ABSTRACT BACKGROUND: This study aimed to compare the effects on mortality of albumin and crystalloid, used for fluid resuscitation among adult patients with septic shock, through conducting a meta-analysis and trial sequential analysis (TSA). DESIGN AND SETTING: Meta-analysis and TSA conducted at Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China. METHODS: Data were collected from several major databases including MEDLINE, EMBASE, Clinical Trials.gov and Cochrane Central Register of Controlled Trials. Studies that compared the effects of albumin therapy versus crystalloid therapy on mortality among adult septic shock patients were eligible for inclusion in the analyses. The study name, year of publication, country of the trial, albumin concentration, type of crystalloid and all reported mortalities at different follow-up endpoints were extracted. RESULTS: Compared with crystalloid, albumin did not decrease all-cause mortality at the final follow-up. However, in TSA, the required information size was not achieved in all groups, which means that the effect size was not definitive and further RCTs are needed to confirm or deny these findings CONCLUSIONS: Compared with crystalloid solutions, albumin was unable to decrease all-cause mortality. However, TSA indicated that these results could be false-negative. Additional randomized controlled trials are needed to clarify this discrepancy.

OBJECTIVE: To evaluate the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures. METHODS: Fifty-six cases of thoracolumbar vertebral fractures treated in our trauma center from October 2012 to October 2013 were included in this study. The fractures were classified by the anteroposterior classification, whereas the severity of intervertebral disc injury was evaluated using magnetic resonance imaging. The Spearman correlation coefficient was used to analyze the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar fractures, whereas a χ2 test was adopted to measure the variability between different fracture types and upper and lower adjacent disc injuries. RESULTS: The Spearman correlation coefficients between fracture types and the severity of the upper and lower adjacent disc injuries were 0.739 (PU<0.001) and 0.368 (PL=0.005), respectively. It means that the more complex Arbeitsgemeinschaft für Osteosynthesefragen (AO) classifications are the disc injury is more severe. There was also a significant difference in the severity of injury between the upper and lower adjacent discs near the fractured vertebrae (p<0.001). CONCLUSIONS: In thoracolumbar spinal fractures, the severity of the adjacent intervertebral disc injury is positively correlated with the anteroposterior fracture type. The injury primarily involves intervertebral discs near the fractured end plate, with more frequent and severe injuries observed in the upper than in the lower discs. The presence of intervertebral disc injury, along with its severity, may provide useful information during the clinical decision-making process.

Desenvolveu-se um procedimento de microextração por emulsificação assistida por ultrassom e aperfeiçoada por surfactante (UASEME) combinado com cromatografia líquida de alta eficiência com detector de arranjo de diodos para a determinação de 17b-estradiol (βE2), estrona (E1) e dietilestilbestrol (DES) em água. Ultrassom foi aplicado para auxiliar a emulsificação e Triton X-100 foi usado como dispersor e emulsificante. Tetracloreto de carbono foi usado como solvente extrator. Empregando otimização global, o procedimento foi caracterizado por um intervalo linear aceitável de 10 a 1000 ng mL-1 para βE2, E1 e DES (r > 0,997), exatidão e precisão validadas (RSD 0,85-1,28% (n = 5)) e alta sensibilidade com limites de detecção de 0,200, 0,100 e 0,125 ng mL-1 para βE2, E1 e DES, respectivamente. O procedimento foi aplicado para a análise de amostras típicas de água, com fatores de enriquecimento de 85,29, 173,45 e 97,05 para βE2, E1 e DES, respectivamente, e boas recuperações (≥ 89,82%). De maneira geral, o procedimento desenvolvido foi simples e confiável, com potencial de aplicação em larga escala para análises da água.

An ultrasound-assisted surfactant-enhanced emulsification microextraction (UASEME) combined with high performance liquid chromatography-diode array detector procedure was developed for the determination of 17β-estradiol (βE2), estrone (E1) and diethylstilbestrol (DES) in water. Ultrasound was applied to assist emulsification, and Triton X-100 was adopted as the disperser and emulsifier. Carbon tetrachloride was applied as the extraction solvent. Global optimization was used and the developed procedure was characterized by an acceptable linear range of 10 to 1000 ng mL-1 for βE2, E1 and DES (r > 0.997), a validated accuracy and precision (RSD 0.85-1.28% (n = 5)), and high sensitivity with limits of detection of 0.200, 0.100 and 0.125 ng mL-1 for βE2, E1 and DES, respectively. Furthermore, we applied this procedure to analyze typical water samples, with enrichment factors of 85.29, 173.45 and 97.05 for βE2, E1 and DES, respectively, and good recoveries (≥ 89.82%). Altogether, the proposed procedure was simple and reliable, with potential application in large-scale water analysis.