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Fang-Jie Zhang, Guo-Qing Huang, Jia Li, Ji Xu, Xiang-Min Li, Ai-Min Wang Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of ChinaCorrespondence: Xiang-Min Li; Ai-Min WangDepartment of Emergency Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of ChinaTel +8613875858068; +8613875927399Email lxm8229@126.com; wangaimin@csu.edu.cnPurpose: To determine the clinical manifestations and results of adult hemophagocytic lymphohistiocytosis (HLH) patients in our emergency department.Methods: We retrospectively evaluated patients with HLH from 1 April 2018 to 31 December 2020. The clinical data of these patients (basic information, symptoms, vital signs, laboratory results, HLH diagnostic criteria, H Score, main treatments, outcomes) were collected.Results: Thirty-three patients (23 males and 10 females; 40.55± 18.78 years) with 34 clinical episodes (one male had two clinical episodes and died during the second episode) were enrolled. Twenty-five patients were placed in a “survivor” group, and nine patients were categorized into a “deceased” group. Fever, splenomegaly, hemoglobin < 90 g/L and platelet count < 100× 109/L most commonly met the diagnostic standard for HLH. The H Score results in the survival group and deceased group was 212.4± 37.18 and 252.1± 40.95, respectively. Viral infection was the most common reason for HLH, followed by immune-system disease and cancer. Laboratory tests showed that deceased-group patients had multiple-organ dysfunction. Multivariate logistic regression showed that the lactate dehydrogenase (lactate dehydrogenase) level (P = 0.039; odds ratio, 0.999) was significantly related to death.Conclusion: In the emergency department, HLH should be considered for critically ill patients with fever, splenomegaly, low hemoglobin and low platelet count. The H Score might be useful to diagnose HLH quickly. In our study, 26.47% of HLH patients died in the emergency department, and patients with a significantly increased lactate dehydrogenase level had a markedly increased risk of death.Keywords: clinical characteristics, hemophagocytic lymphohistiocytosis, emergency department, mortality, lactate dehydrogenase

In this paper we propose a new way to detect sublunar-mass primordial black holes (PBHs) by direct observations of the Earth-Moon binary system.Our method is based on treating PBH as a perturbation term, by assuming that the PBH is far away from the Earth-Moon binary (far greater than 1 AU) and the mass of the PBH is small (less than the lunar mass). This perturbation treatment allows us to develop a framework to calculate the orbits of a generic binary system such as the Earth-Moon binary system. Our numerical results show that the Earth-Moon distance is sensitive to the initial values of the system. In most cases, the long-duration interactions between the PBH and the Earth-Moon system can induce lasting imprints on the Earth-Moon's orbit, and these imprints can accumulate over time, eventually giving rise to observable deviations which can be used to infer the properties of the PBH., 23 pages, 16 figures

Chang-Shou She,1 Yue-Lin Deng,1 Guo-Qing Huang,1 Chao Cheng,2 Fang-Jie Zhang1,3 1Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Department of Clinical Laboratory, Lixian People’s Hospital, Changde, Hunan, People’s Republic of China; 3National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Changsha, Hunan, People’s Republic of ChinaCorrespondence: Fang-Jie Zhang, Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China, Tel +86 15116256248, Email zhangfj@csu.edu.cnPurpose: This study’s goal was to explore risk factors affecting short-term prognosis of cardiorenal syndrome type 1 (CRS1) in acute myocardial infarction (AMI) patients.Methods: In this retrospective analysis of CRS1 in AMI patients hospitalized from January 2011 to December 2014, the patients were classified into deceased or survivor groups. Clinical data, including demographics, laboratory results, and 28-day outcomes, were collected.Results: The incidence rate of CRS1 in AMI patients was 15.2% (274 in 1801). Ultimately, 88 patients were enrolled and 25 (28.4%) were classified into the deceased group, while 63 were classified into the survivor group. There were statistically significant differences between the groups for hypertension, mechanical ventilation, KIDGO stage, NT-proBNP, Hb, ALB, PCI, decreased LVEF, 7th-day SCr value, and the highest SCr value recorded within 7 days (all P < 0.05). Multivariate logistic regression showed that the following factors were significantly related to whether a patient died: requiring mechanical ventilation, increased NT-proBNP levels and 7th-day SCr values, and decreased LVEFs. The APACHE II, SOFA, and SASP II scores on the 7th day were significantly higher in the deceased group (all P < 0.05). The accuracy of APACHE II, SOFA, and SASP II scores on the 7th day for predicting death were 84.1%, 78.4% and 79.5%, respectively. The AUC of 7th-day APACHE II, SOFA, and SASP II scores was 0.844, 0.803, and 0.827, respectively, with no statistically significant differences between the three scores (P > 0.05).Conclusion: The mortality rate of CRS1 in AMI patients was 28.4% (25 in 88) within 28 days. Mechanical ventilation, increased NT-proBNP levels, the 7th-day SCr value, and decreased LVEF were related to death in AMI patients with CRS1. APACHE II, SOFA, and SAPS II scores on the 7th day were satisfactorily accurate in predicting death within 28 days.Keywords: acute myocardial infarction, cardiorenal syndrome type 1, APACHE II, SOFA, SAPS II, mortality

