Poisoning induced by inhalation of hydrogen chloride has significant effects on the respiratory system. It can cause severe pulmonary edema and acute respiratory distress syndrome (ARDS) in the early stage, and even death in critical cases. As a novel treatment for ARDS, the efficacy of sivelestat sodium in infection-induced ARDS has been widely verified, but its application in ARDS caused by chemical poisoning is still scarce in literature. Here we report a case of ARDS induced by hydrogen chloride inhalation which was successfully treated with sivelestat sodium and conventional treatment.

Poisoning induced by inhalation of hydrogen chloride has significant effects on the respiratory system. It can cause severe pulmonary edema and acute respiratory distress syndrome (ARDS) in the early stage, and even death in critical cases. As a novel treatment for ARDS, the efficacy of sivelestat sodium in infection-induced ARDS has been widely verified, but its application in ARDS caused by chemical poisoning is still scarce in literature. Here we report a case of ARDS induced by hydrogen chloride inhalation which was successfully treated with sivelestat sodium and conventional treatment.

Objective:To explore the prognostic risk factors of thymoma patients after resection, and establish a novel nomogram to predict progression free survival(PFS) of patients with thymoma.Methods:A retrospectively analysis was performed on clinicopathological datas of 267 cases of thymoma patients underwent thymoma resection in Beijing Tongren Hospital from January 2010 to December 2019. The univariate and multivariate Cox risk ratio models were used to analyze the related factors that might affect PFS, and the prediction nomogram of PFS after thymoma resection was established using the screened independent risk factors. Then the predictive ability of the model was evaluated. Results:The univariate analysis showed that age, type of surgery, completeness of resection, WHO histologic classification, TNM stage and postoperative adjuvant therapy were significantly correlated with PFS after thymoma resection( P<0.05). The multivariate analysis showed that only age and TNM stage were independent prognostic factors affecting PFS after thymoma resection( P<0.05). The concordance index( C- index) of the prediction model for the prognosis of thymoma patients established by this method was 0.866(95% CI: 0.809-0.923), which had remarkable predictive efficiency. Conclusion:The nomogram model is constructed and verified based on age and TNM stage, excluding the interference of other clinicopathological factors on prognosis assessment, and which is convenient for clinicians to quickly and individually evaluate the prognosis of patients after thymoma resection.

Objective:To investigate the Correlation between ADC combined with serum C-reactive protein (CRP) and delayed encephalopathy after carbon monoxide poisoning (DEACMP), It provides scientific basis for early prediction of DEACMP.Methods:According to the design principle of case-control study, the data of acute carbon monoxide poisoning (ACOP) patients admitted to Shandong Provincial Hospital from December 2017 to December 2021 were retrospectively selected. Among them, patients with DEACMP were selected as the case group, without DEACMP were used as the control group. Univariate and multivariate analyses were performed on the two groups. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of ADC combined with CRP as a combined predictor for disease.Results:A total of 89 patients with ACOP were included, including 33 patients with DEACMP and 56 patients without DEACMP. There were no significant differences in gender, age, smoking, drinking, and underlying diseases (hypertension, coronary heart disease) between groups ( P>0.05). Logistic regression analysis showed that white blood cell count (WBC) ( OR=1.64, 95% CI: 1.19-2.26, P=0.003), CRP ( OR=1.22, 95% CI: 1.03-1.45, P=0.019) and ADC value of central semiovale white matter ( OR=0.99, 95% CI: 0.98-1.00, P=0.010) were associated with DEACMP in patients with ACOP. The ROC curve results showed that the area under the ROC of ADC combined with CRP in the center of semiovale was 0.765 (95% CI: 0.656-0.845), the specificity was 87.9%, the sensitivity was 23.2%, and the cut-off value was 3.5°. Conclusions:WBC, CRP and ADC value of central semiovale are independent factors for DEACMP. ADC value of central semiovale combined with CRP has more clinical value in the early diagnosis of DEACMP. For ACOP patients with DEACMP triggering factors, the diagnosis and treatment awareness of early screening of brain magnetic resonance imaging should be strengthened to avoid DEACMP.

