Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wa...Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wall bushings and disconnecting switches for power transmission & distribution systems. In fact, SEPW is展开更多
Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its...Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its reliabil- ity and accuracy are dependent upon the mathematical model. In this work, an integrated mathematical model for the microchannel in the crimped ribbon flame attesters was set up; the fluid flow behavior and the sensitiv- ities of four chemical kinetics mechanisms of propane-air on the accuracy were analysed. It is shown that turbu- lence is predominant in the microchannel of the crimped ribbon flame arresters under the defiagration and detonation conditions, and a new quenching criterion for the numerical simulation is proposed. The kinetics mechanism of Mansouri et al. among the four ones is the most accurate due to the best agreement of the pre- dicted outlet temperature at the experimental flameproof velocity with the autoignition temperature of propane-air. The species mass fraction profiles and the temperature distribution, which are too difficult to mea- sure due to the tiny dimension of the microchannel in experiments, are captured. The fundamental insights into chemical reactions and heat loss are well portrayed. It can be concluded that the integrated mathematical model established in this work can be used as a reliable tool for modeling, selecting and designing such type of crimped ribbon flame attesters with the propane-air medium in the future.展开更多
Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. Thi...Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. This paper presents the electrical performance of ZnO SAs in 22 kV distribution systems using thermal image camera under the power frequency AC operating voltages. When ZnO surge arresters are installation takes a long time in distribution system over more than 5 years. For the experimental study, as ZnO installation takes a long time over 6 years the leakage current is 63.9 mA, temperature differences were measured over a period of time over 14 degree Celsius. This data will be useful as a guideline for solving problems and reducing power loss from leakage current. Moreover, it will be useful in predicting lifetime of ZnO SAs.展开更多
Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective de...Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective devices. The study was testing performance of arresters on low voltage system. The activity was testing of arresters using steady state and impulse voltages. The arresters consisted of gas tube, zener diode, varistor and spark gap arresters, then it was made a cascade circuit between the varistor and spark gap arresters with a decoupling element. The decoupling elements were used air, iron and ferrite. The test yielded data of current and voltage on the tables and oscilloscope waveforms. The arresters had cut voltages early different from each other, namely the gas tube, zener diode, spark gap and varistor arresters were at the voltages of 500 V, 250 V, 1,000 V and 565 V respectively. The iron core decoupling element cascade circuit had the least oscillation among remaining cores.展开更多
Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to impr...Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are unknown.To this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB pathways.Subsequently,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by asphyxia.The results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these effects.To conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.展开更多
Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Over...Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Overall,different types of plasticity,including stem cell-driven genesis of new neurons(adult neurogenesis),cells in arrested maturation(dormant neurons),neuro-glial and synaptic plasticity,can coexist and contribute to grant plastic changes in the brain,from a cellular to system level(Benedetti and Couillard-Despres,2022;Bonfanti et al.,2023).展开更多
BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subs...BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subsequent respiratory and cardiac arrest,are rarely reported.CASE SUMMARY We present the case of a 35-year-old woman,at 36+5 weeks of gestation,who presented with paroxysmal epigastric pain accompanied by low back pain,nausea,and vomiting.According to the clinical symptoms,B-ultrasound imaging and biochemical indicators,the patient was diagnosed with acute pancreatitis and initially managed conservatively.However,3 hours after admission,the patient experienced respiratory and cardiac arrest,and the fetus died.In this case,the adverse outcomes occurred due to the lack of aggressive fluid resuscitation and an active surgical intervention.CONCLUSION Implementing aggressive fluid resuscitation to sustain tissue perfusion,alongside the proactive evaluation of pharmacological agents that suppress gastric acid secretion and inhibit pancreatic enzyme activity,may be beneficial in mitigating the risk of a severely adverse prognosis.Effective management of acute pancreatitis during pregnancy requires careful timing of surgical intervention,a thorough evaluation of the risks and benefits regarding the continuation or termination of pregnancy,and a focus on safeguarding both maternal and fetal health.展开更多
BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic thera...BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic therapy.Extracorporeal CPR(ECPR)is typically employed as a rescue therapy for selected patients when conventional CPR is failing in settings where it can be implemented.CASE SUMMARY We present a case of a 69-year-old male who experienced a prolonged cardiac arrest in an ambulance with pulseless electrical activity.Upon arrival at the emergency department with ongoing manual chest compressions,bedside pointof-care ultrasound revealed an enlarged right ventricle without contractility.Acute PE was suspected as the cause of cardiac arrest,and intravenous thrombolytic therapy with 50 mg tissue plasminogen activator was administered during mechanical chest compressions.Despite 31 minutes of CPR,return of spontaneous circulation was not achieved until 8 minutes after initiation of Veno-arterial extracorporeal membrane oxygenation(ECMO)support.Under ECMO support,the hemodynamic status and myocardial contractility significantly improved.However,the patient ultimately did not survive due to intracerebral hemorrhagic complications,leading to death a few days later in the hospital.CONCLUSION This case illustrates the potential of combining systemic thrombolysis with ECPR for refractory cardiac arrest caused by acute PE,but it also highlights the increased risk of significant bleeding complications,including fatal intracranial hemorrhage.展开更多
