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Objective To provide a basis for further optimizing the diagnosis and treatment strategies of severe and critical corona virus disease 2019 (COVID-19) by investigating and analyzing the epidemiological and clinical characteristics of the death cases. Methods The epidemiological and clinical characteristics of 47 death cases obtained from Huoshenshan Hospital in Whuhan, Hubei Province were retrospectively analyzed. Results All the patients developed initial symptoms in Wuhan. The time from onset to admission was (12.60±5.60) days. Most of them were male (68.09%) with non-nosocomial infection (91.49%), advanced age (>60 years, 89.36%). Over half of the cases (51.06%) reported a history of contact with suspected or confirmed patients, and comorbidity of chronic diseases (70.21%). Multiple organ dysfunction syndrome (MODS) occurred in 29 cases (61.70%) with heart failure (51.06%) and renal failure (36.17%). The main clinical symptoms included fever, fatigue, dyspnea and cough. At admission,most cases were severe (55.32%) or critical (42.55%), and the in-hospital survival was longer for the severe than for the critical (P=0.02). 76.59% of the patients received invasive mechanical ventilation, and they had a longer in-hospital survival than those with non-invasive mechanical ventilation (P

The present report describes a case of diffuse panbronchiolitis (DPB) in a child from Western China and the favorable outcome associated with early diagnosis. DPB is an uncommon presentation in pediatric patients. A 13-year-old Chinese boy was admitted to the respiratory outpatient department due to recurrent cough and progressive exertional dyspnea that had persisted for 1 year. An initial diagnosis of bronchial asthma was made, and the patient was prescribed inhaled fluticasone combined with salmeterol (50/250 µg, twice daily), and montelukast (4 mg daily). However, 2 months later no clinical improvement was observed. The disease was re-diagnosed as DPB following the identification of features such as centrilobular small nodular opacities, a 'tree-in-bud appearance' and thickening of the bronchial walls meeting the diagnostic criteria for DPB. Complete resolution of the disease and sustained alleviation of the patient's respiratory symptoms were achieved following the early institution of erythromycin therapy, and the exacerbation of chronic bronchitis was reduced. In conclusion, it is essential to consider that successful treatment for DPB lies in early diagnosis and early treatment. DPB may be treated well by use of erythromycin.

A Vibe improved algorithm based on HIS color space and a watershed algorithm are used to obtain the smoke contours. The Vibe algorithm is used to extract smoke anomalies and smoke inaccuracies. In this paper, the classical Vibe algorithm is described, and the existing problems in the smoke detection are analyzed. A Vibe algorithm is proposed to change the gray color space and the HIS color space by using the color feature information and Vibe. The influence of light and shadow on the smoke extraction noise is reduced by using the difference of pixel value based on Euclidean distance. The problem of imprecision of smoke caused by Vibe algorithm is analyzed by using the watershed algorithm. Finally, the proposed method is evaluated by Barnich experiment standard. The experimental results show that the proposed method can extract the smoke profile more accurately and has good robustness.

Using faraday electromagnetic induction principle will car each wheel as a generator. For car generates its own energy recovery; In the front of car set up a blade, It can recovery the wind power what automobile driving produced, For wind power generation, So that it can recover the energy maximum for the car itself. Because of the two kinds of energy all are car generates its own energy, so it can not recovery completely, in addition to there is power loss in the other part of the car, So it needs to the energy loss and power loss for supplement, I choose the solar energy used as supplementary energy that finally achieve the purpose of "ever moving".

The effect of Ru addition (0 wt.%, 3 wt.%, 5 wt.%), on γ morphology, elemental segregation, microstructural stability under long-term thermal exposure at 980 and stress rupture properties at 1100°C/130MPa have been studied. The results showed that with the increase of Ru content, the γ/γ eutectic volume fraction and the dendrite arm spacing decreased gradually. The γ' phase mean size in three alloys decreased with the increase of the Ru content. On the other hand, the dendrite segregation of Al, Ta towards interdendrite area and ReW towards dendrite core area was alleviated gradually with the increase of the Ru content. The increase of Ru content from 0 wt.% to 5 wt.% pronouncedly enhanced the stress rupture properties by suppressing the precipitation of TCP phases effectively at high temperature.

