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Background Acute kidney injury (AKI) is a frequent syndrome in the intensive care unit (ICU). AKI patients with kidney function recovery have better short-term and long-term prognoses compared with those with non-recovery. Numerous studies focus on biomarkers to distinguish them. To better understand the predictive performance of urinary biomarkers of renal recovery in patients with AKI, we evaluated C–C motif chemokine ligand 14 (CCL14) and two first-generation biomarkers (cell cycle arrest biomarkers and neutrophil gelatinase-associated lipocalin) in two ICU settings. Methods We performed a prospective study to analyze urinary biomarkers for predicting renal recovery from AKI. Patients who developed AKI after ICU admission were enrolled and urinary biomarkers including tissue inhibitor of metalloproteinase-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7), CCL14, and neutrophil gelatinase-associated lipocalin (NGAL) were detected on the day of AKI diagnosis. The primary endpoint was non-recovery from AKI within 7 days. The individual discriminative ability of CCL14, [TIMP-2] × [IGFBP7] and NGAL to predict renal non-recovery were evaluated by the area under receiver operating characteristics curve (AUC). Results Of 164 AKI patients, 64 (39.0%) failed to recover from AKI onset. CCL14 showed a fair prediction ability for renal non-recovery with an AUC of 0.71 (95% CI 0.63–0.77, p p p = 0.562). A two-parameter model (non-renal SOFA score and AKI stage) predicted renal non-recovery with an AUC of 0.77 (95% CI 0.77–0.83, p = 0.004). When [TIMP-2] × [IGFBP7] was combined with the clinical factors, the AUC was significantly improved to 0.82 (95% CI 0.74–0.87, p = 0.049). Conclusions Urinary CCL14 and [TIMP-2] × [IGFBP7] were fair predictors of renal non-recovery from AKI. Combing urinary [TIMP-2] × [IGFBP7] with a clinical model consisting of non-renal SOFA score and AKI stage enhanced the predictive power for renal non-recovery. Urinary CCL14 showed no significant advantage in predicting renal non-recovery compared to [TIMP-2] × [IGFBP7].

Understanding the diversity of life history, life stage connectivity and population is essential to determine the spatial scale over which fish populations operate. Otolith microchemistry analysis is a powerful tool to elucidate the life history and population connectivity of fish, providing important insights to the natal origin and population structure. In this study, we used laser ablation inductively coupled plasma mass spectrometry to analyze the chemical composition of otoliths throughout the entire lifetime of endangered fourfinger threadfin species, Eleutheronema tetradactylum. We reconstructed the life history of E. tetradactylum from Southern China collected from different locations over a spatial scale of 1200 km. Sr:Ca and Ba:Ca ratios profiles from otolith core-to-edge analysis suggested two contrasting life history patterns. Based on the differences in early life stages, we identified some fish spending their first year in an estuarine environment with subsequent movement to marine coastal systems, while some fish remaining in the coastal systems throughout their entire early life history stages. The non-metric multi-dimensional scaling showed a strong overlap in otolith core elemental composition, indicating a large-scale connectivity in the life history of E. tetradactylum. The immature fish from different natal origins mixed to a large extent when they fed and overwintered in the extensive offshore waters. Clustering of near core chemistry pointed to three possible sources of nursery for the threadfin fish. This study demonstrated the diversity of life history patterns of E. tetradactylum in Southern Chinese waters. Restoration in egg and larvae densities in coastal waters and estuaries may enhance their population abundances.

Klotho is a life extension factor that has the ability to regulate the function of GluN2B-containing N-methyl-D-aspartate receptors (NMDARs), whose dysfunction in the nucleus accumbens (NAc) underlies critical aspects of the pathophysiology of major depression. Here, we study the functional relevance of klotho in the pathogenesis of depression. A chronic social defeat stress paradigm, in which mice are categorized as either susceptible or unsusceptible based on their performance in a social interaction test, was used in this study. We found that the expression of klotho was largely decreased in the NAc of susceptible mice compared to control or unsusceptible mice. Genetic knockdown of klotho in the NAc induced behavioral alterations relevant to depression in naive mice, while overexpression of klotho produced an antidepressive effect in normal mice and ameliorated the behavioral responses to stress in susceptible mice. Molecularly, knockdown of klotho in the NAc resulted in selective decreases in total and synaptic GluN2B expression that were identical to those in susceptible mice. Elevation of klotho in the NAc reversed the reductions in GluN2B expressions and altered synaptic transmission and spine density in the NAc of susceptible mice. Furthermore, blockade of GluN2B with a specific antagonist abolished the beneficial effects of klotho elevation in susceptible mice. Collectively, we demonstrated that klotho in the NAc modulates behavioral responses to stress by regulating the function of GluN2B-containing NMDARs. These results reveal a novel role for klotho in the pathogenesis of depression, providing new insights into the molecular basis of major depression.

