Search

Background: To assess the outcome of extracorporeal membrane oxygenation (ECMO) for severe adenovirus (Adv) pneumonia with refractory hypoxic respiratory failure (RHRF) in paediatric patients.Methods: A retrospective observational study was performed in a tertiary paediatric intensive care unit (PICU) in China. Patients with RHRF caused by Adv pneumonia who received ECMO support after mechanical ventilation failed to achieve adequate oxygenation between 2017 and 2020 were included. The outcome variables were the in-hospital survival rate and the effects of ECMO on the survival rate.Results: In total, 18 children with RHRF received ECMO. The median age was 19 (9.5, 39.8) months, and the median ECMO duration was 196 (152, 309) h. The in-hospital survival rate was 72.2% (13/18). Thirteen patients (72.2%) required continuous renal replacement therapy (CRRT) due to fluid imbalance or acute kidney injury (AKI). At ECMO initiation, compared with survivors, nonsurvivors had a lower PaO2/FiO2 ratio [49 (34.5, 62) vs. 63 (56, 71); p = 0.04], higher oxygen index (OI) [41 (34.5, 62) vs. 30 (26.5, 35); p = 0.03], higher vasoactive inotropic score (VIS) [30 (16.3, 80) vs. 100 (60, 142.5); p = 0.04], longer duration from mechanical ventilation to ECMO support [8 (4, 14) vs. 4 (3, 5.5) h, p=0.02], and longer time from confirmed RHRF to ECMO initiation [9 (4.8, 13) vs. 5 (1.3, 5.5) h; p = 0.004]. Patients with PaO2/FiO2 <61 mmHg or an OI >43 and hypoxic respiratory failure for more than 9 days before the initiation of ECMO had worse outcomes.Conclusions: ECMO seemed to be effective, as severe paediatric Adv pneumonia patients with RHRF had a cumulative survival rate of 72.2% in our study. Our study provides insight into ECMO rescue in children with severe Adv pneumonia. [ABSTRACT FROM AUTHOR]

Background: Panic disorder (PD) is often undiagnosed, misdiagnosed, or untreated in non-psychiatric clinical settings. Therefore, a cost-effective, accurate and easy-to-administer instrument for PD assessment is still needed. For that reason, the self-report version of the Panic Disorder Severity Scale (PDSS-SR) has been developed and suggested to be a reliable and useful tool in clinical and research settings. The current study aims to evaluate the reliability and validity of the Chinese version of the PDSS-SR and determine the cut-off score of the PDSS-SR. Methods: A total of 133 patients with PD in Shanghai were assessed by the PDSS-SR, PDSS and Hamilton Anxiety Rating Scale (HAMA). Moreover, 117 patients with non-PD anxiety and 51 healthy subjects also completed the PDSS-SR to construct a receiver operating characteristic (ROC) curve with the scores of PD patients. Results: The internal consistency (Cronbach's α) of the PDSS-SR was 0.72–0.80, and the interrater correlation coefficient was 0.78. The results of principal component analysis and varimax rotation indicated that the PDSS-SR had a two-factor structure, with all seven items having salient loadings. The cut-off score was 4, which was associated with high sensitivity (96.03%) and specificity (61.31%). Conclusions: The findings demonstrate that these items and the total score of the PDSS-SR have acceptable reliability and validity in patients with PD and that the PDSS-SR can be used by general doctors for clinical screening in China. [ABSTRACT FROM AUTHOR]

This study presents the particle size distribution and respiratory deposition estimates of airborne perfluoroalkyl acids (PFAAs) during the haze period. Size-segregated haze aerosols were collected from an urban location in Shanghai using an eight-stage air sampler. The samples were analyzed for eight PFAAs using ultra-high-performance liquid chromatography tandem triple quadrupole mass spectrometry. The quantification results showed that the concentrations of particle-bound Σ 8PFAAs ranged from 0.26 to 1.90 ng m −3 (mean: 1.44 ng m −3 ). All of the measured PFAAs particle size distributions had a bimodal mode that peaked respectively in accumulation size range (0.4 < Dp < 2.1 μm) and coarse size ranges ( Dp > 2.1 μm), but the width of each distribution somewhat varied by compound. The emission source, molecular weight, and volatility of the PFAAs were important factors influencing the size distribution of particle-bound PFAAs. Of these compounds, PFUnDA presented a strong accumulation in the fine size range (average 75% associated with particles <2.1 μm), followed by PFOA (69%) and PFDA (64%). The human risk assessment of PFOS via inhalation was addressed and followed the same pattern as the size distribution, with a 2-fold higher risk for the fine particle fraction compared to the coarse particle fraction at urban sites. Approximately 30.3–82.0% of PFAA deposition (∑PFAA: 72.5%) in the alveolar region was associated with particles <2.1 μm, although the contribution of fine particles to the total PFAAs concentration in urban air was only 28–57% (∑8PFAAs: 48%). These results suggested that fine particles are significant contributors to the deposition of PFAAs in the alveolar region of the lung. [ABSTRACT FROM AUTHOR]

