A proof‐of‐concept study of hypervalent chalcogenonium⋅⋅⋅π bonding catalysis was performed. A new catalytic strategy using 1,2‐oxaselenolium salts as chalcogen bond donors and alkenes as chalcogen bond acceptors is described. The feasibility of this concept is demonstrated by the use of trisubstituted selenonium salts in the metal‐free catalytic hydrofunctionalization and polymerization of alkenes via unconventional seleniranium ion‐like intermediates. The results indicate that counter anions have a significant effect on the catalysis based on hypervalent chalcogenonium⋅⋅⋅π bonding interactions.

Objectives The objective of this study was to develop clinical scores to predict the risk of intensive care unit (ICU) admission in patients with COVID-19 and end stage kidney disease (ESKD). Methods This was a prospective study in which 100 patients with ESKD were enrolled and divided into two groups: the ICU group and the non-ICU group. We utilized univariate logistic regression and nonparametric statistics to analyze the clinical characteristics and liver function changes of both groups. By plotting receiver operating characteristic curves, we identified clinical scores that could predict the risk of ICU admission. Results Out of the 100 patients with Omicron infection, 12 patients were transferred to the ICU due to disease aggravation, with an average of 9.08 days from hospitalization to ICU transfer. Patients transferred to the ICU more commonly experienced shortness of breath, orthopnea, and gastrointestinal bleeding. The peak liver function and changes from baseline in the ICU group were significantly higher, with p values <.05. We found that the baseline platelet-albumin-bilirubin score (PALBI) and neutrophil-to-lymphocyte ratio (NLR) were good predictors of ICU admission risk, with area under curve values of 0.713 and 0.770, respectively. These scores were comparable to the classic Acute Physiology and Chronic Health Evaluation II (APACHE-II) score ( p > .05). Conclusion Patients with ESKD and Omicron infection who are transferred to the ICU are more likely to have abnormal liver function. The baseline PALBI and NLR scores can better predict the risk of clinical deterioration and early transfer to the ICU for treatment.

Background Pregnancy-related acute kidney injury (Pr-AKI) is associated with maternal and fetal morbidity and mortality. There are few studies focusing on Pr-AKI at high altitude in the literature. Objectives to investigate the incidence, etiology, clinical features and maternal-fetal outcomes of Pr-AKI in women living at high altitude. Methods 6,512 pregnant women attending the Department of Obstetrics & Gynecology at local hospital from January 2015 to December 2018 were screened for Pr-AKI. Patients with serum creatinine above normal range(> 70umol/L) then underwent assessment to confirm the diagnosis of Pr-AKI. AKI was diagnosed and staged based on Kidney Disease Improving Global Outcomes(KDIGO) guideline. Individuals meeting the Pr-AKI criteria were recruited. Their clinical data were recorded and retrospectively analyzed. Results Pr-AKI was identified in 136/6512(2.09 %) patients. Hypertensive disorders of pregnancy(HDP) was the leading cause of Pr-AKI(35.3 %). 4(2.9 %) women died and the majority(86.1 %) had recovered renal function before discharge. Fetal outcomes were confirmed in 109 deliveries with gestational age ≥ 20 weeks. Pre-term delivery occurred in 30(27.3 %) cases and perinatal deaths in 17(15.5 %). The rate of low birth weight infant(LBWI) and intrauterine growth restriction(IUGR) was 22.0 and 10.9 % respectively. 16(14.5 %) infants were admitted to NICU after birth. Patients with HDP had a higher cesarean rate(56.3 %). More IUGR(25.0 %) and LBWI(37.8 %) were observed in their infants with a higher risk of admission to NICU(22.0 %). High altitude might have an adverse impact on HDP-related Pr-AKI patients with earlier terminated pregnancy and more stillbirth/neonatal death. Logistic regression models indicated that uncontrolled blood pressure, high altitude and advanced AKI were associated with adverse fetal outcomes in HDP-related Pr-AKI patients. Conclusions Pr-AKI was not rare in high-altitude regions and caused severe fetal morbidities and mortalities. Uncontrolled blood pressure, high altitude and advanced AKI were all risk factors for adverse fetal outcomes in Pr-AKI patients, especially for those with hypertensive disorders of pregnancy.