A study on deformation of multipoint flexible clamped thin-wall components during numerical control drilling in vertical direction downward is presented. The finite element model of multipoint flexible clamped thin-wall component during machining is established with program ANSYS, and a static analysis of deformation of the model is conducted. The laws of maximum deformation under different skin thickness, under different cutting force and on the 3 special machining paths in the cut area are obtained. The results show that the maximum deformation is linear with cutting force and exponential with skin thickness, and the function curves of the maximum deformation on the 3 special machining paths are all different, the function curve 2 is the composite superposition of the function curve 1 and the function curve 3.

Recently, high frequency short pulse electrochemical machining is a focus engineering of national research, its mechanism of research must established in the foundation of correct mathematics model, capacitance model is a ideal model to analysis high frequency short pulse, this article is based on capacitance model, make a detailed formula deduction on the main factors for high frequency short pulse electrochemical machining, eventually, acquired high frequency narrow pulse electrolysis processing gap between poles formula which is based on capacitance model.

Ultrasonic flaw detection in weld inspection is commonly used in non-destructive testing methods. But when the ultrasonic inspection of the welds, point location of defects and identify need technical personnel calculation and according to their long-term practical experience, it requirement for inspection personnel has higher technology.And in ultrasonic weld inspection there will be some factors affecting the accuracy of positioning. It will lead to limitations of ultrasonic weld inspection. To solve these problems effectively, AutoCAD will be used in ultrasonic weld inspection.

This paper studies the mechanism and process simulation of removal of molding sand by a high pressure water jet using a nonlinear dynamic damage model and finite element analysis (FEA). The results indicate that a high pressure water jet possesses a strong ability to remove molding sand. The destruction of molding sand is a concurrent result of stress wave and quasi-static pressure, in which the alterative stress wave plays a major role. The numerical results agree with the test results, indicating that the model and FEA are feasible for analyzing the mechanism and process of removal of molding sand by a high pressure water jet. These conclusions can be used for equipment design and process optimization of removal of molding sand for precision castings.

The p38 mitogen-activated protein kinase (MAPK) is a central signaling molecule in many proinflammatory pathways, regulating the cellular response to a multitude of external stimuli including heat, ultraviolet radiation, osmotic shock, and a variety of cytokines especially interleukin-1beta and tumor necrosis factor alpha. Thus, inhibitors of this enzyme are postulated to have significant therapeutic potential for the treatment of rheumatoid arthritis, inflammatory bowel disease, osteoporosis, and many other diseases where aberrant cytokine signaling is the driver of disease. Herein, we describe a novel class of 3-amino-7-phthalazinylbenzoisoxazole-based inhibitors. With relatively low molecular weight, these compounds are highly potent in enzyme and cell-based assays, with minimal protein shift in 50% human whole blood. Compound 3c was efficacious (ED 50 = 0.05 mg/kg) in the rat collagen induced arthritis (CIA) model.

Objective To explore the clinical characteristics and the present status of diagnosis and treatment of chronic cough.Methods The clinical data of 238 in-patients and out-patients of Departments of Respiratory Diseases from 4 teaching hospitals of Chongqing Municipality were collected from Oct.2008 to Dec.2009,and their clinical characteristics,diagnosis and therapeutic effects were retrospectively analyzed.Results A total of 238 patients were enrolled,most of them complained of dry cough and night cough.Throat symptoms were most common,including itching or foreign body sensation,throat discomfort and gastro-oesophageal reflux.Congestion of pharynx and cobblestone like changes in posterior pharyngeal wall were the most common signs in patients with chronic cough.Among all the supplementary examinations,bronchial provocation test resulted in highest positive rate.Etiological diagnosis was done in a total of 254 case-times for diseases leading to chronic cough,among them upper airway cough syndrome(UACS) was suspected in 115 case-times.cough variant asthma(CVA) in 42 case-times,and cough due to gastroesophageal reflux(GERC) in 53 case-times.After the specific treatment targeting UACS,CVA and GERC,in 152 case-times improvement was found after follow-up,including 56,27 and 21 case-times,respectively,with an effective rate of 68.4%(104/152).The final diagnosis for the other 44 case-times with chronic cough was chronic tonsillitis,chronic bronchitis,eosinophilic bronchitis and angiotensin converting enzyme inhibitor(ACEI) induced cough.A definite diagnosis was finally made in 148 out of a total of 254 casses,with a diagnostic rate of 58.3%(148/254).Conclusion The final diagnostic rate in etiology of chronic cough is still poor nowadays in our country,and empirical treatment is still the main practice for chronic cough.