Juan Zhang, Xiangmin Li, Guoqing Huang, Aimin Wang, Fangjie Zhang Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of ChinaCorrespondence: Fangjie ZhangDepartment of Emergency Medicine, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of ChinaTel +86-151 1625 6248Email zhangfj@csu.edu.cnBackground: Musculoskeletal infection (MSKI) is a common reason to seek medical care in the emergency department (ED). We aimed to determine the clinical characteristics and etiology of patients with MSKI in our ED, the characteristics of MSKI with sepsis, and the predictors of death in sepsis patients.Methods: The study retrospectively analyzed patients with MSKI from April 1, 2017, to March 31, 2021. The patients were divided into non-sepsis and sepsis groups. Clinical data of these patients including their basic information, laboratory results, diagnostic results, and outcomes were collected. Statistical analysis was carried out using GraphPad Prism 5.Results: In all, 106 patients (70 male, 36 female) were enrolled in this study: 43 MSKI patients with sepsis and 63 MSKI patients without sepsis. Five patients with sepsis died. The patients’ age and sex ratio were no significantly different between the sepsis and non-sepsis groups. In the sepsis group, the ratio of rheumatic diseases, diabetes, coronary heart disease, and deep vein thrombosis was significantly different than that in the non-sepsis group (all p< 0.05). Fifty-six patients (54.37%) had positive etiology results. Staphylococcus, streptococcus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli were the most common bacteria found in both groups, but sepsis patients had more Candida albicans infections than non-sepsis patients (p=0.0331, p< 0.05). The five patients who died in the sepsis group had higher serum levels of creatinine and procalcitonin (PCT). Multivariate logistic regression analyses showed that PCT (p=0.026; odds ratio, 1.038) was significantly related to mortality.Conclusion: In MSKI patients, rheumatic diseases, diabetes, coronary heart disease, and deep vein thrombosis are the risk factors for sepsis. Staphylococcus, streptococcus, K. pneumoniae, P. aeruginosa, and E. coli were the most common bacteria in MSKI patients, while MSKI patients with sepsis had more C. albicans infections. Elevated PCT was significantly related to death in sepsis patients.Keywords: musculoskeletal infection, sepsis, emergency department, procalcitonin

Objectives: Our goal in this study was to determine 1) whether there are any differences in clinical characteristics between Chinese and Western patients with aortic dissection (AD), and 2) the mortality rate of AD patients in the emergency department (ED) and identify the risk predictors for death. Methods: We retrospectively analyzed patients who were diagnosed with AD and admitted to our ED between September 1, 2017–August 31, 2020. Data on age, gender, clinical manifestation, medical history, routine blood tests, liver and kidney function, coagulation, myocardial enzymology, and mortality were collected. Results: We enrolled 535 AD patients (422 men and 113 women) with a mean age of 54.7±14.1 years. Type A AD constituted 40% of the total number of AD cases, while type B AD constituted 60%. The proportion of those who were females, 10-92 years, with type A AD, and hypertension in the Chinese population was lower than that in the Western population (P

