation process, the results never changed. Thereafter, by using ozonation pre-treatment to degrade the detected organic matter of di-tert-butylphenol and certain isoparaffins, COD, ammonia-N and TN removal rates reached 92%, 62% and 61%, respectively. These results showed that the activities of the microorganisms were increased, thus indicating a net denitrification and nitrification reactions improvement.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has demonstrated several clinical manifestations which include not only respiratory system issues but also liver,kidney,and other organ injuries.One of these abnormalities ...BACKGROUND Coronavirus disease 2019(COVID-19)has demonstrated several clinical manifestations which include not only respiratory system issues but also liver,kidney,and other organ injuries.One of these abnormalities is coagulopathies,including thrombosis and disseminated intravascular coagulation.Because of this,the administration of low molecular weight heparin is required for patients that need to be hospitalized.In addition,Remdesivir is an antiviral that was used against Middle East Acute Respiratory Syndrome,Ebola,Acute Respiratory Syndrome,and other diseases,showing satisfactory results on recovery.Besides,there is evidence suggesting that this medication can provide a better prognosis for patients with COVID-19.AIM To investigate in silico the interaction between Remdesivir and clotting factors,pursuing a possibility of using it as medicine.METHODS In this in silico study,the 3D structures of angiotensin-converting enzyme 2(ACE2),Factor I(fibrinogen),Factor II(prothrombin),Factor III(thromboplastin),Factor V(proaccelerin),Factor VII(proconvertin),Factor VIII(antihemophilic factor A),Factor IX(antihemophilic factor B),Factor X(Stuart-Prower factor),and Factor XI(precursor of thromboplastin(these structures are technically called receptors)were selected from the Protein Data Bank.The structures of the antivirals Remdesivir and Osetalmivir(these structures are called ligands)were selected from the PubChem database,while the structure of Atazanavir was selected from the ZINC database.The software AutoDock Tools(ADT)was used to prepare the receptors for molecular docking.Ions,peptides,water molecules,and other ones were removed from each ligand,and then,hydrogen atoms were added to the structures.The grid box was delimited and calculated using the same software ADT.A physiological environment with pH 7.4 is needed to make the ligands interact with the receptors,and still the software Marvin sketch®(ChemAxon®)was used to forecast the protonation state.To perform molecular docking,ADT and Vina software was connected.Using PyMol®software and Discovery studio®software from BIOVIA,it was possible to analyze the amino acid residues from receptors that were involved in the interactions with the ligands.Ligand tortions,atoms that participated in the interactions,and the type,strength,and duration of the interactions were also analyzed using those software.RESULTS Molecular docking analysis showed that Remdesivir and ACE2 had an affinity energy of-8.8 kcal/moL,forming a complex with eight hydrogen bonds involving seven atoms of Remdesivir and five amino acid residues of ACE2.Remdesivir and prothrombin had an interaction with six hydrogen bonds involving atoms of the drug and five amino acid residues of the clotting factor.Similar to that,Remdesivir and thromboplastin presented interactions via seven hydrogen bonds involving five atoms of the drug and four residues of the clotting factor.While Remdesivir and Factor V established a complex with seven hydrogen bonds between six antiviral atoms and six amino acid residues from the factor,and Factor VII connected with the drug by four hydrogen bonds,which involved three atoms of the drug and three residues of amino acids of the factor.The complex between Remdesivir and Factor IX formed an interaction via 11 hydrophilic bonds with seven atoms of the drug and seven residues of the clotting factor,plus one electrostatic bond and three hydrophobic interactions.Factor X and Remdesivir had an affinity energy of-9.6 kcal/moL,and the complex presented 10 hydrogen bonds and 14 different hydrophobic interactions which involved nine atoms of the drug and 16 amino acid residues of the clotting factor.The interaction between Remdesivir and Factor XI formed five hydrogen bonds involving five amino acid residues of the clotting factor and five of the antiviral atoms.CONCLUSION Because of the in silico significant affinity,Remdesivir possibly could act in the severe acute respiratory syndrome coronavirus 2 infection blockade by interacting with ACE2 and concomitantly act in the modulation of the coagulation cascade preventing the hypercoagulable state.展开更多