The vibration and noise radiation from underwater structures can be harmful for aquatic ecosystems, especially for endangered species which are sensitive to particle motion and sound pressure. In this study, a water supply pipeline was chosen to investigate the flow-induced vibration and underwater noise radiation. A finite element model was developed to predict the vibration of the pipeline-tunnel-soil coupling system using fluid-structure interaction analysis. Next, a three-demission boundary element acoustic model was developed to simulate underwater noise radiation and propagation. Parametric analysis was conducted to investigate the influence of scouring depth on vibration and acoustic radiation. The results showed the flowing fluid-induced vibration produced broad band noise radiation, with dominant frequency range from 3 to 25 Hz. The sound pressure radiated from the model with once-in-a-century scouring depth was about 3 dB larger than the model with normal depth due to thinner sediment. The sourcing depth has significant influence on the noise distribution and radiation directivity. The simulated sound pressure level and water particle motion can exceed the threshold of some underwater species in certain frequency range, especially for the once-in-a-century scouring depth. The proposed methodology can be used for acoustic radiation prediction in further study to reduce the influence on aquatic environment.

Purpose This study aimed to evaluate the attributable mortality of new-onset acute kidney injury (AKI). Methods The data in the present study were derived from a multi-center, prospective cohort study in China that was performed at 18 Chinese ICUs. A propensity-matched analysis was performed between matched patients with and without AKI selected from all eligible patients to estimate the attributable mortality of new-onset AKI. Results A total of 2872 critically ill adult patients were eligible. The incidence of new-onset AKI was 29.1% (n = 837). After propensity score matching, 788 patients with AKI were matched 1:1 with 788 controls (patients without AKI). Thirty-day mortality was significantly higher among the patients with AKI than among their matched controls (25.5% versus 17.4%, p p = 0.509) in 30-day mortality between patients with stage 1 AKI and their matched controls. The attributable mortality values of stage 2 and stage 3 AKI were 12.4% [95% confidence interval (CI) 2.6–21.8%, p = 0.013] and 16.1% (95% CI 8.2–23.8%, p p = 0.001), while no observable difference in 30-day mortality was identified between transient AKI patients and their matched non-AKI controls (p = 0.229). Conclusion The absolute excess 30-day mortality that is statistically attributable to new-onset AKI is substantial (8.1%) among general ICU patients. However, neither stage 1 AKI nor transient AKI increases 30-day mortality.

With the control parameters of the wall thickness of the ball table and the thickness of the pressure plate of the ball table, four universal wrapped assembled joint models were designed for the research of stress performance via static loading test. The failure mode of the joint, the axial force–displacement curve of the web member, the equivalent stress distribution of the ball table and the pressure plate of the ball table were analyzed, and the ABQAUS finite element software was used for the analysis of parameter expansion of the specimen. The research results show that the failure modes of universally wrapped assembled joints can be divided into the buckling failure of the ball table and the strength failure of the material. The wall thickness of the ball table is the key parameter affecting the failure mode of the joints, and the thickness of the pressure plate of the ball table is the crucial parameter influencing the ultimate bearing capacity of the joints. The maximum equivalent stress of the pressure plate and the ball table at compression zone for all the joints is occurred at the side squeezed by the bolt ball, and the growth rate of the equivalent stress for the ball table at compression zone is more uniform than that at tension zone. According to the finite element analysis results, when the wall thickness of the ball table is greater than 7 mm, the thickness of the pressure plate of the ball table is greater than 16 mm, the growth rate of the ultimate bearing capacity of the joint is significantly decreased, therefore, it is recommended to use the wall thickness of 7 mm and the pressure plate thickness of 16 mm in the actual design of the project.