As described in the preceding two papers, our interest in the construction of natural and natural product-like libraries for chemical biology studies led to the development of a new solid-phase cycloloading strategy for the construction of substituted benzopyrans. Herein, we report a parallel solution-phase method that facilitates the enhancement of both the size and diversity of these non-oligomeric benzopyran libraries using the “libraries from libraries” principle. We examine the rationale behind the use of this tandem strategy to construct discrete small molecule libraries, and describe the development of a polymer-assisted solution-phase (PASP) methodology necessary to effect the required transformations. Once developed, this chemistry is applied to two demonstration libraries.

Having developed a reliable and versatile solid-phase strategy for the split-and-pool synthesis of naturally occurring and designed derivatives of the benzopyran template (see preceding paper), we now report the construction of a 10 000-membered natural product-like compound library for chemical biology studies. Concomitantly, we report an early application of the IRORI NanoKan optical encoding system for the high throughput nonchemical tagging and sorting of library members during split-and-pool synthesis. The overall synthetic strategy for library construction is discussed and the individual reaction pathways are examined in the context of specific library members, illustrating reaction conditions as well as yields and purities. The issues of building block selection and quality control of library members are also addressed and, finally, potential applications of the library to chemical biology are discussed.

Herein we report a novel strategy for the design and construction of natural and natural product-like libraries based on the principle of privileged structures, a term originally introduced to describe structural motifs capable of interacting with a variety of unrelated molecular targets. The identification of such privileged structures in natural products is discussed, and subsequently the 2,2-dimethylbenzopyran moiety is selected as an inaugural template for the construction of natural product-like libraries via this strategy. Initially, a novel solid-phase synthesis of the benzopyran motif is developed employing a unique cycloloading strategy that relies on the use of a new, polystyrene-based selenenyl bromide resin. Once the loading, elaboration, and cleavage of these benzopyrans was established, this new solid-phase method was then thoroughly validated through the construction of six focused combinatorial libraries designed around natural and designed molecules of recent biological interest.

[reaction: see text] Interest in bicyclic natural products from the Guttiferae classification has led to the development of an improved method for the selenium-mediated cyclization of alkenyl-substituted beta-dicarbonyls (I) to form a variety of bicyclo[3.3.1]nonan-9-ones (II) both in solution and on solid support.

The reaction of α,β-unsaturated carbonates was carried out in DMF in the presence of PdCl2/dppb (5 mol%), CO and L-alanine at 65 °C for 4 days to give the β,γ-unsaturated amide intermediate of antillatoxin in good yield.

Synthesis of the key intermediate (5) of Antillatoxin (1) is presented. The synthesis is based on the indium-mediated allylation of 2,4,6,6-tetramethyl-2,4-heptadienal (3) and methyl (Z)-2-(bromomethyl)-2-butenoate (4) in saturated ammonium chloride catalyzed by lanthanide triflate which afforded the corresponding product 2 in good yield and high syn selectivity.

A novel synthetic method to introduce a carboncarbon bond at the 2-position of pyrimidinones via nucleophilic addition of Grignard reagents to 2-cyano pyrimidinones at ambient conditions is disclosed. This unique approach leads to the preparation of such biologically important molecules as polysubstituted pyrimidinones in good to excellent yields.