BACKGROUND:Out-of-hospital cardiac arrest(OHCA) is a public health concern, and many studies have been conducted on return of spontaneous circulation(ROSC) and its prognostic factors.Rotational thromboelastometry(ROTE...BACKGROUND:Out-of-hospital cardiac arrest(OHCA) is a public health concern, and many studies have been conducted on return of spontaneous circulation(ROSC) and its prognostic factors.Rotational thromboelastometry(ROTEM?), a point-of-care testing(POCT) method, has been useful for predicting ROSC in patients with OHCA, but very few studies have focused on patients with non-shockable rhythm. We examined whether the parameters of POCT could predict ROSC in patients with OHCA and accompanying non-shockable rhythm.METHODS:This is a single-center, retrospective observational study. Complete blood count,blood gas, and ROTEM POCT measurements were used. This study included patients with nontraumatic OHCA aged 18 years or older who were transported to the emergency department and evaluated using POCT between January 2013 and December 2021. The patients were divided into the ROSC and non-ROSC groups. Prehospital information and POCT parameters were compared using receiver operating characteristic(ROC) curve analysis, and further logistic regression analysis was performed.RESULTS:Sixty-seven and 135 patients were in the ROSC and non-ROSC groups,respectively. The ROC curves showed a high area under the curve(AUC) for K^(+) of 0.77(95%confidence interval [CI]:0.71–0.83) and EXTEM amplitude 5 min after clotting time(A5) of 0.70(95%CI:0.62–0.77). The odds ratios for ROSC were as follows:female sex 3.67(95%CI:1.67–8.04);K^(+)0.64(95%CI:0.48–0.84);and EXTEM A5 1.03(95%CI:1.01–1.06).CONCLUSION:In OHCA patients with non-shockable rhythm, K^(+) level and the ROTEM parameter EXTEM A5 may be useful in predicting ROSC.展开更多
Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admit...Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.展开更多
Indeed,polymeric materials have thrived in worldwide sectors over the last five decades due to their versatility and durability,to the point that we can no longer envisage a product that does not contain them.However,...Indeed,polymeric materials have thrived in worldwide sectors over the last five decades due to their versatility and durability,to the point that we can no longer envisage a product that does not contain them.However,many synthetic polymers that have been produced are mostly sourced from petroleum and coal as raw materials,making them environmentally incompatible because they cannot be integrated with what is a natural recycling system.One of the most important aspects of the transition to a circular bioeconomy(CBE)is the provision of more sustainable strategies for resource and waste management.Considering the environmental consequences associated with petroleum-based polymers(PBPs),natural biopolymers,originating from biomass,can be conceived as a promising solution to gradually replace the PBPs,and address,and resolve the potential challenges and prevailing research gaps in the PBPs.The biopolymers have significant advantages over PBPs in terms of low-cost/zero-cost precursors,environmental friendliness,and user-friendliness.The present review dissects the sources,synthesis pathways,structures,characterization,and employment of biopolymers and their composites in water and wastew-ater treatment applications via different scenarios.Furthermore,the CBE model framework proposes potential approaches to applying CBE principles in the wastewater management sector,with a heavy emphasis on not only technology but also organizational and societal reforms.To sum up,the reliance on biopolymers can be considered a crucial tool for assessing the global progress toward CBE,as well as future environmental management and planning.展开更多
BACKGROUND The ratio of lymphocytes to monocytes(LMR)has been shown to be an effective predictor of gastric cancer prognosis.However,its predictive accuracy for signet ring gastric cancer is currently not well underst...BACKGROUND The ratio of lymphocytes to monocytes(LMR)has been shown to be an effective predictor of gastric cancer prognosis.However,its predictive accuracy for signet ring gastric cancer is currently not well understood.AIM To evaluate the prognosis predictive accuracy of preoperative LMR in signet ring gastric cancer.METHODS A total of 212 signet ring gastric cancer patients admitted at the Xiangya Hospital of Central South University,Department of Gastrointestinal Surgery,from January 2012 to December 2016 were enrolled in the study.The prognosis predictive accuracy of preoperative LMR was explored based on the area under the receiver operating characteristic.Factors that significantly affect the survival of patients were identified using single factor analysis,and those that were independently associated with signet ring gastric cancer were identified through multivariate analysis.RESULTS The results of the single factor analysis revealed a strong correlation between the survival of signet ring gastric cancer patients and several factors,including tumor invasion(χ^(2)=49.726;P<0.001),lymph node metastasis(χ^(2)=30.269;P<0.001),pTNM stage(χ^(2)=49.322;P<0.001),surgical approach(χ^(2)=8.489;P=0.004),age(t=-2.213;P<0.028),carcinoembryonic antigen(CEA)(Z=-3.265;P=0.001),platelet-to-lymphocyte ratio(Z=-2.196;P=0.028),LMR(Z=-2.226;P=0.026),ALB(t=3.284;P=0.001),prognostic nutritional index(t=-3.789;P<0.001)and FIB(Z=-3.065;P=0.002).Furthermore,the multivariate analysis further demonstrated that age(HR:0.563,95%CI:0.363-0.873),tumor invasion depth(HR:0.226,95%CI:0.098-0.520),pTNM stage(HR:0.444,95%CI:0.255-0.771),preoperative CEA level(HR:0.597,95%CI:0.386-8.790),and preoperative LMR level(HR:1.776,95%CI:1.150-2.741)were independent factors influencing the prognosis of signet ring gastric cancer.CONCLUSION In signet ring gastric cancer patients,a low preoperative LMR level predicts poor prognosis.The death risk ratio of the low LMR group compared to the high LMR group is 1.776.展开更多
