Phosgene is a highly reactive chemical substance and a prevalent chemical warfare agent,and it is vitally important for rapid and accurate detection of phosgene to counteract terrorist threats and industrial accidents.In this work,a phosgene probe,designated as SX-Pho,which incorporated benzimidazole and hydroxyl groups as recognition motifs,was prepared through Suzuki coupling and Debus-Radziszewski methodologies to incorporate an electron-donating carbazole moiety.This probe exhibited a large Stokes shift(Approximately 130 nm).Upon exposure to triphosgene/triethylamine conditions(in situ phosgene generation),the fluorescence emission of probe at 470 nm underwent significant quenching,with a 20-fold reduction in intensity,while the fluorescence lifetime decreased from 3.30 ns to 3.06 ns.Concentration titration experiments demonstrated that SX-Pho achieved a lower detection limit of 57.8 nmol/L with high specificity and interference resistance.Preton nuclear magnetic resonance spectroscopy(1H NMR),high-resolution mass spectrometry,and density functional theory(DFT)calculations confirmed the cyclization reaction between hydroxyl groups,imines,and phosgene.The extent of overlap between the highest occupied molecular orbital(HOMO)and the lowest unoccupied molecular orbital(LUMO)was notably decreased,leading to the suppression of radiative transitions.The energy gap underwent a reduction of 0.43 eV,while the non-radiative transition was augmented,resulting in fluorescence quenching and achieving rapid detection of phosgene.Based on this,probe-loaded test strips were prepared.The color change under 365 nm illumination allowed visual discrimination of phosgene at concentrations below 20 μL/L.Furthermore,using a smartphone's built-in RGB application to measure the intensity of the blue(B)channel after the test strips were exposed to phosgene enabled both qualitative and quantitative detection.The detection range was 1.82-50 μL/L,with a limit of detection(LOD)of 1.814 μL/L.

Objective:To investigate the safety and anti-reflux effect of a highly bionic modi-fied esophagogastric anastomosis in the reconstruction of the digestive tract after proximal gas-trectomy,with the aim of providing a safe and simple new option with good anti-reflux effect for the reconstruction of the digestive tract after proximal gastrectomy.Methods:In this retrospec-tive study,30 patients(Study group)who underwent modified esophagogastric anastomosis after proximal gastrectomy in the Department of Gastrointestinal Surgery of Shandong Provincial Hospi-tal Affiliated to Shandong First Medical University from January 2022 to September 2023 were compared with 27(Control group)patients who underwent double-tract reconstruction which is currently recognized as having good anti-reflux effect during the same period,the main compari-sons were made between the surgery-related indexes,the quality of life after the surgery,the postoperative complications,and the anti-reflux effect of the surgery.Results:The study group was significantly better than the control group in terms of operation time and postoperative hospi-talization time,with statistically significant differences(P＜0.05),and the difference between the two groups was comparable in terms of intraoperative bleeding and the anti-reflux effect of the opera-tion,with no statistically significant differences(P＞0.05);in terms of postoperative complications,the incidence of anastomotic fistula and intestinal obstruction was slightly lower in the study group compared with the control group,but in terms of total incidence,the difference was not statistically significant;in terms of quality of life,the difference was not statistically significant when comparing the quality of life of the two groups after treatment(P＜0.05).Conclusion:Highly bionic modified esophagogastric anastomosis is safe and feasible in the treatment of adenocarcinoma of the esophagogastric junction with excellent anti-reflux effect,but the procedure needs further high-quality randomized controlled studies and in-depth exploration.

Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.
Child ; Humans ; Spinal Cord Injuries/complications* ; Spinal Cord