Background We evaluated the safety and efficacy of increasing doses of autologous blood patch pleurodesis in treating persistent air leaks in patients with advanced chronic obstructive pulmonary disease (COPD). Methods Forty-four patients with COPD and spontaneous pneumothorax (SP) on the 7th day after intercostal tube drainage were randomly assigned to 4 groups, with 11 patients in each group. Groups A, B, and C were given increasing doses of autologous blood—ie, 0.5 mL/kg, 1 mL/kg, 2 mL/kg, respectively—whereas group D was given 1 mL/kg normal saline only. The procedure was repeated if the air leak persisted on postoperative days 9 and 11. Patients in group D crossed over and received autologous blood as in group B if the air leak was still present on the 13th postoperative day. Results No patient died in the study. The air leak was sealed by the 13th postoperative day only in patients with air leaks smaller than size 3. Air leaks were classified as 0 to 3 [12], ie, size 0=no air leak; size 1=air leak on vigorous coughing only; size 2=small continuous air leak on gentle respiration; and size 3=large continuous air leak on gentle respiration. The success rates by the 13th postoperative day in groups A, B, C, and D were 27%, 82%, 82%, and 9%, respectively. The success rate (82%) was significantly higher in groups B and C than in group A ( p = 0.003) and D ( p > 0.01). Conclusions Using autologous blood to treat secondary spontaneous pneumothorax (SSP) in patients with advanced COPD is easy, safe, and effective. The dose of blood required for autologous blood patch pleurodesis should be dependent on the body weight, and 1 mL/kg blood may be efficient.

We reported a previously healthy 25-year-old female patient who developed hypersensitivity pneumonitis following repeated exposures to the smoke of mosquito coils. The patient presented with vague symptoms of cough and fever for 3 days. Diagnostic criteria proposed for clinical use in this case included history, exposure to a recognized antigen, physical examination, consistent radiographic images, bronchoalveolar lavage and lung biopsy. Much symptomatic relief and better radiographic response were noted after short-term use of oral corticosteroid and removal of the offending antigen.

To analyze VDPV found from acute flaccid paralysis cases and effectiveness for emergency response in Binzhou, Shandong in 2007.Outbreak investigation, rapid evaluation for oral poliomyelitis attenuate live vaccine (OPV) coverage rate, active searched for acute flaccid paralysis (AFP)cases, supervision for VDPV case, virology and serology surveillance, mopping-up of OPV were used for this emergency response to prevent the possible VDPV spread.The case was reported from the AFP surveillance system. The poliovirus type I was isolated from stool specimen, which was identified as VDPV by gene sequencing. This AFP case was diagnosed as Guillain-barre syndrome (GBS) with 11 doses of OPV and normal self-immunity function test. The investigation results showed that the OPV coverage rates and the neutralization antibody to poliovirus type 1-3 were at high level among the local children, no similar VDPV was isolated from stools of healthy children around the case. The quality of AFP surveillance system was good, and had not found additional similar case in Bizhou city. Additional VDPV was not found in continuous stool specimen from this case. The case was diagnosed as VDPV infected vector but not VDPV case by the national and provincial expert group.This VDPV was found in the area with high coverage rate OPV, There was no evidence for the VDPV circulation. The emergency response for the VDPV was rapid and effective. The VDPV surveillance and research related should be strengthened.

Interest in bicyclic natural products from the Guttiferae classification has led to the development of an improved method for the selenium-mediated cyclization of alkenyl-substituted β-dicarbonyls (I) to form a variety of bicyclo[3.3.1]nonan-9-ones (II) both in solution and on solid support.

