The 2019 novel coronavirus has caused the outbreak of the acute respiratory disease in Wuhan, Hubei Province of China since December 2019. This study was performed to analyze the clinical ...characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease (COVID-19).
Clinical data were collected from two tertiary hospitals in Wuhan. A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19 (death group) and we compare them with recovered patients (recovered group). Continuous variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed by χ test or Fisher exact test as appropriate.
Our study enrolled 109 COVID-19 patients who died during hospitalization and 116 recovered patients. The median age of the death group was older than the recovered group (69 62, 74 vs. 40 33, 57 years, Z = 9.738, P < 0.001). More patients in the death group had underlying diseases (72.5% vs. 41.4%, χ = 22.105, P < 0.001). Patients in the death group had a significantly longer time of illness onset to hospitalization (10.0 6.5, 12.0 vs. 7.0 5.0, 10.0 days, Z = 3.216, P = 0.001). On admission, the proportions of patients with symptoms of dyspnea (70.6% vs. 19.0%, χ = 60.905, P < 0.001) and expectoration (32.1% vs. 12.1%, χ = 13.250, P < 0.001) were significantly higher in the death group. The blood oxygen saturation was significantly lower in the death group (85 77, 91% vs. 97 95, 98%, Z = 10.625, P < 0.001). The white blood cell (WBC) in death group was significantly higher on admission (7.23 4.87, 11.17 vs. 4.52 3.62, 5.88 ×10/L, Z = 7.618, P < 0.001). Patients in the death group exhibited significantly lower lymphocyte count (0.63 0.40, 0.79 vs. 1.00 0.72, 1.27 ×10/L, Z = 8.037, P < 0.001) and lymphocyte percentage (7.10 4.45, 12.73% vs. 23.50 15.27, 31.25%, Z = 10.315, P < 0.001) on admission, and the lymphocyte percentage continued to decrease during hospitalization (7.10 4.45, 12.73% vs. 2.91 1.79, 6.13%, Z = 5.242, P < 0.001). Alanine transaminase (22.00 15.00, 34.00 vs. 18.70 13.00, 30.38 U/L, Z = 2.592, P = 0.010), aspartate transaminase (34.00 27.00, 47.00 vs. 22.00 17.65, 31.75 U/L, Z = 7.308, P < 0.001), and creatinine levels (89.00 72.00, 133.50 vs. 65.00 54.60, 78.75 μmol/L, Z = 6.478, P < 0.001) were significantly higher in the death group than those in the recovered group. C-reactive protein (CRP) levels were also significantly higher in the death group on admission (109.25 35.00, 170.28 vs. 3.22 1.04, 21.80 mg/L, Z = 10.206, P < 0.001) and showed no significant improvement after treatment (109.25 35.00, 170.28 vs. 81.60 27.23, 179.08 mg/L, Z = 1.219, P = 0.233). The patients in the death group had more complications such as acute respiratory distress syndrome (ARDS) (89.9% vs. 8.6%, χ = 148.105, P < 0.001), acute cardiac injury (59.6% vs. 0.9%, χ = 93.222, P < 0.001), acute kidney injury (18.3% vs. 0%, χ = 23.257, P < 0.001), shock (11.9% vs. 0%, χ = 14.618, P < 0.001), and disseminated intravascular coagulation (DIC) (6.4% vs. 0%, χ = 7.655, P = 0.006).
Compared to the recovered group, more patients in the death group exhibited characteristics of advanced age, pre-existing comorbidities, dyspnea, oxygen saturation decrease, increased WBC count, decreased lymphocytes, and elevated CRP levels. More patients in the death group had complications such as ARDS, acute cardiac injury, acute kidney injury, shock, and DIC.
Lethal hemorrhage could endanger lives. Although many hemostatic agents are commercially available with good clinical effect, it is necessary to develop novel hemostatic materials with high efficacy, ...biological safety, low cost, easily preparation and excellent biodegradability and biocompatibility. Here, novel biodegradable and uniform microspheres with regular spherical architecture and porous microstructure were prepared by thermosensitive carboxymethyl chitin (CMCH) with low substitution degree and low deacetylation through physical-crosslinking at high temperature without using any toxic crosslinkers. The obtained CMCH microspheres (CMCH-MS) were non-cytotoxic, low hemolytic potential and biodegradable in the presence of lysozyme. In vitro blood clotting evaluation indicated that the porous microsphere network structures and the hydrophilicity of the CMCH could promote hemostasis due to the quick blood absorption and local concentration of the coagulation factors for the CMCH-MS. The CMCH-MS showed much better hemorrhage control than negative control and traditional hemostatic chitosan, similar hemostatic performance as commercialized cross-linked starch microspheres in both rat tail and liver models. Thus, the new biodegradable porous CMCH-MS may hold great potential for hemorrhage control in medical treatment.