The amplitude of switching overvoltages is a key factor for designing the insulation of UHV equipment. The effect of different arresters needs to be studied, since installing arresters is an important way to suppress ...The amplitude of switching overvoltages is a key factor for designing the insulation of UHV equipment. The effect of different arresters needs to be studied, since installing arresters is an important way to suppress switching overvoltages in UHV transmission lines. Switching overvoltages on the 1000 kV Huainan-Huxi double-circuit transmission line were simulated for different operating modes and different arrester designs using the electromagnetic transient program PSCAD/EMTDC. With parallel resistors, the switching overvoltages are less than 1.70 p.u. （1.0 p.u.=1100×√ 2 /√3 kV）. If the arrestors are better, the switching overvoltages can be reduced even lower to 1.55 p.u. Without parallel resistors, the arresters can reduce three-phase energizing overvoltages to 1.70 p.u, while the single-phase reclosing overvoltages still exceed the limit. The results show that the parallel resistors cannot be eliminated if the arresters are only installed at each end of the transmission line. Also, better quality arresters significantly lower the switching overvoltages.展开更多
Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The mos...Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The most likely underlying pathophysiology is subclinical myopericarditis and reentrant ventri-cular tachycardia or spontaneous ventricular fibrillation that is commonly preci-pitated after a surge in catecholamines during exercise or the waking hours of terminal sleep.Small patches of inflammation and/or edema can be missed on cardiac imaging and autopsy,and the heart can appear grossly normal.This paper reviews evidence linking COVID-19 vaccines to cardiac arrest where unfortu-nately the majority of victims have had no antecedent clinical evaluation.We propose a comprehensive strategy for evaluating cardiovascular risk post-vaccination,incorporating detailed patient history,antibody testing,and cardiac diagnostics in the best attempt to detect abnormalities before sudden cardiac death.This approach aims to identify individuals at higher risk of cardiac events after COVID-19 vaccination and guide appropriate clinical management.It is prudent for each primary care physician to have a pre-established plan when addressing this issue in their practice.展开更多
BACKGROUND: Targeted temperature management(TTM) is a common therapeutic intervention, yet its cost-effectiveness remains uncertain. This study aimed to evaluate the real-world cost-effectiveness of TTM compared with ...BACKGROUND: Targeted temperature management(TTM) is a common therapeutic intervention, yet its cost-effectiveness remains uncertain. This study aimed to evaluate the real-world cost-effectiveness of TTM compared with that of conventional care in adult out-of-hospital cardiac arrest(OHCA) survivors using clinical patient-level data.METHODS: We conducted a retrospective cohort study at an academic medical center in the USA to assess the cost-effectiveness of TTM in adult non-traumatic OHCA survivors between 1 January, 2019 and 30 June, 2023. The primary outcome was survival to hospital discharge. Incremental cost-effectiveness ratios(ICERs) were calculated and compared with various decision makers' willingness to pay. Cost-effectiveness acceptability curves were utilized to evaluate the economic attractiveness of TTM. Uncertainty about the incremental cost and effect was explored with a 95% confidence ellipse.RESULTS: Among 925 non-traumatic OHCA survivors, only 30(3%) received TTM. After adjusting for potential confounders, the TTM group did not demonstrate a significantly lower cost(delta cost-$5,141, 95% confidence interval [95% CI]: $-35,347 to $25,065, P=0.79) and higher survival to hospital discharge(delta effect 6%, 95% CI:-11% to 23%, P=0.41). Additionally, a 95% confidence ellipse indicated uncertainty reflected by evidence that the true value of the ICER could be in any of the quadrants of the cost-effectiveness plane.CONCLUSION: Although TTM did not demonstrate a clear survival benefit in this study, its potential cost-effectiveness warrants further investigation with larger sample sizes. These findings highlight the need for additional research to optimize TTM use in OHCA care and inform resource allocation decisions.展开更多
The incidence of in-hospital cardiac arrest (IHCA) has increased over the past decade,with more than half occurring in intensive care units (ICUs).^([1])ICU cardiac arrest (ICU-CA)presents unique challenges,with worse...The incidence of in-hospital cardiac arrest (IHCA) has increased over the past decade,with more than half occurring in intensive care units (ICUs).^([1])ICU cardiac arrest (ICU-CA)presents unique challenges,with worse outcomes than those in monitored wards,highlighting the need for early detection and intervention.^([2])Up to 80%of patients exhibit signs of deterioration hours before IHCA.^([3])Although early warning scores based on vital signs are useful,their eff ectiveness in ICUs is limited due to abnormal physiological parameters.^([4])Laboratory markers,such as sodium,potassium,and lactate,are predictive of poor outcomes,^([5])but static measurements may not capture the patient’s trajectory.Trends in laboratory indicators,such as variability and extremes,may offer better predictive value.^([6])This study aimed to evaluate ICU-CA predictive factors,with a focus on vital signs and trends of laboratory indicators.展开更多
The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of...The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of automated external defibrillator are increasing,the likelihood of survival to hospital discharge is no more than 8%.To date,various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients.The aim of this review is to discuss strategies that facilitate resuscitation,increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the prehospital setting.展开更多