To evaluate the effect of measles control at different stages in Binzhou of Shandong.The data of measles incidence, measles vaccine (MV) coverage, the population immune levels of measles IgG antibody from 1956 to 2008, and the cost-benefit of measles control were analyzed.The measles incidences were declined continually with implementing the strategies of measles control. Measles vaccine coverages have been keeping at the level of 87.12%-93.45% and the population immune levels of measles IgG antibody have been remaining at high level after implemention EPI. According to the progress of MV immunization strategy, the process of measles control could be divided into stage A (1956-1966, no specific immunization conducted), stage B (1967-1978, MV began to popularized), stage C (1979-1997, the EPI was implemented) and stage D (1998-2008, accelerated measles control and elimination). To compared between stage B and stage A, stage C and stage B, stage D and stage C, the average annual cases were decreased 9989, 18 500, and 378 respectirely, and the average annual dead cases were reduced 267, 49 and 50 respectively. The cost-benefit ratio was 1:22.97 for total 41 years on the process of the measles control and elimination from 1967 to 2008.The effect was obtained on the process of measles control in Binzhou city. More efforts should be made to reach the target of measles elimination.

The Boundary element method (BEM) is a useful engineering tool for structural analysis but there are various strategies to obtain the accurate solutions. We developed an expert system for two-dimensional elastostatic BEM analysis on the engineering work station (EWS). This system supports the input of shapes and boundary condition, modelling, BEM analysis, error estimation, adaptive meshing and post-processing. This paper describes the development of the user interface and the expert system for BEM modelling and meshing, which are developed by using object-oriented programming and representing of knowledge. It is found that the object-oriented representation of knowledge is very useful in the design of user interface and expert system in this study.

Investigations into the structure-activity relationships (SAR) of a series of phthalazine-based inhibitors of p38 are described. These efforts originated from quinazoline 1 and through rational design led to the development of a series of orally bioavailable, potent, and selective inhibitors. Kinase selectivity was achieved by exploiting a collection of interactions with p38alpha including close contact to Ala157, occupation of the hydrophobic gatekeeper pocket, and a residue flip with Gly110. Substitutions on the phthalazine influenced the pharmacokinetic properties, of which compound 16 displayed the most desirable profile. Oral dosing (0.03 mg/kg) of 16 in rats 1 h prior to LPS challenge gave a >50% decrease in TNFalpha production.

A one-pot procedure for the synthesis of 2-alkyl-2-arylcyanoacetates based on a Pd(OAc)2/DPPF (DPPF = 1,1‘-diphenylphosphino ferreocene)-catalyzed enolate arylation followed by in situ alkylation has been developed. This procedure tolerates a diverse range of aryl and heteroaryl bromides, and provides a rapid entry to a variety of 2-alkyl-2-arylcyanoacetates in good to excellent yield.

A one-pot procedure for the synthesis of 2-alkyl-2-arylcyanoacetates based on a Pd(OAc)2/DPPF (DPPF = 1,1‘-diphenylphosphino ferreocene)-catalyzed enolate arylation followed by in situ alkylation has been developed. This procedure tolerates a diverse range of aryl and heteroaryl bromides, and provides a rapid entry to a variety of 2-alkyl-2-arylcyanoacetates in good to excellent yield.