Objective To investigate clinical and epidemiological features of pneumocystis jirovecii pneumonia (PJP) in kidney transplant recipients. Methods Clinical data of 68 kidney transplant recipients admitted from July, 2021 to December, 2021 were collected. All patients were divided into the PJP group (n=11), common pulmonary infection group (n=24) and non-pneumonia group (n=33) according to the status of pulmonary infection. The incidence and treatment of PJP after kidney transplantation were analyzed. Basic characteristics and laboratory parameters of the recipients were compared among all groups. The genotyping and transmission map of PJP patients were evaluated. Results Among 64 kidney transplant recipients, 11 cases were definitely diagnosed with PJP. The most common clinical manifestations included elevated body temperature, and dry cough complicated with progressive dyspnea. Chest CT scan showed diffuse interstitial inflammation and ground glass-like lesions of bilateral lungs in all patients. After diagnosis, all patients were orally given with compound sulfamethoxazole for 3-4 weeks. Two patients received non-invasive ventilator-assisted ventilation due to severe lung infection and dyspnea, and the remaining patients were given with nasal cannula oxygenation. One patient experienced elevated serum creatinine level upon discharge, and developed renal allograft failure. The remaining 10 recipients with PJP obtained normal renal allograft function, and no recipient died. Compared with the non-pneumonia group, the rejection rate was higher, the length of hospital stay was longer, the lymphocyte count was less, the lymphocyte proportion was lower, the levels of C-reactive protein, serum creatinine and lactate dehydrogenase were higher, and the levels of serum albumin was lower and CD4⁺T cell count was less in the PJP group (all P < 0.05). Compared with common pulmonary infection group, the lymphocyte count was less, the lymphocyte proportion was lower, the CD4⁺T cell count was less and 1, 3-β-D- glucan (BDG) level was higher in the PJP group (all P < 0.05). No new genotype was detected in 10 of the 12 testing samples. It was considered that PJP mainly depended on two transmission chains and two independent transmission individuals. Conclusions Kidney transplant recipients are prone to pneumocystis jirovecii (PJ) infection due to impaired cellular immune function. The most common clinical manifestations consist of elevated body temperature and dry cough complicated with progressive dyspnea, accompanied by headache and fatigue in partial patients. Chest CT scan shows diffuse interstitial inflammation and ground glass-like lesion of bilateral lungs. PJ may be transmitted through respiratory tract. Small-scale PJP might occur in the follow-up outpatient of kidney transplant recipients. Preventive measures should be delivered in a timely manner.

Objective: To establish a survival prediction model based on the independent prognostic factors of long-term prognosis after laparoscopic liver resection(LLR) for intrahepatic cholangiocarcinoma(ICC). Methods: The clinical and pathological data of 351 consecutive patients with ICC who received radical LLR in 13 Chinese medical centers from August 2010 to May 2021 were collected retrospectively. There were 190 males and 161 females,aged(M(IQR)) 61(14)years(range:23 to 93 years). The total cohort was randomly divided into a training dataset(264 cases) and a validation dataset(87 cases). The patients were followed up by outpatient service or telephone,and the deadline for follow-up was October 2021. Based on the training dataset,the multivariate Cox proportional hazards regression model was used to screen the independent influencing factors of long-term prognosis to construct a Nomogram model. The Nomogram model's discrimination,calibration,and clinical benefit were evaluated through internal and external validation,and an assessment of the overall value of two groups was made through the use of a receiver operating characteristic(ROC) curve. Results: There was no significant difference in clinical and pathological characteristics and long-term survival results between the training and validation datasets(all P>0.05). The multivariate Cox analysis showed that CA19-9,CA125,conversion to laparotomy during laparoscopic surgery,and lymph node metastasis were independent prognostic factors for ICC patients after LLR(all P<0.05). The survival Nomogram was established based on the independent prognostic factors obtained from the above screening. The ROC curve showed that the area under the curve of 1, 3 and 5-year overall survival rates of patients in the training dataset were 0.794(95%CI:0.721 to 0.867),0.728(95%CI:0.618 to 0.839) and 0.799(95%CI:0.670 to 0.928),and those in the validation dataset were 0.787(95%CI:0.660 to 0.915),0.831(95%CI:0.678 to 0.983) and 0.810(95%CI:0.639 to 0.982). Internal and external validation proved that the model exhibited a certain discrimination,calibration,and clinical applicability. Conclusion: The survival Nomogram model based on the independent influencing factors of long-term prognosis after LLR for ICC(including CA19-9,CA125,conversion to laparotomy during laparoscopic surgery,and lymph node metastasis) exhibites a certain differentiation,calibration,and clinical practicability.
Bile Duct Neoplasms/surgery* ; Bile Ducts, Intrahepatic/pathology* ; CA-19-9 Antigen ; Cholangiocarcinoma/diagnosis* ; Female ; Humans ; Laparoscopy ; Lymphatic Metastasis ; Male ; Nomograms ; Prognosis ; Retrospective Studies