BACKGROUND:This study aims to explore the causal relationship of body weight,body mass index(BMI),and waist circumference (WC) with the risk of cardiac arrest (CA) using two-sample Mendelian randomization (MR).METHODS...BACKGROUND:This study aims to explore the causal relationship of body weight,body mass index(BMI),and waist circumference (WC) with the risk of cardiac arrest (CA) using two-sample Mendelian randomization (MR).METHODS:Data were summarized using genome-wide association studies (GWAS).Twosample MR analyses were performed using the inverse variance weighting (IVW) method,the weighted median method,and the MR-Egger analysis.Heterogeneity test and sensitivity analysis were performed using Cochran’s Q test and the leave-one-out method,respectively.The Steiger test was used to detect reverse causality.Bayesian model-averaged MR was used to identify the most influential risk factors.RESULTS:A total of 13 GWAS data were collected for BMI,body weight and WC.IVW analyses showed a positive correlation of body weight,BMI,and WC with CA (all OR>1 and P<0.05),with MR-Egger and weighted median methods confirming the IVW findings.No horizontal pleiotropy or heterogeneity was observed.Sensitivity analysis indicated that no single nucleotide polymorphism(SNP) caused significant changes in overall causality.Bayesian model-averaged MR was also used to rank causality based on marginal inclusion probability (MIP),and the corresponding modelaveraged causal estimate (MACE) were confirmed,which indicated that WC (GWAS ID:ukb-b-9405)was the highest-ranked risk factor (MIP=0.119,MACE=0.011);its posterior probability was 0.057.A total of 14 sex-specific GWAS data on weight,BMI,and WC were analyzed in relationship with CA,and the MR results showed no significant effects of sex-specific factors.CONCLUSION:Body weight,BMI,and WC are causally associated with an increased risk of CA,with WC identified as the most important risk factor.展开更多
In vitro fertilization(IVF)is one of the most used assisted reproductive technology(ART)techniques today.However,the success of IVF procedures heavily relies on maintaining a sterile environment in laboratories.This n...In vitro fertilization(IVF)is one of the most used assisted reproductive technology(ART)techniques today.However,the success of IVF procedures heavily relies on maintaining a sterile environment in laboratories.This narrative review examines the effects of microbiological contamination in IVF laboratories,exploring its sources,impacts on IVF outcomes,and preventive measures.We conducted a complete literature search using databases such as PubMed and Google Scholar,focusing on studies published within the last fifteen years.Our findings highlight that microbiological contamination can significantly impair embryo quality,reduce implantation and pregnancy rates,and increase the risk of miscarriage and infection.The review also discusses current best practices for contamination prevention and identifies areas for future research.This work emphasizes the critical importance of stringent sterility protocols in IVF laboratories and calls for continued vigilance and innovation in maintaining optimal conditions for assisted reproduction.展开更多
The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Maj...The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Major manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful resuscitation.Why do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was described.By modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony heart.Community awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term outcomes.Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes.This review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation syndrome.The pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for CPR.Although restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and care.The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.展开更多
Aqueous Zn-ion batteries(AZIBs)have attracted increasing attention in next-generation energy storage systems due to their high safety and economic.Unfortunately,the side reactions,dendrites and hydrogen evolution effe...Aqueous Zn-ion batteries(AZIBs)have attracted increasing attention in next-generation energy storage systems due to their high safety and economic.Unfortunately,the side reactions,dendrites and hydrogen evolution effects at the zinc anode interface in aqueous electrolytes seriously hinder the application of aqueous zinc-ion batteries.Here,we report a critical solvation strategy to achieve reversible zinc electrochemistry by introducing a small polar molecule acetonitrile to form a“catcher”to arrest active molecules(bound water molecules).The stable solvation structure of[Zn(H_(2)O)_(6)]^(2+)is capable of maintaining and completely inhibiting free water molecules.When[Zn(H_(2)O)_(6)]^(2+)is partially desolvated in the Helmholtz outer layer,the separated active molecules will be arrested by the“catcher”formed by the strong hydrogen bond N-H bond,ensuring the stable desolvation of Zn^(2+).The Zn||Zn symmetric battery can stably cycle for 2250 h at 1 mAh cm^(-2),Zn||V_(6)O_(13) full battery achieved a capacity retention rate of 99.2%after 10,000 cycles at 10 A g^(-1).This paper proposes a novel critical solvation strategy that paves the route for the construction of high-performance AZIBs.展开更多
Mutations in the microrchidia CW-type zinc finger protein 2(MORC2)gene are the causative agent of Charcot-Marie-Tooth disease type 2Z(CMT2Z),and the hotspot mutation p.S87L is associated with a more seve re spinal mus...Mutations in the microrchidia CW-type zinc finger protein 2(MORC2)gene are the causative agent of Charcot-Marie-Tooth disease type 2Z(CMT2Z),and the hotspot mutation p.S87L is associated with a more seve re spinal muscular atrophy-like clinical phenotype.The aims of this study were to determine the mechanism of the severe phenotype caused by the MORC2 p.S87L mutation and to explore potential treatment strategies.Epithelial cells were isolated from urine samples from a spinal muscular atrophy(SMA)-like patient[MORC2 p.S87L),a CMT2Z patient[MORC2 p.Q400R),and a healthy control and induced to generate pluripotent stem cells,which were then differentiated into motor neuron precursor cells.Next-generation RNA sequencing followed by KEGG pathway enrichment analysis revealed that differentially expressed genes involved in the PI3K/Akt and MAP K/ERK signaling pathways were enriched in the p.S87L SMA-like patient group and were significantly downregulated in induced pluripotent stem cells.Reduced proliferation was observed in the induced pluripotent stem cells and motor neuron precursor cells derived from the p.S87L SMA-like patient group compared with the CMT2Z patient group and the healthy control.G0/G1 phase cell cycle arrest was observed in induced pluripotent stem cells derived from the p.S87L SMA-like patient.MORC2 p.S87Lspecific antisense oligonucleotides(p.S87L-ASO-targeting)showed significant efficacy in improving cell prolife ration and activating the PI3K/Akt and MAP K/ERK pathways in induced pluripotent stem cells.Howeve r,p.S87L-ASO-ta rgeting did not rescue prolife ration of motor neuron precursor cells.These findings suggest that downregulation of the PI3K/Akt and MAP K/ERK signaling pathways leading to reduced cell proliferation and G0/G1 phase cell cycle arrest in induced pluripotent stem cells might be the underlying mechanism of the severe p.S87L SMA-like phenotype.p.S87L-ASO-targeting treatment can alleviate disordered cell proliferation in the early stage of pluripotent stem cell induction.展开更多
BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogrammingrelated parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the ...BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogrammingrelated parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC).METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Aflliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82) and a survival group(n=38).Healthy adult volunteers(n=40) of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogrammingrelated parameters(lactate dehydrogenase [LDH],lactate and pyruvate),neuron-specific enolase(NSE) and interleukin 6(IL-6) were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation II(APACHE II) score and Sequential Organ Failure Assessment(SOFA) score were calculated.The Cerebral Performance Category(CPC) score was recorded on day 28 after ROSC.RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1) significantly increased and were higher in the non-survivors than in the survivors on admission(all P<0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE II score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P<0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC) of 0.904 [95% confidence interval [95% CI]:0.851–0.957]) with 96.8% specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95% CI:0.911–0.989) with 94.7% specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested.CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive eflcacy of LDH during the first week was superior to others.展开更多
Objective Endometrial carcinoma(EC)is a prevalent gynecological malignancy characterized by increasing incidence and mortality rates.This underscores the critical need for novel therapeutic targets.One such potential ...Objective Endometrial carcinoma(EC)is a prevalent gynecological malignancy characterized by increasing incidence and mortality rates.This underscores the critical need for novel therapeutic targets.One such potential target is cell division cycle 20(CDC20),which has been implicated in oncogenesis.This study investigated the effect of the CDC20 inhibitor Apcin on EC and elucidated the underlying mechanism involved.Methods The effects of Apcin on EC cell proliferation,apoptosis,and the cell cycle were evaluated using CCK8 assays and flow cytometry.RNA sequencing(RNA-seq)was subsequently conducted to explore the underlying molecular mechanism,and Western blotting and coimmunoprecipitation were subsequently performed to validate the results.Animal studies were performed to evaluate the antitumor effects in vivo.Bioinformatics analysis was also conducted to identify CDC20 as a potential therapeutic target in EC.Results Treatment with Apcin inhibited proliferation and induced apoptosis in EC cells,resulting in cell cycle arrest.Pathways associated with apoptosis and the cell cycle were activated following treatment with Apcin.Notably,Apcin treatment led to the upregulation of the cell cycle regulator p21,which was verified to interact with CDC20 and consequently decrease the expression of downstream cyclins in EC cells.In vivo experiments confirmed that Apcin treatment significantly impeded tumor growth.Higher CDC20 expression was observed in EC tissue than in nonmalignant tissue,and increased CDC20 expression in EC patients was associated with shorter overall survival and progress free interval.Conclusion CDC20 is a novel molecular target in EC,and Apcin could be developed as a candidate antitumor drug for EC treatment.展开更多
文摘Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wall bushings and disconnecting switches for power transmission & distribution systems. In fact, SEPW is
基金Supported by the National Key Research and Development Program of China(2016YFB0301701)the National Natural Science Foundation of China(21706268+4 种基金9143411421376254)the Postdoctoral Science Foundation of Qingdao Municipal Government(Y7330419DM)the Instrument Developing Project of the Chinese Academy of Sciences(YZ201641)State Key Laboratory of Safety and Control for Chemicals of China
文摘Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its reliabil- ity and accuracy are dependent upon the mathematical model. In this work, an integrated mathematical model for the microchannel in the crimped ribbon flame attesters was set up; the fluid flow behavior and the sensitiv- ities of four chemical kinetics mechanisms of propane-air on the accuracy were analysed. It is shown that turbu- lence is predominant in the microchannel of the crimped ribbon flame arresters under the defiagration and detonation conditions, and a new quenching criterion for the numerical simulation is proposed. The kinetics mechanism of Mansouri et al. among the four ones is the most accurate due to the best agreement of the pre- dicted outlet temperature at the experimental flameproof velocity with the autoignition temperature of propane-air. The species mass fraction profiles and the temperature distribution, which are too difficult to mea- sure due to the tiny dimension of the microchannel in experiments, are captured. The fundamental insights into chemical reactions and heat loss are well portrayed. It can be concluded that the integrated mathematical model established in this work can be used as a reliable tool for modeling, selecting and designing such type of crimped ribbon flame attesters with the propane-air medium in the future.
文摘Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. This paper presents the electrical performance of ZnO SAs in 22 kV distribution systems using thermal image camera under the power frequency AC operating voltages. When ZnO surge arresters are installation takes a long time in distribution system over more than 5 years. For the experimental study, as ZnO installation takes a long time over 6 years the leakage current is 63.9 mA, temperature differences were measured over a period of time over 14 degree Celsius. This data will be useful as a guideline for solving problems and reducing power loss from leakage current. Moreover, it will be useful in predicting lifetime of ZnO SAs.