Objective This study aimed to describe the clinical features of maintenance hemodialysis (MHD)patients with COVID-19 and potential factors related to the time to return negative RT-PCR in discharged. Methods Retrospective analysis was performed on the clinical data of 90 MHD patients and 134 non-dialysis patients who infected with COVID-19 and admitted to our hospital from 1 April 2022 to 10 June 2022. Results The average age of the MHD patients with COVID-19 was 64.8 ± 12.9 years old and 59.3% patients were males. 12.2% MHD patients with COVID-19 were admitted to ICU and they had higher levels of WBC, neutrophils and procalcitonin(PCT)(P < 0.05) and more symptoms of nausea or vomiting at admission(P = 0.0003). The mean lengths of time from positive to two consecutive negative COVID-19 PCR was 18.15 ± 6.37 days in discharged MHD patients and 11.18 ± 3.52 days in non-dialysis patients(P < 0.0001). Discharged MHD patients with hypertension and DM need obviously longer time to negative than without comorbid disease(21.33 ± 7.03 days vs 16.47 ± 3.6, P = 0.0194). Longer time to negative PCR was associated with lower level of Ct-ORF1ab RNA and Ct-N RNA at admission (R2 = 0.05958, P = 0.0291; R2 = 0.06719, P = 0.0202) in MHD patients. Conclusion MHD patients with COVID-19 had a high probability of admitting to ICU and the level of inflammatory indicators were critical factors. It takes a week longer for MHD patients to return negative PCR than non-dialysis patients. MHD patients combined with hypertension and DM, lower level of Ct- RNA need longer SARS-CoV-2 RNA clearance time than others.

BackgroundPregnancy-related acute kidney injury (Pr-AKI) is associated with maternal and fetal morbidity and mortality. There are few studies focusing on Pr-AKI at high altitude in the literature. Objectivesto investigate the incidence, etiology, clinical features and maternal-fetal outcomes of Pr-AKI in women living at high altitude.Methods6,512 pregnant women attending the Department of Obstetrics＆Gynecology at local hospital from January 2015 to December 2018 were screened for Pr-AKI. Patients with serum creatinine above normal range(>70umol/L) then underwent assessment to confirm the diagnosis of Pr-AKI. AKI was diagnosed and staged based on Kidney Disease Improving Global Outcomes(KDIGO) guideline. Individuals meeting the Pr-AKI criteria were recruited. Their clinical data were recorded and retrospectively analyzed. ResultsPr-AKI was identified in 136/6512(2.09%) patients. Hypertensive disorders of pregnancy(HDP) was the leading cause of Pr-AKI(35.3%). 4(2.9%) women died and the majority(86.1%) had recovered renal function before discharge. Fetal outcomes were confirmed in 109 deliveries with gestational age≥20 weeks. Pre-term delivery occurred in 30(27.3%) cases and perinatal deaths in 17(15.5%). The rate of low birth weight infant(LBWI) and intrauterine growth restriction(IUGR) was 22.0% and 10.9% respectively. 16(14.5%) infants were admitted to NICU after birth. Patients with HDP had a higher cesarean rate(56.3%). More IUGR(25.0%) and LBWI(37.8%) were observed in their infants with a higher risk of admission to NICU(22.0%). High altitude might have an adverse impact on HDP-related Pr-AKI patients with earlier terminated pregnancy and more stillbirth/neonatal death. Logistic regression models indicated that uncontrolled blood pressure, high altitude and advanced AKI were associated with adverse fetal outcomes in HDP-related Pr-AKI patients.ConclusionsPr-AKI was not rare in high-altitude regions and caused severe fetal morbidities and mortalities. Uncontrolled blood pressure, high altitude and advanced AKI were all risk factors for adverse fetal outcomes in Pr-AKI patients, especially for those with hypertensive disorders of pregnancy.