BACKGROUND Primary hepatic carcinoma(PHC)has an insidious onset and is usually diagnosed in the middle and late stages.Although transcatheter arterial chemoembolization(TACE)is the preferred option for treating middle...BACKGROUND Primary hepatic carcinoma(PHC)has an insidious onset and is usually diagnosed in the middle and late stages.Although transcatheter arterial chemoembolization(TACE)is the preferred option for treating middle-and advanced-stage PHC,it has limited efficacy in killing tumor cells and poor long-term efficacy.TACE plus percutaneous microwave coagulation therapy(PMCT)is more effective than interventional therapy alone and can improve survival time.However,there are few reports on the effects of TACE and PMCT on serum marker levels and the prognosis of patients with advanced PHC.AIM To investigate the effect of PMCT+TACE on serum tumor markers and the prognosis of middle-late PHC.METHODS This retrospective study included 150 patients with middle-late PHC admitted to Zhongshan People’s Hospital between March 2018 and February 2021.Patients were divided into a single group(treated with TACE,n=75)and a combined group(treated with TACE+PMCT,n=75).Before and after treatment,the clinical efficacy and serum tumor marker levels[carbohydrate antigen 19-9(CA19-9),alpha-fetoprotein(AFP),and carcinoembryonic antigen(CEA)]of both groups were observed.The 1-year survival rates and prognostic factors of the two groups were analyzed.RESULTS The combined group had 21 and 35 cases of complete remission(CR)and partial remission(PR),respectively.The single group had 13 and 25 cases of CR and PR,decreased,with the decrease in the combined group being more significant(P<0.05).The 1-year survival rate of the combined group(80.00%)was higher than that of the single group(60.00%)(P<0.05).The average survival time within 1 year in the combined group was 299.38±61.13 d,longer than that in the single group(214.41±72.97 d,P<0.05).COX analysis revealed that tumor diameter,tumor number,and the treatment method were prognostic factors for patients with middle-late PHC(P<0.05).CONCLUSION TACE+PMCT is effective in treating patients with mid-late PHC.It reduces the levels of tumor markers,prolongs survival,and improves prognosis.展开更多
Colorectal Cancer (CRC) is a common malignant tumour of the gastrointestinal tract in China, with increasing morbidity and mortality rates year by year. Most patients are in the middle and late stage when diagnosed, a...Colorectal Cancer (CRC) is a common malignant tumour of the gastrointestinal tract in China, with increasing morbidity and mortality rates year by year. Most patients are in the middle and late stage when diagnosed, and its high mortality and poor prognosis have seriously threatened the health and life. Fibrinogen (FIB) is mainly used as a coagulation factor in the body to participate in the process of coagulation and haemostasis, and is the main protein in the coagulation process. In recent years, studies at home and abroad have shown that FIB levels correlate with the diagnosis, outcome prediction and prognosis of CRC, and some of the findings are still controversial. This article aims to review the related research and new progress of the relationship between FIB and CRC in recent years.展开更多
基金Supported by Innovation and Entrepreneurship Training Program for College Students(202210580015).
文摘Microplastic is a new kind of pollutant.It exists widely in the aquatic environment and seriously endangers the aquatic ecosystem.In this study,the coagulating sedimentation method was used to remove microplastics in water.Polyethylene(PE)was selected as the representative of microplastics,polyferric sulfate(PFS),polyaluminum chloride(PAC)and aluminum sulfate(AS)were used as coagulant,and polyacrylamide(PAM)was used as coagulant aid to study the effects of pH,coagulant concentration and sedimentation time on the removal of PE by single and composite coagulant.The results showed that when the dosage of PFS was 0.5 g/L and pH was 5.0,the removal rate could reach 82.14%,which was better than PAC and AS,indicating that PFS had better coagulation and sedimentation performance for PE;the composite coagulant of PFS+PAC+AS(1 g/L+0.2 g/L+0.2 g/L,pH was 5.0)had the highest removal rate of PE,reaching 96.06%;the removal rate of PE increased with the increase in sedimentation time,but considering that the longer sedimentation time has less contribution to the improvement of removal rate,it is recommended that 4 h is appropriate.