Isolated superior mesenteric artery dissection (ISMAD) is a relatively rare disease and often lacks specificity in its clinical presentation, diagnosing it in emergency departments quickly and accurately is a challenge. The study was conducted to understand the basic characteristics of ISMAD including age of onset, risk factors, gender difference and whether D-dimer can be used as a biomarker for its detection. We retrospectively analyzed patients with ISMAD admitted to the emergency department of Xiangya Hospital of Central South University from September 1, 2017 to September 30, 2020. The data included the patient’s basic information and the first laboratory test results after admission, including routine blood, liver function, renal function and coagulation function tests. Statistical analysis of results was done using GraphPad Prism 5. There were a total of 17 (15 male and 2 female) patients with a mean age of 52.53 ± 7.11 years diagnosed with ISMAD. Out of these, 7 (41%) patients had history of hypertension, 7 (41%) had history of smoking and/or alcohol intake, and almost all patients experienced significant abdominal pain and fullness. Four patients (24%) were initially misdiagnosed. The laboratory test results of renal, liver function tests and myocardial enzymology were in their normal ranges. In coagulation results, the positive rates of fibrinogen degradation products (FDP) and D-dimer were 29% and 35%, respectively. We compared these ISMAD results with our previous results for acute aortic dissection (AAD). D-dimer and FDP levels were lower in the ISMAD than in the AAD patients (P = 0.0004, P = 0.0325, respectively), and negative rates of D-dimer and FDP in ISMAD (65%, 71%) were higher than in AAD patients (14%, 24%) (P < 0.0001, P = 0.0003, respectively). In our study, ISMAD mostly occurred in middle-aged male patients with known hypertension or active smoking status. Misdiagnosis was common (24% of cases). Since D-dimer and FDP levels proved to be of limited diagnostic value, an abdominal Computed Tomography (CT) scan should be conducted in patients with unclear abdominal pain at an early stage of their diagnostic workup.

To improve morphological structure and stability of soy protein isolate - chitosan coacervate, a soy protein isolate-chitosan-sodium alginate ternary complex coacervate phase was successfully constructed by adding sodium alginate. The ζ -potential and turbidity data showed that soy protein isolate, sodium alginate, and chitosan interacted with each other in the pH range 5.0–7.0. The highest ternary coacervate yield was obtained at soy protein isolate/sodium alginate ratio 12:1 (g/g), soy protein isolate/sodium alginate:chitosan ratio 4:1 (g/g), pH 6.5, and total biopolymer concentration of 5 g/L. The viscoelastic properties and microstructure were also studied using rheology, fourier transform infrared spectroscopy, texture profile analysis, and scanning electron microscopy, which indicated that the ternary coacervates prepared in pH 5.5, 6.0, and 6.5 had a viscoelastic solid behavior (storage moduli between 12,600 and 35,000 Pa; loss moduli between 3440 and 10,000 Pa) with honeycomb porous network structures. The ternary coacervate prepared at pH 6.5 was more compact and clearly porous. The stability of the ternary complex coacervate phase to pH and ionic strength slight increased. The in situ cross-linking of sodium alginate can improve the structure properties of ternary coacervates, which may provide a new carrier to incoporate bioactive ingredients into food products.

Particles self-assembled by the coacervation between proteins and polysaccharides are promising Pickering stabilizers in the food industry. In this work, the ability of the ovalbumin (OVA)-sodium alginate (SAL) coacervates to fabricate Pickering emulsions and the stability of resultant emulsions were evaluated. The coacervates could stabilize O/W emulsions and the maximum oil fraction of 78.57 % was conferred by the particles separated at pH 4.5 instead of the acidity that contributed the greatest coacervation. The emulsification ability of the OVA-SAL coacervates was not affected by the presence of up to 300 mmol/L NaCl or temperatures ranging from 20 °C to 70 °C, but depended closely on their concentrations, in which, high internal phase Pickering emulsions (HIPEs) could be formed only in 1.25 % (w/v) and higher stabilizer concentrations. The HIPEs exhibited excellent stability against environmental pH variation from 2.0–10.0, heating at up to 100 °C, centrifugation, and repeated freezing-thawing and a higher OVA-SAL coacervate concentration favored the stabilities. Hence, the OVA-SAL coacervates could be used as a novel Pickering stabilizer in the food industry.