Long-chain polyunsaturated fatty acids (LC-PUFA), including eicosapentaenoic acid and docosahexaenoic acid, are the essential fatty acids for organs to maintain various biological functions and processes. The threadfin fish Eleutheronema, with its rich nutritional value especially the high fatty acid contents, has become one of the promising aquaculture species in China and the potential food source of fatty acids for human consumption. However, the molecular basis underlying the biosynthesis of fatty acids in Eleutheronema species is still unknown. The elongation of the very long-chain fatty acids (Elovl) gene family in fish plays several critical roles in LC-PUFA synthesis. Therefore, in the present study, we performed genome-wide identification of the Elovl gene family to study their evolutionary relationships and expression profiles in two threadfin fish species Eleutheronema tetradactylum and Eleutheronema rhadinum, the first representatives from the family Eleutheronema. Phylogenetic analysis revealed that the Elovl genes in Eleutheronema were classified into six subfamilies (elovl1a/1b, elovl4a/4b, elovl5, elovl6/6 l, elovl7a, elovl8b). Phylogenetic, gene structure, motif, and conserved domain analysis indicated that the Elovl genes were highly conserved within the same subfamily in Eleutheronema. In addition, the Elovl genes were distributed in 7/26 chromosomes, while the duplicated gene pair, elovl4a and elovl4b, showed collinear relationships. The predicted secondary structure patterns and the 3D models revealed the highly similar functions and evolutionary conserved structure of Elovl proteins in Eleutheronema. The selection pressure analysis revealed that Elovl genes underwent strong purifying selection during evolution, suggesting that their functions might be evolutionarily conserved in Eleutheronema. Additionally, the expression patterns of Elovl genes in different tissues and species were distinct, indicating the possible functional divergence during evolution in the Eleutheronema genus. Collectively, we provided the first comprehensive genomic information on Elovl genes in threadfin fish Eleutheronema. This study enhanced the understanding of the underlying mechanisms of fatty acids biosynthesis in Eleutheronema, and provided new insights on breeding new varieties of fatty acids-enriched fish with potential benefits to farmers and the health of consumers.

To retrospectively explore the characteristics of plasma amino acids (PAAs) in children with autism spectrum disorder and their clinical association via case-control study. A total of 110 autistic and 55 healthy children were recruited from 2014 to 2018. The clinical phenotypes included severity of autism, cognition, adaptability, and regression. Compared with the control group, autistic children had significantly elevated glutamate, γ-Amino-n-butyric acid, glutamine, sarcosine, δ-aminolevulinic acid, glycine and citrulline. In contrast, their plasma level of ethanolamine, phenylalanine, tryptophan, homocysteine, pyroglutamic acid, hydroxyproline, ornithine, histidine, lysine, and glutathione were significantly lower. Elevated neuroactive amino acids (glutamate) and decreased essential amino acids were mostly distinct characteristics of PAAs of autistic children. Increased level of tryptophan might be associated with severity of autism.

Electrochemical nitrogen reduction reaction (NRR) under ambient conditions is highly desirable to achieve sustainable ammonia (NH3) production via an alternative carbon free strategy. Single-atom catalysts (SACs) with super high atomic utilization and catalytic efficiency exhibit great potential for NRR. Herein, a high-performance NRR SAC is facilely prepared via a simple deposition method to anchor Au single atoms onto porous β-FeOOH nanotubes. The resulting Au-SA/FeOOH can efficiently drive NRR under ambient conditions, and the NH3 yield reaches as high as 2,860 µg·h−1·mgAu−1 at −0.4 V vs. reversible hydrogen electrode (RHE) with 14.2% faradaic efficiency, much superior to those of all the reported Au-based electrocatalysts. Systematic investigations demonstrate that the synergy of much enhanced N2 adsorption, directional electron export, and mass transfer ability in Au-SA/FeOOH greatly contributes to the superior NRR activity. This work highlights a new insight into the design of high efficient NRR electrocatalysts by combination of porous metal oxide matrix and highly active single-atom sites.

