A 71-Year-Old Man With Gas Accumulation in the Left Atrium.

A 71-year-old man with a history of atrial fibrillation presented to the emergency department with sudden unconsciousness after finishing lunch. Just 4 weeks ago, the patient underwent radiofrequency ablation for atrial fibrillation and regularly took rivaroxaban for anticoagulant therapy. According to the medical history, the patient suffered recurrent chest tightness and heartburn after radiofrequency ablation without other discomforts.

COVID-19 related acute necrotizing encephalopathy and acute myocarditis in an adult female: a novel case report of brain injury and myocarditis.

Background: Acute necrotizing encephalopathy (ANE) and myocarditis are both acute, life-threatening conditions that can be triggered by COVID-19. We report a case of sequential ANE and myocarditis following a COVID-19 infection.

Case Presentation: A 27-year-old female patient was brought to the emergency department due to episodes of fever for two days and a 9-h altered state of consciousness.

Axillary vein as an alternative venous access site for VV-ECMO cannulation: a case report.

Background: Ultrasound-guided percutaneous axillary vein cannulation can reduce cannulation failure and mechanical complications, is as safe and effective as internal jugular vein cannulation, and is superior to subclavian vein cannulation using landmark technique. As far, reports of venovenous extracorporeal membrane oxygenation (VV-ECMO) with percutaneous axillary vein cannulation are rare.

Case Presentation: A 64-year-old man presenting with dyspnea and chest tightness after aspirating sewage was admitted to the emergency department.

Dynamic arterial elastance as a predictor of arterial pressure response to norepinephrine weaning in mechanically ventilated patients with vasoplegic syndrome-a systematic review and meta-analysis.

Introduction: During the de-escalation phase of circulatory shock, norepinephrine weaning may induce diverse arterial pressure responses in patients with different vasomotor tones. Dynamic arterial elastance (Ea) has been extensively studied to predict the arterial pressure response to interventions. We conducted this meta-analysis to systematically assess the predictive performance of Ea for the mean arterial pressure (MAP) response to norepinephrine weaning in mechanically ventilated patients with vasoplegic syndrome.

Mortality and Cumulative Kidney Score are Associated with Transient and Persistent Acute Kidney Injury in Septic Patients: A Retrospective Study Based on MIMIC-IV.

Background: Acute kidney injury (AKI) is frequently caused by sepsis. Recently, the Acute Disease Quality Initiative (ADQI) workgroup further classified AKI as transient or persistent. Oliguria and increased serum creatinine represent two different kinds of renal impairment.

Prophylactic noninvasive respiratory support in the immediate postoperative period after cardiac surgery - a systematic review and network meta-analysis.

Background: Noninvasive respiratory support has been increasingly applied in the immediate postoperative period to prevent postoperative pulmonary complications (PPCs). However, the optimal approach remains uncertain. We sought to evaluate the comparative effectiveness of various noninvasive respiratory strategies used in the immediate postoperative period after cardiac surgery.

Effective biodegradation of chlorophenols, sulfonamides, and their mixtures by bacterial laccase immobilized on chitin.

Coexisting multi-pollutants like sulfonamides (SAs) and chlorophenols (CPs) in the ecological environment pose a potential risk to living organisms. The development of a strategy for the effective removal of multiple pollutants has become an urgent need. Herein, we systematically investigated the potential of immobilized bacterial laccase to remove chlorophenols (CPs), sulfonamides (SAs), and their mixtures.

Successful management of hemodynamic instability secondary to saddle pulmonary embolism-induced cardiac arrest using VA-ECMO in advanced malignancy with brain metastases.

Background: Saddle pulmonary embolism (SPE) represents a rare type of venous thromboembolism that frequently causes circulation collapse and sudden death. While venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been well established as a salvage treatment for SPE-induced circulatory shock, it is infrequently administered in patients with advanced malignancy, especially those with brain metastases, given the potential bleeding complications and an uncertain prognosis. As far, there are rare case reports regarding the successful management of hemodynamic instability secondary to SPE-induced cardiac arrest using VA-ECMO in advanced malignancy patients with brain metastases.

Deciphering the alkaline stable mechanism of bacterial laccase from Bacillus pumilus by molecular dynamics simulation can improve the decolorization of textile dyes.

Laccases are considered promising tools for removing synthetic dyes from textile and tannery effluents. However, the alkaline pH in the effluents causes laccase instability, inactivation, and difficulty in its bioremediation. Based on a Bacillus pumilus ZB1 (BpLac) derived alkaline stable laccase, this study aimed to elucidate its alkaline stable mechanism at molecular level using molecular dynamics simulation.