Plasma is a partially ionized gas that contains abundant free radicals and UV photons. In this work, the application of low-temperature radio frequency plasma in aflatoxin B1 (AFB1) degradation was investigated and the possible structures of the degradation products were elucidated. It was revealed that AFB1 could be effectively degraded by plasma and exposure to 300 W plasma for 10 min resulted in a degradation rate of up to 88.3 %. Kinetic analysis showed that the degradation process followed a first-order reaction and the generator power was the dominative parameter for AFB1 decomposition. Five major compounds, including 3-(hydromethyl)-8, 9-dihydro-2H-furo[2, 3-h]chromen-8-ol, 1-hydroxy-2-oxo-5-(2, 4, 6-trihydroxy-2, 3, 3a, 8a-tetrahydrofuro[2, 3-b]benzofuran-5-yl)cyclopentanecarboxylic acid, 2-(2, 4-dihydroxy-2, 3, 3a, 8a-tetrahydrofuro[2, 3-b]benzofuran-5-yl)-5-hydroxycyclopent-1-enecarboxylic acid, 1-hydroxy-2-(4-hydroxy-6-methoxy-2-oxo-2, 3, 3a, 8a-tetrahydrofuro[2, 3-b]benzofuran-5-yl)-5-oxocyclopentanecarboxylic acid, and 1, 2-dihydroxy-5-(4-hydroxy-2-oxo-2, 3, 3a, 8a-tetrahydrofuro[2, 3-b]benzofuran-5-yl)cyclopentanecarboxylic acid, were revolved and identified from the degradation product by using UPLC–Q-TOP–MS, and the addition reaction was mainly responsible for AFB1 decomposition. All the five degradation products lost their double bonds in the terminal furan ring and hence theoretically had reduced toxicity compared with AFB1 according to the structure–activity relationship. For this reason, the low-temperature radio frequency plasma is proposed potential in the decontamination of AFB1.

microRNAs (miRNAs/miRs) are a conserved class of endogenous, short non-coding RNAs that post-transcriptionally regulate the expression of genes involved in diverse cellular processes. miR-214 has been reported to be associated with several cancers, including human colon cancer. However, the function of miR-214 in colon cancer development is poorly understood. In the current study, miR-214 was demonstrated to be downregulated in colon cancer tissues compared with healthy colon tissues. Functional studies showed that miR-214 overexpression results in the inhibition of cell viability, colony formation and proliferation, and the induction of cell apoptosis. ADP-ribosylation factor-like protein 2 (ARL2) is predicted to be a target candidate of miR-214. A luciferase reporter assay, western blot analysis and quantitative polymerase chain reaction were performed, which revealed that miR-214 negatively regulates ARL2 expression by targeting its 3' untranslated region directly. In conclusion, the results of the present study revealed that miR-214 suppresses colon cancer cell growth via the suppression of ARL2, and indicated that miR-214 may present a significant potential therapeutic target for colon cancer.

For the complex recognition of signals in the aeronautical communication, the recognition of the star-type MQAM signals is studied under the aeronautical channel. The different scenarios of the aeronautical channel are analyzed and the reasonable channel model is established. The high order cumulant recognition algorithm which applies to the aeronautical channel is proposed, the invariant classification characteristics of modulation signals are constructed by this algorithm, and this algorithm is improved by using the receive diversity technique. Simulation results show that this algorithm significantly improves the correct recognition rate of the received signals has the good anti-fading and anti-noise performance and meets the requirements of the modulation recognition of MQAM signals under the aeronautical channel.

Aiming at the shortcoming that the calculation of the gray relational coefficient is influenced by the number of schemes and distinguishing coefficient, which causes inconsistency of the evaluation results in the traditional gray relational degree, an effectiveness evaluation method is proposed, which is based on the combination of the improved grey relational degree and the analytic hierarchy process (AHP). It uses Delphi method and AHP to establish the scientific and reasonable index system of complex systems; the combination weighting method that AHP combined with entropy method is used to determine the weights, weights can meet the subjective and objective view of demand, which makes the effectiveness evaluation results more reasonable; the compositor results are not affected by the number of schemes and distinguishing coefficient, which overcomes the shortcoming of the traditional grey relational degree. The model of the improved effectiveness evaluation method is established, and the concrete steps of the improved method are given. Three methods were used to analyze the example, the results show that the improved method is reasonable and feasible.