While rich chemistry of phospholyl anions is discovered, phosphafluorenyl anions are only proposed as the critical intermediates for the synthesis of phosphafluorenes. In this article, we reported the direct synthesis of phosphafluorenyl lithiums from white phosphorus (P4) through direct P–C bond formation. The reaction between P4 and biphenyl dilithio reagents efficiently afforded phosphafluorenyl lithiums, which were further used to synthesize different kinds of organophosphorus compounds. The aggregation states of phosphafluorenyl lithiums were investigated for the first time. Mechanistic studies by DFT calculations revealed a cooperative nucleophilic attack of two C−Li bonds on P4 molecule.

The present study focuses on interface microstructure and joint formation. AA6061 aluminum alloy (Al) and commercial pure titanium (Ti) joints were welded by ultrasonic spot welding (USW). The welding energy was 1100–3200 J. The Al-Ti joint appearance and interface microstructure were observed mainly via optical microscopy and field emission scanning electron microscopy. Results indicated that a good joint can be achieved only with proper welding energy of 2150 J. No significant intermetallic compound (IMC) was found under all conditions. The high energy barriers of Al-Ti and difficulties in diffusion were the main reasons for the absence of IMC according to kinetic analysis. The heat input is crucial for the material plastic flow and bonding area, which plays an important role in the joint formation.

Despite major advances in HIV testing, ultrasensitive detection of early infection remains challenging, especially for the viral capsid protein p24, which is an early virological biomarker of HIV-1 infection. Here, To improve p24 detection in patients missed by immunological tests that dominate the diagnostics market, we show a click chemistry amplified nanopore (CAN) assay for ultrasensitive quantitative detection. This strategy achieves a 20.8 fM (0.5 pg/ml) limit of detection for HIV-1 p24 antigen in human serum, demonstrating 20~100-fold higher analytical sensitivity than nanocluster-based immunoassays and clinically used enzyme-linked immunosorbent assay, respectively. Clinical validation of the CAN assay in a pilot cohort shows p24 quantification at ultra-low concentration range and correlation with CD4 count and viral load. We believe that this strategy can improve the utility of p24 antigen in detecting early infection and monitoring HIV progression and treatment efficacy, and also can be readily modified to detect other infectious diseases.

The aim of this study is to investigate the expression and DNA methylation status of the imprinted genes PEG10 and L3MBTL1 in the offspring of assisted reproductive technology (ART). The ART group consists of 30 cases of placenta and umbilical cord blood from ART full-term, uncomplicated singleton pregnancy progeny, and the normal control group consists of 30 cases of placenta and umbilical cord blood from natural full-term, uncomplicated singleton pregnancy progeny. The imprinted genes PEG10 and L3MBTL1 are analyzed, and the expression and methylation status of the two genes are detected using real-time quantitative polymerase chain reaction (QRT-PCR), immunohistochemistry (IHC), Western blotting (WB), and methylation-specific polymerase chain reaction (MSP). Compared with the normal control group, the PEG10 mRNA relative quantity (RQ) value in the placenta is 0.994 ± 0.458, with its RQ value up-regulated (P = 0.015). The PEG10 mRNA RQ value in the umbilical cord blood is 0.875 ± 0.452, with its RQ value up-regulated (P = 0.002). However, the L3MBTL1 mRNA RQ value in the placenta is 0.404 ± 0.234, with its RQ value down-regulated (P = 0.024). The L3MBTL1 mRNA RQ value in the umbilical cord blood is 0.337 ± 0.213, and there is no difference in the umbilical cord blood (P = 0.081). Compared with the normal control group, the expression of PEGl0 protein in the placenta of the ART progeny is up-regulated (P = 0.000), while the expression of L3MBTLl protein is down-regulated (P = 0.000). The methylation status of the PEGl0 promoter region in the placenta in the ART group is lower than that in the normal control group (P = 0.037), and that of the promoter region of the umbilical cord blood is lower than that of the natural pregnancy group (P = 0.032). The methylation status of the L3MBTLl promoter region is higher in the placenta than in the normal control group (P = 0.038), and there is no difference between the two groups in the umbilical cord blood (P = 0.301). In the ART group, the values of PEGl0 and L3MBTLl RQ in the placenta and the umbilical cord blood of the hypermethylated group are lower than in those of the hypomethylated group. ART may increase the risk of the abnormal expression of PEG10 and L3MBTL1 in offspring imprinted genes. The methylation of the promoter region may be the mechanism that regulates the expression of PEGl0 and L3MBTL1.