文摘Graft copolymers of MMA （methyl methacrylate） with NRL （natural rubber latex） referred to as NR-g-PMMA have been prepared using CHP （cumene hydroperoxide）/TEPA （tetraetbylenepentamine） redox initiator. 1H NMR （proton nuclear magnetic resonance） and FTIR （Fourier transform infrared） analysis have confirmed the occurrence of graft copolymerisations of MMA onto NR that containing 30% and 50% of MMA monomer. The influence of coagulating agents such as formic acid, sulfuric acid and boiling water on the coagulation of NR-g-PMMA latices were investigated. These types of coagulating agent formed compact coagulum and the effect of NR-g-PMMA compounds on cure characteristics, physical properties and appearances were reported.
文摘PU dispersion was chosen as an impregnating agent to produce leather-like sheet on spun-laced nonwoven.Three typical coagulating processes were studied.It was found that the best coagulating process for the chosen PUdispersion to get the leather-like sheet was coagulation in a sodium chloride solution.The detailed study of coagu-lating processes in sodium chloride solution was carriedout and optimal condition was obtained.Some experi-mental results were elucidated.Keywords:PU dispersion,coagulating, impregnating,ar-tificial leather,spun-laced nonwoven.
文摘This review describes the mechanisms of natural coagulants.It provides a good understanding of the two key processes of coagulation-flocculation:adsorption and charge neutralization,as well as adsorption and bridging.Various factors have influence the coagulation/flocculation process,including the effect of pH,coagulant dosage,coagulant type,temperature,initial turbidity,coagulation speed,flocculation speed,coagulation and flocculation time,settling time,colloidal particles,zeta potential,the effects of humic acids,and extraction density are explained.The bio-coagulants derived from plants are outlined.The impact of organic coagulants on water quality,focusing on their effects on the physicochemical parameters of water,heavy metals removal,and bacteriological water quality,is examined.The methods of extraction and purification of plant-based coagulants,highlighting techniques such as solvent extraction and ultrasonic extraction,are discussed.It also examines the parameters that influence these processes.The methods and principles of purification of coagulating agents,including dialysis,freeze-drying,ion exchange,electrophoresis,filtration,and centrifugation,are listed.Finally,it evaluates the sustainability of natural coagulants,focusing on the environmental,technical,and economic aspects of their use.At the end of this review,the readers should have a comprehensive understanding of the mechanisms,selection,extraction,purification,and sustainability of plant-based natural coagulants in water treatment.
基金supported by a grant provided by the Coordenacao de Aperfeicoamento de Pessoal de Nível Superior-Brazil-Finance Code 001 and National Council for Scientific and Technological Developmentfinanced in part by the Conselho Nacional de Desenvolvimento Científico e Tecnológico and Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior-Brasil--Finance Code 001funded by the Fundacao de Apoio à Pesquisa do Distrito Federal with grants from demanda espontanea-Edital 09/2022
文摘Background:Hemodialysis(HD) per se is a risk factor for thrombosis.Considering the growing body of evidence on blood-flow restriction(BFR) exercise in HD patients,identification of possible risk factors related to the prothrombotic agent D-dimer is required for the safety and feasibility of this training model.The aim of the present study was to identify risk factors associated with higher D-dimer levels and to determine the acute effect of resistance exercise(RE) with BFR on this molecule.Methods:Two hundred and six HD patients volunteered for this study(all with a glomerular filtration rate of <15 mL/min/1.73 m2).The RE+BFR session consisted of 50% arterial occlusion pressure during 50 min sessions of HD(intradialytic exercise).RE repetitions included concentric and eccentric lifting phases(each lasting 2 s) and were supervised by a strength and conditioning specialist.Results:Several variables were associated with elevated levels of D-dimer,including higher blood glucose,citrate use,recent cardiovascular events,recent intercurrents,higher inflammatory status,catheter as vascular access,older patients(>70 years old),and HD vintage.Furthermore,RE+BFR significantly increases D-dimer after 4 h.Patients with borderline baseline D-dimer levels(400-490 ng/mL) displayed increased risk of elevating D-dimer over the normal range(≥500 ng/mL).Conclusion:These results identified factors associated with a heightened prothrombotic state and may assist in the screening process for HD patients who wish to undergo RE+BFR.D-dimer and/or other fibrinolysis factors should be assessed at baseline and throughout the protocol as a precautionary measure to maximize safety during RE+BFR.