Effects of low-FODMAP diet on irritable bowel symptoms in patients with quiescent inflammatory bowel disease: A protocol for a systematic review and meta-analysis.

Background: Inflammatory bowel disease (IBD) is a chronic disease whose etiology is not yet fully understood, and their course is characterized by periods of exacerbation and remission. In quite a few cases, actual disease remission may also accompany with inflammatory bowel disease (IBS)-like symptoms such as abdominal pain, bloating, flatulence, and diarrhea, may greatly impact quality of life. An army of strong evidence to support the FODMAPs diet (LFD) compounds as an effective dietary approach to IBS treatment.

Optimizing left ventricular-arterial coupling during the initial resuscitation in septic shock - a pilot prospective randomized study.

Background: Left ventricular-arterial coupling (VAC), defined as the ratio of effective arterial elastance (Ea) to left ventricular end-systolic elastance (Ees), has been extensively described as a key determinant of cardiovascular work efficacy. Previous studies indicated that left ventricular-arterial uncoupling was associated with worse tissue perfusion and increased mortality in shock patients. Therefore, this study aims to investigate whether a resuscitation algorithm based on optimizing left VAC during the initial resuscitation can improve prognosis in patients with septic shock.

Predictive performance of dynamic arterial elastance for arterial pressure response to fluid expansion in mechanically ventilated hypotensive adults: a systematic review and meta-analysis of observational studies.

Background: Dynamic arterial elastance (Ea) has been extensively considered as a functional parameter of arterial load. However, conflicting evidence has been obtained on the ability of Ea to predict mean arterial pressure (MAP) changes after fluid expansion. This meta-analysis sought to assess the predictive performance of Ea for the MAP response to fluid expansion in mechanically ventilated hypotensive patients.

Renal replacement therapy modality in critically ill patients with acute kidney injury - A network meta-analysis of randomized controlled trials.

Purpose: This network meta-analysis aims to compare the efficacy and safety of various renal replacement therapy (RRT) modalities in critically ill patients with acute kidney injury (AKI).

Materials And Methods: We searched the electronic databases for randomized controlled trials (RCTs) comparing different RRT modalities, including continuous RRT, intermittent RRT, hybrid RRT, and peritoneal dialysis (PD), in critically ill patients with AKI through July 26, 2020. The primary outcomes were renal recovery and short-term mortality.

Stress ulcer prophylaxis with proton pump inhibitors or histamine 2 receptor antagonists in critically ill adults - a meta-analysis of randomized controlled trials with trial sequential analysis.

Background: Proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) have been widely used as stress ulcer prophylaxis (SUP) in critically ill patients, however, its efficacy and safety remain unclear. This study aimed to assess the effect of SUP on clinical outcomes in critically ill adults.

Methods: Literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane database of clinical trials for randomized controlled trials (RCTs) that investigated SUP, with PPI or H2RA, versus placebo or no prophylaxis in critically ill patients from database inception through 1 June 2019.

[Characteristics of Ozone Pollution Distribution and Source Apportionment in Zhoushan].

The processes affecting photochemical reactions and regional transport of ozone and its precursors in ambient air are very complicated. In this study, statistical analysis of the spatial and temporal distributions of ozone pollution in Zhoushan was carried out based on monitoring data from state monitoring stations in Zhoushan in 2014. Specifically, ozone formation was simulated by CMAQ (the community multiscale air quality) model, and the source contribution rate was calculated using the Integrated Source Apportionment Method (ISAM) source tracking algorithm.

The effects of deterioration and technological levels on pollutant emission factors for gasoline light-duty trucks.

Unlabelled: Vehicle deterioration and technological change influence emission factors (EFs). In this study, the impacts of vehicle deterioration and emission standards on EFs of regulated pollutants (carbon monoxide [CO], hydrocarbon [HC], and nitrogen oxides [NO]) for gasoline light-duty trucks (LDTs) were investigated according to the inspection and maintenance (I/M) data using a chassis dynamometer method. Pollutant EFs for LDTs markedly varied with accumulated mileages and emission standards, and the trends of EFs are associated with accumulated mileages.

Protection of retinal vasculature by losartan against apoptosis and vasculopathy in rats with spontaneous hypertension.

Objectives: Retinal blood vessels may develop vasculopathy and apoptosis in response to hypertension. The present study was aimed at testing the role of losartan, a specific antagonist of angiotensin II receptor type 1 receptor in regulation of vascular apoptosis in retinal vasculature with hypertension.

Methods: Losartan potassium was administered to spontaneously hypertensive rats (SHR).