Size-resolved aerosol samples from the Shanghai atmosphere were analyzed for normal alkanes ( n -alkanes, C 8 –C 40 ) by comprehensive two-dimensional gas chromatography–flame ionization detection and gas chromatography–triple quadruple mass spectroscopy to study their size distribution and contributions from potential regional sources based on a one-year (2012 − 2013) sampling campaign. The n -alkane concentrations ranged from 62.3 to 398.5 ng m − 3 , with an annual average of 227.6 ng m − 3 . Particle-associated n -alkanes exhibited a bimodal distribution with one peak in the accumulation-mode size range and the other in the coarse-mode size range. As the carbon number increased, the peak in the accumulation mode intensified and the peak in the coarse mode weakened, in accordance with variation of their corresponding volatilities. Source indices (carbon preference index, average chain length, odd-even carbon number preference, unresolved to resolved n -alkanes ratio, and plant wax n -alkanes ratio) indicated that the n -alkane source profile shifted from an anthropogenic-dominated pattern in winter and spring to a terrestrial plant wax-influenced pattern in summer and autumn. Further trajectory cluster analysis and potential source contribution function modeling showed that anthropogenic activities were mainly in the North China Plain and East China and that terrestrial plant waxes originated in Anhui, Zhejiang, and Jiangxi Provinces. The results of our study provide useful information for evaluating the influence of anthropogenic and biogenic activities on the atmospheric transport of important secondary organic aerosol precursors to megacities in East Asia. [ABSTRACT FROM AUTHOR]

Submicron aerosol volatility, chemical composition, and mixing state were simultaneously measured using a thermodenuder (TD) in-line with a single particle aerosol mass spectrometry (SPAMS) during Nov.12 to Dec. 11 of 2014 in Shanghai. By heating up to 250 °C, the signals of refractory species such as elemental carbon, metallic compounds, and mineral dust in aerosols were enhanced in the mass spectra. At 250 °C, the main particle types present in the size range of 0.2–1.0 μm were biomass burning (37% by number) and elemental carbon (20%). From 1.0 to 2.0 μm, biomass burning (30%), dust (19%) and metal-rich (18%) were the primary particle types. CN − signal remained in the mass spectra of the heated biomass burning particles suggests the existence of some extremely low-volatility nitrogen-containing organics. Laboratory experiments were conducted by burning rice straws, the main source material of biomass burning particles in Southern China, to confirm the less volatile composition contributed by biomass burning. Strong CN − with relative area >0.21 was observed in most of the laboratory-made biomass burning particles when heated above 200 °C and was selected as a new marker to identify the biomass burning particles in the field. The TD-SPAMS measured the size-resolved chemical composition of the individual particle residues at different temperatures and offered more information on the aging processes of primary particles and their sources. [ABSTRACT FROM AUTHOR]

Abstract: Based on the lidar data obtained from CALIPSO (Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations) satellite of NASA (National Aeronautics and Space Administration), the vertical distributions of aerosols are revealed during dry haze periods in the Shanghai vicinity by analyzing the optical and micro-physical parameters including total attenuated backscatter coefficient (TABC), volume depolarization ratio (VDR) and total attenuated color ratio (TACR). The preliminary conclusion is that when dry haze occurs in the Shanghai vicinity, smoke and maritime aerosols are the major types in summer and autumn and aerosols might be affected by long-distance transport of dust in spring; lower troposphere below 2 km is the layer polluted most severely and aerosol scattering with relatively irregular shape is much stronger than that of aerosols with relatively regular shape within 2–10 km in middle and upper troposphere; relatively large aerosols appear more frequently in lower (0–2 km) and middle troposphere (2–6 km) than those in upper troposphere (6–10 km). In addition, HYSPLIT (Hybrid Single Particle Lagrangian Integrated Trajectory) model is applied to analyze the aerosol sources during two typical episodes. The results indicate that the middle and upper troposphere in the Shanghai vicinity are affected by the long-distance transport of dusts from northwest of China or other upstream regions. The high aerosol concentrations in the Shanghai vicinity are mainly caused not only by local human activities but also by the long-distance transport from other places. [Copyright &y& Elsevier]