Objective: To investigate the ABC prognostic classification and the updated version of Model for End-stage Liver Disease (MELD) score 3.0 and Chinese Group on the Study of Severe Hepatitis B ACLF Ⅱ score (COSSH-ACLF Ⅱ score) to evaluate the prognostic value in acute-on-chronic liver failure (ACLF). Methods: ABC classification was performed on a 1 409 follow-up cohorts. The area under the receiver operating characteristic curve (AUROC) was used to analyze MELD, MELD 3.0, COSSH-Ⅱ and COSSH-Ⅱ score after 3 days of hospitalization (COSSH-Ⅱ-3d). The prognostic predictive ability of patients were evaluated for 360 days, and the prediction differences of different classifications and different etiologies on the prognosis of ACLF were compared. Results: The survival curve of 1 409 cases with ACLF showed that the difference between class A, B, and C was statistically significant, Log Rank (Mantel-Cox) χ²=80.133, P<0.01. Compared with class A and C, χ²=76.198, P<0.01, the difference between class B and C, was not statistically significant χ²=3.717, P>0.05. AUROC [95% confidence interval (CI)] analyzed MELD, MELD 3.0, COSSH-Ⅱ and COSSH-Ⅱ-3d were 0.644, 0.655, 0.817 and 0.839, respectively (P<0.01). COSSH-Ⅱ had better prognostic predictive ability with class A ACLF and HBV-related ACLF (HBV-ACLF) for 360-days, and AUROC (95% CI) were 0.877 and 0.881, respectively (P<0.01), while MELD 3.0 prognostic predictive value was not better than MELD. Conclusion: ACLF prognosis is closely related to ABC classification. COSSH-Ⅱ score has a high predictive value for the prognostic evaluation of class A ACLF and HBV-ACLF. COSSH-Ⅱ score has a better prognostic evaluation value after 3 days of hospitalization, suggesting that attention should be paid to the treatment of ACLF in the early stage of admission.
Humans ; Acute-On-Chronic Liver Failure ; Prognosis ; End Stage Liver Disease/complications* ; Retrospective Studies ; Severity of Illness Index

ObjectiveTo explore the effects of high-salt diet on airway inflammation in mice with allergic asthma. MethodsTwenty 4-week-old female BALB/c mice were randomly divided into four groups， including control group， allergic asthma model group， 4% high-salt diet group and 8% high-salt diet group. Ovalbumin（OVA）was injected intraperitoneally and inhaled to make an asthmatic model. The control group and the model group were fed ordinary diet and drinking water， and the high-salt groups were fed 4% or 8% high-salt diet and 1% saline respectively. After 25 days， the nasal symptoms of each group of mice were observed at the last challenge. The mice were sacrificed 24 hours later. The inflammatory cells of different subtype in the blood were measured by five classification of blood cell analysis. Hematoxylin-eosin （HE） staining was used to observe the infiltration of eosinophils， and periodic acid-schiff （PAS） staining was used to observe the goblet cell proliferation in the lung tissue. Flow cytometry was used to detect the proportion of helper T cells 1（Th1 cells）， Th2， Th17 cells and regulatory T cells （Treg cells） in the lung tissue， and the enzyme-linked immunosorbent assay was used to determine the levels of cytokines interleukin-4 （IL-4）， IL-5， IL-13， and IL-17 of bronchoalveolar lavage fluid （BALF）. ResultsCompared with the allergic asthma model group， 4% and 8% high-salt diet significantly reduced the proportion of eosinophils in blood， the proportion of Th17 cells in lung tissue， and IL-13 and IL-17 levels in BALF， but he effect of 8% high-salt diet on IL-13 was more significant than that of 4% high-salt diet （P<0.05）. However， only 8% high-salt diet significantly relieved nasal symptom， improved eosinophil infiltration and goblet cell proliferation， reduced the proportion of Th2 cells and Th2/ Th1 ratio in lung tissue and the levels of IL-4 and IL-5 in BALF （P<0.05）. ConclusionsShort-term high-salt diet can alleviate airway inflammation in mice with allergic asthma， and the effects of 8% high-salt diet are better than that of 4% high-salt diet.