基金supported by the National Natural Science Foundation of China (No.U1810205).
文摘The coagulation process is a widely applied technology in water and wastewater treatment.Novel composite polyferric mag-nesium-silicate-sulfate(PFMS)coagulants were synthesized using Na_(2)SiO_(3)·9H_(2)O,Fe_(2)(SO_(4))_(3),and MgSO_(4) as raw materials in this paper.The effects of aging time,Fe:Si:Mg,and OH:M molar ratios(M represents the metal ions)on the coagulation performance of the as-pre-pared PFMS were systematically investigated to obtain optimum coagulants.The results showed that PFMS coagulant exhibited good co-agulation properties in the treatment of simulated humic acid-kaolin surface water and reactive dye wastewater.When the molar ratio was controlled at Fe:Si:Mg=2:2:1 and OH:M=0.32,the obtained PFMS presented excellent stability and a high coagulation efficiency.The removal efficiency of ultraviolet UV254 was 99.81%,and the residual turbidity of the surface water reached 0.56 NTU at a dosage of 30 mg·L^(-1).After standing the coagulant for 120 d in the laboratory,the removal efficiency of UV254 and residual turbidity of the surface wa-ter were 88.12%and 0.68 NTU,respectively,which accord with the surface water treatment requirements.In addition,the coagulation performance in the treatment of reactive dye wastewater was greatly improved by combining the advantages of magnesium and iron salts.Compared with polyferric silicate-sulfate(PFS)and polymagnesium silicate-sulfate(PMS),the PFMS coagulant played a better decolor-ization role within the pH range of 7-13.
基金supported by grants from National Key R&D Program of China(No.2023YFC2507800)ECCM Program of Clinical Research Centre of Shandong University(No.2021SDUCRCB008)+2 种基金Young Taishan Scholar Foundation of Shandong Province(No.tsqn201812133)the Fundamental Research Funds of Shandong University(No.2020QNQT001)National Natural Science Foundation of China(No.81900124).
文摘Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.
基金supported by the National Key Research and Development Program of China(2021YFC2501800)Shanghai Committee of Science and Technology(20Y11900100,21MC1930400,and 20DZ2261200)Clinical Research Plan of Shanghai Hospital Development Center(SHDC2020CR4059)。
文摘BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P<0.05).On day 1,the SIC score with a cut-off value>3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.
文摘BACKGROUND Ischemic stroke is a rare event associated with an elevated risk of blood clot formation owing to an underlying malignancy.Herein,we present a case of ovarian carcinoma that led to cerebral infarction.CASE SUMMARY A 43-year-old woman experienced sudden onset right-sided paralysis and difficulty speaking two days after discovery of a large ovarian tumor measuring approximately 14 cm,which was suspected to be malignant.Further examination revealed left middle cerebral artery infarction.The patient had a history of hypertension and adenomyosis.Following stabilization with heparin treatment and vital signs management,the patient underwent debulking surgery,including total hysterectomy,bilateral salpingo-oophorectomy,omentectomy,and bilateral pelvic and para-aortic lymph node dissection.The final diagnosis was clear cell carcinoma of the right ovary(stage IA).Subsequently,the patient completed six rounds of adjuvant chemotherapy while simultaneously undergoing rehabilitation.Presently,the patient is able to walk independently,although she still experiences aphasia.CONCLUSION Prompt medical intervention and interdisciplinary care are crucial in the setting of incidental findings such as a large ovarian tumor.
文摘BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.
文摘BACKGROUND Gastrointestinal(GI)bleeding accounts for over half a million admissions annually and is the most common GI diagnosis requiring hospitalization in the United States.Bipolar electrocoagulation devices are used for the management of gastrointestinal bleeding.There is no data on device-related adverse events for gold probe(GP)and injection gold probe(IGP).AIM To analyze this using the Food and Drug Administration(FDA’s)Manufacturer and User Facility Device Experience(MAUDE)database from 2013 to 2023.METHODS We examined post-marketing surveillance data on GP and IGP from the FDA MAUDE database to report devicerelated and patient-related adverse events between 2013-2023.The MAUDE database is a publicly available resource providing over 4 million records relating to medical device safety.Statistical analyses were performed using IBM SPSS Statistics V.27.0(IBM Corp.,Armonk,NY,United States).RESULTS Our search elicited 140 reports for GP and 202 reports for IGP,respec-tively,during the study period from January 2013 to August 2023.Malfunctions reportedly occurred in 130 cases for GP,and actual patient injury or event occurred in 10 patients.A total of 149 patients(74%)reported with Injection GP events suffered no significant consequences due to the device failure,but 53 patients(26%)were affected by an event.CONCLUSION GP and IGP are critical in managing gastrointestinal bleeding.This study of the FDA MAUDE database revealed the type,number,and trends of reported device-related adverse events.The endoscopist and support staff must be aware of these device-related events and be equipped to manage them if they occur.