Plasma jet has been widely used in supersonic combustor as an effective ignition and combustion assisted method, but currently it is mostly combined with the traditional wall fuel injection method, while the application combined with the central fuel injection method is less. In order to expand the combustion range, the plasma jet was introduced into a strut-cavity combustor with an alternating-wedge. The effects of total pressure of strut fuel injection, total pressure of cavity fuel injection, total pressure of plasma jet injection and plasma jet media on the combustion characteristics were analyzed in supersonic flow by numerical calculations in a three-dimensional domain. The combustion field structure, wall pressure distribution, combustion efficiency and distribution of H2O at the exit of the combustor with different injection conditions were analyzed. The results show that the combustion efficiency decreases with the increase of the strut fuel injection total pressure. However, the combustion area downstream increases when the total pressure of the strut fuel injection increases within the proper range. The combustion range is expanded and the combustion efficiency is improved when the cavity fuel injection total pressure is increased within the range of 0.5–2.0 MPa, but a sharp drop in combustion efficiency can be found due to limited fuel mixing when the total injection pressure of the cavity fuel is excessively increased. With the increased total injection pressure of the plasma jet, the height of the cavity shear layer is raised and the equivalence ratio of the gas mixture in the cavity is improved. When the total pressure of the plasma jet is 1.25 MPa, the combustion efficiency reaches a maximum of 82.1%. The combustion-assisted effect of different plasma jet media is significantly different. When the medium of the plasma jet is O2, the combustion-assisted effect on the combustor is most significant.

Monolayers of layered materials, such as graphite and molybdenum dichalcogenides, have been the focus of materials science in the last decades. Here, we reveal benign stability and intriguing physical properties in the thinnest monolayer wurtzite (wz) semiconductors, which can be exfoliated from their bulk and stacked to reform the wz crystals. The candidate ZnX and CdX (X = S, Se, Te) monolayers possess low cleavage energy and direct bandgaps, which harbor strongly coupled ferroelectricity and ferroelasticity with low transition barriers, giant in-plane negative Poisson’s ratio, as well as giant Rashba spin splitting, enabling the co-tunability of spin splitting and auxetic magnitudes via multiferroic switching. These wz monolayers can be used as building blocks of devices structures, due to their inherent “self-healable” capacity, which offer more flexibility for semiconductor fabrication and provide a natural platform to probe the interplay of multiple physical effects, bringing light into the rich physics in tetrahedral semiconductors.

The threadfin Eleutheronema are the important fishery resources in Indo-Pacific regions and classified as the endangered species with considerable conservation values. Their genetic diversity and population structure remain essentially unknown but are critical for the proper management and sustainable harvests of such important fisheries. Here, the mitochondrial DNA sequences of CO1 and 16s rRNA were determined from 75 individuals of Eleutheronema tetradactylum and 89 individuals of Eleutheronema rhadinum collected from different locations of South China Sea and Thailand coastal waters. Genetic diversity analysis revealed that both E. tetradactylum (Haplotype diversity, H = 0.105–0.211; Nucleotide diversity, π = 0.00017–0.00043) and E. rhadinum (H = 0.074–0.663, π = 0.00013–0.01088) had low diversity. Population structure analysis demonstrated the shallow genetic differentiation among the South China Sea populations. The limited communication between China and Thailand populations caused the high genetic differentiation in all groups due to the low dispersal ability. Reconstruction of CO1 phylogenetic relationships and demographic studies across Indo-West-Pacific regions provided strong evidence for a shared common origin or ancestor of E. tetradactylum and E. rhadinum. Eleutheronema rhadinum were further subdivided into two distinct genetic lineages, with Clade A dominantly distributing in Thailand and Malaysia and Clade B distributing in China coastal waters. Phenotypic divergence, characterized mainly by the depth of caudal peduncle and length of caudal peduncle, was also observed for all populations, which was possibly associated with specific local adaptations to environmental changes. Our study suggested a strong need for the development of proper fishery management strategies and conservation actions for the imperiled Eleutheronema species.