文摘Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective devices. The study was testing performance of arresters on low voltage system. The activity was testing of arresters using steady state and impulse voltages. The arresters consisted of gas tube, zener diode, varistor and spark gap arresters, then it was made a cascade circuit between the varistor and spark gap arresters with a decoupling element. The decoupling elements were used air, iron and ferrite. The test yielded data of current and voltage on the tables and oscilloscope waveforms. The arresters had cut voltages early different from each other, namely the gas tube, zener diode, spark gap and varistor arresters were at the voltages of 500 V, 250 V, 1,000 V and 565 V respectively. The iron core decoupling element cascade circuit had the least oscillation among remaining cores.
基金supported by the Natural Science Fund of Fujian Province,No.2020J011058(to JK)the Project of Fujian Provincial Hospital for High-level Hospital Construction,No.2020HSJJ12(to JK)+1 种基金the Fujian Provincial Finance Department Special Fund,No.(2021)848(to FC)the Fujian Provincial Major Scientific and Technological Special Projects on Health,No.2022ZD01008(to FC).
文摘Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are unknown.To this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB pathways.Subsequently,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by asphyxia.The results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these effects.To conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.
基金supported by Progetto Trapezio,Compagnia di San Paolo(67935-2021.2174)to LB,Fondazione CRT(Cassa di Risparmio di Torino,RF=2022.0618)to LB。
文摘Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Overall,different types of plasticity,including stem cell-driven genesis of new neurons(adult neurogenesis),cells in arrested maturation(dormant neurons),neuro-glial and synaptic plasticity,can coexist and contribute to grant plastic changes in the brain,from a cellular to system level(Benedetti and Couillard-Despres,2022;Bonfanti et al.,2023).
文摘BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subsequent respiratory and cardiac arrest,are rarely reported.CASE SUMMARY We present the case of a 35-year-old woman,at 36+5 weeks of gestation,who presented with paroxysmal epigastric pain accompanied by low back pain,nausea,and vomiting.According to the clinical symptoms,B-ultrasound imaging and biochemical indicators,the patient was diagnosed with acute pancreatitis and initially managed conservatively.However,3 hours after admission,the patient experienced respiratory and cardiac arrest,and the fetus died.In this case,the adverse outcomes occurred due to the lack of aggressive fluid resuscitation and an active surgical intervention.CONCLUSION Implementing aggressive fluid resuscitation to sustain tissue perfusion,alongside the proactive evaluation of pharmacological agents that suppress gastric acid secretion and inhibit pancreatic enzyme activity,may be beneficial in mitigating the risk of a severely adverse prognosis.Effective management of acute pancreatitis during pregnancy requires careful timing of surgical intervention,a thorough evaluation of the risks and benefits regarding the continuation or termination of pregnancy,and a focus on safeguarding both maternal and fetal health.
基金Supported by Scientific Research Projects from Wuhan Municipal Health Commission of China,No.WX23B42.
文摘BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic therapy.Extracorporeal CPR(ECPR)is typically employed as a rescue therapy for selected patients when conventional CPR is failing in settings where it can be implemented.CASE SUMMARY We present a case of a 69-year-old male who experienced a prolonged cardiac arrest in an ambulance with pulseless electrical activity.Upon arrival at the emergency department with ongoing manual chest compressions,bedside pointof-care ultrasound revealed an enlarged right ventricle without contractility.Acute PE was suspected as the cause of cardiac arrest,and intravenous thrombolytic therapy with 50 mg tissue plasminogen activator was administered during mechanical chest compressions.Despite 31 minutes of CPR,return of spontaneous circulation was not achieved until 8 minutes after initiation of Veno-arterial extracorporeal membrane oxygenation(ECMO)support.Under ECMO support,the hemodynamic status and myocardial contractility significantly improved.However,the patient ultimately did not survive due to intracerebral hemorrhagic complications,leading to death a few days later in the hospital.CONCLUSION This case illustrates the potential of combining systemic thrombolysis with ECPR for refractory cardiac arrest caused by acute PE,but it also highlights the increased risk of significant bleeding complications,including fatal intracranial hemorrhage.
基金Supported by the National Natural Science Foundation of China(No. 50737001)
文摘The amplitude of switching overvoltages is a key factor for designing the insulation of UHV equipment. The effect of different arresters needs to be studied, since installing arresters is an important way to suppress switching overvoltages in UHV transmission lines. Switching overvoltages on the 1000 kV Huainan-Huxi double-circuit transmission line were simulated for different operating modes and different arrester designs using the electromagnetic transient program PSCAD/EMTDC. With parallel resistors, the switching overvoltages are less than 1.70 p.u. （1.0 p.u.=1100×√ 2 /√3 kV）. If the arrestors are better, the switching overvoltages can be reduced even lower to 1.55 p.u. Without parallel resistors, the arresters can reduce three-phase energizing overvoltages to 1.70 p.u, while the single-phase reclosing overvoltages still exceed the limit. The results show that the parallel resistors cannot be eliminated if the arresters are only installed at each end of the transmission line. Also, better quality arresters significantly lower the switching overvoltages.