To observe the changes of apoptosis and proliferation of pulmonary tissue cells in rats with chronic obstructive pulmonary disease (COPD).The rat model of COPD was established by exposure to cigarette smoking. Thirty-three Wistar rats were randomly divided into a normal control (NC) group, a smoking inhalation for 1 month (COPD-1) group and a smoking inhalation for 2 month (COPD-2) group. Pathologic changes of lung tissues and inflammatory cell differentials were studied. Immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) methods were carried out to examine the percentage of positive cells and distribution of apoptotic cells and proliferating cells in the lung tissue.Significant increases in total leukocyte numbers and neutrophils in the bronchoalveolar lavage were found in the COPD groups as compared to NC group. Two months after smoking exposure, enlargement of airspaces distal to the terminal bronchiole, destruction of alveolar walls, and loss of the alveolar unit were observed. The percentage of apoptotic cells of airway epithelium, alveolar wall cell and vascular smooth muscle cells were (36.2 +/- 8.5)%, (32.7 +/- 6.4)%, (16.1 +/- 7.2)% in COPD-1 group; (39.5 +/- 9.3)%, (37.3 +/- 7.6)%, (21.4 +/- 6.5)% in COPD-2 group; the difference being significant (all P0.01), as compared with NC group [(5.8 +/- 1.7)%, (6.1 +/- 2.3)%, (4.9 +/- 1.4)%]. The percentage of proliferative cells of airway epithelium, alveolar wall cell and vascular smooth muscle cells were (33.4 +/- 6.3)%, (30.1 +/- 4.6)%, (28.4 +/- 6.3)% in COPD-1 group; (35.5 +/- 9.8)%, (33.2 +/- 7.7)%, (34.5 +/- 6.7)% in COPD-2 group; the difference being significant (all P0.01), as compared with NC group [(7.4 +/- 2.3)%, (5.2 +/- 2.1)%, (4.4 +/- 1.8)%]. The numbers of apoptotic and proliferating cells were significantly higher in the COPD-2 group than those in the COPD-1 group (all P0.01). The ratio of proliferative index (PI)/apoptotic index (AI) of the pulmonary tissue cells were also different. The ratio of PI/AI of airway epithelium in COPD-1 and COPD-2 group [(0.82 +/- 0.13)%, (0.78 +/- 0.24)%] was much lower than NC group [(1.12 +/- 0.23)%, P0.05]; The ratio of PI/AI in small pulmonary vessels in the COPD groups [(1.55 +/- 0.25)%, (1.47 +/- 0.28)%] was significantly higher than NC group [(0.92 +/- 0.05)%, P0.05].The changes of apoptosis and proliferation of pulmonary tissue in COPD rats might contribute to the pathogenesis of COPD.

A new breeding population of Mandarin Duck (Aix galericulata, Linnaeus) was first recorded in 2003 in Jiaotanzhuang-Hehekou region of Pingshan county, Hebei Province, China. Recently, the gradually increasing population indicates that there are suitable breeding habitats (such as foraging habitats and nesting sites) for Mandarin Duck. However, these habitats are always close to human disturbances, which are the potential risk for their population. Therefore, it is urgent to put forward an applicable protection strategy, in order to strengthen the public awareness for this unprotected population.

The Boundary element method(BEM) is an useful engineering tool for structural analysis but there are various strategies to obtain the accurate solutions. We developed an expert system for two-dimensional elastostatic BEM analysis on the engineering work station (EWS). This system supports the input of shapes and boundary conditions, modelling, meshing, BEM analysis, error estimation, adaptive meshing as well as post-processing. This paper describes mainly the development of the user interface and the expert system for BEM modelling and meshing by using object-oriented programming and representing of knowledge. It is shown in this study that the object-oriented representation of knowledge is very useful in the development of user interface and expert system.

Recently it becomes very important to analyze the bonded structures with thin plates, the dissimilar materials, the adhesive joints, and the laminate plates. But in the usual boundary element elastostatic analysis (DSM) of very slender body and very thin plates, it is known that the unstable and inaccurate solutions are sometimes encountered. In the present paper, we point out the factors of this inaccuracy and provide the strategies for each factor to obtain an accurate solution. From this study, the highly-accurate solutions can be obtained even If the aspect ratio of slender beams and thin plates is in thousands and hundreds.

The shape optimization problem for finding minimum stress concentration in orthotropic plate is solved. Boundary element method has been developed for analysis of orthotropic materials involving arbitrary principal material direction by using the rotations of fundamental solution, and the good accuracy and efficiency were shown. The optimization algorithm described in this paper is to introduce the Complex Method, which is an efficient method for finding the minimum value of a general constrained nonlinear function without calculating derivatives, to the mentioned boundary element method. As an important application, the stress concentration problem of the fiber-reinforced composite with a center hole is discussed and optimal hole shape with minimum stress concentration are given for various angle-plys of the fiber and under various biaxial loadings.

In the presence of a catalytic amount of indium(III) chloride (InCl3)(20 mol%), aldehydes react smoothly with ketone trimethylsilyl enol ethers in water to afford the corresponding aldol adducts in good yields.