To investigate the action mechanisms of electroacupuncture (EA) on postoperative immunosuppression. Male C57BL/6 mice (5`-7 weeks old) were randomly divided into: the sham injury group, the surgical trauma stressed group, the EA group [surgery + 2/100 Hz EA at Neiguan (PC 6)], and the EA+ Nal (surgery + EA + intraperitoneal injection of naloxone). Abdominal surgical trauma stress mice model was established. EA was performed on bilateral PC 6 acupoints by an EA apparatus (2/100 Hz) for 20 min once a day for 3 days. The mRNA expressions of MOR, DOR, and KOR in thymus and L3`-L5 dorsal root ganglions (DRG) were determined by quantitative real-time polymerase chain reaction (qRT-PCR) and the protein expressions of MOR, DOR, and KOR in thymus were measured by Western blot. Flow cytometry assay was used to detect the levels of T lymphocyte subtypes in the peripheral blood. Surgical trauma induced decreased the mRNA expression level of MOR in both thymus (P 0.05). Furthermore, T lymphocyte population of CD3+ and CD4+ was decreased in the peripheral blood after surgical trauma (both P

PURPOSE: Primary ciliary dyskinesia (PCD), which commonly causes male infertility, is an inherited autosomal recessive disorder. This study aimed to investigate the clinical manifestations and screen mutations associated with the dynein axonemal assembly factor 2 (DNAAF2) gene in a Han Chinese family with PCD. METHODS: A three-generation family with PCD was recruited in this study. Eight family members underwent comprehensive medical examinations. Genomic DNA was extracted from the participants’ peripheral blood, and targeted next-generation sequencing technology was used to perform the mutation screening. The DNAAF2 expression was analyzed by immunostaining and Western blot. RESULTS: The proband exhibited the typical clinical features of PCD. Spermatozoa from the proband showed complete immotility but relatively high viability. Two novel compound heterozygous mutations in the DNAAF2 gene, c.C156A [p.Y52X] and c.C26A [p.S9X], were identified. Both nonsense mutations were detected in the proband, whereas the other unaffected family members carried either none or only one of the two mutations. The two nonsense heterozygous mutations were not detected in the 600 ethnically matched normal controls or in the Genome Aggregation Database. The defect of the DNAAF2 and the outer dynein arms and inner dynein arms were notably observed in the spermatozoa from the proband by immunostaining. CONCLUSION: This study identified two novel compound heterozygous mutations of DNAAF2 leading to male infertility as a result of PCD in a Han Chinese family. The findings may enhance the understanding of the pathogenesis of PCD and improve reproductive genetic counseling in China. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10815-020-01859-7) contains supplementary material, which is available to authorized users.

SummaryAccumulating evidence suggests that a disruption of early brain development, in which insulin-like growth factor-2 (IGF-2) has a crucial role, may underlie the pathophysiology of schizophrenia. Our previous study has shown that decreased serum IGF-2 was correlated with the severity of psychopathology in patients with schizophrenia. Here we conducted a prospective observation trial to investigate the effects of atypical antipsychotics on serum IGF-2 level and its relationship with clinical improvements in schizophrenia patients. Thirty-one schizophrenia patients with acute exacerbation and 30 healthy individuals were recruited in this study. Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and serum IGF-2 levels were determined using ELISA. We found that schizophrenia patients with acute exacerbation had lower serum IGF-2 levels than control individuals at baseline (PPvs. 426.99±124.26 ng/mL; t =−5.044, Pr=−0.522, P=0.006). Collectively, our findings demonstrated changes of serum IGF-2 response to improvements of negative symptoms in schizophrenia patients treated with atypical antipsychotics, suggesting that serum IGF-2 might be a treatment biomarker for schizophrenia.