文摘Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The most likely underlying pathophysiology is subclinical myopericarditis and reentrant ventri-cular tachycardia or spontaneous ventricular fibrillation that is commonly preci-pitated after a surge in catecholamines during exercise or the waking hours of terminal sleep.Small patches of inflammation and/or edema can be missed on cardiac imaging and autopsy,and the heart can appear grossly normal.This paper reviews evidence linking COVID-19 vaccines to cardiac arrest where unfortu-nately the majority of victims have had no antecedent clinical evaluation.We propose a comprehensive strategy for evaluating cardiovascular risk post-vaccination,incorporating detailed patient history,antibody testing,and cardiac diagnostics in the best attempt to detect abnormalities before sudden cardiac death.This approach aims to identify individuals at higher risk of cardiac events after COVID-19 vaccination and guide appropriate clinical management.It is prudent for each primary care physician to have a pre-established plan when addressing this issue in their practice.
基金supported by Faculty of MedicineChiang Mai University+2 种基金supported by the National Center for Advancing Translational SciencesNational Institutes of Healththrough grant number UL1 TR001860. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH。
文摘BACKGROUND: Targeted temperature management(TTM) is a common therapeutic intervention, yet its cost-effectiveness remains uncertain. This study aimed to evaluate the real-world cost-effectiveness of TTM compared with that of conventional care in adult out-of-hospital cardiac arrest(OHCA) survivors using clinical patient-level data.METHODS: We conducted a retrospective cohort study at an academic medical center in the USA to assess the cost-effectiveness of TTM in adult non-traumatic OHCA survivors between 1 January, 2019 and 30 June, 2023. The primary outcome was survival to hospital discharge. Incremental cost-effectiveness ratios(ICERs) were calculated and compared with various decision makers' willingness to pay. Cost-effectiveness acceptability curves were utilized to evaluate the economic attractiveness of TTM. Uncertainty about the incremental cost and effect was explored with a 95% confidence ellipse.RESULTS: Among 925 non-traumatic OHCA survivors, only 30(3%) received TTM. After adjusting for potential confounders, the TTM group did not demonstrate a significantly lower cost(delta cost-$5,141, 95% confidence interval [95% CI]: $-35,347 to $25,065, P=0.79) and higher survival to hospital discharge(delta effect 6%, 95% CI:-11% to 23%, P=0.41). Additionally, a 95% confidence ellipse indicated uncertainty reflected by evidence that the true value of the ICER could be in any of the quadrants of the cost-effectiveness plane.CONCLUSION: Although TTM did not demonstrate a clear survival benefit in this study, its potential cost-effectiveness warrants further investigation with larger sample sizes. These findings highlight the need for additional research to optimize TTM use in OHCA care and inform resource allocation decisions.
基金supported by grants from the Key R&D Program of Shandong Province (2021ZLGX02)the National Science Foundation of China (81901934, 82325031)+1 种基金the National Key R&D Program of China (2020YFC1512700, 2020YFC1512705, 2020YFC1512703)the Clinical Research Center of Shandong University (2020SDUCRCC025)。
文摘The incidence of in-hospital cardiac arrest (IHCA) has increased over the past decade,with more than half occurring in intensive care units (ICUs).^([1])ICU cardiac arrest (ICU-CA)presents unique challenges,with worse outcomes than those in monitored wards,highlighting the need for early detection and intervention.^([2])Up to 80%of patients exhibit signs of deterioration hours before IHCA.^([3])Although early warning scores based on vital signs are useful,their eff ectiveness in ICUs is limited due to abnormal physiological parameters.^([4])Laboratory markers,such as sodium,potassium,and lactate,are predictive of poor outcomes,^([5])but static measurements may not capture the patient’s trajectory.Trends in laboratory indicators,such as variability and extremes,may offer better predictive value.^([6])This study aimed to evaluate ICU-CA predictive factors,with a focus on vital signs and trends of laboratory indicators.
文摘The estimated annual incidence of out-of-hospital cardiac arrest(OHCA)is approximately 120 cases per 100000 inhabitants in western countries.Although the rates of bystander cardiopulmonary resuscitation(CPR)and use of automated external defibrillator are increasing,the likelihood of survival to hospital discharge is no more than 8%.To date,various devices and methods have been utilized in the initial CPR approach targeting to improve survival and neurological outcomes in OHCA patients.The aim of this review is to discuss strategies that facilitate resuscitation,increase the chance to achieve return to spontaneous circulation and improve survival to hospital discharge and neurological outcomes in the prehospital setting.
基金This study is supported by the National Natural Science Foundation of China (No. 82072127)。
文摘BACKGROUND:This study aims to explore the causal relationship of body weight,body mass index(BMI),and waist circumference (WC) with the risk of cardiac arrest (CA) using two-sample Mendelian randomization (MR).METHODS:Data were summarized using genome-wide association studies (GWAS).Twosample MR analyses were performed using the inverse variance weighting (IVW) method,the weighted median method,and the MR-Egger analysis.Heterogeneity test and sensitivity analysis were performed using Cochran’s Q test and the leave-one-out method,respectively.The Steiger test was used to detect reverse causality.Bayesian model-averaged MR was used to identify the most influential risk factors.RESULTS:A total of 13 GWAS data were collected for BMI,body weight and WC.IVW analyses showed a positive correlation of body weight,BMI,and WC with CA (all OR>1 and P<0.05),with MR-Egger and weighted median methods confirming the IVW findings.No horizontal pleiotropy or heterogeneity was observed.Sensitivity analysis indicated that no single nucleotide polymorphism(SNP) caused significant changes in overall causality.Bayesian model-averaged MR was also used to rank causality based on marginal inclusion probability (MIP),and the corresponding modelaveraged causal estimate (MACE) were confirmed,which indicated that WC (GWAS ID:ukb-b-9405)was the highest-ranked risk factor (MIP=0.119,MACE=0.011);its posterior probability was 0.057.A total of 14 sex-specific GWAS data on weight,BMI,and WC were analyzed in relationship with CA,and the MR results showed no significant effects of sex-specific factors.CONCLUSION:Body weight,BMI,and WC are causally associated with an increased risk of CA,with WC identified as the most important risk factor.