The molecular mechanism for the microgravity‐induced decrease in bone formation remains unclear and there is a lack of effective specific preventative therapies. We recently reported that primary ...cilia of osteoblasts became shorter and even disappeared when the cells were exposed to random positioning machine (RPM)‐simulated microgravity and that the microgravity‐induced loss of osteogenic potential of osteoblasts could be attenuated when the resorption of primary cilia was prevented by treatment with 0.1 μM cytochalasin D. In the current study, it was further found that the loss of the osteogenic capacity of rat calvarial osteoblasts (ROBs) was associated with the inhibition of the BMP‐2/Smad1/5/8 signalling pathway, of which most of the signalling proteins including BMP‐2, BMPRII, Smad1/5/8 and p‐Smad1/5/8 were found localized to primary cilia. Accompanying the resorption of primary cilia following the cells being exposed to simulated microgravity, the expression levels of these signalling proteins were reduced significantly. Furthermore, the expression of miRNA‐129‐3p, a microRNA previously reported to control cilium biogenesis, was found to be reduced quickly and changed in a similar tendency with the length of primary cilia. Moreover, overexpression of miRNA‐129‐3p in ROBs significantly attenuated microgravity‐induced inhibition of BMP‐2 signalling and loss of osteogenic differentiation and mineralization. These results indicated the important role of miRNA‐129‐3p in microgravity‐induced resorption of primary cilia of osteoblasts and the potential of replenishing the miRNA‐129‐3p as an effective countermeasure against microgravity‐induced loss of primary cilia and impairment of osteoblast function.
Halloysite nanotubes (HNTs) are natural occurring mineral clay nanotubes that have excellent application potential in different fields. However, HNTs are heterogeneous in size, surface charge, and ...formation of surfacial hydrogen bond, which lead to weak affinity and aggregation at a certain extent. It is very important to modify the HNTs’ surface to expand its applications. In this review, the structural characteristics, performance, and the related applications of surface-modified HNTs are reviewed. We focus on the surface-modified variation of HNTs, the effects of surface modification on the materials and related applications in various regions. In addition, future prospects and the meaning of surface modification were also discussed in HNTs studies. This review provides a reference for the application of HNTs modifications in the field of new nanomaterials.
Two novel flame retardant and anti‐dripping PE films were successfully synthesized in three steps. PE‐g‐GMA film was first prepared by simultaneous electron beam irradiation to graft glycidyl ...methacrylate (GMA) onto PE film. 4,4′‐1,4‐phenyl‐bis(9,10‐dihydro‐9‐oxa‐10‐phosphaphenanthrene‐10‐yl)dimethyneimino)diphenol (DOPO‐t) and 4,4′‐1,3‐phenyl‐bis (9,10‐dihydro‐9‐oxa‐10‐phosphaphenanthrene‐10‐yl)dimethyneimino)diphenol (DOPO‐m) were then fabricated via a one‐pot method. Finally, two DOPO derivative functionalized PE films were obtained through the ring opening reactions of PE‐g‐GMA film with DOPO‐t and DOPO‐m, respectively. Combustion properties, flame retardancy, thermal performance, and thermal shrinkage of these films were evaluated. Compared with pure PE film, the burning rate of anti‐dripping DOPO‐t/DOPO‐m functionalized PE films was reduced by 13.2% and 50.0%, and the limiting oxygen index value climbed to 18.5 and 19.5, respectively. The residual chars from DOPO‐t/DOPO‐m functionalized PE films at 700°C were increased, and the shrinkage ratio decreased remarkably, which could effectively prevent the spread of fire. We also discussed the effect of structural difference between DOPO‐t and DOPO‐m on the above properties and the flame retardant mechanism of two DOPO derivative functionalized PE films preliminarily. This work provides a method for introducing DOPO derivatives into PE molecules to improve their flame retardancy and anti‐dripping properties.
We have synthesized two DOPO derivative functionalized PE films by simultaneous electron beam irradiation‐induced grafting and ring opening reaction. Compared with the pure PE film, the modified films show improved flame retardancy and anti‐dripping performance with more residual chars and lower thermal shrinkage. By contrast, DOPO‐m is superior to DOPO‐t in improving the above properties, and we further discuss the effect of the structural difference between DOPO‐t and DOPO‐m on the above properties and the flame retardant mechanism of two DOPO derivative functionalized PE films preliminarily.
In this study, a higher metal ions-resistant bacterium,
Stenotrophomonas rhizophila
JC1 was isolated from contaminated soil in Jinchang city, Gansu Province, China. The Pb
2+
(120 mg/L) and Cu
2+
...(80 mg/L) removal rate of the strain reached at 76.9% and 83.4%, respectively. The genome comprises 4268161 bp in a circular chromosome with 67.52% G + C content and encodes 3719 proteins. The genome function analysis showed
czc
operon,
mer
operon,
cop
operon, arsenic detoxification system in strain JC1 were contributed to the removal of heavy metals. Three efflux systems (i.e., RND, CDF, and P-ATPase) on strain JC1 genome could trigger the removal of divalent cations from cells. cAMP pathway and ABC transporter pathway might be involved in the transport and metabolism of heavy metals. The homology analysis exhibited multi-gene families such as ABC transporters, heavy metal-associated domain, copper resistance protein, carbohydrate-binding domain were distributed across 410 orthologous groups. In addition, heavy metal-responsive transcription regulator, thioredoxin, heavy metal transport/detoxification protein, divalent-cation resistance protein CutA, arsenate reductase also played important roles in the heavy metals adsorption and detoxification process. The complete genome data provides insight into the exploration of the interaction mechanism between microorganisms and heavy metals.