文摘Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.
文摘Fluid catalytic cracking (FCC) salty wastewaters, containing quaternary ammonium compounds (QACs), are very difficult to treat by biochemical process. Anoxic/oxic (A/O) biochemical system, based on nitrification and denitrification reactions, was used to assess their possible biodegradation. Because of the negative effects of high salt concentration (3%), heavy metals and toxic organic matter on microorganisms’ activities, some techniques consisting of dilution, coagulation and flocculation, and ozonation pretreatments, were gradually tested to evaluate chemical oxygen demand (COD), ammonia-nitrogen (ammonia-N) and total nitrogen (TN) removal rates. In this process of FCC wastewater, starting with university-domesticated sludge, the ammonia-N and TN removal rates were worst. However, when using domesticated SBR’s sludge and operating with five-fold daily diluted influent (thus reducing salt concentration), the ammonia-N removal reached about 57% while the TN removal rate was less than 37% meaning an amelioration of the nitrification process. However, by reducing the dilution factors, these results were inflected after some days of operation, with ammonia-N removal decreasing and TN barely removed meaning a poor nitrification. Even by reducing heavy metals concentration with coagulation/flocculation process, the results never changed. Thereafter, by using ozonation pre-treatment to degrade the detected organic matter of di-tert-butylphenol and certain isoparaffins, COD, ammonia-N and TN removal rates reached 92%, 62% and 61%, respectively. These results showed that the activities of the microorganisms were increased, thus indicating a net denitrification and nitrification reactions improvement.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has demonstrated several clinical manifestations which include not only respiratory system issues but also liver,kidney,and other organ injuries.One of these abnormalities is coagulopathies,including thrombosis and disseminated intravascular coagulation.Because of this,the administration of low molecular weight heparin is required for patients that need to be hospitalized.In addition,Remdesivir is an antiviral that was used against Middle East Acute Respiratory Syndrome,Ebola,Acute Respiratory Syndrome,and other diseases,showing satisfactory results on recovery.Besides,there is evidence suggesting that this medication can provide a better prognosis for patients with COVID-19.AIM To investigate in silico the interaction between Remdesivir and clotting factors,pursuing a possibility of using it as medicine.METHODS In this in silico study,the 3D structures of angiotensin-converting enzyme 2(ACE2),Factor I(fibrinogen),Factor II(prothrombin),Factor III(thromboplastin),Factor V(proaccelerin),Factor VII(proconvertin),Factor VIII(antihemophilic factor A),Factor IX(antihemophilic factor B),Factor X(Stuart-Prower factor),and Factor XI(precursor of thromboplastin(these structures are technically called receptors)were selected from the Protein Data Bank.The structures of the antivirals Remdesivir and Osetalmivir(these structures are called ligands)were selected from the PubChem database,while the structure of Atazanavir was selected from the ZINC database.The software AutoDock Tools(ADT)was used to prepare the receptors for molecular docking.Ions,peptides,water molecules,and other ones were removed from each ligand,and then,hydrogen atoms were added to the structures.The grid box was delimited and calculated using the same software ADT.A physiological environment with pH 7.4 is needed to make the ligands interact with the receptors,and still the software Marvin sketch®(ChemAxon®)was used to forecast the protonation state.To perform molecular docking,ADT and Vina software was connected.Using PyMol®software and Discovery studio®software from BIOVIA,it was possible to analyze the amino acid residues from receptors that were involved in the interactions with the ligands.Ligand tortions,atoms that participated in the interactions,and the type,strength,and duration of the interactions were also analyzed using those software.RESULTS Molecular docking analysis showed that Remdesivir and ACE2 had an affinity energy of-8.8 kcal/moL,forming a complex with eight hydrogen bonds involving seven atoms of Remdesivir and five amino acid residues of ACE2.Remdesivir and prothrombin had an interaction with six hydrogen bonds involving atoms of the drug and five amino acid residues of the clotting factor.Similar to that,Remdesivir and thromboplastin presented interactions via seven hydrogen bonds involving five atoms of the drug and four residues of the clotting factor.While Remdesivir and Factor V established a complex with seven hydrogen bonds between six antiviral atoms and six amino acid residues from the factor,and Factor VII connected with the drug by four hydrogen bonds,which involved three atoms of the drug and three residues of amino acids of the factor.The complex between Remdesivir and Factor IX formed an interaction via 11 hydrophilic bonds with seven atoms of the drug and seven residues of the clotting factor,plus one electrostatic bond and three hydrophobic interactions.Factor X and Remdesivir had an affinity energy of-9.6 kcal/moL,and the complex presented 10 hydrogen bonds and 14 different hydrophobic interactions which involved nine atoms of the drug and 16 amino acid residues of the clotting factor.The interaction between Remdesivir and Factor XI formed five hydrogen bonds involving five amino acid residues of the clotting factor and five of the antiviral atoms.CONCLUSION Because of the in silico significant affinity,Remdesivir possibly could act in the severe acute respiratory syndrome coronavirus 2 infection blockade by interacting with ACE2 and concomitantly act in the modulation of the coagulation cascade preventing the hypercoagulable state.