ObjectiveTo explore the effects of high-salt diet on airway inflammation in mice with allergic asthma. MethodsTwenty 4-week-old female BALB/c mice were randomly divided into four groups， including control group， allergic asthma model group， 4% high-salt diet group and 8% high-salt diet group. Ovalbumin（OVA）was injected intraperitoneally and inhaled to make an asthmatic model. The control group and the model group were fed ordinary diet and drinking water， and the high-salt groups were fed 4% or 8% high-salt diet and 1% saline respectively. After 25 days， the nasal symptoms of each group of mice were observed at the last challenge. The mice were sacrificed 24 hours later. The inflammatory cells of different subtype in the blood were measured by five classification of blood cell analysis. Hematoxylin-eosin （HE） staining was used to observe the infiltration of eosinophils， and periodic acid-schiff （PAS） staining was used to observe the goblet cell proliferation in the lung tissue. Flow cytometry was used to detect the proportion of helper T cells 1（Th1 cells）， Th2， Th17 cells and regulatory T cells （Treg cells） in the lung tissue， and the enzyme-linked immunosorbent assay was used to determine the levels of cytokines interleukin-4 （IL-4）， IL-5， IL-13， and IL-17 of bronchoalveolar lavage fluid （BALF）. ResultsCompared with the allergic asthma model group， 4% and 8% high-salt diet significantly reduced the proportion of eosinophils in blood， the proportion of Th17 cells in lung tissue， and IL-13 and IL-17 levels in BALF， but he effect of 8% high-salt diet on IL-13 was more significant than that of 4% high-salt diet （P<0.05）. However， only 8% high-salt diet significantly relieved nasal symptom， improved eosinophil infiltration and goblet cell proliferation， reduced the proportion of Th2 cells and Th2/ Th1 ratio in lung tissue and the levels of IL-4 and IL-5 in BALF （P<0.05）. ConclusionsShort-term high-salt diet can alleviate airway inflammation in mice with allergic asthma， and the effects of 8% high-salt diet are better than that of 4% high-salt diet.

Objective: To investigate the effectiveness and adverse effects of Cyberknife stereotactic body radiotherapy (SBRT) on liver metastases from PCa. METHODS: From June 2009 to September 2016, we treated 20 cases of PCa liver metastases by Cyberknife SBRT, at a total dose of 36 (30－50) Gy, on 1－3 liver metastatic lesions, for 3－5 times, with a prescription isodose line of 70－92%. We assessed the therapeutic effect according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST), calculated the survival and disease-control rates using the Kaplan-Meier method, and analyzed the adverse events based on the National Cancer Institute Common Terminology Criteria for Adverse Events－Version 4.0 (CTCAE 4.0). RESULTS: Of all the cases treated, complete response (CR) was found in 8 (40.0%), partial response (PR) in 9 (45.0%), stable disease (SD) in 2 (10.0%), and progressive disease (PD) in 1 (5.0%), with a local control rate (CR+PR) of 85.0% and a disease-control rate (CR+PR+SD) of 95.0%. Among the 14 patients with elevated PSA, 10 (71.4%) showed a significant decrease after treatment. The median follow-up time was 17 months, the 1- and 2-year survival rates were 85.0% and 15.0%, respectively, and the median survival time of the 20 patients was 16.5 months (95% CI: 12.12－22.88). Cyberknife SBRT was well tolerated in all the patients, with only a few mild adverse events (mainly grades 1 and 2 but no 4 and 5) during the whole course of treatment. CONCLUSIONS Cyberknife SBRT is safe and effective in the treatment of PCa liver metastases, with a high local control rate, and capable of reducing the PSA level and raising the long-term survival rate of the patients.

Pregnancy is a critical stimulator of bone mineral resorption.We used to find the MTHFR gene polymorphisms are related with blood lead levels among pregnant women.Pregnancy-stimulated bone turnover may be associated with MTHFR gene polymorphisms too.In this article,we aimed to determine the relationship between MTHFR gene polymorphisms and bone turnover rates among the pregnant women.The participants including pregnant and non-pregnant women were selected and recruited during their routine prenatal or physical examination from July to October in 2012.A total of 1000 participants,including 250 pregnant women in the first,second,and third trimesters and 250 non-pregnant women,were enrolled in the study.Finally,after excluding 27 participants unable to provide blood samples,973 eligible participants (i.e.,234,249,and 248 pregnant women in the first,second,and third trimesters,respectively,and 242 non-pregnant women)were included in the research.The MTHFR gene 1298CC homozygote carriers were more susceptible to yield higher plasma homocysteine levels than the 1298AA/AC carriers,with standardized coefficients of 0.086 (P＜0.05) and 0.104 (P＜0.01) of all the participants and the pregnant women,respectively.The MTHFR gene 1793AA homozygote carriers more likely showed higher plasma osteocalcin levels (standardized β=0.091,P＜0.01) than the 1793GG/GA carriers among all the subjects.Plasma homocysteine levels were positively correlated with blood lead levels among the participants and the pregnant women with standardized coefficients of 0.320 (P＜0.01) and 0.179 (P＜0.01),respectively.Plasma osteocalcin levels were positively associated with blood lead levels among pregnant and non-pregnant women with standardized coefficients of 0.084 (P＜0.05) and 0.125 (P＜0.01),respectively.In conclusion,homocysteine and osteocalcin contents in plasma are associated with the MTHFR gene A1298C polymorphism and blood lead levels among pregnant women.The MTHFR gene A 1298C polymorphism-related homocysteine is a possible risk factor for increased blood lead levels among Chinese women.