文摘In vitro fertilization(IVF)is one of the most used assisted reproductive technology(ART)techniques today.However,the success of IVF procedures heavily relies on maintaining a sterile environment in laboratories.This narrative review examines the effects of microbiological contamination in IVF laboratories,exploring its sources,impacts on IVF outcomes,and preventive measures.We conducted a complete literature search using databases such as PubMed and Google Scholar,focusing on studies published within the last fifteen years.Our findings highlight that microbiological contamination can significantly impair embryo quality,reduce implantation and pregnancy rates,and increase the risk of miscarriage and infection.The review also discusses current best practices for contamination prevention and identifies areas for future research.This work emphasizes the critical importance of stringent sterility protocols in IVF laboratories and calls for continued vigilance and innovation in maintaining optimal conditions for assisted reproduction.
文摘The post-resuscitation period is recognized as the main predictor of cardiopul-monary resuscitation(CPR)outcomes.The first description of post-resuscitation syndrome and stony heart was published over 50 years ago.Major manifestations may include but are not limited to,persistent precipitating pathology,systemic ischemia/reperfusion response,post-cardiac arrest brain injury,and finally,post-cardiac arrest myocardial dysfunction(PAMD)after successful resuscitation.Why do some patients initially survive successful resuscitation,and others do not?Also,why does the myocardium response vary after resuscitation?These ques-tions have kept scientists busy for several decades since the first successful resuscitation was described.By modifying the conventional modalities of resu-scitation together with new promising agents,rescuers will be able to salvage the jeopardized post-resuscitation myocardium and prevent its progression to a dismal,stony heart.Community awareness and staff education are crucial for shortening the resuscitation time and improving short-and long-term outcomes.Awareness of these components before and early after the restoration of circulation will enhance the resuscitation outcomes.This review extensively addresses the underlying pathophysiology,management,and outcomes of post-resuscitation syndrome.The pattern,management,and outcome of PAMD and post-cardiac arrest shock are different based on many factors,including in-hospital cardiac arrest vs out-of-hospital cardiac arrest(OHCA),witnessed vs unwitnessed cardiac arrest,the underlying cause of arrest,the duration,and protocol used for CPR.Although restoring spontaneous circulation is a vital sign,it should not be the end of the game or lone primary outcome;it calls for better understanding and aggressive multi-disciplinary interventions and care.The development of stony heart post-CPR and OHCA remain the main challenges in emergency and critical care medicine.
基金supported by the National Natural Science Foundation of China(No.52272198 and 52002122)the Project funded by China Postdoctoral Science Foundation(No.2021M690947).
文摘Aqueous Zn-ion batteries(AZIBs)have attracted increasing attention in next-generation energy storage systems due to their high safety and economic.Unfortunately,the side reactions,dendrites and hydrogen evolution effects at the zinc anode interface in aqueous electrolytes seriously hinder the application of aqueous zinc-ion batteries.Here,we report a critical solvation strategy to achieve reversible zinc electrochemistry by introducing a small polar molecule acetonitrile to form a“catcher”to arrest active molecules(bound water molecules).The stable solvation structure of[Zn(H_(2)O)_(6)]^(2+)is capable of maintaining and completely inhibiting free water molecules.When[Zn(H_(2)O)_(6)]^(2+)is partially desolvated in the Helmholtz outer layer,the separated active molecules will be arrested by the“catcher”formed by the strong hydrogen bond N-H bond,ensuring the stable desolvation of Zn^(2+).The Zn||Zn symmetric battery can stably cycle for 2250 h at 1 mAh cm^(-2),Zn||V_(6)O_(13) full battery achieved a capacity retention rate of 99.2%after 10,000 cycles at 10 A g^(-1).This paper proposes a novel critical solvation strategy that paves the route for the construction of high-performance AZIBs.