Claudin18.2(CLDN18.2)is a tight junction protein that is overexpressed in a variety of solid tumors such as gastrointestinal cancer and oesophageal cancer.It has been identified as a promising target and a potential biomarker to diagnose tumor,evaluate efficacy,and determine patient prognosis.TST001 is a recombinant humanized CLDN18.2 antibody that selectively binds to the extracellular loop of human Claudin18.2.In this study,we constructed a solid target radionuclide zirconium-89(89Zr)labled-TST001 to detect the expression of in the human stomach cancer BGC823CLDN18.2 cell lines.The[89Zr]Zr-des-ferrioxamine(DFO)-TST001 showed high radiochemical purity(RCP,＞99％)and specific activity(24.15±1.34 GBq/μmol),and was stable in 5％human serum albumin,and phosphate buffer saline(＞85％RCP at 96 h).The EC50 values of TST001 and DFO-TST001 were as high as 0.413±0.055 and 0.361±0.058 nM(P＞0.05),respectively.The radiotracer had a significantly higher average standard uptake values in CLDN18.2-positive tumors than in CLDN18.2-negative tumors(1.11±0.02 vs.0.49±0.03,P=0.0016)2 days post injection(p.i.).BGC823CLDN18.2 mice models showed high tumor/muscle ratios 96 h p.i.with[89Zr]Zr-DFO-TST001 was much higher than those of the other imaging groups.Immunohistochemistry results showed that BGC823CLDN18.2 tumors were highly positive(+++)for CLDN18.2,while those in the BGC823 group did not express CLDN18.2(-).The results of ex vivo biodistribution studies showed that there was a higher distribution in the BGC823CLDN18.2 tumor bearing mice(2.05±0.16％ID/g)than BGC823 mice(0.69±0.02％ID/g)and blocking group(0.72±0.02％ID/g).A dosimetry estimation study showed that the effective dose of[89Zr]Zr-DFO-TST001 was 0.0705 mSv/MBq,which is within the range of acceptable doses for nuclear medicine research.Taken together,these re-sults suggest that Good Manufacturing Practices produced by this immuno-positron emission tomog-raphy probe can detect CLDN18.2-overexpressing tumors.

In our country, there are a large number of carbon monoxide poisoning patients every winter. 10% to 30% of patients with acute carbon monoxide poisoning develop acute carbon monoxide poisoning delayed encephalopathy after a "false recovery period" of about 2 to 60 days. The morbidity and mortality rates of the disease are extremely high, but there is still no effective treatment for this condition. The pathogenesis of the disease is complex, and there is no clear conclusion yet. After consulting a large number of recent relevant literatures, this article reviews the main research results of the pathogenesis of the disease so far, with an aim to facilitate its early clinical diagnosis and correct treatment.

ObjectiveTo investigate the characteristics of pelvic floor structure and electrophysiology in female patients with stroke. MethodsFrom June to December, 2020, 21 female inpatients with stroke in Zhongda Hospital, Southeast University (stroke group) were divided into urinary incontinence (UI) group (n = 6) and non-urinary incontinence (NUI) group (n = 15), and other 20 healthy subjects were as control group. They were observed with pelvic floor ultrasonography and pelvic floor surface electromyogram. ResultsAverage electromyography, integral electromyography, root mean square, mean power frequency and median frequency decreased in UI and NUI groups compared with those of the control group (P < 0.05), but there was no significant difference between UI group and NUI group (P > 0.05). Bladder neck position, bladder neck angle, bladder neck mobility, urethral rotation angle; and anteroposterior diameter, left-right diameter and area of levator ani muscle hiatus after Valsalva's action were all not different among three groups (F < 2.484, P > 0.05). ConclusionThe activities of pelvic floor muscles decrease in female patients with stroke, without obvious changes of pelvic floor supporting structures, whatever UI.