The emergence of nanomedicine has enriched the knowledge and strategies of treating diseases, and especially some incurable diseases, such as cancers, acquired immune deficiency syndrome (AIDS), and ...neurodegenerative diseases. The application of nanoparticles in medicine is in the core of nanomedicine. Nanoparticles can be used in drug delivery for improving the uptake of poorly soluble drugs, targeted delivery to a specific site, and drug bioavailability. Early diagnosis of and targeted therapies for cancers can significantly improve patients' quality of life and extend patients' lives. The advantages of nanoparticles have given them a progressively important role in the nanodiagnosis and nanotherapy of common cancers. To provide a reference for the further application of nanoparticles, this review focuses on the recent development and application of nanoparticles in the early diagnosis and treatment of the three common cancers (lung cancer, liver cancer, and breast cancer) by using quantum dots, magnetic nanoparticles, and gold nanoparticles.
Rapid and effective hemorrhage control is essential to reduce mortality following traumatic injuries. Herein we developed an organic solvent-free process to prepare carboxymethyl chitin microsphere ...(CMCHm) in an aqueous two-phase system through heating and freeze-drying. To further enhance the hemostatic performance of CMCHm, we loaded calcium ions and in-situ polymerized dopamine to get modified hemostatic microspheres CMCHm-Ca2+ and CMCHm-PDA, respectively. The size of these microspheres was mainly distributed between 50 μm and 150 μm, and the porous microstructure was observed by SEM. The data of in vitro degradation, cell cytotoxicity, and hemolysis test indicated good biocompatibility of these microspheres. Importantly, CMCHm-Ca2+ and CMCHm-PDA displayed better hemostatic performance compared with CMCHm and the positive controls Yunnan baiyao® and Quickclean®. Especially, the bleeding time was reduced to 59 s (CMCHm-Ca2+) and 45 s (CMCHm-PDA) in the femoral artery/vein cut model, respectively. All these demonstrate CMCHm-Ca2+ and CMCHm-PDA hold great potential for rapid hemostasis.
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•Carboxymethyl chitin microspheres prepared by an organic solvent-free heating process•Two modified microspheres obtained by loading Ca2+ and dopamine, respectively•These microspheres made by a green way have good biocompatibility and degradability.•Two modified microspheres showed enhanced hemostatic effect in 3 rat bleeding models•These 2 modified porous microspheres hold great potential for clinic rapid hemostasis.
Uncontrolled hemorrhage of deep, narrow and non-compressible perforating wounds is responsible for many trauma deaths. In this work, a novel biodegradable hemostatic sponge based on thermosensitive ...carboxymethyl chitin was prepared via simple cryo-regeneration process without using any crosslinkers. The collagen and polydopamine were added to further enhance mechanical and hemostatic properties of the sponge. All the carboxymethyl chitin based sponges showed high strength with excellent water/blood-triggered shape memory property, and the highest compressive fracture wet-strength could reach about 291.2 kPa, which was almost higher than those of many reported biodegradable hemostatic sponges pre-swelled in water. More importantly, the carboxymethyl chitin-collagen-polydopamine sponges displayed much better blood-clotting capacity and superior hemostasis performance than gauze and clinically used collagen sponge iRegene@ in vitro and in the rat liver perforating wound model. This study revealed a facile strategy to construct the effective carboxymethyl chitin based hemostatic sponges for the deep and non-compressible perforating wound.
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As a minimally invasive method, endovascular embolization has been an effective strategy for controlling bleeding and tumor treatment. Herein, carboxymethyl chitin embolic microspheres were prepared ...with the aqueous two-phase carboxymethyl chitin/polyethylene glycol system without using any crosslinking agents and thrombin-functionalized embolic microsphere named as Thr@CMCHm-30 was made after covalent introduction of thrombin. The size of the microspheres can be adjusted from 5 to 500 μm. The data of in vitro and in vivo tests indicated that these microspheres possessed good degradability and biocompatibility. Meanwhile, Thr@CMCHm-30 can significantly promote blood clotting and enhance the strength of the blood clots. More importantly, Thr@CMCHm-30 displayed better embolization effect than that of the commercial available Gelfoam Alicon® and polyvinyl alcohol-based embolic microspheres CalliSpheres® in rat femoral vein and rabbit ear artery embolization models. Therefore the size-tunable and biodegradable thrombin-functionalized carboxymethyl chitin microspheres Thr@CMCHm-30 possess great potential for effective hemostasis and endovascular embolization.
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