文摘BACKGROUND:Out-of-hospital cardiac arrest(OHCA) is a public health concern, and many studies have been conducted on return of spontaneous circulation(ROSC) and its prognostic factors.Rotational thromboelastometry(ROTEM?), a point-of-care testing(POCT) method, has been useful for predicting ROSC in patients with OHCA, but very few studies have focused on patients with non-shockable rhythm. We examined whether the parameters of POCT could predict ROSC in patients with OHCA and accompanying non-shockable rhythm.METHODS:This is a single-center, retrospective observational study. Complete blood count,blood gas, and ROTEM POCT measurements were used. This study included patients with nontraumatic OHCA aged 18 years or older who were transported to the emergency department and evaluated using POCT between January 2013 and December 2021. The patients were divided into the ROSC and non-ROSC groups. Prehospital information and POCT parameters were compared using receiver operating characteristic(ROC) curve analysis, and further logistic regression analysis was performed.RESULTS:Sixty-seven and 135 patients were in the ROSC and non-ROSC groups,respectively. The ROC curves showed a high area under the curve(AUC) for K^(+) of 0.77(95%confidence interval [CI]:0.71–0.83) and EXTEM amplitude 5 min after clotting time(A5) of 0.70(95%CI:0.62–0.77). The odds ratios for ROSC were as follows:female sex 3.67(95%CI:1.67–8.04);K^(+)0.64(95%CI:0.48–0.84);and EXTEM A5 1.03(95%CI:1.01–1.06).CONCLUSION:In OHCA patients with non-shockable rhythm, K^(+) level and the ROTEM parameter EXTEM A5 may be useful in predicting ROSC.
文摘Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.
文摘Indeed,polymeric materials have thrived in worldwide sectors over the last five decades due to their versatility and durability,to the point that we can no longer envisage a product that does not contain them.However,many synthetic polymers that have been produced are mostly sourced from petroleum and coal as raw materials,making them environmentally incompatible because they cannot be integrated with what is a natural recycling system.One of the most important aspects of the transition to a circular bioeconomy(CBE)is the provision of more sustainable strategies for resource and waste management.Considering the environmental consequences associated with petroleum-based polymers(PBPs),natural biopolymers,originating from biomass,can be conceived as a promising solution to gradually replace the PBPs,and address,and resolve the potential challenges and prevailing research gaps in the PBPs.The biopolymers have significant advantages over PBPs in terms of low-cost/zero-cost precursors,environmental friendliness,and user-friendliness.The present review dissects the sources,synthesis pathways,structures,characterization,and employment of biopolymers and their composites in water and wastew-ater treatment applications via different scenarios.Furthermore,the CBE model framework proposes potential approaches to applying CBE principles in the wastewater management sector,with a heavy emphasis on not only technology but also organizational and societal reforms.To sum up,the reliance on biopolymers can be considered a crucial tool for assessing the global progress toward CBE,as well as future environmental management and planning.
基金the Clinical Research Fund of National Geriatric Disease Clinical Medical Research Center,No.2022LNJ22Guangdong Yiyang Healthcare Charity Foundation,No.JZ2022014.