In our country, there are a large number of carbon monoxide poisoning patients every winter. 10% to 30% of patients with acute carbon monoxide poisoning develop acute carbon monoxide poisoning delayed encephalopathy after a "false recovery period" of about 2 to 60 days. The morbidity and mortality rates of the disease are extremely high, but there is still no effective treatment for this condition. The pathogenesis of the disease is complex, and there is no clear conclusion yet. After consulting a large number of recent relevant literatures, this article reviews the main research results of the pathogenesis of the disease so far, with an aim to facilitate its early clinical diagnosis and correct treatment.

Objective To study the effect of non-self-similar hierarchy on fracture mechanical properties and crack propagation of the biocomposite. Methods The numerical models were established by using ABAQUS, and the stiffness and crack initiation and propagation in the biocomposite with the inclination angles between the axis of the prism and mineralized collagen fibrils θ=0°,20°,40°,60°,80° were simulated by extended finite element method. Results The inclination angle θ had limited influences on biocomposite stiffness at θ≤40°, while biocomposite stiffness decreased with θ at θ>40°. The ultimate tensile strain also increased at θ>40°. Asymmetry in the crack was also found during propagation of matrix surrounded-enhanced phases at θ>0°. The crack propagatation on one side of the long axis of the mineral crystal was relatively easier than that on the other side at θ>0°. Conclusions The non-uniform distributions of cracks were found in biological hard tissues arisen from the non-self-similar hierarchy. The non-uniform crystal arrangement in the biocomposite would result in local damage rather than catastrophic fracture. The findings of this study can provide theoretical support for material design.

OBJECTIVE：To study the anti-inflammatory effects of Yuyang capsule on bacterial dermatitis model rats and its effect on TLR/NF-κ B pathway. METHODS：Minimum inhibition concentration （MIC）and minimal bactericidal concentration （MBC）of Yuyang capsule against Staphylococcus aureus were determined by microdilution test. Totally 50 SD rats were randomly divided into model group ，positive control group （amoxicillin and clavulanate potassium ，120 mg/kg as amoxicillin ），Yuyang capsules high-dose ，medium-dose and low-dose groups （according to MIC ），with 10 rats in each group. The model of bacterial dermatitis was established by using the burned skin of rats infected with S. aureus . 24 h after modeling ，administration groups were intragastrically given the corresponding drug ，and model group was intragastrically given the same amount of normal saline ，once a day，for consecutive 7 days. The skin healing rate was calculated on the 1st，3rd，5th and 7th day of administration ，and the scab formation，decrustation and healing were recorded. The contents of IL- 1β，IL-6，IL-10，TNF-α，hydroxyproline（HYP），collagen Ⅰ（Col Ⅰ）and Col Ⅲ in skin tissue were detected by ELISA. Morphology changes of skin tissues were observed by HE staining. The ultrastructure was observed by transmission electron microscope. Protein expression of TLR 2，TLR4 and p-NF-κB p65 were detected by Western blotting assay. RESULTS ：MIC and MBC of Yuyang capsule were 25 mg/mL and 50 mg/mL，respectively. Dose of Yuyang capsules high-dose ，medium-dose and low-dose groups were set at 600，300，150 mg/kg. Compared with model group，scab appeared on the injured skin 3 days after administration in Yuyang capsule high-dose and medium-dose groups ，and decrustation appeared on the injured skin of part mice 5-7 days after administration ；the skin healing rate of the positive control group，Yuyang capsule high-dose and medium-dose groups were all significantly increased at each time point. The contents of IL- 1 β，IL-6，IL-10 and TNF-α，pathological score ，protein expression of TLR 2，TLR4 and p-NF-κB p65 were decreased significantly （P＜0.05 or P＜0.01）；the pathological changes such as inflammatory cell infiltration in skin tissue were improved. The contents of HYP，Col Ⅰ and Col Ⅲ were increased significantly in positive control group and Yuyang capsule high-dose group （P＜0.05 or P＜0.01）. There was no statistical significance in most above indexes in positive control group ，Yuyang capsule high-dose and medium-dose groups （P＞0.05）. CONCLUSIONS ：Yuyang capsule can promote skin healing of bacterial dermatitis model rats and shows certain anti-inflammatory effects ；the mechanism may be related to inhibiting TLR/NF-κB signaling pathway and reducing inflammatory response.