To evaluate the effects of electrical status epilepticus during sleep (ESES) on cerebral blood flow (CBF) and explore the associated neuro-vascular coupling and neuropsychological deficits. 19 ESES patients were recruited to undergo real-time transcranial doppler ultrasonography (TCD) and video-EEG monitoring (vEEG). Patients were grouped based on their cognitive functions or their EEG patterns. The mean cerebral blood flow velocity (CBFVm) of the unilateral middle cerebral artery was measured using TCD and was used to calculate various relevant parameters. The 19 patients participated in a total of 54 effective TCD-vEEG monitoring sessions. We found a significant effect of clinical severity for the following measurements: spike wave index (SWI), peak and average deep sleep stage (N3) CBFVm, peak, average and minimum deep sleep and awake CBFVm, and CBFVm oscillations during deep sleep. Nevertheless, CBFVm oscillations were not related to SWI. Furthermore, CBFVm oscillations revealed a statistically significant difference between the near-ESES and asymmetric-ESES groups. CBFVm oscillations may reflect the neuro-vascular coupling process associated with ESES disfunction. Understanding the relationship between CBFVm oscillations and epileptic activity will be important for assessing the neuropsychological damage associated with ESES and for developing treatment options for this and other diseases.

Background Acute kidney injury (AKI) is a common disease in the intensive care unit (ICU). AKI patients with nonrecovery of renal function have a markedly increased risk of death compared with patients with recovery. The current study aimed to explore and validate the utility of urinary cell cycle arrest biomarkers for predicting nonrecovery in patients who developed AKI after ICU admission. Methods We prospectively and consecutively enrolled 379 critically ill patients who developed AKI after admission to the ICU, which were divided into a derivation cohort (194 AKI patients) and a validation cohort (185 AKI patients). The biomarkers of urinary tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) were detected at inclusion immediately after AKI diagnosis (day 0) and 24 h later (day 1). The optimal cut-off values of these biomarkers for predicting nonrecovery were estimated in the derivation cohort, and their predictive accuracy was assessed in the validation cohort. The primary endpoint was nonrecovery from AKI (within 7 days). Results Of 379 patients, 159 (41.9%) patients failed to recover from AKI onset, with 79 in the derivation cohort and 80 in the validation cohort. Urinary [TIMP-2]*[IGFBP7] on day 0 showed a better prediction ability for nonrecovery than TIMP-2 and IGFBP7 alone, with an area under the reciever operating characteristic curve (AUC) of 0.751 [95% confidence interval (CI) 0.701–0.852, p 2/1000). When [TIMP-2]*[IGFBP7] was combined with the clinical factors of AKI diagnosed by the urine output (UO) criteria, AKI stage 2–3 and nonrenal SOFA score for predicting nonrecovery, the AUC was significantly improved to 0.852 (95% CI 0.750–0.891, p Conclusion Urinary [TIMP-2]*[IGFBP7] on day 0 showed a fair performance for predicting nonrecovery from AKI. The predictive accuracy can be improved when urinary [TIMP-2]*[IGFBP7] is combined with the clinical factors of AKI diagnosed by the UO criteria, AKI stage 2–3 and nonrenal SOFA score.

Background Lennox-Gastaut syndrome (LGS) is a severe epileptic encephalopathy that can be caused by brain malformations or genetic mutations. Recently, genome-wide association studies have led to the identification of novel mutations associated with LGS. The TANC2 gene, encodes a synaptic scaffolding protein that interacts with other proteins at the postsynaptic density to regulate dendritic spines and excitatory synapse formation. The TANC2 gene mutations were reported in neurodevelopmental disorders and epilepsy but not in LGS ever. Case presentation Here we describe the case of a boy with LGS who presented with multiple seizure patterns, such as myoclonic, atonic, atypical absence, generalized tonic-clonic, focal seizures, and notable cognitive and motor regression. The seizures were refractory to many antiepileptic drugs. He got seizure-free with ketogenic diet combined with antiepileptic drugs. A de novo nonsense mutation c.4321C > T(p.Gln1441Ter) in TANC2 gene was identified by the whole-exome sequencing and confirmed by Sanger sequencing. Conclusion We described the first Chinese case with LGS associated to a de novo nonsense mutation c.4321C > T(p.Gln1441Ter) in TANC2 gene, which would expand the clinical spectrum related to TANC2 mutations and contribute to better understanding of genotype-phenotype relationship to guide precision medicine.