基金supported by the National Natural Science Foundation of China,Nos.82171172(to RZ)and 81771366(to RZ)Fundamental Research Funds for the Central Universities of Central South University,Nos.2021zzts1095(to SZ)and 2022zzts0832(to HY)。
文摘Mutations in the microrchidia CW-type zinc finger protein 2(MORC2)gene are the causative agent of Charcot-Marie-Tooth disease type 2Z(CMT2Z),and the hotspot mutation p.S87L is associated with a more seve re spinal muscular atrophy-like clinical phenotype.The aims of this study were to determine the mechanism of the severe phenotype caused by the MORC2 p.S87L mutation and to explore potential treatment strategies.Epithelial cells were isolated from urine samples from a spinal muscular atrophy(SMA)-like patient[MORC2 p.S87L),a CMT2Z patient[MORC2 p.Q400R),and a healthy control and induced to generate pluripotent stem cells,which were then differentiated into motor neuron precursor cells.Next-generation RNA sequencing followed by KEGG pathway enrichment analysis revealed that differentially expressed genes involved in the PI3K/Akt and MAP K/ERK signaling pathways were enriched in the p.S87L SMA-like patient group and were significantly downregulated in induced pluripotent stem cells.Reduced proliferation was observed in the induced pluripotent stem cells and motor neuron precursor cells derived from the p.S87L SMA-like patient group compared with the CMT2Z patient group and the healthy control.G0/G1 phase cell cycle arrest was observed in induced pluripotent stem cells derived from the p.S87L SMA-like patient.MORC2 p.S87Lspecific antisense oligonucleotides(p.S87L-ASO-targeting)showed significant efficacy in improving cell prolife ration and activating the PI3K/Akt and MAP K/ERK pathways in induced pluripotent stem cells.Howeve r,p.S87L-ASO-ta rgeting did not rescue prolife ration of motor neuron precursor cells.These findings suggest that downregulation of the PI3K/Akt and MAP K/ERK signaling pathways leading to reduced cell proliferation and G0/G1 phase cell cycle arrest in induced pluripotent stem cells might be the underlying mechanism of the severe p.S87L SMA-like phenotype.p.S87L-ASO-targeting treatment can alleviate disordered cell proliferation in the early stage of pluripotent stem cell induction.
基金funded by the Shenzhen Science and Technology Program (JCYJ20230807112007014)Shenzhen Key Medical Discipline Construction Fund (SZXK046)。
文摘BACKGROUND:We aimed to observe the dynamic changes in glucose metabolic reprogrammingrelated parameters and their ability to predict neurological prognosis and all-cause mortality in cardiac arrest patients after the restoration of spontaneous circulation(ROSC).METHODS:Adult cardiac arrest patients after ROSC who were admitted to the emergency or cardiac intensive care unit of the First Aflliated Hospital of Dalian Medical University from August 1,2017,to May 30,2021,were enrolled.According to 28-day survival,the patients were divided into a non-survival group(n=82) and a survival group(n=38).Healthy adult volunteers(n=40) of similar ages and sexes were selected as controls.The serum levels of glucose metabolic reprogrammingrelated parameters(lactate dehydrogenase [LDH],lactate and pyruvate),neuron-specific enolase(NSE) and interleukin 6(IL-6) were measured on days 1,3,and 7 after ROSC.The Acute Physiology and Chronic Health Evaluation II(APACHE II) score and Sequential Organ Failure Assessment(SOFA) score were calculated.The Cerebral Performance Category(CPC) score was recorded on day 28 after ROSC.RESULTS:Following ROSC,the serum LDH(607.0 U/L vs.286.5 U/L),lactate(5.0 mmol/L vs.2.0 mmol/L),pyruvate(178.0 μmol/L vs.70.9 μmol/L),and lactate/pyruvate ratio(34.1 vs.22.1) significantly increased and were higher in the non-survivors than in the survivors on admission(all P<0.05).Moreover,the serum LDH,pyruvate,IL-6,APACHE II score,and SOFA score on days 1,3 and 7 after ROSC were significantly associated with 28-day poor neurological prognosis and 28-day all-cause mortality(all P<0.05).The serum LDH concentration on day 1 after ROSC had an area under the receiver operating characteristic curve(AUC) of 0.904 [95% confidence interval [95% CI]:0.851–0.957]) with 96.8% specificity for predicting 28-day neurological prognosis and an AUC of 0.950(95% CI:0.911–0.989) with 94.7% specificity for predicting 28-day all-cause mortality,which was the highest among the glucose metabolic reprogramming-related parameters tested.CONCLUSION:Serum parameters related to glucose metabolic reprogramming were significantly increased after ROSC.Increased serum LDH and pyruvate levels,and lactate/pyruvate ratio may be associated with 28-day poor neurological prognosis and all-cause mortality after ROSC,and the predictive eflcacy of LDH during the first week was superior to others.
文摘Objective Endometrial carcinoma(EC)is a prevalent gynecological malignancy characterized by increasing incidence and mortality rates.This underscores the critical need for novel therapeutic targets.One such potential target is cell division cycle 20(CDC20),which has been implicated in oncogenesis.This study investigated the effect of the CDC20 inhibitor Apcin on EC and elucidated the underlying mechanism involved.Methods The effects of Apcin on EC cell proliferation,apoptosis,and the cell cycle were evaluated using CCK8 assays and flow cytometry.RNA sequencing(RNA-seq)was subsequently conducted to explore the underlying molecular mechanism,and Western blotting and coimmunoprecipitation were subsequently performed to validate the results.Animal studies were performed to evaluate the antitumor effects in vivo.Bioinformatics analysis was also conducted to identify CDC20 as a potential therapeutic target in EC.Results Treatment with Apcin inhibited proliferation and induced apoptosis in EC cells,resulting in cell cycle arrest.Pathways associated with apoptosis and the cell cycle were activated following treatment with Apcin.Notably,Apcin treatment led to the upregulation of the cell cycle regulator p21,which was verified to interact with CDC20 and consequently decrease the expression of downstream cyclins in EC cells.In vivo experiments confirmed that Apcin treatment significantly impeded tumor growth.Higher CDC20 expression was observed in EC tissue than in nonmalignant tissue,and increased CDC20 expression in EC patients was associated with shorter overall survival and progress free interval.Conclusion CDC20 is a novel molecular target in EC,and Apcin could be developed as a candidate antitumor drug for EC treatment.