The optically active tetra-β-[(S)-2-octanyloxy]-substituted copper and nickel phthalocyanines were synthesized via a two-step route with 4-nitro-phthalonitrile and (S)-2-octanol as the starting materials. Both compounds are fully characterized by MS, 1H NMR, UV-Vis, IR, CD and elemental analysis, and soluble in common organic solvents except methanol. The results showed that they were dispersed into single molecules in chloroform and dichloromethane, but prone to congregate into H-type aggregates in ethanol and diethyl ether. They assembled to H-type aggregates with left-handed helix when deposited as thin films.

To explore the effect of somatostatin on serum interleukin (IL)-6 and tumor necrosis factor (TNF)-alpha in lipopolysaccharide (LPS)-induced septic shock.24 male Wistar rats were randomly divided into 2 groups: intervention group (injected with LPS of Escherichia coli via femoral vein to induce septic shock) and control group (injected with LPS of Escherichia coli and then injected with somatostatin). The mean arterial pressure (MAP), heart rate, respiration rater, and mortality rate were observed before the injection of LPS, and 30, 90, and 360 min after the injection, and the serum IL-6 and TNF-alpha level were detected before the injection of LPS, 30, 90, and 360 min after the injection, or after the death.The IL-6 levels 30 min, 90 min, and 360 min after the injection of the somatostatin intervention group were 233 +/- 47, 212 +/- 33, and 217 +/- 26 mg/L respectively, all significantly lower then those of the control group (308 +/- 56, 260 +/- 32, and 230 +/- 92 mg/L, all P0.05). The TNF-alpha level 30 min, 90 min, and 360 min after the injection of the somatostatin intervention group were 450 +/- 82, 417 +/- 92, and 440 +/- 49 mg/L, all significantly lower than those of the control group (607 +/- 149, 517 +/- 74, and 474 +/- 219 mg/L, all P0.05). In addition, compared with the control group, the MAP of the somatostatin intervention group increased after 90 min. Two rats in the control group died 30 to 90 min later and 4 rats died 90 to 360 min later, however, 360 min later all rats in the somatostatin intervention group were alive (P = 0.0054).Somatostatin can inhibit the level of serum IL-6 and TNF-alpha in septic shock induced by LPS and improve the survival rate.

Dynamically qualitative properties of individual orbits in a new four-dimensional nonlinear circuit are observed on an oscilloscope. Meanwhile, they are also traced numerically with the help of some methods for finding chaos. Comparisons show that the observed results are consistent with the computed ones to a great extent. In addition, the bifurcation, Lyapunvon spectra, fast Lyapunov indicators and small alignment indexes represent almost the same rules of transitivity to chaos on a control parameter. It is found when the parameter has a threshold value from order to chaos, and the chaos gets stronger and stronger, the parameter is smoothly varied from small to large. In particular, the entire set of Lyapunov exponents can lead to another threshold value of the parameter from chaotic to hyperchaotic behaviors.

Objective To investigate the effects of hydrogen sulfide (H 2 S) on brain injury after cardiopulmonary resuscitation (CPR) in rats by examining neurons apoptosis. Methods The 40 male SD rats were randomly divided into experimental and control groups equally. In control group, CPR was performed with Utstein mode at 6 min after CA. On this basis, sodium hydrosulfide was administrated to the rats after restoration of spontaneous circulation in experimental group. On seventh day after CPR, neurons apoptosis was examined using terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labelling (TUNEL) staining and the expression of caspase-3 was detected by the immunohistochemical strepto avidin biotinperoxidase complex (SABC) method in cortex, hippocampus CA1 region and cerebellum of the rats. Results 1. There were 12 and 10 rats completed the experiment in the experimental and control group respectively. Their fate between the two groups was no significant difference (χ 2 =0.404, p=0.376). 2. On seventh day after CPR, The serum concentrations of H 2 S was 9.12±3.17 μmol/l in the experimental group and the contrast was 3.72±1.05 μmol/l, the difference between the two groups had statistic significance (t=5.136, p=0.000). 3. Compared with the control group, the experimental group9s neurons apoptosis index and the sum of integrated optical density (IOD) of caspase-3 in cortex, hippocampus CA1 region and cerebellum were obviously reduced (p Conclusion After CPR, H 2 S can inhabit neurons apoptosis and its mechanism may be through caspase-3 pathway. It may play a role in the treatment of the brain injury after CA.