文摘BACKGROUND The ratio of lymphocytes to monocytes(LMR)has been shown to be an effective predictor of gastric cancer prognosis.However,its predictive accuracy for signet ring gastric cancer is currently not well understood.AIM To evaluate the prognosis predictive accuracy of preoperative LMR in signet ring gastric cancer.METHODS A total of 212 signet ring gastric cancer patients admitted at the Xiangya Hospital of Central South University,Department of Gastrointestinal Surgery,from January 2012 to December 2016 were enrolled in the study.The prognosis predictive accuracy of preoperative LMR was explored based on the area under the receiver operating characteristic.Factors that significantly affect the survival of patients were identified using single factor analysis,and those that were independently associated with signet ring gastric cancer were identified through multivariate analysis.RESULTS The results of the single factor analysis revealed a strong correlation between the survival of signet ring gastric cancer patients and several factors,including tumor invasion(χ^(2)=49.726;P<0.001),lymph node metastasis(χ^(2)=30.269;P<0.001),pTNM stage(χ^(2)=49.322;P<0.001),surgical approach(χ^(2)=8.489;P=0.004),age(t=-2.213;P<0.028),carcinoembryonic antigen(CEA)(Z=-3.265;P=0.001),platelet-to-lymphocyte ratio(Z=-2.196;P=0.028),LMR(Z=-2.226;P=0.026),ALB(t=3.284;P=0.001),prognostic nutritional index(t=-3.789;P<0.001)and FIB(Z=-3.065;P=0.002).Furthermore,the multivariate analysis further demonstrated that age(HR:0.563,95%CI:0.363-0.873),tumor invasion depth(HR:0.226,95%CI:0.098-0.520),pTNM stage(HR:0.444,95%CI:0.255-0.771),preoperative CEA level(HR:0.597,95%CI:0.386-8.790),and preoperative LMR level(HR:1.776,95%CI:1.150-2.741)were independent factors influencing the prognosis of signet ring gastric cancer.CONCLUSION In signet ring gastric cancer patients,a low preoperative LMR level predicts poor prognosis.The death risk ratio of the low LMR group compared to the high LMR group is 1.776.
文摘BACKGROUND Primary hepatic carcinoma(PHC)has an insidious onset and is usually diagnosed in the middle and late stages.Although transcatheter arterial chemoembolization(TACE)is the preferred option for treating middle-and advanced-stage PHC,it has limited efficacy in killing tumor cells and poor long-term efficacy.TACE plus percutaneous microwave coagulation therapy(PMCT)is more effective than interventional therapy alone and can improve survival time.However,there are few reports on the effects of TACE and PMCT on serum marker levels and the prognosis of patients with advanced PHC.AIM To investigate the effect of PMCT+TACE on serum tumor markers and the prognosis of middle-late PHC.METHODS This retrospective study included 150 patients with middle-late PHC admitted to Zhongshan People’s Hospital between March 2018 and February 2021.Patients were divided into a single group(treated with TACE,n=75)and a combined group(treated with TACE+PMCT,n=75).Before and after treatment,the clinical efficacy and serum tumor marker levels[carbohydrate antigen 19-9(CA19-9),alpha-fetoprotein(AFP),and carcinoembryonic antigen(CEA)]of both groups were observed.The 1-year survival rates and prognostic factors of the two groups were analyzed.RESULTS The combined group had 21 and 35 cases of complete remission(CR)and partial remission(PR),respectively.The single group had 13 and 25 cases of CR and PR,decreased,with the decrease in the combined group being more significant(P<0.05).The 1-year survival rate of the combined group(80.00%)was higher than that of the single group(60.00%)(P<0.05).The average survival time within 1 year in the combined group was 299.38±61.13 d,longer than that in the single group(214.41±72.97 d,P<0.05).COX analysis revealed that tumor diameter,tumor number,and the treatment method were prognostic factors for patients with middle-late PHC(P<0.05).CONCLUSION TACE+PMCT is effective in treating patients with mid-late PHC.It reduces the levels of tumor markers,prolongs survival,and improves prognosis.
文摘Colorectal Cancer (CRC) is a common malignant tumour of the gastrointestinal tract in China, with increasing morbidity and mortality rates year by year. Most patients are in the middle and late stage when diagnosed, and its high mortality and poor prognosis have seriously threatened the health and life. Fibrinogen (FIB) is mainly used as a coagulation factor in the body to participate in the process of coagulation and haemostasis, and is the main protein in the coagulation process. In recent years, studies at home and abroad have shown that FIB levels correlate with the diagnosis, outcome prediction and prognosis of CRC, and some of the findings are still controversial. This article aims to review the related research and new progress of the relationship between FIB and CRC in recent years.
