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Long-term alcoholic individuals may develop alcohol withdrawal syndrome （AWS） after abrupt cessation or reduction of alcohol intake. Mild symptoms include involuntary limb trembling， sweating， nausea and vomiting， anxiety and disorder of sleep rhythm， and severe signs consist of hallucination， delirium and even coma. AWS is likely to progress into severe AWS when unrecognized or untreated， which is a potential cause of death. Benzodiazepines are the optimal drugs for the treatment of AWS. Nevertheless， large-dose benzodiazepines alone fail to completely control the symptoms of acute-stage AWS， and it should be combined with other drugs when necessary. In this article， we reported one 41-year-old male case of acute AWS complicated with fever who progressed into severe AWS. The disease condition was finally controlled by combined use of dexmedetomidine and diazepam， a widely prescribed benzodiazepine. The diagnosis and treatment of this case prompt that dexmedetomidine can decrease the dosage of diazepam， ease respiratory depression and mitigate the disorder of sleep rhythm.

The effect of different pH values (8, 9, 10 and 11) on the catalytic activity over CeSiW catalysts was investigated for the selective catalytic reduction of NO by NH3. CeSiW-9 showed a remarkable higher NOx conversion. The strongest interaction was observed between silicotungstic acid and CeO2 over CeSiW-9, resulting in the improvement of redox ability and surface acidity, which could increase the catalytic activity. The superior catalytic performance of the CeSiW-9 catalyst was attributed to the favored pore structures, excellent redox ability and the abundance of surface acid sites, which depended on pH values in the preparation process of CeSiW catalysts. [ABSTRACT FROM AUTHOR]

Background: Accurate assessment of kidney function is clinically important, but estimates of glomerular filtration rate (GFR) by regression are imprecise.Methods: We hypothesized that ensemble learning could improve precision. A total of 1419 participants were enrolled, with 1002 in the development dataset and 417 in the external validation dataset. GFR was independently estimated from age, sex and serum creatinine using an artificial neural network (ANN), support vector machine (SVM), regression, and ensemble learning. GFR was measured by 99mTc-DTPA renal dynamic imaging calibrated with dual plasma sample 99mTc-DTPA GFR.Results: Mean measured GFRs were 70.0 ml/min/1.73 m2 in the developmental and 53.4 ml/min/1.73 m2 in the external validation cohorts. In the external validation cohort, precision was better in the ensemble model of the ANN, SVM and regression equation (IQR = 13.5 ml/min/1.73 m2) than in the new regression model (IQR = 14.0 ml/min/1.73 m2, P < 0.001). The precision of ensemble learning was the best of the three models, but the models had similar bias and accuracy. The median difference ranged from 2.3 to 3.7 ml/min/1.73 m2, 30% accuracy ranged from 73.1 to 76.0%, and P was > 0.05 for all comparisons of the new regression equation and the other new models.Conclusions: An ensemble learning model including three variables, the average ANN, SVM, and regression equation values, was more precise than the new regression model. A more complex ensemble learning strategy may further improve GFR estimates. [ABSTRACT FROM AUTHOR]

The CeO2, CeO2‐ZrO2 and CeO2‐WO3 catalysts were prepared by hydrothermal method and used to the selective catalytic reduction of NOx by NH3. The addition of ZrO2 or WO3 into CeO2 was favorable for pore structure, and then improved the number of active sites. Besides, the introduction of ZrO2 into CeO2 could improve the Lewis acid sites while WO3 could contribute to the generation of Brønsted and Lewis acid sites, which could improve the catalytic performance and N2 selectivity. The CeO2‐WO3 catalyst exhibited optimal catalytic activity with above 90% NOx conversion performance at 220–425 °C and approximately 100% N2 selectivity at 150–425 °C. [ABSTRACT FROM AUTHOR]

To investigate the molecular epidemiology of aminoglycosides resistance among Klebsiella pneumonia in hospitals in China, the antibiotics resistance and the possession of extended-spectrum β-lactamases (ESBLs) from 162 isolates were examined using Kirby-Bauer disk diffusion and PCR sequencing. Overall, 47.5% (77/162) of strains showed an ESBL phenotype. According to antibiotics resistance, ESBLs-positive K. pneumoniae showed significantly higher resistance to most antibiotics than ESBLs-negative strains (P<0.05). Moreover, 162 strains harboured aminoglycoside-modifying enzymes genes (AMEs) including aac (3)-II (n = 49), aac (6')-Ib (n = 32), ant (3")-I (n = 22) and ant (2")-I (n = 7). Overall, 11.1% (18/162) and 6.2% (10/162) of isolates carried 16S rRNA methylase genes (armA and rmtB), in which the aminoglycoside MIC was more than 256 μg/ml. In conclusion, our study characterised aminoglycosides resistance among K. pneumoniae strains in China hospitals and revealed antibiotic resistance and the increased presence of AMEs and 16S rRNA methylase genes in K. pneumonia, enabling the prevalence of aminoglycosides resistance of K. pneumoniae to be tracked from patients.